搜索结果：Obstetric

To evaluate the impact of a formalized uterine manipulator training program on medical students' operating room experiences during their obstetrics and gynecology clerkship. Prospective cohort study with pre- and post-intervention surveys and a hands-on skills evaluation. Uterine manipulator simulation training was delivered during obstetrics and gynecology clerkship orientation at the Larner College of Medicine at University of Vermont. The sessions included a didactic video and hands-on simulation using a low-fidelity pelvic trainer. Eighty-eight third-year medical students rotating through the obstetrics and gynecology clerkship during the 2024-2025 academic year. Prior to the intervention, 69.4% of students reported discomfort assisting with laparoscopic surgery. Following the intervention, over 75% of students agreed that formalized training improved their ability to participate effectively as surgical team members, increased the educational value of laparoscopic hysterectomy cases, and enhanced their comfort assisting in surgery. There was a statistically significant improvement in uterine manipulator knowledge scores between pre- and post-simulation surveys (p&#x2009;<&#x2009;0.001). Students scored an average of 91% on the end-of-rotation technical skills evaluation. A formalized uterine manipulator simulation training program implemented during clerkship orientation improved medical students' comfort assisting with laparoscopic hysterectomy, enhanced the educational value of operative cases, and increased their effective participation as surgical team members.

This study aims to thoroughly investigate the protective effects of various breastfeeding rates on bronchopulmonary dysplasia (BPD), clarify the relationship between them, and further determine the minimum protective threshold. This prospective study enrolled 276 preterm infants who were born in the obstetrics department of a tertiary Grade A hospital in Zhejiang, China, and were directly admitted to the NICU. This study involved 276 infants, categorized into three breastfeeding groups based on proportion: low (100 infants, 36.2%), medium (98 infants, 35.5%), and high (78 infants, 28.3%). Notably, the incidence of BPD in the high-proportion breastfeeding group (19.5%) was significantly lower than that in the medium-proportion group (44.5%) and the low-proportion group (55%) (p < 0.05); however, there was no statistically significant difference in the incidence of BPD between the medium-proportion group and the low-proportion group (p > 0.05). Exploratory nonlinear analyses suggested a possible candidate inflection point around 0.31, above which the inverse association between breastfeeding proportion and BPD appeared stronger. Breastfeeding plays a crucial role in protecting premature infants from BPD. However, this protective effect does not increase linearly but becomes significant only when the breastfeeding rate reaches 31%. However, this threshold-related finding should be interpreted cautiously and requires validation in larger studies with more comprehensive confounder adjustment.

Children, neonates, and pregnant women are particularly vulnerable during disasters. Fragmentation between specialized pediatric-perinatal systems and general disaster response frameworks can hinder coordinated care. Following lessons from the 2011 Great East Japan Earthquake, Japan established the Disaster Liaison for Pediatric and Perinatal Medicine (DLPPM) to embed specialists within disaster command structures. However, large-scale activation under prolonged infrastructure disruption has not been systematically evaluated. We conducted a structured retrospective descriptive analysis of DLPPM operational records during the first month after the 2024 Noto Peninsula Earthquake. Activities were reviewed across five pre-specified domains to examine how the liaison framework functioned during the acute and subacute phases. DLPPM was integrated into the prefectural disaster headquarters and consolidated maternal-child health information, enabling centralized identification of 83 pregnant women, estimated to represent most pregnant women in the severely affected region. Twenty-one obstetric transfers were coordinated. Pediatric transfers and evacuation of medically dependent children were facilitated through established networks. During the subacute phase, DLPPM initiated maternal-child support measures, including a "Children's Conference" and a support website. These findings suggest that DLPPM functioned as a centralized coordination hub linking specialized clinical networks with disaster governance, although real-time identification of vulnerable families in shelters remained limited. Embedding pediatric and perinatal specialists within disaster headquarters can support structured medical coordination for vulnerable populations. Earlier and more systematic integration with public health and welfare systems is essential to extend this hub function beyond hospital-centered care.

Advanced abdominal pregnancies are rare in obstetrics. They have the potential for implantation of the placenta on highly vascular intra-abdominal structures leading to morbidity and mortality. This report presents the case of a 32-year-old woman who underwent delivery at 31&#xa0;weeks of gestation of a heterotopic twin pregnancy (intrauterine and intra-abdominal). Delivery was complicated by life-threatening hemorrhage of the placental bed, which was managed with abdominal packing and open abdomen negative pressure wound therapy for temporary abdominal closure. She subsequently underwent primary abdominal closure with the placenta left in situ and serum beta human chorionic gonadotropin levels trended to zero. Temporary abdominal closure with negative pressure wound therapy is an effective mechanism to minimize surgical morbidity with avoidance of abdominal compartment syndrome and postoperative wound complications in cases of uncontrollable intra-abdominal hemorrhage associated with abdominal placentation.

Immune and inflammatory factors influence endometrial cancer outcomes, the pan-immune inflammation value (PIV) shows potential but remains underexplored. This study aims to evaluate the relationship between preoperative PIV, T cell subtypes, and surgical prognosis in endometrial cancer patients, providing insights for prognostic markers and predictive models. We conducted a prospective observational study involving 101 endometrial cancer patients from August 2022 to August 2024. Based on prognosis within 6 months post-surgery, patients were divided into good and poor prognosis groups. We compared clinical characteristics, inflammatory indices, and T cell immune profiles between the groups. The mean age of participants was 50.12 years, with 23 patients experiencing a poor prognosis. The poor prognosis group exhibited significantly higher proportions of advanced International Federation of Gynecology and Obstetrics (FIGO) stage, larger tumor diameter, elevated neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), and PIV. Conversely, this group showed lower proportions receiving neoadjuvant chemotherapy, CD4+ T cells, and CD4+CD8+ T cell ratios. Notably, elevated PIV emerged as an independent risk factor for poor prognosis, while increased CD4+ T cell proportion and CD4+CD8+ ratio were protective. PIV is significantly associated with poor prognosis in endometrial cancer, serving as an independent risk factor. Higher CD4+ T cell counts and CD4+:CD8+ ratios provide protective benefits. The constructed logistic regression model demonstrates strong predictive capability for post-surgical outcomes. However, limitations, including sample size and short follow-up, necessitate further investigation in larger cohorts.

Interventional radiology (IR) provides minimally invasive diagnostic and therapeutic procedures and is increasingly integrated into routine clinical care. Family physicians play a key role in recognizing indications for IR and referring patients appropriately; however, their level of knowledge regarding IR remains uncertain. To assess the knowledge, awareness, and perceptions of interventional radiology among family medicine residents in Turkey and to evaluate factors associated with knowledge levels. This cross-sectional analytical study was conducted among family medicine residents between August and October 2023 using a structured 21-item online questionnaire. The survey assessed sociodemographic characteristics, exposure to IR training, and knowledge of IR procedures. Knowledge scores were calculated using ten items. Statistical analyses were performed using descriptive statistics, t-tests, ANOVA, and chi-square tests, with significance set at p&#x2009;<&#x2009;0.05. A total of 413 residents participated in the study. Overall, 60.6% of participants reported having an adequate level of knowledge regarding interventional radiology (IR), whereas only 25.5% stated that they directly referred patients to IR units. Commonly performed procedures, such as image-guided biopsy and drainage, were correctly identified by most participants; however, misconceptions were noted regarding several other interventional procedures. Residents who had completed clinical rotations associated with IR, particularly in cardiology and obstetrics and gynecology, demonstrated higher knowledge scores compared with those without such experience. Family medicine residents demonstrated moderate awareness of interventional radiology, with knowledge gaps remaining in specific procedural areas. Clinical exposure through rotations may improve understanding. Incorporating structured IR education into residency training may enhance appropriate referral practices.

Endometrial carcinoma is the most frequently diagnosed gynaecological malignancy in developed countries, and its global incidence continues to increase. Myometrial invasion and lymphovascular spread, driven by epithelial-mesenchymal transition (EMT), are among the most important determinants of clinical outcome. EMT is a dynamic biological process in which epithelial cells develop migratory and invasive mesenchymal characteristics under the influence of transcription factors including SNAIL (SNAI1), SLUG (SNAI2), TWIST, and ZEB2. The aims of this review are to review the current evidence on the immunohistochemical (IHC) expression of the four important EMT transcription factors (SLUG, TWIST, SNAIL, and ZEB2) in endometrial carcinoma and to focus on their clinicopathological correlations, prognostic implications, signalling mechanisms, and potential as therapeutic targets. We conducted a narrative review of the published literature in English using the PubMed, Scopus, and Google Scholar databases. We retrieved and reviewed articles on IHC or molecular expression of SLUG, TWIST, SNAIL, and ZEB2 in endometrial carcinoma. SLUG overexpression independently predicted the advanced International Federation of Gynecology and Obstetrics (FIGO) stage, deep myometrial invasion, lymphovascular space invasion (LVSI), and poorer five-year survival. TWIST expression showed a significant association with the depth of myometrial invasion and loss of E-cadherin expression and was also found to be an independent prognostic factor in multivariate analysis. SNAIL correlates with histological grade, peritoneal cytology positivity, and non-endometrioid histology. High levels of ZEB2 are related to adnexal involvement and higher FIGO stage. Together, these four markers represent a prognostically relevant panel of markers reflecting the invasive phenotype of endometrial carcinoma, which might be targets for novel therapeutic intervention.

Synchronous primary malignancies of the endometrium and ovary are uncommon and require careful differentiation from metastatic disease due to differences in staging, management, and prognosis. We report the case of a 37-year-old nulligravid woman presenting with lower abdominal pain and long-standing menstrual irregularity. Imaging revealed a large left adnexal mass with endometrial thickening. Exploratory laparotomy with intraoperative frozen section suggested malignancy, following which comprehensive surgical staging was performed. Final histopathology confirmed synchronous primary endometrioid adenocarcinoma of the ovary (International Federation of Gynecology and Obstetrics (FIGO) IA, grade I) and endometrium (FIGO II, grade II) without nodal or peritoneal involvement. Immunohistochemistry supported independent primary tumors. The patient had an uneventful recovery. This case emphasizes the importance of thorough surgical staging and meticulous pathological evaluation in establishing synchronous primary disease and guiding appropriate management.

Ovarian cancer (OC) is one of the most common gynecological cancers, representing the abnormal and uncontrolled growth of ovarian cells leading to the formation of tumors. It is one of the leading causes of death in the majority of nations. A wide range of factors, such as lifestyle, environmental factors, genetic factors, hormonal changes, and repeated miscarriages, influence the emergence of OC. Contrary to these factors, breastfeeding, pregnancy, oral contraceptive pills (OCP), and tubal ligation&#xa0;lower the risk of getting OC. The classification of OC as early-stage, advanced-stage, low-grade, or high-grade cancer mainly depends on the histological subtype present at the time of detection. There are various classification systems used to classify OC, but the&#xa0;two most commonly used ones are the International Federation of Gynaecology and Obstetrics (FIGO) staging system and the tumor-node-metastasis (TNM) staging system. The present case is of a 63-year-old female patient diagnosed with high-grade serous carcinoma of the ovary with a TNM staging grade of T1a N0 M0 and an FIGO A1 grade, managed effectively with staging laparotomy. The case study concludes that early identification and care of OC can prevent disease progression, resulting in a better quality of life and prolonging the patient's life. It is crucial to conduct frequent evaluations of a specific age group in the older population to avoid such occurrences.

Type 2 diabetes (T2DM) is clinically heterogeneous. A subgroup with markedly reduced C-peptide has poorer glycemic stability and different therapeutic needs, but the associated peripheral immune features and practical non-invasive markers are not well defined. We investigated whether T2DM with low C-peptide (T2DM-LowC) is associated with a distinct peripheral immune profile. In this single-center, cross-sectional study, patients with T2DM were propensity score-matched 1:1 by disease duration into low C-peptide (T2DM-LowC, n=109) and preserved C-peptide (T2DM-PresC, n=109) groups. Clinical and metabolic variables were compared. In an exploratory sub-cohort (n=21; HC=7, PresC=7, LowC=7), transcriptomic profiling of peripheral blood mononuclear cells (PBMCs) was analyzed using differential expression analysis, weighted gene co-expression network analysis, and CIBERSORTx deconvolution. Candidate genes were validated in an independent cohort (n=40) by RT-qPCR. Compared with T2DM-PresC, the T2DM-LowC subgroup had lower BMI and triglycerides, higher alkaline phosphatase, and a higher systemic inflammation response index (SIRI; neutrophils &#xd7; monocytes/lymphocytes). Higher SIRI remained associated with low C-peptide status after adjustment (OR = 2.38, p = 0.007). Exploratory PBMC transcriptomic analyses identified lower mast-cell-related signatures, higher resting NK-cell and resting CD4 memory T-cell signatures, and a shift toward memory B cells. CSF2RB, NIBAN1, and TLR1 were consistently downregulated in T2DM-LowC, and the three-gene panel discriminated the two T2DM subgroups in the validation cohort (AUC = 0.903; sensitivity 75.0%; specificity 90.0%). In this cross-sectional dataset, low C-peptide T2DM was associated with a distinct clinical and peripheral immune profile. Integrating SIRI with a three-gene PBMC signature may provide a non-invasive adjunct for identifying this subgroup. These deconvolution-derived immune-cell findings require validation in larger and functionally characterized cohorts.

Drug-induced hepatotoxicity is a major adverse effect of first-line anti-tuberculosis (TB) therapy that can compromise treatment safety and outcomes. The objective of this study was to identify and evaluate clinical, laboratory, and nutritional factors associated with drug-induced hepatotoxicity in patients receiving first-line anti-TB therapy. A hospital-based prospective observational study was conducted at Lady Reading Hospital, Peshawar, Pakistan, from January 2023 to June 2024. A total of 220 adult patients with confirmed pulmonary or extrapulmonary TB receiving first-line anti-TB therapy comprising isoniazid, rifampicin, pyrazinamide, and ethambutol were included. Data included demographics, comorbidities, liver function tests (alanine aminotransferase (ALT), aspartate aminotransferase (AST)), and nutritional biomarkers (serum albumin, prealbumin, and total protein). Follow-up liver function tests and nutritional assessments were performed weekly during the first month and subsequently at week 6 and week 8. Drug-induced hepatotoxicity was defined as ALT/AST levels greater than three times the upper limit of normal (ULN) with symptoms or greater than five times ULN without symptoms. Statistical analysis included chi-square test, independent t-test, and multivariate logistic regression. Drug-induced hepatotoxicity occurred in 38 of 220 patients (17.27%). Based on the severity of liver enzyme elevation and clinical presentation, 20 (9.09%) had mild hepatotoxicity, 12 (5.45%) had moderate hepatotoxicity, and six (2.73%) had severe hepatotoxicity. Comparisons were performed using pretreatment clinical, laboratory, and nutritional parameters measured before initiation of therapy, and outcomes were assessed during follow-up. Significant associated factors included age >45 years (47.37% vs 25.82%; adjusted OR (aOR) 2.15), female sex (57.89% vs 42.86%; aOR 1.87), alcohol use (31.58% vs 9.89%; aOR 3.42), and viral hepatitis (21.05% vs 3.85%; aOR 5.28). Nutritional factors associated with hepatotoxicity included low serum albumin (<3.5 g/dL; aOR 2.12) and low prealbumin (<20 mg/dL; aOR 2.45). Liver function test parameters measured at the time of hepatotoxicity diagnosis during follow-up were significantly higher in affected patients compared with those without hepatotoxicity. Drug-induced hepatotoxicity during first-line anti-TB therapy is associated with specific clinical, laboratory, and nutritional risk factors that can help identify patients at higher risk for developing this adverse outcome. Future research should focus on validating these predictors in larger populations and developing targeted monitoring and prevention strategies to improve treatment safety and outcomes.

To evaluate the diagnostic value of routine cystoscopy and rectosigmoidoscopy in staging locally advanced cervical cancer (LACC) in a low - middle - income country (LMIC) setting. A multicenter, retrospective cohort study of 233 patients with LACC (International Federation of Gynecology and Obstetrics 2018 stages IB3-IVB) in Venezuela. All patients underwent clinical examination, magnetic resonance imaging (MRI) and routine endoscopy. The primary outcome was the confirmation of mucosal invasion by endoscopy in patients without prior clinical or radiological suspicion. Endoscopically confirmed bladder and rectal mucosal invasion occurred in 6.0% and 3.0% of patients, respectively. In 95% of all positive cases, suspicion was already present on MRI or clinical symptoms. MRI demonstrated high negative predictive values for bladder (95.9%, confidence interval (CI) 95% 92.5-98.1) and rectal (97.4% CI 95% 92.2-97.8) invasion. Notably, no treatment plan was modified solely based on endoscopic findings. Routine endoscopy was negative in 94% of cystoscopies and 97% of rectosigmoidoscopies. Routine endoscopic staging in LACC showed a very low diagnostic yield and no impact on therapeutic decisions in this LMIC setting. A selective, imaging-guided approach is safe, resource-efficient and aligns with international guidelines, advocating for a change in local protocols. These findings strongly support discontinuing routine endoscopy in LMIC staging protocols.

Indiscriminate maternal slaughter and the resulting foetal wastages are persistent but overlooked threats to livestock productivity, food security, and public health in Africa. Comprehensive data on the drivers and consequences of foetal wastages in Nigerian slaughterhouses remain limited, hampering control efforts. A cross-sectional epidemiological study was conducted for six months in four major slaughterhouses in Enugu State, Nigeria, to determine the pregnancy status of 1745 randomly selected female animals (589 cows, 586 does, 570 sows) slaughtered for meat. Univariable analysis assessed associations between species, age, breed, and season (independent variables) and pregnancy (outcome). Variables with p&#xa0;&#x2264;&#xa0;0.2 were included in the multivariable models, while descriptive statistics were used to summarize the data. Economic losses were estimated based on unit foetal monetary values and adjusted for 5% post-partum mortality. Prevalence of maternal slaughter was 31.7%, 31.1% and 10.5% in goats, cattle, and pigs, respectively. Hot/dry season was associated with pregnancy in goats (AOR&#xa0;=&#xa0;1.58; 95% CI: 1.03-2.42; P&#xa0;=&#xa0;0.036). The 907 foetuses recovered were mostly in the first trimester (38.3-52.2%), with 18.7-25.6% in the third trimester. Foetal disposal included open dumping (28%), sale for dog food (32%), sale for human consumption (18%), and feed for farmed fish (22%). Net economic loss over the six months this study lasted was US$23,659.94. Major drivers of maternal slaughter and foetal wastage included ignorance of pregnancy status (96%), economic hardship (38%), and high meat demands during festivities (20%). Maternal slaughter and foetal wastage are largely driven by systemic failure in livestock production and processing governance. Maternal slaughter impacts livestock farming profitability and productivity, genetic conservation, food security, zoonotic disease spread, occupational and environmental health negatively. Mandatory ante-mortem pregnancy screening, stakeholder education and improved abattoir governance are imperative to limit maternal slaughter, foetal wastage and the negative impacts.

Accurate nodal staging in early-stage cervical cancer remains challenging. Although preoperative imaging is mandatory in the preoperative workup, its limited sensitivity for small-volume disease, together with the suboptimal performance of intraoperative frozen section, may result in undetected lymph node metastases. We report a case from the ongoing RHINOCERUS study (NCT06906705) exploring the feasibility of intraoperative high-frequency ultrasound for sentinel lymph node evaluation. A patient with cervical cancer clinically staged as FIGO 2018 stage IB1, with no evidence of nodal involvement at preoperative imaging, was selected for radical hysterectomy with sentinel lymph node biopsy. After surgical excision, sentinel lymph nodes were intraoperatively assessed ex vivo using a 33&#xa0;MHz high-frequency linear ultrasound probe and classified according to standardized ultrasound criteria. Ultrasound classified one sentinel node as malignant (LN5) and the other as probably malignant (LN4). Histopathological examination subsequently confirmed metastatic involvement in both sentinel lymph nodes. Qualitative comparison demonstrated concordance between ultrasound features and the histopathological correlates. These preliminary findings suggest that high-frequency ultrasound may provide real-time intraoperative morphological assessment of lymph nodes. Intraoperative identification of nodal metastases could inform surgical decision-making. Further prospective evaluation is ongoing to define its diagnostic accuracy and clinical applicability.

暂无摘要（点击查看详情）

Neoadjuvant chemotherapy (NACT) is an established treatment strategy for advanced epithelial ovarian cancer, particularly for patients with high tumour burden or poor surgical fitness. Despite improvement in resectability and reducing perioperative morbidity, current methods for evaluating response, namely imaging, serum biomarkers and histopathology, lack sensitivity and fail to provide timely insights for treatment adaptation. This review critically examines how advances in molecular diagnostics and computational analytics are reshaping the assessment of therapeutic response during NACT in ovarian cancer. The work focuses on the translational potential of liquid biopsy-derived analytes as dynamic biomarkers of treatment efficacy. In parallel, we evaluate the contribution of machine learning and digital twin technologies in refining response prediction, surgical planning, and personalized therapy design. This review synthesizes established and emerging approaches for monitoring response to neoadjuvant chemotherapy in ovarian cancer. We begin by summarizing current clinical tools and highlighting key developments in response-guided treatment strategies. We then examine the potential of liquid biopsy biomarkers, particularly circulating tumour DNA (ctDNA), to provide real-time insights into treatment response. Next, we discuss how clinical and molecular diagnostics combined with computational methods, including machine learning and digital twin technologies, could support personalized treatment design. Future management of ovarian cancer during NACT is likely to move toward real-time, integrated assessment platforms that merge molecular, imaging, and clinical information. While these multimodal approaches show strong promise for enabling precision-guided neoadjuvant care and more individualized therapy, their clinical adoption will depend on robust prospective validation, standardization, and demonstration of meaningful benefit in patient outcomes.

To compare the difference in lung size measurement in fetuses with left-sided congenital diaphragmatic hernia (L-CDH) by means of the observed/expected lung-to-head ratio (O/E-LHR) in two different fetal positions. Prospective cohort of L-CDH fetuses, with O/E-LHR measurements by one experienced investigator but with the fetus in two positions: with the contralateral lung close and one with the lung away from the ultrasound probe. A Bland-Altman analysis was performed to assess the agreement between lung measurements in both fetal positions. 49 L-CDH fetuses underwent paired assessments of lung size at a mean gestational age of 28.8 (17.7-37.7) weeks. Lung size estimation with the lung distant to the probe consistently underestimates the O/E-LHR values compared to measurements obtained using the lung close to the probe. On average, O/E-LHR values were 11.3% (95% confidence intervals (CI), 7.5%-15.0%) higher when the lung was close to the probe. When the lung was distant to the probe, a higher proportion of CDH fetuses were classified in a more severe group than when it was evaluated close to the probe (p&#xa0;<&#xa0;0.01). A consistently lower survival rate was expected when the lung was evaluated distant to the ultrasound probe. Lung size estimation in L-CDH fetuses may be affected by fetal position, which may affect postnatal prognosis, prediction of survival and eligibility for fetal therapy.

Struma ovarii is a rare monodermal teratoma composed predominantly of thyroid tissue. While typically benign, its clinical and radiological presentation can be highly deceptive, often mimicking a malignant ovarian tumor. A 52-year-old postmenopausal Afghan woman presented with progressive abdominal distension, pelvic pain, severe ascites, and a complex, highly vascular right adnexal mass. Imaging (ORADS 5) and markedly elevated CA-125 suggested advanced ovarian carcinoma. Despite receiving seven cycles of carboplatin/paclitaxel chemotherapy for presumed primary peritoneal carcinoma, the mass and ascites persisted. Following laparotomy and left salpingo-oophorectomy, histopathology confirmed benign struma ovarii without peritoneal carcinomatosis. Postoperatively, ascites resolved and CA-125 normalized. The patient remained well with no recurrence at 14-month follow-up. This case underscores the critical importance of considering struma ovarii in the differential diagnosis of a complex ovarian mass, even when clinical features and tumor markers strongly suggest malignancy.

To explore the predictive value of second-trimester ankle-brachial pulse wave velocity (baPWV) and the soluble fms-like tyrosine kinase-1 to placental growth factor ratio(sFlt-1/PlGF) for adverse pregnancy outcomes among women with chronic hypertension in pregnancy. This prospective cohort study consecutively enrolled pregnant women with chronic hypertension. BaPWV and sFlt-1/PlGF were measured at 22-26 weeks of gestation. The observed pregnancy outcomes included pre-eclampsia (PE), gestational age at delivery, newborn birth weight, preterm birth and small for gestational age (SGA). A total of 206 pregnant women with chronic hypertension were enrolled, of whom 108 (52.43%) developed PE. BaPWV did not differ significantly between women who developed PE and those who did not. However, women who subsequently delivered preterm or gave birth to SGA infants had significantly higher baPWV than those without these outcomes (P&#x2009;<&#x2009;0.001 and P&#x2009;=&#x2009;0.001). BaPWV was negatively correlated with both gestational age at delivery (r = -0.324, P&#x2009;<&#x2009;0.001) and neonatal birth weight ( r = &#xf0d;0.26, P&#x2009;=&#x2009;0.002). Multivariate logistic regression analysis identified elevated baPWV as an independent risk factor for both preterm birth (OR&#x2009;=&#x2009;2.62, 95% CI: 1.48-4.63, P&#x2009;<&#x2009;0.001) and SGA (OR&#x2009;=&#x2009;1.18, 95% CI: 1.08-3.03, P&#x2009;=&#x2009;0.024). Receiver operating characteristic curve analysis showed that baPWV alone yielded moderate predictive accuracy for preterm birth (AUC&#x2009;=&#x2009;0.77, 95% CI: 0.69-0.86) and SGA (AUC&#x2009;=&#x2009;0.72, 95% CI: 0.63-0.81). The combination of baPWV and the sFlt-1/PlGF ratio improved predictive performance, the corresponding AUC values rose to 0.87 (95% CI: 0.79-0.95) for preterm delivery and 0.78 (95% CI: 0.68-0.87) for SGA, respectively. Elevated mid-trimester baPWV in pregnant women with chronic hypertension is an independent predictor of preterm birth and SGA. The combination of baPWV and the angiogenic marker sFlt-1/PlGF improves predictive accuracy.