Clinical Outcomes in Maternal–Fetal Medicine

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

Deadline for manuscript submissions: 25 May 2024 | Viewed by 1357

Special Issue Editors


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Guest Editor
Department of Obstetrics, Perinatology and Neonatology, Centre of Postgraduate Medical Education, Marymoncka 99/103, 01-813 Warsaw, Poland
Interests: gynaecology and obstetrics; perinatology

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Guest Editor
Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, 00-189 Warsaw, Poland
Interests: uterine fibroids; pharmacology; miminally invasive therapy; reproductive endocrinology
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Special Issue Information

Dear Colleagues,

Several pregnancy complications, including hypertensive disorders, gestational diabetes, fetal growth abnormalities, preterm delivery, and preterm rupture of membranes, affect approximately a quarter of pregnant women. They may be associated with short-term complications and adverse perinatal outcomes. Today, significant attention is paid to the long-term complications for maternal and offspring health resulting from these pregnancy conditions. The goal of this Special Issue is to present current advances in the screening, diagnosis, management, prediction, and prevention of pregnancy complications and their associated risks for the future health of women and their offspring.

We welcome high-quality and informative original studies (clinical and experimental), meta-analyses, and reviews. We look forward to receiving your contributions.

Dr. Katarzyna Kosinska-Kaczynska
Prof. Dr. Michał Ciebiera
Guest Editors

Manuscript Submission Information

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Keywords

  • pre-eclamsia
  • hypertensive disorders
  • gestational diabetes
  • fetal growth restriction
  • preterm delivery
  • intrahepatic cholestasis of pregnancy
  • perinatal outcome

Published Papers (2 papers)

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Research

9 pages, 204 KiB  
Article
Navigating Uncertain Waters: First-Trimester Screening’s Role in Identifying Neonatal Complications
by Grzegorz Swiercz, Anna Zmelonek-Znamirowska, Karol Szwabowicz, Justyna Armanska, Karolina Detka, Marta Mlodawska and Jakub Mlodawski
J. Clin. Med. 2024, 13(7), 1982; https://doi.org/10.3390/jcm13071982 - 29 Mar 2024
Viewed by 527
Abstract
Background: Contemporary diagnostic methods aimed at assessing neonatal outcomes predominantly rely on the medical history of pregnant women. Ideally, universal biomarkers indicating an increased risk of delivering infants in poor clinical condition, with a heightened likelihood of requiring hospitalization in a Neonatal [...] Read more.
Background: Contemporary diagnostic methods aimed at assessing neonatal outcomes predominantly rely on the medical history of pregnant women. Ideally, universal biomarkers indicating an increased risk of delivering infants in poor clinical condition, with a heightened likelihood of requiring hospitalization in a Neonatal Intensive Care Unit (NICU), would be beneficial for appropriately stratifying pregnant women into a high-risk category. Our study evaluated whether biochemical and ultrasonographical markers universally used in first-trimester screenings for non-heritable chromosomal aberrations could serve this purpose. Methods: This study encompassed 1164 patients who underwent first-trimester screening, including patient history, ultrasound examinations, and biochemical tests for pregnancy-associated plasma protein-A (PAPP-A) and the free beta-HCG subunit (fbHCG), from January 2019 to December 2021. The research concentrated on the correlation between these prenatal test results and neonatal outcomes, particularly Apgar scores, umbilical blood pH levels, and the necessity for NICU admission. Results: In our cohort, neonates scoring lower than 8 on the Apgar scale at birth exhibited lower concentrations of PAPP-A in the first trimester, both in raw and normalized values (PAPP-A MoM 0.93 vs. 1.027, p = 0.032). We also observed a higher pulsatility index in the venous duct in the first trimester in full-term neonates born with <8 points on the Apgar scale. Additionally, newborns born with an umbilical blood pH < 7.2 had lower normalized first-trimester PAPP-A concentrations (0.69 vs. 1.01 MoM, p = 0.04). We also noted that neonates requiring NICU hospitalization post-delivery had lower first-trimester bHCG concentrations (0.93 MoM vs. 1.11 MoM, p = 0.03). However, none of the correlations in our study translated into a robust prognostic ability for predicting dichotomous outcomes. All areas under the curve achieved a value < 0.7. Conclusions: Low concentrations of PAPP-A and free bHCG subunit in the first trimester may be associated with poorer clinical and biochemical conditions in neonates post-delivery. However, the relationship is weak and has limited predictive capability. Further research evaluating these relationships is necessary for the appropriate stratification of pregnant women into high-risk categories for neonatological complications. Full article
(This article belongs to the Special Issue Clinical Outcomes in Maternal–Fetal Medicine)
10 pages, 576 KiB  
Article
A Multicenter, Retrospective Comparison Study of Pregnancy Outcomes According to Placental Location in Placenta Previa
by Seon Ui Lee, Ji Hye Jo, Haein Lee, Yoojin Na and In Yang Park
J. Clin. Med. 2024, 13(3), 675; https://doi.org/10.3390/jcm13030675 - 24 Jan 2024
Viewed by 617
Abstract
Background: We investigated the association between placental location and pregnancy outcomes in placenta previa. Methods: This multi-center retrospective study enrolled 781 women who delivered between May 1999 and February 2020. We divided the dataset into anterior (n = 209) and posterior ( [...] Read more.
Background: We investigated the association between placental location and pregnancy outcomes in placenta previa. Methods: This multi-center retrospective study enrolled 781 women who delivered between May 1999 and February 2020. We divided the dataset into anterior (n = 209) and posterior (n = 572) groups and compared the baseline characteristics and obstetric and neonatal outcomes. The adverse obstetric outcomes associated with placenta location were evaluated using a multivariate logistic analysis. Results: Gestational age at delivery in the anterior group (253.0 ± 21.6) was significantly lower than that in the posterior group (257.6 ± 19.1) (p = 0.008). The anterior group showed significantly higher parity, rates of previous cesarean section, non-vertex fetal positions, admissions for bleeding, emergency cesarean sections, transfusions, estimated blood loss, and combined placenta accrete spectrum (p < 0.05). In the multivariate analysis, the anterior group had higher rates of transfusion (OR 2.23; 95% CI 1.50–3.30), placenta accreta spectrum (OR 2.16; 95% CI 1.21–3.97), and non-vertex fetal positions (OR 2.47; 95% CI 1.09–5.88). Conclusions: These findings suggest that more caution is required in the treatment of patients with anterior placenta previa. Therefore, if placenta previa is diagnosed prenatally, it is important to determine the location of the body and prepare for massive bleeding in the anterior group. Full article
(This article belongs to the Special Issue Clinical Outcomes in Maternal–Fetal Medicine)
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