Fetal Diagnosis and Therapy最新文献

{"title":"Prenatal Fetoscopic Intervention for Gastroschisis: A Systematic Review of First Published Human Cases.","authors":"Maria Celidonio Gutfreund, Gustavo Yano Callado, Mariana Jeszensky Pitta, Luana Perrone Camilo, Javier Svetliza, Gregório Lorenzo Acacio","doi":"10.1159/fdt/acuag026","DOIUrl":"https://doi.org/10.1159/fdt/acuag026","url":null,"abstract":"<p><strong>Objective: </strong>To systematically identify and descriptively summarize the available published human evidence on prenatal fetoscopic intervention for gastroschisis, focusing on reported procedural characteristics, maternal-fetal events, neonatal outcomes, and limitations of the current literature.</p><p><strong>Methods: </strong>A systematic review was conducted according to PRISMA guidance, with protocol registration in PROSPERO (CRD420261338353). MEDLINE/PubMed, Embase, CINAHL, CENTRAL, Scopus, and Web of Science were searched from inception to March 2026. Studies including fetuses with prenatally diagnosed gastroschisis undergoing intrauterine intervention were eligible. Two reviewers independently screened studies, extracted data using a standardized form, and assessed reporting quality using the Joanna Briggs Institute checklist for case reports. Given the nature of the available evidence, synthesis was descriptive only.</p><p><strong>Results: </strong>Of 827 records identified, three single-patient case reports met the inclusion criteria. All described prenatal fetoscopic intervention for gastroschisis in highly specialized centers, with substantial heterogeneity in timing of intervention, uterine access, carbon dioxide insufflation, amniotic fluid management, closure technique, fetal monitoring, and postoperative surveillance. Initial intrauterine bowel reduction was reported in all three cases; however, one fetus developed postoperative bowel re-extrusion within 48 hours, associated with venous Doppler abnormalities, and required delivery followed by EXIT-like repair. All neonates survived, but the absence of comparators, extreme case selection, heterogeneous perioperative management, and likely publication bias preclude any inference regarding efficacy or neonatal benefit.</p><p><strong>Conclusions: </strong>Published human evidence on prenatal fetoscopic intervention for gastroschisis is limited to three isolated case reports. These reports describe procedural completion in highly selected cases managed at specialized fetal surgery centers, but they remain insufficient to determine the generalizable feasibility, safety profile, reproducibility, or clinical benefit of this approach compared with contemporary postnatal management. Prenatal repair should therefore remain investigational and should be evaluated within ethically approved prospective protocols with standardized selection criteria, maternal-fetal safety monitoring, operative reporting, and long-term follow-up.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"1"},"PeriodicalIF":1.7,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective Study of Prenatal Diagnosis for Thalassemia in 58,891 Couples from Guangxi.","authors":"Lifang Liang, Xiuning Huang, Jie Wei, Biyan Chen, Sheng He","doi":"10.1159/fdt/acuag023","DOIUrl":"https://doi.org/10.1159/fdt/acuag023","url":null,"abstract":"<p><p>Objective This study aimed to evaluate a comprehensive prenatal diagnosis service and its effectiveness in reducing the birth of children with severe thalassemia in Guangxi, China. Methods Prenatal diagnosis was offered to 58,891 at-risk couples from Guangxi. Fetal samples were collected via chorionic villus sampling, amniocentesis, and cordocentesis. DNA analysis was performed using polymerase chain reaction, reverse dot blot assay, multiplex ligation-dependent probe amplification, and DNA sequencing. Results From 2018 to 2023, the proportion of umbilical cord blood samples among all tested samples declined annually, while the proportion of chorionic villus samples increased significantly (χ2=382.550, P<0.0001). A total of 71 distinct α-thalassemia mutations and 123 different β-thalassemia mutations were identified among the fetuses. The most common α-thalassemia mutation was --SEA, followed by -α3.7. Hb Bart's hydrops fetalis syndrome was detected in 4,434 cases (12.22%). For β-thalassemia, the most frequent mutation was CD41-42, followed by CD17; 948 homozygous or compound heterozygous cases were identified. The majority of couples whose fetuses were diagnosed with β-thalassemia major opted for pregnancy termination under medical guidance. Postnatal follow-up confirmed all pregnancy outcomes. Conclusion The prenatal diagnostic strategy implemented in Guangxi has effectively facilitated early diagnosis and significantly reduced the incidence of infants born with severe thalassemia.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"1"},"PeriodicalIF":1.7,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiofrequency Ablation for Selective Reduction in Complicated Monochorionic Twin Pregnancies: Pregnancy-Level and Neonatal Outcomes.","authors":"Edis Kahraman, Ahmet Tayyar, Mustafa Deveci, Mehmet Aytac Yuksel","doi":"10.1159/fdt/acuag025","DOIUrl":"https://doi.org/10.1159/fdt/acuag025","url":null,"abstract":"<p><strong>Introduction: </strong>Monochorionic twin pregnancies may be complicated by shared placental vascular anastomoses and hemodynamic interdependence between fetuses. Radiofrequency ablation (RFA) is a vaso-occlusive option for selective reduction when continuation of the affected fetus is expected to endanger the co-twin.</p><p><strong>Methods: </strong>This retrospective cohort study included 39 monochorionic twin pregnancies treated with RFA at two tertiary centers between January 2017 and December 2025. Indications were grouped as TTTS/TAPS-related conditions, selective fetal growth restriction (sFGR)-related conditions, twin reversed arterial perfusion (TRAP) sequence, and discordant major fetal anomaly. The primary outcome was live birth of at least one fetus. Secondary outcomes included miscarriage, stillbirth/intrauterine fetal demise, termination after RFA, preterm prelabor rupture of membranes (PPROM), gestational age at delivery, birth weight, neonatal intensive care unit (NICU) admission, neonatal death, and survival to neonatal hospital discharge.</p><p><strong>Results: </strong>The main indications were sFGR-related conditions (14/39, 35.9%) and TTTS/TAPS-related conditions (12/39, 30.8%). Live birth of at least one fetus occurred in 38/39 pregnancies (97.4%), and pregnancy-level survival to neonatal hospital discharge occurred in 37/39 pregnancies (94.9%). PPROM after RFA occurred in 2/39 pregnancies (5.1%). Among pregnancies with live birth, median gestational age at delivery was 38.00 weeks (IQR, 34.00-39.00). Exploratory comparisons across indication groups, including direct TTTS/TAPS-related versus TRAP comparisons for gestational age at delivery and procedure-to-delivery interval, were not statistically significant.</p><p><strong>Conclusion: </strong>RFA was associated with high rates of live birth and survival to neonatal hospital discharge in this cohort of complicated monochorionic twin pregnancies. Exploratory subgroup comparisons were not statistically significant; therefore, observed indication-specific patterns should be interpreted cautiously and require confirmation in larger multicenter cohorts.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"1"},"PeriodicalIF":1.7,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal echocardiographic predictors that increase the risk of urgent Ballon Atrial Septostomy (BAS) after birth in patients with Dextro-Transposition of the Great Arteries- Retrospective Study from Tertiary Center Lodz- Poland ICZMP (2014-2024).","authors":"Aleksandra Moszura, Iwona Strzelecka, Maria Respondek-Liberska","doi":"10.1159/fdt/acuag022","DOIUrl":"https://doi.org/10.1159/fdt/acuag022","url":null,"abstract":"<p><strong>Objective: </strong>Dextro-transposition of the great arteries (d-TGA) is a critical congenital heart disease (CHD) requiring prompt postnatal intervention, primarily: a line for Prostin infusion, hospitalization in an Intensive Care Unit, and in some cases, Balloon Atrial Septostomy (BAS) as a rescue procedure before planned Arterial Switch Operation (ASO). In this part, we focus on prenatal prediction of postnatal BAS.</p><p><strong>Materials and methods: </strong>This retrospective study was conducted at the Department of Prenatal Cardiology, Polish Mother's Memorial Hospital in Lodz, covering the years 2014-2024. From a total of 112 prenatally diagnosed d-TGA cases, 70 fetuses (46 with isolated d-TGA and 24 with d-TGA and VSD) met the inclusion criteria; follow-up of four pregnancies ended up in other hospitals, so the final series was 66 cases. Statistical analyses were performed using Statistica software.</p><p><strong>Results: </strong>Out of 66 analyzed cases, 32 newborns (48%) required postnatal BAS, with 87.5% of these procedures performed within the first 24-48 hours of life. Prenatal echocardiography correctly predicted the postnatal management pathway in 90.9% of cases (60/66), identifying all 26 neonates requiring urgent balloon atrial septostomy (100% positive predictive value), while 6 neonates in the planned group required unexpected postnatal septostomy. We noted that the 18% (n=6) of cases not identified prenatally occurred when the last scan was performed > 14 days before birth, suggesting that the time interval significantly impacts the reliability of late-gestation FO assessment. The study identified 10 prenatal \"red flags,\" including FO size < 3 mm, bi-directional FO flow, and pulmonary vein velocity ≥ 45 cm/s and other features, as high-reliability indicators for urgent postnatal intervention.</p><p><strong>Conclusion: </strong>Prenatal functional assessment of the foramen ovale in the late third trimester was highly effective in predicting the need for postnatal urgent BAS in d-TGA cases. The accuracy of these \"red flags\" was significantly higher when the last fetal echocardiogram was performed within 14 days to delivery.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"1"},"PeriodicalIF":1.7,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The fetal Ear-Eye and Ear-Rotation angle: A pilot study on novel 3D ultrasound measure-ments for prenatal diagnosis of low-set ears.","authors":"Thabea Katrin Musik, Sara Monteiro, Heidrun Schönberger, Annkathrin Butenschön, Cecile Monod, Jutta Benz, Andreas Schötzau, Beatrice Mosimann, Gwendolin Manegold-Brauer","doi":"10.1159/fdt/acuag019","DOIUrl":"https://doi.org/10.1159/fdt/acuag019","url":null,"abstract":"<p><strong>Introduction: </strong>Low-set ears are frequently associated with chromosomal aberrations, congenital malformations, and genetic syndromes. While typically described postnatally, prenatal diagnosis usually relies on subjective expert pattern recognition. We introduce a standardized 3D ultra-sound measurement approach to assess fetal ear position relative to the eye and head.</p><p><strong>Methods: </strong>Retrospective pilot analysis of prospectively acquired 3D head volumes (16-34 weeks; 10/2023-10/2025). The \"ear-eye angle,\" \"ear-rotation angle,\" and ear length were meas-ured by two blinded examiners in healthy controls and a malformation group.</p><p><strong>Results: </strong>We included 102 fetuses (82 controls, 20 malformations) at a median 21 weeks' gesta-tion (16-34). The malformation group had a significantly larger median ear-eye angle than con-trols (3.29° [-2.81-7.88] vs. 1.02° [-11.04-8.75]; P<0.001) and median ear-rotation angle (17.50° [-33.75-37.20] vs. 12.10° [0.00-38.40]; P=0.029). Logistic regression showed that for every one-degree increase in the ear-eye angle, the odds of a malformation increased significant-ly (OR 1.36; 95% CI: 1.11-1.65; P = 0.002). ROC analysis revealed the ear-eye angle had supe-rior discriminative ability over the ear-rotation angle (AUC 0.76 vs. 0.66). Inter-observer agree-ment was high (ear-eye ICC=0.96; ear-rotation ICC=0.92).</p><p><strong>Conclusion: </strong>Systematic evaluation of the fetal ear on routinely collected 3D volumes is feasible. Both angles were significantly larger in affected fetuses compared to healthy controls. However, due to the limited sample size and prevalence of abnormal cases, these diagnostic performance metrics should be interpreted with caution and require validation in larger cohorts.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"1"},"PeriodicalIF":1.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protease, Amylase, and Secretory Phospholipase A2 Levels in Human Amniotic Fluid of Fetuses with Open Spina Bifida.","authors":"Tess van Schoor, Matthew E Thornton, John Rodman, Arlyn S Llanes, Ramen H Chmait, Brendan H Grubbs","doi":"10.1159/fdt/acuag015","DOIUrl":"https://doi.org/10.1159/fdt/acuag015","url":null,"abstract":"<p><strong>Introduction: </strong>We previously demonstrated elevated levels of secretory Phospholipase A2 (sPLA2) and Amylase in the amniotic fluid (AF) of a fetal rat Retinoic Acid (RA) Induced Open Spina Bifida (OSB) model. Our objective was to determine whether these enzymes, as well as protease, were elevated in the AF of human fetuses with OSB.</p><p><strong>Methods: </strong>AF was collected at the time of diagnosis (Early 21-22 weeks, n=9) or during fetoscopic repair (Late 26-27 weeks, n=12). Controls (21-22 weeks, n=3) were amniocentesis samples collected for advanced maternal age. Activity levels of amylase, protease, and PLA2 in these samples were measured, and we compared enzymatic activity in the control vs. early groups and the early vs. late groups.</p><p><strong>Results: </strong>In comparison to the control group, the activities of Amylase (p=0.003), sPLA2 (p=0.014), and Protease (p=0.012) were increased in the early OSB samples. No significant differences were seen in the activities of these enzymes between the early OSB and late OSB groups.</p><p><strong>Discussion: </strong>Protease, amylase, and sPLA2 levels were increased in the AF of human OSB fetuses but did not appear to increase further during the late second trimester. These neurotoxic enzymes may contribute to the \"second hit\" of OSB, the timing of which appears to be during the first half of the pregnancy. It is important to note that the assays used measure enzyme activity rather than absolute enzyme concentration, and findings should be interpreted accordingly. Direct extrapolation should be made cautiously given differences in study design and species-specific developmental timing (see Discussion).</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"1"},"PeriodicalIF":1.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-mortem MRI assessment of fetal corpus callosum growth patterns between 14 and 22 weeks of gestation.","authors":"Janani Devi Velayutham, Lawrence D Cruze, Easwar Lakshiminarayanan, Suresh Seshadri, Lata Murli, Rajeswaran Rangasami","doi":"10.1159/fdt/acuag024","DOIUrl":"https://doi.org/10.1159/fdt/acuag024","url":null,"abstract":"<p><strong>Introduction: </strong>The corpus callosum (CC) is the largest commissural tract in the human brain, playing a crucial role in interhemispheric communication and neurodevelopment. Although ultrasonography and MRI have been used to assess callosal morphology, most available data are from later gestational ages, with limited normative information for fetuses below 20 weeks. This study aims to fill this gap by evaluating the biometry of the corpus callosum using high-resolution post-mortem fetal brain MRI between 14 and 22 gestational weeks.</p><p><strong>Materials and methods: </strong>This observational cross-sectional study analyzed post-mortem MRI scans of 77 neurotypical fetal brains aged 14-22 gestational weeks. Imaging was performed on a 3T MRI scanner using a dedicated fetal protocol. T2-weighted STIR sequences provided optimal contrast for delineating the corpus callosum. The anteroposterior (AP) length and body thickness were measured on mid-sagittal images. Data were analyzed using SPSS with descriptive statistics, Pearson's correlation, linear regression, and ANOVA at a significance level of p < 0.05.</p><p><strong>Results: </strong>The mean AP length of the corpus callosum was 1.78 ± 0.69 cm, and the mean body thickness was 0.171 ± 0.031 cm. AP length showed a strong positive correlation with gestational age (r = 0.952, p < 0.001), while body thickness showed a moderate correlation (r = 0.613, p < 0.001).</p><p><strong>Conclusion: </strong>This study provides early normative post-mortem MRI data of corpus callosum growth between 14 and 22 weeks. The findings establish reference values that may assist in early detection of callosal dysgenesis and related neurodevelopmental abnormalities.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"1"},"PeriodicalIF":1.7,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endorsed but Undefined: Multidisciplinary Counselling for Closed Spinal Dysraphism - A National Multispecialty Survey from India.","authors":"Suhas Udayakumaran, Rinshi Abid Elayedatt, Vivek Krishnan","doi":"10.1159/fdt/acuag017","DOIUrl":"https://doi.org/10.1159/fdt/acuag017","url":null,"abstract":"<p><p>Objective To characterize current antenatal management practices for closed spinal dysraphism (CSD) among Indian specialists and determine whether practice variation is specialty-dependent or distributed within specialties. Methods A cross-sectional expert-reviewed and pilot-tested web-based survey (15 substantive items) was distributed to obstetricians, perinatologists, and radiologists across India (January-September 2023). Descriptive statistics and chi-square tests were used to evaluate the associations between respondents' characteristics and clinical practices. Response dispersion was quantified using normalized Shannon entropy (nH). Results Of the 209 respondents (104 obstetricians, 54 perinatologists, 51 radiologists), 89.5% encountered <10 CSD cases annually. Only 60.5% of the participants attempted to subtype CSD. Fetal MRI was available to 63.6% of respondents, with significantly higher access at tertiary centers (p < 0.001). While 83.3% endorsed mandatory multidisciplinary counseling, attitudes toward medical termination of pregnancy were widely divergent (normalized Shannon entropy: 0.931). No statistically significant interspecialty differences were found for the clinical decision-making domains, including subtyping, prognostication, MRI, and MTP attitudes (all p > 0.34), indicating that variation in counselling content resided within, rather than between, specialties. Conclusion Antenatal CSD management in India shows wide practice variation that is distributed uniformly within, rather than between, specialties. This pattern is consistent with an absence of condition-specific evidence and guidance rather than with specialty-specific disagreement, and supports the development of standardized prenatal reporting, defined MRI indications, and collaborative evidence-based guidelines.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"1"},"PeriodicalIF":1.7,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Prospective Study of Systematic Postpartum Placental Examination After Fetoscopic Laser Surgery for Twin-to-Twin Transfusion Syndrome: Residual Anastomoses and Clinical Outcomes.","authors":"Neval Kahraman, Tugba Sarac Sivrikoz, Seda Saygili Deniz, Ibrahim Halil Kalelioglu, Recep Has","doi":"10.1159/fdt/acuag021","DOIUrl":"https://doi.org/10.1159/fdt/acuag021","url":null,"abstract":"<p><strong>Objective: </strong>The present study aimed to assess the technical completeness of fetoscopic laser coagulation (FLC) in monochorionic diamniotic (MCDA) twin pregnancies complicated by twin-to-twin transfusion syndrome (TTTS) using systematic postpartum placental dye injection, to identify residual placental vascular anastomoses, and to examine their relationships with perinatal outcomes.</p><p><strong>Methods: </strong>Twenty MCDA twin pregnancies treated with FLC for TTTS were prospectively evaluated. Postpartum placentas were examined using systematic colored dye injection via both umbilical cords to assess residual vascular anastomoses. Placental findings were evaluated in relation to operative characteristics and perinatal outcomes.</p><p><strong>Results: </strong>No macroscopically detectable residual anastomoses were identified in the 8 cases in which Solomonization was performed, whereas residual anastomoses were detected in 5 of the remaining 12 cases. In total, seven residual anastomoses were identified, including six arteriovenous and one arterioarterial anastomosis. Four of the five placentas with residual anastomoses were anteriorly located. Among cases with residual anastomoses, postoperative follow-up revealed TAPS in two cases, persistent TTTS in one, single IUFD in one, and double IUFD in one.</p><p><strong>Conclusion: </strong>Systematic postpartum placental dye injection provides a valuable quality-assessment approach for evaluating the anatomical outcome and technical completeness of FLC. In this selected cohort, beyond aligning with existing literature regarding the presence of residual anastomoses in cases without Solomonization, systematic postpartum placental dye injection provides comprehensive insights into placental vascular architecture while offering valuable post-hoc validation of both the interventional procedures and clinical outcomes in MCDA twin pregnancies. Larger studies incorporating more detailed placental assessment are needed to clarify the clinical significance and determinants of residual anastomoses.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"1"},"PeriodicalIF":1.7,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective assessment of myocardial deformation in fetuses with suspected aortic coarctation.","authors":"Fleur Zwanenburg, Janine Trigler-Rinner, Renée Maria Smit, Renate Oberhoffer, Annette Wacker-Gussmann, Arend D J Ten Harkel, Monique C Haak","doi":"10.1159/fdt/acuag016","DOIUrl":"https://doi.org/10.1159/fdt/acuag016","url":null,"abstract":"<p><strong>Introduction: </strong>Prenatal identification of true aortic coarctation (CoA) remains challenging as evidenced by high false-positive rates. Myocardial deformation has been proposed to improve prediction of postnatal outcome. This prospective study aimed to determine whether fetal myocardial deformation analysis can differentiate true CoA from false-positive cases throughout gestation.</p><p><strong>Methods: </strong>All fetuses with a prenatal suspicion of isolated CoA were prospectively recruited at our fetal cardiology services. Cases were classified as true CoA or false-positives based on their postnatal diagnosis. Speckle-tracking echocardiography was performed longitudinally to assess left and right ventricular global longitudinal strain (GLS), strain rate, and segmental strain throughout gestation. Measurements were compared between true CoA and false-positive cases.</p><p><strong>Results: </strong>Thirty-eight fetuses were included (19 true CoA, 19 false-positives). True CoA cases exhibited smaller left-sided cardiac dimensions, including the aortic valve (mean Z-score -3.2 vs. -1.6, p<0.001), aortic isthmus (-3.5 vs. -1.7, p=0.001), and mitral valve (-4.9 vs. -3.1, p<0.001), whereas right-sided cardiac dimensions were comparable (pulmonary valve Z-score 3.0 vs. 2.6, p=0.64; arterial duct Z-score 1.9 vs. 3.2, p=0.61). No clinically relevant differences in myocardial deformation parameters were observed between groups, with similar left ventricular GLS (-20.1% vs. -20.5%, p=0.57), right ventricular GLS (-20.0% vs. -19.1%, p=0.13), strain rates and segmental strain.</p><p><strong>Conclusion: </strong>Fetal myocardial deformation analysis does not provide additional predictive value for postnatal outcome in prenatally suspected isolated CoA. Conventional assessment of cardiac dimensions and flow patterns remains the cornerstone of prenatal CoA diagnosis, yet current imaging modalities cannot provide sufficient diagnostic certainty to safely triage perinatal management.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"1"},"PeriodicalIF":1.7,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}