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AIM Characteristics of variability of concentrations total protein and its electrophoretic fractions in serum of healthy pregnant women between successive trimesters and post-partum for initial classification of proteins involved in specific metabolic processes associated with pregnancy. METHODS Total serum protein concentrations were measured by biuret method and serum protein fractions were electrophoretically separated in 166 serum samples collected from healthy pregnant women in three trimesters of pregnancy (1st, n = 55; 2nd, n = 42; 3rd, n = 39) and in post-partum (n = 30), and in 20 samples from nonpregnant controls. RESULTS Across pregnancy, there were gradual, but occurring at different rates, decreases over time in serum total protein, albumin and gamma globulins compared to controls (P

Smoking during pregnancy has negative effects on both maternal and fetal health. One of these negative maternal effects is the potential for depression. A high rate of cigarette smoking in pregnancy is an important public health issue since it affects not only the pregnant woman but also the newborn and its healthy development. The aim of this study is to investigate the relationship between smoking, influencing factors, and depression prevalence in pregnant Syrian refugees and pregnant citizens of the Republic of Turkey (TR). Pregnant citizens in the TR and pregnant Syrian refugees who were registered at health centers between 15.04.2017 and 15.10.2017 in the border city of Ceylanpınar in the Province of Şanlıurfa in Syria were visited in their living areas in the district center and at a tent village, respectively. A total of 414 pregnant women agreed to participate in the study and were included in the survey. To collect data for the cross-sectional study, a sociodemographic and pregnancy characteristics questionnaire was used, in addition to the Fageström Test for Nicotine Dependence (FTND) and the Beck Depression Inventory (BDI). The rate of smoking in all pregnant women was determined to be 49.3% (n = 204) before pregnancy and 37.9% (n = 157) during pregnancy. A statistically significant difference was found between age groups and educational status in relation to smoking status (p = 0.005, p = 0.001). There was also a statistically significant difference between the smoking status of pregnant women and that of their partners and family members (p = 0.001, p = 0.002). The percentage of pregnant women who were passive smokers was 80.2% (n = 332), and a statistically significant difference was found between passive smoking and smoking status (Fisher; 0.000). The presence of risk for depression was detected in 49.8% (n = 206) of all pregnant women surveyed; the rate of depression risk was 50.5% (n = 104) in pregnant TR citizens and 49.5% (n = 102) in pregnant refugees, with no significant difference between the two groups. There was a statistically significant difference between smoking status in pregnancy and the presence of depression risk (p = 0.001). 32.5% of pregnant women were highly nicotine dependent. A moderate positive correlation was determined between the FTND and BDI scores of pregnant women (r = 0.346; p = 0.001). It was found that one-third of all pregnant women smoked and that one of every two showed a risk for depression. A statistically significant correlation was found between smoking status and risk for depression. No statistically significant difference was determined between the two groups, despite high levels of smoking, nicotine dependence, and depression in both. These data suggest the need to develop new preventive strategies in regard to smoking among pregnant women.

Objective The risk factors, clinical trends, and maternal and fetal health of early- and late-onset preeclampsia have not been adequately studied. We examined the effects of early- and late-onset preeclampsia on maternal and perinatal outcomes as well as the known risk factors of preeclampsia. Methods One hundred and fifty women with preeclampsia were consecutively enrolled in each group. Those who developed preeclampsia before 34 weeks of gestation were identified as having early-onset preeclampsia, while those who developed at 34 weeks or later were identified as having late-onset preeclampsia. Maternal and perinatal outcomes were compared between groups. Results Compared with the late-onset group, the early-onset group had higher rates of abruptio placentae (16% vs. 7.3%; P=0.019), but there was no intergroup difference in the composite maternal outcomes. A significantly higher number of women with early-onset preeclampsia developed severe features during the disease course, and most required treatment with antihypertensive drugs. Late-onset preeclampsia was more prevalent among primigravid mothers. Babies born to mothers with early-onset preeclampsia had a significantly higher rate of adverse outcomes. Conclusion These study findings indicate that women with early-onset preeclampsia had more adverse outcome than those with late-onset preeclampsia, but the difference was not statistically significant. There were more babies with adverse perinatal outcomes in the early-than late-onset group.

Intrauterine fetal hypoxia is one of the leading cause of perinatal mortality and morbidity. This can eventually lead to severe neurological damage like cerebral palsy and in extreme cases to fetal demise. It is thus necessary to monitor the fetus during intrapartum and antepartum period. Cardiotocograph (CTG) as a method of assessing the status of the fetus had been in use for last six decades. Nowadays it is the most widely used non-invasive technique for the continuous monitoring of the fetal heart rate (FHR) and the uterine contraction pressure (UCP). Though its introduction limited the birth related problems, the accuracy of interpretation was hindered by quite a few factors. Different guidelines that are provided for the interpretation are based on crisp logic which fails to capture the inherent uncertainty present in the medical diagnosis. Misinterpretations had led to inaccurate diagnosis which resulted in many medico-legal litigations. The vagueness present in the physician’s evaluation is best modeled using soft-computing based techniques. In this paper authors used the CTG dataset from UCI Irvine Machine Learning Data Repository which contains 2126 data and each data-point is represented by 37 features. Dimensionality of the feature set was reduced using different automated methods as well as manually by the physicians. The resulting data sets were classified using various machine learning algorithms. Aim of this study is to establish which set of features is best suited to give good insight into the status of the fetus and also determine the most effective machine learning technique for this purpose. The accuracy of the outcomes were measured using statistical methods such as sensitivity, specificity, precision, F-Measure, confusion matrix and kappa value. We obtained an accuracy of 99.91% and kappa measure of 0.997 when the feature set was reduced using MRMR.

The lifestyle of pregnant women has a close relationship with maternal and fetal health. In pregnant women, health-promoting behaviors lead to the promotion of quality of life and improvement of pregnancy outcomes. Therefore, the present study aimed to determine the effect of cognitive-behavioral counseling on pregnant women’s lifestyle. This randomized controlled clinical trial study was performed in the health centers of Sanandaj, Iran. Seventy pregnant women were randomly assigned to intervention (n = 35) and control (n = 35) groups. The study was completed with 33 pregnant women in each group. In addition to routine pregnancy care, the control group received, the intervention group received 8 consecutive 60-90-minute counseling sessions with a cognitive-behavioral approach weekly. The Walker Health Promotion Lifestyle Questionnaire was completed before, immediately, and one month after the intervention by the participants of control and intervention groups. Data were collected from February until June 2017. Data were analyzed using SPSS version 16. The mean score of lifestyle in the intervention and control group was 139.78 ± 21.71 and 142.63 ± 19.12 before the intervention, which reached 151 ± 17.72 and 159.14 ± 14.77, respectively, after the intervention. The difference was significant in the intervention group (P = 0.001) but not in the control group (P = 0.619). Also, the mean scores of the two groups were not significantly different before intervention (P = 0.574), but this difference was statistically significant after the intervention (P = 0.029) and one month after the intervention (P = 0.001). Based on the results of this study, cognitive-behavioral counseling improves the lifestyle of pregnant women. Therefore, it is suggested that this type of counseling be used along with other services to improve the lifestyle of pregnant women in health care centers.

Ultrasound growth measurements are monitored to evaluate if a fetus is growing normally compared with a defined standard chart at a specified gestational age. Using data from the Fetal Growth Longitudinal Study of the INTERGROWTH-21st project, we have modelled the longitudinal dependence of fetal head circumference, biparietal diameter, occipito-frontal diameter, abdominal circumference, and femur length using a two-stage approach. The first stage involved finding a suitable transformation of the raw fetal measurements (as the marginal distributions of ultrasound measurements were non-normal) to standardized deviations (Z-scores). In the second stage, a correlation model for a Gaussian process is fitted, yielding a correlation for any pair of observations made between 14 and 40 weeks. The correlation structure of the fetal Z-score can be used to assess whether the growth, for example, between successive measurements is satisfactory. The paper is accompanied by a Shiny application, see https://lxiao5.shinyapps.io/shinycalculator/ .

Problem Too much or too little gestational weight gain (GWG) can negatively impact maternal and fetal health, according to Institute of Medicine Guidelines. Background Health care providers are key players in providing reliable evidence-informed prenatal advice related to appropriate GWG. However, there appears to be inconsistent GWG communication among healthcare providers during prenatal care. Aim To determine pregnant women and new mothers’ perceptions of healthcare provider GWG and dietary counselling during the pregnancy period. Methods A reliable and validated cross-sectional electronic survey was administered to currently pregnant women and women who had recently given birth. The web-based questionnaire was self-administered and took 10–25 min. Findings A total of 1507 eligible women participated in the survey. More than half (57%) reported that their healthcare provider talked to them about personal weight gain limits. Of these participants, about a third (34%) of participants were counselled regularly at each or most visits. Among the women that were not counselled on personal GWG limits, over half (56%) reported that healthcare provider guidance would have been helpful to achieve their target weight. Less than half (45%) of participants reported that their healthcare providers discussed dietary requirements or changes in pregnancy. Discussion These findings highlight areas for improvement in prenatal dialogue, which can support better outcomes for both mother and baby. Conclusion A better understanding of pregnant and mothers’ perceptions about weight and diet counselling is needed to understand what may need greater attention and clarification and to improve such dialogue.

The review discusses the impact of nutrients on women’s health before and during pregnancy and on the health of their babies. Considerable attention is paid to the short-term and long-term effects of malnutrition or overeating of pregnant women. The article also discusses the need for the use of vitamin-mineral complexes during pregnancy to replenish nutrient stores. The issue of the relationships between the diet and early pregnancy outcomes is considered. Based on the conducted thorough analysis, it is concluded that doctors should inform future mothers about the importance of a balanced diet and additional intake of microelements and vitamins. Although this topic has been extensively studied, it requires further research for working out optimal clinical recommendations regarding the nutritional behavior of pregnant women.

Pregnancy complications are commonplace and the challenges of treatment during pregnancy with few options available pose a risk to the health of both the mother and baby. Patients suffering from conditions such as preeclampsia, placenta accreta, and intrauterine growth restriction have few treatment options apart from emergency caesarean section. Fortunately, researchers are beginning to develop nanomedicine-based therapies that could be utilized to treat conditions affecting the mother, placenta, or fetus to improve the prognosis for mothers and their unborn children. This review summarizes the field’s current understanding of nanoparticle biodistribution and therapeutic effect following systemic or vaginal administration and overviews the design parameters researchers should consider when developing nanomedicines for maternal/fetal health. It also describes safety considerations for nanomedicines to limit undesirable maternal or fetal side effects and discusses future work that should be performed to advance nanomedicine for maternal/fetal health. With additional development and implementation, the application of nanomedicine to treat pregnancy complications may mitigate the need for emergency caesarean sections and allow pregnancies to extend to term.

We estimate the impact of a cash transfer targeting new mothers on their subsequent children's health outcomes at birth. We exploit the unexpected introduction of a generous, universal child benefit in Spain in 2007. Using population-wide, individual-level, high-quality administrative data from birth records and a regression discontinuity approach, we find that women who received the benefit were much less likely to have low-birth-weight children in the future (while their subsequent fertility was unaffected). The overall effect is driven by poor women, unmarried women, and women with low education, and by births taking place relatively soon after the benefit receipt. The €2500 transfer led to a 0.7 percentage-point decline in the fraction of children born under 1500 g in poorer households in the following five years, an 83% reduction. We explore the underlying channels, and find evidence supporting faster intrauterine growth, possibly driven by better maternal health, nutrition, and behaviors. Gestation length, family structure, and parental employment do not seem to play a role. Recent research suggests that targeting pregnant women may be more effective than later interventions (such as cash transfers to families with children), given the strong persistence of fetal health effects. Our results suggest that the impact may be stronger if women are targeted even earlier, before conception. The authors acknowledge financial support from the Spanish Ministry of Economy and Competitiveness, through the Severo Ochoa Program for Centers of Excellence in R&D (CEX2019-000915-S). We also acknowledge funding from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme (grant agreement No 770958).

In a prospective study, 48 fetuses were evaluated with Doppler ultrasound after 34 weeks and classified, according to the cerebroplacental ratio (CPR) and estimated fetal weight (EFW), into fetuses with normal growth and fetuses with late-onset fetal growth restriction (LO-FGR). Overexpression of miRNAs from neonatal cord blood belonging to LO-FGR fetuses, was validated by real-time PCR. In addition, functional characterization of overexpressed miRNAs was performed by analyzing overrepresented pathways, gene ontologies, and prioritization of synergistically working miRNAs. Three miRNAs: miR-25-3p, miR-185-5p and miR-132-3p, were significantly overexpressed in cord blood of LO-FGR fetuses. Pathway and gene ontology analysis revealed over-representation of certain molecular pathways associated with cardiac development and neuron death. In addition, prioritization of synergistically working miRNAs highlighted the importance of miR-185-5p and miR-25-3p in cholesterol efflux and starvation responses associated with LO-FGR phenotypes. Evaluation of miR-25-3p; miR-132-3p and miR-185-5p might serve as molecular biomarkers for the diagnosis and management of LO-FGR; improving the understanding of its influence on adult disease.

In a prospective study, 48 fetuses were evaluated with Doppler ultrasound after 34 weeks and classified, according to the cerebroplacental ratio (CPR) and estimated fetal weight (EFW), into fetuses with normal growth and fetuses with late-onset fetal growth restriction (LO-FGR). Overexpression of miRNAs from neonatal cord blood belonging to LO-FGR fetuses, was validated by real-time PCR. In addition, functional characterization of overexpressed miRNAs was performed by analyzing overrepresented pathways, gene ontologies, and prioritization of synergistically working miRNAs. Three miRNAs: miR-25-3p, miR-185-5p and miR-132-3p, were significantly overexpressed in cord blood of LO-FGR fetuses. Pathway and gene ontology analysis revealed over-representation of certain molecular pathways associated with cardiac development and neuron death. In addition, prioritization of synergistically working miRNAs highlighted the importance of miR-185-5p and miR-25-3p in cholesterol efflux and starvation responses associated with LO-FGR phenotypes. Evaluation of miR-25-3p; miR-132-3p and miR-185-5p might serve as molecular biomarkers for the diagnosis and management of LO-FGR; improving the understanding of its influence on adult disease.

The risk of developing new-onset arrhythmia or exacerbation of a pre-existing arrhythmia is increased during pregnancy because of profound physiological and hormonal changes. The incidence of arrhythmias in pregnancy is not well-reported and especially data on ventricular arrhythmia are scarce. Arrhythmia during pregnancy is associated with adverse maternal and fetal outcomes and the optimization of clinical management is hindered by a paucity of evidence, as guidelines are either based on studies in the general population or on case series in pregnancy. In any case, optimal care for these patients includes a multidisciplinary approach, integrating the different considerations in maternal cardiac, obstetric and fetal health. In this manuscript we present three cases of ventricular arrhythmia during pregnancy and describe our considerations in clinical decision-making with regard to diagnostic challenges and treatment choices.

Fetal echocardiography (FECG) analysis was rarely used earlier in clinical practice using ECG surface electrodes. With recent research studies have been extensively monitoring the wellbeing of the fetus using non-invasive FECG (NIFECG). The reliable assessment of changes in fetus condition is of high importance today. Monitoring changes in the fetal heart rate (FHR) can be used as an excellent diagnostic aid to access fetal health status. NIFECG can be extracted by intelligent detection techniques. In this article, three known FECG extraction algorithms namely, Independent Component Analysis (ICA), Adaptive neuro-fuzzy inference system (ANFIS) and hybrid model of ICA-ANFIS have been evaluated. The results are compared with the direct scalp ECG of the Physionet FECG database. ICA technique with 2 iteration stages matched the scalp FECG FHR. However using ANFIS, the FHR matched almost 100% with the invasive fetal ECG. It shows that the hybrid ICA-ANFIS is a promising non-invasive solution for producing FECG, which is close to invasive scalp FECG peaks.

Fetal distress is the main cause of frequent adverse events such as asphyxia and disability. It is particularly important to monitor the fetal intrauterine state in late pregnancy so as to detect fetal abnormalities in time. Cardiotocography (CTG) is an important tool for fetal health assessment in clinical practice. But the accuracy and consistency of CTG are generally not ideal as the correct interpretation is affected by the doctor's clinical experience and ability. Therefore, this paper proposed an intelligent assistant diagnosis algorithm based on fetal heart rate (FHR) signals, which integrated by the input layer construction based on MelFrequency Cepstral Coefficients (MFCCs) and the deep neural network model based on bidirectional long short-term memory (BLSTM). Through 200 sets of intrapartum data from a public database, the results show that the proposed algorithm achieves a high accuracy of 96.25%, which can achieve a pretty well assessment of the fetal state and assist clinicians to make an auxiliary diagnosis of the fetal health.

As gestational diabetes, which is increasing steadily around the world, can cause complications in the mother and fetus, it is essential to change eating habits and eating behavior to prevent this. According to the 2020 American Diabetes Association recommendations, the food plan should be designed for the adequate calorie intake to achieve glycemic goals and consequently promote maternal and fetal health. Thus, the following study has used the qualitative theme analysis method to assess what it means for 28 South Korean women, who were diagnosed with gestational diabetes for the first time, to change their eating habits and behaviors. As a result, themes were derived related to reflection on daily life, formation of new relationships in the same group, efforts that must be made, rediscovery of couples, and lifestyles reborn as new roles. Based on the results of the study, it is shown that the study participants recovered the peace in their mental state after the crisis of gestational diabetes to pursue relaxation and ultimately higher quality of life by following the plan to fulfill healthy achievements, such as changing their eating habits and behaviors. Therefore, future research and support measures to help the healthy behaviors should be sought by comprehensively exploring the effects of women’s experiences in changing their eating habits and behaviors.

Introduction A clinician’s willingness to provide abortion care is complex. Anesthesia providers’ experiences in providing anesthesia for abortion are not well studied. We aimed to explore anesthesia providers’ perspectives on abortion provision. Methods We conducted semi-structured, qualitative interviews with currently practising anesthesia providers in the southeastern United States. Participants were recruited from scientific meetings of two regional anesthesiology organizations and via snowball sampling. A semi-structured interview guide included domains of standardized second trimester abortion cases and personal abortion attitudes. Data were coded and analyzed iteratively using both inductive and deductive approaches with MAXQDA software. Deductive results are presented. Results Fifteen participants completed interviews from February 2018 to February 2019, at which point thematic saturation occurred. Participants represented a range of provider type, years of experience, workplace setting, and prior abortion experience. Participants demonstrated varied personal abortion attitudes, with greater acceptability of maternal or fetal health indications than social or financial indications for abortion. Most participants were willing to provide anesthesia for abortion in specific clinical scenarios. Conclusions Southeastern U.S. anesthesia providers hold a spectrum of personal views on abortion and are willing to provide anesthesia for second trimester abortion in specific clinical scenarios. Findings may inform future research or professional development activities, which are important efforts toward improving multidisciplinary abortion care.

The universal criticality of mother’s and child’s health can scarcely be overstated. Deterioration in an expectant mother’s health may lead to several complications in the antepartum and intrapartum period that which may be fatal. Hence, simultaneous tracking of prenatal parameters such as uterine contraction and Fetal Heart Rate (FHR) through Cardiotocography (CTG) is of critical importance. This preponderantly remains a manual procedure in developing nations as the inclusion of machine learning (ML) technology is still not widespread. Numerous studies have pointed to the fact that electronic monitoring of FHR has not had any noteworthy benefit in lowering the incidence of perinatal mortality and morbidity. Further, FHR monitoring is beset with other problems such as high disparities in intra-and inter-observations and enhanced rate of caesarean vis-a-vis normal delivery. These drawbacks of FHR notwithstanding, the fact remains that FHR is regarded as a vital obstetric procedure and CTG as equipment is deployed the most in perinatal diagnostics. With advancements in medical technology, techniques viz. computerized analysis of FHR and ECG are now being utilized as an accompaniment to CTG. These sophisticated computerized methods enable an analysis of variations in heart rate and assessing the patterns of short term heart rate. Further studies about multiple parameters causing FHR variability is needed to better our understanding of the primacy and salience of various parameters of raw fetal heartbeat data. Our experimental results using AutoML approach gave an accuracy rate of 0.9561, Recall 0.9056, Kappa 0.8792, Precision 0.9552, AUC 0.9864, F1 0.9550, MCC 0.8805 with model handling time of 2 minutes.

Fetal sex influences placental function as well as maternal and fetal health, being an important factor to consider in pregnancy studies. However, fetal sex determination in the first trimester of pregnancy still faces some technical limitations. Here we describe an RT-qPCR technique to determine fetal sex based on X-inactive specific transcript (XIST) and DEAD-Box helicase 3 Y-linked (DDX3Y) gene expression. This method is straightforward, reliable, fast and applicable on both, placental tissue and primary cells.

Objectives With a growing interest in the mother–infant dyad and the Developmental Origins of Health and Disease hypothesis among biological and medical anthropologists, this study set out to provide all the information required to evaluate if mineralization defects in dentine might be caused by vitamin D deficiency in the critical first 1000 days of life. Materials and Methods Information was compiled on dentine formation in utero to approximately 18 years, and a method for determining the location of the neonatal line in dentine was devised, allowing the assessment of the prenatal and early life period. Re‐evaluation of previously analyzed teeth (n = 61) was undertaken with detailed examination of n = 5/22 first permanent molars forming in the prenatal and critical early life periods. Results First permanent molars and all deciduous teeth give information on intrauterine development and on the first 1000 days postnatally providing a direct window on maternal and fetal health. Three archaeological individuals had interglobular dentine that formed prenatally suggesting that their mothers experienced vitamin D deficiency at the time dentine was forming and all other individuals had a deficiency during the first 1000 days of life. Conditions that could cause systemic mineralization defects were determined, and in each, case they were found to be consistent with vitamin D deficiency. Discussion The neonatal line serves as a clear baseline for determining prenatal and postnatal events, particularly those related to vitamin D, calcium, and phosphate metabolism, and can be used to investigate the maternal–infant dyad for both past and present communities.

Cardiotocography (CTG) is the most popular prenatal diagnostic test for establishing fetal health and consists in simultaneous recording of fetal heart rate (FHR, bpm) and maternal uterine contraction (UC, mmHg) traces. Typically, FHR and UC traces are visually analyzed and interpreted by clinicians. Recently, software applications like CTG Analyzer have been developed to support visual CTG interpretation by making it more objective and independent from clinician’s experience. Automatic CTG analysis requires CTG-traces digitalization and thus assessment of a correct sampling frequency (SF). Thus, this paper aims to investigate dependency of automatic CTG analysis on SF in order to identify optimal SF (OSF) for FHR and UC traces that minimizes computational efforts without jeopardizing CTG interpretation. To this aim, the “CTU-CHB intra-partum CTG database” was considered and visually annotated by an expert gynecologist. FHR and UC traces, originally sampled at 4 Hz, were down sampled at 2 Hz, 1 Hz, 0.4 Hz and 0.2 Hz, and automatically analyzed using CTG Analyzer. Eventually, results obtained through automatic analysis were compared to visual annotations, which were taken as reference. A cumulative statistical index (CSI), ranging from 0.00% to 100.00%, was defined as a linear combination of positive-predictive value, sensitivity, false-positive rate and false-negative rate. OSF was defined as the one that maximizes CSI. If CSI was showing the same value for more than one SF, the lowest SF was selected as the optimal since minimizing computational efforts. Results indicate that OSF for FHR is 2 Hz (CSI ≥ 85.41%), whereas OSF for UC is 0.2 Hz (CSI = 75.21%).

The purpose of this study is to identify the effect of religious beliefs on the attitudes of pregnant women toward the health of the fetus. Pregnancy, one of the important periods of life, is a special period in terms of affecting both the mother’s and the baby’s health. Health beliefs and attitudes are the factors that have effects on mother–baby death rates (mortality)—which is one of the most important criteria showing health level of societies. However, the literature has limited number of studies on this issue. Volunteer participants who applied to the Gynecology and Obstetrics Polyclinic were administered a questionnaire in order to identify the frequency of performing worship practices. Women’s beliefs about their roles in determining their fetus’s health were measured using Fetal Health Locus of Control (FHLC) scale. FHCL scale is composed of 3 sub-scales which include Internality Locus of Control (FHLC-I), Chance Locus of Control (FHLC-C), and Powerful Others Locus of Control (FHLC-P). Non-normally distributed scale scores were analyzed with Mann–Whitney U test for two independent groups and Kruskal–Wallis test for three independent groups. The scores obtained from all the sub-scales of the FHLC scale according to the praying groups were statistically significant (p = 0.008, p < 0.001, p < 0.001, respectively). The sub-scale scores were not statistically significant according to the tendency of giving alms (p = 0.269, p = 0.695, p = 0.079, respectively). The FHLC-I and FHLC-P scores did not indicate differences according to the tendency of going to pilgrimage (p = 0.914, p = 0.578), but FHLC-C scores were significantly higher in those who tended to go to pilgrimage (p = 0.004). There was a significant relationship between the tendency of performing prayer and going to pilgrimage and attitudes toward performing double–triple tests and oral glucose tolerance test (p = 0.002, p = 0.035, respectively). Religious beliefs were influential on the attitudes of pregnant women toward the health of the fetal. Gynecologists should consider patients’ religious belief sensitivity while recommending them screening tests or planning their medication. © 2019, Springer Science+Business Media, LLC, part of Springer Nature. 2-s2.0-85064282093 PubMed: 30972610

The umbilical cord (UC) is a platform for fetal nourishment and growth. The fetus, mother and placenta with UC form a triad, which contributes to pregnancy outcome. When pregnancy is complicated by a medical condition like hypertension, affects both maternal and fetal health. Being a fetal structure it can be used as a window to know the maternal dysfunctions and their impacts on fetal wellbeing. The present study is to explore the histomorphometric changes of the UC and its vessels involved in the development of hypertension during pregnancy. Sixty UCs were used and the following parameters, total UC area; total vessel area; jelly area; wall area, luminal area and wall thickness of umbilical arteries 1 and 2 and vein were studied using ImageJ software. From the results, the mean differences of above parameters of hypertensive UCs were found to be lesser than control and it was significantly higher in cases of severe preeclampsia (P≤0.05). From the present study, we conclude hypertensive cords and its vessels are associated with significant structural changes. Since it is a global health issue it is important to know the factors contributing it to diagnose and prevent.

Introduction: Knowledge of obstetric danger signs among pregnant women is of paramount importance in improving maternal, and fetal health outcomes. This study aims to determine the knowledge of danger signs among pregnant women seeking antenatal care in a teaching hospital. Materials and Methods: A cross-sectional study was carried out for two months among pregnant women who visited the antenatal clinic of a teaching hospital. A pre-tested and pre-designed proforma was used. Mean knowledge scores were computed and knowledge was classified into adequate and inadequate. Results: A total of 170 pregnant women fulfilling the inclusion criteria were included. Mean age of the study participants was found to be 26.40 ± 4.14 years. Nearly 67.10% were aware of bleeding per vagina being a danger sign, 50.0% stated excessive vomiting as a danger sign, 23.50% knew that blurring of vision was a danger, while a mere 20.0% reported that convulsions were a danger sign. Overall, adequate knowledge (total knowledge score of 5 and above) was observed in 54.70% of the participants. Conclusion: Majority of the study participants had adequate knowledge of danger signs in pregnancy. However, when knowledge about specific individual danger signs were further assessed, a high proportion had very poor knowledge. The mean knowledge scores were found to be low.

Background The effects of COVID-19 lockdown measures on maternal and fetal health remain unclear. We examined the associations of COVID-19 lockdown with gestational length and preterm birth (PTB) in a Chinese population. Methods We obtained medical records of 595,396 singleton live infants born between 2015 and 2020 in 5 cities in Guangdong Province, South China. The exposed group (N = 101,900) included women who experienced the COVID-19 Level I lockdown (1/23–2/24/2020) during pregnancy, while the unexposed group (N = 493,496) included women who were pregnant during the same calendar months in 2015–2019. Cumulative exposure was calculated based on days exposed to different levels of emergency responses with different weighting. Generalized linear regression models were applied to estimate the associations of lockdown exposure with gestational length and risk of PTB ( Results The exposed group had a shorter mean gestational length than the unexposed group (38.66 vs 38.74 weeks: adjusted β = − 0.06 week [95%CI, − 0.07, − 0.05 week]). The exposed group also had a higher risk of PTB (5.7% vs 5.3%; adjusted OR = 1.08 [95%CI, 1.05, 1.11]). These associations seemed to be stronger when exposure occurred before or during the 23rd gestational week (GW) than during or after the 24th GW. Similarly, higher cumulative lockdown exposure was associated with a shorter gestational length and a higher risk of PTB. Conclusions The COVID-19 lockdown measures were associated with a slightly shorter gestational length and a moderately higher risk of PTB. Early and middle pregnancy periods may be a more susceptible exposure window.

Introduction: There has been an increase in rate of caesarean section over past five decades. This is matter of public health concern as it increases the caesarean section related maternal morbidity and mortality. Asadvised by WHO guidelines and US health initiative C-section rate should not beyond 15%. According to NHFS-4 C-section rate in India 17.2%. The aim of present study aimed to assess the rate of CS and perform and analysis based on Robson classification system. Methods: In present study all the cases delivered by caesarean section during period of six months were recorded. Data were collected from medical records of women who delivered from October to march 2021.They were classified according to Robsons’10 group classification system. This was an attempt to see which relevant group contributed most to the c- section rates. Results: There was a trend of increased percentage of caesarean section in group5 patients in present study. Poor tolerance to pain and increased rate of previous c section contributes to this. Conclusion: We should make use of vaginal delivery after caesarean section but not at the cost of maternal and fetal health. These target groups require more in depth analysis to identify modifiable risk factors and apply specific intervention to reduce cs rates. Keywords: Indications, Caesarean, Robsons criteria.

BACKGROUND Reference intervals of clinical laboratory indexes are the basis of interpretation of test results. While intrahepatic cholestasis of pregnancy (ICP) could severely threaten maternal and fetal health, reference intervals of the biomarkers serum total bile acids (TBA) and glycocholic acid (GCA) are unsatisfactory. The purpose of this study was to derive gestational age-specific reference intervals for serum TBA and GCA in a Chinese population to promote early diagnosis of ICP. METHODS A total of 416 healthy pregnant Chinese were recruited and divided into three groups by gestational age: 140 in the first trimester (1 - 13 weeks) group, 136 in the second trimester (14 - 27 weeks) group, and 140 in the third trimester (≥ 28 weeks) group. Serum TBA and GCA levels were measured respectively by cyclic enzymatic method and latex enhanced immune turbidimetry. Reference intervals were calculated with non-parametric method. RESULTS The reference intervals of serum TBA are 0.90 - 6.60 μmol/L, 1.20 - 9.10 μmol/L, and 1.50 - 8.90 μmol/L respectively in the first, second, and third trimester. The reference intervals of serum GCA are 0.24 - 1.14 μg/mL in the first and second trimesters (combined) and 0.00 - 2.04 μg/mL in the third trimester. CONCLUSIONS Gestational age-specific reference intervals of serum TBA and GCA for pregnant Chinese were derived in strict accordance with CLSI C28-A3 guidelines, which will be valuable for early diagnosis of ICP.

Maintaining maternal and fetal health is an important challenge in modern healthcare worldwide. Longterm passive monitoring will allow monitoring the condition of the mother and fetus for a long time, which will increase the effectiveness of medical support for a pregnant woman. The motor activity of the fetus is an important marker of its condition and the level of its nervous development. Also, the signal of fetal motor activity can be effectively recorded by passive recorders, which is critically important when organizing a passive monitoring system. The aim of this work is to analyze the applicability of passive recorders (accelerometers and gyroscopes) for recording a signal of fetal motor activity. To improve the accuracy of the analysis of fetal activity, the paper proposes an algorithm for automatic detection of episodes of fetal activity.

The coronavirus 19 (COVID-19) pandemic and the measures implemented for its control meant the interruption of prenatal care, with potential risk to maternal and fetal health. However, conventional in-person prenatal would imply exposure and risk of infection in patients and health care providers. The Instituto Nacional Materno Perinatal (INMP) has incorporated teleconsultation as part of a new model of mixed prenatal care, which aims to reduce in-person appointments and, therefore, the contact and risk of viral transmission. The prenatal care package performs essential activities to care for pregnant women of specific gestational ages with a greater impact on perinatal and maternal outcomes. This new model could be generalized nationally and be part of the solution to the disparities of healthcare in Peru, through policies for the use of telemedicine in prenatal care that facilitate its implementation, as well as its sustainability after the COVID-19 pandemic. La pandemia del coronavirus 19 (COVID-19) y las medidas instauradas para su control significaron la interrupción de la atención prenatal, con potencial riesgo en la salud materna y fetal. Por otro lado, la atención prenatal convencional presencial implicaría exposición y riesgo de infección en pacientes y proveedores de salud. El Instituto Nacional Materno Perinatal (INMP) ha incorporado la teleconsulta como parte de un nuevo modelo de atención prenatal mixto, cuyo objetivo es disminuir las citas presenciales y, por tanto, el contacto y riesgo de transmisión viral. El paquete de atención prenatal incluye actividades esenciales para atender gestantes en edades gestacionales específicas con mayor impacto en los desenlaces perinatales y maternos. Este nuevo modelo podría generalizarse a nivel nacional y ser parte de la solución a las disparidades de atención en el Perú, mediante políticas del uso de la telemedicina en la atención prenatal que faciliten su implementación, así como su sostenibilidad después de la pandemia de COVID-19.

Cardiotocogram (CTG) is the most widely used in the clinical routine evaluation of the main approach to detect fetal state. In this paper, twelve machine learning single models have firstly experimented on CTG dataset. Secondly, the soft voting integration method is used to integrate the four best models to build the Blender Model, and compared with the stacking integration method. Compared with the traditional machine learning models, the model proposed in this paper performed excellently in various Classification Model evaluations, with an accuracy rate of 0.959, an AUC of 0.988, a recall rate of 0.916, a precision rate of 0.959, a F1 of 0.958 and a MCC of 0.886.

We propose a new non-invasive approach to transabdominally measure fetal oxygen saturation based on time-domain interferometric near-infrared spectroscopy. We use the frequency-modulated continuous-wave technique to measure the time resolved reflectance of near-infrared light shining on the maternal abdomen. By modeling the maternal abdomen as two-layered media (i.e. maternal and fetal tissue) through diffusion equations, the optical properties of both the maternal and fetal tissue can be deduced. Using two optical wavelengths, oxygen saturation can be measured for both the mother and fetus. This technique could provide an important assessment of intrapartum fetal health during labor in the delivery room.

Maternal pre‐pregnancy obesity may have an impact on both maternal and fetal health. We examined the microbiome recovered from placentas in a multi‐ethnic maternal pre‐pregnant obesity cohort, through an optimized microbiome protocol to enrich low bacterial biomass samples. We found that the microbiomes recovered from the placentas of obese pre‐pregnant mothers are less abundant and less diverse when compared to those from mothers of normal pre‐pregnancy weight. Microbiome richness also decreases from the maternal side to the fetal side, demonstrating heterogeneity by geolocation within the placenta. In summary, our study shows that the microbiomes recovered from the placentas are associated with pre‐pregnancy obesity. Importance Maternal pre‐pregnancy obesity may have an impact on both maternal and fetal health. The placenta is an important organ at the interface of the mother and fetus, and supplies nutrients to the fetus. We report that the microbiomes enriched from the placentas of obese pre‐pregnant mothers are less abundant and less diverse when compared to those from mothers of normal pre‐pregnancy weight. More over, the microbiomes also vary by geolocation within the placenta.

International audience; Background and aims: Smoking in pregnancy causes substantial avoidable harm to mothers and offspring; nicotine replacement therapy (NRT) may prevent this, and is used to help women to quit. A recently updated Cochrane Review of randomized controlled trials (RCTs) investigating impacts of NRT in pregnancy focuses primarily on efficacy data, but also reports adverse impacts from NRT. Here we identify and summarize NRT impacts on adverse pregnancy outcomes reported in non-randomized controlled trials (non-RCTs).Methods: Systematic reviews and meta-analyses of RCTs and non-RCT studies of NRT in pregnancy, with design-specific risk of bias assessment and grading of recommendations, assessment, development and evaluations (GRADE) criteria applied to selected outcomes.Findings: Relevant Cochrane Review findings are reported alongside those from this new review. Seven RCTs were included; n = 2340. Nine meta-analyses were performed; non-statistically significant estimates indicated potentially reduced risk from NRT compared with smoking for mean birth weight, low birth weight, preterm birth, intensive care admissions, neonatal death, congenital anomalies and caesarean section and potentially increased risks for miscarriage and stillbirth. GRADE assessment for mean birth weight and miscarriage outcomes indicated 'low' confidence in findings. Twenty-three non-RCTs were included; n = 931 163. Eleven large studies from five routine health-care cohorts reported clinical outcomes; 12 small studies investigated mainly physiological outcomes within in-patient women given NRT. Findings from meta-analyses for congenital anomalies, stillbirth and preterm birth were underpowered and not in a consistent direction; GRADE assessment of confidence in findings was 'very low'. Routine health-care studies were of higher quality, but implications of reported findings were unclear as there was inadequate measurement and reporting of women's smoking.Conclusions: Available evidence from randomized controlled trials and non-randomized comparative studies does not currently provide clear evidence as to whether maternal use of nicotine replacement therapy during pregnancy is harmful to the fetus.

Fetal Health denotes the health and growth of the fetal and frequent contacts in the uterus of the pregnant women during pregnancy. Maximum pregnancy period complexities leads fetal to a severe difficulty which limits right growth that causes deficiency or death. Harmless pregnancy period by predicting the risk levels before the occasion of difficulties boost right fetal growth. Forecasting the fetal health and growth state from a set of pre-classified patterns knowledge is vital in developing a predictive classifier model using Machine Learning Algorithms.

Fetal activity is an important indicator of fetal health and its level of neural development. To detect the critical state of the fetus, it is important to monitor the indicators of its state over a prolonged period of time. Long-term monitoring without negatively affecting the fetus and mother’s health is possible through passive methods. This work was aimed at extracting episodes of fetal motor activity from the signal obtained using an accelerometer system of long-term monitoring.

Objective: Pregnant women need health information to ensure their health and to have a healthy delivery. Therefore, equipping them with adequate information can bring desired health outcomes for them and their fetus. The present study was conducted to explore health information needs of women during pregnancy. Materials and methods: The present research was a qualitative study. Thirty-nine participants (pregnant women, midwives, and obstetricians) were selected through purposeful sampling in Isfahan from June to November 2016. Data were collected through in-depth face-to-face semi-structured interviews, daily notes and field notes. Results: Data analysis led to emergence of ten sub-categories including: "common complaints during pregnancy", "problems and complications in pregnancy", "factors affecting fetal health", "proper nutrition and take supplements during pregnancy", "sex during pregnancy", "exercise during pregnancy", "diagnostic tests in pregnancy", "fetal growth and development", "types of childbirth and preparation for delivery" and "baby care and breastfeeding" and finally the main category was the "health information needs". Conclusion: Regarding the health information requests of pregnant women, their needs should be identified and taken into consideration when planning educational programs for this group of women.

There is little written in the orthopaedic literature regarding common musculoskeletal problems that women encounter in relation to pregnancy and their clinical and surgical management. Exercise and other physical activity are generally recommended for most women before, during, and after pregnancy. Unfortunately, a variety of musculoskeletal issues may keep women from starting, continuing, or resuming a healthy exercise regimen throughout a notable portion of their reproductive years. Untreated and undertreated orthopaedic conditions in female athletes may therefore have further unintended negative effects on maternal and fetal health. This article reviews the existing literature on musculoskeletal health considerations before, during, and after pregnancy to provide practical information to orthopaedic surgeons who treat women of all ages and athletic abilities.