Background and Objectives: We aimed to prospectively obtain data on pregnancies complicated with intrauterine growth restriction (IUGR) in the Prenatal Diagnosis Unit of the Emergency County Hospital of Craiova. We collected the demographic data of mothers, the prenatal ultrasound (US) features, the intrapartum data, and the immediate postnatal data of newborns. We aimed to assess the detection rates of IUGR fetuses (the performance of the US in estimating the actual neonatal birth weight), to describe the prenatal care pattern in our unit, and to establish predictors for the number of total hospitalization days needed postnatally. Materials and Methods: Data were collected from cases diagnosed with IUGR undergoing prenatal care in our hospital. We compared the percentile of estimated fetal weight (EFW) using the Hadlock 4 technique with the percentile of weight at birth. We retrospectively performed a regression analysis to correlate the variables predicting the number of hospitalization days. Results: Data on 111 women were processed during the period of 1 September 2019–1 September 2022. We confirmed the significant differences in US features between early- (Eo) and late-onset (Lo) IUGR cases. The detection rates were higher if the EFW was lower, and Eo-IUGR was associated with a higher number of US scans. We obtained a mathematical formula for estimating the total number of hospitalization days needed postnatally. Conclusion: Early- and late-onset IUGR have different US features prenatally and different postnatal outcomes. If the US EFW percentile is lower, a prenatal diagnosis is more likely to be made, and a closer follow-up is offered in our hospital. The total number of hospitalization days may be predicted using intrapartum and immediate postnatal data in both groups, having the potential to optimize the final financial costs and to organize the neonatal department efficiently.

Background and Objectives: In this study, we aimed to describe the clinical and ultrasound (US) features and the outcome in a group of patients suspected of or diagnosed with early onset intrauterine growth restriction (IUGR) requiring iatrogenic delivery before 32 weeks, having no structural or genetic fetal anomalies, managed in our unit. A secondary aim was to report the incidence of the condition in the population cared for in our hospital, data on immediate postnatal follow-up in these cases and to highlight the differences required in prenatal and postnatal care. Materials and Methods: We used as single criteria for defining the suspicion of early IUGR the sonographic estimation of fetal weight < p10 using the Hadlock 4 technique at any scan performed before 32 weeks’ gestation (WG). We used a cohort of patients having a normal evolution in pregnancy and uneventful vaginal births as controls. Data on pregnancy ultrasound, characteristics and neonatal outcomes were collected and analyzed. We hypothesized that the gestational age (GA) at delivery is related to the severity of the condition. Therefore, we performed a subanalysis in two subgroups, which were divided based on the GA at iatrogenic delivery (between 27+0 WG and 29+6 WG and 30+0–32+0 WG, respectively). Results: The prospective cohort study included 36 pregnancies. We had three cases of intrauterine fetal death (8.3%). The incidence was 1.98% in our population. We confirmed that severe cases (very early diagnosed and delivered) were associated with a higher number of prenatal visits and higher uterine arteries (UtA) pulsatility index (PI) centile in the third trimester—TT (compared with the early diagnosed and delivered). In the very early suspected IUGR subgroup, the newborns required significantly more NICU days and total hospitalization days. Conclusions: Patients with isolated very early and early IUGR—defined as ultrasound (US) estimation of fetal weight < p10 using the Hadlock 4 technique requiring iatrogenic delivery before 32 weeks’ gestation—require closer care prenatally and postnatally. These patients represent an economical burden for the health system, needing significantly longer hospitalization intervals, GA at birth and UtA PI centiles being related to it.

This is a single tertiary population-based study conducted at a center in southwest Romania. We retrospectively compared data obtained in two periods: January 2008–December 2013 and January 2018–December 2023. The global incidence of the transposition of great arteries in terminated cases, in addition to those resulting in live-born pregnancies, remained almost constant. The live-birth incidence decreased. The median gestational age at diagnosis decreased from 29.3 gestational weeks (mean 25.4) to 13.4 weeks (mean 17.2). The second trimester and the overall detection rate in the prenatal period did not significantly change, but the increase was statistically significant in the first trimester. The proportion of terminated pregnancies in fetuses diagnosed with the transposition of great arteries significantly increased (14.28% to 75%, p = 0.019).

This is a single tertiary center in southwest Romania, population-based, study. We retrospectively compared data obtained in two periods: January 2008 - December 2013 and January 2018 - De-cember 2023, respectively. The global incidence of transposition of great arteries (TGA) - the ter-minated cases added to the ones resulting in live-born pregnancies, remained almost constant. The live-born incidence of TGA decreased (0.34% to 0.013%). The prenatal detection rate increased slightly (71.42% to 87.5%). The median gestational age at the diagnosis decreased, from 29.3 ges-tational weeks (mean 25.4) to 13.4 weeks (mean 17.2). The proportion of terminated pregnancies significantly increased (14.28% to 75%, p = 0.019).

Background/Objectives: Our aim was to investigate the diagnostic accuracy of prenatal ultrasound (US) in fetal limb abnormalities. As a secondary target, we wanted to correlate various predictors for the diagnosis accuracy. Methods: We prospectively enrolled cases with routine prenatal US performed in five participating centers. Subsequently, we selected and processed all cases with limb abnormalities: suspected, diagnosed, and missed on the prenatal diagnosis scans. We collected data on the type of anomaly, the US equipment and probes used, the operator’s expertise, the gestational age at the diagnosis, the length of the examination, and the use of US reporting form. SPSS 22.0 software was applied to perform the analyses using non-parametric statistical methods. Associations between categorical variables were evaluated using Fisher’s exact test and Chi-square tests. For correlations between the gestational age and the anomaly severity, we used Spearman’s rank-order correlation. Predictive performance of operator- and scan-related variables for diagnostic accuracy was assessed using receiver operating characteristic (ROC) curve analysis, with area under the curve (AUC) estimates, standard errors (SE), confidence intervals (95% CI), and p-values reported. Results: Our data showed that most US examinations were performed as part of routine screening (79.7%), and the most frequent anomaly diagnosed was clubfoot. Operators’ expertise demonstrated the highest predictive performance, while technical parameters—scan duration (AUC = 0.20, p = 0.1188) and US equipment (AUC = 0.30, p = 0.3478)—did not significantly predict diagnostic accuracy. Conclusions: The overall diagnostic accuracy of prenatal US was 85.5%. Our findings indicate that diagnostic performance is driven primarily by operator expertise and training, rather than by gestational age at scan and technical parameters.

Background/Objectives: Fetal growth restriction (FGR) is one of the main causes of perinatal morbidity and mortality, and in most cases the mechanism is placental dysfunction of vascular origin. Hereditary thrombophilias have been evaluated as factors that favor maternal vascular malperfusion, but the data in the literature remain contradictory. The objective of the study was to evaluate the association between the PAI-1 4G/5G, MTHFR C677T and factor V Leiden G1691A polymorphisms and fetal growth restriction, as well as to analyze the dose–effect relationship between the number of thrombophilic variants and the severity of restriction. Methods: This was a retrospective case–control study including 480 singleton pregnancies: 240 cases with fetal growth restriction and 240 pregnant women with eutrophic fetuses, followed up for a period of five years. Cases were defined biometrically as an estimated fetal weight below the 10th centile, without Doppler confirmation, and the phenotype therefore corresponds to small-for-gestational-age rather than to the full consensus definition of fetal growth restriction; a secondary analysis restricted to cases below the 5th centile, performed in response to review, is reported. Maternal characteristics, genotypes, perinatal outcomes, and cumulative pattern of thrombophilic variants were analyzed. Results: PAI-1 4G allele carriers were significantly more frequent in the growth restriction group compared to the control group (70.8% vs. 44.6%; OR 3.02; 95% CI 2.07–4.40; p < 0.001), as were MTHFR C677T allele carriers (57.1% vs. 39.2%; OR 2.07; 95% CI 1.44–2.97; p < 0.001) and factor V Leiden carriers (33.3% vs. 12.1%; OR 3.64; 95% CI 2.27–5.83; p < 0.001). Carrier prevalence increased progressively with severity of restriction for the PAI-1 4G allele and, most steeply, for factor V Leiden (from 12.1% in controls to 75.0% below the 3rd centile; trend test p < 0.001); for the MTHFR 677T allele the increase was confined in the two case strata above the 3rd centile, and the estimate in the smallest subgroup was uninformative. The risk of growth restriction increased with the number of coexisting thrombophilic variants: OR 2.12 (95% CI 1.24–3.64) for one variant, OR 5.60 (95% CI 3.21–9.78) for two, and OR 24.42 (95% CI 7.87–75.78) for all three, compared with the absence of any variant. In multivariable analysis, the three polymorphisms remained independent predictors, with the strongest adjusted association being that of factor V Leiden (adjusted OR 3.33; 95% CI 2.03–5.47). Carriage of each variant was associated with a lower birth-weight centile: −12.3 points for PAI-1 4G, −10.2 for factor V Leiden and −8.0 for MTHFR C677T (all p < 0.001). Conclusions: In this study, PAI-1 4G/5G, MTHFR C677T, and factor V Leiden polymorphisms were independently associated with fetal growth restriction. The results are compatible with a contribution of hypofibrinolysis and inherited thrombophilia to the placental insufficiency phenotype, most clearly in the more severe strata, but they are associative and require confirmation in prospective cohorts incorporating Doppler assessment and placental histopathology.