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.

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 studys 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 newborns 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.

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 evaluating a new tool to predict the risk of postpartum hemorrhage PPH, a serious complication during and after childbirth. The study compares the current basic risk assessment method with an advanced model that uses 21 factors to calculate a more precise risk. This model updates automatically during labor and provides clinicians with a Best Practice Advisory BPA suggesting recommended actions when risk is elevated. Participants will receive standard care, including the usual category-based risk assessment. Those in the intervention group will also have the new risk prediction displayed, which triggers the BPA if the risk is 3% or higher. This advisory includes recommendations such as preventative use of tranexamic acid and second-line uterotonics, guiding providers without requiring mandatory actions. The study aims to see if this enhanced approach improves outcomes for mothers during childbirth. Throughout the study, researchers will collect data on postpartum morbidity and mortality from delivery until hospital discharge and up to 30 days after birth. They will monitor estimated blood loss, treatments for hemorrhage, blood transfusions, complications, and fetal APGAR scores at 1, 5, and 10 minutes. The total participation duration typically covers delivery through 30 days postpartum, focusing on the safety and health of both mother and baby.

Pregnant women with aplastic anemia AA, a rare blood disorder causing bone marrow failure and low blood counts, face serious risks including heavy bleeding, infections, and complications for their babies like preterm birth and restricted growth. This research aims to develop and validate a tool to predict adverse pregnancy outcomes in women with AA, helping guide early clinical decisions and improve health for mothers and infants. The study combines retrospective and prospective data collection across multiple centers to address the current lack of comprehensive data in this area. The study involves observing pregnant women diagnosed with AA either before or during their pregnancy. Researchers will gather baseline information and diagnostic data, then follow participants regularly through questionnaires, phone calls, video consultations, online platforms, and in-person visits. They will record treatments, other health conditions, and pregnancy outcomes, aiming to build a prediction model for adverse outcomes. Participants will be monitored from their first hospital visit during pregnancy until 42 days after delivery. Data collected includes clinical assessments and neonatal Apgar scores shortly after birth. The study will provide detailed information on the health and risks for mothers and babies affected by AA during pregnancy, helping improve care strategies. The total participation duration varies depending on the timing of enrollment and delivery.

Researchers are studying how serum kisspeptin levels change throughout pregnancy in women with polycystic ovary syndrome PCOS. This study aims to understand the relationship between kisspeptin, insulin, glucose, and testosterone levels, and to explore whether kisspeptin can predict gestational diabetes mellitus GDM and other pregnancy complications in PCOS patients. The study is observational and focuses on pregnancies affected by PCOS using the 2003 Rotterdam diagnostic criteria. The study includes two groups pregnant women aged 18 to 40 diagnosed with PCOS before pregnancy, and healthy pregnant women in the same age range without PCOS. Participants will be registered for prenatal check-ups during the first trimester. This is an observational study, so no specific treatments or interventions will be given. Researchers will monitor kisspeptin and related hormone levels at different stages of pregnancy. Participants will be followed throughout pregnancy, with assessments to measure dynamic changes in serum kisspeptin over 40 weeks. The study will also evaluate how kisspeptin levels relate to the development of GDM and insulin resistance. Participants will undergo regular check-ups, laboratory tests, and hormone measurements. The study will help understand hormonal changes in PCOS pregnancies and their potential impact on complications, with a total participation time covering the full pregnancy period.