Complex cesarean section: Surgical approach to reduce the risks of intraoperative complications and postpartum hemorrhage.

The incidence of cesarean section is dramatically increasing worldwide, whereas the training opportunities for obstetrician/gynecologists to manage complex cesarean section appear to be decreasing. This may be attributed to changing working hours directives and the increasing use of laparoscopy for gynecological surgical procedures, including in gynecological oncology. Various situations can create surgical difficulties during a cesarean section; however, two of the most frequent are complications from previous cesarean (myometrial defects, with or without placental intrusion and peritoneal adhesions) and the high risk of postpartum hemorrhage (uterine overdistension, abnormal placentation, uterine fibroids).

Evaluation of fetal exposure to environmental noise using a computer-generated model.

Acoustic noise can have profound effects on wellbeing, impacting the health of the pregnant mother and the development of the fetus. Mounting evidence suggests neural memory traces are formed by auditory learning in utero. A better understanding of the fetal auditory environment is therefore critical to avoid exposure to damaging noise levels.

The human gestational sac as a choriovitelline placenta during early pregnancy; the secondary yolk sac and organoid models.

The yolk sac is phylogenetically the oldest of the extra-embryonic membranes and plays important roles in nutrient transfer during early pregnancy in many species. In the human this function is considered largely vestigial, in part because the secondary yolk sac never makes contact with the inner surface of the chorionic sac. Instead, it is separated from the chorion by the fluid-filled extra-embryonic coelom and attached to the developing embryo by a relatively long vitelline duct.

Exposure to drinking water pollutants and non-syndromic birth defects: a systematic review and meta-analysis synthesis.

Objectives: To evaluate the association between drinking water pollutants and non-syndromic birth defects.

Design: Systematic review and meta-analysis synthesis.

Data Sources: A search of MEDLINE, EMBASE and Google Scholar was performed to review relevant citations reporting on birth defects in pregnancies exposed to water pollutants between January 1962 and April 2023.

Telemedicine ultrasound assessment for placenta accreta spectrum: Utility and interobserver reliability of asynchronous remote imaging review.

Objective: Management of patients with placenta accreta spectrum (PAS) by trained multidisciplinary teams is associated with improved outcomes. Ultrasound can predict intraoperative risks, but expert ultrasound imaging of PAS is often limited. Telemedicine is used increasingly in obstetrics, permitting expert consultation when essential resources are not available locally.