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Maternal Fetal Medicine and Perinatal Management
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Maternal Fetal Medicine and Perinatal Management

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

Deadline for manuscript submissions: 15 November 2024 | Viewed by 6111

Special Issue Editor

Prof. Dr. Ariel Many

E-Mail Website
Guest Editor
Department of Obstetrics and Gynecology, Mayanei Hayeshua Medical Center, Bnei Brak 51544, Israel
Interests: preeclampsia; growth restriction; preterm birth; cesarean section; pregnancy complications; twins

Special Issue Information

Dear Colleagues,

Maternal Fetal Medicine (MFM) is a specialized branch of obstetrics that focuses on the management of high-risk pregnancies and the care of both the mother and the fetus. Perinatal management refers to the overall care and support provided to pregnant women and their unborn babies. It includes prenatal care, monitoring the health and development of the fetus, managing any complications or risks, and making decisions regarding the timing and mode of delivery.

This Special Issue titled ”Maternal Fetal Medicine and Perinatal Management” covers a wide range of topics, including such as preeclampsia and gestational hypertension, gestational diabetes and other metabolic disorders, multiple pregnancies such as twins or higher-order multiples, fetal growth abnormalities or intrauterine growth restriction, preterm labor and the premature rupture of membranes, and fetal congenital anomalies or genetic disorders.

Overall, Maternal Fetal Medicine and perinatal management aim to ensure the best possible care for high-risk pregnancies, promoting the health and well-being of both the mother and the fetus. We look forward to your contributions to the ongoing advancement of Maternal Fetal Medicine and perinatal management.

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
  • gestational diabetes
  • gestational hypertension
  • multiple pregnancies
  • preeclampsia
  • preterm birth
  • growth restriction

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Published Papers (4 papers)

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18 pages, 1113 KiB  
Article
Maternal, Perinatal and Neonatal Outcomes of Triplet Pregnancies According to Chorionicity: Our 15-Year Experience in a Tertiary-Level Center
by Mireia Bernal Claverol, Irene Aracil Moreno, María Ruiz Minaya, María Fernández Muñoz, Zurine Raquel Reyes Angullo, Pablo González Navarro, Natalio García-Honduvilla, Miguel A. Ortega, Santiago García Tizón, María P. Pintado-Recarte and Juan A. de León-Luis
J. Clin. Med. 2024, 13(6), 1793; https://doi.org/10.3390/jcm13061793 - 20 Mar 2024
Viewed by 947
Abstract
Introduction: The goal of this study was to evaluate the effect of chorionicity on maternal, fetal and neonatal morbidity and mortality in triplet pregnancies in our environment. Methods: A retrospective observational study was carried out on triplet pregnancies that were delivered [...] Read more.
Introduction: The goal of this study was to evaluate the effect of chorionicity on maternal, fetal and neonatal morbidity and mortality in triplet pregnancies in our environment. Methods: A retrospective observational study was carried out on triplet pregnancies that were delivered in a tertiary center between 2006 and 2020. A total of 76 pregnant women, 228 fetuses and 226 live newborns were analyzed. Of these triplet pregnancies, half were non-trichorionic. We analyzed maternal characteristics and obstetric, fetal, perinatal and neonatal complications based on their chorionicity, comparing trichorionic vs. non-trichorionic triplet pregnancies. Prematurity was defined as <34 weeks. We measured perinatal and neonatal mortality, composite neonatal morbidity and composite maternal morbidity. Results: Newborns with a monochorionic component had a lower gestational age at birth, presented greater prematurity under 34 weeks, lower birth weight, greater probability of birth weight under 2000 g and an APGAR score below 7 at 5 min after birth, more respiratory distress syndrome and, overall, higher composite neonatal morbidity. The monochorionic component of triple pregnancies may entail the development of complications intrinsic to shared circulation and require premature elective termination. This greater prematurity is also associated with a lower birth weight and to the main neonatal complications observed. These findings are in line with those that were previously published in the meta-analysis by our research group and previous literature. Discussion: Triplet gestations with a monochorionic component present a higher risk of obstetric, fetal and neonatal morbidity and mortality. Full article
(This article belongs to the Special Issue Maternal Fetal Medicine and Perinatal Management)
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10 pages, 248 KiB  
Article
Is Parity a Risk Factor for Late Preterm Birth? Results from a Large Cohort Study
by Lior Kashani-Ligumsky, Ran Neiger, Ella Segal, Ronnie Cohen and Miriam Lopian
J. Clin. Med. 2024, 13(2), 429; https://doi.org/10.3390/jcm13020429 - 12 Jan 2024
Viewed by 1399
Abstract
Most preterm births occur in the late preterm period. While prematurity-related adverse outcomes are significantly diminished when birth occurs during this period, these infants are still at increased risk of complications. Parity affects the incidence of obstetric complications. The purpose of this study [...] Read more.
Most preterm births occur in the late preterm period. While prematurity-related adverse outcomes are significantly diminished when birth occurs during this period, these infants are still at increased risk of complications. Parity affects the incidence of obstetric complications. The purpose of this study was to determine whether parity impacts the risk of spontaneous late preterm birth (SLPTB) and associated complications. A retrospective observational cohort study was conducted. Patients were divided into three study groups according to parity. The primary outcome was the rate of SLPTB in each group. Secondary outcomes were unplanned cesarean delivery (UCD), prolonged third stage of labor respiratory distress syndrome (RDS), transient tachypnea of the newborn (TTN), intraventricular hemorrhage (IVH), neonatal hypoglycemia, duration of NICU admission, neonatal death, and composite adverse neonatal outcome (CANO). Primiparas were more likely to have SLPTB, UCD, and CANO compared to multiparas (2.6% vs. 1.9% OR 1.5 [1.3–1.7] p < 0.01) (4.1% vs. 1.3% OR 2.7 [1.2, 5.9] p < 0.01) (8.5% vs. 4.2 OR 2.1 [1.3–3.5] p = 0.002) and grandmultiparas (2.6% vs. 1.7% OR 1.4 [1.2–1.5] p < 0.001) 8.5% vs. 4.4% OR 2.0 [1.1, 3.8], p = 0.01) but no difference in UCD compared to grandmultiparas (4.1% vs. 3.3% OR 1.2 [0.6–2.7] p = 0.28). Primiparas are at increased risk of SLPTB and UCD, and this is accompanied by an increased risk of adverse neonatal outcomes. Full article
(This article belongs to the Special Issue Maternal Fetal Medicine and Perinatal Management)
11 pages, 1311 KiB  
Article
Semi-Automatic Measurement of Fetal Cardiac Axis in Fetuses with Congenital Heart Disease (CHD) with Fetal Intelligent Navigation Echocardiography (FINE)
by Alexander Weichert, Michael Gembicki, Jan Weichert, Sven Christian Weber and Josefine Koenigbauer
J. Clin. Med. 2023, 12(19), 6371; https://doi.org/10.3390/jcm12196371 - 5 Oct 2023
Cited by 1 | Viewed by 2022
Abstract
Congenital heart disease (CHD) is one of the most common organ-specific birth defects and a major cause of infant morbidity and mortality. Despite ultrasound screening guidelines, the detection rate of CHD is limited. Fetal intelligent navigation echocardiography (FINE) has been introduced to extract [...] Read more.
Congenital heart disease (CHD) is one of the most common organ-specific birth defects and a major cause of infant morbidity and mortality. Despite ultrasound screening guidelines, the detection rate of CHD is limited. Fetal intelligent navigation echocardiography (FINE) has been introduced to extract reference planes and cardiac axis from cardiac spatiotemporal image correlation (STIC) volume datasets. This study analyses the cardiac axis in fetuses affected by CHD/thoracic masses (n = 545) compared to healthy fetuses (n = 1543) generated by FINE. After marking seven anatomical structures, the FINE software generated semi-automatically nine echocardiography standard planes and calculated the cardiac axis. Our study reveals that depending on the type of CHD, the cardiac axis varies. In approximately 86% (471 of 542 volumes) of our pathological cases, an abnormal cardiac axis (normal median = 40–45°) was detectable. Significant differences between the fetal axis of the normal heart versus CHD were detected in HLHS, pulmonary atresia, TOF (p-value < 0.0001), RAA, situs ambiguus (p-value = 0.0001–0.001) and absent pulmonary valve syndrome, DORV, thoracic masses (p-value = 0.001–0.01). This analysis confirms that in fetuses with CHD, the cardiac axis can significantly deviate from the normal range. FINE appears to be a valuable tool to identify cardiac defects. Full article
(This article belongs to the Special Issue Maternal Fetal Medicine and Perinatal Management)
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9 pages, 1430 KiB  
Case Report
Addressing Diagnosis, Management, and Complication Challenges in Placenta Accreta Spectrum Disorder: A Descriptive Study
by Marfy Abousifein, Anna Shishkina and Nicholas Leyland
J. Clin. Med. 2024, 13(11), 3155; https://doi.org/10.3390/jcm13113155 - 28 May 2024
Viewed by 782
Abstract
Introduction: In light of increased cesarean section rates, the incidence of placenta accreta spectrum (PAS) disorder is increasing. Despite the establishment of clinical practice guidelines offering recommendations for early and effective PAS diagnosis and treatment, antepartum diagnosis of PAS remains a challenge. This [...] Read more.
Introduction: In light of increased cesarean section rates, the incidence of placenta accreta spectrum (PAS) disorder is increasing. Despite the establishment of clinical practice guidelines offering recommendations for early and effective PAS diagnosis and treatment, antepartum diagnosis of PAS remains a challenge. This ultimately risks poor mental health and poor physical maternal and neonatal health outcomes. Case Descriptions: This case series details the experience of two high-risk patients who remained undiagnosed for PAS until they presented with antenatal hemorrhage, leading ultimately to necessary, complex surgical interventions, which can only be optimally provide in a tertiary care center. Patient 1 is a 37-year-old woman with a history of three cesarean sections, which elevates her risk for PAS. She had placenta previa detected at 19 weeks, and placenta percreta diagnosed upon hemorrhage. During a hysterectomy, invasive placenta was found in the patient’s bladder, leading to a cystotomy and right ureteric reimplantation. After discharge, she was diagnosed with a vesicovaginal fistula, and is currently awaiting surgical repair. Patient 2 is a 34-year-old woman with two previous cesarean sections. The patient had complete placenta previa detected at 19- and 32-week gestation scans. She presented with antepartum hemorrhage at 35 weeks and 2 days. An ultrasound showed thin myometrium at the scar site with significant vascularity. A hysterectomy was performed due to placental attachment issues, with significant blood loss. Both patients were at high risk for PAS based on past medical history, risk factors, and pathognomonic imaging findings. Discussion: We highlight the importance of the implementation of clinical guidelines at non-tertiary healthcare centers. We offer clinical-guideline-informed recommendations for radiologists and antenatal care providers to promote early PAS diagnosis and, ultimately, better patient and neonatal outcomes through increased access to adequate care. Full article
(This article belongs to the Special Issue Maternal Fetal Medicine and Perinatal Management)
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