Objective: Evaluate the clinical usefulness of cell-free DNA screening (cfDNA screening) in pregnancies with nuchal translucency (NT) between 95th and 99th percentile. Design: Subgroup analysis of a multicenter prospective cohort study Setting: 12 different secondary and tertiary health care institutions in Korea Sample: 7,547 singleton pregnant women with NT between 95th and 99th percentile Methods: All participants were provided with information about aneuploidy screening or diagnostic testing and selected the first tier test after NT assessment. The first tier test included maternal serum screening tests (MSS), cfDNA screening and invasive test (IT). Main outcome measures: First-tier test preference and chromosomal abnormalities in pregnancies with NT between 95th and 99th percentile Results: A total of 7,547 singleton pregnant women were enrolled and 6,717 cases with known pregnancy outcomes were analyzed. Among these, 89 (1.3%) cases showed NT between 95th and 99th percentile. As the first-tier test, 47 (52.8%) cases chose cfDNA screening, 33 (37.1%) cases selected IT, and nine (10.1%) cases underwent MSS. Chromosomal abnormalities were found in five cases (5.6%), including four cases with trisomy 21 (T21) and one with a balanced translocation. No significant chromosomal abnormalities undetected by cfDNA screening were noted in pregnancies with NT between 95th and 99th percentile. Conclusion: cfDNA screening in pregnancies with NT between 95th and 99th percentile may be considered as an acceptable alternative to invasive test for women intending to avoid the risk of miscarriage.

Objectives: To evaluate risks of adverse obstetric outcomes in pregnancies with myoma(s) or in pregnancies following myomectomy. Design: Retrospective cohort Setting: The national health insurance database Population: Women who had delivered in Republic of Korea, between 2004 and 2015 Methods: We analyzed the risks of adverse pregnancy outcomes in pregnancies with myoma(s) or in pregnancies following myomectomy, compared to those in women without a diagnosed myoma. Multivariate logistic regression analysis was performed. Main Outcome Measures: The adverse obstetric outcomes. Results: There are 740,675 women who had never been diagnosed with myoma (Group A), 38,402 women who had diagnosed myoma(s) but no history of myomectomy (Group B), and 9,890 women who had a history of myomectomy (Group C). Group B and Group C had significantly higher risks of cesarean section and placenta previa, compared to Group A. The risks of uterine rupture, preterm birth, and low birth weight were significantly higher in Group C (aOR 12.78, 95% CI 6.5-25.13, p < 0.001; aOR 1.64, 95% CI 1.47-1.84, p < 0.001; and aOR 1.53, 95% CI 1.39-1.68, p < 0.001, respectively), but not in Group B, compared to Group A. The incidence of uterine rupture was the highest at delivery within one year after myomectomy and decreased over time after myomectomy. Conclusions: When a woman who might become pregnant later on is diagnosed with uterine myoma, she should be counseled about the risk of myoma(s) and myomectomy on obstetric complications, especially including the significant risk of uterine rupture in pregnancies following myomectomy.