scholarly journals OC07.02: Cerebroplacental ratio in the late third trimester: association with adverse outcome

2021 ◽  
Vol 58 (S1) ◽  
pp. 21-21
Author(s):  
G. Albaiges ◽  
I. Rodríguez ◽  
S. García ◽  
M. Echevarria ◽  
P. Prats ◽  
...  
Keyword(s):  
Adverse Outcome ◽  
Third Trimester ◽  
Cerebroplacental Ratio

scholarly journals P25.05: Uterine Doppler, cerebroplacental ratio and fetal growth in the late third trimester: association with adverse outcome

2017 ◽  
Vol 50 ◽  
pp. 236-236
Author(s):  
G. Albaiges Baiget ◽  
I. Rodríguez ◽  
E. Meler ◽  
M. Rodríguez ◽  
N. Caner ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Adverse Outcome ◽  
Third Trimester ◽  
Cerebroplacental Ratio

Predicting Perinatal Outcome from Prenatal Ultrasound Characteristics in Pregnancies Complicated by Gastroschisis

2015 ◽  
Vol 39 (4) ◽  
pp. 279-286 ◽  
Author(s):  
Gabriella Martillotti ◽  
Isabelle Boucoiran ◽  
Amélie Damphousse ◽  
Andrée Grignon ◽  
Eric Dubé ◽  
...  
Keyword(s):  
Gestational Age ◽  
Predictive Value ◽  
Intrauterine Growth Restriction ◽  
Adverse Outcome ◽  
Prenatal Ultrasound ◽  
Intestinal Lumen ◽  
Third Trimester ◽  
Mesenteric Circulation ◽  
Intrauterine Growth ◽  
Bowel Dilatation

Introduction: The objective of the study was to establish the predictive value of prenatal ultrasound markers for complex gastroschisis (GS) in the first 10 days of life. Material and Methods: In this retrospective cohort study over 11 years (2000-2011) of 117 GS cases, the following prenatal ultrasound signs were analyzed at the last second- and third-trimester ultrasounds: intrauterine growth restriction, intra-abdominal bowel dilatation (IABD) adjusted for gestational age, extra-abdominal bowel dilatation (EABD) ≥25 mm, stomach dilatation, stomach herniation, perturbed mesenteric circulation, absence of bowel lumen and echogenic dilated bowel loops (EDBL). Results: Among 114 live births, 16 newborns had complex GS (14.0%). Death was seen in 16 cases (13.7%): 3 intrauterine fetal deaths, 9 complex GS and 4 simple GS. Second-trimester markers had limited predictive value. Third-trimester IABD, EABD, EDBL, absence of intestinal lumen and perturbed mesenteric circulation were statistically associated with complex GS and death. IABD was able to predict complex GS with a sensitivity of 50%, a specificity of 91%, a positive predictive value of 47% and a negative predictive value of 92%. Discussion: Third-trimester IABD adjusted for gestational age appears to be the prenatal ultrasound marker most strongly associated with adverse outcome in GS.

Prescriptive Reference Standards of Third-Trimester Cerebroplacental Ratio and Its Physiological Determinants

2020 ◽  
Vol 47 (10) ◽  
pp. 757-764
Author(s):  
Marta Rial-Crestelo ◽  
Laura Garcia-Otero ◽  
Annalisa Cancemi ◽  
Mariella Giannone ◽  
Elena Escazzocchio ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Perinatal Outcomes ◽  
Reference Standards ◽  
Low Risk ◽  
Maternal Body Mass Index ◽  
Third Trimester ◽  
Maternal Body ◽  
Cerebroplacental Ratio ◽  
Singleton Pregnancies

<b><i>Objective:</i></b> To construct valid reference standards reflecting optimal cerebroplacental ratio and to explore its physiological determinants. <b><i>Methods:</i></b> A cohort of 391 low-risk pregnancies of singleton pregnancies of nonmalformed fetuses without maternal medical conditions and with normal perinatal outcomes was created. Doppler measurements of the middle cerebral artery and umbilical artery were performed at 24–42 weeks. Reference standards were produced, and the influence of physiological determinants was explored by nonparametric quantile regression. The derived standards were validated in a cohort of 200 low-risk pregnancies. <b><i>Results:</i></b> Maternal body mass index was significantly associated with the 5th centile of the cerebroplacental ratio. For each additional unit of body mass index, the 5th centile was on average 0.014 lower. The derived 5th, 10th, and 50th centiles selected in the validation cohort were 5, 9.5, and 51% of the measurements. <b><i>Conclusions:</i></b> This study provides methodologically sound prescriptive standards and suggests that maternal body mass index is a determinant of a cutoff commonly used for decision-making.

scholarly journals Prenatal sFlt-1/PlGF value for prediction of adverse neonatal outcome of isolated ultrasonic small-for-gestational-age fetus in normotensive pregnant women: A prospective cohort study

2019 ◽  
Author(s):  
So Hyun Shim ◽  
Haeng Jun Jeon ◽  
Hye Jin Ryu ◽  
So Hyun Kim ◽  
Seung Gi Min ◽  
...  
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Neonatal Outcome ◽  
Adverse Outcome ◽  
Control Group ◽  
Third Trimester ◽  
Cutoff Value ◽  
Adverse Neonatal Outcome ◽  
Increased Risk ◽  
Plgf Ratio

Abstract Background: Not only preeclampsia but also small-for-gestational-age (SGA) neonates in the absence of preeclampsia are at increased risk of morbidity and mortality. Early recognition of fetuses at increased risk of being growth-restricted enables more appropriate surveillance and optimization of management for reduced risk of adverse neonatal outcomes. We investigated potential value of soluble fms-like tyrosine kinase-1 (sFlt-1) to placental growth factor (PlGF) ratio, estimated in late-second and early-third trimester respectively, for prediction of SGA neonates with poor neonatal outcome in the absence of preeclampsia. Methods: Included in this case control study were 530 singleton pregnant women who had attended the prenatal screening program at single institution between January 2011 and March 2012. Demographic and clinical information of maternal and neonatal data were collected. The sFlt-1/ PlGF value at 24 to 28+6 weeks and 29 to 36+6 weeks of gestation were analyzed for comparing appropriate for gestational age control group, SGA and SGA with poor neonatal group. Results: After excluding 22 preeclampsia cases, 47 SGA group and 461 control-group were included. Among SGA group, 17 neonates had adverse neonatal outcome (36.1%, 17/47). Mean gestational age at delivery in SGA group was 37.76±2.05 weeks, which showed no significant difference comparing to control group (38.43±2.1 weeks, p=0.122). The sFlt-1/PlGF ratios at late-second trimester were both higher in the SGA group and poor neonatal SGA group than control group (3.74±2.52 vs 6.73±8.22 vs 7.62±15.2, p=0.63) and especially sFlt-1/PlGF ratio at early-third trimester was significantly higher (14.41±12.5 vs 28.62±37.2 vs 109.12±83.96, p=0.002). As gestational age advances, rapid increase in sflt-1/PlGF ratio detected in poor SGA group comparing to SGA group with no adverse outcome. A cutoff value of 28.15 for the sFlt-1/PlGF ratio at 29 to 36+6weeks significantly predicted SGA neonates who had adverse outcome, with sensitivity and specificity of 76.9% and 88%, respectively. Conclusion: In this study, sFlt-1/PlGF ratio of SGA with adverse neonatal outcome group was significantly higher than control group. This study suggests the feasibility of the sFlt-1/PlGF ratio as helpful objective measurement for predicting the adverse SGA neonatal outcome by providing sFlt-1/PlGF cutoff value, besides ultrasound biometry measurement.

scholarly journals Prenatal sFlt-1/PlGF value for prediction of adverse neonatal outcome of isolated ultrasonic small-for-gestational-age fetus in normotensive pregnant women: A prospective cohort study

2019 ◽  
Author(s):  
So Hyun Shim ◽  
Haeng Jun Jeon ◽  
Hye Jin Ryu ◽  
So Hyun Kim ◽  
Seung Gi Min ◽  
...  
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Neonatal Outcome ◽  
Adverse Outcome ◽  
Control Group ◽  
Third Trimester ◽  
Cutoff Value ◽  
Adverse Neonatal Outcome ◽  
Increased Risk ◽  
Plgf Ratio

Abstract Background Not only preeclampsia but also small-for-gestational-age (SGA) neonates in the absence of preeclampsia are at increased risk of morbidity and mortality. Early recognition of fetuses at increased risk of being growth-restricted enables more appropriate surveillance and optimization of management for reduced risk of adverse neonatal outcomes. We investigated potential value of soluble fms-like tyrosine kinase-1 (sFlt-1) to placental growth factor (PlGF) ratio, estimated in late-second and early-third trimester respectively, for prediction of SGA neonates with poor neonatal outcome. Methods Included in this case control study were 530 singleton pregnant women who had attended the prenatal screening program at single institution between January 2011 and March 2012. The maternal serum levels of sFlt-1 and PlGF at 24 to 28+6weeks and 29 to 36+6weeks of gestation were measured for comparing control and SGA group. Results After excluding 22 preeclampsia cases, 47 SGA group and 461 control-group were included. Mean gestational age at delivery in SGA group was 37.76 ± 2.05weeks, which showed no significant difference comparing to control group (38.43 ± 2.1weeks, p=0.122). The sFlt-1/PlGF ratios at late-second trimester and early-third trimester were both higher in the SGA group than control group (7.62 vs 3.74, p=0.63; 28.62 vs 14.42, p=0.037) and especially sFlt-1/PlGF ratio at early-third trimester was significantly higher in the SGA group. Among SGA group, 17 neonates had adverse neonatal outcome (36.1%, 17/47). Both sFlt-1/PlGF ratios in each trimester were also higher in poor SGA group than control group (6.73 vs 3.77, p = 0.379; 109.12 vs 15.27, p=0.002). As gestational age advances, rapid increase in sflt-1/PlGF ratio detected in poor SGA group comparing to SGA group with no adverse outcome. A cutoff value of 28.15 for the sFlt-1/PlGF ratio at 29 to 36+6weeks significantly predicted SGA neonates who had adverse outcome, with sensitivity and specificity of 76.9% and 88%, respectively. Conclusion In this study, sFlt-1/PlGF ratio of SGA with adverse neonatal outcome group was significantly higher than control group. This study suggests the feasibility of the sFlt-1/PlGF ratio as helpful objective measurement for predicting the adverse SGA neonatal outcome by providing sFlt-1/PlGF cutoff value, besides ultrasound biometry measurement.

scholarly journals Maternal and Fetal Outcome in Pregnancy with Sickle Cell Disease in the Third Trimester in Central India: A Retrospective Study

2021 ◽  
pp. 782-787
Author(s):  
Rashmi Prasad ◽  
Mugdha Jungari ◽  
Deepti Shrivastava ◽  
J. M. Kumbhare
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Adverse Outcome ◽  
Central India ◽  
Obstetric Outcomes ◽  
Cell Disease ◽  
Third Trimester ◽  
The Third ◽  
In Pregnancy

Introduction: Sickle cell disease is an uncommon cause of anemia and jaundice during pregnancy. However, SCD is expected in Maharashtra, especially the Vidarbha region. SCD in pregnancy can cause various maternal and fetal complications. This study was conducted to know maternal and fetal outcomes in pregnancy with sickle cell disease in the third trimester. Methodology: This retrospective data were collected from hospital records of medical colleges located in central India for one and a half years, from November 2019 to January 2021. Forty-two women were admitted with pregnancy with sickle cell disease in the third trimester during the study period. The baseline characteristics, frequency of sickle hemoglobin variants, and maternal and fetal pregnancy outcomes were collected. Results: Compiled data were analyzed by simple descriptive statistics and frequency tables. Majority were primigravida (59.52%). Type of sickle cell was determined based on HB electrophoresis; out of 42 patients, 36 had AS pattern, 5 had SS pattern SCD, and 1 had As+b thal minor. The most common medical complication was anemia [73.80%] and UTI 26.19%. The most common adverse obstetric outcomes observed were IUGR/Oligohydramnios 42.85% and pre-eclampsia 21.42%. Majority of patients delivered by LSCS 42.85%. An adverse outcome in the fetus was fetal distress 45.23% and meconium-stained amniotic fluid 42.86%. Discussion: Due to hematological changes, extra demands, and sickle crisis, complications in both mother and fetus are more common in sickle cell anemia. Conclusions: Early detection and management of sickle cell anemia during pregnancy can reduce the adverse outcome in both mother and baby.

Congenital Cytomegalovirus Infection Following Second and Third Trimester Maternal Infection Is Associated With Mild Childhood Adverse Outcome Not Predicted by Prenatal Imaging

2021 ◽  
Author(s):  
Tal Elkan Miller ◽  
Boaz Weisz ◽  
Yoaz Yinon ◽  
Tal Weissbach ◽  
Hila De Castro ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Adverse Outcome ◽  
Second Trimester ◽  
Cmv Infection ◽  
Third Trimester ◽  
Congenital Cytomegalovirus ◽  
Motor Delay ◽  
Incidence Proportion ◽  
Prenatal Imaging ◽  
Neurodevelopmental Abnormalities

Abstract Background While it is clear that first trimester congenital cytomegalovirus (CMV) infection can lead to serious neonatal and childhood adverse outcome, the extent of the effect of second and third trimester congenital CMV infection is still unclear. Our aim was to study the short- and long-term outcomes following second and third trimester infection and to evaluate the contribution of prenatal imaging in a prospective cohort. Methods We studied pregnant women with primary CMV infection in the second and third trimesters, as diagnosed by well-dated seroconversion, and proof of vertical CMV transmission. All patients underwent serial prenatal ultrasound (US) and most of them fetal magnetic resonance imaging (MRI). Follow-up information was obtained from hospital charts and by telephone interviews with parents. Results Primary CMV infection occurred in 135 patients, 107 and 28 with second and third trimester infection, respectively. The incidence proportion of composite outcome (hearing loss or neurodevelopmental impairment) following second trimester infection was 7% (7/100, after excluding cases that were terminated) with a 3% incidence of partial unilateral sensory neural hearing loss and a 5% incidence of minor neurodevelopmental abnormalities, including slight verbal and motor delay. Following third trimester infection, there was one case of a very mild motor delay. The incidence proportion of abnormal prenatal findings on US or MRI was not significantly correlated to hearing loss or neurodevelopmental abnormalities. Conclusions Second trimester infection is associated with a slight risk of developing mild childhood sequelae, mostly partial unilateral hearing loss, which may develop late in childhood. Prenatal imaging failed to predict the development of childhood adverse outcome.

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