Congenital and Perinatal Viral Infections: Consequences for the Mother and Fetus.

Viruses are the most common congenital infections in humans and an important cause of foetal malformations, neonatal morbidity, and mortality. The effects of these infections, which are transmitted in utero (transplacentally), during childbirth or in the puerperium depend on the timing of the infections. These vary from miscarriages (usually with infections in very early pregnancy), congenital malformations (when the infections occur during organogenesis) and morbidity (with infections occurring late in pregnancy, during childbirth or after delivery).

Fetal Tele-Echocardiography-An Approach to Improving Diagnosis and Management.

: Antenatal diagnosis of cardiac abnormalities and counselling parents about postnatal care require a multidisciplinary team, which includes a paediatric cardiologist, a neonatologist, and a fetal medicine physician. Some of these kinds of expertise are not available in all centres with fetal medicine expertise. However, with modern technology, this could be provided remotely.

Preterm birth in low-middle income Countries.

Preterm birth (PTB), remains a major cause of significant morbidity and mortality world-wide with about 12-15million preterm births occurring every year. Although the overall trend is decreasing, this is mainly in high-income countries (HIC). The rate remains high in low-and middle-income countries (LMIC) varying on average between 10 and 12% compared to 9% in HIC.

An overview of diabetes mellitus in pregnant women with obesity.

Rates of obesity are increasing world-wide with an estimated 1billion people projected to be obese by 2030 if current trends remain unchanged. Obesity currently considered one of the most significant associated factors of non-communicable diseases poses the greatest threat to health. Diabetes mellitus is an important metabolic disorder closely associated with obesity.

An investigation of endometrial vascularity in normally menstruating women and those in other physiological states using 3D ultrasound imaging.

Objectives: This study aimed to determine the normal vasculature indices of the endometrium and to correlate them with those in various physiological states.

Methods: Women undergoing ultrasound at the Feto-Maternal Center, Qatar in 2020-2021 as part of their gynecologic evaluation were enrolled into the study. They were divided into those with normal menses and no additional pathology, those following spontaneous miscarriage, postpartum and menopausal.

Challenges in timing and mode of delivery in morbidly obese women.

Globally obesity is increasing especially in the reproductive age group. Pregnant women with obesity have higher complication and intervention rates. They are also at increased risk of stillbirth and intrapartum complications.

A Meta-Analysis of the Global Stillbirth Rates during the COVID-19 Pandemic.

COVID-19 has been shown to have variable adverse effects on pregnancy. Reported data on stillbirth rates during the pandemic have, however, been inconsistent-some reporting a rise and others no change. Knowing the precise impact of COVID-19 on stillbirths should help with the planning and delivery of antenatal care.

Bariatric surgery and reproduction-implications for gynecology and obstetrics.

As the rates of obesity continue to rise across the world, there has been an increasing resort to bariatric surgery amongst the options for treatment. Through the reproductive lifespan, between menarche and menopause, women might benefit from this surgical intervention, which may have a bearing on other aspects of their health. The consequences of bariatric surgery have been reported and evaluated from various perspectives in obstetrics and gynecology.

The epidemiology of obesity in reproduction.

Over the last decades, overweight and obesity rates have been rising exponentially and have now reached epidemic proportions. These are significantly higher in women than men, and indeed, data from 2022 show rates varying from the lowest (12%) in the South East Asian Region to the highest (82.8%) in the Western Pacific Region.

Prevention of spontaneous preterm delivery - an update on where we are today.

Spontaneous preterm birth (delivery before 37 completed weeks) is the single most important cause of perinatal morbidity and mortality. The rate is increasing world-wide with a great disparity between low, middle and high income countries. It has been estimated that the cost of neonatal care for preterm babies is more than 4 times that of a term neonate admitted into the neonatal care.

Ultrasound diagnosis of infections in pregnancy.

Pregnancy is a unique period in which several changes occur in the mother, to ensure that the semiallograft fetus is not rejected. Some of these changes decrease the immunity of the mother to infections. As such, some infections in pregnancy which may not ordinarily cause severe symptoms can be more severe in the mother and importantly some of these infections pose a danger to the fetus either directly or indirectly.

Amnioinfusion in severe oligohydramnios with intact membrane: an observational study.

Objective: The objective of this article was to evaluate the outcome of transabdominal amnioinfusion in pregnant patients with oligohydramnios.

Method: This is a prospective observational study involving 80 cases of oligohydramnios treated with transabdominal amnioinfusion guided by ultrasound, in the period between 2011 and 2016. The patients were treated in two centers; however, all the procedures were performed by the same operator.

Fetal lung maturity assessment: A historic perspective and Non - invasive assessment using an automatic quantitative ultrasound analysis (a potentially useful clinical tool).

Immature fetal lung is associated with many adverse outcomes including respiratory distress syndrome and transient tachypnoea of the newborn. Several methods/tools have been used over several decades to assess fetal lung maturity prior to delivery. Some of the methods that have been used to assess fetal lung maturity include amniocentesis for the biochemical markers, lecithin and sphingomyelin, lamellar body counts, gray scale ultrasound scan and magnetic resonance imaging.

Practical approach to the prevention of preeclampsia: from screening to pharmaceutical intervention.

Preeclampsia occurs in 3-8% of the pregnancies and is associated with a high rate of morbi-mortality, both for mothers and the fetus. Screening and prevention of patients at risk are the optimal way to reduce the morbi-mortality of this disease. To set-up a preventive approach to preeclampsia (PE), one has to identify using a screening strategy for the population at risk and propose them an appropriate therapeutic intervention that would bear a favorable benefits/risk ratio.

A review of the reproductive consequences of consanguinity.

Background: Consanguinity is the close union, sexual relationship or marriage between persons who have common biological ancestors usually up to about 2nd cousins. Contrary to general opinion consanguinity is quite common and is practiced worldwide. It is an important topic as while rates of consanguineous unions in certain society have decreased over time, rates have remained stable or increased in other societies with rates as high as 80.

Increased rates of cesarean sections and large families: a potentially dangerous combination.

Rates of cesarean sections have been on the rise over the past three decades all over the world, despite the ideal rate of 10-15% that had been set by the World Health Organization (WHO) in 1985, in Fortaleza, Brazil. This epidemic increase in the rate of cesarean delivery is due to many factors which include, cesarean delivery on request, advanced maternal age at first pregnancy, decrease in number of patients who are willing to try vaginal birth after cesarean delivery, virtual disappearance of vaginal breech delivery, perceived increase in the weight of the fetus and increase in the number of women with chronic medical conditions such as Diabetes Mellitus and congenital heart disease in the reproductive age. There is no doubt that cesarean delivery is a safe procedure and it is getting safer and safer for many reasons.

What is the role of amnioinfusion in modern day obstetrics?

Amniotic fluid (AF) is a dynamic medium that plays a significant role in fetal well-being. It is production and amount varies with gestational age. It plays a vital role in fetal life as it contains antimicrobial factors, growth factors and it help the fetal lung to grow and expand.

Role of ultrasound in the management of diabetes in pregnancy.

The purpose of this review is to discuss the established role of ultrasound (US) in the management of pregnancy complicated by diabetes mellitus (DM), as well as new developments with regard to the use of US in this situation. We choose to explore the role of US in pregnancy complicated by DM in three areas: (1) Role of US in estimation of fetal weight. (2) Role of US in diagnosis of congenital malformation.

Use or overuse of antenatal corticosteroids for suspected preterm birth.

Objectives: To determine the ratio of women who received antenatal steroid for suspected preterm birth (PTB) to those who actually deliver before 34 weeks of gestation at a tertiary care center.

Methods: This is a retrospective study. Data was collected from November 2008 to February 2009 on women who presented with suspected PTB had received corticosteroids (between 26 weeks and 33 weeks-6 days of gestation).

The new 3D/4D based spatio-temporal imaging correlation (STIC) in fetal echocardiography: a promising tool for the future.

Congenital heart disease is the commonest congenital anomaly. It is much more common than chromosomal malformations and spinal defects. Its estimated incidence is about 4-13 per 1000 live births.

Non-immune hydrops: Qatar experience.

Objective: To describe the presenting signs, diagnostic findings, and outcomes of 64 cases of non-immune hydrops fetalis (NIHF) cases seen in Women's Hospital, Qatar during the years 2003-2011.

Method: A retrospective chart review of patients with signs suggesting of NIHF was done. A detailed scan was performed and karyotyping and detailed investigations were offered.

Intrauterine growth restriction and cerebral palsy.

Intrauterine growth restriction (IUGR) can be described as condition in which fetus fails to reach his potential growth. It is common diagnosis in obstetrics, and carries an increased risk of perinatal mortality and morbidity. Moreover, IUGR has lifelong implications on health, especially on neurological outcome.