Practical Management of Fetal Obstructive Uropathy
We present a summary of the current literature and a practical guide to the management of obstructive uropathy, including the normal sonographic features of the developing fetal urinary tract, antenatal diagnostic criteria and the approach to postnatal investigation and management. (Source: Journal of Fetal Medicine)
Source: Journal of Fetal Medicine - December 6, 2017 Category: Perinatology & Neonatology Source Type: research
An Inclusive Prototype for an Obstetric Imaging Checklist
(Source: Journal of Fetal Medicine)
Source: Journal of Fetal Medicine - December 6, 2017 Category: Perinatology & Neonatology Source Type: research
A National Referral Laboratory ’s Experience with the Implementation of SNP-Based Non-invasive Prenatal Screening for Fetal Aneuploidy and Select Microdeletion Syndromes
AbstractTo retrospectively evaluate the successful test rate and performance of non-invasive prenatal screening (NIPS) for aneuploidies and microdeletions with international transportation of samples. Blood samples from Iberian women with singleton pregnancies were sent to a US laboratory for NIPS for aneuploidy and microdeletion syndromes (22q11.2, 1p36, Cri-du-chat, Prader Willi and Angelman). The NIPS methodology involved the analysis of single nucleotide polymorphisms in cell-free DNA in maternal plasma. Women with high-risk results were offered karyotyping and/or microarray confirmatory studies. Based on 14,175 women ...
Source: Journal of Fetal Medicine - December 5, 2017 Category: Perinatology & Neonatology Source Type: research
Antenatal Detection of Mosaic Trisomy 22 with a Finding of Blake ’s Pouch Cyst
AbstractThe authors report a case of mosaic trisomy 22 diagnosed antenatally by amniocentesis at 19 weeks. The ultrasound finding was an isolated posterior fossa fluid collection in the brain with features possibly suggestive of a Blake’s Pouch cyst with doubtful hypoplasia of cerebellar vermis. The karyotype of the amniocytes was mos47, + 22[6]/46[8] with two separate clones of cells. Trisom y 22 was seen in one clone (43%) while the other clone (57%) had a normal karyotype. On postnatal examination after termination, there were no dysmorphic features. A selective autopsy of the fetal brain was suggestive of normal p...
Source: Journal of Fetal Medicine - December 4, 2017 Category: Perinatology & Neonatology Source Type: research
Radiofrequency Ablation in Complicated Monochorionic Pregnancy: Initial Experience
AbstractTo evaluate outcomes of complicated monochorionic pregnancies intervened by radiofrequency ablation (RFA) and report the initial experience. It is a retrospective case series of 15 cases of complicated monochorionic twin pregnancies intervened by RFA in Mediscan Systems Chennai, a tertiary referral Fetal Medicine center, from February 2015 till February 2017. Perinatal outcomes were available for all 15 cases. Main indication for RFA was sIUGR in 10 cases, of which 2 had coexistent Twin to Twin Transfusion syndrome. The procedure was technically successful in all cases. Median gestational age at procedure was 22.6 ...
Source: Journal of Fetal Medicine - November 30, 2017 Category: Perinatology & Neonatology Source Type: research
Prenatal Diagnosis of Persistent Right Umbilical Vein: Is It Significant?
AbstractA case of Persistent Right Umbilical Vein (PRUV) is reported. Prenatal diagnosis was made on gray scale and color Doppler at the time of routine anomaly scan. The management is briefly discussed. (Source: Journal of Fetal Medicine)
Source: Journal of Fetal Medicine - November 30, 2017 Category: Perinatology & Neonatology Source Type: research
A Case of Dichorionic Twin Pregnancy with Maternal Propylthiouracil Induced Hypothyroid Goiter in Both Fetuses Treated with Intramniotic Levothyroxine
The objective of the present case report is to outline the details of a twin gestation with hypothyroid goiter in both fetuses managed by intramniotic levothyroxine administration. The index pregnancy was of dichorionic twin gestation in which the mother was receiving oral propylthiouracil. Fetal goiters were first detected in ultrasound performed at 31 weeks of gestation. The hypothyroid nature of goiters was confirmed by cordocentesis from both sacs. Intramniotic administration of 100 µg of levothyroxine into both sacs was performed twice at the interval of two weeks. The response to treatment was assessed by amniot...
Source: Journal of Fetal Medicine - October 31, 2017 Category: Perinatology & Neonatology Source Type: research
Unusual Rhesus Antibodies as a Cause for Fetal Isoimmunisation
AbstractHemolytic disease of the newborn due to Rh isoimmunisation in a Rhesus D (Rh-D) negative mother with an Rh-D positive fetus is a well recognised entity. Although antibody to Rh-D antigen (anti-D antibody) was once the major cause of hemolytic disease of the fetus and newborn (HDFN), widespread adoption of antenatal and postnatal prophylactic anti-D immunoglobulin administration has resulted in a marked decrease in the prevalence of allo-immunisation due to the Rh-D antigen during pregnancy. However, at the same time, the maternal allo-immunisation to other red cell Rhesus antigens became more evident as a cause for...
Source: Journal of Fetal Medicine - October 28, 2017 Category: Perinatology & Neonatology Source Type: research
Prenatal Screening Strategies in Localities with Limited Resources
AbstractSeveral important developments have been made in prenatal screening and diagnosis of serious fetal abnormalities, and prevention of common adverse pregnancy outcomes. However, full implementation is not cost-neutral and in localities with limited resources, compromises are needed. This review considers options for maternal plasma cell free DNA (cfDNA); prenatal microarray analysis; and multi-marker screening for preeclampsia (PE). Although not new, use of first trimester nuchal translucency and additional ultrasound markers is also considered as this is not routinely available in many limited resource localities....
Source: Journal of Fetal Medicine - October 24, 2017 Category: Perinatology & Neonatology Source Type: research
Prenatal Diagnosis of a 20 Mb Terminal Fetal 4q-Deletion in the Cytoband q33q35.2 Inherited from the Mother
AbstractThe authors present a case of prenatally diagnosed fetal terminal 4q deletion in the cytoband 4q33q35.2, inherited from the mother. The index pregnancy was referred at 28+2 weeks of gestation for polyhdramnios. Prior to performing the scan, distinctive facial features were noted in the mother. Target scan confirmed polyhdramnios, and revealed fetal retrognathia. The fetal karyotype reported a terminal 4q33>ter deletion, which was further delineated by chromosomal microarray analysis. Subsequently, maternal karyotype revealed identical deletion. Subtle fetal ultrasound abnormalities should receive meticulous ass...
Source: Journal of Fetal Medicine - October 12, 2017 Category: Perinatology & Neonatology Source Type: research
Hepatic Bubble: Rare Case of a Primary Hepatic Cyst
AbstractFetal hepatic cyst is a rare lesion. The authors present a case of fetal hepatic cyst detected at 20 weeks of gestation during the target scan. Sonography revealed an anechoic lesion in the right upper quadrant of the fetal abdomen lacking vascularity on color Doppler. The lesion remained stable during the course of pregnancy. A baby girl was delivered at 38 weeks of gestation. Postnatal evaluat ion of the child confirmed the diagnosis of a primary hepatic cyst. (Source: Journal of Fetal Medicine)
Source: Journal of Fetal Medicine - October 10, 2017 Category: Perinatology & Neonatology Source Type: research
Prenatal Ultrasound Diagnosis of Diastematomyelia at 11 –14 Week Scan
AbstractDiastematomyelia is a rare form of congenital spinal anomaly in which the spinal cord is longitudinally split by a rigid or fibrous septum. Prenatal diagnosis of this condition has mainly been reported in the mid trimester. The authors report two cases of diastematomyelia detected at the 11 –14 week scan with a brief review of literature. One case detected in the late first trimester was associated with open spina bifida, and the other detected at 12 weeks was a case of isolated diastematomyelia. Though the sonographic features of diastematomyelia are the same in the first and th e second trimester, the findin...
Source: Journal of Fetal Medicine - September 22, 2017 Category: Perinatology & Neonatology Source Type: research
Multifetal Pregnancy Reduction
AbstractMultifetal pregnancy increases maternal, fetal and neonatal complications, most important being preterm delivery and complications of prematurity. Fetal reduction is a procedure for reducing the number of fetuses to a more manageable number. Reduction of triplet or higher order pregnancy is acceptable and the ending number is usually two. Fetal reduction reduces the risk of preterm delivery. Intracardiac/intrathoracic KCl is used for fetal reduction in multichorionic pregnancy. This is not a viable option in monochorionic pregnancy, where vaso-occlusive methods are used. (Source: Journal of Fetal Medicine)
Source: Journal of Fetal Medicine - September 22, 2017 Category: Perinatology & Neonatology Source Type: research
Is Thyroid Replacement Therapy Necessary in Fertility Patients with “Normal” TSH?
AbstractThyroid diseases are very common disorders in women, and thyroid hormones are crucial players in many aspects of fetal growth and neurodevelopment, both of which are dependent on an adequate supply of maternal thyroid hormones from early gestation onwards. It is therefore very important to keep women euthyroid during gestation. Globally, hypothyroidism is still frequently caused by iodine deficiency. In iodine sufficient areas, the most common cause of hypothyroidism is thyroid autoimmunity with positive anti-thyroperoxidase antibodies (anti-TPO) measurable in serum. It is well known that overt maternal and fetal...
Source: Journal of Fetal Medicine - September 9, 2017 Category: Perinatology & Neonatology Source Type: research
Placental Pathology and Stillbirth: A Review of the Literature and Guidelines for the Less Experienced
AbstractThe aim of this review is to examine the role of placental pathology in the understanding of singleton stillbirth. The placenta may be regarded as the “black box” of pregnancy and detailed examination may afford insight into the fetal and maternal events leading to this tragic outcome. In the UK, 1 in 200 to 1 in 240 pregnancies end in stillbirth whilst India accounts for the majority of global stillbirths. Between 2010 and 2013, India showed a decline in the stillbirth rate and it continues to fall–a recent report felt that the majority of deaths in the third trimester were preventable. However, in order to ...
Source: Journal of Fetal Medicine - August 22, 2017 Category: Perinatology & Neonatology Source Type: research
