Fetal intelligent navigation echocardiography (FINE) to obtain standard fetal echocardiography views (1): The most prevalent organ-specific birth defect and the leading cause of infant morbidity and mortality among those with birth defects is congenital heart disease (CHD). However, the prenatal diagnosis of CHD remains suboptimal, with sensitivities ranging from 22.5 to 52.8%. Most cases of CHD occur in pregnancies without risk factors; therefore, midtrimester screening for CHD is the most rational approach for the detection of cardiac anomalies. Fetal intelligent navigation echocardiography (FINE) has recently emerged as a novel approach to examine the fetal heart after a spatiotemporal image correlation (STIC) volume has been acquired. Such a method allows the automatic generation and display of nine standard fetal echocardiography views in normal hearts, including those universally recommended by professional organizations such as the American Institute of Ultrasound in Medicine (AIUM) and the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG). We reported a prospective cohort study of patients with normal fetal hearts (19-30 weeks of gestation), in which one or more STIC volume datasets were obtained (n=463, from 246 patients). When applied to STIC volumes, FINE can successfully generate nine standard fetal echocardiography views in 96-100% of cases in the 2nd-3rd trimesters. Therefore, this technology can be used as a method of screening for congenital heart disease. Quantitative ultrasound lung texture analysis to predict neonatal respiratory morbidity (2): The most common complication in infants born preterm, and even early term (<39 weeks), is neonatal respiratory morbidity (NRM) due to either respiratory distress syndrome or transient tachypnea. The risk of NRM ranges from 5-20% after 34 weeks of gestation, and the assessment of fetal lung maturity at this point is beneficial to gauge risk/benefit ratio of elective delivery and/or with the use of corticosteroids. Typically, amniocentesis has been required; however, image resolution of fetal ultrasound and computer image processing have evolved immensely, providing a non-surgical alternative. We undertook a prospective multicenter study, collecting fetal lung ultrasound images at 25-38.6 weeks of gestation within 48 hours of delivery 883 images (17.3% were discarded due to poor image quality or exclusion criteria), leaving 730 for analysis. The prevalence of neonatal respiratory morbidity was 13.8%. The quantusFLM predicted neonatal respiratory morbidity with sensitivity, specificity, positive and negative predictive values of 74.3%, 88.6%, 51%, and 86.5%, respectively. The advantage of this technique is its noninvasive nature, and these results are similar to those previously reported for other noninvasive tests. Prenatal diagnosis of dextrocardia with complex congenital heart disease using Fetal Intelligent Navigation Echocardiography (FINE) (3): Fetal dextrocardia is associated with a wide spectrum of cardiac defects that are often complex, and this condition is conceptually difficult to understand and diagnose. Fetal intelligent navigation echocardiography (FINE) is able to demonstrate abnormal fetal cardiac anatomy in multiple echocardiography views; however, such method had not been applied thus far to cases of fetal cardiac malposition (such as dextrocardia). We reported for the first time a case of situs solitus and dextrocardia with complex congenital heart disease, diagnosed in the 3rd trimester using FINE. Such method was invaluable in demonstrating the specific abnormalities and defining the complex anatomic relationships difficult to do using real-time echocardiography. This new technology offers great promise in imaging of the fetal heart, and reduces potential operator error. 1. Veronese P, Bogana G, Cerutti A, Yeo L, Romero R, Gervasi MT. A prospective study of the use of fetal intelligent navigation echocardiography (FINE) to obtain standard fetal echocardiography views. Fetal Diagn Ther 2017;41(2):89-99. PMID: 27309391 2. Palacio M, Bonet-Carne E, Cobo T, Perez-Moreno A, Sabria J, Richter J, Kacerovsky M, Jacobsson B, Garcia-Posada RA, Bugatto F, Santisteve R, Vives A, Parra-Cordero M, Hernandez-Andrade E, Bartha JL, Carretero-Lucena P, Tan KL, Cruz-Martinez R, Burke M, Vavilala S, Iruretagoyena I, Delgado JL, Schenone M, Vilanova J, Botet F, Yeo GSH, Hyett J, Deprest J, Romero R, Gratacos E. Prediction of neonatal respiratory morbidity by quantitative ultrasound lung texture analysis: a multicenter study. Am J Obstet Gynecol 2017. In Press PMID: 28342715 3. Yeo L, Luewan S, Markush D, Gill N, Romero R. Prenatal diagnosis of dextrocardia with complex congenital heart disease using Fetal Intelligent Navigation Echocardiography (FINE) and a literature review. Fetal Diagn Ther 2017. In Press PMID: 28641300
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