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Factor XIII deficiency is an extremely rare autosomal recessive genetic disorder, occurring in 1 of 3–5 million people, and is associated with perinatal complications, such as habitual abortion and prolonged bleeding. Although plasma‐derived factor XIII (Fibrogamin®) carries a risk of infection and contains very low concentrated forms of factor XIII (FXIII) used for a pregnant woman with congenital coagulation factor XIII deficiency, recombinant factor XIII (rFXIII, Novo Thirteen®; Tretten®, Novo Nordisk, Bagsværd, Denmark), which has no risk of infection and is highly concentrated, has emerged as a novel formulation. Herein, we report the first case of a Japanese pregnant woman with congenital coagulation factor XIII deficiency successfully managed by rFXIII. She had a good perinatal course without pregnancy‐related complications and transfusion through the perinatal period. [ABSTRACT FROM AUTHOR]

We analysed the effectiveness of transvaginal ultrasonographic and foetal/maternal pulse Doppler findings as predictors of labour onset within 1 week. We included 22 single normal pregnancies and evaluated the one-point and short- and long-term differences in uterine artery pulsatility index (PI), umbilical artery PI, middle cerebral artery PI (MCA-PI), peak systolic velocity, and cervical length (CL). Presence of funnelling and membrane separation over the internal cervical os was evaluated. Significant changes were observed in the one-point measurement of and short-term and long-term differences in CL, the one-point measurement of and long-term difference in MCA-PI, and the presence of membrane separation (Grade 2). In multivariate analysis, the significant predictors were short-term differences in CL (odds ratio [OR]: 5.27), long-term differences in MCA-PI (OR: 13.3), and presence of membrane separation (Grade 2) (OR: 5.38). Transvaginal ultrasonographic and foetal pulse Doppler findings were effective predictors of labour onset within 1 week. What is already known on this subject? Parameters reported to predict labour onset include the Bishop score, cervical length, decreased long-term cervical length, funnelling of the internal cervical os, and adrenal gland volume. What do the results of this study add? Short-term changes in cervical length, long-term changes in middle cerebral artery pulsatility index, and the presence of membrane separation Grade 2 were found to be useful predictive factors of labour onset in this study. What are the implications of these findings for clinical practice and/or further research? The prediction of labour onset enables clinicians to properly manage pregnancy and delivery considering maternal and foetal conditions. [ABSTRACT FROM AUTHOR]

Background: Uterine artery pseudoaneurysm (UAP) normally presents genital bleeding in the puerperal period, and severe hydronephrosis rarely presents during pregnancy. We report a rare case of severe ureteral obstruction accompanied by uterine artery pseudoaneurysm in the early second trimester of pregnancy, which was successfully treated by surgical intervention.Case Presentation: A 42-year-old nulligravid woman who had undergone myomectomy 3 years earlier was referred to our hospital for acute left abdominal pain at the 17th week of gestation. Ultrasonography showed severe left hydronephrosis and a 6-cm mass in the parauterine space. Color Doppler ultrasonography revealed a spinning turbulent flow pattern inside the mass lesion. Contrast-enhanced computed tomography revealed the left uterine artery feeding blood flow to the mass and left ureteral obstruction by the mass. These results indicated left hydronephrosis secondary to left uterine artery pseudoaneurysm. To resolve the problem, laparotomy was performed. As uterine artery isolation was impossible, ligation of the left internal iliac artery and releasing of the ureteral obstruction were carried out. The hydronephrosis and abdominal pain promptly resolved after the surgery. Thereafter, fetal development proceeded normally in the remaining months of the pregnancy. A healthy baby was delivered through cesarean section at 36 weeks gestational age. At the cesarean section, the left lower uterine segment where the UAP had been present was not visible because of the firm adhesion in around it.Conclusions: Uterine artery pseudoaneurysm can cause hydronephrosis in the early second trimester of pregnancy. Ligation of the unilateral internal iliac artery is a safe and effective intervention to block the blood flow to the uterine artery pseudoaneurysm during pregnancy, when uterine artery ligation seems not possible. In the pregnancy after previous surgical procedures to the uterus, uterine artery pseudoaneurysm should be considered in the differential diagnosis of symptomatic hydronephrosis. [ABSTRACT FROM AUTHOR]

Objective: Placental abruption is associated with adverse perinatal outcomes including intrauterine fetal demise, which subsequently results in stillbirth. However, few studies have demonstrated the preventability of stillbirth due to placental abruption. Therefore, we evaluated the possibility of preventing stillbirth caused by placental abruption by reviewing all stillbirths in our region., Methods: This study reviewed all stillbirths after 22 weeks of gestation in Shiga Prefecture, Japan from 2010 to 2019, excluding lethal disorders. We evaluated 350 stillbirth cases, with and without placental abruption., Results: There were 32 stillbirths with PA and 318 without placental abruption. The probability of preventing stillbirth was significantly higher in patients with placental abruption than in those without (30% vs. 8%, p  < 0.001). We also determined the recommendations for preventing stillbirths with placental abruption., Conclusion: Some stillbirths caused by placental abruption can be prevented. We recommend improvements to perinatal maternal-fetal care and perinatal emergency transport systems.