Impact of Postnatal Head Circumference Growth in Normocephalic Infants Prenatally exposed to Zika Virus in Puerto Rico.

Objective: We aimed to describe the head circumference (HC) growth trends for non-microcephalic infants exposed to the Zika virus (ZIKV) in utero.

Methods: This was a medical record review of non-microcephalic neonates exposed to ZIKV whose mothers received prenatal care at the fetal evaluation unit (2015-2017). The mean HC values of babies from prenatal age to 1 year old were compared with the standardized values on HC growth charts.

Prenatal Diagnosis of Vasa Previa by Routine Transvaginal Color Doppler.

The prenatal diagnosis of vasa previa is essential to achieving a safe delivery in patients who suffer from the condition. Transvaginal ultrasound with color Doppler performed at the time of a routine mid-trimester ultrasound is a valuable tool in terms of achieving a timely and accurate diagnosis of vasa previa.

Congenital dacryocystocele: sonographic evaluation of 11 cases.

Purpose: To report prenatal sonographic findings of congenital dacryocystocele.

Methods: The medical records of all cases diagnosed with congenital dacryocystocele at a tertiary care center from 2003 to 2015 were reviewed retrospectively.

Results: Eleven cases of congenital dacryocystocele were analyzed.

Zika Virus Infection in Pregnancy: Maternal, Fetal, and Neonatal Considerations.

An infection with the Zika virus (ZIKV) is usually mild, with nonspecific symptoms and most often asymptomatic. However, because of its causal relationship with severe congenital malformations, the ZIKV epidemic became an imperative for mobilization, renewed strategies for vector control, and biomedical research. A congenital Zika syndrome (CZS) has been characterized with 5 distinctive features that focus on brain development abnormalities (including microcephaly and brain calcifications), retinal manifestations, and defects on extremities including congenital contractures and hypertonia.

Rapid Resolution of Polyhydramnios Foretells Circulatory Collapse for the Donor Twin in Feto-Fetal Transfusion Syndrome.

Feto-fetal transfusion syndrome is a pathological process unique to diamniotic monochorionic pregnancies. It is the consequence of an unbalanced fetal blood flow through communicating vessels within a shared placenta. When it occurs, a polyuric, hypervolemic recipient twin co-exists with a hypovolemic oliguric donor.

Prevalence of recurrent pathogenic microdeletions and microduplications in over 9500 pregnancies.

Objectives: The implementation of chromosomal microarray analysis (CMA) in prenatal testing for all patients has not achieved a consensus. Technical alternatives such as Prenatal BACs-on-Beads(TM) (PNBoBs(TM) ) have thus been applied. The aim of this study was to provide the frequencies of the submicroscopic defects detectable by PNBoBs(TM) under different prenatal indications.

Cerebral palsy, epilepsy, and severe intellectual disability in a patient with 3q29 microduplication syndrome.

Interstitial microduplication of 3q29 has been recently described. Individuals with this syndrome have widely variable phenotypes. We describe the first clinical case with a 1.

Chorioangioma: an uncommon cause of hydramnios and consequent preterm labor in second trimester of pregnancy.

Placental chorioangiomas are relatively common benign placental tumors occurring with an incidence of approximately 1% of histologically studied placentas. However, they show clinical manifestations in very rare pregnancies usually at a median gestational age of 28 weeks. Our report presents an interesting and rare case of severe hydramnios with consequent preterm labor and delivery in the second trimester leading to neonatal death due to placental chorioangioma.

Prenatal diagnosis of a vein of Galen aneurysmal malformation using color Doppler ultrasound: a case report.

Vein of Galen aneurysms are a rare and complex vascular malformation of the brain. Their prevalence is somewhat less than 1 in 25,000 deliveries. Common associated anomalies include ventriculomegaly, cardiomegaly secondary to high cardiac output and enlarged neck vessels, the later being an almost pathognomonic sign.

Effectiveness and safety of lidocaine in the induction of fetal cardiac asystole for second trimester pregnany termination.

Unlabelled: The presence of a major congenital anomaly is a frequent indication for late termination of pregnancy. The possibility of the fetus being born alive is significant, thus, feticide prior to the procedure is desirable. The purpose of this study was to assess the safety and efficacy of lidocaine 1% as a feticidal agent prior to second trimester termination of pregnancy.

Pregnancy after liver transplantation.

Unlabelled: Several reports on liver transplantation and pregnancy have been published recently. Uncertainty remains regarding appropriate management of these patients.

Methods: The study included pregnant women of all ages with liver transplant referred to our center.

Antenatal screening for Down syndrome with special considerations in the Puerto Rican population.

Down syndrome is the most studied chromosomal abnormality, and the risk of having a child with Down syndrome increases as maternal age increases. The prevalence of Down syndrome has been increasing in the last decade because more women older than 35 years of age are having children. In recent decades, the rate of identification of fetal anomalies in the uterus has substantially increased.

Seasonal variations in the incidence of some congenital anomalies in Puerto Rico based on the timing of conception.

Background: Birth defects represent one of the main causes of infant mortality and morbidity around the world.

Objective: The purpose of this study is to identify seasonal changes in the incidence of various congenital anomalies in our population.

Methods: We identified all cases of open neural tube defects, cardiac anomalies, cleft lip and palate and gastroschisis of children born in Puerto Rico and reported to the Health's Department Birth Registry Program between January 1995 and December 2005.

Fetal ultrasound biometry: normative charts for a Puerto Rican population.

Purpose: To evaluate fetal growth parameters throughout gestation in Puerto Rican women and compare them to other mixed U.S. populations.

Seasonal variation in the incidence of cleft lip and palate based on the age of conception.

Background: The purpose of this study is to identify seasonal changes in the incidence of Cleft lip and Palate (CL/P) in our population.

Methods: All cases of isolated CL/P born in Puerto Rico from January 1998 through December 2002 were identified through the Puerto Rican birth defect registry. Conception dates were estimated based on the reported last menstrual period.

Prenatal diagnosis of renal disease.

Introduction: The purpose of this study is to report the range of renal congenital anomalies identified by ultrasonography and to analyze the indications for the ultrasound study that lead to their diagnosis.

Materials And Methods: All cases of renal malformations diagnosed at our institution from June 2001 through May 2004 were evaluated retrospectively. The indications for sonographic evaluation were reviewed.

Mitochondrial DNA error prophylaxis: assessing the causes of errors in the GEP'02-03 proficiency testing trial.

We report the results of the Spanish and Portuguese working group (GEP) of the International Society for Forensic Genetics (ISFG) Collaborative Exercise 2002-2003 on mitochondrial DNA (mtDNA) analysis. Six different samples were submitted to the participating laboratories: four blood stains (M1-M2-M3-M4), one mixture blood sample (M5), and two hair shaft fragments (M6). Most of the labs reported consensus results for the blood stains, slightly improving the results of previous collaborative exercises.

The 2000-2001 GEP-ISFG Collaborative Exercise on mtDNA: assessing the cause of unsuccessful mtDNA PCR amplification of hair shaft samples.

We report the results of Spanish and Portuguese working group (GEP) of International Society of Forensic Genetics (ISFG) Collaborative Exercise 2001-2002 on mitochondrial DNA (mtDNA) analysis. 64 laboratories from Spain, Portugal and several Latin-American countries participated in this quality control exercise. Five samples were sent to the participating laboratories, four blood stains (M1-M4) and a sample (M5) consisting of two hair shaft fragments.

Incidence of fetal echogenic intracardiac foci in a Hispanic population.

Echogenic intracardiac foci (EIF) are small areas of increased echogenicity inside the fetal ventricles. When isolated, they are considered to be a normal finding with prevalence differing among ethnic groups. It has been described as a weak marker for trisomy 21 and other chromosomal anomalies.

Long bone fractures in extreme low birth weight infants at birth: obstetrical considerations.

Background: Cesarean section is a common delivery route for breech fetuses < 1000 gm to prevent trauma. However, abdominal and vaginal delivery maneuvers are similar. Cesarean section avoids the risk of head entrapment but long bone trauma can still occur.

Method of risk assessment affects acceptance rate of amniocentesis.

Risk assessment for aneuploidy is an integral part of modern obstetrics. However, patients might choose or reject an amniocentesis, based, not on the risk, but on the screening method used. We examined records of patients referred for evaluation of aneuploidy risk from January 1999 to December 2000.

How does maternal age affect pregnancy planning in Puerto Rico?

Family planning is essential to most prenatal care programs. It is generally believed that maternal age influences the planning of pregnancy with younger patients having higher incidences of unplanned pregnancies. To test this hypothesis we evaluated 470 consecutive cases of pregnant patients regarding pregnancy planning in their current pregnancy.

Failure of intensive fetal monitoring and ultrasound in reducing the stillbirth rate.

Although highly popularized among obstetricians, there are conflicting results regarding the efficacy of high-resolution ultrasound and other fetal well-being tests on improving neonatal outcome and morbidity. To assess the impact of unrestricted fetal well-being tests and sonographic evaluations on the stillbirth rate, we evaluated a total of 1,810 pregnancies 20 weeks of gestation or more from a single private clinic serving a mixed population of high and low-risk patients. All patients were performed high-resolution sonography during each trimester of pregnancy.

A nationwide program for the use of preconceptional folic acid to prevent the development of open neural tube defects. Who is really using folic acid?

A nationwide program directed at stimulating the preconceptional use of folic acid (FA) for the prevention of open neural tube defects has been in effect in Puerto Rico for the last 4 years. To evaluate its effectiveness, 479 questionnaires were distributed among pregnant patients. The average age was 27 (range 14-21), and 64.