ObjectivesTogether, these factors can be used to identify over a third of pregnancies that will deliver LGA infants.

Summary. Variation in indices used to characterize the maximum frequency outline of waveforms obtained from the uteroplacental and fetal circulations by duplex Doppler ultrasound was studied between observers, over a 24‐h period and before and after a meal. No significant differences were found. Reference ranges were derived for three indices, the A/B ratio, the resistance index and the pulsatility index, for waveforms from the fetal descending aorta, umbilical artery, and the placental and maternal sides of the uteroplacental circulation. Indices from waveforms from the uteroplacental circulation demonstrated a fall from 16 to 24 weeks gestation with no change thereafter. The umbilical artery indices demonstrated a continuing fall with increasing gestation but the A/B ratio and resistance index from the fetal descending aorta did not change with gestation. The pulsatility index from the aorta demonstrated a gentle rise.

Few studies have tested the efficacy of commercially available cosmetic products for preventing striae gravidarum. Therefore, the objective of this study was to evaluate efficacy on prevention of striae gravidarum using a specific anti-stretch mark cream containing hydroxyprolisilane-C, rosehip oil, Centella asiatica triterpenes and vitamin E. A randomized, double-blind, placebo-controlled trial was conducted between November 2009 and April 2011. Pregnant women were included and classified as treated group (emollient and moisturizer containing hydroxyprolisilane C, rosehip oil, Centella asiatica triterpenes and vitamin E) and control group (cream without the active ingredients). Overall incidence of stretch marks during pregnancy was 33.3% for the control group and 37.6% for the treated group (n.s.). Severity of previous stretch marks significantly increased in the control group during the study (17.8%, P = 0.001), but not in the treated group (6.3%, ns). In women who developed new stretch marks during the study, there was a significantly greater 'difference in severity' (between baseline and maximum severity) in control group vs. treated group (0.47 [0.57] vs. 0.14 [0.60], P = 0.031). In women without previous striae, incidence of these marks was significantly lower for the treated group patients compared with control group (5.6% vs. 35%, P = 0.031, OR: 9.2 [95% CI: 1.0-83.3]). The use of the anti-stretch mark product is proved to be effective in reducing severity of the striae during pregnancy, prevents the appearance of new striae and halts progression of those already present. In women who had no striae at baseline, use of the anti-stretch mark cream was more effective than placebo in preventing new stretch marks.

Congenital imperforate hymen is probably the most common obstructive anomaly of the female reproductive tract. The accumulation of fluid in the genital tract leads to a distended uterus and vagina, causing hydrometrocolpos. Prenatal diagnosis of fetal hydrometrocolpos is uncommon, with only 22 cases reported in the literature and only a few cases of prenatal imaging of this condition available to date. The main ultrasound finding is a fetal pelvic mass posterior to the bladder and anterior to the rectum. We present the case of a 37-week female fetus with a fetal pelvic mass detected in a routine obstetric ultrasound examination, and the correlation between the prenatal and postnatal findings.

<b><i>Objective:</i></b> Establish reference ranges for the Elecsys® soluble fms-like tyrosine kinase-1 (sFlt-1)/placental growth factor (PlGF) immunoassay ratio in twin pregnancies. <b><i>Methods:</i></b> Data analyzed were from 3 prospective studies: Prediction of Short-Term Outcome in Pregnant Women with Suspected Preeclampsia (PE) (PROGNOSIS), Study of Early-onset PE in Spain (STEPS), and a multicenter case-control study. Median, 5th, and 95th percentiles for sFlt-1, PlGF, and the sFlt-1/PlGF ratios were determined for normal twin pregnancies for 7 gestational windows and compared with the previous data for singleton pregnancies. <b><i>Results:</i></b> The reference range analysis included 269 women with normal twin pregnancies. Before 29 weeks’ gestation, median, 5th, and 95th percentiles for sFlt-1/PlGF ratios did not differ between twin and singleton pregnancies. From 29 weeks’ gestation to delivery, median, 5th, and 95th percentiles for sFlt-1/PlGF ratios were substantially higher in twin versus singleton pregnancies. sFlt-1 values were higher in women with twin pregnancies across all gestational windows. PlGF values were similar or higher in twin versus singleton pregnancies; PlGF concentrations increased from 10 weeks + 0 days to 28 weeks + 6 days’ gestation. <b><i>Conclusions:</i></b> Reference ranges for the sFlt-1/PlGF ratio are similar in women with twin and singleton pregnancies until 29 weeks’ gestation but appear higher in twin pregnancies thereafter.

Hepatocyte growth factor (HGF) also known as hepatopoietin A (HPTA) (Michalopoulos, FASEB J., 4:176-187, 1990) is a heparin-binding growth factor whose characterization and tissue distribution have been reported elsewhere. This growth factor was recently cloned and its amino acid sequence determined under the name of hepatocyte growth factor (HGF) (Miyazawa et al., Biochem. Biophys. Res. Commun., 163:967-973, 1989; Zarnegar et al., Biochem. Biophys. Res. Commun., 163:1370-1376, 1989; Nakamura et al., Nature, 342:440-443, 1989). Human placenta is one of the tissues that contains significant amounts of HGF. We isolated HGF from human placenta and characterized its biologic effect on rat hepatocytes. Human placenta HGF was isolated in high purity as a single chain molecule. Single chain HGF stimulated DNA synthesis in primary rat hepatocyte cultures in serum-free medium. The maximal effect was seen at 5-10 ng/ml. The maximal response occurred at 25-48 hours after plating of the hepatocytes. Protein synthesis was also stimulated by HGF in primary rat hepatocyte cultures. There were peak responses at 19-24 and 37-42 hours after plating of the hepatocytes. TGF beta 1 inhibited more than 95% of HGF-induced DNA synthesis but only 25% of HGF-induced protein synthesis. HGF interacted in an additive manner with EGF, a well-known hepatocyte mitogen. There was not an additive interaction between HGF and aFGF. Regenerating liver hepatocytes obtained from rats which underwent two-thirds partial hepatectomies (PHX) also responded to HGF in a dose-dependent manner as the hepatocytes from normal liver.

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Cardiac diverticulum is a rare anomaly, which may present in association with pericardial effusion. Only few cases diagnosed during fetal life have been published and only in 12 cases pericardiocentesis was made with good postnatal outcomes in 83% of the cases. In the first trimester of pregnancy only 6 cases were reported. We described the largest series of cases published. We describe a case of cardiac diverticulum complicated with pericardial effusion during the first trimester of pregnancy and resolved by intrauterine pericardiocentesis at 17 weeks of pregnancy. We made a systematic review of the literature with the cases reported of cardiac diverticulum, management, and outcomes.