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Fetal Diagnosis and Therapy

F A R Jansen, E W van Zwet, S M P Everwijn, A K K Teunissen, L Rozendaal, J M M van Lith, N A Blom, M C Haak
OBJECTIVE: The aim of our study is to explore whether the cerebral growth is delayed in fetuses with congenital heart defects (CHD) in the second and early third trimester. METHODS: A prospective cohort study was conducted in 77 CHD cases, with 75 healthy controls. 3D cerebral volume acquisition was performed sequentially. The volumes of the fetal hemicerebrum and extracerebral fluid were compared by linear regression analysis, and the Sylvian fissure was measured...
January 17, 2019: Fetal Diagnosis and Therapy
Marjolein Husen, Pauline C Schut, Adriana C H Neven, Nagma Yousoufi, Nanko de Graaf, Cornelius E J Sloots, Alex J Eggink, Titia E Cohen-Overbeek
OBJECTIVE: To investigate the origin and outcome in a cohort of male and female fetuses with intra-abdominal cysts, in order to provide recommendations on management and to improve prenatal counselling. METHODS: From 2002 to 2016, intra-abdominal cysts were detected by ultrasound in 158 fetuses. Cases with an umbilical vein varix were excluded. Fetal, neonatal, and maternal characteristics were retrieved from electronic patient files. RESULTS: In female fetuses (n = 114), intra-abdominal cysts were diagnosed at a later gestational age compared with male fetuses (n = 44) (median 32...
January 10, 2019: Fetal Diagnosis and Therapy
Laura García-Otero, Olga Gómez, Mérida Rodriguez-López, Ximena Torres, Iris Soveral, Álvaro Sepúlveda-Martínez, Laura Guirado, Brenda Valenzuela-Alcaraz, Marta López, Josep Maria Martínez, Eduard Gratacós, Fàtima Crispi
OBJECTIVE: There is a need for standardized reference values for cardiac dimensions in prenatal life. The objective of the present study was to construct nomograms for fetal cardiac dimensions using a well-defined echocardiographic methodology in a low-risk population. METHODS: This is a prospective cohort study including 602 low-risk singleton pregnancies undergoing a standardized fetal echocardiography to accurately assess fetal cardiac, ventricular, and atrial dimensions...
January 4, 2019: Fetal Diagnosis and Therapy
Lee Na Tan, Ka Wang Cheung, Isaac Philip, Stephen Ong, Mark David Kilby
BACKGROUND/PURPOSE: We report a case study of jejunal atresia and the results of a systematic literature review of all reported cases of bowel complications occurring after fetoscopic laser ablation (FLA) for the treatment of twin-to-twin transfusion syndrome (TTTS). METHODS: A systematic literature review was performed of bowel complications after FLA for TTTS according to PRISMA guidelines. RESULTS: There are 11 published cases of small bowel atresia, 5 cases of necrotising enterocolitis (NEC), and 2 cases with foetal bowel perforations...
December 14, 2018: Fetal Diagnosis and Therapy
Marialuigia Spinelli, Lavinia Di Meglio, Beatrice Mosimann, Edoardo Di Naro, Daniel Surbek, Luigi Raio
BACKGROUND: Normal morphometry of the vermis and its relation to the posterior fossa (PF) rule out most major anomalies of the cerebellum. However, accurate categorization of the position and size of the fetal vermis remains a challenge. OBJECTIVE: Our aim was to test a new method to assess the position and size of fetal vermis on 3-dimensional ultrasound (3D-US). METHODS: We measured the vermian-crest angle (VCA) in normal fetuses using multiplanar 3D-US...
December 5, 2018: Fetal Diagnosis and Therapy
Anna Morandi, Francesco Macchini, Marijke Ophorst, Irene Borzani, Fabrizio Ciralli, Andrea Farolfi, Giuliana Anna Porro, Stefania Franzini, Isabella Fabietti, Nicola Persico, Fabio Mosca, Ernesto Leva
AIM: To evaluate tracheal diameters and their clinical impact in patients with congenital diaphragmatic hernia (CDH) after fetal endoscopic tracheal occlusion (FETO). METHODS: Patients born with CDH between January 2012 and August 2016 were divided into two groups: noFETO and FETO. Tracheal diameters at three levels (T1, carina, and maximum tracheal dilation) on chest X-ray at 1, 3, 6, 12, 24, and 36 months of follow-up, requirements of invasive and noninvasive respiratory support, the incidence of respiratory infections, and results of pulmonary function tests (PFT) were compared...
November 27, 2018: Fetal Diagnosis and Therapy
Lucia Pasquini, Ilaria Ponziani, Enrico Periti, Laura Marchi, Carlo Luchi, Veronica Accurti, Francesco D'Ambrosi, Nicola Persico
OBJECTIVE: To examine the distribution of risks for fetal trisomies after first-trimester combined screening in twins and to investigate different strategies for clinical implementation of cell-free DNA (cfDNA) testing. METHODS: We retrospectively analyzed all twin pregnancies undergoing first-trimester combined screening over a 10 years' period. The population was stratified according to various risk cut-offs, and we examined different screening strategies for implementation of cfDNA testing in terms of impact on invasive testing rate, cfDNA test failure rate, and economic costs...
November 22, 2018: Fetal Diagnosis and Therapy
Gali Pariente, Tamar Wainstock, Asnat Walfisch, Eyal Sheiner, Avi Harlev
OBJECTIVE: We aimed to evaluate the association between advanced maternal age and the long-term health of the offspring. METHODS: In this population-based cohort study, hospitalizations of offspring up to the age of 18 years were compared according to maternal age. The incidence of long-term hospitalizations of the offspring due to cardiovascular, endocrine, neurological, hematological, respiratory and gastro-intestinal morbidities was evaluated. Deliveries occurred between the years 1991 and 2014 in a tertiary medical center...
November 22, 2018: Fetal Diagnosis and Therapy
David W Britt, Mark I Evans, Barry S Schifrin, Robert D Eden
Electronic fetal monitoring (EFM) is a poor predictor of outcomes attributable to delivery problems. Contextualizing EFM by adding maternal, obstetrical, and fetal risk-related information to create an index called the Fetal Reserve Index (FRI) improves the predictive capacity and facilitates the timing of interventions. Here, we test critical assumptions of FRI as a clinical tool. Our conceptualization implies that the earlier one reaches the red zone (FRI ≤25) and the longer one spends in the red zone, the greater the likelihood of emergency operative deliveries (EOD)...
November 21, 2018: Fetal Diagnosis and Therapy
Franziska M Winder, Ladina Vonzun, Martin Meuli, Ueli Moehrlen, Luca Mazzone, Franziska Krähenmann, Margret Hüsler, Roland Zimmermann, Nicole Ochsenbein-Kölble
INTRODUCTION: Despite undoubtable benefits of open fetal myelomeningocele (fMMC) repair, there are considerable maternal risks. The aim of this study was to evaluate and systematically categorize maternal complications after open fMMC repair. METHODS: We analyzed data of 40 fMMC repairs performed at the Zurich Center for Fetal Diagnosis and Therapy. Maternal complications were classified according to a 5-level grading system based on a classification of surgical complications proposed by Clavien and Dindo...
November 14, 2018: Fetal Diagnosis and Therapy
Lisanne S A Tollenaar, Patricia C J Knijnenburg, Janina L Wolf, Femke Slaghekke, Johanna M Middeldorp, Monique C Haak, Frans J C Klumper, Dick Oepkes, Enrico Lopriore
We report a case of a monochorionic diamniotic twin diagnosed with twin-twin transfusion syndrome (TTTS; stage 3) with co-existing severe cerebral damage in the donor twin at 18 + 4 weeks' gestation. After counselling, the parents opted for selective foeticide of the donor twin. For the procedure, radiofrequency ablation (RFA) was used. Serial ultrasound examinations at 20 + 1 and 21 + 1 weeks' gestation showed good recovery of the ex-recipient, after which the patient was sent back to the referring hospital...
November 12, 2018: Fetal Diagnosis and Therapy
Annalisa Inversetti, Vlasta Fesslova, Jan Deprest, Massimo Candiani, Veronica Giorgione, Paolo Cavoretto
BACKGROUND: Fetal growth may vary significantly in different congenital heart defects (CHDs). OBJECTIVES: To investigate prenatal growth of CHD fetuses and its correlation with classifications based upon expected oxygen delivery to the fetal brain or structural findings. METHODS: Seventy-nine euploid fetuses with isolated CHD were recruited prospectively and categorized by the expected oxygen supply to the brain (low, intermediate, and high) or by the expected arterial mixing considering two categories (cyanotic or non-cyanotic)...
November 9, 2018: Fetal Diagnosis and Therapy
Ji Hyae Lim, Bom Yi Lee, Jin Woo Kim, You Jung Han, Min Hyoung Kim, Jin Hoon Chung, Jung Yeol Han, Moon Young Kim, Hyun Mee Ryu
INTRODUCTION: Recently, we identified three novel fetal-specific epigenetic DNA regions (FSERs) on chromosome 21 for detection of noninvasive fetal trisomy 21 (T21). In this study, the diagnostic accuracies of the three FSERs were assessed on a larger panel of the first-trimester pregnant women. MATERIAL AND METHODS: This study was conducted with maternal plasma collected from 167 pregnant women carrying 155 chromosomally normal and 12 T21 fetuses (10-13 gestational weeks)...
November 8, 2018: Fetal Diagnosis and Therapy
Eva Mautner, Hannah Kalchmair, Alexander Avian, Maria Deutsch, Elfriede Greimel, Philipp Klaritsch
INTRODUCTION: The aim of this study was to explore maternal health-related quality of life (HRQoL) and depression following intrauterine interventions in complicated monochorionic twin pregnancies at the Medical University Graz. MATERIAL AND METHODS: In a cross-sectional questionnaire survey, women with at least one liveborn infant following intrauterine intervention during 2011 and 2015 were matched with uncomplicated monochorionic and dichorionic pregnancies. All completed the 12-Item Short Form Health Survey to measure HRQoL and the Patient Health Questionnaire-9 to measure depression...
November 8, 2018: Fetal Diagnosis and Therapy
Przemyslaw Kosinski, Katarzyna Luterek, Dorota Bomba-Opon, Michal Lipa, Miroslaw Wielgos
OBJECTIVE: To evaluate the impact of cervical length and cervical pessary application in congenital diaphragmatic hernia (CDH) treated by the fetoscopic endotracheal occlusion (FETO) procedure. METHODS: The study group consisted of 80 patients with severe CDH treated by FETO. Cervical length measurement was performed by transvaginal ultrasound in all patients within the 24 h prior to the FETO procedure. The study group (n = 44) had cervical pessaries applied routinely within the 24 h following the FETO procedure, whereas the control group (n = 36) were not offered pessaries and only had cervical length measurement performed...
November 7, 2018: Fetal Diagnosis and Therapy
Libera Troìa, Huda B Al-Kouatly, Rebekah McCurdy, Peter S Konchak, Stuart Weiner, Vincenzo Berghella
Massive fetomaternal hemorrhage (FMH) can cause devastating pregnancy outcomes. Perinatal prognosis may be improved by intrauterine transfusion, but the appropriate management for these pregnancies remains unclear. To determine the recurrence risk of FMH after intrauterine transfusion, we performed a systematic review of all case reports/series of patients with proven FMH treated with intrauterine transfusion and who had subsequent follow-up of at least 72 h until delivery. This revealed 13 cases, with 1 additional case from our institution...
2019: Fetal Diagnosis and Therapy
Mert Ozan Bahtiyar, Emre Ekmekci, Emine Demirel, Roxanna A Irani, Joshua A Copel
Monochorionic twin pregnancies are at risk of unique complications due to placental sharing and vascular connections between placental territories assigned for each twin. Twin anemia-polycythemia sequence (TAPS) is an infrequent but potentially dangerous complication of abnormal placental vascular connections. TAPS occurs due to very-small-caliber (< 1 mm) abnormal placental vascular connections which lead to chronic anemia in the donor twin and polycythemia in the recipient twin. TAPS may occur spontaneously or following fetoscopic laser photocoagulation of communicating placental vessels for twin-twin transfusion syndrome...
2019: Fetal Diagnosis and Therapy
Ginevra Salsi, Francesca Romana Grati, Federica Bellussi, Eva Pompilii, Federico Maggi, Giuseppe Simoni, Francesco D'Ambrosi, Michele Orsi, Mattia Gentile, Georgios Rembouskos, Guglielmo Zuliani, Paolo Volpe, Gianluigi Pilu
OBJECTIVE: To estimate the procedure-related risk of miscarriage in pregnancies undergoing amniocentesis (AC) following inconclusive results for a chorionic villus sampling (CVS). METHODS: This was a multicentric retrospective cohort study of patients in which both CVS at 11-13 weeks' gestation and AC at 16-22 weeks were performed between January 1st, 2008, and July 31st, 2017. The primary outcome measure was pregnancy loss prior to 24 weeks gestation; the secondary one was intrauterine demise after 24 weeks...
October 23, 2018: Fetal Diagnosis and Therapy
Olutoyin A Olutoye, Stephanie M Cruz, Adesola C Akinkuotu, Fariha Sheikh, Irving J Zamora, Ling Yu, Adekunle M Adesina, Oluyinka O Olutoye
BACKGROUND: Studies demonstrating an association between anesthesia and brain cell death (neuroapoptosis) in young animals were performed without accompanying surgery. This study tests the hypothesis that fetal surgery decreases anesthesia-induced neuroapoptosis. MATERIALS AND METHODS: Seventy-day-pregnant ewes received 2% isoflurane for 1 h (low dose [LD]) or 4% for 3 h (high dose [HD]) with or without fetal surgery (S). Unexposed fetuses served as controls (C)...
October 12, 2018: Fetal Diagnosis and Therapy
Emilia Holmström, Tarja Myntti, Timo Sorsa, Heidi Kruit, Juuso Juhila, Jorma Paavonen, Leena Rahkonen, Vedran Stefanovic
INTRODUCTION: Intra-amniotic inflammation is defined by elevated inflammatory biomarkers in the amniotic fluid (AF), either due to microbial invasion of the amniotic cavity (MIAC) or sterile inflammation. Amniocentesis being an invasive procedure, we wanted to investigate whether elevated matrix metalloproteinase-8 (MMP-8) or interleukin-6 (IL-6) concentrations could be detected from cervical fluid samples. MATERIALS AND METHODS: This prospective study included 67 women with singleton nondiabetic pregnancies with or without preterm premature rupture of membranes (PPROM) between 22+0 and 37+0 weeks of gestation...
October 11, 2018: Fetal Diagnosis and Therapy
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