A Practical Prenatal Ultrasound Classification System for Lower Limb Anomalies-PRELLIM Classification.

Objective: To address the current lack of a prenatal classification system for fetal lower limb anomalies, we developed and evaluated the PRELLIM (PREnatal Lower LIMb impairment) classification.

Method: A systematic literature review was conducted to identify existing classifications. Based on sonographic features, we developed the PRELLIM classification and applied it to a retrospective cohort of fetuses with isolated lower limb anomalies assessed between 2007 and 2024 at Amsterdam UMC's fetal medicine unit.

The Influence of the Introduction of Fetal Anomaly Scans on Pregnancy Terminations in Cases of Upper Limb Anomalies: A Retrospective Cohort Study From 2000 to 2023.

Objective: To examine the association between the introduction of the fetal anomaly scans in the Netherlands and termination of pregnancy (TOP) in cases of prenatally detected upper limb anomalies.

Methods: We conducted a retrospective study among prenatally detected upper limb anomalies between 2000 and 2023. Anomalies were categorized as reduction defects, syndactyly, or polydactyly, and classified as isolated or non-isolated.

Postnatal outcomes of sonographically suspected isolated congenital lung anomalies.

Introduction: The aim was to evaluate the prenatal course, postnatal outcome and diagnostic accuracy of fetuses with a prenatal diagnosis of isolated congenital lung anomalies (iCLA).

Methods: A retrospective cohort is described from the Amsterdam UMC between January 2007 and January 2022. The CPAM volume ratio (CVR) was calculated.

Pregnancy Complications in Fetal Congenital Heart Disease: A Result of Common Early Developmental Pathways Rather Than Fetal Hemodynamics.

Objective: The aim of this study was to compare placenta-related complications (adverse placental syndrome) between different types of fetal CHD based on cardiac hemodynamics.

Method: All CHD cases diagnosed prenatally by fetal ECHO during 2009-2023 were selected. Exclusion criteria were as follows: multiple pregnancies, pregnancy termination, known genetic aberrations, and extracardiac anomalies.

Phenotype-to-Genotype Description of Prenatal Suspected and Postnatal Discovered Upper Limb Anomalies: A Retrospective Cohort Study.

Objective: To evaluate phenotype and genotype characteristics of fetuses and children with upper limb anomalies.

Method: Retrospective cohort study of a prenatal and postnatal cohort with upper limb anomalies from January 2007 to December 2021 in a Fetal Medicine Unit. Prenatally on ultrasound suspected upper limb anomalies, such as transverse and longitudinal reduction defects, polydactyly, and syndactyly, and postnatally identified children referred to the Congenital Hand Team were evaluated separately.

Pregnant individuals perspectives towards receiving COVID-19 vaccination during their pregnancy: an in-depth qualitative study.

Introduction: Pregnant individuals have an increased risk of severe illness from coronavirus disease 2019 (COVID-19) infection. Vaccination is an effective strategy to prevent severe illness and complications for pregnant individuals. Pregnant individuals are often excluded from research and remain hesitant to receive vaccination against COVID-19.

Prevotella timonensis Bacteria Associated With Vaginal Dysbiosis Enhance Human Immunodeficiency Virus Type 1 Susceptibility Of Vaginal CD4+ T Cells.

Dysbiosis of the vaginal microbiome poses a serious risk for sexual human immunodeficiency virus type 1 (HIV-1) transmission. Prevotella spp are abundant during vaginal dysbiosis and associated with enhanced HIV-1 susceptibility; however, underlying mechanisms remain unclear. Here, we investigated the direct effect of vaginal bacteria on HIV-1 susceptibility of vaginal CD4+ T cells.

Psychological sequelae following second-trimester termination of pregnancy: A longitudinal study.

Introduction: The decision to terminate a pregnancy due to fetal anomalies can have a significant emotional impact, especially in second-trimester terminations. Previous studies on the psychological consequences of pregnancy termination have had limitations, and little is known about the outcomes for partners and the impact of fetal donation. Therefore, we aimed to investigate the psychological effects of second-trimester pregnancy termination and identify factors associated with outcomes in both women and men, including donation of fetal remains to science.

Long-Acting Injectable Cabotegravir and Rilpivirine in a Pregnant Woman With HIV.

This case report describes the effects of bimonthly long-acting injectable cabotegravir (CAB)/RPV before and throughout pregnancy. CAB concentrations were comparable to those in nonpregnant individuals; RPV concentrations were 70%-75% lower. No virologic failure or vertical transmission occurred.

COVID-19 mRNA vaccination during pregnancy does not harm syncytiotrophoblast development.

Objectives: The safety of COVID-19 messenger RNA (mRNA) vaccination during pregnancy remains a topic of concern. Its effect on placenta development has been poorly studied, even though this is essential for healthy pregnancy outcomes. We investigated the effect of the maternal immune response to COVID-19 mRNA vaccination on the development of syncytiotrophoblast (STB), a functional cell layer of the placenta where the maternal-fetal exchange takes place.

Increased Pulmonary-Aortic Interspace in Fetal Right Aortic Arch: A Matched Case-Control Study.

Introduction: The prenatal detection rate of a right aortic arch (RAA) has increased with the implementation of the three-vessel view (3VV) to the second-trimester anomaly scan formed by the pulmonary artery (PA), aorta (Ao), and superior vena cava (SVC). We examined the value of measuring the distance between PA and Ao in the 3VV in cases with an RAA.

Methods: We conducted a case-control study in which fetuses with an isolated RAA were matched to 3 healthy controls.

Changes in the Prevalence of Infection in Pregnant Women during the COVID-19 Lockdown.

Background: During the outbreak of SARS-CoV-2, strict mitigation measures and national lockdowns were implemented. Our objective was to investigate to what extent the prevalence of some infections in pregnancy was altered during different periods of the COVID-19 pandemic.

Methods: This was a single centre retrospective cohort study conducted in the Netherlands on data collected from electronic patient files of pregnant women from January 2017 to February 2021.

Benzylpenicillin concentrations in umbilical cord blood and plasma of premature neonates following intrapartum doses for group B streptococcal prophylaxis.

Background And Method: Dutch obstetrics guideline suggest an initial maternal benzylpenicillin dose of 2,000,000 IU followed by 1,000,000 IU every 4 h for group-B-streptococci (GBS) prophylaxis. The objective of this study was to evaluate whether concentrations of benzylpenicillin reached concentrations above the minimal inhibitory concentrations (MIC) in umbilical cord blood (UCB) and neonatal plasma following the Dutch guideline.

Results: Forty-six neonates were included.

Early Detection of Isolated Severe Congenital Heart Defects Is Associated with a Lower Threshold to Terminate the Pregnancy.

Introduction: Early detection of isolated severe congenital heart defects (CHDs) allows extra time for chromosomal analysis and informed decision making, resulting in improved perinatal management and patient satisfaction. Therefore, the aim of this study was to assess the value of an additional first-trimester screening scan compared to only a second-trimester scan in fetuses diagnosed with isolated severe CHDs. Prenatal detection rate, time of prenatal diagnosis, and pregnancy outcome were evaluated in the Netherlands after implementation of a national screening program.

Financial contribution as reason to opt out of non-invasive prenatal testing.

Objective: First trimester non-invasive prenatal testing (NIPT) provides pregnant women with a reliable, non-invasive method to screen for fetal aneuploidies. In the Netherlands, there is a nationwide prenatal screening program in which pregnant women and their partners are counseled about their options around 10 weeks of pregnancy. The first trimester and second trimester scan are fully reimbursed but the NIPT has an own financial contribution of €175 per participant, irrespective of type of insurance.

The influence of the introduction of a national prenatal screening program on late termination of pregnancy, a retrospective cohort study.

Objective: To assess the influence of a national prenatal screening program on category 1 (lethal anomalies) late terminations of pregnancy (LTOP).

Methods: In this population-based retrospective cohort study, we included all category 1 LTOPs from 2004 to 2015 in the Netherlands. The number of LTOPs before and after the introduction of the program was compared as well as the diagnostic process and factors contributing to LTOP.

Exploring the Breastfeeding Desires and Decision-Making of Women Living with HIV in the Netherlands: Implications for Perinatal HIV Management in Developed Countries.

Guidelines in high-income countries recommend women living with human immunodeficiency virus (HIV) to formula feed their newborns, because the possibility of mother-to-child-transmission of HIV during breastfeeding cannot be ruled out. It is an ongoing debate if the possible transmission risk outweighs the medical, cultural, psychological, and social importance of breastfeeding in women stable on current first-line suppressive antiretroviral regimens. The study aim was to explore breastfeeding desires and decision-making of immigrant and nonimmigrant women living with HIV in the Netherlands.

Vaccination from the early second trimester onwards gives a robust SARS-CoV-2 antibody response throughout pregnancy and provides antibodies for the neonate.

Objectives: Preventive measures against COVID-19 are essential for pregnant women. Pregnant women are particularly vulnerable to emerging infectious pathogens due to alterations in their physiology. We aimed to determine the optimum timing of vaccination to protect pregnant women and their neonates from COVID-19.

Immune activation of vaginal human Langerhans cells increases susceptibility to HIV-1 infection.

Vaginal inflammation increases the risk for sexual HIV-1 transmission but underlying mechanisms remain unclear. In this study we assessed the impact of immune activation on HIV-1 susceptibility of primary human vaginal Langerhans cells (LCs). Vaginal LCs isolated from human vaginal tissue expressed a broad range of TLRs and became activated after exposure to both viral and bacterial TLR ligands.

Short-term outcome after the prenatal diagnosis of right aortic arch.

Objectives: To determine the proportion of children that require surgery in the first year of life and thereafter in order to improve the counseling of parents with a fetus with a right aortic arch (RAA).

Methods: Fetuses diagnosed with isolated RAA, defined as the absence of intra- or extracardiac anomalies, between 2007 and 2021 were extracted from the prospective registry PRECOR.

Results: In total, 110 fetuses were included, 92 with a prenatal diagnosis of RAA and 18 with double aortic arch (DAA).

Diagnostic work-up of urinary tract infections in pregnancy: study protocol of a prospective cohort study.

Introduction: Symptoms of urinary tract infections in pregnant women are often less specific, in contrast to non-pregnant women where typical clinical symptoms of a urinary tract infection are sufficient to diagnose urinary tract infections. Moreover, symptoms of a urinary tract infection can mimic pregnancy-related symptoms, or symptoms of a threatened preterm birth, such as contractions. In order to diagnose or rule out a urinary tract infection, additional diagnostic testing is required.