Diagnosis and Surgical Treatment of Hydatidiform Mole.

Hydatidiform mole is a trophoblastic disorder resulting from abnormal fertilization. Diagnosis is established through a combination of clinical findings, elevated serum human chorionic gonadotropin (hCG) levels, and characteristic features on transvaginal ultrasound. Timely and accurate diagnosis is essential for initiating prompt treatment and preventing medical complications.

Prenatal Ultrasonographic Markers of Macrossomia and C-Peptide in Gestational Diabetes Mellitus: A Prospective Cohort Study.

To investigate the association between prenatal ultrasonographic markers of macrossomia and C-peptide, a neonatal hyperinsulinemia marker, in pregnancies complicated by gestational diabetes mellitus (GDM), with a focus on fetal adipose tissue thickness, liver length, and interventricular septal thickness. : This prospective cohort study included 223 pregnant women followed from 28 to 36 weeks of gestation in two referral centers in Brazil. The GDM group and matched controls underwent serial ultrasound assessments of fetal biometry, including thigh, abdominal, and subscapular skinfolds, fetal liver length, and interventricular septum thickness.

Fetoscopic Reduction and Closure for Complex Gastroschisis: A Novel Minimally Invasive Prenatal Approach.

Unlabelled: Gastroschisis is a congenital defect where fetal intestines herniate through an abdominal wall opening. Although postnatal surgical repair is standard, fetal surgery via fetoscopic techniques is emerging as a potential intervention, particularly for complex cases. This case report documents a fetoscopic technique for in utero gastroschisis correction with favorable outcomes.

Molar Pregnancy: Early Diagnosis, Clinical Management, and the Role of Referral Centers.

Molar pregnancy (MP) is a gestational disorder resulting from abnormal fertilization, leading to atypical trophoblastic proliferation and the formation of a complete or partial hydatidiform mole. This condition represents the most common form of gestational trophoblastic disease (GTD) and carries a significant risk of progression to gestational trophoblastic neoplasia (GTN). Although rare in high-income countries, MP remains up to ten times more prevalent in low-income and developing countries, contributing to preventable maternal morbidity and mortality.

HTLV-1 in Pregnancy and Neonatal Health: Evidence, Challenges, and Future Directions.

Human T-cell lymphotropic virus (HTLV), a retrovirus associated with severe conditions such as leukemia/lymphoma and myelopathy, exhibits variable global prevalence, with higher rates observed in regions such as northeastern Brazil and sub-Saharan Africa. While intrauterine transmission can occur via viral expression in placental tissue and contact with umbilical cord blood, the predominant route is vertical transmission through breastfeeding. Diagnostic testing, particularly serological screening with ELISA and confirmatory methods such as Western blot and PCR, is essential for early detection during pregnancy.

Factors associated with death in newborns with gastroschisis: a retrospective cohort study from a single reference center.

Objective: The objective of this study was to assess the risk factors for neonatal death in newborns with gastroschisis.

Methods: Hospital-based secondary analysis of a retrospective cohort study was performed in a single reference center between January 2014 and December 2023. The following variables were evaluated: maternal characteristics, obstetric aspects, habits, and labor and delivery data.

Prenatal diagnosis of Apert syndrome with continuation of pregnancy-a report of two cases.

Background: Craniosynostosis, the premature fusion of cranial sutures, may occur in isolated or syndromic forms. Among syndromic craniosynostoses, Apert syndrome is a rare but significant condition, characterized by a triad of multisuture craniosynostosis, midface hypoplasia, and symmetric syndactyly of the hands and feet. Early prenatal diagnosis is challenging but essential for appropriate counseling and perinatal planning.

Fetal tachyarrhythmias: current knowledge for clinical practice.

Fetal arrhythmias account for 10-20% of all outpatient consultations in specialized fetal medicine centers. Furthermore, it is evident that tachyarrhythmias account for 8% of all such arrhythmias. Most arrhythmias are benign and easy to manage, but certain tachyarrhythmias require close monitoring due to the risk of decompensation, progression to heart failure with hydrops, and potential fetal death.

Family dynamics after diagnosis and surgical treatment of myelomeningocele: using telemedicine as a complementary tool.

Purpose: This study aimed to understand the late family dynamics of women who had pregnancies with fetuses diagnosed with myelomeningocele and who underwent fetal surgery using telemedicine as a complementary form of contact.

Methods: This retrospective cross-sectional quantitative and qualitative study was conducted between June 2022 and January 2023 at a private tertiary hospital in São Paulo, Brazil. The study participants, women who underwent fetal surgery for myelomeningocele correction, were invited to answer a questionnaire via Google Forms regarding socioeconomic data, prenatal care, information about fetal surgery, postnatal surgical procedures, and multidisciplinary follow-up of children, as well as the current dynamics of personal and family relationships.

Late prenatal diagnosis of complete pentalogy of Cantrell.

Cantrell's pentalogy is a rare syndrome associated with a midline embryological defect involving a series of malformations: anomalies of the lower sternum, anterior diaphragm, heart, and anterior abdominal wall. It can be classified as complete, probable or partial, but the most important thing is to describe and understand the anomalies involved. We describe a case of a late diagnosis of Cantrell's pentalogy at 35 weeks and 5 days of pregnancy in a woman from the interior of Pará state, an Amazon Brazilian region.

Fetal mortality before and during the COVID-19 pandemic: a single-center cohort study in Rio de Janeiro, Brazil.

Objective: The aim of this study was to compare the characteristics of pregnancies that resulted in fetal death before and during the COVID-19 pandemic in a private maternity hospital in Rio de Janeiro, Brazil.

Methods: This retrospective cohort study considered all pregnancies that ended in fetal death in a private maternity hospital in Rio de Janeiro, Brazil, from January 2018 to December 2021. Maternal and fetal characteristics were compared between the periods before the pandemic and during the pandemic.

Severe Maternal Morbidity and near Miss-Events in Women with Heart Disease: Insights from a Cohort Study.

The maternal mortality ratio is one of the global health indicators, and cardiopathies are the leading indirect causes of maternal deaths. Proper management of pregnant women with heart disease is crucial, as the severity of these conditions can lead to complications during the perinatal period. This study aimed to evaluate the rate of severe maternal morbidity and associated factors in pregnant women with heart disease.

Pessary for Prevention of Preterm Birth and Perinatal Mortality in Pregnancies with a Short Cervix: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

This systematic review and meta-analysis aimed to evaluate the efficacy of cervical pessaries in preventing perinatal mortality and extreme preterm birth in pregnancies characterized by a short cervix. : The analysis included data from nine randomized controlled trials (RCTs), incorporating a total of 3813 participants. These studies compared the use of cervical pessaries against standard care or other interventions in preventing preterm births in women with a short cervix, defined as less than 30 mm.

First-trimester screening for preeclampsia between 11 and 13 + 6 weeks of gestation and adverse perinatal outcomes.

Purpose: To evaluate the impact of first-trimester screening for preeclampsia (PE) and its association with adverse perinatal outcomes.

Methods: A retrospective cohort study was conducted in women with (Group I) or without (Group II) first-trimester screening for PE between 11 and 13 + 6 weeks using maternal characteristics, mean arterial pressure, and uterine artery Doppler. Women were classified as low and high risk using a cut-off value of 1:150 according to the Fetal Medicine Foundation guidelines.

Congenital Rubella Syndrome in the Post-Elimination Era: Why Vigilance Remains Essential.

Congenital Rubella Syndrome (CRS) results from maternal infection with the rubella virus during pregnancy, particularly in the first trimester, when the risk of vertical transmission and severe fetal damage is highest. CRS is characterized by a broad spectrum of congenital anomalies, including sensorineural hearing loss, congenital heart defects, cataracts, neurodevelopmental delay, and behavioral disorders. Despite the absence of specific antiviral therapies, active immunization remains the only effective strategy to prevent rubella infection and its congenital consequences.

Perinatal Outcomes Related to the Presence of a Nuchal Cord During Delivery: A Retrospective Cohort Study.

: To evaluate and compare whether the presence of a nuchal cord (NC) and its characteristics had a negative impact on perinatal outcomes during delivery. : This was a retrospective cohort study that analyzed the medical records of pregnant women from March 2020 to June 2023. Pregnant women were divided into groups with and without an NC.

Analysis of the epidemiologic, clinical, laboratory, ultrasonographic, and anatomopathological profile of women with hydatidiform mole at two referral centers in Northeastern Brazil.

Objective: To determine the profile of women undergoing uterine evacuation for suspected hydatidiform mole (HM) according to their clinical, laboratory, ultrasound, and anatomopathological characteristics at two referral centers in Northeastern Brazil.

Methods: Retrospective cohort study was performed in two referral centers between October 2016 and December 2022 with women undergoing uterine evacuation for suspected HM. Socio-demographic characteristics, clinics, biochemistry, ultrasound, anatomopathology, and outcome were evaluated.

Twin Reversed Arterial Perfusion (TRAP) Sequence Phenotypes: A Comprehensive Visual Analysis.

Twin reversed arterial perfusion (TRAP) sequence is a rare and severe complication of monochorionic twins, occurring in approximately 1 in 35 000 pregnancies. It is characterized by the presence of a severely abnormal, nonviable acardiac twin and a structurally normal pump twin, which sustains the circulation of both fetuses through abnormal vascular placental anastomoses. This pictorial essay aims to illustrate the sonographic and Doppler findings associated with TRAP sequence, emphasizing the diagnostic prenatal features.

Development of a Z-score equation for atrioventricular interval measurement by two-dimensional pulsed Doppler echocardiography in normal fetuses between 16 and 33+6 weeks of gestation.

Purpose: Fetal echocardiography is the primary diagnostic tool for assessing the atrioventricular (AV) time interval. Establishing a reference range for this parameter throughout pregnancy is essential for the early detection of potential abnormalities. The aim of this study was to develop a Z-score equation and establish specific percentiles for the AV time interval in normal fetuses between 16 and 33+6 weeks of gestation.

Approach to external cephalic version through social media: experience from a tertiary center in Brazil.

Objective: The aim of this study was to develop a communication and health education page on external cephalic version through the social media Instagram and, second, to assess the degree of patients' prior understanding of the external cephalic version procedure.

Methods: We conducted a prospective cohort study on 133 singleton pregnancies (until 41 weeks of gestation), for which an online questionnaire (Google Forms) was applied on the social media Instagram, with four sections. The questionnaire was applied between January 2022 and December 2023.

Maternal and Perinatal Outcomes in Pregnant Women with Cancer: A Single-Center Retrospective Cohort Study.

The aim of our study was to evaluate maternal and perinatal outcomes in pregnant women diagnosed with cancer and treated at a single referral center in Brazil. This retrospective cohort study analyzed medical records from January 2008 to December 2020. Demographic, clinical, obstetric, and tumor-related variables were assessed.