C.B. Wulff

Risk of fetal loss associated with invasive testing following combined first‐trimester screening for Down syndrome: a national cohort of 147 987 singleton pregnancies

To assess prospectively the risk of fetal loss associated with chorionic villus sampling (CVS) and amniocentesis (AC) following combined first‐trimester screening (cFTS) for Down syndrome.

The Danish Fetal Medicine Database: establishment, organization and quality assessment of the first trimester screening program for trisomy 21 in Denmark 2008–2012

To describe the establishment and organization of the Danish Fetal Medicine Database and to report national results of first‐trimester combined screening for trisomy 21 in the 5‐year period 2008–2012.

Can a 15-mm Cervical Length Cutoff Discriminate between Low and High Risk of Preterm Delivery in Women with Threatened Preterm Labor?

Objectives: To investigate if a cervical length (CL) cutoff of 15 mm is relevant to use in women with threatened preterm labor. Methods: From 2006 to 2009, 146 women with singleton pregnancies were admitted with threatened preterm labor between 23 and 33+6 weeks of gestation at Copenhagen University Hospital. Transvaginal sonographic measurement of CL was carried out on admission. Outcome measures were spontaneous delivery within 48 h, within 7 days and delivery before 34 weeks according to a CL cutoff of 15 mm. Results: CL was <15 mm in 36 women (24.7%) and ≧15 mm in 110 women (75.3%). Spontaneous delivery occurred within 48 h or 7 days of presentation and before 34 weeks in 25, 38.9 and 50.0% of women with CL <15 mm and 3.6, 9.1 and 11.8% of women with CL ≧15 mm, respectively. The 15-mm CL cutoff had a sensitivity, false positive rate and negative predictive value for delivery within 48 h of 69.0, 20.3 and 96.4%, and within 7 days of 58.3, 18.1 and 90.9%. Women with CL <15 mm had odds of delivery within 7 days of 6.4 (95% CI 2.5–16.2). Conclusion: Although a 15-mm CL defines a group of women at high risk of spontaneous preterm delivery, 10 out of 110 women (9.1%) with a CL ≧15 mm deliver within 7 days.

Fractional CO2 laser treatment of caesarean section scars-A randomized controlled split-scar trial with long term follow-up assessment.

Caesarean section (c‐section) scars can be pose functional and cosmetic challenges and ablative fractional laser (AFXL) treatment may offer benefit to patients. We evaluated textural and color changes over time in AFXL‐treated versus untreated control scars.

Parental Decisions about Prenatal Screening and Diagnosis among Infants with Trisomy 21 in a National Cohort with High Uptake of Combined First-Trimester Screening.

Introduction: The aim was to investigate the parental decisions about prenatal screening and diagnosis among infants with trisomy 21 (T21) in a national cohort with high uptake of combined first-trimester screening (cFTS). Material and Methods: This was a nationwide population-based study including infants born in 2009-2012. Information from the cFTS, fetal karyotype results and pregnancy outcome was obtained from the Danish Fetal Medicine Database on all women with a cFTS risk assessment. Cut-off for referral for invasive testing was ≥1:300. Karyotype results from pregnancies with no cFTS were obtained from the Danish Cytogenetic Central Registry. Results: The uptake rate of cFTS was 91.6%, and 82.8% (8,032/9,704) of the screen-positive women opted for invasive testing. Overall, 82.2% (454/552) chose to terminate an affected pregnancy. In the 4-year period, 102 of 232,962 singletons were born alive with T21. The cFTS risk was true-positive, false-negative or not obtained in 21.6, 48.0 and 30.4%, respectively, of these pregnancies. Discussion: In this large national cohort, 4.4 per 10,000 live-born infants had T21. Of 102 infants with T21 from 2009 to 2012, 52.0% were born after the women had not opted for cFTS or were true-positive but declined invasive testing or termination, and 48.0% were born after a false-negative risk assessment.

Children Prenatally Believed to have Isolated Mild Ventriculomegaly

To estimate the prevalence of specific neurodevelopmental disorders in children believed to have isolated mild ventriculomegaly (IMV) prenatally in the second trimester of pregnancy, in order to optimize the counseling process.Citation for pulished version (APA): Thorup, E., Jensen, L. N., Bak, G. S., Ekelund, C. K., Greisen, G., Jørgensen, D. S., Hellmuth, S. G., Wulff, C., Petersen, O. B., Pedersen, L. H., & Tabor, A. (2019). Neurodevelopmental disorder in children believed to have isolated mild ventriculomegaly prenatally. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 54(2), 182-189. https://doi.org/10.1002/uog.20111

Ultrasound in Prenatal Diagnostics and Its Impact on the Epidemiology of Spina Bifida in a National Cohort from Denmark with a Comparison to Sweden

Objectives The aim of this study was to assess the incidence, the prenatal detection rate by ultrasound, and the pregnancy outcome of spina bifida (SB) in Denmark (DK) in 2008–2015 and to compare results to national data from Sweden. Methods Data were retrieved from the Danish Fetal Medicine Database, which includes International Classification of Diseases- (ICD-) 10 codes for pre- or postnatally diagnoses and pregnancy outcome. Missing data were obtained from the National Patient Register. Livebirth data with myelomeningocele (MMC) in Sweden were obtained from different databases. Results There were 234 cases with SB in DK in 2008–2015. The incidence of SB was 4.9 : 10,000; 89% were detected with ultrasound prior to week 22; 90% of these pregnancies were terminated (ToP); 91% were isolated malformations of which 11% showed abnormal karyotype. The incidence of newborns with MMC was 1.3 : 10,000 in Sweden. Conclusions Ultrasound screening has a major impact on the epidemiology of SB. The prenatal detection rate of SB was high, and most SB cases were isolated and had a normal karyotype. Among women with a prenatal fetal diagnosis of SB, 90% chose to have ToP. The incidence of newborns with SB was higher in Sweden than in DK.

OP10.02: Longitudinal transvaginal ultrasound of cervical length in pregnant women with prior conisation

Objectives: Our aim was to evaluate whether placental subclinical inflammation biomarkers predict impaired cognitive development in two year-old children after an episode of suspected preterm labour. Methods: Two-year-old children who were born late preterm (n=21) or at term after suspected preterm labour (n=16) were compared with at-term control children (n=10). Placental samples were collected immediately after delivery. We quantitatively analysed the mRNA expression of inflammatory markers (IL6, IFNγ, and TNFα). Placental inflammation was defined as the presence of both IL6 and TNFα mRNA expression were over 1.5 MoMs. Neurodevelopment was evaluated at a corrected age of 24-29 months with the use of the Merrill-Palmer-Revised Scales of Development. Results: Inflammation was present in the 10% of the controls, 14.3% of late preterm and 18.8% of term-born after suspected preterm labour placentas. Both term-born and late preterm two year-old infants with signs of subclinical placental inflammation had significantly lower mean scores on global cognitive index (86.71 vs 98.29; p= 0.014), cognition (86.85 vs 97.86; p=0.019), fine motor (89.42 vs 97.08; p=0.08), receptive language (83.28 vs 97.56; p=0.08), active and diligent (74 vs 99.72; p=0.07), and easy temper style (81.71 vs 93.62; p=0.06) subtest. An increased placental mRNA expression of IL6 was correlated with the active and diligent (-0.328; p=0.024) and angry and unhelpful (0.302; p=0.039) subtest. Whereas, an increased mRNA expression of TNF-alfa was also correlate with the cognition (-0.294; p=0.047), adaptive behaviour and self-care (-0.353; p=0.015), fine motor (-0.316; p=0.033), receptive language (-0.294; p=0.047), expressive language (-0.310; p=0.036), active and diligent (-0.310; p=0.034), temperament (-0.306; p=0.038) subtest. Conclusions: Placental inflammation is a risk factor for impaired cognitive development at early childhood age after suspected preterm labour both in term and preterm neonates. OP10.02 Longitudinal transvaginal ultrasound of cervical length in pregnant women with prior conisation

OP02.11: Rate of miscarriage and stillbirth following first-trimester risk assessment

W. Hofmann1, M. Stumm2, K. Haug3, C. Blank3, M. Wüstemann4, B. Schulze5, G. Raabe-Meyer5, M. Hempel6, M. Schelling7, E. Ostermayer8, S. Langer-Freitag6, T. Burkhardt9, R. Zimmermann9, M. Beck10, T. Schleicher10, Y. Kumar10, D. Schöner1, S. Grömminger1, M. Entezami2 1LifeCodexx AG, Konstanz, Germany; 2Zentrum für Pränataldiagnostik und Humangenetik, Berlin, Germany; 3Praenatal-Medizin und Genetik, Düsseldorf, Germany; 4Zentrum für Pränatalmedizin, Hannover, Germany; 5Praxis für Humangenetik, Hannover, Germany; 6Institut of Human Genetics, Technische Universität München, München, Germany; 7Praxis für Pränatale Diagnostik, München, Germany; 8Department of Obstetrics and Gynecology, Technische Universität München, München, Germany; 9Klinik für Geburtshilfe, Universitätsspital Zürich, Zürich, Switzerland; 10GATC Biotech AG, Konstanz, Germany