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To overcome this challenge, an engineered on\u2010plate aptamer array (16\u00d724 spots) is developed for continuous scale\u2010up microextraction of plasma sEV and their in situ metabolic analysis using mass spectrometry. With this integrated array strategy, metabolic profiles of sEV are acquired from the plasma of 274 antenatal or postpartum women, reducing analysis time by half (7.5\u00a0h) and sample volume by 95% (only 0.125\u00a0\u00b5L usage) compared to the traditional suspension method. Moreover, using machine learning algorithms on sEV metabolic profiles, a risk score system is constructed that accurately assesses the need for epidural analgesia during childbirth and the likelihood of post\u2010administration fever. The system, based on admission samples, achieves an impressive 94% accuracy. Furthermore, post\u2010administration fever can be identified from delivery samples, reaching an overall accuracy rate of 88%. This work offers real\u2010time monitoring of the childbirth process that can provide timely guidance for maternal delivery, underscoring the significance of sEV detection in large\u2010scale clinical samples for medicine innovation and advancement.<\/jats:p>","DOI":"10.1002\/smtd.202400261","type":"journal-article","created":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T16:40:58Z","timestamp":1717519258000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["In Situ Array Microextraction and Metabolic Profiling of Small Extracellular Vesicles to Guide and Monitor Maternal Delivery"],"prefix":"10.1002","volume":"8","author":[{"given":"Chenyu","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Zhongshan Hospital Department of Chemistry Institutes of Biomedical Sciences Fudan University  Shanghai 200433 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesia Obstetrics &amp; Gynecology Hospital Fudan University  Shanghai 200090 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haolin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Zhongshan Hospital Department of Chemistry Institutes of Biomedical Sciences Fudan University  Shanghai 200433 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Man","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Zhongshan Hospital Department of Chemistry Institutes of Biomedical Sciences Fudan University  Shanghai 200433 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yijie","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Zhongshan Hospital Department of Chemistry Institutes of Biomedical Sciences Fudan University  Shanghai 200433 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangmin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Zhongshan Hospital Department of Chemistry Institutes of Biomedical Sciences Fudan University  Shanghai 200433 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaoqiang","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Anesthesia Obstetrics &amp; Gynecology Hospital Fudan University  Shanghai 200090 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nianrong","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Zhongshan Hospital Fudan University  Shanghai 200032 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8704-7543","authenticated-orcid":false,"given":"Chunhui","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Zhongshan Hospital Department of Chemistry Institutes of Biomedical Sciences Fudan University  Shanghai 200433 China"},{"name":"School of Chemistry and Chemical Engineering Nanchang University  Nanchang 330031 China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,4]]},"reference":[{"key":"e_1_2_7_1_1","doi-asserted-by":"publisher","DOI":"10.1080\/20013078.2018.1535750"},{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.3402\/jev.v4.27066"},{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41556-018-0250-9"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41392-020-00258-9"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrm1451"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00204-010-0609-6"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.3402\/jev.v3.23430"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.3402\/jev.v4.27369"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/20013078.2018.1528109"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-1759(00)00321-5"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1039\/C7LC00592J"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1021\/nn506538f"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1709210114"},{"key":"e_1_2_7_11_1","first-page":"22","volume":"3","author":"Thery C.","year":"2006","journal-title":"Curr. 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