Background: Vasa praevia (VP) is defined as the presence of unsupported fetal blood vessels in close proximity of the internal os of the cervix. There is robust evidence from observational cohort studies and meta-analysis that prenatal diagnosis of VP is associated with excellent perinatal outcomes. We have previously proposed a two-stage strategy for prenatal diagnosis that can be implemented in routine clinical practice leading to effective prenatal diagnosis and prevention of fetal and neonatal mortality and morbidity.
Objectives: To demonstrate the feasibility and effectiveness of a two-stage screening strategy for prenatal diagnosis of VP in routine clinical practice and to estimate the potential impact on prevention of stillbirths and perinatal deaths.
Study Design: This was an observational retrospective cohort study carried out at the Medway Fetal and Maternal Medicine Centre between January 2010 and June 2022. We examined the feasibility and effectiveness of this policy in terms of identification of a high-risk cohort and prenatal diagnosis of VP through routine 11-13 and 20-22 weeks' ultrasound assessments based on the two-stage protocol. We also examined the impact on maternal, neonatal and perinatal outcomes in pregnancies with a confirmed diagnosis of VP. Absolute risks (95 %) were calculated based on rates of events in the two groups. Logistic regression analysis was used to estimate independent contribution from maternal and pregnancy characteristics in prediction of VP.
Results: The study population of 53,648 singleton pregnancies included 45 pregnancies with VP (0.83 per 1,000 pregnancies or an incidence of 1 in 1,192 pregnancies). VP was suspected in 56 cases and were resolved in 11 cases (19.6 %), thus leaving 45 pregnancies with a confirmed diagnosis of VP. The main findings that predicted VP included a low-lying placenta at 20-22 weeks', placenta praevia, bilobed placenta and a velamentous cord insertion. In our study population, pregnancies with a prenatal diagnosis of VP had a livebirth rate of 100 % and an intact perinatal survival rate of 97.8 %.
Conclusion: Our study demonstrates that effective prenatal diagnosis of pregnancies with VP can be achieved in routine clinical practice with good perinatal outcomes.
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http://dx.doi.org/10.1016/j.ejogrb.2024.12.016 | DOI Listing |
BMC Pregnancy Childbirth
December 2024
Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, 5612 AZ, North Brabant, The Netherlands.
This study aimed to predict preterm birth in nulliparous women using machine learning and easily accessible variables from prenatal visits. Elastic net regularized logistic regression models were developed and evaluated using 5-fold cross-validation on data from 8,830 women in the Nulliparous Pregnancy Outcomes Study: New Mothers-to-Be (nuMoM2b) dataset at three prenatal visits: - , - , and - weeks of gestational age (GA). The models' performance, assessed using Area Under the Curve (AUC), sensitivity, specificity, and accuracy, consistently improved with the incorporation of data from later prenatal visits.
View Article and Find Full Text PDFBMC Pregnancy Childbirth
December 2024
Department of Obstetrics and Gynecology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China.
Background: Placenta accreta spectrum (PAS) is one of the most dangerous pregnancy-related conditions. This study aims to conduct a systematic review of current research on the ultrasound scoring systems used in PAS patients with a comprehensive summarization of researches and comparison of prenatal ultrasound scoring in evaluating postpartum outcomes.
Methods: This systematic review was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Cancer Epidemiol
December 2024
College of Public Health, Zhengzhou University, Zhengzhou, Henan Province 450001, China; Henan Key Laboratory of Tumor Epidemiology and State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, Zhengzhou, Henan Province 450052, China. Electronic address:
Background: High fasting plasma glucose (HFPG) has been indicated as one of the important risk factors for cancers. This study aimed to estimate the disease burden of cancers attributable to HFPG in China from 1990 to 2021 and predict the burden until 2031.
Methods: The data of cancers attributable to HFPG were extracted from Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 project.
Cell Mol Biol (Noisy-le-grand)
November 2024
Reproductive Health Research Center, Department of Midwifery and Reproductive Health, Al-Zahra Hospital, Guilan University of Medical Sciences, Rasht, Iran.
Considering the relatively high frequency of genetic disorders associated with negative pregnancy outcomes, in this research, adverse pregnancy outcomes in amniocentesis patients were compared between two groups with normal and abnormal maternal serum analytes. This retrospective cohort study was conducted on singleton pregnant women who underwent amniocentesis and had fetuses with normal chromosomes at the perinatology clinic in Rasht. Eligible patients were divided into two groups of 307 people with normal and abnormal maternal serum analytes based on laboratory screening results.
View Article and Find Full Text PDFReprod Health
December 2024
Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
Background: Tanzania, like most low- and middle-income countries, is facing an increasing prevalence of obesity in the general population, including among women of reproductive age. Excess weight pre-pregnancy is a risk factor for the onset of gestational diabetes mellitus (GDM), which is associated with several poor pregnancy outcomes. Screening for GDM, as a primary preventive measure, is not systematically done in Tanzania.
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