Reference charts for fetal cerebellar vermis height: A prospective cross-sectional study of 10605 fetuses

A prospective cross-sectional study between September 2009 and December 2014 was carried out at ALTAMEDICA Fetal–Maternal Medical Centre, Rome, Italy. Of 25203 fetal biometric measurements, 12167 (48%) measurements of the cerebellar vermis were available. After excluding 1562 (12.8%) measurements, a total of 10605 (87.2%) fetuses were considered and analyzed once only. Parametric and nonparametric quantile regression models were used for the statistical analysis. In order to evaluate the robustness of the proposed reference charts regarding various distributional assumptions on the ultrasound measurements at hand, we compared the gestational age-specific reference curves we produced through the statistical methods used. Normal mean height based on parametric and nonparametric methods were defined for each week of gestation and the regression equation expressing the height of the cerebellar vermis as a function of gestational age was calculated. Finally the correlation between dimension/gestation was measured

Proteomic analysis for the study of amniotic fluid protein composition

Amniotic fluid (AF), routinely used for prenatal diagnosis, contains large amounts of proteins produced by the amnion epithelial cells, fetal tissues, fetal excretions and placental tissues. Although many amniotic fluid proteins have been identified and are currently used to detect potential fetal anomalies, little is known about the functions of these proteins and how they interact with one another. Identification of changes in the protein content of amniotic fluid, therefore, may be used to detect a particular type of pathology, or to ascertain a specific genetic disorder. In the present work we used a proteomic approach, combining 2DE and MS, in order to study the protein composition of AFS

Shoulder dystocia: an Evidence-Based approach

Shoulder Dystocia (SD) is the nightmare of obstetricians. Despite its low incidence, SD still represents a huge risk of morbidity for both the mother and fetus. Even though several studies showed the existence of both major and minor risk factors that may complicate a delivery, SD remains an unpreventable and unpredictable obstetric emergency. When it occurs, SD is difficult to manage due to the fact that there are not univocal algorithms for its management

Reference interval for fetal biometry in Italian population

OBJECTIVES: To validate new references charts and equations for fetal biometry in an Italian unselected population. METHODS: A cross-sectional study involving 4896 women with singleton viable pregnancies, at Artemisia Fetal Maternal Medical Centre between May 2009 and December 2009. Each woman was scanned only once, between 14+0 and 40+0 weeks of gestation. The fetal standard biometric measurements were recorded. For each parameter, regression models were fitted to estimate the percentile at each gestational age. In order to be compared to other reference equations, the fetal biometric measurements at each gestational age were expressed as Z-scores. RESULTS: New fetal charts and references equations for Italian population were developed according to the recommend multistep statistical procedure. CONCLUSION: To our knowledge this is the first Italian study with the largest sample size ever reported in the literature. In addiction, our newer charts of reference centiles for fetal biometric measurements are useful in the obstetrical clinical practice for the Italian population

Analysis of fetal biometric measurements in the last 30 years

Objectives. To compare fetal biometric measurements with standard growth charts for ultrasound parameters existing from the last 30 years. Study design. A preliminary prospective study. Setting. Artemisia Mean Centre of Perinatal Diagnosis, Rome, Italy. Material and method. A cross sectional study involving 1000 pregnant women with uncomplicated singleton pregnancy between 14th and 41th weeks of gestation from 1 January to 30 June 2008. All recruited pregnant women enrolled had an abdominal ultrasonography for fetal biometry. For each measurement, regression models were fitted to estimate the mean and SD. The results were compared with existing references from the last 30 years using Student’s T distribution. Moreover, neonatal weights were obtained from 1977 to 2008 by ISTAT. Results. One thousand normal fetuses from pregnant women, between 22th and 23th weeks, between 32th and 33th weeks and at 38th week, were thoroughly measured. There were significant differences from the comparison with our data for each gestational age: femur length and homer length, abdominal circumference, head circumference and occipito-frontal diameter were longer than all parameters of existing references from the last 30 years. The analysis of neonatal weights on ISTAT data from 1977 to 2007 demonstrated a significant increment through the years. Conclusion. Fetus is grown up across the years. It is necessary to modify the standard growth charts for ultrasound parameters existing from the last 30 years with actually fetal biometric measurements. It is helpful for a correct clinical approach and for an appropriate management mother-fetus

Shape-constrained quantile regression (QR).

<p>Estimates for a range of levels of interest and approximate confidence bands (point-wise bands in dark gray, uniform bands in light gray) compared with the standard normal-based fit.</p

Anderson-Darling tests and the associated diagnostic plots.

<p><i>Top left</i>, Box plot of the original measurements. <i>Bottom left</i>, Raw p-values associated with the Anderson-Darling test of normality for the original measurements. <i>Top right</i>, Box plot of the log-transformed data. <i>Bottom right</i>, Raw p-values associated with the Anderson-Darling test of normality for the log-transformed data. The sizes of the circles in the bubble plot are proportional to the numbers of samples (n) available during that week.</p