Relationship between amniotic fluid metabolic profile with fetal gender, maternal age, and gestational week

Background Amniotic fluid (AF) provides vital information on fetal development, which is also valuable in identifying fetal abnormalities during pregnancy. However, the relationship between the metabolic profile of AF in the second trimester of a normal pregnancy with several maternal–fetal parameters remains poorly understood, which therefore limits its application in clinical practice. The aim of this study was to explore the association between the metabolic profile of AF with fetal gender, maternal age, and gestational week using an untargeted metabolomics method. Methods A total of 114 AF samples were analyzed in this study. Clinical data on fetal gender, maternal age, and gestational week of these samples were collected. Samples were analyzed by gas chromatography/time-of-flight-mass spectrometry (GC-TOF/MS). Principal component analysis(PCA), orthogonal partial least square discrimination analysis(OPLS-DA) or partial least square discrimination analysis (PLS-DA) were conducted to compare metabolic profiles, and differential metabolites were obtained by univariate analysis. Results Both PCA and OPLS-DA demonstrated no significant separation trend between the metabolic profiles of male and female fetuses, and there were only 7 differential metabolites. When the association between the maternal age on AF metabolic profile was explored, both PCA and PLS-DA revealed that the maternal age in the range of 21 to 40 years had no significant effect on the metabolic profile of AF, and only four different metabolites were found. There was no significant difference in the metabolic profiles of AF from fetuses of 17–22 weeks, and 23 differential metabolites were found. Conclusions In the scope of our study, there was no significant correlation between the AF metabolic profile and the fetal gender, maternal age and gestational week of a small range. Nevertheless, few metabolites appeared differentially expressed.

Reasons Pregnant Women seek Prenatal Sonographic Gender Disclosure in Makurdi, Nigeria

Fetal gender disclosure, a non-medical prenatal ultrasonography indication, although largely ethically unjustifiable, continues to grow and thrive in demand due to its request by pregnant women. The study aims at establishing the proportion of women who want to know fetal gender during prenatal ultrasound. This was twelve months` prospective study of all pregnant women, 16weeks and above who presented at our facility for antenatal ultrasound in Makurdi from 7th May 2019 to 6th May 2020. A structured questionnaire was used to obtain information on factors influencing their willingness to know the gender of their unborn children. The information collated was entered into statistical package for social science (SPSS) version 23.0 for analysis. P-values=0.005 was considered significant for the study population. Two hundred and fifty (250) pregnant women were recruited for the study. Majority of the women 233(93.2%) showed marked interest in knowing the gender of the fetus, while 17(6.8%) did not. The main reason for wanting to know the sex of the fetus was for easier choice of clothing and naming; whereas the main reason for not wanting sex disclosure was because any child is good. There was no statistically significant correlation between gender preferences and the other variables such as age, educational attainment, tribe and previous miscarriages (P=0.136, 0.485, 0.275 and 0.942 respectively). Majority of the women 233(93.2%) want fetal gender disclosure due to ease of choice of clothing and naming. The deliberate policy of non-disclosure on account of non-medical indication during prenatal ultrasonography is untenable in our environment.

Prenatal and Obstetric Parameters of Late Terminations: A Retrospective Analysis

Background In Germany, the highly sensitive issue of late terminations of pregnancy and feticide is regulated in Sec. 218a para. 2 of the German Penal Code (medical indication). This study aimed to investigate the prenatal obstetric approach after feticide and the rate of maternal complications. Material and Methods All feticides of singleton pregnancies carried out at Leipzig University Hospital (n = 164) in the period between 01/2016 and 12/2019 were retrospectively analyzed. Selective feticides of multiple pregnancies were excluded from the study. Target indicators for the prenatal obstetric approach were sonographic accuracy of estimation, method used to induce feticide, time between feticide and delivery, and whether curettage was required. The rate of maternal complications was defined as blood loss of ≥ 500 ml. Results The number of feticides as a percentage of the total number of births during the investigation period was 1.6%. None of the terminations were performed primarily because of a serious risk to the motherʼs physical health; all of the indications to terminate the pregnancy were based on the psychosocial burden and the risk to the motherʼs mental health as outlined in Sec. 218a StGB (German Penal Code). The most common fetal diagnoses in the context of a maternal psychosocial emergency were central nervous system abnormalities (29.3%), numerical chromosomal aberrations (29.3%) and structural chromosomal aberrations/syndromes (21.3%). Sonographic measurements were used to estimate fetal weight and the weight of around half of the fetuses was underestimated (− 121.8 ± 155.8 g). The margin of estimation error increased with increasing gestational age (p < 0.001). Misoprostol was the most common drug administered to induce labor. No significant association was found between the method chosen for induction, parity, fetal birth position, fetal anomaly, fetal gender, birth mode or the number of previous cesarean sections and Δdelivery. However, a significantly higher loss of blood was observed with longer Δdelivery (p = 0.02). The likelihood of requiring curettage increased with increasing loss of blood. The number of maternal complications as a percentage of the total patient population was 10.4%. Only 11% of patients agreed to a postmortem examination. Conclusion Late terminations of pregnancy carried out in accordance with Sec. 218a para. 2 StGB are a reality and must be understood and accepted as a possible consequence of modern prenatal medicine. The complication rate after feticide and the subsequent obstetric procedure was 10% for the above-defined maternal complication. Late terminations and their obstetric management should be carried out in specialized perinatal centers which offer interprofessional expertise.

Accuracy of Ultrasound for Determination of Fetal Gender

Aim: To evaluate the accuracy of ultrasound in determining the phenotypic foetal gender in all three trimesters. Study design: Cross sectional study. Place and duration of study: Department of Diagnostic Radiology Combined Military Hospital Lahore from 1st January 2020 to 30th April 2020. Methodology: Three hundred and seventy two patients in the inclusion criteria were selected. Ages of patients, gestational ages of foetuses and their genders were determined according to the ultrasonographic signs using ultrasound examination. Patients were contacted 3 weeks after the estimated date of delivery and phenotypic sex recorded. Results: Mean age was 34 years. Median gestational age was 21 weeks 3 days. Accuracy of gender determination by ultrasound in 1st, 2nd and 3rd trimesters was 62%, 97% and 95% respectively. Sensitivity and specificity of ultrasound in 1st trimester for males are 66% and 72%; and for females are 72% and 66% respectively. Positive and negative predictive values for male are 69% and 71%; and for female are 71% and 69% respectively. Sensitivity and specificity of ultrasound in 2nd trimester for males are 95% and 100%; and for females are 100% and 95% respectively. Positive and negative predictive values for male are 100% and 94%; and for female are 94% and 100% respectively. Sensitivity and specificity of ultrasound in 3rd trimester for males are 94% and 96%; and for females are 96% and 94% respectively. Positive and negative predictive values for male are 97% and 93%; and for female are 93% and 97% respectively. Conclusion: There is a high accuracy of ultrasound in determination of fetal gender in second and third trimesters. Keywords: Ultrasound, Gender, Trimester, Sensitivity, Specificity, Predictive Value

Relationship Between Amniotic Fluid Metabolic Profile With Fetal Gender, Maternal Age, and Gestational Age

Background Amniotic fluid (AF) provides vital information on fetal development, which is also valuable in identifying fetal abnormalities during pregnancy. However, the relationship between the metabolic profile of AF in the second trimester of a normal pregnancy with several maternal-fetal parameters remains poorly understood, which therefore limits its application in clinical practice. The aim of this study was to explore the association between the metabolic profile of AF with fetal gender, maternal age, and gestational age using an untargeted metabolomics method. Methods A total of 114 AF samples of normal pregnancy were selected. Clinical data on fetal gender, maternal age, and gestational week of these samples were collected. Samples were analyzed by gas chromatography/time-of-flight-mass spectrometry (GC-TOF/MS). Principal component analysis(PCA), orthogonal partial least square discrimination analysis༈OPLS-DA༉or partial least square discrimination analysis (PLS-DA) were conducted to compare metabolic profiles, and differential metabolites were obtained by univariate analysis. Results Both PCA and OPLS-DA demonstrated no significant separation trend between the metabolic profiles of male and female fetuses, and there were only 7 differential metabolites. When the association between the maternal age on AF metabolic profile was explored, both PCA and PLS-DA revealed that the maternal age in the range of 21 to 40 years had no significant effect on the metabolic profile of AF, and only four different metabolites were found. There was no significant difference in the metabolic profiles of AF from fetuses of 17–22 weeks, and 23 differential metabolites were found. Conclusions In the scope of our study, there was no significant correlation between the AF metabolic profile and the fetal gender, maternal age and gestational age of a small range. Nevertheless, few metabolites appeared differentially expressed.

Accuracy of Ultrasonography in Fetal Gender Determination in 11 to 14 Week of Gestational Age

Background: Early determination of fetal gender during pregnancy is essential for the early detection of gender-linked diseases in the fetus. Thus, the purpose of this study was to evaluate the sensitivity and specificity of ultrasonography in determining fetal gender in pregnant mothers at 11 to 14 weeks of gestation. Methods: The study included 227 pregnant mothers at 11 to 14 weeks of gestational age. Ultrasonography results were recorded for fetal gender determination based on gestational age and body mass index (BMI). Results: The sensitivity and specificity of ultrasonography for male gender determination were 91.73% and 99.05%, respectively. This value for female gender determination was 99.05% and 91.73%, respectively. Conclusions: The results of our study showed that ultrasonography at 11 to 14 weeks of gestation had high sensitivity and specificity in detecting gender, and its sensitivity in female gender determination was higher.