The course of pregnancy and delivery in a patient with malaria

Malaria is one of the most common lethal parasitic diseases. Infection is transmitted when an infected female mosquito bites a human introducing the sporozoites into human blood. The article presents the course of pregnancy and delivery in a patient complicated by Plasmodium infection. The patient had repetitive several trips to Tanzania over a short time period before she developed the condition. She had been taking antimalarial medication (proguanil-atovaquone) in a prophylactic dose during and after her first travel to Tanzania. Following her first return to Poland she experienced infection-related symptoms

Sonographic imaging and differential diagnosis of fetal perineal masses

This case series describes our experience with a prenatal diagnosis of fetal perineal masses. We propose a clinical-sonographic approach for prenatal workup in cases presenting perineal findings based on imaging the target sign at the posterior perineal triangle, the fetal genitalia, and sacrum. Targeted, structured prenatal anatomical scan in fetuses presenting with perineal masses may aid in the prenatal differential diagnosis and enable appropriate genetic analysis, prenatal counseling, and postnatal treatment

Impact of Prenatal and Postnatal Diagnosis on Parents: Psychosocial and Economic Aspects Related to Congenital Heart Defects in Children

Congenital heart defects (CHD) are defects detected both prenatally and after birth. They are the most common congenital defects. Despite advances in diagnosis and treatment, CHD remain an important cause of morbidity and mortality in newborns, which has a great impact on economic aspects. It is crucial to provide a holistic approach to the care of children with CHD, including regular cardiac check-ups, appropriate drug treatment, surgical or cardiac interventions as needed, rehabilitation, psychological support, and education for patients and their families. Parents experience a variety of psychological problems. This article summarizes the influence of CHD in the psychological and economic areas

Potential Impact of a Pregnant Woman’s Microbiota on the Development of Fetal Heart Defects: A Review of the Literature

Developments in medicine and biology in recent decades have led to a significant increase in our knowledge of the complex interactions between the microbiota and human health. In the context of perinatal medicine and neonatology, particular attention is being paid to the potential impact of the maternal microbiota on fetal development. Among the many aspects of this relationship, the question of the impact of dysbiosis on the development of fetal heart defects is an important one. In this article, we present an analysis of recent research and scientific evidence on the relationship between a pregnant woman’s microbiota and the development of fetal heart defects. We also discuss potential intervention strategies, including the role of probiotics and diet in optimising the maternal microbiota

Assessment of fetal thymus size and BMI in pregnant women with diabetes

Materials and methods: The study group consisted of 63 pregnant women admitted to the Department of Perinatology, Obstetrics and Gynaecology. Inclusion criteria included patients with PGDM – 11 pregnancies, GDM1– 23 pregnancies, and GDM2 – 29 pregnancies. Exclusion criteria included pregnant women with gestational diabetes and history of other comorbidities as well as multiple pregnancies, fetal developmental abnormalities and genetic disorders. Each patient received a detailed fetal ultrasound performed by the team of ultrasound experts specialising in obstetric ultrasonography. Fetal thymus measurements were obtained between 14+5 and 40+0 weeks of gestational age. After the three-vessel view was clearly displayed we assessed longitudinal dimensions of the thymus. The obtained measurements were juxtaposed with nomograms for thymus size in healthy foetuses whose mothers had no history of diabetes. Prior to ultrasound examination the participants were asked to complete a questionnaire regarding their body weight status before 10 weeks of gestational age. Results: The Mann–Whitney U test was used for comparison of two groups, i.e. diabetic pregnancies and non-diabetic pregnancies, whereas Kruskal–Wallis H test was used to compare multiple groups. A linear regression model was used to determine the correlation between the type of diabetes and fetal thymus size as well as between maternal BMI and fetal thymus size. The significance level α was set at 0.05. Thymus size is statistically smaller in foetuses of diabetic mothers when compared to healthy controls. Overweighted and obese pregnancy is not a factor affecting fetal thymus size

Retrospective cohort study of prenatally and postnatally diagnosed coarctation of the aorta ({CoA}): prenatal diagnosis improve neonatal outcome in severe {CoA}

Introduction: Prenatal diagnosis of congenital heart disease (CHD) leads to improved outcome but not mortality rate. This may not be the case for coarctation of the aorta (CoA). The objective of this study is to estimate the effect of a prenatal diagnosis of CoA by comparing neonates with CoA by the time of diagnosis. Materials and methods: The study included 38 neonates with CoA diagnosed prenatally and 102 neonates diagnosed postnatally. The postnatal group was divided into two subgroups: (1) severe CoA: symptoms of CoA within the first 7 days (n = 43) and (2) mild CoA: symptoms within the 8-28th day (n = 34). The neonates diagnosed more than 28 days after delivery were excluded from the study (n = 25). Severe CoA was defined as CHD diagnosed postnatally with clinical symptoms that presented in the first week after birth. Mild CoA was defined as CHD that presented clinical symptoms later than 7 days of life. Results: Prostaglandins were initiated at lower doses (p < .001) in the prenatal group. Severe postnatal CoA was associated with more frequent Neonatal Intensive Care Unit (NICU) visits than mild postnatal CoA (p = .005). The length of hospitalization of neonates with severe postnatal CoA was 10 days longer than compared to the prenatal group, but the difference was not statistically significant. The highest mortality rate was in the severe postnatal CoA group (18.6%) which was significantly higher than the mortality rate in the prenatal group (p = .005). Conclusion: 1. Prenatal identification of fetuses at increased risk of developing CoA may reduce mortality and improve outcome only in neonates with severe CoA (symptoms of CoA within the first 7 days after birth); 2. Prenatal diagnosis of severe CoA was associated with lower prostaglandin doses and lower mortality rate

The International Prenatal Cardiology Collaboration Group – nowa idea międzynarodowych badań naukowych

Congenital heart defects are among the most common congenital defects and contribute substantially to the mortality of newborns and young infants, in spite of well-developed medical and surgical treatments. It is estimated that the mortality of children with congenital heart defects in developing countries is as high as 20%, whereas the incidence of congenital heart defects is approximately 1/100 live births(1). Currently, there is an emphasis on early fetal screening for chromosomal abnormalities and neural tube defects, despite the fact that congenital heart defects are four times more frequent than chromosomal abnormalities and six times more frequent than neural tube defects(2). It should be noted that basic in-utero screening for heart defects is possible as early as the first trimester, which in some cases prompts further work-up and treatment(3). Throughout the world, second trimester screening remains the mainstay of prenatal diagnosis of cardiac anomalies. However, a comprehensive work-up for fetal heart defects can be associated with substantial psychological burden on the mother and her family. Moreover, the prevalence of misdiagnosis can be as high as 36%, thus prompting the need for further training and multidisciplinary team work(4). Furthermore, 33% of heart defects are accompanied by other anomalies(5).Wrodzone wady serca należą do najczęstszych wad wrodzonych i mimo rozwiniętego leczenia zachowawczego, jak i operacyjnego w dalszym ciągu stanowią jedną z najczęstszych przyczyn zgonów w okresie noworodkowym i wczesnoniemowlęcym. Szacunkowo określa się, że śmiertelność może dotykać około 20% dzieci z wrodzonymi wadami serca w krajach rozwijających się, a każdego roku częstość wrodzonych wad serca oscyluje w granicach 1/100 żywych urodzeń(1). Obecnie uwaga jest kierowana głównie w stronę wczesnej diagnostyki genetycznej, tymczasem wrodzone wady serca są aż 6 razy częstsze od wad chromosomalnych i 4 razy częstsze od wad cewy nerwowej(2). Podstawowa diagnostyka kardiologiczna u płodu jest możliwa już w I trymestrze ciąży i w wybranych przypadkach klinicznych przyczynia się do dalszego postępowania diagnostycznego i terapeutycznego(3). Mimo to w dalszym ciągu podstawowe pozostaje badanie serca płodu w II trymestrze. Kompleksowa diagnoza kardiologiczna płodu niesie ze sobą duże obciążenie psychiczne dla ciężarnej i jej rodziny. Wynika z tego konieczność dalszego szkolenia oraz pracy wielodyscyplinarnej, gdyż – jak pokazują dane z piśmiennictwa – odsetek prenatalnie nieprawidłowo postawionych diagnoz może sięgać nawet 36%(4), a aż 33% wad serca nie jest wadą izolowaną(5)

The International Prenatal Cardiology Collaboration Group - a new concept for global research study

status: publishe

Absent pulmonary valve syndrome - diagnosis, associations and outcome in 71 prenatally diagnosed cases

To analyze the spectrum of prenatally diagnosed absent pulmonary valve syndrome (APVS) and the outcome from diagnosis onwards. Fetuses with APVS and tetralogy of Fallot (TOF/APVS) and with APVS and intact ventricular septum (APVS/IVS) were included.status: publishe