• Aortic isthmus Doppler velocimetry: role in assessment of preterm fetal growth restriction.

      Kennelly, M M; Farah, N; Turner, M J; Stuart, B; Ultrasound and Fetal Medicine Centre, Coombe Women & Infants University Hospital,, Dublin, Ireland. mkennelly@doctors.org.uk (2012-02-01)
      Intrauterine fetal growth restriction (IUGR) is an important pregnancy complication associated with significant adverse clinical outcome, stillbirth, perinatal morbidity and cerebral palsy. To date, no uniformly accepted management protocol of Doppler surveillance that reduces mortality and cognitive morbidity has emerged. Aortic isthmus (AoI) evaluation has been proposed as a potential monitoring tool for IUGR fetuses. In this review, the current knowledge of the relationship between AoI Doppler velocimetry and preterm fetal growth restriction is reviewed. Relevant technical aspects and reproducibility data are reviewed as we discuss AoI Doppler and its place within the existing repertoire of Doppler assessments in placental insufficiency. The AoI is a link between the right and left ventricles which perfuse the lower and upper body, respectively. The clinical use of AoI waveforms for monitoring fetal deterioration in IUGR has been limited, but preliminary work suggests that abnormal AoI impedance indices are an intermediate step between placental insufficiency-hypoxemia and cardiac decompensation. Further prospective studies correlating AoI indices with arterial and venous Doppler indices and perinatal outcome are required before encorporating this index into clinical practice.
    • A case of toxoplasmosis causing severe ventriculomegaly in association with reproductive immunotherapy.

      O'Connor, C; Stuart, B; Turner, M J; Kennelly, M M; UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin, Ireland. drclare.oconnor@gmail.com (2012-08)
    • Longitudinal study of aortic isthmus Doppler in appropriately grown and small-for-gestational-age fetuses with normal and abnormal umbilical artery Doppler.

      Kennelly, M M; Farah, N; Hogan, J; Reilly, A; Turner, M J; Stuart, B; Ultrasound and Fetal Medicine Centre, Coombe Women and Infants University Hospital, Dublin, Ireland. mkennelly@doctors.org.uk (2012-04)
      To establish reference ranges using longitudinal data for aortic isthmus (AoI) Doppler indices in appropriate-for-gestational-age (AGA) fetuses and to document the longitudinal trends in a cohort of small-for-gestational-age (SGA) fetuses with normal umbilical artery Doppler and in fetuses with intrauterine growth restriction (IUGR) and abnormal umbilical artery Doppler.
    • The measurement of maternal adiposity.

      Fattah, C; Farah, N; Barry, S; O'Connor, N; Stuart, B; Turner, M J; UCD School of Medicine and Medical Science, Coombe Women and Infants University, Hospital, Dublin, Ireland. (2012-02-01)
      The issue of maternal obesity has become a major public health problem. Internationally, the diagnosis of obesity is based on body mass index (BMI) that is, weight in kg/height in m2. While epidemiological associations have been shown between different BMI categories and adverse clinical outcomes, there is also a growing realisation that BMI has significant limitations. In this review, we assess current methods to measure body fat and, in particular, their application in pregnant women.
    • What is the value of ultrasound soft tissue measurements in the prediction of abnormal fetal growth?

      Farah, N; Stuart, B; Donnelly, V; Rafferty, G; Turner, M; UCD School of Medicine and Medical Science, Coombe Women and Infants University, Hospital, Dublin 8, Ireland. nadine.farah@ucd.ie (2012-02-01)
      Abnormal fetal growth increases the complications of pregnancy not only for the baby but also for the mother. Growth abnormalities also have lifelong consequences. These babies are at increased risk of insulin resistance, diabetes and hypertension later in life. It is important to identify these babies antenatally to optimise their clinical care. Although used extensively antenatally to monitor fetal growth, ultrasound has its limitations. Despite the use of more than 50 different formulae to estimate fetal weight, their performance has been poor at the extremes of fetal weight. Over the past 20 years there has been emerging interest in studying fetal soft tissue measurements to improve detection of growth abnormalities. This review paper outlines the value of soft tissue measurements in identifying fetal growth abnormalities, in estimating fetal weight and in managing diabetes mellitus in pregnancy.