Center for Advanced Fetal Care

Tripoli, Lebanon

Center for Advanced Fetal Care

Tripoli, Lebanon

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News Article | May 3, 2017
Site: www.prweb.com

Mercy Medical Center, PNC Financial Services Group, Inc. (PNC), and Stevenson University have partnered to bring onesies -- an infant's one-piece close-fitting lightweight garment – emboldened with special health and educational messages for newborns at Mercy’s Family Childbirth & Children’s Center. Two Stevenson University students, Amelia Berninger (’17) and Samantha Smith (’18), who created the onesie design, presented samples to mothers and their newborns at Mercy’s Center on April 26th, on the 10th floor of The Mary Catherine Bunting Center, 345 St. Paul Place in downtown Baltimore City. A brief reception followed on the Mezzanine Level of the Bunting Center. In spring 2016, PNC provided funding to Stevenson University for two undergraduates to design an onesie suited for newborns, reflective of PNC’s “Grow Up Great” commitment to early childhood education and the public health issues of “safe sleep.” Mercy’s Family Childbirth & Children’s Center will receive more than 3,000 onesies. Launched in 2004, PNC Grow Up Great® helps children from birth through age five prepare for school by focusing on readiness in vocabulary development, math, science, financial education and the arts. Through distribution of more than $121 million in grants to nonprofit organizations, the program has impacted approximately 3 million children throughout 19 states and the District of Columbia. “More than 3,500 babies in the U.S. die every year while sleeping, often due to Sleep Related Deaths, formerly thought to be due to sudden infant death syndrome (SIDS) or accidental deaths. For their first year, babies should lay on their backs for all sleep times. We know babies who sleep on their backs are far less likely to die of Sleep Related Deaths than those who sleep on their stomachs or sides. It’s important to educate new parents about this, and that’s part of the impetus behind this project,” said neonatologist Dr. Susan J. Dulkerian, Medical Director of Newborn Services in The Family Childbirth and Children’s Center at Mercy. “Growing up great means growing up healthy, and that starts from day one in every child’s life. The onesie project was a perfect fit with our Grow Up Great initiative, a fun and clever way to spread the word about the importance of infant care,” said Laura Gamble, PNC regional president for Greater Maryland. “We were very impressed with the efforts of the Stevenson University students and excited to have the support of Mercy’s Family Childbirth & Children’s Center.” In addition to the importance of infants sleeping “tummy-side up”, the American Academy of Pediatrics (AAP)’s recently updated policy statement and technical report includes new evidence which supports skin-to-skin care for newborn infants. Coupled with the Grow Up Great words of instilling a love of reading and learning in children, all of these elements are incorporated in the writing developed by the Stevenson University students, and found on the new onesie. “This project, a collaboration between Amelia and Sammy, was a strong design challenge -- to create something with meaning that also impacts the community. The students worked diligently and developed ways to visualize the unique messages of their clients, PNC and Mercy. The resulting design merges both the health aspects and educational care infants need as they grow. The onesie project offered our students valuable professional practice and exposure to real design challenges, but it also allowed them to navigate avenues where students can motivate change by building strong ties within their community,” said Meghan Marx, Assistant Professor of Art and Visual Communication Design at Stevenson University. “Hold Me, Rock Me, Read to Me, Talk To Me, Love Me—Put Me to Sleep This Side Up—Comfort Me, Teach Me” appears on the front (stomach) side of the garment. Named The Best Place to Have a Baby by Baltimore’s City Paper, Mercy Medical Center provides a team of obstetricians and other clinical staff, as well as a variety of amenities, programs and education to help mothers, fathers and families prepare for pregnancy, birth and the transition to parenthood. Mercy is home to Center for Advanced Fetal Care providing ultrasound, genetic counseling and testing, comprehensive high-risk pregnancy care, diabetic education, amniocentesis and assessment of fetal well-being. Mercy’s NICU (Neonatal Intensive Care Unit) is a Level III-B intensive care facility offering private rooms and a full complement of specialists providing thorough diagnosis and treatment for a range of the most complex and high-risk conditions in newborn infants. The PNC Foundation, which receives its principal funding from The PNC Financial Services Group (http://www.pnc.com), is a 501(c)(3) charitable organization that actively supports organizations that provide services for the benefit of communities in which it has a significant presence. The PNC Foundation focuses its philanthropic mission on early childhood education and community and economic development, which includes the arts and culture. Through Grow Up Great, its signature cause that began in 2004, PNC has created a bilingual $350 million, multi-year initiative to help prepare children from birth to age 5 for success in school and life. Stevenson University, known for its distinctive career focus, is the third-largest independent university in Maryland with more than 4,100 students pursuing bachelor’s, master’s, and adult bachelor’s programs at locations in Stevenson and Owings Mills. Mercy Medical Center (http://www.mdmercy.com) is a university-affiliated hospital founded in 1874 by the Sisters of Mercy, with a national reputation for women's health care. For more information, visit http://www.mdmercy.com, MDMercyMedia on FACEBOOK and TWITTER, or call 1-800-MD-MERCY.


Abu-Rustum R.S.,Center for Advanced Fetal Care | Daou L.,Hotel Dieu de France | Abu-Rustum S.E.,Nini Obstetrics and Gynecology
Journal of Ultrasound in Medicine | Year: 2010

Objective. The purpose of this series was to determine the sensitivity of ultrasonography in early gestation (UEG) using nuchal translucency (NT) and the 4-chamber view (4CV) in the early diagnosis of congenital heart defects (CHDs). Methods. This was a retrospective chart review of all patients presenting for UEG between 2002 and 2009. At our center, a survey of fetal anatomy is performed at the time of the NT assessment at 11 weeks to 13 weeks 6 days. A second-trimester scan (STS) is done at 20 to 23 weeks and a third-trimester scan at 32 to 35 weeks. Suspected cases of CHDs were evaluated by a pediatric cardiologist. All neonates were examined at birth by a pediatrician, and when clinically indicated, fetal echocardiography was performed. Results. A total of 1370 fetuses were scanned. Congenital heart defects were identified in 8 (0.6%). Nuchal translucency was above the 95th percentile for gestational age (GA) in 6 of 8, and the 4CV was abnormal in 6 of 8. Ultrasonography in early gestation detected 75% fetuses with CHDs, and 25% were detected by an STS. Conclusions. Our study emphasizes the importance of UEG in the detection of CHDs. In this small unselected lowrisk population, UEG detected 75% of CHDs. Nuchal translucency was above the 95th percentile for GA, the 4CV was abnormal, or both in all 8 cases with CHDs. © 2010 by the American Institute of Ultrasound in Medicine.


Abu-Rustum R.S.,Center for Advanced Fetal Care | Daou L.,Hotel Dieu de France | Abu-Rustum S.E.,Nini Obstetrics and Gynecology
Journal of Ultrasound in Medicine | Year: 2010

Objective. We sought to determine the sensitivity of the first-trimester scan in the early diagnosis of aneuploidy and structural fetal anomalies in an unselected low-risk population. Methods. This was a retrospective chart review of all patients having first-trimester scans between 2002 and 2009. At our center, a survey of fetal anatomy is performed at the time of nuchal translucency assessment at 11 weeks to 13 weeks 6 days. A second-trimester scan is done at 20 to 23 weeks and a third-trimester scan at 32 to 35 weeks. Isolated sonographic findings of choroid plexus cysts and echogenic intracardiac foci were excluded. Lethal anomalies and those requiring immediate surgical intervention at birth were considered major structural anomalies. All scans were performed by a single sonologist certified by the Fetal Medicine Foundation. All neonates were examined at birth by a pediatrician. Results. Our study included 1370 fetuses. Six cases of aneuploidy (0.4%) were detected. The first-trimester scan detected 5 of 6 cases of aneuploidy (83%), confirmed by karyotype. There were 36 cases of structural fetal anomalies (2.6%); 20 (1.5%) were major anomalies. The first-trimester scan detected 16 of 36 (44%); 20 (56%) were identified by second- or third-trimester scans. The first-trimester scan detection rate for major structural anomalies was 14 of 20 (70%). The 5 that were missed by the first-trimester scan were detected by a second-trimester scan. Conclusions. Our study emphasizes the importance of the first-trimester scan in the early detection of aneuploidy and structural fetal anomalies. In this small unselected low-risk population, the first-trimester scan detected 83% of aneuploidies and 70% of major structural anomalies. Our results are comparable to previously published studies from other centers and further exemplify the invaluable role of the first-trimester scan in the early detection of aneuploidy and structural anomalies in an unselected low-risk population. © 2010 by the American Institute of Ultrasound in Medicine.


Abu-Rustum R.S.,Center For Advanced Fetal Care | Ziade M.F.,Lebanese University | Abu-Rustum S.E.,Nini Ob Gyn
Prenatal Diagnosis | Year: 2012

Objective: Our study aims at investigating the spatial relationships between eight anatomic planes in the 11+6 to 13+6weeks fetus. Methods: This is a retrospective pilot study where three-dimensional and four-dimensional stored data sets were manipulated to retrieve eight anatomic planes starting from the midsagittal plane of the fetus. Standardization of volumes was performed at the level of the transverse abdominal circumference plane. Parallel shift was utilized and the spatial relationships between eight anatomic planes were established. The median and the range were calculated for each of the planes, and they were evaluated as a function of the fetal crown-rump length. P<0.05 was considered statistically significant. Results: A total of 63 volume data sets were analyzed. The eight anatomic planes were found to adhere to normal distribution curves, and most of the planes were in a definable relationship to each other with statistically significant correlations. Conclusion: To our knowledge, this is the first study to describe the possible spatial relationships between eight two-dimensional anatomic planes in the 11+6 to 13+6weeks fetus, utilizing a standardized approach. Defining these spatial relationships may serve as the first step for the potential future development of automation software for fetal anatomic assessment at 11+6 to 13+6weeks. © 2012 John Wiley & Sons, Ltd.


Votino C.,University Hospital Brugmann | Cos T.,University Hospital Brugmann | Abu-Rustum R.,Center For Advanced Fetal Care | Dahman Saidi S.,University Hospital Brugmann | And 4 more authors.
Ultrasound in Obstetrics and Gynecology | Year: 2013

Objective To assess prospectively the use of four-dimensional (4D) spatiotemporal image correlation (STIC) in the evaluation of the fetal heart at 11-14 weeks' gestation. Methods The study involved offline analysis of 4D-STIC volumes of the fetal heart acquired at 11-14 weeks' gestation in a population at high risk for congenital heart disease (CHD). Regression analysis was used to investigate the effect of gestational age, maternal body mass index, quality of the 4D-STIC volume, use of a transvaginal vs transabdominal probe and use of color Doppler ultrasonography on the ability to visualize separately different heart structures. The accuracy in diagnosing CHD based on early fetal echocardiography (EFE) using 4D-STIC vs conventional two-dimensional (2D) ultrasound was also evaluated. Results One hundred and thirty-nine fetuses with a total of 243 STIC volumes were included in this study. Regression analysis showed that the ability to visualize different heart structures was correlated with the quality of the acquired 4D-STIC volumes. Independently, the use of a transvaginal approach improved visualization of the four-chamber view, and the use of Doppler improved visualization of the outflow tracts, aortic arch and interventricular septum. Follow-up was available in 121 of the 139 fetuses, of which 27 had a confirmed CHD. A diagnosis based on EFE using 4D-STIC was possible in 130 (93.5%) of the 139 fetuses. Accuracy in diagnosing CHD using 4D-STIC was 88.7%, and the results of 45% of the cases were fully concordant with those of 2D ultrasound or the final follow-up diagnosis. EFE using 2D ultrasound was possible in all fetuses, and accuracy in diagnosing CHD was 94.2%. Five of the seven false-positive or false-negative cases were minor CHD. Conclusions In fetuses at 11-14 weeks' gestation, the heart can be evaluated offline using 4D-STIC in a large number of cases, and this evaluation is more successful the higher the quality of the acquired volume. 2D ultrasound remains superior to 4D-STIC at 11-14 weeks, unless volumes of good to high quality can be obtained. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.


Abu-Rustum R.S.,Center for Advanced Fetal Care | Ziade M.F.,Lebanese University | Abu-Rustum S.E.,Nini Obstetrics and Gynecology Tripoli
Journal of Ultrasound in Medicine | Year: 2013

Objectives-The purpose of this study was to establish reference values for the length, area, and circumference of the right and left fetal choroid plexus at 11 to 13 weeks with respect to the fetal biparietal diameter and to compare the right to the left side. Methods-We conducted a prospective study on 114 fetuses at 11 to 13 weeks undergoing first-trimester screening for aneuploidy and structural fetal abnormalities. After the establishment of the fetal situs, the plane of the "butterfly" was obtained on all fetuses, from which the length, area, and circumference of both the right and left choroid plexus were obtained and the right and left sides compared. Using a paired t test, analysis of variance, scatterplots, and linear and logarithmic fittings, reference ranges and charts for the length, area, and circumference of the choroid plexus were then formulated according to their relationship to the fetal biparietal diameter. P < .05 was considered statistically significant. Results-Reference values for the length, area, and circumference of the fetal choroid plexus, with respect to the fetal biparietal diameter, were established. There was a statistically significant difference between the right and left sides for all parameters, with all measurements statistically greater on the left side (P < .0001). Conclusions-Reference values for the length, area, and circumference of the fetal choroid plexus at 11 to 13 weeks are presented. These may prove to be of clinical importance in the early screening for central nervous system abnormalities. In addition, the statistically significant difference between the right and left sides may be an early sign of "developmental" laterality. © 2013 by the American Institute of Ultrasound in Medicine.


Helou N.,Abou Jaoude Hospital | Abdalkader M.,Lebanese University | Abu-Rustum R.S.,Center for Advanced Fetal Care
Journal of Ultrasound in Medicine | Year: 2013

The Sound Judgment Series consists of invited articles highlighting the clinical value of using ultrasound first in specific clinical diagnoses where ultrasound has shown comparative or superior value. The series is meant to serve as an educational tool for medical and sonography students and clinical practitioners and may help integrate ultrasound into clinical practice. © 2013 by the American Institute of Ultrasound in Medicine.


PubMed | Center for Advanced Fetal Care
Type: Journal Article | Journal: Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine | Year: 2010

We sought to determine the sensitivity of the first-trimester scan in the early diagnosis of aneuploidy and structural fetal anomalies in an unselected low-risk population.This was a retrospective chart review of all patients having first-trimester scans between 2002 and 2009. At our center, a survey of fetal anatomy is performed at the time of nuchal translucency assessment at 11 weeks to 13 weeks 6 days. A second-trimester scan is done at 20 to 23 weeks and a third-trimester scan at 32 to 35 weeks. Isolated sonographic findings of choroid plexus cysts and echogenic intracardiac foci were excluded. Lethal anomalies and those requiring immediate surgical intervention at birth were considered major structural anomalies. All scans were performed by a single sonologist certified by the Fetal Medicine Foundation. All neonates were examined at birth by a pediatrician.Our study included 1370 fetuses. Six cases of aneuploidy (0.4%) were detected. The first-trimester scan detected 5 of 6 cases of aneuploidy (83%), confirmed by karyotype. There were 36 cases of structural fetal anomalies (2.6%); 20 (1.5%) were major anomalies. The first-trimester scan detected 16 of 36 (44%); 20 (56%) were identified by second- or third-trimester scans. The first-trimester scan detection rate for major structural anomalies was 14 of 20 (70%). The 5 that were missed by the first-trimester scan were detected by a second-trimester scan.Our study emphasizes the importance of the first-trimester scan in the early detection of aneuploidy and structural fetal anomalies. In this small unselected low-risk population, the first-trimester scan detected 83% of aneuploidies and 70% of major structural anomalies. Our results are comparable to previously published studies from other centers and further exemplify the invaluable role of the first-trimester scan in the early detection of aneuploidy and structural anomalies in an unselected low-risk population.


PubMed | St Joseph University, Nini Hospital, Lebanese University and Center for Advanced Fetal Care
Type: Journal Article | Journal: AJP reports | Year: 2016

ObjectiveThis study aims to assess head volume (HV) alterations at 11 to 14 weeks in fetuses with congenital heart defects (CHD). MethodsA retrospective case-control study on 100 normal and 26 CHD fetuses was conducted. The fetuses had a first trimester scan with volume data sets stored from which HV was calculated. The mean HV and HV as a function of crown-rump length (CRL) in normal fetuses were compared with established normograms. Mean HV, HV as a function of CRL, and HV/CRL were compared between normal and CHD fetuses. Nonparametric Kruskal-Wallis H test was used with p<0.05 considered significant. ResultsOverall, 83 normal and 19 CHD fetuses were included. The mean HV and HV as a function of CRL in the normal fetuses were comparable to what has been established (p=0.451 and 0.801, respectively). The mean HV was statistically smaller in fetuses with CHD, particularly those with hypoplastic left heart (HLH): 10.7 mL in HLH versus 13.0 mL in normal fetuses (p=0.043). The HV/CRL was statistically smaller in fetuses with CHD (p=0.01). ConclusionDespite the small sample size, our case series suggests that alterations in HV may potentially be apparent as early as 11 to 14 weeks in CHD fetuses, particularly those with HLH. Larger prospective studies are needed to validate our findings.


PubMed | Center For Advanced Fetal Care
Type: Evaluation Studies | Journal: Prenatal diagnosis | Year: 2012

Our study aims at investigating the spatial relationships between eight anatomic planes in the 11+6 to 13+6 weeks fetus.This is a retrospective pilot study where three-dimensional and four-dimensional stored data sets were manipulated to retrieve eight anatomic planes starting from the midsagittal plane of the fetus. Standardization of volumes was performed at the level of the transverse abdominal circumference plane. Parallel shift was utilized and the spatial relationships between eight anatomic planes were established. The median and the range were calculated for each of the planes, and they were evaluated as a function of the fetal crown-rump length. P < 0.05 was considered statistically significant.A total of 63 volume data sets were analyzed. The eight anatomic planes were found to adhere to normal distribution curves, and most of the planes were in a definable relationship to each other with statistically significant correlations.To our knowledge, this is the first study to describe the possible spatial relationships between eight two-dimensional anatomic planes in the 11+6 to 13+6 weeks fetus, utilizing a standardized approach. Defining these spatial relationships may serve as the first step for the potential future development of automation software for fetal anatomic assessment at 11+6 to 13+6 weeks.

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