Does the timing of neuraxial analgesia initiation in elective induction of multiparous women prolong the duration of delivery?

Aim: To investigate whether the early initiation of neuraxial analgesia prolongs the duration of electively induced labor in Japanese multiparous women.

Methods: This retrospective study included multiparous term women who underwent elective induction of labor using combined spinal-epidural analgesia at the Showa University Hospital between October 2018 and March 2021. The participants were divided into two groups: early and late.

Evaluation of screening performance of first-trimester competing-risks prediction model for small-for-gestational age in Asian population.

Objective: To examine the external validity of the Fetal Medicine Foundation (FMF) competing-risks model for the prediction of small-for-gestational age (SGA) at 11-14 weeks' gestation in an Asian population.

Methods: This was a secondary analysis of a multicenter prospective cohort study in 10 120 women with a singleton pregnancy undergoing routine assessment at 11-14 weeks' gestation. We applied the FMF competing-risks model for the first-trimester prediction of SGA, combining maternal characteristics and medical history with measurements of mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI) and serum placental growth factor (PlGF) concentration.

Does maternal oxygen administration during non-reassuring fetal status affect the umbilical artery gas measures and neonatal outcomes?

Purpose: To clarify whether maternal oxygen administration during vaginal delivery improves umbilical artery (UA) gas measurements and neonatal outcomes.

Methods: Singleton pregnancies requiring operative vaginal delivery or emergency cesarean section (CS) due to non-reassuring fetal status (NRFS) during vaginal delivery at our hospital from 2018 to 2021 were retrospectively investigated. Intrapartum fetal wellbeing was evaluated based on the 5-tier fetal heart rate (FHR) pattern which is a delivery management method widely used in Japan.

Long-term outcome of cases of fetal pleural effusion: A study at a single perinatal center in Japan.

Purpose: To analyze the long-term prognosis of primary and secondary fetal pleural effusion (FPE).

Methods: We investigated all cases of FPE in a single University hospital (2005-2020). Cases were classified as primary (cases with only pleural effusion) and secondary (cases with other abnormalities such as chromosomal abnormalities or fetal cardiac failure).

The role of first-trimester ultrasound screening for women with positive noninvasive prenatal testing results.

Aim: This study aimed to assess the utility of ultrasound screening for pregnancies with positive noninvasive prenatal testing results for trisomy 21, trisomy 18, and trisomy 13.

Methods: We performed a retrospective analysis of positive noninvasive prenatal testing results and first-trimester ultrasound screening at our department between 2013 and 2019. Invasive genetic testing was performed if the patient had positive noninvasive prenatal testing results.

Ultrasonographic study of umbilical cord twist direction during second trimester.

Objective: To explore/study/evaluate the relationships among umbilical twist direction, the degree of umbilical twist and differences of umbilical arterial diameters (UAD).

Methods: All obstetric patients presenting for prenatal care of singleton fetuses between 18 and 25 weeks gestation to a single provider (MN) from 2015 to 2018 had detailed umbilical cord Doppler measurements. Data including the cord twist direction, degree of twist and number of twists per cord segment length, and the diameters of each UA (UAD) and the umbilical vein (UVD) were extracted from the records.

Perinatal outcomes of cases with umbilical hypocoiled cord: a study at a single perinatal center.

Objectives: To evaluate the perinatal outcomes of hypocoiled cord.

Methods: This retrospective study was carried out in the Department of Obstetrics and Gynecology at Showa University Hospital between 2011 and 2017. Umbilical cord index (UCI) was calculated by dividing the total number of coils by the total length of umbilical cord.

A case of Ewing's sarcoma identified via noninvasive prenatal testing.

Although noninvasive prenatal testing is not intended to identify maternal genomic information, it can provide other information that may lead to the incidental discovery of coexisting conditions including maternal malignancy.

Impact of first trimester determination of abnormal cord insertion on twin-to-twin transfusion syndrome and other adverse outcomes in monochorionic diamniotic twins: A retrospective cohort study.

Objective: To assess the influence of abnormal cord insertion (CI) detected by first trimester ultrasonography on the development of twin-to-twin transfusion syndrome (TTTS) in monochorionic diamniotic (MCDA) twins.

Method: In this retrospective cohort study, consecutive patients with MCDA twins who underwent fetal ultrasound screening in the first trimester between January 2011 and January 2017 were enrolled. The CI sites were evaluated between 11 + 0 and 13 + 6 weeks' gestation.

Prospective evaluation of screening performance of first-trimester prediction models for preterm preeclampsia in an Asian population.

Background: The administration of aspirin <16 weeks gestation to women who are at high risk for preeclampsia has been shown to reduce the rate of preterm preeclampsia by 65%. The traditional approach to identify such women who are at risk is based on risk factors from maternal characteristics, obstetrics, and medical history as recommended by the American College of Obstetricians and Gynecologists and the National Institute for Health and Care Excellence. An alternative approach to screening for preeclampsia has been developed by the Fetal Medicine Foundation.

Differences in perinatal outcomes according to forming period of single umbilical cord in singleton pregnancy.

Objectives: The aim of this study was to establish the frequency and associations of single umbilical artery (SUA) diagnosed until the first vs second or third trimester.

Methods: A retrospective cohort study was conducted on singleton pregnancies at a tertiary perinatal center. All women underwent both the first and second trimester scans in which the number of arteries in the umbilical cord was routinely documented.

Usefulness of color Doppler mode for fetal cardiac ultrasound screening in the second trimester: a study at a single perinatal center.

To evaluate the usefulness of color Doppler in fetal cardiac ultrasound screening in the second trimester. Fetuses who underwent ultrasound screening at 18-20 weeks' gestation at Showa University Hospital between 2011 and 2016 were evaluated. After delivery, neonatal congenital heart abnormalities were reviewed and compared with the antenatal ultrasound findings.

Screening for morbidly adherent placenta in early pregnancy.

Objective: To estimate the diagnostic accuracy of a two-stage strategy for early prediction of morbidly adherent placenta (MAP). In the first stage, at 11-13 weeks' gestation, women with low-lying placenta and history of uterine surgery are classified as being at high risk for MAP and, in the second stage, at 12-16 weeks, these high-risk pregnancies are assessed at a specialist MAP clinic.

Methods: This was a prospective study in women having an ultrasound scan at 11-13 weeks' gestation as a part of routine pregnancy care.

Outcomes in the absence of the ductus venosus diagnosed in the first trimester.

Purpose: To clarify the outcomes of the absence of the ductus venosus (DV) diagnosed in fetuses suspected to have a structural abnormality during a morphological assessment in the first trimester.

Methods: Infants in whom ultrasound fetal morphological assessments were attempted in the first trimester (11 to 13-6 weeks of gestation) and who were subsequently delivered between 2013 and 2015 at Showa University Hospital were enrolled. In cases in which the absence of the DV was diagnosed in the first trimester, the prognosis was assessed.

Prediction of stillbirth from maternal factors, fetal biometry and uterine artery Doppler at 19-24 weeks.

Objectives: To evaluate the performance of screening for all stillbirths and those due to impaired placentation and unexplained or other causes using a combination of maternal factors, fetal biometry and uterine artery pulsatility index (UtA-PI) at 19-24 weeks' gestation and to compare this performance with that of screening by UtA-PI alone.

Methods: This was a prospective screening study of 70 003 singleton pregnancies including 69 735 live births and 268 (0.38%) antepartum stillbirths; 159 (59%) were secondary to impaired placentation and 109 (41%) were due to other or unexplained causes.

Antenatal ultrasound screening using check list before delivery for predicting a non-reassuring fetal status during labor.

Objective: To clarify the effectiveness of ultrasound screening at 36 weeks' gestation for predicting a non-reassuring fetal status during labor (NRFS).

Methods: A prospective cohort study was conducted between 2012 and 2013. Ultrasound evaluations of umbilical cord and placental abnormalities and fetal biometry were performed among pregnant females at 36 weeks' gestation.

Usefulness of antenatal ultrasound fetal morphological assessments in the first and second trimester: a study at a single Japanese university hospital.

Objective: To assess the usefulness of antenatal ultrasound examinations for detecting fetal morphological abnormalities in the first and second trimesters.

Methods: A prospective cohort study was conducted at a single Japanese university hospital in the period from February 2011 to September 2013. Patients in whom ultrasound was attempted at both 11 to 13 + 6 and 18 to 20 + 6 weeks' gestation and who were delivered at our hospital were enrolled.

A case of clonally distinct relapse of Burkitt lymphoma 9 years after complete remission.

We report a case of HIV-negative Burkitt lymphoma (BL) that relapsed 9 years after complete remission. We performed a polymerase chain reaction analysis of three regions of the VDJ junction of the immunoglobulin heavy chain (IGH) gene and compared the clonality of the first and second BL lesions, which were found to be clonally distinct. The patient received the R-Hyper CVAD/R-MA regimen; however, leukoencephalopathy subsequently developed due to the effect of cytarabine, and the regimen was changed to R-IVAM.

Decidual polyps are associated with preterm delivery in cases of attempted uterine cervical polypectomy during the first and second trimester.

Objective: To clarify which types of cervical polyp removed during the first and second trimester are associated with the risk of spontaneous abortion and preterm delivery.

Methods: Pregnant females who underwent attempted polypectomy of cervical polyps during pregnancy and delivered singleton infants between 2005 and 2011 were evaluated. The clinical courses and outcomes of preterm delivery after polypectomy stratified according to the pathologic diagnosis of the polyps were retrospectively reviewed.

Administration of oral and vaginal prebiotic lactoferrin for a woman with a refractory vaginitis recurring preterm delivery: appearance of lactobacillus in vaginal flora followed by term delivery.

Lactoferrin (LF) is one of the prebiotics present in the human body. A 38-year-old multiparous woman with poor obstetrical histories, three consecutive preterm premature rupture of membrane at the 19th, 23rd and 25th week of pregnancy, was referred to our hospital. She was diagnosed as having refractory vaginitis.