Cell‑free fetal DNA at 11‑13 weeks of gestation is not altered in complicated pregnancies

Non-invasive maternal cell-free fetal DNA (cffDNA) is a promising biomarker for screening common genetic syndromes. Alterations in the expression levels of cffDNA in the maternal circulation have been demonstrated in abnormal pregnancies. However, the results are conflicting. The present study aimed to investigate whether cffDNA levels are associated with pregnancy complications. The study group comprised pregnant women who presented with pregnancy complications, such as preterm birth, gestational hypertension, intrauterine growth retardation, gestational diabetes, polyhydramnios, oligohydramnios, vaginal bleeding and placental abruption. The control group comprised women who had a normal pregnancy course. Blood samples were obtained from 500 pregnant women between 11-13 weeks of gestation. cffDNA was amplified, sequenced and analyzed using the next-generation aneuploidy test of a Panorama-Natera kit. Nuchal translucency (NT) thickness as well as pregnancy associated plasma protein-A (PAPP-A) and β-human chorionic gonadotropin (β-hCG) levels were also assessed. Statistical analysis was performed in 494 out of the 500 samples collected with SPSS v.26 using non-parametric methods. The parameters were normalized by the multiples of median (MoM) method. The expression levels of PAPP-A, β-hCG, and the NT mean MoM values were significantly different between the study and control groups (P=0.005, P<0.001 and P=0.007, respectively). However, the expression levels of cffDNA and the mean MoM values were not significantly different between these two groups (P=0.687). The findings of the present study support the conclusion that cffDNA expression is not altered in a series of pregnancy complications. The prognostic value of cffDNA in predicting adverse pregnancy outcomes requires further investigation.

Risk factors for placental abruption

Our case-control study, aiming at identifying the risk factors for placental abruption (PA), looked at variables including maternal age, daily transportation means, folic acid consumption, smoking, past-history of infertility, number of antenatal visits done, presence of pre-eclampsia and umbilical cord insertion. Significant risk factors for PA were frequent transportation by motorbikes, consumption of haematinic preparation not containing folic acid, passive smoking, past-history of infertility, pre-eclampsia and marginal cord insertion. Pregnant women should be counselled about the above-mentioned risk factors.

Pre-eclampsia in a Sub-Saharan African country and maternal-perinatal outcome

Our comparative cohort study, carried out between 3^rd January and 30^th April 2020, looked at the maternal and perinatal outcomes associated with pre-eclampsia. Of 2019 booked pregnant women, 141 (7.0%) had pre-eclampsia, and 59.8% of these were severe at admission. Significant adverse maternal outcomes were eclampsia, HELLP (haemolysis, elevated liver enzymes, and low platelets) syndrome, and placental abruption, and significant adverse perinatal outcomes were intra-uterine fetal death, preterm delivery, low birth weight (LBW), neonatal asphyxia and early neonatal death. Close attention needs to be given to women with pre-eclampsia in poor resource circumstances.

A pregnant woman with a history of SLE with PPROM and severe thrombocytopenia: A case study

This study discusses the management of a pregnant woman with PPROM and a history of lupus. She was found to be severely thrombocytopenic which was unresponsive to prednisolone. During cesarean section, placental abruption was found and postpartum hemorrhage ensued.

Crack abuse during pregnancy: maternal, fetal and neonatal complication

OBJECTIVE

The aim of this study was to assess the effects of crack on pregnancy outcomes.

METHODS

We studied 88 crack user pregnant women in this study. These women were matched to a drug-free group (n = 90) chosen from the population of the same hospital. Maternal outcomes including preeclampsia, placenta abruption, gestational diabetes and preterm labor, and neonatal complication including low birth weight and low Apgar score in 5 min were compared in crack using and drug-free groups. Data were analyzed by SPSS software. Chi-square test and Student's t-test and Relative Risks (RRs) were used in this study.

RESULTS

The results of our study showed that crack abuse during pregnancy was associated with higher rate of preeclampsia p = 0.003 (RR, 1.731; 95% CI, 1.777-2.545), placental abruption p = 0.001 (RR, 2.439; 95% CI, 1.369-4.343), preterm labor p < 0.000 (RR, 3.249; 95% CI, 2.053-5.141) and low birth weight p < 0.000 (RR, 2.179; 95% CI, 1.462-3.247).

CONCLUSIONS

Crack abuse had significant influence on pregnancy outcomes. Crack appears to influence the prevalence of low birth weight, preterm labor, preeclampsia and placental abruption.