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First trimester screening

Dick Oepkes, Lieve C Page-Christiaens, Caroline J Bax, Mireille N Bekker, Catia M Bilardo, Elles M J Boon, G Heleen Schuring-Blom, Audrey B C Coumans, Brigitte H Faas, Robert-Jan H Galjaard, Attie T Go, Lidewij Henneman, Merryn V E Macville, Eva Pajkrt, Ron F Suijkerbuijk, Karin Huijsdens-vanAmsterdam, Diane Van Opstal, E J Joanne Verweij, Marjan M Weiss, Erik A Sistermans
OBJECTIVE: To evaluate the clinical impact of nationwide implementation of genome-wide Non-Invasive Prenatal Testing (NIPT) in pregnancies at increased risk for fetal trisomies 21, 18 and 13. METHOD: Women with elevated risk based on first trimester combined testing (FCT ≥ 1:200) or medical history, not advanced maternal age alone, were offered NIPT as contingent screening test, performed by Dutch University Medical laboratories. We analyzed uptake, test performance, redraw/failure rate, turn-around time and pregnancy outcome...
October 17, 2016: Prenatal Diagnosis
Marja Kaijomaa, Veli-Matti Ulander, Esa Hämäläinen, Henrik Alfthan, Helene Markkanen, Seppo Heinonen, Vedran Stefanovic
OBJECTIVE: To analyze the risk of adverse pregnancy outcome in three subgroups with extremely low maternal PAPP-A, i.e. < 0.3 multiples of median (MoM) at the first trimester screening. METHOD: A cohort of 961 pregnancies with PAPP-A levels < 0.3 MoM at the first trimester combined screening was followed up during the study period of January 2009-December 2012. The incidences of adverse outcomes were determined in three subgroups with PAPP-A levels < 0...
October 17, 2016: Prenatal Diagnosis
Marina Vafeiadi, Theano Roumeliotaki, Georgia Chalkiadaki, Panu Rantakokko, Hannu Kiviranta, Eleni Fthenou, Soterios A Kyrtopoulos, Manolis Kogevinas, Leda Chatzi
BACKGROUND: Persistent organic pollutants (POPs) are a group of diverse substances, including polychlorinated biphenyls (PCBs) and organochlorine pesticides that are resistant to biodegradation and ubiquitously present in our environment. Exposure to endocrine disrupting chemicals such as POPs has been linked to type 2 diabetes and metabolic disturbances in epidemiological and animal studies, but little is known about POPs exposure during pregnancy and the development of gestational diabetes mellitus (GDM)...
October 12, 2016: Environment International
Dorte L Lildballe, Ida Vogel, Ida Lund, Inger Stornes, Mette Warming Jørgensen, Else Marie Vestergaard
No abstract text is available yet for this article.
October 15, 2016: Prenatal Diagnosis
Rachel V van Schendel, Lieve Page-Christiaens, Lean Beulen, Catia M Bilardo, Marjon A de Boer, Audrey B C Coumans, Brigitte H Faas, Irene M van Langen, Klaske D Lichtenbelt, Merel C van Maarle, Merryn V E Macville, Dick Oepkes, Eva Pajkrt, Lidewij Henneman
OBJECTIVE: To evaluate preferences and decision-making amongst high-risk pregnant women offered a choice between Non-Invasive Prenatal Testing (NIPT), invasive testing or no further testing. METHODS: Nationwide implementation study (TRIDENT) offering NIPT as contingent screening test for women at increased risk for fetal aneuploidy based on first-trimester combined testing (>1:200) or medical history. A questionnaire was completed after counseling assessing knowledge, attitudes and participation following the Multidimensional Measure of Informed Choice...
October 14, 2016: Prenatal Diagnosis
Melissa Borelli, Rebecca J Baer, Christina D Chambers, Tyler C Smith, Laura L Jelliffe-Pawlowski
We examined the association between maternal characteristics, routinely collected first- and second-trimester biomarkers and the risk of having an infant with a critical congenital heart defect (CCHD). Included were women who participated in the California Prenatal Screening Program who had nuchal translucency (NT) measurement and first- and second-trimester serum screening. All pregnancies ended in a live birth of an infant without aneuploidy or a neural tube defect. Poisson regression analyses were used to estimate the relative risk and 95% confidence interval of a CCHD by maternal characteristics, first- and second-trimester serum biomarkers or NT measurements...
October 14, 2016: American Journal of Medical Genetics. Part A
Ran Svirsky, Ron Maymon, Yaakov Melcer, Esther Klog, Howard Cuckle
OBJECTIVE: To investigate maternal serum inhibin as a marker of pre-eclampsia in twins. METHODS: 143 twins and 109 unaffected singleton pregnancies were recruited in the first trimester from the same institution. Blood samples were stored at recruitment and in the second trimester, retrospectively tested for inhibin and values expressed in multiples of the gestation-specific median (MoMs) in singletons, adjusted for maternal weight, as appropriate. RESULTS: The median inhibin level in unaffected twins was 2...
October 12, 2016: Prenatal Diagnosis
N Anuradha, Carlton Johnny
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
C N Mnyani, E Nicolaou, S Bister
BACKGROUND: Concerns have been raised about the injudicious use of non-invasive prenatal testing (NIPT) using cell-free DNA (cfDNA), which often leads to inaccuracies in interpretation of the role and value of cfDNA in prenatal screening. OBJECTIVES:  To determine the value and role of NIPT in a select South African (SA) population. METHODS:  A retrospective review of patients who elected to have NIPT between 1 October 2013 and 30 June 2015 at the Morningside Mediclinic Maternal and Fetal Medicine Centre in Johannesburg, SA...
September 9, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Mariya Angelova, Emil Kovachev, Nikolai Todorov
AIM: The aim of this publication is to present a case of CMV infection during pregnancy, with clinical manifestations of the development of microcephaly and simultaneous dilatation of the 3rd and 4th brain ventricle at 23 weeks gestation. This article discusses the role of ultrasound screening in the second trimester of pregnancy. CASE PRESENTATION: We present the case of a 25-year-old woman with the initials S.K. in her second pregnancy that came to our antenatal Consulting Centre...
September 15, 2016: Open Access Macedonian Journal of Medical Sciences
Lijie Li, Yanmei Zheng, Ying Zhu, Jianchun Li
First-trimester screening may be a major advantage over a second-trimester approach since it opens prospects for early and more efficient interventions. The aim of the current study was to evaluate whether the measurement of maternal serum inhibin A, activin A and placental growth factor (PlGF) at three to four months gestation with the second-trimester uterine artery pulsatility index (PI) are useful in predicting preeclampsia in a group of nulliparous women. All the patients also underwent uterine artery Doppler examination to measure the PI at 22-24 weeks gestation...
October 2016: Experimental and Therapeutic Medicine
Katherine E A Semrau, Julie Herlihy, Caroline Grogan, Kebby Musokotwane, Kojo Yeboah-Antwi, Reuben Mbewe, Bowen Banda, Chipo Mpamba, Fern Hamomba, Portipher Pilingana, Andisen Zulu, Pascalina Chanda-Kapata, Godfrey Biemba, Donald M Thea, William B MacLeod, Jonathon L Simon, Davidson H Hamer
BACKGROUND: Chlorhexidine umbilical cord washes reduce neonatal mortality in south Asian populations with high neonatal mortality rates and predominantly home-based deliveries. No data exist for sub-Saharan African populations with lower neonatal mortality rates or mostly facility-based deliveries. We compared the effect of chlorhexidine with dry cord care on neonatal mortality rates in Zambia. METHODS: We undertook a cluster-randomised controlled trial in Southern Province, Zambia, with 90 health facility-based clusters...
September 29, 2016: Lancet Global Health
E Merz, C Thode, B Eiben, S Wellek
AIM: Both previous versions of the German PRC algorithm developed by our group for routine first-trimester screening relied on the assumption that maternal blood sampling and fetal ultrasonography are performed at the same visit of a pregnant women. In this paper we present an extension of our method allowing also for constellations where this synchronization is abandoned through preponing blood sampling to dates before 11 weeks of gestation. METHODS: In contrast to the directly measured concentrations of the serum parameters PAPP-A and free ß-hCG, the logarithmically transformed values could be shown to admit the construction of reference bands covering the whole range from 16 to 84 mm CRL [corresponding to 63 to 98 days of gestation]...
March 2016: Ultrasound Int Open
Wei-Hsiu Chiu, Shy-Ming Lee, Tao-Hsin Tung, Xiao-Mei Tang, Ren-Shyan Liu, Ran-Chou Chen
Antenatal diagnosis of congenital heart disease (CHD) is still low even though screening was first introduced over 25 years ago. The purpose of our study was to determine the efficacy of a second-trimester prenatal ultrasonographic method of screening for CHD.From September 2012 to September 2013, the length and width of the fetal ductus venosus were measured sonographically in 1006 singleton fetuses, and the ratio of length to width was calculated. The accuracy of each fetal measurement and Doppler ultrasonography were determined...
September 2016: Medicine (Baltimore)
G Gagliardi, G M Tiralongo, D Lo Presti, I Pisani, D Farsetti, B Vasapollo, G P Novelli, A Andreoli, H Valensise
INTRODUCTION: Abnormalities of cardiac output, TVR and water body distribution are connected with PE and foetal growth restriction (FGR). Targets: To identify patients at risk of PE in the first trimester through USCOM system, bioimpedance and combined screening (maternal history, biophysical and biochemical markers). We enrolled 150 healthy nulliparous women with normal BMI. RESULTS: The patients were divided into two groups: Group A (TVR <1200 dynes sec cm(-5)), Group B (TVR41200 dynes sec cm(-5))...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
Gavin P Guy, Hua Z Ling, Paula Garcia, Liona C Poon, Kypros H Nicolaides
OBJECTIVE: To examine the possible effects of maternal characteristics and obstetric and medical history on maternal cardiovascular parameters at 35-37 weeks' gestation. METHODS: In 3,013 singleton pregnancies at 35-37 weeks maternal characteristics and medical history were recorded; uterine artery pulsatility index, mean arterial pressure (MAP) and maternal cardiovascular parameters were measured. Multivariable regression analysis was used to determine significant predictors of the cardiovascular parameters amongst gestational age (GA), maternal characteristics and medical history...
September 27, 2016: Ultrasound in Obstetrics & Gynecology
Ioanna Dragan, David Wright, Magdalena Fiolna, Gergo Leipold, Kypros H Nicolaides
OBJECTIVE: To compare the performance of screening of the soluble fms-like tyrosine kinase 1 (sFLT-1) to placental growth factor (PLGF) ratio >38 in the prediction of delivery with preeclampsia (PE) at <1 and at <4 weeks from assessment when the test is carried out at 31-34 versus 35-37 weeks' gestation. METHODS: This was a prospective observational study in women attending for a third-trimester ultrasound scan as part of routine pregnancy care; in the first phase of the study the visit was at 30-34 weeks' gestation and in the second phase the visit was at 35-37 weeks...
September 27, 2016: Ultrasound in Obstetrics & Gynecology
Soo Yeon Park, In Ae Jang, Min Ah Lee, Young Ju Kim, Sun Hee Chun, Mi Hye Park
OBJECTIVE: This study was designed to review the screening performance of combined test at the Ewha Womans University Mokdong hospital. METHODS: All women admitted for routine antenatal care between January 1st 2008 and December 31st 2012 with a known pregnancy outcome were included in this study, totaling 1,156 women with singleton pregnancies presenting at 10 to 13 weeks of gestation. Women were offered screening using a combination of maternal serum pregnancy-associated plasma protein-A, free β-human chorionic gonadotropin and fetal nuchal translucency thickness...
September 2016: Obstetrics & Gynecology Science
Rosiane Maciel Scandiuzzi, Caio Antonio de Campos Prado, Edward Araujo Júnior, Geraldo Duarte, Silvana Maria Quintana, Fabrício da Silva Costa, Gabriele Tonni, Ricardo de Carvalho Cavalli, Alessandra Cristina Marcolin
OBJECTIVE: To assess the maternal demographic characteristics and uterine artery (UA) Doppler parameters at first and second trimesters of pregnancy as predictors for hypertensive disorders (HDs) and adverse perinatal outcomes. METHODS: This prospective cohort study comprised 162 singleton low-risk women undergoing routine antenatal care. The left and right UA were assessed by color and pulsed Doppler and the mean pulsatility and resistance indices as well as the presence of a bilateral protodiastolic notch were recorded at 11 to 14 and 20 to 24 weeks' gestation...
September 2016: Obstetrics & Gynecology Science
Fionnuala Mone, Cecilia Mulcahy, Peter McParland, Fionnuala M McAuliffe
Low-dose aspirin has been demonstrated to reduce the incidence of preeclampsia and fetal growth restriction in at-risk populations. Its role in low-risk populations is as yet unknown. Novel preeclampsia screening tests are emerging that can predict the risk of the development of preeclampsia from as early as 11 weeks of gestation. It may be more efficacious, acceptable, and cost-effective to prescribe low-dose aspirin to all pregnant women from the first trimester as opposed to performing a screening test in the first instance...
September 20, 2016: American Journal of Obstetrics and Gynecology
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