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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
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
Amélie Boutin, Suzanne Demers, Cédric Gasse, Yves Giguère, Amélie Tétu, Geneviève Laforest, Emmanuel Bujold
BACKGROUND: First-trimester maternal serum markers have been associated with preeclampsia (PE). We aimed to evaluate the performance of first-trimester placental growth factor (PlGF) for the prediction of PE in nulliparous women. SUBJECTS AND METHODS: We conducted a prospective cohort study of nulliparous women with singleton pregnancy at 11-13 weeks. Maternal serum PlGF concentration was measured using B·R·A·H·M·S PlGFplus KRYPTOR automated assays and reported in multiple of the median adjusted for gestational age...
October 10, 2018: Fetal Diagnosis and Therapy
Huseyin Canaz, Ibrahim Alatas, Ayten Saracoglu, Kerem Ozel, Ali Gedikbasi
No abstract text is available yet for this article.
October 9, 2018: Fetal Diagnosis and Therapy
Viola Seravalli, Jena L Miller, Dana Block-Abraham, Cyrethia McShane, Sarah Millard, Ahmet Baschat
INTRODUCTION: To evaluate if the volume-corrected renal artery pulsatility index (vcRA-PI) is more closely related to the amniotic fluid level than the uncorrected or the gestational age (GA)-adjusted RA-PI. METHODS: RA-PI and kidney volume were measured in low- and high-risk pregnancies at 17-38 weeks. Fetal anomalies associated with nonrenal causes of abnormal amniotic fluid volume were excluded. The vcRA-PI was calculated by dividing the RA-PI by the renal volume...
October 9, 2018: Fetal Diagnosis and Therapy
Federico Migliorelli, Núria Baños, Martina Aida Angeles, Claudia Rueda, Laura Salazar, Eduard Gratacós, Montse Palacio
OBJECTIVE: To develop a model combining clinical and sonographic features to predict the risk of cesarean delivery after the induction of labor (IOL). METHODS: We designed a prospective observational study involving women admitted for IOL. The main outcome was defined as cesarean delivery due to failed IOL or arrest of labor. Several clinical and ultrasonographic variables were collected. Seventy percent of the sample was used to build the predictive model, using stepwise logistic regression, while the remaining sample was used for validation...
October 5, 2018: Fetal Diagnosis and Therapy
Lone Nikoline Nørgaard, Ulrikka Nygaard, Julie Agner Damm, Barbara Hoff Esbjørn, Mette Marie Agner Pedersen, Amanda Rottbøll, Connie Jørgensen, Karin Sundberg
BACKGROUND: The treatment options for fetal chylothorax include thoracocentesis, thoracoamniotic shunting, and pleurodesis using OK-432. Knowledge on the long-term outcomes after treatment with OK-432 is limited. OBJECTIVE: The aim of this study was to assess the long-term outcomes of children treated in utero with OK-432. METHODS: We performed follow-up on pregnancies and children treated in utero with OK-432 between 2003 and 2009 at Copenhagen University Hospital Rigshospitalet for pleural effusions at gestational age (GA) 16+0-21+6 weeks...
October 3, 2018: Fetal Diagnosis and Therapy
Cecilia Villalain, Ignacio Herraiz, María Soledad Quezada, Paula Gómez Arriaga, Elisa Simón, Enery Gómez-Montes, Alberto Galindo
OBJECTIVE: To compare vaginal delivery rate and perinatal outcomes of fetuses with late-onset fetal growth restriction (FGR) undergoing labor induction, depending on the method for cervical ripening (dinoprostone vs. Foley balloon). MATERIAL AND METHODS: We conducted a retrospective cohort study of 148 consecutive singleton gestations diagnosed with stage I late-onset FGR and Bishop score < 7, in which labor induction was indicated at ≥37 + 0 weeks. Before January 2016, cervical ripening was achieved with 10 mg of vaginal dinoprostone (n = 77) and afterwards with Fo-ley balloon (n = 71)...
September 24, 2018: Fetal Diagnosis and Therapy
Yan Kai Mao, Hai Ya Lou, Mei Pan, Bo Wen Zhao
OBJECTIVES: To determine Z-score equations and reference ranges for mitral valve-tricuspid valve distance (MTD) and the MTD index in the fetal heart. METHODS: A prospective cross-sectional study was performed in 899 normal singleton fetuses from 14 to 40 weeks' gestation. The MTD and interventricular septum length (IVSL) were measured offline after electronic cardiac spatiotemporal image correlation volume acquisition. The MTD index was determined as the ratio of MTD to IVSL...
September 20, 2018: Fetal Diagnosis and Therapy
Julie Antomarchi, Daniel Moeglin, Hélène Laurichesse, Danièle Combourieu, Nicole Bigi, Emeline Maisonneuve, Pascale Legac, Marc Althuser, Jérome Delotte, Jean-Marie Jouannic, André Bongain
OBJECTIVE: To demonstrate the feasibility of measuring the fetal pubic diastasis (PD) distance on antenatal ultrasound in normal fetuses and to compare it to fetuses with bladder exstrophy. METHODS: Firstly, a prospective multicentric study was conducted to determine the feasibility of the PD ultrasound measurement during the second half of pregnancy. Secondly, data from a single center were used to develop a nomogram for PD values in normal fetuses. Thirdly, retrospective PD measurements were collected from fetuses with bladder exstrophy, diagnosed in seven French Multidisciplinary Centers for Prenatal Diagnosis (MCPDs)...
September 19, 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...
September 17, 2018: Fetal Diagnosis and Therapy
Lindsay A Edwards, Diego A Lara, Magdalena Sanz Cortes, Jill V Hunter, Shelley Andreas, Magnolia J Nguyen, Lacey J Schoppe, Jianhong Zhang, Eboni M Smith, Shiraz A Maskatia, S Kristen Sexson-Tejtel, Keila N Lopez, Emily J Lawrence, Yunfei Wang, Melissa Challman, Nancy A Ayres, Carolyn A Altman, Kjersti Aagaard, Judith A Becker, Shaine A Morris
INTRODUCTION: In a pilot study of chronic maternal hyperoxygenation (CMH) in left heart hypoplasia (LHH), we sought to determine effect estimates of CMH on head size, vascular resistance indices, and neurodevelopment compared to controls. MATERIAL AND METHODS: Nine gravidae meeting the inclusion criteria (fetal LHH, ≥25.9 weeks' gestation, and ≥10% increase in percent aortic flow after acute hyperoxygenation) were prospectively enrolled. Controls were 9 contemporary gravidae with fetal LHH without CMH...
September 17, 2018: Fetal Diagnosis and Therapy
Luca Mazzone, Ueli Moehrlen, Barbara Casanova, Samira Ryf, Nicole Ochsenbein-Kölble, Roland Zimmermann, Franziska Kraehenmann, Martin Meuli
OBJECTIVE: The majority of patients counseled for prenatal open spina bifida repair (SBR) do not undergo fetal surgery. The aim of this study was to analyze the reasons for this phenomenon. MATERIALS AND METHODS: The data of the first 160 patients seeking counseling or referred to the Zurich Center for Fetal Diagnosis and Therapy for prenatal SBR between December 2010 and March 2017 were retrospectively analyzed. RESULTS: A total of 104 (65%) patients did not undergo prenatal SBR...
September 11, 2018: Fetal Diagnosis and Therapy
Pascal Heye, Ueli Moehrlen, Luca Mazzone, Robert Weil, Stefan Altermatt, David-Alexander Wille, Ianina Scheer, Martin Meuli, Maya Horst
INTRODUCTION: Fetal spina bifida repair (fSBR) has proven effective in the reversibility of hindbrain herniation, lower rate of shunt-dependent hydrocephalus, and independent ambulation. Besides distinct advantages, there are also concerns related to fSBR. One of these is the postnatal occurrence of inclusion cysts (IC). METHODS: In a prospective study, 48 children who underwent fSBR were followed up. Postnatal assessment included clinical examination, cystometry, and spinal MRI...
September 10, 2018: Fetal Diagnosis and Therapy
Maria Flavia Christino Luiz, Ahmet A Baschat, Cassandra Delp, Jena L Miller
Fetomaternal hemorrhage (FMH) is a rare condition that requires early diagnosis and appropriate treatment due to its potentially severe consequences. We report a case of massive FMH presenting as decreased fetal movement, fetal hydrops, and intracranial hemorrhage at 24 weeks. Treatment considerations were made and amniocentesis, fetal blood sampling, and fetal blood transfusion via cordocentesis were performed. Recurrent FMH required subsequent fetal transfusion 2 days later. Surveillance was continued twice weekly until the patient delivered a viable infant at 38 weeks after spontaneous labor...
September 10, 2018: Fetal Diagnosis and Therapy
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