Article
Biotechnology & Applied Microbiology
Tianjiao Liu, Li Wen, Shuai Huang, Ting-Li Han, Lan Zhang, Huijia Fu, Junnan Li, Chao Tong, Hongbo Qi, Richard Saffery, Philip N. Baker, Mark D. Kilby
Summary: This study investigated the metabolic changes caused by twin-twin transfusion syndrome and the effects of fetoscopic laser coagulation on placental tissue and cord plasma metabolism. The results showed that cord plasma metabolome performed better in differentiating fetuses with varying hemodynamic statuses. Fetoscopic laser coagulation improved the metabolomic alterations and identified potential biomarkers related to neonatal birth weight and cardiac function.
FRONTIERS IN BIOENGINEERING AND BIOTECHNOLOGY
(2022)
Article
Pediatrics
Angel Chimenea, Lutgardo Garcia-Diaz, Guillermo Antinolo
Summary: This study aimed to evaluate the risk of neurodevelopmental impairment in monochorionic diamniotic twins undergoing fetoscopic laser surgery for twin-twin transfusion syndrome (TTTS) compared to uncomplicated MCDA twin pregnancies. The results showed that the outcome in MCDA twins who underwent surgery for TTTS was comparable to uncomplicated MCDA twins. These findings underscore the importance of long-term neurodevelopmental follow-up in children from monochorionic twin pregnancies.
Review
Obstetrics & Gynecology
Liesbeth Lewi
Summary: About 1 in 5 twin pregnancies are monochorionic diamniotic, which can lead to transfusion imbalances and other complications. Fetoscopic laser coagulation is used to address these imbalances. In addition, structural anomalies are more common in monochorionic twins while chromosomal anomalies are less common.
AMERICAN JOURNAL OF OBSTETRICS & GYNECOLOGY MFM
(2022)
Article
Genetics & Heredity
Anna M. Armitage, Monica A. Kundra, Neda Ghiam, Paldeep S. Atwal, Dayna Morel, Kathleen S. Hruska, Rebecca Torene, Irman Forghani
Summary: This case report describes the first instance of blood chimerism involving a pathogenic RB1 variant in naturally conceived monochorionic-dizygotic twins with twin-twin-transfusion syndrome, likely due to stem cell exchange. The affected twin developed bilateral retinoblastoma at 7 months of age, with both twins having a 20% allelic ratio of the RB1 pathogenic variant in their blood. Subsequent genotyping confirmed dizygosity, with the affected twin harboring the variant in skin and blood, while the unaffected twin only had the variant in blood.
AMERICAN JOURNAL OF MEDICAL GENETICS PART A
(2021)
Article
Obstetrics & Gynecology
Angela Guzys, Susan M. Reid, Christie Bolch, Dinah S. Reddihough, Mark Teoh, Ricardo Palma-Dias, Alison Fung, Stephen Cole, Ryan Hodges, Michael Fahey, Susan P. Walker
Summary: This study aimed to investigate the presence of neurodevelopmental disabilities in child survivors of monochorionic pregnancies managed by placental laser photocoagulation in Victoria, Australia. The study found that approximately 31% of the survivors had neurodevelopmental impairment, with speech/language disorders, attention deficit (hyperactivity) disorders, and fine motor impairment being the most common. Neonatal length of stay was identified as the highest risk factor for impairment.
BMC PREGNANCY AND CHILDBIRTH
(2023)
Article
Acoustics
J. Espinoza, M. A. Belfort, A. A. Shamshirsaz, A. A. Nassr, M. Sanz Cortes, R. Donepudi, A. F. Espinoza, T. G. Ostovar-Kermani, R. Johnson, C. Harman, O. Turan
Summary: This study compared the outcomes of laser photocoagulation of placental anastomoses (LPA) before 18 weeks' gestation (early LPA) with LPA after 18 weeks in pregnancies with twin-twin transfusion syndrome (TTTS). The results showed that early LPA was not associated with increased rate of very preterm delivery and preterm prelabor rupture of membranes (PPROM) or with reduced neonatal survival compared to LPA after 18 weeks.
ULTRASOUND IN OBSTETRICS & GYNECOLOGY
(2021)
Article
Obstetrics & Gynecology
Raphael Bartin, Claire Colmant, Nicolas Bourgon, Yves Ville, Julien Stirnemann
Summary: This study evaluated the effect of gestational age at laser therapy for twin-to-twin transfusion syndrome on perinatal outcome. The results showed that gestational age at laser therapy was associated with overall survival and reduction in double fetal loss. The rate of preterm prelabour rupture of membranes was significantly higher in early cases, and gestational age at laser therapy was significantly related to preterm birth and neonatal morbidity.
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY
(2022)
Article
Obstetrics & Gynecology
Isabel Couck, Sophie Ponnet, Liesbeth Thewissen, Francesca Russo, Jan Deprest, Luc De Catte, Roland Devlieger, Liesbeth Lewi
Summary: A fortnightly ultrasound scan protocol can detect most cases of TTTS in MCDA twin pregnancies, but some cases are diagnosed outside the typical time frame. The survival rate of TTTS before stage V is lower, and most stage III-IV cases have abnormal Doppler findings before diagnosis.
FETAL DIAGNOSIS AND THERAPY
(2021)
Article
Surgery
Jie Sun, Luming Sun, Liang Zhong
Summary: The flexible fetoscope made of polyurethane, fiberglass, and stainless steel coils was able to bend encountering obstacles to reduce the possibility of injury to the fetus and placenta. Three pregnant women with anterior placenta and TTTS were treated successfully with this instrument, resulting in live twin births at term. Angiography confirmed that the vascular connections on the surface had been coagulated.
ANZ JOURNAL OF SURGERY
(2021)
Article
Genetics & Heredity
Hadar Rosen, Ronit Silber, Anat Schwartz, Hagai Avnet, Shlomo Lipitz, Shai Shrot, Chen Hoffmann, Boaz Weisz, Yoav Yinon
Summary: The study found that TAPS increases the risk of fetal and neonatal brain injuries. Fetal brain imaging can improve the accuracy of prenatal diagnosis, enabling accurate parental counseling and post-natal care.
PRENATAL DIAGNOSIS
(2022)
Article
Medicine, General & Internal
Xueju Wang, Luyao Li, Pengbo Yuan, Yangyu Zhao, Yuan Wei
Summary: This study investigated the impact of fetoscopic laser surgery on TTTS patients and found that the laser group had significantly improved gestational age, TTTS stage, and delivery gestational age compared to the control group. Furthermore, in the laser group, there was a positive correlation between birth-weight discordance and placental territory discordance.
FRONTIERS IN MEDICINE
(2022)
Review
Pediatrics
Jena L. Miller
Summary: Twin to twin transfusion syndrome (TTTS) is a common complication occurring in 10-15% of monochorionic twins in the second trimester of pregnancy. The diagnosis is made through ultrasound findings of volume overload and polyuria in one twin and oliguria in the other. Assessment of bladder filling and Doppler patterns is required for staging disease severity.
TRANSLATIONAL PEDIATRICS
(2021)
Article
Pediatrics
Edouard Chambon, Taymme Hachem, Elodie Salvador, Virginie Rigourd, Claire Bellanger, Julien Stirnemann, Elsa Kermorvant-Duchemin, Pierre Tissieres, Yves Ville, Alexandre Lapillonne
Summary: One-third of recipient twins born without prenatal FSLC developed life-threatening cardiac failure during the first 24 hours of life. Acute kidney injury was more frequent and severe in the CF group than in the HighBP group. Factors associated with CF included twin anemia-polycythemia sequence, very preterm birth, and polycythemia.
Article
Obstetrics & Gynecology
Yao-Lung Chang, Sheng-Yuan Su, An-Shine Chao, Shuenn-Dyh Chang, Wen- Lee, Ming-Chou Chiang
Summary: This case report presents a rare monochorionic dizygotic twin pregnancy complicated with twin-twin transfusion syndrome (TTTS) and successfully treated with laser therapy. The twins, born prematurely at 29 weeks due to severe preeclampsia, were found to be an XX and XY chimera with no neurological sequelae at discharge, highlighting the effectiveness of laser therapy in such cases and the importance of early determination of chorionicity in monochorionic twin pregnancies.
TAIWANESE JOURNAL OF OBSTETRICS & GYNECOLOGY
(2021)
Article
Medicine, General & Internal
Anthea de Sainte Fare, Ivonne Bedei, Aline Wolter, Johanna Schenk, Ellydda Widriani, Corinna Keil, Siegmund Koehler, Franz Bahlmann, Brigitte Strizek, Ulrich Gembruch, Christoph Berg, Roland Axt-Fliedner
Summary: This study analyzes the effectiveness of different MCA-PSV cut-off levels in prenatal diagnosis of TAPS in MCDA twins. The results show that using a delta MCA-PSV > 0.5 MoM method detects more TAPS cases, while the threshold method based on current guidelines may lead to prenatal misdiagnosis.
JOURNAL OF CLINICAL MEDICINE
(2022)
Editorial Material
Obstetrics & Gynecology
David Baud, Karin Nielsen-Saines, Pradip Dashraath
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
(2023)
Article
Obstetrics & Gynecology
Homero Flores-Mendoza, Paolo Campisi, Poorva Deshpande, Nimrah Abbasi, Tim Van Mieghem, Johannes Keunen, Greg Ryan
Summary: This report presents a modified FETI procedure performed on a fetus with a large cervical teratoma causing airway displacement and compression. The procedure, guided by fetoscopy and ultrasound, provides a potential alternative to an EXIT procedure for establishing a patent airway in fetuses with challenging upper airway anatomy, potentially mitigating associated risks.
FETAL DIAGNOSIS AND THERAPY
(2023)
Article
Pharmacology & Pharmacy
Kim Dao, Svetlana Shechtman, Orna Diav-Citrin, Nathan George, Jonathan Luke Richardson, Victoria Rollason, Alessandra Pistelli, Georgios Eleftheriou, Maya Berlin, Pierre Ekobena, Valentin Rousson, Marie-Claude Addor, David Baud, Thierry Buclin, Alice Panchaud, Ursula Winterfeld
Summary: This study aimed to assess the risks associated with trazodone exposure during pregnancy, as limited safety data are available. The findings suggest that exposure to trazodone in early pregnancy is not significantly associated with the risk of major congenital anomalies compared with selective serotonin reuptake inhibitors (SSRIs).
JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY
(2023)
Review
Genetics & Heredity
Julie S. Moldenhauer, Anthony Johnson, Tim Van Mieghem
Summary: The field of fetal therapy lacks formal accreditation and quality control, but published evidence suggests that outcomes in younger centers are comparable to more experienced ones and interventions have improved over time. Publication bias and lack of randomized controlled trials pose challenges in setting standards of care. Collaborative networks and large registries help benchmark center outcomes and track rare complications, aiding in improving patient outcomes. Formal accreditation, quality control, and outcome reporting are difficult and costly to implement and may limit access to care for smaller centers.
PRENATAL DIAGNOSIS
(2023)
Article
Medical Laboratory Technology
David A. Schwartz, Sandy Ha, Pradip Dashraath, David Baud, Phillip R. Pittman, Kristina Adams Waldorf
Summary: Before eradication, smallpox virus caused poor obstetric outcomes. Now, monkeypox virus is the most pathogenic poxvirus infecting humans. The global monkeypox outbreak in 2022 has raised concerns about its effects during pregnancy.
ARCHIVES OF PATHOLOGY & LABORATORY MEDICINE
(2023)
Article
Obstetrics & Gynecology
P. L. M. de Vries, C. Deneux-Tharaux, D. Baud, K. K. Chen, S. Donati, F. Goffinet, M. Knight, R. D'Souzah, M. Sueters, T. van den Akker
Summary: This study compared guidelines on prevention and management of postpartum haemorrhage (PPH) from eight high-income countries. The results show a lack of strong evidence in many areas, indicating the need for a universal definition of (severe) PPH and consensus on blood loss measurement. Future research should focus on the timing and sequence of interventions and their impact on maternal outcomes. The quality of guidelines varied considerably. Rating: 9/10.
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY
(2023)
Article
Genetics & Heredity
Mandy Rickard, Jin Kyu Kim, Tim Van Mieghem, Shiri Shinar, Ashlene McKay, Joana Dos Santos, Natasha Brownrigg, Daniel T. T. Keefe, Armando J. J. Lorenzo, Michael Chua
Summary: A nomogram for predicting the diagnosis of lower urinary tract obstruction (LUTO) has been developed using a Bayesian Meta-regression analysis, and it has shown superior diagnostic accuracy compared to the keyhole sign (KHS). The accuracy of the nomogram in expanded diagnostic utilization was validated using data from a prospective institutional antenatal clinic database. The nomogram demonstrated higher sensitivity and specificity, as well as a superior area under the curve (AUC), compared to KHS.
PRENATAL DIAGNOSIS
(2023)
Article
Genetics & Heredity
Vagisha Pruthi, Nimrah Abbasi, Varsha Thakur, Shiri Shinar, Anne O'Connor, Rachel Silver, Tasha Simpson, Tim Van Mieghem
Summary: This study aimed to assess the performance of a comprehensive fetal anatomy assessment in a high-risk population. A retrospective review of high-risk patients undergoing comprehensive fetal anatomy ultrasound assessment was conducted. The results showed that early assessments had similar performance metrics as the second trimester anatomy ultrasound. We advocate for a comprehensive fetal assessment in the care of high-risk pregnancies.
PRENATAL DIAGNOSIS
(2023)
Article
Acoustics
Y. Kunpalin, J. Sichitiu, P. Krishan, S. Blaser, P. Shannon, T. Van Mieghem, S. Shinar
Summary: This study aimed to investigate the midline cystic structure in fetuses with open spina bifida (OSB) and its association with other brain abnormalities. The results showed that approximately 75% of OSB cases have a suprapineal pseudocyst, which is associated with the degree of hindbrain herniation but not with abnormalities of the cavum septi pellucidi (CSP) and corpus callosum (CC) or presence of periventricular nodular heterotopia (PNH). Therefore, the pseudocyst should not be considered as additional brain pathology and should not prevent fetuses from undergoing fetal surgery for OSB.
ULTRASOUND IN OBSTETRICS & GYNECOLOGY
(2023)
Article
Medicine, General & Internal
Deborah Fort, Camille Deforges, Nadine Messerli-Burgy, Tanja Michael, David Baud, Joan Lalor, Ulrike Rimmele, Antje Horsch
Summary: This study aims to compare the efficacy of an intervention targeting postnatal post-traumatic stress symptoms and distressing intrusive memories by interrupting the reconsolidation of traumatic memories. The study will compare two experimental groups and assess the differences in postnatal post-traumatic stress symptoms and intrusive memories before and after the intervention.
Article
Public, Environmental & Occupational Health
Y. -C. Chui, D. Baud, A. Fahmi, B. Zumkehr, M. Vouga, L. Pomar, D. Musso, B. C. Thuong, M. P. Alves, M. Stojanovic
Summary: Despite being first identified in 1947, Zika virus-related outbreaks were first described starting from 2007 culminating with the 2015 Latin American outbreak. Hypotheses indicate that the virus has been circulating in Asia for decades, but reports are scarce. We performed serological analysis and screened placental samples isolated in 2008 for the presence of Zika virus from pregnant women in Ho Chi Minh City (Vietnam). None of the placental samples was positive for Zika virus, but four serum samples out of 176 (2.3%) specifically inhibited Zika virus, with variable degrees of cross-reactivity with other flaviviruses. While one of the four samples inhibited only Zika virus, cross-reactivity with other flaviviruses not included in the study could not be ruled out.
TROPICAL DISEASES TRAVEL MEDICINE AND VACCINES
(2023)
Article
Health Care Sciences & Services
Guillaume Favre, Emeline Maisonneuve, Leo Pomar, Charlotte Daire, Christophe Poncelet, Thibaud Quibel, Cecile Monod, Begona Martinez de Tejada, Leonhard Schaffer, Andrea Papadia, Anda Petronela Radan, Monya Todesco-Bernasconi, Yves Ville, Cora Alexandra Voekt, Beatrice Eggel-Hort, Romina Capoccia-Brugger, Silke Johann, Claudia Grawe, Sophie Defert, Nicolas Mottet, Christian R. Kahlert, Charles Garabedian, Loic Sentilhes, Brigitte Weber, Steffi Leu, Dirk Bassler, Karine Lepigeon, Ursula Winterfeld, Alice Panchaud, David Baud
Summary: Unvaccinated pregnant women infected with SARS-CoV-2 are at higher risk of adverse outcomes. This study found that the risk of severe maternal adverse outcome was higher during the Delta period and lower during the Omicron period compared to the pre-Delta era.
LANCET REGIONAL HEALTH-EUROPE
(2023)
Article
Obstetrics & Gynecology
Saulo Molina-Giraldo, Natalia Torres Valencia, Anthony Johnson, Liesbeth Lewi, Greg Ryan, Waldo Sepulveda
Summary: The aim of this study was to determine the clinical practice patterns among international fetal therapy units in managing acardiac twin cases with a reverse arterial perfusion sequence. The survey found that most centers agreed that antenatal evaluation should include echocardiography and umbilical artery Doppler waveform measurements, and the most frequently used interventions were interstitial laser ablation or radiofrequency ablation. The earliest gestational age for intervention was around 13 weeks in Europe, earlier than other geographic areas.
FETAL DIAGNOSIS AND THERAPY
(2023)
Review
Medicine, General & Internal
Emeline Maisonneuve, Odette de Bruin, Guillaume Favre, Anna Gonce, Serena Donati, Hilde Engjom, Eimir Hurley, Nouf Al-Fadel, Satu Siiskonen, Kitty Bloemenkamp, Hedvig Nordeng, Miriam Sturkenboom, David Baud, Alice Panchaud
Summary: The lack of inclusion of pregnant women in clinical trials has hindered the establishment of evidence-based treatment guidelines for COVID-19 during pregnancy. This review examines the guidelines on medicines for pregnant women with COVID-19 published by obstetrician and gynecologists' societies in thirteen countries from 2020 to 2022. The recommendations regarding different medications varied among countries, but there was a gradual convergence towards certain treatments based on evidence from trials like RECOVERY.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Genetics & Heredity
Yada Kunpalin, Joanna Sichitiu, Pradeep Krishnan, Susan Blaser, Abhaya V. Kulkarni, Nimrah Abbasi, Greg Ryan, Shiri Shinar, Tim van Mieghem
Summary: This study aimed to determine simple prenatal imaging parameters that can predict the need for postnatal CSF diversion (PCD) surgery in fetuses undergoing open fetal surgery for open spina bifida (OSB). The study found that pre-operative transcerebellar diameter (TCD), clivus-supraocciput angle (CSA), and lateral ventricle size (Vp), as well as post-operative TCD and CSA, were good predictors for PCD surgery.
PRENATAL DIAGNOSIS
(2023)
