Society of Maternal-Fetal Medicine, Feb. 3-8Last Updated: February 10, 2014.
The annual meeting of the Society of Maternal-Fetal Medicine was held from Feb. 3 to 8 in New Orleans and attracted more than 2,000 participants from around the world, including obstetricians/gynecologists and other clinical practitioners who specialize in maternal-fetal medicine. The conference highlighted recent advances in maternal-fetal medicine, with presentations and abstracts focusing on reducing high-risk pregnancy complications through pregnancy assessment and management.
In one study, Mary E. Norton, M.D., of the University of California in San Francisco, and colleagues evaluated the number and type of chromosomal abnormalities that were detected in women who had a traditional screening test that indicated a high risk for Down syndrome.
"We found that Down syndrome accounted for only about half of the total abnormalities in such women. All in all, about 83 percent of the abnormalities that were found by invasive testing could have been detected if noninvasive prenatal testing (NIPT) with cell-free DNA had been done instead," said Norton. "In the other 17 percent, a variety of less common chromosomal abnormalities were identified which are not targets of NIPT and therefore would have been missed."
According to Norton, NIPT is not a replacement for amniocentesis in high-risk women, because although Down syndrome is the most common aneuploidy, amniocentesis detects many more abnormalities than just Down syndrome and the other common trisomies.
"Patients (and providers) need to understand the trade-off between different prenatal genetic tests," Norton added. "NIPT is very accurate for the common trisomies, but traditional screening can indicate risk for much more than just these common anomalies, and amniocentesis can detect many more chromosomal anomalies than NIPT."
In another study, Liv Freeman, M.D., of Leiden University Medical Center in the Netherlands, and colleagues assessed patient satisfaction regarding pain relief with remifentanil as compared to epidural analgesia during labor.
"The main focus of the study was satisfaction with pain relief. We showed that this satisfaction, or the pain appreciation, is not comparable," said Freeman. "So our main conclusion is that women with epidural analgesia have higher scores on pain appreciation. The impact of this conclusion on clinical practice is that remifentanil patient-controlled analgesia cannot be used as a substitute for epidural analgesia because of lower patient satisfaction. Future research and analysis of additional trial data should reveal more about specific subgroups of women that might benefit from remifentanil patient-controlled analgesia."
Tracy Manuck, M.D., of the University of Utah Health Sciences Center in Salt Lake City, and colleagues found that there are some key genetic differences between women who respond to progesterone for recurrent preterm birth prevention and those who have a recurrent preterm birth at a similar gestational age in pregnancy. The investigators used a new analytic approach which enabled them to scan all parts of the genome that encode genes to look for differences both in individual genes as well as larger networks of genes.
"Our results suggest that someday the hope of being able to create a 'response panel,' which would enable us to test women at the beginning of pregnancy to see if they will respond to progesterone shots, may become a reality," said Manuck. "Our study was based on a small group of women and should be verified and validated in a larger group of women prior to being integrated into clinical practice. However, this study helps provide direction for future studies and analyses."