Tracheomalacia and tracheomegaly in infants and children with congenital diaphragmatic hernia managed with and without fetoscopic endoluminal tracheal occlusion (FETO): a multicentre, retrospective cohort study.

Background: Temporary fetoscopic endoluminal tracheal occlusion (FETO) promotes lung growth and increases survival in selected fetuses with congenital diaphragmatic hernia (CDH). FETO is performed percutaneously by inserting into the trachea a balloon designed for vascular occlusion. However, reports on the potential postnatal side-effects of the balloon are scarce.

Length of hysterotomy for fetal spina bifida repair is associated with prematurity risk.

Objective: To investigate whether prenatal repair of spina bifida aperta through mini-hysterotomy results in less prematurity, as compared to standard hysterotomy, when adjusting for known prematurity risks.

Methods: We performed a bi-centric, propensity score matched, controlled study, that is, adjusting for factors earlier reported to result in premature delivery or membrane rupture, in consecutive women having prenatal repair either through stapled hysterotomy or sutured mini-hysterotomy (≤3.5 cm).

Percutaneous fetal endoscopic third ventriculostomy for severe isolated cerebral ventriculomegaly.

Objective: To demonstrate the feasibility and preliminary results of percutaneous fetal endoscopic third ventriculostomy (ETV) in human fetuses (pfETV) with isolated progressive and/or severe bilateral cerebral ventriculomegaly (IPSBV).

Methods: The initial results of pfETV for IPSBV were described. Perioperative, perinatal and postnatal variables were described.

Fetal open spinal dysraphism repair through a mini-hysterotomy: Influence of gestational age at surgery on children's ability to walk.

Objective: To analyze the impact of gestational age (GA) at the time of fetal open spinal dysraphism (OSD) repair through a mini-hysterotomy on the ability of children to walk.

Methods: Children who underwent in utero repair of OSD and had formal neurological assessment after 2.5 years of age were compared regarding their ability to walk in relation to pre-surgical predictors.

Fetal open spinal dysraphism repair through a mini-hysterotomy: Influence of gestational age at surgery on the perinatal outcomes and postnatal shunt rates.

Objective: To analyze the impact of gestational age (GA) at the time of fetal open spinal dysraphism (OSD) repair through a mini-hysterotomy on the perinatal outcomes and the infants' ventriculoperitoneal shunt rates.

Methods: Retrospective study of cases of fetal OSD correction performed from 2014 and 2019.

Results: One hundred and ninety women underwent fetal surgery for OSD through a mini-hysterotomy, and 176 (176/190:92.

In Vitro Fertilization and Vasa Previa: A Report of Two Cases.

Vasa previa (VP) is a dangerous obstetric condition associated with perinatal mortality and morbidity. In vitro fertilization (IVF) is a risk factor for VP due to the high incidence of abnormal placentation. The diagnosis should be made prenatally, because fetal mortality can be extremely high.

Type II and III Selective Fetal Growth Restriction: Perinatal Outcomes of Expectant Management and Laser Ablation of Placental Vessels.

Objectives: To describe the perinatal outcomes of type II and III selective fetal growth restriction (sFGR) in monochorionic-diamniotic (MCDA) twin pregnancies treated with expectant management or laser ablation of placental vessels (LAPV).

Methods: Retrospective analysis of cases of sFGR that received expectant management (type II, n=6; type III, n=22) or LAPV (type II, n=30; type III, n=9). The main outcomes were gestational age at delivery and survival rate.

Fetal Myelomeningocele Repair through a Mini-Hysterotomy.

Objective: To present the feasibility of fetal myelomeningocele (MMC) repair through a mini-hysterotomy and to describe the perinatal results from our initial experience.

Methods: A descriptive study of cases of fetal MMC correction via mini-hysterotomy performed between 2014 and 2016.

Results: Forty-five women underwent fetal surgery and 87% (39/45) delivered.

Twin-twin transfusion syndrome: neurodevelopment of infants treated with laser surgery.

Objective: To assess the neurodevelopmental functions of survivors of twin-twin transfusion syndrome (TTTS) treated by fetoscopic laser coagulation (FLC), during the first year of life, comparing them to a control group; and to verify the influence of specific variables on neurodevelopment.

Method: This was a prospective, longitudinal study. The sample comprised 33 monochorionic diamniotic twins who underwent FLC for treatment of TTTS and 22 full-term infants of single-fetus pregnancies.

Twin-twin transfusion syndrome: neurodevelopmental screening test.

Objective: To assess the neurodevelopmental functions (cognition, language and motor function) of survivors of twin-twin transfusion syndrome (TTTS).

Method: Observational cross-sectional study of a total of 67 monochorionic diamniotic twins who underwent fetoscopic laser coagulation (FLC) for treatment of TTTS. The study was conducted at the Center for Investigation in Pediatrics (CIPED), Universidade Estadual de Campinas.

Feasibility and reproducibility of diffusion-weighted magnetic resonance imaging of the fetal brain in twin-twin transfusion syndrome.

Objective: The aim of this study is to test the feasibility and reproducibility of diffusion-weighted magnetic resonance imaging (DW-MRI) evaluations of the fetal brains in cases of twin-twin transfusion syndrome (TTTS).

Method: From May 2011 to June 2012, 24 patients with severe TTTS underwent MRI scans for evaluation of the fetal brains. Datasets were analyzed offline on axial DW images and apparent diffusion coefficient (ADC) maps by two radiologists.

Endoscopic laser dichorionization of the placenta in the treatment of severe twin-twin transfusion syndrome.

Objectives: To describe the results of a technique of laser ablation of placental vessels in the treatment of severe twin-twin transfusion syndrome (TTTS), which is characterized by separation of the fetoplacental vascular territories and dichorionization of the placenta.

Patients And Methods: Descriptive analysis of TTTS cases treated with the endoscopic laser dichorionization of the placenta (ELDP) procedure. The variables evaluated were the occurrence of reversal of the donor-recipient phenotype, persistence of TTTS or twin anemia-polycythemia sequence (TAPS); gestational age at delivery; discharge from the hospital of at least 1 or 2 live neonates, and incidence of neurological alterations among survivors.

Fetal interventions for congenital heart disease in Brazil.

Fetal interventions have been performed for some congenital heart diseases. However, these procedures have not gained wide acceptance due to concerns about their efficacy and safety. The aim of this study was to report on a preliminary experience with fetal cardiac interventions in Brazil.

[Longitudinal reference intervals of maternal-fetal Doppler parameters].

Purpose: To create longitudinal reference intervals for pulsatility index (PI) of the umbilical (UA), middle cerebral (MCA), uterine (UtA) arteries and ductus venosus (DV) in a Brazilian cohort.

Methods: A longitudinal observational study performed from February 2010 to May 2012. Low risk pregnancies were scanned fortnightly from 18 to 40 weeks for the measurements of PI of the UA, MCA, DV and UtA.

[Elaboration and validation of longitudinal reference intervals of fetal weight with a sample of the Brazilian population].

Purposes: To elaborate models for the estimation of fetal weight and longitudinal reference intervals of estimated fetal weight (EFW) using a sample of the Brazilian population.

Methods: Prospective observational study. Two groups of patients were evaluated: Group EFW (estimation of fetal weight): to elaborate (EFW-El) and validate (EFW-Val) a model for the prediction of fetal weight; Group LRI (longitudinal reference intervals): To elaborate (LRI-El) and validate (LRF-Val) conditional (longitudinal) percentiles of EFW.

Complex breast masses: assessment of malignant potential based on cyst diameter.

Objectives: The purpose of this study was to assess whether cyst diameter might contribute to the prediction of malignancy in complex breast masses.

Methods: In this cross-sectional study, we identified 48 breast masses that had sonographic features suggestive of benign breast lesions (oval shape, circumscribed margins, parallel axis, and abrupt limits). However, these masses were classified as Breast Imaging Reporting and Data System (BI-RADS) category 4 because of the presence of at least 1 cyst (complex echogenicity).

[Tracheal occlusion for fetuses with severe isolated left-sided diaphragmatic hernia: a nonrandomized controlled experimental study].

Purpose: To compare postnatal survival to hospital discharge of fetuses with severe isolated left-sided congenital diaphragmatic hernia, who underwent tracheal occlusion, with that of nonrandomized contemporaneous controls.

Methods: Experimental nonrandomized controlled study, performed from April 2007 to September 2011. Fetuses with severe isolated left-sided congenital diaphragmatic hernia with liver herniation into the chest and lung area-to-head circumference ratio <1.

[Obstetric ultrasound between the 11th and 14th weeks: beyond the screening for chromosomal abnormalities].

This is a traditional (narrative) review with the objective of highlighting the contribution of obstetric ultrasonography (US) between the 11th and 14th week of pregnancy, commonly called first trimester anomaly scan. In addition to being used for the screening of chromosomal anomalies, US can be employed during this period to confirm or determine gestational age, evaluate fetal anatomy, diagnose malformations, screen major structural abnormalities and genetic syndromes, define the prognosis of pregnancy, diagnose and characterize multiple pregnancies, and screen preeclampsia and intrauterine growth restriction. The most important studies about this subject published between 1990 and 2010 in the Cochrane and PubMed libraries were included.

Fetoscopic endotracheal occlusion for severe isolated diaphragmatic hernia: initial experience from a single clinic in Brazil.

Objective: To report on the initial experience in a single Brazilian university clinic of the use of fetoscopic endotracheal occlusion (FETO) to treat severe isolated congenital diaphragmatic hernia (CDH).

Methods: The inclusion criteria for FETO for this prospective study were isolated CDH and intrathoracic herniation of the liver, as well as the lung area to head circumference ratio (LHR) <1.0.

[Laser ablation of placental vessels for treatment of severe twin-twin transfusion syndrome--experience from an university center in Brazil].

Purpose: To describe the results of laser ablation of placental vessels for the treatment of severe twin-to-twin transfusion syndrome in an university center in Brazil.

Methods: Retrospective observational study of patients treated at UNICAMP from 2007 to 2009. Laser ablation of placental vessels was performed in cases of severe twin-twin transfusion syndrome (Quintero stages II, III and IV) diagnosed before 26 complete weeks of gestation.

[Maternal complications following endoscopic surgeries in fetal Medicine].

Purpose: To describe the maternal complications due to therapeutic endoscopic procedures in fetal Medicine performed at an university center in Brazil.

Methods: Retrospective observational study including patients treated from April 2007 to May 2010 who underwent laser ablation of placental vessels (LAPV) for severe twin-twin transfusion syndrome (TTTS); fetal tracheal occlusion (FETO) and endoscopic removal of tracheal balloon in cases of severe congenital diaphragmatic hernia (CDH); LAPV with or without bipolar coagulation of the umbilical cord in cases of twin reversed arterial perfusion (TRAP) sequence. The main variables described for each disease/type of surgery were maternal complications and neonatal survival (discharge from nursery).

[Fetal bilateral obstructive uropathies: ultrasound findings during pregnancy and postnatal outcomes].

Purpose: to verify the association between ultrasonographic signs during gestation and post-delivery evolution in fetuses with bilateral obstructive uropathies, followed up in an expectant way.

Methods: fetuses with bilateral obstructive uropathies presenting severe oligoamnios and narrow thorax have been compared with fetuses with bilateral obstructive uropathies without those alterations, concerning the presence or absence of cysts in both kidneys, and the presence or absence of parenchymal hyperechogenicity in both kidneys. Cases of neonatal death were compared with cases of neonatal discharge from the nursery, regarding the same renal echographic aspects mentioned above, the presence of severe oligoamnios and narrow thorax.

Congenital hydrocephalus: gestational and neonatal outcomes.

Purpose: To evaluate gestational and neonatal outcomes in pregnancies complicated by fetal hydrocephalus.

Methods: Retrospective analysis of 287 cases of fetal hydrocephalus followed at the Fetal Medicine Unit of the University of Campinas in the period of 1996 to 2006.

Results: Mean maternal age was 25 years, mean gestational age at diagnosis was 27 weeks.

[Natural history of monochorionic diamniotic twin pregnancies with and without twin-twin transfusion syndrome].

Purpose: to evaluate the evolution of monochorionic-diamniotic twin pregnancies with and without the twin-twin transfusion syndrome (TTTS), followed up in an expectant way.

Methods: retrospective study in which the pregnancies with and without TTTS and with mild (Quintero's stage I) and severe (Quintero's stages II, III, IV and V) disease manifestations were compared according to extreme preterm delivery, neurological impairment and the twins' nursery discharge. The extreme preterm twins who had had TTTS, or not, were compared whether they had or not neurological impairment.