Journal of Perinatal Medicine最新文献

{"title":"Neonatal and long-term outcomes in infants born to mothers after solid organ transplantation: a narrative review with Polish cohort data.","authors":"Bożena Kociszewska-Najman, Milan Stanojević, Natalia Czaplińska, Andrzej Domański","doi":"10.1515/jpm-2026-0225","DOIUrl":"https://doi.org/10.1515/jpm-2026-0225","url":null,"abstract":"<p><strong>Introduction: </strong>To review current evidence on pregnancy, neonatal, and long-term outcomes in infants born to transplant recipients, with particular emphasis on the effects of maternal immunosuppressive therapy, and to present data from a Polish cohort, including breastfeeding exposure. A narrative review of the literature was conducted, focusing on maternal, neonatal, and long-term outcomes after solid organ transplantation. Registry data, cohort studies, and pharmacokinetic analyses of immunosuppressive drug transfer into breast milk were included. Findings from a Polish cohort of transplant recipients and their offspring were analyzed to complement available evidence.</p><p><strong>Content: </strong>Pregnancy in transplant recipients is feasible but remains high risk, with increased rates of preterm birth and intrauterine growth restriction. Neonatal outcomes are largely determined by prematurity, while the incidence of major congenital malformations is comparable to the general population when recommended immunosuppressive regimens are used. Temporary alterations in neonatal immune parameters and mild neurological impairment may occur but are not associated with significant long-term sequelae. Available data indicate generally normal growth, neurodevelopment, and immune function. Breastfeeding exposure to corticosteroids, azathioprine, and calcineurin inhibitors is minimal. Data from the Polish cohort confirm low transfer of tacrolimus and cyclosporine into breast milk and favorable infant outcomes.</p><p><strong>Summary and outlook: </strong>With appropriate multidisciplinary care, pregnancy and breastfeeding in transplant recipients can be managed safely. Neonatal risk is primarily related to prematurity, while long-term outcomes appear reassuring. Breastfeeding may be supported in selected patients receiving compatible immunosuppressive therapy. Continued long-term follow-up and prospective studies are needed.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Graphicflow ultrasound in fetal echocardiography: principles, hemodynamics, clinical applications, and future perspectives.","authors":"Wiku Andonotopo, Muhammad Adrianes Bachnas, Mochammad Besari Adi Pramono, Julian Dewantiningrum, Aloysius Suryawan, Ridwan Abdullah Putra, I Nyoman Hariyasa Sanjaya, Dudy Aldiansyah, Efendi Lukas, Nuswil Bernolian, Adhi Pribadi, Waskita Ekamaheswara Kasumba Andanaputra","doi":"10.1515/jpm-2026-0392","DOIUrl":"https://doi.org/10.1515/jpm-2026-0392","url":null,"abstract":"<p><strong>Background: </strong>Graphicflow is a commercially available ultrasound technology that uses trajectory-based blood speckle tracking to display intracardiac blood-cell movement in real time during fetal echocardiography. Unlike conventional Doppler ultrasound, which mainly measures blood-flow velocity and direction, this technique offers an additional perspective by revealing how blood moves, circulates, and organizes within the fetal heart. Although interest in this approach has grown over recent years, the current evidence remains limited and is largely based on early feasibility studies and small observational reports.</p><p><strong>Content: </strong>This illustrated Opinion Paper brings together the available evidence on trajectory-based fetal hemodynamic imaging by reviewing published fetal, neonatal, and pediatric blood speckle-tracking studies alongside international fetal echocardiography guidelines, technical reports, and established principles of cardiovascular fluid dynamics. We discuss the underlying physics of blood speckle tracking, the physiological significance of intracardiac flow patterns, potential clinical applications, existing technical challenges, and key considerations for responsible clinical adoption. We also include original fetal imaging examples and conceptual illustrations to summarize current knowledge while highlighting important gaps that require further investigation. Given the limited clinical validation currently available, this review should be viewed as an evidence-informed synthesis and a framework for generating future research hypotheses rather than evidence supporting routine clinical use.</p><p><strong>Summary: </strong>Current evidence suggests that trajectory-based blood-flow imaging may complement conventional fetal echocardiography by providing qualitative visualization of intracardiac flow organization beyond velocity mapping alone. However, standardized acquisition protocols, quantitative hemodynamic metrics, reproducibility, gestational age-specific normative datasets, and prospective multicenter validation remain necessary before routine clinical implementation can be recommended.</p><p><strong>Outlook: </strong>Future research should prioritize methodological standardization, rigorous clinical validation, and demonstration of incremental clinical value beyond conventional fetal echocardiography to support the responsible integration of trajectory-based fetal hemodynamic imaging into clinical practice.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Normal OGTT does not imply uniform risk: association of area under the curve percentiles with adverse perinatal outcomes.","authors":"Burçin Salman Özgü, Ömer Hamid Yumuşak, Esengül Türkyılmaz Şener, Aytekin Tokmak","doi":"10.1515/jpm-2026-0340","DOIUrl":"https://doi.org/10.1515/jpm-2026-0340","url":null,"abstract":"<p><strong>Objectives: </strong>Although the 75 g oral glucose tolerance test (OGTT) is the standard diagnostic tool for gestational diabetes mellitus (GDM), women with normal OGTT results may still show differences in glucose metabolism. The area under the glucose curve (AUC) reflects the overall glycemic response during the OGTT and may help identify differences in perinatal risk not captured by conventional thresholds. We aimed to evaluate perinatal outcomes across OGTT-AUC quartiles in pregnancies with normal glucose tolerance.</p><p><strong>Methods: </strong>In this retrospective cohort study, 11,607 pregnant women with normal 75 g OGTT results at 24-28 weeks of gestation were stratified into quartiles (Q1-Q4) according to OGTT AUC. Maternal characteristics and obstetric and neonatal outcomes were compared across AUC quartiles using appropriate statistical tests and post-hoc analyses. Multivariable logistic regression analyses were performed to identify independent associations between OGTT-AUC quartiles and selected adverse perinatal outcomes.</p><p><strong>Results: </strong>Among 11,607 normoglycemic pregnancies, increasing OGTT-AUC quartiles were associated with higher cesarean delivery rates, birth weight, LGA, macrosomia, polyhydramnios, preterm birth and NICU admission, whereas SGA rates decreased (all p≤0.001). In multivariable analyses adjusted for maternal age, parity, BMI, fetal sex, smoking, and mode of conception, higher AUC was independently associated with increased odds of LGA, macrosomia, polyhydramnios, preterm birth, and NICU admission, while SGA odds decreased. No independent association was observed with preeclampsia.</p><p><strong>Conclusions: </strong>Among women with normal glucose tolerance, higher OGTT-AUC was independently associated with a distinct pattern of adverse perinatal outcomes, characterized by increased risks of LGA, macrosomia, polyhydramnios, preterm birth, and NICU admission, alongside a lower risk of SGA. These findings support a continuum of maternal glycemic exposure below the diagnostic threshold for GDM and suggest that OGTT-AUC may provide additional prognostic information beyond conventional OGTT-based classification.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significance of perinatal trauma screening and care coordination to improve infant health outcomes.","authors":"Aysha Jawed","doi":"10.1515/jpm-2025-0683","DOIUrl":"https://doi.org/10.1515/jpm-2025-0683","url":null,"abstract":"<p><p>This commentary addresses the need for trauma-informed screening and coordinated mental health care across obstetric (OB) and neonatal intensive care unit (NICU) settings. Perinatal post-traumatic stress disorder (PTSD) and related mental health conditions are common yet under-recognized, particularly among individuals exposed to medical trauma, prior adversity, or interpersonal violence. Perinatal PTSD prevalence estimates range from 3-6 % in community samples and 15-25 % in high-risk populations, including NICU parents, individuals with obstetric complications, and those with prior trauma histories. Infants hospitalized in NICUs experience their own forms of trauma related to pain, sensory overload, and caregiver separation, while parents are critical buffers of infant stress but may be unable to provide effective co-regulation when they are themselves traumatized. Guided by the Substance Abuse and Mental Health Services Administration (SAMHSA) trauma-informed framework, this commentary synthesizes current evidence on screening, perinatal PTSD risk factors, intergenerational trauma, and Collaborative Care models. The author describes how integrated mental health services can be operationalized across care environments and issue a call to action for universal screening, universal education about healthy and unsafe relationship dynamics, coordinated treatment pathways, and equity-focused implementation strategies to protect infant neurodevelopment and interrupt intergenerational cycles of trauma.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum outcomes in sickle cell disease: transfusion exposure, maternal morbidity, and breastfeeding persistence.","authors":"Nawras Zayat, Rachael Bertuzzi, Jared Eckman, Henny Billett","doi":"10.1515/jpm-2026-0271","DOIUrl":"https://doi.org/10.1515/jpm-2026-0271","url":null,"abstract":"<p><strong>Objectives: </strong>To characterize postpartum maternal morbidity in women with sickle cell disease (SCD) and explore whether antepartum disease burden, transfusion exposure, and peripartum clinical factors were associated with postpartum maternal and breastfeeding outcomes.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 37 deliveries in patients with confirmed SCD at a large urban academic center (2015-2025). Maternal, neonatal, transfusion, and breastfeeding outcomes were abstracted from the electronic medical record.</p><p><strong>Results: </strong>Thirty-seven deliveries met inclusion criteria. The predominant genotype was HbSS (24/37, 64.9 %), followed by HbSC (7/37), HbSβ⁰-thalassemia (3/37), HbSβ⁺-thalassemia (2/37), and HbS/HPFH (1/37). More than one-third of deliveries (13/37, 35.1 %) required transfusion within the first postpartum week. Postpartum hemorrhage ≥1,000 mL occurred in 5 of 37 deliveries (13.5 %), and 5 of 36 (13.9 %) required readmission within 6 weeks postpartum, most commonly for vaso-occlusive crisis. NICU admission occurred in 14 of 37 neonates (37.8 %). Breastfeeding intention was high (32/33, 97 %); persistence declined to 23 of 33 (69.7 %) at 6 weeks and 12 of 34 (35.3 %) at approximately 6 months. Exploratory analyses suggested lower breastfeeding persistence among deliveries complicated by NICU admission and among those with greater antepartum clinical burden, including pregnancy transfusion, lower admission hemoglobin, and hospitalization during pregnancy.</p><p><strong>Conclusions: </strong>The postpartum period in women with SCD is characterized by persistent hematologic morbidity, ongoing transfusion requirements, and declining breastfeeding persistence. Greater antepartum disease burden and neonatal complications may identify pregnancies at higher risk for adverse postpartum outcomes, supporting integrated hematology-obstetric care extending into the postpartum period.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Newborns of mothers living with HIV on antiretroviral treatment at late pregnancy are more likely to present low birth weight.","authors":"Edna N Matjuda, Godwill A Engwa, Nandu Goswami, Constance R Sewani-Rusike, Benedicta N Nkeh-Chungag","doi":"10.1515/jpm-2026-0158","DOIUrl":"https://doi.org/10.1515/jpm-2026-0158","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigated the effects of ART on the cardiometabolic health of HIV-infected women during late pregnancy and its relationship with adverse outcomes in exposed newborns.</p><p><strong>Methods: </strong>This was a cross-sectional study conducted among pregnant women living with HIV (pWLWH) on ART and HIV-uninfected pregnant women (controls) in their third trimester. Data on maternal gynaeco-obstetric history and cardiovascular health were collected. At birth, anthropometric measures and placental cord blood samples from newborns were collected to assess lipidaemia, glycaemia, oxidative stress, endothelial function, and inflammatory markers.</p><p><strong>Results: </strong>More pWLWH had previously had hypertension compared (p>0.05) to HIV-uninfected pregnant women (HUPW). Blood creatinine and 8-hydroxydeoxyguanosine were higher, while tumour necrosis factor-alpha and vascular endothelial growth factor receptor were lower in newborns of HIV-infected mothers on ART (HIMA) compared to newborns of HIV-uninfected mothers (HUM) (p<0.05). Similarly, the APGAR scores after 1 and 5 min were lower in newborns of HIMA compared to newborns of HUM (p<0.05). The prevalence of low birth weight (LBW) was higher (p<0.05) in newborns of HIMA (13.2 %) compared to newborns of HUM (8.2 %). Newborns of HIMA were 3.3 times (OR: 3.302; p<0.01) more likely to present LBW compared to newborns of HUM.</p><p><strong>Conclusions: </strong>Newborns of HIV-infected mothers on ART were more likely to have low birth weight than newborns of HIV-uninfected mothers, suggesting an association of ART with low birth weight in newborns. <i>In utero</i> exposure of the foetus to ART might have influenced low birth weight in newborns through the promotion of endothelial dysfunction and oxidative stress.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of growth abnormalities in monochorionic diamniotic twin pregnancies using estimated fetal weight discordance and clinical factors: a retrospective cohort study.","authors":"Yanzhao Liu, Peiyao Yan, Lanqi Zhong, Tianci Liu, Xinyuan Feng, Liang Li","doi":"10.1515/jpm-2026-0211","DOIUrl":"https://doi.org/10.1515/jpm-2026-0211","url":null,"abstract":"<p><strong>Objectives: </strong>To explore whether integrating additional conventional clinical or ultrasonic predictors with mid-pregnancy estimated fetal weight discordance (EFWD) can enhance the predictive ability for fetal growth abnormalities in monochorionic diamniotic (MCDA) twin pregnancies.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted, including MCDA twin pregnancies delivered over a five-year period. Estimated fetal weight was calculated using the Hadlock formula. The primary growth abnormalities investigated were late-onset selective fetal growth restriction (late-onset sFGR), birth weight discordance (BWD) ≥20 %, and small for gestational age (SGA). Binary logistic regression analysis was used to develop prediction models for growth abnormalities using EFWD alone and in combination with other clinical predictors. The models were compared using receiver operating characteristic (ROC) curves and AIC (Akaike Information Criterion).</p><p><strong>Results: </strong>A total of 139 MCDA twin pregnancies were included in the analysis (mean age: 30.40ᵒ±ᵒ3.89 years, 34.5 % conceived through <i>in vitro</i> Fertilization). EFWD (OR 1.25; 95 % CI, 1.14-1.37) and pregnancy complications (OR 2.66; 95 % CI, 1.12-6.32) were significant risk factors for late-onset sFGR. The combined model demonstrated enhanced discriminative ability for late-onset sFGR compared with EFWD alone (area under the ROC curve [AUC]: 0.82 [95 % CI: 0.71-0.94] vs. 0.81 [95 % CI: 0.70-0.92]; p=0.01). EFWD (OR 1.26; 95 % CI, 1.14-1.40) and mean weekly change in EFWD (ΔEFWD/wk) (OR 0.72; 95 % CI, 0.54-0.97) were significant predictors of BWD ≥20 %. The combined model showed superior performance compared with EFWD alone (AUC: 0.84 [95 % CI: 0.76-0.92] vs. 0.79 [95 % CI: 0.70-0.89]; p=0.02). No significant improvement was observed in predicting SGA when combining predictors with EFWD.</p><p><strong>Conclusions: </strong>These combined models may offer incremental value for risk stratification in MCDA twin pregnancies without severe complications before 24 weeks of gestation. Prospective validation is required before clinical implementation.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory morbidity and mortality in Black and White preterm infants.","authors":"Eleanor Jeffreys, Serena Gandino, Charlie Gill, Theodore Dassios, Suresh Victor, Anne Greenough","doi":"10.1515/jpm-2026-0450","DOIUrl":"https://doi.org/10.1515/jpm-2026-0450","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the association between parental ethnicity and respiratory outcomes in infants born before 34 weeks of gestation.</p><p><strong>Methods: </strong>Retrospective matched case-comparison study of inborn infants admitted to two London tertiary neonatal units between September 2022 and September 2025. Infants were included if both parents self-identified as Black (African or Caribbean) or White (British, Irish or Other) ethnicity. Clinical data were collected from electronic records. The primary outcome was the rate of bronchopulmonary dysplasia (BPD).</p><p><strong>Results: </strong>394 infants (197 Black, 197 White) were matched by gestational age (GA). The Black cohort had higher rates of gestational diabetes (GDM) (20.5 vs. 7.6 %, p<0.001) and of being small for gestational age (SGA) (32.0 vs. 19.3 %, p=0.004). After adjustment for GA, GDM and SGA, infants of Black ethnicity had significantly lower odds of requiring mechanical ventilation (p=0.029) and of the composite outcome of BPD or death (p=0.04). When the Black cohort was divided into African (n=157) and Caribbean (n=40) infants, African ethnicity was associated with lower rates of BPD (p=0.011) and of BPD or death (p=0.014) compared with White ethnicity. Caribbean infants had the highest rates of mechanical ventilation (p=0.017) and use of inhaled nitric oxide (p=0.039), and longer durations of mechanical ventilation (p=0.003) and admission (p=0.047), but had similar odds of BPD or of BPD/death to White infants (p=0.98 and p=0.73, respectively).</p><p><strong>Conclusions: </strong>In this UK cohort of preterm infants, respiratory outcomes differed by ethnicity. Further work is needed to identify the genetic, environmental and structural drivers of these difference so that interventions can be appropriately targeted.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatio-temporal images of annular plane systolic excursion: a study of manual intra-observer reliability and correlation with automated values.","authors":"Anna Erenbourg, Manna Elizabeth Philip, Tracie Barber, Neama Meriki, Stefano Faiola, Giulia Lops, Vera Cecotti, Sowmya Arcot, Alec William Welsh","doi":"10.1515/jpm-2025-0729","DOIUrl":"https://doi.org/10.1515/jpm-2025-0729","url":null,"abstract":"<p><strong>Objectives: </strong>Longitudinal ventricular function can be assessed by measuring the annular plane systolic excursion at tricuspid (TAPSE), mitral (MAPSE) or septal (SAPSE) level. This information could be useful in obstetrical practice since common maternal-fetal conditions may modify fetal cardiac function. Automation of these parameters could improve repeatability, enhancing applicability in clinical practice.</p><p><strong>Methods: </strong>Data was prospectively acquired from a mixed cohort of healthy fetuses and those affected by congenital heart disease between 19 + 6 and 36 + 6 gestational weeks. From 90 available STIC volumes, 40 were selected based on a quality scoring system, and TAPSE, MAPSE, and SAPSE were measured by three different operators at different levels of expertise. A recently developed automated tool was applied to calculate TAPSE, MAPSE, and SAPSE from 4D STIC volumes. Intraclass correlation (ICC) was used for analysis.</p><p><strong>Results: </strong>Manual intra-observer repeatability was high for TAPSE, MAPSE, and SAPSE (ICCs 0.92-0.99 (95 % CI 0.86; 0.99), 0.89-0.99 (95 % CI 0.81; 0.94) and 0.89-0.98 (95 % CI 0.83-0.98) respectively). Manual inter-observer repeatability was highest between the operators with the highest and intermediate experience rather than the least experienced. With clear annulus visibility, agreement between automated and manual was excellent for TAPSE and MAPSE (ICCs 0.90 (95 % CI 0.72; 0.97) and 0.97 (95 % CI 0.88; 0.99) respectively) and good for SAPSE (ICC 0.76 (95 % CI -0.56; 0.98)).</p><p><strong>Conclusions: </strong>Automated annular displacement measurement generates excellent results for the degree of agreement with manual measurement for TAPSE and MAPSE, and good for SAPSE under specific conditions. This validated tool may be beneficial for practitioners less experienced in fetal cardiac function assessment. Our encouraging results suggest that further study of the automated method of annular systolic excursion is appropriate.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Propofol and fentanyl for laser photocoagulation in non-intubated preterm infants with retinopathy of prematurity.","authors":"John Tumberger, Chelsey Schartz, Katelyn McKenzie, Matthew Bugada, Travis Langner, Hammad Ganatra, Shawn Sood","doi":"10.1515/jpm-2026-0426","DOIUrl":"https://doi.org/10.1515/jpm-2026-0426","url":null,"abstract":"<p><strong>Objectives: </strong>Retinopathy of prematurity (ROP) is a vasoproliferative retinal disorder of preterm infants, characterized by disrupted retinal vascular development and abnormal neovascularization that result from preterm birth and supplemental oxygen exposure. It is a leading cause of preventable childhood blindness. Laser photocoagulation is a common treatment, but there is no evidence-based consensus on the most appropriate sedation method for this procedure. This study aimed to determine if deep sedation with propofol and fentanyl during laser photocoagulation for ROP is safe and effective while minimizing the side effects of general anesthesia in a vulnerable population.</p><p><strong>Methods: </strong>We retrospectively analyzed preterm infants in the neonatal intensive care unit at a tertiary care medical center who underwent deep sedation with propofol and fentanyl administered by pediatric intensivists during retinal ablation for ROP. The primary outcome was change in vital signs from pre- to post-procedure; secondary outcomes were adverse events, including death, apnea, and emergent airway intervention.</p><p><strong>Results: </strong>Nine preterm infants were identified. Gestational age ranged from 22 to 28 weeks, and median weight at the time of the procedure was 4,000 g (range 1,860-6,500). Median sedation time was 117 min (range 85-188). Vital signs remained stable from pre- to post-procedure (p>0.05 for all). Three patients experienced adverse events: one apnea and two emergent airway interventions. No patient required intubation or mechanical ventilation, and photocoagulation was completed in all cases.</p><p><strong>Conclusions: </strong>Deep sedation with propofol and fentanyl may be effective to control pain during retinal ablation for treatment of ROP for patients with low pre-operative risk. Prospective studies should be conducted to further assess efficacy and safety and to improve the standard of care.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}