Clinical Edge Journal Scan

Key clinical point: Prenatal standard estimated fetal weight (EFW) z-scores can predict small-for-gestational-age (SGA) fetuses with greater accuracy than abdominal circumference (AC) z-scores and postnatal reference standards.

Major finding: The INTERGROWTH-21st project-derived EFW z-scores showed higher accuracy in identifying fetuses with a birthweight of <10th and <3rd percentiles than AC z-scores (both P < .05) and postnatal standards (both P < .05). The Hadlock group-derived EFW z-scores performed better in identifying fetuses <10th percentiles (P < .05) and similarly in identifying fetuses <3rd percentile (P = .344) than AC z-scores, whereas they were more accurate than postnatal standards with both birth-weight percentiles (both P < .05).

Study details: This retrospective study included 406 singleton pregnant women at an increased risk for fetal growth restriction who underwent ultrasound examinations between 24 and 36 weeks of gestation.

Disclosures: The study received no financial support. No conflicts of interest were reported.

Source: Visentin S et al. A prenatal standard for fetal weight improves the prenatal diagnosis of small for gestational age fetuses in pregnancies at increased risk. BMC Pregnancy Childbirth. 2022;22:254 (Mar 26). Doi: 10.1186/s12884-022-04545-x

Key clinical point: Prenatal standard estimated fetal weight (EFW) z-scores can predict small-for-gestational-age (SGA) fetuses with greater accuracy than abdominal circumference (AC) z-scores and postnatal reference standards.

Major finding: The INTERGROWTH-21st project-derived EFW z-scores showed higher accuracy in identifying fetuses with a birthweight of <10th and <3rd percentiles than AC z-scores (both P < .05) and postnatal standards (both P < .05). The Hadlock group-derived EFW z-scores performed better in identifying fetuses <10th percentiles (P < .05) and similarly in identifying fetuses <3rd percentile (P = .344) than AC z-scores, whereas they were more accurate than postnatal standards with both birth-weight percentiles (both P < .05).

Study details: This retrospective study included 406 singleton pregnant women at an increased risk for fetal growth restriction who underwent ultrasound examinations between 24 and 36 weeks of gestation.

Disclosures: The study received no financial support. No conflicts of interest were reported.

Source: Visentin S et al. A prenatal standard for fetal weight improves the prenatal diagnosis of small for gestational age fetuses in pregnancies at increased risk. BMC Pregnancy Childbirth. 2022;22:254 (Mar 26). Doi: 10.1186/s12884-022-04545-x

Key clinical point: Prenatal standard estimated fetal weight (EFW) z-scores can predict small-for-gestational-age (SGA) fetuses with greater accuracy than abdominal circumference (AC) z-scores and postnatal reference standards.

Major finding: The INTERGROWTH-21st project-derived EFW z-scores showed higher accuracy in identifying fetuses with a birthweight of <10th and <3rd percentiles than AC z-scores (both P < .05) and postnatal standards (both P < .05). The Hadlock group-derived EFW z-scores performed better in identifying fetuses <10th percentiles (P < .05) and similarly in identifying fetuses <3rd percentile (P = .344) than AC z-scores, whereas they were more accurate than postnatal standards with both birth-weight percentiles (both P < .05).

Study details: This retrospective study included 406 singleton pregnant women at an increased risk for fetal growth restriction who underwent ultrasound examinations between 24 and 36 weeks of gestation.

Disclosures: The study received no financial support. No conflicts of interest were reported.

Source: Visentin S et al. A prenatal standard for fetal weight improves the prenatal diagnosis of small for gestational age fetuses in pregnancies at increased risk. BMC Pregnancy Childbirth. 2022;22:254 (Mar 26). Doi: 10.1186/s12884-022-04545-x

Key clinical point: Accuracy of ultrasonography for the prenatal diagnosis of placenta accreta spectrum (PAS) disorder is comparable with that of magnetic resonance imaging (MRI).

Major finding: Ultrasonography and MRI showed similar sensitivity (0.90; 95% CI 0.86-0.93 vs. 0.89; 95% CI 0.85-0.92), specificity (0.83; 95% CI 0.79-0.86 vs. 0.87; 95% CI 0.83-0.89), and diagnostic odds ratio (39.5; 95% CI 19.6-79.7 vs. 37.4; 95% CI 17.0-82.3) for PAS diagnosis, with no significant difference between their pooled diagnostic sensitivity (P = .808) and specificity (P = .413).

Study details: This is a meta-analysis of 18 studies including 861 pregnancies at a potential risk for PAS, of which 339 were diagnosed with PAS.

Disclosures: The study was sponsored by the Natural Science Foundation of Science and Technology Commission of Shanghai Municipality. The authors declared no conflicts of interest.

Source: Hong S et al. Performance comparison of ultrasonography and magnetic resonance imaging in their diagnostic accuracy of placenta accreta spectrum disorders: A systematic review and meta-analysis. Insights Imaging. 2022;13:50 (Mar 22). Doi: 10.1186/s13244-022-01192-w

Key clinical point: Accuracy of ultrasonography for the prenatal diagnosis of placenta accreta spectrum (PAS) disorder is comparable with that of magnetic resonance imaging (MRI).

Major finding: Ultrasonography and MRI showed similar sensitivity (0.90; 95% CI 0.86-0.93 vs. 0.89; 95% CI 0.85-0.92), specificity (0.83; 95% CI 0.79-0.86 vs. 0.87; 95% CI 0.83-0.89), and diagnostic odds ratio (39.5; 95% CI 19.6-79.7 vs. 37.4; 95% CI 17.0-82.3) for PAS diagnosis, with no significant difference between their pooled diagnostic sensitivity (P = .808) and specificity (P = .413).

Study details: This is a meta-analysis of 18 studies including 861 pregnancies at a potential risk for PAS, of which 339 were diagnosed with PAS.

Disclosures: The study was sponsored by the Natural Science Foundation of Science and Technology Commission of Shanghai Municipality. The authors declared no conflicts of interest.

Source: Hong S et al. Performance comparison of ultrasonography and magnetic resonance imaging in their diagnostic accuracy of placenta accreta spectrum disorders: A systematic review and meta-analysis. Insights Imaging. 2022;13:50 (Mar 22). Doi: 10.1186/s13244-022-01192-w

Key clinical point: Accuracy of ultrasonography for the prenatal diagnosis of placenta accreta spectrum (PAS) disorder is comparable with that of magnetic resonance imaging (MRI).

Major finding: Ultrasonography and MRI showed similar sensitivity (0.90; 95% CI 0.86-0.93 vs. 0.89; 95% CI 0.85-0.92), specificity (0.83; 95% CI 0.79-0.86 vs. 0.87; 95% CI 0.83-0.89), and diagnostic odds ratio (39.5; 95% CI 19.6-79.7 vs. 37.4; 95% CI 17.0-82.3) for PAS diagnosis, with no significant difference between their pooled diagnostic sensitivity (P = .808) and specificity (P = .413).

Study details: This is a meta-analysis of 18 studies including 861 pregnancies at a potential risk for PAS, of which 339 were diagnosed with PAS.

Disclosures: The study was sponsored by the Natural Science Foundation of Science and Technology Commission of Shanghai Municipality. The authors declared no conflicts of interest.

Source: Hong S et al. Performance comparison of ultrasonography and magnetic resonance imaging in their diagnostic accuracy of placenta accreta spectrum disorders: A systematic review and meta-analysis. Insights Imaging. 2022;13:50 (Mar 22). Doi: 10.1186/s13244-022-01192-w

Key clinical point: Noninvasive prenatal fetal rhesus D (RHD) screening after 11 weeks of gestation offers high accuracy and reliability in routine clinical practice.

Major finding: Fetal RHD testing had a 100% sensitivity (95% CI 95.3%-100.0%) and a 100% specificity (95% CI 91.6%-100.0%), with the negative and positive predictive values being 100.0%. No false-negative or false-positive screening results were reported.

Study details: This was a single-center study wherein fetal RHD testing (real-time polymerase chain reaction targeting RHD exons 5 and 7) was performed using blood samples from 205 RHD-negative pregnant women at ≥11 weeks of gestation and test performance was evaluated using cord blood samples obtained from 62% (n = 127) of women.

Disclosures: The study was sponsored by the Scientific Fund of Hematology. The authors reported no conflicts of interest.

Source: Blomme S et al. Routine noninvasive prenatal screening for fetal Rh D in maternal plasma—A 2-year experience from a single center in Belgium. Transfusion. 2022 (Mar 30). Doi: 10.1111/trf.16868

Key clinical point: Noninvasive prenatal fetal rhesus D (RHD) screening after 11 weeks of gestation offers high accuracy and reliability in routine clinical practice.

Major finding: Fetal RHD testing had a 100% sensitivity (95% CI 95.3%-100.0%) and a 100% specificity (95% CI 91.6%-100.0%), with the negative and positive predictive values being 100.0%. No false-negative or false-positive screening results were reported.

Study details: This was a single-center study wherein fetal RHD testing (real-time polymerase chain reaction targeting RHD exons 5 and 7) was performed using blood samples from 205 RHD-negative pregnant women at ≥11 weeks of gestation and test performance was evaluated using cord blood samples obtained from 62% (n = 127) of women.

Disclosures: The study was sponsored by the Scientific Fund of Hematology. The authors reported no conflicts of interest.

Source: Blomme S et al. Routine noninvasive prenatal screening for fetal Rh D in maternal plasma—A 2-year experience from a single center in Belgium. Transfusion. 2022 (Mar 30). Doi: 10.1111/trf.16868

Key clinical point: Noninvasive prenatal fetal rhesus D (RHD) screening after 11 weeks of gestation offers high accuracy and reliability in routine clinical practice.

Major finding: Fetal RHD testing had a 100% sensitivity (95% CI 95.3%-100.0%) and a 100% specificity (95% CI 91.6%-100.0%), with the negative and positive predictive values being 100.0%. No false-negative or false-positive screening results were reported.

Study details: This was a single-center study wherein fetal RHD testing (real-time polymerase chain reaction targeting RHD exons 5 and 7) was performed using blood samples from 205 RHD-negative pregnant women at ≥11 weeks of gestation and test performance was evaluated using cord blood samples obtained from 62% (n = 127) of women.

Disclosures: The study was sponsored by the Scientific Fund of Hematology. The authors reported no conflicts of interest.

Source: Blomme S et al. Routine noninvasive prenatal screening for fetal Rh D in maternal plasma—A 2-year experience from a single center in Belgium. Transfusion. 2022 (Mar 30). Doi: 10.1111/trf.16868

Key clinical point: Maternal placental growth factor (PlGF) levels measured before labor may aid the prediction of cesarean delivery owing to fetal dysfunction and fetal heart rate (FHR) function at delivery.

Major finding: Women having vaginal delivery had significantly higher pre-labor PlGF levels than those having a cesarean delivery owing to fetal dysfunction (157 ± 106 vs. 74 ± 62 pg/mL; P = .03). PlGF levels showed a significant negative correlation (r = −0.42; P = .01) with FHR findings at delivery according to the five-tier classification system.

Study details: The study analyzed PlGF levels in 33 primiparous singleton pregnant women at 35-42 weeks of gestation who were hospitalized before the onset of labor, of which 26 women had vaginal delivery and 7 had a cesarean delivery due to fetal indications.

Disclosures: The study received no financial support. The authors declared no conflicts of interest.

Source: Tanaka H et al. Placental growth factor level is correlated with intrapartum fetal heart rate findings. BMC Pregnancy Childbirth. 2022;22:215 (Mar 17). Doi: 10.1186/s12884-022-04562-w

Key clinical point: Maternal placental growth factor (PlGF) levels measured before labor may aid the prediction of cesarean delivery owing to fetal dysfunction and fetal heart rate (FHR) function at delivery.

Major finding: Women having vaginal delivery had significantly higher pre-labor PlGF levels than those having a cesarean delivery owing to fetal dysfunction (157 ± 106 vs. 74 ± 62 pg/mL; P = .03). PlGF levels showed a significant negative correlation (r = −0.42; P = .01) with FHR findings at delivery according to the five-tier classification system.

Study details: The study analyzed PlGF levels in 33 primiparous singleton pregnant women at 35-42 weeks of gestation who were hospitalized before the onset of labor, of which 26 women had vaginal delivery and 7 had a cesarean delivery due to fetal indications.

Disclosures: The study received no financial support. The authors declared no conflicts of interest.

Source: Tanaka H et al. Placental growth factor level is correlated with intrapartum fetal heart rate findings. BMC Pregnancy Childbirth. 2022;22:215 (Mar 17). Doi: 10.1186/s12884-022-04562-w

Key clinical point: Maternal placental growth factor (PlGF) levels measured before labor may aid the prediction of cesarean delivery owing to fetal dysfunction and fetal heart rate (FHR) function at delivery.

Major finding: Women having vaginal delivery had significantly higher pre-labor PlGF levels than those having a cesarean delivery owing to fetal dysfunction (157 ± 106 vs. 74 ± 62 pg/mL; P = .03). PlGF levels showed a significant negative correlation (r = −0.42; P = .01) with FHR findings at delivery according to the five-tier classification system.

Study details: The study analyzed PlGF levels in 33 primiparous singleton pregnant women at 35-42 weeks of gestation who were hospitalized before the onset of labor, of which 26 women had vaginal delivery and 7 had a cesarean delivery due to fetal indications.

Disclosures: The study received no financial support. The authors declared no conflicts of interest.

Source: Tanaka H et al. Placental growth factor level is correlated with intrapartum fetal heart rate findings. BMC Pregnancy Childbirth. 2022;22:215 (Mar 17). Doi: 10.1186/s12884-022-04562-w

Key clinical point: Maternal serum lamin A (LMNA) could emerge as a potential biomarker for prenatal diagnosis of fetal congenital heart disease (CHD), neural tube defects (NTD), and preeclampsia (PE).

Major finding: Significantly lower LMNA levels were observed in pregnancies with fetal CHD, NTD, and PE (all P < .0001). The areas under the receiver operating characteristic curve for LMNA in prenatal diagnoses of CHD, NTD, early-onset PE, and late-onset PE were 0.875, 0.871, 0.851, and 0.674, respectively.

Study details: The data are derived from a prospective study including 2711 singleton pregnant women at 15-18 weeks of gestation who underwent measurement of serum LMNA levels.

Disclosures: The study was funded by the National Key Research and Development Program and National Natural Science Foundation of China, among others. The authors reported no conflicts of interest.

Source: Chen L et al. Maternal serum lamin A is a potential biomarker that can predict adverse pregnancy outcomes. EBioMedicine. 2022;77:103932 (Mar 11). Doi: 10.1016/j.ebiom.2022.103932

Key clinical point: Maternal serum lamin A (LMNA) could emerge as a potential biomarker for prenatal diagnosis of fetal congenital heart disease (CHD), neural tube defects (NTD), and preeclampsia (PE).

Major finding: Significantly lower LMNA levels were observed in pregnancies with fetal CHD, NTD, and PE (all P < .0001). The areas under the receiver operating characteristic curve for LMNA in prenatal diagnoses of CHD, NTD, early-onset PE, and late-onset PE were 0.875, 0.871, 0.851, and 0.674, respectively.

Study details: The data are derived from a prospective study including 2711 singleton pregnant women at 15-18 weeks of gestation who underwent measurement of serum LMNA levels.

Disclosures: The study was funded by the National Key Research and Development Program and National Natural Science Foundation of China, among others. The authors reported no conflicts of interest.

Source: Chen L et al. Maternal serum lamin A is a potential biomarker that can predict adverse pregnancy outcomes. EBioMedicine. 2022;77:103932 (Mar 11). Doi: 10.1016/j.ebiom.2022.103932

Key clinical point: Maternal serum lamin A (LMNA) could emerge as a potential biomarker for prenatal diagnosis of fetal congenital heart disease (CHD), neural tube defects (NTD), and preeclampsia (PE).

Major finding: Significantly lower LMNA levels were observed in pregnancies with fetal CHD, NTD, and PE (all P < .0001). The areas under the receiver operating characteristic curve for LMNA in prenatal diagnoses of CHD, NTD, early-onset PE, and late-onset PE were 0.875, 0.871, 0.851, and 0.674, respectively.

Study details: The data are derived from a prospective study including 2711 singleton pregnant women at 15-18 weeks of gestation who underwent measurement of serum LMNA levels.

Disclosures: The study was funded by the National Key Research and Development Program and National Natural Science Foundation of China, among others. The authors reported no conflicts of interest.

Source: Chen L et al. Maternal serum lamin A is a potential biomarker that can predict adverse pregnancy outcomes. EBioMedicine. 2022;77:103932 (Mar 11). Doi: 10.1016/j.ebiom.2022.103932

Key clinical point: Fetal echocardiography can diagnose most major congenital heart diseases (CHD) with high accuracy. The accuracy can be affected by factors such as gestational age at diagnosis and double outlet right ventricle (DORV) diagnosis.

Major finding: Diagnostic accuracy rates were highest for univentricular hearts (97.6%; CI, 86.3%-99.9%), followed by tetralogy of Fallot (97.2%; CI 90.0%-99.2%) and transposition of the great arteries (96.2%; CI 89.2%-98.6%) and the lowest for heterotaxy syndrome (71.1%; CI 56.6%-82.2%). Factors such as a >25-week gestational age at diagnosis (adjusted risk ratio [aRR] 2.1; P = .023) and DORV diagnosis (aRR 8.33; P = .032) affected the diagnostic accuracy.

Study details: The data come from a retrospective, single-center study including 827 fetuses prenatally diagnosed with a major CHD that was confirmed for 589 either postnatally or via fetal autopsies.

Disclosures: This research was sponsored by the Stollery Children’s Hospital Foundation and Lois Hole Women’s Hospital/Royal Alexandra Hospital Foundation. The authors declared no conflicts of interest.

Source: Haberer K et al. Accuracy of fetal echocardiography in defining anatomical details: A single institutional experience over a 12-year period. J Am Soc Echocardiogr. 2022 (Mar 11). Doi: 10.1016/j.echo.2022.02.015

Key clinical point: Fetal echocardiography can diagnose most major congenital heart diseases (CHD) with high accuracy. The accuracy can be affected by factors such as gestational age at diagnosis and double outlet right ventricle (DORV) diagnosis.

Major finding: Diagnostic accuracy rates were highest for univentricular hearts (97.6%; CI, 86.3%-99.9%), followed by tetralogy of Fallot (97.2%; CI 90.0%-99.2%) and transposition of the great arteries (96.2%; CI 89.2%-98.6%) and the lowest for heterotaxy syndrome (71.1%; CI 56.6%-82.2%). Factors such as a >25-week gestational age at diagnosis (adjusted risk ratio [aRR] 2.1; P = .023) and DORV diagnosis (aRR 8.33; P = .032) affected the diagnostic accuracy.

Study details: The data come from a retrospective, single-center study including 827 fetuses prenatally diagnosed with a major CHD that was confirmed for 589 either postnatally or via fetal autopsies.

Disclosures: This research was sponsored by the Stollery Children’s Hospital Foundation and Lois Hole Women’s Hospital/Royal Alexandra Hospital Foundation. The authors declared no conflicts of interest.

Source: Haberer K et al. Accuracy of fetal echocardiography in defining anatomical details: A single institutional experience over a 12-year period. J Am Soc Echocardiogr. 2022 (Mar 11). Doi: 10.1016/j.echo.2022.02.015

Key clinical point: Fetal echocardiography can diagnose most major congenital heart diseases (CHD) with high accuracy. The accuracy can be affected by factors such as gestational age at diagnosis and double outlet right ventricle (DORV) diagnosis.

Major finding: Diagnostic accuracy rates were highest for univentricular hearts (97.6%; CI, 86.3%-99.9%), followed by tetralogy of Fallot (97.2%; CI 90.0%-99.2%) and transposition of the great arteries (96.2%; CI 89.2%-98.6%) and the lowest for heterotaxy syndrome (71.1%; CI 56.6%-82.2%). Factors such as a >25-week gestational age at diagnosis (adjusted risk ratio [aRR] 2.1; P = .023) and DORV diagnosis (aRR 8.33; P = .032) affected the diagnostic accuracy.

Study details: The data come from a retrospective, single-center study including 827 fetuses prenatally diagnosed with a major CHD that was confirmed for 589 either postnatally or via fetal autopsies.

Disclosures: This research was sponsored by the Stollery Children’s Hospital Foundation and Lois Hole Women’s Hospital/Royal Alexandra Hospital Foundation. The authors declared no conflicts of interest.

Source: Haberer K et al. Accuracy of fetal echocardiography in defining anatomical details: A single institutional experience over a 12-year period. J Am Soc Echocardiogr. 2022 (Mar 11). Doi: 10.1016/j.echo.2022.02.015

Key clinical point: The incidence of short cervical length is significantly affected by the method of cervical length measurement, thus necessitating knowledge of the measurement method employed.

Major finding: The lowest mean cervical length was recorded using single-line without cervico-isthmic complex (CIC; 41.04 ± 7.1 mm) compared with two-line without CIC (43.29 ± 7.36 mm) and trace without CIC (44.14 ± 7.60 mm); trace with CIC yielded the longest mean length (49.18 ± 9.05 mm). The incidence of a short cervix (<25 mm) ranged from 0.4% to 1.1%.

Study details: This was a single-center, prospective, cohort study including 1691 nulliparous or parous women with a singleton pregnancy who had undergone cervical length measurement between 18 and 22 weeks of gestation.

Disclosures: The authors reported no source of funding. BW Mol declared receiving a National Health and Medical Research Council Investigator grant and consulting fees from a few pharmaceutical companies.

Source: van Zijl MD et al. Uniform international method to measure cervical length; are we there yet? Fetal Diagn Ther. 2022 (Mar 10). Doi: 10.1159/000523996

Key clinical point: The incidence of short cervical length is significantly affected by the method of cervical length measurement, thus necessitating knowledge of the measurement method employed.

Major finding: The lowest mean cervical length was recorded using single-line without cervico-isthmic complex (CIC; 41.04 ± 7.1 mm) compared with two-line without CIC (43.29 ± 7.36 mm) and trace without CIC (44.14 ± 7.60 mm); trace with CIC yielded the longest mean length (49.18 ± 9.05 mm). The incidence of a short cervix (<25 mm) ranged from 0.4% to 1.1%.

Study details: This was a single-center, prospective, cohort study including 1691 nulliparous or parous women with a singleton pregnancy who had undergone cervical length measurement between 18 and 22 weeks of gestation.

Disclosures: The authors reported no source of funding. BW Mol declared receiving a National Health and Medical Research Council Investigator grant and consulting fees from a few pharmaceutical companies.

Source: van Zijl MD et al. Uniform international method to measure cervical length; are we there yet? Fetal Diagn Ther. 2022 (Mar 10). Doi: 10.1159/000523996

Key clinical point: The incidence of short cervical length is significantly affected by the method of cervical length measurement, thus necessitating knowledge of the measurement method employed.

Major finding: The lowest mean cervical length was recorded using single-line without cervico-isthmic complex (CIC; 41.04 ± 7.1 mm) compared with two-line without CIC (43.29 ± 7.36 mm) and trace without CIC (44.14 ± 7.60 mm); trace with CIC yielded the longest mean length (49.18 ± 9.05 mm). The incidence of a short cervix (<25 mm) ranged from 0.4% to 1.1%.

Study details: This was a single-center, prospective, cohort study including 1691 nulliparous or parous women with a singleton pregnancy who had undergone cervical length measurement between 18 and 22 weeks of gestation.

Disclosures: The authors reported no source of funding. BW Mol declared receiving a National Health and Medical Research Council Investigator grant and consulting fees from a few pharmaceutical companies.

Source: van Zijl MD et al. Uniform international method to measure cervical length; are we there yet? Fetal Diagn Ther. 2022 (Mar 10). Doi: 10.1159/000523996

Key clinical point: Normal fetal lung and liver elasticity values elucidated using two-dimensional shear wave elastography (2D-SWE) are valid and repeatable for a probe-region of interest distance of ≤8 cm and demonstrate the histological modifications of both the organs during gestation.

Major finding: Fetal liver elasticity increased significantly from 3.86 kPa at 24 weeks of gestation (WG) to 4.45 kPa at 39 WG (P < .01). Fetal lung elasticity increased from 4.12 kPa to 5.03 kPa between 24 and 32 WG (P < .002), after which it gradually declined to 4.54 kPa at 36 WG and 3.94 kPa at 39 WG.

Study details: The data come from a prospective, observational, multicenter study that included 72 singleton pregnant women at 24 ±1  WG who underwent 2D-SWE at 28, 32, 36, and 39 WG ± 1 week.

Disclosures: The study was funded by the University Hospital of Besançon, France. The authors declared no conflicts of interest.

Source: Nallet C et al. Prenatal quantification of human foetal lung and liver elasticities between 24 and 39 weeks of gestation using 2D shear wave elastography. Eur Radiol. 2022 (Mar 10). Doi: 10.1007/s00330-022-08654-1

Key clinical point: Normal fetal lung and liver elasticity values elucidated using two-dimensional shear wave elastography (2D-SWE) are valid and repeatable for a probe-region of interest distance of ≤8 cm and demonstrate the histological modifications of both the organs during gestation.

Major finding: Fetal liver elasticity increased significantly from 3.86 kPa at 24 weeks of gestation (WG) to 4.45 kPa at 39 WG (P < .01). Fetal lung elasticity increased from 4.12 kPa to 5.03 kPa between 24 and 32 WG (P < .002), after which it gradually declined to 4.54 kPa at 36 WG and 3.94 kPa at 39 WG.

Study details: The data come from a prospective, observational, multicenter study that included 72 singleton pregnant women at 24 ±1  WG who underwent 2D-SWE at 28, 32, 36, and 39 WG ± 1 week.

Disclosures: The study was funded by the University Hospital of Besançon, France. The authors declared no conflicts of interest.

Source: Nallet C et al. Prenatal quantification of human foetal lung and liver elasticities between 24 and 39 weeks of gestation using 2D shear wave elastography. Eur Radiol. 2022 (Mar 10). Doi: 10.1007/s00330-022-08654-1

Key clinical point: Normal fetal lung and liver elasticity values elucidated using two-dimensional shear wave elastography (2D-SWE) are valid and repeatable for a probe-region of interest distance of ≤8 cm and demonstrate the histological modifications of both the organs during gestation.

Major finding: Fetal liver elasticity increased significantly from 3.86 kPa at 24 weeks of gestation (WG) to 4.45 kPa at 39 WG (P < .01). Fetal lung elasticity increased from 4.12 kPa to 5.03 kPa between 24 and 32 WG (P < .002), after which it gradually declined to 4.54 kPa at 36 WG and 3.94 kPa at 39 WG.

Study details: The data come from a prospective, observational, multicenter study that included 72 singleton pregnant women at 24 ±1  WG who underwent 2D-SWE at 28, 32, 36, and 39 WG ± 1 week.

Disclosures: The study was funded by the University Hospital of Besançon, France. The authors declared no conflicts of interest.

Source: Nallet C et al. Prenatal quantification of human foetal lung and liver elasticities between 24 and 39 weeks of gestation using 2D shear wave elastography. Eur Radiol. 2022 (Mar 10). Doi: 10.1007/s00330-022-08654-1

Key clinical point: Intravoxel incoherent motion (IVIM) imaging could supplement routine ultrasound monitoring to noninvasively differentiate between small-for-gestational-age (SGA) and false-positive SGA (fpSGA) pregnancies.

Major finding: Compared with the control and fpSGA groups, the SGA group had significantly lower mean values of the diffusion coefficient (D; P < .001 and P = .004, respectively), pseudodiffusion coefficient (D*; P = .001 and P = .012, respectively), and perfusion fraction (f; both P < .001). The mean values of D (P = .347), D* (P = .404), and f (P = .880) were similar between the control and fpSGA groups.

Study details: This was a prospective study including 75 singleton pregnant women at >28 weeks of gestation with suspected SGA or nonspecific ultrasonographic soft markers, of which 28, 20, and 27 were assigned to the non-SGA control, fpSGA, and SGA groups, respectively.

Disclosures: The study was sponsored by the National Key Research and Development Program of China. No conflicts of interest were reported.

Source: He J et al. Utility of placental diffusion-weighted magnetic resonance imaging in prenatal diagnosis of small for gestational age infants and pregnancy outcome prediction. Placenta. 2022;121:91-98 (Mar 12). Doi: 10.1016/j.placenta.2022.03.010

Key clinical point: Intravoxel incoherent motion (IVIM) imaging could supplement routine ultrasound monitoring to noninvasively differentiate between small-for-gestational-age (SGA) and false-positive SGA (fpSGA) pregnancies.

Major finding: Compared with the control and fpSGA groups, the SGA group had significantly lower mean values of the diffusion coefficient (D; P < .001 and P = .004, respectively), pseudodiffusion coefficient (D*; P = .001 and P = .012, respectively), and perfusion fraction (f; both P < .001). The mean values of D (P = .347), D* (P = .404), and f (P = .880) were similar between the control and fpSGA groups.

Study details: This was a prospective study including 75 singleton pregnant women at >28 weeks of gestation with suspected SGA or nonspecific ultrasonographic soft markers, of which 28, 20, and 27 were assigned to the non-SGA control, fpSGA, and SGA groups, respectively.

Disclosures: The study was sponsored by the National Key Research and Development Program of China. No conflicts of interest were reported.

Source: He J et al. Utility of placental diffusion-weighted magnetic resonance imaging in prenatal diagnosis of small for gestational age infants and pregnancy outcome prediction. Placenta. 2022;121:91-98 (Mar 12). Doi: 10.1016/j.placenta.2022.03.010

Key clinical point: Intravoxel incoherent motion (IVIM) imaging could supplement routine ultrasound monitoring to noninvasively differentiate between small-for-gestational-age (SGA) and false-positive SGA (fpSGA) pregnancies.

Major finding: Compared with the control and fpSGA groups, the SGA group had significantly lower mean values of the diffusion coefficient (D; P < .001 and P = .004, respectively), pseudodiffusion coefficient (D*; P = .001 and P = .012, respectively), and perfusion fraction (f; both P < .001). The mean values of D (P = .347), D* (P = .404), and f (P = .880) were similar between the control and fpSGA groups.

Study details: This was a prospective study including 75 singleton pregnant women at >28 weeks of gestation with suspected SGA or nonspecific ultrasonographic soft markers, of which 28, 20, and 27 were assigned to the non-SGA control, fpSGA, and SGA groups, respectively.

Disclosures: The study was sponsored by the National Key Research and Development Program of China. No conflicts of interest were reported.

Source: He J et al. Utility of placental diffusion-weighted magnetic resonance imaging in prenatal diagnosis of small for gestational age infants and pregnancy outcome prediction. Placenta. 2022;121:91-98 (Mar 12). Doi: 10.1016/j.placenta.2022.03.010

Key clinical point: The frequency of short-burst and burst uterine electromyography signals is higher in midtrimester pregnant women with a cervical length (CL) <2.5 cm, thus elucidating the biophysiological basis for midtrimester cervical shortening that may be used to predict preterm birth.

Major finding: Women with a short vs. normal CL showed significantly higher median percentages of short-bursts (17.3% vs. 2.5%; P = .001) and bursts (6.6% vs. 0%; P = .014).

Study details: Findings are from a prospective cohort study including 28 women with a singleton non-anomalous pregnancy between 16 weeks 0 days and 22 weeks 6 days of gestation, of which 10 and 18 women had a CL of ≥3 cm (normal) and <2.5 cm (short), respectively.

Disclosures: The study was funded by PreTeL, Inc. RC Young declared being the founder of PreTeL.

Source: Marinescu PS et al. Mid-trimester uterine electromyography in patients with a short cervix. Am J Obstet Gynecol. 2022 (Mar 26). Doi: 10.1016/j.ajog.2022.03.046

Key clinical point: The frequency of short-burst and burst uterine electromyography signals is higher in midtrimester pregnant women with a cervical length (CL) <2.5 cm, thus elucidating the biophysiological basis for midtrimester cervical shortening that may be used to predict preterm birth.

Major finding: Women with a short vs. normal CL showed significantly higher median percentages of short-bursts (17.3% vs. 2.5%; P = .001) and bursts (6.6% vs. 0%; P = .014).

Study details: Findings are from a prospective cohort study including 28 women with a singleton non-anomalous pregnancy between 16 weeks 0 days and 22 weeks 6 days of gestation, of which 10 and 18 women had a CL of ≥3 cm (normal) and <2.5 cm (short), respectively.

Disclosures: The study was funded by PreTeL, Inc. RC Young declared being the founder of PreTeL.

Source: Marinescu PS et al. Mid-trimester uterine electromyography in patients with a short cervix. Am J Obstet Gynecol. 2022 (Mar 26). Doi: 10.1016/j.ajog.2022.03.046

Key clinical point: The frequency of short-burst and burst uterine electromyography signals is higher in midtrimester pregnant women with a cervical length (CL) <2.5 cm, thus elucidating the biophysiological basis for midtrimester cervical shortening that may be used to predict preterm birth.

Major finding: Women with a short vs. normal CL showed significantly higher median percentages of short-bursts (17.3% vs. 2.5%; P = .001) and bursts (6.6% vs. 0%; P = .014).

Study details: Findings are from a prospective cohort study including 28 women with a singleton non-anomalous pregnancy between 16 weeks 0 days and 22 weeks 6 days of gestation, of which 10 and 18 women had a CL of ≥3 cm (normal) and <2.5 cm (short), respectively.

Disclosures: The study was funded by PreTeL, Inc. RC Young declared being the founder of PreTeL.

Source: Marinescu PS et al. Mid-trimester uterine electromyography in patients with a short cervix. Am J Obstet Gynecol. 2022 (Mar 26). Doi: 10.1016/j.ajog.2022.03.046