The purpose of the present research was to investigate the role of the fourth dimensional (4D) ultrasound scanning on the antenatal attachment development, in pregnant women (19-23 weeks of gestation) and their partners. A total of 44 couples were asked to complete questionnaires about maternal and paternal antenatal attachment, before the two-dimensional (2D; control group) and 4D (experimental group) ultrasound scanning and 2 weeks later. In the groups of women, our findings underline the progressive increase in antenatal attachment throughout gestation: the mean level of antenatal attachment was significantly different between the first and the second assessment. No significant differences are shown between 2D and 4D ultrasound scanning groups. We do not eliminate the possibility that ultrasound scanning practice would be a helpful and crucial means of investigation for a complete explanation of prenatal attachment (Ainsworth, Blehar, Waters, & Wall, 1978; Fivaz-Depeursinge & Corboz-Warney, 2000) and parental mental representations (Stern, 1987, 1997).

Objective To review the experience of performing selective feticide with bipolar cord coagulation (BCC) in complicated monochorionic (MC)

Objective: To report the incidence of fetal and maternal complications after selective fetoscopic laser surgery for twin-to-twin transfusion syndrome (TTTS). Methods: A total of 150 cases of TTTS were treated from January 2004 to June 2009 (period 1, 2004–2006, 62 cases; period 2, 2007 to June 2009, 88 cases). Fetal complications (double and single intrauterine fetal death, recurrence of TTTS, twin anemia-polycythemia sequence (TAPS), reversal of TTTS, cerebral lesions in one twin) and maternal complications were recorded, and retrospectively analyzed. Results: Nineteen (12.6%), 58 (38.7%), 61 (40.7%) and 12 cases (8.0%) were classified preoperatively as Quintero stage I, II, III and IV, respectively. The anterior placenta was described in 73 cases (48.6%). Double and single fetal death occurred overall in 7.3 and 36.0% of cases, respectively. The rate of recurrence was 11.3%, of TAPS 3.3%, and of reversal of TTTS 1.3%. Cerebral lesions were diagnosed in 3 donors (2.0%). Eighteen cases (12.0%) of fetal complications had a second procedure (6 repeat laser, 4 serial amnioreduction, 8 bipolar cord coagulation). Pregnancies undergoing a second procedure delivered at a median gestational age of 30.2 weeks compared to 32.1 weeks for those not repeating (p = 0.04). Perinatal survival of at least one twin improved from 66.1 to 79.5% (p = 0.06) in the two consecutive periods. For every 10 laser surgeries performed, there was an average improvement of 1.5% in the predicted percentage of survival of at least one twin (OR 1.09, 95% CI 1.00–1.19). Major maternal complications occurred in 9 cases (6.0%), 3 of which required admission to intensive care unit. Conclusions: Fetal complications are common after fetoscopic laser surgery. In this experience, an increasing number of procedures improved the performance of a new fetoscopic laser center.

The phosphorylated isoform of insulin-like growth factor binding protein-1 in cervical secretions is a potential specific marker for preterm delivery occurring before 37 weeks. This test may have an important role in the management of women presenting with symptoms suggestive of preterm labour.