Background and Objectives: In this study, we aimed to describe the clinical and ultrasound (US) features and the outcome in a group of patients suspected of or diagnosed with early onset intrauterine growth restriction (IUGR) requiring iatrogenic delivery before 32 weeks, having no structural or genetic fetal anomalies, managed in our unit. A secondary aim was to report the incidence of the condition in the population cared for in our hospital, data on immediate postnatal follow-up in these cases and to highlight the differences required in prenatal and postnatal care. Materials and Methods: We used as single criteria for defining the suspicion of early IUGR the sonographic estimation of fetal weight <p10 using the Hadlock 4 technique at any scan performed before 32 weeks’ gestation (WG). We used a cohort of patients having a normal evolution in pregnancy and uneventful vaginal births as controls. Data on pregnancy ultrasound, characteristics and neonatal outcomes were collected and analyzed. We hypothesized that the gestational age (GA) at delivery is related to the severity of the condition. Therefore, we performed a subanalysis in two subgroups, which were divided based on the GA at iatrogenic delivery (between 27+0 WG and 29+6 WG and 30+0–32+0 WG, respectively). Results: The prospective cohort study included 36 pregnancies. We had three cases of intrauterine fetal death (8.3%). The incidence was 1.98% in our population. We confirmed that severe cases (very early diagnosed and delivered) were associated with a higher number of prenatal visits and higher uterine arteries (UtA) pulsatility index (PI) centile in the third trimester—TT (compared with the early diagnosed and delivered). In the very early suspected IUGR subgroup, the newborns required significantly more NICU days and total hospitalization days. Conclusions: Patients with isolated very early and early IUGR—defined as ultrasound (US) estimation of fetal weight <p10 using the Hadlock 4 technique requiring iatrogenic delivery before 32 weeks’ gestation—require closer care prenatally and postnatally. These patients represent an economical burden for the health system, needing significantly longer hospitalization intervals, GA at birth and UtA PI centiles being related to it.

Background and Objectives: We aimed to prospectively obtain data on pregnancies complicated with intrauterine growth restriction (IUGR) in the Prenatal Diagnosis Unit of the Emergency County Hospital of Craiova. We collected the demographic data of mothers, the prenatal ultrasound (US) features, the intrapartum data, and the immediate postnatal data of newborns. We aimed to assess the detection rates of IUGR fetuses (the performance of the US in estimating the actual neonatal birth weight), to describe the prenatal care pattern in our unit, and to establish predictors for the number of total hospitalization days needed postnatally. Materials and Methods: Data were collected from cases diagnosed with IUGR undergoing prenatal care in our hospital. We compared the percentile of estimated fetal weight (EFW) using the Hadlock 4 technique with the percentile of weight at birth. We retrospectively performed a regression analysis to correlate the variables predicting the number of hospitalization days. Results: Data on 111 women were processed during the period of 1 September 2019–1 September 2022. We confirmed the significant differences in US features between early- (Eo) and late-onset (Lo) IUGR cases. The detection rates were higher if the EFW was lower, and Eo-IUGR was associated with a higher number of US scans. We obtained a mathematical formula for estimating the total number of hospitalization days needed postnatally. Conclusion: Early- and late-onset IUGR have different US features prenatally and different postnatal outcomes. If the US EFW percentile is lower, a prenatal diagnosis is more likely to be made, and a closer follow-up is offered in our hospital. The total number of hospitalization days may be predicted using intrapartum and immediate postnatal data in both groups, having the potential to optimize the final financial costs and to organize the neonatal department efficiently.

Central nervous system (CNS) is one of the most frequent sites for prenatal diagnosed congenital abnormalities (10 per 1000 live births, much higher than the heart-eight per 1000, kidneys-four per 1000, and other fetal systems). Due to the evolving pattern, ultrasound screening for fetal brain malformations is usually performed at 19-22 weeks' gestation, but severe congenital anomalies can be diagnosed much earlier. This chapter is a short review, structured in eight subchapters: the first one is dedicated to the normal ultrasound aspect of different CNS segments, and the following ones are to detect pathology in prenatal life. We used many ultrasound images and tried to correlate the prenatal findings with the ones obtained postpartum/postabortum for each case, by means of pathology/imaging techniques.anomalies of the central nervous system develop early, and nowadays, we have the tools to detect some conditions at 11-13 weeks [3][4][5][6][7][8] or even earlier. The first-trimester detection of CNS anomalies is probably the most important advance in modern sonoembriology. Later in pregnancy, neurosonography is a powerful tool in diagnosing CNS pathology.The following chapter is structured as follows: 1. Normal findings 2. Ventricular system (ventriculomegaly, aqueduct stenosis) 3. Neural tube defects (NTDs) (anencephaly, encephalocele, myelomeningocele) 4. Cortical formation abnormalities (schizencephaly, lissencephaly, heterotopia, microcephaly) 5. Midline abnormalities (holoprosencephaly, complete/partial agenesis of corpus callosum or abnormal corpus callosum, absent cavum septum) 6. Posterior fossa abnormalities (mega cisterna magna, Blake's pouch cyst, Dandy-Walker or variant cerebellar, vermian hypoplasia) 7. Vascular abnormalities (hemorrhage, hematoma, dural fistula, aneurysms) 8. Destructive lesions (hydranencephaly, tumors/mass lesions, cysts, periventricular leukomalacia, infections, dysplasias, other lesions). Normal findingsSome intracranial segments of CNS are seen on ultrasound extremely early in development, especially when using high-resolution probes and modern electronic tools. Although many features are indeed recognizable, the clinical utility of such studies is yet to be proven (Figures 1-3).In the late first trimester, current guidelines recommend checking for present cranial bones, for normal midline falx, and for the presence of choroid plexus and filled ventricles [9]. The most recommended planes for assessing the head anatomy are the axial ones. In terms of spine assessment, the guidelines state that "longitudinal and axial views should be obtained to show normal vertebral alignment and integrity, and an attempt should be made to show intact overlying skin" [9] (Figure 4).From the early second trimester onwards, the commendation is to obtain in standard assessment three standard axial planes (transventricular, transthalamic, and transcerebellar), and, if technically feasible, the fetal profile [10] (Figures 5 and 6).The measurements for fetal head biometry (the biparietal diameter-BPD ...