Expanding Access to Fetal Telecardiology During the COVID-19 Pandemic.

This study aims to describe one center's experience in expanding a fetal telecardiology program through collaborative work with maternal fetal medicine (MFM) clinics with the goal of safely reaching mothers during the COVID-19 pandemic. We sought to define the extent of fetal telehealth conversion at a large fetal cardiac care center and evaluate the diagnostic accuracy for studies performed. At our center, fetal telemedicine expanded from one MFM site before the pandemic to four additional sites by May 2020.

Delayed-interval delivery in twin pregnancies.

Objective: To report on pregnancy outcome in six twin pregnancies with delayed-interval delivery in a single maternal-fetal medicine practice.

Study Design: All cases of attempted delayed-interval delivery from January 1988 to August 2000 in a single maternal-fetal medicine practice were retrospectively reviewed. Patients were managed with a treatment protocol that included rescue cerclage after delivery of the first born twin, antibiotics, corticosteroids and tocolysis.

Dorsal penile nerve block vs topical placebo for circumcision in low-birth-weight neonates.

Objective: To investigate the efficacy and safety of dorsal penile nerve block (DPNB) and eutectic mixture of lidocaine (EMLA) for palliation of pain associated with circumcision in low-birth-weight infants.

Design: Randomized, blinded, controlled trial.

Setting: Intensive care nursery (step down unit) at Georgetown University Medical Center, Washington, DC.

Complications of intrauterine placement of a vesicoamniotic shunt.

Background: Fetal obstructive uropathies complicated by severe oligohydramnios can cause neonatal death due to renal dysplasia and pulmonary hypoplasia.

Case: A 31-year-old multigravida was referred at 19.6 weeks with sonographic evidence of fetal megacystis and bilateral hydroureteronephrosis, and severe oligohydramnios.

Prenatal diagnosis of partial trisomy through in situ hybridization on amniocytes with whole chromosome and centromere-specific DNA probes. A case report.

Background: DNA probes specific for whole chromosomes or portions of chromosomes can provide important information to aid the clinician in managing pregnancy and the geneticist in relaying accurate recurrence risk information to the patient.

Case: In this case, sonography was ordered because of a low fundal height in a 29-year-old primigravida at 35 weeks' gestational age; it revealed major fetal anomalies. A small supernumerary marker was seen in some cultured amniocytes.

Prenatal diagnosis of trisomy 12 mosaicism: physical and developmental follow-up.

Follow-up evaluations were performed on a child at the ages of 2 years 8 months and also at 5 years who had been found on prenatal amniocentesis to be mosaic for trisomy 12. Eight of 36 colonies (22 per cent) were trisomy 12 at amniocentesis, with the remaining colonies showing a normal female karyotype. Cord blood, amnion, chorion, placental, and skin fibroblast chromosome studies failed to show any further evidence of a trisomy 12 cell line.

In utero nephrostomy catheter placement.

In utero diagnosis of severe oligohydramnios and fetal ureteral pelvic outlet obstruction resulted in the placement of nephrostomy catheters in two fetuses. The amniotic fluid index improved, mid-chest thoracic circumference increased and renal calyceal dilation decreased in both patients. Both neonates had evidence of pulmonary hypoplasia but survived.

Ultrasound guidance of suprapubic bladder aspiration in neonates.

We performed a prospective, randomized trial comparing ultrasound guidance of suprapubic bladder aspiration with unguided aspiration. The acquisition of urine improved with ultrasound guidance from 60% to 96.4%.

Rapid determination of fetal sex by deoxyribonucleic acid amplification of Y chromosome-specific sequences.

Rapid fetal sex tests use either dot blot hybridization to Y chromosome-specific (male) repeat sequences or polymerase chain reaction deoxyribonucleic acid amplification of these Y-specific sequences. We have performed 35 fetal sex determinations, 16 by dot blot alone, 13 by polymerase chain reaction alone, and 6 by dot blot and polymerase chain reaction on samples of fetal blood, amniotic fluid, and chorionic villi. All results have been confirmed by karyotyping.

Fetal surgery.

Interest in correcting fetal pathology before birth has been stimulated by advancing experimental technology and improvements in the ability of ultrasound to look into the uterus. In this article, diagnosis, management and treatments of three congenital defects, hydronephrosis, ventriculomegaly, and diaphragmatic hernia are discussed. The future of fetal in utero surgery also is considered.