Category: Obstetrics & Gynaecology

Categories : Environmental Effects Obstetrics & GynaecologyTags :

Plastic Additives Tied to Millions of Preterm Births Worldwide

On By ModernMedia
Photo by FLY:D on Unsplash

Exposure to a chemical commonly used to make plastic more flexible may have contributed to about 1.97 million preterm births in 2018 alone, or more than 8 percent of the world’s total, a new analysis of population surveys shows. The chemical was also linked to the deaths of 74 000 newborns, the researchers further estimate.

The toxin, di-2-ethylhexylphthalate (DEHP), is part of a group of chemicals called phthalates, which appear in cosmetics, detergents, bug repellents, and other household products. Experts have found that these substances can break down into microscopic particles and enter the body through food, air, and dust.

Led by NYU Langone Health researchers, the new study focused on preterm birth, which is a major risk factor for lasting learning and developmental issues and is a leading cause of infant death, according to the World Health Organization.

The new analysis provides the first global estimate of preterm births connected to exposure to DEHP and explores which parts of the world are most affected, according to the authors. A report on the findings published online March 31 in the journal eClinicalMedicine.

“By estimating how much phthalate exposure may contribute to preterm birth worldwide, our findings highlight that reducing exposure, especially in vulnerable regions, could help prevent early births and the health problems that often follow,” said study lead author Sara Hyman, MS.

Past studies have linked DEHP exposure to cancer, heart disease, and infertility, among many other health concerns, added Hyman, an associate research scientist at NYU Grossman School of Medicine. There is also a large body of research connecting the chemical to preterm birth.

According to the new work, DEHP exposure may have contributed to 1.2 million years lived with disability, a measure of all the years that people have lived or will live with illnesses, injuries, and other health issues caused by being born prematurely.

Hyman said that while the phthalate is in widespread use, certain regions are estimated to bear a much larger share of the health impacts than others, with the Middle East and South Asia representing 54 percent of estimated illness from preterm birth. These areas have rapidly growing plastics industries and high levels of global plastic waste.

Africa, which accounted for 26 percent of health problems from DEHP-linked preterm birth, has a disproportionate share of deaths compared with its share of overall premature cases. The researchers said this reflects the region’s higher underlying death toll from preterm birth.

For the study, the research team estimated DEHP exposure in 2018 across 200 countries and territories by pulling data from large national surveys in the United States, Europe, and Canada. They also used estimates from earlier investigations to fill in regions that did not have their own data.

The team then drew on earlier research that assessed how phthalate exposure may affect preterm birth and combined those findings with their global exposure estimates. Finally, they combined this information with worldwide figures on preterm births and deaths to gauge what share of these outcomes might be linked to DEHP.

The scientists repeated these steps for another phthalate called diisononyl phthalate (DiNP), a common replacement for DEHP. According to the results, DiNP may pose a similar risk as DEHP, having contributed to about 1.88 million preterm births around the world. The financial costs associated with newborn deaths ranged from millions to hundreds of billions of dollars for both phthalates.

“Our analysis makes clear that regulating phthalates one at a time and swapping in poorly understood replacements is unlikely to solve the larger problem,” said study senior author Leonardo Trasande, MD, MPP, Professor of Pediatrics at NYU Grossman School of Medicine. “We are playing a dangerous game of Whac-A-Mole with hazardous chemicals, and these findings highlight the urgent need for stronger, class-wide oversight of plastic additives to avoid repeating the same mistakes.”

Dr Trasande, who is also a professor in the Department of Population Health and director of the Division of Environmental Pediatrics and the Center for the Investigation of Environmental Hazards, cautions that the investigation was not designed to establish that DEHP and DiNP directly or alone cause preterm birth, nor did it take into account other types of phthalates.

In addition, because there is some uncertainty in the data, the researchers looked at a range of possible values rather than just one estimate. This uncertainty range showed that the true impact of DEHP could be up to four times smaller than the main estimate or slightly higher. Even under the most conservative estimates, the results point to a substantial health burden, said Hyman.

Despite the limits of this kind of global modelling, added Hyman, the work lays important groundwork for future studies to confirm and refine these results and begins to fill a major gap in understanding the extent to which plastic chemicals affect preterm birth worldwide.

Source: NYU Langone Health

Categories : Expert Opinion Obstetrics & GynaecologyTags :

How Women Are Harmed When Clinicians Rely on the Lab More Than the Patient

On By ModernMedia
Photo by Karolina Grabowska on Pexels

Across the world, countless women enter perimenopause only to be told that “everything is normal” because their blood tests do not match their symptoms.

This is one of the most damaging failures in modern women’s health. Perimenopause is not a laboratory diagnosis. It is a clinical diagnosis, made by listening to the woman and recognising the pattern of hormonal transition. Yet many clinicians continue to rely on FSH, LH and oestrogen levels – tests that were never designed to diagnose perimenopause and are physiologically incapable of doing so.

1. Hormone levels in perimenopause are wildly erratic

Oestrogen does not decline smoothly. It surges, crashes, and oscillates unpredictably. FSH and LH follow the same chaotic pattern. A single blood test captures only a moment in this turbulence. It cannot represent the hormonal instability that defines the transition.

This is why women with severe vasomotor symptoms often have “normal” results, while women with mild symptoms may show “abnormal” ones.

Erratic physiology produces erratic numbers. The numbers do not reflect the suffering.

2. Lab ranges do not correlate with symptoms

Laboratory ranges were created for research and population studies – not for diagnosing perimenopause. They do not account for:

  • daily hormonal swings
  • stress
  • sleep deprivation
  • illness
  • cycle timing
  • individual sensitivity to hormonal change

A woman may be drenched in night sweats, unable to sleep, emotionally unstable, and struggling to function – yet her blood tests may look “normal”. This leads to the most common and harmful phrase in women’s health: “Your results are normal, so this is not hormonal.”

3. The harm of relying on lab results

When clinicians wait for “abnormal” results before offering help, women suffer. They are:

  • dismissed
  • misdiagnosed
  • told they are anxious or depressed
  • denied treatment
  • left to struggle through years of avoidable distress

Or are treated inappropriately for life with antidepressants, mood stabilisers, axyiolytics and sedatives. These do little to address the underlying problem but create another set of problems: addiction and a range of side effects. This is not medicine. This is neglect disguised as protocol.

Suffering is prolonged because clinicians rely on lab results rather than the woman’s symptoms. Treating the lab instead of the woman is a betrayal of clinical responsibility.

4. The only test worth doing

There is one test that adds value: TSH and T4 – to exclude thyroid disease, which can mimic some perimenopausal symptoms. Beyond this, further hormone testing wastes time, money, and emotional energy.

5. The clinical truth

Perimenopause is diagnosed by listening to the woman, not by chasing fluctuating hormones. If she has:

• hot flushes

• night sweats

• irritability

• emotional instability

• sleep disturbance

• cycle changes

— she is in perimenopause, regardless of what the blood tests say.

The woman’s story is the evidence.

The numbers are often unreliable and misleading tools.

Dr E.V. Rapiti • April 2026

www.drrapiti.com

Categories : Environmental Effects Obstetrics & GynaecologyTags :

How One ‘Forever Chemical’ Can Disrupt Foetal Facial Development

On By ModernMedia

Researchers discovered perfluorodecanoic acid is the most toxic during foetal craniofacial development

Credit: Chemical Research in Toxicology (2026). doi:10.1021/acs.chemrestox.5c00468

Researchers have long associated per- and polyfluoroalkyl substances (PFAS), commonly known as “forever chemicals,” to certain severe birth defects but exactly how these pollutants harm a developing foetus has remained mostly a mystery. New research now provides the first clear molecular explanation, showing how one PFAS, called perfluorodecanoic acid (PFDA), can trigger craniofacial abnormalities before birth.

The research was published in ACS Chemical Research in Toxicology.

“Most people are exposed to small amounts of PFAS in everyday life but higher exposure can occur through contaminated water, living near manufacturing sites or certain jobs like firefighting and ski waxing, which is why it’s so important to understand the chemicals better,” said the paper’s senior author Jed Lampe, PhD, associate professor at University of Colorado Anschutz Skaggs School of Pharmacy and Pharmaceutical Sciences. “We wanted to understand which PFAS compounds are truly harmful during foetus development, especially for people with higher exposure, and how they cause damage.”

There are approximately 15 000 PFAS used in consumer and industrial products but scientists are increasingly finding that only some pose serious health risks. In this study, Lampe worked with the paper’s first author Michaela Hvizdak and co-author Sylvie Kandel to test 13 commonly found PFAS and discovered PFDA as the most toxic during foetal craniofacial development.

They demonstrated a possible link between PFDA and the extensive facial changes observed in humans and laboratory animals, with some estimates indicating a 10% increased risk at extremely low exposure levels. 

“This finding moves us beyond association by providing a clear explanation for how PFDA can interfere with foetal development. It’s a critical step toward understanding a vast and complex class of environmental chemicals,” said Lampe.

The cause of underdeveloped eyes and an abnormal jaw

They found that PFAS disrupts retinoic acid, a molecule essential for shaping the face and head during early pregnancy. Retinoic acid regulates hundreds of genes and its levels must be controlled. Because a foetus cannot produce or safely eliminate excess retinoic acid, it relies entirely on the mother to maintain the homeostatic balance of the hormone.

The researchers discovered PFDA blocks CYP26A1, a key enzyme responsible for breaking down excess retinoic acid. When this enzyme is inhibited, retinoic acid levels can rise too high, disrupting normal facial development. PFDA also suppresses the genes that produce this enzyme through a separate biological pathway, delivering a “double hit” to the system that regulates early development.

“As a result, severe craniofacial abnormalities can develop, including underdeveloped eyes and abnormal jaw formation, which were the most common effects of PFDA exposure during foetal development,” said Lampe.

The researchers hope by providing a molecular explanation for this abnormality that the research and scientific community can work to develop targeted laboratory assays and computer‑based screening tools to quickly rank PFAS by risk. They say this could help regulators and manufacturers distinguish more dangerous compounds from safer alternatives and guide the design of less toxic chemicals in the future.

They also hope the research can open the door to practical interventions for people with higher exposure, such as firefighters and ski wax technicians. This could include looking into how to reduce exposure levels and whether strategies can be developed to lower PFDA during pregnancy to protect foetal development.

By Julia Milzer

Source: CU Anschutz Medical Campus

Categories : Diet and Nutrition Obstetrics & GynaecologyTags :

Study: Intermittent Fasting Positively Affects Female Hormones in PCOS 

On By ModernMedia
Photo by Sora Shimazaki on Pexels

Polycystic ovary syndrome, or PCOS, affects as many as 18% of all childbearing-age women. The condition occurs when a woman’s body produces too androgens, chiefly testosterone. Menstrual irregularity, obesity and even infertility can result.

The first line of treatment is typically hormonal birth control, said UIC professor of nutrition Krista Varady. But there can be negative side effects to mood, libido and metabolism, plus an increased stroke risk in some people, Varady said.

“We’re looking for other ways of lowering testosterone levels in these women,” she said. “One way is through weight loss. If someone loses around 5% of their body weight, they can actually help lower testosterone levels and sidestep any kind of drug intervention.”

A new study led by Varady tested how one weight-loss method — intermittent fasting — affects hormones and symptoms in patients with PCOS. Published in Nature Medicine, the research shows that restricting eating to a six-hour daily window decreased testosterone without negatively affecting female hormones. The study also showed that weight loss through calorie counting decreased testosterone. 

However, some critics of intermittent fasting have posited that the diet disrupts female hormones, Varady said.

“There’s a particular sentiment that intermittent fasting is really bad for women.” This is untrue, she said. “This study and several other studies published by our lab and others show that intermittent fasting can actually improve female hormone levels, particularly in women with PCOS.” 

Varady and her colleagues studied a type of intermittent fasting called time-restricted eating. In this method, you eat only during a set six- or eight-hour period each day. During the remaining 18 or 16 hours, you fast with calorie-free beverages and water until the next day. 

Simply put, the strategy helps people eat less, Varady said. So does counting calories, a method Varady and her colleagues tested alongside intermittent fasting in the study. But intermittent fasting had some additional benefits.

“It’s a way of reducing energy intake without having to do really complicated calorie counting,” she said about intermittent fasting. Varady and others have shown in previous work that eating only during an eight-hour window can cut around 300 to 500 calories a day.

In addition to obesity and insulin resistance, which raise risks of diabetes and heart disease, PCOS can cause ovarian cysts, acne and facial hair growth.

In a group of 76 pre-menopausal women with PCOS, the researchers tested how outcomes differed after six months between time-restricted eating between 1 and 7 p.m. daily and calorie counting. Both diet schemes ended up cutting participants’ intake by about 200 calories per day, the team found, leading to average weight loss of about 10 pounds over the six months.

Both groups also experienced a decrease in testosterone concentrations. But only time-restricted eating reduced free androgen index, the ratio between testosterone and the protein that transports it through the blood, which is a marker of how much active testosterone is reaching a body’s tissues. It also improved A1C levels, a risk marker for diabetes, Varady said.

Though intermittent fasting did not lessen other PCOS symptoms, like menstrual period irregularity, Varady suggested those symptoms might improve with longer time on the diet and greater weight loss.

About 80% of the participants in the time-restricted eating group said they were going to continue the diet, Varady said.

Story by Tess Joosse

Source: EurekAlert!

Categories : Environmental Effects Obstetrics & GynaecologyTags :

Breakdown Products from ‘Eco-friendly’ Plastics Impede Foetal Development in Mice

On By ModernMedia

Nanoplastics from biodegradable plastics can cross the placenta and accumulate in foetal organs

PLA plastic breakdown product Oligomeric nanoplastics can penetrate the placental barrier and reach the foetus. Image credit: Dr Jia Lv (CC-BY 4.0)

When the “eco-friendly” bioplastic, polylactic acid (PLA), biodegrades, the resulting nanoplastics can accumulate in the foetuses of pregnant mice and interfere with foetal growth. Yichao Huang and De-Xiang Xu of Anhui Medical University, China, and Mingliang Fang of Fudan University, China, report these findings in a new study published March 26thin the open-access journal PLOS Biology.

PLA, which is made from corn starch and sugarcane, came onto the market as a biodegradable alternative to conventional plastics around two decades ago and has since become one of the most widely used bioplastics. Due to exponential growth in the production of PLA for packaging and medical applications, humans are increasingly exposed to its main breakdown product, oligomeric lactic acid (OLA) nanoplastics, which have recently been shown to have negative health effects.

In the new study, researchers exposed pregnant mice to OLA at doses proportional to what a human typically consumes and looked for impacts on the mouse pups. They demonstrated that OLA crosses the placenta and accumulates in various organs in the fetus. Furthermore, they showed that OLA interferes with a signaling pathway that controls the development of blood vessels in the placenta, which leads to slower growth of the fetus. This is a concern, because in humans, low birth weight is associated with an increased risk of stillbirth, as well as a higher risk of developing multiple other health problems later in life.

This work is the first animal study to evaluate the developmental health effects from the breakdown products of a supposedly eco-friendly plastic in pregnant mammals. The researchers propose that future work should focus on evaluating the exposure levels and health risks associated with eco-friendly plastics in humans, and a rethinking of our approach to plastic alternatives.

The authors add, “One of our co-authors Dr Mengjing Wang had previously discovered that the widely merchandised PLA microplastics undergo gut enzyme–mediated hydrolysis into oligomeric products that are toxic to the intestinal tract and can trigger enteritis.”

“To follow up on this work, as toxicologists, we went on to ask an additional question: do these oligomeric products, aka OLA, pose developmental threat particularly during the susceptible stage in utero?”

“What we have found was quite astonishing to us. Even under realistic exposure dose scenario during pregnancy, OLA nanoplastics can penetrate the placenta and even reach the foetus, in a mouse model. Such exposure would then cause placental vascular dysplasia and further lead to compromised foetal development.”

“While biodegradable plastics present a viable path to mitigate traditional plastic pollution, their potential health hazards necessitate a recognition in responsibility toward informed consumer intentions and conscientious usage.”

Provided by PLOS

Categories : Obstetrics & GynaecologyTags :

Why Women’s Health Drives Economic Resilience 

On By ModernMedia
Photo by The Creative Exchange on Unsplash

By Merilynn Steenkamp, Managing Director, Southern Africa, Multi-Country Network, Roche Diagnostics

Across South Africa, women play a central role in sustaining economic activity. They lead classrooms, staff hospital wards, run small businesses, work in agriculture, build enterprises and manage households. In many communities, they are the primary earners and the primary caregivers.1

In March, as South Africa observes International Women’s Month, recognising women’s contribution also means ensuring that systems are structured to protect their health. Reliable access to early diagnostics remains one of the most practical levers available to support that protection.

When women experience illness, the impact extends well beyond a single diagnosis. Time away from work affects income, productivity and career progression. In informal employment, where many South African women operate without formal protections, illness can immediately reduce household earnings. The economic effects are felt first at the family level, then across communities.

Women make up the majority of South Africa’s health and social services workforce. They also carry a disproportionate share of unpaid care work in households². Globally, UN Women reports that women reinvest up to 90 percent of their income into their families and communities³. That reinvestment strengthens education, nutrition and long-term stability across generations.

Imagine a young nurse, working at a local clinic, earning a mid-level salary. As the sole breadwinner in her home, living month-to-month, she must use the funds available to pay school fees and associated costs for her children. As she also cares for her aged mother, five people rely on her steady income to survive. If she becomes seriously ill for an extended period of time, the effects are potentially catastrophic for her family, and compound pressure on the economy at large.

South Africa continues to carry a high burden of infectious diseases, including tuberculosis⁴ and HIV, while non-communicable diseases such as diabetes and cancer are rising. Cervical cancer remains the second most common cancer among South African women⁵. But when this cancer is detected early, the five-year relative survival rate exceeds 90 percent. That makes it imperative to raise awareness around early detection, as when cervical cancer is diagnosed at an advanced stage, survival drops significantly⁶.

Early and accurate diagnostics protect women’s ability to remain economically active, particularly for preventable illnesses. Early testing enables faster treatment, reduces complications and limits the need for more complex interventions later. In the case of infectious diseases, it also reduces transmission and protects colleagues, families and communities.

South Africa has a strong laboratory foundation to build on. The National Health Laboratory Service operates one of the largest diagnostic networks in the region, supporting large-scale testing every day⁷. Leveraging existing laboratory capacity allows screening and early detection programmes to expand in ways that are sustainable and aligned with national health priorities.

High-performance HPV testing, rapid HIV diagnostics, molecular tuberculosis testing and integrated blood panels are examples of tools that shorten the path from suspicion to confirmation. Reducing diagnostic delays supports workplace continuity and strengthens health system efficiency. In a country focused on improving workforce participation and economic resilience, this connection is direct.

Protecting women’s health strengthens household stability, supports workforce participation and reinforces economic resilience. Prioritising early diagnosis is a clear and measurable way to invest in South Africa’s long-term growth. 

It starts at home, with our mothers, sisters and daughters. Let’s keep reminding them, every now and then, to take a moment and consider their own well-being, for them, and for all of us.  

References

  1. Statistics South Africa. Quarterly Labour Force Survey (QLFS). Available at: https://www.statssa.gov.za/?page_id=16408
  2. Statistics South Africa. South Africa Time Use Survey. Available at: https://www.statssa.gov.za
  3. UN Women. Facts and figures: Economic empowerment. Available at: https://www.unwomen.org
  4. World Health Organization. Global Tuberculosis Report. Available at: https://www.who.int/teams/global-tuberculosis-programme/tb-reports
  5. Cancer Association of South Africa (CANSA). Cervical cancer. Available at: https://cansa.org.za/cervical-cancer/
  6. National Cancer Institute. Cervical Cancer Survival Rates. Available at: https://www.cancer.gov/types/cervical/survival
  7. National Health Laboratory Service (NHLS). About NHLS. Available at: https://www.nhls.ac.za/

Categories : Neurology Obstetrics & GynaecologyTags :

More Evidence Tying Epilepsy Drugs in Pregnancy to Developmental Risks

On By ModernMedia

Study adds weight to previously reported risks and calls for monitoring of new antiseizure drugs

Photo by SHVETS production

Findings published by The BMJ reinforce previous research linking use of the antiseizure drug valproate during pregnancy to neurodevelopmental disorders such as ADHD and autism in children, and indicate no substantial risk for several other antiseizure drugs including levetiracetam and lamotrigine.

However, the researchers say continued monitoring of the few signals – possible associations between a medicine and an unintended side effect – that emerged (eg, for zonisamide) will be important.

Antiseizure drugs are commonly and increasingly used by women of childbearing age for conditions like epilepsy, bipolar disorders, and migraine prevention. Women with epilepsy are advised to continue taking these during pregnancy, as uncontrolled seizures pose risks to both mother and child.

Yet, while valproate use during pregnancy has been linked to impaired neurodevelopment in children, information on other antiseizure drugs is limited.

To address this gap, researchers analysed claims data for pregnancies with diagnosed epilepsy from two large US public and commercial insurance databases, spanning the period from 2000 to 2021.

They compared 14,993 children exposed to at least one antiseizure medication during the second half of pregnancy with 8,887 unexposed children. Of these, 5,505 were followed for at least 5 years and 2,516 for at least 8 years after birth.

Potentially influential factors including mother’s age, ethnicity, mental health, substance use, other medication use and underlying conditions were also taken into account.

Valproate and zonisamide showed associations with several neurodevelopmental disorders, whereas levetiracetam and phenytoin were not associated with an increased risk of any of the studied outcomes.

Although no meaningful associations were found for topiramate and lamotrigine across most outcomes, there was a potential signal for intellectual disability (both drugs) and learning difficulty (topiramate only). However, the authors note that  these findings are based on small numbers and require confirmation in follow-up studies.

Several other drugs were also associated with a risk increase for intellectual disability. However, the authors note that these estimates are based on small numbers and therefore should be interpreted with caution.

Carbamazepine and oxcarbazepine also showed a modest risk increase for ADHD and behavioral disorders.

This is an observational study, so no definitive conclusions can be drawn about cause and effect, and the authors point to several limitations including relying on insurance claims data and the potential influence of other unmeasured factors such as underlying epilepsy type and severity.

However, the use of two large nationwide databases of insured pregnant women linked to their children enhanced the generalisability of their findings and enabled them to assess the risk of specific neurodevelopmental disorders associated with individual antiseizure medications. Results were also consistent after additional analyses, suggesting that they are robust.

As such, they conclude: “Our study reinforces the substantial risks of neurodevelopmental disorders associated with prenatal valproate exposure and suggests the need to further evaluate the safety of zonisamide during pregnancy.”

“Continued monitoring of newer antiseizure drugs and the few potential signals that emerged (ie, the moderate increased risk of ADHD and behavioural disorder after carbamazepine and oxcarbazepine exposure, and the association of several antiseizure drugs with intellectual disability) will be important,” they add.

Source: BMJ Group

Categories : Obstetrics & Gynaecology Surgeries & ProceduresTags :

“Two-for-one” C-section and Tummy Tuck Idea Alarms Surgeons

On By ModernMedia
Photo by Jonathan Borba on Unsplash

The ‘mommy makeover’ is trending, and a growing number of patients are now asking whether cosmetic procedures such as a tummy tuck, liposuction, or breast augmentation can be performed at the same time as a Caesarean section. But surgeons warn that combining elective cosmetic surgery with a C-section can sharply escalate risk during an already vulnerable period for the body.

Professor Chrysis Sofianos, a triple-board certified plastic surgeon and Academic Head of the Division of Plastic and Restorative Surgery at the University of the Witwatersrand, says procedures such as a tummy tuck should only be considered once the body has adequately recovered after childbirth – typically around six months after delivery, depending on individual healing.

“Our practice is seeing a growing number of patients ask whether body-contouring surgery can be performed while they are already in theatre for a C-section. But this reflects a dangerous misunderstanding of surgical safety and postpartum physiology.

“While the idea may appear efficient or financially attractive, pairing medically necessary obstetric surgery with elective cosmetic procedures significantly increases operative risk at a time when the patient is physiologically vulnerable.”

Combining surgeries and compounding risks

C-sections account for around 75% of private sector hospital births in South Africa. Professor Sofianos notes that because there is often an overlap between women accessing private medical care and those who may later consider elective cosmetic procedures, more patients are likely to ask whether these operations can be combined.

“However, the more important question is whether they should. And the simple answer is no,” he says. “A C-section is already a major abdominal operation. Introducing additional surgical trauma before the body has recovered would introduce excessive strain and substantially raise the risk of complications.”

Pregnancy and the immediate postpartum period are associated with a hypercoagulable state, meaning the blood has an increased tendency to clot. Postpartum women therefore face a markedly elevated risk of venous thromboembolism, particularly in the first six weeks after delivery. Prolonging operative time and increasing tissue disruption may further elevate this risk by contributing to immobility, tissue stress, and inflammatory response.

A C-section on its own carries recognised complications, including haemorrhage, infection, anaesthetic complications, and clotting risk. Adding abdominoplasty (tummy tuck) can introduce additional risks such as bleeding, fluid accumulation, wound breakdown, delayed healing, and blood clots.

Liposuction also introduces risks, such as fluid imbalance, internal injury, infection, and, in rare but serious cases, fat embolism – a potentially life-threatening condition in which fat enters the bloodstream and compromises vital organs.

The false economy of combining procedures

Professor Sofianos also notes that combining procedures rarely provides the financial or practical advantages patients may assume.

“There is a common a misconception that theatre and anaesthetic fees can be consolidated if surgeries are combined into a single session. In reality, longer operative times, greater monitoring requirements, and the potential for complications may result in far higher medical costs. More importantly, financial reasoning should never supersede patient safety.”

He adds that the combined recovery period can also be far more demanding than patients anticipate.

“Recovery after a C-section already places significant physical, emotional, and psychological demands on a new mother. Adding major cosmetic surgery to that recovery period can complicate mobility, wound care, and pain management at a time when the patient must also care for a newborn.

“A more intensive recovery process may further require extended postoperative care, closer medical oversight, and additional support at home, all of which can add to the existing financial burden.”

Finally, he warns that operating during the immediate postpartum period might not produce the optimal long-term aesthetic result a patient may be looking for, and could expose them to unnecessary revision surgery later.

“Medically and ethically, I do not believe combined C-section and ‘mommy makeover’ surgeries should ever be considered. No responsible surgeon should minimise the compounded risks associated with performing such procedures. Ultimately, safe, staged care remains the gold standard for medical care, or allowing the body to recover fully before elective cosmetic surgery is undertaken.”

Categories : Obstetrics & GynaecologyTags :

Uneven Adherence to Magnesium Sulfate, Steroids in High-risk Pregnancies

On By ModernMedia
Photo by SHVETS production

Prenatal magnesium sulfate and steroids can reduce the risks of cerebral palsy and respiratory complications in preterm infants. A review in the International Journal of Gynecology & Obstetrics found that despite being recommended internationally for pregnant women at risk of preterm delivery, these medications are used variably between and within countries.

When they analysed 2012–2024 information on 45 619 babies born at 24–32 weeks’ gestation at 1111 hospitals in an international network, along with information from the UK National Neonatal Research Database and a literature review, investigators found that on average, less than half of infants had been exposed to preterm magnesium sulfate in middle-income countries, and approximately three-quarters in high-income countries. Even within high-income countries, there were large discrepancies in care. Preterm steroids were used more frequently with less variation, although treatment gaps were still apparent.

“Our study has highlighted the international disparities in how two key treatments to protect pre-term babies are implemented. These gaps aren’t because of a lack of evidence,” said corresponding author Hannah B. Edwards, MA, MSc, of the University of Bristol, in the UK. “Lessons can be learned from successful implementation programs like PReCePT, which has transformed use of magnesium sulphate in pre-term births in England. The bigger-picture goal should now be to ensure that no matter where a baby is born, their mother has access to the evidence-based treatments that offer the best start in life.”

Source: Wiley

Categories : Obstetrics & GynaecologyTags :

Yawns in Healthy Foetuses Might Indicate Mild Distress

On By ModernMedia

Foetuses yawn in the womb, with more yawns associated with a lower weight at birth

Photo by Mart Production on Pexels

Even in the womb, where all oxygen is provided by the parental placenta, foetuses can – and do – yawn. More yawns during observation were associated with a lower weight at birth – potentially indicating mild foetal stress in the womb, according to a study published February 25, 2026 in the open-access journal PLOS One by Damiano Menin, of the Università degli Studi di Ferrara in Italy, and colleagues.

Yawning is a behaviour found across vertebrates – and no one quite knows why. In humans, foetuses yawn in the womb from about 11 weeks. Even though there is no air to breathe, they slowly open their mouths, make motions similar to inhalation and exhalation, and close their mouths again. To understand more about foetal yawns, the authors of this study used ultrasound to observe 32 healthy foetuses (56% female, 44% male) between 23 and 31 weeks. Each foetus was observed for 22.5 minutes.

The authors found that the foetuses yawned between zero and six times during the observation period, with an average of 3.63 yawns per hour. They also showed that foetuses that yawned more during their observations were more likely to have a low weight at birth, which is considered as an indicator of mild distress – though all foetuses in the study were born healthy.

The researchers did not perform any manipulations to see if they could affect foetal yawning and also did not record measures such as foetal heart rate or maternal temperature which might potentially be associated with the behaviour. Additionally, no high-risk pregnancies were observed. Based on their research, the authors suggest that frequent foetal yawning might be a sign of mild distress in the healthy foetus.

The authors add: “We found that yawning frequencies in the womb are negatively related to birth weight, potentially indicating a stress-related response in healthy fetuses. This suggests that even before birth, yawning may serve as an indicator of a foetus’s well-being.”

Provided by PLOS