Ultrasound Obstet Gynecol [JOURNAL]
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Ultrasound Obstet Gynecol
· 2025 Sep · PMID 40921562
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Castro PT, Lopes J, Fazecas T
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, Ribeiro G, Mufarrej G, Jeelani O, Werner H
Ultrasound Obstet Gynecol
· 2026 Mar · PMID 40921185
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Trimarchi E, Caia C, Borso C
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, Galli L, Palladino S, Zanchi L, Paolini B, Chiappa V
Ultrasound Obstet Gynecol
· 2026 Feb · PMID 40916373
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van Eekhout JCA, Bax CJ, Schuurman LVP
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, Becking EC, van der Ven AJEM, Van Opstal D, Boon EMJ, Macville MVE, Bekker MN, Galjaard RJH, Dutch NIPT Consortium
Ultrasound Obstet Gynecol
· 2025 Dec · PMID 40913805
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OBJECTIVE: To evaluate the performance of non-invasive prenatal testing (NIPT) in vanishing-twin and multiple pregnancies. METHODS: This study was conducted as part of the TRIDENT-2 study, in which NIPT was offered as a...
OBJECTIVE: To evaluate the performance of non-invasive prenatal testing (NIPT) in vanishing-twin and multiple pregnancies. METHODS: This study was conducted as part of the TRIDENT-2 study, in which NIPT was offered as a first-tier screening test to women with a multiple pregnancy or vanishing-twin pregnancy between 1 June 2020 and 31 March 2023 in The Netherlands. Abnormal NIPT results were investigated by follow-up invasive prenatal testing and/or postnatal genetic testing. Chorionicity, amnionicity and type of vanishing twin were determined on first-trimester ultrasound examination. A vanishing twin was classified as Type I in the presence of an additional empty gestational sac or as Type II when an additional non-viable embryo was observed on ultrasound. The performance of NIPT (sensitivity, specificity and positive predictive value (PPV)) was assessed. RESULTS: NIPT was performed in 655 women with a vanishing-twin pregnancy, of which 231 were Type I, 374 were Type II and 50 were of unknown type. Women with a Type-II vanishing-twin pregnancy had a significantly higher likelihood of receiving an abnormal NIPT result compared to those with Type I (12.6% vs 1.7%; P < 0.001). Among the 655 vanishing twins, NIPT was indicative of trisomies 21, 18 and 13 in 17 cases (screen-positive rate (SPR), 2.60%), four cases (SPR, 0.61%) and eight cases (SPR, 1.22%), respectively. NIPT was indicative of additional findings (chromosomal aberrations other than the major trisomies) in 29 cases that underwent genome-wide NIPT (SPR, 6.16%). In 7/17 (41.2%) cases, trisomy 21 was confirmed in the remaining fetus by cytogenetic follow-up. The sensitivity of NIPT for the detection of trisomy 21 in vanishing-twin pregnancies was 100% (95% CI, 59.0-100%), the specificity was 98.5% (95% CI, 97.2-99.3%) and the PPV was 41.2% (95% CI, 18.4-67.1%). None of the cases of trisomy 18 (n = 4), trisomy 13 (n = 8) or with additional findings (n = 29) were confirmed in the remaining fetus. Of the 12 cases in which NIPT was performed after 15 weeks' gestation, there were no discordant-positive results. NIPT was performed in 2992 women with a dichorionic diamniotic twin pregnancy, 1112 women with a monochorionic twin pregnancy and 75 women with a triplet pregnancy. Of the 2992 dichorionic twin pregnancies, 27 NIPT results were indicative of trisomy 21, 18 or 13 (SPR, 0.90%), of which 21 were confirmed in one fetus. In addition, 16 NIPT results were indicative of an additional finding (SPR, 0.75%), of which three were confirmed by invasive prenatal testing. In 3/1112 (0.3%) monochorionic twin pregnancies, NIPT was indicative of trisomy 21, which was confirmed in both fetuses in all cases. In addition, NIPT was indicative of an additional finding in four cases (SPR, 0.49%), of which none were confirmed. Of the 75 triplet pregnancies, NIPT was indicative of trisomy 21 in one case (SPR, 1.33%); trisomy 21 was confirmed in one of the three triplet fetuses. CONCLUSIONS: Women with a Type-II vanishing-twin pregnancy are more likely to receive an abnormal NIPT result compared to those with a Type-I vanishing-twin pregnancy. NIPT appears suitable for detecting trisomy 21 in the remaining fetus of a vanishing-twin pregnancy, however, none of the trisomy 18, trisomy 13 or additional findings could be confirmed on cytogenetic follow-up. There were no discordant-positive results reported when NIPT was conducted after 15 weeks' gestation. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Pomar L, Hcini N, Lambert V
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, Dashraath P, Baud D
Ultrasound Obstet Gynecol
· 2025 Oct · PMID 40911776
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Davis Jones G, Albert B, Cooke W
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, Vatish M
Ultrasound Obstet Gynecol
· 2025 Nov · PMID 40908893
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Ramesh P, Lemon L, Larkin JC
Ultrasound Obstet Gynecol
· 2025 Oct · PMID 40908880
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OBJECTIVE: Fetal growth standards determine which fetuses are diagnosed with fetal growth restriction (FGR) and become candidates for enhanced fetal monitoring. Given the existence of race-based differences in fetal and...
OBJECTIVE: Fetal growth standards determine which fetuses are diagnosed with fetal growth restriction (FGR) and become candidates for enhanced fetal monitoring. Given the existence of race-based differences in fetal and neonatal weights, we sought to determine the impact of race-based customization of fetal growth curves on the antenatal detection of FGR. METHODS: This was a retrospective cohort study of 8731 individuals who identified as either White or Black and delivered a liveborn singleton at Magee-Womens Hospital (MWH), Pittsburgh, PA, USA, between January 2003 and January 2013, with at least one sonographic measurement of estimated fetal weight (EFW) taken at 23-41 weeks' gestation. We compared the rates of antenatal FGR diagnosis when EFW was assessed using three distinct growth standards: (1) a standard used at MWH from 2012 to 2018, customized based on the height, weight, parity and race of the pregnant individual (Cust-Race); (2) the same standard without adjustment for race (Cust-NoRace); and (3) the Hadlock standard. Analyses were stratified by the race of the pregnant individual and classification of the neonate as small-for-gestational age (SGA) based on birth weight < 10 percentile. RESULTS: The study population included 1458 (16.7%) individuals who self-identified as Black and 7273 (83.3%) who self-identified as White. SGA was diagnosed in 663 (7.6%) newborns, and was significantly more common in those born to Black vs White individuals (172/1458 (11.8%) vs 491/7273 (6.8%); P < 0.001). Among SGA newborns, 286 (43.1%) had at least one antenatal ultrasound scan that met the diagnostic criteria for FGR using the Cust-Race standard, compared with 306 (46.2%) using Cust-NoRace and 335 (50.5%) using Hadlock; only the difference in FGR diagnosis rate between Cust-Race and Hadlock was significant (P = 0.007). For newborns of Black individuals who were SGA at birth, the Cust-Race growth standard diagnosed 52 (30.2%) cases of antenatal FGR, compared with 72 (41.9%) for Cust-NoRace and 77 (44.8%) for Hadlock; again, only the difference in FGR diagnosis rate between Cust-Race and Hadlock was significant (P = 0.005). The antenatal detection of FGR among newborns of White individuals who were SGA at birth was similar across standards, with 234 (47.7%) detected by Cust-Race, 234 (47.7%) by Cust-NoRace and 258 (52.5%) by Hadlock. CONCLUSIONS: Customization of growth standards with a race variable did not improve the antenatal detection of FGR compared with the Hadlock standard. The Hadlock standard demonstrated an improved ability to detect FGR among Black patients without a negative effect on White patients. Moving away from race-specific growth standards may help to eliminate inequities in resource allocation and reduce racial disparities in obstetric care. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Daruwalla A, Hezelgrave NL, Webb S
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, Stampalija T, Lees C
Ultrasound Obstet Gynecol
· 2025 Nov · PMID 40908861
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van Gils L, Oudijk MA
Ultrasound Obstet Gynecol
· 2025 Dec · PMID 40908852
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Mustafa HJ, Sheikh J, Berghella V
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, Grobman WA, Shamshirsaz AA, Gordijn SJ, Ganzevoort W, Roman A, Khalil A
Ultrasound Obstet Gynecol
· 2025 Dec · PMID 40908850
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Casati D, Lanna MM, Consonni D
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, Balestriero MA, Adami L, Milanta C, Ratti M, Daniele I, Alfei E, Scelsa B
Ultrasound Obstet Gynecol
· 2025 Dec · PMID 40904043
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OBJECTIVE: Emerging evidence indicates that uncomplicated monochorionic diamniotic (MCDA) twins deviate physiologically from singletons, probably owing to adaptations to their unique intrauterine environment. However, th...
OBJECTIVE: Emerging evidence indicates that uncomplicated monochorionic diamniotic (MCDA) twins deviate physiologically from singletons, probably owing to adaptations to their unique intrauterine environment. However, their long-term neurodevelopmental outcomes remain poorly understood. Early identification of neurodevelopmental risks is critical to optimize neuroplasticity during key developmental periods. The aim of this study was to assess neurodevelopmental outcomes in uncomplicated MCDA twins up to 3 years of age and propose recommendations for future research and follow-up protocols. METHODS: This was an observational cohort study of uncomplicated MCDA twins born between January 2015 and January 2022 at a tertiary care center in Italy, which agreed to follow-up. Inclusion criteria included gestational age at birth ≥ 34 weeks and an uncomplicated pregnancy. Neurodevelopmental assessments were performed at 1, 2 and 3 years of age using Bayley Scales of Infant and Toddler Development third edition and neurological evaluations. The primary outcome was the presence and severity of neurodevelopmental impairment (NDI). Crude and multivariable multinomial logistic regression models were used to evaluate associations between NDI (mild or severe) and perinatal or environmental factors, adjusting for familial clustering. RESULTS: Among 138 MCDA twins (69 pregnancies) included in the study, mean Bayley scores were comparable with those of infants from singleton pregnancies. Forty (29.0%) infants had mild NDI and eight (5.8%) had severe NDI. Sixteen (11.6%) infants were diagnosed with behavioral disorders, including eight with autism spectrum disorder (ASD) and eight with emotional dysregulation. Respiratory distress syndrome was the strongest predictor of mild NDI (odds ratio, 4.60 (95% CI, 1.37-15.1)). Female sex of the twin, higher maternal age and higher sociocultural status were associated with a lower risk of mild NDI. Higher maternal age and sociocultural level were also linked to a lower risk of severe NDI. CONCLUSIONS: Despite generally favorable outcomes, mild neurodevelopmental impairment is common in uncomplicated MCDA twins, with a higher incidence of ASD. Early detection is crucial to mitigate long-term impact. A standardized neurodevelopmental follow-up protocol extending through school age is recommended. © 2025 International Society of Ultrasound in Obstetrics and Gynecology.
Pacora-Portella P, Espinoza J, Bergh E
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, Hughes K, Tsao K, Harting MT, Johnson A
Ultrasound Obstet Gynecol
· 2025 Dec · PMID 40904023
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Giné C, Arévalo S, Maiz N
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, Rodó C, Moreno E, Casas B, Manrique S, Meléndez M, López M, Carreras E
Ultrasound Obstet Gynecol
· 2025 Oct · PMID 40903997
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OBJECTIVE: Fetoscopic repair for open neural tube defects (ONTDs) has gained acceptance among leading groups, although it remains controversial owing to the lack of a standardized neurosurgical technique. In 2018, our gr...
OBJECTIVE: Fetoscopic repair for open neural tube defects (ONTDs) has gained acceptance among leading groups, although it remains controversial owing to the lack of a standardized neurosurgical technique. In 2018, our group described a new fetoscopic two-layer procedure with an exteriorized uterus for ONTD reconstruction. This study aimed to report obstetric, surgical and perinatal outcomes for the first 50 cases since the implementation of this technique and to provide comparative data with open fetal surgery studies. METHODS: This was a single-center, observational, prospective study conducted between February 2017 and September 2024. Patients scheduled for fetoscopic repair of ONTD using the two-layer technique with uterine exteriorization were included, and variables such as maternal characteristics, prenatal diagnosis, surgical technique, obstetric outcome, perinatal outcome and complications were evaluated. We compared these with the outcomes of the Management of Myelomeningocele Study (MOMS) cohort and a post-MOMS cohort. RESULTS: Fetoscopic repair of ONTD was performed successfully in all 50 (100%) cases, with no conversions to hysterotomy repair. Of these, 48 cases resulted in a live birth, one in stillbirth and one pregnancy was terminated. Presurgical ultrasound identified myelomeningocele in 29 (58.0%) and ventriculomegaly in 27 (54.0%) cases. The mean ± SD gestational age at surgery was 25.0 ± 1.1 weeks, and the mean procedure duration was 178 ± 37.6 min. In 42 (84.0%) cases, the repair was performed using a two-layer technique. Complications included preterm prelabor rupture of membranes in 24/49 (49.0%) cases and chorioamniotic membrane separation in 11/49 (22.4%). Among the live births, delivery occurred at a median gestational age of 36.0 (interquartile range (IQR), 33.9-37.2) weeks, with 14/48 (29.2%) delivering at term. Median birth weight was 2510 (IQR, 2178-2816) g, and no cases of neonatal death were reported. Postnatal motor function was equal or better than the presurgery motor level in 26/34 (76.5%) cases. No case of cerebrospinal fluid leakage at the spinal repair site was reported. Comparison with the MOMS and post-MOMS studies showed a higher gestational age at delivery, improved motor outcome and less respiratory distress syndrome than in the post-MOMS cohort. Vaginal delivery occurred in 47.9% of cases in our cohort, in contrast to the MOMS and post-MOMS cohorts, in which all deliveries were by Cesarean section. CONCLUSION: The hybrid two-layer closure of ONTDs is a safe procedure, yielding obstetric and perinatal outcomes comparable with those of open surgery. However, it may not be suitable for all types of defect. Long-term data are required to allow for comprehensive comparisons and to determine whether this technique should be recommended over other current surgical options. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Leite MDFP, Bravo-Valenzuela NJ, Araujo Júnior E
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, Ribeiro G, Arcoverde V, Werner H
Ultrasound Obstet Gynecol
· 2025 Nov · PMID 40903982
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Morales-Roselló J
Ultrasound Obstet Gynecol
· 2025 Nov · PMID 40892361
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Packet B, Richter J
Ultrasound Obstet Gynecol
· 2025 Nov · PMID 40892358
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Chudleigh T, Cohen-Overbeek TE, ISUOG Basic Training Sub‐Committee
Ultrasound Obstet Gynecol
· 2025 Sep · PMID 40880196
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Jansen G, de Rooy A, Janssen E
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, Altintas S, van 't Hof A, Mihl C, Kietselaer B, Spaanderman M, Ghossein-Doha C
Ultrasound Obstet Gynecol
· 2026 Jan · PMID 40886380
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OBJECTIVE: Pre-eclampsia complicates up to 8% of pregnancies and is associated with increased risk of ischemic cardiac and cerebral disease, which may be prevented through management of cardiovascular risk when early dis...
OBJECTIVE: Pre-eclampsia complicates up to 8% of pregnancies and is associated with increased risk of ischemic cardiac and cerebral disease, which may be prevented through management of cardiovascular risk when early disease stages are detected. This meta-analysis aimed to determine the prevalence of clinical and subclinical atherosclerosis in women after pre-eclamptic vs non-pre-eclamptic pregnancy with advancing maternal age. METHODS: A systematic search of the literature was conducted in PubMed, Embase and Web of Science for studies reporting on the prevalence of atherosclerosis in women with a previous pre-eclamptic pregnancy and those with a previous uncomplicated pregnancy. Any systemic atherosclerosis documented using ultrasound or computed tomography was included. Random-effects meta-analysis was used to compute the odds ratio (OR) with 95% CI for the association between pre-eclampsia and the presence of atherosclerosis. Subgroup analysis was conducted according to average maternal age at evaluation. RESULTS: A total of 11 articles were included (13 217 participants). The average maternal age at evaluation ranged from 32 to 60 years. Within this age range, the pooled OR for the presence of atherosclerotic plaque after pre-eclampsia was 1.57 (95% CI, 1.39-1.78). The pooled OR of developing atherosclerotic plaque after a pre-eclamptic vs non-pre-eclamptic pregnancy increased gradually with advancing maternal age. The OR was not significant in the 30-39-year-old group (0.64 (95% CI, 0.10-4.15)), but the odds of finding an atherosclerotic plaque were significantly increased after pre-eclamptic pregnancy in the 40-49-year-old group (OR, 1.59 (95% CI, 1.34-1.89)) and 50-60-year-old group (OR, 2.00 (95% CI, 1.30-3.08)). At any given age, the percentage plaque prevalence in formerly pre-eclamptic women was roughly equal to that seen 10 years later in women with a previous non-pre-eclamptic pregnancy. CONCLUSIONS: Women with a previous pre-eclamptic pregnancy exhibit atherosclerosis more frequently and approximately 10 years earlier compared with women with a previous non-pre-eclamptic pregnancy. Targeted primary prevention is required to reduce morbidity and mortality from premature cardiovascular disease in women after pre-eclampsia. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Chen SC, Tai YY, Kuo CH
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, Chang CH, Chang YH, Lin SY, Lin MW, Yen IW, Lee CN, Li HY
Ultrasound Obstet Gynecol
· 2025 Nov · PMID 40886232
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OBJECTIVE: Amniotic fluid volume, measured in terms of the amniotic fluid index (AFI), is used widely in prenatal care to assess fetal health and development. We investigated whether distinct longitudinal AFI trajectorie...
OBJECTIVE: Amniotic fluid volume, measured in terms of the amniotic fluid index (AFI), is used widely in prenatal care to assess fetal health and development. We investigated whether distinct longitudinal AFI trajectories exist during pregnancy and their association with fetal growth. METHODS: This secondary analysis of a randomized controlled trial included singleton pregnancies without pre-existing or gestational diabetes mellitus that received prenatal care at National Taiwan University Hospital in Taipei and its Hsin-Chu Branch in Hsinchu, Taiwan. Ultrasonography was performed at 22 + 0 to 24 + 6 weeks, 30 + 0 to 32 + 6 weeks, 35 + 0 to 37 + 6 weeks and at admission for delivery to measure fetal biometry and AFI. Neonatal anthropometrics and adiposity were measured at delivery. Group-based trajectory modeling was used to identify distinct AFI trajectory patterns during pregnancy. Regression analysis was used to determine differences in fetal and neonatal parameters between AFI trajectory groups, with adjustment for confounders. RESULTS: Overall, 802 pregnancies were included. Two AFI trajectory patterns were identified: one characterized by gradually decreasing AFI during gestation and the other by gradually increasing AFI. On linear regression analysis, compared with the decreasing AFI trajectory, increasing AFI was associated with higher gestational-age-specific Z-scores for abdominal circumference (P = 0.003) and estimated fetal weight (P = 0.036) at 30 + 0 to 32 + 6 weeks, as well as higher sex- and gestational-age-specific Z-scores for birth weight (P = 0.019), neonatal head circumference (P = 0.011), neonatal chest circumference (P = 0.009) and neonatal skinfold thickness (subscapular, P = 0.004; triceps, P = 0.002), after adjusting for maternal prepregnancy body mass index, history of gestational diabetes mellitus and fasting plasma glucose and triglyceride levels. The adjusted odds ratio of high neonatal adiposity for the increasing vs decreasing AFI trajectory was 2.47 ((95% CI, 1.21-5.11); P = 0.014). CONCLUSION: An increasing AFI trajectory during pregnancy was associated with enhanced intrauterine fetal growth, higher birth weight and greater neonatal adiposity. This highlights the potential of AFI trajectory to serve as an indicator of fetal growth alongside fetal biometry. © 2025 International Society of Ultrasound in Obstetrics and Gynecology.
Youssef L, Crispi F, Figueras F
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, Gratacos E
Ultrasound Obstet Gynecol
· 2025 Dec · PMID 40878387
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