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Association of ABO and Rh blood groups with obstetric outcomes in SARS-CoV-2 infected pregnancies: A prospective study with a multivariate analysis.

Eur J Obstet Gynecol Reprod Biol 2021 Jul 7;264:41-48. Epub 2021 Jul 7.

Obstetrics and Gynaecology Department, Puerta de Hierro University Hospital of Majadahonda. Majadahonda, Madrid, Spain; Autónoma University of Madrid, Spain. Electronic address:

Objective: To evaluate the influence of ABO and Rh blood groups on morbidity among SARS-CoV-2 infected pregnancies.

Design: Prospective observational study.

Setting: 78 centers of the Spanish Obstetric Emergency Group. Read More

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Are there excess fetal deaths attributable to waterborne lead exposure during the Flint Water Crisis? Evidence from bio-kinetic model predictions and Vital Records.

J Expo Sci Environ Epidemiol 2021 Jul 16. Epub 2021 Jul 16.

Civil and Environmental Engineering, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.

Background: Flint, Michigan had elevated water lead (Pb) levels during the 2014-15 Flint Water Crisis (FWC) and reports claim the exposures caused excess fetal deaths.

Objective: To model the likelihood of excess fetal deaths occurring from FWC lead exposure and compare results to Vital Records.

Methods: We used an established bio-kinetic model to predict relative blood lead trends in pregnant women from characteristic exposure to 90th percentile water lead levels (WLLs), and another established model to then estimate characteristic miscarriage (<20 gestation weeks) odds ratios (OR) in Flint (2011-17). Read More

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Maternal Hyperglycemia Induces Changes in Gene Expression and Morphology in Mouse Placentas.

Gynecol Reprod Health 2021 ;5(1)

Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN 37080, United States.

Background: Pregestational diabetes complicates one million pregnancies in the United States and is associated with placental dysfunction. Placental dysfunction can manifest as stillbirth, spontaneous abortions, fetal growth restriction, and preeclampsia in the mother. However, the underlying mechanisms of placental dysfunction are not well understood. Read More

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January 2021

Blood pressure thresholds in pregnancy for identifying maternal and infant risk: a secondary analysis of Community-Level Interventions for Pre-eclampsia (CLIP) trial data.

Lancet Glob Health 2021 Aug 5;9(8):e1119-e1128. Epub 2021 Jul 5.

Department of Obstetrics and Gynaecology and BC Children's Hospital Research Institute, University of British Columbia, Vancouver, BC, Canada; Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.

Background: Blood pressure measurement is a marker of antenatal care quality. In well resourced settings, lower blood pressure cutoffs for hypertension are associated with adverse pregnancy outcomes. We aimed to study the associations between blood pressure thresholds and adverse outcomes and the diagnostic test properties of these blood pressure cutoffs in low-resource settings. Read More

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Do patients with a single abnormal OGTT value need a globally admitted definition such as "borderline GDM"? Pregnancy outcomes of these women and the evaluation of new inflammatory markers.

J Matern Fetal Neonatal Med 2021 Jul 5:1-8. Epub 2021 Jul 5.

Obstetrics and Gynecology, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey.

Introduction: One of the approaches to diagnose Gestational Diabetes Mellitus (GDM) is to detect two or more elevated values in 3-h Glucose Tolerance Test (OGTT) after an abnormal 50 gr Glucose Challenge Test (GCT). Patients with single elevated OGTT generally postulated as healthy; however, these patients could experience adverse perinatal and maternal issues more frequently. We aimed to investigate the maternal and neonatal outcomes of women with single abnormal OGTT primarily by comparing these women with healthy controls and GDM patients. Read More

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Placental mitochondrial function as a driver of angiogenesis and placental dysfunction.

Biol Chem 2021 Jul 5;402(8):887-909. Epub 2021 Jul 5.

Aston Medical School, College of Health & Life Sciences, Aston University, Aston Triangle, BirminghamB4 7ET, UK.

The placenta is a highly vascularized and complex foetal organ that performs various tasks, crucial to a healthy pregnancy. Its dysfunction leads to complications such as stillbirth, preeclampsia, and intrauterine growth restriction. The specific cause of placental dysfunction remains unknown. Read More

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The association between placenta-associated circulating biomarkers and composite adverse delivery outcome of a likely placental cause in healthy post-date pregnancies.

Acta Obstet Gynecol Scand 2021 Jul 1. Epub 2021 Jul 1.

Division of Obstetrics and Gynecology, Oslo University Hospital, Ullevål, Oslo, Norway.

Introduction: Post-date pregnancies have an increased risk of adverse delivery outcome. Our aim was to explore the association between placenta-associated circulating biomarkers and composite adverse delivery outcome of a likely placental cause in clinically healthy post-date pregnancies.

Material And Methods: Women with healthy singleton post-date pregnancies between 40 and 42  weeks of gestation were recruited to this prospective, observational study conducted at Oslo University Hospital, Norway (NCT03100084). Read More

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Anti-hypertensive use for non-severe gestational hypertension in Botswana: A case-control study.

Int J Gynaecol Obstet 2021 Jul 1. Epub 2021 Jul 1.

Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA, USA.

Objective: The fetal risks and benefits of antihypertensives to treat gestational hypertension in pregnancy are understudied, particularly in low- and middle-income countries.

Methods: We performed a nested case-control study within a retrospective cohort of obstetrical patients in Botswana from 2014 to 2019. We included women carrying singletons who developed new onset non-severe hypertension (140-159 mm Hg systolic or 90-109 mm Hg diastolic blood pressure) after 20 weeks of pregnancy. Read More

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COVID-19 in pregnancy: the foetal perspective-a systematic review.

BMJ Paediatr Open 2020 25;4(1):e000859. Epub 2020 Nov 25.

Paediatrics, Ras Al Khaimah Medical and Health Sciences University, Ras Al Khaimah, UAE.

Objective: We aimed to conduct a systematic review of the available literature to determine the effects of confirmed cases of COVID-19 in pregnant women from the foetal perspective by estimation of mother to child transmission, perinatal outcome and possible teratogenicity.

Methods: Data sources: eligible studies between 1 November 2019 and 10 August 2020 were retrieved from PubMed, Embase, LitCovid, Google Scholar, EBSCO MEDLINE, CENTRAL, CINAHL, MedRXiv, BioRXiv and Scopus collection databases. English language case reports, case series and cohort studies of SARS-CoV-2 confirmed pregnant women with data on perinatal outcome, congenital anomalies and mother to child transmission were analysed. Read More

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November 2020

Pregnancy-related acute kidney injury at high altitude: a retrospective observational study in a single center.

BMC Nephrol 2021 Jun 9;22(1):215. Epub 2021 Jun 9.

Department of Nephrology, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

Background: Pregnancy-related acute kidney injury (Pr-AKI) is associated with maternal and fetal morbidity and mortality. There are few studies focusing on Pr-AKI at high altitude in the literature.

Objectives: to investigate the incidence, etiology, clinical features and maternal-fetal outcomes of Pr-AKI in women living at high altitude. Read More

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Hemoglobin Level and Associated Factors among Pregnant Women in Rural Southwest Ethiopia.

Biomed Res Int 2021 19;2021:9922370. Epub 2021 May 19.

Department of Nutrition and Dietetics, Jimma University, Jimma, Ethiopia.

Background: Anemia is a situation in which the number and size of red blood cells, or the concentration of hemoglobin, fall below established cut-off values. Low hemoglobin level during pregnancy favors the alteration of placental angiogenesis and resulted in restricting the availability of nutrients to the fetus and consequently causing fetal growth retardation and low weight at birth. This study is aimed at assessing the hemoglobin level and associated factors among pregnant women in rural communities of Jimma zone, Southwest Ethiopia. Read More

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SARS-CoV-2 Infects Syncytiotrophoblast and Activates Inflammatory Responses in the Placenta.

bioRxiv 2021 Jun 2. Epub 2021 Jun 2.

Department of Cell and Developmental Biology, Weill Cornell Medicine, 1300 York Avenue, New York 10065, NY, USA.

SARS-CoV-2 infection during pregnancy leads to an increased risk of adverse pregnancy outcomes. Although the placenta itself can be a target of virus infection, most neonates are virus free and are born healthy or recover quickly. Here, we investigated the impact of SARS-CoV-2 infection on the placenta from a cohort of women who were infected late during pregnancy and had tested positive for SARS-CoV-2 by qRT-PCR at delivery. Read More

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Influence of seasonal variation on post-farrowing dysgalactia syndrome (PFDS) and serum biochemistry profiles in the periparturient sow.

Trop Anim Health Prod 2021 Jun 6;53(3):346. Epub 2021 Jun 6.

ICAR Research Complex for North Eastern Hill Region, Nagaland Centre, Medziphema, Nagaland, 797 106, India.

The objective of this study was to investigate the effect of seasonal variation on the frequency of post-farrowing dysgalactia syndrome (PFDS), sow body condition score (BCS), piglet survival, and weaning to estrus interval under intensive management systems. In addition, the effects of PFDS on litter characteristics and serum biochemistry, oxidative stress indices, thyroid, and cortisol profile were examined in order to identify potential biomarkers in the pre-farrowing stage. The study was conducted in summer and winter seasons in Nagaland, India, on 50 sows from 30 days before farrowing until weaning at 45 days. Read More

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Planned early delivery for late preterm pre-eclampsia in a low- and middle-income setting: a feasibility study.

Reprod Health 2021 Jun 2;18(1):110. Epub 2021 Jun 2.

Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK.

Background: Pre-eclampsia is a leading cause of maternal and perinatal mortality and morbidity globally. Planned delivery between 34 and 36 weeks may reduce adverse pregnancy outcomes but is yet to be evaluated in a low and middle-income setting. Prior to designing a randomised controlled trial to evaluate this in India and Zambia, we carried out a 6-month feasibility study in order to better understand the proposed trial environment and guide development of our intervention. Read More

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Systematic screening for vasa previa at the 20-week anomaly scan.

Acta Obstet Gynecol Scand 2021 Jun 2. Epub 2021 Jun 2.

Ambulatorium für Fetalmedizin Feldkirch, Feldkirch, Austria.

Introduction: The presence of vasa previa carries a high risk for severe fetal morbidity and mortality due to fetal bleeding caused by injury to unprotected fetal vessels when rupture of membranes occurs. Previously, it has been shown that prenatal diagnosis significantly improves the outcome. However, systematic screening for vasa previa is not generally performed and clinical studies demonstrating the performance of systematic screening for vasa previa in routine clinical practice are rare. Read More

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Metabolomic Biomarkers in Gestational Diabetes Mellitus: A Review of the Evidence.

Int J Mol Sci 2021 May 24;22(11). Epub 2021 May 24.

Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne 3168, Australia.

Gestational diabetes mellitus (GDM) is the fastest growing type of diabetes, affecting between 2 to 38% of pregnancies worldwide, varying considerably depending on diagnostic criteria used and sample population studied. Adverse obstetric outcomes include an increased risk of macrosomia, and higher rates of stillbirth, instrumental delivery, and birth trauma. Metabolomics, which is a platform used to analyse and characterise a large number of metabolites, is increasingly used to explore the pathophysiology of cardiometabolic conditions such as GDM. Read More

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Impact of Fusarium-Derived Mycoestrogens on Female Reproduction: A Systematic Review.

Toxins (Basel) 2021 05 24;13(6). Epub 2021 May 24.

Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ 08854, USA.

Contamination of the world's food supply and animal feed with mycotoxins is a growing concern as global temperatures rise and promote the growth of fungus. Zearalenone (ZEN), an estrogenic mycotoxin produced by fungi, is a common contaminant of cereal grains and has also been detected at lower levels in meat, milk, and spices. ZEN's synthetic derivative, zeranol, is used as a growth promoter in United States (US) and Canadian beef production. Read More

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A Review of Research Progress of Pregnancy with Twins with Preeclampsia.

Risk Manag Healthc Policy 2021 18;14:1999-2010. Epub 2021 May 18.

Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China.

Preeclampsia has a significant long-term effect on the health of both mothers and babies. Preeclampsia-related pregnancy complications increase the morbidity and mortality of pregnant women and their fetuses by 5-8%. The recent advancement of assisted reproductive technology, combined with a rise in the number of elderly pregnant women, has resulted in pregnancy incidence with twins. Read More

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Blood pressure and hypertensive disorders of pregnancy at high altitude: A systematic review and meta-analysis.

Am J Obstet Gynecol MFM 2021 May 20:100400. Epub 2021 May 20.

University Department of Obstetrics and Gynaecology, University of Cambridge; NIHR Cambridge Biomedical Research Centre, CB2 2SW, UK.

Objective: Exposure to high altitude (≥2500m) is associated with increased arterial blood pressure. During pregnancy, even mild elevation of maternal blood pressure is associated with reduced birth weight and increased prevalence of pregnancy complications. This paper aims to systematically assess the impact of altitude on maternal blood pressure at term and on the prevalence of hypertensive disorders of pregnancy. Read More

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Antepartum Fetal Surveillance: ACOG Practice Bulletin, Number 229.

Authors:

Obstet Gynecol 2021 Jun;137(6):e116-e127

The goal of antepartum fetal surveillance is to reduce the risk of stillbirth. Antepartum fetal surveillance techniques based on assessment of fetal heart rate (FHR) patterns have been in clinical use for almost four decades and are used along with real-time ultrasonography and umbilical artery Doppler velocimetry to evaluate fetal well-being. Antepartum fetal surveillance techniques are routinely used to assess the risk of fetal death in pregnancies complicated by preexisting maternal conditions (eg, diabetes mellitus) as well as those in which complications have developed (eg, fetal growth restriction). Read More

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The prevalence of abnormal Doppler's of the umbilical artery in a low-risk pregnant population in South Africa.

EClinicalMedicine 2021 Apr 18;34:100792. Epub 2021 Mar 18.

Department of Obstetrics and Gynaecology, University of Pretoria, Unit Private Bag X323 Arcadia, Pretoria 0007, South Africa.

Background: The assessment of fetal blood flow using Doppler waveform can be used to identify placental insufficiency, and hence is a tool to identify fetuses at risk of stillbirth due to fetal growth restriction (FGR). In South Africa the largest category of perinatal deaths is 'unexplained intrauterine death'. The majority of the mothers are clinically healthy women. Read More

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Effect of L-Arginine supplementation in pregnant women with chronic hypertension and previous placenta vascular disorders receiving Aspirin prophylaxis: a randomized control trial.

Minerva Obstet Gynecol 2021 May 12. Epub 2021 May 12.

Obstetrics Unit, Mother Infant Department, University Hospital Policlinico of Modena, Modena, Italy.

Background: The aim of the study is to evaluate the effects of supplementation with Arginine (L-Arg) 3g, (together with Magnesium (Mg) 350 mg and Salicilate (Sal) 100 mg) on maternal blood pressure (BP), uterine artery doppler PI and neonatal outcomes in women with high-risk pregnancy for chronic hypertension (CH) and other previous placenta vascular disorders (PVD) already treated with low dose of aspirin (LDA), as recommended by guidelines.

Methods: We enrolled women affected by CH and other previous PVD referred to the High-Risk Clinic of the Mother-Infant Department of the University of Modena and Reggio Emilia from September 2017 to June 2019. The study design was a controlled, randomized trial of oral supplementation of L-Arg 3g (together with Mg 350 mg and Sal extract 100 mg) + LDA 100 mg/die versus only LDA 100 mg/die. Read More

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Hyperemesis gravidarum induced refeeding syndrome causes blood cell destruction: a case report and literature review.

BMC Pregnancy Childbirth 2021 May 9;21(1):366. Epub 2021 May 9.

Department of Obstetrics Gynecology, Cheeloo College of Medicine, Qilu Hospital, Shandong University, Shandong, 250012, Jinan, China.

Background: Hyperemesis gravidarum (HG) is a common complication during pregnancy, however, HG associated simultaneous onset of blood cell destruction due to electrolyte abnormalities is rare. In this case, a woman with refeeding syndrome (RFS) secondary to electrolyte abnormalities caused by severe HG was diagnosed and managed in our hospital.

Case Presentation: A 29-year old woman was sent to the local hospitals because of severe HG with appetite loss, weight reduction, general fatigue, and she was identified to have severe electrolyte abnormalities. Read More

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Hepatitis E: An update on One Health and clinical medicine.

Liver Int 2021 07 19;41(7):1462-1473. Epub 2021 May 19.

Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany.

The hepatitis E virus (HEV) is one of the main causes of acute hepatitis and the de facto global burden is underestimated. HEV-related clinical complications are often undetected and are not considered in the differential diagnosis. Convincing findings from studies suggest that HEV is clinically relevant not only in developing countries but also in industrialized countries. Read More

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Nationwide survey (Japan) on spontaneous hemoperitoneum in pregnancy.

J Obstet Gynaecol Res 2021 May 4. Epub 2021 May 4.

Department of Obstetrics and Gynecology, Mie University School of Medicine, Mie, Japan.

Aim: The purpose of this study was to evaluate the current state and clinical characteristics of spontaneous hemoperitoneum in pregnancy (SHiP) in Japan by performing a comprehensive survey.

Methods: We reviewed data on pregnant women who developed SHiP during 2013-2017 (for 5 years), and were admitted to any of the perinatal centers in Japan. The survey assessed maternal background and maternal and neonatal prognosis. Read More

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Intravenous infusion of glucose improved farrowing performance of hyperprolific crossbred sows.

J Anim Sci 2021 May;99(5)

Department of Animal Science, Aarhus University, Foulum, DK-8830 Tjele, Denmark.

The sow at parturition is challenged with respect to energy status due to increases in energetic expenses associated with 1) nest building 2) uterine contractions, and 3) colostrum production. A previous study indicated that sows were depleted of glucogenic energy around farrowing. The aim was to investigate whether intravenous infusion of glucose from observed nest-building behavior to 24 h postpartum affected the farrowing kinetics and colostrum production in sows. Read More

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Incidence, Management and Outcomes in Women Undergoing Peripartum Hysterectomy in a Tertiary Care Centre in India.

Cureus 2021 Mar 29;13(3):e14171. Epub 2021 Mar 29.

Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, Delhi, IND.

Background Peripartum hysterectomy (PRH) is the surgical removal of the uterus performed in obstetrical complications such as uncontrolled postpartum haemorrhage (PPH), unrepairable uterine rupture, and sepsis. Its incidence has increased in recent years. The objective of this study was to review all the cases of PRH in a tertiary care teaching hospital over three years (January 2017-December 2019) to determine its incidence and analyse clinico-demographic characteristics in these women. Read More

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Prevalence and risk factors of severe postpartum hemorrhage: a retrospective cohort study.

BMC Pregnancy Childbirth 2021 Apr 26;21(1):332. Epub 2021 Apr 26.

Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.

Background: Although maternal deaths are rare in developed regions, the morbidity associated with severe postpartum hemorrhage (SPPH) remains a major problem. To determine the prevalence and risk factors of SPPH, we analyzed data of women who gave birth in Guangzhou Medical Centre for Critical Pregnant Women, which received a large quantity of critically ill obstetric patients who were transferred from other hospitals in Southern China.

Methods: In this study, we conducted a retrospective case-control study to determine the prevalence and risk factors for SPPH among a cohort of women who gave birth after 28 weeks of gestation between January 2015 and August 2019. Read More

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[Intrahepatic cholestasis of pregnancy].

Gynakologe 2021 Apr 20:1-16. Epub 2021 Apr 20.

Klinik für Gastroenterologie, Hepatologie und Infektiologie, Universität Düsseldorf, Düsseldorf, Deutschland.

Intrahepatic cholestasis of pregnancy (ICP) is the most frequent pregnancy-specific liver disease. It is characterized by pruritus and an accompanying elevation of serum bile acid concentrations and/or alanine aminotransferase (ALT), which are the key parameters in the diagnosis. Despite good maternal prognosis, elevated bile acid concentration in maternal blood is an influencing factor to advers fetal outcome. Read More

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Acute fatty liver of pregnancy causes severe acute pancreatitis and stillborn fetus: A case report.

Medicine (Baltimore) 2021 Apr;100(16):e25524

Department of Critical Care Medicine, Affiliated Hospital of Guangdong Medical University, China.

Rationale: Acutefatty liver of pregnancy (AFLP) is a potentially fatal obstetric emergency characterized by acute hepatic failure secondary to fatty infiltration. The resultant effects include coagulopathy, electrolyte abnormalities, and multisystem organ dysfunction. Pancreatitis typically develops after the onset of renal and hepatic dysfunction. Read More

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