Pub Date : 2025-02-07DOI: 10.1016/j.ajogmf.2025.101636
Melissa Berkowitz MPP, MS, Erica L. Dixon PhD, Jenna White MSW, Tamar Klaiman PhD, MPH, Sindhu K. Srinivas MD, MSCE, Rebecca F. Hamm MD, MSCE
{"title":"Towards optimizing social drivers of health screenings in prenatal care: patient perspectives","authors":"Melissa Berkowitz MPP, MS, Erica L. Dixon PhD, Jenna White MSW, Tamar Klaiman PhD, MPH, Sindhu K. Srinivas MD, MSCE, Rebecca F. Hamm MD, MSCE","doi":"10.1016/j.ajogmf.2025.101636","DOIUrl":"10.1016/j.ajogmf.2025.101636","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 4","pages":"Article 101636"},"PeriodicalIF":3.8,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-06DOI: 10.1016/j.ajogmf.2025.101627
Nicola Volpe MD, PhD, Tullio Ghi MD, PhD
{"title":"Assessing the fetal lateral ventricles at first-trimester ultrasound may predict open spina bifida: a response","authors":"Nicola Volpe MD, PhD, Tullio Ghi MD, PhD","doi":"10.1016/j.ajogmf.2025.101627","DOIUrl":"10.1016/j.ajogmf.2025.101627","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 4","pages":"Article 101627"},"PeriodicalIF":3.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-06DOI: 10.1016/j.ajogmf.2025.101626
Yong-Shan Chen BS, Dong-Zhi Li MD
{"title":"A large choroid plexus with decreased fluid in the ventricular system: first-trimester sonographic marker of open spina bifida","authors":"Yong-Shan Chen BS, Dong-Zhi Li MD","doi":"10.1016/j.ajogmf.2025.101626","DOIUrl":"10.1016/j.ajogmf.2025.101626","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 4","pages":"Article 101626"},"PeriodicalIF":3.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-05DOI: 10.1016/j.ajogmf.2025.101632
Marissa Berry MD, William A. Grobman MD, Jiqiang Wu MSc, Becky McNeil PhD, Lynn M. Yee MD, David M. Haas MD, Jessica L. Pippen MD, Hyagriv N. Simhan MD, Uma M. Reddy MD, Robert M. Silver MD, George R. Saade MD, Judith Chung MD, Lisa Levine MD, Kartik K. Venkatesh MD, PhD
{"title":"Group B Streptococcus colonization and risk of chorioamnionitis among nulliparous individuals","authors":"Marissa Berry MD, William A. Grobman MD, Jiqiang Wu MSc, Becky McNeil PhD, Lynn M. Yee MD, David M. Haas MD, Jessica L. Pippen MD, Hyagriv N. Simhan MD, Uma M. Reddy MD, Robert M. Silver MD, George R. Saade MD, Judith Chung MD, Lisa Levine MD, Kartik K. Venkatesh MD, PhD","doi":"10.1016/j.ajogmf.2025.101632","DOIUrl":"10.1016/j.ajogmf.2025.101632","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 4","pages":"Article 101632"},"PeriodicalIF":3.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-04DOI: 10.1016/j.ajogmf.2025.101628
Beth R. Piscopo BSc (Hons) , Atul Malhotra PhD , Rod W. Hunt PhD , Miranda L. Davies-Tuck PhD , Kirsten R. Palmer PhD , Amy E. Sutherland PhD , Graeme R. Polglase PhD , Beth J. Allison PhD , Suzanne L. Miller PhD
<div><h3>Background</h3><div>Intraventricular hemorrhage (IVH) most commonly occurs in infants born very preterm (<32 weeks’ gestation). There are mixed findings on whether infants small for gestational age (SGA) or with suspected fetal growth restriction (FGR) are at higher risk for IVH. Understanding the relationship between SGA or FGR and IVH is critical to inform clinical care.</div></div><div><h3>Objective</h3><div>The primary aim was to determine the rates of IVH in very preterm newborns, with SGA or suspected FGR, and to stratify for severity of both FGR and IVH. The secondary aim was to identify risk factors for IVH in a large contemporary cohort.</div></div><div><h3>Study Design</h3><div>A population-based retrospective cohort study using data from the Australian and New Zealand Neonatal Network. Participants were babies born before 32 weeks’ gestation (22–31 weeks + 6 days gestation) between 2014 and 2019 inclusive. The primary outcomes were IVH and severity of IVH. Small babies were classified as being SGA (SGA; birth weight <10th percentile), suspected FGR (birth weight <10th and ≥3rd birth weight percentile <em>and</em> abnormal antenatal ultrasound), or severe FGR (birth weight <3rd percentile). Multivariate regression was then performed, adjusting for potential maternal and fetal confounders to determine the association between FGR and IVH.</div></div><div><h3>Results</h3><div>20,551 very preterm newborns were included in the study with a median gestational age (25th, 75th) of 29 (27, 30) weeks gestation and birth weight of 1201 (383.9) grams. The incidence of any IVH was 20.02% (<em>n</em>=4115) and increased with decreasing gestation at birth (10% of infants born at 31 weeks had IVH compared with 70% of infants born at 22 weeks). The rate of severe IVH (Grade 3 or 4) was 3.23%. In this cohort, 7.7% were SGA (<em>n</em>=1583) and 6.23% (<em>n</em>=1281) of babies had suspected early-onset FGR. The incidence of SGA was reduced in babies with IVH (6.0% vs 8.1%, respectively, aOR, 0.82; 95% CI 0.68–0.97). Similarly, suspected FGR was significantly lower in infants with IVH (any grade) compared to those without (2.5% vs 4.6%, respectively, adjusted odds ratio (aOR), 0.69; 95% CI 0.54–0.89). Further, there was a negative association between SGA (aOR, 0.80; 95% CI 0.67–0.95) and FGR (aOR 0.69; 95% CI 0.54–0.88) and the severity of IVH. Severe FGR (<3rd birth weight percentile) was not associated with either the presence (1.9% with IVH, vs 2.1% without IVH, aOR, 0.86; 95% CI 0.64–1.16) or severity of IVH (aOR, 0.85; 95% CI 0.63–1.14).</div></div><div><h3>Conclusion</h3><div>This large retrospective cohort study identified that in very preterm infants born with a median gestational age at birth of 29 weeks and who survive to the neonatal unit, the presence of SGA or suspected FGR is associated with a reduced rate of IVH, compared to infants without SGA/FGR. Future studies should directly assess whether placental insufficien
{"title":"The interplay between birth weight and intraventricular hemorrhage in very preterm neonates—a retrospective cohort study","authors":"Beth R. Piscopo BSc (Hons) , Atul Malhotra PhD , Rod W. Hunt PhD , Miranda L. Davies-Tuck PhD , Kirsten R. Palmer PhD , Amy E. Sutherland PhD , Graeme R. Polglase PhD , Beth J. Allison PhD , Suzanne L. Miller PhD","doi":"10.1016/j.ajogmf.2025.101628","DOIUrl":"10.1016/j.ajogmf.2025.101628","url":null,"abstract":"<div><h3>Background</h3><div>Intraventricular hemorrhage (IVH) most commonly occurs in infants born very preterm (<32 weeks’ gestation). There are mixed findings on whether infants small for gestational age (SGA) or with suspected fetal growth restriction (FGR) are at higher risk for IVH. Understanding the relationship between SGA or FGR and IVH is critical to inform clinical care.</div></div><div><h3>Objective</h3><div>The primary aim was to determine the rates of IVH in very preterm newborns, with SGA or suspected FGR, and to stratify for severity of both FGR and IVH. The secondary aim was to identify risk factors for IVH in a large contemporary cohort.</div></div><div><h3>Study Design</h3><div>A population-based retrospective cohort study using data from the Australian and New Zealand Neonatal Network. Participants were babies born before 32 weeks’ gestation (22–31 weeks + 6 days gestation) between 2014 and 2019 inclusive. The primary outcomes were IVH and severity of IVH. Small babies were classified as being SGA (SGA; birth weight <10th percentile), suspected FGR (birth weight <10th and ≥3rd birth weight percentile <em>and</em> abnormal antenatal ultrasound), or severe FGR (birth weight <3rd percentile). Multivariate regression was then performed, adjusting for potential maternal and fetal confounders to determine the association between FGR and IVH.</div></div><div><h3>Results</h3><div>20,551 very preterm newborns were included in the study with a median gestational age (25th, 75th) of 29 (27, 30) weeks gestation and birth weight of 1201 (383.9) grams. The incidence of any IVH was 20.02% (<em>n</em>=4115) and increased with decreasing gestation at birth (10% of infants born at 31 weeks had IVH compared with 70% of infants born at 22 weeks). The rate of severe IVH (Grade 3 or 4) was 3.23%. In this cohort, 7.7% were SGA (<em>n</em>=1583) and 6.23% (<em>n</em>=1281) of babies had suspected early-onset FGR. The incidence of SGA was reduced in babies with IVH (6.0% vs 8.1%, respectively, aOR, 0.82; 95% CI 0.68–0.97). Similarly, suspected FGR was significantly lower in infants with IVH (any grade) compared to those without (2.5% vs 4.6%, respectively, adjusted odds ratio (aOR), 0.69; 95% CI 0.54–0.89). Further, there was a negative association between SGA (aOR, 0.80; 95% CI 0.67–0.95) and FGR (aOR 0.69; 95% CI 0.54–0.88) and the severity of IVH. Severe FGR (<3rd birth weight percentile) was not associated with either the presence (1.9% with IVH, vs 2.1% without IVH, aOR, 0.86; 95% CI 0.64–1.16) or severity of IVH (aOR, 0.85; 95% CI 0.63–1.14).</div></div><div><h3>Conclusion</h3><div>This large retrospective cohort study identified that in very preterm infants born with a median gestational age at birth of 29 weeks and who survive to the neonatal unit, the presence of SGA or suspected FGR is associated with a reduced rate of IVH, compared to infants without SGA/FGR. Future studies should directly assess whether placental insufficien","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 4","pages":"Article 101628"},"PeriodicalIF":3.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-04DOI: 10.1016/j.ajogmf.2025.101631
Steven T. Papastefan MD , Daniel R. Liesman MD , Yuqi Bian BA , Nkechinyelum Q. Ogu MD , Manmeet Singh MS , William S. Marriott MS , Joyceline A. Ito RN , Jessica T. Fry MD , Aimen F. Shaaban MD , Ashish Premkumar MD, PhD
<div><h3>Background</h3><div>Due to the small number of centers performing maternal-fetal surgery for fetal myelomeningocele, many people are required to travel significant distances for perioperative counseling at an experienced center. As part of the decision-making process for the management of myelomeningocele, some pregnant individuals are interested in, and may ultimately proceed with, termination of pregnancy. Additional travel for abortion care may compound psychological and financial burdens for pregnant individuals, given the existing barriers to accessing abortion care across the United States.</div></div><div><h3>Objective</h3><div>The objective of this study was to evaluate the association between the distance traveled to a fetal care center and the consideration and completion of abortion among patients with fetal myelomeningocele.</div></div><div><h3>Study design</h3><div>We performed a retrospective cohort analysis of all singleton myelomeningocele consultations at a single fetal care center in Illinois from 2018 to 2024. The exposure was the distance traveled to the fetal care center defined as miles from the patient's zip code of residence to the fetal care center. Distance was analyzed in two ways: categorically (dichotomized based on median value) and continuously. The primary outcomes were abortion consideration, ascertained by a nurse during fetal care center intake, and abortion completion. Bivariate and multivariate log-binomial regression analyses were performed. A subgroup analysis was performed by participant state of residence. Statistical significance was considered <em>P</em><.05.</div></div><div><h3>Results</h3><div>There were 133 participants available for the abortion consideration analysis and 157 participants for the abortion completion analysis. Median distance traveled was 39 miles (IQR 15-116 miles). People traveling below the median distance were more likely to identify as Latinx, reside within Illinois, and present at an earlier gestational age when compared with those traveling above the median distance. Distance traveled was independently associated with abortion consideration, after controlling for gestational age at the time of presentation to the fetal care center (aRR 0.44, 95% CI 0.27–0.72). When treating the distance traveled as a continuous outcome, for every mile traveled the risk of considering abortion decreased by 1% (aRR 0.99, 95% CI 0.98–0.99). On subgroup analysis, this finding was persistent only among individuals living in Illinois. There was no significant relationship between the distance traveled to the fetal care center and abortion completion.</div></div><div><h3>Conclusions</h3><div>Increased distance traveled is associated with a lower risk of abortion consideration among individuals presenting to a fetal care center for fetal myelomeningocele consultation. These data emphasize the nuanced relationship between fetal diagnosis and abortion and the importance of providing comprehen
{"title":"Association between distance traveled and abortion consideration and completion among people with fetal myelomeningocele","authors":"Steven T. Papastefan MD , Daniel R. Liesman MD , Yuqi Bian BA , Nkechinyelum Q. Ogu MD , Manmeet Singh MS , William S. Marriott MS , Joyceline A. Ito RN , Jessica T. Fry MD , Aimen F. Shaaban MD , Ashish Premkumar MD, PhD","doi":"10.1016/j.ajogmf.2025.101631","DOIUrl":"10.1016/j.ajogmf.2025.101631","url":null,"abstract":"<div><h3>Background</h3><div>Due to the small number of centers performing maternal-fetal surgery for fetal myelomeningocele, many people are required to travel significant distances for perioperative counseling at an experienced center. As part of the decision-making process for the management of myelomeningocele, some pregnant individuals are interested in, and may ultimately proceed with, termination of pregnancy. Additional travel for abortion care may compound psychological and financial burdens for pregnant individuals, given the existing barriers to accessing abortion care across the United States.</div></div><div><h3>Objective</h3><div>The objective of this study was to evaluate the association between the distance traveled to a fetal care center and the consideration and completion of abortion among patients with fetal myelomeningocele.</div></div><div><h3>Study design</h3><div>We performed a retrospective cohort analysis of all singleton myelomeningocele consultations at a single fetal care center in Illinois from 2018 to 2024. The exposure was the distance traveled to the fetal care center defined as miles from the patient's zip code of residence to the fetal care center. Distance was analyzed in two ways: categorically (dichotomized based on median value) and continuously. The primary outcomes were abortion consideration, ascertained by a nurse during fetal care center intake, and abortion completion. Bivariate and multivariate log-binomial regression analyses were performed. A subgroup analysis was performed by participant state of residence. Statistical significance was considered <em>P</em><.05.</div></div><div><h3>Results</h3><div>There were 133 participants available for the abortion consideration analysis and 157 participants for the abortion completion analysis. Median distance traveled was 39 miles (IQR 15-116 miles). People traveling below the median distance were more likely to identify as Latinx, reside within Illinois, and present at an earlier gestational age when compared with those traveling above the median distance. Distance traveled was independently associated with abortion consideration, after controlling for gestational age at the time of presentation to the fetal care center (aRR 0.44, 95% CI 0.27–0.72). When treating the distance traveled as a continuous outcome, for every mile traveled the risk of considering abortion decreased by 1% (aRR 0.99, 95% CI 0.98–0.99). On subgroup analysis, this finding was persistent only among individuals living in Illinois. There was no significant relationship between the distance traveled to the fetal care center and abortion completion.</div></div><div><h3>Conclusions</h3><div>Increased distance traveled is associated with a lower risk of abortion consideration among individuals presenting to a fetal care center for fetal myelomeningocele consultation. These data emphasize the nuanced relationship between fetal diagnosis and abortion and the importance of providing comprehen","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 4","pages":"Article 101631"},"PeriodicalIF":3.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.ajogmf.2024.101598
Jip A. Spekman BSc , Eva Ros BSc , Liesbeth Lewi MD, PhD , Femke Slaghekke MD, PhD , E.J.T. Joanne Verweij MD, PhD , Anne T.R. Noll MD , Jeanine M.M. van Klink PhD , Monique C. Haak MD, PhD , Lotte E. van der Meeren MD, PhD , Sophie G. Groene PhD , Enrico Lopriore MD, PhD
Background
Monochorionic (MC) twins share a single placenta which can be unequally shared, leading to selective fetal growth restriction (sFGR). Limited data is available on the prevalence and clinical consequences of proximate cord insertion (PCI) in sFGR pregnancies.
Objective
We aimed to investigate the prevalence of PCI in MC placentas with and without sFGR and per type of sFGR, and study the placental characteristics and perinatal outcome of PCI in sFGR pregnancies.
Study design
In this multicenter retrospective cohort study, we included all consecutive placentas of MC twin pregnancies with and without sFGR evaluated between 2002-2023. We excluded MC twins with twin-twin transfusion syndrome, twin anemia polycythemia sequence and monoamnionicity. Our primary outcome included the prevalence of PCI (distance between cord insertions ≤4 cm) and type of cord insertions categorized as concordant, intermediate or discordant. Secondary outcomes consisted of type and size of placental vascular anastomoses and short-term clinical outcomes including fetal demise and birth weight discordance (BWD).
Results
Of 813 MC placentas, 468 were from uncomplicated twins and 345 from sFGR twins (187 type I, 41 type II and 117 type III sFGR). The prevalence of PCI in uncomplicated versus sFGR placentas was 3.8% (18/468) and 4.6% (16/345), respectively (p=0.58). PCI in sFGR type I, II and III was detected in 0.5% (1/187), 0% (0/41) and 12.8% (15/117), respectively (p<0.0001). The prevalence of discordant cord insertions (velamentous-paracentral) in uncomplicated twin placentas and sFGR placentas was 19.9% (93/468) and 45.5% (157/345), respectively (p<0.0001). Diameter of arterio-arterial (AA) anastomoses in sFGR placentas with and without PCI was 3.0 mm (IQR 2.7-5.0) versus 2.2 mm (IQR 1.4-3.1; p<0.0061). BWD in sFGR twins with PCI was 18.5% (IQR 16.4-21.0) and without PCI was 28.0% (IQR 21.8-35.9; p<0.0001). Fetal demise occurred in 12.5% (2/16) of pregnancies with PCI and 6.1% (20/329) of sFGR pregnancies without PCI (p=0.27).
Conclusion
sFGR type III placentas exhibit a high prevalence of PCI, requiring increased awareness due to the presence of larger AA anastomoses and a potentially higher risk of fetal demise.
{"title":"Proximate cord insertion in monochorionic twins with selective fetal growth restriction","authors":"Jip A. Spekman BSc , Eva Ros BSc , Liesbeth Lewi MD, PhD , Femke Slaghekke MD, PhD , E.J.T. Joanne Verweij MD, PhD , Anne T.R. Noll MD , Jeanine M.M. van Klink PhD , Monique C. Haak MD, PhD , Lotte E. van der Meeren MD, PhD , Sophie G. Groene PhD , Enrico Lopriore MD, PhD","doi":"10.1016/j.ajogmf.2024.101598","DOIUrl":"10.1016/j.ajogmf.2024.101598","url":null,"abstract":"<div><h3>Background</h3><div>Monochorionic (MC) twins share a single placenta which can be unequally shared, leading to selective fetal growth restriction (sFGR). Limited data is available on the prevalence and clinical consequences of proximate cord insertion (PCI) in sFGR pregnancies.</div></div><div><h3>Objective</h3><div>We aimed to investigate the prevalence of PCI in MC placentas with and without sFGR and per type of sFGR, and study the placental characteristics and perinatal outcome of PCI in sFGR pregnancies.</div></div><div><h3>Study design</h3><div>In this multicenter retrospective cohort study, we included all consecutive placentas of MC twin pregnancies with and without sFGR evaluated between 2002-2023. We excluded MC twins with twin-twin transfusion syndrome, twin anemia polycythemia sequence and monoamnionicity. Our primary outcome included the prevalence of PCI (distance between cord insertions ≤4 cm) and type of cord insertions categorized as concordant, intermediate or discordant. Secondary outcomes consisted of type and size of placental vascular anastomoses and short-term clinical outcomes including fetal demise and birth weight discordance (BWD).</div></div><div><h3>Results</h3><div>Of 813 MC placentas, 468 were from uncomplicated twins and 345 from sFGR twins (187 type I, 41 type II and 117 type III sFGR). The prevalence of PCI in uncomplicated versus sFGR placentas was 3.8% (18/468) and 4.6% (16/345), respectively (<em>p</em>=0.58). PCI in sFGR type I, II and III was detected in 0.5% (1/187), 0% (0/41) and 12.8% (15/117), respectively (<em>p</em><0.0001). The prevalence of discordant cord insertions (velamentous-paracentral) in uncomplicated twin placentas and sFGR placentas was 19.9% (93/468) and 45.5% (157/345), respectively (<em>p</em><0.0001). Diameter of arterio-arterial (AA) anastomoses in sFGR placentas with and without PCI was 3.0 mm (IQR 2.7-5.0) versus 2.2 mm (IQR 1.4-3.1; <em>p</em><0.0061). BWD in sFGR twins with PCI was 18.5% (IQR 16.4-21.0) and without PCI was 28.0% (IQR 21.8-35.9; <em>p</em><0.0001). Fetal demise occurred in 12.5% (2/16) of pregnancies with PCI and 6.1% (20/329) of sFGR pregnancies without PCI (<em>p</em>=0.27).</div></div><div><h3>Conclusion</h3><div>sFGR type III placentas exhibit a high prevalence of PCI, requiring increased awareness due to the presence of larger AA anastomoses and a potentially higher risk of fetal demise.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 2","pages":"Article 101598"},"PeriodicalIF":3.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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