Objective To compare the performance of screening for pre-eclampsia (PE) based on risk factors from medical history, as recommended by NICE and ACOG, with the method proposed by The Fetal Medicine Foundation (FMF)
Among pregnancies exhibiting TTTS, laser surgery was associated with significant dual-fetus survival. Preoperative ductus venosus anomalies were associated with lower survival among recipient fetuses, and 1-week postsurgical ultrasonography data demonstrated lower survival among recipient fetuses with persistent anomalous ductus venosus compared with normalized ductus venosus.
Oral communication abstractsquestions on the origin aetiology point for these disorders, largely thought to arise from defective placentation in the first trimester.
OC07.02Multicentre screening for pre-eclampsia by maternal factors and biomarkers at 11-13 weeks' gestation: comparison to NICE guidelines and ACOG recommendations Methods: This was a prospective European multicentre study of screening for PE in 8,775 singleton pregnancies at 11-13 weeks' gestation in 12 hospitals. A previously published FMF algorithm was used for the calculation of patient-specific risk of PE in each patient. The detection rates (DR) and false positive rates (FPR) for delivery with PE at <32, <37 and >37 weeks were estimated and compared to those derived from application of NICE guidelines and ACOG recommendations. Results: In the study population there were 239 (2.7%) cases that developed PE, including 17 (0.2%), 59 (0.7%) and 180 (2.0%) at <32, <37 and >37 weeks, respectively. Screening with use of the FMF algorithm and the combination of maternal factors, mean arterial pressure (MAP), uterine artery pulsatility index (UTPI) and serum placental growth factor (PLGF) detected 100% (95% CI 80-100) for PE at <32 weeks, 75% (95% CI 62-85) for PE at <37 weeks and 43% (95% CI 35-50) for PE at >37 weeks, at 10.0% FPR. Screening with use of NICE guidelines detected 41% (95% CI 18-67) for PE at <32 weeks, 39% (95% CI 27-53) for PE at <37 weeks and 34% (95% CI 27-41) for PE at >37 weeks, at 10.3% FPR. Screening with use of ACOG recommendations detected 94% (95% CI 71-100) for PE at <32 weeks, 90% (95% CI 79-96) for PE at <37 weeks and 89% (95% CI 84-94) for PE at >37 weeks, at 64.3% FPR. Conclusions: Performance of screening for PE at 11-13 weeks' gestation by the FMF algorithm and combination of maternal factors, MAP, UTPI and PLGF is by far superior to the methods recommended by NICE and ACOG. Objectives: To evaluate the discriminative capacity of uterine artery pulsatility index (UtA-PI) in the identification of women remaining at high risk of pre-eclampsia (PE) after first trimester initiation of aspirin. Methods: We conducted a post-hoc analysis of data from a clinical randomised controlled trial of women with prior PE singleton fetus randomised to either 80 mg or 160 mg at bedtime from 10-14 weeks and followed until delivery. A follow-up visit was planned at 16-18 weeks for measurement of mean arterial blood pressure (MAP), UtA-PI and PFA-100 to evaluate aspirin non-responsiveness (PFA-100<145). Mean difference and ROC curves analyses with area under the curve (AUC), detection rate (DR) and false-positive rates (FPR) were used. Results: We observed 14 cases (13%) of PE and 3 (3%) cases of preterm PE out of 106 women with complete follow-up. UtA-PI at 16-18 weeks was discriminative of participants who developed preterm PE (AUC: 0.89; 95%CI: 0.77-1.00) but, not for those who developed term PE (AUC: 0.50; 95%CI: 0.32-0.69). Regarding aspirin resistance, participants who developed PE had a lower PFA-100 (mean difference: 50; 95%CI: 21-79,...
Se evaluó la percepción de la población citadina de Lima sobre algunos aspectos relacionados con la evolución e historia natural del ser humano. Un total de 384 personas mayores de 18 años, fueron evaluadas por medio de una encuesta oral. Los resultados indican que un 34% de la población de Lima desconoce el pasado de nuestra especie de al menos unos 70000 años, así como la historia evolutiva de los homínidos, que tiene al menos unos 4 millones de años; el 48% no está de acuerdo con que nos hayamos desarrollado de otras especies animales; y el 32% considera que los seres humanos vivimos al mismo tiempo que los dinosaurios. Los resultados obtenidos deben ser utilizados para establecer políticas que permitan un acercamiento entre la población general y los científicos. Asimismo, estos resultados indican la necesidad de preparar a las nuevas generaciones con un pensamiento crítico apropiado, de manera que pueden tener una percepción adecuada del entorno y de la historia evolutiva de nuestra especie.
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