Flow chart of the study design. PIH, pregnancy-induced hypertension; MAS, meconium aspiration syndrome.

Flow chart of the study design. PIH, pregnancy-induced hypertension; MAS, meconium aspiration syndrome.

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Objective: Meconium aspiration syndrome (MAS), possibly resulting from fetal hypoxia, is a respiratory distress disorder in the infant. Pregnancy-induced hypertension (PIH) can cause placental dysfunction and lead to fetal hypoxia, which may induce the development of MAS. Therefore, the aim of this study was to determine the association between PI...

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... was identified using the ICD-9-CM code: 770.6. The index date for the patients in the PIH cohort was the date of the initial PIH diagnosis. Participants were followed from the index date until the date of a MAS diagnosis, death within 28 days after birth, or the date of the end of the study period. The flow chart of the study design is shown in Fig. 1. Patients characteristics, including age, parity, gestational age, gestational number, experiencing cesarean section or not, and having major comorbidities or not, were obtained. The major comorbidities in this study were as follows: diabetes mellitus (DM) (ICD-9-CM: 250), hypertension (HTN) (ICD-9-DM: 401e405), coronary artery disease ...

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... Pregnant women with severe PE are more likely to have maternal and foetal complications. These include pulmonary oedema, renal failure, coagulopathy, myocardial infarction, cerebral haemorrhage, placental abruption, foetal growth restriction and foetal demise (Chappell et al. 2019;Li et al. 2019). Due to the high complication rate, the diagnosis of severe PE is an indication for delivery in !34 þ 0 weeks pregnancies. ...
Article
Preeclampsia (PE) is characterised by the new onset of hypertension after the 20th week of pregnancy, with or without proteinuria or hypertension that leads to end-organ dysfunction. Since the only definitive treatment is delivery, PE still represents one of the leading causes of preterm birth and perinatal mobility and mortality. Therefore, any strategies that aim to reduce adverse outcomes are based on early primary prevention, prenatal surveillance and prophylactic interventions. In the last decade, intense research has been focussed on the study of predictive models in order to identify women at higher risk accurately. To date, the most effective screening model is based on the combination of anamnestic, demographic, biophysical and maternal biochemical factors. In this review, we provide a detailed discussion about the current and future perspectives in the field of PE. We will examine pathogenesis, risk factors and clinical features. Moreover, recent developments in screening and prevention strategies, novel therapies and healthcare management strategies will be discussed.
... Regardless of all the current diagnostic and therapeutic options for hyperglycaemia management as well Pregnancy outcomes in women with diabetes mellitus -the impact of diabetes type and treatment as improved obstetric surveillance, DM in pregnancy remains a high-risk condition for both mother and child [9]. The most significant pregnancy complications associated with DM are congenital malformations, foetal macrosomia, shoulder dystocia/birth injury, preterm delivery with all its consequences, admission to newborn intensive care unit, and even higher perinatal mortality [7,[10][11][12][13]. ...
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Introduction: It has been estimated that approximately 16% of pregnancies worldwide are affected by pre-existing or gestational insulin-dependent (type 1) or independent (type 2) diabetes mellitus (DM). Diabetes mellitus in pregnancy remains a high-risk condition for both mother and child. This study aimed to investigate pregnancy outcomes regarding DM types. Material and methods: The study included 323 DM patients delivered for 6 years (2012-2017). General and obstetric history data and all complications throughout the pregnancy and the early neonatal period were noted. Based on DM type, women were divided into 4 groups: pre-pregnancy/pre-existing DM, insulin-dependent or independent, and gestational diabetes mellitus with or without insulin therapy. Results: The majority of women had pre-existing insulin-independent DM (type II 62%). Some types of pregnancy/maternal complications were registered in almost 85% of examined pregnancies. However, all babies were live born and mostly with good outcome (36.85% with early neonatal complications). Diabetes mellitus type could not predict the occurrence of neonatal complications (p = 0.342). Pre-existing insulin-dependent DM increased the risk for pregnancy complications (p = 0.031; OR = 1.656). Conclusions: Diabetes mellitus type has a limited impact on pregnancy outcomes and the occurrence of maternal and neonatal complications. With adequate therapy the pregnancy outcome can be good regardless of DM type.
... Usually, pregnancy-induced hypertension (PIH) syndrome occurs in women with more than 20 weeks of pregnancy. Clinically, it mainly manifests itself as hypertension, proteinuria, and edema of limbs [1,2]. PIH syndrome threatens maternal and infant health and can easily cause adverse events such as premature delivery, eclampsia, postpartum infection, or hemorrhage, which is not conducive to pregnancy outcome [3,4]. ...
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Objective: The study focused on the separation effects of ultrasound blood flow signal detection, based on empirical mode decomposition (EMD) algorithm, and the clinical efficacy of Compound Danshen injection and magnesium sulfate in the treatment of pregnancy-induced hypertension (PIH) syndrome. Methods: The empirical mode decomposition (EMD) algorithm was optimized first and compared with other algorithms for the accuracy and stability in separation of blood flow signals. 80 patients with PIH syndrome undergoing ultrasound examination were selected as the research subjects and randomly divided into control group and observation group according to the actual treatment methods. 40 cases in the observation group were treated with Compound Danshen injection + magnesium sulfate, and 40 cases in the control group were treated with magnesium sulfate. After the treatment, the clinical indicators of the two groups of patients were analyzed. Results: The accuracy and stability in separating blood flow signal of the optimized EMD algorithm were better than those of other algorithms. After treatment, the total effective rate and blood pressure control of the observation group were significantly better than those of the control group, and the incidence of adverse maternal and infant outcomes was significantly lower than that of the control group. After treatment, the endothelin-1 (ET-1), C-reactive protein (CRP), and homocysteine (Hcy) indexes of the two groups of patients decreased significantly, and the decrease level of the observation group was significantly greater than that of the control group (P < 0.05). The prothrombin time (PT), fibrinogen (FIB), activated partial thromboplastin time (APTT), and plasma thrombin time (TT) levels of the two groups after treatment were better than those before treatment, and the observation group was better than the control group (P < 0.05). Conclusion: The optimized EMD algorithm is of great value for the separation of ultrasound blood flow signals. For patients with PIH syndrome, Compound Danshen injection combined with magnesium sulfate can be used as a treatment plan, which can improve maternal and infant outcomes; control blood pressure; reduce 24 h urine protein and serum ET-1, Hcy, and CRP levels; and improve coagulation function. It is worthy of promotion.
... Fetal distress is a high-risk pregnancy disorder in obstetrics and gynecology. Acute hypoxia can easily cause neonatal cerebral palsy and hypoxic ischemic encephalopathy [13,14]. Fetal heart detection is a physical detection method to detect whether the fetal body is functioning well. ...
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This study was to improve the feasibility and economic benefits of intelligent medical system Doppler ultrasound (DUS) imaging technology combined with fetal heart detection to predict the fetal distress in pregnancy-induced hypertension (PIH), so as to reduce the risk of deterioration of the patient’s condition. The characteristics of DUS images were analyzed, and a diffusion filter reducing the specificity was adopted to improve the smooth speckle noise of DUS images. 120 pregnant women in hospital were the subjects of the study, all of whom received ultrasound cord blood flow testing and fetal heart monitoring. 88 PIH patients with fetal distress were diagnosed and included in the observation group, and 32 healthy pregnant women tested during the same period were identified as the control group. Clinical data were reviewed and analyzed. The diagnostic rates of fetal distress by simple fetal heart monitoring and DUS detection combined with fetal heart monitoring were compared. The results showed that 26.7% of fetal distress were diagnosed by fetal heart monitoring alone, and 73.3% of fetal distress were diagnosed by combined testing, so the diagnostic accuracy of the combined detection method was greatly higher than the single fetal heart detection (). The Pulsatility index (PI), resistance index (RI), and S/D values detected by the umbilical artery in the observation group were 1.48, 0.85, and 4.31, respectively. The PI, RI, and S/D values detected by the umbilical artery in the control group were 0.96, 0.64, and 3.59, respectively. The results of arterial detection were significantly higher than those of the control group, and the difference was of significant scientific significance (). In summary, the PI and RI values of the middle cerebral artery (MCA) detected by DUS diagnosis can effectively reflect the current status of the fetus in the uterus and reduce the mortality of the fetus. The images guided by DUS imaging technology can clearly show the current status of the fetus in the uterus, effectively improve the medical diagnostic efficiency, and have important reference value for the development of intelligent medical equipment. 1. Introduction Fetal distress is a relatively common complication in the perinatal period of pregnant women, and it is a syndrome of fetal life safety due to hypoxia and acidosis in the womb. The incidence rate is about 5.0%, and the incidence is high in late pregnancy, especially in high-pregnancy pregnant women, which can lead to low fetal intelligence, damage to the nervous system, cerebral palsy, and even perinatal death in severe cases [1]. In the past, clinical detection of fetal distress mainly used fetal heart detection, but there are many interference factors, and false positive results often appear in clinical practice, which seriously affects the judgment and evaluation of doctors, so the accuracy of fetal distress detection appears very important [2]. In recent years, many studies have found that color Doppler ultrasound (DUS) has a significant diagnostic effect, and color Doppler ultrasound combined with fetal heart detection of fetal distress has a high clinical value. DUS technology has many advantages such as nonionizing radiation and noninvasiveness, so it has been widely used in various fields of medicine in the 1940s. The original DUS technology is two-dimensional DUS, which can only reflect the situation in the tissue in a planar state. With the development of DUS imaging technology, color DUS was born, and portable high-resolution DUS probes are widely used clinically [3, 4]. Some scholars apply the matching tracking algorithm to ultrasonic Doppler noise processing, and the ultrasonic signal changes rapidly. The algorithm proposed by Mallat can well reflect local information and reduce noise relatively objectively and fairly. Some scholars also introduced an algorithm based on adaptive decomposition to perform time-frequency analysis on the signal, using the traditional discrete wavelet transform algorithm and wavelet packet transform algorithm to denoise the DUS blood flow signal, and the clarity of the image was well improved. Fetal heart rate detection is also more accurate. Fetal heart detection plays an important role in the diagnosis of the fetus, and it can reflect the fetal heart function of the fetus, which is regulated by the central nervous system [5, 6]. Whether or not the fetus is in good condition can be monitored by electronic fetal heart rate, which can effectively diagnose whether the fetus is hypoxic [7]. DUS image is a kind of real-time image with better imaging effect on blood vessels and soft tissues. Under the guidance of DUS, there is no need to operate, and the patient can be accurately observed locally through images. With the continuous development of computer technology and image recognition technology, artificial intelligence (AI) is widely used in the medical field [8]. AI is a branch of computer science, including intelligent technology, simulation, and extension. It can imitate human thoughts and behaviors, and learn and solve problems. AI has brought about great convenience in finance, games, medicine, health, etc. AI can rapidly, safely, and effectively integrate the information, which has brought disease diagnosis and treatment into a new era [9, 10]. DUS image guidance has a higher success rate than touch-based guidance, and it has been proven in the medical field. Traditional fetal heart detection has also begun to develop in the direction of Internet monitoring and intelligent diagnosis [11]. Fetal detection can clearly reflect the functional status of the fetus. In terms of low price and use, fetal heart detection is the preferred method of fetal detection [12]. DUS imaging can observe the shape of the fetus, but it cannot show whether the fetus is hypoxic or distressed. The fetal heart detection combined with DUS can clearly observe the shape of the fetus and it can also understand whether the fetus is hypoxic, so that predicting fetal distress is more accurate. Traditional ultrasound images are widely used in the detection of certain biological characteristics, mainly for the detection of fetal growth parameters, such as the measurement of amniotic fluid, head circumference, abdominal circumference, biparietal diameter, and placental maturity, but this method is too complicated, and its detection and diagnosis are time-consuming. The image definition is relatively low, and the resolution is not high. The color Doppler ultrasound scanner has high fidelity quality for pregnant women’s uterine artery, renal artery, fetal brain, etc., in the hemodynamic detection of fetal blood circulation. Therefore, the pregnant women with fetal distress were selected as the research objects, and the meaning of pregnancy-induced hypertension (PIH) with fetal distress was predicted based on AI algorithm DUS imaging and fetal heart detection. In addition, the selected AI medical automatic system was tested to obtain certain DUS image characteristics. The algorithm can effectively present the fetal distress situation, and provide a reference basis for clinically ensuring the diagnosis rate of fetal distress and the clinical diagnosis of fetal distress. 2. Methods 2.1. Research Objects Hundred and twenty pregnant women hospitalized in our hospital from 2018 to 2020 were taken as the study subjects. All of them received ultrasound cord blood flow testing and fetal heart monitoring. 88 PIH patients with fetal distress were diagnosed and included in the observation group, and 32 healthy pregnant women tested during the same period were identified as the control group. The age range of the research subjects was 23–36 years old (an average age of 28.6 ± 0.5 years old). All pregnant women were first babies and their menstrual conditions were normal before conception. There was no obvious difference in clinical data of all pregnant women (), and they can be compared. The inclusion criteria were defined as follows: patients who were pregnant, with 37–41 weeks of gestational age, no age limit, single fetus, and no obvious abnormalities in the obstetric examination; all patients who conformed to the diagnostic index of fetal distress; and patients with clinical manifestations of headache, edema, and higher blood pressure concentration. The subjects voluntarily participated in this study. The exclusion criteria were defined as follows: women with gestational age less than 37 weeks; women with bad multiple births; women without routine obstetrics; and women with pregnancy complications. Of all the 120 patients enrolled in the group, 88 cases of fetal distress were detected as the observation group, and 32 healthy pregnant women who were examined at the same time were the control group. The difference in clinical data of patients was not statistically great (). This trial had been endorsed by the ethics committee of the hospital, and all patients and their families had given informed consents and signed the informed consent forms. 2.2. Detection Methods All pregnant women were examined with a color DUS diagnostic apparatus. Pregnant women were required to be in supine position, and the probe frequency was 2–6 MHz. The abdomen of pregnant women was scanned using a probe to find the umbilical artery, and the images were analyzed with the appropriate obstetric analysis software. In the process of maternal umbilical artery measurement, any umbilical cord can be selected to test the blood flow frequency. The double top diameter measurement section of tire head can be selected for translation probe downward. The measurement of middle cerebral artery (MCA) can very well show the fetal basilar artery ring, which was positioned in the middle of the cerebral artery, and the blood flow spectrum can be obtained. The cross section of the cranium can be obtained. The side of the cerebral cortex was selected to detect the flow frequency of the cerebral artery. The blood flow probe can display the beginning of the renal artery beside the left and right veins of the spine in the transverse section of the abdomen, and the Doppler blood flow spectrum can be obtained based on the sampling of the renal artery. The sampling volume of the color DUS measurement was 2 mm, which corrected the angle between the sampling volume and the blood vessel. The Doppler was adjusted to the same direction as the blood flow to obtain at least 3 complete and clear pulse Doppler blood flow images. After the above operations were repeated more than 5 times for each indicator, there was a relatively stable frequency map, and then the measurement was carried out. The DUS instrument had its own calculation program, and the calculation results and images were all analyzed offline. S represented the maximum end-systolic arterial blood flow velocity of the pregnant woman, D represented the end-diastolic blood flow velocity of the pregnant woman, and S/D was the ratio of the peak value of the end-systolic arterial blood flow to the end-diastolic blood flow velocity. Pulsatility index (PI) = (S − D)/average blood flow velocity value and resistance index (RI) = (S − D)/S. The diagnostic criteria for DUS were abnormal changes in fetal heart rate. Amniotic fluid above 80 mm indicated too little amniotic fluid; if the heart rate was higher than 160 beats per minute or lower than 120 beats per minute, it was determined as tachycardia or bradycardia; if the umbilical artery of the fetus was above 3.00 or MCA was below 1.08, it showed abnormal DUS frequency; and if the fetal movement decreased or disappeared gradually, it showed abnormal fetal movement. 2.3. Research on the Core Issues of Imaging Computer-Assisted Interventional Surgery Navigation Advanced surgical medical image processing technology combined with computer AI to participate in medical operations can not only better complete disease diagnosis but also clearly show the shape and characteristics of the fetus in the uterus. Figure 1 shows that the research issues affecting navigation mainly included image processing technology and computer-assisted technology. At this stage, the three-dimensional visualization of medical images, the three-dimensional segmentation of medical images, and preoperative and postoperative operations were all key issues in medical operations.
... The incidence of CSP is increased dramatically. Although the reason is still uncertain, it can be partly explained by a significantly increased cesarean section (C/S) rate, based on varied kinds of clinical situations, such as mal-presentation [3], pregnancy-related crises, including preeclampsia [4], eclampsia [5], cardiovascular accidents [6], and fetus-related urgency, such as acute fetal distress [7], and some premature preterm births [8]. C/S, similar to other intrauterine surgeries, especially instrumentation surgery [9], involves the healing process of the uterus [10,11]. ...
... The excellent and famous health insurance system in Taiwan has been broadcasted worldwide. Taiwan's NHIRD offers a powerful support in the promotion of medical care, since using this database, evidence to change the medical care has been shown [3,4]. In Dr. Ding's article, we were refreshed about the importance of management of infertile women. ...
... [25][26][27][28][29][30][31][32][33][34] Several studies have specifically addressed the higher risk of EOC in patients with a history or a diagnosis of endometriosis. Similar to the design from many population-based cohort studies, [46][47][48][49][50] the majority of the study enrolled the relatively "healthy" women as the reference (standardized incidence rate [SIR]: standardized incidence per 10,000 person-years) for comparison, but the risk calculation is still varied greatly. [35][36][37][38][39][40][41][42][43][44][45] In the real world, these "healthy" women might not receive any kinds of gynecological surgery in their life, such as tubal surgery, ovarian surgery, uterine surgery, including total/subtotal hysterectomy (TH/STH). ...
... The Taiwanese National Health Insurance (NHI) program was founded in 1995, which enrolled more than 99% of the inhabitants living in Taiwan, and as of December 2010, it covered more than 99% of the population and contracted with almost all medical centers, hospitals, and clinics in Taiwan. [46][47][48][49][50] This program also includes all inpatient and outpatient medical benefit claims. [57][58][59][60][61][62] The National Health Research Institute (NHRI) cooperates with the Bureau of NHI to establish an NHI Research Database (NHIRD) in 2000, and guards the privacy and confidentiality of all beneficiaries and provides health insurance data to researchers who have obtained ethical approval. ...
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Purpose: The goal of the current study is to determine the risk of subsequent development of epithelial ovarian cancer (EOC) in women after ovarian surgery for benign ovarian tumors. Patients and methods: We conducted the nationwide population-based historic cohort study using the National Health Insurance Research Database (NHIRD) of Taiwan. Eleven thousand six hundred twenty women who underwent ovarian surgery for ovarian benign diseases were analyzed. The collected data included age, types of ovarian surgery, medical history by Charlson comorbidity index (CCI), infertility (yes/no), pelvic inflammatory disease (PID) (yes/no), tubal ligation (yes/no), total/subtotal hysterectomy (TH/STH) (yes/no), and endometrioma (yes/no). We used the Kaplan-Meier method and the Log-rank test to evaluate the risk factors. Cox proportional hazard methods were used to evaluate risk factors for the subsequent development of EOC. Multivariate analysis using Cox stepwise forward regression was conducted for the covariate selected in univariate analysis. Hazard ratio (HR) and 95% confidence interval (CI) were calculated using the Wald test. Results: Subsequent EOC incidence rate (IR, incidence per 10,000 person-years) of women after ovarian surgery for benign ovarian tumors was 2.98. Separating into four groups based on different age, IR of EOC was 1.57 (<30 years), 4.71 (30-39 years), 3.59 (40-49 years) and 0.94 (≥50 years), respectively. Univariate and multivariate analyses identified only high level of CCI (≥2 or more) as an independent risk factor for subsequent development of EOC in women after ovarian surgery for benign ovarian tumors (HR 59.17, 95% CI 7.50-466.80 in women with CCI level of 2 and HR 190.68, 95% CI 24.33-2494.19, in women with CCI level ≥3, respectively). Conclusion: Our results, if confirmed, suggest that women with other comorbidities (CCI) should be well informed that they may have a higher risk of subsequent development of EOC when ovarian surgery is planned even though the final pathology showed a benign ovarian tumor.
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Background We developed and validated an artificial intelligence (AI)-assisted prediction of preeclampsia applied to a nationwide health insurance dataset in Indonesia. Methods The BPJS Kesehatan dataset have been preprocessed using a nested case-control design into preeclampsia/eclampsia (n = 3318) and normotensive pregnant women (n = 19,883) from all women with one pregnancy. The dataset provided 95 features consisting of demographic variables and medical histories started from 24 months to event and ended by delivery as the event. Six algorithms were compared by area under the receiver operating characteristics curve (AUROC) with a subgroup analysis by time to the event. We compared our model to similar prediction models from systematically reviewed studies. In addition, we conducted a text mining analysis based on natural language processing techniques to interpret our modeling results. Findings The best model consisted of 17 predictors extracted by a random forest algorithm. Nine∼12 months to the event was the period that had the best AUROC in external validation by either geographical (0.88, 95% confidence interval (CI) 0.88–0.89) or temporal split (0.86, 95% CI 0.85–0.86). We compared this model to prediction models in seven studies from 869 records in PUBMED, EMBASE, and SCOPUS. This model outperformed the previous models in terms of the precision, sensitivity, and specificity in all validation sets. Interpretation Our low-cost model improved preliminary prediction to decide pregnant women that will be predicted by the models with high specificity and advanced predictors. Funding This work was supported by grant no. MOST108-2221-E-038-018 from the Ministry of Science and Technology of Taiwan.