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This study aimed (i) to assess the potential effect of placental location on uterine artery (UtA) pulsatility index (PI) and offspring birthweight (BW), and (ii) to examine the potential association of unilaterally increased UtA PI with preeclampsia (PE) or low BW.This was an asynchronous cohort study of singleton pregnancies between 20The analysis included 5506 pregnancies. A lateral placenta was associated with higher mean PI z-score (A lateral placenta is associated with a higher mean UtA PI and lower BW. Unilaterally increased UtA PI still carries a greater risk of PE and low BW than bilaterally normal PI, however this effect appears to be eventually mediated through mean UtA PI z-score, which is relatively increased in these cases.

Background: Pregestational diabetes is associated with adverse maternal and neonatal outcomes. The aim of this study was to summarize and compare evidence-based recommendations on pregestational diabetes and to focus especially on issues related to the management of this entity.Materials and methods: A descriptive review of three recently published national guidelines on pregestational diabetes was conducted: the American Diabetes Association on "Diabetes in Pregnancy: Standards of Medical Care in Diabetes - 2019," the National Institute for Health and Care Excellence on "Diabetes in pregnancy: management from preconception to the postnatal period" and the American College of Obstetricians and Gynecologists on "Pregestational Diabetes Mellitus." These guidelines were compared according to recommendations on management, during the preconception, antenatal, intrapartum and postpartum period.Results: There were many similar recommendations regarding the preconception counseling, the antepartum assessment by specialists, the glycemic control target levels, the pharmacologic treatment and the postpartum period among the three guidelines. On the other hand, the American Diabetes Association makes no recommendations regarding fetal monitoring and obstetric management during pregnancy and the intrapartum period, while there are several similarities between the other two guidelines.Conclusions: The adoption of an international consensus based on evidence - based guidelines will increase the awareness of the healthcare professionals on the management of pregestational diabetes, leading that way to more favorable perinatal outcomes.

Objective: To assess the performance of sonography in the detection of fetal nonchromosomal abnormalities using a standard anatomic examination protocol proposed by International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) at 11+0-13+6 weeks.Materials and methods: A prospective observational study was conducted between June 2013-May 2017 in singleton pregnancies attending for a routine scan at 11+0-13+6 weeks. All examinations were performed by maternal-fetal medicine specialists certified by the Fetal Medicine Foundation according to the anatomic examination protocol described in the ISUOG guidelines. First-trimester findings were compared to those of the anomaly scan at 20+0-23+6 weeks and the postnatal examination. The primary outcome was the detection rate of major structural abnormalities in fetuses with normal karyotype at 11+0-13+6 weeks.Results: After excluding 17 chromosomal abnormalities, major fetal structural defects were detected in 57 (1.7%) of the remaining 3361 cases. Of these, 27 (47.3%) were detected at 11+0-13+6 weeks, including all cases of acrania (4), exomphalos (4), megacystis (2) and body stalk anomaly (2). Furthermore, there was a first-trimester diagnosis in 36.4% (4/11) of major cardiac defects, 38% (6/16) of limb defects, and 100% (2/2) of facial clefts.Discussion: Targeted ultrasound examination may identify all the so called "always" detectable major abnormalities and a significant proportion of the "sometimes", detectable at 11+0-13+6 weeks.

Introduction: Main objective of the present study was to investigate the association between the presence of nuchal cord (NC) and the measurement of the ductus venosus pulsatility index for veins. (Ductus venosus (DV) PIV) Methods: This was a prospective study of 1974 singleton pregnancies that underwent first trimester screening at 11–13 + 6 gestational weeks. Colour Doppler was used to demonstrate the presence of a NC in all cases and the DV PIV was calculated routinely, as part of the standard scan. The association between the presence of a NC and the DV PIV was then examined overall and at each gestational week. Results: A NC was demonstrated in 17.1% of cases. The incidence of nuchal cord was significantly higher at 13–13+6 weeks (24.7%, n = 119) compared to the one at 12–12+6 (16.5%, n = 192) and 11–11+6 weeks (7.9%, n = 26) (p

Estimates for the prevalence of antenatal depression vary widely across different studies and especially concerning high-risk pregnancies. Threatened preterm labor is the most common indication for antenatal obstetric hospitalization. The aim of this study was to screen for depressive symptoms among pregnant women hospitalized in a high-risk pregnancy unit due to threatened preterm labor and also to investigate possible associated risk factors.A total of 103 pregnant women admitted at24 and36 gestational weeks were eligible to participate in the study. The Greek version of the Edinburgh Postnatal Depression Scale (EPDS) was used to detect depressive symptoms on admission. A cutoff score of13 was considered as indicative of depression. Possible associated risk factors were also investigated.The prevalence of antenatal depression (score13) was 24.3% (n = 25). In the multivariate analysis, antenatal depression was significantly correlated with thoughts of abortion (OR: 6.208; 95% CI: 1.141-33.765).About one quarter of the pregnant women hospitalized in the HRPU due to threatened preterm labor were depressed based on the EPDS. Thoughts of abortion were associated with a sixfold increase in the risk of depression, while no associations were found between antenatal depression and other sociodemographic and obstetric parameters.

To investigate the association of epidemiological and pregnancy-related parameters with the latency period achieved in cases of preterm premature rupture of membranes (PPROM).A retrospective study was performed enrolling cases admitted in high-risk pregnancy unit (HRPU) with PPROM between 24 + 0 and 36 + 6 gestational week during 2002-2011. Cases with vaginal bleeding at admission, co-existing maternal or fetal pathology, placenta praevia, previous interventions in cervix or uterus, triplets or higher order pregnancies were excluded. Epidemiological parameters and latency period between admission due to PPROM and delivery were recorded. Obstetrical complications, mode of delivery, and neonatal morbidity parameters were also studied. A multivariate regression model was used to correlate latency period with epidemiological and pregnancy-related risk factors.Overall, there were 319 cases of PPROM admitted, of which 303 (94.9%) met inclusion criteria. Median latency period was 5.2 d. The latency interval exceeded 48 h in 65.0% of cases (197/303). Emergency cesarean was demanded in 20.2% of cases, chorioamnionitis was diagnosed in 7.5% while 76.1% of neonates were admitted in neonatal intensive care unit. Higher gestational week at admission was associated with shorter latency interval (p0.001), twin pregnancy with shorter latency interval (p = 0.02), while latency interval was significantly lower in cases complicated with chorioamnionitis (p = 0.048).Gestational week at PPROM, twin gestation and chorioamnionitis are factors significantly affecting latency interval.