The November issue of Ultrasound in Obstetrics & Gynecology contains, among other articles, an Editorial on early screening and prevention of preterm pre-eclampsia with aspirin, a Systematic Review on the effect of single- vs double-layer uterine closure on the risk of Cesarean scar defect, an Original Article on the pathophysiology of fetuses with D-loop transposition of the great arteries with intact ventricular septum and a nested case–control study on the performance of third-trimester screening by estimated fetal weight centile vs a combined model for the prediction of late-onset fetal growth restriction and small-for-gestational-age neonates.
Please see below a selection of articles from the November issue of the Journal chosen specially by the UOG team. To view all UOG content, become an ISUOG member today.
Early screening and prevention of preterm pre‐eclampsia with aspirin
Pre-eclampsia (PE) is a serious pregnancy complication that is associated with high maternal and perinatal morbidity and mortality and can also impact on future maternal cardiovascular health. Guidance on the identification of women at high risk of developing PE has been published by the American College of Obstetricians and Gynecologists and the National Institute for Health and Care Excellence and a predictive algorithm has been developed by The Fetal Medicine Foundation. In addition, numerous published trials have examined the potential value of aspirin in the prevention of PE with conflicting results. In this timely Editorial, Rolnik et al. evaluate the potential of implementation of early screening and prevention of preterm PE with aspirin in clinical practice based on the latest evidence.
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.
Risk of Cesarean scar defect and uterine closure technique
Cesarean scar defect is a common complication in women with a history of Cesarean delivery (CD). This condition has been associated with prolonged menstrual bleeding and postmenstrual spotting as well as an increased risk for several obstetric complications in subsequent pregnancies. As the rates of CD are rising globally, a growing body of evidence suggests that the surgical technique for uterine closure following CD influences the healing of the Cesarean scar. In a systematic review and meta-analysis of nine randomized controlled trials, Di Spiezo Sardo et al. evaluated the effect of single- vs double-layer uterine closure on the risk of uterine scar defect.
Accompanying this article are a Referee Commentary by Patrick Rozenberg and two Correspondence articles by Huirne et al. and by Demers and Roberge which provide insight and put into perspective the findings of this review.
View the full article and accompanying Referee Commentary, Correspondence by Huirne et al. and Correspondence by Demers and Roberge
This article and the accompanying Referee Commentary and Correspondence letters 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.
D-loop transposition of the great arteries with intact ventricular septum: intrauterine pathophysiology
D-loop transposition of the great arteries with intact ventricular septum (D-TGA/IVS) is one of the most common forms of cyanotic heart disease. While the postnatal physiology and neurodevelopmental implications of this condition are well established, little is known about the intrauterine physiology of D-TGA/IVS. In this original study, Godfrey et al. describe the pathophysiology of fetuses with D-TGA/IVS with regard to the relative contribution to combined ventricular output, as well as the size of the cardiac valves and the direction of flow across the foramen ovale and ductus arteriosus shunts, while also assessing the change of these parameters over gestation.
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.
Estimated fetal weight vs a combined screening model for prediction of fetal growth restriction in the third trimester
Fetal growth restriction (FGR) is associated with high risk of perinatal morbidity and mortality which can be significantly reduced by prenatal diagnosis. Recently, the performance of third-trimester combined screening models that include assessment of maternal characteristics, ultrasound parameters and biochemical markers, has been the focus of numerous studies. These models seem to improve the identification of small fetuses delivered preterm but have limited predictive performance in identifying pathologically small fetuses near or after term. In this nested case–control study involving 1590 singleton gestations, Miranda et al. compare the performance of third-trimester screening, based on estimated fetal weight centile vs a combined model including maternal baseline characteristics, fetoplacental ultrasound and maternal biochemical markers, for the prediction of late-onset FGR and small-for-gestational-age neonates.
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.
Coming up in the next issue of UOG…
- Fetoscopic laser coagulation in 1020 pregnancies with twin-to-twin transfusion syndrome. Preview the accepted article. This article has been chosen for Journal Club, so look out for the accompanying downloadable slides next month.
- Progressive lesions of Central Nervous System in microcephalic fetuses with suspected congenital Zika virus syndrome. Preview the accepted article.