OBJECTIVE: To evaluate the predictive value of thromboelastography, routine blood indices, ultrasound measurements, and placental thickness for fetal outcome.
METHODS: A retrospective analysis of 218 expectant mothers at our hospital from April 2020 to June 2022 was conducted. Mothers were classified into favorable (n=164) and adverse (n=54) fetal outcome groups. We compared thromboelastography, blood counts, and ultrasound parameters, including placental thickness, between the two groups. Predictive models using lasso regression were developed for individual assessment type and their combinations. Model efficacies were evaluated by ROC curves and Delong\'s test.
RESULTS: Thromboelastography indicated significantly higher values of R (P=0.004), Angle (P<0.001), and MA (P=0.002) while notably lower K (P<0.001) in the adverse outcome group compared to the favorable outcome group. Peripheral blood analysis showed elevated levels of WBC (P<0.001), CRP (P=0.001), and PLR (P<0.001) in the adverse outcome group. Ultrasound assessments revealed significant increases in S/D (P<0.001), PI (P=0.016), RI (P<0.001), and placental thickness (P<0.001) in the adverse outcome group. The areas under the curve (AUCs) for the thromboelastography (4 features), peripheral blood indices (3 features), ultrasound parameters (4 features), and combined index model (11 features) were 0.774, 0.779, 0.961, and 0.978, respectively. Delong\'s test indicated that the combined model\'s AUC did not significantly differ from that of the ultrasound parameters (P>0.05) but was superior to the models based on thromboelastography, peripheral blood indices, and placental thickness alone (P<0.001).
CONCLUSIONS: This study underscores the unparalleled predictive value of ultrasound metrics in identifying the risk of adverse pregnancy outcomes, highlighting their critical role in prenatal risk assessment and monitoring frameworks.

With the postponement of female reproductive age and the higher incidence of cancer in young people, fertility preservation has become increasingly important in childbearing age. Chemotherapy during pregnancy is crucial for maternal cancer treatments and fetal outcomes. It is a need to further study ovarian damage caused by chemotherapy drug combinations and long-term effects on offspring development, and a detailed understanding of side effects of chemotherapy drugs. In this study, chemotherapy drug combinations significantly impacted on ovarian function, especially epirubicin/cyclophosphamide (EC) combination led to an unbalance in the development of the left and right ovary. Exposure to EC and cisplatin/paclitaxel (TP) increased the number of progenitor follicles while decreased the count of antral follicles and corpora luteum. As to the estrus cycle, EC exposure resulted in a longer estrus period and diestrus period, while TP exposure only extended the diestrus period. EC and TP affected steroid biosynthesis by reducing the expression of SF1 and P450arom.γ-H2AX was detected in both EC and TP exposure groups. As to the impact on the offspring from 4T1 tumor-bearing pregnant mice injected with EC, no significant difference was observed in the physical and neurological development compared to the control, but the ovarian weights, estrus cycles of the offspring were significantly different. Chemotherapy drug combinations exhibit ovarian toxicity, not only causing direct damage on the follicle cells but also disrupting steroid biosynthesis. The reproductive system of offspring from maternal tumor-bearing mice exposed to chemotherapy drugs was observed disorder, but the concrete mechanism still needs further exploration.

UNASSIGNED: The global problem of teenage pregnancy affects health of the young mother as well as health of the baby to be born. Being both a medical and public health problem, teenage mothers as well as their children are considered as high-risk groups. Current research work is a community-based comparative study to understand the consequences of teenage pregnancy on the health, nutrition, and developmental milestones of the first-born children.
UNASSIGNED: Three parameters, namely, fetal outcome, birth weight of the baby, and child\'s milestones of development, were chosen to analyze the effects of teenage pregnancy on the first-born child. Mothers in a rural district at Bhopal were interviewed and then classified into two groups based on their age - teenage and non-teenage mothers.
UNASSIGNED: The child of teenage mothers had 16% less chances of having birth weight >2.5 kg in comparison to the child of non-teenage mothers. A significant statistical difference in the fetal outcome (teenage mothers vs non-teenage mothers) was observed with a P value of 0.0008. Live births were 80.77% (63) in teenage mothers against 97.44% (76) in non-teenage mothers, whereas a low birth weight (LBW) of <1.5 kg was 5.35 times more in the teenage group.
UNASSIGNED: First-born children of non-teenage mothers were found to be healthier compared to those of the teenage mothers; teenage pregnancy has adverse effects on the health, nutrition, and development of the first-born children and may lead to problems such as still births, LBW, and pre-mature child birth.

BACKGROUND: Family support is one of the determinants of lifestyle habits and relevant health behavior for pregnancy outcomes. In India, the joint family system is still practiced. Due to education, urbanization, and industrialization, the family institution continues to play a central role in people\'s lives. Pregnancy is a crucial period in women\'s lives. Good care during pregnancy is important for the health of the mother and the newborn baby. During this period, hormonal changes are complex and involve multiple hormones working together to support the developing fetus and prepare the mother\'s body for labor, delivery, and breastfeeding. To avoid maternal and fetal complications, she needs support from her family throughout pregnancy and the postnatal period.
OBJECTIVE: This study aims to evaluate the influence of the level and quality of family support during pregnancy on maternal and fetal outcomes and to identify any association between the sociodemographic variables and the impact of the level and quality of family support during the first trimester.
METHODS: This study used a quantitative approach with a survey research design. Data were collected from four Primary Health Centers at Karad, Maharashtra, India, i.e., Rethare, Vadgaon, Kale, and Supane. A consecutive sampling technique was used to select the 344 subjects from the Rethare, Vadgaon, Kale, and Supane areas of Karad Taluka. Data were collected before the completion of the first three months of pregnancy, then during the second trimester and after delivery. Upon evaluation, the tool was validated by experts representing a range of specialties, including community health nursing, mental health nursing, obstetric gynecology, and pediatric care. A pilot study was conducted on 30 samples. The data collected were analyzed by using descriptive and inferential statistics.
RESULTS: The findings of the study show a significant association between the psychosocial support received in the first trimester and the total gestational weeks completed at the time of delivery (p < 0.05). The study suggests the need for psychosocial support during the first trimester for better maternal and fetal outcomes.
CONCLUSIONS: Psychosocial family support is needed by pregnant women during the first trimester to achieve maternal and fetal outcomes.

Introduction: Teenage pregnancy is a global public health challenge, and it is a major contributor to the high maternal and neonatal morbidity and mortality rates reported in sub-Saharan Africa and Uganda. However, there is a paucity of data regarding pregnancy outcomes and their associated factors among teenagers in Uganda. The purpose of this study was to determine the prevalence and factors associated with pregnancy outcomes among teenagers who delivered at a National Referral Hospital in Kampala, Uganda. Materials and Methods: This cross-sectional study was conducted among teenage mothers who delivered at a National Referral Hospital in Kampala, Uganda. Consecutive participant recruitment was done for those who fulfilled the eligibility criteria. The outcomes of interest included adverse maternal outcome with obstructed labor being used as a proxy and adverse fetal outcomes with birth asphyxia used as a proxy. Logistic regression analysis was used to determine the association between independent and dependent variables with a 5% level of statistical significance (α = 0.05). Results: Teenage pregnancy was associated with adverse maternal outcomes which included obstructed labor (18%) and preterm labor (5.5%). There were no maternal deaths during the study period. Adverse fetal outcomes observed in this study population included low birth weight (83%), birth asphyxia (18%), and stillbirth (4%). The only factor associated with adverse maternal outcome was gestational age where teenage mothers had 4 times likelihood of delivering before 37 weeks. Relatedly, teenage mothers had an 81% chance of having a preterm birth. Conclusion: Teenage pregnancy was generally not associated with adverse maternal or fetal outcomes except for preterm birth. The reasons for adverse pregnancy outcomes may reflect a combination of gynecological and biological immaturity, as well as adverse socioeconomic pressures.

OBJECTIVE: The debate about the safest birth mode for breech presentation at term remains unresolved. The comparison of a vaginal breech birth (VBB) with an elective caesarean section (CS) regarding fetal outcomes favors the CS. However, the question of whether attempting a VBB is associated with poorer fetal outcomes is examined in this study. Additionally, the study evaluates factors contributing to a successful VBB and illustrates possible errors in VBB management.
METHODS: We performed a retrospective analysis of term breech births over 15 years in a Perinatal Center Level I regarding fetal, maternal, and obstetric outcomes by comparing successful with unsuccessful VBB attempt and all attempted VBB vs. CS including a multivariate analysis of predictors for a successful VBB. A root cause analysis of severe adverse events (SAE) was conducted to evaluate factors leading to poorer fetal outcomes in VBB.
RESULTS: Of 863 breech cases, in 78 % a CS was performed and in 22 % a VBB was attempted, with 57 % succeeding. Comparing successful with unsuccessful VBB attempts, successful VBB showed significantly lower maternal blood loss (p < 0.001) but poorer umbilical arterial pH (UApH) (p < 0.001), while other fetal outcome parameters showed no significant differences. Predictive factors for a successful VBB attempt were a body mass index (BMI) below 30.0 kg/m2 (p = 0.010) and multiparity (p = 0.003). Comparing all attempted VBB to CS, maternal blood loss was significantly higher in CS (p < 0.001), while fetal outcomes were significantly worse in VBB attempts, included poorer Apgar scores (p < 0.001), poorer UApH values (p < 0.001), higher transfer rate to the Neonatal Intensive Care Unit (NICU) (p < 0.001) and higher rate of respiratory support in the first 24 h (p = 0.003).
CONCLUSIONS: The failed attempt of VBB indicates significantly worse UApH without lower Apgar scores or higher transfer rate to the NICU. The likelihood of a successful VBB is 9% lower with obesity and 2.5 times higher in multiparous women. Attempting a VBB should include detailed pre-labor counseling, regarding predictive success factors, an experienced team, and consistent management during birth.

Introduction Domestic violence (DV) in the form of verbal abuse is very common among women, especially pregnant women, posing as a serious public health issue that could lead to complications in pregnancy and threaten maternal and fetal outcomes. Studies have determined that domestic verbal abuse (DVA) in pregnancy was more common in women less than 25 years of age as well as in those with low education levels. This study determined the overall prevalence of verbal abuse in pregnant women, in a semi-urban population and is unique in that the verbal abuse in pregnant women with a previous girl child was also determined. This study helps healthcare providers identify the potential causes of DVA in pregnancy and provide timely interventions in the form of counseling for pregnant women and families. Objective This observational study was carried out to assess the prevalence of DVA among pregnant women, to determine the trimester of occurrence of DVA among pregnant women, and to explore the associations of DVA with age, employment status, parity gestational age, and birth weight.  Materials and methods This was a six-month hospital-based observational study conducted at Dr D. Y. Patil Medical College\'s in-patient department (IPD) of Obstetrics and Gynecology in Pimpri, Pune. Consent was obtained from 200 pregnant women who received admission for delivery and provided a validated modified copy of a DV assessment screening questionnaire. A statistical analysis was performed using GraphPad Prism 10. A Chi-square test was employed wherever required, and a p-value of less than 0.05 was considered significant. Results The study included 200 pregnant women, who were admitted to the hospital for delivery. The prevalence of DV in the form of verbal abuse was noted to be 74 out of 200 (37%). The working status of the woman showed an influence on DVA. There was also a significant increase in verbal abuse (68%) among the age group between 18 and 23 years. The previous delivery of a female child also had a significant impact on DVA, which turned out to be more prevalent, particularly if two female children were born previously (80%). The study also noted higher rates of preterm deliveries in pregnant women with DVA being 57%. Conclusion The study demonstrates that women, even in modern times, experience DVA during pregnancy, especially among the younger age group. It has also been found that it is more common among women who are financially dependent due to maternal unemployment. As a result, there is a need to routinely screen pregnant women for DVA to avoid potentially detrimental pregnancy outcomes and to prevent ongoing abuse.

BACKGROUND: The implication of intermediately elevated fasting plasma glucose (FPG) in the first trimester of pregnancy is uncertain.
OBJECTIVE: The primary outcome of the meta-analysis was to analyze if intermediately elevated first-trimester FPG could predict development of GDM at 24-28 weeks. The secondary outcomes were to determine if the commonly used FPG cut-offs 5.1 mmol/L (92 mg/dL), 5.6 mmol/L (100 mg/dL), and 6.1 mmol/L (110 mg/dL) correlated with adverse pregnancy events.
METHODS: Databases were searched for articles published from 2010 onwards for studies examining the relationship between first-trimester FPG and adverse fetomaternal outcomes.
METHODS: A total of sixteen studies involving 115,899 pregnancies satisfied the inclusion criteria.
METHODS: Women who developed GDM had a significantly higher first-trimester FPG than those who did not [MD 0.29 mmoL/l (5 mg/dL); 95 % CI: 0.21-0.38; P < 0.00001]. First-trimester FPG ≥5.1 mmol/L (92 mg/dL) predicted the development of GDM at 24-28 weeks [RR 3.93 (95 % CI: 2.67-5.77); P < 0.0000], pre-eclampsia [RR 1.55 (95%CI:1.14-2.12); P = 0.006], gestational hypertension [RR1.47 (95%CI:1.20-1.79); P = 0.0001], large-for-gestational-age (LGA) [RR 1.32 (95%CI:1.13-1.54); P = 0.0004], and macrosomia [RR1.29 (95%CI:1.15-1.44); P < 0.001]. However, at the above threshold, the rates of preterm delivery, lower-segment cesarean section (LSCS), small-for gestational age (SGA), and neonatal hypoglycemia were not significantly higher. First-trimester FPG ≥5.6 mmol/L (100 mg/dL) correlated with occurrence of macrosomia [RR1.47 (95 % CI:1.22-1.79); P < 0.0001], LGA [RR 1.43 (95%CI:1.24-1.65); P < 0.00001], and preterm delivery [RR1.51 (95%CI:1.15-1.98); P = 0.003], but not SGA and LSCS.
CONCLUSIONS: Only one study reported outcomes at first-trimester FPG of 6.1 mmol/L (110 mg/dL), and hence was not analyzed.
CONCLUSIONS: The risk of development of GDM at 24-28 weeks increased linearly with higher first-trimester FPG. First trimester FPG cut-offs of 5.1 mmol/L (92 mg/dL) and 5.6 mmol/L (100 mg/dL) predicted several adverse pregnancy outcomes.

OBJECTIVE: We present low-level mosaic trisomy 21 at amniocentesis and cordocentesis in a pregnancy associated with a favorable fetal outcome.
METHODS: A 26-year-old, primigravid woman underwent amniocentesis at 17 weeks of gestation because of positive non-invasive prenatal testing (NIPT) for trisomy 21 at 16 weeks of gestation. Amniocentesis revealed a karyotype of 47,XX,+21[3]/46,XX[17], and multiplex ligation-dependent probe amplification (MLPA) on uncultured amniocytes revealed rsa X(P095) × 2, (13, 18, 21) × 2. She underwent cordocentesis (cord blood sampling) at 21 weeks of gestation which revealed a karyotype of 47,XX,+21[2]/46,XX[48]. At 27 weeks of gestation, she was referred to our hospital for genetic counseling, and repeat amniocentesis revealed a karyotype of 46,XX in 20/20 colonies. Quantitative fluorescent polymerase chain reaction (QF-PCR) analysis on the DNA extracted from uncultured amniocytes and parental bloods excluded uniparental disomy (UPD) 21. Array comparative genomic hybridization (aCGH) analysis on the DNA extracted from uncultured amniocytes revealed arr (1-22,X) × 2, Y × 0 with no genomic imbalance. Interphase fluorescence in situ hybridization (FISH) analysis on 104 uncultured amniocytes detected one cell (1/104 = 0.9%) with trisomy 21, while the rest cells were disomy 21, compared with 0% (0/100) in the normal control. The woman was encouraged to continue the pregnancy. The pregnancy was carried to 38 weeks of gestation, and a 2771-g female baby was delivered no phenotypic abnormality. aCGH analysis on the cord blood showed arr (1-22,X) × 2, Y × 0 with no genomic imbalance. The umbilical cord had a karyotype of 47,XX,+21[3]/46,XX[37]. The placenta had a karyotype of 46,XX. When follow-up at age 3½ months, the neonate was phenotypically normal and had normal development. The peripheral blood had a karyotype of 46,XX in 40/40 cells. Interphase FISH analysis on buccal mucosal cells detected normal disomy 21 cells in 100/100 cells.
CONCLUSIONS: Low-level mosaic trisomy 21 at amniocentesis and cordocentesis in the second trimester can be associated with perinatal progressive decrease of the trisomy 21 cell line and a favorable fetal outcome.

OBJECTIVE: Preeclampsia (PE) is a major cause of maternal and fetal mortality, and preterm birth. Previous studies indicate that lipid-apheresis may prolong pregnancy, namely heparin-mediated extracorporeal LDL-precipitation (HELP)- and dextran sulfate cellulose (DSC)-apheresis. We now report on double membrane plasmapheresis (DFPP) in early-onset preeclampsia (eoPE).
METHODS: Open pilot study assessing the prolongation of pregnancy in PE by lipoprotein-apheresis (DRKS00004527). Two women with eoPE were treated by DFPP and compared to a historical cohort of 6 patients with eoPE treated by HELP-apheresis (NCT01967355).
METHODS: Clinical outcome of mothers and babies and prolongation of pregnancies (time of admission to birth).
RESULTS: Patient 1 (33y; 22 + 5/7GW) received 4 DFPP. Delivery day 19; birthweight 270 g; weight at discharge 2134 g on day 132. Patient 2 (35y; 21 + 4/7GW) received 2 DFPP. Delivery day 19; birthweight 465 g; weight at discharge 2540 g on day 104. DFPP was well tolerated by both patients.
CONCLUSIONS: DFPP proved to be save and pregnancies remained stable as long as 19 days. Although babies were born very preterm both babies could finally be dismissed from hospital. No relevant clinical differences between DFPP and HELP-apheresis could be observed. Therefore, DFPP may extend the range of available apheresis techniques to prolong pregnancies in early-onset preeclampsia. However, further studies are necessary to gain more information. REGISTER: (DRKS00004527).