First-trimester growth restriction has been reported in certain aneuploid pregnancies. The purpose of this study was to evaluate this association further by comparing the crown-rump lengths (CRLs) and growth rates from 196 chromosomally abnormal fetuses with a control population of 1929 euploid fetuses. The mean CRLs and growth rates were significantly reduced (P < 0.05) in the groups of fetuses with trisomy 18 (n = 49), trisomy 13 (n = 19), and triploidy (n = 8). Using a fifth percentile cut-off, growth rate was a better discriminator than a single CRL in identifying fetuses affected with these aneuploidies. These growth parameters were not significantly reduced in fetuses with trisomy 21 (n = 92), sex chromosome trisomies (n = 20), or 45,X (n = 8). We conclude that fetal growth restriction associated with an underlying chromosome abnormality can occur as early as the first trimester. This phenomenon results from intrinsic fetal factors and not delayed ovulation. Such information is important to establish as first-trimester serum screening evolves.
Amniotic fluid embolism (AFE, also known as anaphylactoid syndrome of pregnancy) at the time of surgery for placenta percreta has been previously reported. We report here a case in which AFE and associated cardiac arrest occurred following a hysterectomy for placenta percreta. In this case, subhepatic manual aortic compression during the cardiac arrest and chest compressions followed by infrarenal aortic cross-clamping during volume infusion and reversal of the coagulopathy were associated with a successful resuscitation and good maternal outcome.
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.