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https://www.readbyqxmd.com/read/30315784/fetal-growth-and-risk-assessment-is-there-an-impasse
#1
Wessel Ganzevoort, Baskaran Thilaganathan, Ahmet Baschat, Sanne Gordijn
Fetal growth restriction is an indicator of placental insufficiency and is strongly associated with adverse perinatal outcome. There is a point that the recent dominance in the medical literature about which reference charts to use and dichotomization of fetal size at the 10th percentile overlooks the fact there is not a single cut-off in any growth chart that acts as an absolute divider between high and low risk for adverse outcome. Thus, the collective goal of all researchers to identify, monitor and effectively manage growth-restricted fetuses is better served by replacing dichotomisation of normal versus abnormal fetal growth at the 10th percentile by interpretation of fetal size in context with other known parameters of fetal risk - all as continuous parameters...
October 10, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/30300895/the-relationship-between-the-fetal-volume-corrected-renal-artery-pulsatility-index-and-amniotic-fluid-volume
#2
Viola Seravalli, Jena L Miller, Dana Block-Abraham, Cyrethia McShane, Sarah Millard, Ahmet Baschat
INTRODUCTION: To evaluate if the volume-corrected renal artery pulsatility index (vcRA-PI) is more closely related to the amniotic fluid level than the uncorrected or the gestational age (GA)-adjusted RA-PI. METHODS: RA-PI and kidney volume were measured in low- and high-risk pregnancies at 17-38 weeks. Fetal anomalies associated with nonrenal causes of abnormal amniotic fluid volume were excluded. The vcRA-PI was calculated by dividing the RA-PI by the renal volume...
October 9, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/30199875/massive-fetomaternal-hemorrhage-remote-from-term-favorable-outcome-after-fetal-resuscitation-and-conservative-management
#3
Maria Flavia Christino Luiz, Ahmet A Baschat, Cassandra Delp, Jena L Miller
Fetomaternal hemorrhage (FMH) is a rare condition that requires early diagnosis and appropriate treatment due to its potentially severe consequences. We report a case of massive FMH presenting as decreased fetal movement, fetal hydrops, and intracranial hemorrhage at 24 weeks. Treatment considerations were made and amniocentesis, fetal blood sampling, and fetal blood transfusion via cordocentesis were performed. Recurrent FMH required subsequent fetal transfusion 2 days later. Surveillance was continued twice weekly until the patient delivered a viable infant at 38 weeks after spontaneous labor...
September 10, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/30134949/core-outcome-set-for-growth-restriction-developing-endpoints-cosgrove
#4
Patricia Healy, Sanne Gordijn, Wessel Ganzevoort, Irene Beune, Ahmet Baschat, Asma Khalil, Louise Kenny, Frank Bloomfield, Mandy Daly, Aris Papageorghiou, Declan Devane
BACKGROUND: Foetal growth restriction (FGR) refers to a foetus that does not reach its genetically predetermined growth potential. It is well recognised that growth-restricted foetuses are at increased risk of stillbirth, foetal compromise, early neonatal death and neonatal morbidity. Later in life, they are prone to health problems, including increased risk of cardiovascular diseases and neurodevelopmental disorders. Interventions for preventing and treating FGR have been studied in many trials, but evidence is often difficult to synthesise and compare because of differences in the selection and definition of outcomes...
August 22, 2018: Trials
https://www.readbyqxmd.com/read/30125411/essential-variables-for-reporting-research-studies-on-fetal-growth-restriction-a-delphi-consenus
#5
Asma Khalil, Sanne J Gordijn, Irene M Beune, Klaske Wynia, Wessel Ganzevoort, Francesc Figueras, John Kingdom, Neil Marlow, Aris T Papageorghiou, Neil Sebire, Jennifer Zeitlin, Ahmet A Baschat
OBJECTIVE: To achieve consensus on the minimum reporting set of study variables for fetal growth restriction (FGR) research studies. Determination of a list of variables considered essential to be reported independent of a specific hypothesis is likely to improve the study quality by inclusion of essential end-points, enhancing the consistency among studies and minimizing potential confounding. This in turn can accelerate generation of generalizable knowledge either by standardization of individual study designs or by enhancing the possibility of individual patient data meta-analysis merging a number of uniformly structured datasets...
August 19, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29874646/preoperative-ultrasound-prediction-of-essential-landmarks-for-successful-fetoscopic-laser-treatment-of-twin-twin-transfusion-syndrome
#6
Jena L Miller, Dana M Block-Abraham, Karin J Blakemore, Ahmet A Baschat
INTRODUCTION: The insertion site of the fetoscope for laser occlusion (FLOC) treatment of twin-twin transfusion syndrome (TTTS) determines the likelihood of treatment success. We assessed a standardized preoperative ultrasound approach for its ability to identify critical landmarks for successful FLOC. METHODS: Three surgeons independently performed preoperative ultrasound and deduced the likely orientation of the intertwin membrane (ITM) and vascular equator (VE) based on the sites of the cord insertion, the lie of the donor, and the size discordance between twins...
June 6, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29780323/editorial-prenatal-beginnings-for-better-health
#7
EDITORIAL
Edward Kim, Maged Costantine, Ahmet A Baschat, Irina Burd
No abstract text is available yet for this article.
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29750436/fetal-blood-gas-values-during-fetoscopic-myelomeningocele-repair-performed-under-carbon-dioxide-insufflation
#8
A A Baschat, E S Ahn, J Murphy, J L Miller
Fetoscopic myelomeningocele (MMC) repair is performed using intrauterine carbon dioxide (CO2 ) insufflation. Sheep experiments have shown that CO2 insufflation is associated with significant fetal acidemia; however, corresponding data for human pregnancy are not available. We performed umbilical venous cord blood sampling in three patients during fetoscopic MMC repair at 25 + 1, 25 + 3 and 24 + 0 weeks' gestation, respectively. Fetal venous pH at the beginning of CO2 insufflation was 7.36, 7.46 and 7...
September 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29606482/planning-management-and-delivery-of-the-growth-restricted-fetus
#9
REVIEW
Ahmet A Baschat
A uniform approach to management of fetal growth restriction (FGR) improves outcome, prevents stillbirth, and allows appropriately timed delivery. An estimated fetal weight below the tenth percentile with coexisting abnormal umbilical artery (UA), middle cerebral artery (MCA), or cerebroplacental ratio Doppler index best identifies the small fetus requiring surveillance. Placental perfusion defects are more common earlier in gestation; accordingly, early-onset (≤32 weeks of gestation) and late-onset (>32 weeks) FGR differ in clinical phenotype...
May 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29528715/value-of-fetal-mri-in-the-era-of-fetal-therapy-for-management-of-abnormalities-involving-the-chest-abdomen-or-pelvis
#10
Elizabeth Snyder, Ahmet Baschat, Thierry A G M Huisman, Aylin Tekes
OBJECTIVE: The purpose of this article is to present illustrative cases highlighting the value of fetal MRI as a problem-solving tool in evaluating anomalies of the fetal chest, abdomen, and pelvis that are being evaluated for fetal therapy. CONCLUSION: Fetal MRI is an increasingly valuable noninvasive tool for evaluating fetal anomalies in the age of fetal therapy. Although ultrasound remains the primary diagnostic imaging modality, MRI can provide additional information to assist parental counseling and patient care...
May 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29405479/persistent-extreme-hyperextension-of-the-fetal-neck-clinical-and-neuroimaging-findings
#11
Shai Shrot, Clark T Johnson, W Christopher Golden, Ahmet A Baschat, Janine E Bullard, Aylin Tekes, Andrea Poretti, Emily Dunn, Thierry A G M Huisman
BACKGROUND AND PURPOSE: Persistent hyperextension of the fetal craniocervical junction or neck is one of several fetal positions commonly observed on prenatal imaging. Underlying fetal structural etiologies such as fetal neck masses and iniencephaly can be detected as causes of hyperextension. Caesarean delivery is considered in cases of vaginal delivery or obstructed labor for fear of cervical spinal cord injury. In this case series, we describe the prenatal magnetic resonance imaging (MRI) findings and their potential role in obstetric management and discuss postnatal outcomes in fetuses demonstrating prenatal imaging findings of persistent extreme hyperextension of the neck...
May 2018: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/29215523/ethical-considerations-concerning-amnioinfusions-for-treating-fetal-bilateral-renal-agenesis
#12
REVIEW
Jeremy Sugarman, Jean Anderson, Ahmet A Baschat, Jaime Herrera Beutler, Jessica L Bienstock, Timothy E Bunchman, Niraj M Desai, Elena Gates, Aviva Goldberg, Paul C Grimm, Leslie Meltzer Henry, Eric B Jelin, Emily Johnson, Christine B Hertenstein, Anna C Mastroianni, Mark R Mercurio, Alicia Neu, Lawrence M Nogee, William J Polzin, Steven J Ralston, Ronald M Ramus, Megan Kasimatis Singleton, Michael J G Somers, Karen C Wang, Renee Boss
Congenital bilateral renal agenesis has been considered a uniformly fatal condition. However, the report of using serial amnioinfusions followed by the live birth in 2012 and ongoing survival of a child with bilateral renal agenesis has generated hope, but also considerable controversy over an array of complex clinical and ethical concerns. To assess the ethical concerns associated with using serial amnioinfusions for bilateral renal agenesis, we assembled a multidisciplinary group to map the ethical issues relevant to this novel intervention...
January 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28891233/fetoscopic-tracheal-occlusion-for-treatment-of-non-isolated-congenital-diaphragmatic-hernia
#13
Viola Seravalli, Eric B Jelin, Jena L Miller, Aylin Tekes, Luca Vricella, Ahmet A Baschat
Fetoscopic endotracheal occlusion (FETO) is a prenatal treatment that may increase survival in severe congenital diaphragmatic hernia (CDH). In the USA, FETO is offered for isolated severe left-sided CDH in the context of an FDA-approved feasibility study. FETO in non-isolated cases of severe CDH is only performed with a compassionate use exemption from US regulatory bodies. Anomalies frequently associated with CDH include congenital cystic lesions of the lung and cardiac defects. We describe two cases of non-isolated severe left-sided CDH that underwent prenatal FETO, survived after birth and underwent postnatal surgical repair...
October 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28709445/twin-twin-transfusion-syndrome-study-protocol-for-developing-disseminating-and-implementing-a-core-outcome-set
#14
REVIEW
Asma Khalil, Helen Perry, James Duffy, Keith Reed, Ahmet Baschat, Jan Deprest, Kurt Hecher, Liesbeth Lewi, Enrico Lopriore, Dick Oepkes
BACKGROUND: Twin-Twin Transfusion Syndrome (TTTS) is associated with an increased risk of perinatal mortality and morbidity. Several treatment interventions have been described for TTTS, including fetoscopic laser surgery, amnioreduction, septostomy, expectant management, and pregnancy termination. Over the last decade, fetoscopic laser surgery has become the primary treatment. The literature to date reports on many different outcomes, making it difficult to compare results or combine data from individual studies, limiting the value of research to guide clinical practice...
July 14, 2017: Trials
https://www.readbyqxmd.com/read/28695721/aortic-isthmus-shunt-dynamics-in-normal-and-complicated-monochorionic-pregnancies
#15
Viola Seravalli, Dana Block-Abraham, Cyrethia McShane, Sarah Millard, Ahmet Baschat, Jena Miller
OBJECTIVE: To study fetal aortic isthmus (AoI) shunt dynamics in monochorionic (MC) twins. METHODS: Normal and complicated MC pregnancies were prospectively enrolled. The relationship of isthmus flow index (IFI) with Doppler parameters of umbilical artery (UA), descending aorta, middle cerebral artery, and ductus venosus and with left and right ventricular cardiac output and stroke volume was studied. RESULTS: The IFI was obtained in 180 examinations from 48 pregnancies (24 twin-twin transfusion syndrome, TTTS; 4 selective intrauterine growth restriction, sIUGR; 12 TTTS + sIUGR; and 8 uncomplicated)...
September 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28636133/association-of-chronic-hypertension-with-birth-of-small-for-gestational-age-neonate
#16
A M Panaitescu, A A Baschat, R Akolekar, A Syngelaki, K H Nicolaides
OBJECTIVE: To examine the effect of chronic hypertension (CH), with and without superimposed pre-eclampsia (PE), on the incidence of a small-for-gestational-age (SGA) neonate and to explore the possible mechanism for such association. METHODS: Data for this study were derived from prospective screening for adverse pregnancy outcomes in women with singleton pregnancy attending their first routine hospital visit at 11-13 weeks' gestation, which included recording of maternal characteristics and medical history and measurement of mean arterial pressure (MAP)...
September 2017: Ultrasound in Obstetrics & Gynecology
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
#17
REVIEW
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...
2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28451583/pregnancy-an-underutilized-window-of-opportunity-to-improve-long-term-maternal-and-infant-health-an-appeal-for-continuous-family-care-and-interdisciplinary-communication
#18
REVIEW
Birgit Arabin, Ahmet A Baschat
Physiologic adaptations during pregnancy unmask a woman's predisposition to diseases. Complications are increasingly predicted by first-trimester algorithms, amplify a pre-existing maternal phenotype and accelerate risks for chronic diseases in the offspring up to adulthood (Barker hypothesis). Recent evidence suggests that vice versa , pregnancy diseases also indicate maternal and even grandparent's risks for chronic diseases (reverse Barker hypothesis). Pub-Med and Embase were reviewed for Mesh terms "fetal programming" and "pregnancy complications combined with maternal disease" until January 2017...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27659738/scn8a-epileptic-encephalopathy-detection-of-fetal-seizures-guides-multidisciplinary-approach-to-diagnosis-and-treatment
#19
Melanie A McNally, Julia Johnson, Thierry A Huisman, Andrea Poretti, Kristin W Baranano, Ahmet A Baschat, Carl E Stafstrom
BACKGROUND: SCN8A mutations are rare and cause a phenotypically heterogeneous early onset epilepsy known as early infantile epileptic encephalopathy type 13 (EIEE13, OMIM #614558). There are currently no clear genotype-phenotype correlations to help guide patient counseling and management. PATIENT DESCRIPTION: We describe a patient with EIEE13 (de novo heterozygous pathogenic mutation in SCN8A - p.Ile240Val (ATT>GTT)) who presented prenatally with maternally reported intermittent, rhythmic movements that, when observed on ultrasound, were concerning for fetal seizures...
November 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/27619545/longitudinal-analysis-of-head-and-somatic-growth-in-fetuses-with-congenital-heart-defects
#20
Sifa Turan, Joshua I Rosenbloom, Mostafa Hussein, Christoph Berg, Ulrich Gembruch, Ahmet A Baschat, Ozhan M Turan
PURPOSE: Fetal head and somatic growth dynamics differs in fetuses with congenital heart defects (CHD). We longitudinally characterized fetal head and somatic growth in relation to the type of CHD. METHODS: Four hundred eleven exams from isolated CHD were compared with 1,219 controls. Head and somatic growth was assessed using head circumference (HC), brain volume (BrV = 1/6 × π × (HC/π)3)/2), fetal cephalization index (FCI = BrV/[estimated fetal weight]), and growth percentile...
February 2017: Journal of Clinical Ultrasound: JCU
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