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Objective: Subclinical hypothyroidism is the most frequent thyroid dysfunction in pregnancy with an incidence of 2-5% which can easily be overlooked due to the absence of clinical symptoms. Studies have shown that thyroid hormones could alter the level of free beta-human chorionic gonadotropin (ß-hCG) and pregnancy-associated plasma protein-A (PAPP-A) released from the placenta during early pregnancy. Since these two serum markers are the two of the parameters used in the first-trimester combined screening, we hypothesized that distorted risk calculation results could be obtained from pregnant women with subclinical hypothyroidism. Methods: We conducted a prospective and cohort study at a tertiary university hospital in northwest Turkey between February 2018 and June 2018, involving 250 pregnant women in their first trimester who were seeking care at the obstetrics outpatient clinic. After evaluation of thyroid functions, first-trimester screening was performed in all 250 singleton pregnancies with fetuses at 11+0 to 13+6 gestational weeks. Thyroid-stimulating hormone (TSH) values above 2,5 mIU/L were considered high. The correlation between the results and parameters of the first-trimester combined screening and thyroid hormone values was examined. Results: Among the participants, after analyzing the fT4 values, all 35 pregnant women with high TSH values were diagnosed with subclinical hypothyroidism. We observed a statistically weak negative correlation between TSH and ß-HCG, which was expected given the similarities in their alpha subunits. There was no statistically significant correlation between TSH and PAPP-A values, combined risk scores, and age risk scores of first-trimester screening. As a matter of course, combined risk scores of first-trimester screening were found to be statistically lower in younger mothers. Conclusion: Pregnant women with normal thyroid functions and subclinical hypothyroidism were investigated for alterations in first-trimester screening parameters and risk scores. As a result, no statistically significant correlation was found between subclinical hypothyroidism and first-trimester screening. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to review the spectrum of the prenatally detected absent pulmonary valve syndrome and its outcome after diagnosis. Methods: Clinical data and echocardiographic findings of 37 cases with a fetal diagnosis of absent pulmonary valve syndrome between 2008 and 2020 were analyzed in this retrospective multicenter study. Results: Median gestational age at diagnosis was 25 weeks. Three subtypes of absent pulmonary valve syndrome were observed: (1) with tetralogy of Fallot (n = 30; 81.0%); (2) absent pulmonary valve syndrome with intact ventricular septum (n = 5; 13.5%); (3) with complete atrioventricular septal defect (n = 2; 5.4%). In contrast to 7/25 fetuses (28%) with tetralogy of Fallot-absent pulmonary valve syndrome who had a patent ductus arteriosus, all 5 fetuses with absent pulmonary valve syndrome-intact ventricular septum had a patent ductus arteriosus (P < .001). No significant difference was found between the z-scores of pulmonary artery branches in fetuses with or without patent ductus arteriosus (P > .05). The analysis did not reveal any correlation between gestational week and z-scores of pulmonary artery, pulmonary artery branches (right pulmonary artery, left pulmonary artery), and ratio of aorta/pulmonary artery ratio. The echocardiographic measurements of survivors did not differ significantly from non-survivors (P > .05). Extracardiac anomalies were observed in 8/37 fetuses (21.6%). The incidence of extracardiac anomaly was significantly higher in cases of tetralogy of Fallot-absent pulmonary valve syndrome (P < .05). Overall, 9 fetuses (24%) had genetic anomalies. All 6 fetuses (20%) with 22q11.2 microdeletion were within the tetralogy of Fallot-absent pulmonary valve syndrome group. Overall survival after initial diagnosis in the total cases was 36.6% (11/30), with 9 of 30 (30%) tetralogy of Fallot-absent pulmonary valve syndrome cases and 2 of 5 (40%) absent pulmonary valve syndrome-intact ventricular septum cases. Conclusions: In this largest series of absent pulmonary valve syndrome, extracardiac, and chromosomal anomalies were found to be a common occurrence. The risk of 22q11.2 microdeletion was higher in tetralogy of Fallot cases at 40%. The sizes of the pulmonary artery and its branches and the aorta had no correlation of high mortality antenatally or after birth, which were 63.4% and 47.7%, respectively. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to determine the seroprevalence of toxoplasmosis during pregnancy in our hospital and thus contribute to screening and management strategies. Materials and Methods: In this retrospective cohort study, the records of 607 pregnant women were analyzed. Patients were tested for serum Toxoplasma gondii antibodies at their first antenatal visit. The seronegative cases were rescreened at 32 weeks’ gestation with immunoglobulin (Ig) M and IgG for seroconversion. Demographic, clinical, and serological characteristics of patients were evaluated. Results: During the study period, 461 (75.94%) patients were seronegative for toxoplasmosis. IgG seropositivity was detected in 110 (18.12%) patients, whereas 33 (5.43%) patients had both IgG and IgM seropositivity; low avidity was observed in 6 (0.98%) of these 33 patients. IgM seropositivity was detected in only 3 (0.49%) cases. Toxoplasma IgG and IgM tests were repeated for 93 seronegative patients at 32 weeks’ gestation but seroconversion was not observed in any patient. Acute Toxoplasma infection during pregnancy was found in 9 (1.48%) patients and amniocentesis was performed in four of these. No infant was diagnosed with congenital Toxoplasma infection. Conclusion: Congenital Toxoplasma infection is clearly a preventable and treatable disease that poses a serious public health risk. Educating people on the transmission routes and implementing routine prenatal testing both regionally and globally during gestation are key preventative measures. [ABSTRACT FROM AUTHOR]

Neuroblastomas are the second most common type of neonatal tumor originating from embryonic nerve cells. It constitutes 20% of all fetal tumors and is incidentally detected on routine ultrasonography (US). Magnetic resonance imaging (MRI) plays a complementary role to US when diagnosis is difficult. In the absence of poor prognostic factors, treatment is not recommended during the prenatal and neonatal periods, and follow-up imaging is considered sufficient. In this case report, we present the US and MRI findings of a fetal neuroblastoma detected in the 25th week of pregnancy in the left fetal adrenal gland.

Neuroblastomas are the second most common type of neonatal tumor originating from embryonic nerve cells. It constitutes 20% of all fetal tumors and is incidentally detected on routine ultrasonography (US). Magnetic resonance imaging (MRI) plays a complementary role to US when diagnosis is difficult. In the absence of poor prognostic factors, treatment is not recommended during the prenatal and neonatal periods, and follow-up imaging is considered sufficient. In this case report, we present the US and MRI findings of a fetal neuroblastoma detected in the 25th week of pregnancy in the left fetal adrenal gland. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate distinguishing the right / left side of the fetus, cardiac axis and position according to the standardized Cordes technique in 20 cases with cardiac malposition. Methods: We studied retrospectively 1536 cases whose fetal echocardiographic examinations were performed between 1999 and 2006 in prenatal cardiology unit. Among these, cardiac malpositions were determined in 20 cases. The cardiac axis and position were determined according to the Cordes technique. All cases were followed-up by serial fetal echocardiograms until birth or intrauterine death occurred. In cases of intrauterine death, an autopsy was performed. After birth, physical and echocardiographic examinations were done and prenatal and postnatal diagnoses were compared. Results: Of 1536 fetal echocardiograms performed, 144 revealed congenital heart diseases (9.4%), among these cases 20 were diagnosed with cardiac malposition. Of cases with cardiac malposition, 16 had congenital heart disease, and four had extracardiac malformation. There were six cases of isolated dextrocardia, three cases of situs inversus totalis, six cases of situs ambiguous, and one case of situs inversus with isolated levocardia. Of four cases with extracardiac malformations, two cases had mesoposition, one had dextroposition, and one had extreme levoposition. In six cases the autopsy findings were the same as that their prenatal echocardiographic findings. When postnatal echocardiographic results of the remaining cases with cardiac malposition due to congenital heart disease were compared with prenatal diagnoses, the same echocardiographic findings were verified. Conclusion: The fetal right/left axis must be determined correctly for the accurate diagnosis of cardiac malpositions. Therefore, we recommend that Cordes technique provides a simple and reliable determination of the fetal right/left axis and fetal situs. [ABSTRACT FROM AUTHOR]