Screening for small for gestational age using third-trimester ultrasound markers: protocol for a systematic review and meta-analysis of screening test accuracy

DiscussionThis systematic review will determine the relevance of routine third-trimester ultrasound markers in the screening for FGR in low-risk or general population and their usefulness in standard pregnancy care. Additionally, this knowledge synthesis represents a step in the optimization of the discriminative ability of third-trimester ultrasound and predictive tools, allowing for targeted interventions aiming at the reduction of FGR complications and ultimately improving infants ’ health.Systematic review registrationThis protocol has been registered at PROSPERO: international prospective register of systematic reviews. The register number isCRD42018085564.
Source: Systematic Reviews - Category: International Medicine & Public Health Source Type: research

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by Judith S. Brand, Romy Gaillard, Jane West, Rosemary R. C. McEachan, John Wright, Ellis Voerman, Janine F. Felix, Kate Tilling, Deborah A. Lawlor BackgroundMaternal smoking during pregnancy is an established risk factor for low infant birth weight, but evidence on critical exposure windows and timing of fetal growth restriction is limited. Here we investigate the associations of maternal quitting, reducing, and continuing smoking during pregnancy with longitudinal fetal growth by triangulating evidence from 3 analytical approaches to strengthen causal inference. Methods and findingsWe analysed data from 8,621 European li...
Source: PLoS Medicine - Category: Internal Medicine Authors: Source Type: research
Intertwin discordance in fetal size at 11-13 weeks' gestation and pregnancy outcome. Ultrasound Obstet Gynecol. 2019 Nov 11;: Authors: Litwinska E, Syngelaki A, Cimpoca B, Sapantzoglou I, Nicolaides KH Abstract OBJECTIVES: To investigate the value of inter-twin discordance in fetal crown-rump length (CRL) at the 11-13 weeks scan in the prediction of adverse outcome in dichorionic (DC), monochorionic diamniotic (MCDA) and monochorionic monoamniotic (MCMA) twin pregnancies. METHODS: This was a retrospective analysis of prospectively collected data on twin pregnancies undergoing routin...
Source: The Ultrasound Review of Obstetrics and Gynecology - Category: Radiology Authors: Tags: Ultrasound Obstet Gynecol Source Type: research
CONCLUSION: Compared to normal, fetuses with TGA-IVS undergo a complex redistribution of flow during the second half of the pregnancy with higher global pulmonary flow, lower ductal flow (with a negative diastolic flow at the end of pregnancy), and a smaller foramen ovale. In addition, fetal cardiac hemodynamic anomalies observed at 28-32 weeks of gestation were associated to lower postnatal tcSO2 . These observations may provide a better understanding of a premature closure of the foramen ovale and postnatal hypoxia that are specific to the physiology in TGA-IVS. This article is protected by copyri...
Source: The Ultrasound Review of Obstetrics and Gynecology - Category: Radiology Authors: Tags: Ultrasound Obstet Gynecol Source Type: research
Abstract OBJECTIVE: To examine multiple of the median (MoM) levels of serum free β-hCG and PAPP-A in a large series of pregnancies with a vanishing twin, determine the association of these levels with the interval between embryonic death and blood sampling and develop a model that would allow incorporation of these metabolites in first-trimester combined screening for trisomies. METHODS: This was a retrospective study comparing maternal serum free β-hCG and PAPP-A levels at 11-13 weeks' gestation in 528 dichorionic pregnancies with vanishing twins, including 194 (36.7%) with an empty gestatio...
Source: The Ultrasound Review of Obstetrics and Gynecology - Category: Radiology Authors: Tags: Ultrasound Obstet Gynecol Source Type: research
Abstract Incomplete maternal vascular responses to pregnancy contribute to pregnancy complications including intrauterine growth restriction and preeclampsia. We aimed to characterize maternal vascular dysfunction in a murine model of fetal growth restriction as an approach toward identifying targetable pathways for improving pregnancy outcomes. We utilized a murine model of late-gestation hypoxia-induced intrauterine growth restriction that reduced E18.5 fetal weight by 34%. Contrary to our hypothesis, uterine artery blood flow as measured in vivo by Doppler ultrasound was increased in mice housed under hypobaric...
Source: Biology of Reproduction - Category: Reproduction Medicine Authors: Tags: Biol Reprod Source Type: research
Pregnant women with abdominal pain can pose a diagnostic dilemma due to the nonspecific nature of symptoms and the desire to avoid radiation to the conceptus. Many algorithms will suggest ultrasound (US) or Magnetic Resonance Imaging (MRI) as the first-line imaging choice in pregnant women with abdominal pain due to the lack of ionizing radiation. However, these studies can have limitations as well. Abdominopelvic MRI is susceptible to respiratory motion that could cause a study to be nondiagnostic (Zaitsev et al., 2015 [1]).
Source: Clinical Imaging - Category: Radiology Authors: Tags: Body Imaging Source Type: research
We present the case of a pregnant woman admitted for sudden and severe abdominal pain at 34 weeks gestation. Her previous medical history included endometriosis suspected by clinical symptoms and ultrasound. During cesarean section, performed by sustained fetal bradycardia, a large volume hemoperitoneum and multiple hemorrhagic foci in the posterior uterine wall were detected. Although rare, spontaneous hemoperitoneum may occur in pregnancy, especially in women with endometriosis. Thus, a prompt suspicion and expedite intervention are needed to improve maternal and fetal outcomes. PMID: 31703187 [PubMed - in process]
Source: Acta Medica Portuguesa - Category: General Medicine Tags: Acta Med Port Source Type: research
Ovarian reserve represents the number of available follicles/oocytes within ovaries and this can be assessed by measuring follicle stimulating hormone (FSH) levels, anti-M üllerian hormone (AMH) levels, and/or antral follicle count (AFC) determined by ultrasound [1]. AMH is produced in women by the granulosa cells of developing follicles and represents a marker of ovarian reserve that can be used in assisted reproduction and for prediction of menopausal age, probabil ity of natural conception, assessment of ovarian function after gonadotoxic treatment or diagnosis of polycystic ovarian syndrome [2], although its relia...
Source: Maturitas - Category: Primary Care Authors: Source Type: research
Purpose of review The implementation of palliative care at birth has led to a significant rise in the number of couples who choose to continue with pregnancies complicated by life-limiting malformations (LLMs). Prenatal counselling and appropriate antenatal/perinatal management in these cases are poorly studied and may pose significant challenges. The purpose of this review is to outline specific obstetric risks and to suggest management for mothers who choose to continue with pregnancies with the most common LLMs. Recent findings In pregnancies complicated by LLMs where parents opt for expectant management, clinician...
Source: Current Opinion in Obstetrics and Gynecology - Category: OBGYN Tags: WOMEN'S HEALTH: Edited by Joseph Aquilina Source Type: research
Authors: Elias KM, Berkowitz RS, Horowitz NS Abstract Gestational trophoblastic disease refers to a series of interrelated tumors arising from the placenta, including benign molar pregnancies as well as the malignant conditions termed gestational trophoblastic neoplasia (GTN). GTN most commonly follows a molar pregnancy but may develop after any gestation. The wide availability of first trimester ultrasound and serum human chorionic gonadotropin (hCG) measurement has changed the presentation of molar pregnancy in recent decades from a second trimester to a first trimester disease, such that most patients have few s...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research
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