Objective To review techniques and outcomes of different prenatal treatments for large placental chorioangiomas. Study Design Presentation of a case of laparoscopic-assisted laser coagulation and a systematic review of the literature for articles related to intervention for placental chorioangioma. Results A total of 37 cases of definitive (n = 23) and supportive therapy (n = 14) were evaluated, including one case treated in our center. Approximately 35% of the patients had a spontaneous preterm delivery in definitive treatment group versus 36% in the supportive group. The infant survival rates were 65 and 71% in the two groups, respectively. We further compared the two types of laser ablation (fetoscopic [n = 10] and interstitial [n = 4]). Approximately 30% of the patients in the fetoscopic and 25% in interstitial group, had a spontaneous preterm delivery. Survival rates were 60 and 100% in fetoscopic and interstitial groups, respectively. Conclusion Laser ablation and embolization of chorioangiomas via minimally invasive approach may prevent or reverse fetal hydrops due to high cardiac states. However, further studies are needed to refine the appropriate selection criteria that will justify the risk of this invasive in utero therapy for chorioangiomas.

Background: Hyperandrogenemia in an obese polycystic ovary syndrome (PCOS) mouse model results in altered glucose/insulin metabolism and mitochondrial structure and function in the oocytes, in part explaining adverse outcomes and inheritance patterns seen in PCOS.Objective: To study the oocyte quality by means of mitochondrial structure and function in a well-established classic PCOS mouse model. Design: Animal study using an obese PCOS mouse model compared with control.Setting: Animal research facility in a tertiary care university hospital setting. Animals: C57/B6J mice. Intervention(s): Three-week-old mice had subdermal implants of dihydrotestosterone controlled release pellet or placebo for 90 days. Main Outcome Measure(s): The mouse model was validated by performing glucose tolerance test and glycated hemoglobin level, body weight, and estrous cycle analyses. Oocytes were subsequently isolated and were used to investigate mitochondrial membrane potential, oxidative stress, lipid peroxidation, adenosine triphosphate production, mitochondrial DNA copy number, transcript abundance, histology, and mitochondrial ultrastructure. Result(s): Results showed glucose intolerance and hyperinsulinemia along with dysregulated estrus cycle. Analysis of the oocytes indicated impaired inner mitochondrial membrane function, increased adenosine triphosphate production and mitochondrial DNA copy number, altered RNA transcript abundance, and aberrant ovarian histology. Electron microscopy of the oocytes revealed severely impaired mitochondrial ultrastructure. Conclusion(s):The obese PCOS mouse model shows a decreased oocyte quality related to impaired mitochondrial function. (Fertil Steril Sci Ò 2021;2:101-12. Ó2020 by American Society for Reproductive Medicine.

Introduction: The objectives of this study were to evaluate the outcome of nonimmune hydrops fetalis in an attempt to identify independent predictors of perinatal mortality. Material and Methods: A retrospective cohort study was conducted including all cases of nonimmune hydrops from two tertiary care centers. Perinatal outcome was evaluated after classifying nonimmune hydrops into ten etiological groups. We examined the effect of etiology, site of fluid accumulation, and gestational age at delivery on postnatal survival. Neonatal mortality and hospital discharge survival were compared between the expectant management and fetal intervention groups among those with idiopathic etiology. Results: A total of 142 subjects were available for analysis. Generally, nonimmune hydrops carried 37% risk of neonatal mortality and 50% chance of survival to discharge, which varies markedly based on the underlying etiology. Ascites was an independent predictor of perinatal mortality (p value = 0.003). There was nonsignificant difference in neonatal mortality and hospital discharge survival among idiopathic cases that were managed expectantly versus those in whom fetal intervention was carried out. Discussion: The outcome of nonimmune hydrops varies largely according to the underlying etiology and the presence of ascites is an independent risk factor for perinatal mortality. In our series, fetal intervention did not offer survival advantage among fetuses with idiopathic nonimmune hydrops.