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Key Clinical Message: Giant chorioangiomas, despite being rare, pose significant fetal and maternal risks. Timely and individualized treatment plans are crucial to reduce morbidity and mortality when fetal compromise occurs. Additionally, successful conservative management relies on consistent ultrasound monitoring, Doppler flowmetry assessments, and amniotic fluid level measurements. Chorioangiomas are benign placental tumors that manifest in approximately 1% of pregnancies. Giant chorioangiomas, characterized by tumors exceeding 4 cm, are exceptionally rare and pose substantial risks to maternal and fetal health. This case report details a patient with multiple giant chorioangiomas, emphasizing the rarity and consequential complications associated with these tumors. A 23‐year‐old woman, G3P2, at 28 weeks gestational age, was diagnosed with multiple large, well‐defined placental masses with increased vascularity, indicative of giant placental chorioangiomas. Subsequent ultrasound revealed various fetal anomalies such as cleft palate and lip, as well as lung and heart abnormalities. At 34+5 weeks of gestation, an emergency cesarean section was performed due to preeclampsia. Subsequently, a female neonate was born with hydrops fetalis. Unfortunately, she passed away within the first hour of her life. Complications associated with chorioangiomas primarily arise from arteriovenous shunts, which potentially lead to compromised fetal perfusion and cardiac failure. Although small‐sized chorioangiomas are often discovered incidentally, Doppler ultrasound and magnetic resonance imaging can reliably distinguish these tumors from other placental lesions. Additionally, management strategies tailored to gestational age and maternal‐fetal symptoms typically necessitate a multidisciplinary approach. However, additional research is essential to understand the mechanisms of chorioangiomas and to develop comprehensive management guidelines. [ABSTRACT FROM AUTHOR]

Objective: Fetal hypoxia is one of the main reasons for the high mortality rate in pregnancy. Delivery is a hypoxic process, with contractions reducing blood flow to the arteries of the uterus, thereby reducing the amount of oxygen available to the placenta and fetus. evaluation of cerebroplacental ratio (CPR) before active phase of labor in prediction of perinatal outcomes in Iranian full-term fetuses appropriate for gestational age. Methods: This was a prospective cohort study in 137 women with singleton term pregnancies. Inclusion criteria were willing to participating in study, patients' age ranged from 18 to 45 years, gestational age ranged between 38-41 completed weeks of gestation, single pregnancy, being married, Iranian nationality, having no history of systemic diseases (diabetes, hypertension, known anemia, autoimmune or inflammatory disease and other diseases requiring special diet), no smoking or drinking alcohol, no drugs intake. Exclusion criteria were unwilling to continue the study. The CPR was calculated as the simple ratio between the middle cerebral artery PI and the umbilical artery PI. The study cohort was divided into 3 groups according to CPR cutoff of the 5th, 5-95th, 95th percentile according to gestational age. The following outcomes measures were considered: meconium-stained amniotic fluid, mode of delivery, 1 and 5-minute Apgar score, NICU admission, arterial cord pH, base excess. Results: There are significant difference in AFI, arterial cord pH, arterial cord pH, base excess, Apgar score at minute 1 and 5 neonatal cord PH, NICU admission rate, cesarean delivery according to CPR categories (P < 0.05). AFI, Apgar score at minute 1 and 5 neonatal cord PH were lower in CPR < 5% compared another group. NICU admission rate and cesarean delivery were higher in CPR < 5% compared another group. Fetal distress was the most important indication for cesarean delivery in all CPR groups (35.13 %, 21.21 % and 11.8% respectively). Conclusion: In conclusion, it's seemed that CPR index is useful in clinical practice in prenatal outcomes monitoring of term uncomplicated women in order to select those at high risk. [ABSTRACT FROM AUTHOR]

Objective: Polyhydramnios can lead to maternal and fetal complication during pregnancy, so diagnosis and management can decrease some perinatal complications.Study Design: One hundred and fourteen singleton pregnancies were diagnosed with idiopathic polyhydramnios in the department of obstetrics at Shiraz University of Medical Sciences between January 2000 and January 2011 and were compared with 114 normal pregnancies for their perinatal outcome. Variables include birth weight, admission to neonatal intensive care unit (NICU), meconium staining, respiratory distress, fetal death, neonatal death, low 1-min and 5-min APGAR score, primary cesarean section (C/S), preterm delivery (<37 weeks), postpartum bleeding, and placental abruption.Results: Low birth weight (<2500 g), macrosoma (>4000 g), NICU admission, fetal distress, fetal death, lower 1-min and 5-min APGAR score, preterm delivery, and neonatal death were higher in the case group. However, meconium staining and malpresentation were equal between the two groups. Except for prematurity and 1-min and 5-min APGAR scores, there were no significant differences in other maternal or fetal outcomes considering the severity of polyhydramnios.Conclusion: Idiopathic polyhydramnios should be considered as a high-risk pregnancy that warrants close surveillance. More studies should be done to detect the best time and interval of fetal surveillance in these patients. Chromosomal and torch studies can determine the definite cause of polyhydramnios. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To examine the association of crown–rump length (CRL) in the first trimester with low birth weight and adverse pregnancy outcome. Methods: In a prospective cross-sectional study, CRL was measured in 876 healthy pregnant women undergoing ultrasound evaluation between 9 and 14weeks of gestation. Birth weight and pregnancy outcomes were analyzed for the 544 participants who met the study criteria. Results: Low (<2500g) and high (>4000g) birth weights were correlated with the difference between actual and expected CRL expressed in days of gestation, but no correlation was found between the difference between actual and expected CRL and premature delivery. Low birth weight (P =0.005) and abortion (P =0.03) were also correlated with the difference between actual and expected CRL. Conclusion: Routinely measuring CRL during the first trimester to detect CRLs shorter than expected for gestational age could be useful to obstetricians. Anticipating a low birth weight and being warned about the possibility of abortion would enable them to manage prenatal care and delivery more appropriately. [Copyright &y& Elsevier]

Objective: To construct improved reference charts for fetal long bones in an Iranian setting and to compare them with previous studies.Methods: The present prospective cross-sectional study included singleton fetuses assessed by ultrasonography at 17-25 weeks of gestation at the Comprehensive Medical Genetics Center, Shahid Soltani, Shiraz, Iran between May 1, 2012, and February 28, 2014. Exclusion criteria included conditions that could affect fetal growth. Fetal long bones (femur, humerus, tibia, fibula, ulna, and radius) were measured with ultrasonography and biometric charts were produced. Regression models were fitted to estimate bone lengths. The models produced were compared with those from previous studies in other populations.Results: There were 660 singleton fetuses included and 660 femur, 633 humerus, 512 tibia, 498 fibula, 505 ulna, and 498 radius biometric measurements were recorded. The models generated to predict the length of the tibia, fibula, ulna, and radius from the length of the femur and humerus demonstrated a high goodness of fit when the predicted lengths were plotted against the actual lengths. Comparisons of mean lengths with previous studies suggested that long-bone length was affected by maternal ethnicity.Conclusion: The equations generated could be used to predict long-bone length in an Iranian population and ethnicity should be considered when using fetal long-bone length as a prenatal diagnostic tool. [ABSTRACT FROM AUTHOR]