Search

Objective: Performing obstetric ultrasound scans is challenging for inexperienced operators; therefore, the prenatal screening artificial intelligence system (PSAIS) software was developed to provide real‐time feedback and guidance for trainees during their scanning procedures. The aim of this study was to investigate the potential benefits of utilizing such an artificial intelligence system to enhance the efficiency of obstetric ultrasound training in acquiring and interpreting standard basic views. Methods: A prospective, single‐center randomized controlled study was conducted at The First Affiliated Hospital of Sun Yat‐sen University. From September 2022 to April 2023, residents with no prior obstetric ultrasound experience were recruited and assigned randomly to either a PSAIS‐assisted training group or a conventional training group. Each trainee underwent a four‐cycle practical scan training program, performing 20 scans in each cycle on pregnant volunteers at 18–32 gestational weeks, focusing on acquiring and interpreting standard basic views. At the end of each cycle, a test scan evaluated trainees' ability to obtain standard ultrasound views without PSAIS assistance, and image quality was rated by both the trainees themselves and an expert (in a blinded manner). The primary outcome was the number of training cycles required for each trainee to meet a certain standard of proficiency (i.e. end‐of‐cycle test scored by the expert at ≥ 80%). Secondary outcomes included the expert ratings of the image quality in each trainee's end‐of‐cycle test and the discordance between ratings by trainees and the expert. Results: In total, 32 residents and 1809 pregnant women (2720 scans) were recruited for the study. The PSAIS‐assisted trainee group required significantly fewer training cycles compared with the non‐PSAIS‐assisted group to meet quality requirements (P = 0.037). Based on the expert ratings of image quality, the PSAIS‐assisted training group exhibited superior ability in acquiring standard imaging views compared with the conventional training group in the third (P = 0.012) and fourth (P < 0.001) cycles. In both groups, the discordance between trainees' ratings of the quality of their own images and the expert's ratings decreased with increasing training time. A statistically significant difference in overall trainee–expert rating discordance between the two groups emerged at the end of the first training cycle and remained at every cycle thereafter (P < 0.013). Conclusion: By assisting inexperienced trainees in obtaining and interpreting standard basic obstetric scanning views, the use of artificial intelligence‐assisted systems has the potential to improve training effectiveness. © 2024 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Objective: Fetuses with single ventricle physiology (SVP) exhibit reductions in fetal cerebral oxygenation, with associated delays in fetal brain growth and neurodevelopmental outcomes. Maternal supplemental oxygen (MSO) has been proposed to improve fetal brain growth, but current evidence on dosing, candidacy and outcomes is limited. In this pilot study, we evaluated the safety and feasibility of continuous low‐dose MSO in the setting of SVP. Methods: This single‐center, open‐label, pilot phase‐1 safety and feasibility clinical trial included 25 pregnant individuals with a diagnosis of fetal SVP. Participants self‐administered continuous MSO using medical‐grade oxygen concentrators for up to 24 h per day from the second half of gestation until delivery. The primary aim was the evaluation of the safety profile and feasibility of MSO. A secondary preliminary analysis was performed to assess the impact of MSO on the fetal circulation using echocardiography and late‐gestation cardiovascular magnetic resonance imaging. Early outcomes were assessed, including perinatal growth and preoperative brain injury, and neurodevelopmental outcomes were assessed at 18 months using the Bayley Scales of Infant and Toddler Development 3rd edition, and compared with those of a contemporary fetal SVP cohort (n = 217) that received the normal standard of care (SOC). Results: Among the 25 participants, the median maternal age at conception was 35 years, and fetal SVP diagnoses included 16 with right ventricle dominant, eight with left ventricle dominant and one with indeterminate ventricular morphology. Participants started the trial at approximately 29 + 2 weeks' gestation and self‐administered MSO for a median of 16.1 h per day for 63 days, accumulating a median of 1029 h of oxygen intake from enrolment until delivery. The only treatment‐associated adverse events were nasal complications that were resolved typically by attaching a humidifier unit to the oxygen concentrator. No premature closure of the ductus arteriosus or unexpected fetal demise was observed. In the secondary analysis, MSO was not associated with any changes in fetal growth, middle cerebral artery pulsatility index, cerebroplacental ratio or head‐circumference‐to‐abdominal‐circumference ratio Z‐scores over gestation compared with SOC. Although MSO was associated with changes in umbilical artery pulsatility index Z‐score over the study period compared with SOC (P = 0.02), this was probably due to initial baseline differences in placental resistance. At late‐gestation cardiovascular magnetic resonance imaging, MSO was not associated with an increase in fetal cerebral oxygen delivery. Similarly, no differences were observed in neonatal outcomes, including preoperative brain weight Z‐score and brain injury, mortality by 18 months of age and neurodevelopmental outcomes at 18 months of age. Conclusions: This pilot phase‐1 clinical trial indicates that low‐dose MSO therapy is safe and well tolerated in pregnancies diagnosed with fetal SVP. However, our protocol was not associated with an increase in fetal cerebral oxygen delivery or improvements in early neurological or neurodevelopmental outcomes. © 2024 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Objective: To assess the capacity of fetal pancreatic size, before standard blood glucose testing for screening and diagnosis, to predict maternal gestational diabetes mellitus (GDM). Methods: This was a retrospective cohort study of low‐risk pregnant women recruited during routine second‐trimester fetal anatomical screening at 20–25 weeks' gestation at two ultrasound units in Israel between 2017 and 2020. The predictive performance of fetal pancreatic circumference ≥ 80th and ≥ 90th centiles and glucose challenge test (GCT) was examined for the outcome of GDM. The independent‐samples t‐test was used to compare mean pancreatic circumference centile between pregnancies with GDM and those without GDM. Diagnostic performance was evaluated with 2 × 2 contingency tables and receiver‐operating‐characteristics (ROC) curves. Results: Overall, 195 women were selected for statistical analysis. Twenty‐four (12.3%) women were diagnosed subsequently with GDM. The mean ± SD fetal pancreatic circumference centile was significantly higher in the GDM group compared with the non‐GDM group (82.4 ± 14.6 vs 62.8 ± 27.6; P < 0.001). The pancreatic circumference centile was correlated positively with the estimated fetal weight centile (Pearson's coefficient, 0.243; P = 0.001). The 80th centile cut‐off for pancreatic circumference had the highest sensitivity (70.8%) and positive predictive value (23.3%) for future maternal GDM, with the best trade‐off between sensitivity and specificity achieved at the 75th centile cut‐off (sensitivity, 79%; specificity, 60%). The GCT had better specificity (90.2%) and negative predictive value (97.9%) compared with both cut‐offs in pancreatic circumference. The area under the ROC curve was higher for pancreatic circumference compared with GCT (0.71 vs 0.64) and only the former was statistically significant (P = 0.001). Conclusions: Fetal pancreatic circumference has a higher positive predictive capacity compared with GCT. Measuring pancreatic circumference can identify pregnancies at high risk for maternal GDM, thereby promoting earlier diagnosis and treatment, decreasing the time period during which the fetus is exposed to high maternal glucose levels and improving infant outcome. © 2024 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Objective: To investigate the trimester‐specific associations between maternal total physical activity level vs moderate‐to‐vigorous exercise and fetal growth disorders. Methods: We analyzed 2062 mother–neonate pairs participating in the longitudinal China Medical University Birth Cohort Study. The Pregnancy Physical Activity Questionnaire was used to assess the physical activity level of women during the three trimesters. A higher level of total physical activity was defined as meeting or exceeding the cohort‐specific 75th percentile, and a higher level of exercise was defined according to the Physical Activity Guidelines for Americans. Fetal growth disorder was defined as small‐for‐gestational age (SGA) or large‐for‐gestational age (LGA) at birth. Results: Of the neonates included in this study, 7.1% were SGA and 15.5% were LGA. A higher level of total physical activity during the first trimester (adjusted relative risk (aRR), 0.62 (95% CI, 0.42–0.91)) and second trimester (aRR, 0.62 (95% CI, 0.41–0.95)) was associated with a lower risk of SGA, and a higher level of total physical activity during the third trimester was associated with a lower risk of LGA (aRR, 0.73 (95% CI, 0.54–0.97)). When analyzing physical activity by subtype, a higher level of occupational physical activity during the first and second trimesters was associated negatively with SGA risk, and higher levels of occupational and low‐intensity physical activity during the first trimester were associated negatively with LGA risk. No significant association was found between maternal adherence to the Physical Activity Guidelines for Americans and risk of fetal growth disorders. Conclusions: A higher total physical activity level during the first and second trimesters was associated with a decreased risk of SGA, whereas a higher total physical activity level in the third trimester was associated with a decreased risk of LGA. Pregnant women should be advised to increase their total physical activity levels instead of focusing on engaging in only moderate‐to‐vigorous exercise. © 2024 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Objectives: An increased nuchal translucency (NT) thickness of ≥ 3.5 mm is a well‐established marker for congenital anomalies and adverse pregnancy outcome between 11 and 14 weeks' gestation, but little is known about its performance as a screening tool before 11 weeks. We aimed to investigate, in a prospective setting, whether fetuses with increased NT before 11 weeks are at risk for adverse pregnancy outcome. Methods: This was a prospective cohort study including pregnant women with a viable fetus with NT ≥ 2.5 mm and a crown–rump length (CRL) < 45 mm. All included women were referred to our fetal medicine unit (FMU) and scheduled for a follow‐up scan where the NT was remeasured after 1 week when the CRL was > 45 mm. Two groups were evaluated: cases with a normalized NT (< 3.5 mm) and cases with persistently increased NT (≥ 3.5 mm). The cases were monitored until 4 weeks after delivery. The main outcome was a composite adverse outcome of aneuploidy, other genetic disorders, structural anomalies and pregnancy loss. We performed subgroup analyses of NT thickness at inclusion and normalized or persistently increased NT at follow‐up. Results: The study included 109 cases, of which 39 (35.8%) had an adverse pregnancy outcome. Of these, 64.1% (25/39) were aneuploid, corresponding to 22.9% (25/109) of the total study population. In the subgroups of NT thickness at inclusion of 2.5–3.4 mm, 3.5–4.4 mm and ≥ 4.5 mm, an adverse outcome was reported in 22.0% (9/41), 40.0% (18/45) and 52.2% (12/23), respectively. In fetuses with a normalized NT and without ultrasound abnormalities at the follow‐up scan, the incidence of adverse outcome was 8.5% (5/59), of which 5.1% (3/59) cases were aneuploid. Conclusions: Fetuses with an early increased NT thickness are at considerable risk of an adverse pregnancy outcome, even if the NT normalizes after 11 weeks. Not all congenital anomalies can be diagnosed with routine first‐trimester screening, such as non‐invasive prenatal testing and/or a first‐trimester anomaly scan. Therefore, expectant parents should always be referred to a FMU for detailed ultrasonography. Invasive prenatal testing should be offered if an increased NT of ≥ 2.5 mm is observed before 11 weeks' gestation. © 2024 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. This article's abstract has been translated into Spanish and Chinese. Follow the links from the abstract to view the translations. Linked article: There is a comment on this article by Jiang and Li. Click here to view the Correspondence. [ABSTRACT FROM AUTHOR]

Objective: To compare the predictive performance of three different mathematical models for first‐trimester screening of pre‐eclampsia (PE), which combine maternal risk factors with mean arterial pressure (MAP), uterine artery pulsatility index (UtA‐PI) and serum placental growth factor (PlGF), and two risk‐scoring systems. Methods: This was a prospective cohort study performed in eight fetal medicine units in five different regions of Spain between September 2017 and December 2019. All pregnant women with singleton pregnancy and a non‐malformed live fetus attending their routine ultrasound examination at 11 + 0 to 13 + 6 weeks' gestation were invited to participate in the study. Maternal characteristics and medical history were recorded and measurements of MAP, UtA‐PI, serum PlGF and pregnancy‐associated plasma protein‐A (PAPP‐A) were converted into multiples of the median (MoM). Risks for term PE, preterm PE (< 37 weeks' gestation) and early PE (< 34 weeks' gestation) were calculated according to the FMF competing‐risks model, the Crovetto et al. logistic regression model and the Serra et al. Gaussian model. PE classification was also performed based on the recommendations of the National Institute for Health and Care Excellence (NICE) and the American College of Obstetricians and Gynecologists (ACOG). We estimated detection rates (DR) with their 95% CIs at a fixed 10% screen‐positive rate (SPR), as well as the area under the receiver‐operating‐characteristics curve (AUC) for preterm PE, early PE and all PE for the three mathematical models. For the scoring systems, we calculated DR and SPR. Risk calibration was also assessed. Results: The study population comprised 10 110 singleton pregnancies, including 32 (0.3%) that developed early PE, 72 (0.7%) that developed preterm PE and 230 (2.3%) with any PE. At a fixed 10% SPR, the FMF, Crovetto et al. and Serra et al. models detected 82.7% (95% CI, 69.6–95.8%), 73.8% (95% CI, 58.7–88.9%) and 79.8% (95% CI, 66.1–93.5%) of early PE; 72.7% (95% CI, 62.9–82.6%), 69.2% (95% CI, 58.8–79.6%) and 74.1% (95% CI, 64.2–83.9%) of preterm PE; and 55.1% (95% CI, 48.8–61.4%), 47.1% (95% CI, 40.6–53.5%) and 53.9% (95% CI, 47.4–60.4%) of all PE, respectively. The best correlation between predicted and observed cases was achieved by the FMF model, with an AUC of 0.911 (95% CI, 0.879–0.943), a slope of 0.983 (95% CI, 0.846–1.120) and an intercept of 0.154 (95% CI, –0.091 to 0.397). The NICE criteria identified 46.7% (95% CI, 35.3–58.0%) of preterm PE at 11% SPR and ACOG criteria identified 65.9% (95% CI, 55.4–76.4%) of preterm PE at 33.8% SPR. Conclusions: The best performance of screening for preterm PE is achieved by mathematical models that combine maternal factors with MAP, UtA‐PI and PlGF, as compared to risk‐scoring systems such as those of NICE and ACOG. While all three algorithms show similar results in terms of overall prediction, the FMF model showed the best performance at an individual level. © 2024 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

This document provides a summary of various studies and research on stillbirths, focusing on risk factors, interventions, and causes. The global stillbirth rate in 2021 was 13.9 per 1000 total births, with a significant number occurring during labor. Low- and lower-middle-income countries account for the majority of stillbirths, particularly in sub-Saharan Africa and Southern Asia. The COVID-19 pandemic has also led to increased stillbirth rates in high-income countries. While the global stillbirth rate has decreased over the past two decades, it still lags behind other mortality indicators. The summary emphasizes the need for a comprehensive approach to address stillbirths, including improved access to healthcare services, health education for mothers, research investment, and international collaboration. Accurate data and high-quality care for pregnant women are urgently needed to reduce stillbirth rates and improve outcomes. [Extracted from the article]

Objectives: Angiogenic marker assessment, such as the ratio of soluble fms‐like tyrosine kinase‐1 (sFlt‐1) to placental growth factor (PlGF), is known to be a useful tool in the prediction of pre‐eclampsia (PE). However, evidence from surveillance strategies in pregnancies with a PE diagnosis is lacking. Therefore, we aimed to assess the predictive performance of longitudinal maternal serum angiogenic marker assessment for both maternal and perinatal adverse outcomes when compared to standard laboratory parameters in pregnancies with confirmed PE. Methods: This was a retrospective analysis of prospectively collected data from January 2013 to December 2020 at the Medical University of Vienna. The inclusion criteria were singleton pregnancy with confirmed PE and post‐diagnosis maternal serum angiogenic marker assessment at a minimum of two timepoints. The primary outcome was the predictive performance of longitudinal sFlt‐1 and PlGF assessment for adverse maternal and perinatal outcomes compared to conventional laboratory monitoring at the same time in pregnancies with confirmed PE. Composite adverse maternal outcome included intensive care unit admission, pulmonary edema, eclampsia and/or death. Composite adverse perinatal outcome included stillbirth, neonatal death, placental abruption, neonatal intensive care unit admission, intraventricular hemorrhage, necrotizing enterocolitis, respiratory distress syndrome and/or mechanical ventilator support. Results: In total, 885 post‐diagnosis sFlt‐1/PlGF ratio measurements were obtained from 323 pregnant women with confirmed PE. For composite adverse maternal outcome, the highest standalone predictive accuracy was obtained using maternal serum sFlt‐1/PlGF ratio (area under the receiver‐operating‐characteristics curve (AUC), 0.72 (95% CI, 0.62–0.81)), creatinine (AUC, 0.71 (95% CI, 0.62–0.81)) and lactate dehydrogenase (LDH) levels (AUC, 0.73 (95% CI, 0.65–0.81)). Maternal platelet levels (AUC, 0.65 (95% CI, 0.55–0.74)), serum alanine aminotransferase (ALT) (AUC, 0.59 (95% CI, 0.49–0.69)) and aspartate aminotransferase (AST) (AUC, 0.61 (95% CI, 0.51–0.71) levels had poor standalone predictive accuracy. The best prediction model consisted of a combination of maternal serum LDH, creatinine levels and sFlt‐1/PlGF ratio, which had an AUC of 0.77 (95% CI, 0.68–0.85), significantly higher than sFlt‐1/PlGF ratio alone (P = 0.037). For composite adverse perinatal outcome, the highest standalone predictive accuracy was obtained using maternal serum sFlt‐1/PlGF ratio (AUC, 0.82 (95% CI, 0.75–0.89)) and creatinine (AUC, 0.74 (95% CI, 0.67–0.80)) levels, sFlt‐1/PlGF ratio being superior to creatinine alone (P < 0.001). Maternal serum LDH levels (AUC, 0.65 (95% CI, 0.53–0.74)), platelet count (AUC, 0.57 (95% CI, 0.44–0.67)), ALT (AUC, 0.58 (95% CI, 0.48–0.67)) and AST (AUC, 0.58 (95% CI, 0.48–0.67)) levels had poor standalone predictive accuracy. No combination of biomarkers was superior to maternal serum sFlt‐1/PlGF ratio alone for prediction of composite adverse perinatal outcome (P > 0.05 for all). Conclusions: In pregnancies with confirmed PE, longitudinal maternal serum angiogenic marker assessment is a good predictor of adverse maternal and perinatal outcomes and superior to some conventional laboratory parameters. Further studies should focus on optimal surveillance following diagnosis of PE. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Objective: To investigate the association between epidural analgesia (EDA) vs patient‐controlled remifentanil analgesia (PCRA) and emergency delivery for presumed fetal compromise, in relation to birth‐weight quintile. Methods: This was a post‐hoc per‐protocol analysis of the RAVEL multicenter equivalence randomized controlled trial. Non‐anomalous singleton pregnancies between 36 + 0 and 42 + 6 weeks' gestation were randomized at the time of requesting pain relief to receive EDA or PCRA. The primary outcome was emergency delivery for presumed fetal compromise. Secondary outcomes included mode of delivery and neonatal outcomes. Analysis was performed according to birth‐weight quintile and was corrected for relevant confounding variables. Results: Of 619 pregnant women, 336 received PCRA and 283 received EDA. Among women receiving EDA, 14.8% had an emergency delivery for presumed fetal compromise, compared with 8.3% of women who received PCRA. After adjusting for parity, women receiving EDA had higher odds of presumed fetal compromise compared to those receiving PCRA (odds ratio, 1.69 (95% CI, 1.01–2.83)). A statistically significant linear‐by‐linear association was observed between presumed fetal compromise and birth‐weight quintile (P = 0.003). The incidence of emergency delivery for presumed fetal compromise was highest in women receiving EDA and delivering a neonate with a birth weight in the lowest quintile. Conclusions: Intrapartum EDA is associated with a higher rate of emergency delivery for presumed fetal compromise compared to treatment with PCRA. Birth‐weight quintile is a strong predictor of this outcome, independent of pain management method. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. Linked articles: There are comments on this article by Cavoretto et al., Rongen et al. and van den Bosch et al. [ABSTRACT FROM AUTHOR]

Objective: To assess the effectiveness, cost and cost‐effectiveness of four screening strategies for first‐trimester (T1) cytomegalovirus (CMV) primary infection (PI) in pregnant women in France. Methods: In a simulated pregnant population of 800 000 (approximate number of pregnancies each year in France), using costs based on the year 2022, we compared four CMV maternal screening strategies: Strategy S1, no systematic screening (current public health recommendations in France); Strategy S2, screening of 25–50% of the pregnant population (current screening practice in France); Strategy S3, universal screening (current medical recommendations in France); Strategy S4, universal screening (as in Strategy S3) in conjunction with valacyclovir in case of T1 PI. Outcomes were total cost, effectiveness (number of congenital infections, number of diagnosed infections) and incremental cost‐effectiveness ratio (ICER). Two ICERs were calculated, comparing Strategies S1, S2 and S3 in terms of euros (€) per additional diagnosis, and comparing Strategies S1 and S4 in € per avoided congenital infection. Results: Compared with Strategy S1, Strategy S3 enabled diagnosis of 536 more infected fetuses and Strategy S4 prevented 375 congenital infections. Strategy S1 was the least expensive strategy (€98.3m total lifetime cost), followed by Strategy S4 (€98.6m), Strategy S2 (€106.0m) and Strategy S3 (€118.9m). In the first analysis, Strategy S2 was dominated and Strategy S3 led to an additional €38 552 per additional in‐utero diagnosis, compared with Strategy S1. In the second analysis, Strategy S4 led to an additional €893 per avoided congenital infection compared with Strategy S1, and was cost‐saving compared with Strategy S2. Conclusions: In France, current screening practice for CMV PI during pregnancy is no longer acceptable in terms of cost‐effectiveness because this strategy was dominated by universal screening. Moreover, universal screening in conjunction with valacyclovir treatment would be cost‐effective compared with current recommendations and is cost‐saving compared with current practice. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

This article discusses a case of ovarian torsion during pregnancy, emphasizing the importance of early diagnosis and treatment to prevent complications such as ovarian necrosis and fetal loss. The case involves a 33-year-old woman who presented with lower abdominal cramps at 6+2 weeks of pregnancy. An ultrasound scan revealed a clear cyst in the right ovary, and the patient was initially managed conservatively. However, she later experienced sudden onset of severe abdominal pain and vomiting, leading to a diagnosis of ovarian torsion. The patient underwent laparoscopic surgery to detorse the ovary and remove the cyst. Follow-up ultrasounds showed a viable fetus and a smaller cyst in the right ovary. The article concludes that detailed sonographic observations are crucial for accurate diagnosis. [Extracted from the article]

This article, published in the journal Ultrasound in Obstetrics & Gynecology, discusses a study conducted in Tunisia to identify predictive factors of preterm delivery in pregnant women hospitalized for threatened preterm delivery between 28 and 34 weeks. The study analyzed 71 primary pregnant women and found that factors such as premature rupture of membranes, urinary tract infection, short cervical length, and a positive sliding sign were potentially predictive of preterm delivery. The multivariate analysis revealed that the presence of premature rupture of membranes, a funnel-shaped image, and a positive cervical sliding sign were the most significant predictive signs of preterm birth. The study concludes that the positive sliding sign is the only significant predictive sign of preterm birth. [Extracted from the article]

This article discusses a study that aimed to investigate the effects of pravastatin and L-arginine therapy on uteroplacental and fetal circulation in pregnant patients with increased uterine artery resistance in the second trimester. The study included 21 patients, and the therapy was administered from the second trimester until delivery. The results showed that the therapy achieved vasodilatory effects in umbilical and fetal circulation, postponing the deterioration in circulation due to vasoconstriction in uteroplacental circulation. The study concluded that this therapy could be beneficial in improving circulation in pregnant patients. [Extracted from the article]

This article compares the effectiveness of transabdominal ultrasound (TAS) alone versus TAS combined with transvaginal ultrasound (TVS) in diagnosing placenta accreta spectrum (PAS) in pregnant women. The study involved 70 high-risk cases of PAS, and the ultrasound images were independently reviewed by two obstetricians with different levels of experience. The results showed that the agreement between observers and the accuracy of diagnosing PAS were higher when TAS and TVS were used together, especially for the more experienced operator. This suggests that combining these two ultrasound techniques can improve the accuracy of diagnosing PAS. [Extracted from the article]

This article examines the value of crystal imaging for diagnosing placenta accreta disease. The study recruited 25 pregnant women with a history of Caesarean section or uterine cavity operation. The results showed that positive crystal imaging, defined as imaging disruption of the underlying membrane of the placenta, was associated with placenta accreta disease. The study concludes that adding crystal imaging to routine ultrasound examinations can provide better diagnostic information for placenta accreta. [Extracted from the article]

This article, published in the journal Ultrasound in Obstetrics & Gynecology, discusses the use of superb microvascular imaging (SMI) to detect prenatal pathological findings in pathologic placentas. The study involved pregnant women who were admitted to a perinatal center for perinatal management. Ultrasound examinations using SMI were performed before delivery, and the accuracy of prenatal ultrasound detection of placental pathologic findings was determined. The results showed that SMI can accurately detect placental pathologic findings, such as placental infarction and avascular villi, which may improve perinatal management in cases of placental dysfunction. [Extracted from the article]

This article, titled "EP14.23: Ultrasound screening for preterm birth in twin pregnancies: a prospective longitudinal pilot study," explores the efficacy of different cervical parameters measured through transvaginal 2D ultrasound and elastography in predicting preterm birth in twin pregnancies. The study collected data from 36 twin pregnant women and compared various parameters between those who delivered at term and those who delivered prematurely. The results showed that the uterocervical angle (UCA) and the ratio of internal os strain (IOS) to external os strain (EOS) were significantly different between the two groups, indicating that a wider angle and higher strain ratio were associated with a higher risk of preterm birth. The study suggests that alternative ultrasound parameters, particularly UCA, may be useful in screening and managing twin pregnancies at risk of premature labor or rupture of membranes. [Extracted from the article]

This article presents the findings of a retrospective cohort study conducted in Victoria, Australia, which aimed to evaluate the rates of adverse maternal and perinatal outcomes in pregnant women with chronic hypertension (CH) compared to normotensive controls. The study analyzed 390,282 births and found that CH, pre-eclampsia (PE), and eclampsia occurred in 1.24%, 2.56%, and 0.08% of pregnant women, respectively. Superimposed PE occurred in 0.25% of the overall population and 20.5% of CH patients. Pregnant women with CH had higher rates of complications such as acute pulmonary edema, PE, eclampsia, disseminated intravascular coagulation, and placental abruption compared to controls. The study also identified multiple pregnancies and being attended on the public health sector as risk factors for superimposed PE. The authors conclude that CH increases the risk of maternal and perinatal complications, and understanding the risk factors for superimposed PE is important for patient counseling. [Extracted from the article]

This article, titled "EP08.46: Comparison of mean uterine artery PI in the second and third trimesters: is it possible that mean uterine artery PI is rising in third trimester?", compares uterine artery Doppler indices in the second and third trimesters of pregnancy. The study was conducted on 100 pregnant women, and various demographic and clinical information was recorded for each patient. The results showed that the mean uterine artery PI in the second trimester was significantly different from that in the third trimester. Additionally, there were significant relationships between PAPP, beta MOM, fetal weight percentile, and uterine artery PI in both trimesters. The study suggests that while the PI of the uterine artery generally decreases in the third trimester, there is a possibility that the mean uterine artery PI value may increase during this period. [Extracted from the article]

This article, titled "Maternal characteristics associated with Crown–rump length in first trimester scan," explores the relationship between maternal characteristics and the measurement of Crown–rump length (CRL) during the first trimester of pregnancy. The study included 2350 pregnant women who underwent a first trimester scan in two different fetomaternal centers in Central Greece over a 10-year period. The results showed a positive correlation between CRL and maternal age and height, indicating that increasing age and height were associated with increased CRL values. However, there was no significant association between maternal Body Mass Index (BMI) and CRL. The findings suggest that understanding these factors can help obstetricians better understand growth patterns in early pregnancy. [Extracted from the article]

This article, titled "Prenatal detection of Down syndrome based on second and third trimester ultrasound scan," examines the incidence of Down Syndrome suspected on late trimester scans. The study analyzed the medical records of pregnant women who gave birth to babies with confirmed Down Syndrome. Out of 126 mothers, 80 had at least one prenatal scan, and 50 of them had abnormal findings on the scans. 15 fetuses were suspected with Down Syndrome, and further genetic testing confirmed the diagnosis in some cases. The article suggests that early prenatal diagnosis through first trimester screening programs could be beneficial for counseling and support. [Extracted from the article]

This article presents a retrospective study conducted in Tunis hospitals to assess the impact of COVID-19 on hospitalized pregnant women. The study population consisted of women aged 28-38 years with diverse educational backgrounds. Most women had no significant medical history, but some had controlled asthma or a prior pregnancy loss. Vaccination rates were high, with the majority receiving prenatal care. Common COVID-19 symptoms were reported in 73% of women, and most cases were mild with no maternal deaths. However, COVID-19 infection was associated with an increased risk of preterm delivery, respiratory distress, and miscarriage. Psychological distress was observed in all women. Delivery outcomes were significantly impacted, with a rise in Caesarean sections and a high preterm birth rate. Neonatal COVID-19 infection occurred in 6% of cases, but most newborns had good Apgar scores. The study emphasizes the importance of continued vaccination efforts and close monitoring throughout pregnancy. [Extracted from the article]

This article, titled "Influence of clinical and anamnestic factors on the severity of the course and early delivery in pregnant women with COVID-19," examines the impact of clinical and anamnestic factors on the severity and early delivery in pregnant women with COVID-19 pneumonia. The study, conducted at a tertiary level COVID hospital, divided the group of patients into three subgroups based on the level of respiratory support required. The results showed that factors such as the onset of the disease during pregnancy, body temperature during illness, and oxygen saturation in ambient air were associated with a higher risk of invasive respiratory support. Additionally, the study found that preterm birth was significantly higher in the third subgroup, and newborns of patients requiring invasive respiratory support had lower birth weights. The authors conclude that these factors can provide valuable information for predicting the severity and early delivery in pregnant patients with COVID-19. [Extracted from the article]

This article discusses the use of three-dimensional ultrasound (3DUS) and magnetic resonance imaging (MRI) to create physical models of fetuses using additive manufacturing (AM) technology. The study used images from 73 pregnant women, including cases of twins, and successfully generated physical models that resembled the postnatal appearance of aborted fetuses or newborns. The authors suggest that these technologies can improve our understanding of fetal anatomical characteristics and be used for educational purposes and to help parents visualize their unborn baby. The images obtained from 3DUS and MRI can be segmented and combined to construct 3D virtual and physical models. [Extracted from the article]

This article presents the findings of a register-based cohort study conducted in Denmark from 2008 to 2018, which aimed to assess and compare the incidence and risk of pre-eclampsia (PE) in twin pregnancies based on various factors. The study included 9,398 dichorionic (DC) and 1,947 monochorionic diamniotic (MCDA) twin pregnancies, as well as 19,341 singletons. The results showed that MCDA twins had a significantly higher cumulative risk of PE at lower gestational ages (GA) compared to DC twins, particularly before 34+0, 36+0, and 38+0 weeks. Additionally, monozygotic (MZ) twins had a higher risk of PE compared to dizygotic (DZ) twins before GA 34+0, and there was a marginal significance in PE risk between male and female MZ twin pregnancies before GA 34+0. However, there were no significant differences in the overall incidence of PE or the risk before GA 28+0 or 32+0 weeks. [Extracted from the article]

This article, titled "Mediterranean diet pattern as a protective factor against pre-eclampsia," explores the relationship between maternal dietary habits and the development of pre-eclampsia. The study, conducted in Barcelona, Spain, found that pregnant women with pre-eclampsia had a lower adherence to the Mediterranean diet compared to those with uncomplicated pregnancies. The study also found that extra virgin olive oil, vegetables, and fruit were associated with a lower risk of developing pre-eclampsia, while saturated fatty acids and ultra-processed food were associated with a higher risk. The consumption of extra virgin olive oil was found to improve the antiangiogenic status in pre-eclamptic women. [Extracted from the article]

This article explores the use of cervical elastography in assessing cervical remodelling and predicting spontaneous preterm birth (sPTB) in singleton pregnancies. The study enrolled pregnant women scheduled for first trimester ultrasound scans, and cervical elastography was conducted in both the first and second trimesters. The results showed that cervical elastography parameters differed significantly between the first and second trimesters, with certain parameters being higher or lower in the preterm birth group compared to the term birth group. The study concludes that cervical elastography can be used to visualize changes in cervical remodelling and that combining certain parameters can help predict the risk of sPTB and a short cervix. [Extracted from the article]

This article, titled "OC17.06: First trimester cardiac function in women with and without high risk of pre-eclampsia," examines the presence of cardiac dysfunction parameters or risk factors in the first trimester of pregnancy in women with and without a high risk of pre-eclampsia. The study involved 322 women, including 86 controls and 224 women at high risk for pre-eclampsia. The results showed significant differences in parameters associated with high risk of pre-eclampsia, such as blood pressure, body mass index, and maternal age. The findings suggest that cardiovascular disease risk factors may be present in the first trimester in women with a high risk of pre-eclampsia, indicating the potential for future cardiac changes. [Extracted from the article]

A study published in the journal Ultrasound in Obstetrics & Gynecology aimed to validate the accuracy of the "amniotic sac sign" in diagnosing early miscarriage. The study involved 1897 pregnancies from 1890 women across five centers. The results showed that the presence of an amniotic sac without a live embryo had 100% specificity for the diagnosis of miscarriage. Implementing this sign could potentially reduce the number of follow-up visits for pregnancies of uncertain viability by 10%, providing benefits in terms of patient anxiety and financial costs. [Extracted from the article]

A trial conducted in Asia aimed to assess the effectiveness, acceptability, and safety of a first trimester screen-and-prevent strategy for preterm pre-eclampsia (PE). The trial involved 48,725 pregnant women in ten regions across Asia from 2019 to 2022. The results showed that 88.04% of women agreed to undergo first trimester screening for preterm PE, and among those identified as high-risk, 82.39% received low-dose aspirin (LDA). The use of LDA was associated with a significant reduction in the incidence of preterm PE, as well as other adverse outcomes. The study concluded that the screen-and-prevent strategy is highly accepted among women from diverse ethnic backgrounds, and LDA is considered a safe intervention during pregnancy. [Extracted from the article]

This article discusses a study that aims to demonstrate the scientific validity of a novel cell-based non-invasive prenatal testing (cbNIPT) method for detecting fetal copy number variants (CNVs) using single cell sequencing of circulating extravillous trophoblasts (cEVTs). The study enrolled 1388 high-risk pregnancies and found a screen positive rate of 18.9% for aneuploidies and 11.2% for pCNVs. The results showed that cbNIPT was able to detect pCNVs <1 Mb in size, which is below the resolution of cell-free DNA screening. The authors conclude that analyzing cEVTs from maternal blood could significantly reduce the residual risk for pCNVs in early gestational weeks. [Extracted from the article]

A study conducted at a University Hospital in Barcelona, Spain, investigated the effects of a Mediterranean diet (MedDiet) or mindfulness-based stress reduction (MBSR) during pregnancy on placental volume and perfusion in high-risk pregnancies. The study randomly assigned 1221 pregnant women at high risk for small for gestational age (SGA) into three groups: MedDiet, MBSR, or usual care. The results showed that both interventions were associated with a lower prevalence of small placental volume compared to usual care. These findings suggest that structured interventions based on MedDiet or MBSR during pregnancy may have beneficial effects on fetal growth. [Extracted from the article]

This article discusses a study conducted at the Fetal Medicine Unit of the University of Chile Hospital between 2018 and 2020. The study aimed to determine the impact of changes in the uterine artery pulsatility index (UtA-PI) on the outcomes of pregnant women using aspirin to prevent preterm pre-eclampsia (PE). The study found that pregnant women at high risk of preterm PE who were treated with aspirin had greater uterine artery vasodilation between the first and second trimesters compared to control pregnant women. However, further research with a larger sample size is needed to confirm these findings. [Extracted from the article]

Objectives: To evaluate the reproducibility of lower uterine segment (LUS) thickness measurement before induction of labor (IOL), and to assess the relationship between LUS thickness and IOL outcomes. Methods: This was a prospective cohort study of pregnant women undergoing IOL at term, conducted in a single tertiary hospital between July 2014 and February 2017. Women with a singleton pregnancy at ≥ 37 weeks' gestation, with a live fetus in cephalic presentation and a Bishop score of ≤ 6, were eligible for inclusion. Both nulliparous and parous women, and those with a previous Cesarean section (CS), were eligible. All women underwent transvaginal ultrasound assessment before IOL admission, and cervical length and LUS thickness were measured offline after delivery. Maternal and obstetric characteristics and Bishop score were recorded. The main outcome was the overall rate of CS after IOL, and secondary outcomes were CS for either failure to progress in the active phase of labor or failed IOL, and CS for failed IOL only. Interobserver agreement for measurement of LUS thickness between two operators was assessed using the intraclass correlation coefficient (ICC) and Bland–Altman analysis with the ANOVA test to evaluate systematic bias. Univariable and multivariable analysis were employed to evaluate the relationship between clinical and sonographic characteristics and IOL outcomes. Results: Of 265 women included in the analysis, 195 (73.6%) had a vaginal delivery and 70 (26.4%) required a CS after IOL. Reproducibility analysis showed excellent interobserver agreement for the measurement of LUS thickness (ICC, 0.96 (95% CI, 0.93–0.98)). On Bland–Altman analysis, the mean difference in LUS thickness between the two operators was 0.15 mm (95% limits of agreement, –1.84 to 2.14 mm), and there was no evidence of systematic bias (ANOVA test, P = 0.46). Univariable analysis showed that LUS thickness was associated significantly with overall CS (P = 0.002), CS for failure to progress in the active phase of labor or failed IOL (P = 0.03) and CS for failed IOL (P = 0.037). On multivariable logistic regression analysis, LUS thickness was an independent predictive factor for overall CS (odds ratio (OR), 1.149 (95% CI, 1.031–1.281)) and CS for failure to progress in the active phase of labor or failed IOL (OR, 1.226 (95% CI, 1.039–1.445)). Conclusions: In women undergoing IOL at term, measurement of LUS thickness is feasible and reproducible, and is associated significantly with IOL outcome. © 2022 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

This article discusses a case of severe fetal growth restriction (FGR) caused by placental implantation on intrauterine synechiae. The case involves a 20-year-old woman who was referred for assessment of fetal growth at 32 weeks' gestation. The ultrasound scans showed that the placenta was implanted on a thin and poorly vascularized uterine synechia, resulting in impaired gas and nutrient exchange. The article also mentions that the exact cause of uterine synechiae is unknown, but they are associated with instrumentation and infection of the uterus. The study concludes that monitoring fetal growth is important when significant portions of the placenta are implanted on intrauterine synechiae. [Extracted from the article]

Objectives: To examine the relationship between the English index of multiple deprivation (IMD) and the incidence of pre‐eclampsia (PE), evaluate the distribution of IMD in a cohort of ethnically diverse pregnant women in South East England and assess whether IMD improves the prediction of PE compared with that provided by the 'history‐only' competing‐risks model (based on maternal characteristics and medical history). Methods: This was a prospective, observational study of 159 125 women with a singleton pregnancy who attended their first routine hospital visit at 11 + 0 to 13 + 6 weeks' gestation in two maternity hospitals in the UK. The inclusion criteria were delivery at ≥ 24 weeks' gestation of babies without major abnormality. Participants completed a questionnaire on demographic characteristics and obstetric and medical history, which was then reviewed by a doctor together with the woman. Patients were asked to self‐identify as white, black, South Asian, East Asian or mixed race. IMD was used as a measure of socioeconomic status, which takes into account income, employment, education, skills and training, health and disability, crime, barriers to housing and services, and living environment. Each neighborhood is ranked according to their level of deprivation relative to that of other areas into one of five equal groups, with Quintile 1 containing the 20% most deprived areas and Quintile 5 containing the 20% least deprived areas. IMD was assigned based on a woman's postcode. Risk factors for PE and its incidence were assessed across IMD using chi‐square test or t‐test, as appropriate. The relationship between IMD and gestational age at delivery with PE was evaluated by fitting parametric survival models for IMD alone, IMD combined with race and IMD combined with the Fetal Medicine Foundation history‐only competing‐risks model. Results: The incidence of PE (n = 4088, 2.6%) increased progressively across IMD quintiles, from 2.0% in Quintile 5 (least deprived) to 3.0% in Quintile 1 (most deprived). Compared with white women and those in other racial groups, black women had a higher incidence of PE (4.8%), were less often in IMD Quintiles 4 and 5, and were more often in IMD Quintiles 1 and 2. None of the IMD quintiles improved the prediction of PE compared with that provided by the history‐only competing‐risks model (which includes race). The history‐only competing‐risks model with vs without IMD had a similar detection rate for delivery with PE at < 37 weeks' gestation (44.1% (95% CI, 41.1–47.2%) vs 43.9% (95% CI, 40.1–47.0%)) and at any gestational age (35.2% (95% CI, 33.8–36.7%) vs 35.1% (95% CI, 33.7–36.6%)), at a 10% screen‐positive rate. Conclusions: The incidence of PE is higher in women living in the most deprived areas in South East England and in black women (vs those of other racial groups), who also live in areas of higher deprivation. However, in screening for PE, inclusion of IMD does not improve the prediction of PE provided by race and other maternal characteristics and elements of medical history. © 2022 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

This article, titled "EP21.11: Factors that can guide follow-up in women diagnosed with pregnancy of unknown viability," discusses a study conducted at a university teaching hospital in London, UK. The study aimed to determine whether factors such as gestational age at presentation, interval between the first positive urine pregnancy test (UPT) and transvaginal ultrasound scan (TVS), and presenting symptoms could guide the need for follow-up in women diagnosed with a pregnancy of unknown viability (PUV). The study found that pregnancies of advanced gestational age diagnosed as PUV were more likely to end in miscarriage, while the interval between the UPT and TVS did not show a significant correlation. Bleeding was found to be associated with a higher likelihood of miscarriage, while pain and a history of miscarriage did not show a significant association. The article concludes that gestational age at scan and symptoms can be used to guide follow-up and counseling for patients diagnosed with PUV. [Extracted from the article]

This article discusses a study that aimed to investigate the differences in cervical elastographic parameters in pregnant women with or without preterm birth (PTB) who had a cervical length of 2.5-2.9 cm in midtrimester. The study included 105 patients, and 7.6% of them had spontaneous PTB. The results showed that there were differences in cervical elastographic parameters between the term and preterm delivery groups, suggesting that these parameters may help in predicting PTB. The study was conducted by the Korean Research Group of Cervical Elastography and was supported by a grant. [Extracted from the article]

This article discusses the experience of conducting first trimester screening for chromosomal abnormalities in a setting with limited resources due to military status. The screening involved assessing the risk of chromosomal abnormalities using factors such as maternal age, medical history, and ultrasound markers. Biochemical studies were limited, so the risks were calculated using software without biochemical markers. The study examined 351 pregnant women, with a majority being Caucasian. The results showed that the screening method used provided optimal information on risk groups and did not miss any cases of chromosomal abnormalities during the two-year study period. [Extracted from the article]

This article discusses a study conducted in Melbourne, Australia, that aimed to investigate the role of repeated cell-free DNA (cfDNA) screening in the third trimester of pregnancy in predicting the likelihood of confined placental mosaicism (CPM) after a false-positive screening result. Pregnant women with high-risk cfDNA screening results that were discordant with fetal diagnostic investigations were offered a repeat cfDNA test at 31-33 weeks' gestation. Maternal plasma samples were collected and analyzed, and placental biopsies were taken after delivery. The preliminary findings suggest that CPM is a significant contributor to discordant cfDNA results, even when repeated at later stages of pregnancy. [Extracted from the article]

This article, titled "Investigation of uterine artery pulsatility index in pregnant women with spontaneous preterm labour," explores the relationship between the pulsatility index (PI) of the uterine artery and spontaneous preterm birth. The study was conducted on 200 pregnant women at the Gynecology and Obstetrics Department of Imam Khomeini Hospital in Ahvaz. The results indicate a significant relationship between the PI of the uterine artery and spontaneous preterm birth. The average age of the mothers was 30 years, and the average PI values were 0.87 for the right uterine artery and 1.02 for the left uterine artery. [Extracted from the article]

This article, titled "EP17.55: Interobserver reproducibility of a novel cervical elastography index," discusses a study that aimed to evaluate the interobserver reproducibility of a new cervical Strain Imaging (elastography) index in pregnant women at 18-24 weeks. The study involved 100 pregnant women at high and low risk for preterm birth, and the elastographic index (EI) was calculated using markers positioned at the external os (EOs) and internal os (IOs) of the cervix. The results showed that the EI obtained through vaginal ultrasonography had a high interobserver reproducibility, but further testing is needed to determine its potential for predicting preterm birth. [Extracted from the article]

This article, published in the journal Ultrasound in Obstetrics & Gynecology, examines the concentrations of PAPP-A protein and bHCG in pregnant women between 11 and 13+6 weeks of gestation who experienced preterm prelabour rupture of membranes (pPROM) compared to those without this complication. The study found that women with pPROM had lower concentrations of fb-HCG and PAPP-A in the first trimester, suggesting that these markers may serve as early predictors for pPROM. Further research is needed to confirm the clinical significance and predictive value of these findings. [Extracted from the article]

This article, published in the journal Ultrasound in Obstetrics & Gynecology, examines the association between low fetal fraction (FF) of cell-free DNA (cfDNA) and obstetric complications. The study analyzed data from 3048 pregnant women who underwent cfDNA screening for chromosomal defects at the GENNET screening center between 2019 and 2022. The results showed that in 1.5% of the tests, the FF was ≤4%. Among the women with low FF, there was a higher incidence of pregnancy-induced hypertension (PIH) and gestational diabetes mellitus (GDM) compared to the control group. However, due to the small sample size, further research with a larger sample is needed to confirm these findings. [Extracted from the article]

This article evaluates the usefulness of the QUiPP App in identifying women at risk of spontaneous preterm birth (sPTB) before 34 weeks' gestation. The study included 40 admitted patients, and the QUiPP App was used to assess the risk of delivery within 14 days. The results showed that the app had a sensitivity of 83.3% and a specificity of 76.5% in predicting delivery within 14 days. The group with negative test results had a higher rate of full-term delivery, suggesting that the app could help avoid unnecessary hospitalization. Overall, the QUiPP App could be a valuable tool in clinical decision-making in Japan, even without the availability of the cervicovaginal fluid quantitative fetal fibronectin (qfFN) test. [Extracted from the article]

This article examines the use of maternal ophthalmic artery Doppler (OAD) in normal pregnancy and pre-eclampsia and its association with pregnancy outcomes. The study found that pre-eclamptic women had significantly higher peak ratios in OAD measurements compared to normotensive women. A higher peak ratio was associated with adverse maternal outcomes such as hypertensive crisis, PRES (Eclampsia/CNS injury), and HELLP Syndrome. The authors suggest that OAD may be a useful tool for assessing the risk of neurological events in pre-eclampsia and guiding appropriate therapy and referral. [Extracted from the article]

This article, titled "Association of placental umbilical cord insertion site with maternal and perinatal outcomes," discusses a study conducted in a tertiary care hospital to determine the different placental umbilical cord insertion sites and their association with maternal and perinatal outcomes. The study found that abnormal cord insertions, specifically marginal and velamentous cord insertions, were associated with a higher risk of complications such as fetal growth restriction, antepartum hemorrhage, and lower birth weight. The authors recommend documenting the placental cord insertion during ultrasound scans to identify pregnant women who may require increased surveillance for optimal perinatal outcomes. [Extracted from the article]

This article discusses a preliminary study on the evaluation of placental perfusion and fetal growth using 3D microvascular flow imaging (MV-FI). The study included 77 pregnant women, with 11 cases of fetal growth restriction (FGR) and 66 cases of normal fetal growth. The results showed that the placenta in the FGR group exhibited thickening, heterogeneous echogenicity, and decreased vascularization index (VI) and vascularization flow index (VFI). The study concludes that 3D MV-FI is a promising tool for assessing placental perfusion and providing new information on pregnancy-related conditions. [Extracted from the article]

Hydronephrosis, the swelling or dilation of the renal pelvis and calyces, is a common condition in pregnancy, with stones in the urinary tract being the most common cause. This article presents two case reports of pregnant women with hydronephrosis and urinary tract stones. The first case involved a 42-year-old woman who underwent nephrostomy and placement of a Double J stent, while the second case involved a 37-year-old woman scheduled for Ureterorenoscopy with Electrohydraulic Lithotripsy (EHL) and DJ stent replacement. The article emphasizes the importance of early and accurate diagnosis using ultrasound and highlights the need for surgical intervention in cases of hydronephrosis accompanied by urinary tract stones and severe pain. [Extracted from the article]

This article discusses a rare case of spontaneous coronary artery dissection (SCAD) in a pregnant woman. The patient, a 35-year-old woman at 36 weeks of gestation, presented with chest pain and respiratory distress. After further investigation, it was determined that she had SCAD in all three coronary vessels. The patient underwent an emergency Caesarean section and was treated with medication in the Cardio ICU. The article emphasizes the importance of further clinical investigation for pregnant women experiencing chest pain and highlights the need for a multidisciplinary approach in assessing and treating pregnant patients with SCAD. [Extracted from the article]