Detection and Classification of Pregnancy StateUsing Deep Learning Technique

This work aims to design and develop a model that detects and classifies pregnancy health status. Ultrasound is one of the most prevalent developments in clinical imaging, as it enables a doctor to evaluate, analyze and treat diseases. Most complications from pregnancy lead to serious problems that restrict healthy growth, causing weakness or death. In this work, an image processing system was developed to recognize the health during pregnancy and classify it for all stages of its development. The technique in deep learning has been implemented, as CNN (Resnet50) image recognition model was applied to detect and classify fetal health status from ultrasound images. The proposed model contributed to providing an integrated solution for each pregnancy period that works to identify all stages of fetal development, starting from the pre-pregnancy stage (here it is known about the suitability of the uterus for pregnancy, the size of the ovum, and its ability to form the fetus) and up to the stage of birth, through training, verification and testing using the cross-verification technique that five folds of the diagnostic rudder were used under the patterns that distinguish each stage from the other and to verify that it is sound or unsound in the concerning stage. This study enhanced diagnostic accuracy by using transfer learning and novel accessory images that were not trained as feedback. The model achieved an accuracy of 96.5% in detecting the fetus and classifying it into any of the stages that were divided according to the features that appear from one stage to the next to eleven categories.

DYNAMICS OF PERINATAL LOSSES IN ALMATY

Динамика и уровень перинатальной смертности за последние десятилетие свидетельствовали о том, что в г. Алматы имеет устойчивую тенденцию к снижению до 8,8‰ к 2019 году. В структуре перинатальной смертности большая часть приходится на антенатальную (5,5-6,5‰); около трети - на раннюю неонатальную смертность (3,2 до 2,3‰). В структуре причин неонатальных потерь наблюдалось устойчивое снижение дыхательных и сердечно-сосудистых нарушений в 2,3-3,8 раза - с 5 до 1,3‰, врожденных аномалий с 4,4 до 0,9‰, неонатальные потери от инфекционных болезней остаются стабильными. Сохраняющие риски инфекционной патологии, особенно в беспрецедентной ситуации в период пандемии диктуют необходимость пересмотра подходов к оказанию перинатальной помощи населению и разработкой новой концепции перинатальной помощи с существенными изменениями в подходах инфекционного контроля, развития превентивной перинатологии с более эффективной антенатальной охраной здоровья плода. The dynamics and level of perinatal mortality over the past decade testified to the fact that in Almaty it has a steady downward trend to 8.8 ‰ by 2019. In the structure of perinatal mortality, most of it falls on antenatal (5.5-6.5 ‰); about a third - for early neonatal mortality (3.2 to 2.3 ‰). In the structure of the causes of neonatal losses, there was a steady decrease in respiratory and cardiovascular disorders by 2.3-3.8 times - from 5 to 1.3 ‰, congenital anomalies from 4.4 to 0.9 ‰, neonatal losses from infectious diseases remain stable. The persisting risks of infectious pathology, especially in an unprecedented situation during a pandemic, dictate the need to revise approaches to providing perinatal care to the population and develop a new concept of perinatal care with significant changes in approaches to infection control, thedevelopment of preventive perinatology with more effective antenatal fetal health care.

Medawar’s PostEra: Galectins Emerged as Key Players During Fetal-Maternal Glycoimmune Adaptation

Lectin-glycan interactions, in particular those mediated by the galectin family, regulate many processes required for a successful pregnancy. Over the past decades, increasing evidence gathered from in vitro and in vivo experiments indicate that members of the galectin family specifically bind to both intracellular and membrane bound carbohydrate ligands regulating angiogenesis, immune-cell adaptations required to tolerate the fetal semi-allograft and mammalian embryogenesis. Therefore, galectins play important roles in fetal development and placentation contributing to maternal and fetal health. This review discusses the expression and role of galectins during the course of pregnancy, with an emphasis on maternal immune adaptions and galectin-glycan interactions uncovered in the recent years. In addition, we summarize the galectin fingerprints associated with pathological gestation with particular focus on preeclampsia.

Causal effects on low Apgar at 5-min and stillbirth in a malaria maternal–fetal health outcome investigation: a large perinatal surveillance study in the Brazilian Amazon

Background Malaria elimination in Brazil poses several challenges, including the control of Plasmodium falciparum foci and the hidden burden of Plasmodium vivax in pregnancy. Maternal malaria and fetal health outcomes were investigated with a perinatal surveillance study in the municipality of Cruzeiro do Sul, Acre state, Brazilian Amazon. The research questions are: what are the causal effects of low birth weight on low Apgar at 5-min and of perinatal anaemia on stillbirth? Methods From November 2018 to October 2019, pregnant women of ≥ 22 weeks or puerperal mothers, who delivered at the referral maternity hospital (Juruá Women and Children’s Hospital), were recruited to participate in a malaria surveillance study. Clinical information was obtained from a questionnaire and abstracted from medical reports. Haemoglobin level and presence of malarial parasites were tested by haematology counter and light microscopy, respectively. Low Apgar at 5-min and stillbirth were the outcomes analysed in function of clinical data and epidemiologic risk factors for maternal malaria infection using both a model of additive and independent effects and a causal model with control of confounders and use of mediation. Results In total, 202 (7.2%; N = 2807) women had malaria during pregnancy. Nearly half of malaria infections during pregnancy (n = 94) were P. falciparum. A total of 27 women (1.03%; N = 2632) had perinatal malaria (19 P. vivax and 8 P. falciparum). Perinatal anaemia was demonstrated in 1144 women (41.2%; N = 2779) and low birth weight occurred in 212 newborns (3.1%; N = 2807). A total of 75 newborns (2.7%; N = 2807) had low (< 7) Apgar scores at 5-min., and stillbirth occurred in 23 instances (30.7%; n = 75). Low birth weight resulted in 7.1 higher odds of low Apgar at 5-min (OR = 7.05, 95% CI 3.86–12.88, p < 0.001) modulated by living in rural conditions, malaria during pregnancy, perinatal malaria, and perinatal anaemia. Stillbirth was associated with perinatal anaemia (OR = 2.56, 95% CI 1.02–6.42, p = 0.0444) modulated by living in rural conditions, falciparum malaria during pregnancy, perinatal malaria, and perinatal fever. Conclusions While Brazil continues its path towards malaria elimination, the population still faces major structural problems, including substandard living conditions. Here malaria infections on pregnant women were observed having indirect effects on fetal outcomes, contributing to low Apgar at 5-min and stillbirth. Finally, the utility of employing multiple statistical analysis methods to validate consistent trends is vital to ensure optimal public health intervention designs.

Characterization of Circulating Androgens, Cortisol and Estrogens During Normal, Abnormal and False Pregnancy in Bottlenose Dolphins (Tursiops truncatus) Under Managed Care

The few hormone studies on bottlenose dolphin (Tursiops truncatus) pregnancy with different reproductive outcomes, e.g., normal birth, stillbirth and abortion, have mostly focused on progestagens or relaxin. However, recent analysis of androgens, glucocorticoids and estrogens has shown they are also biomarkers of cetacean pregnancy. Therefore, our objective was to examine circulating concentrations of androgens, glucocorticoids and estrogens during bottlenose dolphin pregnancies with different reproductive outcomes, including normal pregnancy (NORM, n = 27), failure to thrive (FTT, n = 17), perinatal loss (PNL, n = 20), early loss (EL, n = 12) and false pregnancy (FP, n = 16), to determine if they could be potential indicators of reproductive or fetal health. We analyzed longitudinal serum samples (n = 654) from 57 bottlenose dolphins and 92 reproductive events for testosterone, androstenedione, cortisol, estradiol and estrone conjugates. Testosterone concentrations were higher during EL compared to NORM and lower during FP at MID (day 121 – 240 post ovulation/conception) and LATE (day 241 – end of FP) stages (months post conception/ovulation [MPC, MPO] seven through ten, P &lt; 0.05). During FTT, androstenedione concentrations were increased compared to NORM pregnancies in the EARLY and LATE stages (P ≤ 0.05), and concentrations were reduced during FP (P &lt; 0.05). For cortisol, FTT pregnancies had higher concentrations compared to NORM during all stages (P &lt; 0.05), while PNL had higher cortisol during EARLY and LATE stages (P &lt; 0.05). Estradiol concentrations were lower for EL and FP compared to NORM (P &lt; 0.05), while estrone conjugates were only reduced during FP (P &lt; 0.05). Based on our results only cortisol may be a useful predictor of PNL, while both cortisol and androstenedione were useful for distinguishing FTT pregnancies. Similarly, both testosterone and estradiol during EL and FP were different from NORM. Our data indicate a suite of pregnancy specific hormone biomarkers to evaluate maternal and fetal health in bottlenose dolphins should include cortisol, androgens and estrogens. This research also highlights the importance on non-progestagen hormones as sentinels of cetacean pregnancy and fetal health.

The Ontogeny and Function of Placental Macrophages

The placenta is a fetal-derived organ whose function is crucial for both maternal and fetal health. The human placenta contains a population of fetal macrophages termed Hofbauer cells. These macrophages play diverse roles, aiding in placental development, function and defence. The outer layer of the human placenta is formed by syncytiotrophoblast cells, that fuse to form the syncytium. Adhered to the syncytium at sites of damage, on the maternal side of the placenta, is a population of macrophages termed placenta associated maternal macrophages (PAMM1a). Here we discuss recent developments that have led to renewed insight into our understanding of the ontogeny, phenotype and function of placental macrophages. Finally, we discuss how the application of new technologies within placental research are helping us to further understand these cells.