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J Obstet Gynaecol 2019 Apr 22:1-6. Epub 2019 Apr 22.

a Department of Obstetrics and Gynaecology , University College Cork , Cork , Ireland.

The definition of recurrent miscarriage ranges from two miscarriages according to the American Society for Reproductive Medicine and the European Society of Human Reproduction and Embryology, to three consecutive pregnancy losses as defined by the Royal College of Obstetricians and Gynaecologists. Recent guidelines emphasise the need for further research on the effect of various recurrent miscarriage definitions on diagnosis, treatment and prognosis. Our study examines the management and pregnancy outcomes of nulliparous women attending Cork University Maternity Hospital's Pregnancy Loss Clinic, between 2009 and 2014, with their second consecutive first-trimester miscarriage. Read More

Am J Obstet Gynecol 2019 Apr 14. Epub 2019 Apr 14.

Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York.

Background: As compared to singleton gestations, twin pregnancies are associated with a significantly higher risk of preterm birth, maternal complications, as well as fetal and neonatal morbidity and mortality. Multifetal pregnancy reduction (MPR) is a technique developed in the 1980s to reduce the fetal number in higher-order multiple pregnancies to reduce the risk of adverse pregnancy outcomes, most importantly preterm birth.

Objective: To compare pregnancy outcomes and loss rates in elective twin pregnancy reduction to ongoing twin gestations in a large contemporary cohort. Read More

Am J Epidemiol 2019 Feb 19. Epub 2019 Feb 19.

Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts.

Using birth certificate data for nearly all registered US births from 1976 to 2016 and monthly data on state unemployment rates, we reexamined the link between macroeconomic variation and birth outcomes. We hypothesized that economic downturns reduce exposure to work-related stressors and pollution while increasing exposure to socioeconomic stressors like job loss. Because of preexisting inequalities in health and other resources, we expected that less-educated mothers and black mothers would be more exposed to macroeconomic variation. Read More

Pediatr Infect Dis J 2019 Apr 10. Epub 2019 Apr 10.

Department of Pediatrics, Universidad del Valle, Cali, Colombia.

Background: Despite increasing information in the literature regarding congenital Zika infection, gaps remain in our knowledge of its clinical manifestations.

Methods: We did a prospective observational study of exposed fetuses and infants whose mothers developed symptomatic and confirmed Zika infection during pregnancy in Valle del Cauca, Colombia. We performed neurological, ophthalmological and audiological evaluations, and classified outcomes as possibly or uncertainly related to Zika. Read More

Reprod Biomed Online 2019 Jan 18. Epub 2019 Jan 18.

First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China. Electronic address:

Research Question: What is the association between hyperhomocysteinaemia (HHCY), metabolic syndrome, and reproductive outcomes among women with polycystic ovary syndrome (PCOS).

Design: A secondary analysis of PCOSAct with 21 sites in China. A total of 1000 women with PCOS were enrolled; 936 women with baseline homocysteine (HCY) were analysed. Read More

Women Birth 2019 Mar 28. Epub 2019 Mar 28.

Department of Psychology. Stellenbosch University, South Africa.

Background And Problem: Pregnancy is constructed as a joy-filled and natural experience with a taken-for-granted expectation that the outcome will be a healthy baby. However, in South Africa approximately 1 in 4 pregnancies end in miscarriage and the stillbirth rate is 24 per 100 live births. Despite the overwhelming statistics, reproductive loss is considered a cultural taboo and continues to be silenced in various ways by the medical fraternity and society in general. Read More

Clin Endocrinol (Oxf) 2019 Mar 30. Epub 2019 Mar 30.

Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Objective: Thyroid dysfunction, a common complication of pregnancy, is associated with adverse obstetric and neonatal consequences. This study aimed to determine the effect of TSH levels on early pregnancy outcome in a prospective population-based cohort study.

Design And Methods: The serum TSH, free thyroxine, free triiodothyronine, thyroid peroxidase antibody levels and urinary iodine concentration of 418 pregnant women in their first trimester of pregnancy were measured. Read More

JAMA Netw Open 2019 Mar 1;2(3):e191062. Epub 2019 Mar 1.

Department of Obstetrics and Gynecology, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France.

Importance: Noninvasive prenatal testing (NIPT) using cell-free DNA in maternal blood is increasingly common compared with invasive testing (IT) in routine antenatal detection of Down syndrome (DS).

Objective: To assess attitudes and decision making in pregnant women facing a risk of fetal DS greater than 1 in 250 as established by combined first trimester screening at 11 to 14 weeks of gestation.

Design, Setting, And Participants: Survey study in which data were collected from pregnant women at high risk of fetal DS participating in a randomized clinical trial. Read More

J Matern Fetal Neonatal Med 2019 Mar 21:1-10. Epub 2019 Mar 21.

a Nursing Department and Shaanxi Key Laboratory of Ischemic Cardiovascular Disease , Xi'an Medical College , Xi'an , P. R. China.

Objective: To examine the cellular distribution and the expression of CD200 and its receptor 1 (CD200R1) in human deciduas in first-trimester pregnant women with spontaneous early abortion (SEA) and normal pregnancy, and to explore their role in the etiology of SEA.

Subjects And Methods: Thirty-five women at 6-10-week gestation with SA and 30 women of similar gestational age with a healthy pregnancy were recruited. Expression of CD200 and CD200R1 in the deciduas was determined using immunohistochemistry, confocal laser scanning microscope, Western blot, and real-time PCR (RT-PCR). Read More

J Reprod Infertil 2019 Jan-Mar;20(1):52-56

- Sultan Qaboos University and Hospital, Muscat, Oman.

Background: This study aimed to find out the patients preference towards the management of pregnancy loss to either Misoprostol or dilatation and evacuation or curettage (D&C) in two different study periods.

Methods: Retrospective chart review study included a total of 411 patients. The first study period was January to December 2010 and the second study period was January to December 2014. Read More

Hum Reprod 2019 Mar;34(3):424-432

Nora Therapeutics, Inc., 530 Lytton Avenue, 2nd Floor, Palo Alto, CA, USA.

Study Question: Does administration of recombinant human granulocyte colony stimulating factor (rhG-CSF) in the first trimester improve pregnancy outcomes, among women with a history of unexplained recurrent pregnancy loss?

Summary Answer: rhG-CSF administered in the first trimester of pregnancy did not improve outcomes among women with a history of unexplained recurrent pregnancy loss.

What Is Known Already: The only previous randomized controlled study of granulocyte colony stimulating factor in recurrent miscarriage in 68 women with unexplained primary recurrent miscarriage found a statistically significant reduction in miscarriage and improvement in live birth rates. A further four observational studies where G-CSF was used in a recurrent miscarriage population were identified in the literature, two of which confirmed statistically significant increase in clinical pregnancy and live birth rates. Read More

Hum Reprod Update 2019 May;25(3):362-374

Women's Health Research Unit, Barts and the London School of Medicine and Dentistry, Queen Mary University London, London, UK.

Background: First-trimester miscarriage affects up to a quarter of women worldwide. With many competing treatment options available, there is a need for a comprehensive evidence synthesis.

Objectives And Rationale: We conducted a systematic review and network meta-analysis to assess the effectiveness and safety of treatment options for first-trimester miscarriage: expectant management (EXP), sharp dilation and curettage (D+C), electric vacuum aspiration (EVAC), manual vacuum aspiration (MVA), misoprostol alone (MISO), mifepristone+misoprostol (MIFE+MISO) and misoprostol plus electric vacuum aspiration (MISO+EVAC). Read More

J Reprod Infertil 2018 Oct-Dec;19(4):219-228

- Department of Genetics, Southern Federal University, Rostov-on-Don, Russia.

Background: The study was aimed to investigate the association of V gene polymorphic variants - (rs699947) and - (rs2010963) and gene (rs1800471) and gene expression level with miscarriage in the first trimester.

Methods: 288 women with different courses of pregnancy and 61 chorionic tissue samples were involved in case-control study. Allele-specific polymerase chain reaction in real time was used for genotyping. Read More

Melanoma Res 2019 Feb 5. Epub 2019 Feb 5.

Department of Medical Oncology, Princess Alexandra Hospital, Woolloongabba.

Although T-cell checkpoint blockade has revolutionized melanoma therapy, metastatic melanoma in pregnancy remains a challenging area of unmet need. Treatment with anti-PD1 therapy decreases foetal-maternal tolerance and increases the risk of pregnancy loss in animal studies and is considered category D by the Food and Drug Administration. We describe a unique case of conception and pregnancy, with successful maternal and foetal outcomes, in a patient with metastatic melanoma who had received combination anti-CTLA-4 and anti-PD1 therapy. Read More

Thromb Haemost 2019 Apr 5;119(4):606-617. Epub 2019 Feb 5.

Department of Occupational and Environmental Health, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan.

Background:  Since venous thromboembolism (VTE) is one of the causes of maternal mortality, several guidelines recommend prophylaxis using low molecular weight heparin for women in high-risk groups. The number of large population-based studies examining predictors for VTE has been limited, and there has been no study based on a Japanese population.

Objective:  Our objective was to examine VTE risk factor during the pregnancy and post-partum period. Read More

J Matern Fetal Neonatal Med 2019 Feb 22:1-5. Epub 2019 Feb 22.

a Obstetrics Department , Cliniques Universitaires Saint Luc , Brussels , Belgium.

Background: The diagnosis of cervical insufficiency is based on the previous history of recurrent second or early third trimester losses. Its incidence among pregnant women is 0.5-1% but can be as high as 75% among women with preterm birth. Read More

Reprod Biomed Online 2019 Mar 7;38(3):465-471. Epub 2018 Dec 7.

Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan Shandong 250012, People's Republic of China. Electronic address:

Research Question: What is the diagnostic value of maternal kisspeptin in patients with asymptomatic first-trimester pregnancies, and what is the prognostic significance of kisspeptin versus beta-HCG in early pregnancies.

Design: Case-control study in academic medical centres. Patients with no confounding co-morbidities who conceived by IVF and intracytoplasmic sperm injection were analysed. Read More

Am Fam Physician 2019 Feb;99(3):166-174

University of Michigan Medical School, Ann Arbor, MI, USA.

Approximately one-fourth of pregnant women will experience bleeding in the first trimester. The differential diagnosis includes threatened abortion, early pregnancy loss, and ectopic pregnancy. Pain and heavy bleeding are associated with an increased risk of early pregnancy loss. Read More

Semin Perinatol 2019 Mar 20;43(2):74-79. Epub 2018 Dec 20.

Department of Obstetrics & Gynecology, Columbia University Medical Center, Fertility Center, 5 Columbus Circle, PH, New York, New York, USA.

Objective: To review the current understanding of the role the uterus plays in recurrent pregnancy loss.

Findings: Congenital and acquired uterine abnormalities are associated with recurrent pregnancy loss in the first and second trimester. Relevant congenital Mullerian tract anomalies include unicornuate, didelphys, bicornuate and septate uteri. Read More

Int J Environ Res Public Health 2019 01 23;16(3). Epub 2019 Jan 23.

Post-graduate Programme in Health Sciences, Federal University of Bahia School of Medicine, Praça XV de Novembro-Largo do Terreiro de Jesus, 40025-010 Bahia, Brazil.

Zika virus (ZIKV) infection appeared in Brazil in 2015, causing an epidemic outbreak with increased rates of microcephaly and other serious birth disorders. We reviewed 102 cases of children who were diagnosed with microcephaly at birth and who had gestational exposure to ZIKV during the outbreak. We describe the clinical, neuroimaging, and neurophysiological findings. Read More

Ultrasound Obstet Gynecol 2019 Jan 24. Epub 2019 Jan 24.

Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York.

In this opinion article, we provide compelling arguments of why early screening for pregnancies following previous cesarean delivery would be beneficial. First, we provide an overview of the perils of undiagnosed or misdiagnosed cesarean scar pregnancies (CSP), mostly with bleeding, but also with other complications, that may lead to multiple surgeries, uterine artery embolization, loss of fertility and in rare cases of documented deaths. There is well-documented histopathological connection between CSP and the placental adherence spectrum (PAS) suggesting that CSP is a precursor to PAS. Read More

Emerg Infect Dis 2019 02;25(2):247-255

Zika virus infection during pregnancy may result in birth defects and pregnancy complications. We describe the Zika virus outbreak in pregnant women in the Dominican Republic during 2016-2017. We conducted multinomial logistic regression to identify factors associated with fetal losses and preterm birth. Read More

Acta Otolaryngol 2019 Jan 21;139(1):38-41. Epub 2019 Jan 21.

a Department of Otolaryngology-Head and Neck Surgery , The First Affiliated Hospital of University of South China , Hengyang , China.

Background: Sudden sensorineural hearing loss (SSNHL) may occur during pregnancy with a rare prevalence, and little is known about it.

Aims: To retrospectively analyze cases of SSNHL during pregnancy and investigate their clinical characteristics, management and outcome.

Material And Methods: Records of 30 SSNHL patients during pregnancy were reviewed, including age, localization, duration from onset to treatment, gestation period, accompanying symptoms, initial hearing threshold, final hearing threshold, audiogram, treatment and outcome. Read More

Reprod Med Biol 2019 Jan 1;18(1):91-96. Epub 2018 Nov 1.

Department of Obstetrics and Gynecology Tokushima University Graduate School of Biomedical Sciences Tokushima Japan.

Purpose: A retrospective, cohort study was conducted between 2009 and 2017 in a private infertility center to determine the predictive value of endogenous estrogen (E2) and progesterone (P4) levels in hormone-replacement frozen embryo replacement (FER) treatment cycles.

Methods: A total of 120 consecutive, infertile patients who became pregnant after FER cycles were analyzed (age: 37.4 ± 4. Read More

J Obstet Gynaecol 2019 May 11;39(4):485-491. Epub 2019 Jan 11.

c Department of Women's and Children's Health, Dunedin School of Medicine , University of Otago , Dunedin , New Zealand.

This study aimed to explore the knowledge and practice of New Zealand (NZ) general practitioners (GPs) regarding gestational weight gain (GWG), and identify the current level of involvement NZ GPs have in early pregnancy care. In NZ, the majority of antenatal care is carried out by a midwife lead maternity carer (LMC), with government funding for one first trimester appointment with the woman's GP. A mixed methods survey was conducted on a randomly selected sample of 470 NZ GPs. Read More

Anesthesiol Res Pract 2018 2;2018:4051896. Epub 2018 Dec 2.

Department of Anesthesiology, New York Medical College, Valhalla, New York, USA.

Objective: To determine whether there is a difference in intraoperative bleeding with inhalational versus noninhalational anesthetic agents for patients undergoing suction dilatation and curettage for first-trimester induced abortion.

Methods: This is an IRB-approved retrospective chart review of the electronic medical records of patients undergoing induced abortion at gestational ages between 5 0/7 and 14 0/7 weeks of pregnancy at the New York City Health + Hospitals/Metropolitan. The records of 138 patients who underwent suction dilatation and curettage for induced abortion between June 2012 and June 2014 were reviewed for an association between anesthetic technique and intraoperative hemorrhage. Read More

Obstet Gynecol 2018 Nov;132(5):1311-1313

Early pregnancy loss, or loss of an intrauterine pregnancy within the first trimester, is encountered commonly in clinical practice. Obstetricians and gynecologists should understand the use of various diagnostic tools to differentiate between viable and nonviable pregnancies and offer the full range of therapeutic options to patients, including expectant, medical, and surgical management. The purpose of this Practice Bulletin is to review diagnostic approaches and describe options for the management of early pregnancy loss. Read More

Arch Endocrinol Metab 2018 ;62(6):641-643

Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brasil.

Objective: Universal screening for thyroid dysfunction in pregnant women is not recommended by the American Thyroid Association (ATA) or the American Association of Clinical Endocrinologists (AACE). This study evaluated the frequency of pregnant women that would have an indication for levothyroxine (L-T4) according to the new ATA/AACE guidelines among low-risk women without an indication for screening with TSH.

Subjects And Methods: The sample consisted of 412 pregnant women ranging in age from 18 to 30 years. Read More

Hum Reprod 2019 Apr;34(4):689-701

Department of Obstetrics and Gynaecology, LKS Faculty of Medicine, The University of Hong Kong, 7/F, Laboratory Block, 21 Sassoon Road, Pokfulam, Hong Kong.

Study Question: Does glycodelin-A (GdA) induce conversion of human peripheral blood CD16-CD56bright natural killer (NK) cells to decidual NK (dNK) cells to facilitate placentation?

Summary Answer: GdA binds to blood CD16-CD56bright NK cells via its sialylated glycans and converts them to a dNK-like cells, which in turn regulate endothelial cell angiogenesis and trophoblast invasion via vascular endothelial growth factor (VEGF) and insulin-like growth factor-binding protein 1 (IGFBP-1) secretion, respectively.

What Is Known Already: dNK cells are the most abundant leucocyte population in the decidua. These cells express CD16-CD56bright phenotype. Read More

J Neurol Sci 2019 Feb 21;397:58-60. Epub 2018 Dec 21.

Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Boston, MA, United States.

Objective: To evaluate the effect of pregnancy loss (PL) on MS disease activity.

Methods: Eleven women with first-trimester PLs were identified through a reproductive questionnaire. MS activity (MRI lesions and/or clinical relapses) was compared for the 12 months before conception and after PL. Read More

BMC Pregnancy Childbirth 2018 Dec 20;18(1):502. Epub 2018 Dec 20.

Department of Obstetrics and Gynecology, Erciyes University Faculty of Medicine, Kayseri, Turkey.

Background: Nausea and vomiting occur 50-90% during the first trimester of pregnancy. However, patients with hyperemesis gravidarum (HG) may be hospitalized at an incidence rate of 0.8-2% before the 20th week of gestational age. Read More

Obstet Gynecol 2019 Jan;133(1):137-147

Gynuity Health Projects, New York, New York; the University of Colorado Hospital Anschutz Medical Campus, Aurora, Colorado; and the Department of Mathematics and Statistics, Elon University, Elon, North Carolina.

Objective: To summarize available data on the effectiveness and safety of single-agent misoprostol for medical abortion in the first trimester.

Data Sources: We searched MEDLINE, CABI, Cochrane, EMBASE, LILACS, the Web of Science, and ClinicalTrials.gov for English-language studies that evaluated misoprostol alone for abortion of a viable pregnancy in the first trimester. Read More

Obstet Gynecol 2019 Jan;133(1):149-154

Department of Obstetrics and Gynecology, Division of General Obstetrics and Gynecology, the Division of Family Planning, and the Center for Clinical Epidemiology and Biostatistics, Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

Objective: To document the terminology patients hear during the treatment course for a nonviable pregnancy and to ask patients their perceived clarity and preference of terminology to identify a patient-centered lexicon.

Methods: We performed a preplanned substudy survey of English-speaking participants in New York, Pennsylvania, and California at the time of enrollment in a randomized multisite trial of medical management of first-trimester early pregnancy loss. The six-item survey, administered on paper or an electronic tablet, was developed and piloted for internal and external validity. Read More

Clin Biochem 2019 Feb 1;64:44-48. Epub 2018 Dec 1.

Department of Transfusion Medicine, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, PR China. Electronic address:

Background: Thyroid autoantibody has been associated with adverse pregnancy outcomes. However, thyroid-receptor antibody (TRAb) has not been considered as a potential risk assessment indicator for adverse pregnancy outcomes. Therefore, we assessed the role of TRAb in evaluation of the risk of adverse pregnancy outcomes. Read More

Ultrasound Med Biol 2019 02 22;45(2):429-439. Epub 2018 Nov 22.

Medical Physics Department, University of Wisconsin, Madison, Wisconsin, USA. Electronic address:

As pregnancy progresses, the cervix remodels from a rigid structure to one pliable enough to allow delivery of a fetus, a process that involves progressive disorganization of cervical microstructure. Quantitative ultrasound biomarkers that may detect this process include those derived from the backscattered echo signal, namely, acoustic attenuation and backscattered power loss. We recently reported that attenuation and backscattered power loss are affected by tissue anisotropy and heterogeneity in the ex vivo cervix. Read More

BJOG 2019 Jan;126(2):176-189

Institute of Metabolism and Systems Research, College of Medical & Dental Sciences, University of Birmingham, Birmingham, UK.

Background: There is a substantial body of research evaluating ways to prevent and manage miscarriage, but all studies do not report on the same outcomes.

Objective: To review systematically, outcomes reported in existing miscarriage trials.

Search Strategy: MEDLINE, Embase, CINAHL, and Cochrane were searched from inception until January 2017. Read More

Zhonghua Fu Chan Ke Za Zhi 2018 Nov;53(11):755-760

Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China.

To compare differences of clinical factors related to early pregnancy loss between invitro fertilization-embryo transfer (IVF-ET) treatment and natural pegnancy. A retrospective analysis was performed on the 363 cases of early pregnancy loss between Dec. 2015 to May 2016 in Peking University Third Hospital, during which 173 cases were after IVF-ET treatment (IVF-ET group) , and others were natural pregnancies (natural group) . Read More

Hum Mol Genet 2019 02;28(4):662-674

Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.

Previous studies show that aberrant tryptophan catabolism reduces maternal immune tolerance and adversely impacts pregnancy outcomes. Tryptophan depletion in pregnancy is facilitated by increased activity of tryptophan-depleting enzymes [i.e. Read More

Fertil Steril 2018 11;110(6):1109-1117.e2

Laboratoire de Biologie de la Reproduction, CHU Dijon Bourgogne, Dijon, France; Université Bourgogne Franche-Comté-INSERM UMR1231, Dijon, France. Electronic address:

Objective: To study the impact of in vitro fertilization, with or without intracytoplasmic sperm injection (IVF/ICSI), frozen-embryo transfer (FET), and intrauterine insemination (IUI) on fetal growth kinetics throughout pregnancy and to compare the different modes of conception.

Design: Retrospective cohort study.

Setting: University. Read More

Am J Hematol 2019 Feb 26;94(2):184-188. Epub 2018 Nov 26.

Department of Medicine, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California.

During pregnancy, iron requirements are increased to support maternal erythropoietic expansion and fetal growth and development. To meet these requirements, dietary iron absorption increases, and available iron stores are mobilized. These adjustments are thought to be in large part mediated by the iron-regulatory hormone hepcidin, which controls the concentrations of ferroportin, the sole exporter of iron into the extracellular fluid and blood plasma. Read More

Medicine (Baltimore) 2018 Nov;97(44):e13038

Department of Gynecology, The Nineth Hospital of Xi'an, Shaanxi, China.

This retrospective study investigated the efficacy and safety of letrozole for patients with polycystic ovary syndrome (PCOS).Totally, 136 cases of infertility women with PCOS were analyzed. Of those, 68 patients received letrozole, and were assigned to Letrozole group. Read More

BMC Womens Health 2018 10 29;18(1):176. Epub 2018 Oct 29.

Department of General Practice, University of Melbourne, Parkville, VIC, Australia.

Background: Miscarriage is a common event which is estimated to occur in approximately one in four confirmed pregnancies (Collins et al, Grief Matters Aust J Grief Bereave_ 17:44, 2014, St John et al, Aust J Adv Nurs_ 23:8, 2006). Social networks play an important role in supporting women following this event and positive support experiences can play a role in buffering women's experiences of grief, loss and psychological distress following miscarriage (Rowlands et al, J Reprod Infant Psychol_ 28:274-86, 2010, Stratton et al, Aust New Zeal J Obstet Gynaecol_ 48:5-11).

Methods: Women were recruited through existing networks known to the researcher, miscarriage support organisations and snowball sampling methods. Read More

Ultrasound Obstet Gynecol 2019 02 7;53(2):208-213. Epub 2018 Dec 7.

Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK.

Objective: To report on the routine clinical implementation of cell-free DNA (cfDNA) analysis of maternal blood for trisomies 21, 18 and 13, contingent on the results of the first-trimester combined test in twin pregnancy.

Methods: Screening for trisomies 21, 18 and 13 was carried out in 959 twin pregnancies by assessment of a combination of maternal age, fetal nuchal translucency thickness, and serum free β-human chorionic gonadotropin and pregnancy-associated plasma protein-A at 11-13 weeks' gestation in two UK NHS hospitals. Women in the high-risk group (risk ≥ 1 in 100) were offered the option of invasive testing, cfDNA testing or no further testing, and those in the intermediate-risk group (risk 1 in 101 to 1 in 2500 in the first phase of the study and 1 in 101 to 1 in 500 in the second phase) were offered cfDNA or no further testing. Read More

J Obstet Gynaecol Res 2019 Feb 16;45(2):258-265. Epub 2018 Oct 16.

Division of Biomedical Sciences, Clinical Science Research Laboratories, Warwick Medical School, University of Warwick, Coventry, UK.

Recurrent pregnancy loss (RPL), defined as multiple consecutive miscarriages, is a devastating disorder for which there are no good treatment options. Two opposing paradigms have emerged to explain RPL. The prevailing clinical viewpoint is that RPL is caused by a spectrum of subclinical disorders, ranging from thrombophilia to anatomical, endocrine and immunological disorders, that somehow converge on a 'fragile' early pregnancy state, leading to miscarriage. Read More

Ultrasound Obstet Gynecol 2018 Oct 17. Epub 2018 Oct 17.

Fetal Medicine Department, Hospital Universitario de Torrejón, Madrid, Spain.

Objective: To evaluate the association between physical exercise during pregnancy and maternal gestational weight gain and fetal cardiac function.

Methods: This was a randomized controlled trial of women with a singleton pregnancy managed from the first trimester at the Hospital de Torrejón, Madrid, between November 2014 and June 2015. Women were randomized to either follow a supervised physical conditioning program, consisting of a 60-min session 3 days per week for the duration of pregnancy, or not attend any exercise program (controls). Read More

Front Endocrinol (Lausanne) 2018 26;9:546. Epub 2018 Sep 26.

London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom.

Maternal obesity, excessive gestational weight gain (GWG) and post-partum weight retention (PPWR) constitute new public health challenges, due to the association with negative short- and long-term maternal and neonatal outcomes. The aim of this evidence review was to identify effective lifestyle interventions to manage weight and improve maternal and infant outcomes during pregnancy and postpartum. A review of systematic reviews and meta-analyses investigating the effects of lifestyle interventions on GWG or PPWR was conducted (Jan 2009-2018) via electronic searches in the databases Medline, Pubmed, Web of Science and Cochrane Library using all keywords related to obesity/weight gain/loss, pregnancy or postpartum and lifestyle interventions;15 relevant reviews were selected. Read More

Clin Microbiol Infect 2018 Oct 11. Epub 2018 Oct 11.

Sc Microbiologia e Virologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Dipartimento di Medicina Interna e Terapia Medica, Universita Degli Studi di Pavia, Sc Microbiologia e Virologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.

Objectives: Congenital toxoplasmosis (CT) affects one to ten fetuses per 10 000 live newborns in western countries. Without knowing pre-conception serostatus, it is hard to date the infection when anti-Toxoplasma IgG and IgM antibodies are positive at first screening. Although a high IgG avidity index (AI) in the first trimester excludes CT, the same cannot be said of intermediate and low AI. Read More

Reprod Biol Endocrinol 2018 Oct 11;16(1):95. Epub 2018 Oct 11.

Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.

Background: Studies have commonly assessed the endocrinolgical status of women once miscarriage is threatened or suspected; few studies have explored the antecedent hormonal environment or used a longitudinal strategy. Using refined statistical techniques, we sought to re-evaluate whether gestational hormone trajectories in early pregnancy can identify future miscarriage in asymptomatic pregnancies.

Methods: This prospective cohort study followed 105 women over-conception; 72 had normal term pregnancy outcomes while 33 experienced early pregnancy failure between 35 and 115 days of gestation. Read More

Acta Vet Hung 2018 Sep;66(3):451-461

3 National Agricultural Research and Innovation Center, Research Institute for Animal Breeding, Nutrition and Meat Science , Gesztenyés u. 1, H-2053 Herceghalom , Hungary.

Double ovulation occurs more frequently in multiparous cows with high milk production than in primiparous cows and the rate of twin pregnancy/calving is increasing worldwide. Diagnosis of twin pregnancy is possible by ultrasound at the time of early pregnancy examination [28-34 days after artificial insemination (AI)]. Pregnancy proteins are also well-known indicators of gestation. Read More