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Introduction: Labor induction rates have increased over the last decades, and in many high‐income countries, more than one in four labors are induced. Outpatient management of labor induction has been suggested in low‐risk pregnancies to improve women's birth experiences while also promoting a more efficient use of healthcare resources. The primary aim of this paper was to assess the proportion of women in a historical cohort that would have been eligible for outpatient labor induction with oral misoprostol. Second, we wanted to report safety outcomes and assess efficacy outcomes for mothers and infants in pregnancies that met the criteria for outpatient care. Material and methods: Criteria for outpatient labor induction with oral misoprostol were applied to a historical cohort of women with induction of labor at two Norwegian tertiary hospitals in the period January 1, through July 31, 2021. The criteria included low‐risk women with an unscarred uterus expecting a healthy, singleton baby in cephalic position at term. The primary outcome was the proportion of women eligible for outpatient labor induction. Secondary outcomes included reasons for ineligibility and, for eligible women, safety and efficacy outcomes. Results: Overall, 29.7% of the 1320 women who underwent labor induction in a singleton term pregnancy met the criteria for outpatient labor induction. We identified two serious adverse events that potentially could have occurred outside the hospital if the women had received outpatient care. The mean duration from initiation of labor induction to administration of the last misoprostol was 22.4 h. One in 14 multiparous women gave birth within 3 h after the last misoprostol dose. Conclusions: In this historical cohort, three in ten women met the criteria for outpatient management of labor induction with oral misoprostol. Serious adverse events were rare. The average time span from the initiation of labor induction to the last misoprostol was nearly 24 h. This suggests a potential for low‐risk women with an induced labor to spend a substantial period of time at home before labor onset. However, larger studies testing or evaluating labor induction with oral misoprostol as an outpatient procedure are needed to draw conclusions. [ABSTRACT FROM AUTHOR]

This paper critically analyses 'the paradox of autonomy and consent in maternity care'. It argues that maternity care has certain features that increase the need for explicit attention to, and respect for, both autonomy and rigorous informed consent processes. And, moreover, that the resulting need is considerably greater than in almost all other areas of medicine. These features are as follows: (1) maternity care involves particularly socially sensitive body parts that are regularly implicated in consent‐centred procedures, as well as in unconsented interventions, in ordinary, non‐medical life; and (2) much of maternity care (especially intervening in childbirth) is medically unique, in that it harms one patient (the mother) not primarily for the promotion of her own health but for the benefit of another (the baby). The apt comparison, within medicine, is therefore with non‐therapeutic research and transplantation medicine—both of which have elevated consent requirements characterized by very rigorous consent processes. At the same time—and this delivers the titular paradox—the importance of autonomy and consent in maternity care is at particular risk of being denied or disregarded. Jointly, these considerations make a very strong case for change: attention to and respect for autonomy and consent should be (1) core values; (2) key points of practical attention in the years ahead; and (3) central quality indicators in maternity care. [ABSTRACT FROM AUTHOR]

Objective: To expand the limited knowledge on cell‐free DNA (cfDNA) analysis of maternal blood for trisomies 21, 18 and 13 in twin pregnancy by updating the data from The Fetal Medicine Foundation (FMF) on prospective first‐trimester screening and those identified in a systematic review of the literature. Methods: The FMF data were derived from prospective screening for trisomies 21, 18 and 13 in twin pregnancies at 10 + 0 to 14 + 1 weeks' gestation using the Harmony® prenatal test. A search of MEDLINE, EMBASE, CENTRAL (The Cochrane Library), ClinicalTrials.gov and the International Clinical Trials Registry Platform (World Health Organization) was carried out to identify all peer‐reviewed publications on clinical validation or implementation of maternal cfDNA testing for trisomies 21, 18 and 13 in twin pregnancy, irrespective of gestational age at testing, in which data on pregnancy outcome were provided for at least 85% of the study population. Meta‐analysis was performed using the FMF data and data from the studies identified by the literature search. This review was registered in the PROSPERO international database for systematic reviews Results: In the FMF study, cfDNA testing was carried out in 1442 twin pregnancies and a result was obtained, after first or second sampling, in 1367 (94.8%) cases. In 93.1% (1272/1367) of cases, there was prenatal or postnatal karyotyping or birth of phenotypically normal babies; 95 cases were excluded from further analysis either because the pregnancy ended in termination, miscarriage or stillbirth with no known karyotype (n = 56) or there was loss to follow‐up (n = 39). In the 1272 pregnancies included in the study, there were 20 cases with trisomy 21, 10 with trisomy 18, two with trisomy 13 and 1240 without trisomy 21, 18 or 13. The cfDNA test classified correctly 19 (95.0%) of the 20 cases of trisomy 21, nine (90.0%) of the 10 cases of trisomy 18, one (50.0%) of the two cases of trisomy 13 and 1235 (99.6%) of the 1240 cases without any of the three trisomies. The literature search identified 12 relevant studies, excluding our papers because their data are included in the current study. In the combined populations of our study and the 12 studies identified by the literature search, there were 137 trisomy‐21 and 7507 non‐trisomy‐21 twin pregnancies; the pooled weighted detection rate (DR) and false‐positive rate (FPR) were 99.0% (95% CI, 92.0–99.9%) and 0.02% (95% CI, 0.001–0.43%), respectively. In the combined total of 50 cases of trisomy 18 and 6840 non‐trisomy‐18 pregnancies, the pooled weighted DR and FPR were 92.8% (95% CI, 77.6–98.0%) and 0.01% (95% CI, 0.00–0.44%), respectively. In the combined total of 11 cases of trisomy 13 and 6290 non‐trisomy‐13 pregnancies, the pooled weighted DR and FPR were 94.7% (95% CI, 9.14–99.97%) and 0.10% (95% CI, 0.03–0.39%), respectively. Conclusions: In twin pregnancy, the reported DR of trisomy 21 by cfDNA testing is high, but lower than that in singleton pregnancy, whereas the FPR appears to be equally low. The number of cases of trisomy 18 and more so trisomy 13 was too small for accurate assessment of the predictive performance of the cfDNA test. © 2021 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Objective: Fetal anomalies of the corpus callosum (CC) have been reported in the prenatal imaging literature since 1985, and, especially when isolated, pose challenges for both the patient and fetal medicine specialist. The purpose of this study was to review systematically the literature on prenatally diagnosed abnormalities of the CC, focusing on the terminology used to describe abnormalities other than complete agenesis of the CC, and to assess the heterogeneity of the nomenclature and definitions used. Methods: This study was conducted in accordance with the PRISMA statement for reporting systematic reviews. A literature search was performed to identify prospective or retrospective case series or cohort studies, published in English, French, Italian, German or Spanish, reporting fetal imaging findings and describing anomalies of the CC. Quality and risk of bias of the studies were evaluated using the Newcastle–Ottawa scale and a modification of the scale developed by Conde‐Agudelo et al. for other fetal imaging studies. The data extracted included the number of patients, the number of different anomalies identified, the descriptive names of the anomalies, and, where applicable, the definitions of the anomalies, the number of cases of each type of anomaly and the biometric charts used. Secondary tests used to confirm the diagnosis, as well as the postnatal or post‐termination tests used to ascertain the diagnosis, were also recorded. Results: The search identified 998 records, and, after review of titles and abstracts and full review of 45 papers, 27 studies were included initially in the review, of which 24 were included in the final analysis. These 24 studies had a broad range of quality and risk of bias and represented 1135 cases of CC anomalies, of which 49% were complete agenesis and the remainder were described using the term partial agenesis or nine other terms, of which five had more than one definition. Conclusions: In comparison to the postnatal literature, in the prenatal literature there is much greater heterogeneity in the nomenclature and definition of CC anomalies other than complete agenesis. This heterogeneity and lack of standard definitions in the prenatal literature make it difficult to develop large multicenter pooled cohorts of patients who can be followed in order to develop a better understanding of the genetic associations and neurodevelopmental and psychological outcomes of patients with CC anomalies. As this information is important to improve counseling of these patients, a good first step towards this goal would be to develop a simpler categorization of prenatal CC anomalies that matches better the postnatal literature. © 2020 International Society of Ultrasound in Obstetrics and Gynecology [ABSTRACT FROM AUTHOR]

Introduction/Purpose: Despite the clinical importance of patient‐centred care in the sonographer/patient interaction in obstetric ultrasound, there has been very little current research in Australia on sonographer and sonologist communication practices in the event of an adverse finding. This study sought the views, experiences and practices of Australian sonographers, particularly in relation to adverse findings, with consideration of the implications for their professional role and practice. Methods: Qualified and trainee sonographers who perform obstetric ultrasound were invited to complete a survey through the Australasian Sonographers Association. Using qualitative methodology, the authors developed themes on a range of issues related to sonographer and sonologist communication practices and roles from responses to three open‐ended questions within the survey. Result: Analysis of 249 responses revealed three distinct 'Communicator types'. 'Open Communicators' confidently practice open and direct communication; 'Limited Communicators' perceived barriers preventing them from openly communicating; 'Variable Communicators' indicated various challenging 'grey areas' which created inconsistent communication practices. Variables, such as the complexity of an adverse finding and a reporting sonologist's role, attitude and level of control they exercised over sonographer communication, all influenced respondents' communication practices. Respondents believed professional bodies should agree on a standardised policy regarding sonographers' roles. Discussion: This paper highlights the complexity of the sonographer/patient interaction and outlines the difficulty in providing true patient‐centred care in obstetric ultrasound. Conclusion: The need for a collaborative, patient‐focussed policy, which defines and recognises the role of the sonographer in the event of obstetric adverse findings, will improve the current model of care. [ABSTRACT FROM AUTHOR]

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Davor Jurkovic is an internationally recognized expert in gynecological and early-pregnancy ultrasound, as well as in the surgical outpatient management of early-pregnancy complications. In Zagreb, Davor was one of the first to publish on the use of color Doppler in gynecology. [Extracted from the article]

The article discusses the policies for the submission of papers to the journal "Ultrasound in Obstetrics & Gynecology."

Introduction: Over a fifth of pregnant women are living with multiple long‐term health conditions, which is associated with increased risks of adverse outcomes for mothers and infants. While there are many examples of research exploring individuals' experiences and care pathways for pregnancy with a single health condition, evidence relating to multiple health conditions is limited. This study aimed to explore experiences and care of women with multiple long‐term health conditions around the time of pregnancy. Methods: Semistructured interviews were conducted between March 2022 and May 2023 with women with multiple long‐term health conditions who were at least 28 weeks pregnant or had had a baby in the last 2 years, and healthcare professionals with experience of caring for these women. Participants were recruited from across the United Kingdom. Data were analysed using thematic analysis. Results: Fifty‐seven women and 51 healthcare professionals participated. Five themes were identified. Women with long‐term health conditions and professionals recognised that it takes a team to avoid inconsistent care and communication, for example, medication management. Often, women were required to take a care navigation role to link up their healthcare providers. Women described mixed experiences regarding care for their multiple identities and the whole person. Postnatally, women and professionals recognised a downgrade in care, particularly for women's long‐term health conditions. Some professionals detailed the importance of engaging with women's knowledge, and recognising their own professional boundaries of expertise. Many participants described difficulties in providing informational continuity and subsequent impacts on care. Specifically, the setup of care systems made it difficult for everyone to access necessary information, especially when care involved multiple sites. Conclusion: Pregnant women with long‐term health conditions can experience a substantial burden of responsibility to maintain communication with their care team, often feeling vulnerable, patronised, and let down by a lack of acknowledgement of their expertise. These results will be used to inform the content of coproduction workshops aimed at developing a list of care recommendations for affected women. It will also inform future interventional studies aimed at improving outcomes for these women and their babies. Patient or Public Contribution: Our Patient and Public Involvement group were involved in the design of the study and the analysis and interpretation of the data, and a public study investigator was part of the author group. [ABSTRACT FROM AUTHOR]

Introduction: Birth asphyxia is a leading cause of neonatal mortality in sub‐Saharan Africa. The relationship to grand multiparity (GM), a controversial pregnancy risk factor, remains largely unexplored, especially in the context of large multinational studies. We investigated birth asphyxia and its association with GM and referral in Benin, Malawi, Tanzania and Uganda. Material and methods: This was a prospective cross‐sectional study. Data were collected using a perinatal e‐Registry in 16 hospitals (four per country). The study population consisted of 80 663 babies (>1000 g, >28 weeks' gestational age) delivered between July 2021 and December 2022. The primary outcome was birth asphyxia, defined by 5‐minute appearance, pulse, grimace, activity and respiration score <7. A multilevel and stratified multivariate logistic regression was performed with GM (parity ≥5) as exposure, and birth asphyxia as outcome. An interaction between referral (none, prepartum, intrapartum) and GM was also evaluated as a secondary outcome. All models were adjusted for confounders. Clinical Trial: Pan African Clinical Trial Registry 202006793783148. Results: Birth asphyxia was present in 7.0% (n = 5612) of babies. More babies with birth asphyxia were born to grand multiparous women (11.9%) than to other parity groups (≤7.6%). Among the 76 850 cases included in the analysis, grand multiparous women had a 1.34 times higher odds of birth asphyxia (95% confidence interval [CI] 1.17–1.54) vs para one to two. Grand multiparous women referred intrapartum had the highest probability of asphyxiation (13.02%, 95% CI 9.34–16.69). GM increased odds of birth asphyxia in Benin (odds ratio [OR] 1.37, 95% CI 1.13–1.68) and Uganda (OR 1.29, 95% CI 1.02–1.64), but was non‐significant in Tanzania (OR 1.44, 95% CI 0.81–2.56) and Malawi (OR 0.98, 95% CI 0.67–1.44). Conclusions: There is some evidence of an increased risk of birth asphyxia for grand multiparous women having babies at hospitals, especially following intrapartum referral. Antenatal counseling should recognize grand multiparity as higher risk and advise appropriate childbirth facilities. Findings in Malawi suggest an advantage of health systems configuration requiring further exploration. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to compare placental size and placental size relative to fetal size (ratio) in ongoing pregnancies examined by magnetic resonance imaging (MRI) at gestational week 36 with placental size among all deliveries at gestational week 36 during the same time period. Material and methods: Ongoing unselected singleton pregnancies (n = 89) were examined by MRI at median gestational week 36+5 days during 2017–2018, and placental and fetal volumes (cm3) were calculated. The placental size and ratio in ongoing pregnancies were compared with placental size and ratio among all deliveries in Norway at gestational week 36 (median gestational week 36+4 days) during 2016–2019 (n = 5582). For comparison of size, we converted volume (cm3) in ongoing pregnancies into grams as: cm3 × 1.05 (density of placental and fetal tissue). Results: In ongoing pregnancies, median placental size was 873 (interquartile range [IQR] 265) grams and median size of all delivered placentas was 613 (IQR 290) grams. Placental size was smaller among the delivered placentas independent of delivery mode: 760 (IQR 387) grams among elective cesarean deliveries (n = 465) and 590 (IQR 189) grams among vaginal deliveries after spontaneous onset of labor (n = 2478). Median ratio in ongoing pregnancies was higher than among deliveries: 0.31 (IQR 0.08) vs 0.21 (IQR 0.08). The ratio was higher in ongoing pregnancies independent of delivery mode: 0.24 (IQR 0.17) among elective cesarean deliveries vs 0.21 (IQR 0.05) among vaginal deliveries after spontaneous onset of labor. Conclusions: The placenta is larger in ongoing pregnancies than among deliveries. This finding suggests that placental size decreases during labor and delivery, possibly by transfer of blood to the fetus. Our finding also suggests that reference values of placental size based on delivered placentas are not valid for ongoing pregnancies. [ABSTRACT FROM AUTHOR]

Introduction: The incidence of stillbirth in Sweden has started to decline. However, some comparable high‐income countries in Europe have an even lower incidence, indicating a potential for further reduction. The aim of our study was to investigate how the incidence of stillbirth for singleton pregnancies has changed over the past two decades in the Stockholm Region in different groups of women to detect the groups at highest risk. Material and methods: This was a repeated cross‐sectional study with data from the Stockholm Stillbirth Database and the Pregnancy Register including all cases of stillbirth in Stockholm in singleton pregnancies between 2001 and 2020, in total 1804 stillbirths. The time period was divided into four equal groups and the incidence of stillbirth was compared between the groups. Results: The overall incidence of stillbirth in the Stockholm Region has decreased from 3.8/1000 births in 2001–2005 to 2.9/1000 births in 2016–2020 (P‐value <0.001). In most of the groups studied, the incidence decreased, but among women originating from sub‐Saharan Africa the incidence significantly rose from 7.9/1000 births in 2001–2005 to 10.1/1000 births in 2016–2020 (P‐value 0.025). In this group, stillbirth occurred prematurely to a higher extent and the women were more likely to be multiparous. Conclusions: The incidence of stillbirth in the Stockholm Region has declined. However, among women originating from sub‐Saharan Africa the incidence was significantly higher compared with women originating from other regions and it is still rising. More research is needed to understand why this group is at higher risk and how to monitor their pregnancies to decrease this risk. [ABSTRACT FROM AUTHOR]

Introduction: It is a shortcoming of traditional cardiotocography (CTG) classification table formats that CTG traces are frequently classified differently by different users, resulting in poor interobserver agreements. A fast‐and‐frugal tree (FFTree) flow chart may help provide better concordance because it is straightforward and has clearly structured binary questions with understandable "yes" or "no" responses. The initial triage to determine whether a fetus is suitable for labor when utilizing fetal ECG ST analysis (STAN) is very important, since a fetus with restricted capacity to respond to hypoxic stress may not generate STAN events and therefore may become falsely negative. This study aimed to compare physiology‐focused FFTree CTG interpretation with FIGO classification for assessing the suitability for STAN monitoring. Material and methods: A retrospective study of 36 CTG traces with a high proportion of adverse outcomes (17/36) selected from a European multicenter study database. Eight experienced European obstetricians evaluated the initial 40 minutes of the CTG recordings and judged whether STAN was a suitable fetal surveillance method and whether intervention was indicated. The experts rated the CTGs using the FFTree and FIGO classifications at least 6 weeks apart. Interobserver agreements were calculated using proportions of agreement and Fleiss' kappa (κ). Results: The proportions of agreement for "not suitable for STAN" were for FIGO 47% (95% confidence interval [CI] 42%–52%) and for FFTree 60% (95% CI 56–64), ie a significant difference; the corresponding figures for "yes, suitable" were 74% (95% CI 71–77) and 70% (95% CI 67–74). For "intervention needed" the figures were 52% (95% CI 47–56) vs 58% (95% CI 54–62) and for "expectant management" 74% (95% CI 71–77) vs 72% (95% CI 69–75). Fleiss' κ agreement on "suitability for STAN" was 0.50 (95% CI 0.44–0.56) for the FIGO classification and 0.57 (95% CI 0.51–0.63) for the FFTree classification; the corresponding figures for "intervention or expectancy" were 0.53 (95% CI 0.47–0.59) and 0.57 (95% CI 0.51–0.63). Conclusions: The proportion of agreement among expert obstetricians using the FFTree physiological approach was significantly higher compared with the traditional FIGO classification system in rejecting cases not suitable for STAN monitoring. That might be of importance to avoid false negative STAN recordings. Other agreement figures were similar. It remains to be shown whether the FFTree simplicity will benefit less experienced users and how it will work in real‐world clinical scenarios. [ABSTRACT FROM AUTHOR]

The article presents instructions for contributors to the journal "Ultrasound in Obstetrics and Gynecology" including manuscript style, manuscript submission and reference style.

ABSTRACT Objectives To evaluate the diagnostic accuracy of ultrasound in predicting the location of an intrauterine pregnancy before visualization of the yolk sac is possible. Methods This was a systematic review conducted in accordance with the PRISMA statement and registered with PROSPERO. We searched MEDLINE, EMBASE and The Cochrane Library for relevant citations. Studies were selected in a two-stage process and their data extracted by two reviewers. Accuracy measures were calculated for each ultrasound sign, i.e. gestational sac, double decidual sac sign, intradecidual sign, chorionic rim sign and yolk sac. Individual study estimates were plotted in summary receiver-operating characteristics curves and forest plots for examination of heterogeneity. The quality of included studies was assessed. Results Seventeen studies including 2564 women were selected from 19 959 potential papers. Following meta-analysis, the presence of a gestational sac on ultrasound examination was found to predict an intrauterine pregnancy with a sensitivity of 52.8% (95% CI, 38.2-66.9%) and specificity of 97.6% (95% CI, 94.3-99.0%). The corresponding performance of the double decidual sac sign, intradecidual sign, chorionic rim sign and yolk sac were: 81.8% (95% CI, 68.1-90.4%) and 97.3% (95% CI, 76.1-99.8%); 66.1% (95% CI, 58.9-72.8%) and 100% (95% CI, 91.0-100%); 79.9% (95% CI, 73.0-85.7%) and 97.1% (95% CI, 89.9-99.6%); and 42.2% (95% CI, 27.7-57.9%) and 100% (95% CI, 54.1-100%), respectively. Conclusion Visualization of a gestational sac, double decidual sac sign, intradecidual sign or chorionic rim sign increases the probability of an intrauterine pregnancy but is not as accurate for diagnosis as the detection of the yolk sac. However, the findings were limited by the small number and poor quality of the studies included and heterogeneity in the index test and reference standard. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives To evaluate differences between international fetal centers in their treatment of twin-twin transfusion syndrome ( TTTS) by fetoscopic placental laser coagulation. Methods Fetal therapy centers worldwide were sent a web-based questionnaire. Participants were identified through networks and through scientific presentations and papers. Questions included physician and center demographics, treatment criteria, operative technique and instrumentation. Laser treatment was compared between low-volume (< 20 procedures/year) and high-volume (≥ 20 procedures/year) centers. Data were analyzed using descriptive statistics. Results Of 106 fetal therapy specialists approached, 76 (72%) from 64 centers in 25 countries responded. Of these, 48% (31/64) of centers and 63% (48/76) of operators performed fewer than 20 laser procedures annually. Comparison of low- and high-volume centers showed differences in technique, gestational age limits for treatment and geography. High-volume centers more often used the Solomon technique and applied wider gestational age limits for treatment. Europe and Asia had more high-volume centers, whereas South America, the Middle East and Australia had mainly low-volume centers. Conclusion This survey revealed significant differences between fetal centers in several aspects of fetoscopic placental laser therapy for TTTS. Increasing awareness of TTTS, and of laser coagulation as its preferred treatment, will lead to an increase in centers offering this modality, especially in Asia, Africa, South America and the Middle East. Considering the rarity of TTTS and the relative complexity of the procedure, developing international guidelines for techniques, instrumentation and suggested minimum volumes per center may aid in optimizing perinatal outcome. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

Introduction: There is an increasing incidence of pregnancies with twin gestations. One outcome more likely to occur with multiple gestations is gestational diabetes mellitus. Studies have suggested that in singleton pregnancies, fetal sex may affect insulin resistance. However, the effects of fetal sex in twins and the development of gestational diabetes mellitus are unknown. We hypothesized that rates of gestational diabetes mellitus and degree of insulin resistance might vary in twin gestations based on the fetal sex pairing: male–male, male–female or female–female. We aimed to employ a large population‐based database to ascertain any correlations between fetal sex and gestational diabetes mellitus in multifetal gestations. Material and methods: A two‐hospital, single academic institution database comprised of over 39 000 participants with pregnancy data from August 2011 to January 2022 was employed. All twin deliveries of live‐born neonates >24 weeks' gestational age from gravidae without preexisting diabetes or twin–twin transfusion syndrome were included. Entries were then grouped based on the fetal sex of the pairing. The presence or absence of gestational diabetes and type of gestational diabetes – diet‐controlled (gestational diabetes mellitus classification A1) vs medication‐controlled (gestational diabetes mellitus classification A2) – were identified. Statistical analysis was performed using a generalized linear mixed method, and a P‐value ≤0.05 was considered statistically significant. Results: We identified 1924 twin deliveries that met the inclusion criteria in our database (male–male =652; male–female = 638; female–female = 634). We found no association between fetal sex pairing and the development of gestational diabetes mellitus. There was a significant association between the fetal sex pairing and the type of gestational diabetes mellitus developed, with 32.0% of male–male twins, 33.3% of male–female twins and 58.3% of the female–female twin deliveries associated with medication‐controlled gestational diabetes classification A2: male–female vs female–female (P = 0.05) and male–male vs female–female (P = 0.046). Conclusions: While gestational diabetes mellitus is of multifactorial origin, we found a significant association between the fetal sex pairing and the treatment needed for gravidae with twins who develop gestational diabetes mellitus. A higher proportion of female–female twins was associated with gestational diabetes classification A2 compared with male–female or male–male deliveries. Further research on the physiology driving this association is warranted. [ABSTRACT FROM AUTHOR]

In recent years, the medical establishment has been speaking in favor of women's autonomy in childbirth by advocating cesarean delivery on maternal request (CDMR). This paper offers to look at the ethical dimension of CDMR through a feminist critique of the medicalization of childbirth and its influence on present-day medical ethics. I claim that the medicalization of childbirth reflects a sexist bias with regard to conceptions of the body and needs to be used with caution when applied to women's reproductive health. I then use this perspective to critically analyze the position of the American College of Obstetricians and Gynecologists (ACOG) on the ethics of decision-making in patient-choice surgery. I claim that informed consent cannot be meaningfully exercised unless women are made aware of the sexist underpinnings of the medical model of childbirth and its influence on the ethical reasoning of the American College of Obstetricians and Gynecologists. I also express concern about the effects of normalizing patient-choice cesarean sections on the choices available to pregnant women using as examples the institutional rules on mandatory cesarean sections for women with a previous cesarean delivery or breech presentation. I conclude with a call for more research into the real cost of convenience in CDMR, particularly as our increasingly strained publicly funded healthcare system would greatly benefit from the de-medicalization of normal body functions rather than an increased dependence on costly surgical technology.

The claim that we have a moral obligation, where a choice can be made, to bring to birth the ‘best’ child possible, has been highly controversial for a number of decades. More recently Savulescu has labelled this claim the Principle of Procreative Beneficence. It has been argued that this Principle is problematic in both its reasoning and its implications, most notably in that it places lower moral value on the disabled. Relentless criticism of this proposed moral obligation, however, has been unable, thus far, to discredit this Principle convincingly and as a result its influence shows no sign of abating. I will argue that while criticisms of the implications and detail of the reasoning behind it are well founded, they are unlikely to produce an argument that will ultimately discredit the obligation that the Principle of Procreative Beneficence represents. I believe that what is needed finally and convincingly to reveal the fallacy of this Principle is a critique of its ultimate theoretical foundation, the notion of impersonal harm. In this paper I argue that while the notion of impersonal harm is intuitively very appealing, its plausibility is based entirely on this intuitive appeal and not on sound moral reasoning. I show that there is another plausible explanation for our intuitive response and I believe that this, in conjunction with the other theoretical criticisms that I and others have levelled at this Principle, shows that the Principle of Procreative Beneficence should be rejected. [ABSTRACT FROM AUTHOR]

A general theoretical and empirical model of the impact of regulation on supply and demand (prices and quantities) is developed in this paper. The regulation of midwifery services—of certified nursemidwives (CNMs)—relative to obstetricians (OBs) is analyzed within this framework. Demand-side (quality assurance) effects are distinguished from supply-side (Stigler-Peltzman) effects in the model. Since both unambiguously predict a price increase, we focus on the regulatory impact on quantity. We find, within the empirical model, that while both effects are present, supply-restricting effects dominate quality assurance in the U.S. market for CNM services. When metal regulations are compared to minimum regulations in the sample, CNM births increase from just under 6% of all births to a little over l1%. On net, regulation reduces the quantity of CNM births. [ABSTRACT FROM AUTHOR]

Introduction: There is limited evidence about changes in the pelvic floor during active labor. We aimed to investigate changes in hiatal dimensions during the active first stage of labor and associations with fetal descent and head position. Material and methods: We conducted a longitudinal, prospective cohort study at the National University Hospital of Iceland, from 2016 to 2018. Nulliparous women with spontaneous onset of labor, a single fetus in cephalic presentation, and gestational age ≥37 weeks were eligible. Fetal position was assessed with transabdominal ultrasound and fetal descent was measured with transperineal ultrasound. Three‐dimensional volumes were acquired from transperineal scanning at the start of the active phase of labor and in late first stage or early second stage. The largest transverse hiatal diameter was measured in the plane of minimal hiatal dimensions. The levator urethral gap was measured as the distance between the center of the urethra and the levator insertion using tomographic ultrasound imaging. Measurements of the levator urethral gap were made in the plane of minimal hiatal dimensions and 2.5 and 5 mm cranial to this. Results: The final study population comprised 78 women. The mean transverse hiatal diameter increased 12.4% between the two examinations, from 39.4 ± 4.1 mm (±standard deviation) at the first examination to 44.3 ± 5.8 mm at the last examination (p < 0.01). We found a moderate correlation between the transverse hiatal diameter and fetal station at the last examination (r = 0.44, r2 = 0.19; p < 0.01; regression equation y = 2.71 + 0.014x), and a weak correlation between the change in transverse hiatal diameter and change in fetal station (r = 0.29; r2 = 0.08; p = 0.01; regression equation y = 0.24 + 0.012x). Levator urethral gap increased significantly in all three planes on both the left and right sides. Head position was not associated with hiatal measurements after adjusting for fetal station. Conclusions: We found a significant, but only modest, increase of the hiatal dimensions during the first stage of labor. The risk of levator ani trauma will therefore be low during this stage. The change in transverse hiatal diameter was associated with fetal descent but not with head position. [ABSTRACT FROM AUTHOR]

Objective: To develop a core set of prenatal and neonatal outcomes for clinical studies evaluating perinatal interventions for congenital diaphragmatic hernia, using a validated consensus‐building method. Methods: An international steering group comprising 13 leading maternal–fetal medicine specialists, neonatologists, pediatric surgeons, patient representatives, researchers and methodologists guided the development of this core outcome set. Potential outcomes were collected through a systematic review of the literature and entered into a two‐round online Delphi survey. A call was made for stakeholders with experience of congenital diaphragmatic hernia to review the list and score outcomes based on their perceived relevance. Outcomes that fulfilled the consensus criteria defined a priori were discussed subsequently in online breakout meetings. Results were reviewed in a consensus meeting, during which the core outcome set was defined. Finally, the definitions, measurement methods and aspirational outcomes were defined in online and in‐person definition meetings by a selection of 45 stakeholders. Results: Overall, 221 stakeholders participated in the Delphi survey and 198 completed both rounds. Fifty outcomes met the consensus criteria and were discussed and rescored by 78 stakeholders in the breakout meetings. During the consensus meeting, 93 stakeholders agreed eventually on eight outcomes, which constituted the core outcome set. Maternal and obstetric outcomes included maternal morbidity related to the intervention and gestational age at delivery. Fetal outcomes included intrauterine demise, interval between intervention and delivery and change in lung size in utero around the time of the intervention. Neonatal outcomes included neonatal mortality, pulmonary hypertension and use of extracorporeal membrane oxygenation. Definitions and measurement methods were formulated by 45 stakeholders, who also added three aspirational outcomes: duration of invasive ventilation, duration of oxygen supplementation and use of pulmonary vasodilators at discharge. Conclusions: We developed with relevant stakeholders a core outcome set for studies evaluating perinatal interventions in congenital diaphragmatic hernia. Its implementation should facilitate the comparison and combination of trial results, enabling future research to better guide clinical practice. © 2023 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

This paper examines several aspects of the changing cultural classifications of reproduction through a close reading of obstetrics textbooks. Through the discursive construction of the fetus in obstetric texts, medical accounts are beginning to classify the fetus as a baby. In investigating this transformation, I focus upon two cognitive processes: the splitting of the fetus apart from the pregnant woman and the concurrent lumping of two distinct mental entities-a fetus and an infant into one new medical category: the fetus-infant in addition, textual evidence shows a shift in cognitive orientation away from classifying fetuses based on gestational age to an emphasis on what I term functional age. Further, new knowledge enables physicians to affect functional age, making the fetus with mature function in utero conceptually no different from a baby. [ABSTRACT FROM AUTHOR]

Aim: To explore the relationship between the quality of discharge teaching, readiness for hospital discharge and postdischarge health outcomes in hysterectomy patients. Design: Cross‐sectional online survey. Methods: A cross‐sectional survey design was used to investigate 331 hysterectomy patients in a hospital in Chengdu. The results were analysed using Spearman's correlation and structural equation model. Results: Spearman's correlation analysis revealed moderate‐to‐strong correlations among the quality of discharge teaching, readiness for hospital discharge and postdischarge health outcomes. The total and direct effects of the quality of discharge teaching on patients' readiness for hospital discharge were both 0.70 and readiness for hospital discharge on patients' postdischarge health outcomes were both 0.49. The total, direct and indirect effects of the quality of discharge teaching on patients' postdischarge health outcomes were 0.58, 0.24 and 0.34, respectively. Readiness for hospital discharge mediated the interaction mechanism. [ABSTRACT FROM AUTHOR]

Introduction: Gestational diabetes mellitus (GDM) is associated with adverse perinatal outcomes. Approaches to screening for GDM continue to evolve, introducing potential variability of care. This study explored the impact of these variations on GDM counselling and screening from the perspectives of pregnant individuals. Methods: Following a Corbin and Strauss approach to qualitative, grounded theory we recruited 28 individuals from three cities in Ontario, Canada who had a singleton pregnancy under the care of either a midwife, family physician or obstetrician. Convenience and purposive sampling techniques were used. Semi‐structured telephone interviews were conducted and transcribed verbatim between March and December 2020. Transcripts were analysed inductively resulting in codes, categories and themes. Results: Three themes were derived from the data about GDM screening and counselling: 'informing oneself', 'deciding' and 'screening'. All participants, regardless of geographical region, or antenatal care provider, moved through these three steps during the GDM counselling and screening process. Differences in counselling approaches between pregnancy care providers were noted throughout the 'informing' and 'deciding' stages of care. Factors influencing these differences included communication, healthcare autonomy and patient motivation to engage with health services. No differences were noted within care provider groups across the three geographic regions. Participant experiences of GDM screening were influenced by logistical challenges and personal preferences towards testing. Conclusion: Informing oneself about GDM may be a crucial step for facilitating decision‐making and screening uptake, with an emphasis on information provision to facilitate patient autonomy and motivation. Patient or Public Contribution: Participants of our study included patients and service users. Participants were actively involved in the study design due to the qualitative, patient‐centred nature of the research methods employed. Analysis of results was structured according to the emergent themes of the data which were grounded in patient perspectives and experiences. [ABSTRACT FROM AUTHOR]

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The article presents information about abstracts of various papers that will be discussed at the Platform Session of the 6th European Congress on Epileptology that will be held on May 31, 2004. One of the papers that will be discussed is "The Antiepileptic Drug Pregnancy Registry: A Six-Year Experience," by D.F. Wyszynski and L.B. Holmes. Pregnancy registries have been developed to provide an early signal of an increased frequency of major malformations associated with prenatal exposure to the products monitored by the registry. Other papers that will be discussed are "The Safety of Antiepileptic Drugs in Pregnancy: Results of the UK Epilepsy and Pregnancy Register," by J.I. Morrow and A.J.C. Russell and "Eleven Year Interim Results of an International Observational Study of Pregnancy Outcomes Following Exposure to Lamotrigine," by J.G. Well and M.C. Cunnington.

The Ian Donald Gold Medal is awarded once a year to an individual who has made a significant scientific contribution to the advancement of diagnostic ultrasound in obstetrics and gynecology and who has changed the way in which ultrasound is practiced, through research or innovation. Some 30 years ago, Eduard was resident in obstetrics and gynecology at Hospital Clinic in Barcelona. [Extracted from the article]

The author reflects on the growth of the International Society of Ultrasound in Obstetrics and Gynecology, the publisher of the journal "Ultrasound in Obstetrics and Gynecology." He said that while the organization's journal has been in its 13th anniversary, it has served its purpose which is to provide information related to the field since in its first issue. Meanwhile, the author believes that the society have realized all its goals and have continued serving people as it promised.

Summary: Nitrous oxide is a common choice of labour analgesia in many countries. However, its use is associated with significant cost to the environment as well as potential risks of long‐term occupational exposure. Our hospital is one of a small number of healthcare providers in the United Kingdom trialling technology which catalytically destroys ('cracks') nitrous oxide to reduce greenhouse gas emissions and occupational exposure. When used in the setting of inhaled analgesia, cracking technology relies on capturing the patient's exhaled breath via a facemask or mouthpiece, a technique which requires some user skill and may be challenging for patients. In this report, we present the case of a primiparous 35‐year‐old consultant anaesthetist, who used nitrous oxide cracking technology with inhaled nitrous oxide analgesia (via a facemask) during labour. We present the patient's experiences and discuss the implications of using such technology on ambient nitrous oxide levels in the delivery room. Notably, despite this patient's professional expertise and familiarity with facemask use, nitrous oxide remained detectable throughout her labour, although generally at low levels. This illustrates that whilst this technology has the potential to reduce ambient nitrous oxide levels, its efficacy may vary depending on how it is used, with implications for patient education and support. [ABSTRACT FROM AUTHOR]

A new method based on v ‐support vector regression (v ‐SVR) is proposed to extract the fetal electrocardiogram (FECG) from the abdominal signal recorded at the abdominal areas of the pregnant woman. The maternal electrocardiogram (MECG) component in the abdominal signal is a non‐linearly transformed version of the MECG and the non‐linear transform is estimated by v ‐SVR. The optimal estimation of the MECG component is obtained by the MECG undergoing the estimated non‐linear transform. Then the FECG is extracted by subtracting the estimated MECG component from the abdominal signal. The method is validated by the experiments on both synthetic and real electrocardiogram (ECG) signals. The visual results and signal‐to‐noise ratio (SNR) are used to evaluate the performance of the FECG extraction methods. The experimental results indicated that the proposed method can be used for extracting the FECG from the abdominal signal. [ABSTRACT FROM AUTHOR]

Linked Comment: Ultrasound Obstet Gynecol 2013:42:509–517 [ABSTRACT FROM AUTHOR]

The article presents the author's views on fetal macrosomia. It is comments that ultrasound prediction of macrosomia is inaccurate and brachial plexus injuries are rarely permanent. According to the author, fetal macrosomia should be defined as a birth weight greater than 4.4 kg. It is opined that fetal macrosomia should be taken just as seriously by obstetricians as intrauterine growth restriction.

Aim: To determine prevalence and predictors of perceived stress in women with threatened preterm labour. Design: Cross‐sectional. Methods: We recruited 409 women with threatened preterm labour, hospitalized at two tertiary hospitals. We assessed their socio‐demographic and obstetrics characteristics, and their perceived stress, perceived social support, experience of violence using validated scales. Multiple linear regression was used to determine the predictors. Results: Data from all recruited women were analysed. Most of them had borderline (36%) or high (42%) level stress. Overall, 17 predictors were identified explaining 89.5% of variation in the stress score. Predictors of the higher stress score included: urban living, experience of sexual and psychological violence, perceived insufficient social support, experience of vaginal bleeding during current pregnancy, abnormal results in initial pregnancy tests, having multiple roles at home, being less than 28 weeks pregnant, being parous, sleep disorders, history of health problems, insufficient income and unwanted pregnancy. [ABSTRACT FROM AUTHOR]

Aim Sensory function is assumed to recover almost completely in obstetric brachial plexus lesion (OBPL), and is reported to recover much better than motor function. However, there is no obvious physiological reason why this should be so. Any persistent problems with sensory innervation might contribute to disability, therefore we aimed to assess sensory dysfunction in adults resulting from OBPL. Method Adults with conservatively treated OBPL ( n=17; 12 females, five males; median age 38y; lesion levels: C5-C6, n=7; C5-C7, n=7; C5-C8, n=2; C5-Th1, n=1) and 19 healthy comparison persons (10 females, nine males; median age 23y) were investigated. Sensory function was measured using Semmes-Weinstein monofilaments, two-point discrimination, object recognition, and a locognosia test. Results Scores of the Semmes-Weinstein monofilaments and two-point discrimination, but not object recognition or locognosia, were significantly worse in those with OBPL than in those without OBPL. Interpretation There may be systematic abnormalities in sensory function in adults with conservatively treated OBPL. The existence of these impairments and their contribution to functional impairment needs to be acknowledged. [ABSTRACT FROM AUTHOR]

The article offers information on the Ian Donald Medal recipients, abstract winner, and the best short oral presentations during the 22nd World Congress on Ultrasound in Obstetrics and Gynecology in Copenhagen, Denmark on September 9-13, 2012. It mentions Jens Bang and Mathias Fink as the two recipients of the Ian Donald Medal award. Moreover, it presents the titles and authors of free communications during the said congress.

Information on the 19th World Congress on Ultrasound in Obstetrics and Gynecology in Hamburg, Germany on September 13-17, 2009 is presented. The event, which was dedicated to ultrasound pioneer Manfred Hansmann, featured presentations on various topics including breast ultrasound, first-trimester ultrasound and fetal cardiology. Another highlight of the event was the presentation of the Ian Donald Gold Medal to obstetrician Ulrich Gembruch and Alfred Kratochwil Award to author Wesley Lee.

Objective: To assess the variability of fetal heart and thoracic area and circumference measurements using the ellipse and diameter methods at different gestational ages. Design: This was a prospective cross-sectional study of 200 singleton pregnancies, with no apparent fetal abnormalities. The gestational age ranged between 19 and 42 weeks. At each examination, two transverse frames of the fetal chest at the level of the four-chamber view during diastole were obtained. For each frame, the area and the circumference of the heart and thorax were obtained by the ellipse and diameter methods. In the diameter method, cardiac and thoracic areas and circumferences were derived from the measured anteroposterior and transverse diameters. All measurements were made by the same observer. Results: For the same method, intraobserver variability was good. Coefficient of variation for all measurements varied between 3-11%. The ellipse method tended to give larger measurements than did the diameter method, the absolute difference increasing with fetal age. The mean ellipse/diameter ratio was 1.10, 1.04, 1.05 and 1.02 for heart area, thorax area, heart circumference and thorax circumference, respectively. In most cases, intraobserver variability of the thorax measurements was independent of gestational age. In contrast, there was a greater variability of heart measurements with increasing gestational age. Conclusions: Both the ellipse and diameter methods of measuring cardiothoracic ratio are clinically useful and fairly reproducible at certain gestations, but are not interchangeable as the ellipse method overestimates measurements compared to the diameter method. The less reproducible measurement of heart size in later gestation should be taken into account when assessing cardiothoracic ratios. [ABSTRACT FROM AUTHOR]

Discusses the efficacy of the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) on pregnancy and birth outcomes. Information on potential effects of nutritional and other health interventions on preterm births; Discussion on a tradeoff between under-controlling for maternal characteristics that may affect both birth outcomes and WIC enrollment; Report that intertrial differences in the subjects analyzed may lead to different estimates of treatment effects on different populations.

The article focuses on the study on the quantification of the power Doppler systems and its relation to the index fractional moving blood volume (FMVM). The author asserted that the power Doppler is ideal for the measurement of the values that estimate the regional perfusion. Key information regarding the correlation of the FMVM and perfusion evaluation using radiomicrospheres are also discussed.

The Ian Donald Gold Medal is awarded annually to a physician-scientist who has made a significant scientific contribution to the advancement of diagnostic ultrasound in obstetrics and gynecology and who has changed the way in which ultrasound is practiced through research or innovation. In 1986, he became a lecturer in obstetrics and gynecology at the university's medical school, and in 1989, he became a senior physician and senior lecturer in obstetrics and gynecology. Professor Simcha Yagel fully deserves this award for his outstanding scientific work, which has resulted in an extraordinary contribution to the advancement of ultrasound in obstetrics and gynecology. [Extracted from the article]

Gastroschisis (GS) is a congenital abdominal wall defect, in which the bowel eviscerates from the abdominal cavity. It is a non-lethal isolated anomaly and its pathogenesis is hypothesized to occur as a result of two hits: primary rupture of the 'physiological' umbilical hernia (congenital anomaly) followed by progressive damage of the eviscerated bowel (secondary injury). The second hit is thought to be caused by a combination of mesenteric ischemia from constriction in the abdominal wall defect and prolonged amniotic fluid exposure with resultant inflammatory damage, which eventually leads to bowel dysfunction and complications. GS can be classified as either simple or complex, with the latter being complicated by a combination of intestinal atresia, stenosis, perforation, volvulus and/or necrosis. Complex GS requires multiple neonatal surgeries and is associated with significantly greater postnatal morbidity and mortality than is simple GS. The intrauterine reduction of the eviscerated bowel before irreversible damage occurs and subsequent defect closure may diminish or potentially prevent the bowel damage and other fetal and neonatal complications associated with this condition. Serial prenatal amnioexchange has been studied in cases with GS as a potential intervention but never adopted because of its unproven benefit in terms of survival and bowel and lung function. We believe that recent advances in prenatal diagnosis and fetoscopic surgery justify reconsideration of the antenatal management of complex GS under the rubric of the criteria for fetal surgery established by the International Fetal Medicine and Surgery Society (IFMSS). Herein, we discuss how conditions for fetoscopic repair of complex GS might be favorable according to the IFMSS criteria, including an established natural history, an accurate prenatal diagnosis, absence of fully effective perinatal treatment due to prolonged need for neonatal intensive care, experimental evidence for fetoscopic repair and maternal and fetal safety of fetoscopy in expert fetal centers. Finally, we propose a research agenda that will help overcome barriers to progress and provide a pathway toward clinical implementation. © 2021 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Aim: To identify a set of scientific, systematic and clinically applicable nursing‐sensitive quality indicators for pernicious placenta previa (PPP). Design: A modified Delphi‐Consensus Technique. Methods: According to literature retrieval published between 2009–2019, 38 nursing‐sensitive quality indicators were chosen and a questionnaire was designed. An online survey was conducted in 20 hospitals in China, and data of experts' opinions were collected and analysed by improved Delphi method. Results: 38 nursing‐sensitive quality indicators were identified. The response rates in the two rounds of expert consultation were 97.4% and 100%, and the authoritative coefficients were 0.89 and 0.92. The coefficients of variation ranged from 0.04–0.28. The nursing‐sensitive quality indicators were successfully constructed based on the modified Delphi technique. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the influence of stomach position on postnatal outcome in cases of left congenital diaphragmatic hernia (CDH) without liver herniation, diagnosed and characterized on prenatal ultrasound (US), by comparing those with ('stomach-up' CDH) to those without ('stomach-down' CDH) intrathoracic stomach herniation.Methods: Infants with left CDH who underwent prenatal US and postnatal repair at our institution between January 2008 and March 2017 were eligible for inclusion in this retrospective study. Detailed prenatal US examinations, fetal magnetic resonance imaging (MRI) studies, operative reports and medical records of infants enrolled in the pulmonary hypoplasia program at our institution were reviewed. Cases with liver herniation and those with an additional anomaly were excluded. Cases in which bowel loops were identified within the fetal chest on US while the stomach was intra-abdominal were categorized as having stomach-down CDH. Cases in which bowel loops and the stomach were visualized within the fetal chest on US were categorized as having stomach-up CDH. Prenatal imaging findings and postnatal outcomes were compared between the two groups.Results: In total, 152 patients with left CDH were initially eligible for inclusion. Seventy-eight patients had surgically confirmed liver herniation and were excluded. Of the 74 included CDH cases without liver herniation, 28 (37.8%) had stomach-down CDH and 46 (62.2%) had stomach-up CDH. Of the 28 stomach-down CDH cases, 10 (35.7%) were referred for a suspected lung lesion. Sixty-eight (91.9%) cases had postnatal outcome data available for analysis. There was no significant difference in median observed-to-expected (o/e) lung-area-to-head-circumference ratio (LHR) between cases with stomach-down CDH and those with stomach-up CDH (41.5% vs 38.4%; P = 0.41). Furthermore, there was no difference in median MRI o/e total lung volume (TLV) between the two groups (49.5% vs 44.0%; P = 0.22). Compared with stomach-up CDH patients, stomach-down CDH patients demonstrated lower median duration of intubation (18 days vs 9.5 days; P < 0.01), median duration of extracorporeal membrane oxygenation (495 h vs 223.5 h; P < 0.05), rate of supplemental oxygen requirement at 30 days of age (20/42 (47.6%) vs 3/26 (11.5%); P < 0.01) and rate of pulmonary hypertension at initial postnatal echocardiography (28/42 (66.7%) vs 9/26 (34.6%); P = 0.01). No neonatal death occurred in stomach-down CDH patients and one neonatal death was seen in a patient with intrathoracic stomach herniation.Conclusions: In infants with left CDH without liver herniation, despite similar o/e-LHR and o/e-TLV, those with stomach-down CDH have decreased neonatal morbidity compared to those with stomach herniation. Progressive or variable physiological distension of the stomach over the course of gestation may explain these findings. Stomach-down left CDH is mistaken for a lung mass in a substantial proportion of cases. Accurate prenatal US characterization of CDH is crucial for appropriate prenatal counseling and patient management. © 2021 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Presents abstracts of papers about second and third trimester Doppler presented at the 10th World Congress on Ultrasound in Obstetrics and Gynecology, held in October 2000 in Zagreb, Croatia. Inclusion of 'Fetal cerebral and adrenal blood velocimetry in predicting hypoxia of the fetus,' by G.H. Breborowicz et al; 'The flow redistribution toward the brain: Beneficial and adverse effects on the fetal outcome in hypertensive pregnancies,' by A. Salihagic et al.