Predicting intraoperative blood loss during cesarean sections based on multi-modal information: a two-center study.

Purpose: To develop and validate a nomogram model that combines radiomics features, clinical factors, and coagulation function indexes (CFI) to predict intraoperative blood loss (IBL) during cesarean sections, and to explore its application in optimizing perioperative management and reducing maternal morbidity.

Methods: In this retrospective consecutive series study, a total of 346 patients who underwent magnetic resonance imaging (156 for training and 68 for internal test, center 1; 122 for external test, center 2) were included. IBL+ was defined as more than 1000 mL estimated blood loss during cesarean sections.

Addressing Diagnosis, Management, and Complication Challenges in Placenta Accreta Spectrum Disorder: A Descriptive Study.

Introduction: In light of increased cesarean section rates, the incidence of placenta accreta spectrum (PAS) disorder is increasing. Despite the establishment of clinical practice guidelines offering recommendations for early and effective PAS diagnosis and treatment, antepartum diagnosis of PAS remains a challenge. This ultimately risks poor mental health and poor physical maternal and neonatal health outcomes.

Study on the correlation between endometriosis and adverse pregnancy outcomes.

Objective: This study aims to investigate the correlation between endometriosis (EMS) and adverse obstetric outcomes.

Methods: In this retrospective study 2,925 cesarean section cases were analyzed at the Women and Children's Hospital of Ningbo University, Department of Obstetrics, between May 2019 and December 2023. The study included 1,363 women diagnosed with endometriosis during pregnancy at the time of surgery (study group) and 1,562 women without such a diagnosis (control group).

Predictive Value and Limitations of the Placenta Accreta Index: A Systematic Review.

Our systematic review highlights that multiparametric PAI score assessment is a consistent tool with high sensitivity and specificity for prenatal prediction for placenta accreta spectrum (PAS) in high-risk population with anterior placenta previa or low-lying placenta and prior cesarean deliveries. A systematic search was conducted on November 1, 2022, of MEDLINE via PubMed, Scopus, Web of Science Core Collection, Cochrane Library, and Google Scholar to identify relevant studies (PROSPERO ID # CRD42022368211). A total of 11 articles met our inclusion criteria, representing the data of a total of 1,044 cases.

Postmenopausal Pregnancy Via Oocyte Donor and Suspected Focal Placenta Accreta: A Case Report.

Advances in assisted reproductive technologies have enabled postmenopausal women to achieve pregnancy beyond their reproductive lifespan. Although rare, these pregnancies are challenging and require a multidisciplinary approach due to the higher prevalence of medical comorbidities in this population. The placenta accreta spectrum is characterized by an abnormal invasion of chorionic villi into the myometrium.

Placental T2WI MRI-based radiomics-clinical nomogram predicts suspicious placenta accreta spectrum in patients with placenta previa.

Background: The incidence of placenta accreta spectrum (PAS) increases in women with placenta previa (PP). Many radiologists sometimes cannot completely and accurately diagnose PAS through the simple visual feature analysis of images, which can affect later treatment decisions. The study is to develop a T2WI MRI-based radiomics-clinical nomogram and evaluate its performance for non-invasive prediction of suspicious PAS in patients with PP.

Prevalence of placenta previa among deliveries: An update systematic review and meta-analysis after the introduction of the two-child policy in Mainland China.

Background: As birth policy can affect maternal and infant health, we sought to identify whether and how the introduction of the two-child policy might have affected the prevalence of placenta previa in pregnant women in mainland China.

Methods: In this update meta-analysis and systematic review, we searched PubMed, Web of Science, the Cochrane Library, Weipu, Wanfang, and the China National Knowledge Infrastructure (CNKI) databases for studies evaluating the prevalence of placenta previa in China published between the inception of each database and March 2024, with no restrictions. Two investigators independently extracted the data from each included study.

Risk Factors for Postpartum Hemorrhage in Severe Pre-Eclampsia: A Retrospective Single-Centre Study of 1953 Cases.

BACKGROUND Severe pre-eclampsia (sPE) and postpartum hemorrhage (PPH) in pregnancy have serious impact on maternal and fetal health and life. Co-occurrence of sPE and PPH often leads to poor pregnancy outcomes. We explored risk factors associated with PPH in women with sPE.

Development and validation of a nomogram for predicting placenta accreta spectrum in pregnancies with one previous cesarean delivery.

Objective: This study aimed to develop and validate a prenatal nomogram to predict the risk of placenta accreta spectrum (PAS) in women with one previous cesarean delivery.

Methods: This retrospective study enrolled 5157 pregnant women with one previous cesarean delivery in China from January 2021 to January 2023. The nomogram was developed from a training cohort of 3612 pregnant women and tested on a validation cohort of 1545 pregnant women.

Lower Uterine Segment Corrugated Sutures in Hemorrhage during Cesarean Section because Previal and/or Placenta Accreta Spectrum: Case Reports Series and Literature Review.

Objectives: We present the original technique of compression hemostatic sutures on the lower uterine segment due to early postpartum hemorrhage during cesarean section, with a literature review.

Methods: A retrospective clinical case study was conducted at the tertiary perinatal center. Twelve patients had nine planned and three urgent cesarean sections due to antenatally verified placenta previa and/or placenta accreta spectrum and defined early postpartum hemorrhage > 1000 mL during cesarean section.

Prediction of hemorrhage in placenta previa: Radiomics analysis of pelvic MRI images.

Introduction: Prediction of intraoperative massive hemorrhage is still challenging in placenta previa. Radiomics analysis has been investigated as a new evaluation method for analyzing medical images. We used radiomics analysis on placental magnetic resonance imaging (MRI) images to predict intraoperative hemorrhage in placenta previa.

Differentiating placenta accreta spectrum from scar dehiscence with underlying, non-adherent placenta: A systematic review of scoring systems and primary data analysis.

Introduction: Accurate discrimination between placenta accreta spectrum (PAS) and scar dehiscence with underlying non-adherent placenta is challenging both on prenatal ultrasound and intraoperatively. This can lead to overdiagnosis of PAS and unnecessarily aggressive management of scar dehiscence which increases the risk of morbidity. Several scoring systems have been published which combine clinical and ultrasound information to help diagnose PAS in women at high risk.

Pregnancy with endometriosis: Assessment of national-level trends, characteristics, and maternal morbidity at delivery.

Objective: To examine pregnancy characteristics and maternal morbidity at delivery among pregnant patients with a diagnosis of endometriosis.

Study Design: This cross-sectional study queried the Healthcare Cost and Utilization Project's National Inpatient Sample. Study population was 17,796,365 hospital deliveries from 2016 to 2020, excluded adenomyosis and uterine myoma.

Pregnancy Outcomes and Obstetrical Complications of Twin Pregnancies with Endometriosis: A Single-Center Cohort Study.

Purpose: There are many studies regarding the increased relationship between pregnancy outcomes of singleton with endometriosis. However, there was limited evidence of twin pregnancies with endometriosis. This study aimed to compare the pregnancy outcomes and complications in twin pregnancies with or without endometriosis in a single institution.

Endometriosis, pregnancy and delivery complications: Evidence from the US nationwide inpatient sample 2005-2018.

Objective: Endometriosis is associated with higher risk of ectopic pregnancy, premature delivery, miscarriage, and other adverse maternal and fetal complications. This study aimed to assess the impact of endometriosis on maternal and fetal outcomes of singleton pregnancies in a large nationally representative database.

Materials And Methods: This population-based, retrospective observational study extracted the data of women aged 20-49 years with singleton, spontaneously conceived pregnancies from the US Nationwide Inpatient Sample (NIS) database from 2005 to 2018.

Genotype Distribution and Prevalence of High-Risk Human Papillomavirus among Pregnant Women and Maternal-Fetal Pregnancy Outcomes in a Tertiary Hospital in Beijing, China.

Background: High-risk human papillomavirus (HR-HPV) infection is the primary reason for cervical cancer and precancerous lesions in females. Specific immune alterations in pregnancy led to greater HR-HPV replication and reduced clearance of HR-HPV infection. This study retrospectively obtained and analyzed data from a tertiary hospital in Beijing, China.

Customizing EV-CATCHER to Purify Placental Extracellular Vesicles from Maternal Plasma to Detect Placental Pathologies.

Placenta Accreta Spectrum (PAS) is a life-threatening condition in which placental trophoblastic cells abnormally invade the uterus, often up to the uterine serosa and, in extreme cases, tissues beyond the uterine wall. Currently, there is no clinical assay for the non-invasive detection of PAS, and only ultrasound and MRI can be used for its diagnosis. Considering the subjectivity of visual assessment, the detection of PAS necessitates a high degree of expertise and, in some instances, can lead to its misdiagnosis.

Treatment of intrauterine adhesions and subsequent pregnancy outcomes in an in vitro fertilization population.

Background: Asherman syndrome refers to the presence of intrauterine adhesions, which have clinical implications, including infertility. There are few studies assessing the effect of serial hysteroscopies for adhesiolysis on reproductive and pregnancy outcomes among women who subsequently undergo in vitro fertilization, and none have looked at maternal, neonatal, or placental pregnancy complications.

Objective: This study aimed to explore the effect of hysteroscopic adhesiolysis among a cohort of patients who subsequently undergo in vitro fertilization.

Prenatal Diagnosis of Vasa Previa in the Second Trimester of Pregnancy Based on Non-typical Ultrasound Findings: A Case Report and Mini-Review of the Literature.

Vasa previa is a rare disorder of the placenta. The absence of a prenatal diagnosis is associated with increased perinatal morbidity and mortality. In our patient, ultrasound findings, although atypical, successfully established the prenatal diagnosis of vasa previa in the second trimester of pregnancy.

Hypoxia modulates P-glycoprotein (P-gp) and breast cancer resistance protein (BCRP) drug transporters in brain endothelial cells of the developing human blood-brain barrier.

P-glycoprotein (P-gp) and Breast Cancer Resistance Protein (BCRP) multidrug resistance (MDR) transporters are localized at the luminal surface of the blood-brain barrier (BBB). They confer fetal brain protection against harmful compounds that may be circulating in the peripheral blood. The fetus develops in low oxygen levels; however, some obstetric pathologies such as pre-eclampsia, placenta accreta/previa may result in even greater fetal hypoxic states.

Type III Vasa Previa Associated with Resolution of a Low-Lying Placenta: Case Report and Literature Review.

Vasa previa occurs when fetal vessels lie above the cervical os. A novel type of vasa previa, known as type III, is characterized by an abnormal branching of fetal vessels from the placenta in the absence of velamentous cord insertion (as seen in type I) or multilobed placenta (as seen in type II). Here, we present a case of a type III vasa previa after a resolution of a low-lying placenta.