Machine Learning Prediction of Fetal Health Status from Cardiotocography Examination in Developing Healthcare Contexts

Reducing neonatal mortality is a critical global health objective,especially in resource-constrained developing countries.This study employs machine learning(ML)techniques to predict fetal health status based on cardiotocography(CTG)examination findings,utilizing a dataset from the Kaggle repository due to the limited comprehensive healthcare data available in developing nations.Features such as baseline fetal heart rate,uterine contractions,and waveform characteristics were extracted using the RFE wrapper feature engineering technique and scaled with a standard scaler.Six ML models—Logistic Regression(LR),Decision Tree(DT),Random Forest(RF),Gradient Boosting(GB),Categorical Boosting(CB),and Extended Gradient Boosting(XGB)—are trained via cross-validation and evaluated using performance metrics.The developed models were trained via cross-validation and evaluated using ML performance metrics.Eight out of the 21 features selected by GB returned their maximum Matthews Correlation Coefficient(MCC)score of 0.6255,while CB,with 20 of the 21 features,returned the maximum and highest MCC score of 0.6321.The study demonstrated the ability of ML models to predict fetal health conditions from CTG exam results,facilitating early identification of high-risk pregnancies and enabling prompt treatment to prevent severe neonatal outcomes.

Unusual outcome of in utero infection and subsequent postnatal super-infection with different PCV2b strains

VC2002, isolated from postweaning multisystemic wasting syndrome(PMWS)-affected pig, is a mixture of two porcine circovirus genotype 2b(PCV2b) viruses, K2 and K39. Preliminary experiments disclosed short-term adverse effects of K39, but not K2, on porcine foetuses. These findings led to the hypothesis that infection of immuno-incompetent foetuses with K2 confers a status of immunotolerance, and postnatal super-infection with K39 triggers PMWS. To explore this hypothesis, nine 55-day-old foetuses were inoculated in utero(three with K2-104.3TCID50, three with K39-104.3TCID50 and three with medium), and foeto-pathogenicity examined. At 21 days post-inoculation(dpi), K2 did not induce pathology, whereas pathological effects of K39 were evident. Twenty-four 45-day-old foetuses were subsequently inoculated to examine the long-term effect of K2, including six with K2-high dose-104.3TCID50, six with K2-low dose-102.3TCID50 and 12 mock-inoculated controls. Both doses resulted in five mummified foetuses and one live-born piglet each(69dpi). K2 was recovered from all mummies. K2 and K2-specific antibodies were not detected in serum of the two live-born piglets at birth, indicating full control of K2 infection. The K2-low dose-infected piglet was immunostimulated at day 2, but not the K2-high dose-infected piglet. Both non-stimulated and stimulated K2-infected piglets were super-inoculated with K39 at day 6 or 8(taken as 0 days post super-inoculation). Low viral replication was observed in the non-stimulated K2-K39 piglet(up to 103.3 TCID50/g; identified as K39). In contrast, viral replication was extremely high in the stimulated K2-K39 piglet(up to 105.6TCID50/g) and identified as K2, indicating that K2 infection is controlled during foetal life, but emerges after birth upon immunostimulation. However, none of the piglets showed any signs of PMWS.

Excretion of biliary compounds during intrauterine life

In adults,the hepatobiliary system,together with the kidney,constitute the main routes for the elimination of several endogenous and xenobiotic compounds into bile and urine,respectively.However,during intrauterine life the biliary route of excretion for cholephilic compounds,such as bile acids and biliary pigments,is very poor.Although very early in pregnancy the fetal liver produces bile acids,bilirubin and biliverdin,these compounds cannot be efficiently eliminated by the fetal hepatobiliary system,owing to the immaturity of the excretory machinery in the fetal liver.Therefore,the potentially harmful accumulation of cholephilic compounds in the fetus is prevented by their elimination across the placenta.Owing to the presence of detoxifying enzymes and specifi c transport systems at different locations of the placental barrier,such as the endothe-lial cells of chorionic vessels and trophoblast cells,this organ plays an important role in the hepatobiliary-like function during intrauterine life.The relevance of this excretory function in normal fetal physiology is evident in situations where high concentrations of biliary compounds are accumulated in the mother.This may result in oxidative stress and apoptosis,mainly in the placenta and fetal liver,which might affect normal fetal development and challenge the fate of the pregnancy.The present article reviews current knowledge of the mechanisms underlying the hepatobiliary function of the fetal-placental unit and the repercussions of several pathological conditions on this tandem.

Correlation between ductus venosus spectrum and right ventricular diastolic function in isolated single-umbilical-artery foetus and normal foetus in third trimester

BACKGROUND Single umbilical artery(SUA)is the most common umbilical cord malformation in prenatal diagnosis.The presence of an SUA can cause blood circulation disorder in the foetus and functional changes of the foetal heart,affecting foetal circulation.The right ventricular diastolic functions in foetuses with isolated SUA and in normal foetuses in the third trimester were evaluated using the spectral Doppler of blood flow in the foetal ductus venosus(DV).AIM To evaluate the right ventricular diastolic functions in foetuses with isolated SUA and in normal foetuses in the third trimester.METHODS Colour Doppler was used to measure the spectrum of foetal DV and tricuspid orifice in 34 foetuses with isolated SUA aged 28-39 wk and in age-matched healthy controls.The DV flow velocities and velocity ratios were measured.The early passive/late active(E/A)ratio at the tricuspid orifice and tissue Doppler Tei index of the foetal right ventricular in the two groups were also measured.RESULTS During the third trimester,the isolated SUA group showed a lower‘a’-wave peak velocity in the DV than the control group(P<0.05).The correlations between the velocity ratios and E/A ratio at the tricuspid orifice in the two groups were analysed,and the correlation between the ventricular late diastolic velocity/ventricular diastolic peak flow velocity and E/A ratios was the best(R^2of the isolated SUA group:0.520;R2 of the control group:0.358).The correlations between the velocity ratios and tissue Doppler Tei index of foetal right ventricular in the two groups were analysed,and the correlation between the pulsatility index for veins(PIV)and tissue Doppler Tei index ratios was the best(R2 of the isolated SUA group:0.865;R2 of the control group:0.627).CONCLUSION In the isolated SUA group,the atrial systolic peak velocity‘a’decreased,and this finding might be related to the changes in foetal cardiac functions.The ratio of ventricular late diastolic velocity to ventricular diastolic peak flow velocity was closely related to the E/A ratio at the tricuspid valve and can be used to identify changes in the right ventricular diastolic functions of isolated SUA and healthy foetuses.PIV was closely related to the tissue Doppler Tei index of the foetal right ventricular and can be used to identify the right ventricular overall functions of isolated SUA and healthy foetuses.

Effects of Biological Materials and Collection Media on PCR Detection of <i>Tritrichomonas foetus</i>

Tritrichomonas foetus is an important pathogen of the bovine reproductive tract causing early embryonic death and abortion in cows and persistent, asymptomatic infection in bulls. PCR detection methods have greatly enhanced diagnostic accuracy over culture;however, pre-analytical sample handling is just as critical as technical performance in detecting this pathogen and is not well studied. The purpose of this study was to investigate the effects of biological materials present in the prepuce on PCR detection of T. foetus in a variety of collection media. Simulated preputial samples were created using InPouchTM (IP) media, lactated ringers solution (LRS), or sterile saline (SAL);inoculated with low numbers of one of three T. foetus strains;and spiked with either blood, semen, urine, or sham treatment. Samples were transported to the lab, placed in growth media (LRS and SAL samples), incubated, and tested for T. foetus by PCR. Samples containing urine had statistically significantly greater mean Ct values (P = 0.008) than samples containing other materials, seen most dramatically in IP (P < 0.0001.) Urine contamination resulted in significantly (P = 0.037) fewer samples being identified as “positive” for T. foetus. Overall, SAL collections also had significantly higher mean Ct than IP or LRS (P < 0.001), and were less likely (P = 0.018) to results in classification as a “positive” sample. Results of this study indicate that collection media and biological materials can affect T. foetus PCR detection. The presence of urine in preputial samples can result in false negative results, while blood had no detrimental effects.

Basic biological aspects of Tritrichomonas foetus of re-levance to the treatment of bovines suffering of tricho-moniasis

Tritrichomonas foetus is a flagellate protozoan and the etiological agent of bovine genital tri-chomoniasis [1], which is an infectious vene- real disease. This parasite is usually found as- sociated with the mucosal surface of the uro- genital tract in females or the male preputial and penile membranes. In females, the clinical ma-nifestations may include abortion, with repe- tition of estrus at irregular intervals, vaginitis, cervicitis, endometritis, and pyometra. Parasi- tized males may have a discharge with small nodules in the preputial membrane. After that, the bulls have no clinical symptoms, and are thus an asymptomatic carrier that may spread the infection. Considering that a bull could cover up to twenty females [2], bovine genital trichomoniasis is a serious medical and veteri- nary problem, with economical repercussion for beef and milk production. As T. foetus is an amitochondrial and aerotolerant organism, en- ergy production under low O2 tension in the protozoan is done via hydrogenosome, which, as the name suggests, is the organelle where H2 is generated [3,4,5]. The molecular machinery of mitochondrial cell death is, therefore, absent in this parasite and the mechanism that activates of cell death program is not clear. This review seeks to understand the characteristics of the protozoan parasite T. foetus in order to propose new therapies for animals suffering from this infectious and contagious agent.

Delivery Complications of the Single Fat Large Foetus (Macrosomia) with Teenagers at the Obstetrics and Gynaecology Department of the Donka National Hospital, University Teaching Hospital (CHU) of Conakry, Guinea

Objectives: The objectives of this work were to: 1) Calculate the delivery frequency of the large foetus with complications to teenagers;2) Describe the epidemiological profile of these teenagers;3) Identify the risk factors of the large foetus and to establish the maternal prognosis and foetus. Methodology: This was a prospective descriptive 6-month study performed at the Obstetrics and Gynaecology Department of the Donka National Hospital, CHU of Conakry, Guinea. We chose a regular amplitude of one year and we got the following slices: 16 years, 17 years, 18 years. Results: We recorded 14.23% (801/5629) teenage deliveries of which 9.4% (75/801) deliveries are single fat fetus and 93.3% (70/75) of them developed complications. The epidemiological profile was that of an 18 years old teenager (61.4%), single (58.6%), professional (44.3%), out of school (57.1%), primiparous (68.6%), having performed 3 - 4 CPN (47.1%), coming from home (65.7%) and carrying a full term pregnancy (100%) and having delivered by high way medical assistance (52.9%). Risk factors were dominated by the male foetus (75.7%). Maternal morbidity was dominated by cervico-perineal tears 28.6%. The recorded maternal mortality was 4.3%. The 3 cases of maternal deaths were caused by the hemorrhage. The APGAR score at the first minute was in 51.4% between 4 and 6;at the 5th minute in 80% between 7 and 10. The most common foetal complication was acute foetal distress 44.3%. Foetal lethality was 12.8%. Conclusion: Here, we demonstrated the teenage pregnancy and macrosomia in this area. We did not show how we can improve this situation based on the data;however, describing this situation may be of use as a fundamental data to make a better antenatal checkup and teenager-education.

Dynamic DNA 5-hydroxylmethylcytosine and RNA 5-methycytosine Reprogramming During Early Human Development

After implantation,complex and highly specialized molecular events render functionally distinct organ formation,whereas how the epigenome shapes organ-specific development remains to be fully elucidated.Here,nano-hmC-Seal,RNA bisulfite sequencing(RNA-BisSeq),and RNA sequencing(RNA-Seq)were performed,and the first multilayer landscapes of DNA 5-hydroxymethylcytosine(5hmC)and RNA 5-methylcytosine(m^(5)C)epigenomes were obtained in the heart,kidney,liver,and lung of the human foetuses at 13-28 weeks with 123 samples in total.We identified 70,091 and 503 organ-and stage-specific differentially hydroxymethylated regions(DhMRs)and m^(5)C-modified mRNAs,respectively.The key transcription factors(TFs),T-box transcription factor 20(TBX20),paired box 8(PAX8),krueppel-like factor 1(KLF1),transcription factor 21(TCF21),and CCAAT enhancer binding protein beta(CEBPB),specifically contribute to the formation of distinct organs at different stages.Additionally,5hmC-enriched Alu elements may participate in the regulation of expression of TF-targeted genes.Our integrated studies reveal a putative essential link between DNA modification and RNA methylation,and illustrate the epigenetic maps during human foetal organogenesis,which provide a foundation for an in-depth understanding of the epigenetic mechanisms underlying early development and birth defects.

Cloned goats (Gapra hircus) from foetal fibroblast cell lines

Mammalian cloning has been one of the most active research topics in the world. Cioning with in vitro culured foetal fibroblast cells, in comparison with embryonic cells, can be used not only to theoretically study the embryonic or cellular development and differentiation in mammals, but also to utilize the unlimited fibroblast cells to produce large numbers of clonings. The preliminary results are as follows: (i) The division and development of the cloned embryos with embryonic donor cells and goat foetal fibroblast donor cells were 55%, 77% and 35%, 31%, respectively. There is no significant statistical difference between them. (? These studies result in the birth of two cloned goats derived from two 30-day foetal fibroblast celi lines, which are the first cloned mammals from somatic cells in China. This project has established a technological data base for the furture research on adult mammalian somatic cloning and nucleocytoplasmic interactions in animal development, and a novel technique for the

Utilising ductus venosus Doppler waveform and four-chamber view to screen for foetal cardiac malformation in early second trimester of pregnancy

Background Foetal echocardiography has become a diagnostic method to detect foetal congenital heart disease with high probability. However, it is not only time consuming and but also difficult to visualize outflow tract of foetus early in the second trimester of pregnancy, even for an experienced obstetric uhrasonographer. Recently, many methods for screening foetal cardiac anomalies were explored, but much more work is needed to develop an effective and suitable screening method. The aim of this study was to investigate the clinical significance of utilising the ductus venosus （DV） Doppler examination and the four-chamber view of heart to screen for foetal cardiac malformation in early second trimester of pregnancy. Methods Heart and DV of 401 consecutive foetuses in early second trimester （12^＋1- 17^ ＋6 weeks） in high risk pregnancies were examined with Acuson 128 xp/10 or Sequoia 512 ultrasound diagnostic systems. Absent or reversed flow during atrial contraction （A-wave） in the DV was defined as sufficiently abnormal to screen for foetal cardiac malformations. The foetal echocardiographic diagnosis was confirmed by postnatal echocardiography （or postmortem）. The sensitivities of screening tests were compared among the three methods： DV Doppler examination, four-chamber view alone, and the combination of both techniques.Results Satisfactory examinations were obtained in 383/401 foetuses （95%）. Thirty foetuses with cardiac abnormalities were confirmed by neonatal echocardiography （ or postmortem ）. The sensitivity of DV Doppler examination or four-chamber view alone is 63 % （19/30） and 60 % （ 18/30）, respectively. The sensitivity of combining information, DV Doppler flow waveform and four-chamber view, to screen for foetal cardiac malformation is 83% （25/30） and significantly better than that of either DV Doppler flow waveform or four chamber view alone （ P 〈 0. 05 ）. Conclusion Doppler flow waveform of DV can be used to screen for foetal cardiac malformation early in the second trimester. Combining information from Doppler flow waveform of DV and four-chamber view will improve the overall sensitivity of the screening.

Maxillofacial trauma in a pregnant patient:Contemporary management principles with a case report&review of literature

Trauma during pregnancy deserves special attention because of its management objectives,i.e.well-being of both pregnant woman and foetus.Maxillofacial trauma directly affects the nutrition of foetus by interfering with the normal functions in a pregnant woman such as mouth opening.mastication and breathing,Hence early restitution of form and function of maxillofacial skeleton is essential.However,the gravid status is associated with numerous anatomical and physiological changes which present with clinical dilemma related to imaging and treatment.A careful scrutiny of the patient's systermic and gestational status is absolutely essential before,during and after instituting any interventional proced-ures.We present a case of bilateral condyle fracture in a 30-year-old pregnant woman in the third trimester(32 weeks).She was treated with inter maxillary fixation using orthodontic brackets&elastics.After successful restitution of occlusion,the patient was advised aggressive physiotherapy which ensured normal mouth opening.Two weeks later,the patient delivered uneventfully.The patient was followed up at one month and 3 month and demonstrated restitution of normal occlusion,mouth opening and lower|acial height.This article aims at analyzing the contermporary principles in management of maxillfacial trauma in a pregnant woman and clarifying the common misconceptions.