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Fetal Diagnosis and Therapy

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https://www.readbyqxmd.com/read/28633140/early-intrauterine-transfusion-in-fetuses-with-severe-anemia-caused-by-parvovirus-b19-infection
#1
Astrid Hellmund, Annegret Geipel, Christoph Berg, Rainer Bald, Ulrich Gembruch
OBJECTIVE: To describe procedure-related complications and perinatal survival after intrauterine transfusion (IUT) before 20 weeks of gestation in fetuses with severe anemia due to human parvovirus B19 infection. MATERIALS AND METHODS: A retrospective study was conducted of all fetuses requiring IUT before 20 weeks of gestation in two tertiary referral centers between January 2002 and July 2015. Gestational age (GA) at first IUT, fetal blood sampling results, and presence of hydrops were related to procedure-related complications, fetal death (FD), and perinatal outcome...
June 21, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28624828/unique-imaging-features-enabling-the-prenatal-diagnosis-of-developmental-venous-anomalies-a-persistent-echogenic-brain-lesion-drained-by-a-collecting-vein-in-contrast-with-normal-brain-parenchyma-on-mri
#2
Karina Krajden Haratz, Alon Peled, Boris Weizman, Liat Gindes, Mordechai Tamarkin, Dorit Lev, Dvora Kidron, Liat Ben-Sira, Gustavo Malinger, Tally Lerman-Sagie, Zvi Leibovitz
OBJECTIVE: To describe the prenatal imaging features enabling diagnosis of developmental venous anomalies (DVA). METHODS: Four fetuses with unexplained persistent echogenic parenchymal brain lesions were studied. The evaluation included dedicated neurosonography, fetal MRI, serology for intrauterine infection, screening for coagulation abnormalities, and chromosomal microarray. Postnatal neurodevelopmental follow-up or autopsy results were assessed. RESULTS: DVA presented as very slowly growing echogenic brain lesions without cystic components, calcifications, or structural changes on otherwise normal neurosonographic scans performed at 2- to 3-week intervals...
June 17, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28624818/maternal-subcutaneous-and-visceral-adipose-ultrasound-thickness-in-women-with-gestational-diabetes-mellitus-at-24-28-weeks-gestation
#3
Francesco D'Ambrosi, Francesca Crovetto, Enrico Colosi, Isabella Fabietti, Floriana Carbone, Beatrice Tassis, Silvia Motta, Alessandro Bulfoni, Luigi Fedele, Gabriele Rossi, Nicola Persico
OBJECTIVE: To compare the sonographic measurement of maternal subcutaneous and visceral adipose thickness between pregnant women with gestational diabetes mellitus (GDM) and patients with nondiabetic pregnancies. METHODS: Adipose thickness was measured by transabdominal ultrasound in pregnant women attending our antenatal clinics at 24-28 weeks' gestation. All patients underwent a 75-g oral glucose challenge as a diagnostic test for GDM. RESULTS: The study population comprised 56 women with a positive glucose challenge test and 112 nondiabetic pregnancies...
June 17, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28614833/use-of-the-myocardial-performance-index-in-decreased-fetal-movement-assessment-a-case-control-study
#4
Daphne Ho, Jingjing Wang, Yvette Homann, Jennifer Alphonse, Geraldene Beirne, Alec W Welsh, Amanda Henry
OBJECTIVES: To determine whether there are any fetal cardiac function changes, as measured by the myocardial performance index (MPI), in pregnancies complicated by decreased fetal movement (DFM). METHODS: We performed a prospective cross-sectional case-control study of 50 DFM and 50 uncomplicated third-trimester pregnancies matched within 2 gestational weeks. Routine ultrasound growth and well-being parameters as well as MPI were measured. Average MPI measurements and its component values were compared between the DFM and the control group, as were demographics, other ultrasound data, and perinatal outcomes...
June 15, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28601881/third-trimester-conditional-reference-values-for-longitudinal-fetal-growth-assessment
#5
Tri Rahmat Basuki, Stefania Triunfo, Javier Caradeux, Elisenda Eixarch, Stefan Hansson, Eduard Gratacos, Francesc Figueras
OBJECTIVES: The aim of this study was to derive longitudinal reference values of fetal growth (estimated fetal weight [EFW] and abdominal circumference [AC]) during the third trimester and to develop coefficients for conditional growth assessment. PATIENTS AND METHODS: A prospective cohort study was conducted involving consecutive singleton pregnancies in a low-risk population for a routine third-trimester scan at 30+0-34+6 weeks and follow-up at 37+0-38+6 weeks for an additional ultrasound...
June 10, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28591756/the-fetal-reserve-index-re-engineering-the-interpretation-and-responses-to-fetal-heart-rate-patterns
#6
Robert D Eden, Mark I Evans, Shara M Evans, Barry S Schifrin
OBJECTIVE: Electronic fetal monitoring (EFM) correlates poorly with neonatal outcome. We present a new metric: the "Fetal Reserve Index" (FRI), formally incorporating EFM with maternal, obstetrical, fetal risk factors, and excessive uterine activity for assessment of risk for cerebral palsy (CP). METHODS: We performed a retrospective, case-control series of 50 term CP cases with apparent intrapartum neurological injury and 200 controls. All were deemed neurologically normal on admission...
June 8, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28586779/effect-of-anesthesia-on-the-developing-brain-infant-and-fetus
#7
Dean B Andropoulos
The potential for commonly used anesthetics and sedatives to cause neuroapoptosis and other neurodegenerative changes in the developing mammalian brain has become evident in animal studies over the past 15 years. This concern has led to a number of retrospective studies in human infants and young children, and some of these studies observed an association between exposure to general anesthesia as an infant, and later neurobehavioral problems in childhood. This association is particularly evident for prolonged or repeated exposures...
June 7, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28578350/ex-utero-intrapartum-treatment-to-ventricular-pacing-a-novel-delivery-strategy-for-complete-atrioventricular-block-with-severe-bradycardia
#8
Bettina F Cuneo, Max B Mitchell, Ahmed I Marwan, Matthew Green, Johannes C von Alvensleben, Regina Reynolds, Timothy M Crombleholme, Henry L Galan
Fetuses with anti-SSA-mediated complete atrioventricular block (CAVB) are at high risk for perinatal death if they present at <20 weeks of gestation and develop ventricular rates of <55 beats per minute (bpm), cardiac dysfunction, or hydrops [Izmirly et al.: Circulation 2011;124:1927-1935; Jaeggi et al.: J Am Coll Cardiol 2002;39:130-137; Eliasson et al.: Circulation 2011;124:1919-1926]. After our experience with two such fetuses who died with pulseless electrical activity despite being paced within 30 min of birth, we performed an ex utero intrapartum treatment procedure to ventricular pacing on a 36-week CAVB fetus with cardiac dysfunction, mild hydrops, and a ventricular rate of 46 bpm...
June 3, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28578346/a-new-approach-to-developing-birth-weight-reference-charts-a-retrospective-observational-study
#9
Farmey A Joseph, Jon A Hyett, Kevin McGeechan, Philip J Schluter, Adrienne Gordon, Andrew McLennan, Bradley S De Vries
INTRODUCTION: Birth weight reference charts based on historical infant birth weights have significant bias at preterm gestations because many preterm births are associated with abnormal growth. This study aims to determine whether more accurate birth weight charts can be constructed using data only from births that follow spontaneous onset of labour. MATERIALS AND METHODS: This study was a single-centre retrospective observational study of 115,712 singleton live births...
June 3, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28571031/perimortem-demonstration-and-treatment-of-recipient-to-donor-transfusion-in-monochorionic-diamniotic-twin-gestation
#10
Jessica Parrott, Tricia Schwartz, Tracy Cowles, Marium Holland, Carl P Weiner
Twin-twin transfusion syndrome is a complication of monochorionic-diamniotic placentation. Should one twin die, ≈30% of co-twins will also die, and if they survive, ≈30% experience severe morbidity rates, each believed secondary to hemorrhage of the co-twin into the deceased twin. We report apparently the first ultrasound-documented case of perimortem hemorrhage in twin-twin transfusion syndrome and its treatment by emergent ultrasound-guided percutaneous cord occlusion followed by percutaneous fetal intravascular transfusion...
June 2, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28535541/contribution-of-amniotic-fluid-along-gestation-to-the-prediction-of-perinatal-mortality-in-women-with-early-preterm-premature-rupture-of-membranes
#11
Teresa Cobo, Jordina Munrós, José Ríos, Janisse Ferreri, Federico Migliorelli, Núria Baños, Eduard Gratacós, Montse Palacio
INTRODUCTION: To evaluate the largest vertical pocket (LVP) of amniotic fluid as a time-dependent factor to predict perinatal mortality in women with early preterm premature rupture of membranes (EPPROM). MATERIAL AND METHODS: Observational cohort study of singleton pregnancies with EPPROM <24 weeks. Termination of pregnancy (TOP) was considered if the LVP was <2 cm at 7 days. The maternal and neonatal characteristics of ongoing pregnancies were recorded. Prediction of perinatal mortality was estimated based on the influence of the LVP as a time-dependent factor after adjustment for maternal age, prior invasive procedure, and gestational age at EPPROM...
May 24, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28531885/fetal-treatment-2017-the-evolution-of-fetal-therapy-centers-a-joint-opinion-from-the-international-fetal-medicine-and-surgical-society-ifmss-and-the-north-american-fetal-therapy-network-naftnet
#12
Anita J Moon-Grady, Ahmet Baschat, Darrell Cass, Mahesh Choolani, Joshua A Copel, Timothy M Crombleholme, Jan Deprest, Stephen P Emery, Mark I Evans, Francois I Luks, Mary E Norton, Greg Ryan, Kuojen Tsao, Ross Welch, Michael Harrison
More than 3 decades ago, a small group of physicians and other practitioners active in what they called "fetal treatment" authored an opinion piece outlining the current status and future challenges anticipated in the field. Many advances in maternal, neonatal, and perinatal care and diagnostic and therapeutic modalities have been made in the intervening years, yet a thoughtful reassessment of the basic tenets put forth in 1982 has not been published. The present effort will aim to provide a framework for contemporary redefinition of the field of fetal treatment, with a brief discussion of the necessary minimum expertise and systems base for the provision of different types of interventions for both the mother and fetus...
May 23, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28511174/noninvasive-prenatal-detection-of-trisomy-21-by-targeted-semiconductor-sequencing-a-technical-feasibility-study
#13
Yanwei Xi, Aryan Arbabi, Amy J M McNaughton, Alison Hamilton, Danna Hull, Helene Perras, Tillie Chiu, Shawna Morrison, Claire Goldsmith, Emilie Creede, Gregory J Anger, Christina Honeywell, Mireille Cloutier, Natasha Macchio, Courtney Kiss, Xudong Liu, Susan Crocker, Gregory A Davies, Michael Brudno, Christine M Armour
OBJECTIVE: To develop an alternate noninvasive prenatal testing method for the assessment of trisomy 21 (T21) using a targeted semiconductor sequencing approach. METHODS: A customized AmpliSeq panel was designed with 1,067 primer pairs targeting specific regions on chromosomes 21, 18, 13, and others. A total of 235 samples, including 30 affected with T21, were sequenced with an Ion Torrent Proton sequencer, and a method was developed for assessing the probability of fetal aneuploidy via derivation of a risk score...
May 17, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28505611/novel-insights-in-fetal-cardiomyopathy-due-to-in-utero-herpes-simplex-virus-infection
#14
Tamara Margit Jutta Pahlitzsch, Elisa Theresa Helbig, Nanette Sarioglu, Larry Hinkson, Katharina von Weizsäcker, Wolfgang Henrich
This is a case report of fatal cardiomyopathy in a fetus following maternal intrauterine infection with herpes simplex virus (HSV), despite the mother having no symptoms of an infection. The fetus showed signs of a disseminated infection affecting the heart, brain, lungs, liver, adrenal glands, and skin. HSV cardiomyopathy, characterized by vast necrosis, extensive calcifications, and inflammatory infiltration, was found to be the cause of intrauterine fetal death. To our knowledge, this is a unique report of an asymptomatic maternal nonprimary or recurrent HSV infection that induced a transmission of HSV resulting in extensive and fatal changes in the fetal heart...
May 16, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28505609/disentanglement-of-discordant-monochorionic-monoamniotic-twins-in-a-triplet-pregnancy-an-innovative-approach-utilizing-fetoscopic-laser-coagulation-with-micro-laparoscopic-scissor-dissection
#15
https://www.readbyqxmd.com/read/28482343/fetal-tricuspid-regurgitation-in-the-first-trimester-as-a-screening-marker-for-congenital-heart-defects-systematic-review-and-meta-analysis
#16
Carolina Scala, Maddalena Morlando, Alessandra Familiari, Umberto Leone Roberti Maggiore, Simone Ferrero, Francesco D'Antonio, Asma Khalil
BACKGROUND: Assessment of tricuspid flow has been reported to improve the performance of screening for aneuploidies and congenital heart defects (CHD). However, the performance of tricuspid regurgitation (TR) as a screening marker for CHD in euploid fetuses is yet to be established. The main aim of this meta-analysis was to establish the predictive accuracy of TR for CHD. METHODS: MEDLINE, Embase, and the Cochrane Library were searched electronically utilizing combinations of the relevant medical subject heading for "fetus," "tricuspid regurgitation," and "first trimester...
May 9, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28463850/calprotectin-in-serially-collected-meconium-portions-as-a-biomarker-for-intrauterine-fetal-environment
#17
Barbara Lisowska-Myjak, Ewa Skarżyńska, Joanna Żytyńska-Daniluk
OBJECTIVE: Understanding the pathomechanisms underlying high meconium calprotectin concentrations is the key to the potential uses of this parameter for the assessment of the intrauterine environment in which the fetus develops. The aim of this study was to measure calprotectin concentrations in serial meconium portions passed after birth and to calculate the individual variations in the total meconium calprotectin content accumulated during gestation. METHODS: Calprotectin concentrations were measured using Calprotectin ELISA kit (Immundiagnostik AG) in all meconium portions (n = 81) from 20 healthy neonates...
May 3, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28463844/early-delivery-of-sacrococcygeal-teratoma-with-intraspinal-extension
#18
Erin E Perrone, Marcus D Jarboe, Cormac O Maher, Deborah R Berman, Maria Ladino-Torres, Jeannie Kreutzman, Marjorie C Treadwell, George B Mychaliska
Sacrococcygeal teratoma (SCT) with intraspinal extension is rare. There is a risk of paraplegia associated with prolonged spinal cord compression. We present the case of an infant with a prenatal diagnosis of an SCT with a large intraspinal component that was causing compression of the lower spinal cord. Ultrasound at 33 weeks showed bilateral lower extremity and foot movement without hydrops or cardiac failure. Multidisciplinary decision was made to administer betamethasone and proceed with Cesarean delivery at 34 weeks...
May 3, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28463829/prenatal-sacral-anomalies-leading-to-the-detection-of-associated-spinal-cord-malformations
#19
Baptiste Morel, Stéphanie Friszer, Jean-Marie Jouannic, Hubert Ducou Le Pointe, Eléonore Blondiaux, Catherine Garel
INTRODUCTION: Systematic analysis of the spine is recommended as part of the basic sonographic examination. The aim of our study is to assess the proportion of spinal cord anomalies diagnosed following detection of a sacral anomaly. MATERIAL AND METHODS: We analyzed retrospectively collected data in a prenatal tertiary center during a 9-year period. Patients were referred for second-line ultrasound in the context of diabetes mellitus or following detection of pelvic or lower spine anomalies...
May 3, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28434005/chorioamniotic-membrane-separation-after-fetoscopic-laser-photocoagulation
#20
Mayumi Takano, Masahiko Nakata, Susumu Murata, Masahiro Sumie, Mineto Morita
INTRODUCTION: This study aimed to investigate the risk factors, incidence, and influence on the perinatal outcome of chorioamniotic membrane separation (CMS) after fetoscopic laser photocoagulation (FLP). MATERIAL AND METHODS: This retrospective study included 312 women who underwent FLP for twin-to-twin transfusion syndrome (TTTS). Clinical records were used to review obstetrical examinations, complications, operative data, ultrasonographic findings, and perinatal and neonatal follow-up data in all patients...
April 22, 2017: Fetal Diagnosis and Therapy
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