Search Our Scientific Publications & Authors

J Clin Apher 2021 Apr 13. Epub 2021 Apr 13.

Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.

Aim: To evaluate effectiveness and safety of therapeutic plasma exchange (TPE) and dextran-sulfate plasma adsorption (DSA) for extracorporeal removal of soluble Fms-like tyrosine kinase-1 (sFlt-1) as part of expectant management of preeclampsia at extremely preterm gestational age.

Methods: Retrospective case series of six patients with preeclampsia at <28 weeks of gestation, treated with DSA or TPE. Laboratory results, clinical characteristics and neonatal outcomes were collected from charts and National Perinatal Information System. Read More

Exp Biol Med (Maywood) 2021 Apr 1:15353702211003508. Epub 2021 Apr 1.

BCNatal | Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), University of Barcelona, Barcelona 08028, Spain.

Intrauterine growth restriction affects up to 10% of all pregnancies, leading to fetal programming with detrimental consequences for lifelong health. However, no therapeutic strategies have so far been effective to ameliorate these consequences. Our previous study has demonstrated that a single dose of nutrients administered into the amniotic cavity, bypassing the often dysfunctional placenta via intra-amniotic administration, improved survival at birth but not birthweight in an intrauterine growth restriction rabbit model. Read More

Contraception 2021 Mar 21. Epub 2021 Mar 21.

University of Maryland - School of Public Health, 4200 Valley Drive Suite 1142, College Park, MD 20740, The United States of America. Electronic address:

Objectives: In 2014, Delaware launched a statewide initiative to reduce the rate of unintended pregnancies and increase access to contraception services. Our study objective was to understand the implementation experiences, barriers, and successes across health care practice settings and to provide recommendations for future, similar initiatives.

Study Design: As part of a larger multi-component process evaluation, we conducted semi-structured interviews with 32 leaders from 26 practice settings implementing the initiative across the state. Read More

Twin Res Hum Genet 2021 Mar 22:1-5. Epub 2021 Mar 22.

Department of Obstetrics, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz (IFF/Fiocruz), Rio de Janeiro, Brazil.

Selective intrauterine growth restriction (sIUGR) in monochorionic twin pregnancies is associated with greater morbidity and mortality for both fetuses when compared to singleton and dichorionic pregnancies. This retrospective cohort study aimed to assess the perinatal outcomes of monochorionic twin pregnancies affected by this disorder and conducted expectantly, by analyzing the results according to the end-diastolic flow in the umbilical artery Doppler of the smaller twin (type I: persistently forward/type II: persistently absent or reversed/type III: intermittently absent or reversed). Seventy-five monochorionic diamniotic twin pregnancies with sIUGR were included in this study. Read More

Pediatr Dev Pathol 2021 Mar 17:1093526621999026. Epub 2021 Mar 17.

Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York.

is a gram-positive, rod-shaped bacterium that is commonly implicated in foodborne illness but has also become increasingly recognized as a source of serious non-gastrointestinal infections, including sepsis, meningitis, and pneumonia. Non-gastrointestinal infections have been identified in children, especially in neonates; however, there are no previously described cases of fetal demise associated with placental infection. We present a case of acute chorioamnionitis-related intrauterine fetal demise of twin A at 17 weeks gestation, noted two days after selective termination of twin B. Read More

Zhong Nan Da Xue Xue Bao Yi Xue Ban 2021 Feb;46(2):212-216

Department of Gynecology and Obstetrics, Qingdao Municipal Hospital, Qingdao Shandong 266000.

Heterotopic pregnancies are rare and difficult to be diagnosed early. A patient with combined intrauterine pregnancy and cervical pregnancy was admitted in Qingdao Municipal Hospital in 2019. The patient complained of abnormal vaginal bleeding after menopause and was misdiagnosed as simple intrauterine pregnancy. Read More

J Obstet Gynaecol Res 2021 Feb 25. Epub 2021 Feb 25.

Department of Gynecology and Obstetrics, Shengjing Hospital of China Medical University, Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, Liaoning Province, China.

Aim: To evaluate the theme trends and knowledge structure of multifetal pregnancy reduction (MPR)-related literature by using bibliometric analysis.

Methods: Published scientific papers regarding MPR were retrieved from the PubMed database. Data extraction and statistics were conducted using Bibliographic Item Co-Occurrence Matrix Builder (BICOMB). Read More

Clin Pract 2021 Feb 2;11(1):75-80. Epub 2021 Feb 2.

Department of Obstetrics and Feto-maternal Medicine, Medical University of Vienna, 1090 Vienna, Austria.

Simpson-Golabi-Behmel syndrome (SGBS) is a rare x-linked overgrowth syndrome with distinct clinical features, which is difficult to diagnose prenatally. We report the diagnosis of SGBS in dichorionic-diamniotic twin pregnancies in the first trimester by ultrasound and genetic testing. The affected fetus developed polyhydramnios and the cervical length of the mother decreased significantly. Read More

Front Pharmacol 2020 14;11:602593. Epub 2021 Jan 14.

TocopheRx, Inc., Groton, MA, United States.

An orally active follicle stimulating hormone receptor allosteric agonist would provide a preferred treatment for over 16 million infertile women of reproductive age in low complexity methods (ovulation induction-intrauterine insemination) or in high complexity methods (controlled ovarian stimulation- fertilization). We present two oral follicle stimulating hormone receptor allosteric agonist compounds that have the desired pharmacology, drug metabolism, pharmacokinetics, and safety profile for clinical use. These molecules provide a single agent suitable for ovulation induction-intrauterine insemination or controlled ovarian stimulation- fertilization that is more convenient for patients and achieves similar preclinical efficacy as rec-hFSH. Read More

BMC Pregnancy Childbirth 2021 Jan 9;21(1):41. Epub 2021 Jan 9.

Department of Obstetrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.

Background: Radiofrequency ablation (RFA) is recommended to prevent potential neurological injury or intrauterine foetal death (IUFD) of the co-twin(s) in complicated monochorionic (MC) pregnancies. However, the impacts of various indications on the pregnancy outcome following RFA remain unclear. This study aimed to determine how the indications influence the perinatal outcomes in complicated MC pregnancies undergoing radiofrequency ablation. Read More

Zhonghua Yi Xue Za Zhi 2020 Dec;100(47):3759-3763

Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China.

To explore the incidence, clinical characteristics, management strategies and reproductive outcomes of cesarean scar pregnancies (CSP) after in vitro fertilization-embryo transfer (IVF-ET). The patients who were diagnosed with CSP followed IVF/ET in the Center for Reproductive Medicine of Peking University Third Hospital between April 1, 2010 and March 31, 2020 were included. The clinical data of each patient were analyzed retrospectively. Read More

Placenta 2021 Jan 3;104:89-93. Epub 2020 Dec 3.

Department of Obstetrics and Gynecology, Peking University Third Hospital, No.49 Hua Yuan North Road, Hai Dian District, Beijing, 100191, China.

Introduction: To investigate differences in the pregnancy outcomes and placental characteristics of selective intrauterine growth restriction (sIUGR) with or without twin anemia polythemia sequence (TAPS).

Methods: sIUGR patients were assigned into two groups based on the occurrence of TAPS. The pregnancy outcomes and placental characteristics were compared. Read More

J Urol 2021 Jan 9;205(1):44-51. Epub 2020 Dec 9.

McGill University School of Medicine.

Purpose: The summary presented herein represents Part II of the two-part series dedicated to the Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline. Part II outlines the appropriate management of the male in an infertile couple. Medical therapies, surgical techniques, as well as use of intrauterine insemination (IUI)/in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) are covered to allow for optimal patient management. Read More

Fertil Steril 2021 Jan 30;115(1):191-200. Epub 2020 Nov 30.

Cochrane Gynaecology and Fertility Group, University of Auckland, Auckland, New Zealand.

Study Question: Can a core outcome set to standardize outcome selection, collection, and reporting across future infertility research be developed?

Summary Answer: A minimum data set, known as a core outcome set, has been developed for randomized controlled trials (RCT) and systematic reviews evaluating potential treatments for infertility.

What Is Known Already: Complex issues, including a failure to consider the perspectives of people with fertility problems when selecting outcomes, variations in outcome definitions, and the selective reporting of outcomes on the basis of statistical analysis, make the results of infertility research difficult to interpret.

Study Design, Size, Duration: A three-round Delphi survey (372 participants from 41 countries) and consensus development workshop (30 participants from 27 countries). Read More

Hum Reprod 2020 Dec;35(12):2725-2734

Cochrane Gynaecology and Fertility Group, University of Auckland, Auckland, New Zealand.

Study Question: Can a core outcome set to standardize outcome selection, collection and reporting across future infertility research be developed?

Summary Answer: A minimum data set, known as a core outcome set, has been developed for randomized controlled trials (RCTs) and systematic reviews evaluating potential treatments for infertility.

What Is Known Already: Complex issues, including a failure to consider the perspectives of people with fertility problems when selecting outcomes, variations in outcome definitions and the selective reporting of outcomes on the basis of statistical analysis, make the results of infertility research difficult to interpret.

Study Design, Size, Duration: A three-round Delphi survey (372 participants from 41 countries) and consensus development workshop (30 participants from 27 countries). Read More

Am J Obstet Gynecol 2020 Nov 26. Epub 2020 Nov 26.

Department of Obstetrics and Maternal-Fetal Medicine, Hôpital Necker-Enfants Malades, AP-HP and EA7328, Université de Paris, Paris, France.

Background: Selective fetoscopic laser coagulation of the intertwin anastomotic chorionic vessels is the first-line treatment for twin-twin transfusion syndrome. However, in stage 1 twin-twin transfusion syndrome, the risks of intrauterine surgery may be higher than those of the natural progression of the condition.

Objective: This study aimed to compare immediate surgery and expectant follow-up in stage 1 twin-twin transfusion syndrome. Read More

J Matern Fetal Neonatal Med 2020 Nov 17:1-7. Epub 2020 Nov 17.

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

Objective: To explore differences among placental anastomoses, territory discordance, and umbilical cord insertion of twin-to-twin transfusion syndrome (TTTS) with and without selective intrauterine growth restriction (sIUGR).

Methods: This study retrospectively analyzed 57 patients with TTTS who received conservative treatment and finally delivered at the Department of Obstetrics and Gynecology of Peking University Third Hospital from April 2014 to April 2019. Nine of the patient's placentas were too broken to finish the perfusion, and 48 were kept for graph analysis after perfusion. Read More

Ultrasound Obstet Gynecol 2021 Jan;57(1):126-133

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

Objective: Type-III selective intrauterine growth restriction (sIUGR) is associated with a high and unpredictable risk of fetal death and fetal brain injury. The objective of this study was to describe the prospective risk of fetal death and the risk of adverse neonatal outcome in a cohort of twin pregnancies complicated by Type-III sIUGR and treated according to up-to-date guidelines.

Methods: We reviewed retrospectively all monochorionic diamniotic twin pregnancies complicated by Type-III sIUGR managed at nine fetal centers over a 12-year period. Read More

Case Rep Obstet Gynecol 2020 3;2020:2979261. Epub 2020 Oct 3.

Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Sainte-Justine Mother and Child University Hospital, 3175 Chemin de la Côte Sainte Catherine, Montreal, QC, Canada H3T 1C5.

The optimal management of monochorionic-triamniotic (MCTA) triplet pregnancies is not clearly established, and there is no literature to guide management of MCTA complicated with selective intrauterine growth restriction (sIUGR). This gap in knowledge and the concern for higher risk of severe complications have led some medical societies to recommend selective termination of nontrichorionic triplet pregnancies. We sought to report the favourable outcomes of two MCTA complicated by sIUGR expectantly managed at Sainte-Justine Hospital, Montreal, Canada. Read More

J Obstet Gynaecol India 2020 Oct 29;70(5):349-354. Epub 2020 Jul 29.

Apollo Centre for Fetal Medicine, New Delhi, India.

Background: This study aimed to evaluate the usefulness of the first-trimester crown-rump length (CRL) and nuchal translucency (NT) discordance in monochorionic diamniotic twins (MCDA) for the prediction of complications-twin-twin transfusion syndrome (TTTS), selective fetal growth restriction (sFGR) or intrauterine fetal demise (IUFD).

Methods: Intertwin discordance in the CRL and NT was calculated as a percentage of the larger CRL and NT, respectively. The performance of inter twin discordance (CRL ≥ 10% and NT≥ 20%) for predicting complications was analysed using standard statistical screening test methods. Read More

Ultraschall Med 2020 Oct 5. Epub 2020 Oct 5.

Department of Obstetrics and Fetal Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany.

The following AWMF guideline (DGGG/AGG & DEGUM responsible) deals with the diagnosis, screening and management of twins as well as the timing and mode of birth.Twin pregnancies can be classified as dichorionic diamniotic (DC DA), monochorionic diamniotic (MC DA) and monochorionic monoamniotic (MC MA) which are always monochorionic.Twin pregnancies can be concordant (both twins are affected) or discordant (only one twin is affected) for chromosomal defects, malformations, growth restriction and hemodynamic disorders. Read More

J Matern Fetal Neonatal Med 2020 Sep 9:1-6. Epub 2020 Sep 9.

Gentic Medical Center, Guangdong Women and Children Hospital, Guangzhou, China.

Objective: To compare prenatal and perinatal outcomes of twin pregnancies in which one twin the nuchal translucency (NT) was above the 95th percentile in dichorionic twins (DCT) and monochorionic twins (MCT).

Method: In this retrospective study, 93 twin pregnancies (186 fetuses) in which one twin the NT was above the 95th percentile and the co-twin had normal NT were analyzed. Results of of G-banding and Chromosomal microarray (CMA), ultrasound findings and pregnancy outcomes were reviewed. Read More

Pediatr Dermatol 2020 Nov 8;37(6):1189-1190. Epub 2020 Sep 8.

Division of Dermatology, Department of Medicine, National University Hospital, Singapore, Singapore.

Over the years, the application and complications of radiofrequency ablation (RFA) in selective fetal reduction for complex pregnancies have been increasingly documented. Despite its rising use in the field of obstetrics and gynecology, the cutaneous complications of RFA have not been commonly reported. Here, we present a case of cutaneous thermal injury to the fetus likely secondary to intrauterine RFA for fetal reduction. Read More

J Ayurveda Integr Med 2021 Jan-Mar;12(1):198-205. Epub 2020 Aug 24.

Department of Kriya Sharir Faculty of Ayurveda, Institute of Medical Sciences Banaras Hindu University, Varanasi, India.

Tissue nutrition is the continuous process which is established just after the conception and persists throughout the life. Ayurveda scholars have mentioned that the manner of tissue nutrition is not same in all phases of life. In prenatal life embryo gets nutrition by Upasneha (filtration) and Upasweda (percolation/secretion) and fetus by Garbhanabhinadi (umbilical cord) which is attached with the heart of mother via Rasavahanadi (blood vessels). Read More

BMJ Open 2020 08 13;10(8):e034995. Epub 2020 Aug 13.

Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China

Introduction: Complicated monochorionic twin pregnancies are often associated with high perinatal morbidity and mortality, some of which are severe enough to require a gestational reduction surgery to improve fetal survival and reduce disabilities. While radiofrequency ablation is currently the most commonly used procedure with higher fetal survival and fewer maternal and fetal complications compared with other surgical methods, the therapeutic effect of microwave ablation (MWA) is reported to be better, presumably due to the higher thermal effect and fewer restrictions. Currently there is limited evidence to prove the feasibility of MWA for selective reduction. Read More

Diagnostics (Basel) 2020 Jul 29;10(8). Epub 2020 Jul 29.

Centre for Human Reproduction, Genesis Athens Clinic, 14-16, Papanikoli, 15232 Athens, Greece.

A single, healthy, 44-year-old perimenopausal woman pursuing a pregnancy, employed donor embryos, resulting to a dichorionic diamniotic twin pregnancy. In the 18th week of gestation severe symptoms indicated early onset preeclampsia reporting severe hypertension (BP 180/90 mmHg), intense headaches and nausea as well as elevated 24-h urine protein levels (1.5 g/day). Read More

Fetal Diagn Ther 2020 Jul 31:1-10. Epub 2020 Jul 31.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA,

Introduction: Management options for treatment of twin-twin transfusion syndrome (TTTS) with severe donor intrauterine growth restriction (IUGR) include fetoscopic laser surgery and umbilical cord occlusion (UCO). We studied perinatal survival outcomes in this select group after laser surgery, stratifying patients by preoperative estimated fetal weight (EFW) discordance.

Methods: In this retrospective study of monochorionic diamniotic twin gestations with TTTS and selective donor IUGR who underwent laser surgery (2006-2017), preoperative EFW discordance was calculated ([(larger twin - smaller twin)/(larger twin)] × 100) and cases were divided into discordance strata. Read More

Am J Obstet Gynecol 2021 02 27;224(2):213.e1-213.e11. Epub 2020 Jul 27.

Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, Leiden, the Netherlands.

Background: Twin anemia polycythemia sequence is a chronic form of unbalanced fetofetal transfusion through minuscule placental anastomoses in monochorionic twins, leading to anemia in the donor and polycythemia in the recipient. Owing to the low incidence of twin anemia polycythemia sequence, data on diagnosis, management, and outcome are limited.

Objective: This study aimed to investigate the diagnosis, management, and outcome in a large international cohort of spontaneous twin anemia polycythemia sequence. Read More

Hum Fertil (Camb) 2020 Jul 15:1-11. Epub 2020 Jul 15.

Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.

Intracytoplasmic sperm injection (ICSI) is frequently used to overcome severe deficits in semen quality. Concerns, however, are arising over its increasing use for non-male factor infertility. Moreover, increased risk of cardiovascular disease, congenital abnormalities, aneuploidies and childhood cancers have all been reported in the literature in relation to ICSI and it is possible that the quality of sperm chosen for injection may be an important factor in these unwanted outcomes. Read More

Toxicol Sci 2020 10;177(2):420-430

UCIBIO, REQUIMTE, Laboratório de Bioquímica, Departamento de Ciências Biológicas, Faculdade de Farmácia, Universidade do Porto, 4050-313 Porto, Portugal.

Cannabis consumption is increasing worldwide either for recreational or medical purposes. Its use during gestation is associated with negative pregnancy outcomes such as, intrauterine growth restriction, preterm birth, low birth weight, and increased risk of miscarriage, though the underlying molecular mechanisms are unknown. Cannabis sativa main psychoactive compound, Δ9-tetrahydrocannabinol (THC) is highly lipophilic, and as such, readily crosses the placenta. Read More