Publications
396 results found
Khalil A, Samara A, O'Brien P, et al., 2022, Monkeypox and pregnancy: what do obstetricians need to know?, ULTRASOUND IN OBSTETRICS & GYNECOLOGY, Vol: 60, Pages: 22-27, ISSN: 0960-7692
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- Citations: 25
Masini G, Foo LF, Tay J, et al., 2022, Reply: Preeclampsia has 2 phenotypes that require different treatment strategies, AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, Vol: 227, Pages: 114-115, ISSN: 0002-9378
Chuang M-T, Tsai P-Y, 2022, Optimizing the strategy of antenatal corticosteroids in threatened preterm labor, AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, Vol: 227, Pages: 116-+, ISSN: 0002-9378
Vieira MC, Relph S, Muruet-Gutierrez W, et al., 2022, Evaluation of the Growth Assessment Protocol (GAP) for antenatal detection of small for gestational age: The DESiGN cluster randomised trial, PLoS Medicine, Vol: 19, ISSN: 1549-1277
BACKGROUND: Antenatal detection and management of small for gestational age (SGA) is a strategy to reduce stillbirth. Large observational studies provide conflicting results on the effect of the Growth Assessment Protocol (GAP) in relation to detection of SGA and reduction of stillbirth; to the best of our knowledge, there are no reported randomised control trials. Our aim was to determine if GAP improves antenatal detection of SGA compared to standard care. METHODS AND FINDINGS: This was a pragmatic, superiority, 2-arm, parallel group, open, cluster randomised control trial. Maternity units in England were eligible to participate in the study, except if they had already implemented GAP. All women who gave birth in participating clusters (maternity units) during the year prior to randomisation and during the trial (November 2016 to February 2019) were included. Multiple pregnancies, fetal abnormalities or births before 24+1 weeks were excluded. Clusters were randomised to immediate implementation of GAP, an antenatal care package aimed at improving detection of SGA as a means to reduce the rate of stillbirth, or to standard care. Randomisation by random permutation was stratified by time of study inclusion and cluster size. Data were obtained from hospital electronic records for 12 months prerandomisation, the washout period (interval between randomisation and data collection of outcomes), and the outcome period (last 6 months of the study). The primary outcome was ultrasound detection of SGA (estimated fetal weight <10th centile using customised centiles (intervention) or Hadlock centiles (standard care)) confirmed at birth (birthweight <10th centile by both customised and population centiles). Secondary outcomes were maternal and neonatal outcomes, including induction of labour, gestational age at delivery, mode of birth, neonatal morbidity, and stillbirth/perinatal mortality. A 2-stage cluster-summary statistical approach calculated the absolute difference
Smith ER, Oakley E, He S, et al., 2022, Protocol for a sequential, prospective meta-analysis to describe coronavirus disease 2019 (COVID-19) in the pregnancy and postpartum periods, PLoS One, Vol: 17, ISSN: 1932-6203
We urgently need answers to basic epidemiological questions regarding SARS-CoV-2 infection in pregnant and postpartum women and its effect on their newborns. While many national registries, health facilities, and research groups are collecting relevant data, we need a collaborative and methodologically rigorous approach to better combine these data and address knowledge gaps, especially those related to rare outcomes. We propose that using a sequential, prospective meta-analysis (PMA) is the best approach to generate data for policy- and practice-oriented guidelines. As the pandemic evolves, additional studies identified retrospectively by the steering committee or through living systematic reviews will be invited to participate in this PMA. Investigators can contribute to the PMA by either submitting individual patient data or running standardized code to generate aggregate data estimates. For the primary analysis, we will pool data using two-stage meta-analysis methods. The meta-analyses will be updated as additional data accrue in each contributing study and as additional studies meet study-specific time or data accrual thresholds for sharing. At the time of publication, investigators of 25 studies, including more than 76,000 pregnancies, in 41 countries had agreed to share data for this analysis. Among the included studies, 12 have a contemporaneous comparison group of pregnancies without COVID-19, and four studies include a comparison group of non-pregnant women of reproductive age with COVID-19. Protocols and updates will be maintained publicly. Results will be shared with key stakeholders, including the World Health Organization (WHO) Maternal, Newborn, Child, and Adolescent Health (MNCAH) Research Working Group. Data contributors will share results with local stakeholders. Scientific publications will be published in open-access journals on an ongoing basis.
Gyselaers W, Lees C, 2022, Maternal Low Volume Circulation Relates to Normotensive and Preeclamptic Fetal Growth Restriction, FRONTIERS IN MEDICINE, Vol: 9
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Mylrea-Foley B, Thornton JG, Mullins E, et al., 2022, Perinatal and 2-year neurodevelopmental outcome in late preterm fetal compromise: the TRUFFLE 2 randomised trial protocol, BMJ Open, Vol: 12, Pages: 1-8, ISSN: 2044-6055
Introduction Following the detection of fetal growth restriction, there is no consensus about the criteria that should trigger delivery in the late preterm period. The consequences of inappropriate early or late delivery are potentially important yet practice varies widely around the world, with abnormal findings from fetal heart rate monitoring invariably leading to delivery. Indices derived from fetal cerebral Doppler examination may guide such decisions although there are few studies in this area. We propose a randomised, controlled trial to establish the optimum method of timing delivery between 32 weeks and 36 weeks 6 days of gestation. We hypothesise that delivery on evidence of cerebral blood flow redistribution reduces a composite of perinatal poor outcome, death and short-term hypoxia-related morbidity, with no worsening of neurodevelopmental outcome at 2 years.Methods and analysis Women with non-anomalous singleton pregnancies 32+0 to 36+6 weeks of gestation in whom the estimated fetal weight or abdominal circumference is <10th percentile or has decreased by 50 percentiles since 18–32 weeks will be included for observational data collection. Participants will be randomised if cerebral blood flow redistribution is identified, based on umbilical to middle cerebral artery pulsatility index ratio values. Computerised cardiotocography (cCTG) must show normal fetal heart rate short term variation (≥4.5 msec) and absence of decelerations at randomisation. Randomisation will be 1:1 to immediate delivery or delayed delivery (based on cCTG abnormalities or other worsening fetal condition). The primary outcome is poor condition at birth and/or fetal or neonatal death and/or major neonatal morbidity, the secondary non-inferiority outcome is 2-year infant general health and neurodevelopmental outcome based on the Parent Report of Children’s Abilities-Revised questionnaire.Ethics and dissemination The Study Coordination Centre has obtaine
Salvesen K, Ter Haar G, Miloro P, et al., 2022, ISUOG Safety Committee updated recommendation on use of respirators by practitioners undertaking obstetric and gynecological ultrasound in context of SARS-CoV-2 Omicron variant of concern, Ultrasound in Obstetrics and Gynecology, Vol: 59, Pages: 411-411, ISSN: 0960-7692
Lees CC, Romero R, Stampalija T, et al., 2022, Clinical Opinion: The diagnosis and management of suspected fetal growth restriction: an evidence-based approach, American Journal of Obstetrics and Gynecology, Vol: 226, Pages: 366-378, ISSN: 0002-9378
This study reviewed the literature about the diagnosis, antepartum surveillance, and time of delivery of fetuses suspected to be small for gestational age or growth restricted. Several guidelines have been issued by major professional organizations, including the International Society of Ultrasound in Obstetrics and Gynecology and the Society for Maternal-Fetal Medicine. The differences in recommendations, in particular about Doppler velocimetry of the ductus venosus and middle cerebral artery, have created confusion among clinicians, and this review has intended to clarify and highlight the available evidence that is pertinent to clinical management. A fetus who is small for gestational age is frequently defined as one with an estimated fetal weight of <10th percentile. This condition has been considered syndromic and has been frequently attributed to fetal growth restriction, a constitutionally small fetus, congenital infections, chromosomal abnormalities, or genetic conditions. Small for gestational age is not synonymous with fetal growth restriction, which is defined by deceleration of fetal growth determined by a change in fetal growth velocity. An abnormal umbilical artery Doppler pulsatility index reflects an increased impedance to flow in the umbilical circulation and is considered to be an indicator of placental disease. The combined finding of an estimated fetal weight of <10th percentile and abnormal umbilical artery Doppler velocimetry has been widely accepted as indicative of fetal growth restriction. Clinical studies have shown that the gestational age at diagnosis can be used to subclassify suspected fetal growth restriction into early and late, depending on whether the condition is diagnosed before or after 32 weeks of gestation. The early type is associated with umbilical artery Doppler abnormalities, whereas the late type is often associated with a low pulsatility index in the middle cerebral artery. A large randomized clinical trial indicate
Srinivasan D, Shaw CJ, Dall'Asta A, et al., 2022, Expert opinion: Stepwise ultrasound assessment of suspected placenta accreta spectrum using 2D, Doppler and 3D imaging, EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY, Vol: 270, Pages: 181-189, ISSN: 0301-2115
Bourne T, Kyriacou C, Shah H, et al., 2022, The experiences and wellbeing of healthcare professionals working in the field of ultrasound in Obstetrics and Gynecology as the SARS-CoV-2 pandemic was evolving: a cross-sectional survey study, BMJ Open, Vol: 12, Pages: 1-12, ISSN: 2044-6055
Objectives: Assess experience of healthcare professionals (HCPs) working with ultrasound in Obstetrics and Gynecology during the evolving SARS-CoV-2 pandemic given the new and unprecedented challenges involving viral exposure, personal protective equipment (PPE) and wellbeing.Design: Prospective cross-sectional survey study.Setting: Online international survey. Single-best, open box and Hospital and Anxiety Depression Scale (HADS) questions.Participants: The survey was sent to 35,509 HCPs in 124 countries and was open from 7th-21st May 2020. 2237/3237 (69.1%) HCPs from 115 countries who consented to participate completed the survey. 1058 (47.3%) completed the HADS. Primary outcome measures: Overall prevalence of SARS-CoV-2, depression and anxiety amongst HCPs in relation to country and PPE availability.Analyses: Univariate analyses were used to investigate associations without generating erroneous causal conclusions.Results: Confirmed/suspected SARS-CoV-2 prevalence was 13.0%. PPE provision concerns were raised by 74.1% of participants; highest amongst trainees/resident physicians (83.9%), and amongst HCPs in Spain (89.7%). Most participants worked in self-perceived high-risk areas for SARS-CoV-2 (67.5-87.0%), with proportionately more trainees interacting with suspected/confirmed infected patients (57.1% versus 24.2-40.6%) and sonographers seeing more patients who did not wear a mask (33.3% versus 13.9-7.9%). The most frequent PPE combination used were gloves and a surgical mask (22.3%). UK and US respondents reported spending less time self-isolating (8.8 days) and lower satisfaction with their national pandemic response (37.0-43.0%). 19.8% and 8.8% of respondents met the criteria for moderate to severe anxiety and depression respectively. Conclusions: Reported SARS-CoV-2 HCP prevalence is consistent with literature findings. Most respondents used gloves and a surgical mask, with a greater SARS-CoV-2 prevalence compared with those using ‘full’ PPE. HCP
Masini G, Foo LF, Tay J, et al., 2022, Preeclampsia has two phenotypes which require different treatment strategies, American Journal of Obstetrics and Gynecology, Vol: 226, Pages: S1006-S1018, ISSN: 0002-9378
The opinion on the mechanisms underlying the pathogenesis of preeclampsia still divides scientists and clinicians. This common complication of pregnancy has long been viewed as a disorder linked primarily to placental dysfunction, which is caused by abnormal trophoblast invasion, however, evidence from the previous two decades has triggered and supported a major shift in viewing preeclampsia as a condition that is caused by inherent maternal cardiovascular dysfunction, perhaps entirely independent of the placenta. In fact, abnormalities in the arterial and cardiac functions are evident from the early subclinical stages of preeclampsia and even before conception. Moving away from simply observing the peripheral blood pressure changes, studies on the central hemodynamics reveal two different mechanisms of cardiovascular dysfunction thought to be reflective of the early-onset and late-onset phenotypes of preeclampsia. More recent evidence identified that the underlying cardiovascular dysfunction in these phenotypes can be categorized according to the presence of coexisting fetal growth restriction instead of according to the gestational period at onset, the former being far more common at early gestational ages. The purpose of this review is to summarize the hemodynamic research observations for the two phenotypes of preeclampsia. We delineate the physiological hemodynamic changes that occur in normal pregnancy and those that are observed with the pathologic processes associated with preeclampsia. From this, we propose how the two phenotypes of preeclampsia could be managed to mitigate or redress the hemodynamic dysfunction, and we consider the implications for future research based on the current evidence. Maternal hemodynamic modifications throughout pregnancy can be recorded with simple-to-use, noninvasive devices in obstetrical settings, which require only basic training. This review includes a brief overview of the methodologies and techniques used to study hemody
Ghi T, Conversano F, Zegarra RR, et al., 2022, Novel artificial intelligence approach for automatic differentiation of fetal occiput anterior and non-occiput anterior positions during labor, ULTRASOUND IN OBSTETRICS & GYNECOLOGY, Vol: 59, Pages: 93-99, ISSN: 0960-7692
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- Citations: 6
Di Mascio D, Khalil A, Pilu G, et al., 2021, Role of prenatal magnetic resonance imaging in fetuses with isolated severe ventriculomegaly at neurosonography: A multicenter study, EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY, Vol: 267, Pages: 105-110, ISSN: 0301-2115
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- Citations: 8
Mylrea-Foley B, Wolf H, Stampalija T, et al., 2021, Longitudinal Doppler Assessments in Late Preterm Fetal Growth Restriction, ULTRASCHALL IN DER MEDIZIN, ISSN: 0172-4614
Wolf H, Stampalija T, Lees CC, et al., 2021, Fetal cerebral blood-flow redistribution: analysis of Doppler reference charts and association of different thresholds with adverse perinatal outcome, Ultrasound in Obstetrics and Gynecology, Vol: 58, Pages: 705-715, ISSN: 0960-7692
ObjectivesFirst, to compare published Doppler reference charts of the ratios of flow in the fetal middle cerebral and umbilical arteries (i.e. the cerebroplacental ratio (CPR) and umbilicocerebral ratio (UCR)). Second, to assess the association of thresholds of CPR and UCR based on these charts with short-term composite adverse perinatal outcome in a cohort of pregnancies considered to be at risk of late preterm fetal growth restriction.MethodsStudies presenting reference charts for CPR or UCR were searched for in PubMed. Formulae for plotting the median and the 10th percentile (for CPR) or the 90th percentile (for UCR) against gestational age were extracted from the publication or calculated from the published tables. Data from a prospective European multicenter observational cohort study of singleton pregnancies at risk of fetal growth restriction at 32 + 0 to 36 + 6 weeks' gestation, in which fetal arterial Doppler measurements were collected longitudinally, were used to compare the different charts. Specifically, the association of UCR and CPR thresholds (CPR < 10th percentile or UCR ≥ 90th percentile and multiples of the median (MoM) values) with composite adverse perinatal outcome was analyzed. The association was also compared between chart-based thresholds and absolute thresholds. Composite adverse perinatal outcome comprised both abnormal condition at birth and major neonatal morbidity.ResultsTen studies presenting reference charts for CPR or UCR were retrieved. There were large differences between the charts in the 10th and 90th percentile values of CPR and UCR, respectively, while median values were more similar. In the gestational-age range of 28–36 weeks, there was no relationship between UCR or CPR and gestational age. From the prospective observational study, 856 pregnancies at risk of late-onset preterm fetal growth restriction were included in the analysis. The association of abnorm
Girardelli S, Mullins E, Lees CC, 2021, COVID-19 and pregnancy: Lessons from 2020, Early Human Development, Vol: 162, Pages: 1-6, ISSN: 0378-3782
The outbreak and spread of the coronavirus disease 2019 pandemic has led to an unprecedented wealth of literature on the impact of human coronaviruses on pregnancy. The number of case studies and publications alone are several orders of magnitude larger than those published in all previous human coronavirus outbreaks combined, enabling robust conclusions to be drawn from observations for the first time. However, the importance of learning from previous human coronavirus outbreaks cannot be understated. In this narrative review, we describe what we consider to the major learning points arising from the SARS-CoV-2 pandemic in relation to pregnancy, and where these confound what might have been expected from previous coronavirus outbreaks.
Hassan WA, Taylor S, Lees C, 2021, Intrapartum ultrasound for assessment of cervical dilatation., Am J Obstet Gynecol MFM, Vol: 3
Assessment of cervical dilatation by digital vaginal examination is commonly used during labor as one of the main indicators of labor progress. Despite consistent inaccuracies, this practice remains widely chosen among midwives and obstetricians. Several methods, including electromechanical and electromagnetic devices, have been trialed throughout the decades without being able to provide objective means of obtaining accurate measurements of cervical dilatation during labor. Intrapartum ultrasound in the form of transperineal or translabial applications has shown promising results in the assessment and monitoring of labor progress. Here, we described the validity of intrapartum ultrasound and its usefulness in the assessment of cervical dilatation during labor. Moreover, we highlighted the feasibility of ultrasound in obtaining these assessments.
Spencer RN, Hecher K, Norman G, et al., 2021, Development of standard definitions and grading for Maternal and Fetal Adverse Event Terminology, Prenatal Diagnosis, Vol: 42, Pages: 15-26, ISSN: 0197-3851
ObjectiveAdverse event (AE) monitoring is central to assessing therapeutic safety. The lack of a comprehensive framework to define and grade maternal and fetal AEs in pregnancy trials severely limits understanding risks in pregnant women. We created AE terminology to improve safety monitoring for developing pregnancy drugs, devices and interventions.MethodExisting severity grading for pregnant AEs and definitions/indicators of ‘severe’ and ‘life-threatening’ conditions relevant to maternal and fetal clinical trials were identified through a literature search. An international multidisciplinary group identified and filled gaps in definitions and severity grading using Medical Dictionary for Regulatory Activities (MedDRA) terms and severity grading criteria based on Common Terminology Criteria for Adverse Event (CTCAE) generic structure. The draft criteria underwent two rounds of a modified Delphi process with international fetal therapy, obstetric, neonatal, industry experts, patients and patient representatives.ResultsFetal AEs were defined as being diagnosable in utero with potential to harm the fetus, and were integrated into MedDRA. AE severity was graded independently for the pregnant woman and her fetus. Maternal (n = 12) and fetal (n = 19) AE definitions and severity grading criteria were developed and ratified by consensus.ConclusionsThis Maternal and Fetal AE Terminology version 1.0 allows systematic consistent AE assessment in pregnancy trials to improve safety.
Israfil-Bayli F, Morton VH, Hewitt CA, et al., 2021, C-STICH: Cerclage Suture Type for an Insufficient Cervix and its effect on Health outcomes-a multicentre randomised controlled trial, Trials, Vol: 22, ISSN: 1745-6215
BackgroundPreterm birth is associated with significant mortality and morbidity for mothers and babies. Women are identified as high risk for preterm birth based on either previous medical/pregnancy history or on ultrasound assessment of the cervix. Women identified as high risk can be offered a cervical cerclage (a purse string stitch) around the cervix (neck of the womb) to reduce the risk of preterm birth. In women who have a cervical cerclage, the procedure can be performed using either a monofilament (single-stranded) or braided (woven) suture material. Both suture materials are routinely used for cervical cerclage and there is uncertainty as to which is superior.MethodsA multicentre, open, randomised controlled superiority trial of 2050 women presenting at obstetric units, deemed to be at risk of preterm birth and already scheduled to have a cervical cerclage as part of their standard care. Inclusion criteria include singleton pregnancies and an indication for cervical cerclage for either a history of three or more previous mid-trimester losses or premature births (≤ 28 weeks), insertion of cervical sutures in previous pregnancies, a history of mid trimester loss or premature birth with a (current) shortened (≤ 25 mm) cervix, or women whom clinicians deem to be at risk of preterm birth either by history or the results of an ultrasound scan. Exclusion criteria include women who have taken part in C-STICH previously, are aged less than 18 years old at the time of presentation, require a rescue cerclage, and are unwilling or unable to give informed consent and in whom a cerclage will be placed by any route other than vaginally (e.g. via an abdominal route). Following informed consent, women are randomised on a 1:1 basis to either monofilament or braided suture, by minimisation. The primary outcome is pregnancy loss (miscarriage and perinatal mortality, including any stillbirth or neonatal death in the first week of life), and secondary outcomes include the c
Lees C, Stampalija T, Hecher K, 2021, Re: Outcome-based comparison of SMFM and ISUOG definitions of fetal growth restriction, ULTRASOUND IN OBSTETRICS & GYNECOLOGY, Vol: 58, Pages: 493-+, ISSN: 0960-7692
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- Citations: 1
Shaw CJ, Paramasivam G, Vacca C, et al., 2021, Expectant management versus multifetal pregnancy reduction in dichorionic triamniotic (DCTA) triplets: Single centre experience, EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY, Vol: 264, Pages: 200-205, ISSN: 0301-2115
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- Citations: 4
Sande R, Jenderka K-V, Moran CM, et al., 2021, Safety Aspects of Perinatal Ultrasound., Ultraschall Med
Ultrasound safety is of particular importance in fetal and neonatal scanning. Fetal tissues are vulnerable and often still developing, the scanning depth may be low, and potential biological effects have been insufficiently investigated. On the other hand, the clinical benefit may be considerable. The perinatal period is probably less vulnerable than the first and second trimesters of pregnancy, and ultrasound is often a safer alternative to other diagnostic imaging modalities. Here we present step-by-step procedures for obtaining clinically relevant images while maintaining ultrasound safety. We briefly discuss the current status of the field of ultrasound safety, with special attention to the safety of novel modalities, safety considerations when ultrasound is employed for research and education, and ultrasound of particularly vulnerable tissues, such as the neonatal lung. This CME is prepared by ECMUS, the safety committee of EFSUMB, with contributions from OB/GYN clinicians with a special interest in ultrasound safety.
Kyriacou C, Roper L, Mappouridou S, et al., 2021, Contemporary experience of polyhydramnios: a single-centre experience, Australasian Journal of Ultrasound Medicine, Vol: 24, Pages: 137-142, ISSN: 1441-6891
Introduction: Polyhydramnios is common; the majority of cases are idiopathic, but maybe associated with fetal abnormality. Literature suggests the volume of amniotic fluid discriminates idiopathic from pathological polyhydramnios but is not unanimous. We assessed fetal anomaly incidence amongst women with polyhydramnios and the role of discriminatory variables in identifying pathological cases. Methods: Retrospective observational cohort study at an inner-city London fetal medicine centre. Records for patients referred and/or diagnosed with polyhydramnios were reviewed as well as maternal/fetal demographics, amongst singleton pregnancies using the Astraia™ database from January 2015-2016. Estimated fetal weight was calculated using the Hadlock model (biometry undertaken at diagnosis). Student's t-test/one-way ANOVA compared means; chi-squared tests compared proportions. Results: 120 cases were identified. 36 (30%) had fetal abnormality. There was no difference in AFI between fetuses with an abnormality and without (26.7 vs 25.2 cm, P = 0.22). AFI was normalised for weight (AFI (cm)/estimated fetal weight (kg)): AFI/kg was significantly different between cases with fetal abnormality and without (24.4 vs 16.7 cm/kg, P < 0.001) - incidence of abnormality increased with increasing AFI/kg (P = 0.007). Early gestational diagnosis was associated with higher rates of anomaly (P = 0.004). Differences in AFI/kg between those with and without abnormality were not significant when adjusted for gestation. AFI was significantly higher in cases of abnormality diagnosed at later gestation (P = 0.005). Conclusion: Excess volume of amniotic fluid alone does not denote abnormality. Earlier gestations and higher AFI/kg corresponded with significantly increased rates of anomaly. However, the latter is a result of confounding by gestation, which is closely correlated with fetal weight.
Jones BP, Kasaven L, Vali S, et al., 2021, Uterine Transplantation: Review of Livebirths and Reproductive Implications, TRANSPLANTATION, Vol: 105, Pages: 1695-1707, ISSN: 0041-1337
Bhide A, Acharya G, Baschat A, et al., 2021, ISUOG Practice Guidelines (updated): use of Doppler velocimetry in obstetrics, ULTRASOUND IN OBSTETRICS & GYNECOLOGY, Vol: 58, Pages: 331-339, ISSN: 0960-7692
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
Hafiz N, Allison BJ, Itani N, et al., 2021, Impaired Autonomic Control of Heart Rate Variability during Acute Stress in the Chronically Hypoxic Fetus., SRI Conference 2021, Publisher: SPRINGER HEIDELBERG, Pages: 71A-71A, ISSN: 1933-7191
Salvesen K, Abramowicz J, Ter Haar G, et al., 2021, ISUOG statement on the non-diagnostic use of ultrasound in pregnancy., Ultrasound Obstet Gynecol, Vol: 58, Pages: 147-147
Hafiz N, Shaw C, Allison B, et al., 2021, Potential mechanisms underlying poorer outcomes for chronically hypoxic fetuses during acute stress, RCOG Congress 2021, Publisher: WILEY, Pages: 49-50, ISSN: 1470-0328
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