Clinician-to-Clinician Update Clinician-to-Clinician Update

Maternal-Fetal Medicine Specialty Updates

November 2014 - Maternal Fetal Medicine

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— Tracy Prosen, MD

New Noninvasive Prenatal Testing Study Published

Tracy Prosen, MD, and colleagues recently published a study about utilization of cell-free DNA testing, the newest alternative in noninvasive screening for common fetal aneuploidies. Cell-free DNA testing has been previously shown to have significantly lower false positive rates and higher positive predictive values for detection of trisomies 21 and 18 than standard screening. In their new study, published in October 2014 in the American Journal of Obstetrics & Gynecology, they examined utilization rates for the new testing method and the resulting effects upon invasive procedure volume. The authors found that the introduction of cell-free DNA testing was associated with a decrease in invasive procedure volume, but that invasive procedures were still being performed following negative noninvasive prenatal testing results, particularly at centers in the Western United States. These data suggest the existence of regional differences in adoption of the new noninvasive testing methods.

Reference: Platt LD, Janicki MB, Prosen T, et al. Impact of noninvasive prenatal testing in regionally dispersed medical centers in the United States. Am J Obstet Gynecol. 2014;211(4):368.e1-7.

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— Kirk Ramin, MD

Case Report: The Prenatal Diagnosis of Noncompaction Cardiomyopathy and Coarctation of the Aorta

Left ventricular noncompaction (LVNC) cardiomyopathy is a rare form of cardiomyopathy. It is difficult to diagnose prenatally and therefore not well described in the fetal population. Kirk Ramin, MD, Shanthi Sivanandam, MD and colleagues recently reported a case of LVNC cardiomyopathy and coarctation of the aorta, which was detected prenatally at 29 weeks 6 days of gestation. The infant was treated, stabilized, and discharged at 15 weeks of age. This is the first such case report in the literature, and supports the conclusion that prenatal diagnosis of noncompaction cardiomyopathy may improve neonatal morbidity and mortality. The findings were published in the American Journal of Perinatology Reports.

Reference: Jacobs K, Giacobbe L, Aguilera M, Ramin K, Sivanandam S. A case of fetal diagnosis of noncompaction cardiomyopathy and coarctation of the aorta. AJP Rep. 2014;4(1):45-48.

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— Joseph Hwang, MD

Two new Maternal-Fetal Medicine Specialists have Joined the Program Since April 2013

Joseph Hwang, MD, received his MD from Georgetown University and trained in Maternal-Fetal Medicine at Yale University. He has practiced at Avera Health in South Dakota and Mercy Medical Center in Des Moines, Iowa over the last 13 years. He has a clinical and research interest in preterm labor, preterm birth, prenatal diagnosis, ultrasound, CVS, fetal blood sampling and transfusion, cervical shortening and cerclage.

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— Andrea Shields, MD

Andrea Shields, MD, received her MD from the University of Minnesota and trained in Maternal-Fetal Medicine at Madigan Army Medical Center, in Tacoma, Washington. She served in the Air Force Healthcare System in a number of leadership positions and with academic appointments at the University of Texas Health Science Center, San Antonio, Texas and Wright State Medical School, Dayton, Ohio. She is a member of the National ACOG Technical Bulletins Committee. Her clinic and research interests include preterm labor, prenatal diagnosis, patient safety and quality improvement, placental perfusion and simulation.

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