The April issue contains an Editorial describing a new interactive, web-based atlas of normal and abnormal fetal brain development, a Randomized Controlled Trial on the effect of aspirin on trophoblastic invasion in women with abnormal uterine artery Doppler in early pregnancy and four Original Articles on fetal growth and three on cell-free DNA screening for aneuploidy.
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.
Pocket Brain, an interactive, online ultrasound atlas of the fetal brain
Ultrasound imaging can be taught through various modalities, including direct tuition, supervised acquisition and application of practical skills and observation of educational specimens. Some aspects can be self-taught using multimedia material and ultrasound simulators. A novel interactive web-based ultrasound encyclopaedia of normal and abnormal fetal brain development, known as ‘Pocket Brain’, for both teaching and learning is described in an Editorial by Tutschek and Pilu. The application can be accessed via compatible mobile devices with an internet connection and includes links to ISUOG online lectures and to the ISUOG online encyclopaedia. So far, the index page is available in English, German, Spanish, French and Chinese. There is potential to extend the application to produce a web-based digital library of fetal anatomy and anomalies of all organ systems and include gynecological ultrasound. Volume data from all imaging modalities, including computed tomography and magnetic resonance imaging, could also be implemented in this format.
View the full article and access Pocket Brain at: http://www.pb.fetal.ch/.
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 for full access to UOG.
Impact of aspirin on trophoblastic invasion in women with abnormal uterine artery Doppler at 11–14 weeks
Pre-eclampsia (PE) complicates 2–8% of all pregnancies and is a major cause of maternal morbidity and is often a result of placental ischemia due to defective trophoblastic invasion. Uterine artery (UtA) Doppler is a non-invasive proxy of trophoblastic invasion and placental perfusion, which becomes abnormal at preclinical stages of the disease. The only intervention shown to reduce the risk of PE is low-dose aspirin, however, administration in women with abnormal second-trimester UtA Doppler failed to demonstrate any benefit in reducing PE, suggesting that advanced progression of the disease during the second trimester may have precluded effective prophylaxis. In this randomized controlled trial, Scazzocchio et al. explored whether administration of low-dose aspirin from the first trimester improves trophoblastic invasion in women at high risk for PE.
View the full article.
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 for full access to UOG.
Perinatal and long-term outcome in fetuses with isolated unilateral ventriculomegaly
Ventriculomegaly is a common prenatal ultrasound finding that has been associated with poor outcome. The majority of studies have focused on the perinatal and long-term outcomes in fetuses with bilateral ventriculomegaly. In a new systematic review and meta-analysis, Scala et al. evaluated perinatal and long-term outcomes in fetuses with isolated unilateral ventriculomegaly, diagnosed in the second or third trimesters. Using data from 11 studies, they investigated the incidence of aneuploidy, congenital infection, progression of ventriculomegaly, associated brain and extracerebral abnormalities and neurodevelopmental delay.
View the full article and accompanying Journal Club slides. This month’s Journal Club slides were compiled by Dr Yael Raz.
Screening for fetal aneuploidy
In this issue of UOG are three articles describing experience of screening for fetal aneuploidy: Cirigliano et al. assess the performance of screening for fetal trisomies 21, 18 and 13 by cell-free (cf) DNA analysis of maternal blood using a new method based on paired-end massively parallel shotgun sequencing; Vora et al. estimate the frequency of unexpected first-trimester ultrasound findings that would alter the prenatal genetic testing strategy in pregnant women eligible for cfDNA screening because of advanced maternal age; and Fosler et al. describe their experience of non-invasive prenatal testing for aneuploidy in twin pregnancy.
These articles are only available to subscribers of UOG; remember to login to the ISUOG website to access this article, or become an ISUOG member for full access to UOG.
Assessment of fetal size and growth
One of the main objectives of prenatal care is screening for fetal growth disturbances. Clinicians rely routinely on ultrasound measurements to identify fetuses at risk and it is therefore essential that accurate and reliable reference standards are used. This issue of UOG contains a range of articles on monitoring of fetal size and growth. In a new Open-Access study, Papageorghiou et al. from the INTERGROWTH-21st Project developed a formula to estimate fetal weight based on ultrasound biometry and birth weight and constructed international estimated fetal weight standards for fetuses at 22 to 40 weeks’ gestation. In a flash study by the College Francais d’Echographie Foetale (CFEF), the fetal growth standards of the INTERGROWTH-21st Project were introduced to a large population in France to measure the impact of switching to these reference standards. Poljak et al. determined the diagnostic accuracy of individual fetal and newborn growth charts for the prediction of small-for-gestational age at birth, and Gjessing et al. developed a complete, population-based system that provides a simple summary measure, the ‘percentage birth-weight deviation’, for fetal size monitoring in the second and third trimesters of pregnancy.
The latter three articles are only available to subscribers of UOG; remember to login to the ISUOG website to access this article, or become an ISUOG member for full access to UOG.
Coming up in the next issue of UOG…
• New ISUOG Practice Guidelines for performing fetal MRI.
• A systematic review and meta-analysis of reproductive outcomes following blastocyst vs cleavage-stage embryo transfer in assisted reproduction. Preview the accepted article here.
• A study by Hellmuth et al. evaluating the association between increased nuchal translucency thickness and the risk of neurodevelopmental disorders. Preview the accepted article here. This article has been chosen for Journal Club, so look out for the accompanying downloadable slides next month.
• A range of articles on twin–twin transfusion syndrome, including a systematic review and meta-analysis to assess the role of first- and early second-trimester markers for its early prediction.