Herpes in Pregnancy
AbstractHerpes simplex virus infection (predominantly HSV2) in pregnancy can be a cause of maternal morbidity. The more serious cause of concern is perinatal transmission of infection resulting in neonatal morbidity and mortality. Genital HSV infection can be primary, non-primary first episode or recurrent infection. Clinical and laboratory diagnosis in pregnant women is similar to non-pregnant women. Direct viral testing (PCR) from lesion's and type specific serology are required to classify type of infection. Vertical transmission occurs during labor and delivery. The  risk is higher in primary and non-primary first epi...
Source: Journal of Fetal Medicine - January 24, 2020 Category: Perinatology & Neonatology Source Type: research
Rubella in Pregnancy
AbstractRubella, commonly known as ‘German Measles’ is a common childhood viral disease that may affect adults as well. More than half of the infections are either asymptomatic or present with mild flu like illness with a typical maculopapular rash. In contrast, primary rubella infection in pregnancy, especially in the first trim ester, can have serious consequences, namely miscarriage, intrauterine fetal demise or congenital rubella syndrome (CRS). WHO recognizes CRS as the ‘leading vaccine preventable cause of birth defects’. Antenatal management primarily is based on testing for immunity in the first trimester a...
Source: Journal of Fetal Medicine - January 13, 2020 Category: Perinatology & Neonatology Source Type: research
Fetal Left Brachiocephalic Vein (LBCV): Visualization and Its Measurements in Indian Population
AbstractLeft brachiocephalic vein, also known as innominate vein runs in upper mediastinum posterior to the  thymus and anterior to the transverse aortic arch and aortic branches. LBCV can be visualized on gray scale as well as color Doppler ultrasound at the level above the 3 vessel view. This is the first Indian study to demonstrate the significance of its routine visualization and its measurements on prenatal ultrasound. Isolated intrathymic LBCV is a normal variant and in isolation does not warrant an alteration in routine management of pregnancy. Absent LBCV or dilated LBCV are pathological and warrant a thorough an...
Source: Journal of Fetal Medicine - January 13, 2020 Category: Perinatology & Neonatology Source Type: research
Vasa Praevia: A Nightmare to Good Outcome
We report five cases of vasa praevia with different presentations and outcomes. In the first case, vasa praevia was not diagnosed during the  antenatal period and the baby was stillborn due to ruptured fetal vessels. In the other four cases, vasa praevia was diagnosed in antenatal period and all the cases had good outcomes. In one case there was evidence of marginal and velamentous cord insertion in the same placenta. Pregnancies were t erminated in three cases by elective caesarean section with good perinatal outcome. In one case vasa praevia and placenta praevia resolved in third-trimester, and the baby was delivered va...
Source: Journal of Fetal Medicine - January 8, 2020 Category: Perinatology & Neonatology Source Type: research
Cost-Effectiveness of First Trimester Screening for Preterm Pre-eclampsia in Lebanon
AbstractTo estimate, for Lebanon, the financial benefit of screening for preterm pre-eclampsia (PE) at 11 –13 weeks gestation combining risk factors with mean arterial pressure and maternal serum placental growth factor. Preterm PE cases delivered during 2010–2018 at Rafik Hariri University Hospital were identified from electronic records. Manual nursing notes were reviewed to confirm the diagnosis using international criteria. For each case, adverse maternal and infant events were noted and billing information extracted. A series of 1000 non-PE pregnancies were identified and billing information recorded. Published s...
Source: Journal of Fetal Medicine - January 5, 2020 Category: Perinatology & Neonatology Source Type: research
Epidemiology of TORCH Infections and Understanding the Serology in Their Diagnosis
AbstractTORCH, as coined by Nahmias et al. consists of Toxoplasmosis, other infections (includes, syphilis, HIV, Hepatitis viruses, varicella virus and Parvovirus B19), Rubella, Cytomegalovirus (CMV) and Herpes simplex virus. These infections are transmitted prenatally, perinatally, and postnatally through transplacental passage, contact with blood and vaginal secretions or from exposure to breast milk for CMV, HIV and HSV and infection generally manifests at birth, in infancy or in later years of life. The disease burden is maximum in low to middle-income countries. As treatment and prevention strategies are available for...
Source: Journal of Fetal Medicine - January 1, 2020 Category: Perinatology & Neonatology Source Type: research
Toxoplasmosis in Pregnancy
AbstractToxoplasmosis is a rare but important infection in pregnant women which can potentially cause serious fetal adverse effects. Methods of screening, diagnosing and treating toxoplasmosis in pregnancy have been evaluated for over four decades now but still, there is a lack of robust evidence in these areas to guide care plans. Yet with the advent of newer techniques in imaging and laboratory diagnosis, reasonable protocols can be formulated to optimally mange cases with toxoplasmosis in pregnancy. It is becoming increasingly evident that antenatal treatment definitely helps in reducing fetal and hence neonatal morbidi...
Source: Journal of Fetal Medicine - December 1, 2019 Category: Perinatology & Neonatology Source Type: research
Foetal Venous Anomalies: Experience in a Primary Referral Unit
AbstractCongenital heart disease (CHD) is one of the most common congenital anomalies reported. Incidence of CHD is 8 to 9 per 1000 live births in published data worldwide (Chaudhary and Patil in J Fetal Med 5:221,2018; Hoffman and Kaplan in J Am Coll Cardiol 39(12):1890 –1900,2002; Khalil et al. in Indian Pediatr 31(5):519 –527,1994; Wanni et al. in Heart India 2(3):76 –95,2014). Association of venous anomalies is known and has a significant impact on the  perinatal and postnatal outcome. There is no published data about the incidence and spectrum of foetal venous anomalies in India. We tried to find out the incid...
Source: Journal of Fetal Medicine - November 28, 2019 Category: Perinatology & Neonatology Source Type: research
Neonatal Outcome After Hexoprenaline Compared with Atosiban After Preterm Premature Rupture of Membranes
AbstractPreterm premature rupture of membranes (PPROM) occurs in up to 3% of all pregnancies. Only few comparative studies have investigated potential risks and benefits between different tocolytic substances in women with PPROM. The aim of this study was to compare the neonatal short term outcome after tocolysis with Atosiban or Hexoprenaline in women with PPROM. This is a retrospective observational cohort study of women with PPROM between 24 and 32 Â weeks of gestation comparing neonatal and maternal outcome after tocolysis with atosiban or hexoprenaline. Outcome parameters were short term neonatal outcome, maternal toc...
Source: Journal of Fetal Medicine - November 24, 2019 Category: Perinatology & Neonatology Source Type: research
Case Report of Abdominal Lymphangioma
We present a case of massive abdominal lymphangioma in a fetus diagnosed at 28 Â weeks of gestation. The lesion was located in the abdomen involving lower part of thorax and entire abdominal wall, extending down to the right gluteal region. Detailed structural anomaly scan was performed, growth of the fetus assessed and patient was managed expectantly till delivery. (Source: Journal of Fetal Medicine)
Source: Journal of Fetal Medicine - November 24, 2019 Category: Perinatology & Neonatology Source Type: research
Prenatal Diagnosis of a Fetal Right Ventricular Diverticulum: A Case Report
We present a case of a prenatal diagnosis of right ventricular diverticulum at 20 weeks and 4 days of gestation associated with pericardial effusion. Spontaneous resolution of diverticulum and pericardial effusion was noted in the third trimester scan at around 35 weeks and 5 days. The baby was delivered at 39 weeks and 3 days of gestation by cesarean section for an obstetric indication. The baby was well at 1 year and 2 months of age at the time of writing. Fetal cardiac diverticulum if not associated with rhythm disturbance, signs of ca rdiac failure or other cardiac or extracardiac abnormality carries an excel...
Source: Journal of Fetal Medicine - November 22, 2019 Category: Perinatology & Neonatology Source Type: research
Current Status of Noninvasive Prenatal Testing and Counselling Considerations: An Indian Perspective
AbstractUptake of noninvasive prenatal testing (NIPT) is rapidly expanding around the world. Here, we provide an overview of the current global state of NIPT, describe the expansion of the test menu, highlight alternative prenatal test service delivery, and discuss NIPT counseling considerations. We also provide a perspective on utilisation of NIPT in India, which has unique challenges for implementing NIPT given its large population, vast territory, and diverse ethnic groups. The barriers to implementation of NIPT in India are also discussed. Current recommendations regarding use of NIPT made by professional societies var...
Source: Journal of Fetal Medicine - November 14, 2019 Category: Perinatology & Neonatology Source Type: research
Determination of Fetal Transcerebellar Diameter Nomogram in the Second Trimester
AbstractThe aim of the study was obtain nomogram of fetal transcerebellar diameter at 18 –24 weeks of gestation with known prognosis of normal pregnancies. The study included 1236 healthy fetuses in the 18th–24th gestational week of women aged from 18 to 40 years (mean: 28.70 ± 5.26). The transcerebellar diameter, bi-parietal diameter, femur length and abdominal circumference of the fetuses were measured. Additionally, groups were divided according to maternal age and according to body mass index. The transcerebellar diameter of fetuses from 18 to 24 weeks gestation varied from 18.13 ± 2.16 to 26.42 ±â€...
Source: Journal of Fetal Medicine - November 1, 2019 Category: Perinatology & Neonatology Source Type: research
HIV in Pregnancy
AbstractHIV in pregnancy assumes additional importance because of the risk of perinatal transmission. With the increase in number of people living the HIV –AIDS worldwide, better ART policies and improved heath condition, more women with HIV are getting pregnant. Perinatal transmission occurs mostly during labour and delivery; transmission during antenatal period may also occur. Timely administration of appropriate ART, suppressed viral load, approp riate mode of delivery and safe feeding practices can reduce the risk of perinatal transmission to minimal. ART has evolved from single dose therapy to daily fixed-dose lifel...
Source: Journal of Fetal Medicine - October 22, 2019 Category: Perinatology & Neonatology Source Type: research
Sirenomelia: Study of Three Cases
AbstractSirenomelia is a rare congenital anomaly which is an extreme example of caudal regression syndrome characterized by lower limb fusion, sacral and pelvic bony anomalies with abnormalities in other organ systems, commonly affecting the gastrointestinal and the urogenital systems (Kanagagiri et al. JMSCR 5(7),2017). It is a sporadic occurence with no increased risk in subsequent pregnancies. The syndrome of caudal regression is thought to be the result of injury to the caudal mesoderm early in gestation (Mirzapur et al. Glob J Reprod Med 3(5):555624,2018). Prenatal sonographic findings of sirenomelia (or mermaid fetus...
Source: Journal of Fetal Medicine - October 21, 2019 Category: Perinatology & Neonatology Source Type: research
