International Society of Ultrasound in Obstetrics and Gynecology

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April highlights

The April issue of Ultrasound in Obstetrics & Gynecology contains 12 Original Articles; an Editorial; a Systematic Review; a Randomized Controlled Trial; plus the ISUOG Zika Virus Interim Guidance

Please see below a selection of articles from the April issue of the Journal chosen specially by the UOG team. To view all UOG content become an ISUOG member today.

Zika virus interim guidance
In response to the World Health Organization statement and the international concerns regarding the Zika virus outbreak, ISUOG has published interim guidance for ultrasound in pregnancy that should be taken into consideration by healthcare professionals.
View the interim guidance.

Cesarean delivery, scars and defects
The rate of Cesarean delivery has increased in the last decade and continues to rise and is consequently one of the most common surgical procedures performed worldwide. In this issue of UOG are a number of articles on the topic of Cesarean delivery, in particular the Cesarean scar: in a randomized controlled trial by Bennich et al., chosen as the Journal Club article (JC slides), the impact of adding a second layer to a single unlocked closure of a Cesarean uterine incision was analyzed; Baranov et al. determined the intra- and interobserver reliability of evaluating the appearance and measurement of Cesarean scars using transvaginal ultrasound, with and without saline contrast sonohysterography, in non-pregnant women; Au et al. analyzed whether parameters of a Cesarean scar defect in women with previous Cesarean delivery affected the outcome of termination of pregnancy by oral mifepristone and misoprostol and Jurkovic et al. discuss the efficacy and safety of ultrasound-guided suction curettage for treatment of Cesarean scar ectopic pregnancies.

Fetal heart
Identifying fetal cardiac defects prenatally is vital to improve neonatal outcome, provide optimal management and help develop guidelines for antenatal screening. UOG has published a selection of articles that cover this important area of obstetrics: in a multicenter cohort study and meta-analysis by D’Antonio et al., the outcome of fetal right aortic arch in a large cohort was analyzed in order to guide postnatal management; in a study by Ingul et al., maternal obesity was found to affect fetal myocardial function from as early as in the first trimester; Garcia et al. describe the prospective evaluation of the fetal heart using the novel technique ‘Fetal Intelligent Navigation Echocardiography’.
These articles are only available to subscribers of UOG; remember to login to the ISUOG website to access these articles, or become an ISUOG member to subscribe to UOG.

Ethics and social acceptability of a proposed clinical trial using maternal gene therapy to treat severe early-onset fetal growth restriction
In a recent study by Sheppard et al., a literature review on the ethics and legality of experimental treatments in pregnant women was performed to identify issues which were then used to develop qualitative interviews. Interviews regarding a proposed clinical trial (EVERREST) using maternal gene therapy for treatment of severe early-onset fetal growth restriction (FGR) were carried out in four European countries, including 34 key stakeholders (disability groups, professional bodies and patient support groups) and 24 women/couples who had experienced a pregnancy affected by severe early-onset FGR. The review and interview processes identified two main concerns: ‘is it ethical to give a pregnant woman a potentially risky treatment from which she does not benefit directly?’ and ‘is it ethical to treat a condition of the unborn child, who may then be born with a serious disability when, without treatment, they would have died?’, however the respondents reacted positively to the proposed trial and no fundamental objections were identified.

View the full article here.
View the press release and comment from author, Dr Anna David, here

Prenatal ultrasonographic features of mature cystic teratoma in undescended testicle
Testicular tumors are extremely rare in the fetus and neonate, with an estimated incidence of 0.015 to 0.06 per 1 million neonates. In this Picture of the Month article by Youssef et al., a case of fetal testicular teratoma in an undescended testicle is reported. At 31 weeks’ gestation, a woman was referred following the observation of a fetal single, unilocular anechoic left abdominal cyst with well-defined boundaries, containing a scarcely vascularized small intracystic solid component. After examination of the scrotal sac by two- and three-dimensional ultrasound, only one testicle was identified in the fetal scrotum and an initial diagnosis of fetal testicular teratoma in an undescended testicle was made. Based on this report and the few cases in the medical literature, the authors suggest that the fetal scrotum should be examined routinely in fetuses with intra-abdominal cysts.
View the full article here.
This article is only available to subscribers of UOG; remember to login to the ISUOG website to access this article, or become an ISUOG member to subscribe to UOG.

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