7 results found
Mylrea-Foley B, Arabin B, Bergman E, et al., 2021, Perinatal and 2 year neurodevelopmental outcome in late preterm fetal compromise, BMJ Open, ISSN: 2044-6055
Mylrea-Foley B, Lees C, 2021, Clinical monitoring of late fetal growth restriction, MINERVA OBSTETRICS AND GYNECOLOGY, Vol: 73, Pages: 462-470, ISSN: 2724-606X
Stampalija T, Thornton J, Marlow N, et al., 2020, Fetal cerebral Doppler changes and outcome in late preterm fetal growth restriction: prospective cohort study, Ultrasound in Obstetrics and Gynecology, Vol: 56, Pages: 173-181, ISSN: 0960-7692
ObjectivesTo explore the association between fetal umbilical and middle cerebral artery (MCA) Doppler abnormalities and outcome in late preterm pregnancies at risk of fetal growth restriction.MethodsThis was a prospective cohort study of singleton pregnancies at risk of fetal growth restriction at 32 + 0 to 36 + 6 weeks of gestation, enrolled in 33 European centers between 2017 and 2018, in which umbilical and fetal MCA Doppler velocimetry was performed. Pregnancies were considered at risk of fetal growth restriction if they had estimated fetal weight and/or abdominal circumference (AC) < 10th percentile, abnormal arterial Doppler and/or a fall in AC growth velocity of more than 40 percentile points from the 20‐week scan. Composite adverse outcome comprised both immediate adverse birth outcome and major neonatal morbidity. Using a range of cut‐off values, the association of MCA pulsatility index and umbilicocerebral ratio (UCR) with composite adverse outcome was explored.ResultsThe study population comprised 856 women. There were two (0.2%) intrauterine deaths. Median gestational age at delivery was 38 (interquartile range (IQR), 37–39) weeks and birth weight was 2478 (IQR, 2140–2790) g. Compared with infants with normal outcome, those with composite adverse outcome (n = 93; 11%) were delivered at an earlier gestational age (36 vs 38 weeks) and had a lower birth weight (1900 vs 2540 g). The first Doppler observation of MCA pulsatility index < 5th percentile and UCR Z‐score above gestational‐age‐specific thresholds (1.5 at 32–33 weeks and 1.0 at 34–36 weeks) had the highest relative risks (RR) for composite adverse outcome (RR 2.2 (95% CI, 1.5–3.2) and RR 2.0 (95% CI, 1.4–3.0), respectively). After adjustment for confounders, the association between UCR Z‐score and composite adverse outcome remained significa
Mylrea-Foley B, Bhide A, Mullins E, et al., 2020, Building consensus: thresholds for delivery in the TRUFFLE 2 randomized intervention study., Ultrasound in Obstetrics and Gynecology, Vol: 56, Pages: 285-287, ISSN: 0960-7692
MylreaFoley B, Shaw CJ, Harikumar N, et al., 2019, Early‐onset twin–twin transfusion syndrome: case series and systematic review, Australasian Journal of Ultrasound in Medicine, Vol: 22, Pages: 286-294, ISSN: 1836-6864
IntroductionData on the outcomes of early‐onset twin–twin transfusion syndrome (TTTS), diagnosed before 18 weeks gestational age (GA), are sparse. We aimed to review the diagnosis, management and outcomes of early‐onset TTTS.Material and methodsPregnancy records at a single referral unit 2010‐6 were reviewed. In early‐onset TTTS cases, data for pregnancy characteristics, interventions and outcomes were collected. PubMed and Scopus databases were searched for studies including pregnant women with early‐onset TTTS. The primary outcome measure was livebirths.ResultsCase series: 58 cases of early‐onset TTTS 2010‐6, with full outcome data in 44. Diagnostic criteria were variable. Median GA at intervention was 17+4 (range 15+0‐28+1); 67% of patients had laser therapy (39/58). Overall survival: 60% (53/88). At least one livebirth: 86% (38/44), Two livebirths: 34% (15/44); No survivors: 14% (6/44). GA at delivery was 32+1.5 (range 16+2‐37+4). Systematic review: 16 studies included (n = 171 pregnancies). Diagnostic criteria varied widely: 79% of studies used Quintero staging. Most offered laser (89%) at median 17+0 weeks (range 16+0‐21+6). GA at delivery was 23+0‐39+5 weeks. Overall survival: 69% (129/186). At least one livebirth: 74% (127/171). Two livebirths: 59% (55/93). No survivors: 26% (44/171).ConclusionsIn comparison with the commonly accepted overall survival for TTTS treated after 18 weeks of 60–90%, outcomes in early‐onset TTTS were at the lower bound of this range. Gestational age at intervention is similar to that of later onset TTTS, indicating a lack of therapeutic options when a diagnosis is made before 18 weeks.
Mylrea-Lowndes B, Harikumar N, Shaw C, et al., 2017, OP26.02 A systematic review of diagnosis, management and outcomes for twin-twin transfusion syndrome (TTTS) diagnosed before 18 weeks' gestation, ISUOG World Congress 2017, Publisher: Wiley, Pages: 132-132, ISSN: 0960-7692
Mylrea-Lowndes B, Legg S, Shaw C, et al., 2017, OP26.01 A case series of the characteristics, course and outcomes for twin-twin transfusion syndrome (TTTS) diagnosed before 18 weeks' gestation, ISUOG World Congress 2017, Publisher: Wiley, Pages: 132-132, ISSN: 0960-7692
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