Indian Journal of Maternal-Fetal & Neonatal Medicine

L-arginine is a semi-essential amino acid that plays a critical role in various physiological processes, such as protein synthesis, wound healing, immune function, and cardiovascular regulation. The available data support the hypothesis that L-arginine or L-citrulline supplementation would be suitable for implementation in resource-constrained settings and will enhance placental vascular development and improve birth outcomes. Oligohydromnios and IUGR are pregnancy complications affecting 7 percent of pregnancies. This article explores their causes, focusing on amino acid transfer and placental function. The paradoxical effects of maternal protein supplementation are discussed, alongside the therapeutic potential of Larginine and L-citrulline in improving fetal outcomes.

Large data sets and clever algorithms are the strengths of artificial intelligence (AI) and machine learning, the fields most frequently employed in medicine. These systems have the potential to transform treatment delivery, access to healthcare, and outcome improvement, especially in the field of reproductive medicine. More accurate follicular measurement or more reliable oocyte and embryo grading are just two examples of how AI can help doctors and most importantly, patients provide the best, most customised care possible. All of AI’s potential benefits not with standing, algorithms are not impervious to prejudice and are susceptible to the numerous socio-economic and demographic prejudices that plague the healthcare systems of today. Inaccurate diagnoses and the continuation of healthcare discrimination are real potential outcomes if our understanding of AI’s potential and constraints is lacking. Clinicians will be able to develop and apply machine learning-based innovations for the advancement of reproductive medicine and ultimately the creation of healthy families if they are equipped with the necessary knowledge about how AI can function most effectively in the field of medicine, particularly reproductive medicine.

Mifepristone, a synthetic steroid with potent antiprogestational and antiglucocorticoid activity, has established itself as a versatile pharmacological agent with significant clinical implications. Initially approved for medical termination of early pregnancy, mifepristone functions by competitively inhibiting progesterone receptors, disrupting endometrial support and promoting uterine contractility when used alongside prostaglandins. Its clinical utility, however, extends well beyond reproductive health. It is employed in cervical ripening, second-trimester abortion, and labor induction.Furthermore, mifepristone has demonstrated therapeutic potential in the management of uterine fibroids, endometriosis, and as a targeted treatment in Cushing’s syndrome by modulating glucocorticoid receptors. Emerging research also explores its role in treating hormone-sensitive malignancies, including breast and ovarian cancers. As evidence continues to grow, mifepristone represents a promising tool in both gynecological and endocrine therapy, warranting further exploration and integration into broader clinical practice.

Contraception during lactation represents a critical aspect of postpartum care, balancing the need for effective birth control with the preservation of breastfeeding. The postpartum period is a unique physiological state wherein hormonal changes influence both fertility and contraceptive choices. Lactational Amenorrhea Method (LAM), a natural form of contraception based on exclusive breastfeeding and the absence of menstruation, offers up to 98% effectiveness in the first six months postpartum under specific conditions. However, as breastfeeding patterns change or fertility resumes, additional contraceptive options must be considered. Progestin-only methods such as pills, injectables, and implants are preferred due to their minimal impact on milk production, while non-hormonal methods like intrauterine devices (IUDs) and barrier methods also provide safe alternatives. Individualized counseling is essential to align contraceptive choices with breastfeeding goals, cultural preferences, and medical considerations. Understanding and promoting appropriate contraception during lactation is vital to supporting maternal health, child spacing, and overall reproductive autonomy.

Amniotic band syndrome also called as Streeter’s dysplasia is one of the rare disorders by birth, which causes malformation and deformities in the fetus. The ruptured amniotic membranes constrict the body or limbs or both of the fetus and cause malformations. The main stay of diagnosis is ultrasound during pregnancy but it is mostly missed by healthcare workers. This condition leads to mild to severe deformities like amputation of fingers or toes, club foot in the fetus leading to limited movements of the limbs or even death. The treatment options include observation and exercise in mild cases, and surgical correction, rehabilitation in case of moderate to severe fetal deformities.