Fetal MRI, lower acceptance by women in research vs. clinical setting

Abstract Aim: To determine acceptance of pregnant women to undergo fetal magnetic resonance imaging (MRI) examination in research and clinical setting. Methods: A prospective study included a research group [part of a study comparing brain ultrasound (US) to MRI in fetuses at risk for acquired brain damage] and a clinical group [fetuses with suspected (brain) anomalies after structural US examination] from 2011 to 2014. All women were advised to use sedatives. MRI declinations, use of sedation, MRI duration and imaging quality were compared between both groups. Results: Study participation was accepted in 57/104 (55%) research cases. Fetal MRI was performed in 34/104 (33%) research and 43/44 (98%) clinical cases. Reasons to decline study participation were MRI related in 41%, and participation was too burdensome in 46%. Acceptance was highest for indication infection and lowest in alloimmune thrombocytopenia and monochorionic twin pregnancy. Sedatives were used in 14/34 research and 43/43 clinical cases. Scan duration and quality were comparable (21 and 20 min in research and clinical cases, respectively, moderate/good quality in both groups). Conclusions: Pregnant women consider MRI more burdensome than professionals realize. Two-third of women at risk for fetal brain damage decline MRI examination. Future studies should evaluate which information about fetal MRI is supportive.

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Fetal and Postnatal Brain Imaging for the Detection of ZIKV Encephalopathy in the Fetus/Newborn

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx162.055 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S22-S22

Author(s):

Sarah Mulkey ◽

Gilbert Vezina ◽

Yamil Fourzali ◽

Dorothy Bulas ◽

Margarita Arroyave-Wessel ◽

...

Keyword(s):

Pregnant Women ◽

Imaging Modality ◽

Brain Mri ◽

Cerebellar Atrophy ◽

Fetal Brain ◽

Fetal Mri ◽

Zikv Infection ◽

Chiari Ii ◽

Brain Changes ◽

Prospective Longitudinal

Abstract Background Up to 15% of pregnancies complicated by maternal ZIKV infection result in Zika-virus associated brain abnormalities in the fetus/newborn. Fetal ultrasound (feUS) is the standard imaging modality for the evaluation of fetal anatomy and for brain changes from congenital infection. Fetal MRI (feMRI) may be a useful adjunct. Methods We performed a prospective longitudinal neuroimaging study of fetuses/newborns of pregnant women with clinical and/or lab confirmed (RT-PCR and/or IgM/PRNT) diagnosis of Zika infection in Barranquilla, Colombia (endemic) and in Washington, DC, USA (travel-related). Gestational age (GA) at exposure and timing between ZIKV exposure/symptoms and imaging was documented. Subjects had one to two feMRIs and feUS, depending upon GA at enrollment. The feMRI and feUS protocols were standardized between sites and studies were centrally interpreted at Children’s National. Postnatally, infants received an unsedated brain MRI and head US. Results Forty-eight, ZIKV exposed/infected in first or second trimester pregnant women were enrolled (46 Colombia, 2 USA). Subjects had symptoms of ZIKV infection at mean of 8.4±5.7 week GA. The first feMRI and feUS were performed at 25.1±6.3 week GA. Thirty-six infants had a second feMRI and feUS at 31.1±4.2 week GA. Three of 48 (6%) cases had an abnormal feMRI: (1) heterotopias and abnormal cortical indent; (2) parietal encephalocele and Chiari II; (3) thin corpus callosum, dysplastic brainstem, temporal cysts, subependymal heterotopias, and generalized cerebral/cerebellar atrophy. FeUS in these three cases found (1) normal study; (2) parietal encephalocele and Chiari II; (3) significant ventriculomegaly with decreasing percentiles of head circumference from 32 to 36 week GA (38% to 3.6%). Postnatal head US revealed findings not seen on feUS: choroid plexus or germinal matrix cysts in nine infants and lenticulostriate vasculopathy in one infant. Conclusion FeMRI and feUS provide complimentary information in the assessment of fetal brain changes in ZIKV. In cases of abnormal brain structure, feMRI reveals more extensive areas of brain damage than is seen by US. Further studies are needed to determine whether cystic changes on postnatal head US are related to ZIKV infection, or are incidental findings. Disclosures All authors: No reported disclosures.

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Vitamin C and vitamin E in pregnant women at risk for pre-eclampsia (VIP Trial): randomised placebo-controlled trial

Yearbook of Obstetrics Gynecology and Women s Health ◽

10.1016/s1090-798x(08)70061-4 ◽

2007 ◽

Vol 2007 ◽

pp. 80-82

Author(s):

S. Thung

Keyword(s):

At Risk ◽

Vitamin E ◽

Vitamin C ◽

Pregnant Women ◽

Controlled Trial

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Mental Burden in Data Management for Detection of Pregnant Women at Risk of Preeclampsia

Promoting Population Mental Health and Well-Being ◽

10.26911/theicph.2019.04.055 ◽

2019 ◽

Author(s):

Cahya Tri Purnami ◽

◽

Suharyo Hadisaputro ◽

Lutfan Lazuardi ◽

Syarief Thaufik H ◽

...

Keyword(s):

At Risk ◽

Data Management ◽

Pregnant Women ◽

Risk Of Preeclampsia

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Use of Routine Echocardiographic Screening for Structural Heart Disease in At-Risk Pregnant Women in India

JACC Cardiovascular Imaging ◽

10.1016/j.jcmg.2020.08.032 ◽

2020 ◽

Author(s):

Amisha Patel ◽

Lauren S. Ranard ◽

Nicole Aranoff ◽

Hussein Rahim ◽

Roja Vanukuru ◽

...

Keyword(s):

At Risk ◽

Heart Disease ◽

Pregnant Women ◽

Structural Heart Disease ◽

Women In India

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Safety review of tenofovir disoproxil fumarate/emtricitabine pre-exposure prophylaxis for pregnant women at risk of HIV infection

Expert Opinion on Drug Safety ◽

10.1080/14740338.2021.1931680 ◽

2021 ◽

Author(s):

Randy M. Stalter ◽

Jillian Pintye ◽

Kenneth K. Mugwanya

Keyword(s):

At Risk ◽

Hiv Infection ◽

Pregnant Women ◽

Tenofovir Disoproxil Fumarate ◽

Safety Review ◽

Exposure Prophylaxis

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In utero MRI identifies consequences of early-gestation alcohol drinking on fetal brain development in rhesus macaques

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.1919048117 ◽

2020 ◽

Vol 117 (18) ◽

pp. 10035-10044

Author(s):

Xiaojie Wang ◽

Verginia C. Cuzon Carlson ◽

Colin Studholme ◽

Natali Newman ◽

Matthew M. Ford ◽

...

Keyword(s):

White Matter ◽

Brain Development ◽

Ex Vivo ◽

Early Recognition ◽

Brain Mri ◽

Fetal Brain ◽

Fetal Mri ◽

Diffusion Anisotropy ◽

Self Administration ◽

White Matter Tracts

One factor that contributes to the high prevalence of fetal alcohol spectrum disorder (FASD) is binge-like consumption of alcohol before pregnancy awareness. It is known that treatments are more effective with early recognition of FASD. Recent advances in retrospective motion correction for the reconstruction of three-dimensional (3D) fetal brain MRI have led to significant improvements in the quality and resolution of anatomical and diffusion MRI of the fetal brain. Here, a rhesus macaque model of FASD, involving oral self-administration of 1.5 g/kg ethanol per day beginning prior to pregnancy and extending through the first 60 d of a 168-d gestational term, was utilized to determine whether fetal MRI could detect alcohol-induced abnormalities in brain development. This approach revealed differences between ethanol-exposed and control fetuses at gestation day 135 (G135), but not G110 or G85. At G135, ethanol-exposed fetuses had reduced brainstem and cerebellum volume and water diffusion anisotropy in several white matter tracts, compared to controls. Ex vivo electrophysiological recordings performed on fetal brain tissue obtained immediately following MRI demonstrated that the structural abnormalities observed at G135 are of functional significance. Specifically, spontaneous excitatory postsynaptic current amplitudes measured from individual neurons in the primary somatosensory cortex and putamen strongly correlated with diffusion anisotropy in the white matter tracts that connect these structures. These findings demonstrate that exposure to ethanol early in gestation perturbs development of brain regions associated with motor control in a manner that is detectable with fetal MRI.

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Impairments of vestibular system in infants at risk of early brain damage

Scandinavian Audiology ◽

10.1080/010503901300007498 ◽

2001 ◽

Vol 30 (1) ◽

pp. 191-193 ◽

Cited By ~ 6

Author(s):

Jagoda Vatovec ◽

Milivoj Veličkovič ◽

Lojze Šmid ◽

Klas Brenk ◽

Miha Žargi

Keyword(s):

At Risk ◽

Brain Damage ◽

Vestibular System

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Maternal IgG Avidity and IgM Detected by Blot as Diagnostic Tools to Identify Pregnant Women at Risk of Transmitting Cytomegalovirus

Viral Immunology ◽

10.1089/vim.2000.13.137 ◽

2000 ◽

Vol 13 (1) ◽

pp. 137-141 ◽

Cited By ~ 61

Author(s):

TIZIANA LAZZAROTTO ◽

STEFANIA VARANI ◽

PATRIZIA SPEZZACATENA ◽

LILIANA GABRIELLI ◽

PAOLA PRADELLI ◽

...

Keyword(s):

At Risk ◽

Pregnant Women ◽

Diagnostic Tools ◽

Igg Avidity ◽

Maternal Igg

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Total Usual Dietary Intakes of Pregnant Women in the United States, 2001-2014 (FS08-01-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz048.fs08-01-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Regan Bailey ◽

Susan Pac ◽

Victor Fulgoni ◽

Kathleen Reidy

Keyword(s):

At Risk ◽

Folic Acid ◽

Pregnant Women ◽

Critical Dimension ◽

The United States ◽

Dietary Intakes ◽

Dietary Recommendations ◽

Cross Sectional ◽

Excessive Consumption ◽

Nationally Representative

Abstract Objectives Nutrition during pregnancy is a critical dimension not only for women’s heath, but also for the offspring’s lifelong health. Very limited national data exist on the usual dietary intakes of pregnant women. The objective of this study was to estimate total usual nutrient intakes (from foods and dietary supplements) of pregnant women in the U.S. Methods Cross-sectional analysis of a nationally-representative sample of pregnant U.S. women, ages 20-40 years (n = 1,003) from NHANES 2001-2014. Total usual dietary intakes were estimated using the National Cancer Institute (NCI) method to adjust 2, 24-hour dietary recalls for within-person variation. Adherence with the Dietary Reference Intakes were used to assess the proportion at risk of inadequacy by the Estimated Average Requirement (%< EAR), assumed to be adequate by the Adequate Intake (% >AI), and at risk of excess by the Tolerable Upper Intake Level (% >UL). Results About 70% of pregnant women use a dietary supplement. Less than 5% of pregnant women have usual diets that are at risk for inadequate intakes of riboflavin (3%), niacin (1%), vitamin B12 (1%), iron (2%), phosphorus (< 0.5%), and selenium (< 0.5%). More pregnant women have usual intakes < EAR for vitamins A (15%), B6 (11%), folate (16%), C (11%), D (46%), E (43%), and minerals including copper (5%), calcium (13%), magnesium (47%) and zinc (11%). Few pregnant females have usual intakes >AI for potassium (2%) and choline (8%), whereas only 48% have vitamin K intakes >AI. The majority of pregnant women (95%) exceed the UL for sodium, while folic acid (34%), iron (28%), calcium (3%), and zinc (7%) were also of concern for intakes >UL. Conclusions Many U.S. pregnant women ( >10% < EAR or < 10% >AI) do not consume enough of key nutrients during pregnancy specifically vitamins A, C, D, E, K, B6, folate, and choline and minerals including potassium, calcium, magnesium, and zinc, while almost all are at risk of excessive consumption of sodium, and many at risk of excessive consumption of folic acid and iron. Improved dietary guidance to help pregnant women meet and not exceed dietary recommendations is warranted. Funding Sources Nestle Nutrition.

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