Maternal critical care

Invasive prenatal testing, amniocentesis, and chorionic villus sampling offer insights into fetal genetic integrity and health, but carry inevitable minor risks of miscarriage and infection, thus complicating the decision-making process for parents. Previous research has revealed several factors that influence the decision to undergo invasive prenatal testing, including demographic, clinical, and psychological aspects, and attitudes towards testing. Informed choice, involving understanding options and aligning them with personal values, is crucial, with healthcare providers playing a key role in offering unbiased information...

Primatologists have a long-standing interest in the study of maternal care and nonmaternal handling (NH) of infants stemming from recognition that early social relationships can have enduring consequences. Though maternal care and NH often include expression of similar behaviors, they are regularly studied in isolation from each other with nonoverlapping terminology, thereby overlooking possible interplay between them and obfuscating potential developmental ramifications that ensue from trade-offs made between maternal (MH) and NH during infancy...

BACKGROUND: As a rule, newborns do not require special medical care. If unexpected complications occur peripartum or postpartum, support from and transport to specialised neonatal hospitals might be needed. METHODS: In a retrospective study, all transport protocols of a supraregional paediatric‑neonatological maximum care hospital in northwestern Germany from 01.10.2018 through 30.09.2021 were analysed. The particular focus was on transports of newborns (<7 days) and the leading symptoms that led to contact...

Obstetric violence is an urgent global problem. Recently, several studies have appeared on obstetric violence in the Netherlands, indicating that it is a more widespread phenomenon in Dutch maternity care than commonly thought. At the same time, there has been very little public outrage over these studies. The objective of this qualitative research is to gain insight into the working and normalization of obstetric violence by focusing on the moral and epistemic injustices that both facilitate obstetric violence and make it look acceptable...

The developmental origins of health and disease concept highlights the impact of early environments on chronic non-communicable diseases like diabetes, cardiovascular disease, and cancer. Studies using animal models have investigated how maternal factors such as undernutrition, overnutrition, obesity, and exposure to chemicals or hypoxia affect fetal development and offspring health, leading to issues like low birth weight, high blood pressure, dyslipidemia, and insulin resistance. Given the increasing prevalence of overweight and obesity among reproductive-age women, effective interventions are critical...

OBJECTIVES: COVID-19 is an infectious disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2 virus). This virus evolved into several variants, each with different severity. There are surges in the numbers of infected patients, commonly described as "waves". In Kuwait, three waves occurred. Our study describes and compares the clinical presentation and outcomes of critically ill pregnant patients infected with different variants. METHODS: This was a retrospective cohort study in two intensive care units (ICU) dedicated to patients with COVID-19...

BACKGROUND: Perinatal mental health is a major public health problem that disproportionately affects people from racial and ethnic minority groups. Community-based perinatal mental health programs, such as peer support groups, are essential tools for the prevention and treatment of perinatal depression. Yet, little is known about racial and ethnic disparities in accessibility and utilization of community-based perinatal mental health programs. METHODS: We conducted a cross-sectional study using an online survey with program administrators representing perinatal mental health community-based services and support programs throughout New Jersey...

In 2021, the Preconception Health Network Australia co-developed preconception health core indicators identified as critical to ensuring optimal maternal and child outcomes following conception. We conducted an audit of perinatal databases across each state and territory to identify whether preconception core indicator data were available. Seven health domains co-developed by the Preconception Health Network were mapped against the data collected in the perinatal databases. Indicator data were lacking across all seven health domains, with data missing for social determinants of health indicators...

Interdisciplinary fetal-neonatal neurology (FNN) training considers a woman's reproductive and pregnancy health histories when assessing the "four great neonatal neurological syndromes". This maternal-child dyad exemplifies the symptomatic neonatal minority, compared with the silent majority of healthy children who experience preclinical diseases with variable expressions over the first 1000 days. Healthy maternal reports with reassuring fetal surveillance testing preceded signs of fetal distress during parturition...

Gynecological health remains a critical aspect of women's overall well-being, with profound implications for maternal and reproductive outcomes. This comprehensive review synthesizes the current state of knowledge on four pivotal aspects of gynecological health: preterm birth, breast cancer and cervical cancer and infertility treatment. Machine learning (ML) has emerged as a transformative technology with the potential to revolutionize gynecology and women's healthcare. The subsets of AI, namely, machine learning (ML) and deep learning (DL) methods, have aided in detecting complex patterns from huge datasets and using such patterns in making predictions...

Introduction: Maternal blood pressure (BP) is a critical cardiovascular marker with profound implications for maternal and fetal well-being, particularly in the detection of hypertensive disorders during pregnancy. Although conventional clinic-based BP (CBP) measurements have traditionvally been used, monitoring 24-hour ambulatory BP (ABP) has emerged as a more reliable method for assessing BP levels and diagnosing conditions such as gestational hypertension and preeclampsia/eclampsia. This study aimed to assess the feasibility and acceptability of 24-hour ABP monitoring in pregnant women and report on various ABP parameters, including ambulatory blood pressure variability (ABPV)...

This case report describes the emergent scenario of a 41-year-old primipara at 31.2 weeks of gestation, presenting with abdominal and back pain in the context of a dichorionic diamniotic twin pregnancy complicated by hydrops fetalis. The patient, with a history of hypertension, hyperthyroidism, and a cervical stitch in place, underwent an emergency lower segment cesarean section. The ultrasound revealed an intrauterine left footling in one twin, contributing to the suspected hydrops fetalis. Neonatal complications arose, particularly with Baby B, necessitating immediate resuscitation and intensive care...

Black pregnant and postpartum individuals are at risk for intimate partner violence (IPV), and those with a history of childhood maltreatment and IPV are even more likely to be re-victimized during pregnancy. However, it is unknown if specific types of child maltreatment predict later IPV with and without a weapon better than others. The current study sought to (i) document the prevalence of childhood maltreatment and IPV and (ii) examine the relations among types of childhood maltreatment and later IPV with and without a weapon within a sample of Black individuals seeking prenatal care at a large public hospital in the southeastern United States...

Background Thrombocytopenia is the most prevalent hematological condition in neonates that develops in the neonatal intensive care unit (NICU). This set of illnesses is caused by either decreased platelet production due to placental insufficiency, increased platelet breakdown (consumption), or a combination of the two causes. Based on platelet count, it is defined as mild, moderate, or severe thrombocytopenia, with early and late onset. Purpose The purpose of this study is to determine the prevalence of thrombocytopenia and the factors that contribute to it in newborns hospitalized in the neonatal critical care unit at the Maternity and Children Hospital in Al Ahsa, Saudi Arabia...

BACKGROUND: Empathy is a critical component of nursing care, impacting both nurses' and patients' outcomes. However, perceived empathy from spouses during pregnancy and its impact on health-related quality of life (HRQoL) are unclear. This study aimed to examine pregnant women's perceived empathy from their spouses and assess the relation of perceived empathy on HRQoL. METHODS: This cross-sectional study, performed in the obstetric clinics or wards of four well-known hospitals in Anhui Province, China, included 349 pregnant women in the second or third trimester; participants were recruited by convenience sampling and enrolled from October to December 2021...

CONTEXT: Choline is a critical nutrient. Inadequate choline intake during pregnancy increases the risk of adverse maternal and offspring health. OBJECTIVE: A systematic review and meta-analysis were conducted to examine the current recommendations for choline intake by pregnant women, estimate the overall prevalence of pregnant women with adequate choline intake, and explore associations between maternal choline level and adverse pregnancy outcomes (APOs). METHODS: Choline recommendations for pregnant women were assessed from eight nutrient guidelines of the United States, United Kingdom, Canada, Australia, Asia, International Federation of Gynecology and Obstetrics, and World Health Organization...

BACKGROUND: This study aims to investigate the impact and safety of combining maternal voice stimulation with gravity feeding on low-birth-weight preterm infants. The research focuses on key outcomes such as gastric tube indwelling time, feeding transition time, adequate gastrointestinal nutrition time, recovery of birth weight time, length of hospital stay, and oral motor function in preterm infants. METHODS: A total of 150 low birth weight preterm infants meeting inclusion criteria were recruited from the neonatal care unit and randomly assigned to three groups: traditional nasal feeding, gravity feeding with a homemade bracket, and a combined group receiving both gravity feeding and maternal voice stimulation...

Ascertaining the utility of continuous glucose monitoring (CGM) in pregnancy complicated by diabetes is a rapidly evolving area, as the prevalence of type 1 diabetes (T1D), type 2 diabetes (T2D), and gestational diabetes mellitus (GDM) escalates. The seminal randomized controlled trial (RCT) evaluating CGM use added to standard care in pregnancy in T1D demonstrated significant improvements in maternal glycemia and neonatal health outcomes. Current clinical guidance recommends targets for percentage time in range (TIR), time above range (TAR), and time below range (TBR) during pregnancy complicated by T1D that are widely used in clinical practice...

BACKGROUND: Stillbirth is a silent tragedy that shatters the lives of women, families, and nations. Though affecting over 2 million infants globally in 2019, it remains overlooked, with no specific targets dedicated to its reduction in the sustainable development goals. Insufficient knowledge regarding the primary risk factors contributing to stillbirths hinders efforts to reduce its occurrence. Driven by this urgency, this study focused on identifying the determinants of stillbirth among women giving birth in hospitals across North Wollo Zone, Northeast Ethiopia...

OBJECTIVE: To examine the prevalence, perinatal outcomes and factors associated with neonatal sepsis in referral-level facilities across Nigeria. DESIGN: Secondary analysis of data from the Maternal and Perinatal Database for Quality, Equity and Dignity Programme in 54 referral-level hospitals across Nigeria. SETTING: Records covering the period from 1 September 2019 to 31 August 2020. POPULATION: Mothers admitted for birth during the study period, and their live newborns...