Background: Preeclampsia is a significant cause of maternal morbidity and mortality, often influenced by maternal nutrition. Calcium and zinc are essential micronutrients implicated in the prevention of preeclampsia. This study examines their levels in pregnant women consuming seafood in Ambon City as a local data that could support global data. Methods: This analytical observational study used a case-control design. Calcium and zinc levels were assessed in 120 pregnant women (60 with preeclampsia, 60 without preeclampsia) attending medical facilities in Ambon from June to October 2024. Statistical analyses, including Chi-square tests, were performed. A P-value < 0.05 was considered statistically significant. Results: Pregnant women with preeclampsia in Ambon City had lower calcium levels than those without preeclampsia, especially among those consuming less than four pieces of sea fish per day (≈ 120 g each) (borderline (OR = 3.143, p = 0.053)). Zinc levels showed no significant difference. Women with preeclampsia had a 10.286-fold increased likelihood of low calcium levels. Conclusion: In Ambon City, pregnant women with preeclampsia have lower calcium levels than those without, while zinc levels remain similar between both groups. Higher fish consumption (at least four medium-sized pieces per day) is linked to higher calcium levels in both preeclamptic and non-preeclamptic women, but zinc levels are unaffected by fish intake.

Doppler findings of persistent reverse end-diastolic flow (PREDF) in a fetal middle cerebral artery (MCA) are a very rare sonographic finding and are a marker of poor fetal condition. This finding often leads to intrauterine fetal death or early neonatal death. Reverse end-diastolic flow in the middle cerebral artery is an advanced hemodynamic event. Fetal cerebral circulation normally has a high impedance; in the event of fetal hypoxemia, impedance decreases, resulting in the central redistribution of blood flow to vital organs, which maintains the oxygen delivery to the brain. Reverse flow in the middle cerebral arteries describes the loss of this autoregulatory process. PREDF is a sequence that occurs due to increased extracranial or intracranial pressure. Previous case reports mentioned intracranial hemorrhage, fetal growth restriction, fetal anemia, and fetal hepatic abnormalities as problems leading to PREDF. This condition presumably arises due to cerebral edema associated with severe hypoxemia. We reported Doppler findings of PREDF MCA in a 33-year-old female patient at 30 weeks gestation who was referred to the hospital with severe preeclampsia accompanied by fetal growth restriction and oligohydramnios. A cesarean section was performed due to severe preeclampsia and a low bishop score. Hypotheses on various etiologies and their association with intrauterine/neonatal death as well as the best management still require further investigation.

Doppler findings of persistent reverse end-diastolic flow (PREDF) in a fetal middle cerebral artery (MCA) are a very rare sonographic finding and are a marker of poor fetal condition. This finding often leads to intrauterine fetal death or early neonatal death. The reverse end-diastolic flow in the middle cerebral artery is the terminal hemodynamic event. Fetal cerebral circulation normally has a high impedance; in the event of fetal hypoxemia, impedance decreases, resulting in the central redistribution of blood flow to vital organs, which maintains the oxygen delivery to the brain. Reverse flow in the middle cerebral arteries describes the loss of this autoregulatory process. PREDF is a sequence happening due to increased extracranial or intracranial pressure. Previous case reports mentioned intracranial hemorrhage, intrauterine growth restriction (IUGR), fetal anemia, and fetal hepatic abnormalities as leading problems to PREDF. This condition presumably arises due to cerebral edema associated with severe hypoxemia. We reported Doppler findings of PREDF MCA in a 33-year-old female at 30 weeks gestation who was referred to the hospital with severe preeclampsia accompanied by IUGR and oligohydramnios. A cesarean section was performed due to severe preeclampsia and a low bishop score. Hypotheses on various etiologies and their association with intrauterine/neonatal death as well as the best management still require further investigation.