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Eur J Radiol 2022 Mar 19;148:110166. Epub 2022 Jan 19.

Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India. Electronic address:

Post-mortem MRI (PMMRI) can reliably detect most major organ malformations in cases of stillbirth. However, variable normal post-mortem changes mimicking pathology make the interpretation difficult. Varying morphological appearances of internal organs could be due to differences in gestational age of the fetuses being evaluated or the presence of maceration changes which occur after fetal demise in-utero. Read More

Cesk Patol 2021 ;57(4):203-207

Placental mesenchymal dysplasia is a rare placental lesion characterized by placentomegaly, vascular abnormalities and formation of cystic structures in the placental parenchyma. It can be associated with various genetic abnormalities, fetal growth restriction or intrauterine fetal demise. Placental mesenchymal dysplasia needs to be distinguished from its main differential diagnosis, partial hydatidiform mole. Read More

Ultrasound Obstet Gynecol 2022 04;59(4):497-505

Ontario Fetal Centre, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada.

Objective: Monochorionic twin pregnancies are at increased risk of single intrauterine death (sIUD) and subsequent brain injury in the surviving twin owing to shared placentation. We assessed the association between middle cerebral artery peak systolic velocity (MCA-PSV) and cerebral injury on magnetic resonance imaging (MRI) and examined the association between cerebral findings on diffusion-weighted imaging (DWI) and those on T2-weighted imaging following spontaneous sIUD.

Methods: This was a retrospective cohort study of monochorionic pregnancies complicated by spontaneous sIUD followed at a tertiary center between January 2008 and January 2020. Read More

Medicina (Kaunas) 2021 Nov 18;57(11). Epub 2021 Nov 18.

Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, 71117 Bucharest, Romania.

Wharton's jelly is a specialized connective tissue surrounding and protecting umbilical cord vessels. In its absence, the vessels are exposed to the risk of compression or rupture. Because the condition is very rare and there are no available antepartum investigation methods for diagnosis, these cases are usually discovered after delivery, frequently after in utero fetal demise. Read More

Exp Neurol 2022 01 23;347:113868. Epub 2021 Sep 23.

Department of Neonatology, Children's National, Washington DC, USA. Electronic address:

Placental dysfunction is a major cause of fetal demise, fetal growth restriction, and preterm birth, as well as significant maternal morbidity and mortality. Infant survivors of placental dysfunction are at elevatedrisk for lifelong neuropsychiatric morbidity. However, despite the significant consequences of placental disease, there are no clinical tools to directly and non-invasively assess and measure placental function in pregnancy. Read More

Ultrasound Obstet Gynecol 2022 03;59(3):397-398

Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA.

Ann Med 2021 12;53(1):1502-1508

Department of Obstetrics and Gynecology, Tongji University School of Medicine, Shanghai Tenth People's Hospital, Shanghai, China.

Early fetal demise (absence of cardiac activity in a visible fetus) is a very common event, but there are no reliable biomarkers to predict it. The purpose of the study was to assess the association of platelet parameters with early fetal demise. In this case-control study, we included women with normal deliveries or those ultrasound diagnosed as early fetal demise. Read More

Am J Surg 2022 Jan 20;223(1):182-186. Epub 2021 Jul 20.

Center for Maternal-Fetal Precision Medicine, University of California, San Francisco, San Francisco, CA, USA; Department of Psychiatry and Behavioral Sciences, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA. Electronic address:

Background: To identify genes associated with congenital diaphragmatic hernia (CDH) to help understand the etiology and inform prognosis.

Methods: We performed exome sequencing on fetuses with CDH and their parents to identify rare genetic variants likely to mediate risk. We reviewed prenatal characteristics and neonatal outcomes. Read More

Am J Perinatol 2021 11 19;38(13):1348-1357. Epub 2021 Jul 19.

Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California.

Objective: This study was aimed to evaluate the role of intertwin discrepancy in middle cerebral artery peak systolic velocity (MCA-PSV) and cerebroplacental ratio (CPR) for the prediction of adverse outcomes in monochorionic-diamniotic (MCDA) twin pregnancies.

Study Design: A retrospective cohort study of MCDA pregnancies that underwent ultrasound surveillance at a perinatal referral center from 2007 to 2017. Intertwin MCA-PSV discrepancy (MCA-Δ) was defined as the absolute difference of MCA-PSV multiple of the median (MoM) for gestational age between twins. Read More

J Am Heart Assoc 2021 06 8;10(12):e019713. Epub 2021 Jun 8.

Division of Cardiology Children's National HospitalDepartment of PediatricsGeorge Washington University School of Medicine and Health Sciences Washington DC.

Background Tetralogy of Fallot with absent pulmonary valve is associated with high mortality, but it remains difficult to predict outcomes prenatally. We aimed to identify risk factors for mortality in a large multicenter cohort. Methods and Results Fetal echocardiograms and clinical data from 19 centers over a 10-year period were collected. Read More

Minerva Obstet Gynecol 2021 Aug 27;73(4):409-414. Epub 2021 Apr 27.

Barcelona Center for Maternal-Fetal and Neonatal Medicine, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain -

A fraction of third-trimester small fetuses does not achieve their endowed growth potential mainly due to placental insufficiency, usually not evident in terms of impaired umbilical artery Doppler, but severe enough to increase the risk of perinatal adverse outcomes and long-term complications. The identification of those fetuses at higher-risk helps to optimize their follow-up and to decrease the risk of intrauterine demise. Several parameters can help in the identification of those fetuses at higher risk, defined as fetal growth restricted (FGR) fetuses. Read More

Fetal Diagn Ther 2021 6;48(5):353-360. Epub 2021 Apr 6.

Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium.

Background: Evidence to support a fortnightly scan protocol for monochorionic diamniotic (MCDA) pregnancies to detect twin-twin transfusion syndrome (TTTS) is scarce. Also, TTTS-related mortality in an unselected cohort is not well documented. Finally, common knowledge suggests that a more frequent follow-up may pick up the disease at a milder stage, but little is known on the ultrasound findings before the diagnosis. Read More

Fetal Diagn Ther 2021 20;48(2):158-162. Epub 2021 Jan 20.

Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital-Pavilion for Women, Houston, Texas, USA,

Umbilical vein varices are rare umbilical cord anomalies that typically occur intra-abdominally. Extra-abdominal umbilical vein varices are exceedingly rare and usually diagnosed postnatally on gross pathologic examination. Umbilical vein varices have been associated with increased risk of fetal anemia, cardiac abnormalities, and intrauterine fetal demise. Read More

Hum Reprod 2021 03;36(4):899-906

Molecular and Cellular Biology Laboratory, ICMR-National Institute for Research in Reproductive Health, Indian Council of Medical Research (ICMR), Mumbai, India.

Coronavirus disease 2019 (COVID-19) is caused by infection of the respiratory tract by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which survives in the tissues during the clinical course of infection but there is limited evidence on placental infection and vertical transmission of SARS-CoV-2. The impact of COVID-19 in first trimester pregnancy remains poorly understood. Moreover, how long SARS-CoV-2 can survive in placenta is unknown. Read More

Prenat Diagn 2021 02 9;41(3):332-340. Epub 2021 Jan 9.

Department of Pediatrics, Division of Cardiology, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California, USA.

Objectives: Ebstein anomaly and tricuspid valve dysplasia (EA/TVD) carry high perinatal mortality. Past studies have focused on cardiac predictors of mortality; we sought to describe the fetal echo (FE) extracardiac Dopplers in this cohort and determine their association with perinatal mortality.

Method: Fetuses with EA/TVD at 23 centers from 2005-2011 were included for retrospective study. Read More

Am J Cardiol 2021 02 18;141:106-112. Epub 2020 Nov 18.

Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.

Ebstein anomaly (EA) and tricuspid valve dysplasia (TVD) are rare congenital malformations associated with nearly 50% mortality when diagnosed in utero. The diseases often produce severe tricuspid regurgitation (TR) in the fetus and in some cases, pulmonary regurgitation (PR) and circular shunting ensue. Since the ductus arteriosus (DA) plays a critical role in the circular shunt and may be constricted by transplacental nonsteroidal anti-inflammatory drugs (NSAIDs), we sought to assess the effect of NSAIDs on fetuses with EA/TVD. Read More

Ultrasound Obstet Gynecol 2021 Sep;58(3):369-376

Clinical Sciences Lund, Department of Obstetrics and Gynecology, Lund University, Lund, Sweden.

Objective: To investigate if the extent of absent end-diastolic flow (AEDF) on umbilical artery (UA) Doppler velocimetry predicts pregnancy outcome.

Methods: This was a retrospective observational study based on data from 25 000 Doppler examinations of UA flow performed between 1998 and 2017 at the Blood Flow Laboratory, Level III Perinatal Center, Lund, Sweden. All pregnancies with AEDF in the UA were identified, and the duration of AEDF as a proportion of the total duration of the cardiac cycle (T /T ratio) was measured in digital images of the Doppler spectrum recorded at the last examination showing AEDF before delivery. Read More

Ultrasound Obstet Gynecol 2021 01;57(1):149-154

Institute for Women's Health, University College Hospital, London, UK.

Objectives: To assess the diagnostic value and impact on management of visualizing on ultrasound an amniotic sac without a live embryo (amniotic sac sign). We also examined the potential effect on the number of follow-up visits in early pregnancy units of incorporating this sign into current diagnostic algorithms.

Methods: This was a prospective cohort study of all pregnant women who attended a single specialist early pregnancy unit from July 2017 to November 2018 with symptoms of pain and/or bleeding, or with a history of ectopic pregnancy or miscarriage, at < 14 weeks' gestation. Read More

Eur J Obstet Gynecol Reprod Biol 2020 Dec 10;255:51-55. Epub 2020 Oct 10.

Icahn School of Medicine at Mount Sinai, Department of Obstetrics, Gynecology, and Reproductive Science, Division of Maternal-Fetal Medicine, One Gustave L. Levy Place, New York, NY 10029, USA.

Objective: The placental cord insertion (PCI) to the placental margin has not been well studied as a continuous variable in relation to birth outcomes. We sought to evaluate the impact of PCI distance on outcomes associated with placental function and development of fetal growth restriction (FGR).

Study Design: This was a retrospective study of singleton gestations that underwent a fetal anatomy ultrasound from 2011-2013. Read More

Fetal Pediatr Pathol 2022 Jun 16;41(3):529-532. Epub 2020 Oct 16.

Dr R.K. Hospital for Women and Children, Thanjavur, India.

Tricuspid valve abnormalities detected in fetal life include Ebstein anomaly and tricuspid valve dysplasia. The differentiation between these 2 entities can sometimes be challenging in the 2nd trimester fetus. We report a case of tricuspid valve dysplasia diagnosed on fetal autopsy. Read More

J Perinatol 2020 12 25;40(12):1821-1827. Epub 2020 Sep 25.

Fetal & Neonatal Cardiology Program, Pediatric Cardiology, Women's & Children's Health Research Institute & Mazankowski Heart Institute, University of Alberta, Edmonton, AB, Canada.

Background: Preterm premature rupture of membrane (pPROM) leads to high neonatal mortality due in part to severe lung hypoplasia (LH). In other causes of severe LH, fetal echo-based parameters of smaller branch pulmonary arteries (PA), shorter acceleration to ejection time ratio (AT/ET), increased peak early diastolic reverse flow (PEDRF), and higher pulsatility index (PI) are predictive of worse neonatal outcome. We sought to determine whether these parameters correlated with worse clinical outcome in pPROM. Read More

Brain Pathol 2020 11 29;30(6):1071-1086. Epub 2020 Sep 29.

Laboratory of Molecular Psychiatry, Department of Neuropsychiatry, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Pericytes are vascular mural cells that surround capillaries of the central nervous system (CNS). They are crucial for brain development and contribute to CNS homeostasis by regulating blood-brain barrier function and cerebral blood flow. It has been suggested that pericytes are lost in Alzheimer's disease (AD), implicating this cell type in disease pathology. Read More

Am J Obstet Gynecol 2021 01 16;224(1):103.e1-103.e15. Epub 2020 Jul 16.

Department of Clinical Radiology, Great Ormond Street Hospital for Children, London, United Kingdom; UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children, London, United Kingdom; National Institute for Health Research Biomedical Research Centre, Great Ormond Street Hospital, London, United Kingdom.

Background: Noninvasive imaging autopsy alternatives for fetuses weighing <500 grams are limited. Microfocus computed tomography has been reported as a viable option in small case series with the potential to avoid an invasive autopsy. Implementation of postmortem microfocus computed tomography in a large cohort as part of routine clinical service has yet been unreported, and realistic "autopsy prevention rates" are unknown. Read More

Ultrasound Obstet Gynecol 2021 01;57(1):119-125

Children's Heart Center Linz, Department of Paediatric Cardiology, Kepler University Hospital, Medical Faculty of the Johannes Kepler University, Linz, Austria.

Objective: Critical aortic stenosis (CAS) with a restrictive interatrial septum may lead to fetal congestive heart failure and hydrops, usually culminating in fetal demise if left untreated. The aim of this study was to assess the effects of fetal aortic valvuloplasty (FAV) on hemodynamics and outcome in these patients.

Methods: This was a retrospective review of fetuses with CAS and signs of hydrops that underwent FAV in our center between 2000 and 2020. Read More

Prenat Diagn 2020 10 12;40(11):1366-1374. Epub 2020 Aug 12.

Department of Obstetrics & Gynecology, Baylor College of Medicine, Houston, Texas, USA.

Objectives: To provide an overview of perinatal outcomes in prenatally diagnosed spontaneous chorioamniotic separation (sCAS).

Methods: A systematic search of the literature was performed from inception to July 2019, including PubMed, Ovid MEDLINE, and Ovid EMBASE. All studies reporting prenatally diagnosed sCAS after 16 weeks' gestation in singleton pregnancies were eligible. Read More

Int J Gynaecol Obstet 2020 Sep 16;150(3):299-305. Epub 2020 Jun 16.

Department of Obstetrics and Gynaecology, St. George's University Hospitals NHS Foundation Trust, London, UK.

Placental dysfunction has a deleterious influence on fetal size and is associated with higher rates of perinatal morbidity and mortality. This association underpins the strategy of fetal size evaluation as a mechanism to identify placental dysfunction and prevent stillbirth. The optimal method of routine detection of small for gestational age (SGA) remains to be clarified with choices between estimation of symphyseal-fundal height versus routine third-trimester ultrasound, various formulae for fetal weight estimation by ultrasound, and the variable use of national, customized, or international fetal growth references. Read More

BJOG 2021 01 8;128(2):401-409. Epub 2020 Jun 8.

Obstetrics and Fetal Medicine, Hôpital Necker Enfants Malades, AP-HP, Paris, France.

Objectives: To review perinatal and neurodevelopmental outcome (NDO) following selective fetoscopic laser coagulation (SFLC), cord coagulation (CC) or expectant management of monochorionic diamniotic twin pregnancies complicated with selective intrauterine growth restriction (sIUGR) and absent or reverse end-diastolic flow (AREDF) in the umbilical arteries (UA).

Design And Setting: Single-centre retrospective observational study.

Population: 108 cases of sIUGR diagnosed before 26  weeks' gestation with AREDF in the UA. Read More

Am J Obstet Gynecol 2020 10 4;223(4):493-515. Epub 2020 May 4.

Departments of Obstetrics and Gynecology, University Hospital Brugmann, Université Libre de Bruxelles, Brussels, Belgium. Electronic address:

Fetal death because of miscarriage, unexpected intrauterine fetal demise, or termination of pregnancy is a traumatic event for any family. Despite advances in prenatal imaging and genetic diagnosis, conventional autopsy remains the gold standard because it can provide additional information not available during fetal life in up to 40% of cases and this by itself may change the recurrence risk and hence future counseling for parents. However, conventional autopsy is negatively affected by procedures involving long reporting times because the fetal brain is prone to the effect of autolysis, which may result in suboptimal examinations, particularly of the central nervous system. Read More

Acta Obstet Gynecol Scand 2020 06;99(6):783-790

Center for Fetal Diagnostics, Aarhus University Hospital, Aarhus, Denmark.

Introduction: Applying whole-exome sequencing (WES) for the diagnosis of diseases in children has shown significant diagnostic strength compared with chromosomal microarray. WES may also have the potential of adding clinically relevant prenatal information in cases where a fetus is found to have structural anomalies. We present results from the first fetal exomes performed in a tertiary center in Denmark. Read More

BMJ Sex Reprod Health 2020 10 2;46(4):308-312. Epub 2020 Apr 2.

Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA.

Background: Transient fetal survival is one issue that providers may face while managing late second-trimester abortion. Induction of fetal demise using digoxin and other means has been widely performed by maternal-fetal medicine and family planning subspecialists worldwide. However, there are no data available in Ethiopia as regards preventing transient fetal survival in late second-trimester medical termination of pregnancy. Read More