Introduction: The fetal origins of adult disease, widely known as Barker’s Hypothesis, suggest that adverse fetal environments significantly impact the risk of developing chronic diseases, such as diabetes and cardiovascular conditions, in adulthood. Recent advancements in 4D ultrasound (4D US) and artificial intelligence (AI) technologies offer a promising avenue for improving prenatal diagnostics and validating this hypothesis. These innovations provide detailed insights into fetal behavior and neurodevelopment, linking early developmental markers to long-term health outcomes. Content: This study synthesizes contemporary developments in AI-enhanced 4D US, focusing on their roles in detecting fetal anomalies, assessing neurodevelopmental markers, and evaluating congenital heart defects. The integration of AI with 4D US allows for real-time, high-resolution visualization of fetal anatomy and behavior, surpassing the diagnostic precision of traditional methods. Despite these advancements, challenges such as algorithmic bias, data diversity, and real-world validation persist and require further exploration. Summary: Findings demonstrate that AI-driven 4D US improves diagnostic sensitivity and accuracy, enabling earlier detection of fetal abnormalities and optimization of clinical workflows. By providing a more comprehensive understanding of fetal programming, these technologies substantiate the links between early-life conditions and adult health outcomes, as proposed by Barker’s Hypothesis. Outlook: The integration of AI and 4D US has the potential to revolutionize prenatal care, paving the way for personalized maternal-fetal healthcare. Future research should focus on addressing current limitations, including ethical concerns and accessibility challenges, to promote equitable implementation. Such advancements could significantly reduce the global burden of chronic diseases and foster healthier generations.

The advent of non-invasive prenatal testing (NIPT) utilizing cell-free fetal DNA (cfDNA) has transformed the landscape of early chromosomal anomaly detection. When paired with high-resolution ultrasound imaging, it establishes a robust framework for prenatal diagnostics. This study explores the efficacy of merging NIPT findings with detailed ultrasound markers to enhance the identification of both chromosomal and structural fetal abnormalities. Data from 190 cases demonstrated a cfDNA efficacy rate of 91.58 % (cfDNA ≥4 %) and a detection rate of 4.74 % for aneuploidies. The investigation delves into key findings for trisomies, monosomies, and physical malformations, backed by state-of-the-art diagnostic benchmarks. Markers such as nuchal translucency (NT), craniofacial characteristics, and cardiac irregularities were analyzed alongside genetic results. This integrative strategy significantly refines diagnostic precision, paving the way for personalized prenatal care and management.

The Zero Mother Mortality Preeclampsia (ZOOM) program was adopted as an accelerated initiative to curb mortality related to hypertensive disorders in pregnancy, including preeclampsia. This single-center, retrospective study in Bandung, West Java, aims to evaluate the impact of the ZOOM program implemented from 2015 to 2022. We analyzed 19,176 childbirths and associated maternal deaths due to hypertension in pregnancy. Diagnoses were validated using blood pressure measures, lab tests including urine protein, liver function, blood profiles, platelets, X-ray, echocardiography, and COVID-19 testing. The case fatality rate (CFR) was assessed to evaluate the impact of the ZOOM program. Hypertension in pregnancy was identified in 25.1% of cases, with 9.8% and 1.4% attributed to preeclampsia and eclampsia, respectively. Maternal deaths associated with hypertension accounted for 36.6%, with the majority linked to eclampsia. Heart failure (45.5%) and Hemolysis, Elevated Liver enzymes, and Low Platelets (HELLP) syndrome (22%) were the most common complications. The CFR decreased from 61% in 2018 to 10% in 2022. The overall CFR from 2015 to 2022 was 1.3%, with the highest fatality rate observed in eclampsia cases (9.4%). However, a declining trend was seen since 2018, reaching a low of 0.2% in 2021. The implementation of the ZOOM program, which includes preeclampsia re-education, early detection, prompt intervention, protocol adjustments, and a refined referral system, led to a marked reduction in maternal deaths from hypertensive pregnancy disorders.

Background: Obesity is described as excessive fat accumulation. Almost 47% of pregnant women gain more weight than recommended. The prevalence of obesity doubled from 2007 to 2018 (10.5% to 21.8%) in Indonesia. An increase in body mass index (BMI) before pregnancy is associated with delayed labor and vaginal delivery failure. Women with overweight or obesity in pregnancy are at increased risk of developing gestational hypertension and gestational diabetes, resulting in the induction of labor or elective cesarean section. This study aimed to investigate the correlation between pre-pregnancy BMI and outcomes from induction of labor in 248 women during 1 year at a hospital in Purwokerto, Indonesia. Material/Methods: The study was conducted at Margono Soekarjo General Hospital and involved all pregnant women delivered between 2023 and 2024. Inclusion and exclusion criteria were applied. Total number of pregnant women was 248, BMI used Asian parameters, induction of labor was performed with oxytocin or misoprostol, and outcomes were according to the International Federation of Gynecology and Obstetrics. The design was a case-control study. Statistical analysis performed using IBM SPSS Statistics version 29.0.1.0 was used to analyze odds ratio and chi-square test. Results: This research study revealed pregnant women with obesity had statistically significant higher odds, with an odds ratio of 3.78 (95% CI 1.53-9.31, P =0.002), of labor induction failure than did those without obesity. Conclusions: The findings from this study showed that increased BMI in pre-pregnancy significantly increased the risk of failure of labor induction.

Introduction and importance: Cloacal Exstrophy (CE) is a rare congenital birth defect. A correct prenatal diagnosis of CE is rarely made, even when congenital abnormalities are suspected on prenatal ultrasound examination.Case presentation: We report a case of CE with an abdominal defect about 5.31 cm in diameter seen below the umbilicus covered by a membrane. It was difficult to identify the left kidney, the bladder, the genital, and the anal dimple in the early third trimester ultrasound. The diagnosis of CE was then confirmed postnatally. Clinical discussion: Omphalocele and persistent bladder nonvisualization despite normal amniotic fluid volume detected by prenatal ultrasound can be suggestive for CE.Conclusion: Accurate prenatal diagnosis of CE is important to carry out multidisciplinary management and prenatal counseling to parents.

Introduction: Female technology or ‘femtech’ is the availability of mobile applications (apps) to monitor specific aspects of women’s health. It touts the benefits of technology to empower women with regards to their health, while also allowing close collaboration between patients and physicians. Endometriosis‐specific apps is a channel by which female patients discover their endometriosis diagnosis. However, there is currently a paucity of high‐quality and evidence‐based endometriosis apps. This study assessed the current state and overall quality of such apps. Materials and Methods: This retrospective study assessed patient‐centred endometriosis apps on the Apple iTunes Store, in January 2023, excluding certain categories such as conference guidance, gaming, private healthcare, and clinical trial apps. The key term “endometriosis” was used. All patient‐centred apps were included. The apps were assessed using the APPLICATIONS scoring system, considering objective factors like pricing, subscriptions, literature references, in‐app purchases, connectivity, advertisements, search fields, interoperability, and subjective elements such as navigation ease and presentation. The maximum score is 16 and all applications were assessed in English. Results: Out of the initial 22 apps, 12 (54.5%) were excluded, leaving 10 (45.5%) for analysis. Most apps lacked comprehensiveness, but two apps (LUNA‐endometriosis and Frendo) stood out with high scores. These apps incorporated certified scoring systems, provided recommendations for tests and follow‐up visits, and offered evidence‐based literature on endometriosis. The remaining apps scored poorly, focusing on alternative treatments, healthy diets, or functioning solely as symptom diaries, with limited information on diagnosis and management. Only a few apps allowed booking follow‐up visits, and most lacked the capability to export patient‐specific data. Few apps measured the likelihood of endometriosis whilst others relied on previous diagnoses. The majority of apps were free, whilst in‐app purchases centred around alternative treatments. Overall, the apps were user‐friendly, featuring vibrant colours and intuitive interfaces. Conclusions: Only two patient‐centred endometriosis apps scored highly in the APPLICATIONS scoring system as they were high‐quality, evidence‐based and incorporated valid medical recommendations. Other applications scored low as their recommendations lacked quality scientific evidence.