maternal

Shoulder dystocia is a rare but severe complication of vaginal delivery with possibly serious consequences. Certain risk factors are associated with shoulder dystocia, but a general forecasting model is lacking. We present a Case report using a newly modified Posterior Axilla Maneuver technique that saved a 5.140 g (11 lbs. 5 oz.) newborn from shoulder dystocia. The child was born with Apgar 7/9, pH 7.17. Currently, there are no signs of any long-term sequelae.Our procedure comprised the following steps: 1. First, we pulled the posterior shoulder downwards - in the direction and to the outer surface of the perineum. 2. Then we pulled the posterior shoulder backward - toward the maternal spine - when it was already outside the perineum and finished extracting the posterior shoulder. 3. By completing the first two steps, a Tilt of the shoulder girdle was reached in the midsagittal plane, resulting in a backward slope for the shoulder girdle so that the anterior shoulder touched the symphysis slightly from the back in a skewed manner, freeing it from the initial impacted position. 4. We applied the Kristeller procedure only after dislodging the anterior shoulder from its initial impacted position. 5. We also applied the McRoberts Maneuver at the end of the process to increase the diameter of the birth canal.

A 27-year-old pregnant woman presented with acute pyelonephritis for the first time in her pregnancy. We admitted the patient for treatment. On the second day, her fetus had bradycardia as a result of maternal hypothermia. Infusion of warmed fluid and providing a warm blanket were the definite treatment in this case. However, the fetal heart rate gradually returned to normal after rewarming the patient. We discharged the patient in a good state after one week. No complications were noticed.

Introduction: The rise in cesarean section rates globally has led to a growing population of women with uterine scars, necessitating more targeted obstetric care in subsequent pregnancies. These women are faced with the decision of attempting vaginal delivery after cesarean section (VBAC) or opting for an elective repeat cesarean section. The likelihood of a VBAC depends on various factors both maternal and fetal, gathered in two known scores Grobman and Zhang, utilizing them could make VBAC successful and more widely attempted.  This study aims to validate the prognostic of these scores in a Moroccan population.Objectives:•    Validate the international predictive scores (Grobman and Zhang) for the probability of a successful VBAC in the Moroccan population.•    Explore additional criteria specific to the Moroccan population and develop a simplified VBAC score.  Results:•    Out of 2,973 women with a cesarean history, 313 attempted  TOLAC, 79% of these attempts were successful VBAC.•    The characteristics of successful VBAC included lower BMI, previous vaginal birth, lower estimated fetal weight, younger maternal age, and more favorable cervical conditions at admission.•    The Grobman and Zhang scores showed good predictive accuracy, with both models achieving 82.2% accuracy.•    When dividing women into groups based on predicted success (using both Grobman and Zhang scores), significant differences were found in success rates across different probability categories.Conclusion: Both Grobman and Zhang’s models were effective in predicting VBAC success in the Moroccan population, with a slight preference for the Zhang model. However, further research is needed to validate these models in clinical practice. It could involve developing a more population-specific model.

Background & objectives: Mitochondrial DNA (mtDNA) contains valuable genetic information and plays a crucial role in missing person investigations, mass disasters, and forensic cases involving limited or degraded biological material. mtDNA is maternally inherited, with a highly variable control region divided into three hypervariable regions are generally used for forensic investigation. This study aimed to evaluate maternal inheritance patterns of mtDNA using PCR-RFLP techniques to confirm maternal relatedness. Method: The study was designed after prior permission from the institute’s ethical committee in which subjects were enrolled. This pilot study analyzed 50 voluntary participants (mother-child pairs). DNA was extracted from blood or saliva, and the mtDNA hypervariable region (HV region) was amplified by PCR using specific primers for the HV1 region. The amplified fragments (1024 bp) were subjected to RFLP analysis using seven restriction endonucleases (Alu I, BsuR I (Hae III), Hinf I, HsYF31 (Dde I), Mbo I, Rsa I, and SsPI) to reveal morphotypes. Results: The study identified five morphotypes for Alu I, three for BsuR I (Hae III) and Rsa I, two for Hinf I, and one each for HsYF31 (Dde I), Mbo I, and SsPI. There was minimal genetic polymorphism in the hypervariable region among unrelated individuals, but consistent restriction patterns were observed between mothers and their children in same pair. Conclusion: The findings demonstrate the low genetic polymorphism in the hypervariable region among unrelated individuals and consistent restriction patterns within maternal pairs, underscoring mtDNA's utility in forensic and genealogical applications.