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Objectives: To evaluate the relationship between the attitude of the fetal head quantified by means of the chin‐to‐chest angle (CCA) in fetuses in occiput posterior (OP) position at the beginning of the second stage of labor, and persistent OP position at birth. Methods: This was a single‐center, prospective observational study conducted at the University Hospital of Parma, Parma, Italy. We included singleton pregnancies at term with fetuses in the OP position at the beginning of the second stage of labor. The fetal head position, station by means of angle of progression and head‐to‐perineum distance, and attitude by means of CCA were assessed using transabdominal or transperineal ultrasound. The primary outcome was persistent OP position at birth. Results: Between January and July 2022, 76 women were included in the study. There were 48 (63.2%) spontaneous rotations of the fetal head and spontaneous vaginal delivery occurred in all. Among the 28 (36.8%) fetuses that did not rotate spontaneously into an occiput anterior position, eight (28.6%) had a spontaneous vaginal delivery, while operative vaginal delivery and Cesarean delivery was performed in 11 (39.3%) and nine (32.1%) cases, respectively. Multivariable logistic regression analysis showed that the CCA (adjusted odds ratio (aOR), 2.15 (95% CI, 1.22–3.78); P = 0.008) and nulliparity (aOR, 0.20 (95% CI, 0.06–0.76); P = 0.02) were associated independently with persistent OP position at birth. Moreover, the CCA showed an area under the receiver‐operating‐characteristics curve of 0.69 (95% CI, 0.56–0.82); P = 0.005) for the prediction of persistent OP position. The optimal cut‐off value of the CCA was 36.5°, and was associated with a sensitivity of 0.82 (95% CI, 0.63–0.94), specificity of 0.50 (95% CI, 0.35–0.65), positive predictive value of 0.49 (95% CI, 0.34–0.64), negative predictive value of 0.83 (95% CI, 0.64–0.94), positive likelihood ratio of 1.64 (95% CI, 1.18–2.29) and negative likelihood ratio of 0.36 (95% CI, 0.15–0.83). Conclusions: Our data show that, within a population of women with fetal OP position at the beginning of the second stage of labor, the sonographic fetal head attitude measured by means of the CCA might help in the identification of fetuses at risk of persistent OP position. Such findings can be useful for patient counseling when OP position is diagnosed at full cervical dilatation. Further studies should investigate if the CCA might select patients who may benefit from manual rotation of the fetal head. © 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]

This article, titled "EP08.14: Computerised CTG features in small for gestational age and fetal growth restriction between 32+0 and 36+6 weeks," explores the characteristics of computerized cardiotocography (cCTG) in suspected late-onset fetal smallness and compares cCTG analysis in small-for-gestational age (SGA) and fetal growth restriction (FGR). The study, which included 105 cases and 367 cCTG recordings, found a negative correlation between umbilical artery PI and UCR and long-term variability (LTV) and short-term variability (STV), as well as a positive correlation between these parameters and the length of recording. FGR fetuses showed a longer duration of cCTG recording and lower STV compared to SGA fetuses. The study concludes that there is a relationship between cCTG and fetal Doppler parameters, and that pathological cCTG is mainly accounted for by FGR cases. [Extracted from the article]

This article discusses a study conducted on fetuses with late-onset fetal growth restriction (FGR) to investigate patterns of cardiac remodeling and evaluate fetal cardiac function using speckle tracking fetal echocardiography (STE). The study found three distinct cardiac remodeling phenotypes: a morphologically normal heart, a morphologically elongated heart, and a morphologically globular heart. The comparison of cardiac functional parameters using STE showed differences in left and right ventricular strain among the phenotypes. This study highlights the existence of different cardiac remodeling phenotypes in fetuses with late-onset FGR and their association with variations in ventricular strain. [Extracted from the article]

This article, titled "EP19.15: Intrapartum assessment of head-perineum distance: a comparative study of measurements obtained with and without compression of perineal soft tissues," presents the findings of a study that aimed to evaluate and compare measurements of the head-perineum distance (HPD) obtained with and without compression of the perineal soft tissues. The study involved a series of singleton pregnancies and used transperineal sonography to evaluate the HPD. The results showed a good correlation and reproducibility between the HPD measured with and without compression, and it was also found that the body mass index at delivery may impact the difference in measurements. [Extracted from the article]

This article, titled "EP12.14: Postpartum sonographic measurement of the inferior vena cava and correlation with hemoglobin levels," discusses a study conducted to evaluate the correlation between the diameter of the Inferior Vena Cava (IVC), the Collapsibility Index (CI), and the drop in hemoglobin levels 24 hours after delivery. The study included 47 women who underwent an elective Caesarean Delivery at term. The results showed that there was no correlation between the IVC diameter or the CI and a drop in hemoglobin levels of ≥2g. Therefore, the study suggests that the IVC diameter and CI measured 2 hours after delivery are not associated with a significant drop in hemoglobin levels. [Extracted from the article]

This article discusses the role of 3D ultrasound and Doppler technologies in visualizing the medullary veins of the central nervous system (CNS) in fetal imaging. The accurate imaging of these veins is important for diagnosing CNS malformations. The article presents images and case studies that demonstrate the use of Doppler technologies sensitive to low-velocity flow in visualizing the medullary veins and identifying disruptions in their anatomy. The authors suggest that these technologies have the potential to aid in the diagnosis of complex cerebral anomalies. [Extracted from the article]

Objective: To evaluate the postnatal outcome of children with a prenatal diagnosis of apparently isolated agenesis of the septum pellucidum (ASP). Methods: A retrospective cohort study of cases of prenatally diagnosed ASP followed in two tertiary centers and a meta‐analysis combining data from the cohort study with data from published studies identified in a systematic review were carried out. Only cases with apparently isolated ASP on antenatal ultrasound and/or magnetic resonance imaging and with available postnatal follow‐up data were considered eligible for inclusion. The following outcomes were analyzed: incidence of chromosomal anomalies, agreement between antenatal and postnatal findings, overall incidence of septo‐optic dysplasia (SOD) and incidence of major neurological disability (motor, language, coordination or behavioral disorder or epilepsy) in non‐SOD children. The incidence of SOD in infants with apparently normal optic pathways on antenatal imaging was also evaluated. Results: Fifteen cases of isolated ASP, with median postnatal follow‐up of 36 months (range, 12–60 months), were selected from the two centers. Six previously published studies met the inclusion criteria for the systematic review and a total of 78 cases were eligible for the analysis, including the 15 cases from our series. Genetic tests were carried out antenatally in 30 fetuses, of which two had an abnormal result (pooled proportion, 9.0% (95% CI, 1.8–20.7%); I2 = 0%). Additional or discordant imaging findings were noted postnatally in 9/70 (pooled proportion, 13.7% (95% CI, 3.5–29.0%); I2 = 63.9%) cases. Of all 78 neonates with available follow‐up, SOD was diagnosed postnatally in 14 (pooled proportion, 19.4% (95% CI, 8.6–33.2%); I2 = 51.2%). In 60 cases, the optic pathways were considered to be normal on antenatal imaging, and six of these (pooled proportion, 9.1% (95% CI, 1.1–24.0%); I2 = 62.0%) were diagnosed postnatally with SOD. Of the 46 infants with available neurological follow‐up who were not affected by SOD, a major neurological disability was diagnosed in three (pooled proportion, 6.5% (95% CI, 0.5–18.6%); I2 = 40.1%). Conclusions: In the vast majority of cases with a prenatal diagnosis of apparently isolated ASP, the prognosis is favorable. However, an additional anomaly is detected after birth in about 14% of cases and has a negative impact on clinical outcome. Detailed antenatal assessment of the brain and optic pathways is strongly recommended in order to identify the presence of associated anomalies. Antenatal visualization of apparently normal optic pathways does not rule out SOD. © 2021 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]