[Use of Bufenine in threatened abortion and threatened preterm delivery].
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Abortion, Threatened↗
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Prevention of preterm delivery in twins. A neurohormonal approach.
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Adrenergic beta-Agonists↗
Perinatal mortality and one-year infant morbidity.
Perinatal mortality in Southampton and South-west Hampshire Health District fell from 20.8 per 1000 total births in 1970 to 11.3 per 1000 in 1976. This was atributable mainly to a fall in the stillbirth rate, but also to a recent fall in the neonatal death rate in the first week. All infants born in 1975 who had any problems in the perinatal period were followed up for one year. Of the 12 children identified at one year as having a major handicap, eight suffered from problems of prenatal origin, two from problems associated with preterm delivery, and two from other conditions acquired during the perinatal period. As two-thirds of the major handicaps arose from congenital abnormalities, preterm delivery and low birth weight were not the main causes of major handicap.
Congenital Abnormalities↗
Contemporary management and conduct of preterm labor and delivery: a review.
Current concepts in the conduct of preterm labor and management of delivery of the premature infant are reviewed. Pharmacologic modalities available for inhibiting preterm labor are discussed as well as the efficacy, indications and contraindications for these agents. An analysis of the role of corticosteroids in achieving fetal pulmonary maturity in the preterm infant is reviewed, and based on the existent literature the intrapartum management of the small fetus is outlined. The mode of delivery, vaginal or via cesarean section, for these infants is likewise discussed.
Adrenal Cortex Hormones↗
Effects on the child of alcohol abuse during pregnancy. Retrospective and prospective studies.
Retrospective and prospective investigations of children to alcoholic women gave an incidence of fetal alcohol lesion of one per 300 deliveries of whom half had the complete fetal alcohol syndrome. Perinatal and infant mortalities were increased seven to tenfold and low birth weight (less than or equal to 2 500 g), preterm deliveries (less than 37 weeks) and smallness for gestational age (less than -2 S.D.) were increased eightfold, threefold and twelvefold, respectively. Small size at birth correlated with reduced mental performance later in life, 58% had IQ below 85 and 19% below 70.8% had cerebral palsy. The incidence of cerebral palsy associated with maternal inebriety was 1/5 000 deliveries, i.e. every sixth case of cerebral palsy. Tracing of alcoholic women during pregnancy and treatment gave favourable effect on intrauterine growth when sobriety could be induced early in pregnancy but could not protect from functional brain disturbance measured by neurological performance and be evoked response electroencephalography. Damage to the fetus by alcohol is now the largest known health hazard by a noxious agent that is preventable.
Alcoholism↗
Causes of the excessive rates of perinatal mortality and prematurity in pregnancies complicated by maternal urinary-tract infections.
The study was undertaken to determine the causes of the more frequent pre-term deliveries, fetal and neonatal deaths associated with maternal urinary-tract infections during pregnancy. The combined perinatal mortality rate for eight common placental and fetal disorders was 42 per thousand births in the infected vs. 21 per thousand in the noninfected, owing to a greater mortality from noninfectious placental and fetal disorders in the gestations with the urinary-tract infections (P less than 0.001). All the mortality excess took place when the urinary-tract infections occurred within 15 days of delivery. Death rates were highest when the urinary-tract infections coexisted with maternal hypertension and acetonuria.Hydramnios, amniotic-fluid bacterial infections and abruptio placentae were responsible for two thirds of the more frequent preterm deliveries in the pregnancies complicated by urinary-tract infections.
Abruptio Placentae↗
Pairwise Comparative Safety and Effectiveness of Anti-TNF Blockers, Vedolizumab, and Ustekinumab During Pregnancy: A Systematic Review and Meta-Analysis.
PURPOSE: Biologic therapies, including tumor necrosis factor (TNF) blockers, vedolizumab (VDZ), and ustekinumab (UST), are generally considered safe during pregnancy in patients with inflammatory bowel disease (IBD), though comparative data remain limited. This meta-analysis examines their safety and effectiveness. METHODS: A systematic search of MEDLINE, EMBASE, CINAHL, Cochrane, and Web of Science was conducted through July 2025. Eligible studies reported maternal or neonatal outcomes in pregnant IBD patients treated with biologics. Studies were pooled using a random-effects model to calculate risk ratios (RRs) with 95% confidence intervals. Heterogeneity was assessed using I2. Primary outcomes were preterm birth and disease activity; secondary outcomes included pregnancy and neonatal outcomes. RESULTS: Nine observational studies (n = 6,054) were included. Compared to TNF blockers, VDZ was associated with a higher risk of preterm delivery (RR = 1.35, 95% CI 1.04-1.75, I2 = 0%) and active disease (RR = 1.55, 95% CI 1.01-2.40, I2 = 50%). UST was associated with a higher risk of active disease (RR = 1.30, 95% CI 1.06-1.60, I2 = 0%) and congenital anomalies (RR = 2.08, 95% CI 1.30-3.32, I2 = 0%) compared to TNF blockers. Compared to UST, VDZ was linked to increased risks of preterm birth (RR = 2.60, 95% CI 1.03-6.57, I2 = 0%) and low birth weight (RR = 2.38, 95% CI 1.01-5.60, I2 = 0%). No significant differences were observed for live births, abortions, hospitalizations, or neonatal infections. CONCLUSION: TNF blockers showed a favorable safety and effectiveness profile, VDZ and UST performed broadly similar, and all three biological classes appeared compatible with safe use in pregnancy to maintain effective disease control. Observed differences reflect that VDZ and UST cohorts likely had longer disease duration, prior biologic exposure, and more active disease. The results of this meta-analysis support the continuation of biologic therapy for disease control in pregnant patients with IBD. Treatment decisions should be individualized and tailored to each patient's clinical context.
Female↗
Monitoring of fetuses with retarded BPD growth.
Retarded BPD growth (less than 5th centile) is associated with low birth weight, preterm delivery, and increased perinatal mortality. However, 50% of the fetuses with deviating BPD growth in the 32nd week have normal weight at birth. In this study other biochemical and physical tests were applied to a group of fetuses with deviating BPD growth in order to improve the discriminatory rate between infants subsequently born AGA or SGA. Measurements of the ratio abdomen to head diameter were above the 50th centile in 72% of the infants born AGA and below the 50th centile in 75% of those born SGA. Circumference measurements were less useful in our hands. Urinary oestriol levels were not directly proportional to the intrauterine growth retardation. Recording of fetal breathing movements and nonstressed monitoring of fetal heart rate FHR) had little or no predictive value in the individual case although the incidence of fetal breathing movements was significantly lower in the group with retarded BPD growth.
Abdomen↗
Experimental intraamnionic exposure of bovine fetuses with subgroup 2, type 7 Adenovirus.
Three third trimester fetuses were exposed to a subgroup 2, type 7 adenovirus (adeno 7) by intraamnionic infection. The virus caused preterm delivery of two clinically ill calves and one stillbirth. The two premature calves died 12 and 72 hours after birth. An elevated serum neutralizing antibody titer (1:256) to adenovirus 7 was found in one principal calf at birth. Adenovirus 7 was recovered from several tissues of the live calves and the spleen of the stillborn calf. Fetuses exposed by intraamniotnic injection with virus carrier only, were born healthy after normal gestational periods and no viruses were isolated from the tissues. Clinically ill calves were weak, severely depressed and unable to stand and nurse. Gross postmortem lesions were nonspecific and consisted of petechial and ecchymotic hemorrhages and edema of the gastrointestinal tract. Histopathological lesions included vasculitis, necrosis of the mucosa of the forestomach, mild gastroenteritis and acute, nonsuppurative focal necrosis of the liver, kidney and adrenal gland. Intranuclear inclusion bodies were seen in pericytes, macrophages, hepatocytes, epithelial cells of adrenal cortical sinusoids of the zona glomerulosa and zona fasciculata and renal tubular epithelium.
Adenoviridae↗
Gestation, birth-weight, and spontaneous abortion in pregnancy after induced abortion. Report of Collaborative Study by W.H.O. Task Force on Sequelae of Abortion.
The outcome of pregnancy in 7228 women from eight European cities was studied. In two of the three city clusters, there was a significantly higher risk of adverse outcome in terms of either mid-trimester spontaneous abortion, preterm delivery, or low-birth-weight infant among women whose only previous pregnancy had been surgically terminated only previous pregnancy had been surgically terminated than among primigravidae or women whose only previous pregnancy had ended in live birth. In one city cluster in which surgical termination was accomplished both by conventional dilatation and currettage and by vacuum aspiration (V.A.), an increased risk of short gestation was noted for V.A., but the overall total risk of adverse outcome was not significantly increased. In the third city cluster, in which surgical termination was nearly entirely by V.A., induced abortion was not associated with any increased risk of adverse pregnancy outcome. The effects of spontaneous abortion on the subsequent pregnancy are similar to those of induced abortion.
Abortion, Induced↗
Adverse pregnancy outcomes and long-term cardiovascular disease risk.
Pregnancy provides a unique physiological stress test for the cardiovascular system, during which, adverse pregnancy outcomes (APOs) can unmask latent susceptibility to future disease. Common complications, including hypertensive disorders of pregnancy (HDP), gestational diabetes, and preterm birth (delivery before 37 weeks' gestation), identify women at substantially higher long-term risk of cardiovascular morbidity and mortality compared with women without a history of APOs. These excess risks likely reflect the combined effects of pre-existing cardiometabolic and genetic susceptibility, as well as the haemodynamic and metabolic stressors of pregnancy, heralding accelerated risk factor trajectories, relative impairment in endothelial and microvascular function, and early disease onset. This final Review in the Series extends the focus from cardiovascular disease during pregnancy and HDP to the long-term cardiovascular implications of APOs after delivery. We synthesise epidemiological data quantifying cardiovascular risk across major APO phenotypes and emerging evidence linking maternal APO history with cardiometabolic risk trajectories in offspring. We also delineate putative mechanistic pathways and summarise guidelines and consensus-informed recommendations for short-term and long-term follow-up after APOs. Finally, we propose practical approaches for integrating APO history into cardiovascular disease risk assessment and guideline-directed prevention across the female life course. We highlight key knowledge gaps, including uncertainty about optimal follow-up models, the limitations of current risk-stratification tools, and the absence of APO-specific prevention trials. We also outline priorities for mechanistic and implementation research. Positioning APOs as early, sex-specific indicators of cardiovascular risk offers a key window of opportunity to shift prevention upstream and improve cardiovascular health outcomes for women.
Humans↗
Maternal anemia and the risk of preterm birth: a meta-analysis.
BACKGROUND: Globally, preterm birth continues to be a primary contributor to neonatal complications and fatalities. Anemia among the most common nutritional disorders in pregnancy has been proposed as a potential contributor to early delivery. Although extensively studied, the available evidence does not yet provide a clear consensus. This study aimed to conduct a meta-analysis to quantitatively assess the relationship between maternal anemia and the risk of preterm birth. METHODS: This meta-analysis was conducted and reported in accordance with the PRISMA guidelines and the MOOSE checklist. A systematic and exhaustive search was performed across multiple electronic databases PubMed, Scopus, Web of Science, Embase, and the Cochrane Library to identify relevant studies published from inception to 1 January 2025. Effect sizes were combined using a random-effects meta-analysis. RESULTS: A total of 45 articles, reporting 60 independent study populations comprising 2,119,392 pregnant individuals were included. Considerable heterogeneity was found across the included studies (I2 = 95.54%, p < 0.001), which justified the application of a random-effects model for pooling effect sizes. Maternal anemia was significantly associated with an increased risk of preterm birth (pooled odds ratio[OR] = 1.28, 95% confidence interval [CI]: 1.20-1.36, p < 0.001). Despite substantial heterogeneity, sensitivity analyses confirmed the robustness of this association. The relationship was strongest in studies conducted in Asia (OR = 1.30, 95% CI: 1.22-1.40; p < 0.001) and the Europe (OR = 1.24, 95% CI: 1.08-1.41; p = 0.001) and reached statistical significance when anemia was assessed during the first trimester (OR = 1.12, 95% CI: 1.03-1.51; p = 0.007) and the third trimester (OR = 1.65, 95% CI: 1.42-1.91; p < 0.001), while no significant associations were found in the second trimesters (OR = 1.10, 95% CI: 0.99-1.22; p = 0.05). Funnel plot asymmetry and a significant Egger's test (p = 0.001) indicated potential publication bias, although Begg's test was not significant (p = 0.425). CONCLUSIONS: The current evidence suggests that maternal anemia, particularly in the third trimester, is significantly associated with an increased risk of preterm birth. These findings emphasize the clinical imperative for comprehensive and timely anemia screening during the third trimester. Integrating targeted interventions such as iron and micronutrient supplementation, is essential to mitigate the risk of preterm delivery and improve neonatal outcomes.
Humans↗
The use of betamethasone and timed delivery in management of premature rupture of the membranes in the preterm pregnancy.
Of 43 women admitted with premature rupture of the membranes between 27 and 32 weeks' gestation, 27 received antepartum glucocorticoid with delivery timed to occur approximately 24 hours after the first dose of steriod. Sixteen patients did not receive glucocorticoid and were managed expectantly. Neonatal mortality was significantly less in the steroid group (15% vs. 50%, p less than .01), and this difference was explained by a reduction in deaths from respiratory distress syndrome. Rates of infectious morbidity for both mothers and infants were similar between the steroid-treated group and the group managed expectantly.
Betamethasone↗
Intra-amniotic infection: diagnosis, nomenclature, clinical significance, management, and microbiologic tools used for the diagnosis.
SUMMARYIntra-amniotic infection is the main cause of spontaneous preterm birth and adverse maternal-fetal outcomes; therefore, rapid, robust, and accurate diagnosis remains a clinical priority. Conventional microbiological techniques, especially culture-based methods, are limited by long turnaround times and the inability to detect fastidious or unculturable organisms. This review summarizes the diagnosis, nomenclature, clinical significance, management, and laboratory approaches for diagnosing intra-amniotic infection. Targeted nucleic acid amplification methods, including species-specific polymerase chain reaction and broad-range 16S rRNA gene sequencing, have improved the detection of bacterial DNA and enabled the identification of organisms that evade routine culture in intra-amniotic infection. More recently, whole-genome sequencing and metagenomic next-generation sequencing have provided culture-independent strategies for comprehensive pathogen profiling, allowing simultaneous detection of bacteria, viruses, and fungi, as well as characterization of antimicrobial resistance determinants and virulence-associated genes. However, challenges remain, particularly in low-biomass samples such as amniotic fluid, where contamination, host DNA background, and data interpretation can compromise specificity. This review critically evaluates the advantages and limitations of each molecular modality and discusses pre-analytical, analytical, and bioinformatic considerations essential for reliable implementation. Integration of molecular diagnostics into clinical workflows holds promise for improving etiological diagnosis and guiding targeted therapy in intra-amniotic infection, thereby improving maternal and fetal outcomes.
Humans↗
Intrapartum fetal asphyxia: clinical characteristics, diagnosis, and significance in relation to pattern of development.
The clinical and fetal heart rates and acid-base characteristics and their sequelae have been reviewed in 587 patients. The relevant clinical factors in the asphyxia group were the preterm fetus, the intrauterine growth retarded fetus, maternal toxemia, and midforceps delivery. The duration of the developing metabolic acidosis in the asphyxia group ranged from terminal to the last two hours of labor. Marked patterns of total decelerations and moderate and marked patterns of late decelerations are of predictive value in the diagnosis of intrapartum fetal asphyxia with a trend to an increased incidence in the longer duration categories, between four and two hours prior to delivery, and a significant increase in all categories during the last two hours of labor. The significance of intrapartum fetal asphyxia to the newborn infant is evident from the low Apgar scores, increased incidence of moderate and severe respiratory distress syndrome, and central nervous system complications in the asphixia group in relation to the normal group.
Acid-Base Equilibrium↗
Phosphatidylglycerol in lung surfactant. III. Possible modifier of surfactant function.
Lamellar bodies and alveolar lavage from adult mammalian lung contain unusually high concentrations of phosphatidylglycerol that could serve as a sensitive indicator of surfactant. Phosphatidylglycerol was absent and phosphatidylinositol was correspondingly prominent in surfactant from the preterm rabbit fetus. Phosphatidylglycerol rapidly appeared and phosphatidylinositol decreased following the delivery. Surfactant isolated from the prematurely born rabbit or from humans with respiratory distress syndrome never contained phosphatidylglycerol. Comparison between lamellar bodies from fetal and postnatal rabbits revealed remarkably similar composition except for the acidic phospholipids; however, the physico-chemical properties were different. The compressibility of the surface film (i.e. the ratio of the fractional decrease in surface area and the corresponding decrease in surface tension) at low surface tensions was higher with fetal than with postnatal surfactant, whereas the difference in minimum surface tensions was small. These data suggest that phosphatidylglycerol is not an essential component required for the formation of the complex, but it improves the properties of surfactant in stabilizing the alveoli.
Aging↗
Effect of flufenamic acid on uterine contractions and plasma levels of 15-keto-13,14-dihydroprostaglandin F2alpha in preterm labor.
Flufenamic acid (FA), an inhibitor of the synthesis and action of prostaglandins, was administered to 18 women with preterm labor during the 28th to 36th week of gestation. In 15 patients delivery postponed, the mean admission/delivery interval being 21.5 days. 2 patients with cervical dilatation of 4 cm delivered within 48 h despite medication. The peripheral plasma levels of 15-keto-13,14-dihydroprostaglandin F2alpha (KH2 PG2alpha) was high on admission (216 +/- i4 pg/ml, mean +/- SEM), declined by 50% within 2 h of instituting treatment and remained near the normal level seen in 13 controlled women after the 24th hour.
Adult↗
Perinatal events in the Dunedin City population 1967-1973.
The incidence of an array of maternal, obstetric and neonatal events occurring in the Dunedin City population in the six years from 1 August 1967 is presented. This population was not truly representative of the total New Zealand population. The total births in Dunedin City were 10,091 and the perinatal mortality was 17.5 per 1000 total births. Some of the pertinent findings were: 8.8 percent of the mothers were either not married or were not living with their husbands; 36.5 percent were primigravida; 13.2 percent of mothers were less than 20 years of age; 9.6 percent of mothers had an adverse past obstetric history; 11.5 percent had a diastolic blood pressure in excess of 90mmHg during the pregnancy; 5.0 percent had an antepartum haemorrhage of which 45.4 percent occurred in the first trimester; 6.5 percent of newborns were non-European; 2.0 percent were multiple births; 0.8 percent had a single umbilical artery; in 27.4 percent the delivery was not spontaneous; 6.2 percent had a low birth weight; 4.0 percent were born preterm; 5.2 percent of newborns experience neonatal complications; 2.1 percent had a major, and 6.4 percent a minor congenital fault.
Birth Weight↗