Allison Sadowski

Fetal Hydronephrosis as a Predictor of Neonatal Urologic Outcomes

The ability to predict surgically relevant fetal renal hydronephrosis is limited. We sought to determine the most efficacious second‐ and third‐trimester fetal renal pelvis anteroposterior diameter cutoffs to predict the need for postnatal surgery.

Perinatal outcomes based on the institute of medicine guidelines for weight gain in twin pregnancies

Abstract Objective: To estimate the impact of the Institute of Medicine’s (IOM) weight gain recommendations on perinatal outcomes in twin pregnancies. Methods: In this multicenter cohort study, using the 2009 IOM guidelines, we examined pregnancy outcomes in 570 uncomplicated diamniotic twin pregnancies. Subjects were grouped according to pre-pregnancy body mass index. Perinatal outcomes were assessed based on whether maternal weekly weight gain was less than, at, or in excess of the recommended IOM guidelines. Results: In women with a normal pre-pregnancy BMI, patients whose weight gain met the IOM recommendations had a significantly higher mean gestational age at delivery; less prematurity and larger birth weight infants compared to women whose weekly weight gain was less or excess than the recommended IOM guidelines. Similarly, when compared with their low weight gain counterparts, overweight women with appropriate weight gain had improved outcomes including higher mean gestational age at delivery, higher birth weight infants and less prematurity. In obese women, the amount of pregnancy weight gain did not impact perinatal outcomes. Conclusion: Our results confirm that weekly maternal weight gain according to the IOM guidelines results in improved outcomes in twin pregnancies. Importantly, women with a normal or overweight pre-pregnancy BMI whose weekly weight gain was less than recommended, had increased risks of prematurity and lower birth weight infants. Similarly, women with a normal pre-pregnancy BMI whose weekly weight gain was excess than recommended had increased risks of prematurity and lower birth weight infants.

OC25.02: The impact of fetal renal pelvic diameter on postnatal outcome

during treatment (T1, T2). We characterized change patterns that differentiate between responsive and non-responsive groups. Results: The overall response rate for 45 patients was 67%. Before chemotherapy, FI was significantly higher in responders than non-responders (P < 0.05). Receiver-operating characteristics curve analysis suggested that a sensitivity of 80% and a specificity of 73% can be achieved with an optimum FI threshold of 35.8. During treatment, we observed a dramatic change (increment or decrement) of VI at T1 stage in the responsive group, but not the non-responsive group. When the VI change was more than 42%, we could predict the final response to chemotherapy with a sensitivity of 84% and a specificity of 79%. Patients with VI change more than 42% had a response rate of 96% (26/27), in contrast, the remaining patients has a response rate of 22% (4/18) only (P < 0.001). Conclusions: By using 3D power Doppler, the initial FI and the VI change can be used as early predictors of patient response to neoadjuvant chemotherapy.

OP26.08: Postnatal diagnosis, treatment and follow-up of antenatal hydronephrosis: a health care challenge

A. A. Shamshirsaz1, S. Ravangard1, A. A. Shamshirsaz3, A. Prabulos1, W. Campbell1, R. Billstrom1, A. Sadowski1, J. Makari2, F. A. Ferrer2, K. Herbst2, J. Egan1 1Obstetrics and Gynecology, Maternal-Fetal Medicine, University of Connecticut Health Center, Farmington, CT, USA; 2Pediatric Urology, Connecticut Children’s Medical Center, Hartford, CT, USA; 3Obstetrics and Gynecology, Maternal-Fetal Medicine, Yale University School of Medicine, New Haven, CT, USA