Longitudinal Assessment of Abdominal Circumference versus Estimated Fetal Weight in the Detection of Late Fetal Growth Restriction

Basuki, Tri Rahmat; Caradeux, Javier; Eixarch, Elisenda; Gratacós, E.; Figueras, F.

doi:10.1159/000485889

Cited by 10 publications

(8 citation statements)

References 41 publications

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“…In a more recent study, the same research group suggested that conditional centiles of CPR values offer better prediction for operative delivery for presumed fetal compromise or neonatal care unit admission 30 . Moreover, similar positive findings have been reported for conditional centiles of EFW, though these findings are contested in more recent studies 11,31,46 . The relationship of longitudinal changes with perinatal outcome in early-onset FGR is sparsely reported [47][48][49] .…”

Section: Interpretation Of Study Findings and Comparison With Publishsupporting

confidence: 77%

Longitudinal change in cerebroplacental ratio in small‐for‐gestational‐age fetuses and risk of stillbirth

Kalafat

Öztürk

Sivanathan

et al. 2019

Ultrasound in Obstet & Gyne

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Objective To investigate whether assessment of longitudinal change in Doppler variables in small‐for‐gestational‐age (SGA) fetuses improves the prediction of those at risk of stillbirth. Methods This was a longitudinal study of two cohorts of singleton pregnancies, which included SGA and appropriate‐for‐gestational‐age (AGA) fetuses, respectively. The inclusion criteria for the SGA cohort were singleton pregnancy at ≥ 20 weeks' gestation, classified as SGA (estimated fetal weight < 10th centile). The AGA cohort consisted of singleton pregnancies deemed at high risk of being SGA, which were followed up longitudinally but remained AGA. Fetal middle cerebral artery (MCA) pulsatility index (PI) and umbilical artery (UA)‐PI were measured longitudinally and cerebroplacental ratio (CPR) was calculated, and values were converted to multiples of the median. The last two measurements prior to delivery were included in the analysis. Longitudinal models for Doppler variables were developed using linear‐mixed models and their accuracy in the prediction of stillbirth was tested using generalized linear models. A Bayesian framework was employed to compare the accuracy of longitudinal and standard (last‐scan measurement) models. Results In total, 1549 AGA and 941 SGA pregnancies were included in the analysis. There were 30 (3.2%) and no stillbirth cases in the SGA and AGA groups, respectively. Change in MCA‐PI, UA‐PI and CPR with advancing gestation was significantly different between liveborn AGA and SGA fetuses, with a less pronounced difference with advancing gestation. Using the last measurement, the best models for the prediction of stillbirth in SGA pregnancies were those based on CPR (accuracy, 75.0%; 95% CI, 72.6–77.2%) and UA‐PI (accuracy, 71.0%; 95% CI, 68.6–73.4%). The posterior probability of the standard CPR model having a higher accuracy compared with the UA‐PI model was 97.2% (magnitude of change (MC), 3.9%; 95% credible interval (CrI), 0.5–7.3%). The accuracies of the standard, compared with the longitudinal, models for UA‐PI (71.0% vs 72.8%), MCA‐PI (64.6% vs 63.8%) and CPR (75.0% vs 74.9%) in the prediction of stillbirth were not significantly different. The posterior probabilities for improvement in accuracy using longitudinal, compared with standard, assessment were 50.1% (MC, < 0.1%; 95% CrI, −3.3 to 3.3%), 35.2% (MC, −0.1%; 95% CrI, −4.5 to 2.8%) and 82.2% (MC, 1.9%; 95% CrI, −1.5 to 5.3%) for CPR, MCA‐PI and UA‐PI models, respectively. Therefore, change in Doppler parameters did not improve the accuracy of the prediction of stillbirth, compared with that of the last‐scan measurement. Conclusion Longitudinal assessment of Doppler parameters was not useful in improving the detection of stillbirth in SGA pregnancies, as compared with a single‐point assessment. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.

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Section: Interpretation Of Study Findings and Comparison With Publishsupporting

confidence: 77%

Longitudinal change in cerebroplacental ratio in small‐for‐gestational‐age fetuses and risk of stillbirth

Kalafat

Öztürk

Sivanathan

et al. 2019

Ultrasound in Obstet & Gyne

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“…63 In this sense, fetal complications include miscarriage, fetus with low birthweight (less than 2500grams) resulting from intrauterine growth restriction, and preterm delivery (less than 37 weeks gestation). 10,[64][65][66][67][68][69] Peripheral maternal parasitemia is also associated with adverse effects on infants, including anemia, neonatal and infant mortality, and congenital malaria. Symptoms of the latter tend to appear after 10 to 30 days post-labor and include fever, hepatosplenomegaly, hemolytic anemia, thrombocytopenia, and food intolerance.…”

Section: Clinical Manifestations and Maternal-fetal Complicationsmentioning

confidence: 99%

Malaria and pregnancy: a Venezuelan approach. Review article

Ruiz¹,

Núñez²,

Martín-Castelli³

et al. 2022

OGIJ

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Aim: to review and describe exhaustively the implications of malaria in pregnancy, including its maternal, fetal, and neonatal clinical manifestations and effects; immunopathology and pathophysiology; advancements in its diagnostics, histopathology, and treatment options; and epidemiology, particularly in Venezuela, a country where its data is almost non-existent. Methods: the information used to write this manuscript was obtained during a three-month period, between June and September 2022, from specialized literature, written in English and Spanish, related to malaria associated with pregnancy, mainly published during the last five years, using journals found in the most relevant medical digital archives, including PubMed, SciELO, Elsevier, Google Scholar, Latindex, and Cochrane Plus. Among the keywords used for obtaining this updated information were malaria; malaria in pregnancy; gestational malaria; placental malaria; congenital malaria. Results: all the clinical forms related to malaria in pregnancy, including gestational, placental, and congenital malaria, can cause maternal-fetal alterations, that, in case of progressing, could lead to the death of this binomial. Their pathophysiology and immunopathology can explain the gestational and fetal symptomatology, as well as their complications, depending on the parasite form that affected them. There are new updates regarding the diagnostics, prevention, and treatment of this medical entity. Conclusion: it is imperative to exalt the relevance of studying this disease in pregnant patients, especially in the Venezuelan topography, a focus of infection with a plethora of cases of said entity, whose lack of updated epidemiological data, regarding its prevalence and incidence, is profoundly preoccupying. Pregnant patients are not only one of the most vulnerable risk groups of this parasitosis, but also have the capacity of duplicating the risk of infecting the fetus.

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“…The two main late forms of smallness are FGR and small for gestational age (SGA) fetuses [61]. Late FGR, in comparison to SGA, presents Doppler abnormalities in the fetoplacental circulation but also carries a higher risk of intrauterine death [61][62][63]. On the other hand, both FGR and SGA are associated with intrauterine programming, including abnormal neurodevelopment, increased risk of metabolic and cardiovascular diseases, and including obesity [54][55][56].…”

Section: Pathways Of Placental Aging In Late Fetal Growth Restrictionmentioning

confidence: 99%

Molecular Pathways of Cellular Senescence and Placental Aging in Late Fetal Growth Restriction and Stillbirth

Kajdy

Modzelewski

Cymbaluk‐Płoska

et al. 2021

IJMS

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Abnormally accelerated, premature placental senescence plays a crucial role in the genesis of pregnancy pathologies. Abnormal growth in the third trimester can present as small for gestational age fetuses or fetal growth restriction. One differs from the other by the presence of signs of placental insufficiency and the risk of stillbirth. The majority of stillbirths occur in normally grown fetuses and are classified as “unexplained”, which often leads to conclusions that they were unpreventable. The main characteristic of aging is a gradual decline in the function of cells, tissues, and organs. These changes result in the accumulation of senescent cells in mitotic tissues. These cells begin the aging process that disrupts tissues’ normal functions by affecting neighboring cells, degrading the extracellular matrix, and reducing tissues’ regeneration capacity. Different degrees of abnormal placentation result in the severity of fetal growth restriction and its sequelae, including fetal death. This review aims to present the current knowledge and identify future research directions to understand better placental aging in late fetal growth restriction and unexplained stillbirth. We hypothesized that the final diagnosis of placental insufficiency can be made only using markers of placental senescence.

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Longitudinal Assessment of Abdominal Circumference versus Estimated Fetal Weight in the Detection of Late Fetal Growth Restriction

Cited by 10 publications

References 41 publications

Longitudinal change in cerebroplacental ratio in small‐for‐gestational‐age fetuses and risk of stillbirth

Longitudinal change in cerebroplacental ratio in small‐for‐gestational‐age fetuses and risk of stillbirth

Malaria and pregnancy: a Venezuelan approach. Review article

Molecular Pathways of Cellular Senescence and Placental Aging in Late Fetal Growth Restriction and Stillbirth

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