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JOURNAL ARTICLE
Meredith A Atkinson, Eric B Jelin, Ahmet Baschat, Yair J Blumenfeld, Ramen H Chmait, Elizabeth O'Hare, Julie S Moldenhauer, Michael V Zaretsky, Russell S Miller, Rodrigo Ruano, Juan M Gonzalez, Anthony Johnson, W Andrew Mould, Jonathan M Davis, Daniel F Hanley, Amaris M Keiser, Mara Rosner, Jena L Miller
PURPOSE: Anhydramnios secondary to anuria before 22 weeks of gestational age and congenital bilateral renal agenesis before 26 weeks of gestational age are collectively referred to as early-pregnancy renal anhydramnios. Early-pregnancy renal anhydramnios occurs in at least 1 in 2000 pregnancies and is considered universally fatal when left untreated because of severe pulmonary hypoplasia precluding ex utero survival The Renal Anhydramnios Fetal Therapy (RAFT) trial is a nonrandomized, nonblinded, multicenter clinical trial designed to assess the efficacy, safety, and feasibility of amnioinfusions for patients with pregnancies complicated by early-pregnancy renal anhydramnios...
July 30, 2022: Clinical Therapeutics
#22
JOURNAL ARTICLE
Michael Engelstad, Brandon Tenney, Eugene Brooks, Matthew Thimm, Jeanne S Sheffield, Ahmet Baschat, Claire E Knezevic
BACKGROUND: Umbilical cord blood gas testing is a key component of objective pre- and perinatal evaluation of fetal acid base status to determine presence of intrapartum asphyxia and risk of neonatal encephalopathy. Heparinized cord blood is more likely to form small clots than other blood sources, which can interfere with, or preclude, sample analysis. Cord blood samples are irreplaceable and cannot be recollected, thereby compromising clinical decision-making when analysis is not possible...
June 16, 2022: Journal of Applied Laboratory Medicine
#23
JOURNAL ARTICLE
Shelby R Sferra, Jena L Miller, Magdalena Sanz Cortes, Michael A Belfort, Rogelio Cruz-Martínez, Shaun M Kunisaki, Ahmet A Baschat
BACKGROUND: Fetoscopic endoluminal tracheal occlusion (FETO) was recently shown to improve postnatal survival in a multicenter, randomized controlled trial of infants with severe congenital diaphragmatic hernia (CDH). However, the external validity of this study remains unclear given a lack of standardization in postnatal management approaches. The purpose of this study was to evaluate the impact of an integrated prenatal and postnatal care setting on survival outcomes in severe CDH after FETO...
May 19, 2022: Journal of Pediatric Surgery
#24
JOURNAL ARTICLE
Ahmet A Baschat, Sean B Blackwell, Debnath Chatterjee, James J Cummings, Stephen P Emery, Shinjiro Hirose, Lisa M Hollier, Anthony Johnson, Sarah J Kilpatrick, Francois I Luks, M Kathryn Menard, Lawrence B McCullough, Julie S Moldenhauer, Anita J Moon-Grady, George B Mychaliska, Michael Narvey, Mary E Norton, Mark D Rollins, Eric D Skarsgard, KuoJen Tsao, Barbara B Warner, Abigail Wilpers, Greg Ryan
Fetal therapies undertaken to improve fetal outcome or to optimize transition to neonate life often entail some level of maternal, fetal, or neonatal risk. A fetal therapy center needs access to resources to carry out such therapies and to manage maternal, fetal, and neonatal complications that might arise, either related to the therapy per se or as part of the underlying fetal or maternal condition. Accordingly, a fetal therapy center requires a dedicated operational infrastructure and necessary resources to allow for appropriate oversight and monitoring of clinical performance and to facilitate multidisciplinary collaboration between the relevant specialties...
June 1, 2022: Obstetrics and Gynecology
#25
REVIEW
Ahmet A Baschat, Jena L Miller
Twin anemia polycythemia sequence (TAPS) is a consequence of unequal sharing of red blood cells between monochorionic twins resulting in anemia in the donor and polycythemia in the recipient twin. Prenatally TAPS can occur spontaneously or complicate incomplete laser surgery for twin transfusion syndrome. While there may be clinical overlap with twin transfusion syndrome or selective fetal growth restriction, diagnosis relies on Doppler measurement of middle cerebral artery peak systolic velocities. Significantly discordant velocities are diagnostic, while severity staging is based on signs of cardiovascular compromise...
March 30, 2022: Best Practice & Research. Clinical Obstetrics & Gynaecology
#26
REVIEW
Ahmet A Baschat, Henry L Galan, Wesley Lee, Greggory R DeVore, Giancarlo Mari, John Hobbins, Anthony Vintzileos, Lawrence D Platt, Frank A Manning
Growth-restricted fetuses are at risk of hypoxemia, acidemia, and stillbirth because of progressive placental dysfunction. Current fetal well-being, neonatal risks following delivery, and the anticipated rate of fetal deterioration are the major management considerations in fetal growth restriction. Surveillance has to quantify the fetal risks accurately to determine the delivery threshold and identify the testing frequency most likely to capture future deterioration and prevent stillbirth. From the second trimester onward, the biophysical profile score correlates over 90% with the current fetal pH, and a normal score predicts a pH >7...
April 2022: American Journal of Obstetrics and Gynecology
#27
JOURNAL ARTICLE
Ahmet A Baschat, Jena L Miller, Shaun M Kunisaki
No abstract text is available yet for this article.
November 2021: Journal of Pediatrics
#28
JOURNAL ARTICLE
Jena L Miller, Mari L Groves, Edward S Ahn, David J Berman, Jamie D Murphy, Mara K Rosner, Denise Wolfson, Eric B Jelin, Sarah A Korth, Amaris M Keiser, Melissa Laurie, Sarah E Millard, Aylin Tekes, Ahmet A Baschat
INTRODUCTION: Prenatal closure of open spina bifida via open fetal surgery improves neurologic outcomes for infants in selected pregnancies. Fetoscopic techniques that are minimally invasive to the uterus aim to provide equivalent fetal benefits while minimizing maternal morbidities, but the optimal technique is undetermined. We describe the development, evolution, and feasibility of the laparotomy-assisted 2-port fetoscopic technique for prenatal closure of fetal spina bifida in a newly established program...
2021: Fetal Diagnosis and Therapy
#29
JOURNAL ARTICLE
Lindsay S Cahill, Grace V Mercer, Dakshita Jagota, Anjana Ravi Chandran, Natasha Milligan, Shiri Shinar, Clare L Whitehead, Sebastian R Hobson, Lena Serghides, W Tony Parks, Christopher K Macgowan, John C Kingdom, John G Sled, Ahmet A Baschat
OBJECTIVES: To determine the relationship between blood flow in the fetal descending aorta and discordant umbilical arteries (UAs). METHODS: Pulsed wave Doppler of both UAs and the descending aorta was performed at 4-weekly intervals between 14 and 40 weeks of gestation in 209 pregnant women. In datasets with discordant UAs, a linear mixed effects model was used to determine the categorical relationship between the UA pulsatility index (PI) (high, low and average) and the descending aorta PI...
July 6, 2021: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
#30
JOURNAL ARTICLE
Magdalena Sanz Cortes, Ramen H Chmait, Denise A Lapa, Michael A Belfort, Elena Carreras, Jena L Miller, Robert Brawura Biskupski Samaha, Gerardo Sepulveda Gonzalez, Yuval Gielchinsky, Masami Yamamoto, Nicola Persico, Marta Santorum, Lucas Otaño, Ermos Nicolaou, Yoav Yinon, Fernanda Faig-Leite, Reynaldo Brandt, William Whitehead, Nerea Maiz, Ahmet Baschat, Przemyslaw Kosinski, Adriana Nieto-Sanjuanero, Jason Chu, Amir Kershenovich, Kypros H Nicolaides
BACKGROUND: The multicenter randomized controlled trial Management of Myelomeningocele Study demonstrated that prenatal repair of open spina bifida by hysterotomy, compared with postnatal repair, decreases the need for ventriculoperitoneal shunting and increases the chances of independent ambulation. However, the hysterotomy approach is associated with risks that are inherent to the uterine incision. Fetal surgeons from around the world embarked on fetoscopic open spina bifida repair aiming to reduce maternal and fetal/neonatal risks while preserving the neurologic benefits of in utero surgery to the child...
December 2021: American Journal of Obstetrics and Gynecology
#31
JOURNAL ARTICLE
Daniel Lorber Rolnik, Mario Henrique Burlacchini de Carvalho, Guilherme Antonio Rago Lobo, Stefan Verlohren, Liona Poon, Ahmet Baschat, Jon Hyett, Basky Thilaganathan, Emmanuel Bujold, Fabricio da Silva Costa
No abstract text is available yet for this article.
April 2021: Revista Brasileira de Ginecologia e Obstetrícia
#32
JOURNAL ARTICLE
Lindsay S Cahill, Greg Stortz, Anjana Ravi Chandran, Natasha Milligan, Shiri Shinar, Clare L Whitehead, Sebastian R Hobson, Viji Ayyathurai, Anum Rahman, Rojan Saghian, Karl J Jobst, Cyrethia McShane, Dana Block-Abraham, Viola Seravalli, Melissa Laurie, Sarah Millard, Cassandra Delp, Denise Wolfson, Ahmet A Baschat, Kellie E Murphy, Lena Serghides, Eric Morgen, Christopher K Macgowan, W Tony Parks, John C Kingdom, John G Sled
BACKGROUND: The umbilical artery (UA) Doppler pulsatility index is used clinically to detect elevated feto-placental vascular resistance. However, this metric is confounded by variation in fetal cardiac function and is only moderately predictive of placental pathology. Our group developed a novel ultrasound methodology that measures wave reflections in the UA, thereby isolating a component of the Doppler signal that is specific to the placenta. The present study examined whether wave reflections in the UA are predictive of placental vascular pathology...
April 7, 2021: EBioMedicine
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JOURNAL ARTICLE
Nir Melamed, Ahmet Baschat, Yoav Yinon, Apostolos Athanasiadis, Federico Mecacci, Francesc Figueras, Vincenzo Berghella, Amala Nazareth, Muna Tahlak, H David McIntyre, Fabrício Da Silva Costa, Anne B Kihara, Eran Hadar, Fionnuala McAuliffe, Mark Hanson, Ronald C Ma, Rachel Gooden, Eyal Sheiner, Anil Kapur, Hema Divakar, Diogo Ayres-de-Campos, Liran Hiersch, Liona C Poon, John Kingdom, Roberto Romero, Moshe Hod
Fetal growth restriction (FGR) is defined as the failure of the fetus to meet its growth potential due to a pathological factor, most commonly placental dysfunction. Worldwide, FGR is a leading cause of stillbirth, neonatal mortality, and short- and long-term morbidity. Ongoing advances in clinical care, especially in definitions, diagnosis, and management of FGR, require efforts to effectively translate these changes to the wide range of obstetric care providers. This article highlights agreements based on current research in the diagnosis and management of FGR, and the areas that need more research to provide further clarification of recommendations...
March 2021: International Journal of Gynaecology and Obstetrics
#34
JOURNAL ARTICLE
Dakshita Jagota, Hannah George, Melissa Walker, Anjana Ravi Chandran, Natasha Milligan, Shiri Shinar, Clare L Whitehead, Sebastian R Hobson, Lena Serghides, W Tony Parks, Ahmet A Baschat, Christopher K Macgowan, John G Sled, John C Kingdom, Lindsay S Cahill
BACKGROUND: Fetal sex is known to affect pregnancy outcomes. In current clinical practice, monitoring of fetal well-being is based on Doppler ultrasound measurements of major placental and fetal vessels. The objective of this study was to investigate the effect of fetal sex on Doppler parameters throughout gestation in healthy pregnancy. METHODS: A prospective study was conducted in 240 pregnant women with ultrasound examinations at a 4-weekly interval between 12 and 38 weeks of gestation...
March 10, 2021: Biology of Sex Differences
#35
JOURNAL ARTICLE
Leah Paranavitana, Melissa Walker, Anjana Ravi Chandran, Natasha Milligan, Shiri Shinar, Clare L Whitehead, Sebastian R Hobson, Lena Serghides, W Tony Parks, Ahmet A Baschat, Christopher K Macgowan, John G Sled, John C Kingdom, Lindsay S Cahill
BACKGROUND: There is growing evidence of sex differences in placental vascular development. The objective of this study was to investigate the effect of fetal sex on uterine artery pulsatility index (PI) throughout gestation in a cohort of normal and complicated pregnancies. METHODS: A prospective longitudinal study was conducted in 240 pregnant women. Pulsed wave Doppler ultrasound of the proximal uterine arteries was performed at a 4-weekly interval between 14 and 40 weeks of gestation...
February 2, 2021: Biology of Sex Differences
#36
JOURNAL ARTICLE
Lindsay S Cahill, Shiri Shinar, Clare L Whitehead, Sebastian R Hobson, Greg Stortz, Viji Ayyathurai, Anjana Ravi Chandran, Anum Rahman, John C Kingdom, Ahmet Baschat, Kellie E Murphy, Lena Serghides, Christopher K Macgowan, John G Sled
BACKGROUND: Maternally administered corticosteroids are routinely used to accelerate fetal lung maturation in pregnancies at risk of early preterm delivery. Although, among the subgroup with growth restriction, a majority show a temporary improvement in umbilical artery Doppler waveforms that may be sustained up to 7 days, a minority will acutely decompensate in response to corticosteroids in association with deteriorating umbilical and fetal Doppler waveforms. The basis for such acute Doppler changes is presently unknown...
January 2021: American journal of obstetrics & gynecology MFM
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JOURNAL ARTICLE
John Allotey, Kym Ie Snell, Melanie Smuk, Richard Hooper, Claire L Chan, Asif Ahmed, Lucy C Chappell, Peter von Dadelszen, Julie Dodds, Marcus Green, Louise Kenny, Asma Khalil, Khalid S Khan, Ben W Mol, Jenny Myers, Lucilla Poston, Basky Thilaganathan, Anne C Staff, Gordon Cs Smith, Wessel Ganzevoort, Hannele Laivuori, Anthony O Odibo, Javier A Ramírez, John Kingdom, George Daskalakis, Diane Farrar, Ahmet A Baschat, Paul T Seed, Federico Prefumo, Fabricio da Silva Costa, Henk Groen, Francois Audibert, Jacques Masse, Ragnhild B Skråstad, Kjell Å Salvesen, Camilla Haavaldsen, Chie Nagata, Alice R Rumbold, Seppo Heinonen, Lisa M Askie, Luc Jm Smits, Christina A Vinter, Per M Magnus, Kajantie Eero, Pia M Villa, Anne K Jenum, Louise B Andersen, Jane E Norman, Akihide Ohkuchi, Anne Eskild, Sohinee Bhattacharya, Fionnuala M McAuliffe, Alberto Galindo, Ignacio Herraiz, Lionel Carbillon, Kerstin Klipstein-Grobusch, SeonAe Yeo, Helena J Teede, Joyce L Browne, Karel Gm Moons, Richard D Riley, Shakila Thangaratinam
BACKGROUND: Pre-eclampsia is a leading cause of maternal and perinatal mortality and morbidity. Early identification of women at risk is needed to plan management. OBJECTIVES: To assess the performance of existing pre-eclampsia prediction models and to develop and validate models for pre-eclampsia using individual participant data meta-analysis. We also estimated the prognostic value of individual markers. DESIGN: This was an individual participant data meta-analysis of cohort studies...
December 2020: Health Technology Assessment: HTA
#38
JOURNAL ARTICLE
Kym I E Snell, John Allotey, Melanie Smuk, Richard Hooper, Claire Chan, Asif Ahmed, Lucy C Chappell, Peter Von Dadelszen, Marcus Green, Louise Kenny, Asma Khalil, Khalid S Khan, Ben W Mol, Jenny Myers, Lucilla Poston, Basky Thilaganathan, Anne C Staff, Gordon C S Smith, Wessel Ganzevoort, Hannele Laivuori, Anthony O Odibo, Javier Arenas Ramírez, John Kingdom, George Daskalakis, Diane Farrar, Ahmet A Baschat, Paul T Seed, Federico Prefumo, Fabricio da Silva Costa, Henk Groen, Francois Audibert, Jacques Masse, Ragnhild B Skråstad, Kjell Å Salvesen, Camilla Haavaldsen, Chie Nagata, Alice R Rumbold, Seppo Heinonen, Lisa M Askie, Luc J M Smits, Christina A Vinter, Per Magnus, Kajantie Eero, Pia M Villa, Anne K Jenum, Louise B Andersen, Jane E Norman, Akihide Ohkuchi, Anne Eskild, Sohinee Bhattacharya, Fionnuala M McAuliffe, Alberto Galindo, Ignacio Herraiz, Lionel Carbillon, Kerstin Klipstein-Grobusch, Seon Ae Yeo, Joyce L Browne, Karel G M Moons, Richard D Riley, Shakila Thangaratinam
BACKGROUND: Pre-eclampsia is a leading cause of maternal and perinatal mortality and morbidity. Early identification of women at risk during pregnancy is required to plan management. Although there are many published prediction models for pre-eclampsia, few have been validated in external data. Our objective was to externally validate published prediction models for pre-eclampsia using individual participant data (IPD) from UK studies, to evaluate whether any of the models can accurately predict the condition when used within the UK healthcare setting...
November 2, 2020: BMC Medicine
#39
JOURNAL ARTICLE
Greg Stortz, Lindsay S Cahill, Anjana Ravi Chandran, Ahmet Baschat, John G Sled, Christopher K Macgowan
Elevated umbilical artery pulsatility is a widely used biomarker for placental pathology leading to intra-uterine growth restriction and, in severe cases, still-birth. It has been hypothesized that placental pathology modifies umbilical artery pulsatility by altering the degree to which the pulse pressure wave, which originates from the fetal heart, is reflected from the placental vasculature to interfere with the incident wave. Here we present a method for estimating the reflected pulse wave in the umbilical artery of human fetuses using asynchronously acquired Doppler ultrasound measurements from the two ends of the umbilical cord...
June 23, 2020: IEEE Transactions on Medical Imaging
#40
JOURNAL ARTICLE
Kristin C Darwin, Jerome J Federspiel, Brittany L Schuh, Ahmet A Baschat, Arthur J Vaught
OBJECTIVE: The aim of the study is to compare maternal and neonatal outcomes among patients who are normotensive, hypertensive by Stage I American College of Cardiology-American Heart Association (ACC-AHA) criteria, and hypertensive by American College of Obstetricians and Gynecologists (ACOG) criteria. STUDY DESIGN: Secondary analysis of a prospective first trimester cohort study between 2007 and 2010 at three institutions in Baltimore, MD, was conducted. Blood pressure at 11 to 14 weeks' gestation was classified as (1) normotensive (systolic blood pressure [SBP] <130 mm Hg and diastolic blood pressure [DBP] <80 mm Hg); (2) hypertensive by Stage I ACC-AHA criteria (SBP 130-139 mm Hg or DBP 80-89 mm Hg); or (3) hypertensive by ACOG criteria (SBP ≥140 mm Hg or DBP ≥90 mm Hg)...
August 2021: American Journal of Perinatology
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