Front Med (Lausanne)
June 2024
Introduction: Fetuses with growth abnormalities are at an increased risk of adverse neonatal outcomes. The aim of this study was to investigate if placental growth factor (PlGF), soluble fms-like tyrosine kinase-1 (sFlt-1), or the sFlt-1/PlGF ratio were efficient predictive factors of adverse neonatal outcomes in small-for-gestational-age (SGA) newborns.
Methods: A prospective observational multicenter cohort study was performed between 2020 and 2023.
Accurate prediction of fetal weight at birth is essential for effective perinatal care, particularly in the context of antenatal management, which involves determining the timing and mode of delivery. The current standard of care involves performing a prenatal ultrasound 24 hours prior to delivery. However, this task presents challenges as it requires acquiring high-quality images, which becomes difficult during advanced pregnancy due to the lack of amniotic fluid.
View Article and Find Full Text PDFBackground: Fetal weight is currently estimated from fetal biometry parameters using heuristic mathematical formulas. Fetal biometry requires measurements of the fetal head, abdomen, and femur. However, this examination is prone to inter- and intraobserver variability because of factors, such as the experience of the operator, image quality, maternal characteristics, or fetal movements.
View Article and Find Full Text PDFBackground: SARS-CoV-2 infection in pregnant women may induce inflammation within the amniotic cavity and/or an increase in proinflammatory cytokines in fetal circulation. The aim was to investigate levels of IL-6 in maternal blood, umbilical cord blood, and amniotic fluid in pregnant women infected with SARS-CoV-2 at delivery.
Methods: A single-center prospective observational case-control study of pregnant women diagnosed with SARS-CoV-2 infection at delivery was conducted.
BMJ Open
June 2023
Introduction: Cervical insufficiency accounts for 15% of recurrent pregnancy losses between 16 and 28 weeks of gestation. The aim of the study is to verify the effectiveness of emergency double-level cerclage with vaginal progesterone in cervical insufficiency treatment in terms of the prevention of preterm delivery before 34 weeks of gestation.
Methods And Analysis: This trial is a multicentre, non-blinded, randomised study with 1:1 allocation ratio.
Background: Elevated serum levels of sFlt-1 were found in non-pregnant severe COVID-19 patients. The aim was to investigate sFlt-1/PlGF ratio as a predictor of severe disease and adverse outcome in pregnant women with COVID-19.
Methods: A single-center case-control study was conducted in pregnant women with SARS-CoV-2 infection.
Background: Delayed cord clamping increases placental transfusion. In vaginal deliveries higher hemoglobin concentrations are found in the second-born twin. We hypothesized it is unrelated to intertwin transfusion but to the time of cord clamping.
View Article and Find Full Text PDFInt J Environ Res Public Health
April 2022
Placental abruption (PA) is a separation of the placenta from the uterine wall occurring with the fetus still present in the uterine cavity. It contributes to numerous neonatal and maternal complications, increasing morbidity and mortality. We conducted a retrospective study at a tertiary perinatal care center, which included 2210 cases of labor that took place in 2015 with a PA occurrence of 0.
View Article and Find Full Text PDFBackground: In utero limb ischemia is a rare complication of the monochorionic twin pregnancies complicated with twin to twin transfusion syndrome (TTTS). The condition is more often seen in recipient twins. There are few theories of the pathogenesis including in utero venous thromboembolism, but the cause remains unclear.
View Article and Find Full Text PDFWe report an extraordinary case of double pregnancy in patient with uterus didelphys. This anatomic anomaly originates from the lack of fusion of the paired Mullerian ducts during embryological development with 0.3% prevalence in the population.
View Article and Find Full Text PDFBackground: Preeclampsia occurs more often in dichorionic than in monochorionic twin pregnancy. We hypothesize that serum concentrations of biomarkers: placental growth factor (PlGF), serum soluble fms-like tyrosine kinase-1 (sFlt-1), and endoglin (Eng) differ between monochorionic and dichorionic twin pregnancies.
Methods: A prospective observational study including 43 monochorionic and 36 dichorionic twin gestation was conducted.
Background: The multicenter randomized controlled trial Management of Myelomeningocele Study demonstrated that prenatal repair of open spina bifida by hysterotomy, compared with postnatal repair, decreases the need for ventriculoperitoneal shunting and increases the chances of independent ambulation. However, the hysterotomy approach is associated with risks that are inherent to the uterine incision. Fetal surgeons from around the world embarked on fetoscopic open spina bifida repair aiming to reduce maternal and fetal/neonatal risks while preserving the neurologic benefits of in utero surgery to the child.
View Article and Find Full Text PDFJ Clin Med
July 2020
In twin gestation, the relationship between pregnancy associated plasma protein (PAPP-A) and perinatal outcome is unclear. The aim of the study was to determine if low and high concentrations of PAPP-A in the first trimester are related to perinatal outcome in twins. A retrospective study was conducted.
View Article and Find Full Text PDFSpina bifida aperta is a relatively common congenital defect that occurs in the general population. Once the disorder has been diagnosed, a discussion, that can be emotionally-charged, ensues about whether to treat it prenatally or to only offer surgery postnatally. Given that there are good arguments for and against both options, it is of paramount importance to gain a good understanding of the major advantages and disadvantages of the various surgical approaches.
View Article and Find Full Text PDFWe present the first case of a monochorionic twin pregnancy in which sudden hematologic changes occurred as a complication of the amnioreduction procedure for twin-twin transfusion syndrome (TTTS). At 33 weeks of gestation, 4 days after the amnioreduction, the recipient developed severe anemia while the donor developed severe polycythemia. Postnatal placental examination revealed several arteriovenous and venoarterial anastomoses, a pale placental mass of the recipient and a congested and plethoric placental mass of the donor.
View Article and Find Full Text PDFThe incidence of spontaneous triplet pregnancy is approximately 1 in 7000 deliveries. Due to the fact that every presentation of a triplet and higher order pregnancy is associated with high rate of morbidity and preterm delivery, chorionicity and amnionicity remain significant predictive factors which determine specific management throughout the pregnancy. Ultrasound chorionicity assessment in triplet pregnancies is more complex than in twins, and in many cases it remains unknown.
View Article and Find Full Text PDFPurpose: To estimate whether phosphorylated IGFBP-1 (phIGFBP-1) in cervical secretion in term and post-term pregnancies can predict spontaneous onset of labor or vaginal delivery.
Methods: A prospective cohort study of 167 women in singleton term and post-term pregnancies, was conducted at 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, between 2013 and 2014. phIGFBP-1 test (Actim Partus Medix Biochemica), ultrasound cervix assessment and Bishop score were analyzed in the study group.
Background: The influence of pregnancy on graft function in patients after solid organ transplantation is still uncertain.
Material And Methods: Our study is based on a group of 78 cases after liver (LTR) and/or renal transplantation (RTR) with 91 deliveries in the past 12 years in the 1st Department of Obstetrics and Gynecology, Warsaw Medical University. We compared duration of pregnancy, mode of delivery, weight of neonates, and graft function.
Normal trophoblast growth is one of the more important stages of early pregnancy that has a deciding factor on its later development and normal outcome. Identifying pregnant women who have a high risk of complications connected to hypertension during pregnancy is currently one of the most important tasks of perinatal medicine. Abnormal placentation is related not only to the appearance of preeclampsia, but also to many other complications, such as premature placental abruption, intrauterine fetal demise, and intrauterine growth restriction.
View Article and Find Full Text PDFObjectives: The aim of the study was to determine placental growth factor (PIGF) concentration and uterine artery (UtA) Doppler pulsatility index (PI) at 11-13(+6) weeks of gestation in the Polish population.
Material And Methods: A prospective study was performed in pregnant women who underwent routine ultrasound scan at 11-13(+6) weeks of gestation. All participants completed a questionnaire about their medical history demographics and current pregnancy.
Eur J Obstet Gynecol Reprod Biol
September 2014
Objective: Macrosomia and low birth weight (LBW) can be associated with pregnancy complications and may affect the long-term health of the child. The aim of this study was to evaluate the metabolomic serum profiles of healthy pregnant women to identify early biomarkers of macrosomia and LBW and to understand mechanisms leading to abnormal fetal growth not related to mother's body mass index or presence of gestational diabetes.
Method: Serum samples from 770 women were collected between the 12th and 14th gestational week.