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Case Report: Respiratory outcome in a preterm infant following previable rupture of membranes and persistent oligohydramnios.
Front Pediatr
January 2025
Department of Neonatology, KK Women's and Children's Hospital, Singapore, Singapore.
Mid-trimester preterm premature rupture of membranes is a rare complication of pregnancy associated with significant maternal and fetal risks. The ensuing prolonged oligohydramnios can lead to fetal pulmonary hypoplasia. In addition, there is an increased risk of miscarriage, preterm birth, and chorioamnionitis, contributing to septic morbidity in the mother-baby dyad.
View Article and Find Full Text PDFNon-Surgical Management of Gallstones During Pregnancy: A Clinical Case Report.
Cureus
December 2024
Neurosurgery, County Clinical Emergency Hospital of Sibiu, Sibiu, ROU.
Gallstone disease during pregnancy, or cholelithiasis, presents significant clinical challenges due to hormonal, anatomical, and metabolic changes. Progesterone therapy, commonly used in pregnancy for uterine bleeding, can exacerbate gallstone risk by reducing gallbladder motility and promoting cholesterol gallstone formation. This case report describes a 29-year-old pregnant woman with no prior gallbladder disease who developed multiple cholesterol gallstones during the third trimester while undergoing progesterone therapy for bleeding associated with a bicornuate uterus.
View Article and Find Full Text PDFAI-based analysis of fetal growth restriction in a prospective obstetric cohort quantifies compound risks for perinatal morbidity and mortality and identifies previously unrecognized high risk clinical scenarios.
BMC Pregnancy Childbirth
January 2025
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Utah Health, 30 N. Mario Capecchi Dr., Level 5 South, Salt Lake City, UT, 84132, USA.
Background: Fetal growth restriction (FGR) is a leading risk factor for stillbirth, yet the diagnosis of FGR confers considerable prognostic uncertainty, as most infants with FGR do not experience any morbidity. Our objective was to use data from a large, deeply phenotyped observational obstetric cohort to develop a probabilistic graphical model (PGM), a type of "explainable artificial intelligence (AI)", as a potential framework to better understand how interrelated variables contribute to perinatal morbidity risk in FGR.
Methods: Using data from 9,558 pregnancies delivered at ≥ 20 weeks with available outcome data, we derived and validated a PGM using randomly selected sub-cohorts of 80% (n = 7645) and 20% (n = 1,912), respectively, to discriminate cases of FGR resulting in composite perinatal morbidity from those that did not.
Cerclage in singleton pregnancies with no prior spontaneous PTB and short cervix: a randomized controlled trial.
Am J Obstet Gynecol MFM
January 2025
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College, Thomas Jefferson University.
Background: PTB (PTB) remains a leading cause of neonatal morbidity and mortality. Cerclage for short cervical length (CL) ≤25mm in singletons with a history of spontaneous PTB is associated with decreased neonatal morbidity/mortality. Both vaginal progesterone and cerclage individually have level 1 evidence supporting benefit in prevention of PTB in pregnancies complicated by short CL, however there is a paucity of level 1 evidence regarding the potential benefit of cerclage with progesterone compared to progesterone alone for short CL ≤25mm in singletons without a history of spontaneous PTB.
View Article and Find Full Text PDFOptimizing Diabetes-in-Pregnancy Outcomes Requires a Care Continuum.
Am J Perinatol
January 2025
Center for Advanced Research Training and Innovation, Center for Birth Defects Research, University of Maryland School of Medicine, Baltimore, Maryland.
This study aimed to assess the strengths, limitations, opportunities, and threats presented by diabetes-in-pregnancy. We review the improvements in maternal and fetal mortality since the advent of insulin therapy, evaluate current health challenges, and identify opportunities for preventing increased mortality due to diabetes-in-pregnancy. Prior to 1922, women with type 1 diabetes mellitus (T1DM) of childbearing age were discouraged from becoming pregnant as the maternal and fetal/neonatal mortality rates were extremely high.
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