Uterine Manipulation May Not Influence Ongoing Pregnancy: Case Report and Literature Review.

Abdominal pain is a very common presentation in early pregnancy. Its cause may be gynecological or totally nonpregnancy related. While acute appendicitis is the most common nonobstetric cause of pain in pregnant women, diagnosis and differentiation from other causes, including ectopic pregnancy, remain challenging.

Continuous Glucose Monitoring Feedback in the Subsequent Development of Gestational Diabetes: A Pilot, Randomized, Controlled Trial in Pregnant Women.

Objective: This study evaluated the effects of receiving glucose feedback from continuous glucose monitoring (CGM) by intermittent scanning (unblinded group), and CGM with masked feedback (blinded group) in the subsequent development of gestational diabetes mellitus (GDM).

Study Design: This was a prospective, single-center, pilot, randomized controlled trial including  = 206 pregnant women in the first trimester of pregnancy with no prior diagnosis of type 1 or type 2 diabetes. The participants were randomized into the unblinded group or blinded group and wore the CGM in the first trimester of pregnancy (9-13 weeks), the second trimester of pregnancy (18-23 weeks), and late-second to early-third trimester (24-31 weeks).

Cesarean Scar Pregnancy: Current Understanding and Treatment Including Role of Minimally Invasive Surgical Techniques.

The incidence of cesarean scar pregnancy (CSP) is increasing reflecting the global increase in cesarean section (CS) rate which has almost doubled since 2000. CSP differs from other types of ectopic pregnancy in its ability to progress while still carrying a significant risk of maternal morbidity. Little is known about precise etiology or natural history although current interest in the pathology of placenta accretes spectrum disorders might be enlightening.

Scope and Suction: Hysteroscopic-guided Suction Evacuation of Cesarean Scar Pregnancy - A Safe and Efficacious Treatment for Selected Patients.

Objectives: This study aimed to evaluate hysteroscopic-guided suction evacuation for the treatment of cesarean scar pregnancy (CSP).

Materials And Methods: This was a retrospective analysis of CSP over 2 years. This study was conducted at KK Women's and Children's Hospital (KKH), Singapore, thirty-seven patients with a CSP.

High-intensity Focused Ultrasound for the Treatment of Fibroids: A Single-center Experience in Singapore.

Objectives: Uterine fibroids and adenomyosis are common gynecological conditions that often require surgical treatment. Minimally invasive interventions such as ultrasound-guided high-intensity focused ultrasound (USgHIFU) are gaining popularity as they avoid surgical morbidity and conserve the uterus. We present a single-center experience on the use of USgHIFU for the treatment of fibroids and adenomyosis.

Epidemiology of stillbirths based on different gestational thresholds at a tertiary hospital.

Introduction: The stillbirth rate (SBR) is an important public health indicator. We studied the distribution of maternal and fetal characteristics and time trends of the SBR at KK Women's and Children's Hospital (KKH), Singapore, from 2004 to 2016 based on various definitions of stillbirth.

Methods: Data was obtained from the Data Warehouse and Stillbirth Reporting System of KKH from 2004 to 2016.

Association between gestational weight gain and pregnancy outcomes in a Singaporean population: A prospective cohort study.

Objectives: Inadequate or excessive gestational weight gain (GWG) is associated with adverse pregnancy outcomes. We aimed to study GWG in a Singaporean population and its association with pregnancy outcomes, including small for gestational age (SGA), macrosomia, and caesarean section secondary to failure to progress (FTP) or cephalopelvic disproportion (CPD).

Study Design: 926 women with low-risk singleton pregnancy were enrolled in a prospective cohort study from 2010 to 2014 in a Singapore tertiary maternity hospital.

Sleep quality and BMI in pregnancy- a prospective cohort study.

Background: Pregnancy associated sleep disturbances is a common pregnancy-related complication which can lead to significant maternal distress and adverse pregnancy outcomes. Sleep quality can be affected by multiple factors and obesity has been recognized as one of them. Various previous studies have demonstrated poorer sleep quality during pregnancy.

Discovery and validation of peritoneal endometriosis biomarkers in peritoneal fluid and serum.

Research Question: What are the potential biomarkers for peritoneal endometriosis in peritoneal fluid and serum?

Design: Case-control studies composed of independent discovery and validation sets were conducted. In the discovery set, untargeted liquid chromatography-mass spectrometry (LC-MS/MS) metabolomics, multivariable and univariable analyses were conducted to generate global metabolomic profiles of peritoneal fluid for endometriosis and to identify potential metabolites that could distinguish peritoneal endometriosis (n = 10) from controls (n = 31). The identified metabolites from the discovery set were validated in independent peritoneal fluid (n =19 peritoneal endometriosis and n = 20 controls) and serum samples (n = 16 peritoneal endometriosis and n = 19 controls) using targeted metabolomics.

Interstitial Ectopic Pregnancy and Laparoscopic Removal of the Interstitial Portion of the Tube: the New Frontier?

We present a case of a 40-year-old lady with 9 weeks of amenorrhea diagnosed with an interstitial pregnancy and multiple uterine fibroids. She underwent laparoscopic salpingectomy including the interstitial part of fallopian tube with products of conception without myomectomy and cornuostomy. Intra-operative blood loss was minimal.

Mean arterial pressure for predicting preeclampsia in Asian women: a longitudinal cohort study.

Objective: Previous studies suggested mean arterial pressure (MAP) had moderate predictive values in the first and second trimesters for the prediction of preeclampsia. However, the performance of MAP in Asian women is still unclear. The objective of this study was to examine the predictive values of MAP in Asian population throughout gestation, and to compare the performance of MAP, angiogenic factors and uterine artery Doppler in the prediction of preeclampsia.

Risk factors and outcomes of uterine rupture in Singapore: Emerging trends.

Introduction: Uterine rupture is uncommon but has catastrophic implications on the pregnancy. A scarred uterus and abnormal placentation are known contributory factors. The aim of our study was to review the contributing factors, clinical presentation, complications and management of uterine rupture in our population in light of the changing nature of modern obstetric practices.

Cohort profile: Singapore Preconception Study of Long-Term Maternal and Child Outcomes (S-PRESTO).

The Singapore Preconception Study of Long-Term Maternal and Child Outcomes (S-PRESTO) is a preconception, longitudinal cohort study that aims to study the effects of nutrition, lifestyle, and maternal mood prior to and during pregnancy on the epigenome of the offspring and clinically important outcomes including duration of gestation, fetal growth, metabolic and neural phenotypes in the offspring. Between February 2015 and October 2017, the S-PRESTO study recruited 1039 Chinese, Malay or Indian (or any combinations thereof) women aged 18-45 years and who intended to get pregnant and deliver in Singapore, resulting in 1032 unique participants and 373 children born in the cohort. The participants were followed up for 3 visits during the preconception phase and censored at 12 months of follow up if pregnancy was not achieved (N = 557 censored).

Author Correction: Anthropometric measures and HbA1c to detect dysglycemia in young Asian women planning conception: The S-PRESTO cohort.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Anthropometric measures and HbA1c to detect dysglycemia in young Asian women planning conception: The S-PRESTO cohort.

We investigated whether adding anthropometric measures to HbA1c would have stronger discriminative ability over HbA1c alone in detecting dysglycemia (diabetes and prediabetes) among Asian women trying to conceive. Among 971 Singaporean women, multiple regression models and area under receiver-operating characteristic (AUROC) curves were used to analyze associations of anthropometric (weight, height, waist/hip circumferences, 4-site skinfold thicknesses) and HbA1c z-scores with dysglycemia (fasting glucose ≥6.1 mmol/L with 2-hour glucose ≥7.

Peritoneal Fluid Cytokines Reveal New Insights of Endometriosis Subphenotypes.

Endometriosis is a common inflammatory gynecological disorder which causes pelvic scarring, pain, and infertility, characterized by the implantation of endometrial-like lesions outside the uterus. The peritoneum, ovaries, and deep soft tissues are the commonly involved sites, and endometriotic lesions can be classified into three subphenotypes: superficial peritoneal endometriosis (PE), ovarian endometrioma (OE), and deep infiltrating endometriosis (DIE). In 132 women diagnosed laparoscopically with and without endometriosis ( = 73, 59 respectively), and stratified into PE, OE, and DIE, peritoneal fluids (PF) were characterized for 48 cytokines by using multiplex immunoassays.

Spontaneous preterm birth and cervical length in a pregnant Asian population.

Objective: Preterm birth (birth before 37 weeks of completed gestation) is the leading cause of neonatal death, and has an incidence of 5-13% which is believed to be on the rise. The objective of this study was to determine the rate of spontaneous preterm birth and investigate the relationship between preterm birth and cervical length in a pregnant Asian population.

Materials And Methods: A prospective observational study between September 2010 and November 2013 was performed at KK Women's and Children's Hospital, Singapore.

Trajectories of antenatal maternal psychological stress and their association with gestational age and neonatal anthropometry: A prospective cohort study of multi-ethnic Asian women in an urban setting.

Purpose: To determine common temporal change patterns (i.e., trajectories) of perceived antenatal psychological stress throughout the pregnancy, and to examine associations between these identified trajectories and neonatal birth outcomes.

Angiogenic factors during pregnancy in Asian women with elevated blood pressure in early pregnancy and the risk of preeclampsia: a longitudinal cohort study.

Objective: It remains unclear what roles placenta-originated angiogenic factors play in the pathogenesis of preeclampsia among hypertensive women. We compared maternal soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF) levels throughout pregnancy in women with normal blood pressure (BP), elevated BP and hypertension in early pregnancy and their risks of developing preeclampsia.

Design: A prospective cohort study.

Identifying trajectories of antenatal depression in women and their associations with gestational age and neonatal anthropometry: A prospective cohort study.

Objective: The present study sought to determine the longitudinal trajectories of antenatal depression and examine their associations with birth outcomes.

Method: 926 healthy women with uncomplicated singleton pregnancies within 14 weeks of gestation participated in this prospective cohort study. Women completed a sociodemographic and medical questionnaire and the locally-validated Edinburgh Postnatal Depression Scale (EPDS) in their first, second, and third trimesters, and prior to parturition.

Maternal night-eating pattern and glucose tolerance during pregnancy: study protocol for a longitudinal study.

Introduction: Coordinating eating schedules with day-night cycles has been shown to improve glucose regulation in adults, but its association with gestational glycaemia is less clear. A better understanding on how eating time can influence glucose levels in pregnancy may improve strategies for gestational glycaemic control. This study aims to examine the association of maternal night-eating pattern with glucose tolerance in the second trimester of pregnancy, and to investigate how lifestyle factors may be related to night-eating pattern.

Are women in Singapore gaining weight appropriately during pregnancy: a prospective cohort study.

Background: We aimed to study gestational weight gain (GWG) in a Singaporean population and compare it with Institute of Medicine (IOM) 2009 GWG guidelines.

Methods: Nine hundred twenty-six women with low-risk singleton pregnancy were enrolled in a prospective cohort study from 2010 to 2014 in a Singapore tertiary maternity hospital. Seven hundred twenty-four patients had maternal weight information till term pregnancy and were included in analysis.

Longitudinal circulating placental growth factor (PlGF) and soluble FMS-like tyrosine kinase-1 (sFlt-1) concentrations during pregnancy in Asian women: a prospective cohort study.

Objectives: To analyse the placental growth factor (PlGF) and soluble FMS-like tyrosine kinase-1 (sFlt-1) trends in the normal pregnant Asian population in Singapore.

Design: A prospective study was conducted.

Setting: The largest tertiary hospital in Singapore.