Our rate of malformations associated with I-PRUV (17.9%) is similar to previously published rates. I-PRUV has shown a significant increase in the rate of associated malformations, although this association has only been found to be statistically significant in the genitourinary system. Noteworthy is the fact that this comparative study has not pointed to a significant increase in the congenital heart malformation rate. Diagnosis of isolated I-PRUV does not carry a worse prognosis.
<b><i>Objective:</i></b> To assess the predictive ability of the ultrasound estimated percentile weight (EPW) at 35 weeks of pregnancy to predict adverse perinatal outcomes (APOs) at term delivery according to 5 fetal growth standards, including population, population-customized, and international references. <b><i>Methods:</i></b> This was a retrospective cohort study of 9,585 singleton pregnancies. Maternal clinical characteristics, fetal ultrasound data obtained at 35 weeks and pregnancy and perinatal outcomes were used to calculate EPWs to predict APOs according to: the customized and noncustomized (NC) Miguel Servet University Hospital (MSUH), the customized Figueras, the NC INTERGROWTH-21st, and the NC World Health Organization (WHO) international standards. APOs were defined as the occurrence of cesarean or instrumental delivery for nonreassuring fetal status, 5-min Apgar score < 7, arterial cord blood pH <7.10, or stillbirth. The predictive ability of EPW for APOs was analyzed using the area under the curve (AUC), and sensitivities were calculated for different false-positive rates (FPRs). <b><i>Results:</i></b> For a 10% FPR, detection rates for total APOs ranged between 12.7% with the customized MSUH (AUC 0.52; 95% CI 0.50–0.55) and 14.4% with the NC MSUH standard (AUC 0.55; 95% CI 0.53–0.57) for EPW by ultrasound; and from 22.0% with the customized MSUH standard (AUC 0.60; 95% CI 0.58–0.63) to 27.8% with the NC WHO (AUC 0.65; 95% CI 0.63–0.68) for EPW at delivery. <b><i>Conclusions:</i></b> The predictive capacity of the EPW for APOS is limited and similar, by both ultrasound and at delivery, for the 5 growth standards, without significant differences between customized and NC standards.
normal karyotype relate with negative screening for adverse perinatal results. Method: Retrospective study of cases and controls in single pregnancies, with predictive analysis using multivariate logistic regression. Results: 3,791 screenings were performed at our unit in 2012, with a screening/number of deliveries ratio of 89.9%. There is a greater likelihood of the newborn being underweight (AOR = 2.6, 95% CI 1.2 -5.7), premature (OR = 2.2, 95% CI 1. 03 -4.5), admitted to the ICU (OR = 7.4, or admitted to the Neonates department (AOR = 8.1, in the case group. Conclusion: Combined first trimester screening is a predictive method for pregnant women with a higher risk of adverse perinatal outcomes.
Introduction: Smoking during pregnancy is associated with reduced foetal growth, amongst other effects. Epigenetic modification in the foetus and placenta during embryonic development as a result of changes in the function of miRNAs is one of the pathophysiological mechanisms responsible for this. This dysregulation may be due to environmental changes or toxins such as tobacco. Objective: To study the impact of smoking during pregnancy and its role in intrauterine growth restriction via hypermethylated miRNAs. Materials and methods: The differences in methylation patterns for miRNAs in umbilical cord blood from low-birth-weight newborns of smoking mothers were compared with those from normal-weight newborns using MedIP-seq (StarArray). Results: Seven hypermethylated miRNAs were identified in the epigenetic study of cord blood from low-birth-weight newborns of smoking mothers in our sample. The miRNAs found to be hypermethylated were: MIR7-1, MIR3918, MIR1244-1, MIR4721, MIR25, MIR93, MIR3656. Conclusion: Intrauterine exposure to tobacco induces hypermethylation-mediated miRNA silencing in low-birth-weight newborns by modifying the expression of factors involved in vascular development, growth, and adaptation to hypoxia.
To determine the probability of correctly diagnosing fetal sex during the first trimester by ultrasound according to crown-rump length (CRL) and previous ultrasound experience. Methods: A cohort study was performed from March 2012 to April 2013. The 2,314 first trimester pregnancy ultrasounds were examined. Eight sonographers, according to previous ultrasound experience, were divided into two groups: senior and junior. For fetal sex estimation, the method of a sagittal section and the relation between the angle formed by the genital tubercle and spinal column was used. Results: In 1,986 cases, fetal sex was diagnosed, with a success rate of 90.1%. A directly proportional relationship between the rate of success in fetal sex diagnosis and CRL (P,0.001) was described. The rate of success in male fetuses was significantly higher than in female fetuses (94.6% vs 86.3%, respectively), P,0.001. In the senior sonographers group, the rate of overall success was 89.2% vs 90.5% in the junior group, the difference not being significant. The experience of sonographers did not reach statistical significance (95% confidence interval: 0.871-1.031; P=0.213). Conclusion: The prediction of fetal sex over 65 mm of CRL in both sexes is approximately 95% and from 76 mm onward is 99%. Both CRL and fetal sex influence the rate of success; however, the experience of a sonographer has not proven to be an influential factor. These results could be explained because the technique for diagnosing sex during the first trimester is very simple to learn.
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