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By Chad Klauser Maternal Fetal Medicine physician in NYC
Greggory R DeVore
The cerebroplacental ratio (CPR) is emerging as an important predictor of adverse pregnancy outcome, and this has implications for the assessment of fetal well-being in fetuses diagnosed as small for gestational age (SGA) and those appropriate for gestational age close to term. Interest in this assessment tool has been rekindled because of recent reports associating an abnormal ratio with adverse perinatal events and associated postnatal neurological outcome. Fetuses with an abnormal CPR that are appropriate for gestational age or have late-onset SGA (>34 weeks of gestation) have a higher incidence of fetal distress in labor requiring emergency cesarean delivery, a lower cord pH, and an increased admission rate to the newborn intensive care unit when compared with fetuses with a normal CPR...
July 2015: American Journal of Obstetrics and Gynecology
Germaine M Buck Louis, Jagteshwar Grewal, Paul S Albert, Anthony Sciscione, Deborah A Wing, William A Grobman, Roger B Newman, Ronald Wapner, Mary E D'Alton, Daniel Skupski, Michael P Nageotte, Angela C Ranzini, John Owen, Edward K Chien, Sabrina Craigo, Mary L Hediger, Sungduk Kim, Cuilin Zhang, Katherine L Grantz
OBJECTIVE: Fetal growth is associated with long-term health yet no appropriate standards exist for the early identification of undergrown or overgrown fetuses. We sought to develop contemporary fetal growth standards for 4 self-identified US racial/ethnic groups. STUDY DESIGN: We recruited for prospective follow-up 2334 healthy women with low-risk, singleton pregnancies from 12 community and perinatal centers from July 2009 through January 2013. The cohort comprised: 614 (26%) non-Hispanic whites, 611 (26%) non-Hispanic blacks, 649 (28%) Hispanics, and 460 (20%) Asians...
October 2015: American Journal of Obstetrics and Gynecology
Aya Mochimaru, Shigeru Aoki, Mari S Oba, Kentaro Kurasawa, Tsuneo Takahashi, Fumiki Hirahara
AIM: The aim of this study was to elucidate the risk of poor pregnancy outcomes in women with adenomyosis by comparing their outcomes to those of women without uterine abnormalities. MATERIAL AND METHODS: The subjects were 36 women diagnosed with adenomyosis before pregnancy who were managed at a tertiary care center between January 2002 and December 2012. Our hospital database was retrospectively reviewed to identify pregnancy outcomes associated with adenomyosis...
April 2015: Journal of Obstetrics and Gynaecology Research
Julia Unterscheider, Keelin O'Donoghue, Fergal D Malone
OBJECTIVE: This study aims to compare recommendations from recently published national clinical guidelines for pregnancies complicated by fetal growth restriction (FGR). MATERIALS AND METHODS: Clinical guidelines informing best practice management of pregnancies with FGR issued by the American Congress of Obstetricians and Gynecologists, the Society of Obstetricians and Gynaecologists of Canada and the Royal College of Obstetricians and Gynaecologists in the United Kingdom are reviewed together with the published literature on this topic...
March 2015: American Journal of Perinatology
Elena Contro, Dong Hyun Cha, Irene De Maggio, Sara Yasmin Ismail, Veronica Falcone, Sandro Gabrielli, Antonio Farina
OBJECTIVE: The objective of this article is to evaluate the longitudinal changes in uterine artery Doppler pulsatility index (UtA-PI) in pregnancies complicated with early onset intrauterine growth restriction (IUGR). METHOD: Case-control study comparing UtA-PI from 20 to 34 weeks gestation in pregnancies affected by IUGR at 20 to 28 weeks and confirmed at delivery (cases), matched with 1000 controls. Multivariable analyses were used to estimate the UtA-PI as a function of both gestational age and IUGR severity...
December 2014: Prenatal Diagnosis
J H W Veerbeek, P G J Nikkels, H L Torrance, J Gravesteijn, E D Post Uiterweer, J B Derks, S V Koenen, G H A Visser, B B Van Rijn, A Franx
INTRODUCTION: To identify key pathological characteristics of placentas from pregnancies complicated by early intrauterine growth restriction, and to examine their relations with maternal hypertensive disease and umbilical artery Doppler waveform abnormalities. METHODS: Single-center retrospective cohort study of singleton pregnancies with abnormal umbilical artery Doppler flow patterns resulting in a live birth <34 weeks of a baby with a weight <10th percentile for gestational age...
September 2014: Placenta
Vicky O'Dwyer, Gerard Burke, Julia Unterscheider, Sean Daly, Michael P Geary, Mairead M Kennelly, Fionnuala M McAuliffe, Keelin O'Donoghue, Alyson Hunter, John J Morrison, Patrick Dicker, Elizabeth C Tully, Fergal D Malone
OBJECTIVE: We sought to determine the cause of adverse perinatal outcome in fetal growth restriction (FGR) where umbilical artery (UA) Doppler was normal, as identified from the Prospective Observational Trial to Optimize Pediatric Health (PORTO). We compared cases of adverse outcome where UA Doppler was normal and abnormal. STUDY DESIGN: The PORTO study was a national multicenter study of >1100 ultrasound-dated singleton pregnancies with an estimated fetal weight <10th centile...
October 2014: American Journal of Obstetrics and Gynecology
Michal Kovo, Letizia Schreiber, Osnat Elyashiv, Avi Ben-Haroush, Golan Abraham, Jacob Bar
OBJECTIVE: To compare pregnancy outcome and placental pathology in pregnancies complicated by fetal growth restriction (FGR) with and without preeclampsia. METHODS: Labor, fetal/neonatal outcome, and placental pathology parameters from neonates with a birth weight below the 10 th percentile (FGR), born between 24 and 42 weeks of gestation, were reviewed. Results were compared between pregnancies complicated with preeclampsia (hypertensive FGR [H-FGR]) to those without preeclampsia (normotensive FGR [N-FGR])...
March 2015: Reproductive Sciences
Sari Räisänen, Vijaya Kancherla, Michael R Kramer, Mika Gissler, Seppo Heinonen
OBJECTIVE: To evaluate whether there is an association between placenta previa and delivery of a small-for-gestational-age (SGA) newborn and to quantify the contribution of individual risk factors for SGA that are associated with placenta previa stratified by maternal parity. METHODS: A cross-sectional study using the Finnish Medical Birth Register during 2000-2010. All singleton births (N=596,562) were included; major congenital anomalies were excluded. An association between SGA (less than 2 standard deviations below the mean) and placenta previa was modeled by parity-specific unadjusted and adjusted statistical models...
August 2014: Obstetrics and Gynecology
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