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Clinical Updates on Maternal Fetal Medicine
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Clinical Updates on 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: 20 January 2025 | Viewed by 7605

Special Issue Editors

Dr. Misgav Rottenstreich

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Guest Editor
1. Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University School of Medicine, Jerusalem, Israel
2. Department of Nursing, Jerusalem College of Technology, Jerusalem, Israel
Interests: fetal growth restriction; twin pregnancies; preterm birth; diabetes in pregnancy
Prof. Dr. Roberta Granese

E-Mail Website
Guest Editor
Obstetrics and Gynecology Unit, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University Hospital "G. Martino", Messina, Italy
Interests: endometriosis; laparoscopic ginecology; preterm birth; cholestasis in pregnancy

Special Issue Information

Dear Colleagues,

Maternal fetal medicine (MFM) represents a dynamic field of healthcare that continually evolves to enhance maternal and fetal well-being. This Special Issue, "Clinical Updates on Maternal Fetal Medicine", aims to provide a comprehensive platform for the dissemination of cutting-edge research, clinical insights, and evidence-based practices in the realm of MFM.

Our primary objective is to facilitate the exchange of knowledge among clinicians, researchers, and healthcare professionals, fostering collaborative efforts to address contemporary challenges in the care of expectant mothers and their unborn children. We invite contributions that encompass a wide spectrum of topics within MFM, including, but not limited to, prenatal screening, diagnostic techniques, perinatal interventions, obstetric complications, and neonatal outcomes.

This Special Issue welcomes original research articles and comprehensive reviews that advance our understanding of MFM. We encourage submissions that explore innovative diagnostic tools, therapeutic strategies, and multidisciplinary approaches to optimize maternal–fetal care.

We invite researchers and clinicians to contribute their expertise to this collaborative effort, ultimately advancing the field of maternal fetal medicine and improving outcomes for pregnant individuals and their infants.

Dr. Misgav Rottenstreich
Prof. Dr. Roberta Granese
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

  • diabetes in pregnancy
  • hypertension in pregnancy
  • cholestasis in pregnancy
  • endocrine disorder in pregnancy
  • sepsis in pregnancy

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Published Papers (6 papers)

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Research

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13 pages, 272 KiB  
Article
Detection Rate of Fetal Anomalies in Early Mid-Trimester Compared to Late Mid-Trimester Detailed Scans: Possible Implications for First-Trimester Sonography
by Zangi Yehudit, Michaelson-Cohen Rachel, Weiss Ari, Shen Ori, Mazaki Eyal and Sela Hen Yitzhak
J. Clin. Med. 2024, 13(19), 5750; https://doi.org/10.3390/jcm13195750 - 27 Sep 2024
Viewed by 741
Abstract
Objective: A late mid-trimester fetal organ scan (lMTS) is recommended between 18 and 22 weeks of pregnancy. Evidence has been accumulating on the effectiveness of first-trimester anatomy scans. Early mid-trimester fetal scans (eMTSs; 14–17 weeks) may have the advantage of visualization of [...] Read more.
Objective: A late mid-trimester fetal organ scan (lMTS) is recommended between 18 and 22 weeks of pregnancy. Evidence has been accumulating on the effectiveness of first-trimester anatomy scans. Early mid-trimester fetal scans (eMTSs; 14–17 weeks) may have the advantage of visualization of most organs, hence allowing earlier genetic assessment and decision making. Our aim is to examine the effectiveness of eMTSs in identifying fetal anomalies compared to lMTSs. Methods: A retrospective study was conducted based on data from the multidisciplinary prenatal diagnosis clinic in a tertiary center. During the study period (2011–2021), an out-of-pocket eMTS in a community setting was offered routinely to the general population. Women who had previously undergone an eMTS and were later assessed due to a fetal anomaly in our clinic were included in the study. The cohort was divided into two groups according to whether the anomaly had been detected during the eMTS. We then compared the groups for factors that may be associated with anomaly detection in eMTSs. We used t-tests and chi-square tests, for quantitative and qualitative variables, respectively, to determine variables related to eMTS anomaly detection, and logistic regression for multivariate analysis. Results: Of 1525 women assessed in our multidisciplinary clinic, 340 were included in the study. The anomaly detection rate of the eMTS compared to the lMTS was 59.1% The eMTS detection rates for specific organ systems were as follows: skeletal, 57%; cardiac, 52%; congenital anomalies of the kidneys and urinary tract (CAKUT), 44%; central nervous system, 32.4%; chest, 33%; and abdominal, 28%. In multivariate analysis, abnormal first-trimester screening (aOR 3.2; 95%CI 1.26–8.08) and multiple anomalies (aOR 1.86; 95%CI 1.02–3.37) were found to be associated with eMTS anomaly detection. Conclusions: The eMTS detection rate was nearly 60% and was most accurate in detecting skeletal, cardiac, and CAKUT anomalies. Since the eMTS was community-based, this rate likely reflects a “real-world” scenario. Our findings support consideration of performing an eMTS or first-trimester scan routinely for earlier diagnosis and decision making, as an adjunctive to lMTSs. Future studies will examine the cost-effectiveness of early scans. Full article
(This article belongs to the Special Issue Clinical Updates on Maternal Fetal Medicine)
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9 pages, 1042 KiB  
Article
The Effect of Maternal Parity on Preterm Birth Risk in Women with Short Mid-Trimester Cervical Length: A Retrospective Cohort Study
by Einav Kremer, Elyasaf Bitton, Yossef Ezra, Roie Alter and Doron Kabiri
J. Clin. Med. 2024, 13(16), 4773; https://doi.org/10.3390/jcm13164773 - 14 Aug 2024
Viewed by 748
Abstract
Objectives: To evaluate the effect of maternal parity on the association between mid-trimester cervical length and preterm birth to elucidate the potential intricacies of this relationship. Methods: A retrospective cohort study using Electronic Medical Records (EMR) data. The study population included [...] Read more.
Objectives: To evaluate the effect of maternal parity on the association between mid-trimester cervical length and preterm birth to elucidate the potential intricacies of this relationship. Methods: A retrospective cohort study using Electronic Medical Records (EMR) data. The study population included pregnant women with a singleton fetus and a short mid-trimester cervical length, recorded in the EMR system at a large health maintenance organization. Women were categorized by parity in the current pregnancy, and a statistical analysis was conducted to examine the relationship between parity and premature delivery. Results: Data were collected from 1144 records of cervical length measurements of 738 pregnancies obtained from the HMO database. The study population consisted of 259 nulliparous women (35.1%), 451 multiparous women (61.1%), and 28 grand multiparous women (3.8%). The results from the multivariate analysis of the primary outcome showed that nulliparity was significantly associated with an increased risk of premature delivery, with a risk of 1.557 for nulliparous women compared to parous women. Conclusions: In this study, a statistically significant association was found between nulliparity and preterm birth among women with a short mid-trimester cervical length. Nulliparous women were found to have a higher risk of preterm birth in the current pregnancy compared to parous women. Further research is needed to understand the underlying mechanisms and to develop targeted interventions to reduce the risk of premature birth in this population. These findings highlight the need to consider nulliparity as a potential risk factor in the management of pregnancies with a shortened cervix. Full article
(This article belongs to the Special Issue Clinical Updates on Maternal Fetal Medicine)
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13 pages, 399 KiB  
Article
Labor Induction in Women with Isolated Polyhydramnios at Term: A Multicenter Retrospective Cohort Analysis
by Yael Lerner, Tzuria Peled, Morag Yehushua, Reut Rotem, Ari Weiss, Hen Y. Sela, Sorina Grisaru-Granovsky and Misgav Rottenstreich
J. Clin. Med. 2024, 13(5), 1416; https://doi.org/10.3390/jcm13051416 - 29 Feb 2024
Viewed by 2433
Abstract
Background: With the increasing popularity of elective induction after 39 + 0 weeks, the question of whether induction of labor (IOL) is safe in women with isolated polyhydramnios has become more relevant. We aimed to evaluate the pregnancy outcomes associated with IOL among [...] Read more.
Background: With the increasing popularity of elective induction after 39 + 0 weeks, the question of whether induction of labor (IOL) is safe in women with isolated polyhydramnios has become more relevant. We aimed to evaluate the pregnancy outcomes associated with IOL among women with and without isolated polyhydramnios. Methods: This was a multicenter retrospective cohort that included women who underwent induction of labor at term. The study compared women who underwent IOL due to isolated polyhydramnios to low-risk women who underwent elective IOL due to gestational age only. The main outcome measure was a composite adverse maternal outcome, while the secondary outcomes included maternal and neonatal adverse pregnancy outcomes. Results: During the study period, 1004 women underwent IOL at term and met inclusion and exclusion criteria; 162 had isolated polyhydramnios, and 842 had a normal amount of amniotic fluid. Women who had isolated polyhydramnios had higher rates of the composite adverse maternal outcome (28.7% vs. 20.4%, p = 0.02), prolonged hospital stay, perineal tear grade 3/4, postpartum hemorrhage, and neonatal hypoglycemia. Multivariate analyses revealed that among women with IOL, polyhydramnios was significantly associated with adverse composite maternal outcome [aOR 1.98 (1.27–3.10), p < 0.01]. Conclusions: IOL in women with isolated polyhydramnios at term was associated with worse perinatal outcomes compared to low-risk women who underwent elective IOL. Our findings suggest that the management of women with polyhydramnios cannot be extrapolated from studies of low-risk populations and that clinical decision-making should take into account the individual patient’s risk factors and preferences. Full article
(This article belongs to the Special Issue Clinical Updates on Maternal Fetal Medicine)
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9 pages, 259 KiB  
Article
Metabolic Syndrome Prevalence in Women with Gestational Diabetes Mellitus in the Second Trimester of Gravidity
by Vendula Bartáková, Katarína Chalásová, Lukáš Pácal, Veronika Ťápalová, Jan Máchal, Petr Janků and Kateřina Kaňková
J. Clin. Med. 2024, 13(5), 1260; https://doi.org/10.3390/jcm13051260 - 22 Feb 2024
Viewed by 1248
Abstract
Background: Women with gestational diabetes (GDM) have an increased risk of metabolic syndrome (MS) after delivery. MS could precede gravidity. The aims of this study were (i) to detect the prevalence of MS in women at the time of GDM diagnosis, (ii) [...] Read more.
Background: Women with gestational diabetes (GDM) have an increased risk of metabolic syndrome (MS) after delivery. MS could precede gravidity. The aims of this study were (i) to detect the prevalence of MS in women at the time of GDM diagnosis, (ii) to detect the prevalence of MS in the subgroup of GDM patients with any form of impaired glucose tolerance after delivery (PGI), and (iii) to determine whether GDM women with MS have a higher risk of peripartal adverse outcomes. Methods: A cross-sectional observational study comprised n = 455 women with GDM. International Diabetes Federation (IDF) criteria for MS definition were modified to the pregnancy situation. Results: MS was detected in 22.6% of GDM patients in those with PGI 40%. The presence of MS in GDM patients was associated with two peripartal outcomes: higher incidence of pathologic Apgar score and macrosomia (p = 0.01 resp. p = 0.0004, chi-square). Conclusions: The presence of MS in GDM patients is a statistically significant risk factor (p = 0.04 chi-square) for PGI. A strong clinical implication of our findings might be to include MS diagnostics within GDM screening using modified MS criteria in the second trimester of pregnancy. Full article
(This article belongs to the Special Issue Clinical Updates on Maternal Fetal Medicine)

Review

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11 pages, 664 KiB  
Review
Coxsackievirus Group B Infections during Pregnancy: An Updated Literature Review
by Carolina Longo, Mauricio Saito, Pedro Teixeira Castro, Evelyn Traina, Heron Werner, Julio Elito Júnior and Edward Araujo Júnior
J. Clin. Med. 2024, 13(16), 4922; https://doi.org/10.3390/jcm13164922 - 21 Aug 2024
Viewed by 1709
Abstract
Coxsackievirus group B (CVB), a member of the Picornaviridae family and enterovirus genus, poses risks during pregnancy due to its potential to cause severe fetal and neonatal infections. Transmission primarily occurs through fecal–oral routes, with infections peaking mostly in warmer months. Vertical transmission [...] Read more.
Coxsackievirus group B (CVB), a member of the Picornaviridae family and enterovirus genus, poses risks during pregnancy due to its potential to cause severe fetal and neonatal infections. Transmission primarily occurs through fecal–oral routes, with infections peaking mostly in warmer months. Vertical transmission to the fetus can lead to conditions such as myocarditis, encephalitis, and systemic neonatal disease, presenting clinically as severe myocardial syndromes and neurological deficits. Diagnostic challenges include detecting asymptomatic maternal infections and conducting in utero assessments using advanced techniques like RT-PCR from amniotic fluid samples. Morbidity and mortality associated with congenital CVB infections are notable, linked to preterm delivery, fetal growth restriction, and potential long-term health impacts such as type 1 diabetes mellitus and structural cardiac anomalies. Current treatments are limited to supportive care, with emerging therapies showing promise but requiring further study for efficacy in utero. Preventive measures focus on infection control and hygiene to mitigate transmission risks, which are crucial especially during pregnancy. Future research should aim to fill knowledge gaps in epidemiology, improve diagnostic capabilities, and develop targeted interventions to enhance maternal and fetal outcomes. Full article
(This article belongs to the Special Issue Clinical Updates on Maternal Fetal Medicine)
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Other

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11 pages, 560 KiB  
Systematic Review
The Efficacy and Acceptability of Flash Glucose Monitoring in Pregnant Women with Gestational Diabetes Mellitus: A Systematic Review
by Franciszek Ługowski, Julia Babińska, Zofia Awiżeń-Panufnik, Ewelina Litwińska-Korcz, Magdalena Litwińska, Artur Ludwin and Paweł Jan Stanirowski
J. Clin. Med. 2024, 13(23), 7129; https://doi.org/10.3390/jcm13237129 - 25 Nov 2024
Abstract
Background: Gestational diabetes mellitus (GDM) occurs in approximately 9% of pregnancies, and proper glycemic control is of utmost importance in the prevention of GDM-associated obstetric complications. Flash glucose monitoring (FGM), a subtype of continuous glucose monitoring (CGM), offers intermittent blood glucose scanning and [...] Read more.
Background: Gestational diabetes mellitus (GDM) occurs in approximately 9% of pregnancies, and proper glycemic control is of utmost importance in the prevention of GDM-associated obstetric complications. Flash glucose monitoring (FGM), a subtype of continuous glucose monitoring (CGM), offers intermittent blood glucose scanning and is considered a propitious alternative to the standard method of self-monitoring of blood glucose (SMBG). Aim: The aim of this review was to systematically assess the efficacy and acceptability of FGM in in pregnancies complicated by GDM. Methods: A systematic literature search was performed in the PubMed, MEDLINE, Scopus, and Cochrane databases. The review was conducted following the PRISMA guidelines, and the study protocol has been registered in the PROSPERO database with the registration number CRD42024545874. Results: A total of 872 articles were initially identified, 141 publications underwent an in-depth full-text analysis, resulting in 133 studies being excluded from further assessment. Eventually, eight studies were included in the analysis. Conclusions: The analysis revealed that FGM is a safe and efficient method of glycemic control in GDM. The majority of the studies consider its accuracy comparable to SMBG. Furthermore, FGM is well accepted by patients with numerous advantages in user-friendliness over SMBG. Full article
(This article belongs to the Special Issue Clinical Updates on Maternal Fetal Medicine)
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