Perinatal Outcomes in Foetuses with Increased Nuchal Translucency and Normal Karyotype: A Retrospective Cohort Study from the United Arab Emirates.

This retrospective case-controlled study analysed the outcome of pregnancies with first-trimester enlarged nuchal translucency (NT) and a normal karyotype. A total of 479 pregnancies with first-trimester NT measurements were grouped as control (370 cases; normal NT) and study (109 cases; enlarged NT, ≥95th percentile; with normal karyotype). Adverse outcomes included miscarriage, intrauterine foetal death, termination of pregnancy, neonatal death, and structural/chromosomal/genetic abnormalities. The study was conducted between June 2016 and June 2022 at the Foetal Maternal Unit of Kanad Hospital, UAE. Overall, the live birth rate in the study group was significantly lower (74.3%) compared to the control (94.1%, p < 0.001). All pregnancy outcomes of this group significantly differed compared to the control. The observed miscarriage level was 9.2% (vs. 1.1%, p < 0.001), intrauterine foetal death was 2.8% (vs. 0%, p = 0.001), spontaneous preterm birthwas 11% (vs. 4.9%, p = 0.020), and termination of pregnancy was 3.7% (vs. 0%, p < 0.001). The presence of foetal abnormalities was also significantly higher in the enlarged NT group at 21% (vs. 3.3%, p < 0.001). Results indicate that enlarged NT is associated with adverse pregnancy outcomes even when the karyotype is normal. Based on these results, a comprehensive review of the guidelines for counselling and managing pregnancies with enlarged NT and a normal karyotype is recommended.

Realizing the potential of real-time clinical collaboration in maternal-fetal and obstetric medicine through WhatsApp.

BACKGROUND: This study aimed to explore the potential of using instant messaging to enhance patient-care and physician-education in obstetric medicine and maternal-fetal medicine. METHODS: This retrospective study examined real-time correspondence between a closed group of maternal-fetal medicine physicians and fellows-in-training. Correspondence was grouped into four domains. Time to obtain a response and their utility was analysed. RESULTS: Over the two-year period, 41 international members contributed 534 clinically relevant messages (291 stems and 243 responses). Of these, 33% were advice seeking, 23.4% case-sharing, 35% educational content and 8.2% miscellaneous content. The median response time was 52 min, and 53% responded in less than 60 min. At least one response in each case influenced clinical management. CONCLUSION: Instant messaging is effective for real-time clinical collaboration and could serve as an important platform for enhancing management and continuing education for obstetric medicine and maternal-fetal medicine physicians. International societies should consider exploring this avenue further.

Pregnancy and maternal outcomes in women with prior or current gastrointestinal malignancies.

OBJECTIVES: To review the fetal and maternal outcomes of women with a diagnosis of gastrointestinal (GI) cancer before or during pregnancy. METHODS: We conducted a retrospective cohort study of pregnant women referred to a single tertiary care centre with a current or previous diagnosis of GI malignancy. Maternal, obstetric, and infant data were recorded. RESULTS: We identified 18 pregnancies in 13 women. Nine women were found to have a GI malignancy during pregnancy (group 1). There was an indirect maternal death in this group in a woman with advanced gastric adenocarcinoma. Nine unique pregnancies occurred in eight women with diagnosis and management of GI malignancies before their pregnancies (group 2). CONCLUSION: GI malignancies are difficult to diagnose and manage during pregnancy and are usually advanced at the time of diagnosis. Surgery can be performed during pregnancy if necessary, with chemotherapy and radiotherapy usually deferred to the postpartum period. Women who have had a prior GI malignancy have special circumstances related to the type of surgery performed and previous exposure to chemotherapy. These patients may benefit from a multidisciplinary team effort to optimize their care.

Objectifs : Analyser les issues fœtales et maternelles des femmes ayant reçu un diagnostic de cancer gastro-intestinal (GI) avant ou pendant la grossesse. Méthodes : Nous avons mené une étude de cohorte rétrospective portant sur des femmes enceintes orientées vers un seul centre de soins tertiaire en raison d'un diagnostic actuel ou précédent de tumeur maligne GI. Les données maternelles, obstétricales et infantiles ont été consignées. Résultats : Nous avons identifié 18 grossesses chez 13 femmes. Une tumeur maligne GI a été constatée chez neuf de ces femmes pendant la grossesse (groupe 1). Un décès maternel indirect a été signalé dans ce groupe chez une femme présentant un adénocarcinome gastrique avancé. Neuf grossesses uniques ont été constatées chez huit femmes ayant obtenu un diagnostic de tumeur maligne GI et ayant fait l'objet d'une prise en charge avant la grossesse (groupe 2). Conclusion : Les tumeurs malignes GI sont difficiles à diagnostiquer et à prendre en charge pendant la grossesse, et se trouvent habituellement à un stade avancé au moment du diagnostic. Une chirurgie peut être menée pendant la grossesse, au besoin, les traitements de chimiothérapie et de radiothérapie étant habituellement reportés à la période postpartum. Les femmes ayant déjà présenté une tumeur maligne GI comptent des circonstances particulières liées au type de la chirurgie dont elles ont fait l'objet et à leur exposition précédente à la chimiothérapie. Ces patientes pourraient tirer avantage d'une approche d'équipe multidisciplinaire pour optimiser les soins qu'elles reçoivent.