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Background: Although the association between first-trimester increased nuchal translucency (NT) and chromosomal defects is well-defined, there is little knowledge about the importance of increased NT in fetuses with normal karyotypes. Hence, this study was designed to evaluate outcomes of normal karyotype fetuses with increased NT. Methods: This observational retrospective study was conducted on 720 pregnancies with increased NT (>3mm) at 11 to 13 weeks of gestational age in Yas Hospital, Tehran, Iran, from 2016 to 2020. Study outcomes were incidence of preeclampsia, intrauterine growth restriction) IUGR (, preterm labor, fetal anomaly, cardiac malformations, hydrops fetalis, abortion, and intrauterine fetal death (IUFD) in pregnancies without evident chromosomal karyotype abnormalities. Results: Out of 720 participants who underwent karyotyping in the study center, 523 fetuses had normal karyotype results. In the pregnancies assessed for outcome, 357 (68.3%) reached live birth, 104 (19.9%) aborted, and 62 (11.9%) resulted in IUFD. Study outcomes including preeclampsia (<0.001), IUGR (<0.001), preterm labor (<0.001), fetal anomaly (<0.001), cardiac malformations (<0.001), hydrops fetalis (0.017), abortion (<0.001), and IUFD (<0.001) resulted in a statistically significant difference in the distribution of cases across NT intervals. Conclusion: This study demonstrated adverse pregnancy outcomes increased with increasing NT despite normal karyotyping. Hence, tight observation of mothers and fetuses should be done in normal karyotype fetuses with increased NT. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted for determining pregnancy outcome after selective fetal reduction in twin pregnancies based on the gestational age at the time of the procedure in a referral academic center between 2017 and 2021. Materials and methods: This retrospective cohort study included all women with twin pregnancies who were diagnosed with a genetic or structural anomaly of one fetus or a desire to reduce the number of fetuses in order to reduce pregnancy complications visited in the period of 2017-2021. Reduction was performed due to an abdominal approach at 11 to 23 weeks of pregnancy. Maternal and pregnancy information were recorded. Results: A total of 159 cases of twin dichorionic pregnancies were included. The highest frequency of reduction was performed at the gestational age of 18-20 weeks, and the most common cause of reduction was major structural anomalies in the fetus. The results showed the average gestational age (GA) at the time of delivery to be 37.6 weeks, the average birth weight of 2,999 grams, the incidence of miscarriage (loss before 22 weeks) to be 9.4% and a rate of preterm birth (delivery before 37weeks) of 33.3%. There is not a statistically significant relationship between the gestational age at the time of reduction and preterm birth, the birth weight, the incidence of RDS and the incidence of SGA. Conclusion: Fetal reduction of twins to singleton pregnancy is associated with lower risk of preterm birth (delivery before37 weeks reduction of twins to singleton pregnancy is associated with lower risk of preterm birth (delivery before37 weeks). It causes an increase in birth weight and perinatal outcome in remaining co-twin so we recommend fetal reduction after counselling with patients for their unique situation to improve pregnancy outcome. [ABSTRACT FROM AUTHOR]

Background: Despite technological advancements in perinatal imaging, autopsy examination is still regarded as the reference standard to determine the time and reason of the fetal death. Purpose: This study was conducted to identify the intrauterine postmortem magnetic resonance imaging (PMMR) findings of fetuses, who underwent radiofrequency ablation (RFA). Study Type: Prospective. Population: Fifty‐three twin/triplet complicated pregnancies scheduled for selective reduction of one of the fetuses by RFA were included. Field Strength/Sequence: The imaging methods used are T1‐weighted gradient‐echo imaging (T1 GRE), T2 half‐Fourier acquisition single‐shot turbo spin‐echo (SSTSE), and diffusion‐weighted imaging (DWI) sequences. Assessment: The MRIs were interpreted by three radiologists. Statistical Tests: Data were analyzed using the software package SPSS Statistics Version 22.0. The used tests included one‐way analysis of variance (ANOVA) and Duncan tests (significance level: P value <0.05). This analysis was performed with scikit‐learn library (version 1.1.1) in Python version 3.9. Results: Average PMMR scores of orbit, brain, and abdomen showed significant differences among different PM interval subgroups. The brain apparent diffusion coefficient (ADC) numbers of reduced and living fetuses were significantly different at any PM interval. To determine which findings are closely associated with the timing of fetal death, five different methods of feature selection were employed. The top eight selected features achieved the highest area under the curve (AUC) of 78.19%. Data Conclusion: In utero, PMMR findings may be associated with the time of fetal death. Among different fetal organs evaluated, particularly PMMR top eight features specifically scores of orbits were associated with PM intrauterine time after death. Level of Evidence: 2 Technical Efficacy: Stage 2 [ABSTRACT FROM AUTHOR]

Purpose To compare lung volume, lung apparent diffusion coefficient (ADC) and signal intensity ratio (SIR) on different magnetic resonance imaging (MRI) sequences between intrauterine growth restriction (IUGR) fetuses and the control group. Materials and methods 49 IUGR and 58 non-IUGR fetuses were imaged using 3 Tesla MRI units. Total lung volume (TLV), lung/liver SIR (LLSIR) and lung/muscle SIR (LMSIR) in T1 and T2-weighted sequences and lung/liver ADC ratio (LLADCR) and lung/muscle ADC ratio (LMADCR) were assessed. Results LLSIR and LMSIR were significantly higher in the T1-weighted sequence (p-value: .03) and LLADCR and LMADCR were significantly lower on diffusion-weighted imaging (DWI) in IUGR fetuses compared to the control group (p-value: .01). There was no significant difference in SIRs in the T2-weighted sequence between the two groups. Although TLV was increased with gestational age in both groups, it was significantly lower in the IUGR group (mean: 82 ± 22.7 ml vs. 110.8 ± 18 ml, p-value: <.001). Conclusion The T1-weighted sequence and DWI seem to be better than the T2-weighted sequence for assessing the faint difference of lung maturity between groups. However, SIR differences were not as meaningful as TLV differences and this could be related to the complex maturation process in IUGR fetuses as the effect of higher endogenous corticosteroids. [ABSTRACT FROM AUTHOR]

Purpose: To compare lung volume, lung apparent diffusion coefficient (ADC) and signal intensity ratio (SIR) on different magnetic resonance imaging (MRI) sequences between intrauterine growth restriction (IUGR) fetuses and the control group.Materials and Methods: 49 IUGR and 58 non-IUGR fetuses were imaged using 3 Tesla MRI units. Total lung volume (TLV), lung/liver SIR (LLSIR) and lung/muscle SIR (LMSIR) in T1 and T2-weighted sequences and lung/liver ADC ratio (LLADCR) and lung/muscle ADC ratio (LMADCR) were assessed.Results: LLSIR and LMSIR were significantly higher in the T1-weighted sequence (p-value: .03) and LLADCR and LMADCR were significantly lower on diffusion-weighted imaging (DWI) in IUGR fetuses compared to the control group (p-value: .01). There was no significant difference in SIRs in the T2-weighted sequence between the two groups. Although TLV was increased with gestational age in both groups, it was significantly lower in the IUGR group (mean: 82 ± 22.7 ml vs. 110.8 ± 18 ml, p-value: <.001).Conclusion: The T1-weighted sequence and DWI seem to be better than the T2-weighted sequence for assessing the faint difference of lung maturity between groups. However, SIR differences were not as meaningful as TLV differences and this could be related to the complex maturation process in IUGR fetuses as the effect of higher endogenous corticosteroids. [ABSTRACT FROM AUTHOR]

Background: Rhesus D-antibodies and maternal red blood cell alloimmunizations are the major causes of fetal anemia, which can cause hydrops and perinatal death if not treated through intrauterine intravascular blood transfusion (IUT). This paper sought to report the short-term neonatal outcomes after IUT in a referral academic center. Methods: The population of this retrospective cohort study comprised all pregnancies that underwent IUT between March 2014 and March 2019. The maternal obstetrics characteristics as well as blood group, antibody screen, and titers were reported. Indeed, the fetal and neonatal outcomes and complications were described either. Results: A total of 141 IUTs were performed in 58 women. Of all, 15 fetuses were hydropic at the first transfusion. The mean±SD (standard deviation) of gestational age and hemoglobin at the first transfusion was 27.06±4.25 weeks and 6.62±2.91 g/dL, respectively. The range of transfusions was 1.8 per woman and the mean±SD amount of blood transfusion in IUT was 84.03±48.79 cc. 7/58 (12%) intrauterine and 6/58 (10%) neonatal death were reported, of which, four cases were hydropic and the others suffered from severe anemia. The mean±SD of gestation age at delivery was 33.6 ± 3.33 weeks. A significant difference was observed between mean fetal hemoglobin levels before and after performing the IUT procedure (p< 0.01). Also, middle cerebral artery (MCA) Doppler assessments showed anemia severity decreased following IUT Conclusion: It seems Intrauterine transfusion is a lifesaving procedure that can boost perinatal survival in fetuses with anemia. [ABSTRACT FROM AUTHOR]