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fetal surveillance

L Ormesher, E D Johnstone, E Shawkat, A Dempsey, C Chmiel, E Ingram, L E Higgins, J E Myers
OBJECTIVE: To evaluate the use of plasma Placental Growth Factor (PlGF), recommended by the recent NICE guidance, in women with suspected pre-eclampsia (PE) and/or fetal growth restriction (FGR). STUDY DESIGN: Non-randomised prospective clinical evaluation study in high-risk antenatal clinics in a tertiary maternity unit. METHODS: PlGF testing was performed in addition to routine clinical assessment in 260 women >20 weeks' gestation with chronic disease (hypertension, renal disease ± diabetes) with a change in maternal condition or in women with suspected FGR to determine the impact on clinical management...
March 13, 2018: Pregnancy Hypertension
Sheree L Boulet, Jennifer F Kawwass, Sara Crawford, Michael J Davies, Dmitry M Kissin
We used 2006-2015 US National Assisted Reproductive Technology Surveillance System data to compare preterm birth and fetal growth for livebo n singletons (24-42 week gestation) following donor versus autologous oocyte in vitro fertilization (IVF). Using binary and multinomial logistic regressi n, we computed adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for associations between use of donor oocytes and preterm delivery, small-f r-gestational-age (SGA), and large-for-gestational age (LGA), stratified by fresh and thawed embryo status and accounting for maternal characteristics and year of birth...
March 9, 2018: American Journal of Epidemiology
Kyle K Jensen, Karen Y Oh, Anne M Kennedy, Roya Sohaey
Intrauterine linear echogenicity (ILE) is a common ultrasonographic finding in the gravid uterus and has variable causes and variable maternal and fetal outcomes. Correctly categorizing ILE during pregnancy is crucial for guiding surveillance and advanced imaging strategies. Common causes of ILE include membranes in multiple gestations, uterine synechiae with amniotic sheets, and uterine duplication anomalies. Less common causes include circumvallate placenta, chorioamniotic separation, and hemorrhage between membranes...
March 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Aditya Jain, Catherine Degnin, Yiyi Chen, Mike Craycraft, Arthur Hung, Jerry Jaboin, Charles R Thomas, Timur Mitin
PURPOSE: Most men with stage I testicular seminoma are cured with surgery alone, which is a preferred strategy per national guidelines. The current pattern of practice among US radiation oncologists (ROs) is unknown. MATERIALS AND METHODS: We surveyed practicing US ROs via an online questionnaire. Respondent's characteristics, self-rated knowledge, perceived patient compliance rates with observation were analyzed for association with treatment recommendations. RESULTS: We received 353 responses from ROs, of whom 23% considered themselves experts...
March 9, 2018: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Hyun Sun Ko, Sae Kyung Choi, Jeong Ha Wie, In Yang Park, Yong Gyu Park, Jong Chul Shin
BACKGROUND: The purpose of this study was to compare the fetal/infant mortality risk associated with each additional week of expectant management to that associated with immediate delivery in women with multiple gestations. METHODS: This was a retrospective national cohort study of 94,170 multiple deliveries, 92,619 (98.4%) twin and 1,352 (1.44%) triplet pregnancies, between 32 0/7 and 42 6/7 weeks of gestation recorded in the Korean vital statistics database. We investigated the risks of stillbirth and infant death after birth in Korea according to the week of gestation in twin and triplet pregnancies...
March 5, 2018: Journal of Korean Medical Science
Hao Wang, Ewa Wender-Ozegowska, Ester Garne, Margery Morgan, Maria Loane, Joan K Morris, Marian K Bakker, Miriam Gatt, Hermien de Walle, Susan Jordan, Anna Materna-Kiryluk, Vera Nelen, Guy Thys, Awi Wiesel, Helen Dolk, Lolkje T W de Jong-van den Berg
OBJECTIVES: To evaluate the risk of major congenital anomaly associated with first-trimester exposure to insulin analogues compared with human insulin in offspring of women with pregestational diabetes. DESIGN AND SETTING: A population-based cohort of women with pregestational diabetes (n=1661) who delivered between 1996 and 2012 was established retrospectively from seven European regions covered bythe European Surveillance of Congenital Anomalies (EUROCAT) congenital anomaly registries...
February 24, 2018: BMJ Open
L Ghesquière, C Garabedian, C Coulon, P Verpillat, T Rakza, B Wibaut, A Delsalle, D Subtil, P Vaast, V Debarge
The main cause of fetal anemia is maternal red blood cell alloimmunization (AI). The search of maternal antibodies by indirect antiglobulin test allows screening for AI during pregnancy. In case of AI, fetal genotyping (for Rh-D, Rh-c, Rh-E and Kell), quantification (for anti-rhesus antibodies) and antibody titration, as well as ultrasound monitoring, are performed. This surveillance aims at screening for severe anemia before hydrops fetalis occurs. Management of severe anemia is based on intrauterine transfusion (IUT) or labor induction depending on gestational age...
February 21, 2018: Journal of gynecology obstetrics and human reproduction
Martine Wallon, François Peyron
Maternal infection by Toxoplasma gondii during pregnancy may have serious consequences for the fetus, ranging from miscarriage, central nervous system involvement, retinochoroiditis, or subclinical infection at birth with a risk of late onset of ocular diseases. As infection in pregnant women is usually symptomless, the diagnosis relies only on serological tests. Some countries like France and Austria have organized a regular serological testing of pregnant women, some others have no prenatal program of surveillance...
February 23, 2018: Pathogens
Lesley M McCowan, Francesc Figueras, Ngaire H Anderson
Small for gestational age is usually defined as an infant with a birthweight <10th centile for a population or customized standard. Fetal growth restriction refers to a fetus that has failed to reach its biological growth potential because of placental dysfunction. Small-for-gestational-age babies make up 28-45% of nonanomalous stillbirths, and have a higher chance of neurodevelopmental delay, childhood and adult obesity, and metabolic disease. The majority of small-for-gestational-age babies are not recognized before birth...
February 2018: American Journal of Obstetrics and Gynecology
Francesc Figueras, Javier Caradeux, Fatima Crispi, Elisenda Eixarch, Anna Peguero, Eduard Gratacos
By consensus, late fetal growth restriction is that diagnosed >32 weeks. This condition is mildly associated with a higher risk of perinatal hypoxic events and suboptimal neurodevelopment. Histologically, it is characterized by the presence of uteroplacental vascular lesions (especially infarcts), although the incidence of such lesions is lower than in preterm fetal growth restriction. Screening procedures for fetal growth restriction need to identify small babies and then differentiate between those who are healthy and those who are pathologically small...
February 2018: American Journal of Obstetrics and Gynecology
Cielo Gnecco, S J Carlan, Jeannie McWhorter, Li Ge, Daniel Sanchez, Mario Madruga
BACKGROUND: Burkitt's lymphoma is a highly aggressive B cell non-Hodgkin lymphoma subtype. Its occurrence in pregnancy is rare and often results in a delayed diagnosis. The treatment plan and prognosis depend on a number of variables including the stage at diagnosis. CASE PRESENTATION: A 32 weeks pregnant, 34-year-old white woman presented with weeks of complaints that were similar to typical pregnancy symptoms. Laboratory and ultrasound findings suggested a pathologic process and during the workup non-reassuring fetal surveillance resulted in an emergency cesarean delivery...
February 8, 2018: Journal of Medical Case Reports
M Hassan Toufaily, Marie-Noel Westgate, Angela E Lin, Lewis B Holmes
BACKGROUND: Many different causes of malformations have been established. The surveillance of a consecutive population of births, including stillbirths and elective terminations of pregnancy because of fetal anomalies, can identify each infant with malformations and determine the frequency of the apparent etiologies. This report is a sequel to the first such analysis in the first 10 years of this Active Malformations Surveillance Program (Nelson and Holmes, ). METHODS: The presence of malformations was determined among 289,365 births over 41 years (1972-2012) at the Brigham and Women's Hospital in Boston...
January 2018: Birth Defects Research
Lewis B Holmes, Hanah Nasri, Anne-Therese Hunt, M Hassan Toufaily, Marie-Noel Westgate
BACKGROUND: Postaxial polydactyly, type B is the most common type of polydactyly. The vestigial sixth finger is attached by a narrow neurovascular pedicle to the lateral aspect of the hand or foot at the level of the metacarpal-phalangeal joint or the metatarsal-phalangeal joint. The occurrence of this type of polydactyly varies among racial groups, by sex and sidedness. Postaxial polydactyly, type A is a fully developed extra digit on the lateral aspect of the hand or foot with a bifid fifth or sixth metacarpal/metatarsal and is much less common...
January 2018: Birth Defects Research
Jennifer G Andrews, Maureen K Galindo, F John Meaney, Argelia Benavides, Linnette Mayate, Deborah Fox, Sydney Pettygrove, Leslie O'Leary, Christopher Cunniff
BACKGROUND: The diagnosis of fetal alcohol syndrome (FAS) rests on identification of characteristic facial, growth, and central nervous system (CNS) features. Public health surveillance of FAS depends on documentation of these characteristics. We evaluated if reporting of FAS characteristics is associated with the type of provider examining the child. METHODS: We analyzed cases aged 7-9 years from the Fetal Alcohol Syndrome Surveillance Network II (FASSNetII). We included cases whose surveillance records included the type of provider (qualifying provider: developmental pediatrician, geneticist, neonatologist; other physician; or other provider) who evaluated the child as well as the FAS diagnostic characteristics (facial dysmorphology, CNS impairment, and/or growth deficiency) reported by the provider...
January 25, 2018: Birth Defects Research
Hannah Blencowe, Vijaya Kancherla, Sowmiya Moorthie, Matthew W Darlison, Bernadette Modell
Neural tube defects (NTDs) are associated with substantial mortality, morbidity, disability, and psychological and economic costs. Many are preventable with folic acid, and access to appropriate services for those affected can improve survival and quality of life. We used a compartmental model to estimate global and regional birth prevalence of NTDs (live births, stillbirths, and elective terminations of pregnancy) and subsequent under-5 mortality. Data were identified through web-based reviews of birth defect registry databases and systematic literature reviews...
January 24, 2018: Annals of the New York Academy of Sciences
Luisa D'Oria, Massimo Apicella, Carmen De Luca, Angelo Licameli, Caterina Neri, Marcella Pellegrino, Daniela Simeone, Marco De Santis
BACKGROUND: Obstetricians usually prescribe supplements during pregnancy without actual indication. The use of selenium during pregnancy has increased, due to its function in several antioxidant mechanisms. CASE: A pregnant woman received 200,000 micrograms (μg) per day of a selenium galenic formulation, since gestational week (g.w.) 7 to 12, due to a prescription error. The patient experienced nausea, vomiting, hand and foot paresthesia, followed by fatigue, loss of fingernails and hair...
January 19, 2018: Birth Defects Research
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
M C Veronesi, B Bolis, M Faustini, A Rota, A Mollo
A proper canine neonatal assistance, required to reduce the high perinatal loss rate, imply a full knowledge about the fetal-to-neonatal physiology. Because fetal fluids play an important role throughout mammals pregnancy, influencing fetal growth and development, fetal well being, and contributing to guarantee the most suitable environment for the fetus, the knowledge about fetal fluids biochemical composition is of major importance. At first, the biochemical composition of fetal fluids collected by normal developed, healthy and viable newborns, is necessary to depict the normal features, and represent the first step for the further detection of abnormalities associated to fetal/neonatal distress and useful for the early identification of newborns needing special attention, immediately after birth...
December 14, 2017: Theriogenology
Rebecca Fischer-Betz, Christof Specker
Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease with a high prevalence in females of childbearing age. Pregnancy in SLE nowadays has favorable outcomes for the majority of women. However, flares of disease activity, preeclampsia, fetal loss, and preterm birth are well-known risks in such pregnancies. Anti-SS-A(Ro)/SS-B(La) antibodies put fetuses at risk for congenital heart block and neonatal lupus. Several risk factors for adverse pregnancy outcomes have been identified. Women with antiphospholipid antibodies or antiphospholipid syndrome and lupus nephritis represent a group with high risk for obstetric complications...
June 2017: Best Practice & Research. Clinical Rheumatology
Melanie C Audette, John C Kingdom
Fetal growth restriction (FGR) continues to be a leading cause of preventable stillbirth and poor neurodevelopmental outcomes in offspring, and furthermore is strongly associated with the obstetrical complications of iatrogenic preterm birth and pre-eclampsia. The terms small for gestational age (SGA) and FGR have, for too long, been considered equivalent and therefore used interchangeably. However, the delivery of improved clinical outcomes requires that clinicians effectively distinguish fetuses that are pathologically growth-restricted from those that are constitutively small...
December 5, 2017: Seminars in Fetal & Neonatal Medicine
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