The aim of this study was to determine whether the increased serum cell-free fetal DNA (cffDNA) level of gravidas developed into early-onset preeclampsia (EOPE) subsequently in the early second trimesters is related to prenatal screening markers. Serum was collected from 1011 gravidas. The level of cffDNA and prenatal screening markers were analyzed in 20 cases with EOPE and 20 controls. All fetuses were male. The maternal serum cffDNA level was assessed by amplification of the Y chromosome specific gene. Correlations between the variables were examined. (Logged) cffDNA in EOPE (median, 3.08; interquartile range, 2.93–3.68) was higher than controls (median, 1.79; interquartile range, 1.46–2.53). The increased level of (logged) cffDNA was correlated significantly with the increased human chorionic gonadotropin (HCG) level (r = 0.628, p < 0.001). Significant reciprocal correlations between cffDNA and babies’ birth weight as well as gestation weeks at delivery were noted (r = −0.516, p = 0.001; r = −0.623, p < 0.001, respectively). The sensitivity and specificity of cffDNA to discriminate between the EOPE cases and the controls were 90% and 85%, respectively. CffDNA is a potential marker for EOPE, which had a significant reciprocal correlation with babies’ birth weight and gestation weeks at delivery. Moreover, it may help in indicating the underlying hypoxic condition in the placenta.

Childbirth experience is one of the most intense pain that majority of women will endure during their lifetime. Concerns about pain in labor remain a hot topic, and its popularity gets more common day by day as more women become aware of their rights to achieve a better quality of care during labor. There are various non-pharmacologic (transcutaneous electrical nerve stimulation, hydrotherapy, intradermal water injections and acupuncture) and pharmacologic treatments (nitrous oxide, opioids and regional analgesia techniques: spinal, epidural and combined epidural analgesia) available today. Among these, epidural analgesia offers the most effective form of pain relief and is considered to be the gold standard of labor analgesia. Despite having labor analgesic services, most women still go through painful labor due to lack of knowledge regarding it, particularly in developing countries. The main source of information regarding pain reliefs is from friends and relatives, revealing the lack of information from caregiver's side. So this study reflects that there is a wide gap in the communication between pregnant women and obstetricians. It supports the fact that obstetricians through the practice of routinely offering labor analgesia can significantly improve the maternal and perinatal outcomes of pregnancy. Provision of standardized epidural analgesia information at an appropriate time in their pregnancy may benefit them by the practice of mutual decision-making. Thus, it may prevent women from making a difficult choice of cesarean section to avoid the fear of painful labor.

Women with KIR AA genotype and fewer C2 genes than their fetuses were at risk for preeclampsia in the Chinese Han population, supporting that maternal-fetal KIR-HLA-C interaction plays an important role in preeclampsia development.

Compared with expectant management, pessary could prolong pregnancy and reduce the rate of tocolysis and corticosteroids. More registered trials are ongoing which may substantially change our results.

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