Complement proteins, annexin V, and angiogenic markers in placental tissue of autoimmune disease patients.

Introduction: Autoimmune diseases (AID) such as systemic lupus erythematosus (SLE), antiphospholipid syndrome (APS) or non-criteria-obstetric antiphospholipid syndrome (NC-OAPS) increase the risk of adverse perinatal outcomes (APO). During pregnancy the deregulation of the complement system and the angiogenic factors cause damage to the placenta, resulting in the development of APO. The aim is to evaluate the placental expression of complement proteins, Annexin V (ANNV) and angiogenic factors in patients diagnosed with AID and compare it with healthy controls and fetal growth restricted (FGR) cases.

Clinical practice guidance for the management of fetal growth restriction: an expert review.

Background: Fetal growth restriction (FGR) is associated to increased perinatal morbidity and mortality. Prenatal identification and subsequent intervention can improve outcomes. Our aim was to provide recommendations of the management of FGR reaching all possible scenarios (high-income and low-middle-income countries, referral as well as referring centers) but not to stablish a universal standard of care.

Screening and diagnosis of fetal growth restriction: an expert review.

Background: Fetal growth restriction (FGR) is associated to increased perinatal morbidity and mortality. Prenatal identification and subsequent intervention can improve outcomes. Our aim is to provide recommendations regarding the diagnosis and screening of FGR addresing diverse clinical settings-including both high-income and low-to-middle-income countries, as well as both referral and referring centers.

Economic Impact of Severe Early-Onset Foetal Growth Restriction: A Multicentre Prospective Cohort Study.

Objective: Foetal growth restriction (FGR) affects 10% of pregnancies, contributing to 30% of stillbirths. Current management of early-onset FGR (< 32 + 0 weeks' gestation) delivers the foetus before stillbirth or irreversible organ damage. The resulting preterm births create additional risks independent of FGR.

Preterm prelabor rupture of membranes: the use of amniocentesis to detect intraamniotic infection reduces maternal and neonatal duration of antibiotic exposure.

Background: Current management guidelines for patients with preterm prelabor rupture of membranes at <32+0 weeks of gestation recommend administering antibiotics, although evidence on their benefits for short- and long-term neonatal outcomes is poor.

Objective: This study aimed to evaluate whether the use of amniocentesis to detect intraamniotic infection reduces maternal and neonatal duration of antibiotic exposure.

Study Design: This was a retrospective observational cohort study (2014-2023) including patients diagnosed with preterm prelabor rupture of membranes at <32+0 weeks of gestation who underwent amniocentesis at admission to assess the presence of intraamniotic infection.

Anxiety and depression during pregnancy: Differential impact in cases complicated by preeclampsia and preterm premature rupture of membranes.

Background: Maternal mental health is crucial for the well-being of both the mother and the fetus. Obstetric complications have been linked to anxiety and depression during pregnancy. Among them, preeclampsia (PE) and preterm premature rupture of membranes (PPROM), are the more common causes of maternal admission.

Non-Criteria Obstetric Antiphospholipid Syndrome: Myth or Reality?

Women with adverse pregnancy outcomes suggestive of obstetric antiphospholipid syndrome (OAPS), but not fulfilling clinical and/or laboratory international classification criteria, are increasingly recognized both in clinical practice and in the literature. This entity is termed non-criteria OAPS (NC-OAPS). It includes clinical scenarios such as two unexplained pregnancy losses, three non-consecutive pregnancy losses, late pre-eclampsia/eclampsia/signs of placental insufficiency, or recurrent implantation failure, as well as positive low-titers of antiphospholipid antibodies (aPLs) and non-classical aPLs.

First-Trimester Universal One-Time Serology Screening for Cytomegalovirus: A Pilot Study at Two Tertiary Referral Centers in Barcelona (Catalunya, Spain).

Introduction: Congenital cytomegalovirus (cCMV) is the main infectious cause of sensorineural hearing loss and neurodevelopmental disability. First-trimester and periconceptional period are the most vulnerable times for fetal injury. Universal serological cytomegalovirus (CMV) screening in pregnant women is not currently recommended.

CustOmized versus standard fundal-height measuREments for the detection of small-for-gestational age fetuses in low-risk women (CORE study): A randomized controlled trial.

Objective: To compare the proportion of small-for-gestational age (SGA) infants detected by routine care versus a growth assessment protocol using customized fundal-height charts in low-risk pregnancies of a developing country.

Methods: An open label randomized controlled trial was conducted at the Fatima Memorial Hospital (NUR International University, Pakistan). Low-risk pregnant women were randomly allocated to routine care (Mcdonald's rule for fundal height measurements followed by referral for scan with discrepancy of 3 cm from gestational age and a contingency third trimester scan) or the growth assessment protocol (GAP) developed by the Perinatal Institute (UK), which consists of the use of gestation-related optimal weight (GROW) customized charts, alongside management protocols for suspected SGA fetuses, audit tools and training.

Treatment of early-onset fetal growth restriction with low molecular weight heparin does not prolong gestation: a randomized clinical trial.

Background: Although there is a biological basis for it, there is scarce evidence on the effect of heparin in ameliorating placental insufficiency and maximizing gestational age at delivery among fetal growth restriction pregnancies.

Objective: To explore the effectiveness of treatment using low molecular weight heparin at a prophylactic dose started at the time of diagnosis in prolonging gestation in pregnancies with early-onset fetal growth restriction.

Study Design: This was a phase III, multicenter, triple-blind, parallel-arm randomized clinical trial conducted in 2 university hospitals in Spain.

Added Value in Low-Risk Pregnancies of Longitudinal Changes in Uterine Doppler and Circulating Angiogenic Factors during the Third Trimester in Predicting Term Preeclampsia.

Introduction: The objective of this study was to assess the relationship between longitudinal changes in the uterine Doppler velocimetry and the maternal profile of angiogenic factors in the third trimester and to assess their ability to predict term preeclampsia (PE).

Methods: A cohort of low-risk pregnant women was scheduled for a uterine Doppler evaluation and measurement of the circulating levels of angiogenic factors at ∼30 and ∼36 weeks. The performance of both parameters and their change over time in predicting term PE was evaluated.

Cook's balloon versus dinoprostone for Labour induction of term pregnancies with fetal GROWth restriction: study protocol for a randomised controlled trial in tertiary maternity hospitals in Spain (COLIGROW study).

Introduction: Fetal growth restriction (FGR) affects about 3%-5% of term pregnancies. If prenatally detected and anterograde umbilical artery flow is preserved (stage I), it is recommended to deliver at term (≥ 37+0 weeks). In the absence of contraindications, the vaginal route is preferred, and labour induction is usually required.

[Postpartum progression of anxiety and depression levels in mothers of premature newborns].

Objective: The postpartum period represents a vulnerable time for women's mental health, especially for those with complications and prematurity. This study aims to explore the evolution of depression and anxiety levels during the 12 weeks postpartum in mothers of premature babies.

Design: Prospective study of two parallel cohorts.

Development and validation of a prognostic model to predict birth weight: individual participant data meta-analysis.

Objective: To predict birth weight at various potential gestational ages of delivery based on data routinely available at the first antenatal visit.

Design: Individual participant data meta-analysis.

Data Sources: Individual participant data of four cohorts (237 228 pregnancies) from the International Prediction of Pregnancy Complications (IPPIC) network dataset.

Multicentre randomised trial of screening with sFlt1/PlGF and planned delivery to prevent pre-eclampsia at term: protocol of the PE37 study.

Introduction: Pre-eclampsia affects ~5%-7% of pregnancies. Although improved obstetric care has significantly diminished its associated maternal mortality, it remains a leading cause of maternal morbidity and mortality in the world. Term pre-eclampsia accounts for 70% of all cases and a large proportion of maternal-fetal morbidity related to this condition.

Assessment of the cerebroplacental ratio and uterine arteries in low-risk pregnancies in early labour for the prediction of obstetric and neonatal outcomes.

Background: The evidence-based management of human labor includes the antepartum identification of patients at risk for intrapartum hypoxia. However, available evidence has shown that most of the hypoxic-related complications occur among pregnancies classified at low-risk for intrapartum hypoxia, thus suggesting that the current strategy to identify the pregnancies at risk for intrapartum fetal hypoxia has limited accuracy.

Objective: To evaluate the role of the combined assessment of the cerebroplacental ratio (CPR) and uterine arteries (UtA) Doppler in the prediction of obstetric intervention (OI) for suspected intrapartum fetal compromise (IFC) within a cohort of low-risk singleton term pregnancies in early labor.

Pregnancies through oocyte donation. A mini review of pathways involved in placental dysfunction.

Pregnancies resulting from assisted reproductive techniques (ART) are increasingly prevalent worldwide. While most pregnancies conceived through fertilization (IVF) progress without complications, mounting evidence suggests that these pregnancies are at a heightened risk of adverse perinatal outcomes. Specifically, IVF pregnancies involving oocyte donation have garnered attention due to numerous reports indicating an elevated risk profile for pregnancy-related complications within this subgroup of patients.

Routine third-trimester ultrasound assessment for intrauterine growth restriction.

Intrauterine growth restriction significantly impacts perinatal outcomes. Undetected IUGR escalates the risk of adverse outcomes. Serial symphysis-fundal height measurement, a recommended strategy, is insufficient in detecting abnormal fetal growth.

Term planned delivery based on fetal growth assessment with or without the cerebroplacental ratio in low-risk pregnancies (RATIO37): an international, multicentre, open-label, randomised controlled trial.

Background: The cerebroplacental ratio is associated with perinatal mortality and morbidity, but it is unknown whether routine measurement improves pregnancy outcomes. We aimed to evaluate whether the addition of cerebroplacental ratio measurement to the standard ultrasound growth assessment near term reduces perinatal mortality and severe neonatal morbidity, compared with growth assessment alone.

Methods: RATIO37 was a randomised, open-label, multicentre, pragmatic trial, conducted in low-risk pregnant women, recruited from nine hospitals over six countries.

Perinatal outcomes in 6640 singleton pregnancies after donor oocyte IVF across three continents over 7 years.

Purpose: Are trends in singleton donor oocyte IVF perinatal outcomes consistent over time among four international ethnically diverse infertility centers?

Methods: This retrospective cohort consisted of an infertility network of four international IVF centers across three continents. Singleton live births resulting from fresh and frozen donor oocyte embryo transfers from January 1, 2012 to December 31, 2018 were included. The main outcome measures were birth weight (BW), preterm birth (PTB), large for gestational age (LGA), small for gestational age (SGA) and gestational age (GA) at delivery.

Maternal PlGF and umbilical Dopplers predict pregnancy outcomes at diagnosis of early-onset fetal growth restriction.

BACKGROUNDSevere, early-onset fetal growth restriction (FGR) causes significant fetal and neonatal mortality and morbidity. Predicting the outcome of affected pregnancies at the time of diagnosis is difficult, thus preventing accurate patient counseling. We investigated the use of maternal serum protein and ultrasound measurements at diagnosis to predict fetal or neonatal death and 3 secondary outcomes: fetal death or delivery at or before 28+0 weeks, development of abnormal umbilical artery (UmA) Doppler velocimetry, and slow fetal growth.