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Background/Objectives: Obstetric ultrasound is one of the most commonly used imaging modalities during pregnancy to detect any fetal abnormalities. The aim of this systematic review was to appraise all available scientific literature and summarize current evidence regarding the safety of fetal ultrasound by using the thermal index (TI) and mechanical index (MI). Methods: We applied the PRISMA guidelines in order to prepare the review, and a 2-step process was performed in order to evaluate the available literature and decide which studies to be included. A thorough search of the Medline, Scopus, and Google Scholar databases was performed. Randomized and non-randomized studies were considered for review. The MI and TI were available in ultrasound machines after 1993; thus, studies before that year would not provide data on these two indexes. Results: A total of 21 studies were included in this review, including prospective, retrospective, cross-sectional, and survey-type studies. A common theme of the majority of the studies is the increased acoustic output available to the machines with time and the limited awareness of where the MI/TI indexes are from the operators. Conclusions: This review indicates that, while obstetric ultrasound is predominantly safe, there is a need for operators to consistently observe MI/TI indexes and adhere to the ALARA principle to minimize potential risks. [ABSTRACT FROM AUTHOR]

To determine a possible correlation between SARS-CoV-2 infection during pregnancy and altered fetal behavior. Kurjak's antenatal neurodevelopmental test (KANET) was applied from 28 to 40 weeks in 38 gestations (group A) diagnosed with COVID-19 infection during the first week and 43 non-COVID pregnant women (group B). No statistically significant differences considering maternal age (33±3.9 years for group A vs. 31±4.1 years for group B) and gestational age (33±1.6 weeks for group A compared to 33±2.1 weeks for group B) were observed. KANET scores were not different between the two groups. Fetal behavior differences are not altered in women diagnosed with SARS-CoV-2 infection during the third trimester of pregnancy. [ABSTRACT FROM AUTHOR]

There is controversial evidence that acidification of vaginal pH may increase the efficacy of vaginal prostaglandins in labor induction, with research being mainly focused on misoprostol. This study aims to evaluate the impact of this intervention on the progress of labor induction with dinoprostone (PGE2) vaginal tablet. This double-blind, parallel-group, randomized study was conducted between October 2021 and December 2022 at Alexandra General Hospital, Athens, Greece. A total of 230 women with singleton, full term pregnancy that were scheduled for labor induction were randomly divided into two groups: Group A, who received acidic vaginal wash (5 % acetic acid) and Group B, who received a normal saline vaginal wash. Afterwards, participants received a vaginal tablet of 3 mg dinoprostone every 6 h (maximum two doses). There were no statistically significant differences in mode of delivery, duration of different labor stages, Bishop score changes and possible complications. Participants in the acidification group needed less often labor augmentation with oxytocin and epidural anesthesia (p=0.03). Vaginal acidification seems to have no effect on the efficacy of the dinoprostone vaginal tablet. Even though it may reduce the need for oxytocin augmentation, there is no apparent benefit on clinical outcomes, such as reduction in cesarean section rates or shorter labor duration. Future research is necessary in order to validate these findings. [ABSTRACT FROM AUTHOR]

The Mediterranean Diet, characterized by high consumption of plant-based foods, olive oil, moderate intake of fish and poultry, and low consumption of red meat and processed foods, has been suggested to improve assisted reproductive technology (ART) outcomes. This narrative review aimed to summarize and synthesize the evidence from observational studies on the associations between preconception adherence to the Mediterranean Diet and ART outcomes. PubMed/MEDLINE, Embase, ScienceDirect, Google Scholar, and Web of Science databases were searched to identify relevant studies. Seven observational studies (n = 2321 women undergoing ART) were included. Adherence to the Mediterranean Diet was assessed using food frequency questionnaires with 6–195 items. Three studies found that higher Mediterranean Diet scores were associated with improved clinical pregnancy rates (OR 1.4, 95% CI 1.0–1.9; RR 1.98, 95% CI 1.05–3.78) or live birth rates (RR 2.64, 95% CI 1.37–5.07). Two studies showed a positive effect on embryo yield (p = 0.028) and ovarian response. However, two studies reported no significant associations with ultimate ART success, and four studies found no effects on oocyte and embryo number or quality. The heterogeneity in study designs, Mediterranean Diet assessment methods, and ART protocols limited the strength of conclusions. Evidence for the effects of greater adherence to the Mediterranean Diet on ART outcomes is limited but promising. Future research should focus on conducting randomized controlled trials with standardized Mediterranean Diet assessment methods to establish causal relationships between Mediterranean Diet adherence and ART outcomes, and to elucidate potential mechanisms of action. [ABSTRACT FROM AUTHOR]

Adverse pregnancy outcomes, including preterm birth, are markedly higher among patients with perinatal infections. Stressinduced immune dysregulation may contribute to these effects. Epstein-Barr virus (EBV) infection rarely affects the course of pregnancy since only a few pregnant women are susceptible to the virus; however, when there is a primary infection with severe symptoms, the management of the pregnancy is very challenging for both the patient and the obstetrician. We report a rare case of a 20-year-old primigravida who gave preterm birth due to EBV infection causing fetal hypoxia. [ABSTRACT FROM AUTHOR]

Maturity-onset diabetes of the young (MODY) is a rare form of diabetes that is different from both type 1 and type 2 diabetes and runs strongly in families, with autosomal dominant inheritance. Currently, there are 14 different types of MODY depending on the gene disorder. Glucokinase-related MODY (MODY 2) is a common form of this disorder. Mutations in the gene are associated with gestational diabetes and deviation of the average fetal birth weight. The main features of MODY are: (1) diabetes developing before the age of 25 years, (2) family history, (3) diabetes treated by diet or less often by tablets, and (4) absence of obesity (although overweight or obese people can get MODY) or other problems associated with type 2 diabetes or metabolic syndrome. We present the case of a 35-year-old Caucasian primigravida with a medical and family history of MODY type 2, who attended our unit due to fetal growth restriction (FGR) and increased umbilical artery (UA) Doppler pulsatility index (PI) at 28 weeks of gestation and delivered at 36+6 weeks. Management of such cases requires specific knowledge and a multidisciplinary approach. [ABSTRACT FROM AUTHOR]

Objective: Assessing fetal behavior in utero is challenging and of great value for perinatal screening, but the evolution of ultrasonography has led to a better comprehension of fetal pathology. Antenatal screening for early detection of fetal neurological well-being has provided valuable information. The aim of this study is to determine a possible correlation between hypothyroidism in pregnancy and altered fetal behavior. Materials and methods: Kurjak antenatal neurodevelopmental test (KANET) was applied from 28 weeks to 38 weeks in 85 gestations (group A) with hypothyroidism and 87 euthyroid pregnant women (group B). Results: No statistically significant differences were observed considering maternal age (29.2 ± 4.9 years for group A vs 29.7 ± 3.3 years for group B) and gestational age (GA) (33 ± 1.6 weeks for hypothyroidic compared to 33 ± 2.1 weeks for euthyroidic group). The control group reported higher KANET scores than group A. Conclusion: It appears that fetal behavior differences are observed in women with hypothyroidism. [ABSTRACT FROM AUTHOR]

Placenta accreta spectrum (PAS) disorder is one of the leading causes of peripartum maternal morbidity and mortality; its early identification during pregnancy is of utmost importance to ensure the optimal clinical outcome. The aim of the present study is to investigate the possible association of the presence and type/location of placenta previa on MRI with PAS and maternal peripartum outcome. One hundred eighty-nine pregnant women (mean age: 35 years; mean gestational age: 32 weeks) at high risk for PAS underwent a dedicated placental MRI. All women underwent a C-section within 6 weeks from the MRI. All MRIs were evaluated by two experienced genitourinary radiologists for presence, type (complete/partial vs. marginal/low lying), and location (anterior vs. anterior-posterior vs. posterior) of placenta previa. Statistical analysis was performed for possible association of type/location of previa with placental invasiveness and peripartum outcomes. Intraoperative information was used as a reference standard. Complete/partial previa was detected in 143/189 (75.6%) and marginal/low lying previa in 33/189 (17.5%) women; in 88/189 (46.6%) women, the placenta had anterior–posterior, in 54/189 (28.6%) anterior and in 41/189 (21.7%) posterior. Complete/partial previa had an at least 3-fold probability of invasiveness and was more frequently associated with unfavorable peripartum events, including massive intraoperative blood loss or hysterectomy, compared to low-lying/marginal placenta. Posterior placental location was significantly associated with lower rates of PAS and better clinical outcomes. In conclusion, the type and location of placenta previa shown with MRI seems to be associated with severity of complications during delivery and should be carefully studied. [ABSTRACT FROM AUTHOR]

Aerobic vaginitis (AV) is a distinct clinical entity characterized by inflammation and abnormal vaginal microflora. Often mistaken for bacterial vaginosis, AV remains relatively unknown and underdiagnosed. AV's understanding is evolving, with some experts suggesting it may primarily be an immunological disorder, the prevalence of which has a range of 7–13% in non-pregnant women and 4.1–8.3% during pregnancy. Pregnancy can affect susceptibility to vaginal infections, leading to adverse outcomes for the woman and the newborn. This review summarizes the correlation between AV and adverse pregnancy outcomes, particularly preterm birth, the leading cause of morbidity and mortality among neonates. An improved understanding of AV's impact on pregnancy outcomes can lead to early recognition, proper management, and effective interventions. While some studies support an association between AV and preterm labor, the existing knowledge of this relationship remains limited. The evidence suggests that AV may contribute to adverse pregnancy outcomes, mainly preterm birth, but further research is needed to establish a definitive link. Further studies are needed to investigate the underlying mechanisms and clarify AV's role in premature labor. A comprehensive understanding of AV's impact on pregnancy outcomes is crucial for early recognition, appropriate management, and effective interventions. [ABSTRACT FROM AUTHOR]