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Fetal Diagnosis and Therapy

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/28433990/two-dimensional-ultrasound-evaluation-of-the-fetal-cerebral-aqueduct-improving-the-antenatal-diagnosis-and-counseling-of-aqueductal-stenosis
#11
Fernando Viñals, Pilar Ruiz, Gabriel Quiroz, Francisco A Guerra, Flavia Correa, Daniel Martínez, Bienvenido Puerto
OBJECTIVE: To describe a technique for the visualization and measurement of cerebral aqueduct diameter through a 2D sagittal median plane, and to report its aspect and measurement in fetuses with aqueductal stenosis (AS). METHODS: This was a cross-sectional study of 207 morphologically normal fetuses in low-risk pregnancies between 20 and 36 weeks of gestation. The cerebral aqueduct was visualized transvaginally in a midsagittal plane, and measurements of its greatest diameter (ampulla) were taken independently by an expert and a nonexpert sonographer...
April 22, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28407631/a-longitudinal-study-on-fetal-weight-estimation-at-third-trimester-of-pregnancy-comparison-of-magnetic-resonance-imaging-and-2-d-ultrasound-predictions
#12
Caroline Kadji, Mieke M Cannie, Morgane Van Wettere, Elisa Bevilacqua, Vivien Dütemeyer, Brigitte Strizek, Joe Khalifé, Xin Kang, Jacques C Jani
OBJECTIVE: To prospectively compare magnetic resonance (MR) estimation of fetal weight (MR-EFW) performed at third trimester with ultrasound (US) estimation of fetal weight (US-EFW) and actual birth weight, and to evaluate factors influencing fetal growth rate near term. METHODS: US-EFW and MR-EFW were calculated at a median of 33.0 and 37.7 weeks of gestation in 37 fetuses and plotted on curve centiles to predict birth weights at 39.3 weeks of gestation. The median absolute relative errors for predicted US-EFW and MR-EFW were calculated...
April 14, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28402981/prenatal-nonvisualization-of-the-gallbladder-a-diagnostic-and-prognostic-dilemma
#13
Aina Ruiz, Ana Robles, Francisca Salva, Ana Filgueira, Cristina Díaz, Miquel Juan, Albert Tubau
INTRODUCTION: Nonvisualization of the fetal gallbladder has been associated with benign conditions such as isolated gallbladder agenesis or severe diseases such as biliary atresia (BA). Recently, gamma-glutamyl transpeptidase (GGTP) fetal blood levels were reported as useful after 22 weeks. OBJECTIVE: To determine the contribution of fetal blood GGTP levels after 22 weeks, based on 2 cases. Case 1: 20+4-week secundipara, with subcutaneous edema and pleural effusion...
April 13, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28399531/intrapartum-ultrasound-to-differentiate-flexion-and-deflexion-in-occipitoposterior-rotation
#14
Federica Bellussi, Tullio Ghi, Aly Youssef, Ilaria Cataneo, Ginevra Salsi, Giuliana Simonazzi, Gianluigi Pilu
OBJECTIVE: To evaluate the ability of intrapartum ultrasound to differentiate occipitoposterior (OP) rotation with normal flexion of the head from deflexion, to compare the accuracy of ultrasound with the digital examination, and to assess the outcome of labor according to the type of presentation. PATIENTS AND METHODS: A retrospective study of patients with abnormal labor because of either prolongation and/or abnormal cardiotocography and OP rotation who underwent intrapartum sonography...
April 12, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28399525/prognosis-of-isolated-first-trimester-fetal-megacystis-with-spontaneous-resolution
#15
Noémie Girard, Benjamin Viaris de Lesegno, Paul Bussière, Catherine Egoroff, Anne-Gaël Cordier, Alexandra Benachi
OBJECTIVE: Fetal megacystis has a poor prognosis. During the first trimester, it is frequently associated with chromosomal abnormalities or multiple malformations, but can also be isolated and resolve spontaneously. In this study, our main objective was to determine the fetal and pediatric prognosis in this particular situation. METHODS: This was a retrospective multicenter study. We describe the cases referred to our fetal medicine centers and also cases previously reported in the international literature...
April 12, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28395283/predictive-value-of-second-trimester-biomarkers-and-maternal-features-for-adverse-pregnancy-outcomes
#16
Enav Yefet, Olga Kuzmin, Naama Schwartz, Flora Basson, Zohar Nachum
OBJECTIVE: To establish the predictive probability for placenta-associated morbidities using second-trimester α-fetoprotein (AFP), human chorionic gonadotropin (HCG), and maternal features. PATIENTS AND METHODS: A retrospective database of all singleton deliveries with available second-trimester HCG and AFP results from 2005 to 2012 was built and divided into 0, 1, or 2 elevated markers (defined as ≥2 multiples of the median [MoM]). For each group, we analyzed the risk for adverse obstetric outcome - comprising preeclampsia, placental abruption, and birth weight below the 10th percentile - and the time of delivery in those pregnancies...
April 11, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28391260/self-amputation-of-the-extra-digit-in-a-fetus-with-polydactyly-first-ultrasound-demonstration
#17
Nicola Volpe, Laura Franchi, Eleonora Mazzone, Costanza Migliavacca, Stefano Raboni, Antonio Percesepe, Christine Tita Kaihura, Tiziana Frusca, Tullio Ghi
We herein report the first ultrasound evidence of the self-amputation of an extra digit in case of fetal polydactyly. The prenatal evidence of fetal polydactyly is not always followed by postnatal confirmation. This is not always due to ultrasound misdiagnosis, but often to an in utero self-amputation phenomenon. We demonstrate that there is the detachment of part of the digit, leading to the evidence of a neonatal bump on the site of the prenatal extra digit. This demonstration has been possible by the direct visualization of the remnant by ultrasound...
April 8, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28384638/fetal-aortic-valvuloplasty-experience-and-results-of-two-tertiary-centers-in-spain
#18
Alberto Galindo, Enery Gómez-Montes, Olga Gómez, Mar Bennasar, Fàtima Crispi, Ignacio Herraiz, Alberto Mendoza, David Escribano, Enrique García-Torres, Juan Manuel Carretero, Eduard Gratacós, Josep María Martínez
OBJECTIVE: Fetal aortic valvuloplasty (FAV) may avoid progression of critical aortic stenosis (CAS) to hypoplastic left ventricle, improving the options for biventricular circulation (BVC). We describe the results of FAV in 2 referral centers in Spain. METHODS: We analyzed all FAVs performed in the period 2007-2015. The selection of candidates, the technique, and postnatal management were made following an agreed protocol. A descriptive analysis of survival, type of circulation after birth, and complications was made, considering all deaths in the first 48 h after FAV as FAV-related...
April 7, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28355605/the-use-of-a-software-assisted-method-to-estimate-fetal-weight-at-and-near-term-using-magnetic-resonance-imaging
#19
Caroline Kadji, Maxime De Groof, Margaux F Camus, Riccardo De Angelis, Stéphanie Fellas, Magdalena Klass, Vera Cecotti, Vivien Dütemeyer, Elie Barakat, Mieke M Cannie, Jacques C Jani
OBJECTIVE: The aim of this study was to apply a semi-automated calculation method of fetal body volume and, thus, of magnetic resonance-estimated fetal weight (MR-EFW) prior to planned delivery and to evaluate whether the technique of measurement could be simplified while remaining accurate. METHODS: MR-EFW was calculated using a semi-automated method at 38.6 weeks of gestation in 36 patients and compared to the picture archiving and communication system (PACS)...
March 30, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28351059/sonographic-markers-in-the-prediction-of-fetal-complex-gastroschisis
#20
Walkyria S Andrade, Maria L Brizot, Agatha S Rodrigues, Ana C Tannuri, Vera L Krebs, Estela N Nishie, Rossana P V Francisco, Marcelo Zugaib
OBJECTIVE: To investigate the ultrasound (US) markers predictive of complex gastroschisis (CG), mortality, and morbidity in fetuses with gastroschisis. MATERIALS AND METHODS: This was a retrospective cohort study of 186 pregnancies with isolated fetal gastroschisis. Eight US markers were analyzed. The predictions and associations of US markers with CG, mortality, and morbidity were assessed. Combinations of US markers predictive of CG were investigated. RESULTS: Extra-abdominal bowel dilatation (EABD), intra-abdominal bowel dilatation (IABD), and polyhydramnios were predictive of CG...
March 29, 2017: Fetal Diagnosis and Therapy
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