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https://www.readbyqxmd.com/read/28108156/smfm-consult-series-42-the-role-of-ultrasound-in-women-who-undergo-cell-free-dna-screening
#1
Mary E Norton, Joseph R Biggio, Jeffrey A Kuller, Sean C Blackwell
The introduction of cell-free DNA (cfDNA) screening for aneuploidy into obstetric practice in 2011 revolutionized the strategies utilized for prenatal testing. The purpose of this document is to review the current data on the role of ultrasound in women who have undergone or are considering cfDNA screening. The following are SMFM recommendations: 1) in women who have already received a negative cfDNA screen, ultrasound at 11-14 weeks of gestation solely for the purpose of NT measurement (CPT code 76813) is not recommended (GRADE 1B); 2) we recommend that diagnostic testing should not be recommended to patients solely for the indication of an isolated soft marker in the setting of a negative cfDNA screen (GRADE 2B); 3) in women with an isolated soft marker without other clinical implications (ie, choroid plexus cyst or echogenic intracardiac focus) and a negative cfDNA screen, we recommend describing the finding as "not clinically significant" or as a "normal variant" (GRADE 2B); 4) in women with an isolated soft marker that has no other clinical implication (ie, choroid plexus cyst or echogenic intracardiac focus) and a negative first or second trimester screening result, we recommend describing the finding as "not clinically significant" or as a "normal variant" (GRADE 2B); 5) we recommend that all women in whom a structural abnormality is identified by ultrasound should be offered diagnostic testing with chromosomal microarray (GRADE 1A); 6) we recommend against routine screening for microdeletions with cfDNA (GRADE 1B)...
January 17, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28102101/thyroid-in-pregnancy-from-physiology-to-screening
#2
Drahomira Springer, Jan Jiskra, Zdenka Limanova, Tomas Zima, Eliska Potlukova
Thyroid hormones are crucial for the growth and maturation of many target tissues, especially the brain and skeleton. During critical periods in the first trimester of pregnancy, maternal thyroxine is essential for fetal development as it supplies thyroid hormone-dependent tissues. The ontogeny of mature thyroid function involves organogenesis, and maturation of the hypothalamus, pituitary and the thyroid gland; and it is almost complete by the 12th-14th gestational week. In case of maternal hypothyroidism, substitution with levothyroxine must be started in early pregnancy...
January 19, 2017: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/28099747/observational-study-comparing-the-performance-of-first-trimester-screening-protocols-for-detecting-trisomy-21-in-a-north-indian-population
#3
Anita Kaul, Chanchal Singh, Rachna Gupta, Nidhi Arora, Abha Gupta
OBJECTIVE: To evaluate first-trimester screening protocols for detecting trisomy 21 in an Indian population. METHODS: The present prospective study collected data from women with singleton pregnancies and a crown-to-rump length of 45-84 mm who presented at the fetal medicine unit of a tertiary care center in North India between June 1, 2006, and December 31, 2015, for combined first-trimester screening. Maternal age, nuchal translucency, nasal bone, and maternal serum levels of free beta human chorionic gonadotropin and pregnancy-associated plasma protein A were assessed for calculating the risk of trisomy 21...
December 22, 2016: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28090639/the-psychometric-validation-of-the-epds-k-among-korean-women-does-it-only-measure-depressive-symptoms
#4
Young-Sun Rhee, Jeong-Hwan Park, Hee-Jung Cha, Kye-Ha Kim
PURPOSE: The purpose of this study was to test the validity of the Edinburgh Postnatal Depression Scale-Korean (EPDS-K) and compare the specified models (one-, two-, three-factor model, and a model in the current study) in pregnant, first-trimester Korean women. DESIGN AND METHODS: The study consisted of two groups of 100 first-trimester Korean women recruited from maternity clinics in Korea. FINDINGS: The results show that the EPDS-K has depression, anxiety, and anhedonia factors, and that the validity of the EPDS-K with Korean women is questionable...
January 16, 2017: Perspectives in Psychiatric Care
https://www.readbyqxmd.com/read/28089506/evaluation-of-the-predictive-value-of-placental-vascularisation-indices-derived-from-3-dimensional-power-doppler-whole-placental-volume-scanning-for-prediction-of-pre-eclampsia-a-systematic-review-and-meta-analysis
#5
K A Eastwood, C Patterson, A J Hunter, D R McCance, I S Young, V A Holmes
Pre-eclampsia remains a leading cause of maternal and fetal morbidity and mortality. This systematic review aims to evaluate the ability of placental vascularisation indices (PVIs) derived from 3D power Doppler whole placental volume scanning to predict early, late and any-onset pre-eclampsia (PE). The following databases were searched: MEDLINE, EMBASE and Web of Science. Studies selected for inclusion measured PVIs: Vascularisation Index (%) (VI) and/or Flow Index (FI) and/or Vascularisation Flow Index (VFI) derived from 3D power Doppler whole placental volume scanning via Virtual Organ Computer-aided Analysis (VOCAL) technique prior to diagnosis of PE...
January 5, 2017: Placenta
https://www.readbyqxmd.com/read/28081297/first-trimester-noninvasive-fetal-rhd-genotyping-using-maternal-dried-blood-spots
#6
Yali Xiong, Stacey Jeronis, Barbara Hoffman, Dan A Liebermann, Ossie Geifman-Holtzman
OBJECTIVE: This study was aimed to evaluate whether maternal dried blood spots (DBS) could be a potential source for the non-invasive fetal RHD genotyping, serving as a combined one-step test for both the First Trimester Screen and the fetal RHD genotyping. METHOD: Both the DBS and the peripheral blood samples from nineteen RhD-negative pregnant women were obtained during the First Trimester Screen. DNA was extracted and Sequential Real-time PCRs were performed to determine the fetal RHD genotypes...
January 12, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28078815/repeat-measurements-of-uterine-artery-pulsatility-index-mean-arterial-pressure-and-serum-placental-growth-factor-at-12-22-and-32-weeks-in-the-prediction-of-preeclampsia
#7
Silvia Andrietti, Stefania Carlucci, Alan Wright, David Wright, Kypros H Nicolaides
OBJECTIVE: To investigate the potential value of repeat measurements of uterine artery pulsatility index (UTPI), mean arterial pressure (MAP) and serum placental growth factor (PLGF) at 12, 22 and 32 weeks' gestation in the prediction of preeclampsia (PE) after 32 weeks. METHODS: The data were derived from prospective screening for adverse obstetric outcomes in women attending for their routine hospital visit at 11-13, 19-24 and / or 30-34 weeks' gestation in two maternity hospitals in England...
January 12, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28076990/outcomes-in-the-absence-of-the-ductus-venosus-diagnosed-in-the-first-trimester
#8
Hiroko Takita, Junichi Hasegawa, Tatsuya Arakaki, Shoko Hamada, Mayumi Tokunaka, Masamitsu Nakamura, Ryu Matsuoka, Akihiko Sekizawa
PURPOSE: To clarify the outcomes of the absence of the ductus venosus diagnosed in fetuses suspected to have a structural abnormality during a morphological assessment in the first trimester. METHODS: Infants in whom ultrasound fetal morphological assessments were attempted in the first trimester (11 to 13-6 weeks of gestation) and who were subsequently delivered between 2013 and 2015 at Showa University Hospital were enrolled. In cases in which the absence of the ductus venosus was diagnosed in the first trimester, the prognosis was assessed...
January 11, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28073735/patient-information-websites-about-medically-induced-second-trimester-abortions-a-descriptive-study-of-quality-suitability-and-issues
#9
Tommy Carlsson, Ove Axelsson
BACKGROUND: Patients undergoing medically induced second-trimester abortions feel insufficiently informed and use the Web for supplemental information. However, it is still unclear how people who have experience with pregnancy termination appraise the quality of patient information websites about medically induced second-trimester abortions, whether they consider the websites suitable for patients, and what issues they experience with the websites. OBJECTIVE: Our objective was to investigate the quality of, suitability of, and issues with patient information websites about medically induced second-trimester abortions and potential differences between websites affiliated with the health care system and private organizations...
January 10, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28067011/accuracy-of-competing-risks-model-in-screening-for-pre-eclampsia-by-maternal-factors-and-biomarkers-at-11-13-weeks-gestation
#10
Neil O'Gorman, David Wright, Liona C Poon, Daniel L Rolnik, Argyro Syngelaki, Alan Wright, Ranjit Akolekar, Simona Cicero, Deepa Janga, Jacques Jani, Francisca S Molina, Catalina de Paco Matallana, Nikos Papantoniou, Nicola Persico, Walter Plasencia, Mandeep Singh, Kypros H Nicolaides
OBJECTIVE: To examine the diagnostic accuracy of a previously developed model for prediction of preeclampsia (PE) by a combination of maternal factors and biomarkers at 11-13 weeks' gestation. METHODS: This was a prospective first-trimester multicenter study of screening for PE in 8,775 singleton pregnancies. A previously published algorithm was used for the calculation of patient-specific risk of PE in each patient. The detection rates (DR) and false positive rates (FPR) for delivery with PE at <32, <37 and ≥37 weeks were estimated and compared to those in the dataset used for development of the algorithm...
January 9, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28061818/perspectives-preferences-and-needs-regarding-early-prediction-of-preeclampsia-in-dutch-pregnant-women-a-qualitative-study
#11
Neeltje M T H Crombag, Marije Lamain-de Ruiter, Anneke Kwee, Peter C J I Schielen, Jozien M Bensing, Gerard H A Visser, Arie Franx, Maria P H Koster
BACKGROUND: To improve early risk-identification in pregnancy, research on prediction models for common pregnancy complications is ongoing. Therefore, it was the aim of this study to explore pregnant women's perceptions, preferences and needs regarding prediction models for first trimester screening for common pregnancy complications, such as preeclampsia, to support future implementation. METHOD: Ten focus groups (of which five with primiparous and five with multiparous women) were conducted (n = 45)...
January 7, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28039875/first-trimester-isolated-maternal-hypothyroxinemia-adverse-maternal-metabolic-profile-and-impact-on-the-obstetrical-outcome
#12
Raluca Maria Furnica, Damien Gruson, John H Lazarus, Dominique Maiter, Pierre Bernard, Chantal Daumerie
BACKGROUND: Isolated maternal hypothyroxinemia (IH) is defined as low maternal FT4 (<5(th) percentile) and normal TSH. There is concern on its potential negative effects on the mother and offspring. OBJECTIVE: We aimed to evaluate the prevalence of IH and to assess the consequences of hypothyroxinemia on the maternal and foetal outcomes. SUBJECTS AND METHODS: From a total of 1300 consecutive pregnant women recruited during the prenatal screen (mean gestational age, 11...
December 31, 2016: Clinical Endocrinology
https://www.readbyqxmd.com/read/28029461/-prevention-of-preterm-birth-by-uterine-cervical-cerclage
#13
L Marcellin
OBJECTIVE: To review the scientific literature on cervical insufficiency and indications of cervical cerclage cervix. MATERIALS AND METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and international obstetrical societies between 1972 and June 2016 have been consulted. RESULTS: Cervical insufficiency is a pathophysiological concept and to date no consensual definition is available: the diagnosis is clinical and discussed retrospectively in case of patients with a history of late miscarriages and/or spontaneous preterm delivery, with asymptomatic dilatation of the cervix (professional consensus)...
October 29, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/28029460/-predictive-tools-of-preterm-birth-in-asymptomatic-high-risk-pregnancy
#14
J Blanc, F Bretelle
OBJECTIVE: Describe tools designed to predict preterm birth in asymptomatic high-risk pregnancy and determine their predictive value. METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. RESULTS: Obstetric history particularly spontaneous preterm birth identifies a population at risk for preterm birth for the current pregnancy (LE3). This risk is related to the number of prior preterm birth and is even higher than the term of the prior event is more premature and that the event concerns the last pregnancy (LE3)...
October 29, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/28028874/second-trimester-weight-gain-7-kg-increases-the-risk-of-gestational-diabetes-after-normal-first-trimester-screening
#15
Dittakarn Boriboonhirunsarn
AIMS: The objective of this study was to determine the relationship between second trimester weight gain and the risk of gestational diabetes (GDM) after normal first trimester screening. METHODS: A total of 195 women at risk for GDM who had normal first trimester screening results were enrolled. The study group consisted of 65 women who had second trimester weight gain > 7 kg, while another 130 women with weight gain ≤ 7 kg served as the comparison group, matched 1:2 by pre-pregnancy body mass index...
December 27, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28027672/relationship-between-first-trimester-aneuploidy-screening-test-serum-analytes-and-placenta-accreta
#16
Barış Büke, Hatice Akkaya, Sibel Demir, Sermet Sağol, Deniz Şimşek, Güneş Başol, Burcu Barutçuoğlu
OBJECTIVE: The aim of this study is to determine whether there is a relationship between first trimester serum pregnancy-associated plasma protein A (PAPP-A) and free beta human chorionic gonadotropin (fβhCG) MoM values and placenta accreta in women who had placenta previa. STUDY DESIGN: A total of 88 patients with placenta previa who had first trimester aneuploidy screening test results were enrolled in the study. Nineteen of these patients were also diagnosed with placenta accreta...
December 27, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28026791/intelligent-non-invasive-diagnosis-of-aneuploidy-raw-values-and-highly-imbalanced-dataset
#17
Andreas Neocleous, Kypros Nicolaides, Christos Schizas
The objective of this work is to introduce a noninvasive diagnosis procedure for aneuploidy and minimize the social and financial cost of prenatal diagnosis tests that are performed for fetal aneuploidies in an early stage of pregnancy. We propose a method using artificial neural networks trained with data from singleton pregnancy cases, while undergoing first trimester screening. Three different datasets1 with a total of 122362 euploid and 967 aneuploid cases were used in this study. The data for each case contained markers collected from the mother and the fetus...
December 22, 2016: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28009332/effect-of-intrahepatic-cholestasis-of%C3%A2-pregnancy-on-maternal-serum-screening%C3%A2-tests
#18
G G Türkmen, H Timur, Z Yilmaz, A Kirbas, K Daglar, A Tokmak, D Uygur, N Danişman
OBJECTIVE: In this study, we aimed to evaluate whether the changes in the first and second trimester maternal serum biochemical markers used for prenatal screening are associated with euploid pregnancies complicated by intrahepatic cholestasis of pregnancy (ICP). METHODS: A total of 94 pregnant women were included in this retrospective comparative study. Thirty-seven women whose pregnancy was complicated with ICP constituted the study group whereas 57 of them constituted the control group...
2016: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28006080/crown-rump-length-audit-plots-with-the-use-of-operator-specific-papp-a-and-%C3%A3-hcg-median-mom
#19
Joan Sabria, Laura Guirado, Isabel Miró, Maria Dolors Gómez-Roig, Antoni Borrell
OBJECTIVE: Audit the crown-rump length (CRL) measurements taken at 11-13 weeks scan, using operator-specific median multiples of the median (MoM) for pregnancy-associated plasma protein-A (PAPP-A) and free ß-human chorionic gonadotropin (ß-hCG) plots, to identify deviations potentially related to a systematic CRL bias. METHODS: Study population included consecutive singleton pregnancies undergoing first trimester combined screening, scanned by sonologists with at least 100 scans, during the 2011-12 period...
December 22, 2016: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28005592/ultrasound-in-assisted-reproductive-technologies-and-the-first-trimester-is-there-a-risk
#20
Jacques S Abramowicz
Ultrasound is routinely used in assisted reproductive technology for monitoring of follicular growth, oocyte retrieval and embryo transfer, as well as for the assessment of early embryonic development in the first 5 to 8 weeks of pregnancy. Ultrasound is a form of energy, which will affect live tissues it traverses (bioeffects) by being partially transformed into heat (thermal effect) and by alternating positive and negative pressures (nonthermal or mechanical effect). In the United States 2 indices (thermal and mechanical index) must be displayed on-screen to provide the clinicians an indication of possible thermal and nonthermal changes...
December 21, 2016: Clinical Obstetrics and Gynecology
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