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Objective: To evaluate the clinical features and perinatal outcomes of antenatally diagnosed fetuses with omphalocele and gastroschisis. Material and Methods: This was a retrospective, single-center, cohort study of prenatally diagnosed fetuses with omphalocele and gastroschisis followed-up and delivered at a university hospital. Demographic, pregnancy, birth and perinatal outcomes were compared between gastroschisis and omphalocele. Results: A total of 75 fetuses with omphalocele and 21 cases with gastroschisis were evaluated. The mean maternal age of women carrying a fetus with omphalocele was significantly higher than the women with gastroschisis (p=0.001). Associated structural anomalies were found in 53.3% and 4.7% of fetuses with omphalocele and gastroschisis, respectively (p<0.001). The rate of chromosomal anomaly was 8.3% in pregnancies with omphalocele. In liveborn pregnancies, the mean gestational age at delivery and birth weight did not differ between the study groups. Time to postoperative oral intake, duration of parenteral nutrition and length of hospital stay were significantly longer in babies with gastroschisis than omphalocele (p<0.01). Rates of termination, intrauterine, neonatal and infant death of fetuses with omphalocele were 25.3%, 6.7%, 10.7% and 2.7% respectively. Time to postoperative oral intake, duration of parenteral nutrition and duration of hospitalization were significantly longer in babies with complex compared to simple gastroschisis (p<0.01). Survival rates were 95.2%, 82.9% and 20% in fetuses with gastroschisis, isolated and non-isolated omphalocele, respectively. Conclusion: Associated structural and chromosomal anomalies were significantly more common in fetuses with omphalocele compared to those with gastroschisis. Prognosis of fetuses with omphalocele depended on the associated structural and chromosomal anomalies, whereas bowel compromise was the main determining factor in gastroschisis. [ABSTRACT FROM AUTHOR]

Background: Maternal height has been for long a contributory anthropometric factor that can determine the obstetric outcome. There is always a need of a consistent, reliable, and simple risk indicator which is easy to use for preventing unnecessary complications in a country like India where often antenatal care is provided by dais in rural areas. The background of this research aims to ascertain the relationship between maternal height and mode of delivery based on other intrapartum factors which influence labor and consequent maternal and neonatal outcome. Materials and Methods: All primigravidae at term gestation (>37 weeks) with cephalic presentation on admission to labor suite with no other comorbidities were recruited in the study. Their mode of delivery, maternal outcome, along with neonatal outcome was documented. Results: Out of the 680 patients, 104 patients are considered for the short-stature group (15.29%) who were <150 cm in height. Other group comprised patients who were >150 cm in height, a total of 576 (84.71%). There was a higher incidence of induced labor in the study group (66.35%) and emergency lower-segment cesarean section done due to cephalopelvic disproportion (CPD) (60%) was also higher among the short-stature group. The incidence of normal labor (32.99%) was higher in the tall-stature group. Conclusion: Short height (<150 cm) is an independent risk factor for cesarean delivery due to CPD. Statistical correlation was found between mothers of short stature and babies being born with low birth weight. As labor is influenced by multiple factors, it is fair enough to give a trial of labor for short primigravidae except in uncommon circumstances. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to assess the platelet parameters and their prognostic value for perinatal outcomes in pregnant women with systemic lupus erythematosus (SLE). Methods: This retrospective study involved 180 participants, 90 pregnant women with SLE and 90 healthy pregnant women. Clinical and demographic variables including routine first-trimester neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and platelet parameters such as platelet distribution width (PDW), mean platelet volume (MPV), plateletcrit (PCT) were compared between the groups. The perinatal outcomes of the whole study group were also compared. Results: SLE patients had lower leukocyte (p = 0.001), lymphocyte (p = 0.001) and platelet counts (p = 0.018), higher PDW (p = 0.002), MPV (p = 0.001), NLR (p = 0.008) and PLR (p = 0.015) and lower PCT (p = 0.015) than the control group. The groups had no significant difference in hemoglobin levels (p = 0.936). SLE patients had higher rates of cesarean section (p = 0.002), small for gestational age (SGA) (p = 0.019) and stillbirth (p = 0.017) and lower birth weight (p = 0.001) than the control group. PCT was a significant predictor of stillbirth with a cut-off value of 0.21, sensitivity of 64.3% and specificity of 83.3% (AUC: 0.843, p < 0.001). Conclusion: Pregnant women with SLE have altered platelet parameters and increased inflammatory markers compared to healthy pregnant women. PCT is a simple and useful marker for predicting stillbirth risk in SLE pregnancies. [ABSTRACT FROM AUTHOR]

Objective: To assess the prevalence of adenomyosis at pathologic examination, and its association with obstetric complications, peripartum maternal clinical characteristics and neonatal birth weight in patients undergoing postpartum hysterectomy due to postpartum hemorrhage (PPH). Methods: A multicenter, observational, retrospective, cohort study was carried out including all women who underwent postpartum hysterectomy due to PPH at gestational week 23+0 or later, between January 2010 and May 2023. Patients were categorized into two groups based on the presence of adenomyosis at pathologic examination, and were compared for obstetric complications, peripartum maternal clinical characteristics, and neonatal birth weight. Results: The histologically‐based prevalence of adenomyosis in patients undergoing postpartum hysterectomy due to PPH was 39.4%. Adenomyosis was associated with a longer hospitalization time (regression coefficient: 4.43 days, 95% CI: 0.34–8.52, P = 0.034) and a higher risk of hypertensive disorders (OR: 5.82, 95% CI: 1.38–24.46, P = 0.016), threatened preterm labor (OR: 3.34, 95% CI: 1.08–10.31, P = 0.036), urgent/emergency C‐section (OR: 24.15, 95% CI: 2.60–223.96, P = 0.005), postpartum maternal complications (OR: 4.96, 95% CI: 1.48–16.67, P = 0.012), maternal intensive care unit admission (OR: 3.56, 95% CI: 1.05–12.05, P = 0.041), and low birth weight neonates (OR: 3.8, 95% CI: 1.32–11.02, P = 0.013). Conclusion: In patients undergoing postpartum hysterectomy due to PPH, adenomyosis is a highly prevalent condition among, and is associated with adverse obstetric, maternal, and neonatal outcomes. Synopsis: In patients undergoing postpartum hysterectomy due to postpartum hemorrhage, adenomyosis shows a histologically‐based prevalence of almost 40% and is associated to several adverse obstetric, maternal, and neonatal outcomes. [ABSTRACT FROM AUTHOR]

Objective: The aim of our study was to detect an increase in nuchal translucency (NT) measurement among our patients attending our clinic for 11-14 weeks of control and to examine the perinatal and postnatal outcomes of pregnant women who were recommended an invasive fetal procedure but refused it. Methods: 107 pregnant women between 11-14 weeks of gestation who were evaluated in our center from 2018 to 2021 and who rejected invasive procedures were included. Patients opting for follow-up and delivery at another facility were excluded from the study. The study groups were categorized into 3 groups based on NT values, regardless of gestational age: 1st Group 2.5-3.4 mm, 2nd Group 3.5-4.5 mm, and 3rd Group>4.5 mm. Fetal ultrasound scans were conducted during the antenatal period, with detailed examinations postnatally. Results: Abnormal ultrasound findings were detected in 11.2% of fetuses, with a higher prevalence in groups exhibiting greater NT increases. While chromosomal anomaly was seen in 13% of all fetuses, Group 2 (NT 3.5-4.5mm) had the highest percentage (33.3%). The highest right and healthy birth rates were found in group 1 (91.8%), inversely proportional to the increase in NT. Conclusion: Increased NT values appear to be associated with increased rates of structural anomalies and adverse perinatal outcomes. Although chromosomal anomalies are associated with NT increase, a direct proportional relationship between the two remains undetermined. [ABSTRACT FROM AUTHOR]

Background: To investigate the association between maternal sepsis during pregnancy and poor pregnancy outcome and to identify risk factors for poor birth outcomes and adverse perinatal events. Methods: We linked the Taiwan Birth Cohort Study (TBCS) database and the Taiwanese National Health Insurance Database (NHID) to conduct this population-based study. We analysed the data of pregnant women who met the criteria for sepsis-3 during pregnancy between 2005 and 2017 as the maternal sepsis cases and selected pregnant women without infection as the non-sepsis comparison cohort. Sepsis during pregnancy and fulfilled the sepsis-3 definition proposed in 2016. The primary outcome included low birth weight (LBW, < 2500 g) and preterm birth (< 34 weeks), and the secondary outcome was the occurrence of adverse perinatal events. Results: We enrolled 2,732 women who met the criteria for sepsis-3 during pregnancy and 196,333 non-sepsis controls. We found that the development of maternal sepsis was highly associated with unfavourable pregnancy outcomes, including LBW (adjOR 9.51, 95% CI 8.73–10.36), preterm birth < 34 weeks (adjOR 11.69, 95%CI 10.64–12.84), and the adverse perinatal events (adjOR 3.09, 95% CI 2.83–3.36). We also identified that socio-economically disadvantaged status was slightly associated with an increased risk for low birth weight and preterm birth. Conclusion: We found that the development of maternal sepsis was highly associated with LBW, preterm birth and adverse perinatal events. Our findings highlight the prolonged impact of maternal sepsis on pregnancy outcomes and indicate the need for vigilance among pregnant women with sepsis. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion To compare the pregnancy and perinatal outcomes of frozen–thawed embryo transfer (FET) in patients following transcervical resection of adhesions (TCRA) versus patients with normal uterine morphology, and to investigate the factors influencing pregnancy outcomes in patients undergoing FET after TCRA.We retrospectively analyzed FET cycles from September 2014 to September 2023, comparing patients with normal uterine morphology to those with intrauterine adhesions (IUAs) treated with TCRA. Propensity score matching (PSM) adjusted for confounding factors. LASSO regression and multivariate logistic regression identified predictors of outcomes, which were visually represented in nomograms. Model performance was assessed using calibration curves, ROC curves, and DCA, with bootstrap method for internal validation.Post‐PSM analysis showed higher live birth rates in patients with normal uterine morphology after clinical pregnancy (75.1% vs. 61.7%, P < 0.001). No significant differences were noted in clinical pregnancy rates and perinatal outcomes between the groups. Factors influencing clinical pregnancy in FET after TCRA included basal progesterone levels, endometrial thickness, parity, infertility cause, embryo stage at transfer, number and quality of embryos transferred, IUA severity, and TCRA surgical procedures. Body mass index, basal LH levels, and day 14 HCG levels post‐embryo transfer were determinants of live birth outcome.FET cycles following TCRA showed a lower rate of successful live births, but TCRA did not increase adverse perinatal outcome risks. Our study introduces an innovative predictive model for clinical pregnancy and live birth outcomes in patients undergoing FET following TCRA, addressing a significant void in existing research. [ABSTRACT FROM AUTHOR]

Apert syndrome is an inherited condition with autosomal dominant transmission. It is also known as acrocephalosyndactyly type I, being characterized by a syndrome of craniosynostosis with abnormal head shape, facial anomalies (median hypoplasia), and limb deformities (syndactyly, rhizomelic shortening). The association can suspect the prenatal diagnosis of these types of anomalies. The methodology consisted of revising the literature, by searching the PubMed/Medline database in which 27 articles were selected and analyzed, comprising 32 cases regarding the prenatal diagnosis of Apert syndrome. A series of ultrasound parameters, the anatomopathological abnormalities found, the obstetric results, and the genetic tests were followed. The distribution of imaging results (US, MRI) identified in the analyzed cases was as follows: skull-shaped abnormalities were evident in 96.8% of cases, facial abnormalities (hypertelorism 43.7%, midface hypoplasia 25%, proptosis 21.8%), syndactyly in 87.5%, and cardiovascular abnormalities in 9.3%. The anomalies detected by the ultrasound examination of the fetus were confirmed postnatally by clinical or gross evaluation or imaging. The management of these cases requires an early diagnosis, an evaluation of the severity of the cases, and appropriate parental counseling. [ABSTRACT FROM AUTHOR]

Objective This study investigated the clinical outcome of monochorionic diamniotic (MCDA) twins with selective intrauterine growth restriction (sIUGR). Study Design International Peace Maternal and Child Health Hospital of Shanghai ultrasound database was investigated to identify all MCDA delivered from January 2013 to December 2017. After identifying 43 pairs of MCDA twins with sIUGR and 282 pairs of normal MCDA twins, we compared clinical outcomes between the two groups. Results Compared with normal twins, sIUGR fetuses had significantly shorter gestational age at delivery, smaller average birth weight of both twins, more significant intertwin difference in birth weight, lower Apgar scores, and higher intrauterine fetal demise (IUFD) rate, and smaller placental weight. The rate of abnormal umbilical cord insertions and abnormal blood flow in the ductus venosus (DV) and middle cerebral artery (MCA) is significantly higher in the sIUGR group. In addition, the subtype analysis of sIUGR groups indicated the poorest outcomes in type II with no significant difference between type I and III. Conclusion MCDA twins with sIUGR generally exhibited limited clinical outcomes than normal MCDA twins. These limitations are mainly associated with abnormal umbilical cord insertions and blood flow in the DV and MCA. Clinical outcomes differed among the three types of sIUGR, with type II having the worst prognosis and the highest IUFD rate. Key points sIUGR generally exhibited limited clinical outcomes than normal MCDA twins. These limitations are mainly associated with blood flow of the DV and MCA. sIUGR with type II has the worst prognosis and the highest IUFD rate. [ABSTRACT FROM AUTHOR]

Background: Vitamin D deficiency is associated with several obstetric complications in singleton pregnancy. The aim of this study was to assess whether vitamin D levels affect the outcomes of twin pregnancy and if targeted supplementation can improve perinatal outcomes. Methods: The serum vitamin D levels of 143 women with twin pregnancies were measured during their first trimester. Those with insufficient (10–30 ng/mL; IL group) or severely deficient (<10 ng/mL, DL group) vitamin D levels were supplemented. In the third trimester, vitamin D levels were reassessed. Perinatal outcomes of the IL and DL groups were compared with those of patients with sufficient levels (>30 ng/mL, SL group) since the beginning of pregnancy. Results: Women in the IL and DL groups had a higher incidence of hypertensive disorders of pregnancy (HDP) compared to the SL group (24.8% and 27.8% vs. 12.5%, p = 0.045): OR = 1.58 for the IL group and 1.94 for the DL group compared to the SL group. In patients whose vitamin D levels were restored after supplementation, HDP incidence was lower than in patients who remained in the IL or DL groups (23.4% vs. 27.3%) but higher than those who were always in the SL group (12.5%). Conclusions: Insufficient or severely deficient levels of vitamin D in the first trimester are associated with an increased risk of HDP in twin pregnancy. The beneficial effect of targeted vitamin D supplementation in reducing HDP seems limited. [ABSTRACT FROM AUTHOR]

Purpose: Obesity is a worldwide and growing issue affecting women in childbearing age, complicating surgical procedures as well as pregnancy. Through a reduction of not necessarily required cesarean deliveries—for instance in pregnancies with breech presentation—obesity mediated and surgery-associated morbidity might be contained. Date on the impact of maternal BMI in vaginally attempted breech delivery is not existing. To give insight into whether an elevated BMI leads to an increased perinatal morbidity in vaginally intended deliveries out of breech presentation, we analyzed delivery outcome of laboring women with a singleton baby in breech presentation with overweight and obesity (BMI ≥ 25 kg/m2) in comparison to women with a BMI of below 25 kg/m2. Methods: Based on data from January 2004 to December 2020, a cohort study was performed on 1641 women presenting with breech presentation at term (> 37 weeks). The influence of maternal BMI on perinatal outcome was analyzed with Chi2 testing for group differences and logistic regression analysis. Patients with a hyperglycemic metabolism were excluded from the study. Results: Fetal morbidity was not different when patients with a BMI of ≥ 25 kg/m2 (PREMODA morbidity score 2.16%) were compared to patients with a BMI of below 25 kg/m2 (1.97%, p = 0.821). Cesarean delivery rates were significantly higher in overweight and obese women with 43.9% compared to 29.3% (p < 0.0001). BMI and cesarean delivery were significantly associated in a logistic regression analysis (Chi2 coefficient 18.05, p < 0.0001). In successful vaginal deliveries out of breech presentation, maternal perineal injury rates (vaginal birth in normal-BMI women 48.4%; vaginal birth in overweight and obese women: 44.2%; p = 0.273) and rates of manually assisted delivery (vaginal birth in normal-BMI women: 44.4%; vaginal birth in obese and overweight women: 44.2%; p = 0.958) were not different between BMI groups. Conclusions: Obesity and overweight are not associated with peripartum maternal or newborn morbidity in vaginally attempted breech delivery, if the patient cohort is thoroughly selected and vaginal breech delivery is in an upright maternal position. Reduction of cesarean delivery rates, especially in overweight and obese women might, have an important positive impact on maternal and newborn morbidity. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the elevation of HbA1c before full-term delivery in single pregnancy with normal 75 g- Oral glucose tolerance test (OGTT) screening and its association with adverse perinatal outcomes. Methods: From January to December 2022, an observational prospective study was conducted in a Single centre in China. 365 single pregnant women with normal OGTT were included in the study. HbA1c was measured during OGTT and before full-term delivery, and perinatal outcomes were collected. Participants' pre-delivery HBA1c values were analyzed and perinatal outcomes were compared. Logistic regression analysis was used for independent risk factors associated with elevated pre-delivery HbA1c ≥ 6.0%. The predictive value and truncation value were analyzed by ROC curve. Results: 15.89% (58/365) of the Participants had a pre-delivery HBA1C value ≥ 6.0%. The incidence of neonatal asphyxia (13.79%, vs. 3.45%, vs. 2.26%, P = 0.007) and amniotic fluid fecal staining (29.31%, vs. 12.64%, vs. 12.03%, P = 0.004) were significantly increased in this group. The independent risk factor associated with pre-delivery HBA1c ≥ 6.0% was the fasting blood glucose(FBG) value of OGTT (OR = 51.308, 95% CI 12.93–203.67, P < 0.01) and the HBA1c value measured during OGTT (OR = 3.608, 95% CI 1.432–9.151, P = 0.007). When FBG was < 4.18 mmol/L and HBA1c was < 5.51%, The accuracy of predicting the pre-delivery HBA1c < 6.0% was 98.2%. Conclusions: 15.89% of the single pregnancy with normal OGTT had HbA1c ≥ 6.0% before full-term delivery, and they had an increased incidence of neonatal asphyxia and amniotic fluid fecal staining. When the FBG ≥ 4.18 mmol/l or the HBA1c ≥ 5.51% during the OGTT screening, repeated OGTT were recommended in late pregnancy. [ABSTRACT FROM AUTHOR]

Background: High risk pregnancy is one which is complicated by risk factor that adversely affects the maternal outcome or perintal outcome or both. The antepartum fetal surveillance of high risk pregnancies with Cardiotocographycan effectively help for reducing perintal mortality and morbidity. One of the biophysical methods which is being used extensively in the management of high risk pregnancy is (CTG) Cardiotocography. Aims & Objectives: 1. To assess the benefit of cardiotocography to improve the fetal outcome in high risk pregnancy. 2. To find out the suitable time and mode of delivery of the fetus at risk. Materials and Methods: This is a prospective observational study conducted at Government General Hospital attached to Government Medical College, Kadapa from the month of July 2023 to the month of june 2024. Study includes 100 high risk pregnancies with singleton fetus of 32 weeks or more than 32 weeks of gestation CTG performed within 3 days prior to delivery will be considered for fetal outcome. In all cases detailed history, clinical and obstetric examination USG and alntepartum, intrapartum CTG will be performed and decision for mode of delivary is planned and different Perinatal outcome are assessed as 1 min and 5 min apgar score and NICU admissions. Results: Among 100 high risk pregnancies included in the study the most common risk factor is preeclampsia (25%) followed by oligos (16%). The incidence of non-reactive intrapartum CTG are 33 in number (33%). Out of 100, 43 underwent cesarean section, 54 delivered vaginally and 3 delivered instrumentally. Out of 100 cases one minute apgar was 5-7 in 41 subjects, 8-10 in 58 subjects and <4 in 1 subject. Among the study group 30 (30%) had NICU admissions. Conclusion: CTG is simple, cheap, non invasive cost effective with less training & best screening test to identity patients at a greater risk of intrapartum fetal hypoxia. CTG is effective tool to evaluate fetal condition, to detect fetal distress and there by early intervention to improve the Perinatal outcome. [ABSTRACT FROM AUTHOR]

Objective: To compare maternal and fetal outcomes between early (<2 h) and delayed (>2 h) vacuum extraction (VE) deliveries. Methods: We performed a retrospective cohort study in a single, university‐affiliated medical center (2014–2021). We included term singleton pregnancies delivered by VE, allocated into one of two groups according to second stage duration: <2 h or >2 h. Primary outcome was maternal composite adverse outcome (included chorioamnionitis, 3–4 degree lacerations, and postpartum hemorrhage [PPH]). Results: We included 2521 deliveries: 2261 (89.6%) with early VE and 260 (10.4%) with delayed VE. Study groups' characteristics were not different, except of parity. Maternal composite outcome almost reached a significance (P = 0.054) comparing between the groups. Comparing second stage length up to 2 h versus more, there was similar rate of advance maternal lacerations. However, extending the second stage to more than 3 h was associated with third degree lacerations compared to 2–3 h (9.8% vs 3%, P = 0.011). There were significantly more PPH events in the later VE group (P = 0.004), but the need for blood transfusions was similar. The rates of 5 min Apgar score ≤7 (P = 0.001) and umbilical artery pH <7.0 were significantly higher in group 2 compared with group 1. The effect was much more pronounced when second stage was >3 h. After conducting multiregression analysis, the results became insignificant. Conclusion: Our study suggests that VE performed in the late second stage of labor, up to 3 h, is safe as VE performed in the early stages regarding maternal and neonatal outcomes. Extra caution is needed with extended second stage to more than 3 h. Synopsis: Vacuum extraction delivery performed in the late second stage of labor, up to 3 h, is probably safe as VE performed in the early stages. [ABSTRACT FROM AUTHOR]

Problem: This study aimed to evaluate the predictive value of delta neutrophil index (DNI), a peripheral blood parameter, on perinatal outcomes in pregnant women with systemic lupus erythematosus (SLE). Method of Study: One hundred eighty‐one participants, 78 pregnant women with SLE, and 103 healthy pregnant women were included in this retrospective study. Peripheral blood parameters including neutrophil‐to‐lymphocyte ratio (NLR), platelet‐to‐lymphocyte ratio (PLR), and DNI taken in the first trimester were compared between groups. Results: NLR, PLR, and DNI were significantly higher in the SLE group (p = 0.027, p = 0.007, p = 0.0001, respectively). The same parameters were not found to be significant in determining disease activity in pregnant women with SLE (p > 0.05). When the predictive value of DNI for SGA in pregnancies with SLE was evaluated by receiver operating characteristic curve (ROC), the area under the ROC curve (AUC) was 0.666 (95% CI; 0.544–0.788, p = 0.018) with 84.6% sensitivity, 53.8% specificity, 56.0% PPV, and 78.1% NPV at a cut‐off value of 0.16. The predictive value of DNI according to ROC for stillbirth in pregnancies with SLE was AUC 0.731 (95% CI: 0.539–0.923, p = 0.019) with a cut‐off value of 0.17, sensitivity of 90%, specificity of 51.5%, PPV of 58.5%, and NPV of 87.2%. Conclusions: Although DNI's prediction of SGA and stillbirth in pregnant women with SLE is encouraging, it needs more evidence from prospective studies with larger series. [ABSTRACT FROM AUTHOR]

We aimed to estimate the associations between coronavirus disease 2019 (COVID-19) vaccination during pregnancy and the risks of adverse perinatal outcomes. We performed a literature search in PubMed, Web of Science and Embase to identify eligible studies published up to 24 September 2023, yielding 39 included studies. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated with a random effects model. The pooled results showed that COVID-19 vaccination during pregnancy (any type or dose of COVID-19 vaccination during any trimester) was not associated with an increased risk of adverse perinatal outcomes. In particular, COVID-19 vaccination in the third trimester was associated with a decreased risk of preterm birth (<37 weeks) (RR 0.85 [95% CI 0.74 to 0.98]), 5-min Apgar <7 (RR 0.87 [95% CI 0.78 to 0.97]) and neonatal intensive care unit (NICU) admission (RR 0.90 [95% CI 0.86 to 0.95]). The inverse associations were also found in analysis of one-dose vaccination during pregnancy and the risk of miscarriage (RR 0.83 [95% CI 0.72 to 0.96]) and preterm birth (<37 weeks) (RR 0.90 [95% CI 0.80 to 1.00]) and two-dose vaccination during pregnancy and the risk of NICU admission (RR 0.86 [95% CI 0.76 to 0.96]). COVID-19 vaccination during pregnancy does not increase the risk of negative outcomes for the mother or baby. [ABSTRACT FROM AUTHOR]

Abstract Background To investigate the association between maternal sepsis during pregnancy and poor pregnancy outcome and to identify risk factors for poor birth outcomes and adverse perinatal events. Methods We linked the Taiwan Birth Cohort Study (TBCS) database and the Taiwanese National Health Insurance Database (NHID) to conduct this population-based study. We analysed the data of pregnant women who met the criteria for sepsis-3 during pregnancy between 2005 and 2017 as the maternal sepsis cases and selected pregnant women without infection as the non-sepsis comparison cohort. Sepsis during pregnancy and fulfilled the sepsis-3 definition proposed in 2016. The primary outcome included low birth weight (LBW,

الملخص: أهداف البحث: الاختناق في الفترة المحيطة بالولادة هو السبب الرئيسي لوفيات الأطفال دون الشهر الخامسة ويمارس ضغطا كبيرا على النظام الصحي. تعتبر المراقبة الكافية للجنين أثناء المخاض أمرا بالغ الأهمية في الكشف المبكر عن ضائقة الجنين من أجل منع الاختناق في الفترة المحيطة بالولادة. يتم استخدام عدة طرق لمراقبة الجنين بفاعلية متفاوتة. هدفت هذه الدراسة إلى التحقق من مدى فعالية مقايسة اللاكتات الشريانية السرية في التنبؤ بالنتائج الضارة في الفترة المحيطة بالولادة. طريقة البحث: كانت دراسة طولية مستقبلية شملت 160 امرأة حامل في المرحلة النشطة من المخاض عند الأوان والذين استوفوا معايير الاشتمال. تم استقطابهم باستخدام تقنية أخذ العينات المتتالية وتم إجراء تخطيط القلب لهم. ثم تم تصنيفهم إلى مجموعات تخطيط القلب الطبيعية وغير الطبيعية. عند الولادة، تم جمع الدم الشرياني السري لجميع الأطفال ومعايرته من أجل اللاكتات في الدم وتم ربط المستويات بنتيجة الفترة المحيطة بالولادة. تم قياس النتائج في الفترة المحيطة بالولادة بواسطة درجات أبغار، والقبول في وحدة حديثي الولادة واعتلال الدماغ الإقفاري بنقص التأكسج. تم إجراء التحليل لتحديد حساسية ونوعية اللاكتات الشرياني السري في التنبؤ باختناق الولادة واعتلال الدماغ الإقفاري بنقص التأكسج وقبول وحدة حديثي الولادة. النتائج: كان متوسط العمر ± الانحراف المعياري بين مجموعتي تخطيط القلب، طبيعي (30.55 ±5.59) سنة وغير طبيعي (29.86 ±5.51) سنة، متشابها. تنبأ تركيز اللاكتات الشرياني السري الحرج الذي يزيد عن 9.1 مليمول/لتر بدرجات أبغار 9.1 مليمول/لتر مع حساسية 61.90% (فترة الثقة 38,4-81,9) ونوعية 91.30% (فترة الثقة 85,3-95,4). تنبأت مستويات لاكتات الشريان السري > 11.2 مليمول/لتر بتطور اعتلال الدماغ الإقفاري بنقص التأكسج عند الولدان بحساسية 100% (فترة الثقة 39,8-100) ونوعية 88.39% (فترة الثقة 82,3-93,0). الاستنتاجات: يرتبط لاكتات الشريان السري بنتائج الحمل الضارة وهو أداة ممتازة للتنبؤ بالنتائج الضارة لحديثي الولادة. Abstract: Background: Perinatal asphyxia is a leading cause of under-5 mortality and exerts great pressure on the health system. Adequate foetal monitoring in labour is paramount in the early detection of foetal distress to prevent perinatal asphyxia. Several methods of foetal monitoring are in use with varying efficacy. This study investigated the efficacy of umbilical arterial (UA) lactate assay in predicting adverse perinatal outcomes. Methodology: This was a prospective longitudinal study involving 160 pregnant women in the active phase of labour at term who met the inclusion criteria. They were recruited using a consecutive sampling technique and underwent a cardiotocography. Then they were classified into normal and abnormal cardiotocographic groups. At delivery, the UA blood of all of the babies was collected and assayed for serum lactate, and the levels were correlated with the perinatal outcome. The perinatal outcomes were measured by Apgar scores, admission into the neonatal unit, and hypoxic ischaemic encephalopathy. Analysis was done to determine the sensitivity and specificity of UA lactate in predicting birth asphyxia, hypoxic ischaemic encephalopathy, and neonatal unit admission. Results: The mean age ± standard deviation (SD) between the two cardiotocography (CTG) groups, normal years (30.55 ± 5.59) and abnormal years (29.86 ± 5.51), were similar. A critical UA lactate concentration > 9.1 mmol/L predicted Apgar scores < 7 at 5 min with a sensitivity and specificity of 76.47% (CI: 50.1–93.2) and 91.55% (CI: 85.7–95.6%), respectively. Also, the need for neonatal unit admission was predicted at a cut-off point >9.1 mmol/L with a sensitivity of 61.90% (CI: 38.4–81.9) and specificity of 91.30% (CI: 85.3–95.4). Umbilical artery lactate levels > 11.2 mmol/L predicted the development of hypoxic ischaemic encephalopathy in neonates with a sensitivity of 100% (CI: 39.8–100.0) and specificity of 88.39% (CI: 82.3–93.0). Conclusion: Umbilical artery lactate correlates with adverse pregnancy outcomes and is an excellent tool for predicting adverse neonatal outcome.

Purpose: To assess the incidence of associated structural anomalies, chromosomal/genetic abnormalities, infections, and perinatal outcomes of fetuses with ventriculomegaly (VM), also to evaluate the role of fetal magnetic resonance imaging (MRI) in detecting associated intracranial anomalies. Methods: Retrospective cohort study of 149 prenatally diagnosed pregnancies with fetal VM. VM was classified as mild (Vp = 10–12 mm), moderate (Vp = 12.1–15 mm), and severe (Vp > 15 mm). Fetal MRI was performed to 97 pregnancies. Results: The incidences of an associated CNS, non-CNS, chromosomal anomaly, genetic abnormality and fetal infection were 42.3%, 11.4%, 6.1%, 2.1% and 1.3%, respectively. Fetal MRI identified additional CNS anomalies in 6.7% of cases, particularly in severe VM. The incidences of perinatal outcomes were 18.8% termination of pregnancy, 4% intrauterine and 8.1% neonatal or infant death. The rates of fetuses alive at > 12 months of age with neurological morbidity were 2.6%, 11.1% and 76.9% for mild, moderate and severe isolated VM, respectively. Conclusion: The prognosis of fetuses with VM mostly depends on the severity and the associated anomalies. Mild to moderate isolated VM generally have favorable outcomes. Fetal MRI is particularly valuable in fetuses with isolated severe VM. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to assess whether the choice between double embryo transfer (DET) and single embryo transfer (SET) in healthy women of advanced maternal age (AMA) was associated with an increased risk of adverse outcomes. Materials and Methods: Healthy women aged 39?40 years who achieved live birth after in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment between 2009 and 2020 at Karolinska University Hospital, Stockholm in Sweden, were included in this prospective, single-center cohort study. Results: A total of 310 women, who underwent IVF/ICSI treatments and achieved live births, were included in our analysis. Within this cohort, 78% of the women received SET, while 22% received DET. Nulliparity was common in both the SET (62.7%) and DET (85.3%) groups. Fresh embryo transfers were more prevalent in the DET group (91.2%) than in the SET group (31.1%). The rate of pregnancy-induced hypertension was higher in the SET group (8.3%) compared to the DET group (1.5%, p?=?0.048). Furthermore, the DET group had a significantly higher rate of twin pregnancies (13.2%) compared to the SET group (0.4%). No statistically significant differences were observed in composite obstetric and perinatal complications between the SET and DET groups across all model estimates following different adjustments. Clinical Trial Registration number: ClinicalTrials.gov NTC04602962. Conclusions: While DET was more common in nulliparous women and associated with a higher rate of twin pregnancies, our analysis did not reveal significant differences in adverse outcomes between the SET and DET groups after comprehensive adjustments. Our study suggests that in the absence of co-morbidities, meticulous patient selection coupled with comprehensive maternal care can potentially mitigate potential DET-associated risks in women of AMA.

Background and Objectives: ABO and Rh blood types are known to have associations with health and disease, but studies on their relationship to pregnancy outcomes have been largely inconclusive. We aimed to examine the associations between ABO and Rh blood groups in pregnant women with maternal–neonatal characteristics and outcomes including hypertensive disorders of pregnancy, gestational diabetes, cesarean section rate, preterm birth, postpartum quantitative blood loss, birth weight, and appearance, pulse, grimace, activity, and respiration scores. Methods: At the time of delivery, 2497 consecutive patients were tested for ABO and Rh blood groups. Only those who delivered singleton infants were included in the analysis (2392 patients, 95.8%). Demographic and clinical data were obtained from the electronic medical record. Associations between blood groups and maternal–neonatal characteristics and outcomes were assessed using logistic regression models. A significance threshold of 0.05 was used for all comparisons. Results: Of the 2392 delivering patients, 46.9% were blood group O, 37.5% were blood group A, 12.2% were blood group B, and 3.4% were blood group AB. In addition, 85.9% were Rh-positive and 14.1% Rh-negative. A total of 2127 (88.9%) women delivered at term. The cesarean section rate was 32.4%, 183 (7.7%) had chronic hypertension, 275 (11.5%) had gestational diabetes, and 396 (16.6%) had a postpartum hemorrhage. The median birth weight was 3330 g (interquartile range 2940–3640). No blood groups were significantly associated with these characteristic and outcome measures. Conclusion: At the time of delivery, no significant associations were identified between ABO and Rh blood groups and maternal–neonatal characteristics and outcomes in this delivery cohort of over 2000 women.

Background: Evidence is inconsistent regarding the impact of late gestational diabetes mellitus (GDM) on perinatal outcomes. Objectives: To evaluate associations of GDM diagnosed in the third trimester (late GDM) with adverse obstetric and neonatal outcomes. Search Strategy: We searched Embase, Medline, and Web of Science from January 1, 1990 to June 16, 2022, for observational studies. Selection Criteria: Late GDM was defined as a de novo diagnosis, i.e. after a negative screening for diabetes in the second trimester, and at later than 28 weeks of pregnancy. Data Collection and Analysis: Each abstract and full‐text article was independently reviewed by the same two authors. Quality was assessed with the use of the Newcastle‐Ottawa Scale. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random effects model. Main Results: Twelve studies were identified as meeting the inclusion criteria, including 3103 patients (571 with late GDM and 3103 controls). Incidences of shoulder dystocia (OR 1.57, 95% CI 1.02–2.42, P = 0.040), 5‐minute Apgar score <7 (OR 1.80, 95% CI 1.14–2.86, P = 0.024), cesarean delivery (OR 1.98, 95% CI 1.51–2.60, P < 0.001), and emergent cesarean delivery (OR 1.57, 95% CI 1.02–2.40, P = 0.040) were significantly higher among women with late GDM than among the controls. The groups showed similarity in the rates of fetal macrosomia, large‐for‐gestational‐age fetuses, neonatal hypoglycemia, and hypertensive disorders of pregnancy. Conclusions: This meta‐analysis showed associations of late GDM with increased adverse perinatal outcomes. Prospective studies should evaluate the impact on perinatal outcomes of repeated third‐trimester screening for late GDM. Synopsis: Late gestational diabetes mellitus, diagnosed after 32 weeks, was associated with higher incidence of shoulder dystocia, 5‐minute Apgar score <7 and cesarean delivery. [ABSTRACT FROM AUTHOR]

Purpose: The association between birth order and adverse perinatal outcomes has been well studied in twin pregnancies. However, little is known about the differences in immediate perinatal outcomes as well as long‐term hospitalization of the offspring in triplet pregnancies according to their birth order. As such, we aimed to assess the differences in immediate perinatal outcomes and long‐term hospitalizations among triplets by their birth order. Methods: In a retrospective hospital‐based cohort study, immediate perinatal outcomes and long‐term hospitalizations were compared among triplet siblings according to their birth order. Deliveries occurred between the years 1991 and 2021 in a tertiary medical center. The study groups were followed until 18 years of age for cardiovascular, respiratory, neurological, and infection‐related hospitalizations. Generalized estimation equation (GEE) models were used to control for confounders. Kaplan–Meier survival curves were used to compare cumulative long‐term hospitalization incidences and Cox proportional hazards models were performed to control for confounders. Results: The study included 117 triplet deliveries. Rates of small for gestational age (SGA) infants increased linearly by birth order (6.0%, 7.7%, and 15.4% for the first, second, and third siblings, respectively; p‐value for trends = 0.035). Using a GEE model controlling for maternal age, being born third in a triplet pregnancy was independently associated with SGA (third vs. first sibling, adjusted OR 3.0, 95% CI 1.38–6.59, p = 0.005). No significant differences in cardiovascular, respiratory, neurological, and infection‐related hospitalizations were noted among the first, second, and third siblings. Likewise, using Kaplan–Meier survival analyses, no significant differences in the cumulative incidence of long‐term pediatric hospitalizations were noted between the siblings. In Cox proportional hazards models, controlling for weight and gender, birth order in a triplet pregnancy did not exhibit an association with long‐term hospitalizations of the offspring. Conclusion: Despite the association between birth order and SGA, birth order in triplets does not seem to have an impact on the risk for long‐term offspring hospitalization. [ABSTRACT FROM AUTHOR]

Background: COVID-19 is an infectious pathology that shows vascular changes during pregnancy, as well as in the placentas. The main objectives of this study were to estimate the prevalence and the risk factors for preeclampsia in hospitalized pregnant women with COVID-19. As well as comparing maternal and perinatal outcomes in hospitalized pregnant women with COVID-19 and preeclampsia with those without preeclampsia. Methods: Prospective cohort study of 100 hospitalized pregnant women from two tertiary hospitals, diagnosed with COVID-19, and divided into two groups: PE+ group (pregnant women with COVID-19 and preeclampsia) and PE- group (pregnant women with COVID-19 without preeclampsia). These pregnant women had prevalence, risk factors, maternal and perinatal data analyzed. Results: The prevalence of preeclampsia was 11%. Severe COVID-19 was the main risk factor for preeclampsia (OR = 8.18 [CI 1.53–43.52]), as well as fetal growth restriction was the main perinatal outcome (OR = 8.90 [CI 1.52–38.4]). Comorbidities were more frequent in the PE+ group (63.6% vs 31.5%, p = 0.03), as well as prematurity (81.8% vs 41.6%, p = 0.02), low birth weight (63.6% vs 24.7%, p = 0.01), and the need for neonatal intensive care admission of the newborn (63.6% vs 27.0%, p = 0.03). Pregnant women with PE had twice as long a length of stay in the intensive care unit (RR = 2.35 [CI 1.34–4.14]). Although maternal mortality was more frequent among pregnant women with PE, it was not statistically significant. Conclusions: Prevalence of preeclampsia in hospitalized pregnant women with COVID-19 was 11%. Severe COVID-19 was the main risk factor for preeclampsia and associated comorbidities increased the risk for developing preeclampsia. Long length of stay in the intensive care unit was the main maternal outcome and fetal growth restriction was the main perinatal outcome of preeclampsia. [ABSTRACT FROM AUTHOR]

Objective: Our aim was to investigate the significance of cerebro‐placento‐uterine ratio CPUR, a new Doppler index, and fetal cardiac parameters (Mod MPI, EFT) in early–onset preeclampsia (EOPE) and to examine whether these parameters are related to perinatal outcome. Study design: Forty participants diagnosed with EOPE (preeclampsia cases diagnosed before 34 weeks of gestation) and 40 healthy pregnant women were included in this study. Demographic data were recorded. Doppler parameters such as middle cerebral artery (MCA), umbilical artery (UA), and uterine artery (Ut‐A), and left modified myocardial performance index (Mod–MPI) and epicardial fat thickness (EFT) were measured. Cerebroplacental ratio (CPR) was determined by dividing MCA pulsatility index (PI) by UA PI. CPUR was calculated as the ratio of CPR to mean UtA–PI (CPUR = CPR/UtA–PI). All parameters were compared between the EOPE and control groups. Correlation tests were used to examine the relationship between Doppler parameters and perinatal outcome. p values less than 0.05 were considered statistically significant. Results: The pulsatility index of the middle cerebellar artery, CPUR and CPR values were statistically lower in the EOPE group than in the control group (p = 0.002; p = <0.001; p = <0.001; respectively). No statistical differences were found between groups for isovolumetric contraction time (ICT), isovolumetric relaxation time (IRT), ejection time (ET), left mod‐MPI, EFT (p = 0.117; p = 0.093; p = 0.398; p = 0.882; p = 0.202, respectively). Umbilical artery Doppler pulsatility index (PI), mean uterine artery Doppler pulsatility index (PI), were higher in the EOPE group than in the control group (p = 0.006; and p = <0.001, respectively). The CPUR value for predicting EOPE was ≤1.3652 with 74. 4% sensitivity and 94.9% specificity. Positive correlations were found between CPUR, CPR, and some neonatal parameters. Conclusion: CPUR, a new index combining fetal and uterine Doppler indices, may add contribution to predict adverse perinatal outcome and EOPE. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study is to analyze the morphological findings in the placenta of coronavirus disease-2019 (COVID-19)-positive women in correlation with the severity of infection, elevated inflammatory markers, gestational age at diagnosis and perinatal outcomes. Materials and methods: This is a prospective observational study of 66 singleton placentas of COVID-positive pregnant women over a period of 18 months. Clinical details, inflammatory markers, and perinatal outcomes were collected and analyzed in correlation with placental morphology. Results: Out of 66 pregnancies, 57 (86.3%) culminated in live births, of which 23 (40%) were small for gestation (SGA). Out of 66 cases, 9 (13.7%) experienced complications involving fetal demise intrauterine fetal death (IUFD). Based on the increase in inflammatory markers and gestational age at infection, the pregnancies were analyzed with regard to fetal outcome. Out of 66 pregnancies, 26 (39.4%) had moderate to marked elevation of two or more inflammatory markers. Fetal outcomes in these pregnancies were IUFD (34.6%), SGA (34.6%), appropriate for gestation (AGA) (26.9%) and neonatal death (ND) (3.8%). In women with elevated markers, 20% fetal or neonatal mortality was noted when the infection occurred in the third trimester whereas it was 100% when the infection occurred in the second trimester. All pregnancies affected in the third trimester and without an increase in markers (n = 40) resulted in live birth. The most significant placental finding observed was chronic inflammatory pathology (80%), followed by maternal vascular malperfusion (MVM) with or without fetal vascular malperfusion (FVM) (75.7%), and massive perivillous fibrin deposition (MPVFD) (12%). Conclusion: This study reemphasizes that in maternal COVID, the gestational age at infection, elevated inflammatory markers and severity of placental lesions could explain the perinatal outcomes. [ABSTRACT FROM AUTHOR]

To investigate the clinical outcomes and Doppler patterns changes in monochorionic diamniotic (MCDA) twins with selective fetal growth restriction (sFGR). We retrospectively analyzed 362 sFGR cases from January 2010 to May 2016 at a single tertiary referral center. The Doppler waveforms of umbilical artery end-diastolic flow were collected, and all neonates were subjected to an early neonatal brain scan. A total of 66/100 (66 %) type I cases were stable, whereas 25/100 (25 %) cases changed to type II and 9/100 (9 %) changed to sFGR complicated twin-twin transfusion syndrome (TTTS). A total of 48.9 % (22/45) sFGR cases were complicated with polyhydramnios and 30.4 % (7/23) sFGR cases were complicated with oligohydramnios, both of which were progressed to sFGR with TTTS. Mild cerebral injury was significantly associated with Doppler flow abnormalities, earlier gestational age at delivery and type of sFGR diagnosis. Severe cerebral injury was significantly associated with gestational age at delivery (31.6 vs. 34.1, p=0.002) and larger birthweight discordance (43.9 vs. 29.3 %, p=0.011). Doppler patterns in sFGR can gradually change, with important consequences with regard to management and outcomes. Along with abnormal Doppler findings, earlier occurrence of sFGR and delivery are associated with subsequent neonatal cerebral injury. [ABSTRACT FROM AUTHOR]

Background: Purpose Aim of our study was to compare the prognostic value of the Umbilicalto-Cerebral ratio (UCR) directly to the Cerebroplacental ratio (CPR) in the prediction of poor perinatal outcomes in pregnancies complicated by Fetal Growth Restriction (FGR). Methods: A retrospective study was carried out on pregnant women with either a small-forgestational-age (SGA) fetus or that were diagnosed with FGR. Doppler measurements of the two subgroups were assessed, and the correlation between CPR, UCR, and relevant outcome parameters was evaluated by performing linear regression analysis, binary logistic analysis, and receiver operator characteristic (ROC) curves. Outcomes of interest were mode of delivery, acidosis, preterm delivery, gestational age at birth as well as birthweight and centiles. Results: Boxplots and Scatterplots illustrated the different distribution of CPR and UCR leading to deviant correlational relationships with adverse outcome parameters. In almost all parameters examined, UCR showed a higher independent association with preterm delivery (OR: 5.85, CI 2.23-15.34), APGAR score<7 (OR: 3.52; CI 1.58-7.85) as well as weight under the 10th centile (OR: 2.04; CI 0.97-4.28) in binary logistic regression compared to CPR, which was only associated with preterm delivery (OR: 0.38; CI 0.22-0.66) and APGAR score<7 (OR: 0.27; CI 0.06-1.13). When combined with different ultrasound parameters to differentiate between SGA and FGR during pregnancy, odds ratios for UCR were highly significant compared to odds ratios for CPR (OR: 0.065, 0.168-0.901; p=0.027; OR: 0.810, 0.369-1.781; p=0.601). ROC curves plotted for CPR and UCR showed almost identical moderate prediction performance. Conclusion: These findings indicate that the UCR should be prospectively examined as a prognostic tool while keeping the statistical characteristics and challenges of reversing the ratio in mind. [ABSTRACT FROM AUTHOR]

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Purpose: To evaluate the type of umbilical‐portal anastomosis in late‐onset fetal growth restriction (LO‐FGR) and appropriate for gestational age (AGA) fetuses. To investigate the impact of the type of umbilical‐portal anastomosis on the adverse outcomes in LO‐FGR. Method: This study observed 150 pregnancies with AGA fetuses and 62 pregnancies with fetuses with LO‐FGR. In each case, the point of reference for measuring the abdominal circumference was established. The type of umbilical‐portal anastomosis was evaluated as T‐shaped, X‐shaped, and H‐shaped according to the shape of main portal vein and portal sinus. Incidences of the type of umbilical‐portal anastomosis in AGA and LO‐FGR fetuses were evaluated. Results: T‐shaped anastomosis was the most common (56.7%) in the AGA group and X‐shaped (66.1%) in the LO‐FGR group. In LO‐FGR, T‐shape anastomosis was significantly lower and X‐shape anastomosis was significantly higher than AGA (p < 0.001). X‐shaped anastomosis was associated with LO‐FGR and the RR was 2.3 (95% CI 1.5–3.6; p < 0.001). Incidences of admission to NICU and emergency C/S for fetal distress were higher in fetuses with X ‐shaped anastomosis in the LO‐FGR (p < 0.05). Conclusion: X‐shaped umbilical‐portal anastomosis have a prognostic significance in LO‐FGR fetuses. [ABSTRACT FROM AUTHOR]

Objective Method Results Conclusion This study will evaluate whether fetal cerebroplacental ratio (CPR) can predict perinatal adverse outcomes in singleton pregnancies with mild and moderate idiopathic polyhydramnios (IP).This study was designed as a prospective case–control study between January 2023 and November 2023. Pregnant women diagnosed with mild‐to‐moderate IP and low‐risk singleton pregnancies were included in the study. In all cases, umbilical artery (UA) and middle cerebral artery (MCA) pulsatility indices (PIs) were measured at 36–40 weeks of gestation, and CPR was calculated. The group with polyhydramnios was divided into two parts according to whether the CPR value was below 1.08 or 1.08 and above. Perinatal outcomes of all groups were compared.A total of 140 patients were included in the study. Seventy of these were IP cases, and 70 were low‐risk pregnant women. UA PI in the IP group was not statistically different from that in the low‐risk group, but MCA PI and CPR were significantly lower in the IP group (P = 0.07, P = 0.001, and P = 0.004, respectively). IP cases were divided into a low group (<1.08, n = 18) and a normal group (≥1.08, n = 52) according to the CPR value. Cesarean section rates due to fetal distress were significantly higher in the low‐CPR group (n = 8 [44.4%] vs 5 [9.6%], P = 0.001). In the low‐CPR group, 5‐min Apgar <7, and neonatal intensive care unit (NICU) admission rates were significantly higher (P = 0.045 and P = 0.001, respectively).It is encouraging that in cases with mild‐to‐moderate IP, low CPR predicts emergency delivery due to fetal distress, a low Apgar score at 5 min, and NICU admission. [ABSTRACT FROM AUTHOR]

Visceral leishmaniasis (VL), often referred to as kala-azar, is quite rare in developed countries during pregnancy. Only few studies have evaluated its impact on perinatal outcome. It is caused primarily by Leishmania donovani or Leishmania infantum and presents with a wide spectrum of clinical manifestations from cutaneous ulcers to multisystem disease. Differential diagnosis is challenging as symptoms and signs are insidious, mimicking other diseases. Misdiagnosis can result in severe adverse perinatal outcomes, even maternal/neonatal death. Early treatment with liposomal amphotericin-B (LAmB) is currently the first choice with adequate effectiveness. We report a rare case of VL in a twin pregnancy with onset at the second trimester, presenting with periodic fever with rigors, right flank pain, and gradual dysregulation of all three cell lines. The positive rK39 enzyme-linked immunosorbent assay test confirmed the diagnosis. Treatment with LAmB resulted in clinical improvement within 48 h and in the delivery of two late-preterm healthy neonates with no symptoms or signs of vertical transmission. The one-year follow-up, of the mother and the neonates, was negative for recurrence. To our knowledge, this is the first reported case of VL in a twin pregnancy, and consequently treatment and perinatal outcome are of great importance. [ABSTRACT FROM AUTHOR]

Introduction: Foetal growth restriction (FGR), is a condition that occurs due to various reasons. It is an important cause of foetal and neonatal morbidity and mortality. It has been defined as a rate of foetal growth that is less than the growth potential of that specific infantor as having birth weight less than two standard deviations below the mean or less than the 10th percentile of a population-specific birth weight for specific gestational age. It has been found to be associated with a variety of adverse perinatal outcomes. These infants have many acute neonatal problems that include perinatal asphyxia, hypothermia, hypoglycaemia, polycythaemiaetc. The likely long-term complications that are prone to develop when FGR infants grow up includes growth retardation, major and subtle neurodevelopmental handicaps etc. Methods: This cross-sectional study included all growth restricted babies born in the department of Obstetrics and Gynecology at Government Medical College, IMCH Kozhikodeduring the study period and their mothers. Multiple pregnancy with growth restriction were excluded from the study. Babies born outside IMCH but being referred to IMCH were also excluded. Socio -demographic and fetomaternal characteristics were collected after getting consent. Maternal data regarding socio-demographic variables including age, domicile (rural/urban), socio-economic status, data regarding gestational age, nature of ANC, past obstetric history including parity. Results: Perinatal mortality rate was 64.2/1000 in growth restricted babies born to normotensive mother group. The stillbirth rate was 36.6/1000 in growth restricted babies born to normotensive mother group. Fetal growthrestriction occurred more in rural womencompared to urban women. Women below poverty line had more fetal growth restriction compared to the women above poverty line and the difference was statistically significant. Early neonatal mortality rate was 28/1000 live IUGR babies in normotensive group. Conclusion: Mothers belonging to low socio-economic status have high risk of delivering babies with growth restriction. This is because of inadequate dietary intake, increased physical activity, passive smoking, increased rate of infections and low educational levels leading to decreased awareness regarding health care facilities. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the safety and effectiveness of oocyte vitrification by comparing the clinical pregnancy and perinatal outcomes between transfer cycles of vitrified oocytes and those of vitrified embryos. Methods: A retrospective cohort study was conducted to analyze the clinical data of patients who underwent cleavage-stage embryo transfer at the Department of Reproductive Medicine between January 2011 and June 2021. Seventy-seven transfer cycles of fresh cleavage-stage embryos developed from vitrified-thawed oocytes (oocyte vitrification group) and 2170 transfer cycles of vitrified-thawed cleavage-stage embryos developed from fresh oocytes (embryo vitrification group) were included. Further, 293 cases were selected from the embryo vitrification group after applying propensity score matching at 1:4. The primary outcomes were miscarriage rate, live birth rate, and neonatal birth weight. Results: No statistically significant differences were observed in the baseline data, pregnancy, perinatal outcomes, or neonatal outcomes for either singleton or twin births between the two groups after matching. Backwards stepwise regression was used to analyze the length of gestation. The age of female participants (β = − 0.410, 95% CI = − 1.339 ~ − 0.620, P < 0.001) had a statistically significant effect. Conclusion: Oocyte vitrification results in similar clinical pregnancy and perinatal outcomes as does embryo vitrification; hence, it is a relatively safe assisted reproductive technique. [ABSTRACT FROM AUTHOR]

Background: Despite pregnancy's hypercoagulable state, the correlation between inherited thrombophilia and thrombotic adverse pregnancy outcomes remains uncertain. The objective of this study was to determine the prevalence of inherited thrombophilic polymorphisms among asymptomatic pregnant individuals and to examine their potential correlation with adverse perinatal outcomes. Methods: in this single-center prospective study, 105 healthy pregnant women were included. Genotyping was conducted for factor V Leiden (FVL), prothrombin gene mutation, methylenetetrahydrofolate reductase enzyme (MTHFR) C677T, MTHFR A1298C, and plasminogen activator inhibitor-1 (PAI-1), alongside the assessment of protein C (PC), protein S (PS), and antithrombin (AT) levels. The study analyzed the association between inherited thrombophilic polymorphisms and pregnancy complications linked to placental insufficiency, such as gestational hypertension (GH), preeclampsia (PE), intrauterine death (IUD), fetal growth restriction (FGR), and placental abruption. Results: The prevalence of identifiable thrombophilic polymorphism mutations was 61.9% (95% confidence interval—CI 52.4–70.8%), with the most common single mutation being PAI-1 4G/5G (12/105, 11.4%, 95% CI 6.4–18.5). The most frequent combined mutation was heterozygosity for MTHFR C677T and PAI-1 (12/105, 11.4%, 95% CI 6.4–18.5). Notably, no FVL homozygous carriers or single homozygous and heterozygous carriers for prothrombin polymorphisms were found. Additionally, no deficiencies in PC and AT were detected among participants. Except for homozygosity for PAI-1, none of the studied polymorphisms demonstrated a significant association with pregnancy complications linked to placental insufficiency. Conclusions: The asymptomatic carriers of inherited thrombophilic polymorphisms do not have an increased risk of adverse perinatal outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Pregnancy‐associated gynecological cancer (PAGC) refers to cancers of the ovary, uterus, fallopian tube, cervix, vagina, and vulva diagnosed during pregnancy or within 12 months postpartum. We aimed to describe the incidence of, and perinatal outcomes associated with, invasive pregnancy‐associated gynecological cancer. Material and methods: We conducted a population‐based historical cohort study using linked data from New South Wales, Australia. We included all women who gave birth between 1994 and 2013, with a follow‐up period extending to September 30, 2018. Three groups were analyzed: a gestational PAGC group (women diagnosed during pregnancy), a postpartum PAGC group (women diagnosed within 1 year of giving birth), and a control group (women with control diagnosis during pregnancy or within 1 year of giving birth). We used generalized estimation equations to compare perinatal outcomes between study groups. Results: There were 1 786 137 deliveries during the study period; 70 women were diagnosed with gestational PAGC and 191 with postpartum PAGC. The incidence of PAGC was 14.6/100 000 deliveries and did not change during the study period. Women with gestational PAGC (adjusted odds ratio [aAOR] 6.81, 95% confidence interval [CI] 2.97–15.62) and with postpartum PAGC (aOR 2.65, 95% CI 1.25–5.61) had significantly increased odds of a severe maternal morbidity outcome compared with the control group. Babies born to women with gestational PAGC were more likely to be born preterm (aOR 3.11, 95% CI 1.47–6.59) and were at increased odds of severe neonatal complications (aOR 3.47, 95% CI 1.45–8.31) compared with babies born to women without PAC. Conclusions: The incidence of PAGC has not increased over time perhaps reflecting, in part, the effectiveness of cervical screening and early impacts of human papillomavirus vaccination programs in Australia. The higher rate of preterm birth among the gestational PAGC group is associated with adverse outcomes in babies born to these women. [ABSTRACT FROM AUTHOR]

Objective: Adolescent pregnancies give rise to high maternal and fetal risk. In our study, we aimed to compare the obstetric and neonatal outcomes of adolescent and non-adolescent pregnancies. Methods: This study included pregnant women who gave birth between 2018 and 2021 at Necmettin Erbakan University Faculty of Medicine, Obstetrics and Gynaecology Department. The study included 15 to 19-year-old pregnant women, and the control group was 20 to 34, in which age-related complications are known to be the lowest. Multiple pregnancies decreased birth weight and increased preterm delivery risk, so they were excluded from the study, along with patients with incomplete data. Participants’ socio-demographic and obstetric characteristics were retrospectively reviewed and determined by analyzing delivery records and patient files. The data was analyzed using the SPSS 26, whereas age, gestational diabetes, pre-eclampsia and APGAR scores were correlated using Pearson or Spearman correlation analyses. The study used 0.05 p-value. Results: The age, gravidity, parity, abortion and educational level of adolescent pregnancies were significantly lower than in the normal age group (p=0.001 for all parameters). The rates of pre-eclampsia, gestational diabetes and preterm prelabor rapture of membranes were lower in adolescent pregnancies (p=0.044, p=0.010, p=0.044, respectively), while the rates of fetal growth restriction and fetal distress were higher (p=0.016 and p=0.010). The rate of vaginal delivery was lower and the rate of vaginal delivery with episiotomy was higher in adolescent pregnancies (p<0.05). There were significant correlations between age, gestational diabetes and pre-eclampsia. ROC analysis showed that the risk of complications in adolescent pregnancies varies with age and is higher in pregnancies under 18.5 years. Conclusion: Adolescent pregnancies differ from those of normal age in some parameters of maternal and neonatal outcomes. However, it can be seen that adolescent pregnancies, especially late adolescent pregnancies, can have outcomes that are comparable to those of normal age groups. [ABSTRACT FROM AUTHOR]

Objective: Radiofrequency ablation (RFA) is the preferred approach for selective reduction in complex monochorionic (MC) multiple pregnancies owing to the ease of operation and minimal invasiveness. To optimize the RFA technique and reduce the risk of adverse pregnancy outcome resulting from the heat‐sink effect of RFA therapy, we used an innovative RFA method, in which an electrode needle was expanded incrementally and stepwise. This study aimed to assess the efficacy and safety profile of this novel multistep incremental expansion RFA method for selective fetal reduction in MC twin and triplet pregnancies. Methods: This was a single‐center retrospective cohort study of all MC multiple pregnancies undergoing RFA between March 2016 and October 2022 at our center. The multistep RFA technique involved the use of an expandable needle, which was gradually expanded during the RFA procedure until cessation of umbilical cord blood flow was achieved. The needle used for the single‐step RFA method was fully extended from the start of treatment. Results: In total, 132 MC multiple pregnancies underwent selective reduction using RFA, including 50 cases undergoing multistep RFA and 82 cases undergoing single‐step RFA. The overall survival rates were not significantly different between the multistep and single‐step RFA groups (81.1% vs 72.3%; P = 0.234). Similarly, the rates of preterm prelabor rupture of the membranes within 2 weeks after RFA, procedure‐related complications, spontaneous preterm delivery and pathological findings on cranial ultrasound, as well as gestational age at delivery and birth weight, did not differ between the two groups. However, there was a trend towards a prolonged procedure‐to‐delivery interval following multistep RFA compared with single‐step RFA (median, 109 vs 99 days; P = 0.377). Moreover, the fetal loss rate within 2 weeks after RFA in the multistep RFA group was significantly lower than that in the single‐step RFA group (10.0% vs 24.4%; P = 0.041). The median ablation time was shorter (5.3 vs 7.8 min; P < 0.001) and the median ablation energy was lower (10.2 vs 18.0 kJ; P < 0.001) in multistep compared with single‐step RFA. There were no significant differences in neonatal outcomes following multistep vs single‐step RFA. Conclusions: Overall survival rates were similar between the two RFA methods. However, the multistep RFA technique was associated with a lower risk of fetal loss within 2 weeks after RFA. The multistep RFA technique required significantly less ablation energy and a shorter ablation time compared with single‐step RFA in selective fetal reduction of MC twin and triplet pregnancies. Additionally, there was a trend towards a prolonged procedure‐to‐delivery interval with the multistep RFA technique. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Abstract Background After the outbreak of COVID-19, a huge part of the health care services was dedicated to preventing and treating this disease. In case of COVID-19 infection, severe COVID-19 is reported more in pregnant individuals. Afterward, Vaccination against SARS-CoV-2 became a hot topic due to known effects in preventing severe COVID-19 during pregnancy. Vaccination of pregnant individuals started in August 2021 with the Sinopharm vaccine in Iran. The aim of current study was to determine the incidence of perinatal outcomes in women who were vaccinated during pregnancy. Method This retrospective cohort study included 129,488 singleton births from March 21, 2021, until March 21, 2022, in Tehran, Iran. The data was obtained from the Iranian Maternal and Neonatal (IMaN) Network and the Maternal Vaccination Registry. Adverse perinatal outcomes investigated in this study include preterm birth, extremely preterm birth, low birth weight, very low birth weight, intrauterine growth restriction, stillbirth, neonatal intensive care unit admission, congenital anomaly, neonatal death and low 5-minute Apgar score. The risk of all perinatal outcomes was evaluated using multiple logistic regression. The analysis was done using STATA version 14. Results Of all 129,488 singleton births included in this study, 17,485 (13.5%) were vaccinated against SARS-CoV-2 (all with Sinopharm (BBIBP-CorV)). The exposure to the Sinopharm vaccine during pregnancy caused a significant decrease in the incidence of preterm birth (P =0.006, OR=0.91 [95% CI, 0.85 to 0.97]), extremely preterm birth (P =

Abstract Aim To evaluate placental pathology in term and post-term births, investigate differences in clinical characteristics, and assess the risk of adverse neonatal outcome. Methods This prospective observational study included 315 singleton births with gestational age (GA) > 36 weeks + 6 days meeting the local criteria for referral to placental histopathologic examination. We applied the Amsterdam criteria to classify the placentas. Births were categorized according to GA; early-term (37 weeks + 0 days to 38 weeks + 6 days), term (39 weeks + 0 days to 40 weeks + 6 days), late-term (41 weeks + 0 days to 41 weeks + 6 days), and post-term births (≥ 42 weeks + 0 days). The groups were compared regarding placental pathology findings and clinical characteristics. Adverse neonatal outcomes were defined as 5-minute Apgar score

Abstract Purpose To evaluate the effect of intrahepatic cholestasis of pregnancy (ICP) with gestational diabetes mellitus (GDM) on perinatal outcomes and establish a prediction model of adverse perinatal outcomes in women with ICP. Methods This multicenter retrospective cohort study included the clinical data of 2,178 pregnant women with ICP, including 1,788 women with ICP and 390 co-occurrence ICP and GDM. The data of all subjects were collected from hospital electronic medical records. Univariate and multivariate logistic regression analysis were used to compare the incidence of perinatal outcomes between ICP with GDM group and ICP alone group. Results Baseline characteristics of the population revealed that maternal age (p

Pregnancies involving dichorionic twins have been recognized for their distinct difficulties and complications. The care and outcomes of such pregnancies are further complicated by placental abruption, an uncommon but significant obstetric event. We describe a case of placental abruption in a dichorionic twin pregnancy, including the clinical manifestations, diagnosis, treatment, and prognosis of the mother and fetus. Pregnancies with two separate chorions, or dichorionic pregnancies, are a special type of multiple gestation. Early separation of the placenta from the uterine wall is a potentially fatal event that can have a major influence on the health of both the mother and fetus. It is a key complication of placental abruption. We describe a 32-year-old primigravida who complained of sudden onset abdominal pain and vaginal bleeding at 28 weeks of gestation. She had dichorionic twin pregnancy after 10 weeks of gestation, as determined by ultrasonography. The patient remained stable, and repeated ultrasounds verified that there was no further placental separation. The patient underwent an elective caesarean section at 35 weeks of gestation because of a higher risk of recurrent abruption. Two healthy newborns were delivered, and their weights were consistent with their gestational age.

Objective Understanding the reflections of prematurity is necessary for the management of neonatal complications. We focused on the impact of prematurity and related "maternal risk factors/obstetric complications" on buccal cells of the neonates via evaluation of the Wnt/β-catenin signaling pathway and apoptosis. Study Design This study consisted of "early preterm neonates (EPN) (≤34th gestational week [gw]) (n = 36)," "late preterm neonates (LPN) (34th– < 37th gw) (n = 46)," and "term neonates (control) (≥37th gw) (n = 56)." Cohort was also subclassified according to the presence of maternal risk factors, obstetric complications, and neonatal complications. Wnt/β-catenin signaling and caspase-3 activation pathways were studied immunocytochemically. Results Wnt/β-catenin signaling positivity was statistically more frequent at buccal smears of the EPN and LPN groups compared with controls (p < 0.001). The cutoff for gestational age at delivery in receiver operating characteristic curve with the best balance of sensitivity (67.4%) and specificity (67.3%) was 35.8th gw for determining the reduction of Wnt/β-catenin signaling positivity (p < 0.001). The study demonstrated that obstetric complications significantly affected the activity of signaling, while maternal risk factors do not have any effect on Wnt/β-catenin signaling pathway (p = 0.003 and p = 0.828, respectively). This study also demonstrated a significant relationship between Wnt/β-catenin signaling pathway and the presence of neonatal complications (p = 0.015). Conclusion Dynamic characteristics of buccal cells are influenced by prematurity and related obstetric and neonatal problems. Buccal smear is a good tool to investigate the impact of prematurity and obstetric problems on perinatal outcome. Key Points Neonatal buccal cells are affected by prematurity and related obstetric/neonatal problems. 35.8th gw is critical for determining the reduction of Wnt/β-catenin signaling positivity. Obstetric and neonatal complications significantly related to Wnt/β-catenin signaling activity. [ABSTRACT FROM AUTHOR]

Aim: To evaluate placental pathology in term and post-term births, investigate differences in clinical characteristics, and assess the risk of adverse neonatal outcome. Methods: This prospective observational study included 315 singleton births with gestational age (GA) > 36 weeks + 6 days meeting the local criteria for referral to placental histopathologic examination. We applied the Amsterdam criteria to classify the placentas. Births were categorized according to GA; early-term (37 weeks + 0 days to 38 weeks + 6 days), term (39 weeks + 0 days to 40 weeks + 6 days), late-term (41 weeks + 0 days to 41 weeks + 6 days), and post-term births (≥ 42 weeks + 0 days). The groups were compared regarding placental pathology findings and clinical characteristics. Adverse neonatal outcomes were defined as 5-minute Apgar score < 7, umbilical cord artery pH < 7.0, admission to the neonatal intensive care unit or intrauterine death. A composite adverse outcome included one or more adverse outcomes. The associations between placental pathology, adverse neonatal outcomes, maternal and pregnancy characteristics were evaluated by logistic regression analysis. Results: Late-term and post-term births exhibited significantly higher rates of histologic chorioamnionitis (HCA), fetal inflammatory response, clinical chorioamnionitis (CCA) and transfer to neonatal intensive care unit (NICU) compared to early-term and term births. HCA and maternal smoking in pregnancy were associated with adverse outcomes in an adjusted analysis. Nulliparity, CCA, emergency section and increasing GA were all significantly associated with HCA. Conclusions: HCA was more prevalent in late and post-term births and was the only factor, along with maternal smoking, that was associated with adverse neonatal outcomes. Since nulliparity, CCA and GA beyond term are associated with HCA, this should alert the clinician and elicit continuous intrapartum monitoring for timely intervention. [ABSTRACT FROM AUTHOR]

Background: After the outbreak of COVID-19, a huge part of the health care services was dedicated to preventing and treating this disease. In case of COVID-19 infection, severe COVID-19 is reported more in pregnant individuals. Afterward, Vaccination against SARS-CoV-2 became a hot topic due to known effects in preventing severe COVID-19 during pregnancy. Vaccination of pregnant individuals started in August 2021 with the Sinopharm vaccine in Iran. The aim of current study was to determine the incidence of perinatal outcomes in women who were vaccinated during pregnancy. Method: This retrospective cohort study included 129,488 singleton births from March 21, 2021, until March 21, 2022, in Tehran, Iran. The data was obtained from the Iranian Maternal and Neonatal (IMaN) Network and the Maternal Vaccination Registry. Adverse perinatal outcomes investigated in this study include preterm birth, extremely preterm birth, low birth weight, very low birth weight, intrauterine growth restriction, stillbirth, neonatal intensive care unit admission, congenital anomaly, neonatal death and low 5-minute Apgar score. The risk of all perinatal outcomes was evaluated using multiple logistic regression. The analysis was done using STATA version 14. Results: Of all 129,488 singleton births included in this study, 17,485 (13.5%) were vaccinated against SARS-CoV-2 (all with Sinopharm (BBIBP-CorV)). The exposure to the Sinopharm vaccine during pregnancy caused a significant decrease in the incidence of preterm birth (P =0.006, OR=0.91 [95% CI, 0.85 to 0.97]), extremely preterm birth (P =<0.001,OR=0.55 [95% CI, 0.45 to 0.66]), and stillbirth (P =<0.001, OR=0.60 [95% CI, 0.47 to 0.76]). Exposure to vaccination during the first trimester was associated with an increased risk of preterm birth (P =0.01, OR=1.27 [95% CI, 1.04 to 1.55]) Maternal vaccination during pregnancy was not associated with an increased risk of other adverse perinatal outcomes included in this study. Conclusion: The finding of this population-based study indicated no adverse pregnancy outcome due to vaccination with the Sinopharm vaccine during the second and third trimesters of pregnancy. Overall risk of adverse pregnancy outcomes were lower in the vaccinated individuals compared to the unvaccinated group. Also, vaccination during the first trimester was associated with an increased risk of preterm birth. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of intrahepatic cholestasis of pregnancy (ICP) with gestational diabetes mellitus (GDM) on perinatal outcomes and establish a prediction model of adverse perinatal outcomes in women with ICP. Methods: This multicenter retrospective cohort study included the clinical data of 2,178 pregnant women with ICP, including 1,788 women with ICP and 390 co-occurrence ICP and GDM. The data of all subjects were collected from hospital electronic medical records. Univariate and multivariate logistic regression analysis were used to compare the incidence of perinatal outcomes between ICP with GDM group and ICP alone group. Results: Baseline characteristics of the population revealed that maternal age (p < 0.001), pregestational weight (p = 0.01), pre-pregnancy BMI (p < 0.001), gestational weight gain (p < 0.001), assisted reproductive technology (ART) (p < 0.001), and total bile acid concentration (p = 0.024) may be risk factors for ICP with GDM. Furthermore, ICP with GDM demonstrated a higher association with both polyhydramnios (OR 2.66) and preterm labor (OR 1.67) compared to ICP alone. Further subgroup analysis based on the severity of ICP showed that elevated total bile acid concentrations were closely associated with an increased risk of preterm labour, meconium-stained amniotic fluid, and low birth weight in both ICP alone and ICP with GDM groups. ICP with GDM further worsened these outcomes, especially in women with severe ICP. The nomogram prediction model effectively predicted the occurrence of preterm labour in the ICP population. Conclusions: ICP with GDM may result in more adverse pregnancy outcomes, which are associated with bile acid concentrations. [ABSTRACT FROM AUTHOR]

To evaluate the fetal ductus arteriosus anomalies diagnosed by fetal echocardiography. The perinatal outcomes and associated cardiac and genetic anomalies are also explored. The fetal echocardiography records of 2366 fetuses were evaluated retrospectively. Thirty-seven pregnancies prenatally diagnosed with ductus arteriosus anomalies and evaluated after delivery were enrolled in the study. Perinatal and obstetric outcomes were analyzed. The incidence of ductus arteriosus anomaly in our series was 1.5% (37/2366). The most frequent ductus arteriosus anomaly detected was right-sided ductus arteriosus followed by aneurysm, constriction and bilateral ductus arteriosus with an incidence of 51.3%, 27.1%, 18.9% and 2.7%, respectively. There were 19 fetuses with right-sided ductus arteriosus, of which 15 had tetralogy of Fallot. There were 2 chromosomal anomalies (22q11 microdeletion) in this group. Of the 7 fetuses with ductus arteriosus constriction, 3 (3/7, 42.9%) died in-utero. There were 2 (2/10, 20%) neonatal deaths due to hypoplastic left heart syndrome in the ductus arteriosus aneurysm group. Various types of ductus arteriosus anomalies can be diagnosed prenatally. Perinatal outcomes mostly dependent on the type of the ductus arteriosus anomaly and accompanying cardiac malformations. [ABSTRACT FROM AUTHOR]

Background: Omphalocele and gastroschisis are the most frequent congenital developmental abdominal wall defects. Prenatal diagnosis of omphalocele and gastroschisis is critical in the management of the pregnancy, affording patients the option of termination. This study aims to evaluate the prenatal diagnosis and postnatal outcomes of omphalocele and gastroschisis cases. Materials and Methods: The cases of gastroschisis and omphalocele diagnosed prenatally and followed up at our university were evaluated retrospectively between January 2019 and January 2022. Maternal demographic and clinical characteristics and perinatal outcomes were compared between the cases. Results: This study evaluated 42 omphalocele and nine gastroschisis cases. All gastroschisis cases were isolated (p =.001). Additional anomalies were present in 61.9% of omphalocele cases. While two patients with gastroschisis refused the invasive procedure, the genetic results of the others were normal. The karyotype was abnormal in 42.9% of omphalocele cases (p =.008). Half of the omphalocele cases were terminated, and 38.1% (n = 8) of the terminated omphalocele cases were trisomy 18. The coexistence of multiple system anomalies and cystic hygroma was high in the terminated cases. In all cases of gastroschisis, only the intestines protruded from the abdominal wall into the amniotic fluid. The number of survivors of omphalocele was 23.8%. The median hospital stay was 25 and 14 days for gastroschisis and omphalocele, respectively. Conclusion: Prenatal diagnosis of omphalocele and gastroschisis is critical in pregnancy management. The presence of associated anomalies determines the prognosis of omphalocele and gastroschisis. [ABSTRACT FROM AUTHOR]