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Objective: To assess the capacity of fetal pancreatic size, before standard blood glucose testing for screening and diagnosis, to predict maternal gestational diabetes mellitus (GDM). Methods: This was a retrospective cohort study of low‐risk pregnant women recruited during routine second‐trimester fetal anatomical screening at 20–25 weeks' gestation at two ultrasound units in Israel between 2017 and 2020. The predictive performance of fetal pancreatic circumference ≥ 80th and ≥ 90th centiles and glucose challenge test (GCT) was examined for the outcome of GDM. The independent‐samples t‐test was used to compare mean pancreatic circumference centile between pregnancies with GDM and those without GDM. Diagnostic performance was evaluated with 2 × 2 contingency tables and receiver‐operating‐characteristics (ROC) curves. Results: Overall, 195 women were selected for statistical analysis. Twenty‐four (12.3%) women were diagnosed subsequently with GDM. The mean ± SD fetal pancreatic circumference centile was significantly higher in the GDM group compared with the non‐GDM group (82.4 ± 14.6 vs 62.8 ± 27.6; P < 0.001). The pancreatic circumference centile was correlated positively with the estimated fetal weight centile (Pearson's coefficient, 0.243; P = 0.001). The 80th centile cut‐off for pancreatic circumference had the highest sensitivity (70.8%) and positive predictive value (23.3%) for future maternal GDM, with the best trade‐off between sensitivity and specificity achieved at the 75th centile cut‐off (sensitivity, 79%; specificity, 60%). The GCT had better specificity (90.2%) and negative predictive value (97.9%) compared with both cut‐offs in pancreatic circumference. The area under the ROC curve was higher for pancreatic circumference compared with GCT (0.71 vs 0.64) and only the former was statistically significant (P = 0.001). Conclusions: Fetal pancreatic circumference has a higher positive predictive capacity compared with GCT. Measuring pancreatic circumference can identify pregnancies at high risk for maternal GDM, thereby promoting earlier diagnosis and treatment, decreasing the time period during which the fetus is exposed to high maternal glucose levels and improving infant outcome. © 2024 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Objective: Mitochondrial complex‐I deficiency, nuclear type 16, is a rare autosomal recessive disorder caused by biallelic pathogenic variants in NDUFAF5 (C20orf7) (OMIM 618238). The aim of this study was to describe a severe early prenatal manifestation of this disorder, which was previously considered to occur only postnatally. Methods: This was a multicenter retrospective case series including five fetuses from three non‐related families, which shared common sonographic abnormalities, including brain cysts, corpus callosal malformations, non‐immune hydrops fetalis and growth restriction. Genetic evaluation included chromosomal microarray analysis and exome sequencing. Two fetuses from the same family were also available for pathology examination, including electron microscopy. Results: Chromosomal microarray analysis revealed no chromosomal abnormality in any of the tested cases. Trio exome sequencing demonstrated that three affected fetuses from three unrelated families were compound heterozygous or homozygous for likely pathogenic variants in NDUFAF5. No other causative variants were detected. The association between NDUFAF5 variants and fetal malformations was further confirmed by segregation analysis. Histological evaluation of fetal tissues and electron microscopy of the skeletal muscle, liver, proximal tubules and heart demonstrated changes that resembled postmortem findings in patients with mitochondrial depletion disorders as well as previously undescribed findings. Conclusions: Mitochondrial complex‐I deficiency and specifically biallelic mutations in NDUFAF5 have a role in abnormal fetal development, presenting with severe congenital malformations. Mitochondrial complex‐I disorders should be considered in the differential diagnosis of corpus callosal malformations and brain cysts, especially when associated with extracranial abnormalities, such as fetal growth restriction and non‐immune hydrops fetalis. © 2023 International Society of Ultrasound in Obstetrics and Gynecology. Linked article: There is a comment on this article by Finsterer. Click here to view the Correspondence. [ABSTRACT FROM AUTHOR]

This article, published in the journal "Ultrasound in Obstetrics & Gynecology," discusses the use of ultrasound in diagnosing ovarian torsion, a gynecologic emergency. The study aimed to identify sonographic predictors for the severity of ischemia (lack of blood flow) in the ovary during torsion. The researchers conducted a retrospective study and found that certain sonographic characteristics, such as edema, abnormal flow on Doppler, and free fluid in the Douglas pouch, were associated with ischemic ovaries. They developed a scoring method based on these markers to predict ovarian ischemia, which could potentially aid in early identification and prompt surgical intervention. However, further validation and research are needed to optimize the clinical utility of this scoring method. [Extracted from the article]

This article, titled "EP19.19: Angle of progression for predicting second-stage Caesarean delivery complications," explores the correlation between the angle of progression (AOP) and maternal surgical complications following a second-stage Caesarean delivery (CD). The study retrospectively evaluated women who underwent CD for arrest of descent at the second stage of labor and found that there was a significant correlation between measured AOP and composite maternal outcome. The authors suggest that assessing AOP before surgery may help identify susceptible cases and allow for appropriate preparation. [Extracted from the article]

This article discusses the role of Tricuspid Annular Plane Systolic Excursion (TAPSE) in monitoring cardiac function in fetuses diagnosed with fetal intra-abdominal umbilical vein varix (FIUVV). The study reviewed cases of FIUVV diagnosed between 2018 and 2023 and collected data on varix diameter, associated anomalies, and pregnancy outcomes. The findings suggest that fetuses with FIUVV have a hyperdynamic cardiac state, and TAPSE may be a useful tool in monitoring these fetuses and identifying cardiac decompensation. No cases of thrombosis or fetal demise were reported in the study group. [Extracted from the article]

This article, titled "Diagnostic insights and clinical outcomes of fetal urinary extravasation," presents a retrospective cohort study on cases of prenatal-diagnosed fetal urinary extravasation. The study identified seven cases out of approximately 1750 targeted scans for kidney and urinary tract anomalies, with a gender split of three males and four females. The cases had diverse pre- and postnatal clinical manifestations and outcomes, with some requiring surgical interventions and others being effectively managed conservatively. The article emphasizes the importance of prenatal diagnosis in revealing the underlying etiology and improving parental counseling regarding postnatal surgical intervention and renal outcome. [Extracted from the article]

The synthesis of unsaturated polyesters (UP) by high-temperature polycondensation is accompanied by isomerization of the double bond from the cis to the trans configuration. The presence of the trans double bonds facilitates crosslinking and may have an important influence on rheological and mechanical properties of the UP and the cured end product. All-trans polyesters are not available on the market. A study of 'all-trans' low-temperature polycondensation based on chemical and enzymatic lipase catalysis was recently reported. This paper presents the characteristics of lipase-synthesized UP vs. general-purpose UP, as obtained by X-ray, differential scanning calorimetry (DSC), and other methods. In contrast to the commercial amorphous UP, crystallinity was found in the 'all-trans' enzymatically and chemically synthesized UP. The crystallinity of the enzymatically and chemically synthesized UP. The crystallinity of the enzymatically synthesized UP was confirmed by higher values of elasticity. DSC analyses complemented the results obtained by other methodologies.