Assessment of the Fetal Sylvian Fissure in the Setting of Diffuse Cortical Abnormalities Detection: A Comparison of Published Methods.

Objectives: The aim of this study is to compare the accuracy of the currently published techniques for Sylvian fissure (SF) evaluation on the axial plane in normal fetuses and in fetuses with confirmed diffuse malformation of cortical development (MCD).

Methods: We performed a retrospective study in which the SF was assessed from fetuses between 22 and 33 weeks of gestation on a 2D transabdominal axial plane by means of subjective and objective methods derived from a literature search. The accuracy of the different techniques to predict the presence or the absence of MCD was compared.

Correlation between clinical and sonographic assessment of the fetal head station in the second stage of labor: a prospective observational study.

Background: A correct estimation of the head level is required to evaluate labor progression and decide how to best expedite birth - i.e. instrumental vs cesarean delivery - if dystocia or fetal distress are diagnosed during the second stage.

Standardization of the sonographic measurement of the head to perineum distance: A pilot study comparing techniques with and without perineal compression.

Objectives: To evaluate the relationship between head-to-perineum distance (HPD) measurements obtained with (compressed HPD) and without (uncompressed HPD) compression of the perineum, and to establish a conversion rule between these measurements. Additionally, we investigated whether the body mass index (BMI) of the participant impacted these two types of measurements.

Study Design: Prospective cohort study conducted at the University Hospital of Parma, Italy, involving a non-consecutive cohort of singleton pregnancies with cephalic presenting fetus at 37 weeks or more.

Foetal Cardiac Function in Early Labour and Intrapartum Outcomes: A Prospective Observational Study.

Objective: To assess foetal myocardial deformation in normo-oxygenated foetuses in early labour and its relationship with intrapartum outcomes.

Design: Single centre prospective study.

Setting: Referral tertiary maternity unit.

Intrauterine fetal resuscitation: from maternal repositioning to the latest pharmacological strategies.

Intrauterine resuscitation includes different interventions which aim to improve fetal oxygenation when intrapartum fetal hypoxic stress leading to abnormal CTG features is suspected. Based on the etiology of the hypoxic stress, prompt institution of specific conservative measures, aiming to restore fetal oxygenation and normalize the features of the CTG trace, may reduce the incidence of unnecessary operative deliveries. However, there is paucity of evidence supporting the effectiveness of intrauterine resuscitation measures: based on available data, routine administration of fluid boluses is not recommended and should be limited only to volume-depleted patients, in which intravenous hydration has been associated with potential benefits.

Development and Validation of the Italian Pregnancy Nutrition Knowledge Questionnaire (ItPreNKQ): A Nutrition Knowledge Questionnaire for Pregnant Italian Women.

: Maternal nutrition during pregnancy exerts a significant influence on both maternal and foetal health, as well as long-term child development. Despite its importance, adherence to dietary guidelines among pregnant women remains low. The present study aimed to develop and validate the Italian Pregnancy Nutrition Knowledge Questionnaire (ItPreNKQ), based on national dietary guidelines for the pregnant Italian population, assessing its reliability and validity.

First Intrapartum Sonographic Diagnosis of Fetal Hypoxic-Ischemic Encephalopathy.

Introduction: Hypoxic-ischemic encephalopathy (HIE) is a syndrome involving the fetal central nervous system as the result of a perinatal hypoxic-ischemic injury. To date, transfontanellar ultrasound represents the first-line exam in neonates with clinical suspicion of HIE as it allows the showing of features indicating acute hypoxic injury and excludes potential non-hypoxic determinants of HIE; however, there is no report concerning the sonographic assessment of the brain during labor. In this clinical case, we report the intrapartum sonographic evaluation of the fetal brain as a tool for the differential diagnosis of cardiotocographic abnormalities.

Vacuum extraction is successful in 95% of cases with an occiput posterior position: the results of a prospective, multicenter study.

Background: Occiput posterior position is associated with labor arrest, need for operative delivery, and failed instrumental vaginal delivery, with resulting adverse peripartum outcomes. Vacuum extraction is the most commonly performed type of instrumental delivery worldwide.

Objective: This study aimed to investigate the outcome of vacuum extraction in fetuses with sonographically confirmed occiput posterior position before the procedure.

Efficacy of intrapartum bundles and interventions in reducing vaginal delivery-related perineal trauma: a systematic review.

Objective: The aim of this systematic review is to summarize the current evidence on preventive interventions and bundles, including combinations of multiple techniques, aimed at reducing vaginal delivery-related perineal injury.

Methods: A systematic research of literature was independently conducted on different databases (PubMed, MEDLINE, EMBASE) by the authors, using a combination of the identified keywords and index terms as per current PRISMA guidelines. The research was restricted to papers published in English starting by 2000.

Ultrasound evaluation of the size of the umbilical cord vessels and Wharton's jelly and correlation with intrapartum CTG findings.

Objective: To compare the sonographic measurement of the umbilical cord between women with or without repetitive decelerations during the first stage of labor.

Study Design: Prospective study including a non-consecutive cohort of women at term gestation carrying a normal sized fetus at term in cephalic presentation. The cross-sectional area of the umbilical cord, of its vessels and the amount of the Wharton's jelly were assessed at 2D ultrasound upon labor admission.

Ectopic Atrial Beats May Cause a ZigZag Pattern at Intrapartum Recording of the Fetal Heart Rate Using Fetal Scalp Electrode.

Introduction: Fetal scalp electrode (FSE) is considered the gold standard for the intrapartum monitoring of the fetal heart rate (FHR) being associated with the lowest rate of signal loss and artifacts including the recording of the maternal heart rate. FSE acquires a fetal electrocardiogram and evaluates the time intervals between successive R waves. As such, it allows the recording of the beat-to-beat fluctuation of the FHR.

Reproducibility Analysis of Two Speckle Tracking Software for the Antenatal Semiautomated Assessment of the Fetal Cardiac Function.

Introduction: Speckle tracking echocardiography is a non-Doppler modality allowing the semiautomated evaluation of the fetal cardiac function by tracking the speckles of the endocardial borders. Little evidence is available on the evaluation and comparison of different software for the functional assessment of the fetal heart by means of speckle tracking echocardiography. The aim of this study was to evaluate the reproducibility and agreement of two different proprietary speckle tracking software for the prenatal semiautomated assessment of the fetal cardiac function.

A deep learning approach to identify the fetal head position using transperineal ultrasound during labor.

Objectives: To develop a deep learning (DL)-model using convolutional neural networks (CNN) to automatically identify the fetal head position at transperineal ultrasound in the second stage of labor.

Material And Methods: Prospective, multicenter study including singleton, term, cephalic pregnancies in the second stage of labor. We assessed the fetal head position using transabdominal ultrasound and subsequently, obtained an image of the fetal head on the axial plane using transperineal ultrasound and labeled it according to the transabdominal ultrasound findings.

Relative uteroplacental insufficiency of labor.

Relative uteroplacental insufficiency of labor (RUPI-L) is a clinical condition that refers to alterations in the fetal oxygen "demand-supply" equation caused by the onset of regular uterine activity. The term RUPI-L indicates a condition of "relative" uteroplacental insufficiency which is relative to a specific stressful circumstance, such as the onset of regular uterine activity. RUPI-L may be more prevalent in fetuses in which the ratio between the fetal oxygen supply and demand is already slightly reduced, such as in cases of subclinical placental insufficiency, post-term pregnancies, gestational diabetes, and other similar conditions.