Impact of pregnancy termination law reforms in Ireland on pregnancy termination rates in the setting of fetal congenital heart disease: A trend analysis.

Objective: Prior to 2019, termination of pregnancy (TOP) was unlawful in Ireland. We sought to examine the impact of legislative change on TOP for major congenital heart disease (CHD) and its effect on parental decision-making regarding the options of complex surgery, TOP, or palliative perinatal care.

Methods: This was a trend analysis of second-trimester TOP for major CHD before and after the law reforms relating to pregnancy termination in Ireland.

Feto-maternal indicators of cardiac dysfunction as a justification for the cardiac origins for pre-eclampsia.

While the pathophysiology of pre-eclampsia has been postulated as being secondary to placental dysfunction, a cardiac origin has more recently been proposed. Although an association between fetal congenital cardiovascular disease and pre-eclampsia has been demonstrated, no precise pathophysiologic mechanism for this association has been described. This review highlights the current biophysical (including echocardiography and Doppler indices) and biochemical (including proteomic, metabolomic and genetic/transcriptomic) markers of cardiac dysfunction that have been investigated in maternal and fetal cardiac disease and their overlap with predictors of pre-eclampsia.

The IRELAnD study-investigating the role of early low-dose aspirin in diabetes mellitus: a double-blinded, placebo-controlled, randomized trial.

Background: Although aspirin therapy is being increasingly advocated with the intention of risk modification for a wide range of pregnancy complications, women with prepregnancy diabetes mellitus are commonly excluded from clinical trials.

Objective: The primary aim of this study was to examine the effect of aspirin therapy on a composite measure of adverse perinatal outcome in pregnancies complicated by pregestational diabetes mellitus.

Study Design: A double-blinded, placebo-controlled randomized trial was conducted at 6 university-affiliated perinatology centers.

Critical congenital heart disease: contemporary prenatal screening performance and outcomes in a multi-centre perinatology service.

Background: Prenatal detection of critical congenital heart disease (CCHD) optimises perinatal decision-making and neonatal outcomes. The objective of this study was to determine the prenatal screening performance, care pathways and perinatal outcomes for prenatally and postnatally diagnosed cases of CCHD over a four-year period.

Study Design: This retrospective cohort study in a tertiary centre and its two affiliated secondary sites examined all cases of CCHD, including cases of pregnancy termination and in-utero fetal death, neonatal death and liveborn babies that underwent cardiac catheterization or surgery in the first six weeks of life.