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Ultrasound fetal medicine

Lori A Stolz, Uwe Stolz, J Matthew Fields, Turandot Saul, Michael Secko, Matthew J Flannigan, Johnathan M Sheele, Robert P Rifenburg, Anthony J Weekes, Elaine B Josephson, John Bedolla, Dana M Resop, Jonathan Dela Cruz, Megan Boysen-Osborn, Terrell Caffery, Charlotte Derr, Rimon Bengiamin, Gerardo Chiricolo, Brandon Backlund, Jagdipak Heer, Robert J Hyde, Srikar Adhikari
OBJECTIVES: Emergency ultrasound (EUS) has been recognized as integral to the training and practice of emergency medicine (EM). The Council of Emergency Medicine Residency-Academy of Emergency Ultrasound (CORD-AEUS) consensus document provides guidelines for resident assessment and progression. The Accredited Council for Graduate Medical Education (ACGME) has adopted the EM Milestones for assessment of residents' progress during their residency training which includes demonstration of procedural competency in bedside ultrasound...
October 14, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
C N Mnyani, E Nicolaou, S Bister
BACKGROUND: Concerns have been raised about the injudicious use of non-invasive prenatal testing (NIPT) using cell-free DNA (cfDNA), which often leads to inaccuracies in interpretation of the role and value of cfDNA in prenatal screening. OBJECTIVES:  To determine the value and role of NIPT in a select South African (SA) population. METHODS:  A retrospective review of patients who elected to have NIPT between 1 October 2013 and 30 June 2015 at the Morningside Mediclinic Maternal and Fetal Medicine Centre in Johannesburg, SA...
September 9, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Shari E Gelber, Amos Grünebaum, Frank A Chervenak
BACKGROUND: Due to the recent outbreak of Zika virus, there has been a newfound interest in fetal and neonatal microcephaly. In 1984, Chervenak et al. proposed criteria for the prenatal ultrasound diagnosis of microcephaly as ≤3 standard deviations (SD) from the mean. Despite improvements in medicine these criteria have not been reevaluated in 30 years. OBJECTIVE: To examine how the original 1984 Chervenak et al. criteria for the diagnosis of fetal microcephaly apply to a current population utilizing modern ultrasound equipment and techniques...
September 23, 2016: Journal of Perinatal Medicine
C Scala, S McDonnell, F Murphy, U Leone Roberti Maggiore, A Khalil, A Bhide, B Thilaganthan, A T Papageorghiou
OBJECTIVES: To establish the diagnostic accuracy of obstetric ultrasound at a tertiary fetal medicine centre in the prenatal detection of unilateral and bilateral MCDK in fetuses where this condition was suspected; and to undertake a systematic review of the literature on this topic. METHODS: Retrospective observational study of all cases with an antenatal diagnosis of either unilateral or bilateral MCDK referred to a regional tertiary fetal medicine unit between 1997 and 2015...
September 19, 2016: Ultrasound in Obstetrics & Gynecology
Ioannis Papastefanou, Athanasios Pilalis, Dimitra Kappou, Athena P Souka
INTRODUCTION: Our aim was to establish unconditional and conditional longitudinal reference ranges for cervical length throughout pregnancy. MATERIAL AND METHODS: This is a prospective longitudinal study at 11 to 40 weeks of gestation of all singleton pregnancies followed in our fetal medicine unit during the period 2011-2015. Cervical length measurements were carried out by transvaginal ultrasound. Multilevel modeling was applied to establish cervical length reference ranges from 11 to 40 weeks...
September 16, 2016: Acta Obstetricia et Gynecologica Scandinavica
Jorge Andrés Carvajal, Fernando Andrés Ferrer, Francisca Isabel Araya, Ana María Delpiano
INTRODUCTION: Brain natriuretic peptide (BNP) is synthesized by human fetal membranes, both the amnion and chorion. This locally produced BNP inhibits the contraction of the human myometrium, contributing to the maintenance of myometrial quiescence during pregnancy. Reference values for NT-proBNP concentrations in amniotic fluid at different gestational ages have not been completely defined. We aimed to investigate the range of fetal NT-proBNP values in amniotic fluid in normal pregnancy between 17 and 41weeks of gestation...
September 7, 2016: Clinical Biochemistry
Adeeb Khalifeh, Johanna Quist-Nelson, Vincenzo Berghella
OBJECTIVE: To evaluate the incidence of implementation of universal cervical length (CL) screening for preterm birth (PTB) prevention among institutions with Maternal-Fetal Medicine (MFM) fellowship training in the United states. METHODS: In January 2015, we conducted a national survey of institutions with MFM Fellowship Programs regarding implementation of universal CL screening, defined as CL screening of women with singleton gestations without a prior spontaneous PTB...
September 7, 2016: Journal of Maternal-fetal & Neonatal Medicine
Rosemary J Froehlich, Grecio Sandoval, Jennifer L Bailit, William A Grobman, Uma M Reddy, Ronald J Wapner, Michael W Varner, John M Thorp, Mona Prasad, Alan T N Tita, George Saade, Yoram Sorokin, Sean C Blackwell, Jorge E Tolosa
OBJECTIVE: To evaluate the association between documentation of estimated fetal weight, and its value, with cesarean delivery. METHODS: This was a secondary analysis of a multicenter observational cohort of 115,502 deliveries from 2008 to 2011. Data were abstracted by trained and certified study personnel. We included women at 37 weeks of gestation or greater attempting vaginal delivery with live, nonanomalous, singleton, vertex fetuses and no history of cesarean delivery...
September 2016: Obstetrics and Gynecology
M B Nielsen, K Seitz
The impact factor (IF) for 2015 was recently released and this could be the time to once again reflect on its use as a metric of a journal. Problems and concerns regarding the IF have been addressed extensively elsewhere 1 2. The principle of the IF for a given year is that it represents the average number of citations of articles published in the journal in the two previous years.While authors frequently cite the IF as a determining factor for submission, the IF does not predict how many times individual articles will be cited...
August 2016: Ultraschall in der Medizin
John W Hall, Nicolas Denne, Joseph J Minardi, Debra Williams, B J Balcik
BACKGROUND: Early pregnancy complaints in emergency medicine are common. Emergency physicians (EP) increasingly employ ultrasound (US) in the evaluation of these complaints. As a result, it is likely that rare and important diagnoses will be encountered. We report a case of fetal anencephaly diagnosed by bedside emergency US in a patient presenting with first-trimester vaginal bleeding. CASE REPORT: A 33-year-old patient at 10 weeks gestation presented with vaginal bleeding...
July 2016: Western Journal of Emergency Medicine
Maria Rasmussen, Morten Smaerup Olsen, Lone Sunde, Lene Søndergård Sperling, Olav Bjørn Petersen
OBJECTIVES: To estimate the prevalence of kidney anomalies at second trimester ultrasound screening, and furthermore, to investigate pregnancy outcomes and the pattern of additional malformations. METHODS: We previously identified all women attending second-trimester ultrasound scans in Denmark between 1 January 2007 and 31 December 2012. Using the Astraia databases and the Danish National Patient Registry, we identified all fetuses with kidney anomalies diagnosed prenatally in these women...
September 2016: Prenatal Diagnosis
Stephanie G Valderramos, Rashmi R Rao, Emily W Scibetta, Neil S Silverman, Christina S Han, Lawrence D Platt
BACKGROUND: Since its commercial release in 2011 cell-free DNA screening has been rapidly adopted as a routine prenatal genetic test. However, little is known about its performance in actual clinical practice. OBJECTIVE: We sought to investigate factors associated with the accuracy of abnormal autosomal cell-free DNA results. STUDY DESIGN: We conducted a retrospective cohort study of 121 patients with abnormal cell-free DNA results from a referral maternal-fetal medicine practice from March 2013 through July 2015...
June 28, 2016: American Journal of Obstetrics and Gynecology
Saulo Molina-Giraldo, Luis Alfonso-Ospina, Carolina Parra-Meza, Eder Ariel Lancheros-García, José Luis Rojas-Arias, Edgar Acuña-Osorio
OBJECTIVE: To establish the prevalence of congenital malformations diagnosed in Maternal-Fetal Medicine Unit of Hospital de San José, Bogotá-Colombia and comparing them to national and international reports. MATERIALS AND METHODS: Retrospective, descriptive observational where the quantification of all malformed fetuses diagnosed in Maternal-Fetal Medicine Unit from June 2010 to June 2013 was performed. RESULTS: 236 malformed fetuses, a total of 11,914 births, for a prevalence of 1...
November 2015: Ginecología y Obstetricia de México
Lars H Pedersen, Olav B Petersen, Mette Nørgaard, Charlotte Ekelund, Lars Pedersen, Ann Tabor, Henrik T Sørensen
A linked population-based database is being created in Denmark for research on drug safety during pregnancy. It combines information from the Danish National Health Service Prescription Database (with information on all prescriptions reimbursed in Denmark since 2004), the Danish Fetal Medicine Database, the Danish National Registry of Patients, and the Medical Birth Registry. The new linked database will provide validated information on malformations diagnosed both prenatally and postnatally. The cohort from 2008 to 2014 will comprise 589,000 pregnancies with information on 424,000 pregnancies resulting in live-born children, ∼420,000 pregnancies undergoing prenatal ultrasound scans, 65,000 miscarriages, and 92,000 terminations...
2016: Clinical Epidemiology
Adeeb Khalifeh, Johanna Quist-Nelson, Vincenzo Berghella
INTRODUCTION: To evaluate the incidence of implementation of universal cervical length (CL) screening for preterm birth (PTB) prevention among institutions with Maternal-Fetal Medicine (MFM) fellowship training in the United States. METHODS: In January 2015, we conducted a national survey of institutions with MFM Fellowship Programs regarding implementation of universal CL screening, defined as CL screening of women with singleton gestations without a prior spontaneous PTB...
May 2016: Obstetrics and Gynecology
Stéphanie Friszer, Ferdinand Dhombres, Baptiste Morel, Michel Zerah, Jean-Marie Jouannic, Catherine Garel
OBJECTIVE: To determine the ultrasonographic characteristics of limited dorsal myeloschisis (LDM) at prenatal ultrasound (US) and to highlight the main features that may help differentiate LDM and myelomeningocele (MMC). METHODS: In a tertiary reference center in fetal medicine, we prospectively collected the medical data and ultrasonographic characteristics of all patients referred for in utero prenatal repair of MMC between November 1, 2013 and April 30, 2015...
May 5, 2016: Fetal Diagnosis and Therapy
Haitham Torky, Asem Anwar, Alaa Elebrashy, Fahd Elomda
OBJECTIVES: To determine the prenatal incidence of moderate and severe cardiac anomalies and determine the prenatal pattern of CHD. STUDY DESIGN: Multi-center retrospective observational study. SETTINGS: Cairo, Al-Azhar and 6th October Universities. PATIENTS AND METHODS: 5499 pregnant women in the second and third trimester attending the fetal medicine unit in the three universities from January 2012 to June 2013 for anomaly scan were retrospectively reviewed...
April 2016: Pregnancy Hypertension
Tuangsit Wataganara, Alaa Ebrashy, Labaran Dayyabu Aliyu, Renato Augusto Moreira de Sa, Ritsuko Pooh, Asim Kurjak, Cihat Sen, Abdallah Adra, Milan Stanojevic
Magnetic resonance imaging (MRI) has been increasingly adopted in obstetrics practice in the past three decades. MRI aids prenatal ultrasound and improves diagnostic accuracy for selected maternal and fetal conditions. However, it should be considered only when high-quality ultrasound cannot provide certain information that affects the counseling, prenatal intervention, pregnancy course, and delivery plan. Major indications of fetal MRI include, but are not restricted to, morbidly adherent placenta, selected cases of fetal brain anomalies, thoracic lesions (especially in severe congenital diaphragmatic hernia), and soft tissue tumors at head and neck regions of the fetus...
July 1, 2016: Journal of Perinatal Medicine
Marianne Leruez-Ville, Idir Ghout, Laurence Bussières, Julien Stirnemann, Jean-François Magny, Sophie Couderc, Laurent J Salomon, Tiffany Guilleminot, Philippe Aegerter, Guillaume Benoist, Norbert Winer, Olivier Picone, François Jacquemard, Yves Ville
BACKGROUND: Congenital infection with human cytomegalovirus is a major cause of morbidity and mortality. A randomized controlled trial showed that high-dosage valacyclovir prevents cytomegalovirus disease in transplant recipients. Fetuses showing ultrasound features of infection are at high risk of being symptomatic at or before birth. In a pilot study, oral administration of high-dosage valacyclovir to mothers significantly decreased viral load and produced therapeutic concentrations in the blood of infected fetuses...
October 2016: American Journal of Obstetrics and Gynecology
Erik D Skarsgard
PURPOSE OF REVIEW: The diagnosis and treatment of gastroschisis spans the perinatal disciplines of maternal fetal medicine, neonatology, and pediatric surgery. Since gastroschisis is one of the commonest and costliest structural birth defects treated in neonatal ICUs, a comprehensive review of its epidemiology, prenatal diagnosis, postnatal treatment, and short and long-term outcomes is both timely and relevant. RECENT FINDINGS: The incidence of gastroschisis has increased dramatically over the past 20 years, leading to a renewed interest in causation...
June 2016: Current Opinion in Pediatrics
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