Fetal Diagnosis and Therapy最新文献

{"title":"Callosal Injuries in Cytomegalovirus Fetopathy: A Neurosonographic Study.","authors":"Karina Krajden Haratz, Gustavo Malinger, Hadas Miremberg, Joseph Hartoov, Igal Wolman, Ariel Jaffa, Michael Busilov, Roee Birnbaum","doi":"10.1159/000541794","DOIUrl":"10.1159/000541794","url":null,"abstract":"<p><strong>Introduction: </strong>Among the fetal brain anomalies described in cases of congenital infection, callosal insults are rarely cited in medical literature. The aim of this study was to describe the rate and pattern of callosal injury in cytomegalovirus (CMV) fetopathy.</p><p><strong>Methods: </strong>This retrospective study included fetuses with confirmed CMV-PCR, assessed in a single center. Demographic data including maternal seroconversion info were collected. Dedicated US including neurosonography was performed, with high frequency probes, using TV route whenever feasible. Fetal brain biometry including callosal length and the corpus callosum (CC)/OFD ratio was performed. Length below the 5th centile or morphological abnormalities were considered abnormal. Brain and body morphology were thoroughly assessed, and any abnormal finding reported.</p><p><strong>Results: </strong>Seventy-two patients were included in our cohort. In 76% infection occurred in the 1st T or periconceptional. In 12 patients, the exact time of infection was inconclusive, including two cases of secondary infection. In 34.7%, a callosal anomaly was observed and it was never isolated. CNS abnormalities included: periventricular hyperechogenicity (PVHE) 55.5%, calcifications 52%, ventriculomegaly 33%, periventricular pseudocysts 31.4%, occipital cysts 22.2%, echogenic ganglionic eminence 30.5%, lentostriatal vasculopathy 26.4%, sulcation abnormalities 22.2%, cerebellar findings 18% and HC below -2 SD 18%. In 19 cases, the CC was short with calcifications in four. In one case, the insult was severe and in another the CC was absent. The most common association with CC insult was PVHE (56%) and calcifications (52%).</p><p><strong>Conclusion: </strong>Although not referred as a classic brain structure affected by CMV infection, the CC was injured in one-third of our patients, including cases of late infection. The mechanism of disease and the prenatal patterns of callosal involvement in these cases appear to be different from the postnatal patterns and are not reversible. The presence of a callosal injury would imply a worse prognosis and significant increment to the risk of neurodevelopmental impairment.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"243-253"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased Risk of Persistent Pulmonary Hypertension of the Newborn in Twin Anaemia Polycythaemia Sequence Donors.","authors":"Margot J A van de Sande, Femke Slaghekke, Arjan B Te Pas, Ruben S G M Witlox, Enrico Lopriore, Lisanne S A Tollenaar","doi":"10.1159/000542493","DOIUrl":"10.1159/000542493","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to describe the prevalence and risk factors for respiratory complications in monochorionic twins with twin anaemia polycythaemia sequence (TAPS).</p><p><strong>Methods: </strong>All neonates diagnosed with postnatal TAPS at our center between 2002 and 2023 were included in this retrospective study. The primary outcome was the prevalence of respiratory complications, including respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), and persistent pulmonary hypertension of the newborn (PPHN). Secondary outcomes included need of respiratory support during admission and a risk factor analysis for adverse respiratory outcome.</p><p><strong>Results: </strong>In our study of 100 postnatally diagnosed TAPS pregnancies, 32% (62/199) experienced RDS and 13% (25/199) had BPD, with no difference between donors and recipients. PPHN occurred in 7% of cases, more frequently in donors (11%, 11/100) than in recipients (3%, 3/100) (OR = 1.3, 95% CI: 0.2-2.6). Lower gestational age at birth and severe foetal anaemia were found to be significant independent risk factors associated with PPHN in TAPS twins (OR = 0.3, 95% CI: 0.1-0.5), respectively (OR = 1.9, 95% CI: 0.8-3.1).</p><p><strong>Conclusion: </strong>TAPS donor twins have a fourfold increased risk of PPHN due to anaemia compared to recipient twins. Given the life-threatening nature of PPHN, TAPS twins should be born in hospitals equipped to treat it.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"304-313"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142617774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Speckle Tracking Echocardiography in Twin Pregnancies and the Role of Global Longitudinal Strain and Peak Systolic Strain: A Systematic Review and Meta-Analysis.","authors":"Eline Meireson, Noortje H M van Oostrum, Judith O E H van Laar, Ellen Roets, Esmée M Bijnens, Liesbeth Lewi, Kristien Roelens","doi":"10.1159/000541981","DOIUrl":"10.1159/000541981","url":null,"abstract":"<p><strong>Introduction: </strong>Twin pregnancies are associated with an increased risk of perinatal morbidity and mortality. Pregnancy complications related to twins, such as fetal growth restriction, and twin-to-twin transfusion syndrome (TTTS), are associated with hemodynamic changes in the fetal heart. Two-dimensional speckle tracking echocardiography (2D STE) is a tool to evaluate fetal cardiac function. This paper aims to review the literature regarding global longitudinal strain (rate) and peak systolic strain (rate) assessed with 2D STE in twin pregnancies. Feasibility, frame rate, and angle of the fetal heart at the time of measurement were selected as secondary outcomes.</p><p><strong>Methods: </strong>The databases Medline, Embase, Scopus, and Web of Science were searched.</p><p><strong>Results: </strong>Seven articles met the inclusion criteria and selected all monochorionic diamniotic (MCDA) twins with TTTS as the study population. The global longitudinal strain in the right and left ventricle and the peak systolic strain in the right ventricle of the recipient MCDA twin are significantly decreased compared to the donor MCDA twin. 2D STE assessment was shown feasible and reproducible in MCDA pregnancies. Large heterogeneity in technical characteristics between the articles induces inconsistent results.</p><p><strong>Conclusion: </strong>Although feasible, the knowledge of 2D STE is very limited in twin pregnancy. Prospective studies are needed to evaluate the 2D STE assessment in uncomplicated twin pregnancies considering its possible additive value in the diagnostics of pregnancy-related pathologies.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"291-303"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647208","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":"Cord Occlusion in Twin Reversed Arterial Perfusion Sequence: A Retrospective Study of Laser Photocoagulation versus Radiofrequency Ablation.","authors":"Emi J Komatsu, Catherine Hamzeh, Grace Hamadeh, Arlyn Llanes, Lisa M Korst, Ramen H Chmait","doi":"10.1159/000542494","DOIUrl":"10.1159/000542494","url":null,"abstract":"<p><strong>Introduction: </strong>Twin reversed arterial perfusion (TRAP) sequence is a rare condition complicating monozygotic multiple gestations. Prenatal management via umbilical cord occlusion (UCO) of the anomalous twin has been shown to improve pump twin survival. We compared outcomes of gestations with high-risk TRAP sequence treated with mid-trimester UCO using laser photocoagulation versus radiofrequency ablation (RFA).</p><p><strong>Methods: </strong>This is a retrospective, single-center, cohort study of all patients with high-risk TRAP sequence who underwent UCO from 2006-2023. High-risk criteria were defined as follows: larger abdominal circumference of the anomalous twin, polyhydramnios, critically abnormal Doppler waveforms in the pump twin, hydrops in the pump twin, and/or monoamniotic twins. The primary outcome was 30-day survival of the pump twin.</p><p><strong>Results: </strong>The 74 patients were divided equally between the laser and RFA groups. For the 2 groups, mean gestational age (GA) at UCO (20.5 ± 2.3 vs. 20.7 ± 3.1 weeks, p = 0.987) and mean GA at delivery (35.2 ± 4.6 vs. 34.5 ± 5.7 weeks, p = 0.812) were similar. The 30-day neonatal survival rate did not differ (91.9% [34/37] vs. 89.2% [33/37], OR: 1.37 [0.29-6.61], p = 0.692).</p><p><strong>Conclusion: </strong>No difference in 30-day neonatal survival was identified in patients with high-risk TRAP sequence who underwent mid-trimester UCO by laser versus RFA.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"320-327"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound Guidance to Replicate Transuterine BioGlue Injection in the Fetal Hydrocephalus Sheep Model.","authors":"Ayssa Teles Abrao Trad, Rodrigo Ruano, Liang Zhang, Julian Rechberger, David J Daniels, Amy B Kolbe, Muhammad Yasir Qureshi, Katherine W Arendt, Leal Segura, Eniola R Ibirogba, Amy G Andrews, Adam Loudermilk, Elizabeth Ann L Enninga, Edward S Ahn, Mauro Schenone","doi":"10.1159/000540578","DOIUrl":"10.1159/000540578","url":null,"abstract":"<p><strong>Introduction: </strong>Congenital hydrocephalus often results in irreversible and severe damage to the brain despite postnatal interventions. The potential for prenatal intervention to mitigate these deleterious effects underscores the importance of a suitable animal model. We aimed assess the results of an ultrasound-guided transuterine approach to replicate the BioGlue injection fetal hydrocephalus model.</p><p><strong>Methods: </strong>Pregnant ewes were anesthetized at 95 days of gestation and BioGlue was injected into the fetal cisterna magna under ultrasound guidance through the uterus. Ventriculomegaly was assessed by MRI and histology.</p><p><strong>Results: </strong>Nine pregnant ewes were included in the study, and their fetuses were divided into the BioGlue intervention group (n = 9 fetuses) or the control group (n = 7 fetuses) who were not injected. Although hydrocephalus was noted in 5 of 9 fetuses in the intervention group, the ability to induce hydrocephalus went from 0% to 100% in the last 3 fetuses following technical modifications. None of the controls developed hydrocephalus. Fetal brains with hydrocephalus demonstrated increased IBA1+ compared to control animals.</p><p><strong>Conclusions: </strong>While technical challenges were noted, the ultrasound-guided transuterine approach to replicate the BioGlue fetal hydrocephalus model in sheep showed consistent and reproducible results. This model offers the advantage of directly visualizing the location of the needle tip and injection of the BioGlue. This technique offers an alternative for testing novel approaches for prenatal congenital hydrocephalus treatment.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"81-89"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787710","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":"Management of Twin Reversed Arterial Perfusion Sequence: A Systematic Review and Meta-Analysis.","authors":"Michael A Stellon, Devashish S Joshi, Michael J Beninati, Glen Leverson, Qiuyu Yang, Kathleen M Antony, Leslie Christensen, J Louis Hinshaw, Eric Monroe, Inna N Lobeck","doi":"10.1159/000542841","DOIUrl":"10.1159/000542841","url":null,"abstract":"<p><strong>Introduction: </strong>Twin reversed arterial perfusion (TRAP) sequence is a rare complication of monochorionic twin pregnancies characterized by placental anastomoses between a normally developed twin and an acardiac mass. Though several treatment modalities exist, the optimal management strategy is unclear. This study aimed to compare the various treatment strategies for TRAP sequence.</p><p><strong>Methods: </strong>A systematic review of the literature was performed using PRISMA guidelines including PubMed, Scopus, Web of Science, and the Cochrane Library. Studies were imported into Covidence, where they were independently screened by two authors. Studies included described interventions for TRAP sequence. Those excluded were unavailable in English and lacked differentiation between intervention strategies for TRAP and other monochorionic twin pregnancies. Fisher's exact test and random effects modeling were used for statistical analysis.</p><p><strong>Results: </strong>A total of 2,340 abstracts were screened, of which 218 articles progressed to full review and 120 qualified for data extraction. Overall, 757 twin pregnancies were described. Most were treated with radiofrequency ablation (RFA) (n = 363, 47.95%) and laser ablation (n = 220, 29.06%). Statistically significant differences among the modalities were seen in technical success (p = 0.005), gestational age at presentation (p < 0.01), intervention (p = 0.01), and delivery (p = 0.01), respectively, and time between treatment and delivery (p < 0.01). Notably, pump twin survival did not differ based on treatment modality used (p = 0.196). Overall, complication rates were low with no differences in preterm premature rupture of membranes (p = 0.66), preterm labor (p = 0.58), or maternal hemorrhage between modalities (p = 0.28). Suture cord ligation, however, had a greater hemorrhage rate than RFA (p = 0.03).</p><p><strong>Conclusions: </strong>This embodies the first meta-analysis comparing treatment modalities for TRAP sequence with outcomes and complications. RFA is the most technically successful strategy. Prospective data are required to further understand the optimal modality and gestational age at treatment to ensure best overall outcomes.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"207-222"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767172","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":"Comparison of Serial Amnioinfusion Strategies for Isolated Early-Onset Fetal Renal Anhydramnios.","authors":"Joyce M Cheng, Ahmet A Baschat, Meredith A Atkinson, Mara Rosner, Michelle L Kush, Denise Wolfson, Sarah Olson, Kristin Voegtline, Lindsey Goodman, Angie C Jelin, Jena L Miller","doi":"10.1159/000539732","DOIUrl":"10.1159/000539732","url":null,"abstract":"<p><strong>Introduction: </strong>The optimal protocol for serial amnioinfusions to maintain amniotic fluid in pregnancies with early-onset fetal renal anhydramnios before 22 weeks is not known. We compared the performance of two different approaches.</p><p><strong>Methods: </strong>A secondary analysis was conducted of serial amnioinfusions performed by a single center during the external pilot and feasibility phases of the Renal Anhydramnios Fetal Therapy (RAFT) trial. During the external pilot, higher amnioinfusion volumes were given less frequently; in the feasibility study, smaller volume amnioinfusions were administered more frequently. Procedural details, complications, and obstetric outcomes were compared between the two groups using Pearson's χ2 or Fisher's exact tests for categorical variables and Student's t tests or Wilcoxon rank-sum tests for continuous variables. The adjusted association between procedural details and chorioamniotic separation was obtained through a multivariate repeated measure logistic regression model.</p><p><strong>Results: </strong>Eleven participants underwent 159 amnioinfusions (external pilot: 3 patients, 21 amnioinfusions; feasibility: 8 patients, 138 amnioinfusions). External pilot participants had fewer amnioinfusions (7 vs. 19.5 in the feasibility group, p = 0.04), larger amnioinfusion volume (750 vs. 500 mL, p < 0.01), and longer interval between amnioinfusions (6 [4-7] vs. 4 [3-5] days, p < 0.01). In the external pilot, chorioamniotic separation was more common (28.6% vs. 5.8%, p < 0.01), preterm prelabor rupture of membranes (PPROM) occurred sooner after amnioinfusion initiation (28 ± 21.5 vs. 75.6 ± 24.1 days, p = 0.03), and duration of maintained amniotic fluid between first and last amnioinfusion was shorter (38 ± 17.3 vs. 71 ± 19 days, p = 0.03), compared to the feasibility group. While delivery gestational age was similar (35.1 ± 1.7 vs. 33.8 ± 1.5 weeks, p = 0.21), feasibility participants maintained amniotic fluid longer.</p><p><strong>Conclusion: </strong>Small volume serial amnioinfusions performed more frequently maintain normal amniotic fluid volume longer because of delayed occurrence of PPROM.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"155-163"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11628636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ectopic Atrial Beats May Cause a ZigZag Pattern at Intrapartum Recording of the Fetal Heart Rate Using Fetal Scalp Electrode.","authors":"Andrea Dall'Asta, Chiara Melito, Stefania Fieni, Tullio Ghi","doi":"10.1159/000542935","DOIUrl":"10.1159/000542935","url":null,"abstract":"<p><strong>Introduction: </strong>Fetal scalp electrode (FSE) is considered the gold standard for the intrapartum monitoring of the fetal heart rate (FHR) being associated with the lowest rate of signal loss and artifacts including the recording of the maternal heart rate. FSE acquires a fetal electrocardiogram and evaluates the time intervals between successive R waves. As such, it allows the recording of the beat-to-beat fluctuation of the FHR. However, due to the precise estimation of the inter-beat interval, FSE may also demonstrate recurrent atrial ectopic beats and register a highly oscillatory FHR pattern mimicking a saltatory or ZigZag appearance.</p><p><strong>Case presentation: </strong>We herein describe a case of intrapartum supraventricular ectopic beats leading to the recording of a saltatory appearance of the FHR that could be demonstrated using FSE only and precluded a reliable assessment of intrapartum fetal oxygenation. Transabdominal gray-scale and M-mode ultrasound assessment of the fetal heart documented supraventricular ectopic beats recurring in 1 out of 10-12 beats, thus supporting the hypothesis that the abnormal FHR pattern on the CTG trace was secondary to fetal arrhythmia and not to rapidly evolving fetal hypoxia.</p><p><strong>Conclusion: </strong>In supraventricular fetal arrhythmia, the use of FSE for continuous intrapartum FHR monitoring differently from external ultrasound transducer may capture a highly variable CTG pattern which is caused by the registration of the ectopic atrial beats and not by a rapidly evolving hypoxia.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"314-319"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767181","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":"Reproducibility Analysis of Two Speckle Tracking Software for the Antenatal Semiautomated Assessment of the Fetal Cardiac Function.","authors":"Andrea Di Tonto, Laura Nogue, Beatrice Valentini, Mar Bennasar, Chiara Melito, Sara Sorrentino, Olga Gómez, Enrico Corno, Maria Teresa Baffa, Tullio Ghi, Fàtima Crispi, Andrea Dall'Asta","doi":"10.1159/000541007","DOIUrl":"10.1159/000541007","url":null,"abstract":"<p><strong>Introduction: </strong>Speckle tracking echocardiography is a non-Doppler modality allowing the semiautomated evaluation of the fetal cardiac function by tracking the speckles of the endocardial borders. Little evidence is available on the evaluation and comparison of different software for the functional assessment of the fetal heart by means of speckle tracking echocardiography. The aim of this study was to evaluate the reproducibility and agreement of two different proprietary speckle tracking software for the prenatal semiautomated assessment of the fetal cardiac function.</p><p><strong>Methods: </strong>The prospective study including non-anomalous fetuses was referred for different indications at two tertiary academic units in Italy (University of Parma) and Spain (University of Barcelona). Two-dimensional clips of the four-chamber view of the fetal heart were acquired by two dedicated operators using high-end ultrasound machines with a frame rate higher than 60 Hz. The stored clips were pseudo-anonymized and shared between the collaborating units. Functional echocardiographic analyses were independently performed using the two proprietary software (TomTec GmbH and FetalHQ®) by the same operators. Inter-software reproducibility of the endocardial global longitudinal strain (EndoGLS) and fractional area change (FAC) of the left (LV) and the right ventricles (RV) and ejection fraction (EF) of the LV were evaluated by the intraclass correlation coefficient (ICC).</p><p><strong>Results: </strong>Forty-eight fetuses were included at a median of 31+2 (21+6-40+3) gestational weeks. Moderate reproducibility was found for the functional parameters of the LV: EndoGLS (Pearson's correlation 0.456, p < 0.01; ICC 0.446, 95% CI: 0.189-0.647, p < 0.01); EF (Pearson's correlation 0.435, p < 0.01; ICC 0.419, 95% CI: 0.156-0.627, p < 0.01); FAC (Person's correlation 0.484, p < 0.01; ICC 0.475, 95% CI: 0.223-0.667, p < 0.01). On the contrary, RV functional parameters showed poor reproducibility between the two software: EndoGLS (Pearson's correlation 0.383, p = 0.01; ICC 0.377, 95% CI: 0.107-0.596, p < 0.01) and FAC (ICC 0.284, 95% CI: 0.003-0.524, p = 0.02).</p><p><strong>Conclusion: </strong>Our results demonstrate a moderate reproducibility of the speckle tracking analysis of the LV using TomTec GmbH and FetalHQ®, with poor reproducibility for RV analysis.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"8-18"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142003989","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":"Differences between Myeloschisis and Myelomeningocele in Patients Undergoing Prenatal Repair of Open Spina Bifida.","authors":"José Miguel Müller, Edgardo Corral Sereño, Aura Jimenez, Rodrigo Zapata, Silvana Echeverria, Juan Pablo Jara, Alvaro Santibanez, Carolina Lindsay, Renatto Anfossi","doi":"10.1159/000538099","DOIUrl":"10.1159/000538099","url":null,"abstract":"<p><strong>Introduction: </strong>Open spina bifida (OSB) manifests as myelomeningocele (MMC) or myeloschisis (MS). Both lesions theoretically leak cerebrospinal fluid (CSF) and produce different degrees of Chiari II malformation (CHMII). However, it is not entirely clear whether these forms of OSB have different clinical manifestations. This study aimed to evaluate the clinical and/or radiological differences between MS and MMC in patients who underwent prenatal OSB repair.</p><p><strong>Methods: </strong>A total of 71 prenatal repairs were performed with the open technique at the Public Hospital of Rancagua, Chile, between 2012 and 2022. We performed follow-up magnetic resonance imaging (MRI) of fetuses that qualified for prenatal OSB repair surgery. We examined the correlations between various anthropomorphic measurements and clinical and imaging variables, such as the type of lesion and dimensions such as ventricle atrium diameter, degree of severity of CHMII, need for CSF shunt at 12 months, and walking at 30 months.</p><p><strong>Results: </strong>This study included 71 fetuses with OSB for which 38 MRI examinations were analyzed; 61% (43/71) of lesions were MMC and 39% (28/71) were MS. Grade 3 (severe) Chiari II malformations were found in 80% (12/15) of MS and 43% (10/23) of MMC (p < 0.05). Fetuses with an atrial diameter less than 13.48 mm had a lower probability of requiring a CSF shunt at 12 months (p < 0.05). MMC was associated with a significantly higher frequency of clubfoot at birth (p < 0.05), whereas MS was significantly associated with more severe CHMII (p < 0.05). Although the correlations were not significant, we observed clear trends that more children with MS required shunts at 12 months and could walk at 30 months compared to children with MMC.</p><p><strong>Conclusions: </strong>MS and MMC are distinct subtypes of OSB. Further studies of larger cohorts that include biomolecular and histological analysis are required to better understand the differences between these lesions. The findings of this study may enable healthcare providers to better advise parents and prepare healthcare teams earlier for the management of patients undergoing prenatal repair of OSB.</p>","PeriodicalId":12189,"journal":{"name":"Fetal Diagnosis and Therapy","volume":" ","pages":"114-123"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140109780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}