Objectives This study aimed to investigate whether physiologic variation in cephalic index during routine second-trimester neurosonography influences corpus callosum (CC) and cavum septum pellucidum (CSP) measurements. Methods In this retrospective cross-sectional study, prospectively collected ultrasound data from singleton fetuses at 19-24 weeks of gestation from 2023 to 2025 were analyzed. A total of 1,701 structurally normal fetuses were included and categorized into lower, intermediate, and higher CI groups reflecting physiologic variation in fetal head shape. CC length and CSP width were measured using standardized techniques. Associations between CI and measurements were evaluated using multivariable linear regression adjusted for gestational age. Results CC length did not differ significantly across CI groups (p=0.075), whereas CSP width showed a statistically significant but small difference (p=0.031). Gestational age was strongly associated with both CC length (beta=0.842, p<0.001) and CSP width (beta=0.448, p<0.001). CI demonstrated a modest independent association with CC (beta=0.029, p=0.025) and CSP (beta=0.092, p<0.001), with limited clinical relevance. Conclusions Although small associations between CI and midline measurements were identified, gestational age remained the predominant determinant of CC and CSP size. These findings suggest that fetal head-shape variation during the mid-trimester period is unlikely to substantially affect routine clinical interpretation.
Objectives Umbilical venous Doppler and umbilical vein blood flow assessment complement arterial Doppler indices by reflecting placental-fetal hemodynamics, venous return, and fetal cardiovascular adaptation. Despite decades of research on fetal venous Doppler, its scientific evolution and the position of umbilical vein blood flow within the field remain insufficiently mapped. This study evaluated global research trends in fetal venous Doppler, emphasizing umbilical venous Doppler and umbilical vein blood flow.Methods A bibliometric and visualization analysis was conducted using the Web of Science Core Collection. English-language articles and reviews published between 1980 and 2025 were included. Data were analyzed using bibliometrix and Biblioshiny. Publication trends, citation patterns, leading contributors, collaboration networks, Bradford's Law, keyword co-occurrence, thematic structure, and temporal topic changes were examined.Results The final dataset included 787 documents from 230 sources, involving 2,692 authors and 12,887 cited references. Scientific output increased steadily, with an annual growth rate of 7.93 %. Ultrasound in Obstetrics & Gynecology was the leading journal, while the United States was the most productive country. Keyword, thematic, and trend analyses identified ductus venosus, umbilical vein, Doppler ultrasound, fetal growth restriction, placental function, perinatal outcome, and fetal hemodynamic adaptation as central themes, with recent trends indicating growing interest in quantitative umbilical vein flow assessment.Conclusions Fetal venous Doppler research has expanded steadily over four decades. The increasing focus on umbilical vein blood flow highlights the need for standardized measurement techniques, gestational age-specific reference ranges, reproducibility, and outcome-based validation to clarify its independent clinical value in high-risk pregnancies.
Objectives To characterize postpartum maternal morbidity in women with sickle cell disease (SCD) and explore whether antepartum disease burden, transfusion exposure, and peripartum clinical factors were associated with postpartum maternal and breastfeeding outcomes.Methods We conducted a retrospective cohort study of 37 deliveries in patients with confirmed SCD at a large urban academic center (2015-2025). Maternal, neonatal, transfusion, and breastfeeding outcomes were abstracted from the electronic medical record.Results Thirty-seven deliveries met inclusion criteria. The predominant genotype was HbSS (24/37, 64.9 %), followed by HbSC (7/37), HbS beta 0-thalassemia (3/37), HbS beta+-thalassemia (2/37), and HbS/HPFH (1/37). More than one-third of deliveries (13/37, 35.1 %) required transfusion within the first postpartum week. Postpartum hemorrhage >= 1,000 mL occurred in 5 of 37 deliveries (13.5 %), and 5 of 36 (13.9 %) required readmission within 6 weeks postpartum, most commonly for vaso-occlusive crisis. NICU admission occurred in 14 of 37 neonates (37.8 %). Breastfeeding intention was high (32/33, 97 %); persistence declined to 23 of 33 (69.7 %) at 6 weeks and 12 of 34 (35.3 %) at approximately 6 months. Exploratory analyses suggested lower breastfeeding persistence among deliveries complicated by NICU admission and among those with greater antepartum clinical burden, including pregnancy transfusion, lower admission hemoglobin, and hospitalization during pregnancy.Conclusions The postpartum period in women with SCD is characterized by persistent hematologic morbidity, ongoing transfusion requirements, and declining breastfeeding persistence. Greater antepartum disease burden and neonatal complications may identify pregnancies at higher risk for adverse postpartum outcomes, supporting integrated hematology-obstetric care extending into the postpartum period.
This commentary addresses the need for trauma-informed screening and coordinated mental health care across obstetric (OB) and neonatal intensive care unit (NICU) settings. Perinatal post-traumatic stress disorder (PTSD) and related mental health conditions are common yet under-recognized, particularly among individuals exposed to medical trauma, prior adversity, or interpersonal violence. Perinatal PTSD prevalence estimates range from 3-6 % in community samples and 15-25 % in high-risk populations, including NICU parents, individuals with obstetric complications, and those with prior trauma histories. Infants hospitalized in NICUs experience their own forms of trauma related to pain, sensory overload, and caregiver separation, while parents are critical buffers of infant stress but may be unable to provide effective co-regulation when they are themselves traumatized. Guided by the Substance Abuse and Mental Health Services Administration (SAMHSA) trauma-informed framework, this commentary synthesizes current evidence on screening, perinatal PTSD risk factors, intergenerational trauma, and Collaborative Care models. The author describes how integrated mental health services can be operationalized across care environments and issue a call to action for universal screening, universal education about healthy and unsafe relationship dynamics, coordinated treatment pathways, and equity-focused implementation strategies to protect infant neurodevelopment and interrupt intergenerational cycles of trauma.
