What are the novel findings of this work? This study is the first to directly explore pregnancy outcomes following noninvasive prenatal screening (NIPS) on samples with low fetal fraction (FF). On most NIPS offerings, low-FF samples are failed, yet we find that a customized NIPS that does not fail samples based on FF has comparable sensitivity and specificity for high-and low-FF samples. What are the clinical implications of this work? Test failures due to low fetal fraction (FF) during noninvasive prenatal screening (NIPS) increase patient anxiety, lengthen the prenatal screening process, and complicate provider workflow. Our study shows that a customized NIPS based upon whole-genome sequencing performs comparably at high and low FF, rendering low-FF test failures unnecessary.

Intraamniotic Candida infection is uncommon but the consequence can be catastrophic. Transcer vical amphotericin B and intraamniotic fluconazole administration were identified in the literature. We present a case with intact membranes and ongoing pregnancy treated by maternal intravenous liposomal amphotericin B. A primipara who underwent cerclage placement before fetal viability was diagnosed with intraamniotic Candida infection. Although maternal intravenous liposomal amphotericin B eradicated fungi in the amniotic cavity, Escherichia coli invasion caused devastating chorioamnionitis. The newborn delivered at 27 +3 weeks' gestation did not survive due to respiratory distress syndrome and sepsis. Despite negative conversion of intraamniotic culture results for fungi after treatment, another pathogen such as bacteria could ascend into the amniotic cavity via weak ened membranes. Clinicians should consider broadspectrum antibiotics as well as antifungal agents in this setting.

Objective: To characterize the hematologic profile of preterm fetuses delivered spontaneously with acute histologic chorioamnionitis (HCA). Methods: This was a retrospective cohort study. The relationship between the presence of acute HCA and the change of hematologic profile was examined in 109 singleton pregnant women who were admitted and delivered between 24-32 weeks of gestation. Cases without results of placental histologic examination, cord blood cell count, and the differential count were excluded. From the cord blood, hemoglobin concentration, hematocrit, mean corpuscular volume, total leucocyte count and the differential count, platelet count, normoblast count, and umbilical arterial pH were obtained. All the observed values were corrected for gestational age by calculating a ratio between the observed and mean expected value for gestational age. Results: 1) The prevalence of acute HCA was 60.6% (66/109); 2) newborns with acute HCA had a higher median corrected leucocyte counts and corrected percentage of neutrophil in the differential count and a lower median corrected percentage of lymphocyte in the differential count than those without acute HCA; 3) neutrophilia was significantly frequent in newborns with acute HCA than in those without acute HCA; and 4) acute HCA was not associated with detectable changes in percentage of monocyte, eosinophil, basophil, and normoblast in the differential count, hemoglobin concentration, hematocrit, erythrocyte counts, mean corpuscular volume, platelet counts, or umbilical arterial pH. Conclusion:The hematologic profile of preterm fetuses delivered spontaneously with acute HCA is characterized by significant changes in the total leucocyte count, neutrophil percentage, and lymphocyte percentage. 전신 염증반응증후군으로 진단된 환자에서 혈액계수(hematologic profile)의 변화가 관찰