Pub Date : 2022-09-07DOI: 10.1097/FM9.0000000000000164
Wen Sun, Pei-li Du, Lin Yu, Xiaoyi Wang, F. He, Jingsi Chen, Chunhong Su, Dunjin Chen
To editor: In recent years, obstetricians have needed to manage more complex pregnancies involving acute and chronic medical disorders, and a greater number of pregnancies each year are now delivered by critical care services. Data from the United States show that poorly controlled maternal medical conditions can have an adverse impact on pregnancy outcomes. Given the multitude of maternal complications that may arise and the high stakes associated with management of the critically ill parturient, establishment of a high-risk prenatal care model to improve pregnancy outcome is essential. First, we developed the “321” management model for high-risk pregnancies, which includes multidimension comprehensive maternal care (Fig. S1, http://links.lww.com/MFM/A22). This qualitative study then aimed to explore the satisfaction and experience of high-risk pregnancy patients managed by the “321”model.
{"title":"Exploring Experiences with “321” Model Management for High-Risk Pregnancy: A Qualitative Study","authors":"Wen Sun, Pei-li Du, Lin Yu, Xiaoyi Wang, F. He, Jingsi Chen, Chunhong Su, Dunjin Chen","doi":"10.1097/FM9.0000000000000164","DOIUrl":"https://doi.org/10.1097/FM9.0000000000000164","url":null,"abstract":"To editor: In recent years, obstetricians have needed to manage more complex pregnancies involving acute and chronic medical disorders, and a greater number of pregnancies each year are now delivered by critical care services. Data from the United States show that poorly controlled maternal medical conditions can have an adverse impact on pregnancy outcomes. Given the multitude of maternal complications that may arise and the high stakes associated with management of the critically ill parturient, establishment of a high-risk prenatal care model to improve pregnancy outcome is essential. First, we developed the “321” management model for high-risk pregnancies, which includes multidimension comprehensive maternal care (Fig. S1, http://links.lww.com/MFM/A22). This qualitative study then aimed to explore the satisfaction and experience of high-risk pregnancy patients managed by the “321”model.","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":"5 1","pages":"51 - 53"},"PeriodicalIF":0.0,"publicationDate":"2022-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45110623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-13DOI: 10.1097/fm9.0000000000000153
M. Vidarte, D. Nasner, Á. Nieto-Calvache, M. Echavarria, J. Carvajal
{"title":"How Learning from Trauma Benefits the Obstetric Population? Damage Control Surgery","authors":"M. Vidarte, D. Nasner, Á. Nieto-Calvache, M. Echavarria, J. Carvajal","doi":"10.1097/fm9.0000000000000153","DOIUrl":"https://doi.org/10.1097/fm9.0000000000000153","url":null,"abstract":"","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48752900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-09DOI: 10.1097/fm9.0000000000000154
M. Mangla, Naina Kumar
{"title":"Why the Silent Pandemic of Stillbirths Following COVID-19?","authors":"M. Mangla, Naina Kumar","doi":"10.1097/fm9.0000000000000154","DOIUrl":"https://doi.org/10.1097/fm9.0000000000000154","url":null,"abstract":"","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44458053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-09DOI: 10.1097/FM9.0000000000000149
Yan Yu Li, W. Lok, L. Poon, C. Kong, W. To
Abstract Objective The objective of this study is to evaluate the acceptance of pregnant women with regards to coronavirus disease 2019 (COVID-19) vaccination during pregnancy and to identify any significant changes in their anxiety and knowledge on COVID-19 compared to our previous study. Methods This cross-sectional survey was performed in the antenatal clinics of United Christian Hospital and Tseung Kwan O Hospital of Hong Kong, China. Questionnaires were distributed to pregnant women for self-completion when attending follow-up from August to October 2021. Apart from basic demographic data, the questionnaire comprised of questions including knowledge on COVID-19 and its vaccines in pregnancy as well as attitudes and behaviors of pregnant women and their partners toward COVID-19. Continuous variables were analyzed by Student’s test and Levene’s test was used to confirm normal distribution and homogeneity of variance for continuous variables, whereas categorical variables were analyzed by the Chi-squared test or Fisher’s exact test as appropriate. A P value of <0.05 was considered to be statistically significant. Results A total of 816 completed questionnaires were included for analysis. Pregnant women were less worried about COVID-19 in the current survey as compared to the last survey (393/816, 48.2% vs. 518/623, 83.1%, P?
{"title":"Cross-Sectional Survey of Views on COVID-19 and Its Vaccines Among Pregnant Women","authors":"Yan Yu Li, W. Lok, L. Poon, C. Kong, W. To","doi":"10.1097/FM9.0000000000000149","DOIUrl":"https://doi.org/10.1097/FM9.0000000000000149","url":null,"abstract":"Abstract Objective The objective of this study is to evaluate the acceptance of pregnant women with regards to coronavirus disease 2019 (COVID-19) vaccination during pregnancy and to identify any significant changes in their anxiety and knowledge on COVID-19 compared to our previous study. Methods This cross-sectional survey was performed in the antenatal clinics of United Christian Hospital and Tseung Kwan O Hospital of Hong Kong, China. Questionnaires were distributed to pregnant women for self-completion when attending follow-up from August to October 2021. Apart from basic demographic data, the questionnaire comprised of questions including knowledge on COVID-19 and its vaccines in pregnancy as well as attitudes and behaviors of pregnant women and their partners toward COVID-19. Continuous variables were analyzed by Student’s test and Levene’s test was used to confirm normal distribution and homogeneity of variance for continuous variables, whereas categorical variables were analyzed by the Chi-squared test or Fisher’s exact test as appropriate. A P value of <0.05 was considered to be statistically significant. Results A total of 816 completed questionnaires were included for analysis. Pregnant women were less worried about COVID-19 in the current survey as compared to the last survey (393/816, 48.2% vs. 518/623, 83.1%, P?<?0.001). Fewer pregnant women believed that pregnancy were more susceptible to contract SARS-CoV-2 as compared to the last survey (265/816, 32.5% vs. 261/623, 41.9%, P?<?0.001). They have significant knowledge gap and concerns about COVID-19 vaccines. Nearly half of the participants believed that pregnant women cannot have COVID-19 vaccination (402/816, 49.3%) and it is unsafe to fetus (365/816, 44.7%). Around a third of women perceived that they were more prone to the side effects and complications of COVID-19 vaccines than the general population (312/816, 38.2%) and did not recognize that maternal COVID-19 vaccination could effect transferral of antibodies to the fetus to promote postnatal passive immunity (295/816, 36.2%). Most of them had not been vaccinated (715/816, 87.6%) and only (12/715) 1.7% of them would consider vaccination during pregnancy. Conclusion Despite the local and international recommendations for pregnant women to be vaccinated, the uptake of COVID-19 vaccines during pregnancy remained extremely low. Efforts should be made to effectively provide information about the safety and benefits of COVID-19 vaccines during pregnancy. There is an urgent need to booster vaccination rates in pregnant women to avoid excessive adverse pregnancy outcomes related to COVID-19.","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":"5 1","pages":"80 - 87"},"PeriodicalIF":0.0,"publicationDate":"2022-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47185249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-09DOI: 10.1097/FM9.0000000000000150
G. Song, Yumei Wei, J. Juan, R. Su, Jianying Yan, M. Xiao, Xianlan Zhao, Meihua Zhang, Yuyan Ma, Haiwei Liu, Jingxia Sun, Kejia Hu, Huixia Yang
Abstract Objective This study aimed to determine the likelihood of gestational diabetes mellitus (GDM) in subsequent pregnancy among women without GDM history and to identify risk factors for GDM in subsequent pregnancy. Methods This retrospective cohort study involved participants who delivered twice in same hospital of 18 research centers when delivered the second baby from January 2018 to December 2018. Finally 6204 women were enrolled and 5180 women without GDM history were analyzed further. Women were categorized as non-GDM or GDM based on the blood glucose values of the subsequent pregnancy, and the characteristics and GDM risk of these groups were compared. A univariate analysis of potential risk factors was performed using the Chi-squared test and/or t-test for qualitative or quantitative variables, respectively. Associations with P values <0.1 were chosen to be included in the multivariate binary logistic regression model. Results In primary analysis of 6204 women, the incidence of GDM in subsequent pregnancy is 48.9% (490/1002) in women with GDM history and 16.1% (835/5202) in women without GDM history. In a further analysis for 5180 women without GDM at index pregnancy, compared with the non-GDM group, the GDM group had a significantly higher age, prepregnancy body mass index, and blood glucose value at each oral glucose tolerance test (OGTT) timepoint (fasting, 1 h and 2 h) during the index and subsequent pregnancies, as well as higher weight retention during the interval between the two pregnancies (P<0.001). Age above 35 years in subsequent pregnancy (odds ratio (OR)=1.540, 95% confidence interval (CI) = 1.257–1.886, P<0.001), macrosomia in index pregnancy (OR=1.749, 95% CI=1.277–2.395, P=0.001), OGTT blood glucose values in index pregnancy (fasting, OR=2.487, 95% CI=1.883–3.285, P<0.001; 1 h, OR=1.142, 95% CI=1.051–1.241, P=0.002; 2 h, OR=1.290, 95% CI=1.162–1.432, P<0.001) and weight retention (OR=1.052, 95% CI=1.035–1.068, P<0.001) were independent risk factors for GDM in subsequent pregnancy. Conclusion For women without GDM history, GDM risk factors including age, macrosomia history, OGTT value, and weight retention, these can be evaluated before a subsequent pregnancy. Early warning and interventions are needed for women at high risk.
{"title":"Risk Factors for Gestational Diabetes Mellitus (GDM) in Subsequent Pregnancy Among Women Without GDM History in China: A Multicenter Retrospective Study","authors":"G. Song, Yumei Wei, J. Juan, R. Su, Jianying Yan, M. Xiao, Xianlan Zhao, Meihua Zhang, Yuyan Ma, Haiwei Liu, Jingxia Sun, Kejia Hu, Huixia Yang","doi":"10.1097/FM9.0000000000000150","DOIUrl":"https://doi.org/10.1097/FM9.0000000000000150","url":null,"abstract":"Abstract Objective This study aimed to determine the likelihood of gestational diabetes mellitus (GDM) in subsequent pregnancy among women without GDM history and to identify risk factors for GDM in subsequent pregnancy. Methods This retrospective cohort study involved participants who delivered twice in same hospital of 18 research centers when delivered the second baby from January 2018 to December 2018. Finally 6204 women were enrolled and 5180 women without GDM history were analyzed further. Women were categorized as non-GDM or GDM based on the blood glucose values of the subsequent pregnancy, and the characteristics and GDM risk of these groups were compared. A univariate analysis of potential risk factors was performed using the Chi-squared test and/or t-test for qualitative or quantitative variables, respectively. Associations with P values <0.1 were chosen to be included in the multivariate binary logistic regression model. Results In primary analysis of 6204 women, the incidence of GDM in subsequent pregnancy is 48.9% (490/1002) in women with GDM history and 16.1% (835/5202) in women without GDM history. In a further analysis for 5180 women without GDM at index pregnancy, compared with the non-GDM group, the GDM group had a significantly higher age, prepregnancy body mass index, and blood glucose value at each oral glucose tolerance test (OGTT) timepoint (fasting, 1 h and 2 h) during the index and subsequent pregnancies, as well as higher weight retention during the interval between the two pregnancies (P<0.001). Age above 35 years in subsequent pregnancy (odds ratio (OR)=1.540, 95% confidence interval (CI) = 1.257–1.886, P<0.001), macrosomia in index pregnancy (OR=1.749, 95% CI=1.277–2.395, P=0.001), OGTT blood glucose values in index pregnancy (fasting, OR=2.487, 95% CI=1.883–3.285, P<0.001; 1 h, OR=1.142, 95% CI=1.051–1.241, P=0.002; 2 h, OR=1.290, 95% CI=1.162–1.432, P<0.001) and weight retention (OR=1.052, 95% CI=1.035–1.068, P<0.001) were independent risk factors for GDM in subsequent pregnancy. Conclusion For women without GDM history, GDM risk factors including age, macrosomia history, OGTT value, and weight retention, these can be evaluated before a subsequent pregnancy. Early warning and interventions are needed for women at high risk.","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":"5 1","pages":"9 - 15"},"PeriodicalIF":0.0,"publicationDate":"2022-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44093336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-01DOI: 10.1097/fm9.0000000000000157
Xiaojing Zeng, Jing Zhu, Jun Zhang
{"title":"Establishing Chinese Fetal Growth Standards: Why and How","authors":"Xiaojing Zeng, Jing Zhu, Jun Zhang","doi":"10.1097/fm9.0000000000000157","DOIUrl":"https://doi.org/10.1097/fm9.0000000000000157","url":null,"abstract":"","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49197573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-01DOI: 10.1097/FM9.0000000000000159
Dayuan Shi, Luyao Cai, Luming Sun
Abstract Fetal growth restriction (FGR) is associated with multiple adverse perinatal outcomes, such as increased risk of intrauterine death, neonatal morbidity and mortality, and long-term adverse outcomes. Genetic etiological factors are critical in fetuses with intrauterine growth restriction, including chromosomal abnormalities, copy number variants, single gene disorders, uniparental disomy, epigenetic changes, and confined placental mosaicism. This paper aims to provide an overview of genetic defects related to FGR and to highlight the importance of prenatal genetic counseling and testing for precise diagnosis and management of FGR.
{"title":"Genetics Etiologies Associated with Fetal Growth Restriction","authors":"Dayuan Shi, Luyao Cai, Luming Sun","doi":"10.1097/FM9.0000000000000159","DOIUrl":"https://doi.org/10.1097/FM9.0000000000000159","url":null,"abstract":"Abstract Fetal growth restriction (FGR) is associated with multiple adverse perinatal outcomes, such as increased risk of intrauterine death, neonatal morbidity and mortality, and long-term adverse outcomes. Genetic etiological factors are critical in fetuses with intrauterine growth restriction, including chromosomal abnormalities, copy number variants, single gene disorders, uniparental disomy, epigenetic changes, and confined placental mosaicism. This paper aims to provide an overview of genetic defects related to FGR and to highlight the importance of prenatal genetic counseling and testing for precise diagnosis and management of FGR.","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":" 18","pages":"206 - 209"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41312357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-01DOI: 10.1097/FM9.0000000000000156
Liqun Sun
Abstract Fetal growth restriction (FGR) has a prevalence of about 10% worldwide and is associated with an increased risk of perinatal mortality and morbidity. FGR is commonly caused by placental insufficiency and can begin early (<32 weeks) or in late (≥32 weeks) gestational age. A false positive antenatal diagnosis may lead to unnecessary monitoring and interventions, as well as cause maternal anxiety. Whereas a false negative diagnosis exposes the fetus to an increased risk of stillbirth and renders the pregnancy ineligible from the appropriate care and potential treatments. The clinical management of FGR pregnancies faces a complex challenge of deciding on the optimal timing of delivery as currently the main solution is to deliver the baby early, but iatrogenic preterm delivery of infants is associated with adverse short- and long-term outcomes. Early and accurate diagnosis of FGR could aid in better stratification of clinical management, and the development and implementation of treatment options, ultimately benefiting clinical care and potentially improving both short- and long-term health outcomes. The aim of this review is to present the new insights on biomarkers of placenta insufficiency, including their current and potential value of biomarkers in the prediction and prevention for FGR, and highlight the association between biomarkers and adverse outcomes in utero to explore the specific mechanism of impaired fetal growth that establish the basis for disease later in life.
{"title":"The Update of Fetal Growth Restriction Associated with Biomarkers","authors":"Liqun Sun","doi":"10.1097/FM9.0000000000000156","DOIUrl":"https://doi.org/10.1097/FM9.0000000000000156","url":null,"abstract":"Abstract Fetal growth restriction (FGR) has a prevalence of about 10% worldwide and is associated with an increased risk of perinatal mortality and morbidity. FGR is commonly caused by placental insufficiency and can begin early (<32 weeks) or in late (≥32 weeks) gestational age. A false positive antenatal diagnosis may lead to unnecessary monitoring and interventions, as well as cause maternal anxiety. Whereas a false negative diagnosis exposes the fetus to an increased risk of stillbirth and renders the pregnancy ineligible from the appropriate care and potential treatments. The clinical management of FGR pregnancies faces a complex challenge of deciding on the optimal timing of delivery as currently the main solution is to deliver the baby early, but iatrogenic preterm delivery of infants is associated with adverse short- and long-term outcomes. Early and accurate diagnosis of FGR could aid in better stratification of clinical management, and the development and implementation of treatment options, ultimately benefiting clinical care and potentially improving both short- and long-term health outcomes. The aim of this review is to present the new insights on biomarkers of placenta insufficiency, including their current and potential value of biomarkers in the prediction and prevention for FGR, and highlight the association between biomarkers and adverse outcomes in utero to explore the specific mechanism of impaired fetal growth that establish the basis for disease later in life.","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":"4 1","pages":"210 - 217"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45298459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-01DOI: 10.1097/FM9.0000000000000160
Laure Noël, C. Coutinho, B. Thilaganathan
Abstract Stillbirth is a devastating pregnancy complication that still affects many women, particularly from low and middle-income countries. It is often labeled as “unexplained” and therefore unpreventable, despite the knowledge that placental dysfunction has been identified as a leading cause of antepartum stillbirth. Currently, screening for pregnancies at high-risk for placental dysfunction relies on checklists of maternal risk factors and serial measurement of symphyseal-fundal height to identify small for gestational age fetuses. More recently, the first-trimester combined screening algorithm developed by the Fetal Medicine Foundation has emerged as a better tool to predict and prevent early-onset placental dysfunction and its main outcomes of preterm preeclampsia, fetal growth restriction and stillbirth by the appropriate use of Aspirin therapy, serial growth scans and induction of labour from 40 weeks for women identified at high-risk by such screening. There is currently no equivalent to predict and prevent late-onset placental dysfunction, although algorithms combining an ultrasound-based estimation of fetal weight, assessment of maternal and fetal Doppler indices, and maternal serum biomarkers show promise as emerging new screening tools to optimize pregnancy monitoring and timing of delivery to prevent stillbirth. In this review we discuss the strategies to predict and prevent stillbirths based on first-trimester screening as well as fetal growth and wellbeing assessment in the second and third trimesters.
{"title":"Preventing Stillbirth: A Review of Screening and Prevention Strategies","authors":"Laure Noël, C. Coutinho, B. Thilaganathan","doi":"10.1097/FM9.0000000000000160","DOIUrl":"https://doi.org/10.1097/FM9.0000000000000160","url":null,"abstract":"Abstract Stillbirth is a devastating pregnancy complication that still affects many women, particularly from low and middle-income countries. It is often labeled as “unexplained” and therefore unpreventable, despite the knowledge that placental dysfunction has been identified as a leading cause of antepartum stillbirth. Currently, screening for pregnancies at high-risk for placental dysfunction relies on checklists of maternal risk factors and serial measurement of symphyseal-fundal height to identify small for gestational age fetuses. More recently, the first-trimester combined screening algorithm developed by the Fetal Medicine Foundation has emerged as a better tool to predict and prevent early-onset placental dysfunction and its main outcomes of preterm preeclampsia, fetal growth restriction and stillbirth by the appropriate use of Aspirin therapy, serial growth scans and induction of labour from 40 weeks for women identified at high-risk by such screening. There is currently no equivalent to predict and prevent late-onset placental dysfunction, although algorithms combining an ultrasound-based estimation of fetal weight, assessment of maternal and fetal Doppler indices, and maternal serum biomarkers show promise as emerging new screening tools to optimize pregnancy monitoring and timing of delivery to prevent stillbirth. In this review we discuss the strategies to predict and prevent stillbirths based on first-trimester screening as well as fetal growth and wellbeing assessment in the second and third trimesters.","PeriodicalId":74121,"journal":{"name":"Maternal-fetal medicine (Wolters Kluwer Health, Inc.)","volume":"4 1","pages":"218 - 228"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46574051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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