Clinical application of airbag bionic midwifery technology in vaginal delivery of pregnancy with scarred uterus.

This was an original article, mainly explored the effect of applying airbag bionic midwifery technology in vaginal delivery of scarred uterus pregnancy. Sixty patients were chosen, and divided into an intervention group (IG) and a control group (CG). The results showed that in contrast to the CG, the IG had shorter first, second and total stages of labor (P<0.

Predicting purulent meningitis in very preterm infants: a novel clinical model.

Background: Purulent meningitis (PM) is a commonly encountered infectious condition in newborns, which unfortunately can result in infant mortality. Newborns with PM often present nonspecific symptoms. The success of lumbar puncture, an invasive test, relies on the operator's expertise.

Successful pregnancy outcome in a recipient of simultaneous pancreatic kidney transplantation.

There is limited information available regarding post-simultaneous pancreatic kidney transplantation (SPKT) pregnancies. The present case describes a woman in her early 30s with first pregnancy who conceived spontaneously 4 years after SPKT. Her pancreatic and kidney graft function remained stable throughout the pregnancy.

The effect of fixed-time interval and on-demand analgesia protocols for post cesarean pain on maternal chronic pain and child development - follow up of randomized controlled trial.

Objective: Post-cesarean delivery (CD) acute pain may progress to chronic pain, which may impair maternal bonding and child development. In 2013, we compared the efficacy of versus on-demand oral analgesia for post-caesarean pain in a randomized-controlled-trial. The fixed-time-interval group had received scheduled paracetamol, tramadol, and diclofenac regardless of pain level, and the on-demand group received medication as needed, with oxycodone reserved for unrelieved pain in both groups.

Severe maternal morbidity contributed by obstetric hemorrhage: Maryland, 2020-2022.

Background: Obstetric hemorrhage is the leading cause of maternal mortality and severe maternal morbidity (SMM) in Maryland and nationally. Currently, through a quality collaborative, the state is implementing the Alliance for Innovation on Maternal Health (AIM) patient safety bundle on obstetric hemorrhage.

Objective: To describe SMM events contributed by obstetric hemorrhage and their preventability in Maryland.

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).

Unintentional exposure to leuprolide acetate during early pregnancy with a huge intramural myoma.

Leuprolide acetate is commonly used to reduce the size of myomas before surgery. Initially, it stimulates pituitary gonadotropin secretion, followed by sustained suppression of gonadal function. However, the impact on pregnancy outcomes from inadvertent exposure remains unclear.

Health Inequalities Between Afro-descendants and Non-Afro-descendants in Peru: Evidence from the Demographic and Family Health Survey.

Background: The Afro-Peruvian population is one of the ethnic minorities most affected by cultural, socioeconomic, and health barriers; however, there is little evidence on health inequalities in this ethnic group. Therefore, We aimed to determine health inequalities among the Peruvian Afro-descendant population in comparison with non-Afro-descendants.

Methods: A cross-sectional study was conducted using data from the Demographic and Family Health Survey 2022.

The mediating effects of gestational diabetes mellitus and hypertensive disorders of pregnancy between maternal advanced age, previous caesarean section and the risk of small- or large-for-gestational-age newborns: a multicentric prospective cohort study in southern China.

Background: Maternal obstetric characteristics have a key role in determining the occurrence of pregnancy-related disorders and subsequent neonatal outcomes. We aimed to investigate the mediating impact of gestational diabetes mellitus (GDM) and hypertensive disorder of pregnancy (HDP) on the relationship between maternal advanced age, previous caesarean section, and the risk of either large for gestational age (LGA) or small for gestational age (SGA) infants.

Methods: We used data from a prospective multicentre cohort study conducted through China's National Maternal Near-miss Surveillance System from January 2012 to December 2021.

Diagnosis of infiltrating bladder endometriosis after fourth cesarean section.

Objectives: This case report highlights the clinical presentation, diagnostic challenges, and effective management of bladder endometriosis, while emphasizing the importance of considering this diagnosis in patients with chronic pelvic pain and urinary symptoms.

Methods: A 32-year-old woman presented with severe pelvic pain, dysuria, and dyspareunia. Diagnosis of bladder endometriosis was achieved through clinical suspicion supported by vaginal ultrasound, 3D imaging, and magnetic resonance imaging.

Comparative Evaluation of Two Doses of IV Dexamethasone for Postoperative Analgesia in Patients Undergoing Lower Segment Cesarean Section Under Spinal Anesthesia: A Randomized Controlled Trial.

Introduction Effective postoperative analgesia following lower segment cesarean section (LSCS) is crucial for promoting surgical recovery and fostering maternal-neonatal bonding. This study aimed to compare the efficacy of two IV dexamethasone doses (8 mg and 4 mg) in managing postoperative pain in LSCS patients. The objective was to assess whether the 4 mg dose provides comparable pain relief to the 8 mg dose, with the goal of identifying the optimal dosage for effective pain management with minimal side effects.

Exosomes derived from hUC-MSCs exhibit ameliorative efficacy upon previous cesarean scar defect via orchestrating β-TrCP/CHK1 axis.

Previous cesarean scar defect (PCSD), also acknowledged as the myometrium of uterus defects, which commonly results in myometrial discontinuity between the uterine and cervical cavity. Current literatures have indicated the efficacy of MSCs and MSC-derived exosomes (MSC-Exos) for diverse refractory disease administration, yet the feasibility of MSC-Exos for PCSD treatment is largely obscure. In this study, we took advantage of the in vivo myofibrotic model for mimicking the typical manifestation of PCSD and the assessment of fertility.

Mode of birth in nulliparous term singleton pregnancies in vertex presentation before and after implementation of an evidence-based intervention: quality-improvement study.

Purpose: The main objective of this study was to assess the impact of a composite quality improvement intervention on mode of birth in nullipara term singleton vertex (NTSVs).

Material And Methods: This was an ambidirectional study following the implementation of the intervention to reduce cesarean section rate in NSTV by comparing two birth cohorts, pre-composite quality improvement intervention cohort (January 2013-December 2015) and post-composite quality improvement intervention cohort (January 2018-December 2020).

Results: In the studied periods, there was a total of 7713 NTSV births.

Placenta accreta spectrum disorders: A Canadian tertiary care centre's experience over 10 years.

Objectives: The placenta accreta spectrum disorders (PASD) are associated with significant maternal and neonatal morbidity and mortality worldwide. As cesarean delivery rates increase, so does the rate of PASD. PASD antepartum diagnosis and perioperative management are evolving, and we primarily aimed to share our tertiary care centre's institutional approach and outcomes over a decade.

Trends in Antepartum, Delivery, and Postpartum Venous Thromboembolism.

Objective: To assess trends in risk for obstetric venous thromboembolism (VTE).

Methods: This retrospective cohort study analyzed data from the 2008-2019 Merative MarketScan Commercial Claims and Encounters and Medicaid Multi-State databases. Women aged 15-54 years with a delivery hospitalization and health care enrollment from 1 year before pregnancy to 60 days after delivery were identified.

ESAIC focused guidelines for the management of the failing epidural during labour epidural analgesia.

Background: Labour epidural analgesia reportedly fails in up to 10 to 25% of cases. A joint taskforce of European Society of Anaesthesiology and Intensive Care (ESAIC) experts was created to develop this focused guideline on the management of failing epidural analgesia in a previously well functioning epidural catheter.

Design: Six clinical questions were defined using a PICO (Population/Intervention/Comparison/Outcome) strategy to conduct a systematic literature search.

An assessment of cord ferritin concentration and its predictors among a cohort of Canadian preterm and term infants.

Low iron stores at birth may adversely influence child cognitive and motor development. The aims of this study were to assess cord blood iron levels and explore maternal and neonatal factors associated with iron status. Cord blood specimens (=46) were obtained from the BC Children's Hospital BioBank in Vancouver, Canada.

The impact of uterine position on conception modes and perinatal outcomes in nulliparous patients.

Purpose: Retroverted uterus affects 15-20% of patients. While typically not a cause for concern, some studies suggest a relationship between a retroverted uterus and subfertility. Study objective was to investigate the association between uterine position and spontaneous conception rates, as well as potential risks for adverse pregnancy outcomes in nulliparous patients.

Comprehensive analysis of transplacental transfer of environmental pollutants detected in paired maternal and cord serums.

Prenatal exposure to hazardous environmental pollutants is a critical global concern due to their confirmed presence in umbilical cord blood, indicating the ability of pollutants to cross the placental barrier and expose the fetus to harmful compounds. However, the transplacental transfer efficiencies (TTEs) of many pollutants remain underexplored. Herein, we developed a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method to quantitatively analyze 91 environmental pollutants, including 13 bisphenols (BPs), 18 organophosphorus flame retardants (OPFRs), 7 brominated and other flame retardants (BFRs), 34 phthalates (PAEs), and 19 per- and polyfluoroalkyl substances (PFASs), in paired maternal and cord serums.

Predictors of conversion to cesarean section in a French cohort of 236 class III (body mass index of 40 or more) obese women attempting vaginal delivery: A restrospective multicentric study.

Background: Due to the global growth of its prevalence and its impact on patient health, obesity is considered a near-epidemic condition by the World Health Organization (WHO). Its overall prevalence has now reached 17 % in France. The impact of obesity is also a concern for pregnant women, due to the risk of maternal and fetal complications.

Lessons learned from a case of placenta previa totalis complicated by placenta accreta spectrum: Importance of timely decision-making.

Introduction And Clinical Importance: Placenta previa (PP) is characterized by abnormal placental placement in the lower uterine segment, obstructing the cervical opening. Placenta previa totalis (PPT) occurs when the placenta completely covers the internal cervical os. This condition can lead to placenta accreta spectrum (PAS), where the placenta adheres abnormally to the uterine wall, complicating separation.

Correlation between the 5-tier fetal heart rate pattern classification at delivery and Apgar scores.

Aim: In Japan, the fetal heart rate pattern on cardiotocography is usually categorized into five levels for intrapartum management; however, studies on the 5-tier cardiotocography classification are limited. This study aimed to determine the correlation between 5-tier cardiotocography levels at delivery, neonatal Apgar scores and perinatal prognosis using a perinatal registry database.

Methods: This retrospective study used the 2018 Perinatal Registry Database of the Japan Society of Obstetrics and Gynecology.

A case of assisted reproductive technology-induced maternal alloimmunization: an emerging sensitizing factor to consider?

Red blood cell (RBC) alloimmunization can occur because of exposure to various sensitizing factors and poses a constant threat in transfusion. Assisted reproductive technology (ART) involves manipulation of sperm, ova, or embryos with the goal of producing a pregnancy. We present an interesting case of ART-induced maternal alloimmunization (AIMA) due to anti-c in a woman carrying a twin pregnancy.