Mitochondrial Myopathy, Encephalomyopathy, Lactic Acidosis, Stroke-like Episodes Syndrome: Pregnancy Outcomes [14R]
Bibliographic record
Abstract
INTRODUCTION: The purpose of this study was to systematically review the literature on pregnancy outcomes in women with MELAS syndrome, one of the commonest mitochondrial disorders, and summarize strategies for their preconceptional, antepartum and intrapartum care. METHODS: MEDLINE, EMBASE, Web of Science, and PubMed were searched from inception to January 2016 for publications describing pregnancies with MELAS syndrome. Studies were only restricted to humans. The grey literature and references of relevant articles were hand-searched. Authors were contacted for missing data or eligibility inquiries. Article selection, data extraction and risk of bias assessment were performed in duplicate with discrepancies resolved by a third reviewer. Articles were excluded if MELAS syndrome was not confirmed or pregnancy outcomes were not described. RESULTS: Of 1412 identified titles and abstracts, 53 full texts were retrieved; 12 case reports were retained for final analysis, including one from our institution. In 2/12 (17%) cases, MELAS syndrome was diagnosed in pregnancy. Up to 11/12 (91%) women experienced severe maternal or obstetric complications such as admission to the intensive care unit, stroke-like episodes, or hypertensive disorders of pregnancy. Adverse fetal or neonatal outcomes, such as pregnancy loss or intrauterine growth restriction, were seen in 8/16 (50%) and 4/11 (36%) pregnancies respectively. Adverse outcomes occurred even when women were in complete remission pre-pregnancy. There were no maternal or neonatal deaths. CONCLUSION: MELAS syndrome is a multi-organ disorder associated with significant adverse medical and obstetric outcomes. Patients with this diagnosis should have preconception counseling and multidisciplinary pregnancy management in a tertiary center to optimize outcomes.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.019 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.005 | 0.008 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".