scholarly journals Consensus definition and essential reporting parameters of selective fetal growth restriction in twin pregnancy: a Delphi procedure

2019 ◽  
Vol 53 (1) ◽  
pp. 47-54 ◽  
Author(s):  
A. Khalil ◽  
I. Beune ◽  
K. Hecher ◽  
K. Wynia ◽  
W. Ganzevoort ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Twin Pregnancy ◽  
Growth Restriction ◽  
Consensus Definition ◽  
Delphi Procedure

scholarly journals Consensus definition of fetal growth restriction: a Delphi procedure

2016 ◽  
Vol 48 (3) ◽  
pp. 333-339 ◽  
Author(s):  
S. J. Gordijn ◽  
I. M. Beune ◽  
B. Thilaganathan ◽  
A. Papageorghiou ◽  
A. A. Baschat ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Growth Restriction ◽  
Consensus Definition ◽  
Delphi Procedure ◽  
Definition Of

scholarly journals Consensus Definition of Fetal Growth Restriction in Intrauterine Fetal Death: A Delphi Procedure

2020 ◽  
Author(s):  
Irene Maria Beune ◽  
Stefanie Elisabeth Damhuis ◽  
Wessel Ganzevoort ◽  
John Ciaran Hutchinson ◽  
Teck Yee Khong ◽  
...  
Keyword(s):  
Birth Weight ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Fetal Death ◽  
Weight Ratio ◽  
Liver Weight ◽  
Growth Restriction ◽  
Intrauterine Fetal Death ◽  
Consensus Definition ◽  
Definition Of

Context.— Fetal growth restriction is a risk factor for intrauterine fetal death. Currently, definitions of fetal growth restriction in stillborn are heterogeneous. Objectives.— To develop a consensus definition for fetal growth restriction retrospectively diagnosed at fetal autopsy in intrauterine fetal death. Design.— A modified online Delphi survey in an international panel of experts in perinatal pathology, with feedback at group level and exclusion of nonresponders. The survey scoped all possible variables with an open question. Variables suggested by 2 or more experts were scored on a 5-point Likert scale. In subsequent rounds, inclusion of variables and thresholds were determined with a 70% level of agreement. In the final rounds, participants selected the consensus algorithm. Results.— Fifty-two experts participated in the first round; 88% (46 of 52) completed all rounds. The consensus definition included antenatal clinical diagnosis of fetal growth restriction OR a birth weight lower than third percentile OR at least 5 of 10 contributory variables (risk factors in the clinical antenatal history: birth weight lower than 10th percentile, body weight at time of autopsy lower than 10th percentile, brain weight lower than 10th percentile, foot length lower than 10th percentile, liver weight lower than 10th percentile, placental weight lower than 10th percentile, brain weight to liver weight ratio higher than 4, placental weight to birth weight ratio higher than 90th percentile, histologic or gross features of placental insufficiency/malperfusion). There was no consensus on some aspects, including how to correct for interval between fetal death and delivery. Conclusions.— A consensus-based definition of fetal growth restriction in fetal death was determined with utility to improve management and outcomes of subsequent pregnancies.

scholarly journals OP0175 INTERNATIONAL MULTICENTRIC PROSPECTIVE STUDY ON PREGNANCY IN SYSTEMIC SCLEROSIS (IMPRESS-2)

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 105.1-105
Author(s):  
E. Tombetti ◽  
V. Ramoni ◽  
M. Betelli ◽  
Y. Allanore ◽  
M. Matucci Cerinic ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Twin Pregnancy ◽  
Gestational Hypertension ◽  
Immunosuppressive Agents ◽  
Growth Restriction ◽  
Controlled Study ◽  
Obstetric Outcomes

Background:Data about the obstetric outcomes of pregnant women with Systemic Sclerosis (SSc) mainly derive from retrospective studies. Moreover, little evidence is available to define if pregnancy impacts on SSc course and if children of SSc mothers have a normal post-natal development.Objectives:To assessed the obstetric, pediatric and rheumatologic outcomes of SSc pregnancies in a prospective controlled studyMethods:Prospective recruitment of three cohorts.1) 110 pregnant women with SSc.2) 218 control pregnancies without systemic autoimmune diseases3) 78 non-pregnant control SSc with a matching subject in cohort-1.SSc was characterized for disease activity, severity, cutaneous/organ involvement and therapy. Women and their offspring were followed until 21 months after enrollment (ie, 12 months after expected delivery).Results:Gestational and neonatal outcomesMiscarriages and fetal death occurred in 7% and 5% of SSc pregnancies. Compared to control pregnancies, SSc pregnancies had higher rates of gestational hypertension (12% Vs 4%, p=0.004), pre-eclampsia (9% Vs 1%, p=0.002), fetal growth-restriction (13% Vs 4%, p=0.004), prematurity (26% Vs 7%, p<0.001) and cesarean section (52% Vs 4%, p=0.002). Newborns from SSc mothers weighted less (2773 Vs 3243g, p<0.001), were more frequently small for gestational age (SGA, 18% Vs 12%, p=0.05) and required neonatal-intensive care unit (ICU) more frequently (12% Vs 1%, p<0.001). Rates of newborn malformation/death, and one year-pediatric outcomes were similar.Univariate and multivariate analyses were performed for relevant outcomes. For example, pre-eclampsia positively associated with baseline skin score and its evolution during pregnancy (p=0.015 and 0.013), immunosuppressive agents, bosentan and iloprost at baseline (p=0.001, 0.041 and 0.007), and twin pregnancy(p=0.006). Multivariate logistic regression for pre-eclampsia in SSc identified baseline arterial hypertension, immunosuppressive agents or of iloprost, twin pregnancy and assisted conception as risk factors (p=0.000, 0.002, 0.0025, 0.000 and 0.027), and baseline calcium channel blockers as protective factors (p=0.001).SSc course during pregnancyAs compared to matched non-pregnant SSc, SSc pregnant women had lower Medsger disease severity index (0.6 +/-0.9 Vs 1.0 +/-1.1, p=0.022), health assessment questionnaire (HAQ, 0.21 +/-0.38 Vs 0.40 +/-0.55, p=0.026), and lower rate of iv iloprost (21% Vs 42%, p=0.006). Pregnant and non-pregnant SSc women had a similar disease course during the 21 months of follow-up, despite a lower use of immunosuppressive agents (17% Vs 36%, p=0.014). Two scleroderma-renal-crises (SRC) occurred during pregnancy (one was a relapse of a previous SRC; the other occurred at week 33, and resolved after premature delivery of a SGA newborn and ACE-inhibitors, preventing differentiation from pre-eclampsia).Conclusion:SSc pregnancies have generally a favorable obstetric/pediatric outcome, albeit at a higher risk of gestational hypertension, pre-eclampsia, fetal growth restriction, prematurity, delivery of SGA newborn and requirement of neonatal-ICU. Pregnancy does not impact on SSc course, although SRC during late pregnancy and pre-eclampsia might be hardly discriminated.References:[1]Taraborelli M et al., Arthritis Rheum, 2012.Disclosure of Interests:None declared

Possible molecular and biological mechanisms for the development of selective fetal growth restriction in monochorionic twin pregnancy

2021 ◽  
Vol 10_2021 ◽  
pp. 5-12
Author(s):  
Neftereva A.A. Neftereva ◽  
Sakalo V.A. Sakalo ◽  
Gladkova K.A. Gladkova ◽  
Kоstyukov K.V. Kоstyukov K ◽  
Khodzhaeva Z.S. Khodzhaeva ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Twin Pregnancy ◽  
Growth Restriction ◽  
Biological Mechanisms ◽  
Monochorionic Twin
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