%0 Journal Article
%~ PubMed
%A Gardener, Glenn J
%A Legler, Tobias J
%A Hyett, Jonathan A
%A Liew, Yew-Wah
%A Flower, Robert L
%A Hyland, Catherine A
%T Anti-D in pregnant women with the RHD(IVS3+1G>A)-associated DEL phenotype.
%B Transfusion
%D 2012
%C United States
%I Wiley-Blackwell Publishing, Inc.
%V 52
%N 9
%P 2016-2209
%@ 1537-2995
%X BACKGROUND: Pregnant women with the DEL phenotype appear to be D- by routine serology. Women with DEL phenotypes that show a partial D-like epitope loss may develop anti-D. It has been proposed that this alloantibody could have a deleterious effect with respect to hemolytic disease in the fetus and newborn. CASE REPORTS: Two pregnant women, one in Australia and one in Germany, were serotyped as D- and were sensitized to the D antigen. Noninvasive fetal RHD genotyping was performed to plan pregnancy management. RESULTS: In both cases the fetal RHD status could not be assigned due to the presence of a maternal DEL allele. This was suspected through detection of high RHD amplicon levels during quantitative polymerase chain reaction. For both cases extended molecular typing of the maternal genomic DNA revealed a RHD(IVS3+1G>A) allele. For case one, the D+ infant developed a mild hemolytic disease requiring phototherapy. In the second case a D- (or DEL) newborn was unaffected. CONCLUSION: Fetal genotyping from maternal plasma reveals RHD variants in pregnant women with anti-D. Fetuses and newborns of sensitized pregnant women carrying the RHD(IVS3+1G>A) allele are at risk of hemolytic disease.
%Z FOR Codes: 1104


%0 Journal Article
%~ PubMed
%A Mogra, Ritu
%A Alabbad, Nasser
%A Hyett, Jon
%T Increased nuchal translucency and congenital heart disease.
%B Early Human Development
%D 2012
%C Ireland
%I Elsevier Ireland Ltd
%V 88
%N 5
%P 261-267
%@ 1872-6232
%X Sonographic assessment of fetal nuchal translucency (NT) thickness is the cornerstone of screening for chromosomal abnormality at 11-13(+6) weeks gestation. This marker was first recognized in pregnancies being karyotyped for advanced maternal age, but its underlying pathophysiology remains to be fully determined. Although increased NT is clearly associated with changes in both lymphatic and cardiac development, neither is an obvious causative agent. The association with cardiac defects has now being subjected to a significant amount of research, with a large body of evidence showing that this marker is also a screening tool for major cardiac defects - although it performs more modestly than for chromosomal abnormality. The field continues to change rapidly. Recent evidence that uses a combination of increased NT, tricuspid regurgitation and abnormal flow in the ''a'' wave of the ductus venosus can provide an effective screening strategy to predict many major cardiac defects at this early stage of pregnancy.
%Z FOR Codes: 1112


%0 Journal Article
%~ PubMed
%A Phipps, Hala
%A de Vries, Bradley
%A Lee, Ping N
%A Hyett, Jon A
%T Management of occiput posterior position in the second stage of labour: A survey of obstetric practice in Australia and New Zealand.
%B The Australian & New Zealand Journal of Obstetrics & Gynaecology
%D 2012
%C Australia
%I Wiley-Blackwell Publishing Asia
%V 52
%N 5
%P 450-454
%@ 1479-828X
%X BACKGROUND: Issues in the management of the occipito posterior (OP) position have been the subject of clinical controversy over decades. Manual rotation has the potential to reduce operative delivery for fetal malposition. AIM: To determine the current obstetric practice with regard to manual rotation in the management of the second stage of labour. METHODS: Survey mailed to all members and fellows of the Australian and New Zealand College of Obstetricians and Gynaecologists. RESULTS: Of 1805 surveyed, 60% responded, of whom 68% were currently practising obstetrics. Ninety-seven per cent of respondents thought that manual rotation at full dilatation was a valid intervention, 85% stated that manual rotation was acceptable prior to instrumental delivery, and 70% thought that manual rotation was acceptable without assisted delivery. Only 41% of practising obstetricians had performed a manual rotation in the last year, and only 9% had performed more than five. Obstetricians would routinely perform manual rotation for OP position if it reduced operative delivery from 68% to a median of 50%. CONCLUSION: Manual rotation is currently performed by only a minority of obstetricians in Australia and New Zealand, yet is considered to be an acceptable procedure by the vast majority. The survey confirmed that obstetricians would be willing to perform prophylactic manual rotation if this was known to reduce the operative delivery rate, suggesting that there is a scope to introduce this procedure into widespread clinical practice.
%Z FOR Codes: 111402


%0 Journal Article
%~ PubMed
%A Carberry, Angela E
%A Gordon, Adrienne
%A Bond, Diana M
%A Hyett, Jon
%A Raynes-Greenow, Camille H
%A Jeffery, Heather E
%T Customised versus population-based growth charts as a screening tool for detecting small for gestational age infants in low-risk pregnant women.
%B Cochrane Database of Systematic Reviews
%D 2011
%C United Kingdom
%I John Wiley & Sons Ltd.
%V 12
%N 
%P CD008549
%@ 1469-493X
%X Fetal growth restriction is defined as failure to reach growth potential and considered one of the major complications of pregnancy. These infants are often, although not universally, small for gestational age (SGA). SGA is defined as a weight less than a specified percentile (usually the 10th percentile). Identification of SGA infants is important because these infants are at increased risk of perinatal morbidity and mortality. Screening for SGA is a challenge for all maternity care providers and current methods of clinical assessment fail to detect many infants that are SGA. Large observational studies suggest that customised growth charts may be better able to differentiate between constitutional and pathologic smallness. Customised charts adjust for physiological variables such as maternal weight and height, ethnicity and parity.
%Z FOR Codes: 111403 111706


%0 Journal Article
%~ PubMed
%A Leung, Tak Yeung
%A Vogel, Ida
%A Lau, Tze Kin
%A Chong, Wilson
%A Hyett, Jonathan A
%A Petersen, Olav Bjørn
%A Choy, Kwong Wai
%T Identification of submicroscopic chromosomal aberrations in fetuses with increased nuchal translucency and an apparently normal karyotype.
%B Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
%D 2011
%C United Kingdom
%I John Wiley & Sons Ltd.
%V 38
%N 3
%P 314-9
%@ 1469-0705
%X Fetal nuchal translucency (NT) is assessed by ultrasonography as a screening tool for aneuploidy at 11 to 13 + 6 weeks'' gestation. Fetuses with increased NT but apparently normal karyotype are still at higher risk of structural abnormality and a range of genetic syndromes, which may be related to major and submicroscopic chromosomal abnormalities. The aim of this study was to report the prevalence of submicroscopic chromosomal abnormalities in a cohort of apparently euploid fetuses that presented with increased NT.
%Z FOR Codes: 60412 111401


%0 Journal Article
%~ PubMed
%A Mogra, Ritu
%A Schluter, Philip
%A Ogle, Robert
%A Walter, Mary
%A Borg, Michael
%A Hyett, Jon
%T Normal ranges for fetal nasal bone length determined by ultrasound at 18-20 weeks of gestation in a multiethnic Australian population.
%B The Australian & New Zealand journal of obstetrics & gynaecology
%D 2011
%C Australia
%I Wiley-Blackwell Publishing Asia
%V 51
%N 4
%P 347-52
%@ 1479-828X
%X Absence or hypoplasia of the nasal bone is commonly reported in Down syndrome fetuses. We define normal ranges and the 2.5th centile for fetal nasal bone length (NBL) in a multiethnic Australian population at 18-20 weeks of gestation.
%Z FOR Codes: 111401


%0 Journal Article
%A Bond, Diana
%A Gordon, Adrienne
%A Hyett, Jonathan
%A de Vries, Bradley
%A Carberry, Angela
%A Morris, Jonathan
%T Planned Early Delivery vs. Expectant Management of the Term Suspected Compromised Baby for Improving Outcomes
%B Cochrane Database of Systematic Reviews
%D 2011
%C United Kingdom
%I John Wiley & Sons Ltd.
%V 1
%N 
%P 1
%@ 1469-493X
%X 
%Z FOR Codes: 111402


%0 Journal Article
%~ PubMed
%A Evans, Nicholas
%A Hyett, Jon A
%T Preface to haemodynamics edition of seminars in fetal and neonatal medicine.
%B Seminars in fetal & neonatal medicine
%D 2011
%C United Kingdom
%I WB Saunders Co. Ltd.
%V 16
%N 1
%P 1
%@ 1878-0946
%X 
%Z FOR Codes: 1114


%0 Journal Article
%~ PubMed
%A Nisbet, D
%A McLennan, A
%A Robertson, A
%A Schluter, P J
%A Hyett, J
%T Reducing Inter-Rater Variability in the Assessment of Nuchal Translucency Image Quality.
%B Fetal diagnosis and therapy
%D 2011
%C Switzerland
%I S. Karger AG
%V 30
%N 2
%P 128-34
%@ 1421-9964
%X Standardization of first-trimester nuchal translucency (NT) image acquisition is crucial to the success of screening for Down syndrome. Rigorous audit of operator performance and constructive feedback from assessors maintain standards. This process relies on good inter-rater agreement on image assessment. We describe the Australian approach to NT image assessment and evaluate the impact of a targeted intervention on inter-rater agreement.
%Z FOR Codes: 111401


%0 Journal Article
%~ PubMed
%A Mogra, Ritu
%A Schluter, Philip J
%A Ogle, Robert F
%A O'Connell, Justine
%A Fortus, Lou
%A Hyett, Jon A
%T A prospective cross-sectional study to define racial variation in fetal nasal bone length through ultrasound assessment at 18-20???weeks' gestation.
%B The Australian & New Zealand Journal of Obstetrics & Gynaecology
%D 2010
%C Australia
%I Wiley-Blackwell Publishing Asia
%V 50
%N 6
%P 528-533
%@ 1479-828X
%X Objective:??? An absent or short nasal bone is highly predictive of Down syndrome in Caucasian populations, but Asians may have shorter nasal bones - increasing the false positive rate of screening. We examine differences in nasal bone length (NBL) in Caucasian and Asian populations. Methods:??? This prospective cohort study involved pregnant women attending for their routine anomaly scan at 18-20???weeks'' gestation. Ethnicity of the patient and their partner was recorded, and the nasal bone was measured three times. Mean NBL was calculated and used to investigate the effect of ethnicity first with a simple linear regression model and second with a mixed-effects regression model that accounted for variability of measurement between sonographers. Results:??? A total of 1087 families were involved in the study, including 592 (54%) Caucasians, 214 (20%) East Asians, 110 (10%) South Asians and 171 (16%) West Asians. Twenty-three sonographers performed the scans with an average of 19 scans each. There is no significant difference in NBL between Caucasian and Asian populations. The mixed-effects model shows that accounting for sonographer variation is important, with 6.7% of the total variance in measurement being related to this random effect. Conclusions:??? There is no significant difference in NBL between Caucasian and Asian populations. It is reasonable to use criteria established in a Caucasian population to define the characteristics of an absent/short nasal bone in Asian fetuses. This finding also removes difficulties in counselling mixed race couples.
%Z FOR Codes: 111401


%0 Journal Article
%~ PubMed
%A Nisbet, Debbie L
%A Robertson, Ann C
%A Schluter, Philip J
%A McLennan, Andrew C
%A Hyett, Jon A
%T Auditing ultrasound assessment of fetal nuchal translucency thickness: A review of Australian national data 2002-2008.
%B The Australian & New Zealand Journal of Obstetrics & Gynaecology
%D 2010
%C Australia
%I Wiley-Blackwell Publishing Asia
%V 50
%N 5
%P 450-455
%@ 1479-828X
%X Background:??? Nuchal translucency (NT) measurement is the ultrasound component of first trimester combined screening for Down syndrome. In 2002, a NT ultrasound education and monitoring program was established in Australia. Between 2002 and 2008, a total of 728???502 NT scans were audited through this process. Overall aim:??? To audit the availability and performance of certified operators measuring NT following implementation of the Australian education and monitoring program in 2002. Methods:??? Retrospective review of the central database that is used to monitor performance of individuals and practices performing NT scans in both public and private practice settings throughout Australia between 2002 and 2008. The performance of operators was assessed by a widely used international standard - that 40-60% of NT measurements should be above the median value for gestational age. Results:??? The number of certified operators has increased (from 184 in 2002 to 477 in 2008). There is wide variation between states in the number of operators per birth. The percentage of certified operators with a measurement distribution meeting the international standard has increased from 40% in 2002 to 55% in 2008. Greatest improvement has been seen in operators performing 30-199 scans per year. There has been no overall improvement in performance over the last three audit cycles. Conclusions:??? The number of operators certified to perform the NT scan has increased since 2002, although availability in some states remains low. An initial improvement in performance of operators appears to have reached a plateau. It is time to become more proactive in engaging operators in the audit cycle.
%Z FOR Codes: 111401


%0 Journal Article
%A Carberry, Angela
%A Gordon, Adrienne
%A Bond, Diana
%A Hyett, Jonathan
%A Raynes-Greenow, Camille
%A Jeffery, Heather
%T Customised versus population-based growth charts as a screening tool for detecting small for gestational age infants in low-risk pregnant women
%B Cochrane Database of Systematic
Reviews
%D 2010
%C United States
%I Wiley-Blackwell Publishing Ltd.
%V 2010
%N 6
%P CD008549
%@ 1469-493X
%X 
%Z FOR Codes: 111401


%0 Journal Article
%~ PubMed
%A Deprest, J A
%A Hyett, J A
%A Flake, A W
%A Nicolaides, K
%A Gratacos, E
%T Current controversies in prenatal diagnosis 4: Should fetal surgery be done in all cases of severe diaphragmatic hernia?
%B Prenatal Diagnosis
%D 2009
%C United Kingdom, Uni
%I John Wiley & Sons Ltd.
%V 29
%N 1
%P 15-19
%@ 0197-3851
%X 
%Z FOR Codes: 111401


%0 Journal Article
%~ PubMed
%A Hyland, Catherine A
%A Gardener, Glenn J
%A Davies, Helen
%A Ahvenainen, Minna
%A Flower, Robert L
%A Irwin, Darryl
%A Morris, Jonathan M
%A Ward, Christopher M
%A Hyett, Jonathan A
%T Evaluation of non-invasive prenatal RHD genotyping of the fetus.
%B The Medical Journal of Australia
%D 2009
%C Australia
%I Australasian Medical Publishing Company Pty. Ltd.
%V 191
%N 1
%P 21-25
%@ 0025-729X
%X OBJECTIVE: To evaluate a non-invasive molecular test using free circulating fetal DNA in maternal plasma to predict the fetal RHD type. DESIGN: A prospective cohort study. PARTICIPANTS AND SETTING: Venous blood samples were collected from 140 Rhesus (Rh) D-negative women booked for antenatal care in two tertiary maternity hospitals in Sydney and Brisbane between November 2006 and April 2008. Cell-free DNA, including free maternal and fetal DNA, was extracted from maternal plasma in the tertiary Australian Red Cross Blood Service laboratory, and three exon regions of the RHD gene were amplified. MAIN OUTCOME MEASURES: Comparison of the predicted fetal RHD status and the infant''s RhD serotype. Secondary analysis involved using SRY and RASSF1A assays as internal controls to confirm the presence of fetal DNA in RHD-negative samples. RESULTS: Of 140 samples tested, results for RHD status were assigned for 135, and all 135 predictions were correct. A result was not assigned in five cases: three did not meet strict threshold criteria for classification, and two were due to RHD variants. Fetal SRY status was correctly predicted in 137 of 140 cases. In 16 samples typed both RHD- and SRY-negative, a positive RASSF1A result verified the presence of fetal DNA. CONCLUSIONS: Non-invasive testing of multiple exons provides a robust method of assessing fetal RHD status, and provides a safer alternative to amniocentesis for the management of RhD-negative pregnant women who are isoimmunised.
%Z FOR Codes: 111401


%0 Journal Article
%~ PubMed
%A McLennan, A
%A Schluter, P J
%A Pincham, V
%A Hyett, J
%T First-trimester fetal nasal bone audit: evaluation of a novel method of image assessment.
%B Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
%D 2009
%C United Kingdom
%I John Wiley & Sons Ltd.
%V 34
%N 6
%P 623-8
%@ 1469-0705
%X Absence of the nasal bone has been recognized to be a strong ultrasound marker for Down syndrome and its inclusion in combined first-trimester screening would increase the sensitivity and specificity of this test. We describe the development of a method of image scoring that should allow reliable assessment of practitioners submitting themselves to peer review for nasal bone imaging.
%Z FOR Codes: 110320 111401


%0 Journal Article
%A Mogra, Ritu
%A Moore, David LH
%A Hyett, Jonathan
%T Management Conundrums in Multiple Pregnancies with Selective Reduction, Intrauterine Fetal Death or Spontaneous Abortion
%B Fetal and Maternal Medicine Review
%D 2009
%C United Kingdom
%I Cambridge University Press
%V 20
%N 3
%P 247-267
%@ 0965-5395
%X 
%Z FOR Codes: 111401