Management of Pregnancy Complications

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: 20 August 2024 | Viewed by 4352

Special Issue Editor


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Guest Editor
1. Department of Obstetrics and Gynecology, Mayanei Hayeshua Medical Center, Bnei Brak 51544, Israel
2. Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
Interests: high-risk pregnancy; preterm labor; fetal growth restriction

Special Issue Information

Dear Colleagues,

We are seeking papers on the topic of high-risk pregnancies, complications, and innovative treatments. High-risk pregnancies are those in which the mother, fetus, or both are at increased risk of complications or adverse outcomes. These can include preterm labor, preeclampsia, diabetes, fetal growth restriction, and many other medical and environmental conditions.

We welcome original research articles, reviews, case reports, and perspectives on any aspect of high-risk pregnancies, including (but not limited to):

  • Identification and management of high-risk pregnancies.
  • Predictive factors for adverse outcomes in high-risk pregnancies.
  • Novel diagnostic tools and interventions for high-risk pregnancies.
  • Innovative genetic and other fetal diagnostic tools.
  • Long-term outcomes for mothers and babies after high-risk pregnancies.
  • High risk deliveries, complications, and treatments.
  • Ethical considerations in managing high-risk pregnancies.

We welcome submissions from obstetricians, gynecologists, maternal–fetal medicine specialists, neonatologists, geneticists, endocrinologists, epidemiologists, and other researchers interested in high-risk pregnancies.

All submitted papers will undergo rigorous peer-review by our expert panel of reviewers. Accepted papers will be published in a Special Issue dedicated to high-risk pregnancies. We look forward to receiving your contributions.

Prof. Dr. Ariel Many
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • high-risk pregnancy
  • preterm labor
  • fetal growth restriction
  • gestational diabetes
  • twins
  • hypertensive disorders during pregnancy
  • preeclampsia
  • IUGR
  • prenatal genetics
  • congenital anomalies detection
  • cesarean section
  • complications of labor and delivery

Published Papers (4 papers)

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18 pages, 2507 KiB  
Article
The sFlt-1/PlGF Ratio at 12, 24, and 32 Weeks Gestation in Twin Pregnancies as a Predictor of Placental Dysfunction
by Elena Satorres-Pérez, Alicia Martínez-Varea, Blanca Novillo-Del Álamo, José Morales-Roselló and Vicente Diago-Almela
J. Clin. Med. 2024, 13(6), 1784; https://doi.org/10.3390/jcm13061784 - 20 Mar 2024
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Abstract
Background: This study aims to assess the utility of the sFlt-1/PlGF ratio throughout pregnancy in predicting placental dysfunction and neonatal outcomes in twin pregnancies. Methods: Prospective study at a tertiary hospital. All pregnant women with a twin pregnancy who signed the informed consent [...] Read more.
Background: This study aims to assess the utility of the sFlt-1/PlGF ratio throughout pregnancy in predicting placental dysfunction and neonatal outcomes in twin pregnancies. Methods: Prospective study at a tertiary hospital. All pregnant women with a twin pregnancy who signed the informed consent were included. The sFlt-1/PlGF ratio was measured at 12, 24, and 32 weeks’ gestation. Results: Seventy patients were included, and 30% developed placental dysfunction. Differences were found in the mean sFlt-1/PlGF ratios at week 32 (13.6 vs. 31.8, p = 0.007). Optimal cutoffs at 12, 24, and 32 weeks to identify patients who develop placental dysfunction were 32.5, 8.5, and 30.5, respectively, with ORs of 4.25 (1.13–20.69 95% IC; p = 0.044), 13.5 (3.07–67.90 95% IC; p = 0.001), 14.29 (3.59–66.84 95% IC; p < 0.001). The sFlt-1/PlGF ratio at 32 weeks was associated with gestational age at birth. The sFlt-1/PlGF ratio in weeks 24 and 32 had a statistically significant negative correlation with the birth weight percentile in both twins. Conclusions: The potential of the sFlt-1/PlGF ratio as a predictive tool for placental dysfunction in twin pregnancies is underscored. Full article
(This article belongs to the Special Issue Management of Pregnancy Complications)
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12 pages, 552 KiB  
Article
The 300 versus 300 Study—Low Volume versus High Volume Single Balloon Catheter for Induction of Labor: A Retrospective Case-Control Study
by Maciej W. Socha, Wojciech Flis, Miłosz Pietrus, Mateusz Wartęga and Monika Szambelan
J. Clin. Med. 2023, 12(14), 4839; https://doi.org/10.3390/jcm12144839 - 22 Jul 2023
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Abstract
The use of a Foley catheter is one of the oldest known methods of labor induction. Therefore, protocols using different volumes of Foley catheter balloons have been developed and tested to accurately determine their effectiveness. In this study, it was decided to retrospectively [...] Read more.
The use of a Foley catheter is one of the oldest known methods of labor induction. Therefore, protocols using different volumes of Foley catheter balloons have been developed and tested to accurately determine their effectiveness. In this study, it was decided to retrospectively evaluate two induction of labor (IOL) protocols. The last 300 eligible patients who met the criteria and underwent the low-volume balloon protocol (40–60 mL) IOL were selected. Then next, 300 patients who met the criteria and underwent high-volume balloon (80–100 mL) IOL were selected. Outcomes included time to delivery and parturition type, oxytocin augmentation, operative deliveries and application of intrapartum anesthesia. Overall, the majority of patients delivered within 24 h. Patients who received a high-volume Foley catheter had statistically significantly more vaginal deliveries. The mean-time to delivery in the high-volume catheter group was statistically significantly shorter than in the low-volume catheter group. Patients who received a high-volume Foley catheter required statistically significantly less oxytocin augmentation during induction of labor compared to patients with a low-volume Foley catheter. Regardless of the balloon volume used, the percentage of operative deliveries remained at a similar, low level (8.36% and 2.14%). Regardless of the catheter volume used, the majority of patients chose epidural over intravenous anesthesia. In conclusion, a high-volume balloon Foley catheter IOL is characterized by an increased percentage of vaginal deliveries, shortened time to delivery regardless of the type of delivery, and lower need for oxytocin augmentation. Full article
(This article belongs to the Special Issue Management of Pregnancy Complications)
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15 pages, 1640 KiB  
Systematic Review
Is a Higher Amniotic Fluid Viral Load Associated with a Greater Risk of Fetal Injury in Congenital Cytomegalovirus Infection—A Systematic Review and Meta-Analysis
by Noa Gilad, Swati Agrawal, Eleni Philippopoulos, Kellie E. Murphy and Shiri Shinar
J. Clin. Med. 2024, 13(7), 2136; https://doi.org/10.3390/jcm13072136 - 07 Apr 2024
Viewed by 404
Abstract
Background: Numerous studies have aimed to predict prenatal and neonatal outcomes for pregnancies complicated by congenital cytomegalovirus (CMV). Presently, assessing CMV severity prenatally relies largely on fetal imaging. A controversy exists regarding CMV viral load (VL) and its association with fetal and [...] Read more.
Background: Numerous studies have aimed to predict prenatal and neonatal outcomes for pregnancies complicated by congenital cytomegalovirus (CMV). Presently, assessing CMV severity prenatally relies largely on fetal imaging. A controversy exists regarding CMV viral load (VL) and its association with fetal and neonatal sequelae. Objective: To perform a systematic review and meta-analysis investigating the association between CMV DNA VL in amniotic fluid and fetal and neonatal outcomes in pregnancies with congenital CMV. Results: All cohort, case-control and observational studies that compared outcomes of fetuses with congenital CMV and provided information on individual patient CMV VL quantified in copies per milliliter (c/mL) from inception to January 2023 were included, with no geographical or language restrictions. A total of 1251 citations were reviewed with eight studies meeting inclusion criteria and included in meta-analysis. Affected pregnancies had a higher VL in the amniotic fluid compared to those unaffected with a mean difference of 2.2e+7 (range 1.5e+7 to 2.8e+7). In subgroup analysis, the VL was significantly higher in the fetuses, with imaging findings related to CMV compared to asymptomatic fetuses with a mean difference of 4.1e+7 (95% CI 2.8e+7–5.4e+7). However, among babies with congenital CMV, the VL was not significantly different between symptomatic and asymptomatic babies. Conclusions: Amniotic fluid CMV VL is associated with fetal sequalae in congenital CMV, with a higher VL conferring a greater risk for prenatal injury. Full article
(This article belongs to the Special Issue Management of Pregnancy Complications)
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7 pages, 1192 KiB  
Brief Report
Fetal Renal Duplicated Collecting System at 14–16 Weeks of Gestation
by Nizar Khatib, Moshe Bronshtein, Gal Bachar, Ron Beloosesky, Yuval Ginsberg, Osnat Zmora, Zeev Weiner and Ayala Gover
J. Clin. Med. 2023, 12(22), 7124; https://doi.org/10.3390/jcm12227124 - 16 Nov 2023
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Abstract
(1) Background: To examine the incidence of the prenatal diagnosis of the renal double-collecting system (rDCS) and describe its clinical outcome and associated genetic abnormalities. (2) Methods: This retrospective study included women who attended the obstetric clinic for early fetal anatomic sonography with [...] Read more.
(1) Background: To examine the incidence of the prenatal diagnosis of the renal double-collecting system (rDCS) and describe its clinical outcome and associated genetic abnormalities. (2) Methods: This retrospective study included women who attended the obstetric clinic for early fetal anatomic sonography with findings of a renal DCS. Diagnosis was conducted by an expert sonographer using defined criteria. (3) Results: In total, 29,268 women underwent early ultrasound anatomical screening at 14–16 weeks, and 383 cases of rDCS were diagnosed (prevalence: 1:76). Associated abnormalities were diagnosed in eleven pregnancies; four had chromosomal aberrations. No chromosomal abnormalities were reported in isolated cases. Ectopic uretrocele and dysplastic kidney were diagnosed in 6 (1.5%) and 5 (1.3%) fetuses, respectively. One girl was diagnosed with vesicoureteral reflux and recurrent UTIs, and two boys were diagnosed with undescended testis. The recurrence rate of rDCS was 8% in subsequent pregnancies. (4) Conclusions: In light of its benign nature, we speculate that isolated rDCS may be considered a benign anatomic variant, but a repeat examination in the third trimester is recommended to assess hydronephrosis. Full article
(This article belongs to the Special Issue Management of Pregnancy Complications)
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