Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
3.6
2.6
Journals
Medicina
Special Issues
Diagnosis, Evaluation, and Management of Diseases during Pregnancy: Part II
share announcement

Diagnosis, Evaluation, and Management of Diseases during Pregnancy: Part II

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Obstetrics and Gynecology".

Deadline for manuscript submissions: 20 August 2024 | Viewed by 8655

Special Issue Editors

Prof. Dr. Marius L. Craina

E-Mail Website
Guest Editor
Department of Obstetrics and Gynecology, University of Medicine and Pharmacy "Victor Babes", 300001 Timisoara, Romania
Interests: gynecology; obstetrics, gynecological oncology; endocrinology and reproductive medicine; ethics; medical education; research design; epidemiology and statistics
Special Issues, Collections and Topics in MDPI journals
Dr. Elena Bernad

E-Mail Website
Guest Editor
Department of Obstetrics and Gynecology, University of Medicine and Pharmacy "Victor Babes", 300001 Timisoara, Romania
Interests: gynecology; obstetrics; gynecological oncology; endocrinology and reproductive medicine; ethics; medical education; research design; epidemiology and statistics; computer applications
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

How an individual’s associated comorbidity can affect their pregnancy has always been an essential concern of medical specialists. The presence of these health conditions, no matter how minor, requires additional evaluation and appropriate treatment to avoid complications. They can worsen throughout the gestation period, influencing maternal health status, the evolution of pregnancy, and the outcome of birth. The perinatologist will evaluate the pathology in collaboration with the specialist to reach the most favorable outcome for the patient and the fetus. The purpose of this Special Issue is to share current management strategies regarding maternal-associated pathology from personal acquired experience and guidelines worldwide. This Special Issue allows specialists worldwide to make public results of state-of-the-art research in prenatal care in cases with comorbidities. Despite success in understanding the pathophysiology and treatment development of multiple pathological conditions over the last few decades, many questions remain unsolved.

This Special Issue collects papers that reflect further progress in this field in the form of original research manuscripts, reviews, and case reports.

This Special Issue is the continuation of the Special Issue "Diagnosis, Evaluation, and Management of Diseases during Pregnancy".

Prof. Dr. Marius L. Craina
Dr. Elena Bernad
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. Medicina is an international peer-reviewed open access monthly 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 1800 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

  • pregnancy
  • fetus prenatal care
  • high risk
  • pathology
  • genetics
  • endocrine system diseases
  • nutrition disorders
  • cardiovascular diseases
  • female urogenital diseases
  • immune system diseases
  • infections
  • neoplasms

Published Papers (7 papers)

Download All Papers
Order results
Result details
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:

Research

Jump to: Review, Other

7 pages, 282 KiB  
Article
Intrahepatic Cholestasis of Pregnancy during COVID-19 Pandemic
by Paulina Malarkiewicz, Urszula Nowacka, Aleksandra Januszaniec, Alicja Mankiewicz, Szymon Kozłowski and Tadeusz Issat
Medicina 2024, 60(4), 676; https://doi.org/10.3390/medicina60040676 - 22 Apr 2024
Viewed by 263
Abstract
Background and Objectives: Intrahepatic cholestasis of pregnancy (ICP) stands as one of the most prevalent concerns in maternal–fetal medicine, presenting a significant risk to fetal health and often associated with liver dysfunction. Concurrently, the coronavirus-19 (COVID-19) infection can lead to hepatic cell [...] Read more.
Background and Objectives: Intrahepatic cholestasis of pregnancy (ICP) stands as one of the most prevalent concerns in maternal–fetal medicine, presenting a significant risk to fetal health and often associated with liver dysfunction. Concurrently, the coronavirus-19 (COVID-19) infection can lead to hepatic cell injury through both direct and indirect pathways. Hypothetically, these two conditions may coincide, influencing each other. This study aimed to comparatively assess the incidence and severity of ICP before and during the COVID-19 pandemic. Methods: A retrospective cohort study was conducted, comparing the incidence and severity of ICP between January 2018 and February 2020 (pre-COVID-19 period) and March 2020 to March 2022 (COVID-19 period) across two hospitals, encompassing 7799 deliveries. The diagnosis of ICP was established using the ICD-10 code and defined as total bile acids (BA) levels ≥ 10 μmol/L. Statistical analysis included descriptive statistics, Chi-square and Mann–Whitney U tests, as well as multiple or logistic regression analysis. Results: A total of 226 cases of ICP were identified. The incidence of mild cholestasis (BA < 40 μmol/L) was lower during the pandemic compared to before (3% before versus 2%, p < 0.05), while the incidence of moderate and severe ICP remained unchanged (0.6% before vs. 0.4%, p = 0.2). Overall, the total incidence of ICP was lower during the pandemic (3.6% before versus 2.4%, p = 0.01). No significant differences were observed in severity (as defined by BA and liver function test levels), rates of caesarean section, or neonatal birth weights. Conclusions: During the COVID-19 pandemic, the total incidence of ICP appeared to be lower. However, this reduction was primarily observed in cases of mild ICP, potentially indicating challenges in detection or reduced access to medical services during this period. The incidence of moderate and severe ICP remained unchanged, suggesting that these forms of the condition were unaffected by the pandemic’s circumstances. Full article
(This article belongs to the Special Issue Diagnosis, Evaluation, and Management of Diseases during Pregnancy: Part II)
9 pages, 261 KiB  
Article
Effect of Pethidine Injection on the Duration of Labor and Pregnancy Outcomes: A Retrospective Cohort Study
by Eun Byeol Cho, Hyun Joo Chae, Jung Min Ryu, Hyo Jin Lee, Seong Yeon Hong and Jin Young Bae
Medicina 2024, 60(1), 143; https://doi.org/10.3390/medicina60010143 - 12 Jan 2024
Viewed by 1432
Abstract
Background and Objectives: Long and ineffective labor causes hardships for mothers and doctors and increases the rate of cesarean sections and medical comorbidities. Several factors contribute to effective and less painful labor, including maternal age, parity, fetal characteristics, and the medications or [...] Read more.
Background and Objectives: Long and ineffective labor causes hardships for mothers and doctors and increases the rate of cesarean sections and medical comorbidities. Several factors contribute to effective and less painful labor, including maternal age, parity, fetal characteristics, and the medications or procedures that obstetricians use for labor. We aimed to study the factors that affect labor duration and identify those that make labor more effective. Materials and Methods: This retrospective study included 141 patients who underwent normal vaginal deliveries at the Daegu Catholic University Medical Center between April 2013 and April 2022. Among the 141 patients, 44 received pethidine intravenously, 88 received oxytocin intravenously, and 64 received epidural anesthesia. The duration of the active phase and second stage of labor were recorded according to the findings of a manual examination of the cervix and continuous external electronic monitoring. We analyzed maternal and neonatal medical records and performed binomial logistic regression to identify the factors associated with a shorter active phase of labor. The clinical outcomes in mothers and neonates were also evaluated. Results: Among the various clinical factors, multiparity (odds ratio of parity 0.325) and the use of pethidine (odds ratio 2.906) were significantly associated with shortening the active phase of labor to less than 60 min. The use of epidural anesthesia or oxytocin was not significantly associated with reducing the active phase of labor. When patients were divided into two groups based on whether a pethidine injection had been used during labor, the duration of the active phase was shorter in the pethidine injection group than in the control group for both nulliparas and multiparas. No significant differences in the duration of the second stage of labor were observed between the pethidine injection and control groups. There were no significant differences in pregnancy outcomes, including the need for mechanical ventilation of neonates, Apgar scores, neonatal intensive care unit admissions, number of precipitous deliveries, maternal adverse side effects of drugs, or duration of maternal hospitalization between the two groups. Conclusions: Pethidine can be safely administered to women during labor to help reduce the duration of the active phase by promoting dilatation of the cervix and preventing complications that may result from prolonged labor. Pethidine may be helpful, especially for those who cannot receive epidural anesthesia or who cannot afford it. However, large-scale randomized controlled studies are required to evaluate the efficacy and safety of this drug during labor. Furthermore, it would be helpful if various studies were conducted depending on the timing of administration and indications for delivery. Full article
(This article belongs to the Special Issue Diagnosis, Evaluation, and Management of Diseases during Pregnancy: Part II)
11 pages, 2195 KiB  
Article
The Impact of Assisted Reproductive Technology on Umbilical Cord Insertion: Increased Risk of Velamentous Cord Insertion in Singleton Pregnancies Conceived through ICSI
by Eriko Fukuda, Akihiro Hamuro, Kohei Kitada, Yasushi Kurihara, Mie Tahara, Takuya Misugi, Akemi Nakano, Mami Tamaue, Sae Shinomiya, Hisako Yoshida, Masayasu Koyama and Daisuke Tachibana
Medicina 2023, 59(10), 1715; https://doi.org/10.3390/medicina59101715 - 25 Sep 2023
Viewed by 951
Abstract
Background and Objectives: Vasa previa (VP) is a significant perinatal complication that can have serious consequences for the fetus/neonate. Velamentous cord insertion (VCI) is a crucial finding in prenatal placental morphology surveillance as it is indicative of comorbid VP. Assisted reproductive technology [...] Read more.
Background and Objectives: Vasa previa (VP) is a significant perinatal complication that can have serious consequences for the fetus/neonate. Velamentous cord insertion (VCI) is a crucial finding in prenatal placental morphology surveillance as it is indicative of comorbid VP. Assisted reproductive technology (ART) has been identified as a risk factor for VCI, so identifying risk factors for VCI in ART could improve VP recognition. This study aims to evaluate the displacement of umbilical cord insertion (CI) from the placental center and to examine the relationship between the modes of conception. Materials and Methods: We conducted a retrospective study at the Obstetrics Department of Osaka Metropolitan University Hospital in Japan between May 2020 and June 2022. The study included a total of 1102 patients who delivered after 22 weeks of gestation. They were divided into three groups: spontaneous pregnancy, conventional in vitro fertilization (cIVF), and in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). We recorded patient background information, perinatal complications, perinatal outcomes, and a numerical “displacement score”, indicating the degree of separation between umbilical CI and the placental center. Results: The displacement score was significantly higher in the cIVF and IVF/ICSI groups compared with the spontaneous conception group. Additionally, the IVF/ICSI group showed a significantly higher displacement score than the cIVF group. Conclusions: Our study provides the first evidence that the methods of ART can affect the location of umbilical CI on the placental surface. Furthermore, we found that IVF/ICSI may contribute to greater displacement of CI from the placental center. Full article
(This article belongs to the Special Issue Diagnosis, Evaluation, and Management of Diseases during Pregnancy: Part II)
►▼ Show Figures

Figure 1

Review

Jump to: Research, Other

11 pages, 637 KiB  
Review
Cracking the Code: Investigating the Correlation between Aerobic Vaginitis and Preterm Labor
by Panagiota Zarmakoupi, Alexandros Psarris, Christina Karasmani, Panagiotis Antsaklis, Marianna Theodora, Michael Syndos, Andreas Pampanos, Kalliopi I. Pappa, Ekaterini Domali, Nikolaos Thomakos, Karolina Akinosoglou, Aristotelis Tsiakalos and George Daskalakis
Medicina 2024, 60(4), 648; https://doi.org/10.3390/medicina60040648 - 18 Apr 2024
Viewed by 335
Abstract
Aerobic vaginitis (AV) is a distinct clinical entity characterized by inflammation and abnormal vaginal microflora. Often mistaken for bacterial vaginosis, AV remains relatively unknown and underdiagnosed. AV’s understanding is evolving, with some experts suggesting it may primarily be an immunological disorder, the prevalence [...] Read more.
Aerobic vaginitis (AV) is a distinct clinical entity characterized by inflammation and abnormal vaginal microflora. Often mistaken for bacterial vaginosis, AV remains relatively unknown and underdiagnosed. AV’s understanding is evolving, with some experts suggesting it may primarily be an immunological disorder, the prevalence of which has a range of 7–13% in non-pregnant women and 4.1–8.3% during pregnancy. Pregnancy can affect susceptibility to vaginal infections, leading to adverse outcomes for the woman and the newborn. This review summarizes the correlation between AV and adverse pregnancy outcomes, particularly preterm birth, the leading cause of morbidity and mortality among neonates. An improved understanding of AV’s impact on pregnancy outcomes can lead to early recognition, proper management, and effective interventions. While some studies support an association between AV and preterm labor, the existing knowledge of this relationship remains limited. The evidence suggests that AV may contribute to adverse pregnancy outcomes, mainly preterm birth, but further research is needed to establish a definitive link. Further studies are needed to investigate the underlying mechanisms and clarify AV’s role in premature labor. A comprehensive understanding of AV’s impact on pregnancy outcomes is crucial for early recognition, appropriate management, and effective interventions. Full article
(This article belongs to the Special Issue Diagnosis, Evaluation, and Management of Diseases during Pregnancy: Part II)
►▼ Show Figures

Figure 1

Other

Jump to: Research, Review

12 pages, 1168 KiB  
Case Report
Two Cases of Congenital Hypothyroidism Revealing Thyroid Agenesis
by Leonard Năstase, Octaviana Cristea, Alexandra Diaconu, Silvia-Maria Stoicescu, Ramona Mohora, Bogdan Mihai Pascu, Simona Tania Tala and Ioana Roșca
Medicina 2023, 59(10), 1887; https://doi.org/10.3390/medicina59101887 - 23 Oct 2023
Viewed by 2870
Abstract
Congenital hypothyroidism (CH) may have major detrimental effects on growth and neurological development, but early intervention leads to excellent outcomes. CH is classified as transient or permanent, primary or secondary, with primary CH being the most common neonatal endocrine disorder. Most patients with [...] Read more.
Congenital hypothyroidism (CH) may have major detrimental effects on growth and neurological development, but early intervention leads to excellent outcomes. CH is classified as transient or permanent, primary or secondary, with primary CH being the most common neonatal endocrine disorder. Most patients with CH do not present any typical signs and symptoms of hypothyroidism shortly after birth, partly due to transplacental maternal thyroid hormone transfer and residual neonatal thyroid function. This paper reports on two CH cases. During the initial Neonatal Intensive Care Unit (NICU) admission phase, CH was not suspected due to nonspecific signs. The distinct characteristics of our cases are as follows: both infants were admitted to the NICU for respiratory distress syndrome, requiring invasive mechanical ventilation, and both were born to diabetic mothers. Following extubation, they both showed similar neurological issues, including reduced muscle tone and feeding difficulties. Initially, those symptoms were attributed to delayed clearance of analgesic and sedative medication. However, symptoms progressively worsened over time. Subsequent tests revealed both meeting CH diagnostic criteria: an unusual ultrasound indicating thyroid agenesis and abnormal hormone levels. Guided by the pediatric endocrinology team, prompt hormonal treatment was started with improvements in neurocognitive function and feeding. Usually, CH screening involves blood samples from healthy newborns at 2–3 days of life. Abnormal results require confirmation, prompting treatment within two weeks. Certain NICU-admitted infants face higher diagnosis delays, as seen in those two cases where CH screening was postponed. Thus, for all neonates with persistent pathologies unresponsive to standard etiological treatment, conducting a comprehensive anamnestic evaluation of the medical history, along with maternal preconceptional and prenatal nutrition, is recommended. Full article
(This article belongs to the Special Issue Diagnosis, Evaluation, and Management of Diseases during Pregnancy: Part II)
►▼ Show Figures

Figure 1

12 pages, 15456 KiB  
Case Report
Nonfamilial VACTERL-H Syndrome in a Dizygotic Twin: Prenatal Ultrasound and Postnatal 3D CT Findings
by Seol Young Hong, Soo Jung Kim, Mi-Hye Park and Kyung A. Lee
Medicina 2023, 59(8), 1387; https://doi.org/10.3390/medicina59081387 - 28 Jul 2023
Viewed by 1156
Abstract
Background: VACTERL association is a widely known congenital malformation that includes vertebral, anal, cardiac, tracheoesophageal, renal, and limb anomalies. Patients with VACTERL and hydrocephalus appear to form a distinct group, both genetically and phenotypically, and their condition has been called VACTERL-H syndrome. [...] Read more.
Background: VACTERL association is a widely known congenital malformation that includes vertebral, anal, cardiac, tracheoesophageal, renal, and limb anomalies. Patients with VACTERL and hydrocephalus appear to form a distinct group, both genetically and phenotypically, and their condition has been called VACTERL-H syndrome. Most cases of VACTERL-H have been reported postnatally, as VACTER-H syndrome is difficult to diagnose prenatally. Case Presentation: Here, we report a case of VACTERL-H syndrome in a dichorionic and diamniotic twin diagnosed prenatally by ultrasonography and confirmed postnatally by three-dimensional computed tomography (3D CT). A 34-year-old multiparous female was referred to our institution at 31 + 3 weeks gestation for suspected fetal ventriculomegaly. Detailed examinations using two-dimensional and Doppler ultrasounds revealed hydrocephalus, bilateral dysplastic upper arms, radial aplasia, unilateral pulmonary agenesis, dextrocardia with right atrial enlargement, a unilateral hypoplastic ectopic kidney, a single umbilical artery, a tracheoesophageal fistula with a small stomach, polyhydramnios, and anal atresia. Findings from the postnatal 3D CT aligned with the prenatal diagnosis, showing upper-limb agenesis, dextrocardia with pulmonary hypoplasia, tracheoesophageal fistula, imperforate anus, and colon dilatation. The affected 1390-g male twin had an unaffected 1890-g female twin sister and a healthy 6-year-old brother. Conclusions: Upon encountering fetuses with multiple anomalies, including ventriculomegaly, a small stomach with polyhydramnios, an abnormally positioned heart, and upper-limb abnormalities, clinicians should perform systematic ultrasonographic examinations to detect associated anomalies and be aware of VACTERL-H syndrome. Full article
(This article belongs to the Special Issue Diagnosis, Evaluation, and Management of Diseases during Pregnancy: Part II)
►▼ Show Figures

Figure 1

6 pages, 2504 KiB  
Case Report
What Is the Optimal Digoxin Level? Challenging Case of Fetal Atrial Flutter Treatment in a Monochorionic Diamniotic Twin
by Soo Jung Kim, Hee Do Jeon, So-Yeon Shim, Yi-Seul Kim, Mi-Hye Park and Kyung A. Lee
Medicina 2023, 59(7), 1198; https://doi.org/10.3390/medicina59071198 - 25 Jun 2023
Viewed by 1082
Abstract
Background: Atrial flutter is an infrequent yet potentially fatal arrhythmia. Digoxin is the preferred first-line treatment for fetal atrial flutter due to its efficacy and favorable safety profile. The optimal digoxin serum target level for neonatal atrial flutter management remains uncertain, with [...] Read more.
Background: Atrial flutter is an infrequent yet potentially fatal arrhythmia. Digoxin is the preferred first-line treatment for fetal atrial flutter due to its efficacy and favorable safety profile. The optimal digoxin serum target level for neonatal atrial flutter management remains uncertain, with the standard target level ranging from 1.0 to 2.0 ng/mL due to potential toxicity concerns above this threshold. Case Presentation: We present a case of atrial flutter in a fetus within a monochorionic diamniotic (MCDA) twin pregnancy that was successfully managed using a higher-than-standard target level of digoxin. A 34-year-old nulliparous woman was referred to our institution at 31 + 3 weeks of gestation due to fetal distress in an MCDA twin pregnancy. Fetal echocardiography revealed a ventricular rate of 214 bpm in twin A, while twin B exhibited no abnormal findings. Conclusions: Our case highlights a distinct correlation between the serum digoxin level and its impact on atrial flutter. A higher target serum level of digoxin may be necessary to achieve sinus conversion due to the unique maternal and fetal circulatory characteristics in MCDA pregnancies. Full article
(This article belongs to the Special Issue Diagnosis, Evaluation, and Management of Diseases during Pregnancy: Part II)
►▼ Show Figures

Figure 1

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-7
Back to TopTop