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Clinical Outcomes in Maternal–Fetal Medicine
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Clinical Outcomes in Maternal–Fetal Medicine

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

Deadline for manuscript submissions: 25 May 2024 | Viewed by 2039

Special Issue Editors

Dr. Katarzyna Kosinska-Kaczynska

E-Mail Website
Guest Editor
Department of Obstetrics, Perinatology and Neonatology, Centre of Postgraduate Medical Education, Marymoncka 99/103, 01-813 Warsaw, Poland
Interests: gynaecology and obstetrics; perinatology
Prof. Dr. Michał Ciebiera

E-Mail Website
Guest Editor
Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, 00-189 Warsaw, Poland
Interests: uterine fibroids; pharmacology; miminally invasive therapy; reproductive endocrinology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Several pregnancy complications, including hypertensive disorders, gestational diabetes, fetal growth abnormalities, preterm delivery, and preterm rupture of membranes, affect approximately a quarter of pregnant women. They may be associated with short-term complications and adverse perinatal outcomes. Today, significant attention is paid to the long-term complications for maternal and offspring health resulting from these pregnancy conditions. The goal of this Special Issue is to present current advances in the screening, diagnosis, management, prediction, and prevention of pregnancy complications and their associated risks for the future health of women and their offspring.

We welcome high-quality and informative original studies (clinical and experimental), meta-analyses, and reviews. We look forward to receiving your contributions.

Dr. Katarzyna Kosinska-Kaczynska
Prof. Dr. Michał Ciebiera
Guest Editors

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

  • pre-eclamsia
  • hypertensive disorders
  • gestational diabetes
  • fetal growth restriction
  • preterm delivery
  • intrahepatic cholestasis of pregnancy
  • perinatal outcome

Published Papers (3 papers)

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Research

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9 pages, 204 KiB  
Article
Navigating Uncertain Waters: First-Trimester Screening’s Role in Identifying Neonatal Complications
by Grzegorz Swiercz, Anna Zmelonek-Znamirowska, Karol Szwabowicz, Justyna Armanska, Karolina Detka, Marta Mlodawska and Jakub Mlodawski
J. Clin. Med. 2024, 13(7), 1982; https://doi.org/10.3390/jcm13071982 - 29 Mar 2024
Viewed by 640
Abstract
Background: Contemporary diagnostic methods aimed at assessing neonatal outcomes predominantly rely on the medical history of pregnant women. Ideally, universal biomarkers indicating an increased risk of delivering infants in poor clinical condition, with a heightened likelihood of requiring hospitalization in a Neonatal [...] Read more.
Background: Contemporary diagnostic methods aimed at assessing neonatal outcomes predominantly rely on the medical history of pregnant women. Ideally, universal biomarkers indicating an increased risk of delivering infants in poor clinical condition, with a heightened likelihood of requiring hospitalization in a Neonatal Intensive Care Unit (NICU), would be beneficial for appropriately stratifying pregnant women into a high-risk category. Our study evaluated whether biochemical and ultrasonographical markers universally used in first-trimester screenings for non-heritable chromosomal aberrations could serve this purpose. Methods: This study encompassed 1164 patients who underwent first-trimester screening, including patient history, ultrasound examinations, and biochemical tests for pregnancy-associated plasma protein-A (PAPP-A) and the free beta-HCG subunit (fbHCG), from January 2019 to December 2021. The research concentrated on the correlation between these prenatal test results and neonatal outcomes, particularly Apgar scores, umbilical blood pH levels, and the necessity for NICU admission. Results: In our cohort, neonates scoring lower than 8 on the Apgar scale at birth exhibited lower concentrations of PAPP-A in the first trimester, both in raw and normalized values (PAPP-A MoM 0.93 vs. 1.027, p = 0.032). We also observed a higher pulsatility index in the venous duct in the first trimester in full-term neonates born with <8 points on the Apgar scale. Additionally, newborns born with an umbilical blood pH < 7.2 had lower normalized first-trimester PAPP-A concentrations (0.69 vs. 1.01 MoM, p = 0.04). We also noted that neonates requiring NICU hospitalization post-delivery had lower first-trimester bHCG concentrations (0.93 MoM vs. 1.11 MoM, p = 0.03). However, none of the correlations in our study translated into a robust prognostic ability for predicting dichotomous outcomes. All areas under the curve achieved a value < 0.7. Conclusions: Low concentrations of PAPP-A and free bHCG subunit in the first trimester may be associated with poorer clinical and biochemical conditions in neonates post-delivery. However, the relationship is weak and has limited predictive capability. Further research evaluating these relationships is necessary for the appropriate stratification of pregnant women into high-risk categories for neonatological complications. Full article
(This article belongs to the Special Issue Clinical Outcomes in Maternal–Fetal Medicine)
10 pages, 576 KiB  
Article
A Multicenter, Retrospective Comparison Study of Pregnancy Outcomes According to Placental Location in Placenta Previa
by Seon Ui Lee, Ji Hye Jo, Haein Lee, Yoojin Na and In Yang Park
J. Clin. Med. 2024, 13(3), 675; https://doi.org/10.3390/jcm13030675 - 24 Jan 2024
Viewed by 735
Abstract
Background: We investigated the association between placental location and pregnancy outcomes in placenta previa. Methods: This multi-center retrospective study enrolled 781 women who delivered between May 1999 and February 2020. We divided the dataset into anterior (n = 209) and posterior ( [...] Read more.
Background: We investigated the association between placental location and pregnancy outcomes in placenta previa. Methods: This multi-center retrospective study enrolled 781 women who delivered between May 1999 and February 2020. We divided the dataset into anterior (n = 209) and posterior (n = 572) groups and compared the baseline characteristics and obstetric and neonatal outcomes. The adverse obstetric outcomes associated with placenta location were evaluated using a multivariate logistic analysis. Results: Gestational age at delivery in the anterior group (253.0 ± 21.6) was significantly lower than that in the posterior group (257.6 ± 19.1) (p = 0.008). The anterior group showed significantly higher parity, rates of previous cesarean section, non-vertex fetal positions, admissions for bleeding, emergency cesarean sections, transfusions, estimated blood loss, and combined placenta accrete spectrum (p < 0.05). In the multivariate analysis, the anterior group had higher rates of transfusion (OR 2.23; 95% CI 1.50–3.30), placenta accreta spectrum (OR 2.16; 95% CI 1.21–3.97), and non-vertex fetal positions (OR 2.47; 95% CI 1.09–5.88). Conclusions: These findings suggest that more caution is required in the treatment of patients with anterior placenta previa. Therefore, if placenta previa is diagnosed prenatally, it is important to determine the location of the body and prepare for massive bleeding in the anterior group. Full article
(This article belongs to the Special Issue Clinical Outcomes in Maternal–Fetal Medicine)
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Review

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10 pages, 519 KiB  
Review
Awareness of Pregnant Patients about Congenital Cytomegalovirus Infection—A Semi-Systematic Review
by Paweł Bartnik, Aleksandra Bender, Joanna Kacperczyk-Bartnik, Michał Ciebiera, Aleksandra Urban, Anna Sienko, Esra Bilir, Ewa Romejko-Wolniewicz and Jacek Sieńko
J. Clin. Med. 2024, 13(9), 2586; https://doi.org/10.3390/jcm13092586 - 28 Apr 2024
Viewed by 393
Abstract
Background: Cytomegalovirus (CMV) infection represents a major issue worldwide, since it constitutes the most common viral congenital infection, with a prevalence of 0.58% and 1–5% in developed and developing countries, respectively. According to recent studies, prenatal treatment significantly decreases the risk of [...] Read more.
Background: Cytomegalovirus (CMV) infection represents a major issue worldwide, since it constitutes the most common viral congenital infection, with a prevalence of 0.58% and 1–5% in developed and developing countries, respectively. According to recent studies, prenatal treatment significantly decreases the risk of vertical CMV transmission, and early intervention may even prevent the termination of pregnancy. This study aimed to investigate the level of awareness of CMV among pregnant patients through a semi-systematic review. Methods: We included all of the original articles investigating knowledge and awareness about CMV infection among pregnant women. Our research included the PubMed database. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement, the Covidence system automatically guided us to screen the titles and/or abstracts, and then full-texts, followed by data extraction from the eligible studies. Results: We screened 764 studies altogether, with 13 studies included in this analysis. Knowledge about the existence of CMV infection risk varied between the articles, ranging from 11.4% in a study performed in Ireland to 60% reported in a study on the French population. Studies analyzing the impact of educational interventions on patients’ knowledge about preventive measures reported significant improvement compared to their level of awareness before the intervention. Conclusions: Patients’ awareness and knowledge about CMV seemed to be generally low or very low during the last decade before the development of effective secondary prevention methods. Educational interventions seem to be effective, and therefore their wide use could be of potential benefit. In the era of available secondary prevention of vertical transmission, it is crucial to concentrate the efforts of different stakeholders to increase the awareness of cCMV among pregnant women. Full article
(This article belongs to the Special Issue Clinical Outcomes in Maternal–Fetal Medicine)
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