Preeclampsia (PE) complicated by fetal growth restriction (FGR) is associated with high pediatric morbidity and mortality. The current predictive model mainly focus on using ultrasound or serum biomarkers that is relative high testing cost and a lack of technical accessibility in low-income countries. Our study aimed to investigate whether the occurrence of FGR in patients with PE could be predicted using results from low-cost complete blood count (CBC) tests at 20–24 weeks of gestation. In this retrospective study, we reviewed all cases of patients with PE who received routine prenatal care and delivered at our hospital from April 2019 to April 2022. Patients diagnosed with PE were paired with healthy pregnant women using 1:1 matching on the basis of similar age, parity, and pregestational body mass index (BMI). Routine peripheral blood cell results between 20 and 24 weeks of gestation were collected and analyzed using logistic regression to identify independent risk factors in the normotensive pregnancy, the PE with FGR and the PE with normal birth weight (NBW) groups. A nomogram was subsequently developed to quantify the risk of FGR in patients with PE. Finally, we assessed the model’s predictive performance. A total of 392 patients with PE were included, consisting of 66 patients with FGR, 326 with NBW, and 392 with normotensive pregnancies. The nomogram included three independent risk factors: a lymphocyte count ≥ 2.05 × 109/L, a neutrophil-to-lymphocyte ratio (NLR) ≤ 4.04, and a platelet-to-lymphocyte ratio (PLR) ≤ 93.51. The diagnostic performance of the nomogram was moderate, with an area under the curve (AUC) of 0.72, a specificity of 80.1

Pre-existing anti-polyethylene glycol (PEG) antibodies represent risk factors for reduced efficacy and increased adverse reactions in seropositive individuals, but neither the seropositivities, nor levels nor influencing factors have been investigated in pregnant women or newborns. Herein, maternal and cord blood samples were respectively collected from 256 pregnant women and corresponding 256 newborns at the Women's Hospital, Zhejiang University School of Medicine in China for further determination of pre-existing anti-PEG antibodies, along with questionnaire interviews, demographic and clinical data collections. Our data showed that the seropositivities of total anti-PEG antibodies, anti-PEG IgG1 and IgG2, anti-PEG IgM, and coexistence of anti-PEG IgM and IgG were 19.14%, 2.34%, 7.03%, 10.94% and 1.17%, respectively, in pregnant women, and 5.47%, 2.73%, 2.73%, 0% and 0%, respectively, in newborns. Anti-PEG IgG3, IgG4 and IgE were undetectable in all blood samples. Median anti-PEG IgG1, IgG2 and IgM concentrations were 273.88 ng/mL, 748.35 ng/mL and 175.07 ng/mL, respectively, in pregnant women. Median anti-PEG IgG1 and IgG2 concentrations were 207.92 ng/mL and 336.52 ng/mL, respectively, in newborns. Interestingly, in-depth statistical analyses revealed that maternal age, take-out food consumption and cosmetic use were influencing factors of maternal anti-PEG antibodies, while newborn anti-PEG antibodies were affected by maternal age and cosmetic use. These seroepidemiological characteristics raise concerns over the clinical use of PEGylated drugs in pregnant women and newborns, and provide valuable insight into the induction of risky pre-existing anti-PEG antibodies.

Placental growth factor (PLGF) dynamics exhibit significant variations between singleton and twin pregnancies, necessitating distinct clinical reference intervals. This large study established and validated trimester-specific reference intervals (RIs) for maternal PLGF levels in 16,877 singleton and 940 twin pregnancies, with subsequent evaluation of their predictive accuracy for pregnancy complications. Key findings revealed that twin pregnancies demonstrated elevated median PLGF concentrations compared to singletons from 1st (≤13 weeks) through 2nd-late (22-27 weeks), followed by a reversal of this trend in the 3rd-early (28-32 weeks) with significantly lower PLGF levels persisting until delivery. Chorionicity did not influence PLGF levels in twins (p > 0.05). Using the 2.5th-97.5th percentile ranges, gestational age-specific RIs were defined for both cohorts. In validation cohorts comprising pregnancies complicated by preeclampsia (PE), fetal growth restriction (FGR), placental abruption (PA), or postpartum hemorrhage (PPH), PLGF thresholds were stratified relative to lower reference limits (LRLs). PLGF concentrations below 80%, 100%, and 120% of LRLs were strongly associated with elevated risks for all studied complications. Adjusted logistic regression models demonstrated a dose-dependent relationship, with adjusted odds ratios (aOR) escalating inversely to PLGF thresholds: aOR = 3.2 (95% CI: 2.5-4.1) at 120% LRL, increasing to aOR = 8.7 (95% CI: 6.3-12.0) at 80% LRL. These findings confirm that trimester-specific PLGF RIs effectively stratify pregnancy risks, with sub-LRL values serving as independent predictors of adverse outcomes. This established RIs enhance obstetric risk assessment frameworks, supporting PLGF integration as a complementary biomarker for targeted monitoring and early intervention in both singleton and twin pregnancies.

Background: Cysteine sulfinate decarboxylase (CSAD) has been implicated in cancer progression based on recent studies, yet its specific role in type I endometrial carcinoma (EC), the most prevalent subtype of endometrial cancer, remains poorly understood. Notably, the incidence of type I EC has been on the rise, and patient prognosis is significantly influenced by the stage of the disease at diagnosis as well as other clinicopathological parameters. Methods: The study involved 350 endometrium lesion patients at Zhejiang University's Women's Hospital. Immunochemical staining was performed on samples of normal endometrium (NE), atypical endometrial hyperplasia (AEH), and type I EC. The study evaluated the association of CSAD staining with clinical characteristics and patient survival. Results: CSAD expression in type I EC was elevated in comparison with NE, and increased expression correlates with Federation of Gynecology and Obstetrics (FIGO) stages, Lymph vascular space invasion (LVSI), and Lymph node metastasis (LNM). High CSAD levels are associated with poor disease-free survival and overall survival. Small interfering RNAs (siRNAs) can decrease CSAD expression, inhibit cancer cell proliferation, and affect B-cell lymphoma-2 (BCL-2) and BCL2-Associated X (BAX) protein expression. Conclusions: Our research indicates that higher levels of CSAD expression in type I EC was significantly associated with some clinical variables indicating poor prognosis and survival rate in patients with type I EC. patients and could promote cancer cell growth by affecting cell apoptosis rate.

Congenital heart defects(CHDs)are among the most common congenital mal-formations in humans,yet only about 15％of cases can be traced to a clear ge-netic defect,posing challenges for effec-tive clinical management[1-3].Recent studies indicate that the internal human exposure levels of fluorene-9-bisphenol(BHPF)can induce significant cardiac developmental defects in animal mod-els[4],and BHPF has been detected in various environmental media and human tissues[5,6].Recognizing the implica-tions of these findings,we undertook a clinical case-control study to investigate whether BHPF is associated with CHDs.From June 2024 to January 2025,21 943 pregnant individuals underwent prenatal examinations at the Women's Hospital,School of Medicine,Zhejiang University in Hangzhou,China.Among the fetuses of these pregnant women,191 cases were diagnosed with CHDs,which included 20 cases of cardiac structural abnormali-ties,1 case of cardiac rhythm abnormal-ities,and 170 cases of CHDs were ex-cluded(including 46 cases who did not deliver in our hospital,23 twin pregnan-cies with fetal cardiac anomalies,8 with autoimmune diseases,25 with chromo-somal anomalies,46 without chromoso-mal testing and 22 who did not wish to be enrolled).Finally,21 valid CHD cases were catalogued as the CHD group,including 8 cases of ventricular septal defect,2 cases of tetralogy of Fallot,2 cases of Ebstein's anomaly,2 cases of persistent truncus arteriosus,2 cases of complete transposition of the great arter-ies,1 case of hypoplastic left heart syn-drome,1 case of double outlet right ven-tricle,1 case of complete atrioventricu-lar septal defect,1 case of pulmonary valve stenosis and 1 case of paroxysmal supraventricular tachycardia.

Early-onset pre-eclampsia (PE), which delivered before 34 weeks of gestation, is associated with high maternal and pediatric morbidity and mortality. Several studies have examined predictive factors and models to identify individuals at risk for early-onset pre-eclampsia. However, implementing these methods often requires additional tests and increases the financial burden on pregnant women. Our study aimed to determine if early-onset PE development could be predicted using a simple, convenient, and easily accessible test: the peripheral blood count. In this study, we conducted a review of pregnant women who received routine prenatal visit and delivered in our hospital from April 2019 to April 2022. For each patient with PE, we matched them 1:1 with healthy pregnant women who were similar in terms of age, parity, and pre-gestational BMI. We gathered routine peripheral blood cell results between 12 and 18 weeks of gestation and utilized multivariate logistic regression to determine independent risk factors. Subsequently, a nomogram was created to forecast the likelihood of early-onset pre-eclampsia. Lastly, we assessed the model’s predictive performance. In our study, a total of 254 patients with PE were included, comprising of 41 patients with early-onset PE and 213 patients with late-onset PE, as well as 254 cases of normotensive pregnancy. The nomogram included four risk factors: mean corpuscular hemoglobin concentration (MCHC) ≥ 340.50 g/l, neutrophil-to-lymphocyte ratio (NLR) ≤ 4.40, platelet-to-lymphocyte ratio (PLR) ≤ 118.01, and platelet-to-mean platelet volume (PC/MPV) ≤ 17.81. Notably, the nomogram exhibited good diagnostic performance with an area under the curve (AUC) of 0.874, sensitivity of 95.1

To retrospectively analyze the preoperative and intraoperative influencing factors in predicting the escalation of surgical pathological staging in patients with clinical stage I endometrioid carcinoma. Patients with clinical stage I endometrioid carcinoma at Women's Hospital, School of Medicine, Zhejiang University, between January 2002 and December 2015 were enrolled in this study. Due to preoperative or intraoperative surgical exploration, the patients with one or more preoperative or intraoperative high-risk factors underwent total hysterectomy, bilateral salpingo-oophorectomy and lymphadenectomy, totaling 535 cases. The preoperative and intraoperative influencing factors that could lead to the escalation of postoperative surgical pathological staging were further analyzed. 1. There were 535 patients diagnosed with clinical stage I endometrioid carcinoma before surgery, 125 patients were upgraded with postoperative pathological staging, for a rate of 23.36%. 2. Kaplan-Meier survival curve analysis showed that the prognosis in postoperative surgical pathological staging upgraded cases was worse than that in nonupgraded cases. The tumor-free survival and overall survival rates in the 2 groups were significantly different (P < .001). 3. Univariate analysis showed that preoperative degree of myometrial infiltration, intraoperative visual myometrial infiltration depth, massive size of tumor (diameter ≥ 4 cm) and preoperative abnormal serum cancer antigen 125 (CA125) level were associated with the escalation of surgical pathological staging (P < .05). Multivariate analysis indicated that massive size of tumor and preoperative serum abnormal CA125 level were independent predictors of whether postoperative pathological staging would be upgraded (P < .05). 4. The receiver operating characteristic curve drawn with the massive size of tumor and/or the preoperative serum CA125 level abnormality could be used to predict the probability of postoperative pathological upstaging. The results showed that the area from the combination of the 2 factors under the receiver operating characteristic curve was 0.723 (95% confidence interval, 0.672-0.773), suggesting that the combination of massive size of tumor and abnormal preoperative serum CA125 level may serve as an influencing factor for predicting the postoperative pathological staging upgrades. The clinical stage I endometrioid carcinoma patients with massive size of tumor and abnormal preoperative serum CA125 level need to be fully evaluated to ensure appropriate management as soon as possible, since they are more likely to experience postoperative pathological staging upgrades.

A short cervix in mid-trimester pregnancy is a risk factor for spontaneous preterm birth. However, there is currently a lack of predictive models and classification systems for predicting spontaneous preterm birth in these patients, especially those without additional risk factors for spontaneous preterm birth. A retrospective observational cohort study of low-risk singleton pregnant women with a short cervix (≤ 25 mm) measured by transvaginal ultrasonography between 22 and 24 weeks was conducted. A multivariate logistic regression model for spontaneous preterm birth < 32 weeks in low-risk pregnant women with a short cervix was constructed. Moreover, we developed a nomogram to visualize the prediction model and stratified patients into three risk groups (low-, intermediate-, and high-risk groups) based on the total score obtained from the nomogram model. Between 2020 and 2022, 213 low-risk women with a short cervix in mid-trimester pregnancy were enrolled in the study. Univariate logistic analysis revealed that a high body mass index, a history of three or more miscarriages, multiparity, a short cervical length, leukocytosis, and an elevated C-reactive protein level were associated with spontaneous preterm birth < 32 weeks, but multivariate analysis revealed that multiparity (OR, 3.31; 95

The analysis of genomic variations in offspring after implantation has been infrequently studied. In this study, we aim to investigate the extent of de novo mutations in humans from developing fetus to birth. Using high-depth whole-genome sequencing, 443 parent-offspring trios were studied to compare the results of de novo mutations (DNMs) between different groups. The focus was on fetuses and newborns, with DNA samples obtained from the families' blood and the aspirated embryonic tissues subjected to deep sequencing. It was observed that the average number of total DNMs in the newborns group was 56.26 (54.17-58.35), which appeared to be lower than that the multifetal reduction group, which was 76.05 (69.70-82.40) (F = 2.42, P = 0.12). However, after adjusting for parental age and maternal pre-pregnancy body mass index (BMI), significant differences were found between the two groups. The analysis was further divided into single nucleotide variants (SNVs) and insertion/deletion of a small number of bases (indels), and it was discovered that the average number of de novo SNVs associated with the multifetal reduction group and the newborn group was 49.89 (45.59-54.20) and 51.09 (49.22-52.96), respectively. No significant differences were noted between the groups (F = 1.01, P = 0.32). However, a significant difference was observed for de novo indels, with a higher average number found in the multifetal reduction group compared to the newborn group (F = 194.17, P < 0.001). The average number of de novo indels among the multifetal reduction group and the newborn group was 26.26 (23.27-29.05) and 5.17 (4.82-5.52), respectively. To conclude, it has been observed that the quantity of de novo indels in the newborns experiences a significant decrease when compared to that in the aspirated embryonic tissues (7-9 weeks). This phenomenon is evident across all genomic regions, highlighting the adverse effects of de novo indels on the fetus and emphasizing the significance of embryonic implantation and intrauterine growth in human genetic selection mechanisms.

Background Strong and synchronized contractions that occur in the last stage of pregnancy are essential for onset of labor. In clinics, the lack of effective description of these characteristics results in inaccurate prediction of the onset of labor. The commonly used contraction monitoring device tocodynamometer (TOCO) detects contractions with relatively high specificity but is unable to quantify the strength and synchrony. The electrohysterography (EHG) quantifies the myoelectric activities that trigger contractions of muscle cells under the electrodes. Therefore, multiple channel EHG signals are well suited for characterizing the strength and synchrony of uterine contractions via their spatiotemporal pattern. Object: The purpose of this study was to provide quantitative descriptions of the contraction characteristics and to investigate their significance for predicting the spontaneous onset of labor in nulliparous women. Study Design: 100 pregnant women with a gestational age of more than 37 weeks were recruited for the study. Multichannel EHG and tocodynamometer recordings were performed simultaneously for 46 of them, both during pregnancy and during labor (defined a time to onset of labor (TTL) less than 24 h). Contractions were identified from the TOCO recordings, and then the frequency and duration of contractions were determined. The multichannel EHG segments under the identified contractile time windows were used to calculate the strength and level of synchrony. Statistical analyses were carried to demonstrate the difference of these variables between the pregnant and labor groups. Multivariate logistic regression was created to provide obstetricians with an assessment tool in predicting spontaneous onset of term labor. Results The frequency, duration, strength, and level of synchrony of uterine contractions for 46 pregnant women during their 37 weeks of gestation to the onset of labor were quantified. All constructed features in labor, with the exception of concordance correlation-based synchrony \(\:\psi\:\), showed statistically significant differences from those in pregnant phase, with degree of synchrony described by the sample entropy SamEn being the strongest feature for distinguishing pregnant and labor (0.5154 ± 0.1720 vs. 0.3555 ± 0.1422, \(\:p=0.00001\)). The multivariate logistic regression model constructed from these features showed high significance in identifying the onset of spontaneous labor in nulliparous women, with an AUC value of 0.80. Conclusion The contraction properties in terms of frequency, duration, strength, and level of synchrony have been quantitated. Continuous observations on 46 pregnant women throughout their pregnancy demonstrated statistically significant difference between contractions in pregnant and labor phase, which enabled a prediction model on spontaneous onset of labor in term nulliparous women.

OBJECTIVES:To compare the clinical characteristics of pregnant women with polycystic ovary syndrome (PCOS) and perinatal outcomes with or without preeclampsia (PE) and to factors that are potentially associated with the onset of PE.MATERIAL AND METHODS:This was a retrospective study of pregnant women diagnosed with PCOS from January 2017 to December 2021. Eligible patients were divided into two groups based on the presence or absence of preeclampsia: a PE group and a non-PE group. Demographics, clinical characteristics, maternal and perinatal outcomes, and potential factors linked to disease recurrence were analyzed.RESULTS:In total, 616 patients were enrolled and respectively classified into the PE group (n = 51) and the non-PE group (n = 565). The incidence of PE in pregnant women with PCOS was 8.28%; this was significantly higher than that in non-PCOS pregnant women (3.22%, p < 0.001). Logistic regression analysis of the predictive factors for PE in women with PCOS revealed that the combination of maternal hyperandrogenism, a pre-pregnancy BMI ≥ 24 kg/m², and a family history of cardiovascular disease (CVD) and assisted reproductive techniques (ART) exhibited the steepest receiver-operating characteristic (ROC) curve value at 0.797 [95% confidence interval (CI): 0.733-0.862].CONCLUSIONS:Patients with PCOS have a higher incidence of PE. We identified a series of significant and independent factors associated with PE in PCOS: maternal hyperandrogenism, a pre-pregnancy BMI ≥ 24 kg/m², and a family history of CVD and ART.

PurposeThis study aimed to explore the real experiences and needs of neonatal intensive care unit (NICU) preterm intergenerational caregivers for discharge preparation and provide a basis for nursing staff to formulate systemic and personalized health education plans and continuous nursing plans for preterm discharge.Design and methodsThis was a descriptive qualitative study. An objective sampling method was used to select 16 intergenerational caregivers of preterm infants admitted to the NICU of tertiary obstetrics and gynecology hospitals in Zhejiang and Jilin provinces from December 2023 to February 2024. Semi-structured interviews were conducted on the day of discharge of the preterm infants and six weeks after discharge. Colaizzi's seven-step analysis method was used to analyze the interview data.ResultsBased on the existence, relatedness, and growth (ERG) theory, the discharge preparation experiences and needs of neonatal intergenerational caregivers in the NICU were summarized into three themes: psychological condition, care capacity condition, and multi-party support needs.ConclusionsIn the process of hospital discharge preparation, intergenerational caregivers of premature infants in NICU have multiple needs, including enhancing nursing ability and obtaining psychological and multi-party support. It is helpful to take effective interventions to improve their readiness for discharge.Practice implicationsThe nursing staff should develop personalized discharge health education plans and continuous nursing plans to improve the level of discharge preparation.Patient or public contributionsThere were no patient or public contributions.

Background The fetal neurodevelopmental microstructural alterations of intrauterine exposure to preeclampsia (PE) or gestational hypertension (GH) remain unknown. Purpose To evaluate the differences in diffusion‐weighted imaging (DWI) of the fetal brain between normotensive pregnancies and PE/GH pregnancies, with a focus on PE/GH pregnancies with fetal growth restriction (FGR). Study Type Retrospective matched case–control study. Population 40 singleton pregnancies with PE/GH complicated by FGR, and 3 paired control groups (PE/GH without FGR, normotensive FGR, normotensive pregnancies) (28–38 gestational weeks). Field Strength/Sequence DWI with single‐shot echo‐planar imaging at 1.5 Tesla. Assessment The apparent diffusion coefficient (ADC) values were calculated in the centrum semi‐ovale (CSO), parietal white matter (PWM), frontal white matter (FWM), occipital white matter (OWM), temporal white matter (TWM), basal ganglia, thalamus (THAL), pons, and cerebellar hemisphere. Statistical Tests Student t test or Wilcoxon matched test was used to reveal the difference of ADC values among the investigated brain regions. A correlation between gestational age (GA) and ADC values was determined by linear regression analysis. Results Compared with fetuses in PE/GH without FGR and those with normotensive pregnancies, fetuses in the PE/GH with FGR group had significantly lower average ADC measurements of supratentorial regions (1.65 ± 0.09 vs. 1.71 ± 0.10 10 −3 mm 2 /sec; vs. 1.73 ± 0.11 10 −3 mm 2 /sec, respectively). Regions of significantly decreased ADC values in the fetal brain included CSO, FWM, PWM, OWM, TWM and THAL in cases of PE/GH with FGR. ADC values from supratentorial regions in PE/GH pregnancies were not significantly correlated with GA ( P = 0.12, 0.26); however, this trend was statistically significant in the normotensive groups. Data Conclusion ADC values may indicate fetal brain developmental alterations in PE/GH with FGR fetuses but more microscopic and morphological studies are necessary to provide additional evidence to offer a different interpretation of this trend in fetal brain. Level of Evidence 4 Technical Efficacy Stage 3

Background:Pregnancy luoteomas are tumor-like ovarian lesions that emerge during pregnancy and spontaneously regress after delivery. Antenatal diagnosis is infrequently reported, and unnecessary surgery appears to be common in literature reports. Case summary:A 28-year-old primigravida with bilateral adnexal masses was discovered at 32 + 5 weeks during prenatal ultrasound evaluation. Combined with clinical presentation, auxiliary examinations including blood test, magnetic resonance imaging, gastroscopy, and consultation of multi-disciplinary team, we successfully made a diagnosis of pregnancy luteoma and provided conservative management recommendations. A cesarean section was conducted on this patient at 34 + 2 weeks of gestation due to fetal distress. The newborn was small for gestational age but normal in appearance. We performed biopsies of the adnexal masses, which were confirmed to be pregnancy luteomas using both intraoperative frozen section and final pathological diagnosis. Serum testosterone, cancer antigen 125, and alpha-fetoprotein levels gradually declined and normalized on postoperative day 28. The masses significantly decreased in size as shown by ultrasonic and magnetic resonance imaging examination on postoperative day 7, with the ovaries returning to their normal size by postoperative day 30. Conclusion:Prenatal diagnosis of pregnancy luteoma poses a challenge, requiring hormonal examinations, ultrasound, magnetic resonance imaging, and gastrointestinal endoscopy for identification. Caution must be exercised to avoid overtreatment. While additional cases are needed to summarize the imaging features and effects of excess hormones on the both mother and fetus, further research is necessary for a comprehensive understanding.

To investigate the role of MRI in the diagnosis and classification of fetal microtia. Ninety-five fetuses with suspected microtia based on ultrasound and MRI performed within 1 week were enrolled in this study. The diagnosis based on MRI was compared with postnatal diagnosis. Among the microtia cases suspected on the basis of MRI, mild and severe cases were further classified. In addition, external auditory canal (EAC) atresia was evaluated by MRI in 29 fetuses with a gestational age > 28 weeks, and the accuracy of MRI in the diagnosis and classification of microtia was determined. Of 95 fetuses, 83 were considered to have microtia on the basis of MRI, 81 were confirmed to have microtia, and 14 were found to be normal according to postnatal diagnosis. Among 190 external ears in 95 fetuses, 40 ears were suspected to have mild microtia, and 52 ears were suspected to have severe microtia on the basis of MRI. According to the postnatal diagnosis, mild and severe microtia were confirmed in 43 and 49 ears, respectively. Among the 29 fetuses with a gestational age > 28 weeks, 23 ears were suspected to have EAC atresia according to MRI and 21 ears were ultimately confirmed to have EAC atresia. The accuracy of MRI in diagnosing microtia and EAC atresia was 93.68 • MRI is a useful adjunct to prenatal ultrasound. • MRI has a higher accuracy rate than ultrasound in diagnosing fetal microtia. • The accurate classification of fetal microtia and the diagnosis of external auditory canal atresia through MRI may help guide clinical management.

Uterine contractions are routinely monitored by tocodynamometer (TOCO) at late stage of pregnancy to predict the onset of labor. However, TOCO reveals no information on the synchrony and coherence of contractions, which are important contributors to a successful delivery. The electrohysterography (EHG) is a recording of the electrical activities that trigger the local muscles to contract. The spatial-temporal information embedded in multiple channel EHG signals make them ideal for characterizing the synchrony and coherence of uterine contraction. To proceed, contractile time-windows are identified from TOCO signals and are then used to segment out the simultaneously recorded EHG signals of different channels. We construct sample entropy SamEn and Concordance Correlation based feature ψ from these EHG segments to quantify the synchrony and coherence of contraction. To test the effectiveness of the proposed method, 122 EHG recordings in the Icelandic EHG database were divided into two groups according to the time difference between the gestational ages at recording and at delivery (TTD). Both SamEn and ψ show clear difference in the two groups (p<10-5) even when measurements were made 120 h before delivery. Receiver operating characteristic curve analysis of these two features gave AUC values of 0.834 and 0.726 for discriminating imminent labor defined with TTD ≤ 24 h. The SamEn was significantly smaller in women (0.1433) of imminent labor group than in women (0.3774) of the pregnancy group. Using an optimal cutoff value of SamEn to identify imminent labor gives sensitivity, specificity, and accuracy as high as 0.909, 0.712 and 0.743, respectively. These results demonstrate superiority in comparing to the existing SOTA methods. This study is the first research work focusing on characterizing the synchrony property of contractions from the electrohysterography signals. Despite the very limited dataset used in the validation process, the promising results open a new direction to the use of electrohysterography in obstetrics.

N6-methyladenosine (m6A) is a critical regulator in the fate of RNA, but whether and how m6A executes its functions in different tissues remains largely obscure. Here we report downregulation of a crucial m6A reader, YTHDF2, leading to tissue-specific programmed cell deaths (PCDs) upon fluorene-9-bisphenol (BHPF) exposure. Currently, Bisphenol A (BPA) substitutes are widely used in plastic manufacturing. Interrogating eight common BPA substitutes, we detected BHPF in 14% serum samples of pregnant participants. In a zebrafish model, BHPF caused tissue-specific PCDs triggering cardiac and vascular defects. Mechanistically, BHPF-mediated downregulation of YTHDF2 reduced YTHDF2-facilitated translation of m6A-gch1 for cardiomyocyte ferroptosis, and decreased YTHDF2-mediated m6A-sting1 decay for caudal vein plexus (CVP) apoptosis. The two distinct YTHDF2-mediated m6A regulations and context-dependent co-expression patterns of gch1/ythdf2 and tnfrsf1a/ythdf2 contributed to YTHDF2-mediated tissue-specific PCDs, uncovering a new layer of PCD regulation. Since BHPF/YTHDF2-medaited PCD defects were also observed in mammals, BHPF exposure represents a potential health threat.

OBJECTIVE:To investigate the factors influencing preterm birth in patients after ultrasound-indicated cerclage with different cervical lengths (CL), and explore the optimal cut-off value of CL. MATERIALS AND METHODS:The retrospective study included 87 pregnant women with a history of preterm birth and second-trimester loss that received ultrasound-indicated cerclage in our hospital between January 2004 and April 2021. Groups were divided by CL at the demarcation point of 1.0, 1.5 and 2.0 cm respectively. The pregnancy outcomes were compared. Logistic regression analysis was performed to assess the independent influence factors. Receiver-operating characteristic (ROC) curves were constructed and the area under the curve (AUC) was used to compare the prediction capability of the associated factors. RESULTS:Significant difference was found in terms of patients delivered at ≥32 weeks of gestation (19 [55.9%]vs. 41 [77.4%], p < 0.05) and neonatal birth weight (2495 [1138,3185]vs. 2995 [2155,3235] g, p < 0.05), when the CL was categorized at the demarcation point of 1.5 cm. Body mass index (BMI) (odds ratio [OR] = 1.224, p < 0.05), a history of preterm birth and second-trimester loss (OR = 3.153, p < 0.05), and C-reactive protein (CRP) > 5 mg/L (OR = 8.097, p < 0.05) were independent risk factors for gestational age more than 28 weeks. The AUC of joint predictor A included those factors was 0.849 (95% CI: 0.701-0.998, p < 0.05). CRP>5 mg/L was found to be a significant independent risk factor for different gestational age at delivery. CONCLUSIONS:A CL of 1.5 cm was the optimal cut-off value that could help women who underwent serial CL surveillance choose ultrasound-indicated cerclage at an appropriate time. High BMI, more history of preterm birth and second-trimester loss and abnormal CRP could be used as combined predictors to recognize the risk of preterm birth (<28 weeks) post-surgery.

ObjectiveAccumulating evidence has demonstrated that lncRNA Taurine-upregulated gene 1 (TUG1) plays an important role in regulation of cell morphology, migration, proliferation and apoptosis. Our aim was to evaluate the oncogenic role of TUG1 in type I Endometrial Carcinoma (EC) and explore the precise mechanism of TUG1 involved in tumor progression.Materials and methodsThe GSE17025 data set was used to analyze the correlation of TUG1 expression with type I EC patients’ prognosis. Furthermore, TUG1 expression profiles were measured by qRT-PCR from carcinoma tissues and adjacent nonneoplastic tissues (NNT) of 105 type I EC patients. The regulation of epithelial–mesenchymal transition (EMT) related molecules, p-AKT and AKT by TUG1 knockdown was investigated using Western blot analysis; meanwhile, the oncogenic roles of TUG1 were evaluated using cell viability and transwell migration/invasion assay in Hec-1-A and Ishikawa cell lines.ResultsFirstly, we observed a significant association between higher TUG1 expression and lower survival rate in type I EC patients using the GSE17025 data set. A significant elevation of TUG1 levels was confirmed in type I EC tissues compared with NNT in the 105 type I EC patients, and high expression of TUG1 was associated with lymph vascular space invasion (LVSI) and lymph node metastasis (LNM). Subsequently, TUG1 knockdown could remarkably inhibit the Hec-1-A and Ishikawa cell invasion and migration in the functional experiment. Furthermore, our results showed that the protein levels of E-cadherin increased and N-cadherin decreased significantly, while β-catenin and Vimentin were not significantly altered upon TUG1 silencing in both Hec-1-A and Ishikawa cells. Finally, we found the p-AKT and AKT protein levels, and the rate of p-AKT/t-AKT has a tendency to be down-regulate in Hec-1-A cells, while the AKT pathway was not change significantly in Ishikawa cells after TUG1 knockdown.ConclusionCollectively, our data reveal that TUG1 might be regarded as an oncogenic molecule that promotes type I EC cells metastasis leading to tumor progression, at least partially, by regulating E–N cadherin switch and the AKT pathway.