Ultrasound in Obstetrics & Gynecology最新文献

{"title":"Correction to 'Role of artificial-intelligence-assisted automated cardiac biometrics in prenatal screening for coarctation of aorta'.","authors":"","doi":"10.1002/uog.29156","DOIUrl":"10.1002/uog.29156","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"512"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal biometry reference ranges derived from prospective twin population and evaluation of adverse perinatal outcome.","authors":"P Dicker, S Daly, R M Conroy, F M McAuliffe, M P Geary, J J Morrison, S S Carroll, F D Malone, F M Breathnach","doi":"10.1002/uog.29190","DOIUrl":"10.1002/uog.29190","url":null,"abstract":"<p><strong>Objectives: </strong>Ultrasound-derived estimates of fetal size play an integral role in the prenatal management of twin pregnancy. These biometric measurements are conventionally plotted against singleton standards. We sought to establish fetal growth references for abdominal circumference, head circumference, biparietal diameter, femur diaphysis length and estimated fetal weight (EFW) in twin pregnancy. We also aimed to determine whether the performance of a twin fetal growth reference was superior to a singleton reference in the prediction of adverse perinatal outcome in twin pregnancies.</p><p><strong>Methods: </strong>This was a retrospective analysis of data collected prospectively in the Evaluation of Sonographic Predictors of Restricted growth in Twins (ESPRiT) study, which was conducted at eight academic perinatal centers in Ireland, all with tertiary neonatal intensive care facilities. Only diamniotic twin pregnancies with two live fetuses were eligible for inclusion. Exclusion criteria were monoamnionicity, congenital abnormality, twin-to-twin transfusion syndrome or previable fetal demise (< 24 weeks' gestation). Using serial ultrasound observations, we applied fractional polynomial multilevel models to derive an equation for fetal centile determination. We compared these centiles with published singleton and twin fetal references, with particular focus on the Fetal Medicine Foundation (FMF) references. Using the last ultrasound examinations before delivery, we determined associations between biometric measures and a composite measure of adverse perinatal outcome (intraventricular hemorrhage, periventricular leukomalacia, hypoxic ischemic encephalopathy, necrotizing enterocolitis, bronchopulmonary dysplasia, sepsis or perinatal death), neonatal intensive care unit admission, preterm delivery (< 34 weeks) and birth-weight discordance ≥ 25%, based on the varied prevalence of these outcomes. We compared our results with the singleton and twin FMF reference ranges and the twin reference of the Southwest Thames Obstetric Research Collaborative (STORK) study.</p><p><strong>Results: </strong>Among the 948 twin pairs that met the inclusion criteria, 776 (81.9%) dichorionic and 172 (18.1%) monochorionic twin pairs completed the prospective 2-weekly ultrasound surveillance program. Fetal biometric measurements were obtained in 15 274 ultrasound assessments (12 279 in dichorionic and 2995 in monochorionic twin pairs) from serial ultrasound assessments. The median number of ultrasound assessments per pregnancy was 8 (interquartile range, 7-9). Growth trajectories in this cohort were consistent with the FMF and STORK published twin cohorts and notably less consistent with the FMF singleton standard. Compared with the FMF singleton standards, the 50<sup>th</sup> centiles for twins were greater early in pregnancy and lower later in pregnancy for all biometric measures, in both dichorionic and monochorionic twin pregnancies. This crossover","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"436-446"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased nuchal translucency thickness and normal chromosomal microarray: Danish nationwide cohort study.","authors":"K Gadsbøll, N Brix, P Sandager, O B Petersen, A P Souka, K H Nicolaides, I Vogel","doi":"10.1002/uog.29198","DOIUrl":"10.1002/uog.29198","url":null,"abstract":"<p><strong>Objective: </strong>To assess the outcome of pregnancies with increased fetal nuchal translucency (NT) thickness and a normal result from chromosomal microarray (CMA) vs conventional karyotyping.</p><p><strong>Methods: </strong>This was a Danish nationwide registry-based cohort study of all singleton pregnancies seen for combined first-trimester screening between 2008 and 2018. Data on NT thickness and pregnancy outcome were retrieved from the Danish Fetal Medicine Database, whereas data on cytogenetic and molecular karyotypes were retrieved from the Danish Cytogenetic Central Register. Pregnancies were stratified according to NT thickness, and we computed the prevalence of chromosomal aberration, termination of pregnancy (due to non-genetic abnormal findings aside from increased NT), pregnancy loss, major congenital malformation and unaffected live birth (live birth ≥ 24 weeks' gestation with no chromosomal aberration or major congenital malformation diagnosed). The prevalence of the different outcomes was further estimated for pregnancies with increased NT (≥ 3.5 mm) and a normal CMA result. Finally, to assess the impact of CMA compared with conventional karyotyping for increased NT, we compared the prevalence of chromosomal aberrations and each pregnancy outcome between the periods 2008-2012 and 2014-2018 (during which < 3% and > 60%, respectively, of pregnancies with increased NT were examined using CMA).</p><p><strong>Results: </strong>We identified 557 896 pregnancies with a NT measurement for which outcome data were registered. Fetal NT was ≥ 3.5 mm in 3717 (0.7%) pregnancies, of which 3368 (91%) underwent genetic examination. The prevalence of chromosomal aberrations increased significantly with increasing NT thickness, from 21% in pregnancies with NT of 3.5-4.4 mm to 69% in pregnancies with NT ≥ 6.5 mm. Trisomies 21, 18 and 13 accounted for the majority of chromosomal aberrations diagnosed in all subgroups of increased NT (range, 61-87%). In pregnancies with increased NT and a normal CMA result, the prevalence of unaffected live birth decreased significantly from 87% for NT of 3.5-4.4 mm to 29% for NT ≥ 6.5 mm. Increased uptake of CMA during 2014-2018 compared with 2008-2012 slightly increased the detection of submicroscopic aberrations. However, a normal CMA result, compared with a normal result from conventional karyotyping, did not substantially improve the prognosis in pregnancies with increased NT.</p><p><strong>Conclusions: </strong>Our study reaffirms the association between increased NT and chromosomal aberrations. Although CMA improves diagnostic resolution in pregnancies with increased NT, a normal test result does not substantially impact the prevalence of unaffected live births. This highlights the ongoing need for accurate clinical guidance and continued research, especially as whole-genome sequencing is increasingly adopted in prenatal care. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"462-469"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11961099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of endometrial preparation protocols on pregnancy outcomes in patients with unexplained recurrent implantation failure undergoing frozen embryo transfer.","authors":"J Huang, Y Liao, L Xia, H Wu, Z Liu, J Lin, J Zhu, Y Zhao, Q Wu, H Chen, F von Versen-Höynck, L Tian","doi":"10.1002/uog.29209","DOIUrl":"https://doi.org/10.1002/uog.29209","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the impact of different endometrial preparation protocols on pregnancy outcomes in patients with unexplained recurrent implantation failure (uRIF) undergoing frozen embryo transfer (FET).</p><p><strong>Methods: </strong>This retrospective cohort study reviewed 110 372 FET cycles from three fertility centers in China between January 2014 and July 2021. Among them, 4346 cycles were performed in patients with uRIF, including 557 who had the natural cycle (NC) protocol, 1310 who had the stimulated cycle (SC) protocol and 2479 who had the artificial cycle (AC) protocol. The primary outcome measure was live birth rate. For singleton live births, the main obstetric outcomes (hypertensive disorders of pregnancy, gestational diabetes mellitus, abnormal placentation and prelabor rupture of membranes) and neonatal outcomes (Cesarean delivery, preterm birth, post-term birth, low birth weight, macrosomia, small-for-gestational age, large-for-gestational age and major birth defect) were collected through standardized questionnaire interviews. Potential confounders were controlled by 1:1:1 propensity score matching and multivariable logistic regression analysis using prematched data.</p><p><strong>Results: </strong>There were 397 cycles in each group after matching and all baseline characteristics were balanced with no significant differences between the groups. The live birth rate was comparable among the NC, SC and AC groups (29.5% vs 35.3% vs 33.0%, respectively; P = 0.21), as were the rates of clinical pregnancy, embryo implantation and miscarriage. The three groups differed significantly in Cesarean delivery rate (65.6% vs 71.1% vs 81.1%, respectively; P = 0.04), with post-hoc statistical significance identified between the NC and AC groups (P = 0.01). No significant associations were observed between endometrial preparation protocols and other pregnancy, obstetric and neonatal outcomes. The results after matching were in good agreement with the multivariable-adjusted outcomes before matching.</p><p><strong>Conclusions: </strong>Our findings do not prioritize one specific endometrial preparation protocol over another for improving pregnancy rates among patients with uRIF; however, the increased risk of Cesarean delivery in the AC group necessitates careful consideration to optimize delivery outcomes. Nonetheless, given the overall high rate of Cesarean delivery in all three groups, further clarification is required on whether medical indication or personal preference influenced the decision on the mode of delivery. © 2025 International Society of Ultrasound in Obstetrics and Gynecology.</p>","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Middle cerebral artery velocity time integral as a predictor of fetal anemia using fetal hemoglobin Bart's disease as study model.","authors":"N Parapob, P Jatavan, S Luewan, T Tongsong","doi":"10.1002/uog.29213","DOIUrl":"https://doi.org/10.1002/uog.29213","url":null,"abstract":"<p><strong>Objective: </strong>To assess the diagnostic performance of middle cerebral artery (MCA) velocity time integral (VTI) in predicting fetal hemoglobin (Hb) Bart's disease.</p><p><strong>Methods: </strong>This was a secondary analysis of data collected prospectively from pregnant women at risk for fetal Hb Bart's disease assessed at 17-22 weeks' gestation, receiving care at the Maternal-Fetal Medicine Unit, Chiang Mai Hospital, Thailand, between January 2008 and December 2023. Each fetus underwent prenatal measurement of MCA peak systolic velocity (PSV) and MCA-VTI. Final diagnosis of Hb Bart's disease was confirmed by Hb typing of cord blood, obtained by cordocentesis. MCA-PSV and MCA-VTI were evaluated both as absolute values and multiples of median (MoM) normalized for gestational age. Diagnostic performance of MCA-PSV and MCA-VTI for predicting fetal Hb Bart's disease was evaluated and compared using area under the receiver-operating-characteristics curve (AUC), sensitivity, specificity and positive and negative predictive values.</p><p><strong>Results: </strong>A total of 485 fetuses at risk for Hb Bart's disease (109 affected, 376 unaffected) met the inclusion criteria. Absolute MCA-VTI values were significantly higher in affected compared with unaffected fetuses (7.9 ± 1.8 vs 5.4 ± 1.3; P < 0.001) as were MoM values (1.5 ± 0.3 vs 1.0 ± 0.2; P < 0.001). The diagnostic performance of MCA-VTI was superior to that of MCA-PSV for detecting fetal anemia due to Hb Bart's disease, with AUCs of 0.877 (95% CI, 0.836-0.917) and 0.898 (95% CI, 0.857-0.938) for absolute MCA-VTI values (in cm) and MCA-VTI MoM, respectively, compared with 0.842 (95% CI, 0.795-0.889) and 0.854 (95% CI, 0.809-0.899) for absolute MCA-PSV values (in cm/s) and MCA-PSV MoM, respectively (P < 0.001).</p><p><strong>Conclusion: </strong>MCA-VTI is more accurate compared with MCA-PSV for predicting fetal Hb Bart's disease, which indirectly reflects anemia. This suggests that MCA-VTI could serve as an alternative or adjunct to MCA-PSV for detecting fetal anemia, particularly in cases of Hb Bart's disease and potentially for other etiologies. © 2025 International Society of Ultrasound in Obstetrics and Gynecology.</p>","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of intrauterine transfusion techniques in hemolytic disease of the fetus and newborn.","authors":"R M van 't Oever, V M van Duijn, F Slaghekke, M C Haak, D P de Winter, E Lopriore, M de Haas, S Le Cessie, E J T Verweij","doi":"10.1002/uog.29201","DOIUrl":"https://doi.org/10.1002/uog.29201","url":null,"abstract":"<p><strong>Objectives: </strong>Intrauterine transfusions (IUTs) are the cornerstone in treatment for hemolytic disease of the fetus and newborn (HDFN). It has been suggested that a non-vascular intraperitoneal blood transfusion used in conjunction with an intravascular IUT can slow the decrease in fetal hemoglobin (Hb) levels, potentially extending the interval between transfusions. Our aim was to evaluate the rate of decline in Hb levels and the interval between transfusions using different IUT techniques, including intrahepatic transfusions with and without intraperitoneal transfusion, and transplacental transfusion at the site of the placental cord insertion.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study at the Leiden University Medical Center, the national referral center for HDFN, between January 2006 and December 2022. All cases that underwent intrahepatic (with and without intraperitoneal transfusion) and placental cord insertion IUTs during the study period were included. The primary outcome was the decline in Hb levels per week, measured by comparing the Hb level immediately after the IUT with the Hb level before the subsequent IUT or birth. The primary outcome was analyzed using generalized estimating equations with and without adjustment for confounders.</p><p><strong>Results: </strong>We included 309 fetuses that received a total of 791 IUTs, of which 151 were intrahepatic-only transfusions, 273 were intrahepatic + intraperitoneal transfusions and 367 were placental cord insertion transfusions. We found an adjusted mean difference in the decline in Hb levels of 0.48 (95% CI, 0.29-0.66) g/dL/week between the group that underwent intrahepatic-only transfusion and the group that underwent intrahepatic + intraperitoneal transfusion (P < 0.001). The adjusted mean difference between the intrahepatic-only IUT group and the placental cord insertion IUT group was 0.49 (95% CI, 0.05-0.94) g/dL/week (P = 0.030). The median interval to the next IUT for the total cohort was 21 (interquartile range (IQR), 18-28) days. Similarly, in the intrahepatic-only and placental cord insertion IUT groups, the median interval to the next IUT was 21 (IQR, 19-28) and 21 (IQR, 15-26) days, respectively. In the intrahepatic + intraperitoneal transfusion group, the median interval was slightly higher (26 (IQR, 21-28) days).</p><p><strong>Conclusion: </strong>Decline in Hb levels was slower when using intrahepatic + intraperitoneal transfusion compared with other IUT techniques and seemed to prolong the interval between IUT procedures. The potential clinical advantages of the intrahepatic + intraperitoneal transfusion technique need to be weighed against the increased complexity and extended duration of the procedure on an individual basis. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.</p>","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of magnetic resonance imaging-derived maternal and fetal parameters with shoulder dystocia: matched case-control study.","authors":"D A Badr, F Abi-Khalil, C Kadji, N Marroun, A Carlin, M M Cannie, J C Jani","doi":"10.1002/uog.29210","DOIUrl":"https://doi.org/10.1002/uog.29210","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To assess the association of fetal body measurements and maternal pelvic measurements obtained using magnetic resonance imaging (MRI) with the incidence of shoulder dystocia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a retrospective, single-center, case-control study conducted between January 2015 and December 2022. Patients whose delivery was complicated by shoulder dystocia and who underwent fetal MRI in the third trimester were included in the case group. Patients without shoulder dystocia who were delivered normally and who also underwent fetal MRI in the third trimester were included in the control group. Cases of multiple pregnancy, planned or emergency Cesarean delivery, fetal malformation or those with incomplete MRI examination were excluded. The case group was matched with the control group in a 1:2 ratio according to maternal age, maternal body mass index, gestational diabetes mellitus, diabetes mellitus Type 1 or 2, gestational age at MRI examination, gestational age at birth and birth weight. Shoulder dystocia was defined as per the Royal College of Obstetricians and Gynecologists and significant shoulder dystocia was defined as shoulder dystocia that was not resolved by the McRoberts' maneuver or suprapubic pressure. The following fetal and maternal measurements were quantified on MRI in both groups by two readers (one experienced and one inexperienced physician) who were blinded to the obstetric outcomes: fetal body volume (FBV), shoulder skin-to-skin distance, interhumeral distance, biparietal diameter (BPD), head circumference, obstetric conjugate (OC), sagittal outlet diameter (SOD), coccygeal pelvic outlet (CPO) and maximal transverse diameter (MTD). A stepwise backward logistic regression that included all measurements was performed. The inter-rater reliability of the measurements was estimated using interclass correlation coefficient (ICC). Statistical significance was set at P &lt; 0.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 1843 patients included in the study, there were 63 (3.4%) cases of shoulder dystocia. After matching, the case group comprised 36 patients and the control group comprised 72 patients. Patients who had shoulder dystocia, compared to those without, had higher FBV (P = 0.023), higher shoulder skin-to-skin distance (P = 0.003), lower OC (P = 0.021), lower SOD (P = 0.004), lower CPO (P = 0.045) and lower MTD (P = 0.001) in comparison with those without. The logistic regression model showed that FBV, shoulder skin-to-skin distance, BPD, SOD and MTD were independent predictors of shoulder dystocia. The measurements of interest had moderate to excellent reliability when repeated by an inexperienced reader. In those who had non-significant shoulder dystocia, only shoulder skin-to-skin distance was significantly greater and OC was significantly lower in comparison with the control group, whereas in those who had significant shoulder dystocia, only SOD and MTD were significantly lower","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of serial fetal echocardiograms in detecting in-utero changes for single-ventricle lesions: an 11-year experience.","authors":"S S Ro, A Saini, G Morrow, D Ketchum, J Kreeger, E Michelfelder","doi":"10.1002/uog.29206","DOIUrl":"https://doi.org/10.1002/uog.29206","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Current guidelines in fetal echocardiography recommend serial evaluation every 4 weeks for single-ventricle lesions. However, there are limited data on the type and frequency of in-utero cardiac changes seen on fetal echocardiograms (FEs) based on the type of single-ventricle lesion. We aimed to evaluate the utility of serial FEs in detecting cardiac changes during gestation and how these changes impact postnatal management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We performed a retrospective review of all FEs for fetuses diagnosed with a single-ventricle lesion at the Children's Healthcare of Atlanta, between January 2012 and January 2023. All patients included in the study had two or more FEs and were evaluated for in-utero cardiac changes based on eight cardiac categories: atrioventricular (AV) valve regurgitation; systemic ventricular dysfunction; ductus arteriosus flow; atrial-level restriction; umbilical artery Doppler pattern; umbilical vein Doppler pattern; evidence of hydrops; and evidence of arrhythmias. All in-utero cardiac changes were classified into three categories: improving, worsening or critical. Any changes noted on serial FEs that altered the fetal cardiac diagnosis were also recorded. Fisher's exact test was used to determine whether the proportion of fetuses with in-utero cardiac changes differed significantly between different segmental findings and single-ventricle lesion subtype.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 721 FEs were performed for 248 patients over the 11-year study period. The majority of fetuses had hypoplastic left heart syndrome (HLHS) (63.7%) and most changes were seen in the third trimester (median gestational age, 29.3 (range, 17.4-38.4) weeks). In-utero cardiac changes observed on serial FEs were reported in 38 (15.3%) fetuses, with a total of 42 changes noted throughout the study period. However, only eight (3.2%) fetuses had a critical change that impacted perinatal management. All eight fetuses had HLHS, of which the majority developed hydrops (4/8) or atrial-level restriction (3/8). In addition, there were 34 non-critical changes seen in 30 (12.1%) fetuses, largely in the form of intermittent premature atrial contractions, AV valve regurgitation or ventricular dysfunction. There were 12 (2.5%) follow-up FEs that resulted in a change to the fetal cardiac diagnosis, confirmed by postnatal echocardiography.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In fetuses with single-ventricle lesions, there was a low rate of in-utero cardiac changes that led to alterations in perinatal management. However, fetuses with HLHS were most likely to develop critical changes affecting delivery-room management, often in the form of atrial-level restriction and/or evolving hydrops. It is important to consider these factors when considering the timing of visits for families who face a prenatal diagnosis of a single-ventricle lesion. © 2025 International Society of Ultrasound in Obstetrics and Gynecolo","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for pre-eclampsia using pregnancy-associated plasma protein-A or placental growth factor measurements in blood samples collected at 8-14 weeks' gestation.","authors":"L Rode, A Wright, D Wright, M Overgaard, L Sperling, P Sandager, P Nørgaard, F S Jørgensen, H Zingenberg, I Riishede, A Tabor, C K Ekelund","doi":"10.1002/uog.29204","DOIUrl":"https://doi.org/10.1002/uog.29204","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To assess the value of pregnancy-associated plasma protein-A (PAPP-A) in screening for preterm pre-eclampsia (PE) (delivery &lt; 37 weeks' gestation) measured in maternal blood samples collected before 11 weeks, and to compare the screening performance of PAPP-A with that of placental growth factor (PlGF) from blood samples collected at 8-14 weeks.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study analyzed data from women who participated in the PRESIDE (Pre-eclampsia Screening in Denmark) study, a prospective, non-interventional multicenter study investigating the predictive performance of the Fetal Medicine Foundation first-trimester screening algorithm for PE in a Danish population. As part of combined first-trimester screening, a routine blood sample was collected at 8-14 weeks' gestation and PAPP-A was measured. Excess serum was stored at -80°C and analyzed for PlGF in batches after delivery. Most women in the PRESIDE study had an extra blood sample collected at the time of the first-trimester scan at 11-14 weeks, which was also analyzed for PlGF and PAPP-A in batches after all the participants had delivered. Screening performance was assessed in terms of the detection rate at a 10% screen-positive rate (SPR) for a combination of PAPP-A or PlGF with maternal factors alone and for a combination of each of these biomarkers with maternal factors, mean arterial pressure (MAP) and uterine artery pulsatility index (UtA-PI).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study population comprised 8386 women who had a routine combined first-trimester aneuploidy screening blood sample collected at 8-14 weeks' gestation. In pregnancies that developed preterm PE, the median PAPP-A multiples of the median from routine blood samples were 0.78 (95% CI, 0.67-0.90) before 10 weeks, 0.80 (95% CI, 0.58-1.10) at 10 weeks and 0.64 (95% CI, 0.53-0.78) at 11-14 weeks. In women with samples collected before 10 weeks, there was no significant improvement in the detection rate of preterm PE when PAPP-A or PlGF was combined with maternal factors alone or when combined with maternal factors, MAP and UtA-PI. In routine samples collected at or after 10 weeks, PAPP-A only increased the detection rate of preterm PE slightly. However, PlGF in samples collected at or after 10 weeks increased the detection rate from 31.3% (95% CI, 16.1-50.0%) to 56.3% (95% CI, 37.7-73.6%) at a 10% SPR, i.e. an increase in the detection rate of 25.0% (95% CI, 4.3-44.4%), when combined with maternal factors alone. When PlGF collected from the PRESIDE sample at 11-14 weeks was combined with maternal factors, MAP and UtA-PI, there was an increase in the detection rate from 50.9% (95% CI, 37.1-64.6%) to 67.3% (95% CI, 53.3-79.3%), i.e. an increase of 16.4% (95% CI, 5.6-29.0%) at a 10% SPR.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;PAPP-A has limited value in first-trimester screening for PE, whereas PlGF adds significantly to the detection rate of preterm PE at 10-14 weeks' gestation. © 202","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Small-for-gestational age according to INTERGROWTH-21^st fetal weight standard misses most pregnancies at risk of stillbirth identified by GROW.","authors":"O Hugh, E Butler, H Ellson, J Mytton, J Gardosi","doi":"10.1002/uog.29214","DOIUrl":"https://doi.org/10.1002/uog.29214","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}