Clinical Research Directory

Fetal Transverse Thalamic Diameter and Assessment of Gestational Age as a Fetal Growth Parameter Using 2D Ultrasound

The thalamus is a nuclear complex which located in the diencephalon of the brain. Its main function is to relay messages which affect the sensory and motor functions in the body. A lot of behavioral functions are accredited to it such as memory, learning, attention and language. (Sridar P,et al 2020) There is an automatic thalamic diameter measurement to estimate the thalamic diameter, with the measurement accuracy as good as the clinical assessment.( Sridar P,et al 2016) Transverse thalamic diameter increased significantly with increasing gestational age, head circumference, and trans-cerebellar diameter linearly, and normal range thalamic charts are presented. The guitar shape provided good reproducibility of thalamic diameter measures. (Sridar P,et al 2020) Also the evaluation of echogenic thalamus is beneficial, and can be considered as a new marker of fetal lung maturity. ( Rasheed FA, et al 2012). Maternal hyperglycemia was significantly associated with an increase in the widths of fetal posterior lateral ventricles, cavum septum pellucidi, and cisterna magna and a decrease in fetal trans-cerebellar diameter with no difference was found between three groups in terms of fetal thalamus size (Ekin A. et al 2023). However, little is known about the growth pattern of thalami during fetal life, and virtually nothing is known about the possible association of deviations from the normal growth pattern with the abnormal conditions. There is a study published on fetal thalami which compare the volumes of cerebral structures, including thalami, between two group's normally growing and growth-restricted fetuses and reported lack of significant difference in thalamic volumes between the two groups. (Elshal RS.etal 2023). During fetal life, the thalamus increases in size between the ages of 20 to 43 weeks of gestation (Tutunji R et al 2018 ) The development of the thalamus is not a unified progress as it shows remarkable dynamism and heterogeneity ( Zheng et al., 2023) For example, before 35 weeks post-menstrual age ,morphological changes were relatively uniform across the thalamus, and after 35 weeks post menstrual age, deformation was more obvious at the rim than in the central part of the thalamus (Liu et al., 2021). Prospective research ensures focused attention to the structures to be measured, with more clearly imaged by the operator and using variable contrast resolution to ensuring clarity of the measured structure and prevent any artefacts which prevent visualization. .( Sridar P etal 2020) While Ultrasound allows the measurement of the fetal brain in real time and has fewer artefacts from the movement of the fetus, it is operator dependent. (Bookstein S etal 2024).

The Value of Advanced Imaging Sequences for Fetal MRI in Clinical Practice

This project is split into 4 sections: 1. Can improvements be made in the Magnetic resonance imaging sequences used to image the fetus in order to improve diagnostic accuracy? 2. Does 3T improve the quality and diagnostic value of fetal MRI when compared to 1.5T 3. Can fetal MRI be used to image the fetal heart? 4. Can fetal MRI be used to image the fetal Bones?

The Effect of Stress Ball Intervention During Non-Stress Test on Anxiety and Fetal Well-Being in High-Risk Pregnancy

This research will be conducted to determine the effect of stress ball intervention during NST on anxiety and fetal well-being in high-risk pregnant women. Women with high-risk pregnancies randomly assigned to intervention (n=43) and control (n=43) groups at a state and a faculty hospital in Turkey will be included in the study. Pregnant women in the intervention group will be told to squeeze and release the ball once after counting to three, to inhale each time they press the ball, to exhale when they relax their grip and to focus only on the ball. Pregnant women will be instructed to continue this practice throughout the NST procedure (approximately 20 minutes). Pregnant women in the control group will not receive any intervention other than routine hospital care during the NST procedure. Data on anxiety and fetal well-being outcomes will be collected before and after NST.

A Prospective Study on the Role of Karl Storz Curved and Straight Fetoscopes (11508AAK and 11506AAK) for Fetoscopic Intrauterine Procedures

In this research study, the investigators want to learn more about the role of new innovative surgical devices, the Karl Storz Curved and Straight Fetoscopes for in-utero surgery. A fetoscope is like a small telescope that can see inside of the uterus (womb) during minimally invasive surgery. The curved scope is used for patients with an anterior placenta (front of uterus), while the straight scope is used for patients with a posterior placenta (back of uterus). The scopes will be used to assist in procedures involving fetoscopic laser photocoagulation (FLP), which is a minimally invasive surgery that uses a small camera (fetoscope) to locate abnormal blood vessel connections in the placenta and seal them off using laser energy. These fetoscopes will be utilized in the diagnosis and management of various fetal conditions that can arise during pregnancy. Outcome data will be reported in a descriptive statistical analysis. The investigators will assess the surgical outcomes, short and long-term morbidity, complications, and gestational age of participants in order to evaluate the benefit of using these devices.