Andrew Gerson

Is Cerclage Height Associated with the Incidence of Preterm Birth in Women with a History-Indicated Cerclage?

This study was performed to determine if cerclage height is associated with spontaneous preterm birth in patients with a history-indicated cerclage. We performed a retrospective cohort study of women with a history-indicated cerclage. Functional cervical length and the cerclage height (distance from cerclage to the external cervical os) were obtained. The cohort was grouped into thirds, based on cerclage height percentile. Our primary outcome was spontaneous preterm birth <35 weeks. There were 21 women in group 1 (cerclage height <10 mm), 53 in group 2 (cerclage height 10 to 19 mm), and 31 in group 3 (cerclage height ≥20 mm). The rates of spontaneous preterm birth <35 weeks were similar between each group: 24, 17, and 10%, respectively ( P = 0.38). Cerclage height is not associated with a reduction in spontaneous preterm birth for women with a history-indicated cerclage. The association between longer cerclage height and decrease in preterm birth was nonsignificant possibly due to the small sample size.

Comparative Analysis of Two- Versus Three-Dimensional Sonography for Nuchal Translucency Measurement.

OBJECTIVE The aim of this article is to test the hypothesis that three-dimensional (3D) sonography is correlated to the two-dimensional (2D) sonography for nuchal translucency (NT) measurement during first trimester screening (FTS). METHODS We performed a prospective observational study on patients presenting for FTS. Three NT measurements were performed using the current standardized 2D method at the midsagittal planes, and NT sonography was then repeated for each case using 3D sagittal and axial plane. The Kruskal-Wallis test and the Spearman rank correlation were used to evaluate the relationship between 2D and 3D NT methods of measurement. A p-value <0.05 was considered significant. RESULTS The study included 366 patients with singleton pregnancies. Mean maternal age was 31.2 years, and mean gestational age was 12(3/7) weeks. The mean maximal NT measurement for 2D and 3D sagittal and axial planes were 1.65, 1.70, and 1.66 mm, respectively (p = 0.42). The Spearman rank correlation of 2D sagittal plane sonography with 3D sagittal and axial planar sonography was 0.73 and 0.68, respectively (p < 0.001). CONCLUSION 3D NT measurement appears to be a tool highly correlated to the conventional 2D sonographic approach. This may be useful in selected cases in which there is difficulty in obtaining optimal 2D measurements of the NT space.

Pregnancy and warm autoantibodies : a case report

The presence of the maternal warm antibody in pregnancy should not be ignored. As there is risk of both maternal and fetal anemia, both patients need to be followed for the development of such. Serial complete blood counts in the mother and treatment if significant fetal anemia develops should be considered. Serial amniocentesis and nonstress testing should be part of any management plan in the presence of a maternal warm antibody.