Colombian Consensus on the Treatment of Placenta Accreta Spectrum (PAS).

Introduction: Placenta accreta spectrum (PAS) is a condition associated with massive postpartum bleeding and maternal mortality. Management guidelines published in high income countries recommend the participation of interdisciplinary teams in hospitals with sufficient resources for performing complex procedures. However, some of the recommendations contained in those guidelines are difficult to implement in low and medium income countries.

Amniotic band sequence: prenatal diagnosis, phenotype descriptions, and a proposal of a new classification based on morphologic findings.

Objective: The aim of this study is to describe the phenotype of fetuses affected by amniotic band sequence (ABS) that were diagnosed at the Instituto Nacional de Perinatología Isidro Espinosa de los Reyes and to propose a new classification based on morphologic findings.

Material And Methods: Cases with a final diagnosis of amniotic band sequence, diagnosed between January 1993 and July 2010 in the Department of Maternal Fetal Medicine, were reviewed. Demographic, clinical, and periconceptional data were collected, and the defects were described and classified.

Doppler evaluation of the posterior cerebral artery in normally grown and growth restricted fetuses.

Objective: To evaluate Doppler parameters of the two segments of the posterior cerebral artery (PCA) in normally grown and growth restricted (IUGR) fetuses.

Methods: Normal reference values of the pulsatility index (PI), peak systolic velocity, end-diastolic velocity, and time-averaged maximum velocity from the two segments of the PCA (segment one, PCA-S1; segment two, PCA-S2) were constructed in 350 pregnant women from 20 to 40 weeks of gestation. The association of the two PCA segments with the middle cerebral artery (MCA), and with the umbilical artery was evaluated in 50 IUGR fetuses.

Major craniofacial defects: case series and prenatal diagnosis at the Instituto Nacional de Perinatología, Mexico.

Objective: To describe the prenatal diagnosis, characteristics, development, perinatal outcome, and final diagnosis of pregnancies complicated by fetuses with major craniofacial defects, at the Instituto Nacional de Perinatologia, México, 1997-2008.

Material And Methods: A retrospective, descriptive study from January of 1997 to January 2008, analyzed 152 pregnancies complicated by fetuses with major craniofacial defects, diagnosed at the Department of Fetal Medicine of the National Institute of Perinatology. Data were obtained from patients clinical records.

Evaluation of conventional Doppler fetal cardiac function parameters: E/A ratios, outflow tracts, and myocardial performance index.

Structural evaluation of the fetal heart is well established. Functional evaluation using pulsed-wave Doppler may also be performed. E/A ratios express the relationship between the maximal velocities of the E and A waveforms of ventricular filling.

[Laser ablation of the placental vascular anastomoses for the treatment of twin-to-twin transfusion syndrome].

Aim: To report the experience of the intrauterine treatment of monochorionic biamnotic (MC/BA) twin pregnancies complicated with twin-to-twin transfusion syndrome (TTTS) applying laser ablation of the placental vascular anastomoses (LAPVA).

Material And Methods: During 18 months period 35 MC/BA twin pregnancies were treated. TTTS was diagnosed based on the discrepancies in amniotic fluid and bladder size between both twins.

Automatic segmentation of the cerebellum of fetuses on 3D ultrasound images, using a 3D Point Distribution Model.

Analysis of fetal biometric parameters on ultrasound images is widely performed and it is essential to estimate the gestational age, as well as the fetal growth pattern. The use of three dimensional ultrasound (3D US) is preferred over other tomographic modalities such as CT or MRI, due to its inherent safety and availability. However, the image quality of 3D US is not as good as MRI and therefore there is little work on the automatic segmentation of anatomic structures in 3D US of fetal brains.

[Prevalence and complications of monochorionic diamniotic twin pregnancy].

Background: Monochorionic biamniotic (MC/BA) twin pregnancies are at higher risk for twin-to-twin transfusion syndrome (TTTS), selective intrauterine growth restriction (sIUGR) and structural defects.

Material And Method: During an 18 months period all MC/BA twins referred to our unit for clinical surveillance were evaluated. Chorionicity was assessed based on the characteristics of the intertwin amniotic membrane.

Cardiac dysfunction and cell damage across clinical stages of severity in growth-restricted fetuses.

Objective: The purpose of this study was to assess cardiac function and cell damage in intrauterine growth-restricted (IUGR) fetuses across clinical Doppler stages of deterioration.

Study Design: One hundred twenty appropriate-for-gestational-age and 81 IUGR fetuses were classified in stages 1/2/3 according umbilical artery present/absent/reversed end-diastolic blood flow, respectively. Cardiac function was assessed by modified-myocardial performance index, early-to-late diastolic filling ratios, cardiac output, and cord blood B-type natriuretic peptide; myocardial cell damage was assessed by heart fatty acid-binding protein, troponin-I, and high-sensitivity C-reactive protein.

[Doppler ultrasound to detect Rh: a systematic review].

Background: Red cell alloimmunization is an important cause of perinatal morbidlity and mortality. Invasive procedures used to diagnose fetal anemia are associated with serious fetal and maternal complications. The development of noninvasive techniques as Doppler ultrasound can help us in the fetal anemia diagnosis.