Y. Ville

Relationship between monitoring parameters and perinatal outcome in severe, early intrauterine growth restriction

To investigate whether pathological changes in the umbilical artery (UA), ductus venosus (DV) and short‐term fetal heart variation are related to perinatal outcome in severe, early intrauterine growth restriction (IUGR).

Screening for fetal aneuploidies and fetal cardiac abnormalities by nuchal translucency thickness measurement at 10–14 weeks of gestation as part of routine antenatal care in an unselected population

Objectives To evaluate first trimester pregnancy screening for fetal aneuploidy and congenital heart defects by maternal age and nuchal translucency measurement and screening for fetal aneuploidies and congenital heart defects by ultrasound in an unselected population.

First-trimester transabdominal fetal echocardiography

BACKGROUNDnFetal echocardiography is usually done during the second trimester of pregnancy, but waiting until that time can lead to anxiety for the parents if the fetus is at high risk of having cardiac abnormalities. We report the feasibility of transabdominal first-trimester fetal echocardiography for early reassurance of normality or a prenatal diagnosis of a cardiac malformation.nnnMETHODSnWe did first-trimester fetal echocardiography and colour-flow mapping with a 5 MHz curvilinear transducer at 13 weeks gestation (range 12-13+6 days) in 15 fetuses at risk of cardiac defects. The fetus was judged to be normal if the investigation showed normal visceral situs, four-chamber view, and two normally related great arteries of similar size. We did second-trimester scans and neonatal follow-up for the women who continued with their pregnancies; necropsy was done in two cases of pregnancy termination.nnnFINDINGSnTen fetuses had normal hearts at the time of the first scan, which was confirmed during second-trimester assessment. In one fetus, the four-chamber view was asymmetrical and a moderate-sized apical muscular ventricular septal defect (VSD) was diagnosed after birth. In another two fetuses we diagnosed small muscular VSD on the second-trimester scans. A complex cardiac malformation was correctly diagnosed in one fetus at 12 weeks of gestation. Thus, in 11 fetuses, the imaging was of sufficient quality to reassure the family or to diagnose an abnormality. In the other four fetuses, the investigation was judged to be incomplete, but no definite cardiac abnormality was identified.nnnINTERPRETATIONnTransabdominal fetal echocardiography in the first trimester of pregnancy is feasible. In most patients the resolution of images is sufficient to allow assessment of basic cardiac anatomy, when normal, or detection of complex malformations, when present.

Twin reversed arterial perfusion: fetoscopic laser coagulation of placental anastomoses or the umbilical cord

To assess the feasibility and outcome of fetoscopic laser coagulation in pregnancies with twin reversed arterial perfusion (TRAP) sequence.

Estimation of fetal weight: reference range at 20–36 weeks' gestation and comparison with actual birth‐weight reference range

To formulate reference charts and equations for estimated fetal weight (EFW) from a large sample of fetuses and to compare these charts and equations with those obtained for birth weight during the same study period and in the same single health authority.

Sex‐specific antenatal reference growth charts for uncomplicated singleton pregnancies at 15–40 weeks of gestation

Female fetuses, on average, weigh less than male fetuses at all gestational ages. The purpose of this study was to compare female and male fetuses in terms of intrauterine ultrasound growth measurements and to develop gestational‐age‐related charts based on a computerized perinatal database.

The impact of choice of reference charts and equations on the assessment of fetal biometry

The assessment of fetal biometry is usually based on the comparison of measured values with predicted values derived from reference charts or equations in a normal population. This study was undertaken to assess the impact of the choice of reference charts and to develop a Z‐score‐based tool that could help sonographers to choose the reference charts that best fit their practice.

Growth discrepancy in twins in the first trimester of pregnancy

The prevalence and significance of intertwin growth discrepancy in the first trimester of pregnancy are controversial. The aim of this study was to refine the incidence and outcome of this discrepancy in relation to dating of the pregnancy and other biometric parameters.

Fetal medicine: Intrauterine fetal demise following laser treatment in twin‐to‐twin transfusion syndrome

Objectiveu2002 To evaluate the incidence, risk factors and consequences of intrauterine fetal demise (IUFD) of at least one twin in twin‐to‐twin transfusion syndrome (TTTS) treated by laser.

Cervical length as a prognostic factor for preterm delivery in twin‐to‐twin transfusion syndrome treated by fetoscopic laser coagulation of chorionic plate anastomoses

To evaluate the risk of spontaneous preterm delivery in relation to cervical length in severe cases of twin‐to‐twin transfusion syndrome (TTTS) diagnosed before 26 weeks of gestation and treated by laser coagulation of the intertwin placental anastomoses.