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There are no data on usefulness of optic nerve sheath diameter (ONSD) as a marker of patient’s fluid status in preeclampsia. The objective was to examine potential correlation between ONSD and lung ultrasound estimates of extravascular lung water in severe preeclampsia.

Microcephaly ('small head') is usually a consequence of fetal brain maldevelopment resulting in micrencephaly ('small brain'). The development of the fetal brain can be affected by various pathologic events causing [...], * Context.--The 2015 outbreak of Zika virus in Brazil resulted in a 20-times increased prevalence of congenital microcephaly in stillborns and neonates and was instrumental in raising the suspicion of a causal association between Zika virus and microcephaly. Objective.--To provide a comprehensive description of the neuropathologic features of congenital Zika virus infection. Design.--Autopsy evaluation of the brain from a fetus of 32 weeks and 6 days of gestation, with a prenatal diagnosis of microcephaly associated with polymerase chain reaction-confirmed, fetal, Zika virus infection. Results.--Multiple severe pathology findings were present. These included lissencephaly, except for the occipital lobes, where some pachygyria was observed. Also present was reduction and thinning of white matter, ventriculomegaly of the lateral ventricles, and coalescent calcifications in the cortical-subcortical white matter border associated with glioneuronal outbursting into the subarachnoid space above and heterotopias below. There were small, scattered calcifications in the basal ganglia, with fewer in the white matter and germinal matrix, and none in the cerebellum and brainstem. The cerebellum and pontine base were atrophic because of Wallerian degeneration or maldevelopment of descending tracts and pontocerebellar connections. Conclusion.--Our findings are in agreement with neuroimaging of Zika virus-associated fetal and infant micrencephaly brains and, to some extent, with neuroimaging of other intrauterine infections causing microcephaly. (Arch Pathol Lab Med. 2017;141:73-81; doi: 10.5858/arpa.2016-0341-SA)

Objective: To examine the outcomes among discordant dichorionic (DC) twins, where the smaller twin is small for gestational age (SGA) or non-SGA.Materials and methods: We used the national perinatal registry to compare the relationship between selected maternal characteristics (age, parity, body mass index, gestational diabetes, hypertensive disorders, and gestational age at delivery) and neonatal outcomes in discordant >25% DC twins. Chorionicity was established by standard ultrasound criteria and confirmed postpartum. The smaller of the twins was further classified as SGA or non-SGA. The neonatal outcomes included 5-min Apgar score <7, admission to neonatal intensive care unit, early neonatal death and neonatal morbidities.Results: We identified 377 pairs of DC discordant twins >25% born during the 15 years study period, 270 (71.6%) of which included an SGA smaller twin and 107 (28.4%) were non-SGA smaller twin. Maternal characteristics and neonatal morbidities were unrelated to the smaller discordant twin being SGA. A significantly increased incidence of stillbirth was found in the SGA group. Early neonatal deaths were only found in the SGA group.Conclusion: When the smaller twin is SGA, the growth discordant DC twin pair is associated with increased incidence of perinatal deaths. These appear unrelated to maternal characteristics and neonatal morbidity. [ABSTRACT FROM AUTHOR]

Objective:To assess the effect of the combination of gestational diabetes mellitus (GDM) and pre-gravid obesity (‘diabesity’) in singleton gestations. Methods:We compared perinatal outcomes of singleton gestations in mothers with GDM and pre-gravid obesity, with GDM but with normal pre-gravid BMI, and obese mothers without GDM. Results:We compared diabesity mothers (n = 1525, 24.4% of mothers with GDM, 9.9% of all obese women) to mothers with GDM but with normal BMI (n = 4704, 75.6% of mothers with GDM) and to obese mothers without GDM (n = 13,937, 90.1% of all obese mothers). Obesity, with and without GDM, increased the odds of having chronic hypertension whereas preeclampsia appears to be influenced by obesity only, as were the risk of births at <33 weeks’ gestation, of birth weight >4000 g, low 5-min Apgar scores and NICU admissions. Conclusion:Obesity (without diabetes) is more frequently associated with adverse perinatal outcomes than diabesity or GDM in non-obese mothers. A campaign to decrease pre-gravid obesity should have at least the same priority as any campaign to control GDM. [ABSTRACT FROM PUBLISHER]

Objective: To investigate the relationships among different forms of violence before and during pregnancy. Material and methods: An anonymous questionnaire (adapted NorAQ) was given to 1269 women after childbirth. Results: The response rate was 80% (n = 1018). Different forms of violence were experienced by 46.9% of the women; 9.2% reported violence in pregnancy. Suffering from the consequences of violence was reported by 43.8% of the women; sexual (76.6%) and psychological (54.1%) ranked the highest. Past experience of any form of violence increased the risk of violence in pregnancy, violences experienced in adulthood even more than that in childhood [odds ratio (OR) 4.2, 95% confidence interval (CI) 2.7-6.5 vs. OR 1.9, 95% CI 1.2-2.9]. The onset of violence during pregnancy is rare. Violence was most frequently exerted by the intimate partner. Conclusion: Healthcare systems have access to most women of reproductive age, thus they have the unique opportunity to identify and adequately manage violence against women and its consequences. [ABSTRACT FROM AUTHOR]

Introduction: To estimate the procedure-related risks of pregnancy loss following chorionic villus sampling (CVS) and amniocentesis (AC) compared to pregnancies without procedure.

Objective: To evaluate neonatal respiratory morbidity in infants born late-preterm to mothers with or without gestational diabetes mellitus (GDM). Methods: Analysis of a population-based cohort of all live-born singletons, born at 34 0/7 to 36 6/7 weeks to mothers with and without GDM, focusing on transient tachypnea of the newborn (TTN) and respiratory distress syndrome (RDS). Results: The study group comprised 363 (4.7%) singletons born to mothers with GDM and the controls were 7400 born to mothers without GDM. Mothers with GDM were older (31.4 ± 5.1 versus 29.5 ± 5.1 years,p < 0.001) and were more likely to be hypertensive (OR 1.5, 95% CI 1.1–2.1). Neonates of GDM mothers were heavier at birth (2769 ± 539 versus 2636 ± 473 g,p < 0.001). We found a similar incidence of RDS and TTN in both groups. The multiple regression analysis showed cesarean delivery and lower gestational age were independently associated with RDS and TTN. Conclusion: GDM,per se, is not a major contributor to RDS in late pre-term infants. Rather, the combination of prematurity and cesarean birth act independently to increase the risk of respiratory morbidity. [ABSTRACT FROM PUBLISHER]

Objective: To evaluate the possible relationship between maternal height and fetal size. Patients and methods: We used a population-based cohort of apparently healthy mothers of singletons to evaluate quartiles of the maternal height distribution for parity, being overweight or obese, and for gestational age and birth weight parameters. We also generated birth weight by gestational age curves for each quartile. Results: We analyzed data of 198 745 mothers. Mother from the four quartiles had similar parity, pre-gravid BMI, and gestational age at birth. Short mothers had a significantly higher rate of VLBW and LBW and 2501–4000 g infants, for an OR = 1.38 (95% CI: 1.17–1.62), OR = 2.2 (95% CI: 2.05–2.37) and OR = 1.82 (95% CI: 1.73–1.87) between the shortest and tallest mothers, respectively. By contrast, the opposite trend was noticed for birth weights >4000 g, for an OR = 2.77 (95% CI: 2.65–2.89) between the tallest and shortest mothers. A very similar “growth curve” was apparent until 33 weeks, when a slower growth velocity was observed for shorter compared with taller women. Conclusions: Maternal stature does not appear to be associated with gestational age but significantly influences birth weight. Height-related differences between mothers appears to begin after 33 weeks’ gestation. [ABSTRACT FROM PUBLISHER]

Objective: To examine the impact of pre-pregnancy obesity on adverse outcomes in twin compared to singleton pregnancies. Methods: Dichorionic twin gestations with maternal body mass index >30 were matched to three singleton controls. Both obese groups were matched (1:3) with non-obese controls. Rates of preeclampsia, gestational diabetes, cesarean section, and preterm birth were compared. Results: One hunder eighty-nine dichorionic twin pregnancies in obese mothers were matched to 567 twin pregnancies in non-obese mothers, and to 567 singleton pregnancies in obese mothers. The latter were matched to 1701 non-obese mothers with singletons. Preeclampsia was more common in obese mothers with both twins and singletons (odds ratio (OR) 3.95, 95% confidence interval (CI) 2.18-7.16 and OR 6.53, 95% CI 3.75-11.4, respectively) as was gestational diabetes (OR 4.35, 95% CI 2.18-8.69; OR 5.53 95% CI 3.60-8.50). Obese mothers with singletons were more likely to deliver abdominally, but the cesarean rates were obesity independent in twins. Obese mothers were more likely to deliver at < 34 weeks in both twin and singleton groups (OR 1.65, 95% CI 1.10-2.48, and OR 2.41, 95% CI 1.21-4.77, respectively). Conclusion: Obesity-attributable adverse outcomes are lower in twins compared to singletons. Obesity increases the risk of preterm birth regardless of plurality. [ABSTRACT FROM AUTHOR]

Objectives: Increased screen-positive rate was observed in the first-trimester screening for trisomy 21 (T21) among women after assisted conception. The aim of this study was to identify the trends of changes in serum marker levels after different modes of assisted conception., Methods: Retrospectively, we analyzed the levels of free beta human chorionic gonadotrophin (f beta HCG), pregnancy-associated plasma protein-A (PAPP-A) and inhibin A in maternal serum, and fetal nuchal translucency (NT) thickness at 10-14 gestational weeks in 1098 women with singleton pregnancies: 130 after IVF-ET, 54 after ICSI and 914 after spontaneous conception., Results: In women after IVF-ET and ICSI, PAPP-A was decreased (0.94 MoM and 0.82 MoM, respectively) and inhibin A increased (1.11 MoM and 1.48 MoM, respectively) in comparison to the women after spontaneous conception. With increasing number of oocytes retrieved PAPP-A decreased and inhibin A increased. In women pregnant after assisted conception without ovarian stimulation (transfer of frozen-thawed embryo or in spontaneous cycle) the marker levels were not significantly different from those in women after spontaneous conception., Conclusions: The presence of multiple corpora lutea may be responsible for the changes in marker levels. In spite of the differences in marker levels, the screen-positive rate for T21 is not significantly increased in women after assisted conception., (Copyright (c) 2006 John Wiley & Sons, Ltd.)

Objective: To find whether fbetahCG, PAPP-A and inhibin-A levels in maternal serum or fetal nuchal translucency (NT) thickness at the first-trimester screening for trisomy 21 (T21) might detect women at high risk for adverse pregnancy outcomes., Methods: A retrospective analysis of 1136 women with singleton pregnancy between 10 and 14 weeks. Women with pregnancy complications were allotted to five subgroups: small for gestational age (SGA), large for gestational age (LGA), gestational diabetes (GDM), hypertensive disorders, preterm delivery; women with normal pregnancy represented the control group. NT, maternal serum fbetahCG, PAPP-A and inhibin-A were measured. Mann-Whitney test was used for the comparison of fbetahCG, PAPP-A, inhibin-A and NT between a subgroup of a certain pregnancy complication and the control group. Multivariate logistic regression models were built to explore the relationship among different variables and the occurrence of pregnancy complications., Results: PAPP-A values were significantly lower in women who delivered SGA babies (n=51, 0.76 MoM; p=0.002) and significantly higher in women who delivered LGA babies (n=120, 1.12 MoM; p=0.036). In women with GDM (n=27), fbetahCG, PAPP-A and inhibin-A were insignificantly lower than in controls, whereas in women with hypertensive disorders (n=56) no significant differences between the groups were found. In women with a preterm delivery (<34 weeks) (n=17), inhibin-A levels were significantly higher (1.25 MoM; p=0.015)., Conclusion: Low PAPP-A level is associated with the delivery of an SGA baby and high PAPP-A with the delivery of an LGA baby. High inhibin-A is associated with preterm delivery before 34 weeks. Feto-placental products in the first trimester do not prove to be useful as a screening tool for predicting pregnancy complications., (Copyright 2003 John Wiley & Sons, Ltd.)