Search

Conclusion As recently as the 1980s, it was not uncommon for paediatric surgeons to operate on infants without anaesthesia. Today, the same omission would be considered criminal malpractice, and there is an increased concern with the possibility of consciousness in the earliest stage of human infancy. This concern reflects a more general trend that has characterised science since the early 1990s of taking consciousness seriously. While this attitude shift has opened minds towards the possibility that our earliest experiences predate our first memories, convincing demonstrations of infant consciousness remain challenging given that infants cannot report on their experiences. Furthermore, while many behavioural and neural markers of consciousness that do not rely on language have been validated in adults, no one specific marker can be confidently translated to infancy. For this reason, we have proposed the ‘cluster‐based’ approach, in which a consensus of evidence across many markers, all pointing towards the same developmental period, could be used to argue convincingly for the presence of consciousness.We review the most promising markers for early consciousness, arguing that consciousness is likely to be in place by 5 months of age if not earlier. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical value of whole‐exome sequencing (WES) in the diagnosis of foetuses with central nervous system (CNS) abnormalities but having a normal karyotyping and chromosomal microarray result. Method: During the period of 2016–2022, there were a total of 149 foetuses with CNS abnormalities but having negative karyotyping and chromosomal microarray analysis results; WES was performed on these foetuses and their parents. Variants were classified according to ACMG guidelines, and the association of pathogenic variants with specific types of CNS abnormalities was explored. Results: Among these 149 foetuses, three categories of abnormalities, namely, single CNS abnormality, multiple CNS abnormalities, CNS abnormalities along with other organ system abnormalities were identified, for which the detection rate of P/LP variants is 17.4% (12/69), 28.6% (14/49) and 54.8% (17/31), respectively. Conclusion: WES brought about an increase of 28.9% in diagnostic yield in the prenatal evaluation of foetuses with CNS abnormalities but having negative karyotyping and chromosome array results. WES may also be of benefit for the diagnosis of foetuses with isolated CNS abnormalities, as well as for making more informed interpretations of imaging findings and for providing better genetic counselling. [ABSTRACT FROM AUTHOR]

The skull is a complex, vital structure made up of many bones. It has been observed that studies on skulls help to determine species and sex. In recent years, craniometric studies have been frequently used to determine morphometric features in animals. In our study, 150 skulls were studied, 50 from the second trimester (25 males and 25 females), 50 from the third trimester (25 males and 25 females), and 50 from the third and fourth week after birth (25 males and 25 females). The skulls were sectioned by computerised tomography and stored in DICOM format. From the images, nine different measurements and five index calculations were made. The similarities and differences between species were determined by ignoring sex differences. Correlation analyses were performed to compare measurement parameters between animal species. In addition, the results of statistical analyses between sexes were evaluated without species distinction. SL, CW and ICI parameters were highly statistically significant between measurements in the second trimester, third trimester and postnatal group (p < 0.01). In the third trimester, the EHC measurement parameter was found to be highly significant between males and female (p < 0.01). In Table 5, the CL parameter was positively correlated with CW, IHC, EHC, ILC, ELC, FMW and FMH. There are very few studies on foetal development. It is predicted that the data obtained can be used in zoo‐archaeology, anatomy, surgery and forensic medicine. In addition, radiographic determination of craniometric features will help in the treatment and prognosis of diseases. [ABSTRACT FROM AUTHOR]

Criminal law of the Republic of Moldova safeguards the life of a person not the life of a human being in general. The life of an unborn human being is protected partially in Romania. This is because the product of conception does not have the status of a person, while a pregnant woman is free to decide either to terminate or to continue her pregnancy. This Study proposes certain legislative amendments aimed to provide for a more efficient criminal-law defence of an unborn human being. Such a defence cannot have an absolute feature as the right to life of a person is not an absolute right either. [ABSTRACT FROM AUTHOR]

Ectopia Cordis (EC) is a rare congenital malformation in which the heart is located partially or totally outside the thoracic cavity. It results from the failure of migration of the lateral mesoderm into the midline. The four main ectopic positions are cervical, thoracic, thoracoabdominal and abdominal. EC can manifest as an isolated deformity or as part of a broader group of ventral body wall defects affecting the abdomen, thorax, or both. Pentalogy of Cantrell is a well known association that comprises EC, omphalocele (typically supraumbilical), congenital diaphragmatic hernia, sternal cleft and congenital heart disease. A 27-year-old primigravida came for a routine antenatal ultrasound at 13 weeks of gestation. There was no family history of congenital anomalies, genetic abnormalities, or exposure to teratogenic agents. The ultrasound showed a single foetus corresponding to 13 weeks of gestation with an anterior thoracic defect and an extrathoracic heart, along with partial herniation of the liver near the midline in the epigastric region. These findings were confirmed by foetal Magnetic Resonance Imaging (MRI). An unfavourable prognosis for the foetus was explained to the parents, and medical termination of pregnancy was performed. Therefore, prenatal ultrasonographic diagnosis of EC should be followed by a thorough search for associated defects, as the prognosis may vary.

Introduction: Hypertension (HTN) is a common complication in 6-10% of pregnancies and is one of the prime factors for foetal, as well as, maternal fatalities and morbidities. Significant pathological changes are seen in the placenta in hypertensive pregnancies before affecting the foetus. These changes may serve as an early warning system for detecting foetal issues like low birth weight and growth restriction. Early detection and intervention of morphological changes in the placenta and umbilical cord can help prevent adverse foetal outcomes. Aim: To study the macroscopic changes in the placenta in women with HTN induced by pregnancy compared to non hypertensive pregnant women. Materials and Methods: The present cross-sectional descriptive study was conducted in the Department of Anatomy and the Department of Obstetrics and Gynaecology, Ramaiah Medical College Hospital, Bengaluru, Karnataka, India, between December 2017 and January 2019. A sample size of 43 each was taken for non hypertensive and hypertensive subjects, including those with preeclampsia and chronic HTN with superimposed preeclampsia. The placental morphological parameters, routine biochemical tests and neonatal outcomes of both groups were analysed statistically using the Shapiro-Wilk test, Independent t-test and Chi-square test. A probability value less than 0.05 was considered for statistical significance. Results: The mean age of participants was 28.35±3.026 years in the hypertensive group and 26.23±2.636 years in the control group. The circular, oval and irregular shapes were 29 (65.9%), 10 (22.7%) and 4 (9.3%) in non hypertensive subjects and 33 (78.6%), 7 (16.27%) and 3 (7.1%) in the hypertensive subjects, respectively. The surface area (mean-142.44±49.69; p-value

Simple Summary: Assisted reproduction technologies (ARTs) are usually safe; however, recent evidence suggests we need to look at potential risks in adulthood for better safety. ART techniques, like embryo vitrification, differ from natural conditions, which can potentially impact foetal development and life after birth. This study examined whether hepatic changes previously described after birth are already present in foetal livers at the end of gestation. We performed a comparison of phenotype and hepatic genome-wide mRNA expression via RNA sequencing between fresh and vitrified transferred rabbit embryos. As a result, we found phenotypic differences at 24 days of gestation, with vitrified embryos having lower foetal and liver weights and shorter body lengths. Moreover, offspring derived from vitrified embryos tended to be heavier, indicating a growth spurt in the last week of gestation. Additionally, only a total of 12 differentially expressed genes (DEGs) were detected among foetus groups, some of which are known for their role in lipid metabolism and the stress and immune response. Therefore, our results suggest that vitrification and embryo transfer manipulation induce an adaptive response in embryos and foetuses, which is apparent in the hepatic tissue at the end of the gestation period. Assisted reproduction technologies (ARTs) are generally considered safe; however, emerging evidence highlights the need to evaluate potential risks in adulthood to improve safety further. ART procedures like rederivation of embryos by vitrification differ from natural conditions, causing significant disparities between in vitro and in vivo embryos, affecting foetal physiology and postnatal life. This study aims to investigate whether hepatic transcriptome and metabolome changes observed postnatally are already present in foetal livers at the end of gestation. This study compared fresh and vitrified rabbit embryos, finding differences between foetuses obtained by the transfer of fresh and vitrified embryos at 24 days of gestation. Rederived embryos had reduced foetal and liver weights and crown-rump length. However, the offspring of vitrified embryos tended to be born with higher weight, showing compensatory growth in the final week of gestation (59.2 vs. 49.8 g). RNA-Seq analysis revealed 43 differentially expressed genes (DEGs) in the foetal liver of vitrified embryos compared to the fresh group. Notably, downregulated genes included BRAT1, CYP4A7, CYP2B4, RPL23, RPL22L1, PPILAL1, A1BG, IFGGC1, LRRC57, DIPP2, UGT2B14, IRGM1, NUTF2, MPST, and PPP1R1B, while upregulated genes included ACOT8, ERICH3, UBXN2A, METTL9, ALDH3A2, DERPC-like, NR5A2-like, AP-1, COG8, INHBE, and PLA2G4C. Overall, a functional annotation of these DEGs indicated an involvement in lipid metabolism and the stress and inflammatory process or immune response. Thus, our results suggest that vitrification and embryo transfer manipulation induce an adaptive response that can be observed in the liver during the last week of gestation. [ABSTRACT FROM AUTHOR]

In treating preeclampsia-induced wistar rats, this study examined the effects of methanolic plant extracts of Jatropha curcas, Alchonnea cordifolia, and Secamone afzelii, respectively, on the evaluation of HELLP syndrome. Fifteen sets of age-matched female Wistar rats were employed, with one serving as a control group. The Adriamycin Model was used to induce preeclampsia. The rats were then administered 50, 100, and 200 mg/kg of the extracts. Another group was administered methyl DOPA (at 10 mg/kg). At the end of the study, the arts were anesthetized and sacrificed humanely. Platelet counts, hemoglobin, and liver enzymes were measured following standard procedure. The study found that extracts of plant extracts did not cause any toxic effects on test animals, and there was no mortality at 5000 mg/kg. Aspartate transaminase levels increased during preeclampsia, but J. curcas and A. cordifolia extracts at low-to-moderate concentrations reduced these levels. Post-partum AST levels decreased from 60.7 U/l during preeclampsia to 25.3 - 39.2 U/l. There were no significant alterations in total protein levels (p>0.05). Preeclamptic Wistar rats treated with theextracts showed higher packed cell volume and platelet counts during preeclampsia. Upon administration of 100 mg/kg J. curcas and 200 mg/kg S. afzelii, the prognosis of preeclampsia was generally better after postpartum than during the third trimester. The study reveals that preeclampsia treatment with J. curcas, A. cordifolia, and S. afzelii extracts improves liver enzymes, total protein levels, packed cell volume, and platelet counts, suggesting potential therapeutic options. [ABSTRACT FROM AUTHOR]

Copyright of Türkiye Adalet Akademisi Dergisi is the property of Justice Academy of Turkey and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pre-natal existence has been protected in some way by every age, by every society, and mapped out in its system of rules. This is still the case today, but man's knowledge today is incomparably more complex than in previous ages due to the advances in medicine and biology of the last few decades. Through the practitioners of medicine, knowledge of the ontogenesis of man spans the entire period from conception to death. Life conceived but not yet born is protected by the State's duty to protect life. However, can the State today, with the instruments and concepts of the law, fully discharge this duty of protection? While medical science can account for almost every minute of the biology of embryonic development, jurisprudence cannot do the same for the objective institutional protection of the whole period of embryonic life. Catching up in this area is essential because the backlog is enormous. [ABSTRACT FROM AUTHOR]

Variations in the arch of the aorta and aortic valves among fetal, cadaveric, and post-mortem specimens present a spectrum of anatomical configurations, posing challenges in establishing a standard norm. While some variations hold surgical significance, many bear little functional consequence but provide insights into embryological origins. The aortic arch exhibits diverse branching patterns, including common trunks and different orders, relevant for endovascular surgeries. Meanwhile, malformations in the aortic valve, affecting the aorta, may lead to ischemia and cerebral infarction, warranting understanding of coexisting arch and valve anomalies to predict complications like aortic dissection. Studies in the Indian population mirror global variations, underscoring the need to explore embryological, clinical, and surgical implications for safer vascular surgeries involving the aortic arch and valves. The study's objectives included examining branching patterns, diameters, and distances between arch branches and exploring aortic valve variations. Employing a cross-sectional design, the study was conducted across Anatomy, Forensic Medicine, and Obstetrics and Gynecology departments. A sample of 100, comprising cadavers, fetuses, and postmortem specimens, were gathered. Specimens ranged from 14 weeks of intrauterine life to 85 years, with intact thoracic cages as inclusion criteria. Methodology involved dissection, specimen fixation, and macroscopic examination for variations and morphological parameters. Results showed aortic diameter increase with age, with significant gender differences. A statistically significant association between arch variations and anomalous valves was observed, suggesting mutual predictability. Individuals with valve anomalies should undergo comprehensive cardiology evaluation to avert complications like aortic dissection during endovascular surgeries. While atheromatous plaques were prevalent in younger groups, their frequency rose with age, necessitating vigilant vascular monitoring. Careful handling during surgeries is paramount, given potential adverse outcomes resulting from variations. Overall, the study underscores the importance of comprehensive anatomical understanding in clinical contexts, guiding effective management strategies and ensuring patient safety in vascular surgeries. [ABSTRACT FROM AUTHOR]

Background: Preconception care mainly depends on minimising the risks faced before conception, collecting all possible information before conception, and using all sources to improve the reproductive health of pregnant women. Preconception is a great opportunity for early determination of any health risk and to optimise the health of implicit moms and protect the unborn foetus from any type of health risk as well as birth defect. This study presents the best scientific approach method for developing preconception intervention packages under different conditions. Objective: To determine the awareness of the importance of lifestyle modification in the prevention of gestational complications during the preconception period. Methods: This study was approved by the Ethical Committee and Protocol Committee (protocol no. 600/2022-2023). The subjects of this observational study were women who are primigravidae and reside in Karad, India. Using random sampling, 93 participants who were primigravidae were included. A questionnaire was distributed to individuals within the age range of 21 to 30 years, based on preconception care, lifestyle modification, family support and precautionary measures. Results: It was found that out of 91 participants, only 4.3% had excellent knowledge, 8.6% had very good knowledge, 27.96% had good knowledge, 53.76% had fair knowledge and 5.38% had poor education regarding preconception care. Conclusion: The awareness among women regarding the importance of lifestyle modification in the prevention of gestational complications during the preconception period was significantly lower. [ABSTRACT FROM AUTHOR]

Eschewing the symbolic in favour of commitment to the unmediated replication of exactly that which is actually observed, Hunter's attitude to the images in his Anatomy of the Human Gravid Uterus embraces a juridical ideal of scientific representation: images should tell the truth, the whole truth and nothing but the truth. Contemporary scholars have questioned this appeal to objectivity, maintaining representation always exists inside culture and arguing gender frequently inflects purportedly neutral scientific vision. I extend that debate via a reading of Plate XXVI, which is frequently misunderstood as representing something completely different to what it actually depicts. Its sequence of images, I argue, chart a narrative of enlightenment wherein folk mythologies of the uterus are subdued by the controlling scientific gaze. I also suggest a previously unrecognised correspondence between Plate XXVI and one of the plaster casts of the dissected bodies preserved in the University of Glasgow's Anatomy Museum. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective To investigate the clinical value of whole‐exome sequencing (WES) in the diagnosis of foetuses with central nervous system (CNS) abnormalities but having a normal karyotyping and chromosomal microarray result. Method During the period of 2016–2022, there were a total of 149 foetuses with CNS abnormalities but having negative karyotyping and chromosomal microarray analysis results; WES was performed on these foetuses and their parents. Variants were classified according to ACMG guidelines, and the association of pathogenic variants with specific types of CNS abnormalities was explored. Results Among these 149 foetuses, three categories of abnormalities, namely, single CNS abnormality, multiple CNS abnormalities, CNS abnormalities along with other organ system abnormalities were identified, for which the detection rate of P/LP variants is 17.4% (12/69), 28.6% (14/49) and 54.8% (17/31), respectively. Conclusion WES brought about an increase of 28.9% in diagnostic yield in the prenatal evaluation of foetuses with CNS abnormalities but having negative karyotyping and chromosome array results. WES may also be of benefit for the diagnosis of foetuses with isolated CNS abnormalities, as well as for making more informed interpretations of imaging findings and for providing better genetic counselling.

Abstract Introduction Uganda with 17.8 stillbirths per 1,000 deliveries in 2021, is among the countries with a high burden of stillbirths globally. In 2014, Uganda adopted the World Health Organization Every New-born Action Plan (ENAP), which targets 28 weeks of pregnancy or weighing > 1000 g before or during birth and reported to a health facility. We calculated annual incidence rates of stillbirths per 1,000 deliveries at district, regional, and national levels. We used logistic regression to determine the significance of trends. Results The overall national annual incidence of stillbirths decreased from 24/1,000 deliveries in 2014 to 17/1,000 deliveries in 2020. During the same period, reporting rates declined from 71% in 2014 to 46% in 2020. The central region continuously had the highest incidence rate for the past 5 years despite the largest decline (OR = 0.79; CI = 0.77–0.83, P 30/1000) included Mubende, Kalangala, Hoima, and Nebbi. There was no difference in the reporting rates of the most- vs. least-affected districts. Conclusion Even with suboptimal reporting, the incidence of stillbirths remained above the national target. Specific areas in the country appear to have particularly high stillbirth rates. We recommend continuous capacity building in managing pregnant women with an emphasis on the most affected districts, and investigation into the reasons for low reporting.

Introduction: Uganda with 17.8 stillbirths per 1,000 deliveries in 2021, is among the countries with a high burden of stillbirths globally. In 2014, Uganda adopted the World Health Organization Every New-born Action Plan (ENAP), which targets < 10 stillbirths per 1,000 deliveries by 2035. Little is known about the trends of stillbirth burden since ENAP was introduced. We assessed the temporal, and spatial distribution of stillbirths, in Uganda, 2014–2020, to inform programming for safe pregnancies and deliveries. Methods: We obtained and analysed stillbirth surveillance data from the District Health Information System, 2014–2020. A stillbirth was defined as the death of a foetus > 28 weeks of pregnancy or weighing > 1000 g before or during birth and reported to a health facility. We calculated annual incidence rates of stillbirths per 1,000 deliveries at district, regional, and national levels. We used logistic regression to determine the significance of trends. Results: The overall national annual incidence of stillbirths decreased from 24/1,000 deliveries in 2014 to 17/1,000 deliveries in 2020. During the same period, reporting rates declined from 71% in 2014 to 46% in 2020. The central region continuously had the highest incidence rate for the past 5 years despite the largest decline (OR = 0.79; CI = 0.77–0.83, P < 0.001) while the eastern region had the smallest decline (OR = 0.59; CI = 0.57–0.61, P < 0.001). Districts with persistently high annual incidence rates of stillbirths (> 30/1000) included Mubende, Kalangala, Hoima, and Nebbi. There was no difference in the reporting rates of the most- vs. least-affected districts. Conclusion: Even with suboptimal reporting, the incidence of stillbirths remained above the national target. Specific areas in the country appear to have particularly high stillbirth rates. We recommend continuous capacity building in managing pregnant women with an emphasis on the most affected districts, and investigation into the reasons for low reporting. [ABSTRACT FROM AUTHOR]

ObjectiveThis study aims to establish a prediction model of foetal umbilical vein standardised blood flow volume (sQuv) on estimated foetal weight (EFW) in the third trimester.MethodsA case-cohort study involving 200 eligible normal foetuses was conducted at the Ultrasound Department of Longquanyi District of Maternity and Child Healthcare Hospital between June 1, 2020 and December 31, 2021. Ultrasound measurements were taken at two separate intervals to assess EFW and the rate of EFW (rEFW) [first: between 28 w and 33 w6d of gestational age (GA); second: after 4–6 weeks]. Umbilical vein blood flow volume (Quv) and sQuv (normalised with EFW) were calculated only during the initial measurement. Using general linear regression, a prediction model for EFW based on GA and sQuv was developed, with the gestational week employed as a calibration scalar and validated using linear regression cross-validation.ResultsIn the third trimester, EFW exhibited significant correlations with GA, abdominal circumference (AC), head circumference (HC) and Quv (all ρ > 0.6, P 0.6, P

Abstract Introduction Dent disease type I is a rare X-linked recessive renal tubular disease resulting from pathogenic variants in the CLCN5 gene. Due to the rarity of Dent disease type I and the diversity of its phenotypes, its clinical diagnosis is complex and poses a challenge to clinicians. Methods A foetus and a child from a 36-year-old pregnant woman with a birth history of abnormal children were enrolled in this study. Pregnant women undergo amniocentesis for prenatal diagnosis at the gestational age of 12+ 3 weeks. Chromosomal microarray (CMA) analysis and whole-exome sequencing (WES) were employed to investigate the chromosomal copy number and single gene variants. Literature retrieval and data analysis were performed for genotype and phenotype collection analysis. Results No chromosomal abnormalities or CNVs were detected in the entire family through karyotype and familial CMA analyses. WES identified a nonsense pathogenic variant in CLCN5 of the X chromosome, c.1942 C > T (exon 11, NM_000084), which was inherited from his mother, who exhibited regular clinical features. Conclusion This study suggests that children with low-molecular-weight proteinuria and hypercalciuria should undergo prompt genetic testing to exclude Dent disease.

Introduction: Dent disease type I is a rare X-linked recessive renal tubular disease resulting from pathogenic variants in the CLCN5 gene. Due to the rarity of Dent disease type I and the diversity of its phenotypes, its clinical diagnosis is complex and poses a challenge to clinicians. Methods: A foetus and a child from a 36-year-old pregnant woman with a birth history of abnormal children were enrolled in this study. Pregnant women undergo amniocentesis for prenatal diagnosis at the gestational age of 12+ 3 weeks. Chromosomal microarray (CMA) analysis and whole-exome sequencing (WES) were employed to investigate the chromosomal copy number and single gene variants. Literature retrieval and data analysis were performed for genotype and phenotype collection analysis. Results: No chromosomal abnormalities or CNVs were detected in the entire family through karyotype and familial CMA analyses. WES identified a nonsense pathogenic variant in CLCN5 of the X chromosome, c.1942 C > T (exon 11, NM_000084), which was inherited from his mother, who exhibited regular clinical features. Conclusion: This study suggests that children with low-molecular-weight proteinuria and hypercalciuria should undergo prompt genetic testing to exclude Dent disease. [ABSTRACT FROM AUTHOR]

A popular tactic for defending abortion rights is appealing to self-ownership: since I own my body, a foetus has the right to occupy it only if I allow it. One cannot be forced to bring a pregnancy to term because that would violate one's self-ownership. The same logic applies to speech: we have freedom of speech because we produce speech using the bodies that we own. To curtail that speech violates our self-ownership, or in a phrase: my body, my speech. [ABSTRACT FROM AUTHOR]

Scrub typhus, caused by Orientia tsutsugamushi, is a re-emerging endemic zoonosis in the Asia Pacific region. It is a febrile condition ranging in severity from mild to severe, with fatality rates as high as 30%. The present study aims towards analysing the clinical profile and pregnancy outcomes in 27 cases of scrub typhus admitted to a tertiary care centre in North India. The medical records of 27 pregnant women who had scrub typhus were analysed. The IgM ELISA was used to look for IgM antibodies to Orientia tsutsugamushi in the patient's serum sample. An optical density of more than or equal to 0.468 was considered as positive. Majority of the pregnant females delivered healthy and live babies. However, poor foetal outcomes were observed in four (14.8%) cases with intrauterine deaths occurring in two (7.4%) cases and still birth in one (3.7%) case, while one (3.7%) patient had spontaneous abortion. Maternal mortality was reported in one patient (3.7%) due to a delay in diagnosis. In endemic settings, a strong index of suspicion for scrub typhus is necessary in pregnant females presenting with fever. The key to reducing morbidity in both the mother and foetus is early diagnosis and treatment. What is already known on this subject? Scrub typhus is a febrile condition ranging in severity from mild to severe, with 30% mortality in untreated patients. What do the results of this study add? Majority of the pregnant females delivered healthy and live babies. However, poor foetal outcomes were observed in four (14.8%) cases with intrauterine deaths occurring in two (7.4%) cases and still birth in one (3.7%) case, while one (3.7%) patient had spontaneous abortion. Maternal mortality was reported in one patient (3.7%) due to a delay in diagnosis. What are the implications of these findings for clinical practice and/or further research? In endemic settings, a strong index of suspicion for scrub typhus is necessary for pregnant females presenting with fever. The key to reducing morbidity in both the mother and foetus is early diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Histochemical study were made on trachea of buffalo foetuses  ranging from 4.3 to 44 cm CRL (crown rump length) to elucidate distribution of neutral and acid Mucopolysaccharides. During initial development up to 15.8 cm CRL tracheal eqithelium was strong to moderately positive from neutral mucopolysaccharides. The ground substance of developing cartilage primodria was weakly positive from acid mucopolysaccharide linging was present on the surface of PAS positive epithelia cells. The primordial of tracheal glands were positive for neutral mucopolysachharide content with well developed PAS positive submucosal tracheal glands.

Introduction: Perinatal mortality includes both late foetal deaths and early neonatal deaths. The perinatal mortality rate in India was 23/1000 live births for the year 2016, with congenital anomalies being the major cause of perinatal mortality. Thus, foetal autopsy plays an important role in identifying various types of congenital anomalies, determining the cause of foetal death, and thereby helping in counselling the parents. Aim: To identify various causes of foetal death and determine the most prevalent cause of foetal death. Materials and Methods: The present cross-sectional study was conducted in the Department of Pathology, PES Institute of Medical Sciences and Research (rural tertiary care referral Institute), Kuppam, Andhra Pradesh, India, from January 2018 to December 2022. Autopsies were performed according to a standard protocol and categorised using the Cunningham and Hollier classification. The data were entered into Microsoft (MS) Excel 2007 and further analysed using Statistical Package for the Social Sciences (SPSS) software version 26.0. Results: The maternal age ranged from 19-36 years with a mean±Standard Deviation (SD) of 24.1±3.37 years. Out of the 41 cases, 29 (70.73%) cases were terminated, and 12 (29.26%) cases had intrauterine foetal death. The majority of cases were in the second trimester, with 37 (90.24%) cases, followed by 4 (9.75%) cases in the third trimester. Foetal causes constituted the majority of cases, 23 (56.09%), followed by placental causes, 12 (29.26%) and maternal causes, 6 (14.63%). Conclusion: The present study concluded that congenital anomalies constituted the most prevalent cause of foetal death, with central nervous system anomalies being the most common. This information helps clinicians in early intervention and counselling parents to avoid similar outcomes in subsequent pregnancies.

Introduction: The partograph is a simple, inexpensive tool that provides a continuous pictorial overview of labour. It helps to identify obstructed or prolonged labour and determines when appropriate actions should be taken to prevent complications. The partograph is a valuable tool for making early decisions, including transferring patients to higher-level centres when labour is not progressing. Need for the study: This research aims to contribute to the development of a standardised approach for healthcare personnel to ensure accuracy and reliability in observations and data collection. Aim: This study will compare the efficacy of the World Health Organisation (WHO)-modified partograph versus the paperless partograph. Materials and Methods: This will be a prospective interventional study conducted at the Department of Obstetrics and Gynaecology, JNMC, Wardha, Maharashtra, India over a two-year duration from January 2024 to January 2026. The study will include 200 pregnant women who will be divided into two groups. One group will use the WHO-modified partograph, while the other group will use the paperless partograph. The comparison will be based on the effective management of labour using the action and alert line Estimated Time of Delivery (ETD) between the two partographs. The overall usefulness will be evaluated using the Chi-square test/Fisher’s-exact test, with a statistical value of

Cet article vise à dégager la nature du fœtus et les conflits qui résultent autour de l’avortement et les valeurs, tout en cherchant à savoir entre la vie de la mère et du fœtus, laquelle a une valeur supérieure.

Introduction: Acute Kidney Injury (AKI) poses life-threatening risks in pregnancy, leading to adverse perinatal and maternal outcomes. Aim: To estimate the incidence of Pregnancy-Related Acute Kidney Injury (PRAKI) and describe maternal and foetal outcomes in cases of Acute Renal Failure (ARF) at a tertiary care institute. Materials and Methods: A prospective descriptive study was conducted on 104 antenatal women with ARF attending King George Hospital, Visakhapatnam, Andhra Pradesh, India, from January to December 2020. A total of 7,409 deliveries occurred during the study period, and antenatal women with evidence of pre-existing renal disease were excluded. A detailed history was obtained, and evaluation included renal function tests and a total abdominal scan. Mode of delivery, foetal deaths, stillbirths, maternal deaths, and APGAR scores were analysed. Laboratory findings were also reported. Data analysis was performed using coGuide statistical software, and results were expressed in terms of frequency and percentages. Results: The incidence of PRAKI was 14 per 1,000 deliveries (1.4%). The mean age of the participants was 24.05±4.11 years. The majority (78 out of 104, 75%) were in the third trimester. Out of the 104 cases of PRAKI, 77 (74%) were due to hypertension. There were 16 (15.4%) maternal deaths and 19 (21.8%) perinatal deaths. Conclusion: Pregnant women with ARF experienced increased morbidity and mortality. Urgent improvements in antenatal care, early detection of complications, effective management, and timely referrals to tertiary centres are crucial.

Assisted reproduction technologies (ARTs) are generally considered safe; however, emerging evidence highlights the need to evaluate potential risks in adulthood to improve safety further. ART procedures like rederivation of embryos by vitrification differ from natural conditions, causing significant disparities between in vitro and in vivo embryos, affecting foetal physiology and postnatal life. This study aims to investigate whether hepatic transcriptome and metabolome changes observed postnatally are already present in foetal livers at the end of gestation. This study compared fresh and vitrified rabbit embryos, finding differences between foetuses obtained by the transfer of fresh and vitrified embryos at 24 days of gestation. Rederived embryos had reduced foetal and liver weights and crown-rump length. However, the offspring of vitrified embryos tended to be born with higher weight, showing compensatory growth in the final week of gestation (59.2 vs. 49.8 g). RNA-Seq analysis revealed 43 differentially expressed genes (DEGs) in the foetal liver of vitrified embryos compared to the fresh group. Notably, downregulated genes included BRAT1, CYP4A7, CYP2B4, RPL23, RPL22L1, PPILAL1, A1BG, IFGGC1, LRRC57, DIPP2, UGT2B14, IRGM1, NUTF2, MPST, and PPP1R1B, while upregulated genes included ACOT8, ERICH3, UBXN2A, METTL9, ALDH3A2, DERPC-like, NR5A2-like, AP-1, COG8, INHBE, and PLA2G4C. Overall, a functional annotation of these DEGs indicated an involvement in lipid metabolism and the stress and inflammatory process or immune response. Thus, our results suggest that vitrification and embryo transfer manipulation induce an adaptive response that can be observed in the liver during the last week of gestation.

Hydrops foetalis (HF) is the excessive fluid accumulation in at least two foetal body cavities, including pleural, pericardial, and peritoneal cavities, with associated soft tissue oedema. Most cases of hydrops foetalis were due to severe erythroblastosis foetalis, secondary to Rhesus isoimmunization. However, other variants include non-immune hydrops foetalis (NIHF). Foetal cystic hygroma, which occurs due to lymphatic obstruction, is commonly associated with immune hydrops foetalis (IHF). A combination of the conditions in a foetus tends to portend an abysmal prognosis because it can lead to abortion, intrauterine foetal death (IUFD) and early neonatal death (ENND). We report a case of a 22-year-old woman with a prenatal ultrasound diagnosis of a combination of NIHF and foetal cystic hygroma at 20 weeks of gestation. Therefore, there is a need for early diagnosis of the anomalies so that early termination of pregnancy can be performed if the patient desires.

Scrub typhus, caused by Orientia tsutsugamushi, is a re-emerging endemic zoonosis in the Asia Pacific region. It is a febrile condition ranging in severity from mild to severe, with fatality rates as high as 30%. The present study aims towards analysing the clinical profile and pregnancy outcomes in 27 cases of scrub typhus admitted to a tertiary care centre in North India. The medical records of 27 pregnant women who had scrub typhus were analysed. The IgM ELISA was used to look for IgM antibodies to Orientia tsutsugamushi in the patient’s serum sample. An optical density of more than or equal to 0.468 was considered as positive. Majority of the pregnant females delivered healthy and live babies. However, poor foetal outcomes were observed in four (14.8%) cases with intrauterine deaths occurring in two (7.4%) cases and still birth in one (3.7%) case, while one (3.7%) patient had spontaneous abortion. Maternal mortality was reported in one patient (3.7%) due to a delay in diagnosis. In endemic settings, a strong index of suspicion for scrub typhus is necessary in pregnant females presenting with fever. The key to reducing morbidity in both the mother and foetus is early diagnosis and treatment.Impact Statement What is already known on this subject? Scrub typhus is a febrile condition ranging in severity from mild to severe, with 30% mortality in untreated patients. What do the results of this study add? Majority of the pregnant females delivered healthy and live babies. However, poor foetal outcomes were observed in four (14.8%) cases with intrauterine deaths occurring in two (7.4%) cases and still birth in one (3.7%) case, while one (3.7%) patient had spontaneous abortion. Maternal mortality was reported in one patient (3.7%) due to a delay in diagnosis. What are the implications of these findings for clinical practice and/or further research? In endemic settings, a strong index of suspicion for scrub typhus is necessary for pregnant females presenting with fever. The key to reducing morbidity in both the mother and foetus is early diagnosis and treatment.

Introduction: Acute Kidney Injury (AKI) poses life-threatening risks in pregnancy, leading to adverse perinatal and maternal outcomes. Aim: To estimate the incidence of Pregnancy-Related Acute Kidney Injury (PRAKI) and describe maternal and foetal outcomes in cases of Acute Renal Failure (ARF) at a tertiary care institute. Materials and Methods: A prospective descriptive study was conducted on 104 antenatal women with ARF attending King George Hospital, Visakhapatnam, Andhra Pradesh, India, from January to December 2020. A total of 7,409 deliveries occurred during the study period, and antenatal women with evidence of pre-existing renal disease were excluded. A detailed history was obtained, and evaluation included renal function tests and a total abdominal scan. Mode of delivery, foetal deaths, stillbirths, maternal deaths, and APGAR scores were analysed. Laboratory findings were also reported. Data analysis was performed using coGuide statistical software, and results were expressed in terms of frequency and percentages. Results: The incidence of PRAKI was 14 per 1,000 deliveries (1.4%). The mean age of the participants was 24.05±4.11 years. The majority (78 out of 104, 75%) were in the third trimester. Out of the 104 cases of PRAKI, 77 (74%) were due to hypertension. There were 16 (15.4%) maternal deaths and 19 (21.8%) perinatal deaths. Results: The incidence of PRAKI was 14 per 1,000 deliveries (1.4%). The mean age of the participants was 24.05±4.11 years. The majority (78 out of 104, 75%) were in the third trimester. Out of the 104 cases of PRAKI, 77 (74%) were due to hypertension. There were 16 (15.4%) maternal deaths and 19 (21.8%) perinatal deaths. [ABSTRACT FROM AUTHOR]

Aims In long QT syndrome (LQTS), primary prevention improves outcome; thus, early identification is key. The most common LQTS phenotype is a foetal heart rate (FHR) < 3rd percentile for gestational age (GA) but the effects of cohort, genotype, variant, and maternal β-blocker therapy on FHR are unknown. We assessed the influence of these factors on FHR in pregnancies with familial LQTS and developed a FHR/GA threshold for LQTS. Methods and results In an international cohort of pregnancies in which one parent had LQTS, LQTS genotype, familial variant, and maternal β-blocker effects on FHR were assessed. We developed a testing algorithm for LQTS using FHR and GA as continuous predictors. Data included 1966 FHRs at 7–42 weeks' GA from 267 pregnancies/164 LQTS families [220 LQTS type 1 (LQT1), 35 LQTS type 2 (LQT2), and 12 LQTS type 3 (LQT3)]. The FHRs were significantly lower in LQT1 and LQT2 but not LQT3 or LQTS negative. The LQT1 variants with non-nonsense and severe function loss (current density or β-adrenergic response) had lower FHR. Maternal β-blockers potentiated bradycardia in LQT1 and LQT2 but did not affect FHR in LQTS negative. A FHR/GA threshold predicted LQT1 and LQT2 with 74.9% accuracy, 71% sensitivity, and 81% specificity. Conclusion Genotype, LQT1 variant, and maternal β-blocker therapy affect FHR. A predictive threshold of FHR/GA significantly improves the accuracy, sensitivity, and specificity for LQT1 and LQT2, above the infant's a priori 50% probability. We speculate this model may be useful in screening for LQTS in perinatal subjects without a known LQTS family history. [ABSTRACT FROM AUTHOR]

Identifying how specific nutrients can impact fertility, pregnancy, and neonatal outcomes will yield important insights into the biological mechanisms linking diet and reproductive health. Our study investigates how dietary vitamin C intake affects various fertility parameters and pregnancy and neonatal outcomes in the guinea pig, a natural model of vitamin C dependency. Dunkin Hartley guinea pigs were fed an optimal (900 mg/kg feed) or low (100 mg/kg feed) vitamin C diet ad libitum for at least three weeks prior to mating and throughout pregnancy. We found that animals receiving the low vitamin C diet had an increased number of unsuccessful matings, a higher incidence of foetal reabsorption, and, among pregnancies resulting in delivery at term, produced fewer offspring. Neonates from mothers on the low vitamin C diet had significantly decreased plasma vitamin C concentrations at birth and exhibited mild growth impairments in a sex-dependent manner. We conclude that a diet low of vitamin C induces a state of subfertility, reduces overall fecundity, and adversely impacts both pregnancy outcomes and growth in the offspring. Our study provides an essential foundation for future investigations to determine whether these findings translate to humans. If so, they could have important clinical implications for assisted reproductive technologies and nutritional recommendations for couples trying to conceive, pregnant women, and breastfeeding mothers. [ABSTRACT FROM AUTHOR]

Introduction: The placental examination provides important information about the effect of maternal abnormalities on the placenta or the cause of preterm delivery, fetal growth restriction, or fetal neurodevelopmental damage. Placental anatomical and pathologic lesions are usually associated with pregnancy complications and neonatal impaired outcome. Patients and methods: We included in our study 100 patients with gestational age of 37–40 weeks. These cases have been then subdivided into the following study groups: Group A: 50 placentas from pathological pregnancies; and, Group B: a control group of 50 physiological or normal pregnancies due to the absence of maternal, fetal, and early neonatal pathologies. Results: In group of complicated pregnancies (Group A), most common complication was severe pre-eclampsia (20%) followed by Gestational hypertension (18%) and Anaemia (16%). Abnormal placental findings were seen in 42% in Group A and in 24% patients in group B. C. Over all neonatal complications were significant significantly high in group A compared to Group B (60% and 36%). LBW (40% and 22%), Need for NICU admission (52% and 32%) and APGAR Score < 7, (8% and 2%) were significantly high in group A compared to Group B. One neonate was expired in Group A and in Group B, no mortality seen. Conclusions: Present study shows that identification of placental histology can be associated with pregnancy outcomes and complications. Understanding Placental histology could help in association with biological markers or more sophisticated instruments for early diagnosis. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Legal Theory / Jogelméleti Szemle / Zeitschrift für Rechtstheorie is the property of Journal of Legal Theory / Jogelmeleti Szemle / Zeitschrift fur Rechtstheorie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Cancer during pregnancy presents a delicate coexistence, imposing ethical and professional challenges on both the patient and medical team. In this study, we aimed to explore in a pre-clinical model the impact of tumour evolution in serum, placental and foetal metabolomics profiles during pregnancy in a time-course manner. Pregnant Wistar rats were distributed into two experimental groups: Control (C) and Walker-256 tumour-bearing (W). The rats were euthanised on three different gestational periods: at 12 days post-conception (dpc), at 16 dpc, and at 19 dpc. Serum, placenta and foetal metabolomic profiles were performed by 1H-NMR spectra following the analyses using Chenomx NMR Analysis Software V8.3. The tumour evolution was exponential, affecting the placental metabolomic profile during all the pregnancy stages. The placental tissue in tumour-bearing dams developed at a lower speed, decreasing the foetus's weight. Associated with the serum metabolomic changes related to tumour growth, the placental metabolomic alterations impacted many metabolic pathways related to energy provision, protein synthesis and signalling, which directly harmed the foetus's development. The development of the foetus is clearly affected by the damage induced by the tumour evolution, which alters the metabolic profile of both the serum and the placenta, impairing early embryonic development. [ABSTRACT FROM AUTHOR]

Gestational Age (GA) is important because it helps guide prenatal care. The foetus plays a pivotal role in assessing its progress and establishing the anticipated delivery date. As GA increases, standard biometric markers like biparietal diameter, head circumference, and foetal length become less accurate, making accurate determination of Foetal Gestational Age (FGA) a significant barrier for patient care. The accuracy of Foetal Kidney Length (FKL) in predicting FGA in the third trimester has been established in several populations. The growth of foetal kidneys is linear with GA, and they are easily identifiable around 18 weeks, following the mid-trimester. The present paper discusses various related research, including the relationship between GA and the length of the foetal kidney

Despite attempts at highlighting continuities across the reproductive process from conception to childcare, reproduction and parenting still tend to be studied as a collection of separate objects. This article contributes to the cross-fertilisation of reproductive and parenting culture studies by first introducing anticipation as a transversal analytical lens. A conceptual framework for the analysis of anticipatory regimes in reproduction is introduced with a focus on subjectification effects and future images. Second, the importance of pregnancy as a connector between reproduction and parenting is highlighted. These propositions are fleshed out with reference to an ethnography of pregnancy care in Switzerland. The results demonstrate that pregnant women are expected to act as anticipating agents and that foetuses are treated as future children. Future images reveal how prenatal care reproduces gender norms. Analysing anticipatory regimes contributes to discussions of power relations in prenatal care, the stratification of reproduction and challenges to reproductive justice. [ABSTRACT FROM AUTHOR]

Foetus-in-fetu (FIF) is a condition where one of the twin foetuses is found developing inside the other. Differentiating this condition from fetiform teratoma (FT), in which the teratoma becomes highly differentiated to take a foetus-like appearance, often becomes arduous. Unfamiliarity with the situation and the presence of bone and hair within such lesions can potentially mislead the surgeon to diagnose it as a dermoid cyst erroneously. Suboptimal surgery can complicate things further when it comes to redoing operations and the final histopathological reporting. We report this case of a partially removed cystic retroperitoneal mass in a 14-year-old male, posing a significant surgical challenge due to dense adhesions to the vital retroperitoneal structures, such as common iliac vessels and ureter. We also faced similar diagnostic dilemmas during histopathology due to the tissues removed during the previous surgery. Based on gross and microscopic features, the possibility of a FIF or FT was rendered.

Upside down, a couple of weeks before birth, the baby "listens" to the extrauterine world that awaits him, traslated and interpreted by the organic reactions of the mother's body. [ABSTRACT FROM AUTHOR]

In French, it is the same signifier that refers to the two different signifieds, namely the organs of sensoriality (the senses) and signification (the meaning), which emphasises that access to meaning depends fundamentally on sensoriality. From there, the article addresses the question of foetal sensoriality, and in particular auditory sensoriality, from the perspective of Suzanne Maiello's work on the first prenatal sound object. The question of polysensoriality is then raised, with reference to intersubjectivity, presymbolic representations and the language of the body and of the act. The article concludes with some reflections on the dialectic between being and existence and on autistic functioning between autosensuality and autoeroticism. [ABSTRACT FROM AUTHOR]

Copyright of Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Birth weight is a key factor for piglet survival, and therefore, there is ongoing interest in how nutrition during gestation can influence birth weight. Interestingly, sows are generally fed one single diet throughout gestation. This paper reviews past attempts to increase foetal growth to term and discusses opportunities to target nutritional manipulations at specific windows of gestation where key developmental events occur. Birth weight limits chances to survive mainly in piglets with birth weight below 1 kg. These piglets represent around 16% of the population. Given the normal distribution of birth weight, the mean birth weight needs to be increased by at least 50–100 g to have a meaningful impact on this proportion of the population and on perinatal survival. Based on existing variation in reported mean birth weight across a number of studies, it is argued that it is unrealistic to expect an increase in mean birth weight of more than 100 g. Attempts in the past to increase birth weight have focussed on the last trimester of gestation, when foetal growth is accelerated. Increase in feed allowance or nutritional concepts that target placenta vascularisation have not been successful. It is argued that nutritional manipulations should rather focus on the middle of gestation, since in that period, placenta growth occurs and since placenta size limits the foetal size. Alternatively, nutritional manipulations can target placentation during the embryonic phase.

Gestational Age (GA) is important because it helps guide prenatal care. The foetus plays a pivotal role in assessing its progress and establishing the anticipated delivery date. As GA increases, standard biometric markers like biparietal diameter, head circumference, and foetal length become less accurate, making accurate determination of Foetal Gestational Age (FGA) a significant barrier for patient care. The accuracy of Foetal Kidney Length (FKL) in predicting FGA in the third trimester has been established in several populations. The growth of foetal kidneys is linear with GA, and they are easily identifiable around 18 weeks, following the mid-trimester. The present paper discusses various related research, including the relationship between GA and the length of the foetal kidney. [ABSTRACT FROM AUTHOR]

Abstract Background Post-mortem imaging has been suggested as an alternative to conventional autopsy in the prenatal and postnatal periods. Noninvasive autopsies do not provide tissue for histological examination, which may limit their clinical value, especially when infection-related morbidity and mortality are suspected. Methods We performed a prospective, multicentre, cross-sectional study to compare the diagnostic performance of post-mortem magnetic resonance imaging with computed tomography-guided biopsy (Virtopsy®) with that of conventional autopsy in foetuses and infants. Cases referred for conventional autopsy were eligible for enrolment. After post-mortem imaging using a computed tomography scanner and a magnetic resonance imaging unit, computed tomography-guided tissue sampling was performed. Virtopsy results were compared with conventional autopsy in determining the likely final cause of death and major pathologies. The primary outcome was the proportion of cases for which the same cause of death was determined by both methods. Secondary outcomes included the proportion of false positive and false negative major pathological lesions detected by virtopsy and the proportion of computed tomography-guided biopsies that were adequate for histological examination. Results Overall, 101 cases (84 fetuses, 17 infants) were included. Virtopsy and autopsy identified the same cause of death in 91 cases (90.1%, 95% CI 82.7 to 94.5). The sensitivity and specificity of virtopsy for determining the cause of death were 96.6% (95% CI 90.6 to 98.8) and 41.7% (95% CI 19.3 to 68.0), respectively. In 32 cases (31.7%, 95% CI 23.4 to 41.3), major pathological findings remained undetected by virtopsy, and in 45 cases (44.6%, 95% CI 35.2 to 54.3), abnormalities were diagnosed by virtopsy but not confirmed by autopsy. Computed tomography-guided tissue sampling was adequate for pathological comments in 506 of 956 biopsies (52.7%) and added important diagnostic value in five of 30 cases (16.1%) with an unclear cause of death before autopsy compared with postmortem imaging alone. In 19 of 20 infective deaths (95%), biopsies revealed infection-related tissue changes. Infection was confirmed by placental examination in all fetal cases. Conclusions Virtopsy demonstrated a high concordance with conventional autopsy for the detection of cause of death but was less accurate for the evaluation of major pathologies. Computed tomography-guided biopsy had limited additional diagnostic value. Trial registration ClinicalTrials.gov (NCT01888380).