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Commentary on: MacGregor KA, Ho FK, Celis-Morales CA, et al. Association between menstrual cycle phase and metabolites in healthy, regularly menstruating women in UK Biobank, and effect modification by inflammatory markers and risk factors for metabolic disease. BMC Med. 2023;21:488.
Implications for practice and research Fat mass, physical activity level and cardiorespiratory fitness were identified as factors that influence the relationship between the menstrual cycle and levels of glucose, triglycerides, the triglyceride-to-glucose index, high-density lipoproteins (HDL) and low-density lipoproteins (LDL) cholesterol and the total-to-HDL cholesterol ratio. Future studies should investigate whether these relationships indicate a causal mechanism responsible for the variations in metabolic control throughout the menstrual cycle.
The rate of impaired metabolic regulation is rising among premenopausal women, characterised by decreased insulin sensitivity, increased fasting blood sugar levels and abnormal lipid profiles.
Measuring foetal heart rate (FHR) is critical for assessing foetal well-being, and traditional cardiotocography (CTG), though effective, has limitations such as cost, accessibility and observer bias. Newer non-invasive foetal ECG (NIFECG) devices offer more precise, reliable metrics for FHR variability and could enable remote monitoring, potentially improving early detection of foetal complications like hypoxia and stillbirth.
This is a single-centre prospective cohort study taking place in a tertiary maternity unit in the UK. Women with a singleton pregnancy over 26+0 weeks will be approached for participation in the control, foetal growth restriction (FGR) or diabetic groups. The NIFECG home monitoring schedule is 60 min daily for 7 days in the control group, daily from diagnosis until delivery for the FGR group, and daily from 36 weeks until delivery in the Insulin-dependent diabetic group. Longitudinal FHR raw ECG signals will be collected from participants across different gestational age ranges. Reference standards for FHR variability using metrics such as short-term variation, phase-rectified signal averaging acceleration and deceleration capacity will be established. The study will also aim to explore differences in FHR variability in FGR cases against controls and propose safety thresholds to guide decision-making for delivery.
Approvals have been obtained from the London Stanmore Research Ethics Committee and from the Medicines and Healthcare Regulatory Agency. The results will be published in peer-reviewed journals, presented at conferences and used by the commercial sponsor to pursue European Conformity regulatory compliance marking and future clinical studies.
Commentary on: Nielsen JM, Humaidan P, Jensen MB, et al. Early pregnancy bleeding after assisted reproductive technology: a systematic review and secondary data analysis from 320 patients undergoing hormone replacement therapy frozen embryo transfer. Hum Reprod 2023;38:2373–81.
Implications for practice and research Patients with autologous vitrified blastocyst transfer treated with a hormone replacement therapy frozen embryo transfer (FET) protocol should be informed that at least minor bleeding appears to be a common adverse event early in pregnancy. Future studies should include patients with natural timing of ovulation (natural cycle frozen embryo transfer, NC-FET) and placental attachment.
Vaginal bleeding is an adverse event that occurs in 20% of spontaneous pregnancies. Although many women with bleeding have normal term pregnancies, profuse bleeding, especially accompanied by pain, carries an increased risk of miscarriage. Our knowledge about early bleeding in pregnancy after hormone replacement therapy (HRT)...
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