Pregnancy Complication

Spinal anesthesia-induced hypotension is a common and significant complication affecting up to 50-80% of pregnant women undergoing elective cesarean section. This trial evaluates whether a brief 5-minute mindfulness-based breathing exercise given just before spinal anesthesia can influence blood pressure changes during surgery. The study compares this breathing technique to standard care in pregnant women aged 18 to 45 years scheduled for elective cesarean delivery. Participants will be randomly assigned to either perform the mindfulness-based breathing exercise or receive standard preoperative care. The breathing exercise involves slow diaphragmatic breathing at about six breaths per minute, guided by a trained anesthesiologist or nurse, with mindful repetition of the phrase "My body is relaxing as I exhale." Both groups receive spinal anesthesia with specific medications, and careful monitoring of heart rate and blood pressure is performed. During the study, participants will be closely observed for changes in systolic blood pressure and heart rate within 10 minutes after spinal anesthesia. Anxiety levels, incidence of early hypotension, and medication use to support blood pressure will also be measured. The trial includes standard monitoring such as ECG and oxygen saturation, with safety and response data collected throughout the procedure. Participants' involvement includes a short breathing exercise or equivalent wait time before anesthesia, with follow-up assessments during surgery.

Researchers are evaluating how well symphysis fundal height (SFH) measurements alone compare to SFH combined with point of care ultrasound (POC-US) measuring fetal abdominal circumference (AC) for detecting small or large for gestational age infants among low-risk pregnant women after 35 weeks' gestation. The study aims to improve prenatal identification of abnormal fetal growth, which is linked to risks for mother and baby. This open-label, randomized trial is investigator-sponsored and focuses on low-risk pregnancies managed by midwives. Participants are randomly assigned to one of two groups: one group will have fetal growth monitored using SFH measurements alone, while the other will have SFH plus POC-US to measure fetal AC and assess amniotic fluid volume. Measurements occur at scheduled antenatal visits at 35-38, 40, 41, and beyond 41 weeks' gestation. If screening suggests abnormal growth or amniotic fluid levels, a formal obstetric ultrasound by a specialist will be performed. All women will have POC-US at 41 and 41+ weeks to check amniotic fluid, regardless of group. During the study, midwives will review medical histories, conduct physical measurements, and perform ultrasound assessments following the assigned method. Researchers will compare prenatal screening results to actual birth weights to identify small or large infants. They will also track the number of formal ultrasounds requested, cases of abnormal amniotic fluid, and maternal and neonatal outcomes. Participation lasts from enrollment at 35-38 weeks through delivery and initial postnatal assessment, about one year on average.

This research aims to compare the effectiveness of monitoring blood sugar levels at 1 hour versus 2 hours after meals in pregnant women diagnosed with Gestational Diabetes Mellitus who require treatment. The study focuses on understanding which monitoring time better supports managing blood sugar during pregnancy to improve outcomes for both mother and baby. Participants are pregnant women attending an antenatal clinic and are treated with metformin, insulin, or a combination. Participants will be randomly assigned to monitor their blood sugar either 1 hour or 2 hours after meals using self-monitoring of capillary blood glucose. Their blood sugar is tracked at seven staggered points to provide a detailed profile. This monitoring continues until delivery, with participants followed regularly in the research clinic. Throughout the study, women will have regular visits to assess their health and that of their baby. Researchers will collect data on mode of delivery, gestational age at birth, and fetal weight. They will also monitor maternal and perinatal complications from randomization to delivery. The total participation lasts from enrollment until the birth of the baby, allowing detailed observation of pregnancy outcomes related to the glucose monitoring method.

Placenta accreta spectrum disorders (PASD) include abnormal implantation of the placenta into the uterine wall, such as placenta accreta, increta, and percreta. This condition is a significant obstetric concern, and current antenatal diagnostic methods do not provide complete certainty in diagnosis. This study aims to compare two common ultrasound methods, 3D ultrasound and 2D ultrasound with color Doppler, to assess their effectiveness in diagnosing placenta accreta spectrum. The study evaluates 3D ultrasound using placental volume measurements and vascular indices including vascularization index, flow index, and vascularization flow index. The 2D ultrasound assessment includes examining placental invasion criteria such as lacunar vascular flow, abnormal utero-placental interface, myometrial thinning, absence of retroplacental myometrium, interruptions at the utero-vesical interface, and lower uterine segment hypervascularity. These two diagnostic approaches are observed and compared during the study period. Participants will be pregnant women diagnosed with placenta previa and will undergo ultrasound examinations using both 3D and 2D methods. The primary outcome measure is the vascular index assessed at 1 month. Secondary outcomes include evaluation of 2D ultrasound parameters at the same time point. This observational study involves ultrasound imaging to monitor placental characteristics and blood flow, aiming to improve antenatal diagnosis of placenta accreta spectrum disorders.

This research aims to evaluate the feasibility of using pembrolizumab, an immunotherapy drug, before surgery in patients with post-molar gestational trophoblastic neoplasia (GTN), a rare pregnancy-related condition involving abnormal growth of placental cells. The study focuses on patients with low-risk, recurrent GTN who have not responded fully to initial surgical treatment. By exploring pembrolizumab as a less toxic alternative to chemotherapy, the trial hopes to find safer treatment options for these patients. Participants will be randomly assigned to one of two groups: one group will receive a second surgical removal alone, while the other will receive a single intravenous dose of pembrolizumab followed by surgery. Twenty patients in total will be recruited and evenly divided between these two groups. The study will take place at a single hospital and will include follow-up monitoring for one year after surgery. During the study, participants will undergo assessments including blood tests to measure hormone levels, imaging tests such as chest X-rays to check for disease spread, and evaluations of overall health and organ function. The main goal is to determine if delivering pembrolizumab before surgery is practical and acceptable. Researchers will also monitor the safety of this approach and compare the rates of surgical cure between the two groups. Participants' health will be tracked for up to one year following treatment.

Researchers are conducting a nationwide observational study in China to create a detailed group of patients diagnosed with hydatidiform mole, a type of molar pregnancy. The study's main focus is to understand how often these moles become cancerous and to explore the mechanisms behind this transformation. The goal is to improve and spread precise diagnosis and treatment methods for this condition across the country. This study involves closely monitoring patients without providing any additional treatment, supporting the development of evidence-based care strategies for molar pregnancy. Patients will have their beta-hCG hormone levels checked regularly after uterine evacuation to watch for signs of malignant changes. Those with partial hydatidiform mole can stop follow-up once hormone levels normalize, while patients with complete hydatidiform mole will be monitored monthly for six months due to a higher risk of progression. Participants will undergo regular clinical and pathological evaluations, including hormone monitoring every 1-2 weeks post-surgery. Researchers will also assess fertility outcomes at one and two years and measure psychological well-being using anxiety, depression, and reproductive concern scales three months after uterine evacuation. Follow-up will continue for at least six months to track any malignant changes, with the total study duration extending up to several years depending on individual patient progress.

Researchers are studying pregnant women to understand how microbiome, proteomics, and serum markers might help predict preeclampsia, a condition that can affect pregnancy. This multicenter, prospective cohort study also aims to explore how these biological markers relate to pregnancy outcomes such as complications during pregnancy, delivery, and the newborn's health. The study is conducted by Zhujiang Hospital and focuses on maternal and infant microecology in China. Pregnant women who come to the hospital before 14 weeks of gestation are invited to participate. After consenting, they will complete a questionnaire and provide samples including urine, serum, saliva, vaginal swabs, and feces at several points during pregnancy: 11-14 weeks, 22-28 weeks, 32-34 weeks, and at delivery. If possible, placenta, cord blood, and amniotic fluid will also be collected at delivery. Women with preeclampsia during pregnancy will be followed up with similar sampling up to two years after their child is born. Participants will be monitored through various laboratory assessments including 16S rRNA gene sequencing for microbiome analysis and advanced techniques like MALDI-TOF peptidomics and mass spectrometry metabonomics. The study will also evaluate patient-specific risk of preeclampsia using clinical measurements such as mean arterial pressure and serum placental growth factor. Follow-up visits after delivery will occur at 6 weeks, 6 months, 1 year, and 2 years to continue monitoring maternal and infant health. The primary outcomes include microbiome, proteomics, and metabonomics data collected over 34 months, with secondary outcomes assessed over 10 months.

Preeclampsia (PE) is a serious condition affecting 3-8% of pregnancies and is a leading cause of illness and death for mothers and babies. It involves high blood pressure and organ damage or growth problems in the fetus. There are two main types: placental PE, linked to problems with the placenta and early pregnancy complications, and metabolic PE, related to maternal metabolic issues like obesity and inflammation. Recent research suggests that changes in the mother's gut bacteria may influence the immune system and play a role in PE development. This study aims to better understand the gut microbiota differences in these two PE types to improve prediction and prevention. The study observes pregnant women from 11 to 13 weeks gestation who are either at high risk or low risk for developing PE based on early screening. Participants include women over 18 with a single pregnancy and a live fetus. Researchers will monitor maternal gut microbiota, metabolic markers, and immune system characteristics during the first trimester without providing any treatments. The study includes a control group of low-risk pregnancies followed throughout pregnancy to compare with the high-risk group. Participants will undergo assessments including gut microbiota analysis, metabolic profiling, and immune function tests during early pregnancy. Researchers will track outcomes related to PE development and fetal growth restriction, aiming to identify biomarkers that could help predict PE types. The study lasts about one year per participant, with data collected during pregnancy and after delivery. This observational study does not involve treatment but focuses on collecting detailed biological and clinical information to improve understanding of PE.

Researchers are exploring how giving pregnant individuals a choice among different nutrition and exercise programs affects their ability to stick to the program and maintain healthy pregnancy outcomes. The study focuses on preventing excessive gestational weight gain by comparing adherence to three lifestyle intervention strategies within the Nutrition and Exercise Lifestyle Intervention Program (NELIP). This research uses a pseudo-randomized design to examine if choice improves participation compared to no choice in pregnant individuals between 12 and 18 weeks of pregnancy with a single fetus. Participants are divided into two groups: one group chooses from three intervention strategies and the other group is matched to a choice participant and receives the same strategy without choice. The three strategies vary in timing of introducing nutrition and exercise components; either both simultaneously starting at 12-18 weeks, or nutrition first followed by exercise at 25 weeks, or exercise first followed by nutrition at 25 weeks. The exercise involves a supervised walking program with gradually increasing duration, and nutrition is based on a modified gestational diabetic meal plan tailored per participant. The full program continues until delivery, with final intervention measures between 34 and 36 weeks gestation. Participants will be monitored weekly for adherence using a point system, with additional assessments of satisfaction and health outcomes like weight gain, birth measurements, and pregnancy complications. Follow-up visits occur at birth and at 2, 6, and 12 months postpartum to track maternal and infant health. The study collects detailed data on nutrition, exercise, and pregnancy progress to understand how choice impacts adherence and outcomes over this extended timeline.

Researchers are studying postpartum hemorrhage (PPH), a serious complication during and after childbirth that can cause significant health problems for mothers. This trial aims to improve how the risk of PPH is predicted using a new computer model that considers 21 factors and updates automatically during labor. The study compares this new model combined with a provider-facing alert system to current basic risk tools, with the hope of improving outcomes for mothers. The study includes two groups: one receives the usual care with a traditional category-based risk assessment, and the other group receives standard care plus the new risk prediction model. If the new model predicts a risk of 3% or higher, it triggers an alert recommending best practice steps like preventive medications. Providers can decide whether to follow these recommendations. Both groups receive standard care risk assessments as part of their admission process. Participants are all women admitted for vaginal or cesarean delivery at the medical center. Researchers will collect and compare data on a range of health outcomes related to bleeding and complications from the time of delivery until 30 days later. They will use hospital records to measure blood loss, treatments given, length of stay, and other health events. The study aims to see if the new model and alerts lead to better health outcomes for mothers during and after childbirth.