Variations in antenatal management and outcomes in haemolytic disease of the fetus and newborn: an international, retrospective, observational cohort study.

Background: Advances in haemolytic disease of the fetus and newborn have led to numerous treatment options. We report practice variations in the management and outcomes of haemolytic disease of the fetus and newborn in at-risk pregnancies.

Methods: In this international, retrospective, observational cohort study, data from cases with moderate or severe haemolytic disease of the fetus and newborn were retrieved from 31 centres in 22 countries.

Fetal aortic valvuloplasty as the first step in a complex therapeutic strategy.

Background: Fetal aortic valvuloplasty (FAV) is proposed to prevent hypoplastic left heart syndrome due to fetal critical aortic stenosis.

Objective: to report our experience on FAV as the first step in a complex therapeutic strategy.

Method: Series of patients with FAV over an 18-year period.

Perinatal outcomes of two consecutive strategies for the management of fetal growth restriction: a before-after study.

Purpose: We aim to compare the perinatal outcomes of two consecutive management strategies for fetal growth restriction (FGR), with or without the inclusion of additional Doppler parameters.

Methods: A quasi-experimental before/after study was conducted in which we compared a composite perinatal outcome, prematurity rate, and neonatal complications between two management strategies in small fetuses. In the strategy 1 (S1), the management was based on fetal biometry and umbilical artery Doppler.

Congenital heart disease, prenatal diagnosis and management.

Among congenital malformations, heart defects are the most common type of anomaly, and these are associated with a high perinatal, longterm morbidity and mortality. The objective of this update was to review the rate of prenatal detection, screening characteristics throughout the pregnancy, in both the first and second trimesters, indications for advanced echocardiography, and to establish a management algorithm in case of prenatal diagnosis of a congenital heart disease. Potential invasive and non-invasive tests and obstetric follow-up will be discussed here.

Preterm premature rupture of membranes.

Preterm premature rupture of membranes occurs in around 3% of pregnancies, and several aspects related to its management are still controversial. The objective of this update is to provide a detailed review of strategies aimed at reducing morbidity and mortality associated with this maternal condition. We will discuss the available evidence regarding the maternal use of antibiotics, the use of corticosteroids according to gestational age, the use of magnesium sulphate for fetal neuroprotection, the use of tocolytic agents, and the best moment for and route of delivery.

Update on the use of magnesium sulphate for fetal neuroprotection in preterm birth.

The administration of magnesium sulphate to mothers at risk for preterm birth for fetal neuroprotection has demonstrated to reduce the risk of cerebral palsy and gross motor dysfunction by 30-40%. Although there is controversy regarding the regimen of administration of magnesium sulphate, the gestational age limit, the extent of its potential benefit or even if it provides any benefit, current evidence is enough to support the use of magnesium sulphate in women at imminent risk for preterm delivery before 32 weeks of gestation. The objective of this study is to describe available evidence and current recommendations regarding neuroprotection with magnesium sulphate.

Prenatal diagnosis of CHDs: a simple ultrasound prediction model to estimate the probability of the need for neonatal cardiac invasive therapy.

Objectives: To develop a prediction model based on echocardiographic findings to estimate the probability of the need for neonatal cardiac invasive therapy, including cardiac surgery or catheter-based therapy, in foetuses with CHD.

Methods: Retrospective cohort study: a prediction model was developed based on echocardiographic findings on the examination of the four-chamber, the three-vessel, and the three-vessel and tracheal views. We assessed performance using the area under the curve of the receiver operating characteristic.

Association and prediction of amniotic fluid measurements for adverse pregnancy outcome: systematic review and meta-analysis.

Background: Measurements of amniotic fluid volume are used for pregnancy surveillance despite a lack of evidence for their predictive ability.

Objective: To evaluate the association and predictive value of ultrasound measurements of amniotic fluid volume for adverse pregnancy outcome.

Search Strategy: Electronic databases (inception to October 2011), reference lists, hand searching of journals, contact with experts.

[Advances in fetal therapy].

Fetal therapy may be needed in certain clinical settings with the primary indication to improve perinatal or long-term outcomes for the fetus or the newborn. It can be classified in pharmacotherapy or non-invasive, and invasive therapy. The first one involves the administration of drugs to the mother that cross the placenta and get to the fetus, a non-invasive approach.

Use of prenatal chromosomal microarray: prospective cohort study and systematic review and meta-analysis.

Objectives: Chromosomal microarray analysis (CMA) is utilized in prenatal diagnosis to detect chromosomal abnormalities not visible by conventional karyotyping. A prospective cohort of women undergoing fetal CMA and karyotyping following abnormal prenatal ultrasound findings is presented in the context of a systematic review and meta-analysis of the literature describing detection rates by CMA and karyotyping.

Methods: We performed a prospective cohort study of 243 women undergoing CMA alongside karyotyping when a structural abnormality was detected on prenatal ultrasound.

Prenatal diagnosis of isolated right pulmonary agenesis using sonography alone: case study and systematic literature review.

Pulmonary agenesis is a rare congenital anomaly, estimated to complicate around 1 per 15,000 pregnancies, in which there is complete absence or severe hypoplasia of one or both lungs, frequently associated with other abnormalities. A prospective prenatal diagnosis is a challenge, and a substantial proportion of cases are diagnosed by fetal magnetic resonance imaging, postnatal computed tomography, or postmortem. Thus, there are only a few reported cases of prenatal diagnosis in the literature.

Fluorosis, caries and oral hygiene in schoolchildren on the Ombili Foundation in Namibia.

Purpose: The aim of the present study was to analyse caries prevalence and fluorosis as well as oral hygiene habits in schoolchildren in north Namibia.

Materials And Methods: In 2004, 120 pupils (1st to 8th grade, mean age: 12.3 ± 2.

Effect of lactoperoxidase on the antimicrobial effectiveness of the thiocyanate hydrogen peroxide combination in a quantitative suspension test.

Background: The positive antimicrobial effects of increasing concentrations of thiocyanate (SCN-) and H2O2 on the human peroxidase defence system are well known. However, little is known about the quantitative efficacy of the human peroxidase thiocyanate H2O2 system regarding Streptococcus mutans and sanguinis, as well as Candida albicans. The aim of this study was to evaluate the effect of the enzyme lactoperoxidase on the bactericidal and fungicidal effectiveness of a thiocyanate-H2O2 combination above the physiological saliva level.