Pulmonary T2* quantification of fetuses with congenital diaphragmatic hernia: a retrospective, case-controlled, MRI pilot study.

Background: Advanced MRI techniques, motion-correction and T2*-relaxometry, may provide information regarding functional properties of pulmonary tissue. We assessed whether lung volumes and pulmonary T2* values in fetuses with congenital diaphragmatic hernia (CDH) were lower than controls and differed between survivors and non-survivors.

Methods: Women with uncomplicated pregnancies (controls) and those with a CDH had a fetal MRI on a 1.

Controversies in the diagnosis and management of preterm prelabour rupture of the membranes.

Preterm prelabour rupture of the membranes precedes around 30% of spontaneous preterm births. As well as its associations with complications of prematurity, it is additionally associated with pulmonary hypoplasia as well as increased rates of maternal sepsis and its sequelae. However, all stages of clinical management remain a challenge: from diagnosis, through to management and timing of delivery.

Setting the Research Priorities for Pregnancy Scanning: A Nationally co-produced vision with expectant women, the public and healthcare professionals.

Objectives: Despite sonography studies being integral to routine high quality antenatal care, clinical research in this field is less commonly initiated or led by sonography professionals. It is also unclear what the research priorities are for service users within the UK's sonography screening and diagnostic pathway.

Methods: Here, we present a national priority setting partnership project, which included two surveys which were co-produced with the oversight of a stakeholder PSP group comprising service users and healthcare professionals, n = 12.

Intraoperative Ultrasound as a Decision-Making Tool in Modern Gynecologic Oncology.

Intraoperative ultrasound (IOUS) is revolutionizing gynecologic oncology surgery by overcoming the limitations of traditional imaging and intraoperative assessment. Its real-time, high-resolution capabilities address critical needs in tumor localization, fertility preservation, refined intraoperative decisions, and complete cytoreduction. We reviewed clinical studies (1998-2024) evaluating IOUS applications, analyzing data on detection accuracy, surgical outcomes, and implementation challenges from peer-reviewed literature and institutional experiences.

Comprehensive assessment of uterine contractility using a large database of dynamic T2∗ studies.

Introduction: Uterine contractile activity, essential for vaginal birth, begins early in gestation, but quantitative assessment remains limited. T2∗ relaxometry detects placental oxygenation changes during contractions, offering insights into placental function. This study uses a large dynamic T2∗ MRI database and an AI-driven pipeline to assess contractile activity, quantify prevalence, and explore links with clinical and scanning variables.

Diversity of representation in pregnancy research: A national mixed-methods survey of women's perceptions and experiences in the United Kingdom.

Aim: To explore the experiences and perceptions of women who may take part in antenatal research, including their perceived motivators, enablers, and barriers to participating in research with a sub-analysis of under-represented groups.

Methods: A mixed-methods parallel explanatory design was employed, and a national semi-structured online survey was circulated nationally using a start to end participatory framework. Likert scale responses and participant experience and demographic data were cross-tabulated to explore the differences between groups using descriptive and non-parametric statistics.

The role of cervical cerclage in preventing preterm birth.

Cervical cerclage is an established intervention for the prevention of preterm birth in high-risk pregnancies. Although there is evidence to support the use of cervical cerclage in certain clinical situations, questions remain regarding its optimal application. As there are multiple underlying aetiologies of preterm birth, identifying the population of women who would benefit most from cerclage remains an ongoing clinical challenge.

Escalating caesarean deliveries and the impact on subsequent preterm birth.

The rate of caesarean section, including those performed in-labour, is on the rise. Worldwide 1 in 5 women are delivering by caesarean section. Emerging evidence has demonstrated an association between in-labour caesarean section and mid-trimester loss (delivery between 14 and 24 weeks gestation) as well as spontaneous preterm birth, (delivery before 37 weeks' gestation).

Automated cervix biometry, volumetry and normative models for 3D motion-corrected T2-weighted 0.55-3T fetal MRI during 2nd and 3rd trimesters.

Fetal MRI provides superior tissue contrast and true 3D spatial information however there is only a limited number of number of MRI studies investigating cervix during pregnancy. Furthermore, there are no clearly formalised protocols or automated methods for MRI cervical measurements. This work introduces the first deep learning pipeline for automated multi-layer segmentation and biometry for 3D T2w images of the pregnant cervix.

Automatic flow planning for fetal cardiovascular magnetic resonance imaging.

Background: Widening access to fetal flow imaging by automating real-time planning of two-dimensional (2D) phase-contrast flow imaging (OWL).

Methods: Two subsequent deep learning networks for fetal body localization and cardiac landmark detection on a coronal whole-uterus scan were trained on 167 and 71 fetal datasets, respectively, and implemented for real-time automatic planning of phase-contrast sequences. OWL was evaluated retrospectively in ten datasets and prospectively in seven fetal subjects (36+3-39+3 gestational weeks), with qualitative and quantitative comparisons to manual planning.

Real-time fetal brain and placental T2* mapping at 0.55T MRI.

Purpose: To provide real-time, organ-specific quantitative information - specifically placental and fetal brain T2 * - to optimize and personalize fetal MRI examinations.

Methods: A low-latency setup enables real-time processing, including segmentation, T2* fitting, and centile calculation. Two nnU-Nets were trained on 2 989 fetal brains, and 540 placental datasets for automatic segmentation.

Management of impacted fetal head at caesarean section - Current practice and future development.

Worldwide, more than 1 in 5 women give birth by cesarean delivery, and at least 5% of these births are at full dilatation. In labour and at full dilatation, a caesarean section can be technically challenging and is associated with greater risks. The fetal head is lower and can be wedged within the maternal pelvis making it more difficult to deliver, a situation known as 'impacted fetal head'.

Scanner-based real-time three-dimensional brain + body slice-to-volume reconstruction for T2-weighted 0.55-T low-field fetal magnetic resonance imaging.

Background: Motion correction methods based on slice-to-volume registration (SVR) for fetal magnetic resonance imaging (MRI) allow reconstruction of three-dimensional (3-D) isotropic images of the fetal brain and body. However, all existing SVR methods are confined to research settings, which limits clinical integration. Furthermore, there have been no reported SVR solutions for low-field 0.

Assessment of the thymus in fetuses prior to spontaneous preterm birth using functional MRI.

Objectives: The aim of this study was to utilise T2* relaxometry (an indirect method of quantifying tissue oxygenation) to assess the fetal thymus in uncomplicated pregnancies throughout gestation and in a cohort of fetuses that subsequently deliver very preterm.

Methods: A control group of participants with low-risk pregnancies were recruited and retrospectively excluded if they developed any pregnancy related complications after scanning. Participants were recruited who were deemed to be at very high risk of delivery prior to 32 weeks' gestation and retrospectively excluded if they did not deliver prior to this gestation.

Automated craniofacial biometry with 3D T2w fetal MRI.

Objectives: Evaluating craniofacial phenotype-genotype correlations prenatally is increasingly important; however, it is subjective and challenging with 3D ultrasound. We developed an automated label propagation pipeline using 3D motion- corrected, slice-to-volume reconstructed (SVR) fetal MRI for craniofacial measurements.

Methods: A literature review and expert consensus identified 31 craniofacial biometrics for fetal MRI.

T* relaxometry of fetal brain structures using low-field (0.55T) MRI.

Purpose: Human brain development during gestation is complex, as both structure and function are rapidly forming. Structural imaging methods using MRI are well developed to explore these changes, but functional imaging tools are lacking. Low-field MRI is a promising modality to bridge this gap.

The role of virtual wards in maternity in the United Kingdom.

Virtual wards are an initiative which aims to provide hospital care from the comfort of the patient's own home. Monitoring and additional services, such as intravenous drugs and fluids and blood tests can be undertaken through this system. Although virtual wards have been used in the UK since 2005 in specialties such as General Medicine, General Surgery and Paediatrics, their use in maternity has been more limited.

INSIGHT-2: mechanistic studies into pregnancy complications and their impact on maternal and child health-study protocol.

Background: Pregnancy and early childhood cohorts provide a framework for investigating the complex interplay between early-life exposures and health outcomes, thereby informing prevention strategies and interventions to improve maternal and child health. In this paper, we outline the objectives, methodologies and expected contributions of INSIGHT-2, a comprehensive cohort study dedicated to advancing our understanding of pregnancy and pregnancy complications towards improving the health and well-being of mothers and their offspring.

Methods: Over the course of 5 years, the study aims to establish a diverse cohort of 1700 pregnant women and to follow up their children up to 2 years of age.

Placental T2* as a measure of placental function across field strength from 0.55T to 3T.

Placental MRI is increasingly implemented in clinical obstetrics and research. Functional imaging, especially T2*, has been shown to vary across gestation and in pathology. Translation into the clinical arena has been slow because of time taken to mask the region of interest and owing to differences in T2* results depending on field strength.

Automated Craniofacial Biometry with 3D T2w Fetal MRI.

Objectives: Evaluating craniofacial phenotype-genotype correlations prenatally is increasingly important; however, it is subjective and challenging with 3D ultrasound. We developed an automated landmark propagation pipeline using 3D motion-corrected, slice-to-volume reconstructed (SVR) fetal MRI for craniofacial measurements.

Methods: A literature review and expert consensus identified 31 craniofacial biometrics for fetal MRI.

Characterizing T1 in the fetal brain and placenta over gestational age at 0.55T.

Purpose: T1 mapping and T1-weighted contrasts have a complimentary but currently under utilized role in fetal MRI. Emerging clinical low field scanners are ideally suited for fetal T1 mapping. The advantages are lower T1 values which results in higher efficiency and reduced field inhomogeneities resulting in a decreased requirement for specialist tools.

Cervical cerclage: An evolving evidence base.

Cervical cerclage is an established intervention for the management of pregnancies at high risk of preterm birth. Although studies exist to support its use in certain situations, particularly in singleton pregnancies, many questions such as adjunct therapies and efficacy in specific subgroups of high-risk women have not been fully elucidated. This review will assess the current evidence as well as areas where there is currently a paucity of data and an urgent requirement for further research.