Brainstem Glioma in Pregnancy: A Systematic Review [6N]
Bibliographic record
Abstract
INTRODUCTION: Information on pregnancy outcomes in women with brainstem glioma during pregnancy is limited to case reports. METHODS: We conducted a systematic review in accordance with PRISMA guidelines and registered with the PROSPERO website (CRD42017060196). Four databases were searched using appropriate indexing terms. Quality assessment was performed in duplicate using the Joanna Briggs Institute Critical Appraisal Checklist for case reports. Outcomes were reported as proportions. RESULTS: We identified 2726 titles and abstracts of which 89 full texts were screened and 12 articles describing 17 pregnancies in 16 women were included. Most studies had a low or moderate risk of bias. Of the 14 (82.4%) antenatal diagnoses, 10 (58.8 %) were made in the second trimester. Clinical presentation included headaches, nausea and vomiting, focal neurological findings and sudden death. Antenatal treatment included surgical resection in four women, radiation in three and endoscopic third ventriculostomy in one. Postpartum treatment included surgical resection and radiation in two women each. Of the eight maternal deaths (47.1%), five were in the antenatal period, and three were within four months of delivery. Follow up was available for six of the eight survivors, for a median of 24 months, during which time two (33.3%) deteriorated. Fetal outcomes included 4/17 (23.5%) losses secondary to maternal demise, one therapeutic abortion and 5/12 (41.7%) preterm deliveries (median 34 weeks, interquartile range 6). CONCLUSION: Prognosis for women with brainstem glioma remains guarded despite multidisciplinary care in tertiary-level centers and prompt attention to diagnosis and treatment. In survivors, fetal outcomes are reassuring.
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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 | 0.012 | 0.071 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.005 |
| Bibliometrics | 0.008 | 0.011 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 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".