Analysis of amino acids and acylcarnitines profiles in small, appropriate, and large for gestational age neonates.

OBJECTIVE: To identify the amino acid (AA) and acylcarnitines (ACs) profiles in dry blood spot (DBS) of small, appropriate and large for gestational age neonates, and to investigate the difference AA and AC profiles in groups. METHODS: Eight thousand nine hundred and fourteen healthy singleton newborns were divided into three groups: small for gestational age (SGA) (n = 713), appropriate for gestational age (AGA) (n = 7866), and LGA (n = 335). Electrospray ionization tandem mass spectrometry was taken to evaluate the concentrations of 11 AAs and 31 ACs in DBS specimens obtained from all enrolled neonates. RESULTS: Compared with the AGA neonates, except propionylcarnitine, the concentrations of SGA neonatal most AAs and AC in the newborn were higher, while those of the newborns in the LGA group were lower. CONCLUSION: Different concentrations of AAs and ACs in the three groups suggest that SGA may be associated with under anabolic metabolism, while LGA may be associated with over anabolic metabolism.

Prenatal and perinatal outcomes of twin pregnancy discordant for one fetus with nuchal translucency above the 95th percentile.

OBJECTIVE: To compare prenatal and perinatal outcomes of twin pregnancies in which one twin the nuchal translucency (NT) was above the 95th percentile in dichorionic twins (DCT) and monochorionic twins (MCT). METHOD: In this retrospective study, 93 twin pregnancies (186 fetuses) in which one twin the NT was above the 95th percentile and the co-twin had normal NT were analyzed. Results of of G-banding and Chromosomal microarray (CMA), ultrasound findings and pregnancy outcomes were reviewed. RESULTS: Totally, 57 pregnancies (114 fetuses) were DCT and 36 pregnancies (72 fetuses) were MCT. Karyotyping and CMA results shown that clinically significant chromosomal abnormalities were found in 16 fetuses, including 13 aneuploidies, 2 chromosomal mosaic and 1 pathological Copy number variations (CNVs) (14 were DCT and 2 were MCT). Overall, the incidence of fetal chromosomal abnormalities was 12.3% (14/114) in DCT and 2.8%(2/72) in MCT (χ2 = 3.932, p = 0.047). Among the cases with normal prenatal diagnosis result, structural abnormalities were found in four fetuses (4.0%, 4/100) in DCT and two fetuses (2.9%, 2/70) in MCT (p > 0.999). There were one intrauterine fetal demises (IUFD) and two miscarry in DCT. One IUFD, three subsequently developed Twin-to-Twin Transfusion Syndrome (TTTS) and four developed selective intrauterine growth restriction (sIUGR) in MCT. Totally, the overall fetal survival rate was 85.1% (97/114) in DCT and 80.6% (58/72) in MCT (χ2 = 0.653, p = 0.419). CONCLUSION: Compared to MCT, the incidence of chromosomal abnormalities in DCT discordant for one fetus with NT above the 95th percentile was higher. The risk of structural abnormalities and the rate of fetal survival for both MCT and DCT was similar.

A cohort study of the perinatal outcome of radiofrequency ablation in complicated monochorionic multiple pregnancies based on a different needle insert angle.

OBJECTIVE: To compare the pregnancy outcomes of radiofrequency ablation (RFA) for complicated multiple pregnancies between fetal abdominal and dorsal needle insertion angles. METHODS: We performed a historical cohort study of patients who underwent selective reduction using RFA through different needle insertion angles from 2015 to 2018 at a local hospital. Dorsal needle insertion cases were consecutively selected and abdominal needle insertion cases were selectively enrolled. The Cox proportional hazards model was constructed to identify predictors of fetal survival time with different needle insertion angles. RESULTS: The RFA procedure was performed in 28 women through an abdominal insertion angle and in 28 women through a dorsal insertion angle. There were no significant differences in perinatal outcomes between the two groups. The overall live birth rate after RFA in the two groups was 73.5% and the mean gestation was 31.6 ± 6.5 weeks. The Cox model showed that gestational age at RFA was a predictor of the duration of the period between RFA and delivery. CONCLUSION: RFA conducted through the dorsal insertion angle is technically feasible for selective reduction in complex monochorionic multiple pregnancies. Gestational age at this procedure is an independent risk factor for the duration of pregnancy post-RFA.