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Fetal Diagnosis and Therapy

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https://www.readbyqxmd.com/read/29791899/national-practice-patterns-for-prenatal-monitoring-in-gastroschisis-gastroschisis-outcomes-of-delivery-good-provider-survey
#1
Ruchi Amin, Aaron Domack, Joseph Bartoletti, Erika Peterson, Britton Rink, Jennifer Bruggink, Melissa Christensen, Anthony Johnson, William Polzin, Amy J Wagner
BACKGROUND: Gastroschisis is an abdominal wall defect with increasing incidence. Given the lack of surveillance guidelines among maternal-fetal medicine (MFM) specialists, this study describes current practices in gastroschisis management. MATERIALS AND METHODS: An online survey was administered to MFM specialists from institutions affiliated with the North American Fetal Therapy Network (NAFTNet). Questions focused on surveillance timing, testing, findings that changed clinical management, and delivery plan...
May 23, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29791897/cutis-marmorata-telangiectatica-congenita-presenting-as-a-fetal-hemothorax
#2
Rodrigo A Mon, Ellen Mozurkewich, Marjorie C Treadwell, Deborah R Berman
We report a case of a fetus diagnosed at 28 weeks' gestation with a spontaneous prenatal hemothorax. Fetal intervention consisted of 2 thoracenteses with analysis of the pleural effusion. The pregnancy was further complicated by recurrence of the hemothorax, with subsequent mediastinal shift, hydrops, and nonreassuring antenatal testing requiring delivery at 31 weeks' gestation. Postnatal workup established the diagnoses of cutis marmorata telangiectatica congenita (CMTC) and pulmonary lymphangiectasia. The child is currently 4 years old and without any active medical issues or sequelae from the CMTC, pulmonary lymphangiectasia, or prenatal interventions...
May 23, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29772579/antenatal-workup-of-early-megacystis-and-selection-of-candidates-for-fetal-therapy
#3
Federica Fontanella, Leonie Duin, Phebe N Adama van Scheltema, Titia E Cohen-Overbeek, Eva Pajkrt, Mireille Bekker, Christine Willekes, Caroline J Bax, Dick Oepkes, Catia M Bilardo
OBJECTIVE: To investigate the best criteria for discriminating fetuses with isolated posterior urethral valves from those theoretically not eligible for fetal treatment because of complex megacystis, high chance of spontaneous resolution, and urethral atresia. METHODS: A retrospective national study was conducted in fetuses with megacystis detected before 17 weeks' gestation (early megacystis). RESULTS: In total, 142 cases with fetal megacystis were included in the study: 52 with lower urinary tract obstruction, 29 with normal micturition at birth, and 61 with miscellaneous syndromal associations, chromosomal and multiple structural abnormalities (complex megacystis)...
May 17, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29734172/preemptive-delivery-and-immediate-resection-for-fetuses-with-high-risk-sacrococcygeal-teratomas
#4
Heron D Baumgarten, Juliana S Gebb, Nahla Khalek, Julie S Moldenhauer, Mark P Johnson, William H Peranteau, Holly L Hedrick, N Scott Adzick, Alan W Flake
INTRODUCTION: Fetuses with "high-risk" sacrococcygeal teratoma (SCT) have a mortality rate of 40-50%. While fetal surgery may benefit select fetuses prior to 27 weeks' gestation, many fetuses die due to consequences of rapid tumor growth after 27 weeks. Here we report our experience applying "preemptive" delivery to fetuses who manifest signs of decompensation between 27 and 32 weeks. METHODS: A retrospective review of SCT fetuses delivered between 2010 and 2016 at ≤32 weeks' gestation was performed...
May 7, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29734144/long-term-neurodevelopmental-and-respiratory-outcome-after-intrauterine-therapy-for-fetal-thoracic-abnormalities
#5
Ruben S G M Witlox, Enrico Lopriore, Monique Rijken, Frans J C M Klumper, Dick Oepkes, Jeanine M M van Klink
INTRODUCTION: The aim of this study is to evaluate long-term neurodevelopmental and respiratory outcome after fetal therapy for fetal pleural effusion, congenital cystic adenomatoid malformation, and bronchopulmonary sequestration. METHODS: Children ≥18 months of age underwent an assessment of neurologic, motor, and cognitive development. Medical records were reviewed to determine respiratory outcome. Behavioral outcome was assessed using the Child Behavioral Checklist...
May 7, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29730664/fetal-biometry-and-doppler-study-for-the-assessment-of-perinatal-outcome-in-stage-i-late-onset-fetal-growth-restriction
#6
Cecilia Villalaín, Ignacio Herraiz, María Soledad Quezada, Paula Isabel Gómez-Arriaga, Enery Gómez-Montes, Alberto Galindo
OBJECTIVE: To compare perinatal outcomes on fetuses classified as stage I late-onset fetal growth restriction (FGR) depending on the estimated fetal weight (EFW) centile category and the fetal and maternal Doppler study. MATERIAL AND METHODS: Retrospective cohort study on 131 cases of stage I late-onset FGR (diagnosis ≥32+0 weeks), defined as: EFW < 3rd centile and normal Doppler (G1) or EFW < 10th centile and mean uterine artery pulsatility index (PI) > 95th centile (G2) or EFW < 10th centile and mild fetal Doppler alteration: umbilical artery PI > 95th centile, middle cerebral artery PI < 5th centile, or cerebroplacental ratio < 5th centile (G3)...
May 4, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29730660/perinatal-outcome-and-long-term-neurodevelopment-after-intracranial-haemorrhage-due-to-fetal-and-neonatal-alloimmune-thrombocytopenia
#7
Dian Winkelhorst, Marije M Kamphuis, Sylke J Steggerda, Monique Rijken, Dick Oepkes, Enrico Lopriore, Jeanine M M van Klink
OBJECTIVES: To evaluate the perinatal and long-term neurodevelopmental outcome in a cohort of children with intracranial haemorrhage (ICH) due to fetal and neonatal alloimmune thrombocytopenia (FNAIT) and to clearly outline the burden of this disease. SUBJECTS AND METHODS: We performed an observational cohort study and included all consecutive cases of ICH caused by FNAIT from 1993 to 2015 at Leiden University Medical Centre. Neurological, motor, and cognitive development were assessed at a minimum age of 1 year...
May 4, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29689556/assessment-of-placental-perfusion-in-the-preeclampsia-l-name-rat-model-with-high-field-dynamic-contrast-enhanced-mri
#8
Marie Lémery Magnin, Victor Fitoussi, Nathalie Siauve, Laetitia Pidial, Daniel Balvay, Gwennhael Autret, Charles André Cuenod, Olivier Clément, Laurent Julien Salomon
PURPOSE: To evaluate placental function and perfusion in a rat model of preeclampsia infused with L-nitro-arginine methyl ester (L-NAME) by dynamic contrast-enhanced (DCE) MRI using gadolinium chelates. METHODS: Pregnant female Sprague-Dawley rats were fitted on embryonic day 16 (E16) with subcutaneous osmotic minipumps loaded to deliver, continuously, L-NAME (50 mg/day per rat; case group) or saline solution (control group). DCE MRI was performed on E19 using gadolinium chelates and a 4...
April 24, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29684915/histological-analysis-of-term-placentas-from-hyperimmune-globulin-treated-and-untreated-mothers-with-primary-cytomegalovirus-infection
#9
Liliana Gabrielli, Maria Paola Bonasoni, Maria Pia Foschini, Enrico Maria Silini, Arsenio Spinillo, Maria Grazia Revello, Angela Chiereghin, Giulia Piccirilli, Evangelia Petrisli, Gabriele Turello, Giuliana Simonazzi, Dino Gibertoni, Tiziana Lazzarotto
BACKGROUND: The Congenital Human Cytomegalovirus Infection Prevention (CHIP) study, a randomized, blinded, placebo-controlled trial, demonstrated that the efficacy of hyperimmune globulin (HIG) was not different from that of placebo regarding transmission of cytomegalovirus (CMV) from mothers to newborns. Our aim was to analyze histologically HIG effects on placentas collected for the CHIP study. MATERIALS AND METHODS: Virological and histological analyses were performed on 40 placentas from transmitter and nontransmitter HIG-treated and untreated mothers by assessing the number of CMV-positive cells, tissue viral load, tissue damage, and compensatory mechanisms...
April 23, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29672287/early-administration-of-magnesium-sulfate-during-open-fetal-myelomeningocele-repair-reduces-the-dose-of-inhalational-anesthesia
#10
Roopali Donepudi, Melissa Huynh, Kenneth J Moise, Ramesha Papanna, Anthony Johnson, Mary Austin, KuoJen Tsao, Ranu Jain
INTRODUCTION: Optimal uterine relaxation is achieved through higher minimum alveolar concentration (MAC) of inhalational anesthetics, increasing risks to mother and fetus. Our objective was to determine if earlier administration of magnesium sulfate would reduce the requirement of inhalational anesthetics in fetal myelomeningocele repair. MATERIALS AND METHODS: Prospective observational study of fetal myelomeningocele repair was performed from September 2011 to August 2017...
April 19, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29669344/unique-heterogeneous-topological-pattern-of-the-metabolic-landscape-in-rabbit-fetal-lungs-following-tracheal-occlusion
#11
Ahmed I Marwan, Uladzimir Shabeka, Julie A Reisz, Connie Zheng, Natalie J Serkova, Evgenia Dobrinskikh
INTRODUCTION: Fetal tracheal occlusion (TO) is currently an experimental approach to drive accelerated lung growth. It is stimulated by mechanotransduction that results in increased cellular proliferation and growth. However, it is currently unknown how TO affects the metabolic landscape of fetal lungs. MATERIALS AND METHODS: TO or sham was performed on fetal rabbits at 26 days followed by lung harvest on day 30. Mass spectrometry was performed to evaluate global metabolic changes...
April 18, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29669341/management-and-neonatal-outcomes-of-pregnancies-with-fetal-neonatal-alloimmune-thrombocytopenia-a-single-center-retrospective-cohort-study
#12
Stefania Ronzoni, Johannes Keunen, Prakeshkumar S Shah, Edmond N Kelly, Rory Windrim, P Gareth Seaward, Greg Ryan
BACKGROUND: There is no consensus regarding the optimal antenatal treatment of fetal/neonatal alloimmune thrombocytopenia (F/NAIT). We aimed to review the fetal blood sampling (FBS)-related risk, fetal response to maternal intravenous immunoglobulin (IVIG), and cesarean section (CS) rate in pregnancies with a history of F/NAIT. METHODS: Maternal demographics, alloantibodies, pregnancy management, fetal and neonatal outcomes, and index case characteristics were collected...
April 18, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29642057/in-utero-fetal-intubation-for-a-large-neck-mass-a-minimally-invasive-exit-option
#13
Ramen H Chmait, Andrew H Chon, Dean Anselmo, Douglas L Vanderbilt, Jae Townsend, Beth Julian-Wang, Debra Don
Fetuses with obstructive neck and orofacial lesions have been delivered via an ex utero intrapartum treatment (EXIT) procedure to facilitate securement of the airway while on placental circulation. Pregnancy-related cardiovascular changes and technical issues unique to an EXIT procedure increase fetal and maternal risks relative to a standard cesarean section. In order to circumvent such issues, fetal endoscopic intubation has been proposed. We report a case of a fetus with a large neck mass (mixed solid and multiloculated cystic lesion measuring 9...
April 11, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29635237/maternal-serum-interleukin-6-a-non-invasive-predictor-of-histological-chorioamnionitis-in-women-with-preterm-prelabor-rupture-of-membranes
#14
Raigam Jafet Martinez-Portilla, Ameth Hawkins-Villarreal, Pamela Alvarez-Ponce, Zarela Lizbeth Chinolla-Arellano, Ana Lisbeth Moreno-Espinosa, Ana Lilia Sandoval-Mejia, Nallely Moreno-Uribe
OBJECTIVE: To assess the added value of maternal serum levels of IL-6 in women with preterm-prelabor rupture of membranes (PPROM) as a non-invasive test for the prediction of histological chorioamnionitis (HCA). METHODS: This was a prospective cohort study of pregnant women between 20 + 0 and 36 + 6 weeks of gestation with a confirmed diagnosis of PPROM. Logistic regression models were created for the prediction of HCA and compared by assessing the improvement in their Naegelkerke R2 as a measure of goodness of fit...
April 10, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29558751/sudden-fetal-hematologic-changes-as-a-complication-of-amnioreduction-in-twin-twin-transfusion-syndrome
#15
Katarzyna Kosinska-Kaczynska, Michal Lipa, Iwona Szymusik, Dorota Bomba-Opon, Robert Brawura-Biskupski-Samaha, Szymon Kozlowski, Lisanne S A Tollenaar, Dick Oepkes, Miroslaw Wielgos, Enrico Lopriore
We present the first case of a monochorionic twin pregnancy in which sudden hematologic changes occurred as a complication of the amnioreduction procedure for twin-twin transfusion syndrome (TTTS). At 33 weeks of gestation, 4 days after the amnioreduction, the recipient developed severe anemia while the donor developed severe polycythemia. Postnatal placental examination revealed several arteriovenous and venoarterial anastomoses, a pale placental mass of the recipient and a congested and plethoric placental mass of the donor...
March 20, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29539628/prenatal-abo-rhd-genotyping-a-new-paradigm-to-allow-for-fresh-whole-blood-for-cardiopulmonary-bypass-in-the-immediate-newborn-period
#16
Juliet Chhay Bishop, Karin Blakemore, Luca Vricella, Priya Sekar, Katelynn Sagaser, Jude Crino, Paul Ness, Benjamin K Kogutt, Joan Boyd, Susan Aucott, Angie C Jelin, Joanne Chiu, Eric Gehrie, Kristen Nelson McMillan
Compared to standard component therapy, fresh whole blood (FWB) offers potential benefits to neonates undergoing cardiopulmonary bypass (CPB) in the context of open cardiac surgery: decreased blood loss and subsequent risk of volume overload, improved coagulation status, higher platelet counts during and following CPB, circumvention of limited vascular access, and significantly reduced donor exposures. Obtaining FWB, however, entails 2-5 days of preparation, which often precludes its availability for neonates requiring CPB in the immediate newborn period...
March 14, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29533957/in-utero-partial-exchange-transfusion-combined-with-in-utero-blood-transfusion-for-prenatal-management-of-twin-anemia-polycythemia-sequence
#17
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...
March 13, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29533928/validation-of-reference-charts-for-mid-trimester-fetal-biometry
#18
K van de Kamp, E Pajkrt, A H Zwinderman, J A van der Post, R J M Snijders
OBJECTIVE: The aim of our study was to assess charts proposed for international use in the Intergrowth-21st Project. METHODS: Ultrasound data were collected from 43,923 healthy singleton pregnancies examined at 18-23 weeks of gestation in the Netherlands. Fetal measurements were converted into Z-scores using previous and current Dutch reference charts and Intergrowth charts. The distributions of the Z-scores were compared with the expected standard normal distribution...
March 13, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29518777/apparent-diffusion-coefficient-of-the-placenta-in-twin-versus-singleton-pregnancies
#19
Gali Shapira-Zaltsberg, David Grynspan, Deepti Reddy, Elka Miller
Previous studies in singleton pregnancies reported conflicting trends in apparent diffusion coefficient (ADC) values with gestational age (GA) and stable relative ADC (rADC; ADC placenta divided by ADC globe) throughout pregnancy. The purpose of our study was to compare the ADC and rADC of placentas of twin and singleton pregnancies. MATERIALS AND METHODS: Fetal MRI of 11 twin and 23 singleton pregnancies were retrospectively analyzed. Each group was further divided by GA (≤24 and >24 weeks)...
March 8, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29506014/effect-of-milking-maneuver-in-preterm-infants-a-randomized-controlled-trial
#20
Víctor Lago Leal, Loida Pamplona Bueno, Lucía Cabanillas Vilaplana, Estefanía Nicolás Montero, Mónica Martín Blanco, Cristina Fernández Romero, Sara El Bakkali, Tamara Pradillo Aramendi, Lara Sobrino Lorenzano, Paula Castellano Esparza, Esther Ballesteros Benito, Nieves Rayo Navarro, Pablo Del Barrio Fernández, Vanesa Ocaña Martínez, Luis Martínez Cortés
OBJECTIVE: To assess the short and medium-term effects of milking maneuver (MM) compared with early cord clamping for infants born before 37 weeks of pregnancy. MATERIAL AND METHODS: 138 infants between 24+0 and 36+6 weeks of gestation were allocated to MM or early cord clamping. Primary outcomes were the requirement of red blood cell transfusions or phototherapy. RESULTS: Initial hemoglobin was significantly higher in the MM group by 1.675 g/dL (p < 0...
March 5, 2018: Fetal Diagnosis and Therapy
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