Post-mortem imaging combined with systematic organ biopsies is highly acceptable among all parents independent of their religion and the method used for organ biopsy.

Human papillomavirus (HPV) is an epitheliotropic virus typically infecting keratinocytes but also possibly epithelial trophoblastic placental cells. In the present study, we set out to investigate whether HPV can be recovered from transabdominally obtained placental cells to avoid any confounding contamination by HPV-infected cervical cells. Thirty-five placental samples from women undergoing transabdominal chorionic villous sampling were analyzed, and we detected HPV-16 and HPV-62 in 2 placentas. This study suggests that HPV infection of the placenta can occur early in pregnancy. The overall clinical implication of these results remains to be elucidated.

Objective: To evaluate the Fetal Medicine Foundation (FMF) algorithm prospectively at 11-13 weeks' gestation in the prediction of preeclampsia (PE). Methods: Single-center prospective screening study for PE of singleton pregnancies at 11-13 weeks. The FMF algorithm takes into account maternal characteristics and biomarkers. Detection rate (DR) for a 10% false-positive rate (FPR) for delivery with preterm and term PE was estimated. Results: Between January 2011 and December 2013, of 3,239 patients available for final analysis, 36 (1.1%) subsequently developed preterm and 44 (1.4%) term PE. In combined screening by maternal factors, mean arterial pressure, uterine artery pulsatility index, and serum placental growth factor, the DR was 80.6% (95% CI 64.0-91.8) for PE at <37 weeks and 31.8% (95% CI 18.6-47.6) for PE at ≥37 weeks, at a 10% FPR. Conclusion: Our data suggest that the FMF algorithm provides effective first-trimester screening for preterm PE.

We compared the diagnostic yield of fetal clinical exome sequencing (fCES) in prospective and retrospective cohorts of pregnancies presenting with anomalies detected using ultrasound. We evaluated factors that led to a higher diagnostic efficiency, such as phenotypic category, clinical characterization, and variant analysis strategy. Methods: fCES was performed for 303 fetuses (183 ongoing and 120 ended pregnancies, in which chromosomal abnormalities had been excluded) using a trio/duo-based approach and a multistep variant analysis strategy. Results: fCES identified the underlying genetic cause in 13% (24/183) of prospective and 29% (35/120) of retrospective cases. In both cohorts, recessive heterozygous compound genotypes were not rare, and trio and simplex variant analysis strategies were complementary to achieve the highest possible diagnostic rate. Limited prenatal phenotypic information led to interpretation challenges. In 2 prospective cases, in-depth analysis allowed expansion of the spectrum of prenatal presentations for genetic syndromes associated with the SLC17A5 and CHAMP1 genes. Conclusion: fCES is diagnostically efficient in fetuses presenting with cerebral, skeletal, urinary, or multiple anomalies. The comparison between the 2 cohorts highlights the importance of providing detailed phenotypic information for better interpretation and prenatal reporting of genetic variants.

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Oral communication abstractsthat failed expectant management, 17.1mm, and for those that failed medical management, 17.8 mm. There were no statistically significant differences amongst these four groups. Applying cut-offs for size of EP mass and success rate of expectant or medical management, there was a trend observed for the success of medical management. The medical management success rate was stable at around 85% for EP <24 mm; however it lowered to 67% for EP > =24 mm and < 28mm, and then to ∼ 50% for EP >28mm. These differences were not statistically significant. Conclusions: In this study, size of tubal EP mass was not found to be an independent predictor of successful expectant or medical management of EP. OC19.02Is there an optimal 48/0 hour hCG ratio cut-off to predict successful conservative management of tubal ectopic pregnancy? Objectives: Aim to determine the optimal cut-offs for 48/0 hour hCG ratio to predict successful conservative management of tubal ectopic pregnancy (EP). Methods: This was a prospective cohort study of women presenting to the Early Pregnancy Unit (EPU) between January 2006 and September 2013. All women diagnosed with a tubal EP on TVS were included. The decision to offer expectant or medical management was based primarily on the 48/0 hCG ratio. With a ratio <1; expectant management was offered, whereas Methotrexate (MTX) was advised if the ratio was > =1.0. hCG levels at 0 and 48 hours were recorded, and the 48/0 h hCG ratio was calculated. Logistic regression was performed to establish the relationship between 48/0 h hCG ratio and subsequent successful conservative management. Results: 5415 consecutive women attended the EPU. 227 (4.2%) cases of tubal EP were included in the final analysis. 113 cases were managed conservatively (49.8%). Of these, 61 were managed expectantly while 52 received MTX. The success rate for expectant and medical management was 84% and 83%, respectively.The AUC for the 48/0 hour hCG ratio and successful expectant management was 0.66. At a ratio of ≤0.5 the success rate was 100%. For hCG ratios >0.5; the success rate varied between 82 and 95%. For cases managed medically, the AUC for the 48/0 hour hCG ratio was 0.56. At a ratio of 1.08; the success rate was 89%, whereas with ratios >1.08; the success rate varied between 80 and 86%. With ratios <1.08; success rates were quite variable (50−88%). Conclusions:The optimal hCG ratio associated with successful expectant management of tubal EP was 0.5. For medical management, an hCG ratio of 1.08 confers optimal success rate. OC19.03PAPP-A at 5-11 weeks' gestation and the prediction of pregnancy outcome Objectives: Pregnancy-associated plasma protein A (PAPP-A) is a biochemical marker currently used as part of combined first trimester screening. A low PAPP-A at 11−13 weeks' gestation is predictive of miscarriage and late adverse pregnancy outcomes. We aimed to determine whether PAPP-A measured at 5−11 weeks would be predictive of early pregnancy loss. Methods: Women attending our early pregnancy assessment s...