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PURPOSE: To evaluate the role of ultrasound screening for fetal structural abnormalities at 20 and 30 weeks' gestation. METHODS: This retrospective study included women with singleton pregnancies who underwent routine ultrasound screening at our hospital between May 2014 and April 2021. Participants received two ultrasound screening examinations: at 20 and 30 weeks' gestation. We evaluated the frequency and details of fetal structural abnormalities identified during each examination. RESULTS: A total of 10,560 pregnant women underwent ultrasound screening at 20 and 30 weeks' gestation and delivered at our hospital. Structural abnormalities were observed in 142 (1.3%) women; of note, screening examinations at 20 and 30 weeks detected 42.3% and 23.9% of cases, respectively. Routine point-of-care ultrasound examinations performed between 20 and 30 weeks and beyond 30 weeks detected 8.5% and 6.3% of cases, respectively, with 19.0% of cases identified after birth. Cleft lip and palate and ventricular septal defects (VSDs) were the most common abnormalities detected at the 20-week ultrasound screening. At the 30-week ultrasound screening, in addition to hydronephrosis, VSD, and vascular rings, which were also detected at the 20-week ultrasound screening, diaphragmatic hernia, ovarian cysts, achondroplasia, duodenal atresia, and meconium peritonitis, which could be apparent later in pregnancy, were detected. CONCLUSIONS: The 20-week ultrasound screening revealed common fetal structural abnormalities, and the 30-week ultrasound screening detected fetal structural abnormalities that failed to be detected during the 20-week ultrasound screening and became apparent later in pregnancy. Adding a 30-week ultrasound screening provides enhanced diagnostic details in comparison to 20-week screening.

DOI： 10.1007/s10396-025-01609-1

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INTRODUCTION: Accurate assessment of fetal supraventricular tachycardia (SVT) frequency is critical for deciding treatment strategies. In this study, we evaluated the potential of prolonged non-invasive fetal electrocardiography (fECG) monitoring for assessing SVT and guiding therapy. CASE PRESENTATION: A 37-year-old woman at 28 weeks of gestation was referred to our hospital for fetal tachycardia. The patient was diagnosed with fetal arrhythmia, including occasional premature atrial contractions and SVT. Fetal heart rate monitoring using Doppler-based cardiotocography (CTG) with external transducers was insufficient for accurate frequency evaluation; moreover, brief fetal echocardiography was inadequate due to marked diurnal variation in SVT frequency. Prolonged fECG monitoring at 29 and 31 weeks of gestation revealed that SVT did not persist for 12 or more hours or for more than 50% of the monitoring period, indicating a low risk for fetal hydrops. The pregnancy proceeded normally, and the infant was born healthy at 38 weeks. CONCLUSION: This report suggests that prolonged fECG monitoring is a more reliable and less invasive method for assessing fetal SVT frequency compared with traditional CTG or fetal echocardiography. Furthermore, it provides a non-invasive and accurate approach for evaluating the need for fetal therapy, especially in arrhythmia cases where frequency assessment is essential.

DOI： 10.1159/000547011

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DOI： 10.1016/S0140-6736(24)01511-3

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To assess the association between gestational weight gain (GWG) and the risk of developing chronic diseases in later life, this historical cohort study of 318 non-overweight women was conducted between April 2017 and November 2020 at a hospital in Tokyo. Data about GWG in the last pregnancy and the development of any chronic diseases of the subjects were retrieved from the women's Maternal and Child Health Handbooks and through a questionnaire survey, respectively. The outcomes were chronic diseases, such as diabetes mellitus (DM), hypertension, hyperlipidemia, and being overweight (body mass index [BMI] ≥ 25 kg/m2). Association between GWG and outcomes were assessed using a logistic regression analysis.There were significant positive linear associations between GWG and the risks of developing DM, hypertension, and being overweight (P = 0.013, 0.050, and 0.017, respectively). After adjusting for later-life BMI, a significant association between GWG and DM (P = 0.025) remained, but the association between GWG and hypertension disappeared. GWG was significantly associated with DM, hypertension, and being overweight later in life. Although the association between GWG and DM was partially independent of BMI later in life, the association between GWG and hypertension was influenced by being overweight later in life.

DOI： 10.1038/s41598-023-50844-4

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Mucopolysaccharidosis (MPS)-VII, called Sly disease, is a lysosomal storage disorder that can cause fetal hydrops, including fetal hydrothorax (FHT). We describe two fetal cases that received thoracoamniotic shunting for FHT, which was later found to be associated with MPS-VII by exome sequencing. Bilateral FHT accompanied by skin edema and ascites was found before 20 weeks of gestation in both cases. One fetus died in utero at 35 weeks of gestation, and the other survived with preterm delivery at 30 weeks of gestation. Both cases inherited compound pathogenic variants of GUSB from parents. Comparison with previously reported primary FHT cases revealed distinct clinical features in MPS-VII-associated FHT: early gestational age at diagnosis (<26 weeks), bilateral effusion, skin edema with ascites, and poor survival. A genetic analysis would be considered for FHT cases, with consideration of shunting when they show early-onset bilateral effusions with skin edema and ascites.

DOI： 10.1111/jog.15744

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