Introduction Early Chinese thought enjoys a wide appeal, in the scholarly world as much as elsewhere, as people are keen on learning about the ideas of Confucius, Mencius, and other thinkers whose views have shaped traditional Chinese culture. In the study of early Chinese thought, emphasis has long been on what thinkers said, not on how they proffered their views. Even studies that do consider the how, tend to focus on logic and argumentation, rather than rhetoric. Fortunately, in the past f...

Objective: To develop a prediction model for maternal adverse outcomes in high‐risk pregnant populations based on clinical history, biophysical parameters, and placental angiogenic biomarkers.Design: Prospective, observational, and multicenter study.Setting: Two university hospitals in Northern Italy.Population: Women affected by hypertensive disorder of pregnangy (HDP) and/or foetal growth restriction (FGR).Methods: Fms‐like tyrosine kinase‐1 (sFlt‐1) and placental growth factor (PlGF) were measured at recruitment. First, the whole cohort was stratified according to sFlt‐1/PlGF ratio risk categories. Second, the Cox Model was adapted with sFlt‐1/PlGF ratio integrated as a continuous variable together with demographic, clinical and biophysical risk factors to develop a prediction model for the maternal adverse outcomes (severe pre‐eclampsia, HELLP syndrome, abruptio placenta and liver haematoma).Results: We recruited 335 consecutive singleton high‐risk pregnancies (109 with HDP, 95 with HDP‐FGR, and 131 with FGR). Seventy‐one of these developed severe‐pre‐eclampsia, 11 suffered from placental abruption and seven developed HELLP syndrome. At survival analysis, the probability to develop adverse outcomes was significantly different between patients with medium (38–85, 38–110) to very high (> 85/110) sFlt‐1/PlGF ratio compared to those with low sFlt‐1/PlGF ratio (< 38). The Cox multivariable clinical model was significantly associated with maternal complications: the area under the curve was 89.5% after 1 week, 93.8% after 2 weeks, 93.7% after 4 weeks and 96.1% after 8 weeks.Conclusions: In a cohort of women with HDP and/or FGR, a prediction model, based on demographic, clinical, biophysical risk factors and sFlt‐1/PlGF ratio, can predict the risk of developing maternal complications from the time at diagnosis and up to 1, 2, 4, and 8 weeks. The inclusion of sFlt‐1/PlGF ratio, as a continuous variable, significantly improved the risk prediction.

(1) Background: Maternal venous hemodynamic dysfunction is an intrinsic part of the pathophysiology of pre-eclampsia and fetal growth restriction. The aim of this study is to evaluate whether venous hemodynamic dysfunction is present in women with a history of (unexplained) recurrent miscarriage, and to link this pilot observation to reported data in the literature. (2) Methods: A retrospective search of hospital records was conducted to find data on recurrent miscarriage and hemodynamics assessment prior to conception. We also performed a scoping search of the literature regarding the association between recurrent miscarriage and maternal hemodynamics, reproductive outcomes, maternal complications, neonatal complications, and long-term cardiovascular function in women and their offspring. (3) Results: Six out of nine women with a history of recurrent miscarriage had preconception venous hemodynamic dysfunction. This observation is in line with the reported data on reduced venous reserves in association with low plasma volume in women with recurrent miscarriage, and adds to the reported link between recurrent miscarriage, poor reproductive outcomes, and chronic cardiovascular disease. (4) Discussion: This retrospective observational cohort supports an association between venous hemodynamic dysfunction and recurrent miscarriage that is corroborated by data reported in the literature. Abnormal venous hemodynamic function can be improved before conception, and this opens a new and currently unexplored pathway in the management of recurrent miscarriage.

Background/Objectives: Clinical risk measures such as pre-pregnancy body mass index (BMI) and gestational weight gain do not distinguish the expansion of fluid, lean, and adipose compartments. Standardized obstetric reference curves for bioelectrical impedance analysis (BIA) are lacking. This study aimed to establish longitudinal, trimester-specific BIA reference curves in uncomplicated pregnancies. Methods: This multicenter, prospective, longitudinal cohort study was conducted at three Italian tertiary research hospitals from September 2020 to September 2025. BIA assessments (InBody 270^®) were performed at 10–15, 23–25, and 34–37 gestational weeks. Generalized additive models for location, scale, and shape were used to derive reference centiles and BMI-conditioned contour plots for total body water, lean mass, fat mass, and visceral fat level. Pregnancies with complications or incomplete longitudinal data were excluded from the primary reference cohort. Results: Among 442 healthy pregnant women, all parameters increased progressively across gestation. Each 1-unit increase in pre-pregnancy BMI was associated with a larger shift in fat mass (1.88 kg; 95% CI, 1.77–1.99) than in total body water (0.47 L; 95% CI, 0.38–0.57). Conclusions: These multicenter, BMI-conditioned, trimester-specific BIA reference curves provide normative benchmarks for maternal hydration and body composition and may support the identification of early deviations from physiological gestational trajectories.

"Chapter 7 Aides of Quality" published on 18 Dec 2019 by Brill.