MRI Signs Associated With Bladder Injury During Cesarean Delivery in Severe Placenta Accreta Spectrum Disorders.

Background: Bladder injury during cesarean delivery (CD) in pregnant women with severe placenta accreta spectrum (PAS) disorders mostly occurs in the dissection of vesico-uterine space. Placental MRI may help to assess the risk of bladder injury preoperatively.

Purpose: To identify the high-risk MRI signs of bladder injury during CD in women with severe PAS.

Fetal Tetra-Amelia Birth: A Case Report.

Fetal limb anomaly presentation varies greatly. It can present as amelia (complete absence of skeletal part of one or more limb), meromelia (partial absence of skeletal part of one or more limb), phocomelia (only rudimentary limb formed), and minor limb disorders like polydactyly. The complete absence of the four fetal limbs is extremely rare.

Dermoscopic Features of Cutaneous Endometriosis Arising in a Cesarean Scar: A Case Report.

Cutaneous endometriosis is a rare manifestation of endometriosis, and few reports on its dermoscopic features have been published. In this case report, we present a 40-year-old female with cutaneous endometriosis arising in a caesarean scar, exhibiting unique and distinct dermoscopic features. The patient presented with a nodular, papillomatous growth in the right end of the scar, and dermoscopic examination revealed structureless red papillomatous projections, as well as nonpapillomatous areas with red dotted vessels surrounded by a white reticular network.

The effect of an abdominal binder on pain, bleeding and breastfeeding success after cesarean delivery: A randomized controlled trial.

This randomized controlled intervention study aims to determine the effect of an abdominal binder on pain, bleeding, and breastfeeding success after cesarean delivery. The study was conducted with women who underwent cesarean section and were followed-up for the first 48 hours at the obstetrics clinic of a state hospital in Türkiye between September 2020-March 2021. The study was completed with a total of 128 women who met the inclusion criteria (Intervention (IG):64, Control (CG):64).

Birth Outcomes of Infants Born to Mothers with Alopecia Areata: A Nationwide Population-based Study in Korea.

Data on pregnancy outcomes in patients with alopecia areata (AA) are limited. The aim of this study is to determine the association between maternal AA and risk of adverse birth outcomes in children. A retrospective cohort study was conducted on 45,328 children born to mothers with AA and 4,703,253 controls born to mothers without AA using the Korean National Health Insurance Claims database from 2002 to 2016.

Unexpected placenta accreta spectrum in an unscarred uterus causing catastrophic post-partum hemorrhage: a case report and review of the literature.

Background: Placenta accreta spectrum (PAS) disorder is a fatal condition responsible for obstetric haemorrhage, which contributes to increased feto-maternal morbidity and mortality. The main contributing factor is a scarred uterus, often from a previous cesarean delivery, myomectomy, or uterine instrumentation. The occurrence of PAS in an unscarred uterus is extremely rare, with only anecdotal cases reported so far in the literature.

Wound Healing After Vaginal Delivery, Episiotomy, and Cesarean Section Delivery Among Women With IBD: Results From the PIANO Registry.

Background: Women with inflammatory bowel disease (IBD) face complexities of disease management during pregnancy and childbirth. Apprehension regarding vaginal delivery in pregnant individuals with IBD persists due to concern for perianal disease and perineal trauma. The incidence of poor wound healing after obstetric anal sphincter injury is approximately 4% in the general population.

Effect of phenylephrine infusion on postpartum blood loss after cesarean delivery: A Placebo-controlled, randomized clinical trial.

Background: Preclinical studies have documented the role of alpha-adrenergic agonists in myometrial contraction. Phenylephrine is frequently used to prevent and treat post-spinal hypotension during cesarean delivery. We hypothesized phenylephrine would reduce postpartum blood loss due to alpha-1 receptor-mediated uterine and vascular smooth muscle contraction.

Fetal Therapy for Severe Drug-Resisted Tachyarrhythmia With Progressive Hydrops by Fetoscopic Transesophageal Pacing: A Successful Attempt in Single Chinese Fetal Medicine Center.

Objective: To describe the outcome of a case of severe drug-resistant fetal tachyarrhythmia with progressive hydrops treated with fetoscopic transesophageal pacing (FTEP).

Method: A case of fetal tachyarrhythmia complicated by progressive hydrops is presented. The fetus, diagnosed at 26 weeks of gestation, had supraventricular tachycardia with a mechanism suggestive of atrial reentry.

Perioperative Management of Unexpected Placenta Percreta in a Twin Gestation.

Placenta accreta represents a spectrum of adherent placental anomalies and is an atypical invasion of the placenta. The major predisposing factor is a prior cesarean delivery. Placenta previa is considered an additional risk factor.

Racial and Ethnic Trends in Cesarean Delivery on Maternal Request.

Objective: To evaluate race and ethnicity differences in rates of cesarean delivery on maternal request (CDMR) in nulliparous, term, singleton, vertex presentation (NTSV) cesarean deliveries.

Methods: We conducted a retrospective cohort study of NTSV cesarean deliveries within our institution from 2016 to 2020. The primary outcome was CDMR and the primary predictor was maternal race and ethnicity.

Angiogenic factors versus fetomaternal Doppler for fetal growth restriction at term: an open-label, randomized controlled trial.

Small fetuses, with estimated fetal weight (EFW) below the tenth percentile, are classified as fetal growth restriction (FGR) or small for gestational age (SGA) based on prenatal ultrasound. FGR fetuses have a greater risk of stillbirth and perinatal complications and may benefit from serial ultrasound scans to guide early delivery. Abnormal serum angiogenic factors, such as the soluble fms-like tyrosine kinase-1 (sFlt-1):placental growth factor (PlGF) ratio, have shown potential to more accurately distinguish FGR from SGA, with fewer false positives.

Pharmacogenetics of opioid medications for relief of labor pain and post-cesarean pain: a systematic review and meta-analysis.

Objective: Several studies have attempted to identify genetic determinants of clinical response to opioids administered during labor or after cesarean section. However, their results were often contrasting. A systematic review and meta-analysis was conducted to quantitatively assess the association between gene polymorphisms and clinical outcomes of opioid administration in the treatment of labor pain and post-cesarean pain.

A randomized comparative study to prevent supine hypotension syndrome in pregnant females undergoing LSCS after giving spinal anesthesia using a wedge and novel 3D printed uterine displacement device.

Introduction: Pregnancy induces physiological changes, including alterations in cardiovascular dynamics, predisposing pregnant women to supine hypotension syndrome (SHS) during lower-segment cesarean section (LSCS) under spinal anesthesia. Various methods, including manual displacement of the uterus and use of wedges or cushions, have been proposed to prevent SHS, but their effectiveness remains variable. This study aimed to compare the efficacy of a novel 3D-printed uterine displacement device with that of a traditional wedge in preventing SHS during LSCS after spinal anesthesia.

The Effect of Low-dose Aspirin on Disease Activity in Pregnant Individuals with Inflammatory Bowel Disease.

Objectives: Low-dose aspirin (LDA) is recommended for pregnant individuals at elevated risk for hypertensive disorders of pregnancy (HDP). However, regular aspirin use may raise concerns of increased disease activity in patients with inflammatory bowel disease (IBD). We aimed to evaluate the prevalence of LDA use in pregnant IBD patients and the effect of LDA on IBD disease activity.

Risk of Adverse Pregnancy Outcomes Associated With Antiseizure Medications and Their Indications: A Systematic Review and Meta-Analysis.

Background And Objectives: Aside from congenital malformations and impaired postnatal neurodevelopment, risks associated with antiseizure medication (ASM) use during pregnancy have been sparsely investigated, particularly outside of epilepsy. We aimed to assess these risks through a systematic literature review and meta-analysis, including ASM exposure for indication.

Methods: We searched MEDLINE, EMBASE, and Cochrane for studies including pregnant women on ASMs for any indication and untreated pregnant women, investigating obstetric complications and fetal/neonatal complications other than congenital malformations and impaired neurodevelopment.

Medical Malpractice Litigation Associated With Anesthesia: Result From the Lexis China Claims Database 2013 to 2022.

Purpose: This study conducted an analysis of medical malpractice litigation associated with anesthesia from 2013 to 2022, aiming to evaluate incidents of anesthesia-related safety concerns among surgical patients. The use of data derived from medical malpractice claims provided valuable insights into potential risks associated with anesthesia, contributing to the mitigation of medical malpractice and the enhancement of patient safety.

Design: A retrospective study.

Effects of the application of combined plan-do-check-action and enhanced recovery by nurses on patients undergoing cesarean section.

This study examined the effects of a combination of plan-do-check-action (PDCA) and enhanced recovery after surgery (ERAS) on patients undergoing cesarean section. One hundred and thirty patients undergoing caesarean section at the Second Affiliated Hospital of Nantong University comprised the study group. They were randomly divided into a control group (CG) and an intervention group (IG).

Factors Associated with the Prolonged Use of Donor Human Milk at the Da Nang Hospital for Women and Children in Vietnam.

Background And Objectives: Donor human milk (DHM) from a human milk bank (HMB) is used to feed low-birthweight (LBW) and preterm infants when mothers cannot provide their own breastmilk. The misuse of DHM could interfere with mothers' breastmilk and weaken breastfeeding efforts. This study aimed to identify factors behind prolonged DHM usage during the first six years of Vietnam's first HMB.

Obstetric Intensive Care Admissions and Neonatal Outcomes: 15 Years of Experience from a Single Center.

Maternal severe morbidity and mortality are measures for assessing maternal healthcare, and admissions to the intensive care unit (ICU) can be used to study these metrics. Here, we analyze ICU admissions of pregnant or postpartum women in a tertiary hospital. This is a retrospective, single-center, observational cohort study of obstetric intensive care admissions at a Portuguese hospital spanning 15 years.

Pregnancy Outcomes and Maternal Characteristics in Women with Pregestational and Gestational Diabetes: A Population-Based Study in Spain, 2016-2022.

: The objective of this study was to compare trends in the incidence of deliveries and in obstetric interventions and outcomes in women with and without type 1 diabetes (T1DM), type 2 diabetes (T2DM), and gestational diabetes (GDM). : This was an observational study using the Spanish National Hospital Discharge Database (2016-2022). : A total of 1,995,953 deliveries were recorded between 2016 and 2022 (6495 mothers with T1DM, 5449 with T2DM, and 124,172 with GDM).

Double-J Ureteral Stenting in Obstetrics and Gynecology: Pivotal or Problematic?

: Double-J stents are urinary catheters that are frequently used in urology. They are now also used in other specialist areas such as obstetrics and gynecology. However, the use of double-J stents is not without side effects.

Effect of Anesthetic Modality on Decision-to-Delivery Interval and Maternal-Neonatal Outcomes in Category 2 and 3 Cesarean Deliveries.

The optimal anesthetic technique for category 2 and 3 cesarean deliveries remains debated, with concerns about impacts on decision-to-delivery interval (DDI) and perinatal outcomes. This study examined the influence of epidural, spinal, and general anesthesia on DDI, surgical and postoperative complications, and neonatal outcomes. : This prospective cohort study at a tertiary perinatology center enrolled parturient women undergoing category 2 and 3 cesarean deliveries.

COVID-19 Pandemic Impact on the Birth Weight of Children Born in a Brazilian Metropolis.

Objective: To assess the birth weight of newborns whose mothers gave birth during the COVID-19 pandemic.

Methods: A cross-sectional study based on data collected from medical records and through postnatal interviews to assess maternal and neonatal health outcomes (n = 470) during the pandemic. All participants were assisted in three Brazilian public hospitals in 2020.