Relationship among anogenital distance, adrenal gland volume, and penile length and width at 22-36 weeks of pregnancy.

OBJECTIVES: The subject of current work was to determine the relationship of fetal ultrasonographic biomarkers, including anogenital distance (AGD), adrenal gland volume, and penile length and width in mothers with male fetuses at 22-36 weeks of gestation for the assessment of the effect of fetal adrenal gland producing androgens on the male anogenital structures that are exposed to androgen effects as anogenital region and penis. METHODS: This study is a prospective cross-sectional study conducted in our hospital's outpatient perinatal care unit. One hundred and seventy pregnant women with a male fetus aged 22-36 weeks of gestation were included in the study. The fetal adrenal gland length, width, and depth for the calculation of adrenal volume, AGD, and penile length and width were measured for each participant. The Pearson coefficients were calculated to assess the correlation among these parameters. RESULTS: The adrenal gland volume had a meaningful, positive moderate relationship with both the AGD (r=0.60) and penile length and width (r=0.57 and r=0.59, respectively; p<0.001). The AGD had a positive, strong correlation with the penile length and width (r=0.74 and r=0.76, respectively; p<0.001). CONCLUSIONS: The fetal adrenal gland as one of the androgen sources of the fetus is an influencer of the development of the anogenital and penile region. The findings of the current study support that the adrenal gland considerably affects the masculinization of male fetuses, since there were remarkable correlations among the AGD, adrenal gland volume, and penile length and width.

Clinical Value of Serum BMP-4, BMP-2, GDF-15, MMP-9, GP39 Levels in Pregnant Women with Obesity and the Related Comorbidities Diabetes Mellitus and Gestational Hypertension.

AIMS: We evaluated the clinical value of selected serum biomarkers BMP-4, BMP-2, GDF-15, MMP-9, and GP39 in pregnant women with obesity and the comorbidities diabetes mellitus (DM) and gestational hypertension (GHT). METHODS: This observational study had groups of controls, including healthy pregnant women; women with only obesity, including pregnant women with BMI≥30 kg/m2; women with gestational DM (GDM) with obesity, including pregnant women with GDM and obesity; women with pregestational DM (PGDM) with obesity, including pregnant women with PGDM and obesity; and women with GHT with obesity, including pregnant women with GHT and obesity. We measured serum levels of selected biomarkers by ELISA. RESULTS: Obesity increased serum levels of all the biomarkers; GDM developed in obese women caused a more pronounced increase in the serum levels of BMP-4 and BMP-2, and GHT developed in obese women caused a more pronounced increase in the serum levels of GDF-15. In the women with GDM-, PGDM-, and GHT-complicated obesity, serum levels of MMP-9 and GP39 did not change meaningfully. CONCLUSIONS: Obesity and its comorbidities DM and GHT lead to meaningful changes in the studied serum biomarkers. Since obesity has a causal effect on developing numerous conditions, reliable clinical biomarkers are needed to improve the early prediction and diagnosis of high-risk conditions during pregnancy.

Choice of anesthesia technique for emergent cesarean sections during COVID-19 era in a tertiary care hospital.

BACKGROUND: This study explored the change of anesthesia management for emergent cesarean sections in our tertiary care hospital in the first year of pandemic. We searched primarily for the changes in spinal to general anesthesia rate and secondarily for presented adult and neonatal intensive care needs in comparison to the year before the pandemic. We also presented the postoperative PCR tests of the emergent cesarean sections as a tertiary outcome. METHODS: We retrospectively analyzed clinical data such as anesthetic technique, need for postoperative intensive care, duration of hospital stays, postoperative PCR result, and newborn status. RESULTS: The rate of spinal anesthesia changed remarkably from 44.1% to 72.1% after the pandemic (p=0.001). The comparison of the median duration of hospital stays of the pre-pandemic group and post-pandemic group was found significantly longer than that of the before COVID-19 group (p=0.001). The rate of need for postoperative intensive care in the after COVID-19 group was higher (p=0.058). The rate of postoperative intensive care of the newborns in the after COVID-19 group was significantly higher than that of the before COVID-19 group (p=0.001). CONCLUSION: The spinal anesthesia rate for emergent cesarean sections increased significantly during the peak of the COVID-19 pandemic in tertiary care hospitals. Total health care services after the pandemic were enhanced as seen with elevated numbers of hospital stays, postoperative need of adult and neonatal intensive care.