Thyroid disease in pregnancy: A review of diagnosis, complications and management

Malfunction of the thyroid gland is the second most common endocrine disorder encountered during pregnancy. It is well known that overt disease of the thyroid gland, either hyper or hypo can adversely affect pregnancy outcome. There is also an ongoing debate surrounding the issue of subclinical hypothyroidism and its effect on the cognitive development of the unborn child. The goal of this paper is to present a systematic review of the literature and the current recommendations for diagnosis and treatment of thyroid disease in pregnancy and postpartum.

COVID-19 in pregnancy:Perinatal outcomes and complications

BACKGROUND The risk of severe coronavirus disease 2019(COVID-19)in pregnant women is elevated.AIM To examine the outcomes of pregnant women with COVID-19 and report perinatal outcomes and complications,while providing a brief review of current literature.METHODS The study included pregnant women presenting from April 2020 to February 2022 to the emergency department(ED)of a tertiary hospital.We retrospectively recorded the maternal and perinatal files,including patient epidemiological and clinical characteristics,laboratory values,outcomes,treatment modalities and associations were explored.RESULTS Among the 60 pregnant women,25%required hospitalization,all of whom were symptomatic.Preterm delivery occurred in 30%of cases.Ten percent of neonates required admission to the neonatal intensive care unit,and 5%were classified as small for their gestational age.All mothers survived COVID-19 and pregnancy,with 6.6%requiring invasive mechanical ventilation.Preterm delivery rates did not differ between hospitalized and non-hospitalized pregnant women;composite unfavorable perinatal outcomes,including stillbirth,small for gestational age,or neonatal intensive care unit(ICU)admission,did not significantly increase in the cases hospitalized for COVID-19(P=0.09).The odds of hospitalization increased 2.3-fold for each day of delayed ED presentation[adj.OR(95%CI:1.46-3.624),P<0.001].Comorbidity status was an independent predictor of hospitalization,albeit with marginal significance[adj.OR=16.13(95%CI:1.021-255.146),P=0.048].No independent predictors of adverse fetal outcome(composite)were identified,and eventual hospitalization failed to reach statistical significance by a slight margin(P=0.054).CONCLUSION Delayed ED presentation and comorbidities increase hospitalization odds.This study highlights the importance of continuous and specific guidance for managing pregnant COVID-19 patients,including timely and appropriate interventions to minimize maternal and perinatal morbidity and mortality.

Cardiovascular complications following medical termination of pregnancy: An updated review

BACKGROUND Around 1 million cases of medical termination of pregnancy(MTP)take place yearly in the United States of America with around 2 percent of this population developing complications.The cardiovascular(CVD)complications occurring post MTP or after stillbirth is not very well described.AIM To help the reader better understand,prepare,and manage these complications by reviewing various cardiac comorbidities seen after MTP.METHODS We performed a literature search in PubMed,Medline,RCA,and google scholar,using the search terms“abortions”or“medical/legal termination of pregnancy”and“cardiac complications”or“cardiovascular complications”.RESULTS The most common complications described in the literature following MTP were infective endocarditis(IE)(n=16),takotsubo cardiomyopathy(TTC)(n=7),arrhythmias(n=5),and sudden coronary artery dissection(SCAD)(n=4).The most common valve involved in IE was the tricuspid valve in 69%(n=10).The most observed causative organism was group B Streptococcus in 81%(n=12).The most common type of TTC was apical type in 57%(n=4).Out of five patients de veloping arrhythmia,bradycardia was the most common and was seen in 60%(3/5)of the patients.All four cases of SCAD-P type presented as acute coronary syndrome 10-14 d post termination of pregnancy with predominant involvement of the right coronary artery.Mortality was only reported following IE in 6.25%.Clinical recovery was reported consistently after optimal medical management following all these complications.CONCLUSION In conclusion,the occurrence of CVD complications following pregnancy termination is infrequently documented in the existing literature.In this review,the most common CVD complication following MTP was noted to be IE and TTC.

Maternal-Fetal Pregnancy Complications of in Minors Raped with or without Physical Restraint in Eastern Democratic Republic of Congo

Introduction: Pregnancy resulting from rape is a public health and sexual and reproductive health issue, especially among minors. Rape can be perpetrated with or without physical restraint. The objective of the present study is to highlight the prevalence of physical coercion leading to pregnancy and the associated maternal-fetal complications. Methodology: This was a comparative descriptive and analytical cross-sectional study of complications associated with post-rape pregnancy by physical restraint among minors who were treated at the General Reference Hospital of Panzi over a two-year period from June 2020 to June 2022. A total of 140 minor survivors of violence with pregnancy were included in the study. Data were collected using a questionnaire, coded and analyzed in Excel and XLSTAT version 2014. Results: The prevalence of physical constraints was 65%. After mulltivariate analyses, denial of pregnancy (ORa: 9.64 95% CI: 1.1 - 81.2;p-value: 0.0370), attempted abortion (ORa: 56.1 95% CI: 1.5 - 2027.6;p-value: 0.0278) and agitation during delivery (ORa: 88.7 95% CI: 4.5 - 1715;p-value: 0.0030) were the complications associated with pregnancy in minors who experienced physical restraint rape. In addition, BMI was a factor in reducing the risk of physical restraint rape at the ORa of 0.5054 [0.3;0.8];p 0.006). Conclusion: Pregnancy among minors is a reality and occurs in a situation of physical coercion in the eastern Democratic Republic of Congo. These pregnancies are often associated with complications that require an intensive management system since they can jeopardize the maternal-fetal prognosis of minors.

Neutrophil-lymphocyte ratio in pregnancy-associated maternal complications: A review

Pregnancy associated diseases/disorders are associated with significant maternal and neonatal morbidities and mortalities.Devising/validating cost effective and easily accessible predictive,diagnostic and risk stratification markers are critical to the management and improved outcome in these diseases.Inflammation forms the backbone of most of the routinely encountered maternal complications of pregnancy.Hematological markers can be considered as a direct reflection of the systemic inflammatory milieu.Recently,the neutrophil lymphocyte ratio has been explored for its potential to assess the severity of inflammation and thus the severity of the underlying disorder.The neutrophil-lymphocyte ratio has gained scientific attention as a potential prognostic/predictive marker of acute as well as chronic inflammatory diseases including gynecological and reproductive disorders.This present study reviews the mechanistic role of neutrophils and lymphocytes in fueling or propagating the inflammatory cascades in the three most common maternal complications of pregnancy and the evidence of clinical importance of the neutrophil to lymphocyte ratio in predicting,diagnosing,and prognosticating pregnancy-associated complications.

Prevelance of Pregnancy Complications among Women Aged 15 - 49 in Oğuzeli, Turkey

As maternal deaths have decreased worldwide, increasing attention has been placed on the study of severe obstetric complications, such as hemorrhage, eclampsia, and obstructed labor, to identify where improvements can be made in maternal health. The objective of this study was to determine pregnancy complications and prenatal care among women aged 15 - 49 in O&#287;uzeli, Turkey, and to provide data for prevention in the field. This descriptive, cross-sectional study was conducted between February and May 2013 in O&#287;uzeli distinct, Turkey. The total women registered to family doctors in O&#287;uzeli was listed and, 470 women were selected using a stratified and simple random sampling technique. Pregnancy complications were asked for the last pregnancy of each women. Of the women, 23.9% (n = 109) declared that they experienced pregnancy complications during their pregnancies. The most frequent problems were anemia (11.1%) hypertension (3.7%) and diabetes mellitus (2.4%) respectively. Women having chronic diseases before their pregnancy were more likely to have pregnancy complications compared to healthy women (p = 0.005). The mean number of prenatal care among women having pregnancy complications was 5.47 ± 3.57, while it was 3.84 ± 3.00 among healthy women (p = 0.000). Women having chronic diseases should be handled carefully and, pregnancy should be delayed until the chronic disease’s remission. Family planning in primary care is the key measure to archive this. Early diagnosis of hypertension among young women is highly important for the women’s and infants’s health during pregnancy, and for the women’s future heath. During prenatal care, women should be trained about correct eating habits and activity.

Pregnancy and retinal and retinal vascular complications

Pregnancy requires several changes in the body of the mother to successfully carry and deliver a child.Multiple alterations occur,including changes in cardiovascular system to meet the increased demands of the mother and placenta,the tilting of the hypercoagulable status to a more pro-coagulable state to prevent excessive blood loss post-delivery,and immunologic manipulations to protect the mother and fetus and decreasing the risk of a fatal immunologic response to the allogeneic fetus.These alterations are physiologically normal and expected,but can become pathologic when thresholds are crossed.Pregnancy may cause or exacerbate underlying retinal vascular diseases,a class of disorders compromised predominantly of retinal vein occlusion(RVO),retinal artery occlusion(RAO),central serous retinopathy(CSR),diabetic retinopathy,and hypertensive-related retinopathy,which includes pre-eclampsia,eclampsia,and hemolysis,elevated liver enzymes,and low platelets(HELLP)syndrome.The majority of the literature on retinal changes associated with pregnancy has focused on diabetic retinopathy,while the knowledge regarding the pathogenesis and treatment options of other pregnancy-related vascular diseases remains scarce.Understanding the implications pregnancy has on these rare,but severe,retinal vascular complications can help guide clinical management and potential treatment modalities.This paper aims to serve as a review of the retinal manifestations of diseases outside of diabetic retinopathy.

Macrosomia in non-gestational diabetes pregnancy:glucose tolerance test characteristics and feto-maternal complications in tropical Asia Pacific Australia

Objective:To look into the glucose tolerance test characteristics and determine complications in non-gestational diabetes pregnant subjects.Methods:From 2006 to 2009 all non-gestational diabetes mellitus(non-CDM)pregnant women who delivered macrosomia at the North Australia's Townsville Hospital were retrospectively reviewed by extracting data from clinical record.Glucose tolerance tests results were analysed in the light of an earlier diagnosis of non-GDM.Results:Ninety-one non-CDM mothers with macrosomia were studied and compared with 41normoglycemic subjects without macrosomia.Of the subjects with non-GDM macrosomia,45(49.4%)had normal SO g glucose challenge test(GCT)without further testing,another 8(8.8%)had abnormal GCT but normal 75 g oral glucose tolerance test(OGTT).A total of 4(4.4%)subjects had normal GCT and OGTT.Interestingly.14 out of 16(87.5%)subjects who were tested with OGTT owing to past history of macrosomia had normal results but delivered macrosomic babies.Only 12 subjects had both GCT and OGTT,the rest of the cohort had either of the two tests.Subjects with non-CDM macrosomia had higher frequency of neonatal hypoglycaemia 34%as compared to 10%in nonmacrosomic babies(P=0.003).Other feto-maternal complications were similar in both groups.Conclussions:No significant pattern of glucose tolerance characteristics was identified in nonGDM mothers with macrosomic babies.In spite of being normoglycemic significant neonatal hypoglycaemia was recorded in non-GDM macrosomic babies.Further prospective studies on a larger population are needed to verify our findings.

Study of the Prevalence of Hypertension and Complications of Hypertensive Disorders in Pregnancy

Introduction: Hypertension is one of the common problems associated with pregnancy that may be followed by eclampsia, acute renal failure, maternal death, premature delivery, intra-uterine growth restriction and other. This study was conducted to determine the results of pregnancies associated with hypertension in patients visiting in the Delivery Ward of Valiasr Hospital. Methods: A descriptive study was conducted on all the patients admitted to the aforementioned department and who possessed the inclusion criteria for hypertensive pregnancy. Results: Among the 1694 delivery cases examined, 173 cases had hypertension (9.8%). Among these, 75 (45%) had gesta-tional hypertension;24 (14.8%) had preeclampsia-eclampsia;30 (18%) had preeclampsia su-perimposed on chronic hypertension;21 (13.5%) cases had chronic hypertension;and 13 (8%) had pregnancy-aggravated chronic hypertension. Ninety-six point three percent (96.3%) had a systolic blood pressure (BP) of 140 - 190 mmHg, and 3.7% had a systolic BP greater than 190 mmHg. Whereas 61.1% of diastolic blood pressure 90 - 110 mmHg and 38.9% of the mothers had diastolic BP greater than 110 mmHg. The HELLP (Hemolysis, Elevated Liver enzymes & Low Platelet count) syndrome was present in 4.9% of cases;52.6% experienced premature delivery;7.4% had IUFD (intra uterine fetal death);9.9% had IUGR (intrauterine growth retardation);and 17.3% had LBW babies. Conclusions: Based on our results, hypertensive mothers who are younger and have lower weight babies at birth experience more perinatal complications. The unpleasant effects of hypertension in pregnancy warrant the need for training, routine prenatal care, the early detection and treatment of hypertension at younger ages of pregnancy, and follow-up after delivery.

Birth outcomes and pregnancy complications of women with uterine leiomyoma—a population-based case-control study

Objective Uterine leiomyoma is not a rare pathological condition in pregnant women;thus the aim of the study was to evaluate the recent progress in the treatment of these pregnant women on the basis of the association of leiomyoma in pregnancy (LP) with pregnancy complications and birth outcomes including structural birth defects, i.e. congenital abnormalities (CA) in the offspring. Design Cases with CA and matched controls without CA in the population-based Hungarian Case-Control Surveillan- ce System of Congenital Abnormalities (HCC SCA) were evaluated. Only women with prospectively and medically recorded LP in prenatal maternity logbook and medically recorded birth outcomes (gestational age, birth weight, CA) were included to the study. Setting the HCCSCA, 1980-1996 contained 22,843 cases with CA and 38,151 matched controls without CA. Population Hungarian pregnant women and their informative offspring: live births, stillbirths and prenatally diagnosed malformed fetuses. Methods Comparison of birth outcomes of ca- ses with matched controls and pregnancy com- plications of pregnant women with or without LP. Main outcome measures Pregnancy complications, mean gestational age at delivery and birth weight, rate of preterm birth, low birthweight, CA. Results A total of 34 (0.15%) cases had mothers with LP compared to 71 (0.19%) controls. There was a higher incidence of threatened abortion, placental disorders, mainly abruption placentae and anaemia in mothers with LP. There was no significantly higher rate of preterm birth in the newborns of women with LP but their mean birth weight was higher and it associated with a higher rate of large birthweight newborns. A higher risk of total CA was not found in cases born to mothers with LP (adjusted OR with 95% CI = 0.7, 0.5-1.1), the spe- cified groups of CAs were also assessed versus controls, but a higher occurrence of women with LP was not revealed in any CA group. Con- clusions Women with LP have a higher risk of threatened abortion, placental disorders and anaemia, but a higher rate of adverse birth outcomes including CAs was not found in their offspring.

Pregnancy complications effect on the nickel content in maternal blood,placenta blood and umbilical cord blood during pregnancy

BACKGROUND Nickel(Ni)may accumulate in the human body and has biological toxicity and carcinogenicity.Ni has an extensive impact on the health of pregnant women and fetuses during gestation.AIM To evaluate Ni exposure in pregnant women in Kunming,Yunnan Province,China;to describe the distribution of Ni in the maternal-fetal system and placental barrier function;and to investigate the effect of Ni exposure on fetal health in mothers with pregnancy complications.METHODS Seventy-two pregnant women were selected using a case-control design.The women were divided into two groups:The control group(no disease;n=29)and the disease group[gestational diabetes(GDM),hypertensive disorder complicating pregnancy(HDCP),or both;n=43].The pregnant women in the disease group were further divided as follows:14 cases with GDM(GDM group),13 cases with HDCP(HDCP group)and 16 cases with both GDM and HDCP(disease combination group).Basic information on the pregnant women was collected by questionnaire survey.Maternal blood,placenta blood and cord blood were collected immediately after delivery.The Ni content in paired samples was determined using inductively coupled plasma mass spectrometry.RESULTS Compared to the control group,age was higher and body mass index was greater in pregnant women in the disease groups(28.14±2.54 vs 28.42±13.89,P<0.05;25.90±3.86 vs 31.49±5.30,P<0.05).The birth weights of newborns in the HDCP group and the control group were significantly different(2.52±0.74 vs 3.18±0.41,P<0.05).The content of Ni in umbilical cord blood in the entire disease group was higher than that in the control group(0.10±0.16 vs 0.05±0.07,P<0.05).CONCLUSION In the maternal-fetal system of women with pregnancy complications,the barrier effect of the placenta against Ni is weakened,thus affecting healthy growth of the fetus in the uterus.

Women’s Knowledge and Attitudes about Complications during Pregnancy and Childbirth in Guinea

Introduction: Maternal mortality remains a major public health problem in the world. Complications during pregnancy and childbirth are the main causes of maternal mortality in low-income countries. It is estimated that 15% of deaths are related to these complications. Studies have shown that women have little or no acquaintance on sign danger and complications during pregnancy and childbirth. Limited literature exists on women’s knowledge and attitudes about pregnancy and childbirth’s complications as well as the barriers for their management, therefore necessity to carry out this study. Objective: To explore women’s knowledge and attitudes in the community about complications during pregnancy and childbirth. Method: A qualitative study was conducted in three prefectures of Guinea. Eighteen focus groups were conducted with women of reproductive age living in urban and rural areas. Results: Complications during pregnancy and childbirth are common among pregnant women in Guinea. Many women have knowledge about various sorts of complications related to pregnancy and childbirth. These complications were mostly vaginal bleeding, abortions and maternal mortality. The use of a health facility in case of complications during pregnancy and childbirth was reported as a major attitude in this study. Accompanying the woman to the health facility was another attitude identified. Lack of financial means, the distance from the health facilities and the lack of means of transport were listed as barriers to the management of complications during pregnancy and childbirth. Conclusion: This study showed that women’s knowledge and attitudes about obstetric complications are insufficient. To that effect, women counselling during prenatal consultations on the risks of complications and especially the identification of sign danger during pregnancy and childbirth is essential to reduce maternal and neonatal mortality in our less equipped countries.

Metabolic Syndrome and Pregnancy, Its Prevalence, Obstetrical and Newborns Complications

Background: The metabolic syndrome affects more and more global people. Although it shows increasing prevalence in general population, the syndrome affects more women than men, what makes its risk of being developed during pregnancy period. Also, possible perinatal adverse effects are always lurking. Objective: the objective was demonstrated what’s new in literature on metabolic syndrome and pregnancy. Methods: A literature review was performed to extract the articles published on metabolic syndrome and pregnancy, its prevalence, obstetrical complications and its perinatal adverse effects. This review was conducted by online researching in PubMed, Lilacs, Medline, Embase, Scopus, Medscape, Libertas Academica and CINAHL database, Science database and also by researches in books. 27 selected articles on metabolic syndrome after this research were all published between 1988 and 2015. Results: Among those 27 articles and two books studied, SM rate in obstetric population ranged from 3% to 42% depending on the previously manifested components of the syndrome, age and region. Women with previously manifested components showed more adverse perinatal effects. Conclusion: Women with pregestational DM or SM and SM develop more during pregnancy, obstetric complications and adverse perinatal outcomes.

Study of the Effect of Intralipid Infusion during Pregnancy as an Additive Treatment for Reducing Pregnancy Complications Caused by Antiphospholipid Antibody Syndrome

Aim: To evaluate the safety and efficacy of intralipid infusion in addition to other lines of treatment in reduction of complications caused by antiphospholipid antibody syndrome. Methods: This study was held in the period from June 1, 2016, to December 1, 2019. This study was conducted in the Department of Obstetrics and Gynecology, Tanta University on patients attending the antenatal care clinic and also on patients attending the researcher’s private clinics for antenatal care, 105 patients were enrolled after application of strict inclusion and exclusion criteria. They were randomized into 2 groups. In group A (study group 1) the patients received in addition to the conventional basic treatment of APS, intralipid 20% (Frezenius, Clayton, NC, USA) in a dose of 4 ml diluted in 250 ml 0.9% regular saline IV and to be repeated every 2 weeks. In group B (control group 2) the patients received the conventional basic treatment of APS. The outcome measures were the incidence of pregnancy complications of APS namely fetal loss, premature delivery, IUGR and preeclampsia. Results: 49 patients were enrolled in the study group, and 48 patients were enrolled in the control group, after exclusion of the skipped cases. The demographic data and the gestational age at the beginning of the study show insignificant differences. There were insignificant differences as regard the gestational age at which the pregnancy was terminated and fetal birth weight in patients with positive ACL test, positive LA test and positive B2 however the mean gestational age at which pregnancy was terminated was higher in study group. Also, there was insignificant difference as regards no of patients who complicated with abortion or who completed to full term. But had significant decrease number of case who complicated with preeclampsia (8, 21 patients in study and control group respectively). Conclusion: Intralipid infusion is a promising treatment option for control and prevention of problems caused by antiphospholipid antibody syndrome.

A Cross-Sectional Study on Current Practice of the Management of Pregnancy Induced Hypertension and Its Maternal and Foetal Complications and Outcome in the Western Part of the State of Libya

Background: Maternal and perinatal mortality and morbidity are mainly affected by hypertension during pregnancy (pre-eclampsia). Haemorrhage and cerebral bleeding are the primary and significant complications of pre-eclampsia. Abruption of the placenta and renal failure are among the major complications caused by this disease. The perinatal complications include Intrauterine Growth Restriction (IUGR), Intrauterine Foetal Death (IUFD), neonatal death, and prematurity. Objective: The purpose of the present study was to examine the incidence of Pregnancy-Induced Hypertension (PIH), pre-eclampsia, the management of PIH, including the early diagnosis, the pharmacological drug management used, and the prevalence of maternal and perinatal complications. Methods and Patients: This cross-sectional study took place in Aljalaa maternity hospital, which represented the west of the state of Libya in the period from 1st January 2012 to 31st December 2012, with patients who were diagnosed, managed, and terminated according to protocol management of the hospital. Results: In the present study, from the total deliveries in Aljalaa Maternity hospital, the incidence of PIH is 8.4% and pre-eclampsia is 5.1%. No maternal mortality, CNS haemorrhaged, hepatic failure, or renal failure. The reported maternal complications included: Eclampsia, HELLP syndrome (Haemolysis, Elevated Liver enzymes and Low platelets), abruption placenta, and pulmonary oedema see in eighteen percent, six percent, nine percent, four percent and less than one percent, respectively. The foetal complications were preterm babies and Intrauterine Growth Restriction (IUGR) in nineteen percent, Low Birth Weight (LBW) in twenty-five percent, Intrauterine Foetal Death (IUFD) in five percent, neonatal death in two percent and, perinatal death in six percent. In the PIH patients, the presence of associated symptoms such as headache, blurred vision, irritability, and the presence of signs such as severe hypertension, generalized oedema, exaggerated reflexes, and abnormal investigations (protein urea, high uric acid, abnormal LFT, haemoconcentration, and low pits) increased the risk of maternal and foetal complications. Conclusion: To decrease mother and newborn mortality and morbidity in PIH patients, a rigorous management protocol is required to implement evidence-based guidelines.

Association of in-vitro fertilization twin pregnancy with maternal and perinatal complications

Objective: To analyze maternal and perinatal complication rates in in-vitro fertilization (IVF) twins and spontaneous twin pregnancies. Methods: The information on obstetric and perinatal outcomes and complications covering 95 IVF twins and 165 spontaneous twin pregnancies was collected from the medical records of Riga Maternity Hospital. Statistical analysis and adjustment for confounders was performed using the SPSS v24.0 software. The continuous data were compared using the t-test and Mann-Whitney U test for parametrical and non-parametrical data accordingly. The nominal data were analyzed using Pearson's Chi-square test and Fisher's exact test. Results: The preterm labor risk, intrauterine growth restriction, fetus weight between IVF and spontaneous twins were not statistically significant (P>0.005). At the same time our study revealed a statistically significant association of gestational diabetes and pregnancy induced hypertension with IVF twin pregnancies (P=0.025 and P=0.003, respectively). Moreover, IVF twins had higher odds to be delivered by cesarean section (P=0.001). Conclusions: IVF twin pregnancies are associated with a higher risk of development of gestational diabetes and gestational hypertension than spontaneous twin pregnancies.

Pregnancy complications and outcomes in women with epilepsy

Epilepsy is the most common serious neurological disorder. This is prospective study to investigate whether women with epilepsy have an increased risk of fetal and maternal complications during pregnancy. In this descriptive cross-sectional study, 50 pregnant women who were presented for delivery at Afzalipour Hospital, Kerman, Iran during 2003 to 2009 were assessed. The groups were compared using the Student’s t-test, and one-way-ANOVA for continuous variables and the chisquare test (or Fisher’s exact test if required) for categorical variables. P values of 0.05 or less were considered statistically significant. All the statistical analyses were performed using SPSS version 13 (SPSS Inc, Chicago, IL, USA) for Windows.In 32 (64%) of cases no fetal complication was found, in 5 cases (10.0%) intrauterine growth retardation (IUGR), in 2 cases (4.0%) post-term labor, in 2 cases (4.0%) fetal distress and in 9 cases (18.0%) preterm labor were found. In 15 patients (30.0%) no maternal complication was found;in 2 cases (4.0%) pregnancy induced hypertension (PIH), in 12 cases (24.0%) preterm labor , in 4 cases (8.0%) bleeding, in 14 cases (28.0%) premature rupture of the membranes (PROM) and in 3 cases (6.0%) other complications were detected. Given these findings and previous studies, it seems that epileptic women required more care during pregnancy and the rate of maternal, fetal and obstetrical complications are relatively high among them.

Link between caries,periodontitis,and pregnancy:The role of personalized oral hygiene

Optimal health during pregnancy is crucial for ensuring the well-being of the mother and the developing fetus.This article is focused on the impact of oral health and the role of personalized oral hygiene management in addressing prevalent dental issues among pregnant women,with particular emphasis on periodontal disease and dental caries.Despite the high prevalence of these dental problems and their association with obstetric complications such as pre-term birth and low birth weight,many pregnant women do not receive adequate dental care.This gap in care is often due to misconceptions about the safety of dental treat-ments during pregnancy and lack of awareness on the part of healthcare profes-sionals.Appreciations of the impacts of oral health and personalization of oral hygiene strategies such as tailored education and support,have proven effective in improving oral health in this population.Significant reductions in the incidence of caries and periodontal disease may be achieved by adapting care to the specific needs of each patient,thereby enhancing maternal and fetal health outcomes.Integration of personalized oral hygiene management into maternal health pro-grams and enhancement of ongoing education for pregnant women and healthcare professionals are essential steps in the reduction of pregnancy-related risks and improvement of maternal and neonatal well-being.Core Tip:In this article,we reviewed a recent study on the effects of personalized oral hygiene management on the oral health of pregnant women,as discussed in the article by Men et al.The study demonstrated that personalized oral hygiene interventions significantly improved oral health outcomes during pregnancy by reducing the prevalence of dental caries and periodontal disease.We emphasized the importance of individualized oral care programs that integrate education and tailored support,and we highlighted their significance in enhancing maternal and fetal health.This approach underscores the need for incorporating personalized oral hygiene management into routine prenatal care in order to optimize health outcomes.CONCLUSION This article emphasizes the critical role of personalized oral hygiene management in improving oral health during pregnancy.By tailoring oral care strategies to individual needs,significant improvements in dental health may be achieved,as evidenced by the reduced CAT scores observed in the experimental group in the study by Men et al[25].This personalized approach not only addresses common oral issues such as dental caries and periodontal disease but also underscores the broader implications for maternal and fetal health.Despite the positive results,there remains a gap in consistency in the application of oral health practices during pregnancy,partly due to misconceptions and lack of awareness among patients and healthcare providers.Future research should aim at validating these findings across diverse populations,investigating the impact of oral hygiene interventions at various stages of pregnancy,and evaluating their long-term effects on maternal and fetal health.Integrating personalized oral hygiene management into maternal health programs and promoting continuous education for pregnant women and healthcare professionals are essential steps toward enhancing overall health outcomes.By proactively managing oral health,the risks associated with pregnancy may be reduced while improving maternal and neonatal well-being.

Maternal and fetal death associated with acute pancreatitis during pregnancy:A case report

BACKGROUND Acute pancreatitis in pregnancy is a rare but serious condition that can lead to high maternal mortality and fetal loss.Instances of pregnancy complicated by severe acute pancreatitis,particularly with subsequent respiratory and cardiac arrest,are rarely reported.CASE SUMMARY We present the case of a 35-year-old woman,at 36+5 weeks of gestation,who presented with paroxysmal epigastric pain accompanied by low back pain,nausea,and vomiting.According to the clinical symptoms,B-ultrasound imaging and biochemical indicators,the patient was diagnosed with acute pancreatitis and initially managed conservatively.However,3 hours after admission,the patient experienced respiratory and cardiac arrest,and the fetus died.In this case,the adverse outcomes occurred due to the lack of aggressive fluid resuscitation and an active surgical intervention.CONCLUSION Implementing aggressive fluid resuscitation to sustain tissue perfusion,alongside the proactive evaluation of pharmacological agents that suppress gastric acid secretion and inhibit pancreatic enzyme activity,may be beneficial in mitigating the risk of a severely adverse prognosis.Effective management of acute pancreatitis during pregnancy requires careful timing of surgical intervention,a thorough evaluation of the risks and benefits regarding the continuation or termination of pregnancy,and a focus on safeguarding both maternal and fetal health.

Surgical site soft tissue thickness as a predictor of complications following arthroplasty

Appreciation of soft-tissue thickness(STT)at surgical sites is an increasingly recognized aspect of arthroplasty procedures as it may potentially impacting postoperative outcomes.Recent research has focused on the predictive value of preoperative STT measurements for complications following various forms of arthroplasty,particularly infections,across procedures such as total knee,hip,shoulder,and ankle replacements.Several studies have indicated that increased STT is associated with a higher risk of complications,including infection and wound healing issues.The assessment of STT before surgery could play a crucial role in identifying patients at a higher risk of complications and may be instru-mental in guiding preoperative planning to optimize outcomes in arthroplasty procedures.Standardized measurement techniques and further research are essential to enhance the reliability and clinical utility of STT assessment for arthro-plasty surgery.