Cic edizioni internazionali
Journal of Prenatal Medicine

Congenital cervical teratoma in association with neuronal migration disorder

Review article, 1 - 7
doi: 10.11138/jpm/2017.11.1.001
Tag this article
Enhanced HTML Full text PDF
Congenital cervical teratoma is a rare congenital malformation with an estimated incidence of one in 20,000-40,000 live births. Due to its mass effect it has a potential to cause significant fetal airway obstruction, while its hyper-vascularity may result in fetal heart failure and hydrops fetalis. An association with intracranial abnormalities has been previously described but is extremely rare and no cases of postnatal survival have previously been reported. In this study we report the first case of congenital cervical teratoma with neuronal migration disorder in a live-born infant and the role of in-utero cyst drainage as an airway salvage intervention.
We also present a literature review on etiology, diagnosis, management options and prognosis of congenital cervical teratoma with and without intracranial abnormalities.

The cervical length correlates with the amount of bleeding during cesarean section of the pernicious placenta previa

Original Article, 8 - 13
doi: 10.11138/jpm/2017.11.1.008
Tag this article
Enhanced HTML Full text PDF
Introduction: to investigate the association between the amount of bleeding during a cesarean section and the effacement of the uterine cervix in patients with pernicious placenta previa.
Methods: this study reviewed 50 singleton pregnancies with pernicious placenta previa. In cases of pernicious placenta previa, the cervical length were retrospectively measured and compared with the amount of bleeding during the cesarean section.
Results: there was a significantly negative correlation between the amount of bleeding and cervical length (r = -0.390, P =0.005). The threshold cervical length associated with massive bleeding (>2500 mL) was 34.5mm, based on an ROC curve.
Then, all cases were stratified by cervical length, ≤34.5mm was defined as Group S, and 34.5 mm as Group L. The amount of bleeding in Group S was significantly larger than in Group L, and the length of hospital stay was longer in Group S. It was also found that hysterectomy after CS was significantly higher in Group S than in Group L. However, there were no significant differences in any of the other maternal demographics between the two groups.
Conclusion: this study demonstrated that a short cervical length, in cases with pernicious placenta previa, was associated with massive bleeding during the operation. In addition, short cervical length seems to be one of the warning signs for massive bleeding and cesarean hysterectomy during the operation for pernicious placenta previa.

Association between echogenic intracardiac focus in first trimester and biochemical screeningan analysis

Original Article, 14 - 17
doi: 10.11138/jpm/2017.11.1.014
Tag this article
Enhanced HTML Full text PDF
Introduction: to analyze the relation between presence of EIF in the first trimester, nuchal translucency (NT) and combined biochemical screening.
Methods: a total of 1245 viable low-risk singleton pregnancies was scanned from 11 to 14 weeks gestation. The presence of echogenic intracardiac focus (EIF) in the fetal heart was noted. The ultrasonography was performed by a Fetal Medicine Foundation (FMF) accredited Fetal Medicine Consultant, using recommended guidelines transabdominally and transvaginally when required, by Voluson E6 (GE Healthcare, Kretztechnik, Zipf, Austria). Patients were assessed for the estimated risk of aneuploidy based on their combined first trimester screening report, that included Maternal serum Beta HCG, PAPP-A and nuchal translucency (NT) scan using LifeCycle software.
Nasal bone was not included for calculation of risk. An analysis was then performed between the presence of EIF, combined first trimester screening and NT scan reports.
Results: in 26 patients among the 1245, echo - genic intracardiac focus was identified. Ductus venosus and tricuspid flow was assessed and were found to be normal.The biochemical screening for all patients were screen-negative. NT value of the EIF and combined first trimester screening fetuses were retrospectively analyzed.
Taking this into consideration, all the fetuses identified with EIF, were observed to fall under low-risk category.
Conclusion: presence of EIF in the first trimester does not necessarily mean increased risk for aneuploidy. Larger multivariate studies incorporating ultrasound soft markers identified in first trimester scan in detecting aneuploidy will assist physicians in adequate counseling of mothers and thus help in better guidance and management.