Fetal cystoscopy (FC) and vesicoamniotic shunting (VAS) in lower urinary tract obstruction (LUTO): a meta-analysis of long-term outcome and current technical limitations.

Purpose: To compare obstetrical, survival, and nephro-urological outcomes of fetuses diagnosed with lower urinary tract obstruction (LUTO) undergoing antenatal procedures by vesicoamniotic shunting (VAS) or fetal cystoscopy (FC).

Methods: This study was a literature search using MEDLINE, Scopus, Embase, and Cochrane reference lists. All studies reporting VAS and FC's effectiveness, complications, and technical issues in the prenatal treatment of LUTO were selected for a single-proportion meta-analysis.

Comparison of Three Different Staging Systems Capable of Predicting the Severity of Congenital Lower Urinary Tract Obstruction (LUTO) and Its Prognosis.

Lower urinary tract obstruction (LUTO) is a rare but severe fetal condition associated with significant morbidity and long-term renal risk. Several prenatal staging systems have been proposed to guide management and predict outcomes, yet their comparative prognostic value remains uncertain. This review provides a structured evaluation of three staging systems currently used in clinical practice: those proposed by Ruano, Fontanella, and Nassr.

Successful perinatal management of a large fetal intrapericardial teratoma by serial fetal echocardiogram and ex-utero intrapartum treatment.

Introduction: Pericardial teratomas are rare tumors located in the pericardial space compressing the heart from the outside and usually associated with pericardial effusions. When these tumors are diagnosed in utero, there are some management challenges, including the best approach of prenatal follow-up, the ideal timing of delivery and the perinatal therapeutic strategies. The tumors although benign, tend to grow considerably prenatally, imposing increased risk of worsening pericardial effusion, compression of the heart and potentially compromising cardiac output, leading to intrauterine death.

Serial Amnioinfusion Therapy for Treatment of Congenital Bilateral Renal Agenesis-A Systematic Review.

Serial amnioinfusion therapy (SAT) has emerged as a potential mitigatory intervention to adverse perinatal outcomes associated with congenital bilateral renal agenesis (BRA). However, its efficacy, safety, and ethical implications warrant thorough evaluation. This systematic review, developed according to PRISMA guidelines, analyzes the published data on outcomes of SAT for BRA and explores its implications.

Chest Wall Lymphangiomas: Systematic Review of the Literature and Presentation of Two Prenatally Detected Cases in Monochorionic Diamniotic Twins.

A systematic review of the literature on fetal chest wall lymphangioma with case presentations occurring in monochorionic pregnancies is reported. Potential complications during intrauterine life include the invasion or compression of adjacent structures or vital organs. The risk of dystocia during labor is also a cause for concern.

Efficacy of therapeutic interventions for idiopathic recurrent pregnancy loss: a systematic review and network meta-analysis.

Background: Approximately 50% of cases of recurrent pregnancy loss (RPL) remain unexplained, and there is a lack of consensus concerning the effective treatments for idiopathic RPL. We used network meta-analyses to evaluate the efficacy of several prophylactic therapeutic interventions used in women with idiopathic RPL.

Materials And Methods: We conducted a systematic literature search using several databases from their inceptions to 20 July 2023.

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.

Prenatal Diagnosis and Prognostic Factors in Fetuses With Arthrogryposis Multiplex Congenita-A Systematic Review.

Arthrogryposis Multiplex Congenita (AMC) is characterized by the presence of multiple joint contractures in the fetus' body. The diagnosis of AMC is complex and often missed prenatally. This comprehensive review of the literature published over the last 20 years, with an emphasis on the role of prenatal ultrasound in predicting postnatal outcomes in a fetus with AMC, showed that ultrasound is a crucial tool to diagnose and prognosticate this rare disease.

Placental and Umbilical Cord Anomalies Detected by Ultrasound as Clinical Risk Factors of Adverse Perinatal Outcomes. Case Series Review of Selected Conditions. Part 3: Vascular Anomalies of the Umbilical Cord and Fetoplacental Vascular Malperfusion.

In the previous published reviews Part 1 and Part 2, we examined the association between placental and umbilical cord anomalies in relation to adverse perinatal outcomes. In this conclusive Part 3, only umbilical cord vascular anomalies are considered, together with the perinatal effects caused by maternal vascular malperfusion and the secondary fetal vascular malperfusion anomalies. Specifically, the review comprises the following umbilical cord pathologies: umbilical cord torsion/stricture, amniotic band syndrome and umbilical cord strictures/strangulation, umbilical cord hemorrhagic cyst, umbilical cord rupture/cord hemangioma, umbilical cord hematoma, and umbilical cord ulceration.

Placental and Umbilical Cord Anomalies Detected by Ultrasound as Clinical Risk Factors of Adverse Perinatal Outcome: Case Series Review of Selected Conditions. Part 2: Umbilical Cord Abnormalities.

The aim of this second extended review is to describe the pathogenetic mechanisms underlying umbilical cord (UC) anomalies and their relationship with adverse perinatal outcomes. Review of the literature with case presentations to illustrate the relationship between UC pathologies and adverse perinatal outcomes are also reported. Prenatal ultrasound findings and perinatal care in these cases are presented.

Artificial Intelligence in Fetal Growth Restriction Management: A Narrative Review.

This narrative review examines the integration of Artificial Intelligence (AI) in prenatal care, particularly in managing pregnancies complicated by Fetal Growth Restriction (FGR). AI provides a transformative approach to diagnosing and monitoring FGR by leveraging advanced machine-learning algorithms and extensive data analysis. Automated fetal biometry using AI has demonstrated significant precision in identifying fetal structures, while predictive models analyzing Doppler indices and maternal characteristics improve the reliability of adverse outcome predictions.

Outcomes of Intrauterine Interventions in Twin Reversed Arterial Perfusion (TRAP) Sequence: A Systematic Review of the Literature Over the Past 35 Years.

Twin reversed arterial perfusion (TRAP) sequence is an uncommon disease affecting monochorionic twin pregnancies. The diagnosis can be made by ultrasound allowing to plan optimal antenatal management. An electronic search was conducted from inception to July 2024 to systematically evaluate and compare the outcomes of different intrauterine interventions in this condition.

Indications and Outcomes of Fetal Cystoscopy for Lower Urinary Tract Obstruction: A Comprehensive Review.

Fetal lower urinary tract obstruction (LUTO) encompasses a spectrum of rare congenital anomalies affecting the fetal urinary system, leading to significant morbidity and mortality. This condition, arising from various anatomical anomalies such as posterior urethral valves (PUV), urethral atresia, and cloacal malformations, disrupts normal urine flow, resulting in secondary complications such as pulmonary hypoplasia and renal impairment. Current management strategies, including fetal vesicoamniotic shunting (VAS) and fetal cystoscopy, aim to alleviate obstruction and mitigate associated risks.

Ultrasound-guided transuterine coil embolization of a Vein of Galen malformation.

Vein of Galen malformations (VOGMs) are rare and complex congenital vascular anomalies that can lead to severe morbidity and mortality. Management predominantly focuses on postnatal endovascular interventions. However, these may not be feasible for fetuses with hemodynamic instability and high-output cardiac failure and may fail to prevent irreversible brain damage induced by prolonged compression by the venous varix, hemodynamic alterations and resultant potential ischemic injury.

Fetal Face: Enhancing 3D Ultrasound Imaging by Postprocessing With AI Applications: Myth, Reality, or Legal Concerns?

The use of artificial intelligence (AI) platforms is revolutionizing the performance in managing metadata and big data. Medicine is another field where AI is spreading. However, this technological advancement is not amenable to errors or fraudulent misconducts.

Ultrasound Microvessel Imaging of the Human Placenta Demonstrates Altered Vessel Densities in Fetal Growth Restriction With Vascular and Immune Pathologies: A Pilot Case-Control Study.

Objectives: Fetal growth restriction (FGR) is commonly associated with placental dysfunction, increasing perinatal morbidity and mortality. Visualizing placental vessels in utero would be advantageous for identifying functional FGR cause and determining proper management strategies. We aimed to utilize high-sensitivity ultrasound microvessel imaging (HUMI) for quantifying placental vessel density (VD) in pregnancies diagnosed with FGR.

The Use of 3D Printing in Fetal Surgery for Surgical Planning: A Scoping Review.

: We sought to identify in which clinical scenarios 3D printed models are used to plan for fetal surgeries as well as the main purpose and the imaging method utilized for the models. In addition, we describe benefits and shortcomings of the models, as well as potential future improvements. : In this scoping review, data were collected retrospectively from scientific databases (PubMed, Embase, Cochrane CENTRAL, CINAHL, Scopus, and the Web of Science platform) and screened by title, abstract, and full text against strict criteria.

Placental and umbilical cord anomalies detected by ultrasound as clinical risk factors of adverse perinatal outcome: Case series review of selected conditions. Part 1: Placental abnormalities.

Background: The aim of this extended review of multicenter case series is to describe the prenatal ultrasound features and pathogenetic mechanisms underlying placental and umbilical cord anomalies and their relationship with adverse perinatal outcome. From an educational point of view, the case series has been divided in three parts; Part 1 is dedicated to placental abnormalities.

Methods: Multicenter case series of women undergoing routine and extended prenatal ultrasound and perinatal obstetric care.

Fetoscopic Release of Amniotic Bands Based on the Evidence-A Systematic Review.

The purpose of this review is to provide an overview of the perinatal outcomes of fetuses who underwent fetal surgery for the management of Amniotic Band Syndrome (ABS). A systematic review of studies reporting on the perinatal outcome of fetuses undergoing fetoscopic release of amniotic bands according to the (PRISMA) guidelines was performed. The MEDLINE, Embase, Scopus, and Cochrane Library databases were systematically searched.

Ultrasound Guidance to Replicate Transuterine BioGlue Injection in the Fetal Hydrocephalus Sheep Model.

Introduction: Congenital hydrocephalus often results in irreversible and severe damage to the brain despite postnatal interventions. The potential for prenatal intervention to mitigate these deleterious effects underscores the importance of a suitable animal model. We aimed assess the results of an ultrasound-guided transuterine approach to replicate the BioGlue injection fetal hydrocephalus model.

Fetoscopic Tracheal Occlusion for Isolated Severe Left Diaphragmatic Hernia: A Systematic Review and Meta-Analysis.

We aimed to conduct a systematic review and meta-analysis to evaluate the fetoscopic tracheal occlusion in patients with isolated severe and left-sided diaphragmatic hernia. Cochrane Library, Embase, and PubMed (Medline) databases were searched from inception to February 2024 with no filters or language restrictions. We included studies evaluating the outcomes of fetoscopic intervention compared to expectant management among patients with severe congenital diaphragmatic hernia exclusively on the left side.