Ultrasound Screening for Vasa Previa: A Systematic Review and Meta-Analysis.

Objective: To evaluate the prenatal detection of vasa previa (VP) and perinatal survival in studies that implemented standardized protocols of prospective second-trimester ultrasound screening protocols followed by ultrasound confirmation in the third trimester.

Data Sources: PubMed/MEDLINE, Web of Science, EMBASE, Global Health, and Global Index Medicus were searched from inception to February 16, 2024.

Study Eligibility: We included cohort studies that implemented standardized second-trimester ultrasound protocols - either universal or targeted - for VP screening, with third-trimester ultrasound confirmation and verification at delivery, over at least one year.

How should we address pregnant patients in clinical practice?

Language, both spoken and written, plays a critical role in shaping clinical communication, documentation, research integrity, and patient trust. In obstetric care, terminology must align with biological reality, uphold clinical accuracy, respect patient identity, and increasingly, comply with federal policy. As of January 2025, Executive Order 14,168 reframes gender-inclusive language as a threat to women's dignity, safety, and well-being, asserting that "efforts to eradicate the biological reality of sex fundamentally attack women" and it mandates sex-based language, reversing prior encouragement of gender-inclusive terminology.

Intertwin Membrane Placental Cord Insertions in a Dichorionic Diamniotic Twin Pregnancy: Case Report.

Introduction: Intertwin membrane cord insertion (IMCI) is a rare variation of velamentous cord insertion (VCI) that can be seen in dichorionic twin pregnancies. This condition exposes fetal vessels to risks such as compression and rupture, which can lead to complications including fetal growth restriction (FGR) and preterm delivery.

Clinical Presentation: A 30-year-old woman, gravida 1 para 0, was referred at 19+5 weeks for evaluation of a dichorionic diamniotic twin pregnancy due to an abdominal cyst in Twin A, transposition of the great arteries in Twin B, and suspected abnormal cord insertions.

Postpartum Hemorrhage.

Obstetric hemorrhage is the leading cause of maternal death in childbirth; it is estimated that one woman dies every four minutes from postpartum hemorrhage (PPH). PPH is the cause of approximately one-quarter of maternal deaths worldwide and is thus a major public health issue of great importance. Despite modern advances in medicine, hemorrhage continues to lead the causes of pregnancy-related death in most countries, with increasing disparity between countries with highly developed and underdeveloped national healthcare systems.

Impact of Preterm Birth Subtype on Risk of Diagnosis of Autism Spectrum Disorders in the Offspring.

Preterm birth (PTB) can result from spontaneous preterm labor (spontaneous PTB, SPTB) or as an intervention by obstetricians where the baby is deliberately delivered preterm (Indicated PTB, IPTB) to get them to neonatal intensive care. The impact of these PTB subtypes on ASD risk is unclear. Therefore, we compared the risk of ASD diagnosis for children born from pregnancies that ended in SPTB or IPTB with those born at term.

Perinatal outcomes of cystic hygroma: a systematic review and meta-analysis.

Objectives: The aim of this systematic review and meta-analysis was to describe the perinatal outcomes and modifiers of antenatally diagnosed cystic hygroma (CH).

Data Sources: The PubMed, Embase and Web of Science Core Collection databases were searched from inception until March 18, 2024.

Study Eligibility Criteria: Full-text English-language observational cohort studies reporting any pregnancy and postnatal outcomes for fetuses with a CH diagnosed on prenatal ultrasound were included in this study.

Hemorrhagic placental lesions on ultrasound: a continuum of placental abruption.

Placental abruption has classically been defined as the premature separation of a normally located placenta before delivery of the fetus. Traditionally, this diagnosis was based on clinical symptoms, including vaginal bleeding, pain, and fetal distress. This definition, however, preceded the advent of obstetric ultrasound.

Fetoscopic Laser Surgery for Vasa Previa: Feasibility, Safety, and Future Directions.

Vasa previa is an uncommon, potentially life-threatening condition where fetal vessels traverse the membranes over the cervix without Wharton jelly protection, risking fetal exsanguination if undiagnosed. Prenatal ultrasound and planned preterm cesarean reduce perinatal mortality to under 1%, though concerns about prematurity persist. Fetoscopic laser photocoagulation, initially used for twin-twin transfusion syndrome, shows promise in select cases, potentially allowing vaginal delivery at term.

Postpartum Depression Increases the Risk of Childhood Attention Deficit Hyperactivity Disorder Diagnosis.

Postpartum Depression (PPD) is a common adverse pregnancy outcome, but the extent to which PPD correlates with attention deficit hyperactivity disorder (ADHD) in the offspring is unclear. Therefore, we examined if children of mothers who experienced PPD are at risk for developing ADHD and how this association may be modified by the child's sex, race/ethnicity, and gestational age at delivery. A retrospective cohort study of singleton-born children aged 3-12 years and delivered in Kaiser Permanente Southern California hospitals between 01/01/2010-12/31/2019 (n = 229,860) was performed using electronic health records.

Non-Invasive Prenatal Testing Results, Nuchal Translucency Size, and Second Trimester Resolution Modify First Trimester Cystic Hygroma Outcomes.

Objectives: The aim of our study was to describe outcomes of fetuses with cystic hygromas (CH) based on results of non-invasive prenatal testing (NIPT), nuchal translucency (NT) size, and spontaneous hygroma regression.

Methods: This was a retrospective cohort study of all patients with a CH diagnosed on first trimester ultrasound at our institution over a 9-year period. The primary outcomes were pathogenic genetic abnormalities, structural malformations and perinatal loss.

Vasa Previa: Prenatal Diagnosis and the Rationale Behind Using a 5 cm Distance from Internal Os.

In pregnancies with vasa previa, prenatal diagnosis and pre-labor cesarean delivery are associated with significantly improved perinatal outcomes compared to undetected cases. However, a universally accepted ultrasonographic definition of vasa previa is lacking. Specifically, the distance from the cervical internal os beyond which vaginal delivery can be safely recommended remains to be determined.

Case report of recurrent vasa previa.

Introduction: Vasa previa is a complication of pregnancy, which affects approximately 1:1200 pregnancies, and when undiagnosed prenatally, it can be associated with significant perinatal mortality. This condition is thought to be a sporadic entity without known genetic or familial associations and thus considered to carry a negligible recurrence risk.

Key Findings: We present a case of a 42-year-old gravida 3 para 2 diagnosed on transvaginal ultrasound with a vasa previa at 34 weeks associated with vaginal bleeding, which required an urgent caesarean in a prior spontaneous pregnancy.

We Should Perform a Systematic Evaluation of the Placenta.

Despite its critical importance, the placenta receives substantially less attention during obstetric ultrasound examinations compared to the fetus. The evaluation of the placenta is typically limited to determining its location within the uterus, particularly its relationship to the cervix. Abnormal placenta findings are the result of gross anomalies identified by chance during obstetric examinations, rather than from a systematic evaluation.

Respect for history: an important dimension of contemporary obstetrics and gynecology.

"" This maxim underscores the importance of historical awareness in medicine, particularly for obstetricians and gynecologists (ObGyns). ObGyns significantly impact societal health through their care for pregnant women, fetuses, and newborns, uniquely positioning them to advocate for health initiatives with lasting societal benefits. Despite its importance, the history of medicine is underrepresented in medical curricula, missing opportunities to foster critical thinking and ethical decision-making.

The potential impact of universal screening for vasa previa in the prevention of stillbirths.

Objectives: To estimate the number of pregnancies complicated by vasa previa annually in nine developed countries, and the potential preventable stillbirths associated with undiagnosed cases. We also assessed the potential impact of universal screening for vasa previa on reducing stillbirth rates.

Methods: We utilized nationally-reported birth and stillbirth data from public databases in the United States, United Kingdom, Canada, Germany, Ireland, Greece, Sweden, Portugal, and Australia.

Fetoscopic laser photocoagulation: a medically reasonable treatment option in the management of types II and III vasa previa.

Vasa previa is a condition where unprotected fetal vessels cross the cervix within the membranes, posing a considerable risk of fetal death or severe morbidity if the membranes rupture before or during delivery. There has not been a definitive treatment for this condition. Patients are typically closely monitored and hospitalized in the early third trimester and scheduled for cesarean delivery before term.