Isolated Single Umbilical Artery and Fetal Echocardiography: A 25-Year Experience at a Tertiary Care City Hospital.

Objectives: To review our 25-year experience with a single umbilical artery and fetal echocardiography to estimate the need for this test in cases of an isolated single umbilical artery.

Methods: We conducted a retrospective review of 436 patients with a diagnosis of a single umbilical artery at our institution between 1990 and 2015. Two hundred eighty-eight women had both an anatomic survey and a fetal echocardiogram.

First Trimester Aneuploidy Screening Markers in Women with Pre-Gestational Diabetes Mellitus.

Objective: To investigate whether maternal serum pregnancy associated plasma protein-A (PAPP-A), total β human chorionic gonadotropin (hCG) levels and nuchal translucency (NT) measurements differ in women with pre-gestational diabetes mellitus (PGDM) compared to non-diabetic controls and to assess whether correction factors are needed for diabetic women in calculation of aneuploidy risks.

Study Design: We performed a retrospective study of all women who underwent first trimester aneuploidy screening (11 + 0 to 13 + 6 weeks) from 2005 to 2011. The primary study outcome was the difference in PAPP-A, β-hCG and NT multiples of median between women with PGDM and non-diabetic women.

Efficacy of the genetic sonogram in a stepwise sequential protocol for down syndrome screening.

Objectives: The purpose of this study was to evaluate the efficacy of the genetic sonogram in Down syndrome screening for women who have received the stepwise sequential test.

Methods: This retrospective cohort study included women with singleton pregnancies who underwent stepwise sequential (first-trimester combined and second-trimester serum) screening and then had a genetic sonogram between March 2005 and January 2010. Stepwise sequential Down syndrome risks were multiplied by either a positive or negative likelihood ratio based on the second-trimester sonographic findings to determine the final Down syndrome risk.

Impact of diabetes on aneuploidy screening.

Maternal pregestational diabetes mellitus is a known risk factor for multiple nonchromosomal congenital anomalies, but there is no clear evidence that diabetes increases the risk for aneuploidy. However, diabetes affects maternal serum analyte concentrations that are used for aneuploidy screening and can alter the false-positive rates of the screening tests. Correction factors are used for women with pregestational diabetes for second-trimester serum analytes used in aneuploidy screening.

Fetal hydronephrosis as a predictor of neonatal urologic outcomes.

Objectives: The ability to predict surgically relevant fetal renal hydronephrosis is limited. We sought to determine the most efficacious second- and third-trimester fetal renal pelvis anteroposterior diameter cutoffs to predict the need for postnatal surgery.

Methods: We retrospectively reviewed the medical records of mothers and neonates who had a prenatal sonographic examination in our Perinatal-Pediatric Urology Clinic and received follow-up care.

Distortions of sex ratios at birth in the United States; evidence for prenatal gender selection.

Objective: The normal male to female livebirth sex ratio ranges from 1.03 to 1.07.