Lymphangioma is a rare developmental anomaly of the lymphatic system, commonly arising at birth, in infancy, or early childhood. Treatment is rarely curative. We report a case of macrocystic lymphangioma treated with sildenafil in a 16-year-old Filipino child diagnosed clinically, radiologically and histologically. The patient presented with grouped papulovesicles on the left lower extremity, associated with limb length discrepancy, unilateral leg pain and difficulty in ambulation. Given the recurrent course of this condition, even with surgical management, the use of a non-invasive approach such as sildenafil as a potential treatment option for lymphangioma is an important emerging area of study.

BACKGROUND

Despite policies promoting facility births, home deliveries attended by traditional birth attendants (TBAs/hilot) persist in rural Philippines. We examined determinants of home delivery and the continuing role of TBAs in Palawan.

We used a convergent mixed-methods design: a survey of 48 postpartum mothers and 48 in-depth interviews (45–90 minutes). The survey captured socio-demographics, delivery histories, and preferences; interviews explored decision-making, experiences with TBAs and facilities, and barriers to care. Descriptive statistics summarized quantitative patterns; inductive thematic analysis generated qualitative themes. Findings were integrated via a joint-display matrix to produce meta-inferences.

Respondents reported 141 lifetime deliveries; 85.8% (121/141) occurred at home and 81.0% (98/121) of home births were TBA-attended. Three-quarters lived >1 km from the nearest facility, and 89.6% had monthly household income below the provincial poverty threshold. Over half (54.2%) planned their most recent birth at home and 81.3% intended to deliver at home again. Qualitatively, mothers valued TBAs' accessibility, flexible/low payment, and relational care. Facilities were associated with indirect costs, distance, scolding, invasive procedures, and loss of dignity; decisions were commonly joint with partners/elders, reflecting relational autonomy.

Home birth in Palawan represents a constrained preference shaped by structural barriers (poverty, distance), cultural trust in TBAs, and relational decision-making. Safety messaging alone is insufficient without respectful, affordable, and accessible facility care. Policy actions should: (1) reduce non-fee costs (transport/food; maternity waiting homes), (2) institutionalize Respectful Maternity Care, and (3) integrate TBAs as trained community referral partners within UHC.

Sacrococcygeal teratoma is one of the most common pediatric tumors. In contrast, its highly developed variant known as Fetiform Teratoma is an extremely rare elusive subtype with overall incidence of 0.01% and reported in only 35 cases worldwide.

This is a case report of a large sacrococcygeal fetiform teratoma in a 3-year-old female from the Philippines seen at the Outpatient Department presenting with history of sacrococcygeal mass initially noted since birth. Work-ups revealed normal tumor markers and a large multi-lobulated, heterogenous and hypervascular Altmann type I sacrococcygeal teratoma on imaging. Preoperative endovascular angioembolization with subsequent En Bloc Excision and coccygectomy was performed. The tumor was confirmed to be fully excised, and no malignant or immature features were found on histopathological examination. Early diagnosis, meticulous preoperative preparation, complete surgical excision, involvement of multidisciplinary team, active surveillance and long-term follow-up are key in the management of sacrococcygeal tumors. Utilization of preoperative endovascular angioembolization is an innovative, safe, feasible, and beneficial in minimizing perioperative blood loss and improving outcomes for large pediatric sacrococcygeal tumors.

The options for prenatal genetic testing have evolved rapidly in the past decade, and advances in sequencing technology now allow genetic diagnoses to be made down to the single-base-pair level, even before the birth of the child. This offers women the opportunity to obtain information regarding the foetus, thereby empowering them to make informed decisions about their pregnancy. As genetic testing becomes increasingly available to women, clinician knowledge and awareness of the options available to women is of great importance. Additionally, comprehensive pretest and posttest genetic counselling about the advantages, pitfalls and limitations of genetic testing should be provided to all women. This review article aims to cover the range of genetic tests currently available in prenatal screening and diagnosis, their current applications and limitations in clinical practice as well as what the future holds for prenatal genetics.
Child ; Pregnancy ; Female ; Humans ; Prenatal Diagnosis ; Knowledge ; Parturition

Pregnancy ; Female ; Humans ; COVID-19/epidemiology* ; Singapore ; Telemedicine ; SARS-CoV-2 ; Parturition

Objective: This research aims to unravel the local knowledge, practices, and experiences of care during pregnancy and childbirth in one community in Batangas. Methods: Qualitative interviews with two hilots and a mother, two focus group discussions with mothers from different generations, and indigenous research methods – pakikipagkwentuhan (story-telling or informal discussions with the locals) and pagmamasid (observations of the local practices in the community) were used in this ethnographic study. The data gathered through these methods were analyzed using an interpretive approach. Results: Data showed that knowledge and practices related to pregnancy and childbirth which were viewed as rituals remain to be significant in the community because they are sources of psychological support in a highly intimate situation. These practices also help in creating a feeling of security and safety during this very uncertain period. The data also showed the different ways of making sense of risks associated with pregnancy and childbirth and this affects the decisions made by mothers, midwives and hilots during birthing. Lastly, we saw the effects of the implementation of the no home birthing policy on the hilots and the life and well-being of the pregnant women in the community. Conclusions Local practices of care during pregnancy and childbirth remain significant today because these cater to the overall well-being of women giving birth. For these women, the implementation of the no home birthing policy that changed the status of the hilots (TBAs) in the community does not address the real issues on maternal healthcare. For them, the government should have focused on continuing to address the structural and institutional problems that they have encountered in their experiences of birthing. This can be done by providing more facilities that would readily cater to the needs of birthing women and by creating a more holistic healthcare system.
Pregnancy ; Parturition ; Midwifery

Female ; Fetus ; Firefighters ; Follow-Up Studies ; Humans ; International Classification of Diseases ; Korea ; Parturition ; Postpartum Period ; Pregnancy ; Reproductive Health

Birth Weight ; Blood Glucose ; Diabetes, Gestational ; Fasting ; Female ; Fetal Growth Retardation ; Head ; Heme ; Humans ; Hypertension, Pregnancy-Induced ; Infant ; Iran ; Iron ; Iron, Dietary ; Nausea ; Parturition ; Pre-Eclampsia ; Pregnancy ; Pregnancy Outcome ; Pregnancy Trimester, First ; Pregnancy ; Pregnant Women ; Prospective Studies ; Vomiting

Cohort Studies ; Coinfection ; Hepatitis B virus ; HIV Infections ; HIV ; Humans ; Immunization, Secondary ; Korea ; Parturition ; Prevalence ; Vaccination

BACKGROUND: Although the clinical importance of the immunological benefits of breastfeeding has been emphasized for decades, their direct relationship with acute pyelonephritis (APN) is still not clear. Our goal was to determine whether breastfeeding truly provides protection against APNs, while investigating the effects of other factors such as sex, age, mode of delivery, and birth weight on APN.METHODS: A total of 62 infants under 6 months of age who had both microbiologically and radiologically-confirmed APN were enrolled in the case group. Healthy infants (n = 178) who visited the hospital for scheduled vaccinations were enrolled in the control group. The following participant characteristics were compared between the case and control groups: age, sex, birth order among siblings, feeding methods, weight percentile by month, birth weight percentile by gestational age, gestational age at birth, and mode of delivery.RESULTS: Babies exclusively fed with manufactured infant formulae before 6 months of age had significantly higher risk for APN than breastfed or mixed-fed infants (odds ratio [OR], 3.4; 95% confidence interval [CI], 1.687–7.031; P = 0.001). Firstborn babies had lower risk for APN than 2nd- or 3rd-born babies (OR, 0.43; 95% CI, 0.210–0.919). Other factors that increased the risk for APN were low birth weight percentiles (OR, 8.33; 95% CI, 2.300–30.166) and birth via caesarean section (OR, 2.32; 95% CI, 1.097–4.887). There were more preterm births in the case group (10.9% vs. 1.7%; P = 0.002), but this did not increase the risk for APN (OR, 4.47; P = 0.063).CONCLUSION: Feeding exclusively with formula before 6 months of age was related to higher risk for APN, which demonstrates that breastfeeding has a protective effect against APN. The other risk factors for APN were birth order (≥ 2nd-born), low birth weight, and birth via caesarean section.
Birth Order ; Birth Weight ; Breast Feeding ; Cesarean Section ; Feeding Methods ; Female ; Gestational Age ; Humans ; Infant Formula ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Parturition ; Pregnancy ; Premature Birth ; Pyelonephritis ; Reproductive History ; Risk Factors ; Siblings ; Urinary Tract Infections ; Vaccination