Multiple Gestation after Elective Single-Embryo Transfer: A State-of-the-Art Review of Literature and Suggested Mechanisms.

Background: Elective single-embryo transfers are being increasingly used to curb the increase in multiple gestation rates. However, it has been documented that single-embryo transfers could still result in twins and on rarer occasions in triplet pregnancies. Main Body. A literature review was done to highlight the possible mechanisms leading to embryonic splitting. In this review, the incidence of zygotic splitting was addressed and the notion of chorionicity was explained. Risk factors for zygotic splitting and suggested mechanisms for both twin and higher order pregnancies were suggested and discussed. Conclusion: The hypotheses that we have so far remain unproven due to the rarity of zygotic splitting as well as the ethicolegal considerations of human embryo research. The presence of such incidents necessitates extensive counselling of the couple.

Food safety knowledge among pregnant women in the United Arab Emirates amid the COVID-19 pandemic.

Studies have indicated shortcomings in food safety knowledge and practices among pregnant women in the Arab region. A high-risk group for having severe outcomes from foodborne illnesses. This study aimed to assess self-reported food safety knowledge and practices among pregnant women in the UAE during the COVID-19 pandemic. A total of 354 pregnant women residing in the UAE completed an online survey between October 2021 and January 2022. The questionnaire included socio-demographic information, food safety knowledge, and food practices during the COVID-19 pandemic. Correct answers for food safety knowledge were scored out of 50 and the total score was compared by sociodemographic characteristics. The total mean score for the study population was 26.7 ± 4.6 out of 50. Participants had good knowledge about foodborne diseases (81.3%) and personal hygiene practices (61.8%). While they were least knowledgeable about cross-contamination (43.3%) and temperature control practices (35.8%). Significantly higher knowledge scores were observed with higher levels of education and primigravida women (p<0.05). Knowledge about the COVID-19 virus and its relation to food safety was adequate for most participants. This study infers the need for food safety-related education and training programs to reduce the risk of foodborne disease among this vulnerable group. It also highlights the need to enhance the role of healthcare professionals as trusted sources of information in improving food safety during pregnancy.

Impact of coronavirus 2019 on mental health and lifestyle adaptations of pregnant women in the United Arab Emirates: a cross-sectional study.

BACKGROUND: In light of the pandemic, pregnant women are particularly vulnerable to increased psychological distress and in need of imperative preventive measures. This study aimed to investigate the impact of the pandemic on mental health, lifestyle adaptations, and their determinants among pregnant women in the United Arab Emirates. METHODS: A survey was conducted electronically between June and August 2020. Pregnant women were recruited from prenatal clinics in the UAE and invited to participate in an online survey developed on Google Forms. The questionnaire included socio-demographic characteristics, the Impact of Event Scale- Revised, the Perceived Support Scale and lifestyle-related factors. RESULTS: A total of 384 pregnant women completed the questionnaire of whom 20.6% were in their 1st trimester, 46.1% in their 2nd and 33.3% in their 3rd trimester. The mean IES-R score for the respondents was 26.15 ± 13.55, corresponding to a mild stressful impact, which did not differ significantly among trimesters of pregnancy. Pregnant women expressed increased stress from staying home (64%), work (40%), feeling frightened (66%) and apprehensive (59%). Women reported increased support and sharing their feelings with family members (59%), mainly in the 1st and 3rd trimester of pregnancy (P < 0.05). There was a greater attention to mental health (48%), resting time (55.3%), and relaxing time (57.3%); while a decreased amount of time was spent engaging in physical activities (53.6%), which differed significantly between trimesters (P = 0.02). CONCLUSIONS: The COVID-19 pandemic was associated with a mild stressful impact among pregnant women in the UAE, braced by strong family support and self-care mental health behaviors.

The effect of religious background on the attitude towards sex selection.

OBJECTIVES: Surveys of the general population regarding sex selection using pre-implantation genetic diagnosis are limited and were mainly conducted in the United States and Northern Europe. In those Western societies, surveys have shown that people's interest in using sex selection techniques is encouraged by the desire for a sexually balanced family. It is important to determine attitudes to sex selection in a wider range of countries especially that cultural differences exist among countries. STUDY DESIGN: A questionnaire-based cross-sectional study regarding attitudes towards sex selection for non-medical reasons was designed. One thousand five hundred participants of the reproductive age group presenting to the Women s Health Center at the American University of Beirut Medical Center were offered to complete the survey. The questionnaire included demographic details, obstetric and infertility history, opinions regarding sex selection, personal interest in expanding the family, and personal interest in choosing the sex of a future child. RESULTS: The response rate was 86.6%. Nineteen per cent of the respondents considered it strictly prohibited, 38.8% considered the technique acceptable only if medically indicated while 33.4% believed that it should be available to all those who request it. Multivariate logistic regression on the predictors of the variable affecting the attitudes towards sex selection showed that the educational level, religious disapproval and the desire of the opposite sex of the already existing children were the only significant predictors. CONCLUSION: The middle-eastern multi-religious population studied has a negative attitude towards sex selection through pre-implantation genetic diagnosis. Religion, educational status and desire of children of both genders were identified as the significant predictors of the decision whether to accept sex selection or not.

No association between the presence of periodontal disease and poor IVF outcomes: a pilot study.

Background: Periodontal disease can lead to bacteremia with release of cytokines, affecting implantation in women trying to conceive through in vitro fertilization (IVF). A potential association between maternal periodontal disease and poor IVF outcomes has been described. Objective: The aim of the study is to assess whether pre-existing periodontal disease has any effect on IVF parameters. Method: A pilot study composed of 34 women was conducted at a tertiary care center. Prior to IVF, dental examination, IVF parameters were collected. Results: Thirty-four women participated in the study. The outcomes of 28 women (82.3%) were analyzed. Out of the 28 patients, 17 patients had a positive pregnancy test (60.7%) with a total of 13 live births (46.4%) and 4 pregnancy losses (14.3%). Plaque and bleeding index scores were both lower in patients who achieved pregnancy after IVF yet did not reach statistical significance (p=0.309 and 0.422). Comparison of mean values for the different infertility parameters showed no significant differences among women with different IVF outcomes (p>0.05). Different degrees of inflammation of the gingiva did not have an effect on the different clinical parameters and the live birth rates. Conclusion: The evidence provided by the present study does not support the hypothesis. Addressing the status of oral health before any infertility treatment remains to be elucidated.

Unexplained First Trimester Intrahepatic Cholestasis of Pregnancy: A Case Report and Literature Review.

Intrahepatic cholestasis of pregnancy (ICP) is a condition that usually affects the 3rd trimester-pregnant women and is associated with adverse pregnancy outcomes. We present a 31-year-old G2P1 patient with symptoms of ICP as early as 10 weeks of gestation (WG). Her pruritis was initially attributed to eczema. Due to the intensity of her discomfort and failure of topical treatment, ICP was suspected, total bile acid salt levels were taken and ursodeoxycholic acid was subsequently started at 18 WG. The patient was followed closely during her pregnancy to adjust the dose of the medication accordingly. Induction of labor was performed at 37 WG without complications. This case demonstrated the importance of clinical suspicion in the setting of such symptomatology in order not to miss or delay treatment of threatening conditions such as ICP.