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Clinical Advances in Maternal-Fetal Medicine
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Clinical Advances 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: closed (30 August 2024) | Viewed by 23595

Special Issue Editor

Prof. Dr. Erich Cosmi

E-Mail Website
Guest Editor
Department of Woman’s and Child’s Health, University of Padova, Padova, Italy
Interests: fetus; maternal fetal medicine; doppler; cardiovascular diseases; endometrosis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Since the 1970s, maternal and fetal medicine (as a branch of obstetrics and gynecology) has been revolutionized.

Research is very important for cases of high-risk pregnancies, and it is not only limited to the clinical aspects but it also concerns biochemical markers, precision medicine, and recently, artificial intelligence and its perspective on the varieties of diseases.

Therefore, this Special Issue encourages scientists to publish papers concerning all the aspects of maternal and fetal medicine.

Prof. Dr. Erich Cosmi
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

  • precision medicine
  • omics
  • clinical
  • fetus
  • Doppler

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Published Papers (5 papers)

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Editorial

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3 pages, 190 KiB  
Editorial
Current Understanding and Future Challenges in Physical Activity during Pregnancy
by Lulu Wang and Yanting Wu
J. Clin. Med. 2023, 12(12), 3986; https://doi.org/10.3390/jcm12123986 - 12 Jun 2023
Viewed by 1238
Abstract
Obesity and overweight attributed to poor nutrition and a lack of physical activity increasingly become a serious problem among women of reproductive age [...] Full article
(This article belongs to the Special Issue Clinical Advances in Maternal-Fetal Medicine)

Research

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15 pages, 1195 KiB  
Article
Monitoring of Women with Anti-Ro/SSA and Anti-La/SSB Antibodies in Germany—Status Quo and Intensified Monitoring Concepts
by Ivonne Alexandra Bedei, David Kniess, Corinna Keil, Aline Wolter, Johanna Schenk, Ulrich J. Sachs and Roland Axt-Fliedner
J. Clin. Med. 2024, 13(4), 1142; https://doi.org/10.3390/jcm13041142 - 17 Feb 2024
Cited by 1 | Viewed by 3583
Abstract
Background: The fetuses of pregnant women affected by anti-Ro/anti-La antibodies are at risk of developing complete atrioventricular heart block (CAVB) and other potentially life-threatening cardiac affections. CAVB can develop in less than 24 h. Treatment with anti-inflammatory drugs and immunoglobulins (IVIG) can restore [...] Read more.
Background: The fetuses of pregnant women affected by anti-Ro/anti-La antibodies are at risk of developing complete atrioventricular heart block (CAVB) and other potentially life-threatening cardiac affections. CAVB can develop in less than 24 h. Treatment with anti-inflammatory drugs and immunoglobulins (IVIG) can restore the normal rhythm if applied in the transition period. Routine weekly echocardiography, as often recommended, will rarely detect emergent AVB. The surveillance of these pregnancies is controversial. Home-monitoring using a hand-held Doppler is a promising new approach. Methods: To obtain an overview of the current practice in Germany, we developed a web-based survey sent by the DEGUM (German Society of Ultrasound in Medicine) to ultrasound specialists. With the intention to evaluate practicability of home-monitoring, we instructed at-risk pregnant women to use a hand-held Doppler in the vulnerable period between 18 and 26 weeks at our university center. Results: There are trends but no clear consensus on surveillance, prophylaxis, and treatment of anti-Ro/La positive pregnant between specialists in Germany. Currently most experts do not offer home-monitoring but have a positive attitude towards its prospective use. Intensified fetal monitoring using a hand-held Doppler is feasible for pregnant women at risk and does not lead to frequent and unnecessary contact with the center. Conclusion: Evidence-based guidelines are needed to optimize the care of anti-Ro/La-positive pregnant women. Individual risk stratification could help pregnancy care of women at risk and is welcmed by most experts. Hand-held doppler monitoring is accepted by patients and prenatal medicine specialists as an option for intensified monitoring and can be included in an algorithm for surveillance. Full article
(This article belongs to the Special Issue Clinical Advances in Maternal-Fetal Medicine)
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10 pages, 1309 KiB  
Article
Fetal Third-Trimester Functional Cardiovascular Abnormalities and Neonatal Elevated Bilirubin Level
by Maria Respondek-Liberska, Oskar Sylwestrzak, Julia Murlewska, Łucja Biały, Michał Krekora, Monika Tadros-Zins, Ewa Gulczyńska and Iwona Strzelecka
J. Clin. Med. 2023, 12(18), 6021; https://doi.org/10.3390/jcm12186021 - 17 Sep 2023
Viewed by 2566
Abstract
Background: The aim of the study was to analyze the neonatal outcomes of fetuses with diagnosed functional cardiovascular abnormalities, also considering the connection with neonatal hyperbilirubinemia. Materials and Methods: It was an observational study of 100 neonates who had fetal echocardiography examinations in [...] Read more.
Background: The aim of the study was to analyze the neonatal outcomes of fetuses with diagnosed functional cardiovascular abnormalities, also considering the connection with neonatal hyperbilirubinemia. Materials and Methods: It was an observational study of 100 neonates who had fetal echocardiography examinations in the third trimester (mean gestational age during the last echocardiography was 34 ± 3 weeks and mean birth weight was 3550 g). There were two groups: A: normal heart anatomy + no functional anomalies; group B: normal heart anatomy + functional abnormalities. Hyperbilirubinemia was defined as a bilirubin level of >10 mg%. Results: In group A, there were 72 cases and only 5 cases despite having normal heart anatomy and normal heart study that presented additional problems. In group B (28 cases), the prenatal functional findings included tricuspid regurgitation (TR) (15 cases, 53%), pericardial effusion (4 cases, 14%), myocardial hypertrophy (4 cases, 14%), cardiomegaly (2 cases, 7%), abnormal bidirectional blood flow across the foramen ovale (3 cases, 11%), aneurysm of atrial septum (2 case, 7%), abnormal E/A ratio for mitral and tricuspid valve (1 case, 3%), bright spot (3 case, 11%), abnormal Doppler flow in ductus arteriosus compared to aortic arch (difference >60 cm/s) (1 case, 3%), supraventricular tachycardia (SVT) (1 case), and mitral regurgitation (1 case, 3%). In group A (n = 72 cases), bilirubin levels of >10 mg/dL were observed in 8% of newborns. In group B (n = 28), bilirubin levels of > 10 m/dL were observed in 46% of cases and TR was present in group B in 53% of cases (15/28 cases). The difference between group A and B in terms of elevated bilirubin levels was statistically significant (p < 0.001). Conclusions: In the case of fetal normal heart anatomy and normal heart study, a good neonatal outcome may be expected. When fetal cardiovascular functional abnormalities in normal heart anatomy are detected, with special attention paid to tricuspid valve regurgitation, a neonatal elevated bilirubin level (mean 11 mg/dL, range 10–15 mg/dL) may be expected. Full article
(This article belongs to the Special Issue Clinical Advances in Maternal-Fetal Medicine)
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Review

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21 pages, 1980 KiB  
Review
Non-Pharmacological Pain Management in Labor: A Systematic Review
by Wassan Nori, Mustafa Ali Kassim Kassim, Zeena Raad Helmi, Alexandru Cosmin Pantazi, Dragos Brezeanu, Ana Maria Brezeanu, Roxana Cleopatra Penciu and Lucian Serbanescu
J. Clin. Med. 2023, 12(23), 7203; https://doi.org/10.3390/jcm12237203 - 21 Nov 2023
Cited by 15 | Viewed by 14144
Abstract
Childbirth is a remarkable, life-changing process and is frequently regarded as an excruciating, physically and emotionally demanding experience that women endure. Labor pain management poses a significant challenge for obstetricians and expectant mothers. Although pharmacological pain management is the gold standard, it still [...] Read more.
Childbirth is a remarkable, life-changing process and is frequently regarded as an excruciating, physically and emotionally demanding experience that women endure. Labor pain management poses a significant challenge for obstetricians and expectant mothers. Although pharmacological pain management is the gold standard, it still imposes risks on the mother and baby. Recently, non-pharmacological pain management (NPPM) has emerged as a safe, effective option. Six databases were searched for articles published up to 2023 using specific related keywords and defined inclusion and exclusion criteria. The extraction and gathering of data was made so as to be categorized into physical, psychological, and complementary NPPM techniques. In light of the enormous development and diversity of NPPM techniques, the present review aims to examine contemporary NPPM knowledge and application, discussing efficacy, advantages, limitations, and potential adverse effects, with a specific focus on women’s individual requirements, to strengthen obstetricians’ knowledge in guiding decision-making for women in childbirth. Full article
(This article belongs to the Special Issue Clinical Advances in Maternal-Fetal Medicine)
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Other

10 pages, 393 KiB  
Systematic Review
Cerebroplacental Ratio as a Predictive Factor of Emergency Cesarean Sections for Intrapartum Fetal Compromise: A Systematic Review
by Blanca Novillo-Del Álamo, Alicia Martínez-Varea, Elena Satorres-Pérez, Mar Nieto-Tous, Silvia Bello-Martínez de Velasco, María Victoria García-Florenciano, Carmen Padilla-Prieto, Fernando Modrego-Pardo and José Morales-Roselló
J. Clin. Med. 2024, 13(6), 1724; https://doi.org/10.3390/jcm13061724 - 17 Mar 2024
Cited by 4 | Viewed by 1303
Abstract
Background: This systematic review aimed to clarify the association between the cerebroplacental ratio (CPR) and emergency cesarean sections (CSs) due to intrapartum fetal compromise (IFC). Methods: Datasets of PubMed, ScienceDirect, CENTRAL, Embase, and Google Scholar were searched for studies published up [...] Read more.
Background: This systematic review aimed to clarify the association between the cerebroplacental ratio (CPR) and emergency cesarean sections (CSs) due to intrapartum fetal compromise (IFC). Methods: Datasets of PubMed, ScienceDirect, CENTRAL, Embase, and Google Scholar were searched for studies published up to January 2024 regarding the relationship between the CPR and the rate of CS for IFC, as well as the predictive value of the CPR. Results: The search identified 582 articles, of which 16 observational studies were finally included, most of them with a prospective design. A total of 14,823 patients were involved. A low CPR was associated with a higher risk of CS for IFC. The predictive value of the CPR was very different among the studies due to substantial heterogeneity regarding the group of patients included and the time interval from CPR evaluation to delivery. Conclusions: A low CPR is associated with a higher risk of CS for IFC, although with a poor predictive value. The CPR could be calculated prior to labor in all patients to stratify the risk of CS due to IFC. Full article
(This article belongs to the Special Issue Clinical Advances in Maternal-Fetal Medicine)
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