M. Mar Gil

Objectives To examine the predictive performance of the Fetal Medicine Foundation (FMF) competing‐risks model for the first‐trimester prediction of a small‐for‐gestational‐age (SGA) neonate in a large, independent, unselected European cohort and to compare the competing‐risks algorithm with previously published logistic‐regression models. Methods...

Objective To evaluate the accuracy of fetal biparietal diameter (BPD) measurement in comparison with crown–rump length (CRL) measurement for pregnancy dating at 11–13 weeks' gestation. Methods This was a retrospective multicenter cohort study performed in five maternity units in Spain, the UK, Belgium and Bulgaria between January 2011 and December...

Early-onset (EOPE) and late-onset preeclampsia (LOPE) pose significant challenges to maternal and child health, highlighting the need for early, non-invasive risk identification. In this prospective longitudinal study, we followed 9,586 pregnant women, collecting blood samples each trimester: 9-14 weeks (T1), 18-28 weeks (T2), and after 28 weeks or...

Background and Objectives: To evaluate the diagnostic accuracy of widely available biomarkers longitudinally measured throughout pregnancy to predict all and term (delivery at ≥ 37 weeks) preeclampsia (PE). Materials and Methods: This is a retrospective study performed at Hospital Universitario de Torrejón (Madrid, Spain) and Shterev Hospital (Sofi...

Objective To compare the predictive performance for pre‐eclampsia (PE) of three different first‐trimester mathematical models of screening, which combine maternal risk factors with mean arterial pressure (MAP), uterine artery pulsatility index (UtA‐PI) and serum placental growth factor (PlGF), and two risk scoring systems, based on NICE and ACOG re...

Objective Effective first‐trimester screening for preeclampsia(PE) can be achieved with the use of a competing risks model that combines risk factors from the maternal history with multiple of the median (MoM) values of biomarkers. A new model with the use of artificial intelligence (AI) through machine‐learning methods has been shown to achieve a...

( BJOG . 2022;129:2082–2093) Pre-eclampsia is a complication affecting 2% to 4% of pregnancies and is associated with a high rate of maternal and infant mortality. The risk of developing pre-eclampsia is related to age, weight, race, method of conception, personal and family history, and pre-existing conditions. Studies from predominantly white cou...

Objective: To evaluate the diagnostic accuracy of the Fetal Medicine Foundation (FMF) competing risk model (the triple test) for the prediction of preterm pre-eclampsia (PE) in a Spanish population. Methods: This was a prospective cohort study performed in eight fetal-medicine units in five different regions of Spain between September 2017 and D...

Objectives: We aimed to examine the relationship between the English Index of Multiple Deprivation (IMD) and the incidence of stillbirth and to assess whether IMD contributes to the prediction of stillbirth over and above what is provided by the combination of maternal demographic characteristics and elements of medical history. Methods: This wa...

(Abstracted from Ultrasound Obstet Gynecol 2022;59:162–168) Chorionic villus sampling (CVS) and its procedure-related risk of fetal loss in twin pregnancy have not been investigated in a randomized controlled trial setting. Authors of previous studies have concluded that only investigation of low-risk pregnancies could demonstrate the true effect o...

SARS‐CoV‐2 antibodies have been found in breast milk following natural SARS‐CoV‐2 infection or COVID‐19 vaccination. This is a prospective study to evaluate the temporal changes in amount and neutralization capacity of the anti‐SARS‐CoV‐2 antibodies in breast milk stimulated by natural infection and vaccination by collecting serial breast milk samp...

Objective: To estimate the risk of fetal loss associated to chorionic villus sampling (CVS) in twin pregnancies using propensity score analysis. Methods: This was a multicenter cohort study performed in eight fetal-medicine units in which the leadership were trained at the Harris Birthright Research Centre for fetal medicine in London and the pr...

Participation of pregnant women in clinical trials entails challenges mainly related to concerns about the risks for fetuses. We undertook a qualitative study from June to October 2020 to assess the acceptability of participating in COVID-19 clinical trials among pregnant women in Spain. Phenomenology and grounded theory were used as methodological...

Background: Effective screening for term preeclampsia is provided by a combination of maternal factors with measurements of mean arterial pressure, serum placental growth factor and serum soluble fms-like tyrosine kinase-1 at 35 to 37 weeks of gestation, with detection rate of about 75%, at screen positive rate of 10%. However, there is no known in...

Objective This study aimed to evaluate the evidence of mother-to-child transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Methods This is a descriptive, multicenter, observational study in nine tertiary care hospitals throughout Spain. The study population was women with COVID-19 during pregnancy. Mother-to-child transmi...

Objective: To expand the limited knowledge on cell-free (cf)DNA analysis of maternal blood for trisomies 21, 18 and 13 in twin pregnancies by updating the data from the Fetal Medicine Foundation (FMF) on prospective first trimester screening and those arising from systematic review of the literature. Methods: The FMF data were derived from prosp...

Objective:. To determine the incidence of preeclampsia (PE) and preterm PE in Spain and to identify the risk factors for developing the disease. Methods:. This is a multicenter prospective cohort study performed at six maternity units across Spain. Women with singleton pregnancies attending their first-trimester routine visit at the hospital were o...

Objectives The primary objectives of the study are: 1. To assess the effect of hydroxychloroquine (HCQ) in reducing SARS-CoV-2 viral shedding by PCR in infected pregnant women with mild symptoms. 2. To assess the efficacy of HCQ to prevent SARS-CoV-2 infection in pregnant women in contact with an infected or suspected case. 3. To evaluate the effec...

In this paper, the scientific societies SEGO, SEQC ML and AEDP provide a series of consensus-based recommendations for prenatal screening and diagnosis of genetic abnormalities. A set of evaluation indicators are also proposed as a means to improve the quality of the biochemical, ultrasound, and genetic processes involved in prenatal screening and...

Resumen El objetivo de este trabajo es difundir las recomendaciones del consenso entre las sociedades científicas SEGO, SEQC ML y AEDP sobre cribado y diagnóstico prenatal de anomalías genéticas, así como una propuesta de indicadores de evaluación, desde una perspectiva de mejora de cada uno de los procesos que constituyen el campo de aplicación de...

Background In women with a singleton pregnancy and sonographic short cervix in mid-gestation, vaginal administration of progesterone reduces the risk of early preterm birth and improves neonatal outcomes, without any demonstrable deleterious effects on childhood neurodevelopment. In women with twin pregnancies the rate of spontaneous early preterm...

Objective: To evaluate the effects of coronavirus disease 2019 (COVID-19) on maternal, perinatal and neonatal outcomes by performing a systematic review of available published literature on pregnancies affected by COVID-19. Methods: We performed a systematic review to evaluate the effects of COVID-19 on pregnancy, perinatal and neonatal outcomes...

Objective: To estimate the risk of miscarriage associated to chorionic villus sampling (CVS). Methods: This was a retrospective cohort study performed in eight fetal-medicine units in Spain, Belgium and Bulgaria. Two populations were included: first, all singleton pregnancies attending to their first-trimester assessment in Murcia, Spain, and se...

(Abstracted from Ultrasound Obstet Gynecol 2019;53:734–742) Cell-free DNA (cfDNA) analysis of maternal blood is useful and effective when screening for trisomies 21, 18, and 13 in singleton pregnancies. However, in twin pregnancies, data on cfDNA tests are much more limited: in a previous literature review and meta-analysis, there were only 5 prosp...

(Abstracted from Ultrasound Obstet Gynecol 2019;53(2):208–213) In singleton pregnancies, screening for the major trisomies using a combination of fetal nuchal translucency (NT) thickness, serum β-human chorionic gonadotropin, and pregnancy-associated plasma protein A can detect approximately 90% of cases of trisomy 13, 18, or 21, at a false-positiv...

In the past 9 years, several externally blinded validation and implementation studies have shown that it is now possible, through analysis of cell-free (cf) DNA in maternal blood, to effectively detect a high proportion of fetuses affected by trisomies 21, 18, and 13 at a much lower false positive rate than all other existing screening methods. Thi...

Objectives: To report on the routine clinical implementation of cell-free DNA (cfDNA) analysis of maternal blood for trisomies 21, 18 and 13 in twin pregnancy and to define the performance of the test by combining our results with those identified in a systematic review of the literature. Methods: The data for the prospective study were derived...

Objective: To examine factors affecting the rate of failure to obtain a result from cell-free DNA (cfDNA) testing of maternal blood for fetal trisomies 21, 18 and 13 in singleton and twin pregnancies in the first trimester. Methods: This was a prospective study of 23 495 singleton and 928 twin pregnancies undergoing screening for fetal trisomy b...

Objective: To examine the potential value of fetal ultrasound and maternal characteristics in the prediction of antepartum stillbirth after 32 weeks’ gestation. Methods: This was a retrospective multicenter study in Spain. In 29 pregnancies, umbilical artery pulsatility index (UA PI), middle cerebral artery pulsatility index (MCA PI), cerebroplacen...

Objective: To report on the routine clinical implementation of cell-free (cf)DNA analysis of maternal blood for trisomies 21, 18 and 13 contingent on the results of the first-trimester combined test in twin pregnancies. Methods: Screening for trisomies 21, 18 and 13 was carried out by a combination of maternal age, fetal nuchal translucency (NT)...

Objective: To evaluate the interobserver repeatability of the coronal view measurements and classification of the uterine malformations (UM) according to the ESHRE/ESGE consensus by transvaginal three-dimensional ultrasound (3D-US). Methods: 89 transvaginal 3D-US volumes acquired during the last two years at Delta Ecografía in Madrid, Spain, wer...

Objective: To review clinical validation or implementation studies of maternal blood cell-free (cf) DNA analysis and define the performance of screening for fetal trisomies 21, 18 and 13 and sex chromosome aneuploidies. Data sources: Searches of PubMed, Embase and the Cochrane library were performed to identify all peer-reviewed articles on cfDN...

Objective: To describe our experience in first-trimester screening for trisomies 21 and 18 firstly by the combined test alone and secondly by cell-free (cf)DNA testing contingent on the results from a previously performed combined test. Methods: Women with singleton pregnancies attending Torrejon University Hospital in Madrid, Spain, from November...

Abstracted from Ultrasound Obstet Gynecol 2016;47:45–52 Although detection of trisomies 21, 18, and 13 by cell-free DNA (cfDNA) analysis of maternal blood is superior to other methods of screening, it is expensive. To maximize performance at reduced cost, a strategy that can be used is to offer cfDNA testing contingent on the results of the first-t...

Objectives: Cell-free DNA (cfDNA) analysis of maternal blood for detection of trisomies 21, 18 and 13 is superior to other methods of screening but is expensive. One strategy to maximize performance at reduced cost is to offer cfDNA testing contingent on the results of the first-trimester combined test that is used currently. The objectives of thi...

Objective: To review clinical validation or implementation studies of maternal blood cell-free (cf) DNA analysis and define the performance of screening for fetal trisomies 21, 18 and 13 and sex chromosome aneuploidies. Methods: Searches of PubMed, EMBASE and The Cochrane Library were performed to identify all peer-reviewed articles on cfDNA tes...

Objective To examine the performance of cell-free (cf)DNA testing for trisomies 21, 18 and 13 in a general population at 10–11 weeks’ gestation.Methods In 2,905 singleton pregnancies prospective screening for trisomies was performed by chromosome-selective sequencing of cfDNA in maternal blood at 10–11 weeks and by the combined test at 11–13 weeks....

Objectives To report clinical implementation of cell-free (cf)DNA analysis of maternal blood in screening for trisomies 21, 18 and 13 in twin pregnancies and examine variables that could influence the failure rate of the test.MethodscfDNA testing was performed in 515 twin pregnancies at 10–28 weeks’ gestation. Failure rate of the test to provide re...

Objective The study reports the clinical implementation of cell-free (cf)DNA testing, contingent on the results of the combined test, in screening for fetal trisomies 21, 18 and 13 in two UK NHS hospitals. Women with combined test risk of ≥1:100 (high-risk) are offered the options of chorionic villous sampling (CVS), cfDNA testing or no further tes...

To evaluate the hypothesis that intrapartum ultrasound (ITU) measurements, including the angle of progression (AOP), progression distance (PD), and head direction (HD), can predict uncomplicated forceps delivery in non-occiput posterior deliveries. In this prospective observational study, a single operator performed ITU for 30 patients, as indicate...

There is increasing interest in the development of imaging tests to screen for breast cancer, especially in high-risk groups where conventional technology falls short. Breast imaging has made huge advances in the last decade, and along with newer techniques to diagnose primary breast cancer, many novel methods are being used and look promising in d...

Objective To review clinical validation or implementation studies of maternal blood cell-free (cf) DNA analysis and define the performance of screening for fetal trisomies 21, 18 and 13 and sex chromosome aneuploidies.Methods Searches of PubMed, EMBASE and The Cochrane Library were performed to identify all peer-reviewed articles on cfDNA testing i...

Objective: To examine the performance of chromosome-selective sequencing of cell-free (cf) DNA in maternal blood for assessment of fetal sex chromosome aneuploidies. Methods: This was a case-control study of 177 stored maternal plasma samples, obtained before fetal karyotyping at 11-13 weeks of gestation, from 59 singleton pregnancies with fetal...

Objective: To examine the clinical implementation of chromosome-selective sequencing of cell-free DNA (cfDNA) in maternal blood and an algorithm that relies on the lower fetal fraction contribution of the 2 fetuses in the assessment of risk for trisomies in twin pregnancies. Methods: Risk for trisomies 21, 18 and 13 by cfDNA testing were estimat...

Objective: To examine potential performance of screening for trisomies by cell-free (cf) DNA testing in maternal blood contingent on results of first-line testing by combinations of fetal translucency thickness (NT), fetal heart rate (FHR), ductus venosus pulsatility index (DV PIV), and serum-free β-human chorionic gonadotropin (β-hCG), pregnancy-...

Objective: To investigate potential performance of cell-free DNA (cfDNA) testing in maternal blood in detecting fetal triploidy. Methods: Plasma and buffy coat samples obtained at 11-13 weeks' gestation from singleton pregnancies with diandric triploidy (n=4), digynic triploidy (n=4), euploid fetuses (n=48) were sent to Natera, Inc. (San Carlos,...

To explore the feasibility of routine maternal blood cell-free (cf) DNA testing in screening for trisomies 21, 18 and 13 at 10 weeks' gestation. In this prospective study, women attending The Fetal Medicine Centre in London, UK, between October 2012 and April 2013, with singleton pregnancy and live fetus with CRL 32–45 mm, were screened for trisomi...

To define risk cut-offs with corresponding detection rates (DR) and false-positive rates (FPR) in screening for trisomy 21 using maternal age and combinations of first-trimester biomarkers in order to determine which women should undergo contingent maternal blood cell-free (cf) DNA testing. From singleton pregnancies undergoing screening for aneupl...

Objective: To assess the performance of cell-free DNA (cfDNA) testing in maternal blood for detection of fetal aneuploidy of chromosomes 13, 18, 21, X, and Y using targeted sequencing of single-nucleotide polymorphisms. Methods: Prospective study in 242 singleton pregnancies undergoing chorionic villus sampling at 11 to 13 weeks. Maternal blood...

Background: Different ways of nutritional supplementation are being advised by physicians during pregnancy, but there is a lack of literature focused on its metabolical results. Aims: Check if the control of the impact that the multiple metabolic changes related to multiple pregnancies have on the mother's homeostasis is achieved with the supplemen...