fetal medicine foundation

OBJECTIVES: Indonesia is the fifth country with the highest number of preterm births worldwide. More than a third of neonatal deaths in Indonesia were attributed to preterm birth. Residential areas affected the occurrence of preterm birth due to differing socioeconomic and environmental conditions. Many studies have investigated the determinants of prematurity in Indonesia, however, most of them were performed in rural areas. This study is the first meta-analysis describing the determinants of preterm birth in urban Indonesia, which aimed to become the foundation upon implementing the most suitable preventative measure and policy to reduce the rate of preterm birth...

OBJECTIVE: Fetal growth assessment by ultrasound aims to identify small babies that are at higher risk of perinatal morbidity and mortality. The current study explores if the association between suboptimal fetal growth and adverse perinatal outcome varies with different definitions of fetal growth restriction and weight charts/standards. METHODS: This was a retrospective cohort study of 17261 singleton non-anomalous pregnancies from 24+0 weeks' gestation at a tertiary referral hospital...

OBJECTIVE: Exploring the perinatal outcomes of forceps delivery and the risk factors of postpartum hemorrhage, laying a certain foundation for early identification of indications for forceps assisted delivery and suppressing the risk of bleeding during forceps assisted delivery, and improving delivery quality. METHOD: Retrospective analysis was made on the clinical information of 1520 parturients delivered by vagina in hospitals from December 2019 to December 2021...

Detailed numerical data about the development of primary ossification centers in human fetuses may influence both better evaluation and early detection of skeletal dysplasias, which are associated with delayed development and mineralization of ossification centers. To the best of our knowledge, this is the first report in the medical literature to morphometrically analyze the primary ossification center of the squamous part of temporal bone in human fetuses based on computed tomography imaging. The present study offers a precise quantitative foundation for ossification of the squamous part of temporal bone that may contribute to enhanced prenatal care and improved outcomes for fetuses with inherited cranial defects and skeletodysplasias...

Preeclampsia is a major cause of maternal and perinatal morbidity and mortality. It is important to identify women who are at high risk of developing this disorder in their first trimester of pregnancy to allow timely therapeutic intervention. The use of low-dose aspirin initiated before 16 weeks of gestation can significantly reduce the rate of preterm preeclampsia by 62 %. Effective screening recommended by the Fetal Medicine Foundation (FMF) consists of a combination of maternal risk factors, mean arterial pressure, uterine artery pulsatility index (UtA-PI) and placental growth factor (PLGF)...

BACKGROUND: Azithromycin, one of the new-generation macrolides, is an effective medicine for the treatment of mycoplasma infection during pregnancy. Epidemiological studies have reported adverse pregnancy outcomes with prenatal azithromycin exposure (PAzE). However, the effect of PAzE on fetal hippocampal development is unclear. This study aimed to explore the effects and potential mechanism of PAzE-induced fetal hippocampal development at different doses, courses, and time. METHOD: Pregnant mice were administered azithromycin by gavage at different doses (50, 100 or 200 mg/kg...

The combination of deserts in maternal-fetal medicine coverage across the United States and the COVID-19 pandemic accelerated the implementation of telemedicine programs for maternal-fetal medicine care delivery. While telemedicine-based care has the potential to facilitate timely access to maternal-fetal medicine services, which can improve maternal and neonatal outcomes, telemedicine is a relatively novel healthcare modality that needs to be implemented strategically. As with any medical service, telemedicine care requires rigorous evaluation to assess outcomes and ensure quality...

OBJECTIVES: Non-invasive prenatal testing (NIPT) is utilized for screening the likelihood of fetal aneuploidy, presenting the benefits of non-invasiveness, high sensitivity, and specificity. Its application in prenatal screening has become ubiquitous. The inquiry into how pregnant women comprehend and determine NIPT screening strategies is paramount. Regrettably, there has been a dearth of research on this subject in China. Consequently, this study scrutinizes pregnant women's cognizance and perspectives concerning NIPT, furnishing a foundation for advancing its judicious implementation...

OBJECTIVE: To derive reference distributions of estimated fetal weight (EFW) in twins relative to singletons. METHODS: Gestational-age- and chorionicity-specific reference distributions for singleton percentiles and EFW were fitted to data on 4391 twin pregnancies with two liveborn fetuses from four European centers, including 3323 dichorionic (DC) and 1068 monochorionic diamniotic (MCDA) twin pregnancies. Gestational age was derived using the larger of the two crown-rump length measurements obtained during the first trimester of pregnancy...

This article is a report of a two-day workshop, entitled "Social Determinants of Health and Obstetric Outcomes," held during the Society for Maternal-Fetal Medicine 2022 Annual Pregnancy Meeting. Participants' fields of expertise included obstetrics, pediatrics, epidemiology, health services, health equity, community-based research, and systems biology. The Commonwealth Foundation and the Alliance of Innovation on Maternal Health co-sponsored the workshop and the Society for Women's Health Research provided additional support...

INTRODUCTION: the measurement of nuchal translucency is crucial for the assessment risk of aneuploidies in the first trimester. We investigate the ability of nuchal translucency (NT) assessed by a transverse view of the fetal head to detect fetuses at increased risk of common aneuploidies at 11-13 weeks of gestation. METHODS: we enrolled a nonconsecutive series of women who attended our outpatient clinic from January 2020 to April 2021 for aneuploidies screening by means of first trimester combined test...

Age estimation is crucial when the state of personhood is a mitigating factor in the identification of immature human remains. The maturation sequence of immature bones is a valuable alternative to dental development and eruption standards. Bordering the foramen magnum and pars basilaris, the pars lateralis is somewhat understudied. The aim of this study was to comprehensively describe the morphology of the immature human pars lateralis bone. Human pars laterali were sourced from the crania of 103 immature individuals of unknown provenance from the Johannesburg Forensic Paediatric Collection (JFPC), University of the Witwatersrand (HREC-Medical: M210855)...

BACKGROUND: Pre-eclampsia is when high blood pressure develops after 20 weeks of pregnancy and either proteinuria, maternal end-organ dysfunction, or uteroplacental dysfunction causing fetal growth restriction also develops. The Fetal Medicine Foundation has created an algorithm ("the FMF algorithm") that uses maternal factors in combination with biophysical and biochemical markers to identify people at high risk for pre-eclampsia so that they can been offered acetylsalicylic acid (Aspirin) as a preventive measure...

OBJECTIVE: To report the predictive performance for preterm birth (PTB) of the Fetal Medicine Foundation (FMF) triple test and National Institute for health and Care Excellence (NICE) guidelines used to screen for pre-eclampsia and examine the impact of aspirin in the prevention of PTB. DESIGN: Secondary analysis of data from the SPREE study and the ASPRE trial. SETTING: Multicentre studies. POPULATION: In SPREE, women with singleton pregnancies had screening for preterm pre-eclampsia at 11-13 weeks of gestation by the FMF method and NICE guidelines...

Pregnancy predisposes to arrhythmias in females due to physiological changes in the cardiovascular system, enhanced activity of the sympathetic nervous system (SNS), and changes in the endocrine system, regardless of whether there exist cardiovascular diseases before the pregnancy. Tachyarrhythmias may present for the first time or worsen persistently during pregnancy, potentially leading to maternal heart failure and sudden death, as well as some adverse fetal outcomes such as growth restriction, distress, premature birth, and stillbirth...

OBJECTIVES: To evaluate the new 36 weeks' Fetal Medicine Foundation (FMF) competing risks model for the prediction of small for gestational age (SGA) at an earlier gestation of 30+0 to 34+0 weeks. METHODS: This is a retrospective multi-center cohort study of prospectively collected data on 3,012 women with singleton pregnancies undergoing ultrasound examination at 30+0 - 34+0 weeks' gestation, as part of a universal screening program. We used the default 36 weeks' FMF competing risks model for prediction of SGA, combining maternal factors (age, obstetric and medical history, weight, height, smoking, race, conception), estimated fetal weight (EFW) and uterine artery pulsatility index (UtA-PI), to calculate risks for different cut-offs of birth weight percentile and gestational age at delivery...

OBJECTIVE: Using lengths of stay in neonatal intensive care unit (NICU) as a measure of morbidity, the objective is to compare twins and singletons according to classification of small for gestational age (SGA) using the 10th percentile for twins or the 10th percentile for singletons. METHODS: NICU lengths of stay were compared in 1,150 twins neonates and 29,035 singleton neonates all scanned at between 35+0 and 36+6 weeks' gestation. Estimated fetal weights were obtained from measurements of head circumference, abdominal circumference and femur length using the Hadlock formula...

OBJECTIVE: This systematic review and meta-analysis aimed to evaluate the performance of existing externally validated prediction models for pre-eclampsia (specifically for any- early- late-onset and preterm pre-eclampsia). METHODS: A systematic search was conducted in five databases (MEDLINE, Embase, Emcare, CINAHL, and Maternity and Infant Care Database) to identify studies based on Population, Index model, Comparator, Outcome, Timing, and Setting (PICOTS) approach until May 20, 2023...

OBJECTIVE: Effective first-trimester screening for preeclampsia(PE) can be achieved with the use of a competing risks model that combines risk factors from the maternal history with multiple of the median (MoM) values of biomarkers. A new model with the use of artificial intelligence (AI) through machine-learning methods has been shown to achieve a similar performance of screening without the need for conversion of raw data of biomarkers to MoMs. We aimed to show how this model can be used across populations without specific adaptations...

OBJECTIVES: To describe the distributional properties and assess the performance of placental growth factor (PlGF) measured in blood samples collected before 11 weeks' gestation in prediction of preeclampsia. METHODS: The study population consisted of pregnant women included in the PRESIDE study (Preeclampsia Screening in Denmark) with a PlGF measurement from the routine combined first trimester screening (cFTS) blood sample collected at 8-14 weeks' gestation...