Showing papers by "Elisenda Eixarch published in 2007"
TL;DR: The association between smallness for gestational age (SGA) and perinatal morbidity was stronger when birthweight limits were customised, and resulted in an additional 4.1% neonates being classified as SGA.
Abstract: Objective: Fetal growth restriction is associated with adverse perinatal outcome but is often not recognised antenatally, and low birthweight centiles based on population norms are used as a proxy instead. This study compared the association between neonatal morbidity and fetal growth status at birth as determined by customised birthweight centiles and currently used centiles based on population standards. Design: Retrospective cohort study. Setting: Referral hospital, Barcelona, Spain. Patients: A cohort of 13 661 non-malformed singleton deliveries. Interventions: Both population-based and customised standards for birth weight were applied to the study cohort. Customised weight centiles were calculated by adjusting for maternal height, booking weight, parity, ethnic origin, gestational age at delivery and fetal sex. Main outcome measures: Newborn morbidity and perinatal death. Results: The association between smallness for gestational age (SGA) and perinatal morbidity was stronger when birthweight limits were customised, and resulted in an additional 4.1% (n = 565) neonates being classified as SGA. Compared with non-SGA neonates, this newly identified group had an increased risk of perinatal mortality (OR 3.2; 95% CI 1.6 to 6.2), neurological morbidity (OR 3.2; 95% CI 1.7 to 6.1) and non-neurological morbidity (OR 8; 95% CI 4.8 to 13.6). Conclusion: Customised standards improve the prediction of adverse neonatal outcome. The association between SGA and adverse outcome is independent of the gestational age at delivery.
135 citations
TL;DR: Isolated hemivertebra(e) with an intact neural tube might be associated with a good postnatal outcome, and Associated anomalies are frequent but prenatal ultrasonography was accurate in identifying them.
Abstract: fetuses was found to have a chromosomal aberration. 3D evaluation of the fetal spine was performed in all cases, and it did not add significant information to the 2D examination. Conclusions: Isolated hemivertebra(e) with an intact neural tube might be associated with a good postnatal outcome. Associated anomalies are frequent but, in our experience, prenatal ultrasonography was accurate in identifying them.
3 citations
2 citations
TL;DR: This study shows that UVVF R/D imbalance occurs in cases with the polyhydramnios and oligohydramsnios sequence found in TTTS, and that normal monochorionic pregnancies lack this imbalance.
Abstract: Objectives: Umbilical vein volume flow (UVVF), calculated as velocity (cm/s) times transversal section area at the straight portion of the intra-abdominal umbilical vein (cm2), is an interesting parameter to study in twin–twin transfusion syndrome (TTTS). Recipients were found to have 2 to 3 times higher UVVF than donors, but this parameter was not studied in normal monochorionic pregnancies. Methods: Comparison of recipient to donor (rec/don) UVVF ratio and bigger-to-smaller UVVF ratio in non-TTTS monochorionic twin pregnancies (control group). The method of dividing the same parameter from each pair of twins aimed to emulate other factors such as gestational age and maternal condition, which change between pregnancies. The control group consisted of monochorionic twin pregnancies with normal umbilical artery Doppler and normal amniotic fluid (2 to 8 cm of MVP), between 18 and 26 weeks. Results: Eight-four TTTS and 24 normal monochorionic twin pregnancies were compared. The median weight discordance was 1.3 (rec/don) and 1.2 respectively (big/small, Wilcoxon P < 0.7). The UVVF ratio between recipients and donors (UVVF R/D) was greater than that of the bigger to smaller UVVF ratio from normal monochorionic twins (medians 2.2 and 1.3, Wilcoxon P < 0.001). Conclusions: This study shows that UVVF R/D imbalance occurs in cases with the polyhydramnios and oligohydramnios sequence found in TTTS, and that normal monchorionic pregnancies lack this imbalance. The difference is not due to fetal weight discordance as it was shown that normal monochorionic twins had similar discordance. The parameter has still not proven to be useful in screening for early diagnosis by this methodology, but it describes that UVVF imbalance between twins does not exist in normal monochorionic pregnancies. OP10.02 The CHOP cardiovascular score: a method for quantification of cardiovascular abnormality in the twin–twin transfusion syndrome
1 citations
TL;DR: The associations with adverse outcomes were assessed for small-for-gestational age babies who had normal and abnormal Doppler, compared with neonates who were not small for gestational age.
Abstract: A cohort was created of 7645 singleton pregnancieswithout congenital anomalies. Fetuses suspected antenatally ofbeing small for gestational age were referred for assessment byumbilical artery Doppler. The associations with adverse outcomewere assessed for small-for-gestational age babies who had normaland abnormal Doppler, compared withneonates whowerenotsmallfor gestational age. Perinatal outcome indicators were collected,including fetal distress requiring Cesarean section and neonatalmorbidity (neonatal intensive care
1 citations