The July issue of Ultrasound in Obstetrics & Gynecology includes a study on the risk of fetal loss after chorionic villus sampling in twin pregnancy, a study on the prenatal sonographic manifestation of esophageal atresia with or without tracheoesophageal fistula, a study on the effect of elective induction of labor at 39 weeks on children’s educational outcomes, and a Consensus Statement from ESGO/ISUOG/IOTA/ESGE on the preoperative diagnosis of ovarian tumors.
Fetal loss after chorionic villus sampling in twin pregnancy
There is limited evidence regarding the risk of fetal loss after chorionic villus sampling (CVS) in twin pregnancy. Elger et al. estimated the CVS-related risk of fetal loss in 8581 twin pregnancies after adjustment for chorionicity, nuchal translucency thickness, intertwin discordance in crown–rump length, maternal demographic characteristics and serum pregnancy-associated plasma protein-A and free β-human chorionic gonadotropin. It was found that, in twin pregnancies undergoing CVS, compared to those not undergoing CVS, there is a 2-fold increased risk of fetal loss at <24 weeks’ gestation and loss at any stage in pregnancy, but that this risk can, to a great extent, be explained by maternal and pregnancy characteristics rather than the invasive procedure itself. Watch the accompanying video abstract:
Esophageal atresia and tracheoesophageal fistula: prenatal sonographic manifestation from early to late pregnancy
Despite improvements in ultrasound technology, esophageal atresia with or without tracheoesophageal fistula (EA/TEF) remains one of the most frequently missed diagnoses prenatally. Kassif et al. aimed to elucidate the sonographic manifestation of EA/TEF throughout pregnancy, finding that prenatal diagnosis of EA/TEF on ultrasound is not feasible before the late second trimester. It was determined that a small/absent stomach may be visualized as early as 15 weeks, that polyhydramnios does not develop before the mid-trimester, and that an esophageal pouch can be detected as early as 22 weeks on a targeted scan in suspected cases. The detection rates of all three signs increase with advancing pregnancy, peaking in the third trimester. The early and mid-trimester anomaly scans perform poorly as a screening and diagnostic test for EA/TEF.
Elective labor induction vs expectant management of pregnant women at term and children’s educational outcomes at 8 years of age
Several studies have found that elective induction of labor at 39 weeks reduces the rate of adverse perinatal outcome. However, there has been limited research on the effect on children’s educational outcomes. Using whole-population perinatal data on infants born in South Australia from 1999 to 2008 and data from the National Assessment Program for Literacy and Numeracy, Yisma et al. examined whether elective induction of labor at 39 weeks, compared with expectant management, had an effect on the educational outcomes of 31,120 children at 8 years of age, finding there to be no effect on children’s standardized literacy and numeracy testing outcomes.
ESGO/ISUOG/IOTA/ESGE Consensus Statement on preoperative diagnosis of ovarian tumors
The accurate characterization of newly diagnosed adnexal lesions is of paramount importance to define appropriate treatment pathways. Developed jointly by ESGO, ISUOG, the IOTA group and ESGE, this Consensus Statement presents clinically relevant and evidence-based statements on the preoperative diagnosis of ovarian tumors and assessment of disease spread, including imaging techniques, biomarkers and predictive models.
Coming up next month…
- Newly updated ISUOG Practice Guidelines on the use of Doppler velocimetry in obstetrics.
- A systematic review and meta-analysis on cell-free DNA testing of maternal blood in screening for trisomies in twin pregnancy. Preview the Accepted Article.
- An economic analysis of prenatal fetoscopic vs open neural tube defect repair. Preview the Accepted Article.