Maternal PlGF and umbilical Dopplers predict pregnancy outcomes at diagnosis of early-onset fetal growth restriction.

BACKGROUNDSevere, early-onset fetal growth restriction (FGR) causes significant fetal and neonatal mortality and morbidity. Predicting the outcome of affected pregnancies at the time of diagnosis is difficult, thus preventing accurate patient counseling. We investigated the use of maternal serum protein and ultrasound measurements at diagnosis to predict fetal or neonatal death and 3 secondary outcomes: fetal death or delivery at or before 28+0 weeks, development of abnormal umbilical artery (UmA) Doppler velocimetry, and slow fetal growth.

Perinatal and 2-year neurodevelopmental outcome in late preterm fetal compromise: the TRUFFLE 2 randomised trial protocol.

Introduction: Following the detection of fetal growth restriction, there is no consensus about the criteria that should trigger delivery in the late preterm period. The consequences of inappropriate early or late delivery are potentially important yet practice varies widely around the world, with abnormal findings from fetal heart rate monitoring invariably leading to delivery. Indices derived from fetal cerebral Doppler examination may guide such decisions although there are few studies in this area.

[High prenatal detection rates of complex congenital heart defects (CHD)].

Aim: To analyze prenatal detection rates of complex CHD after the implementation of an expanded three-tiered screening model at the Skane University Hospitals in Lund and Malmö in 2015.  Methods: Retrospective review of pregnancies screened from January 1, 2015 and being born by June 30, 2018. Complex CHD was defined as needing intervention in the first year of life.

Development of standard definitions and grading for Maternal and Fetal Adverse Event Terminology.

Objective: Adverse event (AE) monitoring is central to assessing therapeutic safety. The lack of a comprehensive framework to define and grade maternal and fetal AEs in pregnancy trials severely limits understanding risks in pregnant women. We created AE terminology to improve safety monitoring for developing pregnancy drugs, devices and interventions.

Cerebroplacental ratio as predictor of adverse perinatal outcome in the third trimester.

Introduction: Fetal growth restriction is associated with adverse perinatal outcome and the clinical management of these pregnancies is a challenge. The aim of this study was to investigate the potential of cerebroplacental ratio (CPR) to predict adverse perinatal outcome in high-risk pregnancies in the third trimester. Another aim was to study whether the CPR has better predictive value than its components, middle cerebral artery (MCA) pulsatility index (PI) and umbilical artery (UA) PI.

Underlying maternal and pregnancy-related conditions account for a substantial proportion of neonatal morbidity in late preterm infants.

Aim: We studied the impact of maternal and pregnancy-related conditions and the effect of gestational age itself, on the health of infants born late preterm.

Methods: Singletons born in gestational weeks 34 + 0 to 41 + 6 in 1995-2013 in the southern region of Sweden were identified from a perinatal register. We found 14 030 infants born late preterm and 294 814 born at term.

EVERREST prospective study: a 6-year prospective study to define the clinical and biological characteristics of pregnancies affected by severe early onset fetal growth restriction.

Background: Fetal growth restriction (FGR) is a serious obstetric condition for which there is currently no treatment. The EVERREST Prospective Study has been designed to characterise the natural history of pregnancies affected by severe early onset FGR and establish a well phenotyped bio-bank. The findings will provide up-to-date information for clinicians and patients and inform the design and conduct of the EVERREST Clinical Trial: a phase I/IIa trial to assess the safety and efficacy of maternal vascular endothelial growth factor (VEGF) gene therapy in severe early onset FGR.

Cardiovascular function in children born very preterm after intrauterine growth restriction with severely abnormal umbilical artery blood flow.

Aims: Low birthweight has been linked to increased cardiovascular risk in adulthood. We evaluated the effect on cardiovascular outcome of intrauterine growth restriction (IUGR) with abnormal fetal blood flow in children born very preterm.

Methods: Blood pressure, cardiac function and size, diameters, distensibility, and stiffness of the abdominal aorta, carotid, and popliteal arteries, and endothelial function were assessed non-invasively in 7-year-old children (n = 32) born very preterm with IUGR, with birthweight (median, range) 650 g (395-976 g) and gestational age 27 weeks (24-29 weeks).

Volume blood flow estimation in the normal and growth-restricted fetus.

The objective was to compare volume blood flow (VBF) in the descending aorta (DAo) of gestational age and weight-matched growth restricted (GR) and normal (N) fetuses. A longitudinal study of 20 N was compared with 11 GR in two analyses matched for weight and gestation. DAo dimensions and flow velocity were measured simultaneously using a new technique combining an ultrasonic phase-locked echo-tracking system synchronized with a pulsed Doppler velocimeter.