American Journal of Obstetrics & Gynecology Mfm最新文献

{"title":"Antenatal corticosteroids for patients at risk of late preterm birth: a systematic review and meta-analysis of randomized controlled trials","authors":"Fabrizio Zullo MD , Moti Gulersen MD, MSc , Daniele Di Mascio MD , Stephanie C. Roth MLIS , Teresa C. Logue MD, MPH , Giuseppe Rizzo MD , Antonella Giancotti MD , Hector Mendez Figueroa MD , Anthony C. Sciscione DO , Gabriele Saccone MD, PhD , Suneet P. Chauhan MD, Hon, DSc , Vincenzo Berghella MD","doi":"10.1016/j.ajogmf.2025.101709","DOIUrl":"10.1016/j.ajogmf.2025.101709","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effectiveness of antenatal corticosteroid administration in the late preterm period (34 0/7–36 6/7 weeks of gestation).</div></div><div><h3>Data Sources</h3><div>A Medical Librarian performed a search in the following databases and grey literature sources from inception until July 15, 2024: PubMed (NLM), Embase.com (Elsevier), Scopus (Elsevier), Cochrane CENTRAL (Wiley), CINAHL Ultimate (EBSCOHost), ClinicalTrials.gov and WHO ICTRP.</div></div><div><h3>Eligibility criteria for selecting studies</h3><div>This study screened studies using 2 independent reviewers based on the predefined inclusion/exclusions criteria. This study included randomized controlled trials (RCTs) comparing antenatal corticosteroid administration with placebo or with no treatment given to individuals with singleton gestations at 34 0/7–36 6/7 weeks.</div></div><div><h3>Study appraisal and synthesis methods</h3><div>This study appraised the included randomized controlled trials using 2 independent reviewers based on the Cochrane RoB 2 tool and other assessment measures. The primary outcome was the incidence of respiratory distress syndrome (RDS) (6 trials, 5163 newborns). Secondary outcomes included hypoglycemia (as defined by each trial) (4 trials, 4750 newborns), incidence of transient tachypnea of the newborn (TTN) (4 trials, 4292 newborns), neonatal intensive care unit (NICU) admission (6 trials, 5169 newborns), continuous positive airway pressure (CPAP) use for ≥2 hours (4 trials, 4760 newborns), surfactant administration (2 trials, 3100 newborns), neonatal sepsis (4 trials, 4754 newborns), neonatal mortality (5 trials, 4920 newborns), need for resuscitation in the labor suite (4 trials, 4647 newborns), hyperbilirubinemia (2 trials, 1156 newborns), necrotizing enterocolitis (NEC) (2 trials, 3710 newborns), mechanical ventilation (5 trials, 5069 newborns) and Apgar Score at 5 minutes of life (2 trials) and maternal outcomes. The summary measures were reported as relative risk (RR) or as mean difference (MD) with 95% of confidence interval (CI) using the random effects model of DerSimonian and Laird. I-squared(Higgins I<sup>2</sup>) greater than 0% was used to identify heterogeneity.</div></div><div><h3>Results</h3><div>Six RCTs, encompassing 5143 deliveries, were included for analysis. The incidence of RDS was similar in the 2 groups (RR 0.89, 95% CI 0.68–1.16), as was the rate of transient tachypnea of the newborn (TTN) (RR 0.93, 95% CI 0.67–1.29). Antenatal corticosteroids significantly reduced the use of CPAP ≥2 hours (RR 0.78, 95% CI 0.65–0.94; <em>P=.</em>007) and surfactant (RR 0.61, 95% CI 0.38-0.99; <em>P=.</em>04) compared to the control. There were no significant differences in mechanical ventilation (RR 0.75, 95% CI 0.51–1.11), NICU admission rate (RR 0.92, 95% CI 0.82–1.03), hypoglycemia (RR 1.28 95% CI 0.93–1.74) neonatal death (RR 0.94, 95% CI 0.34–2.63), Apgar Score at 5 min (MD 0.07 95% CI 95% –0.03, 0.17) betwee","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 8","pages":"Article 101709"},"PeriodicalIF":3.8,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Propranolol to decrease time to delivery: a meta-analysis of randomized controlled trials.","authors":"Sonia Biswas, Mariella Toro, Rebecca Horgan, Rodney A McLaren, Vincenzo Berghella, Huda B Al-Kouatly","doi":"10.1016/j.ajogmf.2025.101705","DOIUrl":"10.1016/j.ajogmf.2025.101705","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the effect of propranolol on the time to delivery among patients undergoing induction or augmentation of labor.</p><p><strong>Data sources: </strong>PubMed, Scopus, Cochrane Library, ClinicalTrials.gov, and CINAHL (EBSCO) databases were searched from inception to December 2023.</p><p><strong>Study eligibility criteria: </strong>Randomized controlled trials that examined the effect of propranolol on the time to delivery among patients undergoing induction or augmentation of labor were included. Randomized controlled trials that included stillbirth before randomization, nonrandomized trials, observational, cohort, case-control, or studies in which the control group included an intervention other than standard care were excluded.</p><p><strong>Methods: </strong>The primary outcome was time to delivery after the administration of propranolol among patients undergoing induction or augmentation of labor. The summary measures were reported as summary mean difference or relative risk with 95% confidence interval.</p><p><strong>Results: </strong>A total of 5 randomized controlled trials involving 660 patients were included in this meta-analysis. 1 study investigated the effect of propranolol compared with that of placebo among patients undergoing induction of labor and did not demonstrate a significant decrease in the time to delivery (828±324 minutes in the propranolol group vs 858±318 minutes in the placebo group; P=.48). In addition, 4 studies investigated the effect of propranolol among patients undergoing augmentation of labor and showed no significant decrease in the time to delivery (mean difference, -2.98 minutes [95% confidence interval, -21.6 to 15.6]). Our pooled analysis demonstrated that the use of propranolol in the induction and augmentation of labor was not associated with a decrease in the time to delivery from the administration of propranolol compared with that of placebo (mean difference, -4.33 minutes [95% confidence interval, -22.48 to 13.83]). The meta-analysis found no increased risk of postpartum hemorrhage, blood transfusion, cesarean delivery rate, or neonatal intensive care unit admission with the use of propranolol during labor.</p><p><strong>Conclusion: </strong>The use of propranolol during induction and augmentation of labor did not significantly decrease the time to delivery.</p>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101705"},"PeriodicalIF":3.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perinatal outcomes of cystic hygroma: a systematic review and meta-analysis","authors":"Michelle J. Wang MD ,&nbsp;Maria Bazan MD ,&nbsp;Tina Hsieh MD ,&nbsp;Carol Mita MLIS ,&nbsp;Millie A. Ferrés MD ,&nbsp;Yinka Oyelese MD","doi":"10.1016/j.ajogmf.2025.101704","DOIUrl":"10.1016/j.ajogmf.2025.101704","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of this systematic review and meta-analysis was to describe the perinatal outcomes and modifiers of antenatally diagnosed cystic hygroma (CH).</div></div><div><h3>Data Sources</h3><div>The PubMed, Embase and Web of Science Core Collection databases were searched from inception until March 18, 2024.</div></div><div><h3>Study Eligibility Criteria</h3><div>Full-text English-language observational cohort studies reporting any pregnancy and postnatal outcomes for fetuses with a CH diagnosed on prenatal ultrasound were included in this study.</div></div><div><h3>Methods</h3><div>The primary outcome was the incidence of genetic diagnosis and incidence of major structural anomalies. Secondary outcomes included the incidence of perinatal loss, termination of pregnancy, CH resolution, live birth rate and normal postnatal outcomes. Stratified analyses were conducted of cases diagnosed in the first trimester as well as all cases with septations as part of diagnostic criteria. Pooled proportions were calculated for the different outcomes.</div></div><div><h3>Results</h3><div>Fifty-seven studies met inclusion criteria (including 4693 cases of CH); these were cohort studies that included any of our primary search outcomes. The pooled prevalence of genetic diagnosis (56 studies, 3837 fetuses) was 55% (95% CI, 0.51–0.58). For specific aneuploidies, the pooled prevalence was 21% for Turner syndrome, 17% for Trisomy 21, 10% for Trisomy 18, 3% for Trisomy 13, and 5% for other genetic diagnoses. The overall pooled prevalence of major structural anomalies (30 studies, 1987 fetuses) was 42%; across 16 studies (1815 fetuses), 16% of fetuses with CH and an additional structural abnormality had no identified genetic diagnosis. Furthermore, 20% of all CH regressed or resolved during the pregnancy. The findings from the studies that that defined CH by the presence of septations, as well as those focusing solely on first trimester CH were consistent with the overall outcomes.</div></div><div><h3>Conclusions</h3><div>Our findings confirm that while CHs have a strong association with common trisomies and Turner syndrome, there is a proportion of cases with nonaneuploidy genetic diagnoses. Forty percent of cases are also associated with other structural anomalies that may be able to be elicited with a detailed first trimester anatomic ultrasound. Further studies should explore modifiers of CH outcomes to allow for more accurate and tailored patient counseling.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 7","pages":"Article 101704"},"PeriodicalIF":3.8,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meaningful clinical outcomes: perspectives of primary caregivers with lived experience of spontaneous preterm birth following spontaneous preterm labor","authors":"Elizabeth Gargon PhD ,&nbsp;Rosie Sharp MSci ,&nbsp;Laura Grant MSc ,&nbsp;Anya Francis BSc ,&nbsp;Damien J. Croft MD, MPH ,&nbsp;Edith Roset Bahmanyar MD ,&nbsp;Kara M. Rood MD ,&nbsp;Vanessa Perez Patel PhD, MS","doi":"10.1016/j.ajogmf.2025.101701","DOIUrl":"10.1016/j.ajogmf.2025.101701","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Patient-centered research is foundational to informing the measurement of clinical benefit in interventional studies. Understanding caregivers’ lived experience of spontaneous preterm birth (sPTB) resulting from spontaneous preterm labor (sPTL) and characterizing their perspectives on the clinical outcomes of greatest importance and relevance are essential for advancing the development of interventions for the delay or prevention of sPTB.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This mixed methods study aimed to identify which clinical outcomes deriving from a (hypothetical) successful sPTL intervention are most important and relevant from the caregiver perspective to advance the therapeutic landscape for sPTB resulting from sPTL.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;A targeted literature review was conducted to obtain preliminary insights, which informed the content of semi-structured, qualitative, concept elicitation telephone interviews with primary caregivers in the United States who had a live, singleton sPTB between 23 and 36 weeks’ gestational age resulting from sPTL. Primary caregivers were those who self-identified as the parent who gave birth to the child preterm, had assumed the primary caring and parenting responsibility since birth, and understood the child’s health-related needs since birth. Interview transcripts were thematically analyzed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Twenty-four primary caregivers were interviewed. Delaying delivery from sPTL onset was the clinical outcome most associated with a successful intervention for sPTL and considered most important by caregivers due to anticipated subsequent fetal, neonatal, and maternal benefits (which were also perceived as distinct benefits of an intervention). One to 2 days was typically considered the threshold defining a meaningful delay to delivery from sPTL onset.&lt;/div&gt;&lt;div&gt;Additionally, caregivers did not view the individual components of the neonatal morbidity and mortality composite endpoint (historically used to measure clinical benefit in trials of sPTB interventions) as equally relevant to their children’s experiences, or as equally important due to perceived differences in their severity and potential for causing further health complications.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;This study centralizes the primary caregiver’s voice regarding which clinical outcomes are most important and appropriate to measure for the demonstration of meaningful clinical benefit in interventional studies assessing the delay or prevention of sPTB. Specifically, caregivers perceived delaying delivery from sPTL onset, typically by a minimum of 1 or 2 days, as the most important clinical outcome. The findings confirm an unmet need for such interventions, provide a benchmark for defining a patient-perceived clinically meaningful time to delivery from sPTL onset, and establish the inadequacy of the traditional neonatal morbidity and mortality composite e","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 7","pages":"Article 101701"},"PeriodicalIF":3.8,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to Editor regarding “Proximate cord insertion in monochorionic twins with selective fetal growth restriction”: proximate cord insertion and its hidden challenges in monochorionic twin pregnancies","authors":"Ruijuan Chen MD,&nbsp;Jingni Zhao MD,&nbsp;Binglin Li MD","doi":"10.1016/j.ajogmf.2025.101699","DOIUrl":"10.1016/j.ajogmf.2025.101699","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 7","pages":"Article 101699"},"PeriodicalIF":3.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep during pregnancy: a systematic review of racial and ethnic disparities and associations to experiences of discrimination","authors":"Zhiqi Zhang BA ,&nbsp;Jaimie Lee BA ,&nbsp;Anita Kiafar MA ,&nbsp;Marie-Hélène Pennestri PhD ,&nbsp;Claudia Lugo-Candelas PhD","doi":"10.1016/j.ajogmf.2025.101688","DOIUrl":"10.1016/j.ajogmf.2025.101688","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;OBJECTIVE&lt;/h3&gt;&lt;div&gt;Sleep is critical for perinatal health with poor quality and short sleep duration in pregnancy being associated with adverse maternal outcomes (eg, preterm birth, preeclampsia, depression) and an increased risk for poor offspring outcomes (eg, lower birth weight, risk for neurodevelopmental disorders). However, a growing body of work documents the existence of ethnic and racial sleep health disparities, but no reviews have examined these disparities during pregnancy, a period when sleep is critical for the health of the pregnant person and offspring and when stark disparities in pregnancy and delivery outcomes are also observed. We reviewed the available evidence regarding racial/ethnic disparities in prenatal sleep health and the association between exposure to racial/ethnic discrimination and prenatal sleep, a potential mechanism that underlie the disparities.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;DATA SOURCES&lt;/h3&gt;&lt;div&gt;PubMed, MEDLINE, Embase, PsycINFO, CINAHL, and ClinicalTrials.gov were searched from inception to November 3, 2023.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY ELIGIBILITY CRITERIA&lt;/h3&gt;&lt;div&gt;Peer-reviewed quantitative studies that examined (1) racial/ethnic disparities in sleep and/or (2) associations with exposure to racial/ethnic discrimination in the prenatal period.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY APPRAISAL AND SYNTHESIS METHODS&lt;/h3&gt;&lt;div&gt;In this systematic review, a narrative synthesis was conducted using the National Heart, Lung, and Blood Institute Quality Assessment tool for Observational Cohort and Cross-sectional Studies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;A total of 18 studies were included; 12 found disparities, 3 did not, and 3 documented associations between experiences of discrimination and sleep. Overall, African American/Black pregnant persons were found to experience shorter sleep durations and poorer sleep quality than White persons. Studies yielded mixed findings when sleep disturbances, latency, and insomnia symptoms were examined. Findings were mixed for Hispanic/Latine persons with some studies finding increased risk for short and long sleep duration and both increased and decreased sleep disruptions. Studies of other racial/ethnic groups were too few to draw conclusions. Associations between experiencing racial/ethnic discrimination and poorer prenatal sleep were documented across the 3 studies that examined the topic, but 2 studies had overlapping samples, precluding any conclusions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;CONCLUSION&lt;/h3&gt;&lt;div&gt;Studies suggest the presence of ethnic/racial disparities in prenatal sleep, emphasizing the need for targeted interventions and support. However, important gaps remain, including poor consideration of covariates like socioeconomic status and maternal age, health conditions, and depression. However, studies that controlled for socioeconomic status documented disparities, suggesting that disparities persist when factors like educational attainment and income are considered. There was considerable vari","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 7","pages":"Article 101688"},"PeriodicalIF":3.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuing the discussion regarding \"Nonsevere hypertensive disorders of pregnancy and oral antihypertensive medications: an argument against use\".","authors":"Laurie B Griffin, Rachel Sinkey, Alan Tita, Dwight J Rouse","doi":"10.1016/j.ajogmf.2025.101703","DOIUrl":"10.1016/j.ajogmf.2025.101703","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":" ","pages":"101703"},"PeriodicalIF":3.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The invaluable importance of color dye injection of monochorionic twin placentas","authors":"Jip A. Spekman BSc,&nbsp;Femke Slaghekke MD, PhD,&nbsp;Enrico Lopriore MD, PhD","doi":"10.1016/j.ajogmf.2025.101700","DOIUrl":"10.1016/j.ajogmf.2025.101700","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 7","pages":"Article 101700"},"PeriodicalIF":3.8,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Next-generation sequencing–based approach for fetal DNA quantification and blood antigen detection in alloimmunized pregnancies","authors":"Tesfai Emahazion PhD ,&nbsp;Ahlam Badri MSc ,&nbsp;Elisabeth Jalkesten BSc ,&nbsp;Mari Flodström BSN ,&nbsp;Gunilla Ajne MD, PhD ,&nbsp;Mehmet Uzunel PhD ,&nbsp;Agneta Wikman MD, PhD","doi":"10.1016/j.ajogmf.2025.101694","DOIUrl":"10.1016/j.ajogmf.2025.101694","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Erythrocyte and platelet alloimmunization during pregnancy can be severe and are closely monitored throughout pregnancy. However, the blood type of the fetus and the associated risk are often unknown. Here, fetal erythrocyte and platelet genotype from maternal plasma were determined using next-generation sequencing, providing noninvasive prenatal testing as an alternative to traditional methods for monitoring alloimmunized pregnancies.</div></div><div><h3>OBJECTIVE</h3><div>This study aimed to validate an innovative next-generation sequencing method for the detection of specific blood antigens in maternal plasma-derived cell-free DNA, focusing on key antigens associated with immunizations. By analyzing free-circulating fetal DNA across various gestational stages, the study seeks to achieve high-precision identification of clinically relevant erythrocyte and platelet antigens.</div></div><div><h3>STUDY DESIGN</h3><div>Maternal whole blood samples were consecutively collected from 74 immunized and nonimmunized pregnant women at 13 to 27 weeks of gestation in Stockholm County, Sweden. Next-generation sequencing analysis was performed on maternal plasma using a prototype kit from Devyser AB (Stockholm, Sweden). The kit detects several erythrocyte blood group markers, 2 human platelet antigen markers (HPA-1 and HPA-5), XY chromosome markers, and 12 insertions and deletions from different chromosomes to identify and quantify fetal DNA. After birth, genomic DNA from umbilical cord blood samples were genotyped with various methods and compared with noninvasive prenatal testing results obtained during pregnancy.</div></div><div><h3>RESULTS</h3><div>A total of 95 samples from 74 pregnancies were analyzed. Fetal DNA was successfully identified in 72 of 74 cases (97.3%) using insertion and deletion and Y chromosome markers. In 2 cases, fetal DNA could not be detected because of the absence of informative markers. The noninvasive prenatal testing results showed 100% concordance with the genotyped newborns. Among the fetuses of 22 immunized women, 6 were antigen negative, 10 were antigen positive, 5 had antigens not included in the next-generation sequencing panel (3 anti-Cw, 1 anti-M, and 1 anti-Ge2), and 1 had an inconclusive result.</div></div><div><h3>CONCLUSION</h3><div>Our study highlights the feasibility of using next-generation sequencing for comprehensive fetal antigen screening, paving the way for a personalized approach to managing alloimmunized pregnancies. By accurately identifying fetuses expressing antigens corresponding to maternal antibodies and those not at risk, it enhances the precision of targeted care.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 7","pages":"Article 101694"},"PeriodicalIF":3.8,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Achieving water-tight open spina bifida closure through a novel three-port three-layer fetoscopic repair","authors":"Robin Bowman MD ,&nbsp;Amir Alhajjat MD ,&nbsp;Rya Muller BA ,&nbsp;Jonathan Scoville MD, MSPH ,&nbsp;Aimen Shaaban MD","doi":"10.1016/j.ajogmf.2025.101697","DOIUrl":"10.1016/j.ajogmf.2025.101697","url":null,"abstract":"<div><div>About 3,000 individuals in the United States are born with spina bifida each year. Prenatal surgery for open spina bifida has demonstrated improved neurological and functional outcomes compared to postnatal closure. However, open maternal fetal surgery is associated with increased obstetric complications, such as uterine ruptures and need for cesarean deliveries in the current and any subsequent pregnancies. Minimally invasive fetoscopic approaches were subsequently developed to decrease maternal morbidity from large hysterotomies while preserving the fetal benefits of prenatal repair.</div><div>Single and 2-layer fetoscopic closure techniques have been described, but concerns remain regarding the ability to achieve water-tight closure via minimally invasive approaches. Water-tight closure is critical for preventing postoperative complications, particularly cerebrospinal fluid (CSF) leakage and wound dehiscence.</div><div>This report describes a novel 3-port, 3-layer fetoscopic repair technique. The accompanying video demonstrates the technique and procedural steps in detail. This method may facilitate higher rates of water-tight dural closure via the fetoscopic approach, potentially reducing postoperative complications.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 7","pages":"Article 101697"},"PeriodicalIF":3.8,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}