Prenatal diagnosis of fetal skeletal dysplasias in a tertiary Hospital in Spain.

Objective: To assess the diagnostic accuracy of prenatal ultrasound for detecting fetal skeletal dysplasias and to describe its role in orienting genetic studies.

Study Design: Observational study of pregnant women surveyed in our hospital, between 2011 and 2018, with fetal long bones below the 3rd centile (shortened long bones), either as an isolated finding or associated to other skeletal anomalies. We used a systematic protocol for the ultrasound evaluation and selection of those fetuses suspected of having a skeletal dysplasia.

Clinical application of a contingent screening strategy for trisomies with cell-free DNA: a pilot study.

Background: Different strategies have been designed for clinical implementation of cell-free DNA (cfDNA) testing. We aimed to evaluate the performance of a contingent strategy based on conventional screening and offering cfDNA to the intermediate-risk group, for the screening for trisomies 21, 18 and 13. Secondary objectives were to assess the uptake of cfDNA in women with intermediate-risk, to evaluate the performance of cfDNA testing, and the preferences of pregnant women with intermediate risk.

Accuracy of prenatal ultrasound in the diagnosis of corpus callosum anomalies.

The main objective of this study was to evaluate the accuracy of prenatal ultrasound to diagnose corpus callosum alterations, compared to prenatal magnetic resonance imaging (MRI), postnatal image techniques (ultrasound and/or MRI), and post-mortem examination in terminated pregnancies. Retrospective review of 86 cases of prenatal ultrasound diagnosis of corpus callosum anomalies between January 2007 and December 2015 at a third level Maternal Fetal Medicine center. The study reviewed the findings of prenatal ultrasound and MRI, post-mortem examination in cases of termination of pregnancy (TOP) or stillbirths and postnatal ultrasound, and MRI in neonates.

Follow-up of fetuses with congenital diaphragmatic hernia: The quantitative lung index.

Objective: To assess the longitudinal behavior of Quantitative Lung Index (QLI) for the follow-up of fetuses with congenital diaphragmatic hernia.

Study Design: Retrospective study of fetuses with isolated left congenital diaphragmatic hernia. The fetuses were assessed by ultrasound at different gestational ages and QLI was retrospectively calculated by means of previous lung-to-head ratio measurements.

Fetal intracranial hemorrhage. Prenatal diagnosis and postnatal outcomes.

Objective: To present our experience with 14 cases of fetal intracranial hemorrhage (ICH).

Methods: Cases of fetal ICH detected in our institution between 2005 and 2016 by ultrasonography. Maternal characteristics, ultrasound and MRI findings, and postnatal outcome were noted.

Brainstem-vermis and brainstem-tentorium angles: 3D ultrasound study of the intra- and inter-observer agreement.

Objective: The brainstem-vermis angle (BVA) and the brainstem-tentorium angle (BTA) have been proposed to quantify vermian and tentorial alterations associated to fetal posterior fossa malformations. Our objective is to evaluate the intra- and inter-observer agreement for the measurement of these angles during the prenatal ultrasound scan.

Methods: Fifteen 3 D sets from fetuses with posterior fossa pathology were processed by multiplanar navigation.

The quantitative lung index and the prediction of survival in fetuses with congenital diaphragmatic hernia.

Introduction: The lung-to-head ratio (LHR) is routinely used to select the best candidates for prenatal surgery and to follow-up the fetuses with congenital diaphragmatic hernia (CDH). Since this index is gestation-dependent, the quantitative lung index (QLI) was proposed as an alternative parameter that stays constant throughout pregnancy. Our objective was to study the performance of QLI to predict survival in fetuses with CDH.

Single center experience in selective feticide in high-order multiple pregnancy: clinical and ethical issues.

Objective: This paper describes the 20-year experience with selective feticide (SF) of high-order multiple quadruplet and higher pregnancies in a single center.

Methods: The paper describes protocols, procedures, management, outcomes, and ethical issues.

Results: SF was performed in 49 pregnancies with 244 fetuses, with median gestational age of 12+2 weeks.

Influence of gravidity and foetal gender on the value of screening variables in the first trimester of pregnancy.

Objectives: Combined screening for chromosome abnormalities in the first trimester of pregnancy is based on maternal age, nuchal translucency (NT) and biochemical markers (PAPP-A and free β-hCG). We sought to assess the value of the variables used in the combined screening strategy taking into account maternal gravidity and foetal gender.

Study Design: Between July 1999 and December 2009, a total of 21,193 singleton pregnancies were screened for aneuploidy in the first trimester, in the Hospital Clínico San Carlos (Madrid, Spain).

Intracranial translucency at 11-13 weeks of gestation: prospective evaluation and reproducibility of measurements.

Objective: This paper aimed to determine the feasibility of identification and measurement reproducibility of intracranial translucency (IT) in our population.

Methods: This is a prospective study in which five accredited operators attempted to identify and measure the IT during first-trimester sonographic screening for aneuploidy in 990 fetuses. The presence or absence of spina bifida was determined at the time of the second-trimester scan or after birth.

First trimester screening for aneuploidies in successive pregnancies: correlations between markers.

Objectives: Screening for chromosomal abnormalities in the first trimester of pregnancy is based on maternal age, nuchal translucency (NT), and biochemical markers (pregnancy-associated plasma protein-A and free beta human chorionic gonadotrophin). We have assessed the influence of screenings and outcomes in previous pregnancies on screenings in subsequent pregnancies.

Methods: Retrospective study of the correlation between the variables of first trimester combined screening for chromosome abnormalities in patients with subsequent pregnancies.

Antenatally diagnosed renal duplex anomalies: sonographic features and long-term postnatal outcome.

Objectives: The purpose of this study was to assess the diagnostic accuracy and infant outcomes of antenatally detected renal duplex anomalies.

Methods: An observational longitudinal study of cases of renal duplex anomalies diagnosed on prenatal sonography was conducted. Information on the prenatal sonographic findings, antenatal course, and perinatal outcome was obtained by reviewing the sonography reports and delivery records.

First-trimester assessment of the nasal bones using the retronasal triangle view: a 3-dimensional sonographic study.

Objective: The purpose of this study was to evaluate a new sonographic technique for identifying the nasal bones using the retronasal triangle view, ie, the coronal plane at which the palate and frontal processes of the maxilla are simultaneously visualized.

Methods: Three-dimensional (3D) volumes were acquired from women undergoing first-trimester sonographic screening for aneuploidy by 2 accredited operators. Those data sets in which the fetal face was clearly identified were selected for offline analysis by 2 other observers who were unaware of the sonographic or clinical findings.

Selective pelvic arterial embolization in the management of obstetric hemorrhage.

Objective: Retrospective evaluation of pelvic arterial embolization for the treatment of severe post-partum hemorrhage.

Methods: Data were collected, from our departmental clinical records, on all patients with life-threatening post-partum hemorrhage managed with arterial embolization between January 2001 and December 2003.

Results: During the period analyzed, there were 29,119 deliveries in our institution.