Search

Objective: To determine the diagnostic accuracy of prenatal ultrasound in detecting coarctation of the aorta (CoA). Methods: An individual participant data meta‐analysis was performed to report on the strength of association and diagnostic accuracy of different ultrasound signs in detecting CoA prenatally. MEDLINE, EMBASE and CINAHL were searched for studies published between January 2000 and November 2021. Inclusion criteria were fetuses with suspected isolated CoA, defined as ventricular and/or great vessel disproportion with right dominance on ultrasound assessment. Individual participant‐level data were obtained by two leading teams. PRISMA‐IPD and PRISMA‐DTA guidelines were used for extracting data, and the QUADAS‐2 tool was used for assessing quality and applicability. The reference standard was CoA, defined as narrowing of the aortic arch, diagnosed after birth. The most commonly evaluated parameters on ultrasound, both in B‐mode and on Doppler, constituted the index test. Summary estimates of sensitivity, specificity, diagnostic odds ratio (DOR) and likelihood ratios were computed using the hierarchical summary receiver‐operating‐characteristics model. Results: The initial search yielded 72 studies, of which 25 met the inclusion criteria. Seventeen studies (640 fetuses) were included. On random‐effects logistic regression analysis, tricuspid valve/mitral valve diameter ratio > 1.4 and > 1.6, aortic isthmus/arterial duct diameter ratio < 0.7, hypoplastic aortic arch (all P < 0.001), aortic isthmus diameter Z‐score of < −2 in the sagittal (P = 0.003) and three‐vessel‐and‐trachea (P < 0.001) views, pulmonary artery/ascending aorta diameter ratio > 1.4 (P = 0.048) and bidirectional flow at the foramen ovale (P = 0.012) were independently associated with CoA. Redundant foramen ovale was inversely associated with CoA (P = 0.037). Regarding diagnostic accuracy, tricuspid valve/mitral valve diameter ratio > 1.4 had a sensitivity of 72.6% (95% CI, 48.2–88.3%), specificity of 65.4% (95% CI, 46.9–80.2%) and DOR of 5.02 (95% CI, 1.82–13.9). The sensitivity and specificity values were, respectively, 75.0% (95% CI, 61.1–86.0%) and 39.7% (95% CI, 27.0–53.4%) for pulmonary artery/ascending aorta diameter ratio > 1.4, 47.8% (95% CI, 14.6–83.0%) and 87.6% (95% CI, 27.3–99.3%) for aortic isthmus diameter Z‐score of < –2 in the sagittal view and 74.1% (95% CI, 58.0–85.6%) and 62.0% (95% CI, 41.6–78.9%) for aortic isthmus diameter Z‐score of < –2 in the three‐vessel‐and‐trachea view. Hypoplastic aortic arch had a sensitivity of 70.0% (95% CI, 42.0–88.6%), specificity of 91.3% (95% CI, 78.6–96.8%) and DOR of 24.9 (95% CI, 6.18–100). The diagnostic yield of prenatal ultrasound in detecting CoA did not change significantly when considering multiple categorical parameters. Five of the 11 evaluated continuous parameters were independently associated with CoA (all P < 0.001) but all had low‐to‐moderate diagnostic yield. Conclusions: Several prenatal ultrasound parameters are associated with an increased risk for postnatal CoA. However, diagnostic accuracy is only moderate, even when combinations of parameters are considered. © 2024 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]

Objective: To develop a model for the prediction of adverse perinatal outcome in growth‐restricted fetuses requiring delivery before 28 weeks in order to provide individualized patient counseling. Methods: This was a retrospective multicenter cohort study of singleton pregnancies with antenatal suspicion of fetal growth restriction requiring delivery before 28 weeks' gestation between January 2010 and January 2020 in six tertiary public hospitals in the Barcelona area, Spain. Separate predictive models for mortality only and mortality or severe neurological morbidity were created using logistic regression from variables available antenatally. For each model, predictive performance was evaluated using receiver‐operating‐characteristics (ROC)‐curve analysis. Predictive models were validated externally in an additional cohort of growth‐restricted fetuses from another public tertiary hospital with the same inclusion and exclusion criteria. Results: A total of 110 cases were included. The neonatal mortality rate was 37.3% and, among the survivors, the rate of severe neurological morbidity was 21.7%. The following factors were retained in the multivariate analysis as significant predictors of mortality: magnesium sulfate neuroprotection, gestational age at birth, estimated fetal weight, male sex and Doppler stage. This model had a significantly higher area under the ROC curve (AUC) compared with a model including only gestational age at birth (0.810 (95% CI, 0.730–0.889) vs 0.695 (95% CI, 0.594–0.795); P = 0.016). At a 20% false‐positive rate, the model showed a sensitivity, negative predictive value and positive predictive value of 66%, 80% and 66%, respectively. For the prediction of the composite adverse outcome (mortality or severe neurological morbidity), the model included: gestational age at birth, male sex and Doppler stage. This model had a significantly higher AUC compared with a model including only gestational age at birth (0.810 (95% CI, 0.731–0.892) vs 0.689 (95% CI, 0.588–0.799); P = 0.017). At a 20% false‐positive rate, the model showed a sensitivity, negative predictive value and positive predictive value of 55%, 63% and 74%, respectively. External validation of both models yielded similar AUCs that did not differ significantly from those obtained in the original sample. Conclusions: Estimated fetal weight, fetal sex and Doppler stage can be combined with gestational age to improve the prediction of death or severe neurological sequelae in growth‐restricted fetuses requiring delivery before 28 weeks. This approach may be useful for parental counseling and decision‐making. © 2023 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Objective: A favorable postnatal prognosis in cases of pulmonary atresia/critical stenosis with intact ventricular septum (PA/CS‐IVS) is generally equated with the possibility of achieving biventricular (BV) repair. Identification of fetuses that will have postnatal univentricular (UV) circulation is key for prenatal counseling, optimization of perinatal care and decision‐making regarding fetal therapy. We aimed to evaluate the accuracy of published models for predicting postnatal circulation in PA/CS‐IVS using a large internationally derived validation cohort. Methods: This was a systematic review of published uni‐ and multiparametric models for the prediction of postnatal circulation based on echocardiographic findings at between 20 and 28 weeks of gestation. Models were externally validated using data from the International Fetal Cardiac Intervention Registry. Sensitivity, specificity, predictive values, area under the receiver‐operating‐characteristics curves (AUCs) and proportion of cases with true vs predicted outcome were calculated. Results: Eleven published studies that reported prognostic parameters of postnatal circulation were identified. Models varied widely in terms of the main outcome (UV (n = 3), non‐BV (n = 3), BV (n = 3), right‐ventricle‐dependent coronary circulation (n = 1) or tricuspid valve size at birth (n = 1)) and in terms of the included predictors (single parameters only (n = 6), multiparametric score (n = 4) or both (n = 1)), and were developed on small sample sizes (range, 15–38). Nine models were validated externally given the availability of the required parameters in the validation cohort. Tricuspid valve diameter Z‐score, tricuspid regurgitation, ratios between right and left cardiac structures and the presence of ventriculocoronary connections (VCC) were the most commonly evaluated parameters. Multiparametric models including up to four variables (ratios between right and left structures, right ventricular inflow duration, presence of VCC and tricuspid regurgitation) had the best performance (AUC, 0.80–0.89). Overall, the risk of UV outcome was underestimated and that of BV outcome was overestimated by most models. Conclusions: Current prenatal models for the prediction of postnatal outcome in PA/CS‐IVS are heterogeneous. Multiparametric models for predicting UV and non‐BV circulation perform well in identifying BV patients but have low sensitivity, underestimating the rate of fetuses that will ultimately have UV circulation. Until better discrimination can be achieved, fetal interventions may need to be limited to only those cases in which non‐BV postnatal circulation is certain. © 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]

Objective: To analyze the capability to predict perinatal survival and severe neonatal morbidity at diagnosis of early-onset fetal growth restriction (eoFGR) using maternal variables, ultrasound parameters and angiogenic markers.Methods: Prospective observational study in a cohort of singleton pregnancies with a diagnosis of eoFGR (< 32+0 weeks). At diagnosis of eoFGR, complete assessment was performed, including ultrasound examination (anatomy, biometry and Doppler study) and maternal serum measurement of the angiogenic biomarkers sFlt-1 and PlGF. Logistic regression models for the prediction of perinatal survival (in cases diagnosed < 28+0 weeks) and severe neonatal morbidity (in all cases) were calculated.Results: We included 210 eoFGR cases, with 185 (88%) perinatal survivors. Median gestational age at diagnosis was 27+0 weeks. All cases diagnosed at ≥ 28+0 weeks survived. In cases diagnosed < 28+0 weeks, survivors (vs. non-survivors) showed at diagnosis: higher gestational age (26.1 vs. 24.4 weeks), estimated fetal weight (626 vs. 384 g), cerebroplacental ratio (1.1 vs. 0.9) and PlGF (41 vs. 18 pg/ml), and lower sFlt-1/PlGF ratio (129 vs. 479), all p < 0.001. The best combination of two variables for predicting perinatal survival was provided by EFW and PlGF (AUC 0.83; 95% CI, 0.74 - 0.92). These were also the best variables for predicting severe neonatal morbidity (AUC 0.73; 95% CI, 0.65 - 0.80).Conclusions: EFW and maternal serum determination of PlGF accurately predict perinatal survival in eoFGR cases diagnosed before 28 weeks. Prenatal prediction of severe neonatal morbidity in eoFGR performs modestly. This article is protected by copyright. All rights reserved. [ABSTRACT FROM AUTHOR]

Objective: To analyze the value of the soluble fms‐like tyrosine kinase‐1/placental growth factor (sFlt‐1/PlGF) ratio in predicting the time to delivery in early‐onset fetal growth restriction (FGR) with preserved antegrade umbilical artery (UA) flow at diagnosis. Methods: This was a prospective observational single‐center cohort study of pregnancies with early‐onset (< 32 + 0 weeks) FGR and antegrade UA flow, in which maternal serum sFlt‐1/PlGF ratio was determined at diagnosis. FGR was defined as estimated fetal weight < 3rd centile or < 10th centile with UA pulsatility index > 95th centile, fetal middle cerebral artery pulsatility index < 5th centile or cerebroplacental ratio < 5th centile. The previously described sFlt‐1/PlGF ratio cut‐off value of 85 for facilitating the diagnosis of pre‐eclampsia was assessed in the prediction of the need to deliver in < 1 week and ≥ 4 weeks. Results: In total, 120 cases were included. There were 116 (96.7%) liveborn neonates and 108 (90.0%) perinatal survivors. Median (interquartile range (IQR)) gestational age at diagnosis of early‐onset FGR was 27.1 (25.7–29.4) weeks. Median (IQR) sFlt‐1/PlGF ratio at diagnosis was 196 (84–474). Ninety (75.0%) cases had a sFlt‐1/PlGF ratio ≥ 85. Among pregnancies with a liveborn neonate, median (IQR) interval to delivery in the groups with sFlt‐1/PlGF ratio < 85 and ≥ 85 was 41 (22–54) days and 11 (4–20) days, respectively (P < 0.01). The probability of having to deliver within 1 week after diagnosis was 0% and 35.6% in those with sFlt‐1/PlGF ratio < 85 and ≥ 85, respectively (P = 0.03), and the probability of delaying delivery for ≥ 4 weeks was 72.4% and 19.5%, respectively (P < 0.01). Conclusion: sFlt‐1/PlGF ratio < 85 at diagnosis of early‐onset FGR with antegrade UA flow identifies a group of pregnancies in which the need to deliver within 1 week is very low and the interval to delivery is expected to be prolonged for ≥ 4 weeks in > 70% of cases. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

Objective: To describe the evolution of soluble fms-like tyrosine kinase-1 to placental growth factor (sFlt-1/PlGF) ratio in the last 5 weeks prior to delivery in singleton pregnancy complicated by early-onset fetal growth restriction (FGR), with or without pre-eclampsia (PE).Methods: This was a prospective observational cohort study of early-onset FGR cases that underwent serial assessment of maternal serum sFlt-1/PlGF ratio from diagnosis to delivery. Measurements were made at weekly intervals and within the last 48 h before birth. Absolute values and percentage increase between time intervals were computed, and previously described cut-off values of 38 (suspicion of PE), 85 (aids diagnosis of PE) and 655 (high risk for imminent delivery) were used for analysis of the sFlt-1/PlGF ratio. We compared findings between cases with early-onset FGR only (n = 37) and those that additionally developed PE (n = 36).Results: Overall perinatal survival was 63/73 (86.3%). A sFlt-1/PlGF ratio above 38 was observed 4 weeks before delivery in most FGR-only and FGR with PE cases (73% and 100%, respectively), but absolute values of sFlt-1/PlGF were significantly higher in FGR cases with PE. Extremely elevated values of the ratio (≥ 655) within the last 48 h before delivery were found in 65% of cases of FGR with PE, but in only 8% of isolated FGR cases (P < 0.001).Conclusion: Elevated sFlt-1/PlGF was observed in most early-onset FGR pregnancies from 4 weeks before delivery, and values were even higher if there was concurrent PE. However, serial measurements of the ratio were of limited value, being useful only to anticipate the need for imminent delivery in cases of FGR with PE when sFlt-1/PlGF values ≥ 655 were reached. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

Objective: To assess the impact of prenatal diagnosis of transposition of the great arteries (TGA) on postnatal outcome.Methods: Hundred and fifty-four patients with either simple (n = 101) or complex forms (n = 53) of TGA, diagnosed prenatally (G1, n = 88) or postnatally (G2, n = 66), who were admitted and underwent surgical correction in our centre between 1998 and 2014, were analysed.Results: Prostaglandin E1 (PgE1) infusion and balloon atrial septostomy (BAS) were performed in the first 48 h after birth more commonly in G1. The hospital mortality rate for the whole group was 7.1%, higher for complex forms (13.2%) than for simple TGA (3.9%), (p = 0.034). The overall mortality rate was similar in G1 and G2. The mortality for simple TGA was higher when PgE1 infusion and BAS were implemented after the first 48 h (p = 0.001). All deaths in G2 occurred in patients first receiving PgE1 and BAS beyond 48 h. PgE1 was initiated in the first 48 h in most patients (83%) with simple TGA postnatally diagnosed.Conclusions: Adequate measures in the first 48 h after birth are essential to reduce the early mortality in TGA, especially in the simple form. This can be provided by prenatal diagnosis or by early neonatal clinical suspicion and prompt measures. [ABSTRACT FROM AUTHOR]

Baseline maternal and fetal characteristics at diagnosis were compared and selected for logistic regression for the prediction of perinatal survival. To evaluate the main prognostic markers of perinatal survival in fetuses diagnosed of early-onset growth restriction (eoFGR). Conclusions Serum determination of PlGF at diagnosis of eoFGR combined with EFW can accurately predict the risk of perinatal death in eoFGR. [Extracted from the article]

Conclusions The most important prognostic factor of perinatal mortality is its association with other anomalies. To evaluate prenatal markers of perinatal survival and diagnostic accuracy in common arterial trunk (CAT). [Extracted from the article]

Results A total of 215 women with eoPE were evaluated and 47.9% required delivery within 7 days of diagnosis and 21.9% developed either HELLP syndrome or abruptio. EP01.28: Prediction of delivery within seven days after diagnosis of early-onset pre-eclampsia using machine learning models To develop a prediction model (model D) using machine learning tools for the need of delivery within 7 days of diagnosis of early-onset pre-eclampsia (eoPE) and one for the risk of developing HELLP syndrome/ I abruptio i (model HA). [Extracted from the article]

The authors discuss the implications for clinical practice in the implementation of soluble fms-like tyrosine kinase receptor-1 and placental growth factor ratio for diagnosis and prediction of pre-eclampsia (PE) in singleton pregnancy. It outlines the consensus statements in applying risks for developing PE algorithm in women with signs and symptoms of PE and asymptomatic women at high risk of developing PE. It concludes that the ratio has not been incorporated into official guidelines.

ABSTRACT Objective To evaluate the performance of the mean uterine artery pulsatility index ( UtA-PI) and the automated measurement of the soluble fms-like tyrosine kinase-1 ( sFlt-1)/placental growth factor ( PlGF) ratio for the prognostic assessment of both maternal and perinatal outcomes, and the time-to-delivery interval in early-onset (≤ 34 + 0 weeks) pre-eclampsia ( PE) cases with attempted expectant management. Methods Fifty-one singleton pregnancies with early-onset PE were enrolled in the study. Mean UtA-PI and sFlt/ PlGF ratio were measured at diagnosis. The association of each marker and their combinations with adverse maternal and perinatal outcomes was assessed by univariable comparisons and multivariable logistic regression analysis and time-to-delivery interval by survival analysis. Results Twenty-six (51%) had adverse maternal outcome and 14 (27%) had adverse perinatal outcome. At the time of onset of PE, only gestational age was significantly related to maternal complications. Gestational age at onset, mean UtA-PI and sFlt-1/ PlGF ratio were significantly associated with perinatal complications, their combination reaching a sensitivity of 64% with 95% specificity, and an area under the receiver-operating characteristics curve of 0.89 (95% CI, 0.79-0.99). Regarding the time until delivery, 92% (12/13) of cases with sFlt-1/ PlGF ratio > 655 and 39% (15/38) of cases with a ratio ≤ 655 delivered within the first 48 h, 8% (1/13) and 19% (7/38), respectively, delivered between 48 h and 7 days and 0% (0/13) and 42% (16/38), respectively, delivered after 7 days. Conclusion Mean UtA-PI and sFlt-1/ PlGF ratio in combination with gestational age are useful for the prognostic assessment of perinatal complications at the time of diagnosis of early-onset PE, but this combination has limited value for the prediction of maternal complications. Moreover, sFlt-1/ PlGF ratio > 655 is closely related to the need to deliver within 48 h. [[ArtCopyrightmsg]] [ABSTRACT FROM AUTHOR]

Abstract: Nephrops landings from Spanish trawlers in Porcupine bank (West of Ireland) have decreased a 90% in the last 25 years. With the aim of studying the causes of this situation, the relation between CPUE (1979–2005) and several environmental and population factors is investigated through a monthly time series approach. Discards in the fishery are negligible. As LPUE time series exhibits a seasonal pattern, a seasonal decomposition of the CPUE is carried out showing a decreasing trend from 1982 to 2003. The LPUE series is modelized resulting in an autoregressive and moving average model (ARMA) that highlights a monthly positive and seasonal negative autodependence. Population and environmental parameters (i.e. recruits per unit effort “RPUE”, sex ratio, ovigerous females’ proportion, North Atlantic Oscillation index “NAO” and Atlantic Multidecadal Oscillation index “AMO”) were tested at different lags as independent variables of the ARMA model. The outcoming multivariated dynamic ARMA model states that CPUE is positively related to sex ratio lagged by 8 years and negatively related to the NAO index from 6.5 years before. In accordance with those results 1978, 1983, 1986, 1989, 1992, 1995 and 1996 Porcupine Bank stormy, warm and wet conditions would be linked to the 1984, 1989, 1993, 1996, 1998, 2001 and 2003 Nephrops CPUE low values. Those results show an expectable model in relation to Nephrops density in which environmental conditions would have a relevant role. [Copyright &y& Elsevier]

Nephrops norvegicus is a burrowing decapod with patchy distribution. In the North and Northwest Iberian shelf and upper slope, it is a by-catch species of the bottom trawl mixed fisheries. The International Council for the Exploration of the Sea (ICES) assesses four Nephrops stocks in the area: North Portugal, West and North Galicia and Cantabrian Sea. From a relatively buoyant Nephrops fishery in the period 1975–1989, with annual average landings of 1225 t for the entire area, the landings declined substantially to 270 t in 2000. The general trend for the region is a decline of more than 60% in the catch-per-unit-effort in the last decade. These indicators make the status of the Nephrops stocks a matter of concern. In this paper, trends in the time series of Nephrops fishery data are described and evidence from age-based assessment is given of sharp declines in stock biomass and recruitment. [Copyright &y& Elsevier]

To identify independent risk factors for vaginal delivery in cases of labour induction for late-onset fetal growth restriction (FGR) and to elaborate a multivariate predictive model. Retrospective cohort study in 201 singleton pregnancies diagnosed of late-onset stage I FGR that required labour induction with cervical ripening. Independent factors associated to an increase in vaginal delivery were: labour induction method (Foley balloon), higher cerebro-placental ratio (CPR), lower pre-gestational BMI and absence of pre-eclampsia. [Extracted from the article]

OP10.05: Fetal growth assessment and perinatal outcomes associated with extremely high sFlt-1/PlGF value To describe the occurrence and evolution of fetal growth restriction (FGR) as well as perinatal adverse outcomes in pregnancies with high values of the sFlt-1/PlGF in a context of placental dysfunction (preeclampsia or FGR). Perinatal outcome and severe complications stratified by gestational age at sFlt-1/PlGF measurement are depicted in table 1 and figure 1, respectively. [Extracted from the article]

OP10.03: sFlt-1/PlGF ratio at diagnosis of previable fetal growth restriction and expected time to delivery To evaluate the relationship between sFlt-1/PlGF ratio and the time-to-delivery in previable stage I fetal growth restriction (FGR). The sFlt-1/PlGF ratio is a useful prognostic tool in previable stage I FGR that can help clinicians counsel and establish a follow-up plan. [Extracted from the article]

OP10.04: Prognostic value of the sFlt-1/PlGF in stage I early-onset fetal growth restriction To evaluate the prognostic value of the sFlt-1/PlGF at diagnosis of stage I early-onset fetal growth restriction. Time-to-delivery interval and perinatal results were stratified by sFlt1/PlGF ratio at diagnosis < 85 (G1,n=19) vs > =85 (G2,n=63). [Extracted from the article]

Objectives Circulating placental growth factor (PlGF) is a potential biomarker for preeclampsia. Prior studies show its limited precision in predicting or diagnosing preeclampsia, underscoring a common problem in biomarker data analyses in general – that large studies are needed to overcome clinical heterogeneity and to provide sufficient statistical power. Attaining such sample sizes often requires aggregation of cohorts. Different studies may use disparate platforms for laboratory analyses, complicating data merging. Here, we assessed whether PlGF concentrations could be merged across studies using inter-platform standardization. Methods Of 16516 pregnancies from 23 cohorts, 12,804 had at least one PlGF concentration (gestational age >20 weeks), analyzed using one of four platforms: R&D Systems, Alere-Triage, Roche-Elecsys or Abbott-Architect. Two merging algorithms, using Z -Score or Multiple of Median (MOM) transformations, were applied. A single Best Reference Curve (BRC), based on merged non-case PlGF concentrations, was constructed. Case-identification performance of the BRC for PlGF was compared to platform-specific curves. Results PlGF concentrations from different analytical platforms were merged ( Z -scores marginally better than MOMs) and, overall, BRC case-identification rates out-performed platform-specific curves. Conclusions Laboratory measurements from different platforms can be standardised and merged to give reference curves from aggregated PlGF datasets. This method allows for analysis of PlGF as a diagnostic marker for preeclampsia and is generalisable to other medical questions, thereby extending the scope of individual studies to answer a variety of important medical questions. Disclosures O. Burke: None. S. Benton: None. P. Szafranski: None. P. von Dadelszen: None. C. Buhimschi: None. I. Cetin: None. L. Chapell: None. F. Figueras: None. A. Galindo: None. I. Herraiz: None. C. Holzman: None. C. Hubel: None. U. Knudsen: None. C. Kronborg: None. H. Laivuori: None. T. McElrath: None. M. Moertl: None. J. Meyers: None. R.B. Ness: None. L. Oliviera: None. G. Olson: None. L. Poston: None. C. Ris-Stalphers: None. J.M. Roberts: None. E. Schistermann: None. E. Steegers: None. H. Stepan: None. O. Lapaire: None. D. Schlembach: None. S. Timmermans: None. V. Tsatsaris: None. J.A. van der Post: None. S. Verlohren: Consultant, Research Support Recipient, Commercial Interest: Roche Diagnostics, ThermoFisher, Novartis. P.M. Villa: None. D. Williams: None. H. Zeisler: None. C. Zhang: None. C.W. Redman: None. A. Staff: None. [ABSTRACT FROM AUTHOR]

An abstract of the article "Isolated aberrant right subclavian artery: a marker of trisomy 21," by E. Gomez Montes, I. Herraiz, J. M. Martinez-Moratalla Valcarcel, and A. Galindo is presented.

An abstract of the article "Impact of prenatal diagnosis of transposition of the great arteries in short-term mortality and morbidity," by P. Domínguez-Manzano and colleagues is presented.

An abstract of the article "Mode of delivery on late intrauterine growth-restricted fetuses: is induction of labour a feasible option?," by I. Herraiz and colleagues is presented.

An abstract of the article "Clinical implementation of the sFlt-1/PlGF ratio at 24-28 weeks' gestation to detect pre-eclampsia among high-risk women selected by risk factors and uterine artery Doppler" by I. Herraiz and colleagues is presented.

An abstract of the article "Clinical implementation of the sFlt-1/PlGF ratio at 24-28 weeks' gestation to detect intrauterine growth restriction among high-risk women selected by risk factors and uterine artery Doppler" by I. Herraiz and colleagues is presented.