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Ahmet baschat

Nickie Andescavage, Sonia Dahdouh, Marni Jacobs, Sayali Yewale, Dorothy Bulas, Sara Iqbal, Ahmet Baschat, Catherine Limperopoulos
BACKGROUND: The objective of this study was to characterize structural changes in the healthy in vivo placenta by applying morphometric and textural analysis using magnetic resonance imaging (MRI), and to explore features that may be able to distinguish placental insufficiency in fetal growth restriction (FGR). METHODS: Women with healthy pregnancies or pregnancies complicated by FGR underwent MRI between 20 and 40 weeks gestation. Measures of placental morphometry (volume, elongation, depth) and digital texture (voxel-wise geometric and signal-intensity analysis) were calculated from T2W MR images...
January 25, 2019: Pediatric Research
Lindsay S Cahill, Yu-Qing Zhou, Johnathan Hoggarth, Lisa X Yu, Anum Rahman, Greg Stortz, Clare L Whitehead, Ahmet Baschat, John C Kingdom, Christopher K Macgowan, Lena Serghides, John G Sled
Current methods to detect placental vascular pathologies that monitor Doppler ultrasound changes in umbilical artery (UA) pulsatility have only moderate diagnostic utility, particularly in late gestation. In fetal mice, we recently demonstrated that reflected pressure waves propagate counter to the direction of flow in the UA, and proposed the measurement of these reflections as a means to detect abnormalities in the placental circulation. In the present study, we used this approach in combination with micro-computed tomography to investigate the relationship between altered placental vascular architecture and changes in UA wave reflection metrics...
January 11, 2019: American Journal of Physiology. Heart and Circulatory Physiology
Asma Khalil, James M N Duffy, Helen Perry, Wessel Ganzevoort, Keith Reed, Ahmet A Baschat, Jan Deprest, Eduardo Gratacos, Kurt Hecher, Liesbeth Lewi, Enrico Lopriore, Dick Oepkes, Aris Papageorghiou, Sanne J Gordijn
BACKGROUND: Selective fetal growth restriction in monochorionic twin pregnancies is associated with an increased risk of perinatal mortality and morbidity and represents a clinical dilemma. Interventions include expectant management with early preterm delivery if there are signs of fetal compromise, selective termination of the compromised twin, fetoscopic laser coagulation of the communicating placental vessels or termination of the whole pregnancy. Previous studies evaluating interventions have reported many different outcomes and outcome measures...
January 9, 2019: Trials
Rosemary Townsend, Filomena Sileo, Linden Stocker, Hafsah Kumbay, Patricia Healy, Sanne Gordijn, Wessel Ganzevoort, Irene Beune, Ahmet Baschat, Louise Kenny, Frank Bloomfield, Mandy Daly, Declan Devane, Aris Papageorghiou, Asma Khalil
BACKGROUND: Fetal growth restriction (FGR) contributes to stillbirth, prematurity, neonatal and infant mortality and morbidity. Although FGR is well known to be associated with adverse outcomes for the mother and offspring, effective interventions for the prevention of FGR are yet to be established. The majority of pregnancies complicated by FGR are not detected antenatally and there are limited effective interventions for established FGR. Trials reporting interventions for the prevention and treatment of FGR may be limited by heterogeneity in the underlying pathophysiology...
December 6, 2018: Ultrasound in Obstetrics & Gynecology
Jena L Miller, Mari L Groves, Ahmet A Baschat
INTRODUCTION: Spina bifida is the most common non-lethal congenital birth defect of the central nervous system that causes chronic disability due to the combined effects of local nerve damage and the sequelae of non-communicating hydrocephalus. This abnormality can be identified early in gestation and the damage can be progressive over the course of pregnancy. Advances in fetal treatment have made minimally invasive prenatal surgery a realistic consideration for spina bifida in order to improve the outcome for children affected this condition...
November 27, 2018: Minerva Ginecologica
Wessel Ganzevoort, Baskaran Thilaganathan, Ahmet Baschat, Sanne Gordijn
No abstract text is available yet for this article.
October 10, 2018: American Journal of Obstetrics and Gynecology
Viola Seravalli, Jena L Miller, Dana Block-Abraham, Cyrethia McShane, Sarah Millard, Ahmet Baschat
INTRODUCTION: To evaluate if the volume-corrected renal artery pulsatility index (vcRA-PI) is more closely related to the amniotic fluid level than the uncorrected or the gestational age (GA)-adjusted RA-PI. METHODS: RA-PI and kidney volume were measured in low- and high-risk pregnancies at 17-38 weeks. Fetal anomalies associated with nonrenal causes of abnormal amniotic fluid volume were excluded. The vcRA-PI was calculated by dividing the RA-PI by the renal volume...
October 9, 2018: Fetal Diagnosis and Therapy
Maria Flavia Christino Luiz, Ahmet A Baschat, Cassandra Delp, Jena L Miller
Fetomaternal hemorrhage (FMH) is a rare condition that requires early diagnosis and appropriate treatment due to its potentially severe consequences. We report a case of massive FMH presenting as decreased fetal movement, fetal hydrops, and intracranial hemorrhage at 24 weeks. Treatment considerations were made and amniocentesis, fetal blood sampling, and fetal blood transfusion via cordocentesis were performed. Recurrent FMH required subsequent fetal transfusion 2 days later. Surveillance was continued twice weekly until the patient delivered a viable infant at 38 weeks after spontaneous labor...
September 10, 2018: Fetal Diagnosis and Therapy
Patricia Healy, Sanne Gordijn, Wessel Ganzevoort, Irene Beune, Ahmet Baschat, Asma Khalil, Louise Kenny, Frank Bloomfield, Mandy Daly, Aris Papageorghiou, Declan Devane
BACKGROUND: Foetal growth restriction (FGR) refers to a foetus that does not reach its genetically predetermined growth potential. It is well recognised that growth-restricted foetuses are at increased risk of stillbirth, foetal compromise, early neonatal death and neonatal morbidity. Later in life, they are prone to health problems, including increased risk of cardiovascular diseases and neurodevelopmental disorders. Interventions for preventing and treating FGR have been studied in many trials, but evidence is often difficult to synthesise and compare because of differences in the selection and definition of outcomes...
August 22, 2018: Trials
Asma Khalil, Sanne J Gordijn, Irene M Beune, Klaske Wynia, Wessel Ganzevoort, Francesc Figueras, John Kingdom, Neil Marlow, Aris T Papageorghiou, Neil Sebire, Jennifer Zeitlin, Ahmet A Baschat
OBJECTIVE: To achieve consensus on the minimum reporting set of study variables for fetal growth restriction (FGR) research studies. Determination of a list of variables considered essential to be reported independent of a specific hypothesis is likely to improve the study quality by inclusion of essential end-points, enhancing the consistency among studies and minimizing potential confounding. This in turn can accelerate generation of generalizable knowledge either by standardization of individual study designs or by enhancing the possibility of individual patient data meta-analysis merging a number of uniformly structured datasets...
August 19, 2018: Ultrasound in Obstetrics & Gynecology
Jena L Miller, Dana M Block-Abraham, Karin J Blakemore, Ahmet A Baschat
INTRODUCTION: The insertion site of the fetoscope for laser occlusion (FLOC) treatment of twin-twin transfusion syndrome (TTTS) determines the likelihood of treatment success. We assessed a standardized preoperative ultrasound approach for its ability to identify critical landmarks for successful FLOC. METHODS: Three surgeons independently performed preoperative ultrasound and deduced the likely orientation of the intertwin membrane (ITM) and vascular equator (VE) based on the sites of the cord insertion, the lie of the donor, and the size discordance between twins...
June 6, 2018: Fetal Diagnosis and Therapy
Edward Kim, Maged Costantine, Ahmet A Baschat, Irina Burd
No abstract text is available yet for this article.
2018: Frontiers in Pharmacology
A A Baschat, E S Ahn, J Murphy, J L Miller
Fetoscopic myelomeningocele (MMC) repair is performed using intrauterine carbon dioxide (CO2 ) insufflation. Sheep experiments have shown that CO2 insufflation is associated with significant fetal acidemia; however, corresponding data for human pregnancy are not available. We performed umbilical venous cord blood sampling in three patients during fetoscopic MMC repair at 25 + 1, 25 + 3 and 24 + 0 weeks' gestation, respectively. Fetal venous pH at the beginning of CO2 insufflation was 7.36, 7.46 and 7...
September 2018: Ultrasound in Obstetrics & Gynecology
Ahmet A Baschat
A uniform approach to management of fetal growth restriction (FGR) improves outcome, prevents stillbirth, and allows appropriately timed delivery. An estimated fetal weight below the tenth percentile with coexisting abnormal umbilical artery (UA), middle cerebral artery (MCA), or cerebroplacental ratio Doppler index best identifies the small fetus requiring surveillance. Placental perfusion defects are more common earlier in gestation; accordingly, early-onset (≤32 weeks of gestation) and late-onset (>32 weeks) FGR differ in clinical phenotype...
May 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
Elizabeth Snyder, Ahmet Baschat, Thierry A G M Huisman, Aylin Tekes
OBJECTIVE: The purpose of this article is to present illustrative cases highlighting the value of fetal MRI as a problem-solving tool in evaluating anomalies of the fetal chest, abdomen, and pelvis that are being evaluated for fetal therapy. CONCLUSION: Fetal MRI is an increasingly valuable noninvasive tool for evaluating fetal anomalies in the age of fetal therapy. Although ultrasound remains the primary diagnostic imaging modality, MRI can provide additional information to assist parental counseling and patient care...
May 2018: AJR. American Journal of Roentgenology
Shai Shrot, Clark T Johnson, W Christopher Golden, Ahmet A Baschat, Janine E Bullard, Aylin Tekes, Andrea Poretti, Emily Dunn, Thierry A G M Huisman
BACKGROUND AND PURPOSE: Persistent hyperextension of the fetal craniocervical junction or neck is one of several fetal positions commonly observed on prenatal imaging. Underlying fetal structural etiologies such as fetal neck masses and iniencephaly can be detected as causes of hyperextension. Caesarean delivery is considered in cases of vaginal delivery or obstructed labor for fear of cervical spinal cord injury. In this case series, we describe the prenatal magnetic resonance imaging (MRI) findings and their potential role in obstetric management and discuss postnatal outcomes in fetuses demonstrating prenatal imaging findings of persistent extreme hyperextension of the neck...
May 2018: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
Jeremy Sugarman, Jean Anderson, Ahmet A Baschat, Jaime Herrera Beutler, Jessica L Bienstock, Timothy E Bunchman, Niraj M Desai, Elena Gates, Aviva Goldberg, Paul C Grimm, Leslie Meltzer Henry, Eric B Jelin, Emily Johnson, Christine B Hertenstein, Anna C Mastroianni, Mark R Mercurio, Alicia Neu, Lawrence M Nogee, William J Polzin, Steven J Ralston, Ronald M Ramus, Megan Kasimatis Singleton, Michael J G Somers, Karen C Wang, Renee Boss
Congenital bilateral renal agenesis has been considered a uniformly fatal condition. However, the report of using serial amnioinfusions followed by the live birth in 2012 and ongoing survival of a child with bilateral renal agenesis has generated hope, but also considerable controversy over an array of complex clinical and ethical concerns. To assess the ethical concerns associated with using serial amnioinfusions for bilateral renal agenesis, we assembled a multidisciplinary group to map the ethical issues relevant to this novel intervention...
January 2018: Obstetrics and Gynecology
Viola Seravalli, Eric B Jelin, Jena L Miller, Aylin Tekes, Luca Vricella, Ahmet A Baschat
Fetoscopic endotracheal occlusion (FETO) is a prenatal treatment that may increase survival in severe congenital diaphragmatic hernia (CDH). In the USA, FETO is offered for isolated severe left-sided CDH in the context of an FDA-approved feasibility study. FETO in non-isolated cases of severe CDH is only performed with a compassionate use exemption from US regulatory bodies. Anomalies frequently associated with CDH include congenital cystic lesions of the lung and cardiac defects. We describe two cases of non-isolated severe left-sided CDH that underwent prenatal FETO, survived after birth and underwent postnatal surgical repair...
October 2017: Prenatal Diagnosis
Asma Khalil, Helen Perry, James Duffy, Keith Reed, Ahmet Baschat, Jan Deprest, Kurt Hecher, Liesbeth Lewi, Enrico Lopriore, Dick Oepkes
BACKGROUND: Twin-Twin Transfusion Syndrome (TTTS) is associated with an increased risk of perinatal mortality and morbidity. Several treatment interventions have been described for TTTS, including fetoscopic laser surgery, amnioreduction, septostomy, expectant management, and pregnancy termination. Over the last decade, fetoscopic laser surgery has become the primary treatment. The literature to date reports on many different outcomes, making it difficult to compare results or combine data from individual studies, limiting the value of research to guide clinical practice...
July 14, 2017: Trials
Viola Seravalli, Dana Block-Abraham, Cyrethia McShane, Sarah Millard, Ahmet Baschat, Jena Miller
OBJECTIVE: To study fetal aortic isthmus (AoI) shunt dynamics in monochorionic (MC) twins. METHODS: Normal and complicated MC pregnancies were prospectively enrolled. The relationship of isthmus flow index (IFI) with Doppler parameters of umbilical artery (UA), descending aorta, middle cerebral artery, and ductus venosus and with left and right ventricular cardiac output and stroke volume was studied. RESULTS: The IFI was obtained in 180 examinations from 48 pregnancies (24 twin-twin transfusion syndrome, TTTS; 4 selective intrauterine growth restriction, sIUGR; 12 TTTS + sIUGR; and 8 uncomplicated)...
September 2017: Prenatal Diagnosis
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