The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians最新文献

{"title":"The value of prenatal magnetic resonance imaging and postnatal follow-up using Gesell Developmental Schedules score for mild-to-moderate simple bilateral fetal ventriculomegaly.","authors":"Zhi Li,&nbsp;Liming Pan,&nbsp;Yaning Chen,&nbsp;Diyun Meng,&nbsp;Yuqin Liu,&nbsp;Lan Li,&nbsp;Mingsong Liu,&nbsp;Zhiqin Luo","doi":"10.1080/14767058.2021.1910657","DOIUrl":"https://doi.org/10.1080/14767058.2021.1910657","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship of mild-to-moderate simple bilateral fetal ventriculomegaly with postnatal neurological development.</p><p><strong>Methods: </strong>Cases of simple lateral ventricular dilatation (273) were divided into bilateral mild dilatation (10.0-12.0 mm, 62), bilateral moderate dilatation (12.1-15.0 mm, 29), unilateral mild dilatation (133), and unilateral moderate dilatation (49) groups. The control group comprised 50 normal fetuses. Neurological development was assessed using Gesell Developmental Schedules (GDS) at postnatal 3, 6, 12, and 18 months.</p><p><strong>Results: </strong>At postnatal 6, 12, and 18 months, the GDS score was higher for bilateral than for unilateral dilatation (<i>p</i> < .05). At postnatal 3 and 6 months, the GDS score was higher for the bilateral dilatation groups than for the control group (<i>p</i> < .05). At postnatal 6, 12, and 18 months, the GDS score was higher for the bilateral moderate dilatation group than for the unilateral moderate dilatation group (<i>p</i> < .05). Further, at postnatal 3, 6, 12, and 18 months, the GDS score was higher for the bilateral moderate dilatation group than for the control group (<i>p</i> < .05).</p><p><strong>Conclusion: </strong>At postnatal month 6, the GDS evaluation results of the bilateral dilatation groups were significantly inferior compared to those of the unilateral dilatation group.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"6229-6235"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1910657","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38883164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of isotonic versus hypotonic intravenous fluid for maintenance fluid therapy in neonates more than or equal to 34 weeks of gestational age - a randomized clinical trial.","authors":"Krishna Dathan,&nbsp;Mangalabharathi Sundaram","doi":"10.1080/14767058.2021.1911998","DOIUrl":"https://doi.org/10.1080/14767058.2021.1911998","url":null,"abstract":"<p><strong>Background and objectives: </strong>The use of hypotonic fluids as maintenance therapy in the neonatal population has been in practice for a long time, but there is a lack of evidence for the choice of this fluid in neonates. This study compared isotonic (sodium chloride, 0.9%, and dextrose, 5%) versus hypotonic (sodium chloride, 0.15%, and dextrose, 5%) intravenous fluid for maintenance fluid therapy in neonates more than or equal to 34 weeks of gestational age.</p><p><strong>Methods: </strong>In this triple-blind randomized clinical trial, we recruited 60 neonates admitted to a neonatal intensive care unit of a tertiary care children's hospital from June 2017 through May 2018 with normal baseline serum sodium levels, anticipated to require intravenous maintenance fluids for 24 hours or longer (intention-to-treat analyses). Patients were randomized to receive isotonic or hypotonic intravenous fluid at maintenance rates for 72 hours. The primary outcome was the incidence of hyponatremia (defined as serum sodium <135mEq/L) at 24 hours in both groups. The secondary outcomes were incidence of hypernatremia at 24 hours (defined as serum sodium >145 mEq/L), the incidence of hypo and hypernatremia at 48 and 72 hours, mean serum sodium at 24, 48, and 72 hours, rate of change of serum sodium during the study period, mean serum osmolality at the end of the study period, the absolute difference in osmolality during the study period, the absolute difference in weight during the study period and edema during the study period.</p><p><strong>Results: </strong>Of 60 enrolled neonates, 31 received isotonic fluids and 29 received hypotonic fluids. Three patients in the hypotonic group developed hyponatremia and none in isotonic group at 24 h (RR = 0.13; 95% CI = 0.007 - 2.485; <i>p</i> = .106). Fourteen neonates developed hypernatremia in the isotonic group and one in hypotonic group at 24 h (RR = 13.09; 95% CI = 1.83 - 93.4; <i>p</i> = .0001).</p><p><strong>Conclusions: </strong>Our study results do not support the hypothesis that isotonic fluid is superior to hypotonic fluid in reducing the proportion of neonates developing hyponatremia after 24 hours of intravenous fluid therapy. The proportion of neonates developing hypernatremia is significantly higher after using isotonic fluid for maintenance therapy. TRIAL REGISTRATION CTRI/2017/05/008585.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"6338-6345"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1911998","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38893299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Normal delivery: physiologic support and medical interventions. Guidelines of the French National Authority for Health (HAS) with the collaboration of the French College of Gynecologists and Obstetricians (CNGOF) and the French College of Midwives (CNSF).","authors":"Karine Petitprez,&nbsp;Aurélien Mattuizzi,&nbsp;Sophie Guillaume,&nbsp;Maud Arnal,&nbsp;France Artzner,&nbsp;Catherine Bernard,&nbsp;François-Marie Caron,&nbsp;Isabelle Chevalier,&nbsp;Claude Daussy-Urvoy,&nbsp;Anne-Sophie Ducloy-Bouthorsc,&nbsp;Jean-Michel Garnier,&nbsp;Hawa Keita-Meyer,&nbsp;Jacqueline Lavillonnière,&nbsp;Valérie Lejeune-Sadaa,&nbsp;Camille Le Ray,&nbsp;Anne Morandeau,&nbsp;Marjan Nadjafizade,&nbsp;Franck Pizzagalli,&nbsp;Clemence Schantz,&nbsp;Thomas Schmitz,&nbsp;Raha Shojai,&nbsp;Bernard Hédon,&nbsp;Loïc Sentilhes","doi":"10.1080/14767058.2021.1918089","DOIUrl":"https://doi.org/10.1080/14767058.2021.1918089","url":null,"abstract":"<p><strong>Objective: </strong>To define for women at low obstetric risk methods of management that respect the rhythm and the spontaneous course of giving birth as well as each woman's preferences.</p><p><strong>Methods: </strong>These clinical practice guidelines were developed through professional consensus based on an analysis of the literature and of the French and international guidelines available on this topic.</p><p><strong>Results: </strong>Labor should be monitored with a partograph (professional consensus). Digital cervical examination should be offered every 4 h during the first stage of labor, hourly during the second. The choice between continuous (cardiotocography) or discontinuous (by cardiotocography or intermittent auscultation) monitoring should be left to the woman (professional consensus). In the active phase of the first stage of labor, dilation speed is considered abnormal if it is less than 1 cm/4 h between 5 and 7 cm or less than 1 cm/2 h after 7 cm. In those cases, an amniotomy is recommended if the membranes are intact, and the administration of oxytocin if the membranes are already broken and uterine contractions are judged insufficient (professional consensus). It is recommended that pushing not begin when full dilation has been reached; rather, the fetus should be allowed to descend (grade A). Umbilical cord clamping should be delayed beyond the first 30 s in newborns who do not require resuscitation (grade C).</p><p><strong>Conclusion: </strong>The establishment of these clinical practice guidelines should enable women at low obstetric risk to receive better care in conditions of optimal safety while supporting physiologic birth.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"6576-6585"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2021.1918089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38905177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should pregnant women with diabetes be counseled differently if nephropathy was detected? a population database study.","authors":"Sarah Aldhaheri,&nbsp;Haitham Baghlaf,&nbsp;Ahmad Badeghiesh,&nbsp;Michael H Dahan","doi":"10.1080/14767058.2022.2049749","DOIUrl":"https://doi.org/10.1080/14767058.2022.2049749","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of diabetes mellitus has increased tremendously in the last two decades among women of reproductive age and this is mainly due to the pandemic of obesity. Diabetes mellitus is a well-known cause of maternal and neonatal complications in pregnancy. Diabetic nephropathy is a marker of severe diabetes and results in organ damage. However, only a small number of studies have evaluated the implications of diabetic nephropathy on pregnancy complications, with most having 50 to 100 nephropathy subjects. Our study aims to compare pregnant women with diabetes mellitus complicated by nephropathy or not and evaluate the relationship with obstetrical and perinatal morbidity and mortality, on a larger population.</p><p><strong>Methods: </strong>This was a population-based study using data from the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS) including women who delivered between 2004 and 2014. Multivariate logistic regression was used to control for confounding effects.</p><p><strong>Results: </strong>Among 86,615 pregnancies that were complicated by diabetes mellitus, 1,241 (1.4%) had diabetic nephropathy. Diabetic nephropathy was strongly associated with preeclampsia (aOR 2.3, 95% CI 1.90-2.68), as well as chronic hypertension with superimposed preeclampsia or eclampsia (aOR 4.2, 95% CI 3.53-5.01), preterm birth (aOR 1.8, 95% CI 1.59-2.1), and blood transfusion (aOR 3.6 95% CI 2.82-4.46). Both groups were similar in age and income.</p><p><strong>Conclusion: </strong>Diabetic nephropathy is associated with increased obstetrical and perinatal morbidity compared to diabetes mellitus alone. These patients may benefit from a high dose of folic acid, more vigilant antenatal surveillance, delivery in a tertiary care center, and more rigorous screening and prevention methods for pregnancy-induced hypertension diseases at antenatal care visits.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"9614-9621"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40327945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and genetic approach in the characterization of newborns with anorectal malformation.","authors":"Ingrid Anne Mandy Schierz,&nbsp;Ettore Piro,&nbsp;Mario Giuffrè,&nbsp;Giuseppa Pinello,&nbsp;Alice Angelini,&nbsp;Vincenzo Antona,&nbsp;Marcello Cimador,&nbsp;Giovanni Corsello","doi":"10.1080/14767058.2020.1854213","DOIUrl":"https://doi.org/10.1080/14767058.2020.1854213","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate clinical, surgical, and genetic data of neonates with anorectal malformation (ARM).</p><p><strong>Study design: </strong>A retrospective observational study was conducted on neonates with ARM as an isolated type (group 1), with ≤2 (group 2), and with ≥3 associated malformations (group 3), born between 2009 and 2020. Distribution of ARM, associated abnormalities and genetic testing were analyzed, and risk factors for adverse outcomes were identified.</p><p><strong>Results: </strong>The 45 ARM cases (36% females) were divided as follows: 13 neonates belonging to group 1 (29%), 8 to group 2 (18%), and 24 to group 3 (53%). Cases were equally distributed over 11 years. Krickenbeck anatomy was: without fistula/imperforate anus (18%), perineal fistula (36%), rectourethral fistula (4%), rectovesical fistula (2%), vestibular fistula (4%), cloaca (4%), and rare ARMs (31%). Groups showed differences in anthropometric data, Krickenbeck anatomy, and intensive care burden. Additional major congenital abnormalities were prevalent specific of VATER/VACTERL spectrum (vertebral/anorectal/cardiac/tracheoesophageal/renal/limb defects), but also Hirschsprung disease was found in 3/20 biopsies (15%). The most frequent minor abnormality was a single umbilical artery. In group 3, we identified four <i>de novo</i> microdeletions at 8p23.2, 8q13.3, Xp22.31-p22.2, Xq28, four <i>de novo</i> microduplications at 1p36.32, 6p24.1-p23, 13q14.11, 15q11.2, one microdeletion at 9q33.1 inherited from the affected mother, one microdeletion at 7q35 inherited from the unaffected father, one structurally uncharacterized rearrangement involving 9p23-q34.3. Thus, we attributed the Xq28 deletion with inactivated <i>FAM58A</i> gene in one girl to the X-linked dominant STAR syndrome (toe syndactyly-telecanthus-anogenital/renal malformations).</p><p><strong>Conclusions: </strong>Despite the great physical and social burden on ARM patients and their parents, in the majority of cases, the etiology is largely unknown and attributed to be multifactorial. In females, STAR syndrome should be part of the differential diagnosis. Associated malformations of other organ systems interact in outcome parameters.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"4513-4520"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/14767058.2020.1854213","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40350802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of hydrolyzed formulas on gastrointestinal tolerance in preterm infants: a systematic review and meta-analysis.","authors":"Mengyuan Li,&nbsp;Yuehui Fang,&nbsp;Yiyao Lian,&nbsp;Xiaodi Lu,&nbsp;Meijuan Qiu,&nbsp;Yuna He","doi":"10.1080/14767058.2022.2122794","DOIUrl":"https://doi.org/10.1080/14767058.2022.2122794","url":null,"abstract":"<p><strong>Objective: </strong>Hydrolyzed formulas (HFs) have been increasingly used in early enteral feeding in preterm infants. The current study aimed to compare the effect of HFs with standard preterm formula (SPF) on gastrointestinal tolerance in preterm infants by systematically reviewing the randomized controlled trials (RCTs) related.</p><p><strong>Methods: </strong>Relevant studies published until August 2021 were searched in English and Chinese databases, including PubMed, Embase, Cochrane Library, CNKI, WanFang Data, and VIP. Three outcomes, including the incidence of feed intolerance (FI), necrotizing enterocolitis (NEC), and the time to full enteral feeding, were chosen to evaluate the effect on gastrointestinal tolerance comprehensively.</p><p><strong>Results: </strong>Ten eligible studies with 886 participants were included in the final analysis. Infants who received HFs showed a lower risk of FI (RR = 0.61, 95% CI = 0.42-0.90; <i>p</i> < .05) and shorter time to full enteral feeding (MD = -0.56, 95% CI = -1.03 to -0.10; <i>p</i> < .05) compared with those fed with SPF. There was no significant difference in risk of NEC (RR = 0.48, 95%CI = 0.21 - 1.08; <i>p</i> > .05) between the two groups.</p><p><strong>Conclusions: </strong>The results showed that HFs may have benefits in improving gastrointestinal tolerance in preterm infants, including reducing the risk of FI and shortening the time to full enteral feeding.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"10173-10180"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40356936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simplifying the prediction of vaginal birth after cesarean delivery: role of the cervical exam.","authors":"Megan C Oakes,&nbsp;Drew M Hensel,&nbsp;Jeannie C Kelly,&nbsp;Roxane Rampersad,&nbsp;Ebony B Carter,&nbsp;Alison G Cahill,&nbsp;Nandini Raghuraman","doi":"10.1080/14767058.2022.2086795","DOIUrl":"https://doi.org/10.1080/14767058.2022.2086795","url":null,"abstract":"<p><strong>Objective: </strong>Predicting likelihood of vaginal birth after cesarean (VBAC) is a cornerstone in counseling patients considering a trial of labor after cesarean (TOLAC). Yet, the simplified Bishop score (SBS), a score comprised cervical dilation, station, and effacement assessment used to predict successful vaginal delivery, has not been applied to the TOLAC population. We evaluated the relationship between admission SBS and likelihood of successful VBAC. We also determined the predictive characteristics of SBS, compared to cervical dilation alone, for successful VBAC.</p><p><strong>Methods: </strong>This is a secondary analysis of a prospective cohort study of patients with a singleton gestation, ≥37 0/7 weeks gestation, and prior cesarean admitted to Labor & Delivery between 2010 and 2014. The primary outcome of successful VBAC was compared between those with a favorable (score >5) and unfavorable (score ≤5) admission SBS. Secondary outcomes were select maternal and neonatal outcomes. Adjusted risk ratios were estimated using multivariable logistic regression analyses. Receiver-operating characteristic curves compared predictive capabilities of cervical dilation alone to SBS for successful VBAC.</p><p><strong>Results: </strong>Of the 656 patients who underwent a TOLAC during the study period, 421 (64%) had a successful VBAC. 203 (31%) and 453 (69%) had a favorable and an unfavorable admission SBS, respectively. After adjusting for body mass index and prior vaginal delivery, patients with a favorable admission SBS had a 30% greater likelihood of successful VBAC compared to those with an unfavorable SBS (aRR 1.30, 95% CI 1.16-1.40). Admission cervical dilation alone performed similarly to SBS as a predictor of successful VBAC, with a receiver-operator characteristic curve area under the curve (AUC) of 0.68 (95% CI 0.64-0.72) versus an AUC 0.66 (95% CI 0.62-0.70), respectively (<i>p</i> = .07). There were no differences in adverse maternal or neonatal outcomes between those with an unfavorable and favorable SBS.</p><p><strong>Conclusions: </strong>A favorable admission SBS is associated with an increased likelihood of VBAC. Although both admission SBS and cervical dilation alone are only modest predictors of VBAC, admission cervical dilation performs overall similarly to current models for VBAC prediction and is an objective, reproducible, and generalizable measure. Our study highlights the value of waiting until end of pregnancy (rather than the first prenatal visit) to conclude patient counseling on the decision to TOLAC in order to consider admission cervical assessment, particularly cervical dilation.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"10030-10035"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40070049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NAFTNet retrospective report on the treatment of anti-Ro/SSA mediated fetal heart block with dexamethasone.","authors":"Sherzana Sunderji,&nbsp;Shabnam Peyvandi,&nbsp;Edgar Jaeggi,&nbsp;Anita Szwast,&nbsp;Greg Ryan,&nbsp;Francine Tessier,&nbsp;Saad Siddiqui,&nbsp;Bettina Cuneo,&nbsp;Shreya Sheth,&nbsp;Marjorie Treadwell,&nbsp;Michele Frommelt,&nbsp;Shifa Turan,&nbsp;Joshua Copel,&nbsp;Stephen Emery,&nbsp;Larry Rand,&nbsp;Anita J Moon-Grady","doi":"10.1080/14767058.2022.2025536","DOIUrl":"https://doi.org/10.1080/14767058.2022.2025536","url":null,"abstract":"<p><strong>Background: </strong>Complete atrioventricular block (CAVB) is a complication of maternal antibody positivity and treatment of fetal disease is controversial in terms of efficacy and safety. We hypothesized that dexamethasone treatment for fetal anti-Ro/SSA antibody-mediated cardiac disease leads to better pregnancy outcomes than expectant management.</p><p><strong>Methods: </strong>A retrospective multi-center cohort study of anti-Ro/SSA antibody positive pregnancies with fetal conduction disease reported by participating North American Fetal Therapy Network (NAFTNet) centers between January 2010 and December 2018. The primary outcomes included: fetal death, oligohydramnios, growth restriction, preterm delivery, and new maternal comorbidities. Secondary outcomes included: pacemaker prior to 28 days, transplantation, and neonatal death in maternal/fetal dyads treated with dexamethasone versus not.</p><p><strong>Results: </strong>In 127 anti-Ro/SSA positive pregnancies, 98 were treated with dexamethasone and 29 were not. Of those treated, 61/96 (63.5%) met the primary outcome including 45/91 (49.4%) premature deliveries; 20 mothers developed comorbidities during treatment (fetal death 5, 10 growth restriction, 14 oligohydramnios, two new/worsening gestational diabetes). In the untreated group, 15/25 (60%) met the primary outcome including 11/22 (50%) premature deliveries and four mothers developing comorbidities during their pregnancy (fetal death 3, one growth restriction, one new onset maternal hypertension). Regarding secondary outcomes, 37/96 (43%) treated fetuses required a pacemaker or died by 28 days, while untreated 13/25 (52%) required pacemaker placement, died prior to 28 days or required listing for transplantation. Excluding terminations, survival without transplant was 17 (68%) in untreated and 85 (89%) in treated patients (<i>p</i><.01).</p><p><strong>Conclusions: </strong>While the use of dexamethasone in anti-Ro/SSA positive pregnancies is associated with a high rate of poor pregnancy outcomes, there was an unexpected similarly high rate in untreated positive pregnancies. This suggests that the maternal disease itself is influencing pregnancy complications independent of dexamethasone. Our data, which show that treatment decreases neonatal morbidity and overall mortality without increasing overall pregnancy complications, warrant further study.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"9263-9270"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39809647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expectant management for umbilical artery thrombosis: a report of two cases and literature review.","authors":"Caixia Han,&nbsp;Kun Dong,&nbsp;Zongyang Jia,&nbsp;Guangcai Zhao,&nbsp;Wenhui Chen,&nbsp;Haiying Liu","doi":"10.1080/14767058.2022.2029398","DOIUrl":"https://doi.org/10.1080/14767058.2022.2029398","url":null,"abstract":"<p><strong>Objectives: </strong>Umbilical artery thrombosis (UAT) is considered a marker for poor fetal prognosis. Because of limited studies, the clinical management for this disease remains a challenge. Most of the previously reported cases chose emergency cesarean section at the confirmation of this disease.</p><p><strong>Cases presentation: </strong>Here, we studied two cases of UAT choosing expectant management with strict fetal observation. Both cases had good maternal and fetal outcomes without any complications.</p><p><strong>Conclusions: </strong>For UAT patients with good maternal and fetal status, especially for the preterm group with an urgent need to extend the pregnancy period, expectant management with the US and close fetal monitoring may be an alternative to emergent delivery.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"9296-9298"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39864993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telehealth multidisciplinary prenatal consultation during the COVID-19 pandemic: enhancing patient care coordination while maintaining high provider satisfaction.","authors":"Angela Hargis-Villanueva,&nbsp;Krista Lai,&nbsp;Kathleen van Leeuwen,&nbsp;Erica M Weidler,&nbsp;Jessica Felts,&nbsp;Alicia Schmidt,&nbsp;Wayne J Franklin,&nbsp;Christopher Lindblade,&nbsp;Gregory C Martin,&nbsp;Avinash S Patil,&nbsp;Luis F Goncalves","doi":"10.1080/14767058.2022.2053101","DOIUrl":"https://doi.org/10.1080/14767058.2022.2053101","url":null,"abstract":"<p><strong>Objective: </strong>Comprehensive fetal care centers address congenital anomalies by developing pre- and post-natal care plans in a multidisciplinary format. To reduce exposure during the Coronavirus Infectious Disease-2019 (COVID-19) pandemic, the Centers for Medicare & Medicaid Services (CMS) broadened access to telehealth services. We assessed provider satisfaction with the rapid transition from in-person prenatal visits to multidisciplinary consultations <i>via</i> telehealth as an adaptive response to the pandemic.</p><p><strong>Methods: </strong>Patients referred to an urban academic fetal care center during the first 6 weeks of the COVID-19 pandemic underwent advanced imaging including fetal MRI, focused ultrasound, and fetal echocardiography. Subsequently, multidisciplinary telehealth consultations occurred with all providers attending virtually. Patients were given the option of attending the multidisciplinary telehealth consultation in a conference room in the hospital or from home. During these meetings, relevant images were reviewed with all participants <i>via</i> screen sharing through a secure video platform. Provider satisfaction with the telehealth paradigm was assessed using an electronic survey.</p><p><strong>Results: </strong>Twenty-two surveys were administered with a response rate of 82%. 89% of providers were highly satisfied with the telehealth format. 72% of providers would prefer the multidisciplinary telehealth format to an in-person visit for future visits after COVID-19 restrictions are lifted. 22% of providers would leave the choice to the patient's family. One provider preferred in-person visits. Some providers noted that virtual conferences limited the ability to draw pictures, show educational materials, and provide emotional support.</p><p><strong>Conclusion: </strong>Providers were overwhelmingly supportive of continuing multidisciplinary telehealth conferences for complex prenatal consultations, even after restrictions are lifted, which has led to the continuation of this model for the duration of the pandemic. Providers highlighted the convenience and improved care coordination across specialties. Further studies to examine the patient experience with virtual consultations are warranted.</p>","PeriodicalId":520807,"journal":{"name":"The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians","volume":" ","pages":"9765-9769"},"PeriodicalIF":1.8,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40329864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}