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First trimester screening

Erol Arslan, Selim Büyükkurt, Mete Sucu, Mehmet Özsürmeli, Selahattin Mısırlıoğlu, S Cansun Demir, I Cüneyt Evrüke
OBJECTIVE: Fetal structural malformations affect approximately 2-3% of all pregnancies. Only focusing on trisomy screening in first trimester and deferring the anatomical screening to second trimester may result with late detection of major anomalies that can be diagnosed earlier with a careful examination. MATERIAL AND METHODS: This was a descriptive study retrospective data that was obtained from all terminated single pregnancies due to ultrasonographic findings of major anomalies from 2011 to 2016 in our department...
March 16, 2018: Journal of the Turkish German Gynecological Association
M Y Tan, D Wright, A Syngelaki, R Akolekar, S Cicero, D Janga, M Singh, E Greco, A Wright, K Maclagan, L C Poon, K H Nicolaides
OBJECTIVE: To test the hypothesis that the performance of first-trimester screening for pre-eclampsia (PE) by a method that uses Bayes' theorem to combine maternal factors with biomarkers is superior to that defined by current National Institute for Health and Care Excellence (NICE) guidelines. METHODS: This was a prospective multicenter study (screening program for pre-eclampsia (SPREE)) in seven National Health Service maternity hospitals in England, of women recruited between April and December 2016...
March 14, 2018: Ultrasound in Obstetrics & Gynecology
Esra Ozkavukcu, Andelib Babaturk, Nuray Haliloglu, Tuncay Yuce, Tayfun Ucar
Congenital aneurysms and diverticula of the heart are rare anomalies and their prenatal diagnosis is challenging. Fetuses with suspected cardiac aneurysms on ultrasound (US) screening should undergo targeted fetal echocardiography, postnatal imaging, and follow-ups. Herein, we describe the second trimester US scan and postnatal cardiac magnetic resonance imaging (MRI) findings of a baby girl with concurrent septal and right ventricular cardiac aneurysms. Other cardiac and extra-cardiac structures were normal...
February 2018: Eurasian Journal of Medicine
Sara Filoche, Beverley Lawton, Angela Beard, Anthony Dowell, Peter Stone
Non-invasive prenatal testing (NIPT) is a new screen for fetal chromosomal abnormalities. It is a screening test based on technology that involves the analysis of feto-placental DNA that is present in maternal blood. This DNA is then analysed for abnormalities of specific chromosomes (eg 13, 18, 21, X, Y). NIPT has a much higher screening capability for chromosomal abnormalities than current combined first trimester screening, with ~99% sensitivity for trisomy 21 (Down syndrome) and at least a 10-fold higher positive predictive value...
December 2017: Journal of Primary Health Care
Asanka Jayawardane, Malitha Patabendige, Dulani Samaranayake, Medini Boteju, Shamalka Dahanayake, Ruvini Perera, Sumudu Jayasinghe, Dakshila Galappatti, C N Wijeyaratne
AIM: To study case mix, risk factors, adverse outcomes and associations of hyperglycemia in pregnancy in a cohort of Sri Lankans. METHODS: Prospective observational study, from April 2011-October 2015 at a tertiary care referral center, Colombo, Sri Lanka. Data from first trimester to delivery of HIP was analyzed. Three subgroups were defined: Diabetes in pregnancy (DIP), Hyperglycemia in early Pregnancy (HIEP) [<24 weeks] and Gestational diabetes (GDM) [>24 weeks]...
March 8, 2018: Diabetes Research and Clinical Practice
Catarina Canário, Bárbara Figueiredo
AIMS: The aims of this study were to analyse the changes in anxiety and depression symptoms from early pregnancy to 30 months postpartum according to gender and parity. METHOD: 129 couples (N = 258) recruited from an obstetrics unit completed self-report measures of anxiety and depression at each pregnancy trimester, childbirth, 3 and 30 months postpartum. Using multilevel modelling, piecewise dyadic growth curve models were performed, assessing time, gender and parity as predictors of anxiety and depression symptoms...
November 2017: Journal of Reproductive and Infant Psychology
Burak Asiltas, Esma Surmen-Gur, Gurkan Uncu
OBJECTIVE: Early diagnosis of preeclampsia (PE) is very important and various parameters, individually or in combined models, are reported useful for prediction of PE. The objective of this study is to investigate the predictive value of pregnancy-associated plasma protein-A (PAPP-A), placental protein-13 (PP-13), human Chorionic Gonadotropin (B-HCG), and oxidative stress marker malondialdehyde (MDA), individually and in combination. MATERIALS AND METHODS: Maternal sera of 38 cases with PE and 122 controls were collected for first trimester screening and tested for PAPP-A and B-HCG by chemiluminescence, for PP-13 by using ELISA, and for MDA by high-performance liquid chromatography...
February 27, 2018: Pathophysiology: the Official Journal of the International Society for Pathophysiology
Mary Sawtell, Lorna Sweeney, Meg Wiggins, Cathryn Salisbury, Sandra Eldridge, Lauren Greenberg, Rachael Hunter, Inderjeet Kaur, Christine McCourt, Bethan Hatherall, Gail Findlay, Joanne Morris, Sandra Reading, Adrian Renton, Ruth Adekoya, Belinda Green, Belinda Harvey, Sarah Latham, Kanta Patel, Logan Vanlessen, Angela Harden
BACKGROUND: The provision of high-quality maternity services is a priority for reducing inequalities in health outcomes for mothers and infants. Best practice includes women having their initial antenatal appointment within the first trimester of pregnancy in order to provide screening and support for healthy lifestyles, well-being and self-care in pregnancy. Previous research has identified inequalities in access to antenatal care, yet there is little evidence on interventions to improve early initiation of antenatal care...
March 5, 2018: Trials
David Wright, Daniel L Rolnik, Argyro Syngelaki, Catalina de Paco Matallana, Mirian Machuca, Mercedes de Alvarado, Sofia Mastrodima, Min Yi Tan, Siobhan Shearing, Nicola Persico, Jacques C Jani, Walter Plasencia, George Papaioannou, Francisca S Molina, Liona C Poon, Kypros H Nicolaides
BACKGROUND: Preeclampsia is a major pregnancy complication with adverse short- and long-term implications for both the mother and baby. Screening for preeclampsia at 11-13 weeks' gestation by a combination of maternal demographic characteristics and medical history with measurements of biomarkers can identify about 75% of women that develop preterm-preeclampsia with delivery at <37 weeks' gestation and 90% of those with early-preeclampsia at <32 weeks, at a screen positive rate of 10%...
March 2, 2018: American Journal of Obstetrics and Gynecology
Sissel Kramer Aagaard, Agnete Larsen, Mette Findal Andreasen, Iana Lesnikova, Rasmus Telving, Anna Louise Vestergaard, Niels Tørring, Niels Uldbjerg, Pinar Bor
OBJECTIVE: The aim of this study was to investigate the prevalence of xenobiotic substances, such as caffeine, nicotine and illicit drugs (eg, cannabis and cocaine), in blood samples from first-trimester Danish pregnant women unaware of the screening. DESIGN: A cross - sectional study examined 436 anonymised residual blood samples obtained during 2014 as part of the nationwide prenatal first-trimester screening programme. The samples were analysed by ultra performance liquid chromatography with high-resolution time-of-flight mass spectrometry...
March 3, 2018: BMJ Open
Alexandra Miranda, Nuno Sousa
An adverse maternal hormonal environment during pregnancy can be associated with abnormal brain growth. Subtle changes in fetal brain development have been observed even for maternal hormone levels within the currently accepted physiologic ranges. In this review, we provide an update of the research data on maternal hormonal impact on fetal neurodevelopment, giving particular emphasis to thyroid hormones and glucocorticoids. Thyroid hormones are required for normal brain development. Despite serum TSH appearing to be the most accurate indicator of thyroid function in pregnancy, maternal serum free T4 levels in the first trimester of pregnancy are the major determinant of postnatal psychomotor development...
February 2018: Brain and Behavior
Ana Maria Vayna, Alina Veduta, Simona Duta, Anca Maria Panaitescu, Sabrina Stoica, Natalia Buinoiu, Florina Nedelea, Gheorghe Peltecu
OBJECTIVES: To assess the performance of first-trimester ultrasound (US) in identifying major fetal structural abnormalities in an unselected population. METHODS: We conducted a retrospective analysis of all pregnancies that underwent the 11- to 14-week scan in the Fetal Medicine Department of Filantropia Hospital in Bucharest, which were prospectively examined within our screening program. The purpose of the first-trimester US was to evaluate the risk for chromosomal abnormalities and to conduct fetal anatomic examination using a detailed protocol...
February 24, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Debbie Nisbet, Ann Robertson, Blessy Mannil, Vanessa Pincham, Andrew Mclennan
BACKGROUND: Nuchal translucency measurement has an established role in first trimester screening. Accurate measurement requires that technical guidelines are followed. Performance can be monitored by auditing the distribution of measurements obtained in a series of cases. AIMS: The primary aim is to develop an accessible, theory-based educational program for individuals whose distribution of measurements at audit falls outside an acceptable range, and assess operator performance following this intervention...
February 22, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Virginia B Bowen, Thomas A Peterman, Dinorah L Calles, Antoine Thompson, Robert Kirkcaldy, Melanie Taylor
This article summarizes a multi-state outbreak of heterosexual syphilis, including 134 cases of syphilis in adults and adolescents and at least two cases of congenital syphilis, which occurred on an American Indian reservation in the United States during 2013-2015. In addition to providing salient details about the outbreak, the article seeks to document the case-finding and treatment activities undertaken, their relative success or failure, and the lessons learned from a coordinated, multiagency response. Of 134 adult cases of syphilis, 40% were identified by enhanced, interagency contact tracing and partner services; 26% through symptomatic testing; and 16% through screening of asymptomatic individuals as the result of an electronic medical record (EMR) screening prompt...
February 13, 2018: Sexually Transmitted Diseases
Chung-Yuan Yang, Chuan-Chi Kao, Shuenn-Dyn Chang, Shih-Yin Huang
OBJECTIVE: To present a case with prenatal diagnosis and cytogenetic characterization of 1p36 deletion syndrome whose first trimester combined testing is abnormal but a normal NIPT result. CASE REPORT: A 33-year-old had an abnormal 1st trimester fetal aneuploidy screening result, but no trisomies 13, 18, 21 were detected by the noninvasive prenatal testing. Amniocentesis was performed after ultrasound showed fetal ventriculomegaly and echogenic bowel. The final conventional cytogenetics revealed a karyotype of 46, XX, del(1)(p36)...
February 2018: Taiwanese Journal of Obstetrics & Gynecology
Bridget Knight, Aaron Brereton, Roy J Powell, Helen Liversedge
Introduction: In the UK an accurate gestational age is confirmed by ultrasound measured foetal crown rump length (CRL) at 11 + 2-14 + 1 weeks of gestation. The currently recommended Robinson and Fleming crown rump length reference chart was develop in 1975. Advances in ultrasound technology and standardized crown rump length measurement training could mean this is now out of date. Our study aimed to assess its accuracy in current routine antenatal care. Methods: Retrospective data from 178 IVF pregnancies seen for routine antenatal care at a UK Regional Maternity Unit between 1 January 2006 and 1 January 2016 was retrieved...
February 2018: Ultrasound: Journal of the British Medical Ultrasound Society
Victoria H Coleman-Cowger, Emmanuel A Oga, Erica N Peters, Kathleen Trocin, Bartosz Koszowski, Katrina Mark
INTRODUCTION: Prescription-drug use in the USA has increased by more than 60% in the last three decades. Prevalence of prescription-drug use among pregnant women is currently estimated around 50%. Prevalence of illicit drug use in the USA is 14.6% among pregnant adolescents, 8.6% among pregnant young adults and 3.2% among pregnant adults. The first step in identifying problematic drug use during pregnancy is screening; however, no specific substance-use screener has been universally recommended for use with pregnant women to identify illicit or prescription-drug use...
February 17, 2018: BMJ Open
Marta Hernández, Carolina López, Berta Soldevila, Laura Cecenarro, María Martínez-Barahona, Elisabet Palomera, Ferran Rius, Albert Lecube, Maria José Pelegay, Jordi García, Dídac Mauricio, Manel Puig Domingo
OBJECTIVE: An association of pregnancy outcomes with subclinical hypothyroidism has been reported, however there still exists a strong controversy regarding whether subclinical hypothyroidism ought to be dealt with or not. The objective of the study was to evaluate the association of fetal-maternal complications with first trimester maternal TSH values. DESIGN: A retrospective study in a single tertiary care hospital was performed. PATIENTS: 1981 pregnant women were studied during 2012...
February 17, 2018: Clinical Endocrinology
Kristen A Schmidt, Andrew J Lancia, Saad Alvi, Jean C Aldag
Introduction: Studies show alcohol-preferring mice reduce their alcohol intake during pregnancy; this study questions if the same is true for humans. The current investigation compares women's pre-pregnancy and first trimester alcohol consumption, examines if women with problem drinking diminish their alcohol intake during pregnancy, and determines if prenatal alcohol reduction is associated with characteristics of pregnancy, patients or smoking. Methods: 126 participants in weeks 1-12 of pregnancy, recruited from Obstetric and Family Practices, completed a survey during their initial prenatal visit including two gender-specific AUDITs (Alcohol Use Disorders Identification Tests) querying current and pre-pregnancy alcohol use...
June 2017: Addictive Behaviors Reports
Tuangsit Wataganara, Jarunee Leetheeragul, Suchittra Pongprasobchai, Anuwat Sutantawibul, Chayawat Phatihattakorn, Surasak Angsuwathana
The benefit of the early administration of aspirin to reduce preterm pre-eclampsia among screened positive European women from multivariate algorithmic approach (ASPRE trial) has opened an intense debate on the feasibility of universal screening. This review aims to assess the new perspectives in the combined screening of pre-eclampsia in the first trimester of pregnancy and the chances for prevention using low-dose aspirin with special emphasis on the particularities of the Asian population. PubMed, CENTRAL and Embase databases were searched from inception until 15 November 2017 using combinations of the search terms: preeclampsia, Asian, prenatal screening, early prediction, ultrasonography, pregnancy, biomarker, mean arterial pressure, soluble fms-like tyrosine kinase-1, placental growth factor, pregnancy-associated plasma protein-A and pulsatility index...
February 14, 2018: Journal of Obstetrics and Gynaecology Research
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