Search Results (407)

The rhesus macaque (Macaca mulatta) is a valuable model for pregnancy research due to its physiological similarity to humans and the ability to conduct studies in a controlled environment. Our previous work used non-invasive imaging methods to assess placental hemodynamics across gestation with correlative tissue analysis post-delivery. Here, we expand access to longitudinal timepoints from ongoing pregnancies by obtaining placental biopsies using ultrasound-guided needle aspiration. This approach aligns with New Approach Methods (NAMs) and supports animal welfare by reducing the number of animals required. We describe a chorionic villus sampling (CVS) simulation model which facilitates training to gain proficiency in technical skills prior to performing the procedure on animals. We report outcomes from three rhesus macaques that underwent CVS three times between gestational days 40 to 106 (term: 165 days). Although biopsy samples are smaller than whole placenta, tissue yields were sufficient for multiple uses. We demonstrate (1) appropriate histology from aspirated samples, (2) good RNA quality and yield, and (3) the ability to isolate trophoblast organoids, an advancement in NAMs that reduces the need for first-trimester surgical delivery. No spontaneous preterm delivery occurred following serial CVS procedures, supporting the use of this sampling method to maximize animal utilization in longitudinal pregnancy studies. Full article

Background and Objectives: Early mother–newborn skin-to-skin contact (SSC) after birth is widely recommended to support neonatal physiological stabilization, including thermoregulation. Under routine clinical practice, however, SSC may be brief or interrupted, and its effectiveness in maintaining neonatal body temperature under such conditions is less well described. This study aimed to evaluate early neonatal temperature changes under routine post-birth care practices that included brief SSC followed by separation for incubation care. Materials and Methods: This retrospective cohort study included 620 term mother–infant dyads delivered at a single regional teaching hospital. Newborns were managed according to routine clinical practice and were allocated to either a brief early SSC group or a control group without SSC. SSC duration differed by mode of delivery (approximately 10 min after cesarean section and 20 min after vaginal birth). Infant body temperature was recorded at predefined time points from birth through early incubation care. Associations between temperature changes and clinical factors, including mode of delivery, gestational age, parity, and birth weight, were analyzed. Results: No significant difference was observed between the SSC and control groups in overall changes in infant body temperature from birth to the beginning of incubation care (p = 0.245). After one hour of incubation, mean body temperature was comparable between groups (p = 0.357). Within the SSC group, infant body temperature decreased significantly during the SSC period (change from birth: −0.68 °C ± 0.35 °C; p < 0.001). At the start of incubation care, a significantly lower proportion of infants in the SSC group (22%) had body temperatures below 36.5 °C compared to the control group (32%) (p = 0.018). Multivariable analysis identified mode of delivery, reflecting differences in post-birth care routines and SSC duration, as the only factor independently associated with temperature changes during SSC. Conclusions: Under routine clinical conditions, brief and interrupted SSC was associated with transient reductions in neonatal body temperature; however, brief SSC was associated with a lower proportion of hypothermia compared with immediate incubation care, suggesting that even short periods of SSC may support early neonatal thermoregulation. Full article

Little is known about the reproductive impacts of the GAA, creatine precursor, in ruminants. This study aimed to evaluate the effects of GAA supply during the transition period in ewes with single pregnancies on their uterine involution. Sixteen ewes with single pregnancy were allocated to two groups: one receiving a basal diet (WGAA, n = 8) and another receiving a basal diet supplemented daily with 0.6 g/kg DM diet of GAA (RUGAA, n = 8) from 100 days of gestation to 35 days postpartum (PP). The RUGAA group showed increased feed intake after delivery and modified diet selectivity. Also, at parturition, a smaller cotyledonary surface area and lower offspring weight at birth were observed. During PP, RUGAA exhibit a slight reduction in the loin depth and backfat thickness, and higher peripheral glutathione peroxidase level. Also in PP, RUGAA expressed a greater rate of uterine lumen shrinkage, more efficient mammary parenchyma growth and a higher relative lambs growth rate. We concluded that supplementation with 0.6 g of GAA in ewes with single pregnancies improved postpartum uterine involution, but also altered the mother-fetus communication system, affecting the birth weight of the offspring. Therefore, we believe further studies are necessary to efficiently align creatine demand with the distinct physiological events that occur during gestation and the postpartum period. Full article

Background/Objectives: Antepartum computerized cardiotocography (cCTG) represents an essential tool for assessing fetal well-being. This study aimed to comparatively evaluate antepartum cCTG-derived indices across high-risk pregnancies to identify distinctive fetal autonomic and reactivity profiles. Methods: A comparative analysis of antepartum cCTG parameters was conducted. The cohort included pregnancies beyond 28 weeks of pregnancy, 169 cases of hypertensive disorders of pregnancy (HDP), 146 of gestational diabetes mellitus (GDM), 86 of intrahepatic cholestasis (ICP), and 87 low-risk pregnancies as controls. Results: Baseline FHR remained within the physiological range across all groups (110–160 bpm; p > 0.05). Dynamic cCTG parameters exhibited clear pathology-dependent alterations. Short-term variability (STV) showed a stepwise decline from controls to ICP and GDM, reaching its lowest values in HDP (mean 1.08 bpm; p < 0.00001), accompanied by an increased proportion of epochs with STV < 1 bpm. Long-term variability suppression (LTV < 5 bpm) was significantly higher in GDM and HDP (p = 0.0077). Acceleration frequency decreased across all pathological groups, with the most pronounced reduction observed in HDP, whereas fetal movements were paradoxically elevated in both GDM and HDP. Total decelerations were more frequent in ICP and HDP; however, repetitive, late, prolonged, and >5 min decelerations remained rare and did not differ significantly between groups. Conclusions: HDP showed the most unfavorable cCTG profiles, consistent with impaired fetal autonomic regulation and chronic subclinical hypoxemia. GDM and ICP had moderate changes, suggesting milder adaptive responses. These findings emphasize the value of quantitative cCTG in differentiating fetal autonomic patterns in high-risk pregnancies and the importance of tailored surveillance strategies. Full article

Sodium (Na) is essential not only for maintaining extracellular fluid homeostasis as the dominant extracellular cation, but also for supporting the rapid tissue growth characteristic of the neonatal period. Despite its importance, the precise sodium requirements of preterm infants remain insufficiently defined. The immature renal tubules of preterm neonates lead to significant renal sodium losses, making negative sodium balance a common feature in this population. This issue has become increasingly relevant as survival rates improve among extremely preterm infants, while most available data are derived from studies involving more mature preterm or even full-term neonates. Fractional excretion of sodium (FENa) shows a clear inverse correlation with both gestational age and postnatal age, highlighting the developmental limitations in sodium retention among the youngest and most vulnerable infants. Current guidelines on sodium supplementation aim to promote optimal growth and neurodevelopment but vary across organizations. For instance, the most recent ESPGHAN recommendations suggest higher sodium intakes, in the range of 3–8 mEq/kg/day, whereas the American Academy of Pediatrics (AAP) provides more conservative guidance. These discrepancies underscore ongoing uncertainty in determining optimal sodium provision. This narrative review examines both classic and contemporary data on sodium needs in preterm neonates, with the goal of clarifying existing evidence and offering practical insights for clinical care. It also emphasizes unresolved questions and the need for well-designed studies that address the unique physiology of extremely preterm infants. A deeper understanding of sodium metabolism in this population is crucial for improving outcomes and guiding evidence-based supplementation strategies. Full article

Exosomes are nanoscale extracellular vesicles that mediate intercellular communication by transporting microRNAs, proteins, and lipids. Generated through Endosomal Sorting Complex Required for Transport (ESCRT)-dependent mechanisms or ESCRT-independent pathways, exosomes are released when multivesicular bodies fuse with the plasma membrane. The ESCRT-dependent pathway involves sequential protein complexes (ESCRT-0, I, II, III) that recognize and sort ubiquitinated cargo, induce membrane budding, and facilitate vesicle scission. In contrast, the ESCRT-independent pathway relies on membrane lipids such as ceramide and proteins like tetraspanins (CD9, CD63, CD81) to promote vesicle formation without ESCRT machinery. Furthermore, post-translational modifications, including ubiquitination, sumoylation, and phosphorylation, further serve as molecular switches, modulating the affinity of ESCRT complexes or cargo proteins for membrane domains and affecting ILV formation rates. In reproductive medicine, exosomes regulate oocyte maturation, embryo–endometrial crosstalk, placental development, and maternal–fetal communication. Altered exosomal signaling contributes to obstetric complications, including preeclampsia, gestational diabetes mellitus, and preterm birth, whereas distinct exosomal miRNA signatures serve as potential diagnostic biomarkers. In gynecology, dysregulated exosomes are implicated in endometriosis, polycystic ovary syndrome, premature ovarian insufficiency, and gynecological malignancies. In contrast, mesenchymal stem cell-derived exosomes show therapeutic promise in restoring ovarian function and enhancing fertility outcomes. The distinctive molecular profiles of circulating exosomes enable minimally invasive diagnosis, while their biocompatibility and ability to cross biological barriers position them as vehicles for targeted drug delivery. Characterization of accessible data provides non-invasive opportunities for disease monitoring. However, clinical translation faces challenges, including standardization of isolation protocols, establishment of reference ranges for biomarkers, and optimization of therapeutic dosing. This review summarizes exosome biogenesis, characterization methods, physiological functions, and clinical applications in obstetrics and gynecology, with an emphasis on their diagnostic and therapeutic potential. Future directions include large-scale biomarker validation studies, engineering approaches to enhance exosome targeting, and integration with precision medicine platforms to advance personalized reproductive healthcare. Full article

In viviparous teleosts, the lack of oviducts defines intraovarian gestation, with the ovary being the site for oogenesis but also the site for insemination, fertilization, and gestation. Consequently, intraovarian gestation is a complex and exceptional type of reproduction among vertebrates. The analysis of the morphological and physiological components of intraovarian gestation documents the evolutionary process of nutrition in viviparous species. Two types of embryonic nutrition may occur during gestation: (a) lecithotrophy, when most nutrients for the embryo come from the abundant yolk stored during oogenesis, and (b) matrotrophy, when nutrients for the embryo with scarce yolk must be obtained during gestation by additional maternal provisioning, developing a placenta. Then, investment of maternal nutrients for the embryo is greater during oogenesis in lecithotrophic species, and investment of maternal resources for the nutrition of the embryo is greater during gestation in matrotrophic species. Microscopic techniques allow for proper observation of maternal and embryonic structures involved in both types of nutrition during the development of embryos. Specifically, we focused on the morphology of placental structures associated with embryonic nutrition at different stages of development, which are the yolk sac and the pericardial sac. The oocytes of Poecilia latipinna contain a large amount of yolk (an average oocyte diameter of 1.9 mm); in contrast, the oocytes of Heterandria formosa contain extremely reduced amounts of yolk (an average oocyte diameter of 0.4 mm). Therefore, these species represent appropriate models for studying the strategy of two different types of embryonic nutrition, lecithotrophy and matrotrophy, in viviparous teleosts. Full article

The objective of this study was to evaluate how parity (primiparous vs. multiparous) influences metabolic profile, performance, and offspring growth in grazing Nellore cows, and to explore potential associations among key metabolic traits, milk yield, and performance indicators. Thirty-four pregnant Nellore cows at approximately 230 ± 20 days of gestation were sorted by parity group and randomly allocated into one of six Uruchloa decumbens pastures, totaling 17 multiparous cows (597.8 ± 39 kg; age = 4 to 6 yrs) and 17 primiparous cows (407 ± 33 kg, age = 2 to 3 yrs). Considering calving day as day 0, cow full BW and BCS were collected on days −63, −21, −7, 0, 7, 21, 63, 91, 140 and 203. Cow blood samples were collected on days −21, −14, −7, 0, 7, 14, 21, 42, 63, 91, 140 and 203. Milk yield was measured in the following day after all blood collections. Primiparous cows had higher glucose on days −7 and 0 (p = 0.04), greater NEFA concentration from −14 to 63 days (p < 0.001), and lower IGF-1 concentration from days 7 to 42 but higher on days 140 and 203 (p < 0.001). They also exhibited lower total proteins, albumin, and globulins, but higher serum urea N concentration (p < 0.001). Primiparous cows also had lower milk yield (p = 0.02), calf birth (p = 0.02) and weaning weights (p = 0.01) compared with multiparous cows. Pearson correlation analysis revealed distinct metabolic and physiological interrelationships across gestational and lactational stages in multiparous and primiparous cows. Overall, multiparous cows showed a less catabolic metabolic profile during the periparturient period to lactation. Primiparous cows experienced a more intense mobilization of body reserves during the early lactation period, but a more positive nutritional status towards late lactation, evidenced by recovery of IGF-1 levels and body weight gain. Full article

Background: Hypertensive conditions during pregnancy, such as preeclampsia (PE), are multisystem obstetric complications, accompanied by changes in the immunological status. Although several types of immune cells are involved in pathogenesis of preeclampsia, such as regulatory T cells, macrophages, natural killer cells, and neutrophils, most studies have focused on the concentration of circulating cytokines. Much less is known about intracellular cytokine production at the level of individual groups of peripheral blood immune cells. This gap limits our understanding of the early immunological changes that precede the clinical manifestation of the disease. Thus, the study of intracellular cytokine production in various leukocyte populations may provide new biomarkers for predicting preeclampsia. Objectives: To test the hypothesis that women with preeclampsia exhibit distinct intracellular cytokine profiles in specific peripheral blood immune cell subsets compared with normotensive pregnant women, and to assess whether these differences could serve as potential biomarkers for disease prediction. Methods: The study included a total of 78 pregnant women admitted to labor with physiological pregnancy (n = 32) and with gestational hypertension (GH) (n = 39) and PE (n = 7). The multicolor immunophenotyping with intracellular cytokine production of TNF, GM-CSF, IGF and receptor VEGFR-2 by different immunocompetent cell types was evaluated on a BD FACS CALIBUR flow cytometer. Results: Flow cytometry revealed a marked increase in the proportion of CD8⁺ GM-CSF⁺, CD56⁺VEGFR2⁺, CD14⁺IL-10⁺, and CD19⁺IGF⁺ cells in both hypertensive groups versus controls (p < 0.001). In contrast, CD56⁺TNF⁺ levels were significantly reduced (p < 0.001). For differentiating PE from GH, CD56+VEGFR2+ and CD19+IGF+ should be prioritized (AUC~0.66–0.78) with good specificity and moderate sensitivity. Conclusions: These data will not only expand existing knowledge about the role of intracellular cytokines in the pathogenesis of preeclampsia, but will also help to obtain new markers for predicting preeclampsia. Full article

Background/Objectives: Pregnancy represents a unique physiological state marked by extensive metabolic adaptations, particularly in lipid pathways essential for maternal adjustments, fetal development, and postpartum recovery. This study aimed to explore these changes through untargeted lipidomic profiling. Methods: This observational, comparative, non-interventional clinical study included 107 women, of which 65 were in the third trimester of pregnancy (mean age 27.9 ± 5 years) and 42 were in the early postpartum period (≤7 days, mean age 28.9 ± 5.9 years). Inclusion criteria were singleton, term pregnancies (37–41 weeks) with neonates weighing > 2500 g and no associated pregnancy-related pathologies; exclusion criteria included multiple gestation, use of lipid-altering medications, maternal age > 40 years, or diagnosed pregnancy complications. Plasma samples were analyzed using High-Performance Liquid Chromatography–Quadrupole Time-Of-Flight–Electrospray Ionization (positive mode)–Mass Spectrometry, data were processed with MetaboAnalyst 6.0 using multivariate and univariate analyses (Partial Least Squares–Discriminant Analysis, Volcano Plot, Random Forest, Receiver Operating Characteristic analysis), with statistical significance set at p < 0.05. Results: Multivariate analysis demonstrated a clear separation between groups with high predictive accuracy as reflected by strong classification metrics (Accuracy = 0.90, R² = 0.75, Q² = 0.68). Several discriminative lipids were consistently identified across statistical models, including 2-Methoxyestrone (AUC = 0.861), Eicosanedioic acid (AUC = 0.854), and Pregnenolone sulfate (AUC = 0.843). These biomarkers were further categorized into five major lipid classes: steroid hormones, long-chain fatty acids, lysophospholipids, ceramides/sphingolipids, and glycerolipids. Conclusions: Untargeted lipidomic profiling revealed distinct metabolic signatures that differentiate late pregnancy from early post-partum states. The identification of robust lipid biomarkers with high discriminative performance highlights their potential utility in maternal health monitoring, obstetric risk assessment, and postpartum recovery surveillance. Full article

Introduction: The contribution of SARS-CoV-2 infection to the severity of placental alterations in preeclampsia remains unclear. This study aimed to evaluate the morphological changes in placentas of women who experienced COVID-19 during pregnancy, with a focus on the presence or absence of preeclampsia. Materials and Methods: The study included placentas from: (1) patients with both COVID-19 during pregnancy and preeclampsia (n = 20, 2022); (2) patients with COVID-19 during pregnancy without preeclampsia (n = 20, 2022); (3) patients with preeclampsia but without COVID-19 (n = 5, 2019); (4) patients with physiological pregnancies without COVID-19 or gestational complications (n = 5, 2019). Histological and immunohistochemical examinations of the placentas were performed using antibodies against the SARS-CoV-2 spike protein, DPP4 (CD26), and VEGF. Results: Placentas from patients with both COVID-19 and preeclampsia demonstrated the most pronounced stromal and vascular alterations, including pseudo-infarctions and villous fibrosis. Chorangiosis, excessive fibrinoid deposition in the intervillous space, and accelerated villous maturation with an increased number of syncytial knots were more common in the preeclampsia groups, regardless of prior COVID-19 infection. Symptomatic forms of coronavirus infection were associated with more severe manifestations of malperfusion. Expression of the SARS-CoV-2 spike protein was detected in 78% of syncytiotrophoblast cells and 37% of decidual cells in 28 of 40 placentas from women with previous COVID-19, while its presence in the vascular endothelium, macrophages, and villous fibroblasts was focal, as was CD26 expression. VEGF expression did not differ significantly between patients with and without COVID-19. Conclusions: COVID-19 is associated with more pronounced stromal–vascular alterations in the placenta; however, not all of these changes are directly caused by the virus itself but rather reflect the severe course of preeclampsia. Inflammatory alterations are nonspecific for COVID-19, even though CD26 and the SARS-CoV-2 spike protein are detectable in nearly all placental structures, whereas VEGF levels remain comparable to those observed in placentas prior to the coronavirus pandemic. Full article

(1) Background: In arid regions, limited forage availability increases feeding costs for small ruminants. Sunflower hulls (SFH), a low-cost agro-industrial by-product, may serve as an alternative fiber source, yet their effects on pregnant Naemi ewes remain unclear. This study aimed to evaluate how graded levels of SFH affect intake, digestibility, rumen fermentation, and metabolic responses during gestation and early lactation. (2) Methods: Eighty-four ewes were assigned to diets containing 0%, 12%, 20%, or 28% SFH in a total mixed ration and monitored across early gestation, late gestation, and lactation. (3) Results: Increasing SFH significantly increased dry matter intake, with the highest intake in the 28% SFH group (p < 0.05). Body weight remained unaffected, whereas body condition score varied by physiological stage. Digestibility of major nutrients was unchanged; however, acid detergent lignin digestibility increased at 28% SFH (p < 0.05). Higher SFH levels (20–28%) reduced total volatile fatty acids by approximately 12–18% and lowered acetate and propionate concentrations, especially in late gestation. Blood metabolites differed among treatments but remained within physiological reference ranges, confirming metabolic safety. (4) Conclusions: SFH can be safely included at up to 28% of diet dry matter; however, 12–20% SFH appears most practical, supporting adequate fiber intake without compromising rumen fermentation efficiency. This provides a cost-effective strategy for ewe feeding under forage-limited arid conditions. Full article

Background: Pregnancy induces substantial cardiovascular remodeling, yet whether maternal cardiac adaptation differs across ethnic groups remains unclear. Body size, ventricular geometry, and thoracoabdominal configuration may modulate key functional indices such as left ventricular ejection fraction (LVEF) and global longitudinal strain (LV-GLS). This systematic review compared echocardiographic characteristics between Asian and Western healthy pregnant women in late gestation and explored physiological mechanisms underlying observed differences. Methods: A comprehensive search of PubMed, Scopus, and EMBASE identified studies reporting transthoracic echocardiography in healthy singleton third-trimester pregnancies across Asian and Western populations. Extracted variables included anthropometry, ventricular dimensions and volumes, LVEF, and LV-GLS. Pooled estimates were calculated using inverse-variance weighting, with heterogeneity quantified using the I² statistic. Study quality was assessed with the NIH Case–Control Quality Assessment Tool. Comparative forest plots visualized population differences. Results: Twenty studies involving 1431 participants (578 Asian and 853 Western women) met inclusion criteria. Asian women consistently exhibited smaller ventricular chambers, higher LVEF, and more favorable LV-GLS. Importantly, these differences persisted after indexing LV-GLS to BSA, indicating that body-size normalization attenuates—but does not eliminate—population differences in myocardial deformation. Western women demonstrated slightly attenuated GLS despite preserved LVEF, plausibly attributable to larger cardiac size, higher wall stress, greater diaphragmatic elevation, and increased extrinsic thoracic compression. Between-study heterogeneity was substantial (I² > 95%) due to variation in imaging platforms, strain software, and population characteristics. Methodological quality was fair, with frequent lack of sample-size justification and incomplete confounder adjustment. Conclusions: Healthy Asian pregnant women display a hyperdynamic systolic phenotype, whereas Western women show a physiologically appropriate, load-related attenuation of LV-GLS with preserved LVEF. These findings highlight the need for ethnicity-associated and anatomy-aware echocardiographic reference values and support incorporating thoracic geometric indices, such as the modified Haller Index, into strain interpretation during pregnancy. Full article

Perineal tears are common during vaginal delivery and are associated with significant maternal morbidity. While chorioamnionitis and intrapartum fever are known to affect labor dynamics and perineal tissue integrity, their relationship with perineal trauma in spontaneous vaginal deliveries has not been established. This study aimed to evaluate the prevalence of perineal tears among women with intrapartum fever who delivered spontaneously. This retrospective cohort study included women who underwent spontaneous vaginal delivery during 2013–2021 in Israel. The study group comprised women diagnosed with intrapartum fever (≥38 °C), while afebrile women served as controls in a 1:2 ratio matched by age (<35 or ≥35 years) and gestational age (preterm/term). Perineal tears were classified according to the Royal College of Obstetricians and Gynaecologists (RCOG) criteria. Multivariable logistic regression was performed to adjust for statistically significant variables including obesity, induction of labor, epidural analgesia, amniotomy, delivery week, gestational diabetes, birth number, duration of the second stage of labor, and episiotomy. The cohort included 373 women with intrapartum fever and 746 controls. The overall rate of perineal tears was similar between febrile and afebrile women (42% vs. 40%; adjusted odds ratio [aOR] 0.99, 95% confidence interval [CI] 0.72–1.36). However, the rate of obstetric anal sphincter injury (OASIS) was lower among women with intrapartum fever (0.5% vs. 2.0%; aOR 0.10, 95% CI 0.02–0.52). Intrapartum fever was associated with higher rates of postpartum hemorrhage, manual exploration of the uterus, endometritis, anemia, and blood transfusion. Bacterial cultures were positive in 31% of febrile women, predominantly Escherichia coli and Group B Streptococcus, without association with perineal trauma. Alltogether, Intrapartum fever did not increase the risk of perineal tears in spontaneous vaginal deliveries and was paradoxically associated with a lower rate of OASIS. Further studies are warranted to explore the underlying physiological mechanisms linking temperature and perineal tissue resilience. Full article

Background: Central nervous system (CNS) tumors during pregnancy are rare but present significant diagnostic, therapeutic, and ethical challenges. These include both primary and metastatic lesions, which share overlapping clinical features and management complexities. Their clinical course is influenced by gestational physiological changes, which can mask symptoms and delay diagnosis, thereby increasing maternal and fetal risks. Objective: This review aims to synthesize current evidence on the epidemiology, pathophysiology, clinical presentation, diagnostic strategies, treatment options, prognosis, and ethical considerations related to CNS tumors in pregnant patients. Methods: A comprehensive literature review was conducted, including retrospective and prospective studies, clinical guidelines, and systematic reviews focusing on brain and spinal tumors diagnosed during pregnancy. Particular attention was given to the impact of gestational age, tumor histology, and maternal condition on treatment outcomes. Results: Hormone-sensitive tumors such as meningiomas and prolactinomas may exhibit accelerated growth during pregnancy due to elevated progesterone and prolactin levels. Diagnosis is often delayed due to symptom overlap with normal gestational changes. MRI without contrast remains the imaging modality of choice. Glucocorticoids and selected chemotherapy agents can be cautiously used depending on gestational age. Surgical resection, particularly in the second trimester, has been shown to be safe and effective in appropriate clinical scenarios. Multidisciplinary coordination is essential. Prognosis varies based on tumor type and timing of intervention, with maternal survival prioritized in high-risk situations. Ethical management hinges on patient autonomy, informed consent, and proportionality of medical interventions. Conclusions: CNS tumors during pregnancy require early recognition, individualized treatment planning, and ethical vigilance. Multidisciplinary collaboration is vital to optimizing outcomes for both mother and fetus. Future efforts should focus on developing standardized protocols and expanding evidence through multicenter studies. Full article