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Objective To assess the risk of adverse pregnancy outcomes in subsequent pregnancies among women treated with methotrexate for ectopic pregnancy. Methods In a retrospective single-center study, data were assessed for women treated with methotrexate for ectopic pregnancy at Asaf Harofe Medical Center, Zerifin, Israel, between May 2004 and May 2014. Results Overall, 226 women were treated with methotrexate for ectopic pregnancy and subsequently conceived. The median time from treatment to conception was 10 months (range 1–120 months), and 127 women conceived within 12 months of treatment. Except for early missed abortion—which affected 23 (10.2%) pregnancies—adverse pregnancy outcomes such as fetal malformations were rare. The frequency of early abortion was lowest for women who conceived within 6 months of treatment with methotrexate (3/93, 3.2%), increased between 6 and 23 months (15/83, 18.1%), and remained high thereafter (7/50, 14.0%; P=0.006). Conclusion The frequency of fetal malformation in a subsequent pregnancy was low among women treated with methotrexate for ectopic pregnancy. The frequency of early missed abortion was lowest during the first 6 months after treatment with methotrexate. This article is protected by copyright. All rights reserved.

Objective The article aimed to assess the spectrum of fetal renal tract abnormalities as a major finding leading to termination of pregnancy (TOP). Method The study population included all pregnant women with singleton pregnancy who underwent TOP in our institute because of fetal renal tract indications between 1998 and 2015. We specifically excluded TOPs performed because of multiple pregnancies, multisystem defects, abnormal karyotype and chromosomal or genetic defect not related to renal tract abnormalities. The patients were stratified into late TOP (≥24 weeks' gestation) and early TOP (

OBJECTIVE The objective of this study was to compare the associations of crown-rump length (CRL) discrepancy with birthweight discordance in spontaneous versus in vitro fertilization (IVF) monochorionic (MC) twin pregnancies. METHOD This is a multicenter retrospective study on women with twin pregnancies assessed for nuchal translucency between January 1997 and July 2013. The study group was subdivided into MC twins conceived spontaneously and after IVF. Pregnancies with later fetal death or twin transfusion syndrome were excluded. A large-weight discordance was defined as a difference of birthweights of >15%. RESULTS The study group included 171 pregnancies; of them, 142 (83%) were spontaneous and 29 (17%) were IVF conceived. In the entire cohort, we found a significant correlation between birthweight discordance and CRL discrepancy (r = 0.173, P

Objective This study aims to evaluate the distribution of mean arterial pressure (MAP) and uterine artery Doppler pulsatility index (PI) in first trimester twins with and without preeclampsia. Method A total of 147 twins were recruited from a specialist clinic and 110 unaffected singleton pregnancies attending the same institution served as controls. MAP and Doppler PI values were expressed in multiples of the gestation-specific median using published equations. Results Among the twins, 12 had preeclampsia and two had pregnancy-induced hypertension. Among unaffected pregnancies, there was no significant difference in MAP levels between twins and singletons (P = 0.17, Wilcoxon rank sum test, two-tail). However, the Doppler PI levels were highly statistically significantly lower than in singletons (P

Objective This study aimed to compare the associations of crown–rump length (CRL) discrepancy with birthweight discordance in spontaneous versus vitro fertilization (IVF) conceived dichorionic twin pregnancies. Method A computerized retrospective study of women referred to our ultrasonographic unit for nuchal translucency examination between January 1997 and December 2011. The study group was subdivided into twins conceived after IVF, non-IVF fertility treatment and spontaneously conceived twins. Birthweight discordance was defined as a difference of birthweights of >20%. Results A total of 688 dichorionic twin pregnancies were included, all of them ending in live birth of both twins. IVF-conceived pregnancies were associated with a significant increased risk of extreme birthweight discordance compared with spontaneous-conceived twin pregnancies (OR = 2.3; CI = 1.4–3.8, P

Objectives The current study aims were to assess the long-term outcomes of children who were diagnosed with umbilical vein varix (UVV) prenatally. Methods The study included fetuses with UVV diagnosed in the community between the years 2005 and 2011. They all have been refereed to our Ultrasound Unit for diagnosis' confirmation. This has been conducted locally by a single operator. After delivery, they were matched by gestational age at birth with a set of newborns from a random list. Developmental delay was assessed by telephone interview using a questionnaire based on Ages and Stages Questionnaire. If the child's score (both in the study and control group) was below the cut-off in one or more domain(s), the families were offered an examination by a child developmental health care team. Results There was no perinatal mortality in both groups. A low-development score was found in 41.7% (15/36) and 3.7% (4/108) in UVV and control group, respectively (P

Objective. To characterize the clinical and laboratory features of coagulopathy following second-trimester surgical abortions. Design. Retrospective study. Setting. Gynecologic unit of a university-affiliated medical center. Population. 1249 consecutive women underwent late second-trimester (16–24 weeks) surgical abortions between January 2002 and June 2010. Of those, 20 women (1.6%) were diagnosed with excessive bleeding accompanied by coagulopathy. Methods. Women were divided into two groups based on whether the abortion was performed for fetal demise (n=14) or pregnancy termination (n=6). Main outcome measures. Gestational age, indication for abortion, blood clotting tests, number of blood products and coagulation factors administered. Results. Women who had pregnancy termination began to bleed significantly earlier than those with fetal demise (p

Objective To assess long-term outcomes of children who had ovarian cysts diagnosed prenatally. Methods We reviewed prenatal records of fetuses diagnosed with ovarian cysts in our ultrasound unit between January 1997 and December 2008. During January–April 2009, those children were invited to our institute for transabdominal pelvic sonographic re-examination. Demonstration of the uterus and adnexa was required. Results Twenty-one children were diagnosed prenatally with either simple (n = 11) or complex (n = 12) ovarian cysts and treated by either conservative management (n = 13) or surgical intervention (n = 10) postnatally. The ipsilateral ovary was not detected in 8 of 11 children in whom a complex cyst had been detected on the first postnatal scan. Significantly higher rate of ovarian loss was diagnosed when the sonographic appearance of the ovarian cyst was simple on the prenatal scan and complex on the postnatal scan (six of seven) compared with when the ovarian cyst was simple on both scans (one of four, P = 0.04). Conclusion Prenatal detection of complex ovarian cyst might indicate close monitoring in order to alert the need for early intervention for preventing impending ovarian loss. Further researches are needed to empower this study. Copyright © 2010 John Wiley & Sons, Ltd.