The June issue of Ultrasound in Obstetrics & Gynecology includes a systematic review evaluating perinatal outcomes following intrauterine transfusion for fetal anemia secondary to fetal or placental tumor, a 7-year national cohort study reporting national epidemiological data on maternal cytomegalovirus infection during pregnancy in France and the impact of evolving screening and management practices, a prospective study assessing the predictive performance of the Fetal Medicine Foundation first-trimester screening algorithm for pre-eclampsia in pregnancies conceived by assisted reproductive technology, after ovulation induction or through spontaneous conception, and a prospective multicenter study reporting primary results of the CANNES trial comparing the diagnostic accuracy of ultrasound, positron-emission tomography/computed tomography and diffusion-weighted magnetic resonance imaging for preoperative pelvic lymph node assessment in cervical cancer patients.
Please see below a selection of articles from the June issue of the Journal chosen specially by the UOG team. To view all UOG content, become an ISUOG member today or login and upgrade.
Perinatal outcomes following intrauterine transfusion for fetal anemia secondary to fetal or placental tumor: systematic review
Evidence showing the characteristics and clinical outcomes of pregnancies complicated by fetal anemia secondary to a placental or fetal tumor treated with intrauterine transfusion (IUT) is scarce. In this systematic review, Schenone et al. evaluated the characteristics and outcomes of these pregnancies, reporting high rates of additional non-structural complications. The rate of perinatal death in this population was high, likely reflecting the severity of the fetal condition and high rates of obstetric complications and preterm birth, which occurred in 81.1% of cases. The authors conclude that IUT as a standalone therapy may be reasonable in selected cases, but ideal candidates for this approach and the most effective management strategies remain to be determined.
Changing trends in prenatal screening and treatment of cytomegalovirus infection in France: 7-year national cohort study (2017–2023)
Cytomegalovirus (CMV) is the leading cause of infectious neurosensory impairment in newborns, with approximately 0.4% of neonates in France having a congenital CMV (cCMV) infection. In their study, Coste-Mazeau et al. aimed to describe national trends in the identification, screening and management of maternal CMV infection during pregnancy in France over a 7-year period, as well as the impact of changes in screening practices and clinical management of affected pregnant women and their newborns. Compared with the period from 2017 to 2020, between 2021 and 2023 there was a significant increase in both systematic CMV screening and maternal requests for testing, with antiviral therapy for maternal infection administered more frequently in this period. Of note, there were significantly fewer terminations of pregnancy for early maternal CMV primary infection between 2021 and 2023 compared with the period from 2017 to 2020. These findings support the safety and potential benefits of offering CMV serological testing during pregnancy, particularly in the context of evidence-based therapeutic options.
Predictive performance of Fetal Medicine Foundation first-trimester screening algorithm for pre-eclampsia according to conception mode
Pregnancies conceived using assisted reproductive technology (ART) carry an elevated risk of pre-eclampsia (PE) and while ART is considered a risk factor in the Fetal Medicine Foundation (FMF) algorithm, concerns have been raised about its performance for specific ART treatments. In this prospective study, Kjaer et al. investigated the incidence of PE and the predictive performance of the FMF first-trimester PE screening algorithm across pregnancies conceived using ART, after ovulation induction and through spontaneous conception. A higher incidence of PE was observed in women who conceived using ART and the FMF first-trimester PE screening algorithm showed high detection rates across all conception groups. However, differences in screen-positive rates and individual risk marker profiles suggest that incorporating ART-subgroup-specific adjustments could improve the model’s predictive performance in ART pregnancies. These findings underscore the need for tailored clinical management and patient communication.
Prospective comparison of diagnostic accuracy of ultrasound, PET/CT and DW-MRI for preoperative assessment of pelvic lymph nodes in cervical cancer patients: results of the CANNES trial
Preoperative imaging is an essential component of cervical-cancer staging, and while ultrasound and magnetic resonance imaging (MRI) are well validated for local tumor staging, evidence for imaging-based lymph-node assessment remains limited. Frühauf et al. report the primary results of the CANNES trial, a prospective imaging study comparing the diagnostic accuracy of ultrasound, MRI and positron-emission tomography/computed tomography (PET/CT) in the preoperative assessment of lymph nodes in cervical cancer, aiming to determine whether the diagnostic accuracy of ultrasound for the preoperative detection of pelvic lymph-node macrometastases in cervical cancer is non-inferior to that of PET/CT and diffusion-weighted (DW) MRI. The results from this trial indicate that ultrasound was non-inferior to PET/CT and DW-MRI in overall diagnostic accuracy, with comparable sensitivity. These findings support ultrasound as a widely accessible and reliable option for preoperative pelvic lymph-node assessment in cervical cancer.