A conditional standard for the customized fetal growth trajectory in twin pregnancy.

Background: The difference in the birth weights between twins and singletons grows with advancing gestation. Although many fetal weight standards based on ultrasonographic measurements have been created for tracking fetal growth in twin pregnancies, their applicability to other groups is limited by the fact that they are population specific.

Objective: This study aimed to generate conditional centiles for growth assessment of twin fetuses and to compare them with other population-based growth standards for singleton and twin fetuses.

Ablative effect of the interstitial laser setting in the human placental model.

Aim: To assess the impact of laser power and time on interstitial ablation generated by neodymium-doped yttrium aluminium garnet (Nd:YAG) and diode laser in the human placental model.

Methods: The experiment was carried out in a simulation model of interstitial laser ablation on ex-vivo placental tissue. One-hundred and forty-four pieces of fresh placentae were interstitially ablated with Nd:YAG or diode laser at various power (15, 20, 25, 30 W)-time (5, 10, 15 s) combinations.

Reference values for fetal Doppler-based cardiocirculatory indices in monochorionic-diamniotic twin pregnancy.

Background: Placental anastomoses in monochorionic diamniotic (MCDA) twin pregnancy have a major impact on fetal circulation. This study was designed to define reference ranges of cardiac and vascular Doppler indices in MCDA twin pregnancies.

Methods: This cross-sectional study included 442 uncomplicated MCDA twin fetuses undergoing Doppler ultrasonography at 18-35 weeks of gestation.

A 10-Year Retrospective Review of Prenatal Applications, Current Challenges and Future Prospects of Three-Dimensional Sonoangiography.

Realistic reconstruction of angioarchitecture within the morphological landmark with three-dimensional sonoangiography (three-dimensional power Doppler; 3D PD) may augment standard prenatal ultrasound and Doppler assessments. This study aimed to (a) present a technical overview, (b) determine additional advantages, (c) identify current challenges, and (d) predict trajectories of 3D PD for prenatal assessments. PubMed and Scopus databases for the last decade were searched.

Morphology, intrafetal vascular pattern, and umbilical artery Doppler indices of acardiac twins.

Background: Twin reversed arterial perfusion (TRAP) sequence consists of acardiac twin (A) paradoxically perfused by pump twin (P) through an umbilical artery (UA). We proposed characterization of acardiac twins with intrafetal vascular pattern (IVP), and assessed its correlation with morphology and UA Doppler indices.

Methods: We prospectively evaluated 21 cases of TRAP sequence.

Additional benefits of three-dimensional ultrasound for prenatal assessment of twins.

Three-dimensional ultrasound (3DUS) may provide additional information for prenatal assessment of twins. It may improve the diagnostic confidence of dating, nuchal translucency (NT) and chorionicity assignment in twin pregnancies. The "virtual 3DUS placentoscopy" can guide selective fetoscopic laser photocoagulation (SFLP) to treat twin-twin transfusion syndrome (TTTS).

Simulation-based fetal shunting training.

Objectives: To develop a simulation model and assess the learning curve of fetal shunting.

Methods: Three staff and three trainees performed fetal shunting on a model using the fetal bladder stent. The model was evaluated according to various sources of validity evidence.

Comparison of Mannequin Training Satisfaction with a Conventional Box Trainer and a Low-Fidelity Fetoscopic Surgical Simulator for Selective Fetoscopic Laser Photocoagulation.

Background: A low-fidelity fetoscopic surgical simulator (FSS) for training of selective fetoscopic laser photocoagulation (SFLP) was developed.

Objective: To evaluate and compare training satisfaction with an FSS and with a conventional box trainer (BT).

Methods: The BT consisted of a cleaned human placenta attached to the inside of a plastic storage box with a watertight lock cover and an ultrasound-transparent rubber skin.

Long-Term Assessment of a Prospective Cohort of Patients Undergoing Laparoscopic Sacrocolpopexy.

Objective: To report long-term outcomes after laparoscopic sacrocolpopexy.

Methods: We conducted a prospective descriptive cohort study on 331 consecutive patients who underwent laparoscopic sacrocolpopexy for symptomatic prolapse (Pelvic Organ Prolapse Quantification [POP-Q] system stage 2 or greater) at one center, with minimum 1.5 years of follow-up by April 30, 2014.

Advanced ultrasound for prenatal interventions.

Ultrasound is an integral part of prenatal interventions. Doppler studies and 3-dimensional ultrasound (3DUS) are frequently used to determine whether fetal surgery is required. The operator's experience remains crucial for reducing procedure-related morbidity.

Time and temperature dependence of radiofrequency ablation in the human placenta.

Objective: The objective of the study is to compare radiofrequency (RF) effects on fresh placentae with varying levels of sustained time (Ts) and degrees of target temperature (°t).

Method: A total of 108 pieces of fresh placentae were coagulated with a 2-cm RF needle at 60 W in an organ bath. The vertical and horizontal diameters (Vd, Hd) of tissue coagulation visualized by ultrasound were measured.

Model Surgical Training: Skills Acquisition in Fetoscopic Laser Photocoagulation of Monochorionic Diamniotic Twin Placenta Using Realistic Simulators.

Fetoscopic laser coagulation of arterio-venous anastomoses (AVA) in a monochorionic placenta is the standard of care for twin-twin transfusion syndrome (TTTS), but is technically challenging and can lead to significant complications. Acquiring and maintaining the necessary surgical skills require consistent practice, a critical caseload, and time. Training on realistic surgical simulators can potentially shorten this steep learning curve and enables several proceduralists to acquire procedure-specific skills simultaneously.

Undiagnosed Uterine Sarcomas Identified During Surgery for Presumed Leiomyoma at a National Tertiary Hospital in Thailand: A 10-Year Review.

Objectives: The aim of this study was to evaluate the rate, clinical characteristics, and survival outcomes of an undiagnosed uterine malignancy in patients who underwent surgical treatment for presumed leiomyomas.

Methods: Medical records of patients who underwent surgical treatment for presumed leiomyomas, from January 2004 to September 2013, were retrospectively reviewed, and the data were followed until September 2016. Demographic data, tumor characteristics, oncologic treatment, and response rate were analyzed by descriptive statistics.

Three-dimensional ultrasound for prenatal assessment of conjoined twins: additional advantages?

Conjoined twins are a rare, but serious, complication of monozygotic twins. Early prenatal diagnosis of conjoined twins is increasingly made with transvaginal ultrasound and color Doppler studies. Most prenatally diagnosed conjoined twins are terminated due to the high perinatal mortality, but advancement in pediatric surgery has allowed for successful postnatal separation in a small number of cases, and some parents may consider this option over termination of pregnancy.

Establishing Prenatal Surgery for Myelomeningocele in Asia: The Singapore Consensus.

Objectives: The Management of Myelomeningocele Study (MOMS Trial) has inspired many fetal therapy centers (FTCs) to offer open fetal surgery for myelomeningocele (MMC). This is an initial effort to create a candidate model that can be applicable to many parts of Asia.

Material And Methods: A limited selection of specialists from 4 established FTCs in Thailand, Hong Kong, India, and Singapore met for a round table discussion.

In vivo evidence by magnetic resonance volumetry of a gestational age dependent response to tracheal occlusion for congenital diaphragmatic hernia.

Objective: We aimed to assess in vivo changes in lung and liver volumes in fetuses with isolated congenital diaphragmatic hernia, either expectantly managed or treated in utero.

Method: This is a secondary analysis of prospectively collected data at two fetal therapy centers. We used archived magnetic resonance images of fetuses taken ≥7 days apart, creating paired observations in 20 expectantly managed cases, 41 with a second magnetic resonance prior to balloon reversal and 64 after balloon removal.

Correlation of observed-to-expected total fetal lung volume with intrathoracic organ herniation on magnetic resonance imaging in fetuses with isolated left-sided congenital diaphragmatic hernia.

Objectives: To assess using fetal magnetic resonance imaging (MRI) the relationship between the position of the stomach as well as the volume of herniation of organs into the thorax, and the observed-to-expected total fetal lung volume (o/e-TFLV), as a measure of pulmonary hypoplasia, in fetuses with isolated left-sided congenital diaphragmatic hernia (LCDH).

Methods: This was a single-center retrospective study using archived MR images from fetuses > 20 weeks' gestation evaluated for isolated LCDH over an 11-year period between July 2002 and September 2013. We retrieved data on the gestational age at MRI, o/e-TFLV and liver position.

Right-sided congenital diaphragmatic hernia in a decade of fetal surgery.

Objective: To report a recent update on fetuses with right-sided congenital diaphragmatic hernia (RCDH) in the era of fetal surgery.

Design: Retrospective review of prospectively collected data.

Setting: Fetal treatment centres in Leuven and Barcelona.

Comparison of matching by body volume or gestational age for calculation of observed to expected total lung volume in fetuses with isolated congenital diaphragmatic hernia.

Objective: To determine the bias induced by matching fetuses according to gestational age (GA) or fetal body volume (FBV) when calculating the observed to expected total fetal lung volume (o/e TFLV) in cases of isolated congenital diaphragmatic hernia (CDH).

Methods: This was a single-center, retrospective study on archived magnetic resonance (MR) images of fetuses with isolated CDH over a 10-year period. We retrieved the TFLV, GA and o/e TFLVGA , and delineated FBV to obtain TFLVFBV in each case.

Awareness of the benefits of folic acid and prevalence of the use of folic acid supplements to prevent neural tube defects among Thai women.

Objective: To determine the level of knowledge about the usefulness of periconceptional folic acid supplementation among pregnant women.

Materials And Methods: An anonymous questionnaire was completed by selected subjects to assess folic acid awareness. The questionnaire was administered to pregnant women who were seeking antenatal care at King Chulalongkorn Memorial Hospital May to December 2005.