BACKGROUND: The aim of this extended review of multicenter case series is to describe the prenatal ultrasound features and pathogenetic mechanisms underlying placental and umbilical cord anomalies and their relationship with adverse perinatal outcome. From an educational point of view, the case series has been divided in three parts; Part 1 is dedicated to placental abnormalities.
METHODS: Multicenter case series of women undergoing routine and extended prenatal ultrasound and perinatal obstetric care.
RESULTS: Prenatal ultrasound findings, perinatal care, and pathology documentation in cases of placental pathology are presented.
CONCLUSIONS: Our case series review and that of the medical literature confirms the ethiopathogenetic role and involvement of placenta abnormalities in a wide variety of obstetrics diseases that may jeopardize the fetal well-being. Some of these specific pathologies are strongly associated with a high risk of poor perinatal outcome.

UNASSIGNED: The high neonatal mortality rate in low- and middle-income countries (LMICs) such as Nigeria has lasted for more than 30 years to date with associated nursing fatigue. Despite prominent hard work, technological improvements, and many publications released from the country since 1990, the problem has persisted, perhaps due to a lack of intervention scale-up. Could there be neglected discoveries unwittingly abandoned by Nigerian policymakers over the years, perhaps locked up in previous publications? A careful review may reveal these insights to alert policymakers, inspire researchers, and refocus in-country research efforts towards impactful directions for improving neonatal survival rates. The focus was to determine the prevailed effectiveness of LMIC medical academia in creating solutions to end the high neonatal mortality rate.
UNASSIGNED: An unconventional systematic review protocol structure following the PRISMA 2020 checklist was designed and registered at INPLASY (registration number: INPLASY202380096, doi: 10.37766/inplasy2023.8.0096). A jury of paediatricians was assembled and observed by a team of legal professionals. The jury searched the literature from 1990 to the end of 2022, extracted newborn-related articles about Nigeria, and assessed and debated them against expected criteria for solution creation, translation, scale-up, sustainability, and national coverage. Each juror used preset criteria to produce a verdict on the possibility of a published novel idea being a potential game-changer for improving the survival rate of Nigerian neonates.
UNASSIGNED: A summation of the results showed that 19 out of 4,286 publications were assessed to possess potential strategies or interventions to reduce neonatal mortality. Fourteen were fully developed but not appropriately scaled up across the country, hence denying neonates proper access to these interventions.
UNASSIGNED: Nigeria may already have the required game-changing ideas to strategically scale up across the nation to accelerate neonatal survival. Therefore, LMIC healthcare systems may have to look inward to strengthen what they already possess.
UNASSIGNED: https://inplasy.com/, identifier (INPLASY202380096).

BACKGROUND: Most countries are off-track to achieve global maternal and newborn health goals. Global stakeholders agree that investment in midwifery is an important element of the solution. During a global shortage of health workers, strategic decisions must be made about how to configure services to achieve the best possible outcomes with the available resources. This paper aims to assess the relationship between the strength of low- and middle-income countries\' (LMICs\') midwifery profession and key maternal and newborn health outcomes, and thus to prompt policy dialogue about service configuration.
METHODS: Using the most recent available data from publicly available global databases for the period 2000-2020, we conducted an ecological study to examine the association between the number of midwives per 10,000 population and: (i) maternal mortality, (ii) neonatal mortality, and (iii) caesarean birth rate in LMICs. We developed a composite measure of the strength of the midwifery profession, and examined its relationship with maternal mortality.
RESULTS: In LMICs (especially low-income countries), higher availability of midwives is associated with lower maternal and neonatal mortality. In upper-middle-income countries, higher availability of midwives is associated with caesarean birth rates close to 10-15%. However, some countries achieved good outcomes without increasing midwife availability, and some have increased midwife availability and not achieved good outcomes. Similarly, while stronger midwifery service structures are associated with greater reductions in maternal mortality, this is not true in every country.
CONCLUSIONS: A complex web of health system factors and social determinants contribute to maternal and newborn health outcomes, but there is enough evidence from this and other studies to indicate that midwives can be a highly cost-effective element of national strategies to improve these outcomes.

BACKGROUND: Maternal and Perinatal Death Surveillance and Response (MPDSR) systems provide an opportunity for health systems to understand the determinants of maternal and perinatal deaths in order to improve quality of care and prevent future deaths from occurring. While there has been broad uptake and learning from low- and middle-income countries, little is known on how to effectively implement MPDSR within humanitarian contexts - where disruptions in health service delivery are common, infrastructural damage and insecurity impact the accessibility of care, and severe financial and human resource shortages limit the quality and capacity to provide services to the most vulnerable. This study aimed to understand how contextual factors influence facility-based MPDSR interventions within five humanitarian contexts.
METHODS: Descriptive case studies were conducted on the implementation of MPDSR in Cox\'s Bazar refugee camps in Bangladesh, refugee settlements in Uganda, South Sudan, Palestine, and Yemen. Desk reviews of case-specific MPDSR documentation and in-depth key informant interviews with 76 stakeholders supporting or directly implementing mortality surveillance interventions were conducted between December 2021 and July 2022. Interviews were recorded, transcribed, and analyzed using Dedoose software. Thematic content analysis was employed to understand the adoption, penetration, sustainability, and fidelity of MPDSR interventions and to facilitate cross-case synthesis of implementation complexities.
RESULTS: Implementation of MPDSR interventions in the five humanitarian settings varied in scope, scale, and approach. Adoption of the interventions and fidelity to established protocols were influenced by availability of financial and human resources, the implementation climate (leadership engagement, health administration and provider buy-in, and community involvement), and complex humanitarian-health system dynamics. Blame culture was pervasive in all contexts, with health providers often facing punishment or criminalization for negligence, threats, and violence. Across contexts, successful implementation was driven by integrating MPDSR within quality improvement efforts, improving community involvement, and adapting programming fit-for-context.
CONCLUSIONS: The unique contextual considerations of humanitarian settings call for a customized approach to implementing MPDSR that best serves the immediate needs of the crisis, aligns with stakeholder priorities, and supports health workers and humanitarian responders in providing care to the most vulnerable populations.

Stüve-Wiedemann syndrome (SWS) is a rare autosomal recessive disorder that is characterized by bowing of long bones, dysautonomia, temperature dysregulation, swallowing and feeding difficulties, and frequent respiratory infections. Respiratory distress and hyperthermic events are the leading causes of early neonatal death, and most patients are not expected to survive past infancy. Here, we report on the survival of a 5-year-old male with SWS, discussing his case presentation, providing a brief clinical course, and discussing the outcome. This case adds to the literature surrounding rare instances of childhood survivors of SWS and raises awareness for this syndrome to facilitate an earlier recognition, intervention, and genetic counseling for the families, thereby improving understanding of this disease and the health outcomes for the children affected by this condition.

There is a growing recognition globally that care regarding lactation following a perinatal death needs to potentially offer the opportunity for maternal donation. This article discusses this experience and perspectives from a human milk bank (HMB) in Vietnam. This is a descriptive exploratory case study that has a long tradition in both the social and health sciences. Triangulated data collection involved a review of video data, interview data with the donor, and data review for the Da Nang HMB, a Center for Excellence in Breastfeeding. We found that although it is common for mothers in Vietnam to donate breastmilk to HMBs, it is less common for this to occur following perinatal loss. We offer a descriptive case study of the maternal loss of twins and a subsequent choice to donate for approximately 1 month to the Da Nang HMB, the first HMB in Vietnam. We discuss four reasons derived from this case regarding donation following perinatal loss. (1) A strong motivation to donate breastmilk when aware of the service, (2) donating breastmilk helped her deal with grief, (3) family members supported her through this tough time and supported her decision, and (4) health staff supported her decision. While human milk sharing (e.g., wet nursing) has been practiced in Vietnam, breastmilk donation from bereaved mothers has neither been discussed nor well-researched. Because maternal grief is complex and individual, deciding to donate breastmilk is a personal decision that needs to be supported, without creating guilt for those who do not wish to donate.

More than half of Bhutan\'s under-five mortality is attributed to neonatal deaths. Despite this, there is a lack of local evidence on determinants of neonatal mortality. It is critical to generate new evidence to accelerate interventions to achieve sufficient reduction of neonatal mortality rate in line to sustainable development goal target 3.2. Thus, this study was aimed at exploring determinants of neonatal mortality in Bhutan. A case-control study was performed with reported neonatal deaths from hospitals and primary health centers between 2018 and 2019. A total of 181 neonatal deaths were included as cases along with three corresponding controls. Epidata and STATA were used for data management and analysis, respectively. A multivariable model was fitted to identify determinants of neonatal mortality. History of obstetric complications (odds ratio [OR] = 3.53; 95% confidence interval [CI] = 1.48-8.42), intrapartum complications (OR = 3.86; 95% CI = 1.71-8.74) gestational age (OR = 8.07; 95% CI = 2.89-22.52), and Apgar 1 minute (OR = 4.40; 95% CI =1.83-10.59) were associated with neonatal death. Therefore, quality of care during pregnancy and childbirth besides promoting supportive family environment is essential to reduce neonatal mortality.

UNASSIGNED: Early neonatal death is an essential epidemiological indicator of maternal and child health.
UNASSIGNED: To identify risk factors for early neonatal deaths in the Gaza Strip.
UNASSIGNED: This hospital-based case-control study included 132 women who experienced neonatal deaths from January to September 2018. The control group comprised 264 women who were selected using systematic random sampling and gave birth to live newborns at the time of data collection.
UNASSIGNED: The controls who had no history of neonatal death or stillbirth were less likely to have an early neonatal death than women who had such history. The controls who did not have meconium aspiration syndrome or amniotic fluid complications were less likely to have an early neonatal death than women who experienced these complications during delivery. The controls who had a singleton birth outcome were less likely to have an early neonatal death than women who had multiple births.
UNASSIGNED: Interventions are needed to provide preconception care, improve the quality of intrapartum and postnatal care, provide high-quality health education, and improve the quality of care provided by neonatal intensive care units in the Gaza Strip.
دراسة حالات وشواهد مستنِدة إلى المستشفيات لعوامل الخطر المتعلقة بوفيات المواليد المبكرة في قطاع غزة.
أسماء النجار، ختام أبو حمد.
UNASSIGNED: تُعدُّ وفيات المواليد المبكرة مؤشرًا وبائيًّا أساسيًّا لصحة الأمهات والأطفال.
UNASSIGNED: هدفت هذه الدراسة إلى تحديد عوامل الخطر المتعلقة بوفيات المواليد المبكرة في قطاع غزة.
UNASSIGNED: شملت دراسة الحالات والشواهد المستنِدة إلى المستشفيات 132 امرأة تُوفي مولودها في المدة من يناير/ كانون الثاني إلى سبتمبر/ أيلول 2018. وتألفت المجموعة الشاهدة من 264 امرأة مُُختارة باستخدام عينة عشوائية منتظمة، وولدت طفلًًا حيًّا في وقت جمع البيانات.
UNASSIGNED: كانت النساء ضمن المجموعة الشاهدة اللاتي لم يسبق أن يملصن أو يُتوفى مواليدهن أقل عرضة لوفاة مواليدهن مبكرًا من النساء اللاتي لهن سوابق في ذلك. وكانت النساء ضمن المجموعة الشاهدة اللاتي لم يعانين من متلازمة اسْتِنشَاق العِقْي أو مضاعفات السائل السَّلَوي أقل عرضة لوفاة مواليدهن مبكرًا من النساء اللاتي عانين من هذه المضاعفات أثناء الولادة. وكانت النساء ضمن المجموعة الشاهدة اللاتي وضعن مواليد فرادى (حمل فردي) أقل عرضة لوفاة مواليدهن مبكرًا من النساء اللاتي ولدن ولادات متعددة (توائم).
UNASSIGNED: يلزم إعداد تدخلات لتوفير الرعاية السابقة للحمل، وتحسين جودة الرعاية أثناء الولادة وبعدها، وتوفير تثقيف صحي عالي الجودة، وتحسين جودة الرعاية التي تقدمها وحدات الرعاية المركزة للحديثي الولادة في قطاع غزة.
Étude cas-témoins en milieu hospitalier des facteurs de risque de mortalité néonatale précoce dans la bande de Gaza.
UNASSIGNED: La mortalité néonatale précoce est un indicateur épidémiologique essentiel de la santé maternelle et infantile.
UNASSIGNED: Identifier les facteurs de risque des décès néonatals précoces dans la bande de Gaza.
UNASSIGNED: La présente étude cas-témoins en milieu hospitalier a été menée auprès de 132 femmes ayant perdu un/des nouveau-né(s) entre janvier et septembre 2018. Le groupe témoin comprenait 264 femmes qui ont été sélectionnées par échantillonnage aléatoire systématique et qui ont donné naissance à des nouveau-nés vivants au moment de la collecte des données.
UNASSIGNED: Les témoins qui n\'avaient pas d\'antécédents de décès néonatal ou de mortinatalité étaient moins susceptibles d\'avoir un décès néonatal précoce que les femmes qui avaient de tels antécédents. Les témoins qui n\'avaient pas de syndrome d\'aspiration méconiale ou de complications au niveau du liquide amniotique étaient moins susceptibles d\'avoir un décès néonatal précoce que les femmes ayant connu ces complications pendant l\'accouchement. Les témoins qui ont eu une grossesse unique avaient une moins grande probabilité d\'avoir un décès néonatal précoce que les femmes ayant eu des naissances multiples.
UNASSIGNED: Il est nécessaire de mettre en place des interventions pour fournir des soins préconceptionnels, améliorer la qualité des soins intrapartum et postnatals, assurer une éducation sanitaire de haute qualité et renforcer la qualité des soins dispensés par les unités de soins intensifs néonatals dans la bande de Gaza.

According to the World health organization, neonatal mortality is defined as the death of babies within the first 28 days of their lives. The newborn period is the most vulnerable period for a child\'s survival, with the bulk of neonatal deaths occurring on the first day and week. According to a recent study, about a third of all newborn deaths occur within the first day of life, and nearly three-quarters occur within the first week. This study aimed to assess the determinants of neonatal mortality among neonates admitted to the neonatal intensive care unit in Dessie comprehensive and specialized hospital, northeast Ethiopia.
Health institution-based unmatched case-control study was conducted among neonates admitted to Dessie comprehensive and specialized hospital, Ethiopia from February 01 up to March 30, 2020. After keeping cases and controls in separate frames, study participants were chosen using a simple random sampling procedure until the sample size was met. Epi data version 7.0 and SPSS version 25 were used for data entry and analysis respectively. P ≤ 0.05 was used as a cut point of statistical significance in multivariable binary logistic regression.
A total of 698 (233 cases and 465 controls) participated in the study. Pregnancy induced hypertension (AOR = 3.02; 95% CI; 1.47-6.17), public hospital delivery (AOR = 3.44; 95% CI; 1.84-6.42), prematurity (AOR = 2.06; 95% CI; 1.43-2.96), being referred (AOR = 4.71; 95% CI; 3.01-7.39), and hypothermia (AOR = 2.44; 95% CI; 1.56-3.82) were determinant factors of neonatal mortality.
Pregnancy-induced hypertension, public hospital delivery, prematurity, referral, and hypothermia were found to be the determinant factors of neonatal mortality. It would be important to give due attention to neonates delivered from mothers with a history of hypertensive disorder. Besides better to give due attention to neonates delivered in public health institutions, prematurely delivered, referred, and hypothermic neonates. Lastly, further research should be conducted to investigate the additional determinants of neonatal mortality.

UNASSIGNED: Neonatal mortality rate (NMR) refers to the number of deaths occurring from birth to 28 days of life per-1000 Live Births (LB). The global NMR declined from 37 deaths per- 1,000 LB in 1990 to 18 in 2017, whereas it was 27 deaths per 1000 LB in the Sub-Saharan region. Ethiopia plans to reduce the NMR from 28 deaths to 11 deaths per 1,000 LB by 2020 and to end all preventable child deaths by 2035. The aim of this study was to identify the determinants of neonatal mortality in the neonatal intensive care unit (NICU) of Dilla University Referral Hospital (DURH).
UNASSIGNED: An age-matched case control study was conducted at DURH\'s NICU. Two controls having age 2 days before or after the case were used for matching. One hundred eighteen cases (died) and 236 controls (survived) neonates admitted to the NICU from January 11, 2018, to February 25, 2020, were studied. Missed data were filled by multiple imputations. Multicollinearity was checked by the variance inflation factor. For variables with a P-value <0.2 on bivariable conditional logistic regression, multivariable conditional logistic regression analysis was performed to control for confounders using clogit command in a survival package to identify the risk factors for neonatal mortality using R version 3.6.3.
UNASSIGNED: Gestational age <37 weeks (Adjusted matched odds ratio (AmOR): 14.02; 95% confidence interval (CI): 3.68-53.46), first-minute APGAR score <7 (AmOR: 5.68; 95% CI: 1.76-18.31), perinatal asphyxia (PNA) (AmOR: 4.62; 95% CI: 1.15-18.53) and being twins (AmOR: 6.84; 95% CI: 1.34-34.96) were significantly associated with neonatal deaths in our study. Furthermore, antenatal care and follow-up during pregnancy (AmOR: 0.15; 95% CI: 0.04-0.53) and having a normal random blood sugar level at admission (AmOR: 0.1; 95% CI: (0.02-0.66) were found to be determinant of neonatal mortalities in our study.
UNASSIGNED: Gestational age less than 37 weeks, first-minute APGAR scores <7, being twins, diagnosis of PNA, antenatal care and follow-up of mothers during pregnancy and normoglycemia in neonates at admission were significant determinant of neonatal death in the NICU of DURH.