Pub Date : 2014-11-01DOI: 10.1017/S0965539516000012
S. Jahanfar, K. Lim
{"title":"A SYSTEMATIC REVIEW OF BIRTH WEIGHT DISCORDANCE AND PERINATAL OUTCOMES","authors":"S. Jahanfar, K. Lim","doi":"10.1017/S0965539516000012","DOIUrl":"https://doi.org/10.1017/S0965539516000012","url":null,"abstract":"","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"25 1","pages":"232-262"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0965539516000012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56979754","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 : 2014-11-01DOI: 10.1017/S0965539515000030
R. Spencer, D. Carr, A. David
The first clinical trials of gene therapy in the 1990s offered the promise of a new paradigm for the treatment of genetic diseases. Over the decades that followed the challenges and setbacks which gene therapy faced often overshadowed any successes. Despite this, recent years have seen cause for renewed optimism. In 2012 Glybera™, an adeno-associated viral vector expressing lipoprotein lipase, became the first gene therapy product to receive marketing authorisation in Europe, with a licence to treat familial lipoprotein lipase deficiency. This followed the earlier licensing in China of two gene therapies: Gendicine™ for head and neck squamous cell carcinoma and Oncorine™ for late-stage nasopharyngeal cancer. By this stage over 1800 clinical trials had been, or were being, conducted worldwide, and the therapeutic targets had expanded far beyond purely genetic disorders. So far no trials of gene therapy have been carried out in pregnancy, but an increasing understanding of the molecular mechanisms underlying obstetric diseases means that it is likely to have a role to play in the future. This review will discuss how gene therapy works, its potential application in obstetric conditions and the risks and limitations associated with its use in this setting. It will also address the ethical and regulatory issues that will be faced by any potential clinical trial of gene therapy during pregnancy.
{"title":"Gene therapy for obstetric conditions","authors":"R. Spencer, D. Carr, A. David","doi":"10.1017/S0965539515000030","DOIUrl":"https://doi.org/10.1017/S0965539515000030","url":null,"abstract":"The first clinical trials of gene therapy in the 1990s offered the promise of a new paradigm for the treatment of genetic diseases. Over the decades that followed the challenges and setbacks which gene therapy faced often overshadowed any successes. Despite this, recent years have seen cause for renewed optimism. In 2012 Glybera™, an adeno-associated viral vector expressing lipoprotein lipase, became the first gene therapy product to receive marketing authorisation in Europe, with a licence to treat familial lipoprotein lipase deficiency. This followed the earlier licensing in China of two gene therapies: Gendicine™ for head and neck squamous cell carcinoma and Oncorine™ for late-stage nasopharyngeal cancer. By this stage over 1800 clinical trials had been, or were being, conducted worldwide, and the therapeutic targets had expanded far beyond purely genetic disorders. So far no trials of gene therapy have been carried out in pregnancy, but an increasing understanding of the molecular mechanisms underlying obstetric diseases means that it is likely to have a role to play in the future. This review will discuss how gene therapy works, its potential application in obstetric conditions and the risks and limitations associated with its use in this setting. It will also address the ethical and regulatory issues that will be faced by any potential clinical trial of gene therapy during pregnancy.","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"25 1","pages":"147-177"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0965539515000030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56979339","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 : 2014-11-01DOI: 10.1017/S0965539515000042
Shorok Ali Al Dorazi, W. A. Talalwah
{"title":"A SYSTEMATIC REVIEW OF MATERNAL CALCIUM SUPPLEMENTATION AND PAEDIATRIC HEALTH","authors":"Shorok Ali Al Dorazi, W. A. Talalwah","doi":"10.1017/S0965539515000042","DOIUrl":"https://doi.org/10.1017/S0965539515000042","url":null,"abstract":"","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"25 1","pages":"178-196"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0965539515000042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56979446","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 : 2014-11-01DOI: 10.1017/S0965539516000073
A. Kaul, B. Thilaganathan, T. Rahman
Physiological changes associated with pregnancy are well documented, the liver is no exception. Changes to maternal physiology during pregnancy can give rise to a change in liver function tests.
与怀孕有关的生理变化是有据可查的，肝脏也不例外。怀孕期间产妇生理的变化可引起肝功能检查的变化。
{"title":"PREGNANCY ASSOCIATED HEPATOBILIARY DYSFUNCTION","authors":"A. Kaul, B. Thilaganathan, T. Rahman","doi":"10.1017/S0965539516000073","DOIUrl":"https://doi.org/10.1017/S0965539516000073","url":null,"abstract":"Physiological changes associated with pregnancy are well documented, the liver is no exception. Changes to maternal physiology during pregnancy can give rise to a change in liver function tests.","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"25 1","pages":"318-331"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0965539516000073","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56979747","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 : 2014-11-01DOI: 10.1017/S096553951600005X
C. Aiken, J. Brockelsby
Artificial reproductive technology (ART) was first introduced to clinical practice in the late 1970s 1 and has subsequently resulted in approximately 5 million births worldwide 2 . Globally, the rates of assisted conceptions continue to rise 3 . In 2011, approximately 1.5% of all pregnancies in the US were conceived using ART 4 . Since its introduction, much interest has been generated regarding the effects of ART on the developing fetus and potential adverse impacts on the health of the mother. In particular, early studies suggested an increase in fetal genetic and structural anomalies, and a high risk of perinatal complications. As experience with pregnancies conceived using ART has increased worldwide and more data regarding the outcomes of ART-conceived pregnancies have been reported, many of the initial worries have been shown to be unfounded. However, concern still exists regarding whether any adverse fetal and maternal outcomes result from the use of this technology. Many studies have reported higher risks of fetal complications following the use of ART including an increase in perinatal mortality, even in singleton pregnancies 5,6 . However, interpretation of these data are far from simple and it is important to consider that observations of higher rates of complications do not equate to a causal relationship between adverse pregnancy outcomes and the use of ART 7 . There are multiple confounding factors that may account for these associations, many of which are difficult to control for in large-scale studies.
{"title":"FETAL AND MATERNAL CONSEQUENCES OF PREGNANCIES CONCEIVED USING ART","authors":"C. Aiken, J. Brockelsby","doi":"10.1017/S096553951600005X","DOIUrl":"https://doi.org/10.1017/S096553951600005X","url":null,"abstract":"Artificial reproductive technology (ART) was first introduced to clinical practice in the late 1970s 1 and has subsequently resulted in approximately 5 million births worldwide 2 . Globally, the rates of assisted conceptions continue to rise 3 . In 2011, approximately 1.5% of all pregnancies in the US were conceived using ART 4 . Since its introduction, much interest has been generated regarding the effects of ART on the developing fetus and potential adverse impacts on the health of the mother. In particular, early studies suggested an increase in fetal genetic and structural anomalies, and a high risk of perinatal complications. As experience with pregnancies conceived using ART has increased worldwide and more data regarding the outcomes of ART-conceived pregnancies have been reported, many of the initial worries have been shown to be unfounded. However, concern still exists regarding whether any adverse fetal and maternal outcomes result from the use of this technology. Many studies have reported higher risks of fetal complications following the use of ART including an increase in perinatal mortality, even in singleton pregnancies 5,6 . However, interpretation of these data are far from simple and it is important to consider that observations of higher rates of complications do not equate to a causal relationship between adverse pregnancy outcomes and the use of ART 7 . There are multiple confounding factors that may account for these associations, many of which are difficult to control for in large-scale studies.","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"25 1","pages":"281-294"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S096553951600005X","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56979793","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 : 2014-11-01DOI: 10.1017/S0965539516000061
S. Drury, M. Hill, L. Chitty
The ability to obtain fetal material that could be used for prenatal genetic diagnosis without requirement for an invasive test was a watershed moment in antenatal care. Cell-free fetal DNA (cffDNA) was identified in the maternal plasma by Lo and colleagues in 1997 1 and despite being technically challenging, non-invasive tests for fetal sex determination, fetal rhesus D ( RHD ) genotyping, some single gene disorders and the major aneuploidies are now being offered in clinical practice throughout the world 2 . Progress continues at pace and recent developments in next generation sequencing (NGS) are driving significant advances in research and in the clinical application of non-invasive prenatal testing (NIPT) and diagnosis (NIPD) ( Table 1 ).
{"title":"RECENT DEVELOPMENTS in NON-INVASIVE PRENATAL DIAGNOSIS and TESTING","authors":"S. Drury, M. Hill, L. Chitty","doi":"10.1017/S0965539516000061","DOIUrl":"https://doi.org/10.1017/S0965539516000061","url":null,"abstract":"The ability to obtain fetal material that could be used for prenatal genetic diagnosis without requirement for an invasive test was a watershed moment in antenatal care. Cell-free fetal DNA (cffDNA) was identified in the maternal plasma by Lo and colleagues in 1997 1 and despite being technically challenging, non-invasive tests for fetal sex determination, fetal rhesus D ( RHD ) genotyping, some single gene disorders and the major aneuploidies are now being offered in clinical practice throughout the world 2 . Progress continues at pace and recent developments in next generation sequencing (NGS) are driving significant advances in research and in the clinical application of non-invasive prenatal testing (NIPT) and diagnosis (NIPD) ( Table 1 ).","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"25 1","pages":"295-317"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0965539516000061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56979574","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 : 2014-11-01DOI: 10.1017/S0965539516000024
N. Tan, N. Jonas
{"title":"IMMEDIATE POST-NATAL AIRWAY MANAGEMENT WHERE THERE ARE ANTENATAL CONCERNS","authors":"N. Tan, N. Jonas","doi":"10.1017/S0965539516000024","DOIUrl":"https://doi.org/10.1017/S0965539516000024","url":null,"abstract":"","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"163 1","pages":"263-280"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0965539516000024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56979763","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 : 2014-11-01DOI: 10.1017/S0965539515000066
M. Vigliani, A. Bakardjiev
In this article we present a novel model for how the human placenta might get infected via the hematogenous route. We present a list of diverse placental pathogens, like Listeria monocytogenes or Cytomegalovirus, which are familiar to most obstetricians, but others, like Salmonella typhi, have only been reported in case studies or small case series. Remarkably, all of these organisms on this list are either obligate or facultative intracellular organisms. These pathogens are able to enter and survive inside host immune cells for at least a portion of their life cycle. We suggest that many blood-borne pathogens might arrive at the placenta via transportation inside of maternal leukocytes that enter the decidua in early pregnancy. We discuss mechanisms by which extravillous trophoblasts could get infected in the decidua and spread infection to other layers in the placenta. We hope to raise awareness among OB/GYN clinicians that organisms not typically associated with the TORCH list might cause placental infections and pregnancy complications.
{"title":"Intracellular Organisms as Placental Invaders.","authors":"M. Vigliani, A. Bakardjiev","doi":"10.1017/S0965539515000066","DOIUrl":"https://doi.org/10.1017/S0965539515000066","url":null,"abstract":"In this article we present a novel model for how the human placenta might get infected via the hematogenous route. We present a list of diverse placental pathogens, like Listeria monocytogenes or Cytomegalovirus, which are familiar to most obstetricians, but others, like Salmonella typhi, have only been reported in case studies or small case series. Remarkably, all of these organisms on this list are either obligate or facultative intracellular organisms. These pathogens are able to enter and survive inside host immune cells for at least a portion of their life cycle. We suggest that many blood-borne pathogens might arrive at the placenta via transportation inside of maternal leukocytes that enter the decidua in early pregnancy. We discuss mechanisms by which extravillous trophoblasts could get infected in the decidua and spread infection to other layers in the placenta. We hope to raise awareness among OB/GYN clinicians that organisms not typically associated with the TORCH list might cause placental infections and pregnancy complications.","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"25 3-4 1","pages":"332-338"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0965539515000066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56979633","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 : 2014-11-01DOI: 10.1017/S0965539515000054
A. Staelens, P. Bertrand, S. Vonck, M. Malbrain, W. Gyselaers
In a non-obstetric population, the optimization of cardiac output (CO) had been shown to improve survival and to reduce postoperative complications, organ failure and the length of stay 1 . CO monitoring might be very useful in the obstetric population as well, as physiologic changes of CO during pregnancy are mandatory for a normal outcome. An uncomplicated pregnancy is associated with a 50% increase in maternal CO, which is mediated by plasma volume expansion and a decrease in peripheral resistance 2 . An aberrant change of this maternal CO might influence pregnancy outcome: pregnancies complicated with foetal growth restriction and/or preeclampsia are characterized by increased total vascular resistance and reduced systolic function (i.e. lower CO and stroke volume (SV)) 3 – 5 .
{"title":"Non-Invasive Methods for Maternal Cardiac Output Monitoring","authors":"A. Staelens, P. Bertrand, S. Vonck, M. Malbrain, W. Gyselaers","doi":"10.1017/S0965539515000054","DOIUrl":"https://doi.org/10.1017/S0965539515000054","url":null,"abstract":"In a non-obstetric population, the optimization of cardiac output (CO) had been shown to improve survival and to reduce postoperative complications, organ failure and the length of stay 1 . CO monitoring might be very useful in the obstetric population as well, as physiologic changes of CO during pregnancy are mandatory for a normal outcome. An uncomplicated pregnancy is associated with a 50% increase in maternal CO, which is mediated by plasma volume expansion and a decrease in peripheral resistance 2 . An aberrant change of this maternal CO might influence pregnancy outcome: pregnancies complicated with foetal growth restriction and/or preeclampsia are characterized by increased total vascular resistance and reduced systolic function (i.e. lower CO and stroke volume (SV)) 3 – 5 .","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"25 1","pages":"197-213"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0965539515000054","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56979520","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 : 2014-11-01DOI: 10.1017/S0965539515000091
C. Ogilvie
The possibility of prenatal screening for genetic disorders was raised as early as the mid-1950s, and with the introduction in 1966 of amniocentesis for sampling fetal material, it became possible to identify pregnancies with trisomy 21 (Down syndrome), the most common prenatal genetic abnormality. The fetal cells in the amniotic fluid could be cultured, then harvested, followed by chromosome spreading on microscope slides. These chromosome spreads, each representing the chromosomes from a single cell nucleus, could be stained, visualised by light microscopy and counted to establish the chromosome number. However, diagnosis of Down syndrome was expensive, and in the early days of amniocentesis, there was an associated risk of miscarriage; most countries therefore recommended this procedure only for women who were identified as having a raised risk of chromosome abnormality. As it is well established that raised maternal age increases the risk of Down syndrome, amniocentesis was first offered only to women above an age cut-off (usually 35). However, although the risk to an individual woman of having a Down syndrome pregnancy is greater in this age group, the majority of Down syndrome babies are born to younger women, due to the preponderance of pregnancies in the younger group.
{"title":"FREE FETAL DNA AS A SCREENING TEST FOR ANEUPLOIDY – DOES IT ADD UP?","authors":"C. Ogilvie","doi":"10.1017/S0965539515000091","DOIUrl":"https://doi.org/10.1017/S0965539515000091","url":null,"abstract":"The possibility of prenatal screening for genetic disorders was raised as early as the mid-1950s, and with the introduction in 1966 of amniocentesis for sampling fetal material, it became possible to identify pregnancies with trisomy 21 (Down syndrome), the most common prenatal genetic abnormality. The fetal cells in the amniotic fluid could be cultured, then harvested, followed by chromosome spreading on microscope slides. These chromosome spreads, each representing the chromosomes from a single cell nucleus, could be stained, visualised by light microscopy and counted to establish the chromosome number. However, diagnosis of Down syndrome was expensive, and in the early days of amniocentesis, there was an associated risk of miscarriage; most countries therefore recommended this procedure only for women who were identified as having a raised risk of chromosome abnormality. As it is well established that raised maternal age increases the risk of Down syndrome, amniocentesis was first offered only to women above an age cut-off (usually 35). However, although the risk to an individual woman of having a Down syndrome pregnancy is greater in this age group, the majority of Down syndrome babies are born to younger women, due to the preponderance of pregnancies in the younger group.","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"25 1","pages":"339-348"},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0965539515000091","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56979713","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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