Article
Medicine, General & Internal
Piotr Tousty, Magda Fraszczyk-Tousty, Anna Golara, Adrianna Zahorowska, Michal Slawinski, Sylwia Dzidek, Hanna Jasiak-Jozwik, Magda Nawceniak-Balczerska, Agnieszka Kordek, Ewa Kwiatkowska, Aneta Cymbaluk-Ploska, Andrzej Torbe, Sebastian Kwiatkowski
Summary: This study aimed to evaluate the implementation of low-dose acetylsalicylic acid (ASA) for the prevention of pregnancy-induced hypertension (PE) and fetal growth restriction (FGR) in a Polish population. The results showed that patients in the high-risk group were more likely to experience complications during pregnancy, including pre-eclampsia, fetal growth restriction, gestational diabetes, and cesarean section. The conclusion is that the first-trimester screening is crucial in identifying high-risk pregnancies, and ASA prophylaxis may have the most beneficial effect on these high-risk patients.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Acoustics
U. Nowacka, I Papastefanou, A. Bouariu, A. Syngelaki, R. Akolekar, K. H. Nicolaides
Summary: This study investigates the additional value of second-trimester placental growth factor (PlGF) in predicting small-for-gestational-age (SGA) neonates and examines second-trimester contingent screening strategies. The results show that the combination of maternal risk factors, estimated fetal weight (EFW), uterine artery pulsatility index (UtA-PI), and PlGF significantly improves the prediction of SGA compared to maternal risk factors alone. However, the incremental improvement decreases when PlGF is added to screening with a combination of maternal risk factors, EFW, and UtA-PI. By reserving measurements of UtA-PI and PlGF for a certain percentage of the population, similar detection rates and false-positive rates can be achieved. The study concludes that the combination of maternal risk factors, EFW, UtA-PI, and PlGF provides an effective prediction of SGA in the second trimester.
ULTRASOUND IN OBSTETRICS & GYNECOLOGY
(2022)
Article
Biochemistry & Molecular Biology
Nikolaos Vrachnis, Savvas Argyridis, Dionysios Vrachnis, Nikolaos Antonakopoulos, Georgios Valsamakis, Christos Iavazzo, Dimitrios Zygouris, Nikolaos Salakos, Alexandros Rodolakis, Nikolaos Vlahos, George Mastorakos, Peter Drakakis, Zoi Iliodromiti
Summary: The study found that both FGF21 and insulin concentrations increased in cases of abnormal fetal growth. Higher levels of these hormones were observed in fetuses with restricted growth (SGA) or macrosomia (LGA).
Article
Biochemistry & Molecular Biology
Ilona Hromadnikova, Katerina Kotlabova, Ladislav Krofta
Summary: The study aimed to determine the diagnostic potential of cardiovascular disease-associated microRNAs for the early detection of SGA and FGR without PE. The findings suggest that these microRNAs could serve as promising biomarkers and improve the detection rate of these conditions.
Article
Acoustics
G. Albaiges, I. Papastefanou, I. Rodriguez, P. Prats, M. Echevarria, M. A. Rodriguez, A. Rodriguez Melcon
Summary: This study examines the external validity of the new Fetal Medicine Foundation (FMF) competing-risks model for predicting small-for-gestational-age (SGA) neonates in midgestation. The study finds that the model performs well in a large independent Spanish population.
ULTRASOUND IN OBSTETRICS & GYNECOLOGY
(2023)
Article
Medicine, General & Internal
Chiara Lubrano, Emanuela Taricco, Chiara Coco, Fiorenza Di Domenico, Chiara Mando, Irene Cetin
Summary: Alterations in intrauterine fetal growth increase the risk of adverse perinatal and neonatal outcomes. Risk factors for fetal growth alterations include advanced age, being primiparous, and a lower pregestational BMI. Prematurity, hyperlactacidemia, and hypoxemia are the main factors contributing to worse neonatal outcomes.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Cristina Trilla, Cristina Luna, Silvia De Leon Socorro, Leire Rodriguez, Aina Ruiz-Romero, Josefina Mora Brugues, Taysa Benitez Delgado, Marta Fabre, Alicia Martin Martinez, Sara Ruiz-Martinez, Elisa Llurba, Daniel Oros
Summary: This study aims to determine the predictive and preventive capacity of a universal first-trimester screening model for preeclampsia by determining PlGF levels in intermediate-risk patients. The screening model is expected to achieve similar diagnostic performance as universal determination of PlGF but at a lower economic cost.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Medicine, General & Internal
Stephanie Springer, Katharina Worda, Marie Franz, Eva Karner, Elisabeth Krampl-Bettelheim, Christof Worda
Summary: Early prediction of fetal growth restriction is important for treatment options and neonatal outcomes. This study assessed the association of parameters used in first-trimester screening and the development of fetal growth restriction. The findings showed that PAPP-A levels and uterine artery Doppler pulsatility index weresignificantly associated with fetal growth restriction.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Acoustics
I Papastefanou, D. Wright, A. Syngelaki, M. Lolos, K. Anampousi, K. H. Nicolaides
Summary: This study developed a new competing-risks model for predicting small-for-gestational-age (SGA) neonates, with PlGF showing better performance in predicting SGA compared to PAPP-A, especially in the presence of pre-eclampsia (PE). The model can be tailored to individual pregnancies and clinical requirements.
ULTRASOUND IN OBSTETRICS & GYNECOLOGY
(2021)
Review
Obstetrics & Gynecology
Piya Chaemsaithong, Daljit Singh Sahota, Liona C. Poon
Summary: Preeclampsia is a significant threat to both mothers and babies, and early-onset disease requiring preterm delivery increases the risk of complications. Low-dose aspirin initiated before 16 weeks reduces the rate of preterm preeclampsia. Identifying pregnant women at risk during the first trimester is crucial, and current screening methods have suboptimal performance compared to the Fetal Medicine Foundation's first trimester prediction model (the triple test). This model has high detection rates and low false-positive rates, outperforming traditional risk factor screening methods.
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
(2022)
Article
Obstetrics & Gynecology
Selvaraj Lakshmy, Thasleem Ziyaulla, Nity Rose
Summary: The study aimed to evaluate the performance and feasibility of different screening protocols for preeclampsia and fetal growth restriction in low resource settings. Results showed that the multiparametric approach in the first trimester had a higher detection rate of 60% for preeclampsia and 85% for fetal growth restriction, with an even higher detection rate of 98% for early onset preeclampsia in certain cases. Implementing screening for preeclampsia with available resources in peripheral areas is crucial to prevent severe complications, and a multiparametric approach in the first trimester could be an effective strategy in low resource settings.
JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE
(2021)
Article
Multidisciplinary Sciences
Sarang Younesi, Laleh Eslamian, Nikta Khalafi, Mohammad Mahdi Taheri Amin, Pourandokht Saadati, Soudabeh Jamali, Payam Balvayeh, Mohammad-Hossein Modarressi, Shahram Savad, Saloomeh Amidi, Saeed Delshad, Fariba Navidpour, Bahareh Yazdani, Fatemeh Aasdi, Samira Chagheri, Yalda Mohammadi, Vajiheh Marsoosi, Ashraf Jamal, Soudeh Ghafouri-Fard
Summary: Multiples of the normal median (MoM) of free beta HCG is a valuable parameter in evaluating risk of adverse pregnancy outcomes. This retrospective study examined the maternal and fetal outcomes of pregnant women with MoM levels of free beta HCG < 0.2 or > 5 in their first trimester screening. The study found that high MoM levels were associated with an increased risk of trisomy 21, while low MoM levels were associated with a higher risk of trisomies 13 and 18 and Turner syndrome. Other chromosomal abnormalities were equally detected in both groups. There was also an increased risk of certain complications such as hydrocephaly, hydrops fetalis, low birth weight, gestational diabetes mellitus, preeclampsia, preterm delivery, and vaginal bleeding with higher MoM levels.
SCIENTIFIC REPORTS
(2023)
Article
Acoustics
M. van Roekel, J. Henrichs, A. Franx, C. J. Verhoeven, A. de Jonge
Summary: This study aimed to examine the implications of third-trimester small-for-gestational-age (SGA) screening accuracy on severe adverse perinatal outcome (SAPO) and obstetric intervention. The results showed that infants suspected of being SGA during pregnancy had a higher risk of SAPO and obstetric intervention. However, third-trimester sonographic growth-trajectory measurements did not provide significant additional value in predicting SAPO in low-risk populations.
ULTRASOUND IN OBSTETRICS & GYNECOLOGY
(2023)
Article
Medicine, General & Internal
Urszula Nowacka, Ioannis Papastefanou, Alexandra Bouariu, Argyro Syngelaki, Kypros H. Nicolaides
Summary: A new approach for predicting SGA, considering it a spectrum condition, has better predictive ability than traditional methods. However, the study found that second trimester levels of sFlt-1 and sFlt-1/PlGF are not useful in screening for SGA.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Acoustics
I. Papastefanou, U. Nowacka, A. Syngelaki, V. Dragoi, G. Karamanis, D. Wright, K. H. Nicolaides
Summary: This study demonstrated that adding second-trimester estimated fetal weight (EFW) improves the prediction of small-for-gestational-age (SGA) neonates, particularly in cases of prematurity and severe smallness. Screening based on maternal characteristics and EFW can more accurately identify SGA neonates, enhancing the model's accuracy.
ULTRASOUND IN OBSTETRICS & GYNECOLOGY
(2021)
Article
Acoustics
I. Papastefanou, D. Wright, A. Syngelaki, K. Souretis, E. Chrysanthopoulou, K. H. Nicolaides
Summary: This study developed a new competing-risks model for predicting small-for-gestational-age (SGA) neonates based on maternal factors and biophysical and biochemical markers at 11-13 weeks' gestation. The model showed improved prediction for SGA cases with increasing prematurity, severity of smallness, coexistence of pre-eclampsia, and number of biomarkers. The new model was well-calibrated and could be used for personalized antenatal care plans.
ULTRASOUND IN OBSTETRICS & GYNECOLOGY
(2021)
Article
Acoustics
I Papastefanou, D. Wright, A. Syngelaki, M. Lolos, K. Anampousi, K. H. Nicolaides
Summary: This study developed a new competing-risks model for predicting small-for-gestational-age (SGA) neonates, with PlGF showing better performance in predicting SGA compared to PAPP-A, especially in the presence of pre-eclampsia (PE). The model can be tailored to individual pregnancies and clinical requirements.
ULTRASOUND IN OBSTETRICS & GYNECOLOGY
(2021)
Article
Acoustics
I. Papastefanou, U. Nowacka, A. Syngelaki, V. Dragoi, G. Karamanis, D. Wright, K. H. Nicolaides
Summary: This study demonstrated that adding second-trimester estimated fetal weight (EFW) improves the prediction of small-for-gestational-age (SGA) neonates, particularly in cases of prematurity and severe smallness. Screening based on maternal characteristics and EFW can more accurately identify SGA neonates, enhancing the model's accuracy.
ULTRASOUND IN OBSTETRICS & GYNECOLOGY
(2021)
Article
Obstetrics & Gynecology
Ioannis Papastefanou, Urszula Nowacka, Argyro Syngelaki, Tanvi Mansukhani, George Karamanis, David Wright, Kypros H. Nicolaides
Summary: This study aimed to develop a new competing risks model for the prediction of small-for-gestational-age neonates based on a combination of maternal demographic characteristics and medical history with sonographic estimated fetal weight, uterine artery pulsatility index, and mean arterial pressure. The model showed superior performance in screening for small-for-gestational-age neonates compared to screening by maternal characteristics and medical history alone. The model demonstrated good calibration and detection rates in both the training and test data sets, confirming its internal validity.
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
(2021)
Article
Acoustics
U. Nowacka, I Papastefanou, A. Bouariu, A. Syngelaki, R. Akolekar, K. H. Nicolaides
Summary: This study investigates the additional value of second-trimester placental growth factor (PlGF) in predicting small-for-gestational-age (SGA) neonates and examines second-trimester contingent screening strategies. The results show that the combination of maternal risk factors, estimated fetal weight (EFW), uterine artery pulsatility index (UtA-PI), and PlGF significantly improves the prediction of SGA compared to maternal risk factors alone. However, the incremental improvement decreases when PlGF is added to screening with a combination of maternal risk factors, EFW, and UtA-PI. By reserving measurements of UtA-PI and PlGF for a certain percentage of the population, similar detection rates and false-positive rates can be achieved. The study concludes that the combination of maternal risk factors, EFW, UtA-PI, and PlGF provides an effective prediction of SGA in the second trimester.
ULTRASOUND IN OBSTETRICS & GYNECOLOGY
(2022)
Article
Medicine, General & Internal
Urszula Nowacka, Ioannis Papastefanou, Alexandra Bouariu, Argyro Syngelaki, Kypros H. Nicolaides
Summary: A new approach for predicting SGA, considering it a spectrum condition, has better predictive ability than traditional methods. However, the study found that second trimester levels of sFlt-1 and sFlt-1/PlGF are not useful in screening for SGA.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Obstetrics & Gynecology
Kypros H. Nicolaides, Ioannis Papastefanou, Argyro Syngelaki, Ghalia Ashoor, Ranjit Akolekar
Summary: This study aimed to assess the predictive performance of a competing risks model for stillbirths related to placental dysfunction, based on a combination of maternal risk factors, estimated fetal weight, and uterine artery pulsatility index. The performance of this model was compared to a stillbirth-specific model and the Royal College of Obstetricians and Gynecologists (RCOG) guideline. The results showed that the competing risks model had similar predictive performance to the stillbirth-specific model and performed better than the RCOG guideline.
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY
(2022)
Article
Acoustics
G. Ashoor, A. Syngelaki, I Papastefanou, K. H. Nicolaides, R. Akolekar
Summary: The study demonstrates that a model combining maternal risk factors, UtA-PI, and EFW at 19-24 weeks' gestation can effectively predict antepartum stillbirths due to impaired placentation, especially those occurring preterm.
ULTRASOUND IN OBSTETRICS & GYNECOLOGY
(2022)
Article
Genetics & Heredity
David Basurto, Francesca Maria Russo, Ioannis Papastefanou, Emma Bredaki, Karel Allegaert, Africa Pertierra, Anne Debeer, Luc De Catte, Liesbeth Lewi, Roland Devlieger, Paolo De Coppi, Eduard Gratacos, Olga Gomez, Jan Deprest
Summary: This study aimed to determine the prevalence of pulmonary hypertension (PAH) in left-sided congenital diaphragmatic hernia (CDH) and explore the predictors and contribution of PAH to mortality prediction. The results showed that PAH was associated with observed/expected-lung/head-ratio and fetoscopic endoluminal tracheal occlusion on postnatal day 1, and its occurrence further increased the risk of death. Antenatal prediction of PAH was limited, highlighting the need for more accurate predictors.
PRENATAL DIAGNOSIS
(2022)
Article
Acoustics
I Papastefanou, V Thanopoulou, S. Dimopoulou, A. Syngelaki, R. Akolekar, K. H. Nicolaides
Summary: This study developed a competing-risks model for predicting SGA neonates by incorporating sonographically estimated fetal weight (EFW) and biomarkers of impaired placentation at 36 weeks' gestation. The performance of the new model was compared with that of the traditional EFW < 10th percentile cut-off. The new model showed better predictive performance, especially when there was a longer time interval between assessment and delivery.
ULTRASOUND IN OBSTETRICS & GYNECOLOGY
(2022)
Article
Obstetrics & Gynecology
Ioannis Papastefanou, David Wright, Argyro Syngelaki, Ranjit Akolekar, Kypros H. Nicolaides
Summary: This study aimed to stratify pregnancy care for high-risk pregnancies at risk of delivering small for gestational age neonates based on the application of a competing-risks model that combines maternal factors with sonographic estimated fetal weight and uterine artery pulsatility index at midgestation.
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
(2023)
Editorial Material
Acoustics
I. Papastefanou, K. H. Nicolaides, L. J. Salomon
ULTRASOUND IN OBSTETRICS & GYNECOLOGY
(2023)
Article
Acoustics
G. Albaiges, I. Papastefanou, I. Rodriguez, P. Prats, M. Echevarria, M. A. Rodriguez, A. Rodriguez Melcon
Summary: This study examines the external validity of the new Fetal Medicine Foundation (FMF) competing-risks model for predicting small-for-gestational-age (SGA) neonates in midgestation. The study finds that the model performs well in a large independent Spanish population.
ULTRASOUND IN OBSTETRICS & GYNECOLOGY
(2023)
Article
Acoustics
I. Papastefanou, E. Gyokova, B. Gungil, A. Syngelaki, K. H. Nicolaides
Summary: This study aims to investigate the association between birth weight and gestational age at delivery with adverse neonatal outcomes and describe the distribution of adverse neonatal outcomes within different risk strata derived from a population stratification scheme based on the midgestation risk assessment for small-for-gestational-age neonates. The results showed that birth weight has a continuous association with adverse neonatal outcomes, influenced by gestational age. Pregnancies at high risk of small-for-gestational-age, estimated at midgestation, are also at increased risk for adverse neonatal outcomes.
ULTRASOUND IN OBSTETRICS & GYNECOLOGY
(2023)
Article
Obstetrics & Gynecology
Ioannis Papastefanou, Ghalia Ashoor, Argyro Syngelaki, Ranjit Akolekar, Kypros H. Nicolaides
Summary: This study aimed to investigate the association between antepartum stillbirth and the distribution of neonatal/fetal weight for different gestational ages. The study found a continuous association between fetal weight and the weight of antepartum stillbirth, which was influenced by gestational age. The highest risk of stillbirth occurred in fetuses with weights below the 1st percentile between 24 and 28 weeks' gestation.
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY
(2023)