Rhombencephalitis in Pregnancy-A Challenging Case of Probable Infection.

Rhombencephalitis refers to inflammation of the brainstem and cerebellum, and can be caused by infections, autoimmune disorders or paraneoplastic syndromes. The most common infective cause is the bacterium Listeria monocytogenes. Listeria monocytogenes is the predominant species to cause human listeriosis, and is commonly due to the ingestion of contaminated foods.

Euglycaemic ketoacidosis in pregnant women with COVID-19: two case reports.

Background: Euglycaemic ketoacidosis (EKA) is an infrequent but serious condition which usually follows a period of starvation, severe vomiting or illness in individuals with or without diabetes. Ketoacidosis is associated with materno-fetal morbidity and mortality necessitating prompt diagnosis and management. Physiological increases in insulin resistance render pregnancy a diabetogenic state with increased susceptibility to ketosis.

Second-trimester uterine artery Doppler in the prediction of stillbirths.

Objective: To examine the role of second-trimester uterine artery Doppler in the prediction of stillbirths.

Methods: Uterine artery pulsatility index (PI) was measured at 20-24 weeks' gestation in 65,819 singleton pregnancies. The PI was converted to multiples of median (MoM) and compared in live births and stillbirths.

Maternal serum vitamin D at 11-13 weeks in pregnancies delivering small for gestational age neonates.

Objectives: To determine if maternal serum levels of 25(OH)D at 11-13 weeks' gestation are altered in pregnancies that subsequently deliver small for gestational age (SGA) neonates and whether the levels are related to placental function reflected in serum concentration of pregnancy-associated plasma protein-A (PAPP-A).

Methods: Serum 25(OH)D and PAPP-A were measured at 11-13 weeks in 150 singleton pregnancies that delivered SGA neonates and 1,000 appropriate for gestational age (AGA) controls. The median 25(OH)D and PAPP-A multiple of the unaffected median (MoM) in the outcome groups were compared.

Normal range of maternal serum vitamin d at 11-13 weeks' gestation.

Objective: To establish a normal range of maternal serum levels of total vitamin D at 11-13 weeks' gestation and examine factors from maternal characteristics and obstetric history affecting these levels.

Methods: Serum 25-hydroxyvitamin D [25(OH)D] was measured by liquid chromatography-tandem mass spectrometry in 1,000 singleton pregnancies with normal outcome. Multiple regression analysis was used to determine the factors from maternal characteristics and obstetric history affecting the measured 25(OH)D levels and the regression model was used to convert each measurement into a multiple of the median (MoM).

Maternal serum adiponectin at 11-13 weeks of gestation in preeclampsia.

Objective: To determine whether the maternal serum levels of adiponectin in the first trimester of pregnancy are altered in cases that develop preeclampsia (PE) and whether the levels are related to pregnancy-associated plasma protein-A (PAPP-A) and uterine artery pulsatility index (PI).

Methods: Serum adiponectin, PAPP-A and uterine artery PI were measured at 11-13 weeks in 90 cases that developed PE, including 30 that required delivery before 34 weeks (early PE) and 300 unaffected controls. The median adiponectin, PAPP-A and uterine artery PI multiple of the unaffected median (MoM) in the outcome groups were compared.

Maternal uterine artery Doppler flow velocimetry and the risk of stillbirth.

Objective: We sought to relate the risk of antepartum stillbirth to uterine artery Doppler flow velocimetry at 22-24 weeks.

Methods: Data were available from 30,519 unselected women from seven units in the UK who had uterine artery Doppler performed between 22 and 24 weeks of gestation. The risk of stillbirth (n=109) was assessed using time to event and logistic regression analysis.

Endothelial nitric oxide synthase gene polymorphism (Glu298Asp) and development of pre-eclampsia: a case-control study and a meta-analysis.

Background: Pre-eclampsia is thought to have an important genetic component. Recently, pre-eclampsia has been associated in some studies with carriage of a common eNOS gene Glu298Asp polymorphism, a variant that leads to the replacement of glutamic acid by aspartic acid at codon 298.

Method: Healthy women with singleton pregnancies were recruited from 7 district general hospitals in London, UK.

First trimester sex hormone-binding globulin and subsequent development of preeclampsia or other adverse pregnancy outcomes.

Objective: To investigate whether first trimester maternal serum sex hormone-binding globulin (SHBG) concentrations are altered in women who subsequently develop preeclampsia or other pregnancy complications.

Population: Women undergoing first trimester combined ultrasound and biochemical screening for chromosomal anomalies. We searched the database and identified 32 pregnancies resulting in miscarriage, 64 pregnancies with preexisting or gestational diabetes mellitus, 107 with fetal growth restriction, 103 with preeclampsia, 64 with pregnancy-induced hypertension, and 26 with spontaneous preterm delivery.

An integrated model for the prediction of preeclampsia using maternal factors and uterine artery Doppler velocimetry in unselected low-risk women.

Objective: The purpose of this study was to develop a predictive model for preeclampsia.

Study Design: This was a prospective screening study for preeclampsia using uterine artery Doppler ultrasound in unselected low-risk singleton pregnancies at community hospitals in the UK (n = 32,157). Logistic regression models were developed and their predictive ability assessed using the area under the receiver operator curve (AROC).

Prediction of pregnancy complications by first-trimester maternal serum PAPP-A and free beta-hCG and with second-trimester uterine artery Doppler.

Background: Previous studies have shown an association between low first trimester maternal serum free beta-hCG and PAPP-A and subsequent development of pregnancy complications. Similarly, uterine artery Doppler in the late second trimester has shown that high impedance to flow is associated with increased risk for preeclampsia and fetal growth restriction. The objective of this study is to determine whether there is an association between the maternal serum concentration of PAPP-A and free beta-hCG at 11-13(+6) weeks with the uterine artery pulsatility index (PI) at 22-24 weeks, and secondly, to compare the screening characteristics of the two methods in the prediction of adverse pregnancy outcome.

Assessment of risk for the development of pre-eclampsia by maternal characteristics and uterine artery Doppler.

Objective: To develop a method for the estimation of patient-specific risk for the development of pre-eclampsia by combining maternal history and uterine artery Doppler.

Design: Prospective multicentre observational study.

Setting: Antenatal clinics in seven hospitals in the UK and three overseas centres.

The role of uterine artery Doppler in predicting adverse pregnancy outcome.

The complications of placental insufficiency, pre-eclampsia and fetal growth restriction (FGR) are major causes of perinatal as well as maternal morbidity and mortality. In normal pregnancy, impedance to flow in the uterine arteries decreases with gestation, and histopathological studies suggest that this is due to trophoblastic invasion of the spiral arteries and their conversion into low-resistance vessels. Failure of trophoblastic invasion is associated with complications of uteroplacental insufficiency.