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Fetal demise

Christina M Ferrer, Marielle Alders, Alex V Postma, Seonmi Park, Mark A Klein, Murat Cetinbas, Eva Pajkrt, Astrid Glas, Silvana van Koningsbruggen, Vincent M Christoffels, Marcel M A M Mannens, Lia Knegt, Jean-Pierre Etchegaray, Ruslan I Sadreyev, John M Denu, Gustavo Mostoslavsky, Merel C van Maarle, Raul Mostoslavsky
It has been well established that histone and DNA modifications are critical to maintaining the equilibrium between pluripotency and differentiation during early embryogenesis. Mutations in key regulators of DNA methylation have shown that the balance between gene regulation and function is critical during neural development in early years of life. However, there have been no identified cases linking epigenetic regulators to aberrant human development and fetal demise. Here, we demonstrate that a homozygous inactivating mutation in the histone deacetylase SIRT6 results in severe congenital anomalies and perinatal lethality in four affected fetuses...
March 19, 2018: Genes & Development
Solina Tith, Garinder Bining, Laurent Bollag
Background : Opioid use during pregnancy is a growing concern in the United States. Buprenorphine has been recommended by "The American College of Obstetrics and Gynecology" as an alternative to methadone to decrease risks associated with the use of illicit opioids during pregnancy. The partial μ-opioid agonists' unique pharmacology, including its long half time and high affinity to the μ-opioid receptor, complicates patient management in a highly kinetic, and often urgent field like obstetric anesthesia...
2018: F1000Research
Juliana S Gebb, Nahla Khalek, Huma Qamar, Mark P Johnson, Edward R Oliver, Beverly G Coleman, William H Peranteau, Holly L Hedrick, Alan W Flake, N Scott Adzick, Julie S Moldenhauer
OBJECTIVE: Tumor volume to fetal weight ratio (TFR) > 0.12 before 24 weeks has been associated with poor outcome in fetuses with sacrococcygeal teratoma (SCT). We evaluated TFR in predicting poor fetal outcome and increased maternal operative risk in our cohort of SCT pregnancies. METHODS: This is a retrospective, single-center review of fetuses seen with SCT from 1997 to 2015. Patients who chose termination of pregnancy (TOP), delivered elsewhere, or had initial evaluation at > 24 weeks were excluded...
March 1, 2018: Fetal Diagnosis and Therapy
Silvia Carta, Andrea Kaelin Agten, Chiara Belcaro, Amarnath Bhide
OBJECTIVE: To quantify survival and neurodevelopmental outcome of fetuses with prenatally detected isolated severe bilateral ventriculomegaly form published literature. METHODS: Medline, Embase and the Cochrane Library were searched electronically. Only cases with prenatal diagnosis of apparently isolated severe ventriculomegaly and postnatal neurodevelopment assessment were selected and included. Severe ventriculomegaly was defined by the authors as enlargement of the ventricular atria, with a diameter greater than 15 mm on the transventricular plane while all cases where the investigators were unable to detect associated structural abnormality, chromosomal abnormality or fetal infections, and regarded the ventriculomegaly to be apparently isolated were included...
February 26, 2018: Ultrasound in Obstetrics & Gynecology
Simi Gupta, Mackenzie Naert, Jennifer Lam-Rachlin, Ana Monteagudo, Andrei Rebarber, Daniel Saltzman, Nathan S Fox
OBJECTIVE: Early onset fetal growth restriction is associated with poor pregnancy outcomes, but frequently is due to fetal structural or chromosomal abnormalities. The objective of this study was to determine outcomes in patients with early onset fetal growth restriction without diagnosed fetal or genetic anomalies and to identify additional risk factors for poor outcomes in these patients. METHODS: This was retrospective cohort study of singleton pregnancies in women with early onset growth restriction defined as a sonographic estimated fetal weight < 10% diagnosed between 16-28 weeks' gestation...
February 25, 2018: Journal of Maternal-fetal & Neonatal Medicine
Christopher Kevin Huls, Corey Detlefs
Trauma is the leading non-obstetric cause of death during pregnancy and approximately 6-8% of all pregnancies are complicated by injury, both accidental and intentional. The initial evaluation and management of the injured pregnant patient often requires a multidisciplinary, collaborative team to provide the optimal outcome for both mother and fetus. It is important to recognize that even minor mechanisms of injury may result in poor outcomes for both fetus and mother. Injured pregnant patients meeting admission criteria experience a progressive increase in the number of complications as well as the number of patients that require delivery...
February 2018: Seminars in Perinatology
Shih-Ting Lai, Chih-Ping Chen, Chen-Ju Lin, Chin Yuan Hsu, Peih-Shan Wu, Chen Chi Lee, Chen Wen Pan, Wayseen Wang
OBJECTIVE: We present two cases of late-onset bilateral fetal pleural effusions associated with fetal Down syndrome. CASE REPORTS: Case 1. A 33-year-old Vietnamese woman had undergone regular sonographic examinations since 23 weeks of gestation and no abnormality had been noted. However, bilateral moderate pleural effusions were found at 33 weeks of gestation, and massive pleural effusion, ascites and polyhydramnios developed at 34 weeks of gestation. Aspiration of the pleural effusion was subsequently performed...
February 2018: Taiwanese Journal of Obstetrics & Gynecology
Nazeer Muhammad, Muhammad Sharif, Javeria Amin, Riffat Mehboob, Syed Amir Gilani, Nargis Bibi, Hasnain Javed, Naseer Ahmed
Sudden unexpected perinatal collapse is a major trauma for the parents of victims. Sudden infant death syndrome (SIDS) is unexpected and mysterious death of an apparently healthy neonate from birth till 1 year of age without any known causes, even after thorough postmortem investigations. However, the incidence of sudden intrauterine unexplained death syndrome (SIUDS) is seven times higher as compared with SIDS. This observation is approximated 40-80%. Stillbirth is defined as death of a fetus after 20th week of gestation or just before delivery at full term without a known reason...
2018: Frontiers in Pediatrics
Stacey Bregman, William H Frishman
Survival rates and life expectancies for patients with congenital heart disease (CHD) have dramatically increased, and these patients are now reaching reproductive age. As they reproduce, questions pertaining to recurrent risk of disease and the impact on incidence rates have emerged. Recurrence rates for CHD have been estimated at 3% to 5%, although, due to the complex genetics underlying CHD, this range may represent an underestimation of the true risk. Debate still exists on whether the impact of recurrence of disease has been reflected in incidence rates...
March 2018: Cardiology in Review
Mi Sun Kim, Dong Hee Choi, Hwang Kwon, Eunhee Ahn, Hee Young Cho, Min Jung Baek, Ji Eun Shin, Myoung Jin Moon
OBJECTIVES: Few studies have compared embryo reduction (ER) and fetal reduction (FR) for multifetal pregnancy reduction (MPR). This study investigated the procedure-related adverse events and the obstetrical outcomes in women with multifetal pregnancies (MPs) in whom MPRs to twins or a single fetus were performed at different gestational ages. METHODS: We retrospectively analyzed the data from MPs on which transvaginal ER (n = 181) at a mean gestational age of 7...
February 8, 2018: Ultrasound in Obstetrics & Gynecology
Courtney Olson-Chen, Kripa Balaram, David N Hackney
OBJECTIVES: We conducted a meta-analysis to determine the association between Chlamydia trachomatis and adverse perinatal outcomes. METHODS: Electronic databases were searched between 1970 and 2013. Included studies reported perinatal outcomes in women with and without chlamydia. Summary odds ratios were calculated using fixed- and random-effects models. Study bias was assessed using a Funnel Plot and Begg's test. RESULTS: Of 129 articles identified, 56 studies met the inclusion criteria encompassing 614,892 subjects...
February 7, 2018: Maternal and Child Health Journal
Derek J Platt, Amber M Smith, Nitin Arora, Michael S Diamond, Carolyn B Coyne, Jonathan J Miner
Although Zika virus (ZIKV) infection in pregnant women can cause placental damage, intrauterine growth restriction, microcephaly, and fetal demise, these disease manifestations only became apparent in the context of a large epidemic in the Americas. We hypothesized that ZIKV is not unique among arboviruses in its ability to cause congenital infection. To evaluate this, we tested the capacity of four emerging arboviruses [West Nile virus (WNV), Powassan virus (POWV), chikungunya virus (CHIKV), and Mayaro virus (MAYV)] from related (flavivirus) and unrelated (alphavirus) genera to infect the placenta and fetus in immunocompetent, wild-type mice...
January 31, 2018: Science Translational Medicine
Emma L Mohr, Lindsey N Block, Christina M Newman, Laurel M Stewart, Michelle Koenig, Matthew Semler, Meghan E Breitbach, Leandro B C Teixeira, Xiankun Zeng, Andrea M Weiler, Gabrielle L Barry, Troy H Thoong, Gregory J Wiepz, Dawn M Dudley, Heather A Simmons, Andres Mejia, Terry K Morgan, M Shahriar Salamat, Sarah Kohn, Kathleen M Antony, Matthew T Aliota, Mariel S Mohns, Jennifer M Hayes, Nancy Schultz-Darken, Michele L Schotzko, Eric Peterson, Saverio Capuano, Jorge E Osorio, Shelby L O'Connor, Thomas C Friedrich, David H O'Connor, Thaddeus G Golos
Congenital Zika virus (ZIKV) infection impacts fetal development and pregnancy outcomes. We infected a pregnant rhesus macaque with a Puerto Rican ZIKV isolate in the first trimester. The pregnancy was complicated by preterm premature rupture of membranes (PPROM), intraamniotic bacterial infection and fetal demise 49 days post infection (gestational day 95). Significant pathology at the maternal-fetal interface included acute chorioamnionitis, placental infarcts, and leukocytoclastic vasculitis of the myometrial radial arteries...
2018: PloS One
Jessica Lu, Devereux N Saller, Luanne M Fraer, Beatrice A Chen
Cell-free DNA (cfDNA) testing has increased sensitivity and specificity compared to other prenatal screening methods, but invasive diagnostic testing (IDT) is recommended for confirmation. We performed a retrospective chart review of 39 women with abnormal cfDNA results between March 2012 and September 2015 at an urban academic hospital to evaluate patient choice and pregnancy outcomes. We analyzed data using descriptive statistics, Fisher's exact tests, and Wilcoxon rank-sum tests. Median maternal age was 36...
January 24, 2018: Journal of Genetic Counseling
Nesrin Ghanem-Zoubi, Silvia Pessah Eljay, Emilia Anis, Mical Paul
To investigate the association between the incidence of human brucellosis (HB) and adverse pregnancy outcomes (APOs), a population-based, cross-sectional aggregate data study was conducted in Israel between 2010 and 2014. HB-endemic localities were matched by ethnicity, population size and socioeconomic status to localities with a low incidence of HB. We compared APO rates in high-incidence vs low-incidence localities. The primary outcome was intrauterine fetal demise (IUFD). Secondary outcomes were premature birth (less than 37 weeks), early or threatened labour and poor fetal growth...
January 17, 2018: European Journal of Clinical Microbiology & Infectious Diseases
Miriam Ziemann, Rolf Fimmers, Anastasiia Khaleeva, Rainer Schürg, Markus A Weigand, Thomas Kohl
BACKGROUND: Percutaneous partial amniotic carbon dioxide insufflation (PACI) is one of the most important means for improving visualization during minimally invasive fetoscopic surgery of fetal spina bifida. The purpose of the present study was to analyze maternal and fetal safety aspects of PACI in a recent patient cohort and to present management improvements. METHODS: PACI under general materno-fetal anesthesia was performed during 65 interventions for fetoscopic patch coverage of fetal spina bifida aperta between 21 + 0 and 29 + 1 weeks of gestation...
January 16, 2018: Surgical Endoscopy
Hiroko Konno, Takeshi Murakoshi, Akiko Yamashita, Mitsuru Matsushita
AIM: We evaluated risk factors for birthweight discordance in monochorionic diamniotic (MCDA) twin pregnancies without twin-twin transfusion syndrome (TTTS). METHODS: We investigated all MCDA twin placentas injected with colored dye at our institution between 2007 and 2015. We excluded pairs of twins with TTTS, fetal demise, or severe fetal malformation. All pairs of twins were assigned to the discordant group (birthweight discordance ≥ 25%) or the concordant group (birthweight discordance < 25%)...
January 5, 2018: Journal of Obstetrics and Gynaecology Research
Sarah A Robertson, Peck-Yin Chin, Joseph G Femia, Hannah M Brown
Cytokines in the reproductive tract environment at conception mediate a dialogue between the embryo and maternal tissues to profoundly influence embryo development and implantation success. Through effects on gene expression and the cell stress response, cytokines elicit an epigenetic impact with consequences for placental development and fetal growth, which in turn affect metabolic phenotype and long-term health of offspring. There is substantial evidence demonstrating that pro-survival cytokines, such as GM-CSF, CSF1, LIF, HB-EGF and IGFII, support embryos to develop optimally...
February 2018: Journal of Reproductive Immunology
Laura J Yockey, Kellie A Jurado, Nitin Arora, Alon Millet, Tasfia Rakib, Kristin M Milano, Andrew K Hastings, Erol Fikrig, Yong Kong, Tamas L Horvath, Scott Weatherbee, Harvey J Kliman, Carolyn B Coyne, Akiko Iwasaki
Zika virus (ZIKV) infection during pregnancy is associated with adverse fetal outcomes, including microcephaly, growth restriction, and fetal demise. Type I interferons (IFNs) are essential for host resistance against ZIKV, and IFN-α/β receptor (IFNAR)-deficient mice are highly susceptible to ZIKV infection. Severe fetal growth restriction with placental damage and fetal resorption is observed after ZIKV infection of type I IFN receptor knockout ( Ifnar1 -/- ) dams mated with wild-type sires, resulting in fetuses with functional type I IFN signaling...
January 5, 2018: Science Immunology
Luke Eckersley, Lisa K Hornberger
Evaluation of fetal cardiac function is one of the most important components of fetal echocardiography. Fetal cardiac dysfunction is closely linked to risk of intrauterine fetal demise, in many, but not all cases is indicative of worse postnatal prognosis and may prompt the use of medications or interventions to optimize outcomes. There may be implications for termination versus continuation of pregnancy, an indication for early delivery, a change in location and even mode of delivery. In extreme cases, fetal cardiac dysfunction may prompt prenatal or early neonatal listing for cardiac transplantation...
December 2017: Echocardiography
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