Clinical Features and Surgical Management of Pituitary Adenoma During Pregnancy: Case Series and Literature Review

Purpose Although conservative treatment was recommended for pregnant patients with pituitary adenomas (PAs), surgical treatment is occasionally necessary for those with acute symptoms. However, surgical intervention among these patients is poorly studied. Methods Six patients with PAs who underwent surgical treatment during pregnancy at Peking Union Medical College Hospital between January 1990 and June 2021 and another 35 pregnant patients profiled in the literature were included. Results All the 41 enrolled patients (mean age 29.8 ± 5.3 years) had acute symptoms including visual field defects, severe headaches, or vision loss requiring emergency pituitary surgeries. Mean tumor diameter was 2.16 ± 0.9 cm, and 92.6% were macroadenomas. PA apoplexies were found in 23 patients. The average gestation time at surgery was 25.1 ± 7.1 weeks; 55.9% of these patients underwent surgery in the second trimester of pregnancy. Multidisciplinary team was involved from before surgery to after delivery. Except one patient underwent an induced abortion, and one fetus died due to a nuchal cord, thirty-nine patients delivered successfully, and 37 of fetuses were healthy till the last follow-up. One fetus died of congenital diaphragmatic hernia, and another had a low Apgar score after a cesarean section but survived. Conclusion PA surgery for pregnant patients with PAs is effective and safe during the second and third trimesters. Pregnant patients requiring emergency PA surgery need multidisciplinary evaluation and healthcare management. Cooperation of neurosurgery, endocrinology, obstetrics, anesthesiology, and neonatology is necessary for a successful surgical intervention for pregnant patients with PAs.

Stability and Hopf Bifurcation of a Stage-Structured Cannibalism Model with Two Delays

In this work, we consider a stage-structured cannibalism model with two delays. One delay characterizes the lag effect of negative feedback of the prey species, the other has the effect of gestation of the adult predator population. Firstly, criteria for the local stability of feasible equilibria are established. Meanwhile, by choosing delay as a bifurcation parameter, the criteria on the existence of Hopf bifurcation are established. Furthermore, by the normal form theory and center manifold theorem, we derive the explicit formulas determining the properties of periodic solutions. Finally, the theoretical results are illustrated by numerical simulations, from which we can see that the predator’s gestation time delay can make the chaotic phenomenon disappear and maintain periodic oscillation, and that a large feedback time delay of prey can make predators extinct and prey form a periodic solution.

Preterm Birth Affects Early Motor Development in Pigs

Background: Preterm infants frequently show neuromotor dysfunctions, but it is not clear how reduced gestational age at birth may induce developmental coordination disorders. Advancing postnatal age, not only post-conceptional age, may determine neuromuscular development, and early interventions in preterm newborns may improve their later motor skills. An animal model of preterm birth that allows early postnatal detection of movement patterns may help to investigate this hypothesis.Methods: Using pigs as a model for moderately preterm infants, preterm (106-day gestation, equivalent to 90% of normal gestation time; n = 38) and term (115-day gestation, equivalent to 99% of normal gestation time; n = 20) individuals were delivered by cesarean section and artificially reared until postnatal day 19 (preweaning period). The neuromotor skills of piglets were documented using spatiotemporal gait analyses on video recordings of locomotion at self-selected speed at postnatal age 3, 4, 5, 8, and 18 days. Results were controlled for effects of body weight and sex.Results: Both preterm and term piglets reached mature neuromotor skills and performance between postnatal days 3–5. However, preterm pigs took shorter steps at a higher frequency, than term piglets, irrespective of their body size. Within preterm pigs, males and low birth weight individuals took the shortest steps, and with the highest frequency.Conclusion: Postnatal development of motor skills and gait characteristics in pigs delivered in late gestation may show similarity to the compromised development of gait pattern in preterm infants. Relative to term pigs, the postnatal delay in gait development in preterm pigs was only few days, that is, much shorter than the 10-day reduction in gestation length. This indicates rapid postnatal adaptation of gait pattern after reduced gestational age at birth. Early-life physical training and medical interventions may support both short- and long-term gait development after preterm birth in both pigs and infants.

Hubungan Kejadian Pandemi Covid 19 Dengan Kecemasan Ibu Hamil Trimester Tiga

Objective : Pregnancy is one of the crowning moments in the life of women (Yuniastari et al., 2014). according to the Federasi Obstetri Ginekologi Internasional, Pregnancy defined as fertilization or union of spermatozoa and ovum and followed by nidasi or implantation. If counted and fertilization to this baby, normal gestation time would be held for 40 week or 10 month or 9 moon rotate international calendar. at this time corona virus desease The case go global begins with pneumonia or chafe paru-paru mysterious 2019 on december. When that happens the pandemic covid 19 that directly impact to all indonesian people in general. In the world health of pregnant women also did not escape the effects of the pandemic covid 19 this.The number of pregnant women third trimester there dipustu arawa it makes it very anxious in dealing with the delivery processMetodhe : Methods used is Desain Observasional Deskriptif. In this study , researchers will assess the degree or rate of anxiety for pregnant women third trimesterResults: This study has been implemented in march - april 2021 at pustu arawa That is in the work area puskesmas lawawoi kabupaten sidrap with the total sample 48 respondents . The sample technique used is simple random sampling Pregnant women and patients who came third trimester pustu arawa in the work area puskesmas lawawoi kabupaten sidrap Selected at random. Conclusion: The research found that there was a correlation between the pandemic covid 19 with anxiety pregnant women got the third trimester p = 0.002 < 0,05

Maintenance of Maternal Breastfeeding up to 6 Months: Predictive Models

Background: There is evidence of the benefits of exclusive breastfeeding (EBF) but maintaining EBF for the minimum recommended time of 6 months is challenging. Aims: This study aimed to determine the prevalence of breastfeeding types in a Spanish setting, explore the influencing factors, and analyze the relationships between the reasons for EBF cessation and the EBF durations achieved. Method: This longitudinal descriptive study included 236 healthy children with standard weight followed up by the public health system. A baseline survey and three telephone interviews (1, 3, and 6 months) were conducted. Results: The prevalence of EBF at 6 months was 19.49%. The mean age of the mothers was 32.3 (±5.3). The variables influencing EBF maintenance were the prior decision to practice EBF (p = 0.03), the belief that EBF is sufficient (p = 0.00), not offering water or fluid to the child (p = 0.04), delaying pacifier use (p < 0.001), a longer gestation time (p = 0.05), and previous experience with practicing EBF for more than 6 months (p = 0.00). The reason for the earliest EBF cessation (mean 52.63 ± 56.98 days) was the mother’s lack of self-efficacy (p = 0.05). Conclusion: Knowing the reasons for EBF cessation among mothers is important for helping mothers and preventing early weaning. A safe environment and support can prevent early weaning.

Opportunities for predicting cesarean scar insufficiency

Objective. The study aimed to compare the diagnostic value of different methods of assessing the condition of the scar on the uterus after a cesarean section.Materials and methods. A comparative analysis of the diagnostic value of assessing the validity of the scar on the uterus in the pre-graviridar period and during pregnancy ultrasound (ultrasound) investigation with dopplerometry (DM), magnetic resonance imaging (MRI), and microwave radiothermometry (RTM). The study included fertile patients after delivery by cesarean section (n = 56), at the planning stage, during pregnancy and after delivery, both through natural birth pathways and by re-cesarean section.Results. A comparative analysis of the assessment of the scar in the uterus by the mentioned methods revealed the comparable diagnostic value of these methods during the planning phase of pregnancy and in gestation time 11–12 and 20 –21 weeks, while at the period of 37–38 weeks, the sensitivity of RTM was significantly (1.6 times) higher than ultrasound investigation.Conclusions. Despite the high diagnostic effectiveness of all three methods of assessing the condition of the uterine scar after cesarean section, the method of microwave radiothermometry has advantages in the simplicity of the method, lack of need for expensive equipment, and specialized qualifications of the doctor.

Developing a theoretical evolutionary framework to solve the mystery of parturition initiation

Eutherian mammals have characteristic lengths of gestation that are key for reproductive success, but relatively little is known about the processes that determine the timing of parturition, the process of birth, and how they are coordinated with fetal developmental programs. This issue remains one of biology's great unsolved mysteries and has significant clinical relevance because preterm birth is the leading cause of infant and under 5 year old child mortality worldwide. Here, we consider the evolutionary influences and potential signaling mechanisms that maintain or end pregnancy in eutherian mammals and use this knowledge to formulate general theoretical evolutionary models. These models can be tested through evolutionary species comparisons, studies of experimental manipulation of gestation period and birth timing, and human clinical studies. Understanding how gestation time and parturition are determined will shed light on this fundamental biological process and improve human health through the development of therapies to prevent preterm birth.

Automation of COVID-19 detection in pregnant womens

Introduction. In the article we discuss the use of information technology in obstetric care during the COVID-19 pandemic. The aim was reached by continuous monitoring of all cases of upper respiratory infection in pregnant women, women in labor and postpartum women in each specific medical organization and in the whole Sverdlovsk region with subsequent information digiti- zation and automated analysis of different COVID – 19 forms: suspicious, probable and confirmed. Materials and methods. «Regional obstetric monitoring (AIST «ROM») digital system was used for automated COVID-19 diagnosis in pregnant women, women in labor and postpartum women, as well as for detection of suspicious cases. AIST «RAM» allows to analyze patient’s epidemiological data and objective indicators of their physical status and automatically generate signal information. Results. The automatic analysis of the data on the COVID-19 situation in the region is implemented. A register of pregnant patients with COVID-19 is being formed, taking into account the severity of the disease and gestation time. A situational awareness is main- tained using the algorithms of AIST «ROM»: each participant of the process receives information about patient’s condition and his passage through the routing stages. Conclusions. A database, containing information about pregnant and postpartum women, who have COVID-19, is created. This data could be used in further large-scale studies.