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Objectives: To evaluate the relationship between the attitude of the fetal head quantified by means of the chin‐to‐chest angle (CCA) in fetuses in occiput posterior (OP) position at the beginning of the second stage of labor, and persistent OP position at birth. Methods: This was a single‐center, prospective observational study conducted at the University Hospital of Parma, Parma, Italy. We included singleton pregnancies at term with fetuses in the OP position at the beginning of the second stage of labor. The fetal head position, station by means of angle of progression and head‐to‐perineum distance, and attitude by means of CCA were assessed using transabdominal or transperineal ultrasound. The primary outcome was persistent OP position at birth. Results: Between January and July 2022, 76 women were included in the study. There were 48 (63.2%) spontaneous rotations of the fetal head and spontaneous vaginal delivery occurred in all. Among the 28 (36.8%) fetuses that did not rotate spontaneously into an occiput anterior position, eight (28.6%) had a spontaneous vaginal delivery, while operative vaginal delivery and Cesarean delivery was performed in 11 (39.3%) and nine (32.1%) cases, respectively. Multivariable logistic regression analysis showed that the CCA (adjusted odds ratio (aOR), 2.15 (95% CI, 1.22–3.78); P = 0.008) and nulliparity (aOR, 0.20 (95% CI, 0.06–0.76); P = 0.02) were associated independently with persistent OP position at birth. Moreover, the CCA showed an area under the receiver‐operating‐characteristics curve of 0.69 (95% CI, 0.56–0.82); P = 0.005) for the prediction of persistent OP position. The optimal cut‐off value of the CCA was 36.5°, and was associated with a sensitivity of 0.82 (95% CI, 0.63–0.94), specificity of 0.50 (95% CI, 0.35–0.65), positive predictive value of 0.49 (95% CI, 0.34–0.64), negative predictive value of 0.83 (95% CI, 0.64–0.94), positive likelihood ratio of 1.64 (95% CI, 1.18–2.29) and negative likelihood ratio of 0.36 (95% CI, 0.15–0.83). Conclusions: Our data show that, within a population of women with fetal OP position at the beginning of the second stage of labor, the sonographic fetal head attitude measured by means of the CCA might help in the identification of fetuses at risk of persistent OP position. Such findings can be useful for patient counseling when OP position is diagnosed at full cervical dilatation. Further studies should investigate if the CCA might select patients who may benefit from manual rotation of the fetal head. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Objectives: To describe the appearance and size of the ganglionic eminence (GE) in normal fetuses on midtrimester three‐dimensional (3D) neurosonography and to report on the association between GE alterations (cavitation or enlargement) and malformation of cortical development (MCD). Methods: This was a prospective multicenter cohort study of normal fetuses and a retrospective analysis of pathological cases with MCD. From January 2022 to June 2022, patients attending our tertiary centers for an expert fetal brain scan were recruited for the purpose of the study. A 3D volume of the fetal head, starting from the sagittal plane, was acquired in apparently normal fetuses using a transabdominal or transvaginal approach. Stored volume datasets were then evaluated independently by two expert operators. Two measurements (longitudinal diameter and transverse diameter) of the GE in the coronal view were obtained twice by each operator. Intra‐ and interobserver measurement variation was calculated. Reference ranges for GE measurements were calculated in the normal population. A previously stored volume dataset of 60 cases with MCD was also analyzed independently by the two operators using the same method in order to assess if GE abnormalities (cavitation or enlargement) were present. Postnatal follow‐up was obtained in all cases. Results: In the study period, 160 normal fetuses between 19 and 22 weeks of gestation were included in the study. The GE was visible in the coronal plane on 3D neurosonography in 144 (90%) cases and was not clearly visible in the remaining 16 (10%) cases. The intra‐ and interobserver agreement was almost perfect for the longitudinal diameter, with an intraclass correlation coefficient (ICC) of 0.90 (95% CI, 0.83–0.93) and 0.90 (95% CI, 0.86–0.92), respectively, and substantial for the transverse diameter, with an ICC of 0.80 (95% CI, 0.70–0.87) and 0.64 (95% CI, 0.53–0.72), respectively. A retrospective analysis of 50 cases with MCD in the second trimester showed that GE enlargement was present in 12 cases and GE cavitation was present in four cases. Conclusions: Systematic assessment of the GE in fetuses at 19–22 weeks of gestation is feasible on 3D neurosonography, with good reproducibility in normal cases. Cavitation or enlargement of the GE can be demonstrated in fetuses with MCD. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

This article, titled "OC19.08: Effectiveness of the antihypertensive therapy based on maternal hemodynamic findings in women with HDP: a multicentre prospective study," discusses a study that aimed to compare the effectiveness of appropriate and inappropriate antihypertensive therapy in women with hypertensive disorders of pregnancy (HDP). The study included 152 women and assessed their hemodynamic profile before prescribing antihypertensive therapy. The results showed that women who received appropriate therapy had a lower occurrence of severe hypertension and were more likely to achieve target blood pressure values within 48-72 hours compared to those who received inappropriate therapy. The study suggests that considering the maternal hemodynamic profile when prescribing antihypertensive therapy can lead to better outcomes for women with HDP. [Extracted from the article]

This article, titled "Circulating angiogenic factors levels in women with hypertensive disorders of pregnancy according to the baseline hemodynamic findings," explores the relationship between hemodynamic phenotype and the predictive value of sFLT‐1/PlGF ratio for adverse outcomes in women with hypertensive disorders of pregnancy (HDP). The study included a cohort of women with new-onset HDP and assessed their hemodynamic parameters using USCOM-1A. The results showed that the sFLT1/PlGF ratio was significantly higher in women with a hypodynamic profile, and there was a significant association between the ratio and adverse maternal and neonatal outcomes in this group. Overall, the findings suggest that the sFLT1/PlGF ratio is associated with adverse outcomes only in women with a hypodynamic profile. [Extracted from the article]

Objective: To evaluate the relationship between the fetal head‐circumference‐to‐maternal‐height (HC/MH) ratio measured shortly before delivery and the occurrence of Cesarean section (CS) for labor dystocia. Methods: This was a multicenter prospective cohort study involving four tertiary maternity hospitals. An unselected cohort of women with a singleton fetus in cephalic presentation, at a gestational age beyond 36 + 0 weeks and without any contraindication for vaginal delivery, was enrolled between September 2020 and November 2021. The MH and fetal HC were measured on admission of the patient to the labor ward. The primary outcome of the study was the performance of the HC/MH ratio in the prediction of CS for labor dystocia. Women who underwent CS for any indication other than failed labor progression, including fetal distress, were excluded from the final analysis. Results: A total of 783 women were included in the study. Vaginal delivery occurred in 744 (95.0%) women and CS for labor dystocia in 39 (5.0%). CS for labor dystocia was associated with shorter MH (mean ± SD, 160.4 ± 6.6 vs 164.5 ± 6.3 cm; P < 0.001), larger fetal HC (339.6 ± 9.5 vs 330.7 ± 13.0 mm; P < 0.001) and a higher HC/MH ratio (2.12 ± 0.11 vs 2.01 ± 0.10; P < 0.001) compared with vaginal delivery. Multivariate logistic regression analysis showed that the HC/MH ratio was associated independently with CS for labor dystocia (adjusted odds ratio, 2.65 (95% CI, 1.85–3.79); P < 0.001). The HC/MH ratio had an area under the receiver‐operating‐characteristics curve of 0.77 and an optimal cut‐off value for discriminating between vaginal delivery and CS for labor dystocia of 2.09, which was associated with a sensitivity of 0.62 (95% CI, 0.45–0.77), specificity of 0.79 (95% CI, 0.76–0.82), positive predictive value of 0.13 (95% CI, 0.09–0.19) and negative predictive value of 0.98 (95% CI, 0.96–0.99). Conclusions: In a large cohort of unselected pregnancies, the HC/MH ratio performed better than did fetal HC and MH alone in identifying those cases that will undergo CS for labor dystocia, albeit with moderate predictive value. The HC/MH ratio could assist in the evaluation of women at risk for CS for labor dystocia. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

This article, titled "EP12.14: Postpartum sonographic measurement of the inferior vena cava and correlation with hemoglobin levels," discusses a study conducted to evaluate the correlation between the diameter of the Inferior Vena Cava (IVC), the Collapsibility Index (CI), and the drop in hemoglobin levels 24 hours after delivery. The study included 47 women who underwent an elective Caesarean Delivery at term. The results showed that there was no correlation between the IVC diameter or the CI and a drop in hemoglobin levels of ≥2g. Therefore, the study suggests that the IVC diameter and CI measured 2 hours after delivery are not associated with a significant drop in hemoglobin levels. [Extracted from the article]

This article, published in the journal Ultrasound in Obstetrics & Gynecology, explores the correlation between angiogenetic biomarkers, urinary protein values, and the presence of maternal ascites in women with new-onset Hypertensive Disorders of Pregnancy (HDP). The study included 80 patients with new-onset HDP and found a linear correlation between the SFLT-1/PlGF ratio and 24-hour urinary protein values. Additionally, higher values of the SFLT-1/PlGF ratio were associated with higher levels of urinary protein and a higher incidence of maternal ascites. The findings suggest a potential link between these biomarkers and the severity of HDP. [Extracted from the article]

This article, published in the journal Ultrasound in Obstetrics & Gynecology, describes a study conducted at two referral Fetal Medicine units to examine the sonographic features of the caudo-thalamic (CT) groove in the third trimester of pregnancy. The study included a cohort of normal fetuses who underwent 3D ultrasound of the fetal brain, and the results showed that the CT groove was consistently visible in the majority of cases. Additionally, the researchers found five cases with abnormal appearance of the groove, which suggests that abnormal findings at this level can be detected during antenatal brain ultrasound. The study provides valuable insights into fetal neurosonography and its potential for detecting abnormalities. [Extracted from the article]

This article, titled "EP19.15: Intrapartum assessment of head-perineum distance: a comparative study of measurements obtained with and without compression of perineal soft tissues," presents the findings of a study that aimed to evaluate and compare measurements of the head-perineum distance (HPD) obtained with and without compression of the perineal soft tissues. The study involved a series of singleton pregnancies and used transperineal sonography to evaluate the HPD. The results showed a good correlation and reproducibility between the HPD measured with and without compression, and it was also found that the body mass index at delivery may impact the difference in measurements. [Extracted from the article]

This article discusses the role of 3D ultrasound and Doppler technologies in visualizing the medullary veins of the central nervous system (CNS) in fetal imaging. The accurate imaging of these veins is important for diagnosing CNS malformations. The article presents images and case studies that demonstrate the use of Doppler technologies sensitive to low-velocity flow in visualizing the medullary veins and identifying disruptions in their anatomy. The authors suggest that these technologies have the potential to aid in the diagnosis of complex cerebral anomalies. [Extracted from the article]

Objective: To investigate the correlation between epidural analgesia (EA) administered during labour and the risk of requiring an operative delivery (caesarean section or operative vaginal delivery).Methods: This was a retrospective, multicentric cohort study. All singleton births of viable foetuses in cephalic presentation with a gestational age ≥ 37 weeks delivered between 2016 and2019 were included. A propensity score (PS) matching analysis was used to obtain comparable groups, balancing the maternal and pregnancy characteristics that required epidural analgesia during labour. The risk of operative delivery in women with and without epidural analgesia was estimated following PS-matching analysis (1:1 ratio).Results: As per the unmatched analysis, the occurrence of Caesarean section (CS) was significantly higher in women administered EA compared with the non-EA group (14.0 % vs 5.0 %; p < 0.001). The incidence of operative vaginal delivery (OVD) (9.1 % vs 4.0 %; p < 0.001) showed a similar pattern. The PS algorithm matched 16.301 cases who were administered EA with 16.301 cases not administered EA and found a significantly increased risk of CS (OR, 1.6; 95 %CI 1.5-1.7) and OVD (OR, 1.2; 95 % CI 1.1-1.2) in the former group.Conclusion: The risk of operative delivery almost halved in the EA group compared with the non-EA group, compared with the baseline risk of the unmatched subjects. [ABSTRACT FROM AUTHOR]

Most brain abnormalities are present in the first trimester, but only a few are detected so early in gestation. According to current recommendations for first-trimester ultrasound, the fetal head structures that should be visualized are limited to the cranial bones, the midline falx and the choroid-plexus-filled ventricles. Using this basic approach, almost all cases of acrania, alobar holoprosencephaly and cephalocele are detected. However, the majority of other fetal brain abnormalities remain undiagnosed until the midtrimester. Such anomalies would be potentially detectable if the sonographic study were to be extended to include additional anatomic details not currently included in existing guidelines. The aim of this review article is to describe how best to assess the normal fetal brain by first-trimester expert multiplanar neurosonography and to demonstrate the early sonographic findings that characterize some major fetal brain abnormalities. © 2020 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the performance of a new ultrasound technique for the automatic assessment of the change in head–perineum distance (delta‐HPD) and angle of progression (delta‐AoP) during the active phase of the second stage of labor. Methods: This was a prospective observational cohort study including singleton term pregnancies with fetuses in cephalic presentation during the active phase of the second stage of labor. In each patient, two videoclips of 10 s each were acquired transperineally, one in the axial and one in the sagittal plane, between rest and the acme of an expulsive effort, in order to measure HPD and AoP, respectively. The videoclips were processed offline and the difference between the acme of the pushing effort and rest in HPD (delta‐HPD) and AoP (delta‐AoP) was calculated, first manually by an experienced sonographer and then using a new automatic technique. The reliability of the automatic algorithm was evaluated by comparing the automatic measurements with those obtained manually, which was considered as the reference gold standard. Results: Overall, 27 women were included. A significant correlation was observed between the measurements obtained by the automatic and the manual methods for both delta‐HPD (intraclass correlation coefficient (ICC) = 0.97) and delta‐AoP (ICC = 0.99). The high accuracy provided by the automatic algorithm was confirmed by the high values of the coefficient of determination (r2 = 0.98 for both delta‐HPD and delta‐AoP) and the low residual errors (root mean square error = 1.2 mm for delta‐HPD and 1.5° for delta‐AoP). A Bland–Altman analysis showed a mean difference of 0.52 mm (limits of agreement, −1.58 to 2.62 mm) for delta‐HPD (P = 0.034) and 0.35° (limits of agreement, −2.54 to 3.09°) for delta‐AoP (P = 0.39) between the manual and automatic measurements. Conclusions: The automatic assessment of delta‐AoP and delta‐HPD during maternal pushing efforts is feasible. The automatic measurement of delta‐AoP appears to be reliable when compared with the gold standard manual measurement by an experienced operator. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the diagnostic accuracy of a new ultrasound sign, intracervical lakes (ICL), in predicting the presence of placenta accreta spectrum (PAS) disorder and delivery outcome in patients with placenta previa or low-lying placenta.Methods: This was a retrospective multicenter study of women with placenta previa or low-lying placenta at ≥ 26 weeks' gestation, who were referred to three Italian tertiary units from January 2015 to September 2018. The presence of ICL, defined as tortuous anechoic spaces within the cervix which appeared to be hypervascular on color Doppler, was evaluated on ultrasound images obtained at the time of referral. The primary aim was to explore the diagnostic accuracy of ICL in detecting the presence and depth of PAS disorder. The secondary aim was to explore the accuracy of this sign in predicting total estimated blood loss, antepartum bleeding, major postpartum hemorrhage at the time of Cesarean section and need for Cesarean hysterectomy. The diagnostic accuracy of ICL in combination with typical sonographic signs of PAS disorder, was assessed by computing summary estimates of sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios and diagnostic odds ratios (DOR).Results: A total of 332 women with placenta previa or low-lying placenta were included in the analysis, with a median maternal age of 33.0 (interquartile range, 29.0-37.0) years. ICL were noted in 15.1% of patients. On logistic regression analysis, the presence of ICL was associated independently with major postpartum hemorrhage (odds ratio (OR), 3.3 (95% CI, 1.6-6.5); P < 0.001), Cesarean hysterectomy (OR, 7.0 (95% CI, 2.1-23.9); P < 0.001) and placenta percreta (OR, 2.8 (95% CI, 1.3-5.8); P ≤ 0.01), but not with the presence of any PAS disorder (OR, 1.6 (95% CI, 0.7-3.5); P = 0.2). Compared with the group of patients without ultrasound signs of PAS disorder, the presence of at least one typical sonographic sign of PAS disorder in combination with ICL had a DOR of 217.2 (95% CI, 27.7-1703.4; P < 0.001) for placenta percreta and of 687.4 (95% CI, 121.4-3893.0; P < 0.001) for Cesarean hysterectomy.Conclusion: ICL may represent a marker of deep villus invasion in women with suspected PAS disorder on antenatal sonography and anticipate the occurrence of severe maternal morbidity. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the ultrasound characteristics and outcome of fetuses with non-visualization of the fetal gallbladder (NVFGB) followed in our tertiary university hospital, and to provide a comprehensive review of the literature on prenatal findings and outcome of NVFGB.Methods: NVFGB was defined as non-visualization of the gallbladder on two targeted ultrasound examinations performed within a 1-week period. First, we reviewed the medical records of NVFGB cases managed in our center over a 9-year period. Then, we performed a systematic review of the literature to identify studies on NVFGB. The incidence of chromosomal anomalies, later visualization of the gallbladder, gallbladder agenesis, cystic fibrosis and biliary atresia was assessed in fetuses with isolated and non-isolated NVFGB. The role of hepatic enzyme measurements in the diagnosis of cystic fibrosis and biliary atresia in fetuses with NVFGB was also reviewed.Results: Sixteen cases of NVFGB were followed in our center, in 10 (62.5%) of which it was an isolated finding. The incidence of biliary atresia was 12.5% and that of gallbladder agenesis was 12.5%, while no case of cystic fibrosis was reported. The gallbladder was visualized later in pregnancy or postnatally in 43.8% and 25.0% of cases, respectively. A total of seven studies, including our cohort, involving a total of 280 NVFGB cases, met the inclusion criteria for the systematic review. Overall, 20.5% of fetuses had an associated ultrasound anomaly, and the incidence of chromosomal anomaly in this group was 20.4%. In cases with isolated NVFGB, the incidence of chromosomal anomaly was 1.9%. In fetuses with normal karyotype and isolated NVFGB, the gallbladder was later visualized in 70.4% of cases, while the incidence of gallbladder agenesis, cystic fibrosis and biliary atresia was 25.2%, 3.1% and 4.8%, respectively. In fetuses with non-isolated NVFGB, the incidence of cystic fibrosis and biliary atresia was 23.1% and 18.2%, respectively. The negative predictive value of amniotic fluid enzyme levels for the prediction of severe disease (including biliary atresia or cystic fibrosis) ranged between 94% and 100% when evaluated before 22 weeks' gestation, and dropped to 88% after 22 weeks.Conclusions: In cases with persistent NVFGB, the risk of a severe postnatal condition should be considered. A detailed ultrasound scan should be offered and parents tested for cystic fibrosis gene mutation. An invasive procedure for karyotyping and measurement of liver enzyme concentrations before 22 weeks constitutes a reasonable work-up. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Obesity and gestational diabetes mellitus (GDM) are rising worldwide. This study retrospectively evaluated the role of excessive gestational weight gain (eGWG) in women with GDM and different pre-pregnancy body mass indices (BMIs). PATIENTS AND METHODS: Optimal glycaemic control was defined as achieving glucose target thresholds in more than 80% of measurements. 283 women with GDM were categorized as underweight, normal weight, overweight or obese based on WHO's classification scheme. eGWG was defined as >18.0 kilograms for women who were underweight, >15.8 kilograms for those who were normal weight, >11.3 kilograms for those who were overweight and >9.0 kilograms for those who were obese. For the analysis, women were divided into two groups: normal and excessive GWG. The main outcomes measured were incidences of large/ small for gestational age (LGA/SGA), macrosomia, preterm delivery, hypertensive disorders and caesarean sections (CS). RESULTS: Excessive GWG was associated with higher birth weight and percentile (p<0.001), and with a higher prevalence of LGA (p<0.001), macrosomia (p=0.002) and hypertensive disorders (p=0.036). No statistical differences were found for the week of delivery, or prevalence of CS and SGA. The multivariate analysis highlighted both pre-pregnant BMI and eGWG as independent risk factors for LGA and macrosomia. Women with a pre-pregnant BMI of at least 25 and eGWG have a 5.43-fold greater risk of developing LGA (p=0.005). CONCLUSIONS: When combined with an inadequate pre-pregnant BMI, eGWG acts as a "synergic risk factor" for a poor outcome. When obesity or GDM occur, an optimal GWG can guarantee a better pregnancy outcome. [ABSTRACT FROM AUTHOR]

Objective: To investigate the ultrasound characteristics and outcome of pregnancies with fetal intra-abdominal umbilical vein varix (FIUVV).Methods: Cases of FIUVV managed at our tertiary university hospital over an 8-year period were reviewed. Information retrieved included gestational age and diameter of the umbilical varix at diagnosis, increase in varix diameter, associated ultrasound or chromosomal anomalies and pregnancy outcome. Furthermore, a systematic review and meta-analysis of series of FIUVV in the literature was performed to assess the incidence of chromosomal anomalies, small-for-gestational age infants and intrauterine fetal demise (IUFD), and to pool odds ratio (OR) estimates on the relationship between the incidence of these outcomes and the presence of additional associated ultrasound anomalies.Results: Thirteen cases of FIUVV were included in the cohort study. Additional ultrasound anomalies were found in two (15.4%) of 13 cases. One case of IUFD was observed and no case of chromosomal anomaly or thrombosis of varix was recorded. A total of five studies comprising 254 cases met the inclusion criteria of the systematic review. FIUVV was associated with additional ultrasound anomalies (non-isolated FIUVV) in 19% (95% CI, 10.9-29.1%) of cases. No case of chromosomal abnormality or IUFD was reported in fetuses with isolated FIUVV. In contrast, in the group of non-isolated FIUVV, the incidence of chromosomal anomalies was 19.6% and that of IUFD was 7.3%, with ORs of 14.8 (95% CI, 2.9-73.0) and 8.2 (95% CI, 1.05-63.1), respectively, when compared with the group of isolated FIUVV.Conclusion: When isolated, the outcome of cases affected by FIUVV is usually favorable. In about 20% of cases, additional ultrasound anomalies are found, which are associated with an increased risk for chromosomal abnormalities and IUFD. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

Also, no correlation was found between the total deceleration area in labour and both the WJA/birthweight and the UCA/birthweight ratio. The correlation between the total deceleration area during labour and the WJA/birthweight and the UCA/ birthweight ratio was also assessed. The WJA/birthweight and the UCA/birthweight ratio were compared between women who underwent an OI (i.e. Caesarean section, operative vaginal deliveries or intrapartum resuscitation) for suspected fetal compromise (group OI) and those where this was not necessary (group no OI). [Extracted from the article]

Cardiac Output and Systemic Vascular Resistance showed the highest accuracy in predicting the risk of LVH (AUC 94.4 95% CI 0.86-0.99 cut-off 5.8 and AUC 94.0% 95% CI 0.86-0.99 cut-off 1387, respectively). To evaluate the accuracy of hemodynamic parameters in predicting the risk of left ventricular hypertrophy (LVH) in women with chronic hypertension (CH). [Extracted from the article]

OP05.04: Expert neurosonography versus magnetic resonance imaging: comparison of techniques in detecting cortical abnormalities in a high-risk population A non-consecutive series of cases with a diagnosis of central nervous system (CNS) abnormality at antenatal NSG and MRI, were included in the study. To compare the accuracy of neurosonography (NSG) and magnetic resonance imaging (MRI) in the assessment of the fetal cortex in a high-risk cohort of fetuses. [Extracted from the article]

Holoprosencephaly (HPE) is a brain malformation caused by the failure of the cleavage of the prosencephalon resulting from varying degrees of lack of separation of the cerebral hemispheres and associated with craniofacial abnormalities in up to 80% of cases. High-resolution 3D rendering confirmed hypertelorism (figure 1b, 4) associated with midfacial hypoplasia (figure 1b, 5) and median facial cleft involving the secondary palate (figure 1b, 6). Trisomy 13 was confirmed at chorionic villous sampling, and the patient opted for TOP. [Extracted from the article]

Conclusions The RPI seems a valuable anatomic landmark to define normal kidneys position on a coronal view in the first trimester (figure 1A). To define the normal position of fetal kidneys at 1st trimester. [Extracted from the article]

To evaluate the relationship between fetal Doppler parameters and functional echocardiography in fetuses at risk for late-onset fetal growth restriction (FGR). Conclusions Functional echocardiographic findings on a selected population of fetuses at risk for late-onset FGR and birthweight < 10th percentile demonstrate a relationship between the UA Doppler and left ventricular strain and EF. At sub-analysis performed according to the birthweight, fetuses with birthweight 3 SP rd sp -10 SP th sp percentile and abnormal UA Doppler showed lower LV global longitudinal strain (-18.6 versus -21.9, p = 0.01), LV global radial strain (-31.1 versus -47.5, p = 0.003), LV global circumferential strain (-24.4 versus -31.6, p = 0.03) and EF (52.5 versus 60.2, p = 0.004) compared to those with normal UA Doppler. [Extracted from the article]

To evaluate the relationship between the fetal attitude in fetuses in occiput posterior (OP) at full cervical dilatation and the chance of rotation to occiput anterior (OA) at birth. Occiput rotation from OP to occiput anterior position was defined based on the occiput position at delivery. [Extracted from the article]

The primary outcome of this study was to evaluate the prevalence and the laterality of the CBS at antenatal ultrasound and MRI. Cases with additional central nervous system (CNS) anomalies not involving the cortex were excluded. To describe a specific marker of cortex anomaly in fetuses with complete callosal agenesis. [Extracted from the article]

CPVLr shows higher association with BSA, and the evidence of a reduced CPVLr at 11-13 weeks should prompt detailed evaluation of the fetal brain. To evaluate the association between ventriculomegaly and brain structural anomalies (BSA) at 11 + 0-13 + 6 weeks of gestation. We selected a non-consecutive series of fetuses with a BSA detected in the first trimester, excluding neural tube defects, and a group of normal fetuses as controls. [Extracted from the article]

CPVAr shows higher association with NTDs, and the evidence of an increased CPVLr or CPVAr at 11-13 weeks should prompt detailed evaluation of the fetal spine. To evaluate the association between first trimester sonographic measurements of the lateral ventricles and neural tube defects (NTDs) at 11+0-13+6 weeks of gestation. The CPVLr and CPVAr best cut-off values to detect NTDs were 0.72 and 0.56 respectively, with areas under the ROC curve of 0.86 for CPVLr and 0.95 for CPVAr. [Extracted from the article]

The aim of our study was to describe the sonographic measurement of the Obstetric Conjugate (OC) at transabdominal two-dimensional (2D) ultrasound and to assess its reproducibility. A non-consecutive series of pregnant women with uncomplicated singleton pregnancies from 34 weeks of gestation onward were included. Conclusions Our study demonstrated that among pregnant women at term gestation the sonographic measurement of the OC is feasible and reproducible. [Extracted from the article]

At ROC curve analysis the AUC of the HC/OC ratio for the prediction of a CS for labour dystocia was 0.72. To evaluate the performance of the ratio between the fetal head circumference (HC) to the obstetric conjugate (OC) (HC/OC ratio) in the prediction of the mode of delivery. [Extracted from the article]

To evaluate whether the cervical sliding sign (CSS) can predict the outcome of induction of labour (IoL). Similar figures have been found for multiparous patients, who showed higher rate of D24 (86,8% vs 17.1%, p = 0,01) and shorter Latency (11 ±7.6 vs 16.7 ±9.1 hours, p < 0.01) and TtD (13.8 ±8.7 vs 19.6 ±9.6 hours, p < 0.001) compared to parous women with no CSS. In nulliparous patients the presence of CSS was associated with an increased frequency of D24 (52.4% vs 24.6%, p < 0.01) and shorter latency (30 ±10.7 vs 20.1 ±10.8 hours, p < 0.01) and TtD (24.9±12.1 vs 30 ±10.7, p = 0.01) compared to nulliparae with no CSS. [Extracted from the article]

A OSA/AoP ratio above 1.19 showed 100% sensitivity, 85.7% specificity, 64.3% PPV and 100% NPV for CD; a OSA/HPD ratio below 2.72 identified 7/9 cases of CD and was associated with 77.8% sensitivity, 91.4% specificity, 100% PPV and 94.1% NPV for CD. To evaluate whether in non-occiput posterior fetuses with favourable head flexion the actual occiput position plays a role in the occurrence of Caesarean delivery (CD). [Extracted from the article]

Methods A non-consecutive series of normal fetuses undergoing first trimester screening scan was assessed by a single experienced operator. Conclusions The ultrasound evaluation of the maxilla and upper lip on the axial plane is feasible at the 11+0-13+6 weeks' scan. To evaluate the feasibility of the visualisation of the maxilla and upper lip on the axial plane at 11+0-13+6 weeks of gestation, and to evaluate the sensitivity of the view in the detection of orofacial clefts (OFC). [Extracted from the article]

Conclusions The evaluation of CPF structures on the coronal plane is feasible and could be useful for the early characterisation of some CPF structural abnormalities. To describe the sonographic appearance of the cranial posterior fossa (CPF) on the coronal plane in the first trimester of pregnancy in normal and abnormal cases. Open spina bifida cases showed a dry ventricular system, with the remaining CPF structures resembling a "jumping frog" (figure 1B). [Extracted from the article]

To evaluate the performance of maternal and fetal Doppler in early labour in the screening of intrapartum fetal distress (IFD) leading to obstetric intervention (OI). Cases were submitted to Doppler measurement of the umbilical artery (UA), middle cerebral artery (MCA) and of the uterine arteries (UtA) in early labour. OC14.06: Maternal and fetal Doppler in low-risk term pregnancy in early labour: can we screen for intrapartum fetal distress leading to obstetric intervention?. [Extracted from the article]

During pregnancy thrombo-prophylaxis could be required in high risk women. If a severe allergic reaction to low-molecular-weight-heparin (LMWH) or a heparin-induced-thrombocytopenia (HIT) occurs, it's mandatory to stop the drug. Fondaparinux could be an effective option. In the present review, the maternal and pregnancy outcomes of 65 pregnancies in women using Fondaparinux were reported. It was well-tolerated and rate of pregnancy complications was similar to that observed in general population. Regarding congenital malformations, further studies are necessary to investigate the safety of the drug. [ABSTRACT FROM AUTHOR]

Distinguishing between true preterm labor and transient early uterine contractions would avoid unnecessary hospitalization and potentially harmful treatment in low-risk patients[1]-[3]. GRAPH: Table S1 Clinical characteristics and pregnancy outcome in study population of 75 pregnant women with preterm uterine contractions, overall and according to presence of cervical sliding sign (CSS) GRAPH: Table S2 Occurrence of cervical sliding sign (CSS) and delivery within 7 and 14 days after assessment in the study population of 75 pregnant women with preterm uterine contractions, according to cervical length (CL). [Extracted from the article]

Objective: To investigate the predictive value of serum C3 and C4 complement component levels in relation to pregnancy outcome in patients with antiphospholipid syndrome (APS).Materials and methods: A prospective study of 47 pregnancies associated with APS was performed. Pregnancy outcome was analyzed in terms of: fetal loss, preterm delivery (≤34 gestational weeks), fetal intrauterine growth restriction (IUGR), birth weight <2500 g and preeclampsia. Week at delivery, neonatal birth weight and neonatal birth weight percentile were also investigated. Hypocomplementemia, positivity for anti-dsDNA and triple positivity for antiphospholipid antibodies (aPL) were related to pregnancy outcome.Results: Forty-three pregnancies ended in live births with a fetal loss rate of 8.5%. Fetal death, preterm delivery and birth weight <2500 g were associated with hypocomplementemia (p = 0.019, p = 0.0002, p < 0.0001 respectively). Lower neonatal birth weight, lower neonatal birth weight percentile and lower week at delivery were associated with hypocomplementemia (p < 0.0001, p = 0.0003, p < 0.0001 respectively) and with triple aPL positivity (p = 0.008, p = 0.014, p = 0.03 respectively). A poor pregnancy outcome was confirmed among primary APS (PAPS) pregnancies with hypocomplementemia. Multivariate analysis confirmed that hypocomplementemia was an independent predictor of lower neonatal birth weight (p = 0.0001) and lower week at delivery (p = 0.002).Conclusion: Hypocomplementemia could be considered a novel prognostic factor for pregnancy outcome in APS patients. [ABSTRACT FROM AUTHOR]

The secondary aim was to explore the accuracy in predicting total estimated blood loss; antepartum bleeding; post-partum haemorrhage at the time of Caesarean Section; need for Caesarean hysterectomy. At logistic regression analysis, intracervical lakes were independently associated with major post-partum haemorrhage (OR 3.3; 95% CI 1.6-6.51; p < 0.001), hysterectomy (OR 7.02; 95% CI 2.06-23.9; p < 0.001), placenta percreta (OR 2.78; 95%CI 1.34-5.77; p = 0.004). [Extracted from the article]

Cardiac output (CO), systemic vascular resistance (SVR), stroke volume (SV) and heart rate (HR) were measured and compared among the three groups (controls vs. Women with FGR had a significantly lower CO-Z score and a significantly higher SVR Z-score compared with both SGA and controls. Incidence of NICU admission did not differ between SGA and FGR fetuses although FGR had an overall higher length of hospitalisation compared to SGA fetuses (14.2 ± 17.7 vs. 4.5 ± 1.6 days; p = 0.02). [Extracted from the article]