Elevated fetal fraction levels at 14.1-20.0 weeks' gestation were significantly associated with an increased incidence of preterm birth. Our findings warrant future exploration including validation in a larger, general population and investigation of the potential mechanisms that may be responsible for the initiation of preterm labor associated with increased fetal cell-free DNA.
Enoxaparin therapy and obesity were associated with an increased incidence of a failed cfDNA test due to low FF. Further research is needed to determine the mechanism by which anticoagulation therapy alters cfDNA test functionality and identify approaches to improve test performance in these women.
(Abstracted from Prenat Diagn 2017;37:1125–1129)
Fetal cell-free DNA (cfDNA) screening has been established as a screening method for trisomies 13, 18, and 21, as well as sex chromosome aneuploidies. Despite its rapid technological advancement since becoming clinically available in 2011, some women do not receive valid results after undergoing cfDNA testing because of a low fetal fraction (FF).
Twin pregnancy in a predominantly healthy cohort of women who were at least 45 years old when they delivered was associated with high rates of cesarean delivery, preeclampsia, and gestational diabetes, but overall favorable outcomes.
a novel surgical approach for paraaortic lymphadenectomy with cervical cancer was started in our department, this surgical procedure has been performed with a new single-site approach exclusively via a single 2-to 3-cm left iliac incision. The patients were selected to record Body Mass Index (BMI), operative time, intraoperative blood loss, the number of paraaortic lymph node and positive lymph nodes, abdominal drainage tubes removal time, postoperative bowel function recovery time, total hospital stay time and perioperative complications. Measurements/Results: All 3 cases were successfully operated without conversion to laparotomy or conventional laparoscopy. The BMI (kg/m 2 ) was 20.4, 22.9 and 23.4; The operative time (min) was 140.6, 193.5 and 128.3; The intraoperative blood loss (ml) was 121, 109 and 95; The number of paraaortic lymph node dissections was 8, 13 and 15. All postoperative lymph node biopsy results were negative. The total hospital length of stay was from 7 to 13 days. No serious perioperative complications occurred. Conclusions: Single-site laparoscopic retroperitoneal para-aortic lymphadenectomy is feasible for cervical cancer treatment. However, due to limited cases, further evaluation regarding safety is warranted.
INTRODUCTION:
Singleton pregnancies in well-selected women 45 and older undergoing assisted reproduction have a high likelihood of successful pregnancies with an increased risk of hypertensive disorders of pregnancy. Our objective was to investigate outcomes of twin gestations in women age 45 or older.
METHODS:
Historical cohort of 97 women age 45 or older with twin gestations cared for by 2 referral centers between 2005-2016. Analysis included baseline demographic and clinical characteristics. Pregnancy outcomes included gestational age at delivery, hypertensive disease in pregnancy, gestational diabetes, and IUGR. Univariate analysis of association between patient characteristics and outcomes were performed using student t-test and chi square.
RESULTS:
Mean maternal age at delivery was 47.7 +/- 2.0 with 99% undergoing IVF and 95.9% using donor egg. Patients have low baseline rates of hypertension (6.2%), obesity (8.0%) and pre-gestational diabetes (1%). 40.2% of women developed preeclampsia, 45.8% developed IUGR, 14.5% developed gestational diabetes, and 13.4% had an indicated preterm birth prior to 34 weeks. On univariate analysis, No baseline risk factors were associated with the development of preeclampsia or IUGR. Women of white race had a decreased risk of indicated preterm birth < 34 weeks (8.2% vs. 29.2%, p=0.009) and a decreased risk of gestational diabetes (9.6% vs. 30.4%, p=0.014).
CONCLUSION:
Twin pregnancy in women age 45 or older is associated with high rates of hypertensive disease in pregnancy and IUGR but overall outcomes are reassuring. Twin pregnancy should not be discouraged in well-selected, healthy women age 45 or older simply due to age alone.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.