Obstetricians and midwives perspective of the alarming high cesarean section rates in Greece and worldwide.

Introduction: This study aimed to outline the perspectives of obstetricians/gynecologists (physicians) and midwives regarding the alarmingly high rates of cesarean sections (CSs) to identify areas for improvement and describe the role of a regional obstetric quality initiative.

Material And Methods: A cross-sectional study was performed utilizing real-world data from questionaries provided to Greek midwives and obstetricians. Primary outcomes included the attitudes of Greek physicians and midwives toward the CS rates in Greece and around the world, as well as identifying potential solutions for lowering these rates.

Selective fetal reduction of uncomplicated dichorionic twins on parental request vs ongoing twins and pregnancy outcomes: a systematic review and meta-analysis.

Objective: This study aimed to assess the effect of elective fetal reduction on maternal-fetal outcomes in uncomplicated twin pregnancies compared with ongoing twin pregnancies.

Data Sources: The data sources included PubMed, Scopus (until December 2023), and references of retrieved articles.

Study Eligibility Criteria: We included clinical studies examining the association between selective fetal reduction of uncomplicated dichorionic twins on pregnancy outcomes.

Safety of COVID-19 Vaccination in Pregnancy: A Systematic Review.

The COVID-19 pandemic has posed significant risks to pregnant women and those recently pregnant, leading to heightened mortality and morbidity rates. Vaccination has emerged as a pivotal strategy in reducing COVID-19-related deaths and illnesses worldwide. However, the initial exclusion of pregnant individuals from most clinical trials raised concerns about vaccine safety in this population, contributing to vaccine hesitancy.

Genomic abnormalities in apparently isolated polyhydramnios and the role of confirmed fetal phenotype: a systematic review and meta-analysis.

Objective: The aim of this systematic review and meta-analysis was to assess the rate of genomic abnormalities detected in pregnancies with apparently isolated hydramnios and to explore the role of confirmed fetal phenotype.

Data Sources: The PubMed, Cochrane Library, Google Scholar, and Scopus databases were searched up to May 4, 2024.

Study Eligibility Criteria: Observational studies that were published after the year 2000, written in a European language, and that reported the genomic outcomes of pregnancies complicated by prenatally diagnosed isolated polyhydramnios were included in this meta-analysis.

A novel ABCC9 variant in a Greek family with Cantu syndrome affecting multiple generations highlights the functional role of the SUR2B NBD1.

Cantu syndrome (CS) (OMIM #239850) is an autosomal dominant multiorgan system condition, associated with a characteristic facial phenotype, hypertrichosis, and multiple cardiovascular complications. CS is caused by gain-of-function (GOF) variants in KCNJ8 or ABCC9 that encode pore-forming Kir6.1 and regulatory SUR2 subunits of ATP-sensitive potassium (K) channels.

Breaking Bad News During Prenatal Screening: The Role of Professional Obstetricians and Midwives in Greece.

Introduction: Breaking bad news is one of the most difficult responsibilities in medical practice. Although medical staff in clinical practice often encounter situations that necessitate the announcement of unpleasant news, there is a lack of training regarding their communication with patients and their families. Effective interaction between medical staff and pregnant women constitutes a crucial component of breaking down unpleasant news.

Effect of type III female genital mutilation on obstetric outcomes: A systematic review and meta-analysis.

Background: Controversial evidence suggests a potential association between female genital mutilation (FGM/C) and adverse obstetric outcomes, with type III FGM/C (infibulation) carrying the greatest risk. The aim of this systematic review and meta-analysis was to assess current rate of adverse obstetric outcomes in women with type III female genital mutilation and cutting (FGM/C; infibulation) delivering across different settings worldwide.

Methods: PubMed, Scopus, Embase, and ClinicalTrials.

The Effect of Maternal Diet and Physical Activity on the Epigenome of the Offspring.

The aim of this review was to examine the current literature regarding the effect of maternal lifestyle interventions (i.e., diet and physical activity) on the epigenome of the offspring.

Uterine Arteries Resistance in Pregnant Women with Gestational Diabetes Mellitus, Diabetes Mellitus Type 1, Diabetes Mellitus Type 2, and Uncomplicated Pregnancies.

Background: The examination of the uterine arteries using Doppler in the first trimester of pregnancy serves as a valuable tool for evaluating the uteroplacental circulation. Diabetes mellitus is associated with altered placental implantation and pregnancy-related pathologies, such as preeclampsia. The aim of this study was to compare the uterine arteries' pulsatility indices (UtA PI) in women with diabetes mellitus type 1 (DM1), diabetes mellitus type 2 (DM2), gestational diabetes mellitus (GDM), and uncomplicated pregnancies.

Sentinel lymph node biopsy for breast cancer during pregnancy: A comprehensive update.

Background: Pregnant patients diagnosed with breast cancer (PrBC) may receive substantially different treatments compared to general population, considering that certain treatment options cannot be applied during pregnancy due to their potential harmful effects to the foetus. Regarding the use of sentinel lymph node biopsy (SLNB) in pregnant patients, potential concerns include foetal harm from radiation exposure, possible teratogenic effects of blue dyes and maternal anaphylaxis to isosulfan.

Objective: The main objective of the present systematic review is to summarize and present current knowledge and up-to-date evidence about the safety and efficacy of SLNB in PABC.

Validation of Fetal Medicine Foundation competing-risks model for small-for-gestational-age neonate in early third trimester.

Objective: To evaluate the new 36-week Fetal Medicine Foundation (FMF) competing-risks model for the prediction of small-for-gestational age (SGA) at an earlier gestation of 30 + 0 to 34 + 0 weeks.

Methods: This was a retrospective multicenter cohort study of prospectively collected data on 3012 women with a singleton pregnancy undergoing ultrasound examination at 30 + 0 to 34 + 0 weeks' gestation as part of a universal screening program. We used the default FMF competing-risks model for prediction of SGA at 36 weeks' gestation combining maternal factors (age, obstetric and medical history, weight, height, smoking status, race, mode of conception), estimated fetal weight (EFW) and uterine artery pulsatility index (UtA-PI) to calculate risks for different cut-offs of birth-weight percentile and gestational age at delivery.

Pregnancy outcomes in the different phenotypes of gestational diabetes mellitus based on the oral glucose tolerance test. A systematic review and meta-analysis.

Aims: To assess the prevalence variation in pregnancy outcomes of the different phenotypes of gestational diabetes mellitus (GDM).

Materials: Cohort, cross sectional and case control studies grouping together pregnant women with GDM, based on the results of oral glucose tolerance test(OGTT) and reporting pregnancy outcomes in each group, were included. The primary outcomes were (i)large for gestational age and ii)hypertensive disorders of pregnancy (HDP).

The Effect of Resolution Level and Targeted Design in the Diagnostic Performance of Prenatal Chromosomal Microarray Analysis.

Introduction: This study was performed to assess the optimal resolution for prenatal testing by array comparative genomic hybridization (aCGH), aiming to balance between maximum diagnostic yield and minimal detection of variants of uncertain significance (VOUS).

Methods: This was a prospective study using data of 2,336 fetuses that underwent invasive prenatal diagnosis, and the samples were analyzed by aCGH. In total, six different aCGH platforms were studied; four different resolutions (0.

The effect of valacyclovir on secondary prevention of congenital cytomegalovirus infection, following primary maternal infection acquired periconceptionally or in the first trimester of pregnancy. An individual patient data meta-analysis.

Objective: Recent studies have shown that a dosage of 8 g/d of oral valacyclovir reduces substantially the vertical transmission rate of cytomegalovirus in women with primary cytomegalovirus infection acquired periconceptionally or during the first trimester of pregnancy. This individual patient data meta-analysis aimed to assess the effectiveness and safety of valacyclovir treatment in the secondary prevention of congenital cytomegalovirus infection.

Data Sources: MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, the US registry of clinical trials (www.

Effect of mode of delivery on perinatal outcome in severe preterm birth: systematic review and meta-analysis.

Objective: To review the evidence on the effect of mode of delivery on perinatal outcome of fetuses born before 32 weeks' gestation.

Methods: MEDLINE, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), the ClinicalTrials.gov registry and gray literature sources were searched, starting from the year 2000 to reflect contemporary practice in perinatal care.

Third-trimester cervical length assessment for the prediction of spontaneous late preterm birth.

Background: The usefulness of cervical length (CL) measurement in asymptomatic pregnancies in the third trimester of pregnancy is not certain. Therefore, the objective of this study was to assess the performance of CL measurement at 31-34 gestational weeks for the prediction of spontaneous late preterm birth (PTB).

Materials And Methods: This was a prospective study of women with a singleton pregnancy, who had their routine third-trimester scan at 31-34 weeks.

Prevalence of preeclampsia and uterine arteries resistance in the different phenotypes of gestational diabetes mellitus.

Aims: This study aims to investigate the different phenotypes of Gestational Diabetes Mellitus (GDM), in correlation to preeclampsia and uterine arteries resistance.

Materials: This is a prospective cohort study including women with and without GDM per the IADPSG criteria. Three phenotypes of GDM emerged, women with only abnormal fasting (AF) glucose levels, women with only abnormal post-load (AP) glucose levels at 60' and/or 120' and women with abnormal combined (AC) fasting and post-load glucose values.

Neonatal and long-term outcomes of infants with congenital cytomegalovirus infection and negative amniocentesis: systematic review and meta-analysis.

Objective: Cytomegalovirus (CMV) DNA is detectable in the amniotic fluid collected by amniocentesis in cases in which the fetus has been infected. However, cases of congenital neonatal CMV infection with a negative amniocentesis result have also been reported in the literature. The aim of the present study was to compare pregnancies with a negative amniocentesis result to those with a positive amniocentesis result in terms of incidence of fetal insult and long-term sequelae.