How to provide fertility treatment during COVID-19 pandemic
The objective of this review is to summarize how this pandemic has affected the activity of a Reproductive Medicine Center, which established a series of measures in parallel with governments decisions and scientific societies. Recent findings The control measures adopted for restarting the healthcare activity should be equitable and inclusive. Moreover, this pandemic has implied changes in treatments and strategies to be alert regarding the daily changing information. Finally, for ensuring a safe practice both for patients and staff, it is important to detect asymptomatic patients, so Reproductive Medicine centers ...
Source: Current Opinion in Obstetrics and Gynecology - May 1, 2021 Category: OBGYN Tags: FERTILITY, IVF AND REPRODUCTIVE GENETICS: Edited by Emre Seli and Juan A. Garcia Velasco Source Type: research

Editorial: Assisted reproductive technology (ART) in a changing world
No abstract available (Source: Current Opinion in Obstetrics and Gynecology)
Source: Current Opinion in Obstetrics and Gynecology - May 1, 2021 Category: OBGYN Tags: FERTILITY, IVF AND REPRODUCTIVE GENETICS: Edited by Emre Seli and Juan A. Garcia Velasco Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Obstetrics and Gynecology)
Source: Current Opinion in Obstetrics and Gynecology - May 1, 2021 Category: OBGYN Tags: EDITORIAL INTRODUCTIONS Source Type: research

The role of chromosomal microarray and exome sequencing in prenatal diagnosis
Purpose of review Advancements in technologies have revolutionized prenatal diagnosis. Chromosomal microarray analysis (CMA) became a proven method and was implemented to detect gains and losses of DNA and absence of heterozygosity across the genome. Next-generation sequencing technologies have brought opportunities and challenges to genetic testing. Exome sequencing detects single-nucleotide variants (SNVs) across the exome and its prenatal application is an emerging field. We reviewed the literature to define the role of CMA and exome sequencing in prenatal diagnosis. Recent finding The application of exome se...
Source: Current Opinion in Obstetrics and Gynecology - March 10, 2021 Category: OBGYN Tags: PRENATAL DIAGNOSIS: Edited by Jane Chueh Source Type: research

Is it time for prenatal chromosomal-microarray analysis to all women? A review of the diagnostic yield in structurally normal fetuses
Purpose of review Chromosomal-microarray analysis (CMA) is the first-tier test in pregnancies with structural malformations. Accumulating data show that pathogenic copy number variants (CNVs) can also be identified in structurally normal fetuses. We set out to summarize the published data on the diagnostic yield of CMA in structurally normal fetuses. Recent findings Six studies summarize a total of 29,612 prenatal CMAs performed in structurally normal fetuses. The incidence of highly penetrant pathogenic/likely pathogenic CNVs is 0.4–2.5%. Variability was demonstrated in the timing of CMA testing and type of C...
Source: Current Opinion in Obstetrics and Gynecology - March 10, 2021 Category: OBGYN Tags: PRENATAL DIAGNOSIS: Edited by Jane Chueh Source Type: research

Brain views that benefit from three-dimensional ultrasound
Purpose of review Fetal central nervous system malformations are among the most common congenital anomalies. Whereas simple axial views are sufficient for basic fetal brain examination, other important views are essential for a more detailed examination, which are sometimes challenging to obtain. Three-dimensional ultrasound can be helpful in obtaining standardized and reproducible images of many difficult fetal brain views. The aim of the present review is to explore the most recent evidence on the utility and technique of three-dimensional ultrasound in the examination of the fetal brain, with particular emphasis on ...
Source: Current Opinion in Obstetrics and Gynecology - March 10, 2021 Category: OBGYN Tags: PRENATAL DIAGNOSIS: Edited by Jane Chueh Source Type: research

Improving uptake of perinatal autopsy
Purpose of review Uptake of perinatal autopsy has declined in the West over the past 30 years, largely because of reduced parental acceptance of a traditional invasive autopsy. Several studies have recently investigated the decline to identify the key factors and how they may be mitigated. Recent findings Three main themes were identified that have been found to improve uptake of perinatal autopsy: improved communication, in particular ensuring the consent process was conducted as a conversation with time spent talking through the procedure and allowing time for questions; health professional training to ensur...
Source: Current Opinion in Obstetrics and Gynecology - March 10, 2021 Category: OBGYN Tags: PRENATAL DIAGNOSIS: Edited by Jane Chueh Source Type: research

Selection of candidates for foetal intervention in congenital lower urinary tract obstruction
Purpose of review Congenital lower urinary tract obstruction (LUTO) is a rare group of conditions characterized by high perinatal morbidity and mortality if associated with oligohydramnios or anhydramnios in early pregnancy. Although foetal intervention has the potential to improve perinatal survival in a select group of foetuses with LUTO, the actual selection of those candidates most likely to benefit from intervention remains challenging. Recent findings Foetuses with LUTO who are potential candidates for prenatal intervention should undergo detailed multidisciplinary evaluation to ensure proper assessment an...
Source: Current Opinion in Obstetrics and Gynecology - March 10, 2021 Category: OBGYN Tags: PRENATAL DIAGNOSIS: Edited by Jane Chueh Source Type: research

Role of whole exome sequencing for unidentified genetic syndromes
Purpose of review The current review seeks to provide a comprehensive update on the revolutionary technology of whole exome sequencing (WES) which has been used to interrogate abnormal foetal phenotypes since the last few years, and is changing the paradigms of prenatal diagnosis, facilitating accurate genetic diagnosis and optimal management of pregnancies affected with foetal abnormalities, as well enabling delineation of novel Mendelian disorders. Recent findings WES has contributed to identification of more than 1000 Mendelian genes and made rapid strides into clinical diagnostics in recent years. Diagnostic...
Source: Current Opinion in Obstetrics and Gynecology - March 10, 2021 Category: OBGYN Tags: PRENATAL DIAGNOSIS: Edited by Jane Chueh Source Type: research

Genetics of recurrent pregnancy loss: a review
Purpose of review Human reproduction is remarkably inefficient; with pregnancy loss occurring in 10–30% of clinically recognized pregnancies. Of those, 3–5% of couples experience recurrent pregnancy loss (RPL), more than 50% of who never receive an underlying diagnosis. Herein, we review evidence that genetic changes, including pathogenic variant(s) in highly penetrant genes, may provide an explanation for a proportion of couples with pregnancy loss. Recent findings Genetic abnormalities that may predispose to pregnancy loss include chromosomal aneuploidy, copy number variants, single-gene changes and others...
Source: Current Opinion in Obstetrics and Gynecology - March 10, 2021 Category: OBGYN Tags: PRENATAL DIAGNOSIS: Edited by Jane Chueh Source Type: research

Pregnancy from mosaic embryo transfer: genetic counseling considerations
Purpose of review The transfer of mosaic embryos during an IVF procedure is becoming more common. There is limited information regarding the outcomes for such transfers, making it difficult to establish best practices for prenatal counseling of patients considering transfer of mosaic embryos. In addition, genetic counseling may be delivered by different providers in the preimplantation and pregnancy timeframes which can contribute to inconsistent information. Recent findings There are many types of aneuploid results from preimplantation genetic testing for aneuploidy (PGT-A), with mosaicism being a possibility. ...
Source: Current Opinion in Obstetrics and Gynecology - March 10, 2021 Category: OBGYN Tags: PRENATAL DIAGNOSIS: Edited by Jane Chueh Source Type: research

Postpartum headaches after epidural or spinal anesthesia
Purpose of review Postpartum headache is a common occurrence with various obstetric, neurologic, and anesthetic etiologies. Post dural puncture headache (PDPH) after neuraxial anesthesia is a culprit that may be less familiar to obstetricians. In this review, authors will discuss the differential diagnosis and management of postpartum headache, review PDPH, and explore evidence suggesting that PDPH may have greater implications than previously considered. Recent findings Emerging evidence suggests that PDPH, previously believed to be benign and self-limited, is associated with significant acute and chronic seque...
Source: Current Opinion in Obstetrics and Gynecology - March 10, 2021 Category: OBGYN Tags: MATERNAL FETAL MEDICINE: Edited by Deirdre Lyell, Mark Boddy and Martha Rode Source Type: research

Postpartum recovery: what does it take to get back to a baseline?
Purpose of review Limited guidance exists regarding how to assess postpartum recovery. In this article, we discuss various aspects of inpatient and outpatient postpartum recovery. Recent findings The postpartum period for many women includes sleep deprivation, maternal–neonatal bonding, breastfeeding, and integrating a new life into the family unit. Factors which impact inpatient quality of recovery include pain, nausea or vomiting, dizziness, shivering, comfort, mobilization, ability to hold and feed the baby, personal hygiene maintenance, and feeling in control. Outpatient recovery domains include psychosoci...
Source: Current Opinion in Obstetrics and Gynecology - March 10, 2021 Category: OBGYN Tags: MATERNAL FETAL MEDICINE: Edited by Deirdre Lyell, Mark Boddy and Martha Rode Source Type: research

An old disease on the rise: new approaches to syphilis in pregnancy
Purpose of review Maternal and congenital syphilis infection is on the rise in the United States and worldwide. Without adequate testing or provider recognition of infection, treatment can be neglected resulting in significant perinatal morbidity and mortality. This review article discusses the epidemiology of T. pallidum, describes novel diagnostic tests, and considers the need to expand therapeutic options. Recent findings A new chemiluminescence immunoassay for use in the reverse-sequence algorithm is more sensitive and specific in pregnant women than previously noted and is helpful for identifying pregnant w...
Source: Current Opinion in Obstetrics and Gynecology - March 10, 2021 Category: OBGYN Tags: MATERNAL FETAL MEDICINE: Edited by Deirdre Lyell, Mark Boddy and Martha Rode Source Type: research

Prevention of preterm birth in multiples
Purpose of review Multifetal pregnancy carries increased risk of preterm delivery, and consensus on management options to prevent early birth in this population has not been reached. This review serves to summarize the most contemporary findings on this controversial topic. Recent findings Examination-indicated cerclage is effective in reducing preterm birth in twin pregnancies, whereas cerclages for other indications are less convincing. Cervical pessary may be beneficial for patients with a short cervix and in those who have had threatened preterm labor. Progesterone supplementation for multifetal gestation al...
Source: Current Opinion in Obstetrics and Gynecology - March 10, 2021 Category: OBGYN Tags: MATERNAL FETAL MEDICINE: Edited by Deirdre Lyell, Mark Boddy and Martha Rode Source Type: research