Fetal Diagnosis and Therapy

INTRODUCTION: Congenital pulmonary airway malformations (CPAM), intra- and extralobar bronchopulmonary sequestrations (iBPS/eBPS), CPAM-BPS hybrid lesions (HL), congenital lobar emphysema (CLE), bronchial atresia (BA), and foregut duplication cysts (FDC), collectively referred to as congenital thoracic lesions (CTL), are mostly solitary. Patients with multiple CTL are rare, and reports on such cases are scarce. To address this dearth, we analyzed a large multifocal CTL patient cohort...

INTRODUCTION: The International Fetal Medicine and Surgery Society (IFMSS) was founded in 1984, to offer a collegial, interdisciplinary forum for fetal specialists worldwide, allowing innovations, successes and failures to be reported freely. Herein, we examine progress in fetal medicine, reflected by the diversity and frequency of IFMSS presentations. We also test the hypothesis that IFMSS has remained at the forefront of new developments in this field. METHODS: The scientific programs of annual conferences were reviewed for title and subject and assigned one or more keywords, and a single category...

INTRODUCTION: To determine the impact of the stage-based classification of FGR on the magnitude of FGR, preterm births and birthweight in a rural population of Madhya Pradesh in central India Methods: The program covered 168 public sector centres for pregnant women and infants that provided services to nearly 220,000 people. The third-trimester assessments included fetal biometry, growth and environment assessments, and Doppler assessments. Fetal growth was staged using the Barcelona protocol as stages 1 to 4 FGR, small for gestational age (SGA) and no FGR...

Introduction Limited evidence exists on borderline oligohydramnios. Our objective was to determine perinatal outcomes in uncomplicated term pregnancies with borderline oligohydramnios. Methods This retrospective analysis compared adverse perinatal outcomes among pregnancies during 2018-2022, between those with borderline oligohydramnios defined as amniotic fluid index (AFI) 5.1-8.0 cm, those with oligohydramnios (AFI ≤5 cm) and those with normal AFI (8.1-25 cm). The latter, matched one-to-one to the borderline oligohydramnios group, served as the control group...

Introduction Speckle tracking echocardiography (STE) is a non-Doppler modality allowing the semiautomated evaluation of the fetal cardiac function by tracking the speckles of the endocardial borders. Little evidence is available on the evaluation and comparison of different software for the functional assessment of the fetal heart by means of STE. The aim of this study is to evaluate the reproducibility and agreement of two different proprietary speckle tracking software for the prenatal semi-automated assessment of the fetal cardiac function...

INTRODUCTION: Spina bifida guidelines recommend neurosurgical involvement in prenatal counseling (nPNC) to inform decision-making between prenatal and postnatal MMC repair. This study examines whether families with myelomeningocele (MMC) presenting to one fetal center had timely nPNC encounters, and assesses modifiable and non-modifiable treatment-determining factors. METHODS: History and timing of nPNC were quantified among infants undergoing postnatal and prenatal MMC repair, pregnant patients referred, and MMC studies in a fetal MRI database (2015-2023)...

INTRODUCTION: Limited data exist regarding outcomes when pre- and periviable PPROM (PPROM ≤26 weeks of gestation) occurs as a complication of fetoscopic laser surgery (FLS) for twin-twin transfusion syndrome (TTTS) Methods: This is a retrospective cohort study of FLS cases performed at a single institution between January 2015 and May 2021. Study inclusion was limited to patients with monochorionic-diamniotic twin pregnancies complicated by TTTS who underwent FLS. Patients were grouped by pPPROM status, and further stratified to those continuing with expectant management, and outcomes were compared between groups...

INTRODUCTION: We investigated whether structured maternal lifestyle interventions based on Mediterranean diet or stress reduction influence fetal-infant neurodevelopment detected by detailed fetal neurosonography and Ages and Stages Questionnaires 3rd edition (ASQ) at 12months old. METHODS: This was a secondary analysis of a randomized clinical trial (2017-2020) including 1,221 singleton pregnancies at high-risk for small-for-gestational age. Participants were randomized into three groups at 19-23 weeks' gestation: Mediterranean diet intervention, stress reduction program or usual care...

INTRODUCTION: Congenital hydrocephalus often results in irreversible and severe damage to the brain despite postnatal interventions. The potential for prenatal intervention to mitigate these deleterious effects underscores the importance of a suitable animal model. We aimed assess the results of an ultrasound guided transuterine approach to replicate the BioGlue injection fetal hydrocephalus model. METHODS: Pregnant ewes were anesthetized at 95 days of gestation and BioGlue was injected into the fetal cisterna magna under ultrasound guidance through the uterus...

BACKGROUND: Fetal lower urinary tract obstruction (LUTO) is a rare congenital anomaly in which the bladder cannot empty properly. The clinical presentation is variable. On the severe end of the spectrum the amniotic fluid index can be sufficiently low resulting in fetal lung development that is incompatible with life outside the womb. The pressure in the urinary tract system can also result in severe damage to the kidney, resulting in renal failure in utero or in the first couple years of life...

INTRODUCTION: Chorioamniotic membrane separation (CMS) is a known complication after fetal spina bifida (fSB) repair. This study's goal was to analyze women's outcomes with open fSB repair and CMS (group A) compared to the ones without (group B) and to assess the influence of CMS size and patient management. METHODS: 194 women with open fSB repair at our center were included in this retrospective study. Outcomes of group A were compared to the ones of group B. Regression analysis was performed to assess risk factors for CMS...

Introduction Our aim was to develop and evaluate the performance of population-based sex-specific and unisex prescriptive fetal abdominal circumference growth charts in predicting small-for-gestational-age (SGA) birthweight, severe SGA (sSGA) birthweight and severe adverse perinatal outcomes (SAPO) in a low-risk population. Methods This is a post hoc analysis of the Dutch nationwide cluster-randomised IRIS study, encompassing ultrasound data of 7,704 low-risk women. IRIS prescriptive unisex and IRIS sex-specific abdominal circumference (AC) fetal growth charts were derived using quantile regression...

The beginning of the conflict in Ukraine has reminded Europeans the many and diverse consequences of armed conflicts. Indeed, the ever more sophisticated conflicts have led to the diffusion of numerous chemicals whose consequences spread even after the end of the war. We present through this paper a review of the consequences on pregnancies of the major conflicts that took place since the end of World War II. MEDLINE, Web of science, and Embase were screened for articles linking perinatal death or birth defects to wartime...

Introduction Our aim was to investigate the incidence, co-morbidities and outcomes of fetuses with an elevated middle cerebral artery peak systolic velocity MCA-PSV >1.5 multiples of median (MoM), despite normal hemoglobin (Hgb) levels on Fetal Blood Sampling (FBS). Methods Single centre observational retrospective cohort study of all fetuses undergoing FBS and MCA-PSV >1.5 MoM. Only those fetuses with no or mild anemia were included. Indications for Doppler assessment, associated anomalies and neonatal outcomes were collected...

INTRODUCTION: The aim of this systematic review and meta-analysis was to evaluate fetal cardiac function in fetuses of mothers with diabetes compared to those of mothers without diabetes using 2D-STE. METHODS: Embase, MEDLINE, and CENTRAL were searched for observational studies on 2D-STE fetal left and right ventricular global longitudinal strain and strain rate that included singleton, non-anomalous pregnancies complicated by pregestational or gestational diabetes mellitus compared to uncomplicated pregnancies...

INTRODUCTION: The aim of this study was, firstly, to investigate the difference in fetal atrioventricular conduction in patients with and without intrahepatic cholestasis of pregnancy (ICP) by measuring the fetal PR interval; secondly, to evaluate the altering effect of ursodeoxycholic acid (UDCA) treatment on the fetal PR interval in ICP patients. METHODS: The study consisted of 42 ICP patients and 48 healthy pregnant women. Fetal echocardiography was performed to measure the mechanical PR interval...

INTRODUCTION: Fetal aqueductal stenosis (AS) affects approximately 1:1,000 pregnancies. Obstruction of cerebral spinal fluid (CSF) circulation occurs at the aqueduct of Sylvius, leading to progressive hydrocephalus, often necessitating cesarean section (CS) with a classical uterine incision. The purpose of this study is to describe maternal outcomes associated with fetal aqueductal stenosis. METHODS: This study is conducted through the North American Fetal Therapy Network (NAFTNet)...

INTRODUCTION: To identify predictive values of the soluble fms-like tyrosine kinase / placental growth factor (sFlt-1/ PlGF) ratio and interleukin (IL)-6, assessed with a clinically available method in a large-volume biochemistry laboratory, in maternal blood, amniotic fluid, and umbilical cord blood for the presence of the placental lesions consistent with maternal vascular malperfusion (MVM) and acute histological chorioamnionitis (HCA), respectively. Methods of Study This retrospective study included 92 women with preterm labor with intact membranes (PTL) delivered within seven days of admission with gestational ages between 22+0 and 34+6 weeks...

INTRODUCTION: Immune checkpoint inhibitors (ICIs) are extensively used in present-day clinical practice for treating many types of cancers at different stages. To date, there is scarce data on the use of immunotherapy in pregnancy. Immune-related adverse events (irAE) are a typical consequence of this therapy miming autoimmune diseases. CASE PRESENTATION: A 35-year-old woman (G1P0) diagnosed with gastric carcinoma underwent neoadjuvant chemotherapy followed by surgery...

INTRODUCTION: Congenital microgastria (CM) is a rare condition due to early interruption of stomach development between the 4th and 8th week of gestation, leading to a small midline tubular stomach. Prenatal diagnosis of CM is a challenge with important implications. This study explores the value of biochemical amniotic fluid (AF) analysis and fetal magnetic resonance imaging (MRI) for the prenatal diagnosis of CM in case of non visible stomach on fetal ultrasound. CASE PRESENTATION: Four cases of CM were retrospectively investigated in terms of fetal ultrasound, MRI findings and biochemical AF analyses...