Full Text Available Objetivo: La identificación de cromosomopatía fetal es un factor importante para el mejor manejo perinatal y pediátrico en los embarazos de alto riesgo. El objetivo de esta publicación es mostrar al personal de salud, los resultados de nuestros ensayos de cariotipo en líquido amniótico, obtenidos desde el momento en que han sido acreditados por el Ente Costarricense de Acreditación y compararlos con los estándares internacionales. Métodos: Se realizó cultivo abierto de 100 muestras recibidas desde enero del 2009 hasta diciembre 2010, provenientes de hospitales de la seguridad social y de servicios de salud privados y la cosecha de los “amniocitos” mediante suspensión enzimática. La indicación de amniocentesis en el 65% de los casos fue por ecografía anormal y el 28% de las veces por edad materna avanzada. Resultados: La cromosomopatía fetal encontrada fue de 35%. Para muestras en cantidad y calidad aceptables, el éxito de los cultivos fue 100% y el tiempo de respuesta fue de 13 días promedio. Estos datos concuerdan con las normas internacionales en esta materia. Además, anualmente participamos satisfactoriamente en rondas de evaluación externa de la calidad organizados por la Cytogenetic European Quality Assessment. Conclusión: En Costa Rica contamos con servicios de perinatología con equipos ecográficos muy sofisticados y con personal altamente especializado, de manera que los defectos anatómicos fetales y otras patologías rara vez pasan desapercibidas. El cariotipo fetal es el complemento indispensable para el abordaje clínico óptimo de estos casos, sobre todo, cuando se cuenta con la calidad que garantizan los ensayos acreditados.
Isabel Castro Volio
Full Text Available El objetivo de este estudio fue identificar cromosomopatía fetal en voluntarias con embarazos de alto riesgo genético, a fin de brindar adecuada atención obstétrica y pediátrica y asesoramiento genético. Las células fetales se obtuvieron mediante amniocentesis (N=506 y cordocentesis (N=46 desde 1993 hasta 1998 inclusive. Ambas punciones fueron transabdominales, guiadas por ultrasonografía y se realizaron en los hospitales Calderón Guardia (63% de las amniocentesis y 45 cordocentesis, México (21% de las amniocentesis y una cordocentesis, en la consulta privada (12% y otros hospitales. La indicación del 62% de las amniocentesis y de casi todas las cordocentesis fue el examen ultrasonográfico anormal y el 23% de las punciones fue por edad materna avanzada. El 66% de las veces el estudio se realizó en la segunda mitad del embarazo. De las 552 muestras de líquido amniótico y sangre fetal, en 109 no fue posible obtener resultados. Los 443 cariotipos fetales obtenidos fueron anormales en 39 casos (9%: 21 cariotipos trisómicos, ocho casos con síndrome de Turner (45,X, tres mosaicos cromosómicos y siete cariotipos anormales por otras causas. El resultado final se obtuvo en 15 días (mediana. En el seguimiento de los casos se encontró concordancia entre el cariotipo y el fenotipo del recién nacido, al igual que entre el diagnóstico ultrasonográfico fetal y la condición del neonato. El diagnóstico prenatal de cromosomopatía permitió el asesoramiento genético y el manejo obstétrico y pediátrico de los casos de manera adecuada. En los embarazos con cariotipo normal, esta información alivió la preocupación de muchos de los padres.The results of 506 genetic amniocentesis and 46 percutaneous umbilical blood samplings, from 1993 to 1998, are reported. There were two main reasons for referral: abnormal ultrasound assessment (62% of cases and advanced maternal age (23%. Most procedures (66% were performed during the second half of
Full Text Available Objetivo: La identificación de cromosomopatía fetal es un factor importante para el mejor manejo perinatal y pediátrico en los embarazos de alto riesgo. El objetivo de esta publicación es mostrar al personal de salud, los resultados de nuestros ensayos de cariotipo en líquido amniótico, obtenidos desde el momento en que han sido acreditados por el Ente Costarricense de Acreditación y compararlos con los estándares internacionales. Métodos: Se realizó cultivo abierto de 100 muestras recibidas desde enero del 2009 hasta diciembre 2010, provenientes de hospitales de la seguridad social y de servicios de salud privados y la cosecha de los “amniocitos” mediante suspensión enzimática. La indicación de amniocentesis en el 65% de los casos fue por ecografía anormal y el 28% de las veces por edad materna avanzada. Resultados: La cromosomopatía fetal encontrada fue de 35%. Para muestras en cantidad y calidad aceptables, el éxito de los cultivos fue 100% y el tiempo de respuesta fue de 13 días promedio. Estos datos concuerdan con las normas internacionales en esta materia. Además, anualmente participamos satisfactoriamente en rondas de evaluación externa de la calidad organizados por la Cytogenetic European Quality Assessment. Conclusión: En Costa Rica contamos con servicios de perinatología con equipos ecográficos muy sofisticados y con personal altamente especializado, de manera que los defectos anatómicos fetales y otras patologías rara vez pasan desapercibidas. El cariotipo fetal es el complemento indispensable para el abordaje clínico óptimo de estos casos, sobre todo, cuando se cuenta con la calidad que garantizan los ensayos acreditados.Aims: The identification of fetal abnormal chromosomes in high risk pregnancies, allows proper pediatric and obstetric management of the cases as well as genetic counseling. The results of 100 genetic amniocentesis from January 2009 to December 2010, since the accreditation of these
Susana Posada Céspedes
Full Text Available Resumen. Colombia es considerado un país megabiodiverso, ostentando varias especies endémicas como Saguinus leucopus. El Tití gris, como es vulgarmente llamado, habita bosques tropicales, es omnívoro y de hábitos diurnos, y se destaca como dispersor de semillas. Morfológicamente se caracteriza por su reducido tamaño, pelaje café y dorso plateado. Se organiza en grupos familiares formados por la pareja y su descendencia, con una hembra dominante, la cual es la única que cría. Debido a factores fundamentalmente de origen antrópico, se encuentra catalogada como especies en peligro de extinción por la UICN y está registrado en el apéndice I del CITES. Aun cuando se han realizados estudios sobre su biología básica, son pocos los reporte sobre la evaluación citogenética y ninguno sobre cariotipo con bandas R-Replicativa. En esta investigación se realizó el cariotipo y el idiograma, con bandas R-Replicativas, mediante la incorporación de 5'-bromo-2'-deoxiuridina (BrdU en sangre periférica estimulada con fitohemaglutinina de S. leucopus. Los resultados mostraron un cariotipo 2n = 46, con un número fundamental (NF de 76. Los cromosomas se organizaron en cinco grupos de acuerdo con su forma y tamaño. El grupo A, es conformado por 3 pares de cromosomas grandes submetacéntricos; el grupo B, por 5 pares de cromosomas de tamaño medio metacéntricos o submetacéntricos; el grupo C, por 6 pares acrocéntricos y el grupo D, por 8 pares subtelocéntricos y el par sexual XX/XY. El cromosoma "X" es de tamaño medio submetacéntrico y el "Y" es metacéntrico, y de los más pequeños del genoma. Finalmente, se propone un idiograma con bandas R- Replicativa con base en mitosis en estadio III de replicación.Abstract. Colombia is considered a mega-biodiverse country, boasting several endemic species such as Saguinus leucopus. The Marmoset gray, as is commonly called, inhabits tropical forests, is omnivorous and diurnal, and stands as seed
Héctor Rondón B.
Full Text Available Objetivo. Estudiar el ciclo celular y realizar la descripción cromosómica de Espeletiopsis muiska, utilizando células meristemáticas de ápices radicales obtenidos a través de cultivo in vitro de embriones en medio MS suplementado con AIB. Materiales y métodos. Se colectaron ápices radicales a diferentes horas del día y se contaron en ellos las células presentes en cada fase mitótica, se determinó la duración del ciclo celular y la hora de mayor actividad mitótica. La descripción de los cromosomas y la elaboración del cariotipo de la especie, se realizó utilizando un protocolo que permitió la obtención de cromosomas metafásicos. Resultados. Respecto a la duración del ciclo celular, se encontró que la interfase comprende el 94.65% y la mitosis el 5.35% del total del ciclo celular. Entre las fases mitóticas la profase tiene mayor duración, 1.92%, mientras que la anafase es la más corta, 0.96%. En cuanto a la hora mitótica, las células meristemáticas de los ápices radicales presentaron mayor actividad entre las 10:30 y las 11:15. Con el estudio citogenético se encontraron 19 pares de cromosomas con longitudes e índices centroméricos similares y cariotipo asimétrico. Conclusiones. El estudio detallado de los cromosomas, permitió determinar un complemento cromosómico 2n=38+2B, dos cromosomas con microsatélites terminales y uno con constricción secundaria.
Viviana G. Solis Neffa
Full Text Available Se describe el cariotipo de 6 especies de Turnera. El cariotipo de T.melochioides (Leiocarpae, 2n = 2x = 14, está compuesta por 10 m + 4sm. En T.grandiflora, T.candida, T.scabra, T.hermannioides y T.Joelii (Canaligerae, todos con 2n = 2x = 10, la fórmula cariotípica es 8m + 2sm. Estas especies se distinguen por la longitud del cromosoma, el tamaño y la posición de los satélites y por los índices de asimetría. T.scabra con citotipo autopoliploide muestra cromosomas más cortos y cariotipos más simétrico. En informes anteriores son confirmados 6 taxones.
Laura A. Zanín
Full Text Available En el presente trabajo se informa el número de cromosomas somáticos y el cariotipo de Hoffmannseggia glauca. Su número es 2n=24 como previamente fue citado para otras especies de Hoffmannseggia. El cariotipo es simétrico y está compuesto por 8 pares m, 3 pares sm y 1 par st . Los cromosomas son de pequeño tamaño. El tamaño promedio es 0,87-1,31 mm para el tipo m, 1,17-1,51 mm para el tipo sm y 0,90 mm para el tipo st
Ana I. Honfi
Full Text Available Los cromosomas somáticos de dos especies de árboles han sido estudiados, ambos tienen 2n = 26. Los cariotipos de Anadenanthera colubrina (Vell. Brenan var. cebil (Griseb. Altschul (18m + 8sm y Parapiptadenia rigida (Benth. Brenan (12m + 14sm se describen tor primera vez. Estas especies se distinguen por la fórmula de cariotipo y la longitud total del cariotipo.
López Ortiz Juan Bautista
Full Text Available El presente trabajo reporta la dotación cromosómica de Agouti paca, una especie considerada en vía de extinción. Además, se muestra la estandarización de la técnica para la obtención de cromosomas en sangre periférica y el tiempo óptimo del pulso terminal de 5-bromo-2 'deoxiuridina (BrdUrd para la obtención de bandas R-replicativas de alta resolución. También, se compara el cariotipo obtenido usando tinción convencional de Giemsa, con el realizado utilizando bandeo replicativo de alta resolución. El análisis de la morfología cromosómica del cariotipo de Agouti paca, muestra 29 pares de cromosomas subtelocéntricos, 2 cromosomas acrocéntricos y 5 pares cromosómicos metacéntricos. De todo el cariotipo, el cromosoma X es el más grande y lo clasificamos como: submetacéntrico. El cromosoma Y es el más pequeño y lo consideramos acrocéntrico. Además, al igual que en todas las hembras de mamíferos, la hembra de guagua exhibe un cromosoma X inactivo de replicación tardía. Con base en los resultados obtenidos, se determina el número cromosómico 2n = 74. De acuerdo con la ISCI (1995, propusimos una clasificación en 5 grupos: grupo A del 1 al 10, grupo B del 11 al 20, grupo C del 21 al 29, grupo D del 30 al 31 y grupo E del 32 al 36, además del parsexual (XX si es hembra, XY si es macho. Estos hallazgos posibilitarán en el futuro, establecer la correlación entre anormalidades cromosómicas y cambios fenotípicos o trastornos reproductivos de la especie; además, servirá como parámetro citogenético en la comparación de Agouti paca con otros Hystricomorfos relacionados. Este resultado se constituye en el primer cariotipo de Agouti paca (guagua, reportado; además, es el primer estudio citogenético donde se realizan bandas R-replicativas de alta resolución para cariotipar especies animales promisorias
Graciela Inés Lavia
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Viviana G. Solis Neffa
Full Text Available Se han estudiado los cromosomas mitóticos de quince especies de Serjania Mill., con 2n = 24, de América del Sur. Los resultados incluyen los primeros recuentos de S. paludosa Cambess. y S. setigera Radlk. Fueron analizados los cariotipos de todas las especies, trece de ellos se describen por primera vez. Aunque no ha habido ningún cambio en el número de cromosomas durante la evolución de Serjania y los cariotipos muestran un moderado grado de asimetría, hay una considerable variabilidad en tamaño de los cromosomas entre las especies. El análisis comparativo de las especies de la misma sección muestra diferencias en la longitud de los cromosomas y la constitución cariotípica. Esto fue también evidente en las dos accesiones de S. laruotteana Cambess. y S. meridionalis Cambess. La variabilidad cariotípica observada en Serjania sería el resultado de reordenamientos cromosómicos estructurales y/o la adición de material genético.
Rosaralis Arrieta García
Full Text Available Se presenta un caso de un escolar de 9 años que es remitido a la consulta de Genética Clínica por presentar dismorfia facial, retardo en el desarrollo psicomotor y malformaciones congénitas urogenitales. El estudio citogenético reveló defecto estructural con fórmula 46, XY(r 9. Este rearreglo estructural es infrecuente y se desconoce su prevalencia. En el reporte se realiza la correlación fenotipo¿cariotipo y se describe la evolución del paciente. No se encontraron reportes anteriores descritos en el país.
Carlos M. Baeza
Full Text Available Alstroemeria (Alstroemeriaceae es un género endémico de América del Sur. En Chile, este género se distribuye desde el extremo norte hasta la Patagonia, y la mayor diversidad de especies se encuentra en la zona central. Precisamente en esta zona crece Alstroemeria ligtu con sus 3 subespecies: A. ligtu subsp. ligtu, A. ligtu subsp. incarnata, A. ligtu subsp. simsii. Se realizó un estudio comparativo del cariotipo de individuos provenientes de 5 poblaciones de A. ligtu subsp. ligtu de la VIII Región, y de una población de A. ligtu subsp. simsii de la V Región, mediante tinción de los cromosomas con DAPI u orceína acética. Las seis poblaciones estudiadas presentaron un cariotipo asimétrico, con 2n=2x=16 cromosomas. Las poblaciones de A. ligtu subsp. ligtu presentaron una fórmula haploide conformada por cuatro cromosomas metacéntricos (los pares 1 y 2 con microsatélites, uno submetacéntrico con microsatélite y tres telocéntricos con microsatélites. La población de A. ligtu subsp. simsii se caracterizó por poseer cinco cromosomas metacéntricos (el par 2 con un microsatélite y el par 6 con una constricción secundaria y tres cromosomas telocéntricos con satélite. Estos resultados indican que el cariotipo en A. ligtu es variable, y es probable que cambios a nivel cromosómico hayan contribuido en la diversificación de esta especie.
Carlos M Baeza
Full Text Available Se describe el cariotipo de Alstroemeria patagonica Phil. a partir de material de Chile. Esta especie presenta un cariotipo 2n = 2x = 16, y una fórmula haploide de 1m + 2sm + 1sm-sat + 2st + 1st-sat + 1t. El cariotipo encontrado es muy asimétrico (AsK % = 76,0.The karyotype of Alstroemeria patagonia Phil. from Chile was described. The species had a karyotype 2n = 2x = 16, and the haploid formula was 1m + 2sm + 1sm-sat + 2st + 1st-sat + 1t. The reported karyotype was very asymmetric (AsK % = 76.0.
Full Text Available El Laboratorio ha recibido 31 muestras de restos de abortos desde 2005. Para 24 casos se tiene información acerca de la semana de edad gestacional en que se tomó la muestra. Todos los casos fueron pérdidas gestacionales tempranas, excepto uno con 26 semanas de embarazo. El promedio de edad gestacional para los casos de abortos tempranos fue de 8 semanas y 6 días. Todas las muestras tenían algún grado de contaminación bacteriana. Sin embargo, de 31, solamente no se lograron cultivos celulares en 7 muestras muy contaminadas. La tasa de fracaso de los cultivos fue, por lo tanto, del 22%. De los 24 cariotipos obtenidos, 15 fueron 46, XX, 3 fueron 46, XY y 6 resultaron anormales, para un 25% de cromosomopatía en estas muestras. Es posible que el porcentaje de cromosomopatía encontrado esté subestimado, debido a la contaminación de las muestras con células maternas. El tiempo promedio de respuesta del Laboratorio, para el 90 % de los casos, fue de 24 días.
Full Text Available El entendimiento de la diversidad de los primates es esencial para establecer prioridades en losplanes de su conservación, la taxonomía precede la conservación y en la mayoría de los génerosde los primates Platyrrhini, la taxonomía aún es controvertida. (Rylans y colaboradores 2000.Por otra parte, son numerosos los ejemplos en los cuales los cariotipos de primates destacancaracterísticas, que contribuyen al reconocimiento de diferentes formas y así pueden aclararproblemas taxonómicos.
Full Text Available Justificación y objetivos: En Costa Rica, el diagnóstico de anomalías cromosómicas fetales se realiza solo mediante el análisis citogenético convencional de cromosomas obtenidos de cultivos celulares. Además de que la espera por los resultados puede ser larga, con alguna frecuencia fracasa el cultivo, por contaminación o por mala calidad de la muestra, o las figuras mitóticas no se pueden analizar, por lo que es necesario disponer de una metodología sencilla y barata, para obtener un diagnóstico prenatal rápido y fiable de trisomía 21, 18 ó 13, en embarazos de alto riesgo genético sometidos a amniocentesis o cordocentesis. Métodos: Se diseñaron tres PCRs multiplex para amplificar cuatro distintas repeticiones cortas en tándem, de cada uno de los cromosomas 21, 18 y 13. Se colectaron 93 muestras (88 líquidos amnióticos y 5 sangres fetales, recibidas en el laboratorio entre 2006 y 2008, con solicitud de análisis cromosómico. Los resultados de la reacción en cadena de la polimerasa cuantitativa fluorescente, fueron comparados con el cariotipo obtenido de las mismas muestras para demostrar la fiabilidad del ensayo Resultados: Para este grupo de datos, la exactitud del ensayo fue del 100% y se consiguió obtener resultados en 48 horas. Se logró realizar el análisis de repeticiones cortas en tándem en el 77% de las muestras en las que no se pudo obtener crecimiento celular. Conclusión: La reacción en cadena de la polimerasa cuantitativa fluorescente demostró ser una metodología sencilla, fiable y rápida, por lo que podría convertirse en una herramienta complementaria del análisis cromosómico convencional. La obtención de resultados rápidos en casos de diagnóstico prenatal podría disminuir el periodo de ansiedad parental por la espera de los resultados, así como permitir un mejor abordaje terapéutico de los fetos afectados.
... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Fetal Circulation Updated:Oct 18,2016 click to enlarge The ... fetal heart. These two bypass pathways in the fetal circulation make it possible for most fetuses to survive ...
Hansen, John T.; Sladek, John R.
This article reviews some of the significant contributions of fetal research and fetal tissue research over the past 20 years. The benefits of fetal research include the development of vaccines, advances in prenatal diagnosis, detection of malformations, assessment of safe and effective medications, and the development of in utero surgical therapies. Fetal tissue research benefits vaccine development, assessment of risk factors and toxicity levels in drug production, development of cell lines, and provides a source of fetal cells for ongoing transplantation trials. Together, fetal research and fetal tissue research offer tremendous potential for the treatment of the fetus, neonate, and adult.
Yolimar Navarro Briceño
Full Text Available La ascitis fetal esta comúnmente asociada a malformaciones gastrointestinales y urinarias, anemia, infección y anomalías cromosómicas. La ascitis fetal masiva idiopática es rara. Se reporta un caso de una embarazada de 33 años referida a las 17 semanas después que se detectó ascitis en ausencia de anomalías estructurales. La evaluación cardiaca y las pruebas diagnósticas de infecciones virales fueron negativas. A las 28 semanas se detectó ascitis masiva sin otros signos de hidrops fetal. La velocidad sistólica pico de la arteria cerebral media fetal estaba elevada. El Doppler de la arteria umbilical, crecimiento fetal y volumen de líquido amniótico estaban normales. El ecocardiograma fetal estaba normal. Se realizó la amniocentesis con resultados normales del cariotipo. A pesar de la persistencia de la ascitis masiva durante el seguimiento, el crecimiento fetal y el volumen de líquido amniótico eran normales con valores elevados de la velocidad sistólica pico de la arteria cerebral media fetal. A las 33 semanas la paciente se realizó cesárea de emergencia por sufrimiento fetal agudo. Se obtuvo un recién nacido vivo femenino normal con valores normales de hemoglobina al nacer. El flujo vascular hepático, vesical y hepato-portal fueron normales. La ascitis se resolvió completamente al octavo día después del nacimiento y el recién nacido fue dado de alta a los 15 días.
LUIS ALEJANDRO GONZÁLEZ S.
Full Text Available El estudio citogenético mediante tinción con Giemsa, en tres regiones xerofíticas (continental, peninsular e insular del oriente de Venezuela, demostró un número diploide 2n=36, compuesto por seis pares de macrocromosomas metacéntricos y submetacéntricos y 12 pares de microcromosomas acrocéntricos manteniéndose esta característica en machos y hembras en las tres poblaciones estudiadas. Se determinó que el primer par de macrocromosomas es metacéntrico y en la región continental representa 13% de longitud relativa total (LRT, siendo el cromosoma de mayor tamaño con respecto a la población peninsular con un 9,4 % y a la población insular con 7,1 %, conteniendo esta última población los cromosomas más pequeños. Considerando las diferencias cromosómicas y el aislamiento geográfico existente, estos lagartos podrían presentar un proceso de especiación alopátrica de tipo vicariante.
Full Text Available El estudio citogenético mediante tinción con Giemsa, en tres regiones xerofíticas (continental, peninsular e insular del oriente de Venezuela, demostró un número diploide 2n=36, compuesto por 6 pares de macrocromosomas metacéntricos y submetacéntricos y 12 pares de microcromosomas acrocéntricos manteniéndose, esta característica en machos y hembras en las tres poblaciones estudiadas. Se determinó que el primer par de macrocromosomas es metacéntrico y en la región continental representa un 13% de longitud relativa total (LRT siendo el cromosoma de mayor tamaño, con respecto a la población peninsular con un 9,4 % y a la población insular con 7,1 %, conteniendo esta última población los cromosomas más pequeños. El bandeo C, siguiendo los protocolos propuestos por Sumner (1972, evidencio en términos generales poca cantidad de bandas de heterocromatina, localizada en las regiones teloméricas, teloméricas con intersticiales y centroméricas con intersticiales. Considerando las diferencias cromosómicas y el aislamiento geográfico existente, estos lagartos presentan un proceso de especiación vicariante.
SAONA UGARTE, Pedro
La percepción de la actividad fetal por la madre es la técnica más antigua y menos costosa de controlar el bienestar fetal. Tradicionalmente se ha considerado la disminución o ausencia de movimientos fetales percibidos por la madre, como una señal de alarma, en especial cuando existe insuficiencia útero placentaria. Varios investigadores han descrito el valor del registro diario de movimientos fetales como un método para identificar el feto en peligrote morir. El poder discernir si el feto se...
... might need special care in the hospital's neonatal intensive care unit. Keep in mind that your baby might ... References Copel JA, et al. Fetal macrosomia. In: Obstetric Imaging. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www. ...
... needle placement during certain prenatal tests, such as amniocentesis or chorionic villus sampling. Determine fetal position before ... home. Accessed Aug. 11, 2015. Ghidini A. Diagnostic amniocentesis. http://www.uptodate.com/home. Accessed Aug. 11, ...
Adama van Scheltema, Phebe
Recent studies have suggested that the fetus is capable of exhibiting a stress response to intrauterine needling, resulting in alterations in fetal stress hormone levels. Intrauterine transfusions are performed by inserting a needle either in the umbilical cord root at the placental surface (PCI), or in the intrahepatic portion of the umbilical vein (IHV). Aim of our study was to test the hypothesis that fetal hormonal changes during intrauterine transfusion are more pronounced when the needl...
Adama van Scheltema, Phebe
Recent studies have suggested that the fetus is capable of exhibiting a stress response to intrauterine needling, resulting in alterations in fetal stress hormone levels. Intrauterine transfusions are performed by inserting a needle either in the umbilical cord root at the placental surface (PCI), o
Full Text Available Justificación y objetivos: En Costa Rica, el diagnóstico de anomalías cromosómicas fetales se realiza solo mediante el análisis citogenético convencional de cromosomas obtenidos de cultivos celulares. Además de que la espera por los resultados puede ser larga, con alguna frecuencia fracasa el cultivo, por contaminación o por mala calidad de la muestra, o las figuras mitóticas no se pueden analizar, por lo que es necesario disponer de una metodología sencilla y barata, para obtener un diagnóstico prenatal rápido y fiable de trisomía 21, 18 ó 13, en embarazos de alto riesgo genético sometidos a amniocentesis o cordocentesis. Métodos: Se diseñaron tres PCRs multiplex para amplificar cuatro distintas repeticiones cortas en tándem, de cada uno de los cromosomas 21, 18 y 13. Se colectaron 93 muestras (88 líquidos amnióticos y 5 sangres fetales, recibidas en el laboratorio entre 2006 y 2008, con solicitud de análisis cromosómico. Los resultados de la reacción en cadena de la polimerasa cuantitativa fluorescente, fueron comparados con el cariotipo obtenido de las mismas muestras para demostrar la fiabilidad del ensayo Resultados: Para este grupo de datos, la exactitud del ensayo fue del 100% y se consiguió obtener resultados en 48 horas. Se logró realizar el análisis de repeticiones cortas en tándem en el 77% de las muestras en las que no se pudo obtener crecimiento celular. Conclusión: La reacción en cadena de la polimerasa cuantitativa fluorescente demostró ser una metodología sencilla, fiable y rápida, por lo que podría convertirse en una herramienta complementaria del análisis cromosómico convencional. La obtención de resultados rápidos en casos de diagnóstico prenatal podría disminuir el periodo de ansiedad parental por la espera de los resultados, así como permitir un mejor abordaje terapéutico de los fetos afectados.Justification and aims: In Costa Rica, the diagnosis of chromosomal fetal anomalies is
Los cariotipos de Cologania grandiflora y Erythrina americana (Leguminosae- Papilionoideae-Phaseoleae de la Reserva Ecológica del Pedregal de San Ángel, México Karyotypes of Cologania grandiflora and Erythrina americana (Leguminosae-Papilionoideae- Phaseoleae of Reserva Ecológica del Pedregal de San Ángel, Mexico
Full Text Available Se analizaron citogenéticamente células provenientes de meristemos radiculares de 2 leguminosas, Cologania grandiflora y Erythrina americana, que en la actualidad están incluidas en la flora de la Reserva Ecológica del Pedregal de San Ángel, México, D. F., mediante una técnica de extendido en superficie y secado al aire para determinar los números cromosómicos somáticos. Por vez primera se obtuvieron la morfología cromosómica y otras características cuantitativas de los cariotipos en C. grandiflora (2n= 44= 26m +18sm y en E. americana (2n= 42= 36m + 4sm +2st sat, primeras también en ambos géneros. Cologania y Erythrina se reconocen como poliploides estabilizados y el hallazgo de un único par de cromosomas con satélites (dominancia nucleolar en las especies estudiadas aquí, favorece la opinión de un origen alopoliploide para estos taxa.Meristematic root cells from Cologania grandiflora and Erythrina americana from Reserva Ecológica del Pedregal de San Ángel, Distrito Federal, Mexico, were analyzed cytogenenetically using a surface-spreading and air-drying method. The somatic chromosome numbers were determined. Chromosome morphology and others quantitative features of the karyotypes obtained for first time in C. grandiflora (2n= 44= 26m + 18sm and E. americana (2n= 42= 36m + 4sm + 2st sat and also the first in both genera. Cologania and Erythrina are recognized as stabilized polyploids and the finding of just one pair of chromosomes with satellites (nucleolar dominance in the species analyzed here supports the view of allopolyploid origin of these taxa.
Guo, Anne; Chitayat, David; Blaser, Susan; Keating, Sarah; Shannon, Patrick
We explored the prevalence of syringomyelia in a series of 113 cases of fetal dysraphism and hindbrain crowding, of gestational age ranging from 17.5 to 34 weeks with the vast majority less than 26 weeks gestational age. We found syringomyelia in 13 cases of Chiari II malformations, 5 cases of Omphalocele/Exostrophy/Imperforate anus/Spinal abnormality (OEIS), 2 cases of Meckel Gruber syndrome and in a single pair of pyopagus conjoined twins. Secondary injury was not uncommon, with vernicomyelia in Chiari malformations, infarct like histology, or old hemorrhage in 8 cases of syringomyelia. Vernicomyelia did not occur in the absence of syrinx formation. The syringes extended from the sites of dysraphism, in ascending or descending patterns. The syringes were usually in a major proportion anatomically distinct from a dilated or denuded central canal and tended to be dorsal and paramedian or median. We suggest that fetal syringomyelia in Chiari II malformation and other dysraphic states is often established prior to midgestation, has contributions from the primary malformation as well as from secondary in utero injury and is anatomically and pathophysiologically distinct from post natal syringomyelia secondary to hindbrain crowding.
César Bernardo Ospina Arcila
Full Text Available Con base en el artículo clásico "Monte Everest in utero" se hace un análisis de la situación que afronta el feto con respecto a la disponibilidad de oxígeno; para una mejor comprensión del sufrimiento fetal se revisan los siguientes conceptos: presión barométrica, presión parcial del oxígeno atmosférico, presión parcial del oxígeno inspirado, presión barométrica intranasal, ecuación del gas alveolar y difusión de gases a través de la membrana alvéolo capilar. Based on the classical paper by Eastman "Mount Everest in utero" an analysis is made of the situation faced by the fetus with respect to the availability of oxygen; for a better under. standing of fetal distress the following concepts are reviewed: barometric pressure, partial pressure of atmosferic oxygen, partial pressure of inspired oxygen, barometric intranasal pressure, alveolar gas equation and gas diffusion through alveolo-capilar membrane.
The fetus reacts to nociceptive stimulations through different motor, autonomic, vegetative, hormonal, and metabolic changes relatively early in the gestation period. With respect to the fact that the modulatory system does not yet exist, the first reactions are purely reflexive and without connection to the type of stimulus. While the fetal nervous system is able to react through protective reflexes to potentially harmful stimuli, there is no accurate evidence concerning pain sensations in this early period. Cortical processes occur only after thalamocortical connections and pathways have been completed at the 26th gestational week. Harmful (painful) stimuli, especially in fetuses have an adverse effect on the development of humans regardless of the processes in brain. Moreover, pain activates a number of subcortical mechanisms and a wide spectrum of stress responses influence the maturation of thalamocortical pathways and other cortical activation which are very important in pain processing.
Vanhatalo, S; van Nieuwenhuizen, O
During the last few years a vivid debate, both scientifically and emotionally, has risen in the medical literature as to whether a fetus is able to feel pain during abortion or intrauterine surgery. This debate has mainly been inspired by the demonstration of various hormonal or motor reactions to noxious stimuli at very early stages of fetal development. The aims of this paper are to review the literature on development of the pain system in the fetus, and to speculate about the relationship between "sensing" as opposed to "feeling" pain and the number of reactions associated with painful stimuli. While a cortical processing of pain theoretically becomes possible after development of the thalamo-cortical connections in the 26th week of gestation, noxious stimuli may trigger complex reflex reactions much earlier. However, more important than possible painfulness is the fact that the noxious stimuli, by triggering stress responses, most likely affect the development of an individual at very early stages. Hence, it is not reasonable to speculate on the possible emotional experiences of pain in fetuses or premature babies. A clinically relevant aim is rather to avoid and/or treat any possibly noxious stimuli, and thereby prevent their potential adverse effects on the subsequent development.
Visser, Gerard H. A.; Mulder, Eduard J. H.; Ververs, F. F. Tessa
Ultrasound studies of fetal motor behavior provide direct - in vivo - insight in the functioning of the motor component of the fetal central nervous system. In this article, studies are reviewed showing changes in the first timetable of appearance of fetal movements, changes in quality and/or quanti
La ascitis fetal aislada es una entidad asociada a múltiples patologías, el diagnostico se realiza usualmente cuando fueron descartados las otras causas de ascitis fetal. Se describe el diagnóstico prenatal de un paciente con ascitis fetal aislada compatible con atresia ileal y peritonitis meconial secundaria a perforación de ileon distal. La ascitis fetal se resolvió posterior a la cirugía al segundo día de vida. Este caso tiene un buen pronostico debido al control tanto prenatal como intra ...
... specific prenatal tests to monitor both the mother's health and fetal health during each trimester. With modern technology, health professionals can Detect birth defects Identify problems that ...
Maribel Rodríguez Matos; Laritza Isabel Mengana Fontes; Mayda Urrutia Carmenaty
La hidropesía fetal es un grave proceso de elevada mortalidad perinatal, de etiología multifactorial, caracterizado por un síndrome edematoso generalizado, con o sin acumulación de líquido en las cavidades serosas del organismo fetal. Se presenta un caso de hidropesía fetal no inmunológica en una paciente de sexo femenino, de color de piel blanca y de 20 años de edad con enfermedad hipertensiva grave, diagnosticada mediante ultrasonido, como estudio de bienestar fetal a las 35,1 semanas de ge...
Caley, Linda M.; Kramer, Charlotte; Robinson, Luther K.
Fetal alcohol spectrum disorder (FASD) is a serious and widespread problem in this country. Positioned within the community with links to children, families, and healthcare systems, school nurses are a critical element in the prevention and treatment of those affected by fetal alcohol spectrum disorder. Although most school nurses are familiar…
Fetal scalp blood; Scalp pH testing; Fetal blood testing - scalp; Fetal distress - fetal scalp testing; Labor - fetal scalp testing ... a baby. In these cases, testing the scalp pH can help the doctor decide whether the fetus ...
Chandar Mohan Batra
Full Text Available Fetal thyrotoxicosis is a rare disease occurring in 1 out of 70 pregnancies with Grave′s disease or in 1 out of 4000-50,000 deliveries. The mortality is 12-20%, usually from heart failure, but other complications are tracheal compression, infections and thrombocytopenia. It results from transfer of thyroid stimulating immunoglobulins from mother to fetus through the placenta. This transplacental transfer begins around 20 th week of pregnancy and reaches its maximum by 30 th week. These autoantibodies bind to the fetal thyroid stimulating hormone (TSH receptors and increase the secretion of the thyroid hormones. The mother has an active autoimmune thyroid disease or has been treated for it in the past. She may be absolutely euthyroid due to past treatment by drugs, surgery or radioiodine ablation, but still have active TSH receptor stimulating autoantibodies, which can cause fetal thyrotoxicosis. The other features of this disease are fetal tachycardia, fetal goiter and history of spontaneous abortions and findings of goiter, ascites, craniosyntosis, fetal growth retardation, maceration and hydrops at fetal autopsy. If untreated, this disease can result in intrauterine death. The treatment for this disease consists of giving carbimazole to the mother, which is transferred through the placenta to the fetus. The dose of carbimazole is titrated with the fetal heart rate. If the mother becomes hypothyroid due to carbimazole, thyroxine is added taking advantage of the fact that very little of thyroxine is transferred across the placenta. Neonatal thyrotoxicosis patients are very sick and require emergency treatment. The goal of the treatment is to normalize thyroid functions as quickly as possible, to avoid iatrogenic hypothyroidism while providing management and supportive therapy for the infant′s specific signs and symptoms.
Full Text Available "nFetal biophysical profile scoring is a sonographic-based method of fetal assessment first described by Manning and Platt in 1980. "nThe biophysical profile score was developed as a method to integrate real-time observations of the fetus and his/her intrauterine environment in order to more comprehensively assess the fetal condition. These findings must be evaluated in the context of maternal/fetal history (i.e., chronic hypertension, post-dates, intrauterine growth restriction, etc, fetal structural integrity (presence or absence of congenital anomalies, and the functionality of fetal support structures (placental and umbilical cord. For example, acute asphyxia due to placental abruption may result in an absence of the acute variables of the biophysical profile score (fetal breathing movements, fetal movement, fetal tone, and fetal heart rate reactivity with a normal amniotic fluid volume. With post maturity the asphyxial event may be intermittent and chronic resulting in a decrease in amniotic fluid volume, but with the acute variables remaining normal. "nWhile the 5 components of the biophysical profile score have remained unchanged since 1980 (Manning, 1980, the definitions of a normal and abnormal parameter have evolved with increasing experience. "nIn 1984 the definition of oligohydramnios was increased from < 1cm pocket of fluid to < 2.0 x 1.0 cm pocket. Oligohydramnios is now defined as a pocket of amniotic fluid < 2.0 x 2.0 cm (Manning, 1995a "nIf the four ultrasound variables are normal, the accuracy of the biophysical profile score was not found to be significantly improved by adding the non-stress test. As a result, in 1987 the profile score was modified to incorporate the non-stress test only when one of the ultrasound variables was abnormal (Manning 1987. Table 1 outlines the current definitions for quantifying a variable as present or absent. "nEach of the 5 components of the biophysical profile score does not have equal
Táboas Lima, Esther
El uso de los ultrasonidos (US) en la obstetricia es una herramienta esencial, siendo España uno de los países con mayor uso de la ecografía durante el embarazo. La aparición de nuevos marcadores de salud fetal, como son el estudio mediante Doppler pulsado del Ductus venoso fetal, en torno a la semana 14 de gestación, lleva asociada una mayor duración de las exposiciones en edades fetales muy tempranas. La posibilidad de un posible efecto dañino sobre el feto tras el uso del Doppler pulsa...
Quintin, Aurelie; Schizas, Constantin; Scaletta, Corinne; Jaccoud, Sandra; Applegate, Lee Ann; Pioletti, Dominique P.
Tissue-specific stem cells found in adult tissues can participate to the repair process following injury. However adult tissues, such as articular cartilage and intervertebral disc, have low regeneration capacity, whereas fetal tissues, such as articular cartilage, show high regeneration ability. The presence of fetal stem cells in fetal cartilaginous tissues and their involvement in the regeneration of fetal cartilage is unknown. The aim of the study was to assess the chondrogenic differenti...
In this thesis fetal fluid and protein dynamics are investigated to gain insight in fetal (patho-)physiology. Studies were performed in fetuses with severe anemia and/or hydrops fetalis. Measurements were performed in fetal blood or amniotic fluid, obtained before or during intrauterine transfusion.
The association between stillbirth and fetal growth restriction is strong and supported by a large body of evidence and clinically employed for the stillbirth prediction. However, although assessment of fetal growth is a basis of clinical practice, it is not trivial. Essentially, fetal growth is a result of the genetic growth potential of the fetus and placental function. The growth potential is the driving force of fetal growth, whereas the placenta as the sole source of nutrients and oxygen might become the rate limiting element of fetal growth if its function is impaired. Thus, placental dysfunction may prevent the fetus from reaching its full genetically determined growth potential. In this sense fetal growth and its aberration provides an insight into placental function. Fetal growth is a proxy for the test of the effectiveness of placenta, whose function is otherwise obscured during pregnancy.
LUIS ALEJANDRO GONZÁLEZ S.
Full Text Available El estudio citogenético mediante tinción con Giemsa, en tres regiones xerofíticas (continental, peninsular e insular del oriente de Venezuela, demostró un número diploide 2n=36, compuesto por seis pares de macrocromosomas metacéntricos y submetacéntricos y 12 pares de microcromosomas acrocéntricos manteniéndose esta característica en machos y hembras en las tres poblaciones estudiadas. Se determinó que el primer par de macrocromosomas es metacéntrico y en la región continental representa 13% de longitud relativa total (LRT, siendo el cromosoma de mayor tamaño con respecto a la población peninsular con un 9,4 % y a la población insular con 7,1 %, conteniendo esta última población los cromosomas más pequeños. Considerando las diferencias cromosómicas y el aislamiento geográfico existente, estos lagartos podrían presentar un proceso de especiación alopátrica de tipo vicariante.A cytogenetic study by Giemsa staining in three xerophytic regions (continental, peninsular and insular in eastern Venezuela, showed a diploid number 2n=36, consisting of 6 pairs of metacentric and submetacentric macrochromosomes and 12 pairs of acrocentric microchromosomes maintained, this feature in males and females in the three populations studied. It was determined that the first pair of macrochromosomes is metacentric and the continental region represents 13% of total relative length (LRT as the larger chromosome, with respect to the peninsular population with 9.4% and the insular population 7.1%, the latter population containing the smallest chromosomes. Whereas chromosomal differences and geographic isolation exists, these lizards have a process of vicariant allopatric speciation.
Full Text Available Se determinó el tamaño del genoma y la estructura del cariotipo de 2 poblaciones silvestres de Agave aktites Gentry de Las Bocas y San Carlos, Sonora, México. El contenido de ADN nuclear en tejido foliar se determinó por citometría de flujo y los cromosomas se observaron en metafase mitótica de meristemos radiculares. Las plantas en ambas poblaciones son diploides (2n= 2x= 60. El contenido promedio 2C de ADN nuclear fue de 8.404 pg; 1Cx= 4 120 millones de pares de nucleótidos. El cariotipo bimodal fue similar en las 2 poblaciones y consistió de 10 cromosomas grandes y 50 pequeños y correspondió a 46m+6st+8t: también mostró un par de cromosomas telocéntricos grandes con constricción secundaria. El cociente de los brazos cromosómicos fue diferente en los pares 7, 8, 14 y 16 del grupo de cromosomas pequeños que presentan diferencias morfológicas entre las 2 poblaciones. Estos rearreglos cromosómicos podrían deberse a intercambios cromosómicos heterocigóticos espontáneos y son evidencia de que los genomas de distintas poblaciones de A. aktites se encuentran en un activo proceso de diferenciación que podría llevar a la especiación. Los análisis son básicos para conocer la diversidad genética intraespecífica de A. aktites y para establecer estrategias de conservación in situ y ex situ para esta especie.Genome size and karyotype structure of 2 wild populations of Agave aktites Gentry from Las Bocas and San Carlos, Sonora, Mexico were determined. Nuclear DNA content of leaf tissue was measured through flow cytometry, and chromosomes were observed in mitotic metaphase of root tips. All individual plants studied in both populations are diploids (2n= 2x= 60. The mean 2C nuclear DNA content was 8.404 pg; 1Cx= 4 120 million of base pairs. All plants of the 2 populations of A. aktites show a bimodal karyotype consisting of 10 large + 50 small chromosomes and corresponded to 46m+6st+8t; they also have a pair of large telocentric
Kiserud, Torvid; Acharya, Ganesh
Accumulating data on the human fetal circulation shows the similarity to the experimental animal physiology, but with important differences. The human fetus seems to circulate less blood through the placenta, shunt less through the ductus venosus and foramen ovale, but direct more blood through the lungs than the fetal sheep. However, there are substantial individual variations and the pattern changes with gestational age. The normalised umbilical blood flow decreases with gestational age, and, at 28 to 32 weeks, a new level of development seems to be reached. At this stage, the shunting through the ductus venosus and the foramen ovale reaches a minimum, and the flow through the lungs a maximum. The ductus venosus and foramen ovale are functionally closely related and represent an important distributional unit for the venous return. The left portal branch represents a venous watershed, and, similarly, the isthmus aorta an arterial watershed. Thus, the fetal central circulation is a very flexible and adaptive circulatory system. The responses to increased afterload, hypoxaemia and acidaemia in the human fetus are equivalent to those found in animal studies: increased ductus venosus and foramen ovale shunting, increased impedance in the lungs, reduced impedance in the brain, increasingly reversed flow in the aortic isthmus and a more prominent coronary blood flow.
Gabucio López, Pedro
Introducción: Las disfunciones de hombro son un problema de salud común en las sociedades occidentales. Algunos protocolos de tratamiento han sido desarrollados mediante ensayos clínicos con pacientes que presentan dolor de hombro. Sin embargo, no hay evidencias que sustenten que un protocolo es mejor que otros. El principal objetivo de este trabajo es presentar un caso clínico en el que mediante terapia manual y la prescripción de ejercicios físicos se consigue la resolución del ...
Bloomfield, Frank H; Jaquiery, Anne L; Oliver, Mark H
Fetal growth is largely regulated by nutritional supply. The placenta is responsible for fetal nutrient supply for much of pregnancy, but in early pregnancy nutrition is histiotrophic. Both placental size and efficiency, and fetal growth, may be affected by maternal nutritional state before and during very early pregnancy. In contrast, manipulating maternal nutrition during later stages of pregnancy has a smaller than expected effect on fetal growth. Maternal nutrition before and during early pregnancy also has a greater effect on gestation length than maternal nutrition later in pregnancy, suggesting that nutritional status may regulate both fetal growth trajectory and gestation length and that these two outcomes may be linked. Thus, determination of the nutritional factors regulating fetal growth, and potentially postnatal growth and body phenotype, may lie with the maternal nutritional status even before conception.
Simon, Erin M. [Departement of Radiology, Children' s Hospital of Philadelphia, PA (United States)
Magnetic resonance imaging of the fetal spine is a vital complement to fetal sonographic examination. Assessing the wide spectrum of spinal dysraphism, as well as spinal neoplasia, allows for more correct prenatal diagnoses, patient care planning, and patient counselling. Proper appraisal of the value of experimental procedures, such as fetal myelomeningocoele repair, requires a high level of diagnostic accuracy for the selection and follow-up of appropriate candidates. (orig.)
Cristina Y. Molina-Reyes
Full Text Available Objetivo principal: Valorar la rotación fetal de posición occipitoposterior (OP a occipitoanterior (OA durante el parto con la postura "manos-rodillas" (MR frente a la postura "decúbito lateral (DL hacia la espalda fetal". Metodología: Ensayo clínico multicéntrico. Mediante asignación aleatoria, 65 gestantes con posición fetal OP adoptaron la postura MR (grupo MR y 70 gestantes la postura DL hacia la espalda fetal (grupo DL durante 30 minutos. Resultados principales: Similar rotación fetal a OA durante la intervención del grupo MR frente al grupo DL (55,4% vs. 54,3%; Odds Ratio de 1,04 para un intervalo de confianza al 95%:0,53-2,06. Tampoco hubo diferencias estadísticamente significativas para los resultados de duración y tipo de terminación del parto entre los grupos. Conclusión principal: Para mejorar los resultados de los partos con posición fetal occipitoposterior recomendamos la adopción de las posturas MR y DL hacia la espalda fetal durante el parto, pues ambas tienen similar eficacia de rotación fetal a occipitoanterior.
Agerholm, J.S.; Boye, Mette; Aalbæk, B.
were found in several tissues. Histologically, placental lesions were characterized by locally diffuse infiltration of neutrophils, closely associated with abundant small Gram-negative and FISH-positive rods, thrombosis and necrosis. Lesions in the fetal-maternal interface were multifocal and consisted...... of villous necrosis and suppurative inflammation. Spread to the fetus from the placenta appeared to occur in two ways. Some fetuses had multifocal necrotizing hepatitis consistent with haematogenous spread through the umbilical vein; further dissemination to other organs occurred. Transplacental spread...
The cardiovascular system of the fetus is physiologically different than the adult, mature system. Unique characteristics of the myocardium and specific channels of blood flow differentitate the physiology of the fetus from the newborn. Conditions of increased preload and afterload in the fetus, such as sacrococcygeal teratoma and twin-twin transfusion syndrome, result in unique and complex pathophysiological states. Echocardiography has improved our understanding of human fetal cadiovasvular physiology in the normal and diseased states, and has expanded our capability to more effectively treat these disease processes.
Cooke, Paul S.; Nicoll, Charles S.
Summarizes recent research on hormonal control of fetal growth, presenting data obtained using a new method for studying the area. Effects of endocrine ablations and congenital deficiencies, studies of hormone/receptor levels, in-vitro techniques, hormones implicated in promoting fetal growth, problems with existing methodologies, and growth of…
Mulder, EJH; Beemer, FA; Stoutenbeek, P
We report three siblings from consecutive pregnancies affected with restrictive dermopathy (RD). During the second pregnancy, fetal behavioural development and growth were studied extensively using ultrasound at 1-4 week intervals. Dramatic and sudden changes occurred in fetal body movements and gro
Quartero, H.W.P.; Stinstra, J.G.; Golbach, E.G.M.; Meijboom, E.J.; Peters, M.J.
Objectives To test the usefulness and reliability of fetal magnetocardiography as a diagnostic or screening tool, both for fetuses with arrhythmias as well as for fetuses with a congenital heart defect. Methods We describe 21 women with either a fetal arrhythmia or a congenital heart defect disc
Full Text Available Prenatal diagnosis of congenital heart disease is now well established for a wide range of cardiac anomalies. Diagnosis of congenital heart disease during fetal life not only identifies the cardiac lesion but may also lead to detection of associated abnormalities. This information allows a detailed discussion of the prognosis with parents. For continuing pregnancies, appropriate preparation can be made to optimize the postnatal outcome. Reduced morbidity and mortality, following antenatal diagnosis, has been reported for coarctation of the aorta, hypoplastic left heart syndrome, and transposition of the great arteries. With regard to screening policy, most affected fetuses are in the "low risk" population, emphasizing the importance of appropriate training for those who undertake such obstetric anomaly scans. As a minimum, the four chamber view of the fetal heart should be incorporated into midtrimester anomaly scans, and where feasible, views of the outflow tracts should also be included, to increase the diagnostic yield. Newer screening techniques, such as measurement of nuchal translucency, may contribute to identification of fetuses at high risk for congenital heart disease and prompt referral for detailed cardiac assessment.
Mohamed Alkhatim Alsammani
Full Text Available Background: Fetal macrosomia remains a considerable challenge in current obstetrics due to the fetal and maternal complications associated with this condition. Aim: This study was designed to determine the prevalence of fetal macrosomia and associated fetal and maternal morbidity and mortality in the Al Qassim Region of Saudi Arabia. Materials and Methods: This register-based study was conducted from January 1, 2011 through December 30, 2011 at the Maternity and Child Hospital, Qassim, Saudi Arabia. Macrosomia was defined as birth weight of 4 kg or greater. Malformed babies and those born dead were excluded. Results: The total number of babies delivered was 9241; of these, 418 were macrosomic. Thus, the prevalence of fetal macrosomia was 4.5%. The most common maternal complications were postpartum hemorrhage (5 cases, 1.2%, perineal tear (7 cases, 1.7%, cervical lacerations (3 cases, 0.7%, and shoulder dystocia (40 cases, 9.6% that resulted in 4 cases of Erb′s palsy (0.96%, and 6 cases of bone fractures (1.4%. The rate of cesarean section among women delivering macrosomic babies was 47.6% (199, while 52.4% (219 delivered vaginally. Conclusion: Despite extensive efforts to reduce fetal and maternal complications associated with macrosomia, considerable fetal and maternal morbidity remain associated with this condition.
Victoria, Teresa; Chauvin, Nancy Anne; Johnson, Ann M.; Kramer, Sandra Sue; Epelman, Monica [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Capilla, Elena [Hospital Universitario Clinico San Carlos de Madrid, Madrid (Spain)
Fetal demise is an uncommon event encountered at MR imaging. When it occurs, recognition by the interpreting radiologist is important to initiate appropriate patient management. To identify MR findings of fetal demise. Following IRB approval, a retrospective search of the radiology fetal MR database was conducted searching the words ''fetal demise'' and ''fetal death.'' Fetuses with obvious maceration or no sonographic confirmation of death were excluded. Eleven cases formed the study group. These were matched randomly to live fetuses of similar gestational age. Images were reviewed independently by three pediatric radiologists. The deceased fetus demonstrates decreased MR soft-tissue contrast and definition of tissue planes, including loss of gray-white matter differentiation in the brain. The signal within the cardiac chambers, when visible, is bright on HASTE sequences from the stagnant blood; the heart is small. Pleural effusions and decreased lung volumes may be seen. Interestingly, the fetal orbits lose their anatomical round shape and become smaller and more elliptical; a dark, irregular rim resembling a mask may be seen. Although fetal demise is uncommonly encountered at MR imaging, radiologists should be aware of such imaging findings so prompt management can be instituted. (orig.)
Parmarth G Chandane
Full Text Available Antenatal use of anticonvulsant valproic acid can result in a well-recognized cluster of facial dysmorphism, congenital anomalies and neurodevelopmental retardation. In this report, we describe a case with typical features of fetal valproate syndrome (FVS. A 26-year-old female with epilepsy controlled on sodium valproate 800 mg/day since 3 years, gave birth to a male child with characteristic features of FVS. She also had 3 spontaneous first-trimester abortions during those 3 years. Sodium valproate, a widely used anticonvulsant and mood regulator, is a well-recognized teratogen that can result in facial dysmorphism, craniosynostosis, neural tube defects, and neurodevelopmental retardation. Therefore, we strongly recommend avoidance of valproic acid and supplementation of folic acid during pregnancy.
Van de Velde, Marc; Jani, Jacques; De Buck, Frederik; Deprest, J
This paper gives an overview of current science related to the concept of fetal pain. We have answered three important questions: (1) does fetal pain exist? (2) does management of fetal pain benefit the unborn child? and (3) which techniques are available to provide good fetal analgesia?
Ekelund, Charlotte; Kopp, Tine Iskov; Tabor, Ann
trimester ultrasound scan performed at all public hospitals in Denmark are registered in the database. MAIN VARIABLES/DESCRIPTIVE DATA: Data on maternal characteristics, ultrasonic, and biochemical variables are continuously sent from the fetal medicine units' Astraia databases to the central database via...... analyses are sent to the database. CONCLUSION: It has been possible to establish a fetal medicine database, which monitors first-trimester screening for chromosomal abnormalities and second-trimester screening for major fetal malformations with the input from already collected data. The database...
ESTIMATIVA DA DATA DO PARTO EM CADELAS ROTTWEILER ATRAVÉS DA BIOMETRIA FETAL REALIZADA POR ULTRASSONOGRAFIA ESTIMATION OF PARTURITION DATE THROUGH ULTRASONOGRAPHIC FOETAL BIOMETRY IN ROTTWEILER BITCHES ESTIMACIÓN DE LA FECHA DEL PARTO EN PERRAS ROTTWEILER A TRAVÉS DE LA BIOMETRÍA FETAL REALIZADA POR EL ULTRASONIDO
Karina Costa Moreira de Melo; Daniela Maria Bastos de Souza; Maria Juliana Teixeira; Áurea Wischral
Utilizou-se a ultrassonografia neste experimento para avaliar o desenvolvimento fetal e determinar a idade gestacional em cadelas Rottweiler. Tomaram-se e avaliaram-se as medidas da vesícula embrionária/fetal (VE) e do corpo fetal mediante análise de regressão, estabelecendo-se as equações de regressão linear e seus coeficientes. Os diâmetros biparietal (DBP) e do abdome (DA) dos fetos foram os que apresentaram os melhores resultados, considerando-se os coeficientes de correlação (0,89 e 0,90...
Mathis, Jérôme; Raio, Luigi; Baud, David
Fetoscopic coagulation of placental anastomoses is the treatment of choice for severe twin-to-twin transfusion syndrome. In the present day, fetal laser therapy is also used to treat amniotic bands, chorioangiomas, sacrococcygeal teratomas, lower urinary tract obstructions and chest masses, all of which will be reviewed in this article. Amniotic band syndrome can cause limb amputation by impairing downstream blood flow. Large chorioangiomas (>4 cm), sacrococcygeal teratomas or fetal hyperechoic lung lesions can lead to fetal compromise and hydrops by vascular steal phenomenon or compression. Renal damage, bladder dysfunction and lastly death because of pulmonary hypolasia may be the result of megacystis caused by a posterior urethral valve. The prognosis of these pathologies can be dismal, and therapy options are limited, which has brought fetal laser therapy to the forefront. Management options discussed here are laser release of amniotic bands, laser coagulation of the placental or fetal tumor feeding vessels and laser therapy by fetal cystoscopy. This review, largely based on case reports, does not intend to provide a level of evidence supporting laser therapy over other treatment options. Centralized evaluation by specialists using strict selection criteria and long-term follow-up of these rare cases are now needed to prove the value of endoscopic or ultrasound-guided laser therapy.
Van de Velde, Marc; De Buck, Frederik
For many prenatally diagnosed conditions, treatment is possible before birth. These fetal procedures can range from minimal invasive punctions to full open fetal surgery. Providing anesthesia for these procedures is a challenge, where care has to be taken for both mother and fetus. There are specific physiologic changes that occur with pregnancy that have an impact on the anesthetic management of the mother. When providing maternal anesthesia, there is also an impact on the fetus, with concerns for potential negative side effects of the anesthetic regimen used. The question whether the fetus is capable of feeling pain is difficult to answer, but there are indications that nociceptive stimuli have a physiologic reaction. This nociceptive stimulation of the fetus also has the potential for longer-term effects, so there is a need for fetal analgesic treatment. The extent to which a fetus is influenced by the maternal anesthesia depends on the type of anesthesia, with different needs for extra fetal anesthesia or analgesia. When providing fetal anesthesia, the potential negative consequences have to be balanced against the intended benefits of blocking the physiologic fetal responses to nociceptive stimulation.
... this page: //medlineplus.gov/ency/article/003407.htm Fetal-maternal erythrocyte distribution To use the sharing features ... unborn baby is leaking into the mother's blood circulation. The more of the baby's cells there are, ...
Ekelund, Charlotte K; Petersen, Olav Bjørn; Jørgensen, Finn S
OBJECTIVE: To describe the establishment and organization of the Danish Fetal Medicine Database and to report national results of first-trimester combined screening for trisomy 21 in the 5-year period 2008-2012. DESIGN: National register study using prospectively collected first-trimester screening...... data from the Danish Fetal Medicine Database. POPULATION: Pregnant women in Denmark undergoing first-trimester screening for trisomy 21. METHODS: Data on maternal characteristics, biochemical and ultrasonic markers are continuously sent electronically from local fetal medicine databases (Astraia Gmbh......%. The national screen-positive rate increased from 3.6% in 2008 to 4.7% in 2012. The national detection rate of trisomy 21 was reported to be between 82 and 90% in the 5-year period. CONCLUSION: A national fetal medicine database has been successfully established in Denmark. Results from the database have shown...
Qing-bo Fan; Ming-ying Gai; Jian-qiu Yang; Fei-fei Xing
Objective To explore fetal arrhythmia clinical significance and its correlation with fetal prognosis.Methods Twenty-six cases of fetal arrhythmia detected among 12 799 pregnant women recorded over a ten-year period in Peking Uinon Medical College (PUMC) Hospital were reviewed retrospectively. Fetal arrhythmia was diagnosed by fetal auscultation, ultrasonography, electric fetal heart monitoring, and fetal echocardiography.Results Twenty-six fetuses were documented with fetal arrhythmia (3 tachycardia, 4 bradycardia, 19 normal heart rate with irregular fetal cardiac rhythm). The incidence of fetal arrhythmia in our hospital was 0.2%. They were diagnosed at the average of 35 weeks' gestation (15 to 41 weeks). Twenty-two cases were diagnosed by antenatal fetal auscultation, 1 case was diagnosed by ultrasonography, and 3 cases were diagnosed by electric fetal heart monitoring. Fetal echocardiograms were performed on 17 fetuses, 6 cases (35.3%) of which showed that ventricular premature beats with normal structure of fetal heart.All neonates survived postnatally and 24 of them (92.3%) were followed up. Echocardiograms were performed for 16 neonates and 2 of them were identified as atrial septal defects with normal heart rhythms. The results of follow-up showed that the two patients had no apparent clinical manifestation. The echocardiogram showed that atrial septal defect obliterated already.Conclusion The prognosis is well for most of the fetuses with arrhythmias, with low incidence of heart deformation.
Botkin, J R
With the advent of new and better contraceptive methods and the ability to facilitate and manipulate fertilization and gestation, couples will gain greater control over their fertility. Once a pregnancy has been established or an in vitro embryo created, the ability to evaluate the embryo and fetus will increase dramatically with progress in human genetic research. Preconception and preimplantation genetic testing and screening are now possible, and the technology to perform prenatal screening early in gestation is advancing rapidly. Nonsurgical methods facilitate induced abortion with a relatively lower degree of trauma upon the woman undergoing the procedure. These capabilities may all be used to enable and even encourage the genetic selection of future children. Despite the ethical concerns associated with prenatal testing and abortion, these services will continue to be an integral aspect of reproductive medicine. As technology advances, however, it will be possible to test and screen for conditions which do not produce serious defects. Genetic conditions which produce relatively mild impacts upon health will be identifiable in the embryo or fetus, while late-onset conditions and genetic factors which have only a probability of affecting health will also be located in the fetal genome. Prospective parents may therefore soon have the capability of selecting their most desirable embryo in vitro, or terminating all undesirable fetuses in vivo until the preferred child is delivered. The medical profession must take some responsibility for establishing guidelines on the use of reproductive technology. The standards of practice for the medical profession must reflect the results of a broad social debate over competing moral values. The author develops an argument for legal and ethical limitations on the application of prenatal testing and screening technology, suggesting that for some medical conditions, respect for the privacy and confidentiality of the fetus
O'Donoghue, Keelin; Chan, Jerry
Stem cells have been isolated at all stages of development from the early developing embryo to the post-reproductive adult organism. However, the fetal environment is unique as it is the only time in ontogeny that there is migration of stem cells in large numbers into different organ compartments. While fetal neural and haemopoietic stem cells (HSC) have been well characterised, only recently have mesenchymal stem cells from the human fetus been isolated and evaluated. Our group have characterised in human fetal blood, liver and bone marrow a population of non-haemopoietic, non-endothelial cells with an immunophenotype similar to adult bone marrow-derived mesenchymal stem cells (MSC). These cells, human fetal mesenchymal stem cells (hfMSC), are true multipotent stem cells with greater self-renewal and differentiation capacity than their adult counterparts. They circulate in first trimester fetal blood and have been found to traffic into the maternal circulation, engrafting in bone marrow, where they remain microchimeric for decades after pregnancy. Though fetal microchimerism has been implicated in the pathogenesis of autoimmune disease, the biological role of hfMSC microchimerism is unknown. Potential downstream applications of hfMSC include their use as a target cell for non-invasive pre-natal diagnosis from maternal blood, and for fetal cellular and gene therapy. Using hfMSC in fetal therapy offers the theoretical advantages of avoidance of immune rejection, increased engraftment, and treatment before disease pathology sets in. Aside from allogeneic hfMSC in utero transplantation, the use of autologous hfMSC has been brought a step forward with the development of early blood sampling techniques, efficient viral transduction and clonal expansion. Work is ongoing to determine hfMSC fate post-transplantation in murine models of genetic disease. In this review we will examine what is known about hfMSC biology, as well as discussing areas for future research. The
Full Text Available Introduction: Anterior fetal neck masses are rarely encountered. Careful routine ultrasound screening can reveal intrauterine fetal goiters (FGs. The incidence of goitrous hypothyroidism is 1 in 30,000-50,000 live births. The consequences of both FG and impaired thyroid function are serious. Aims and Objectives: To emphasize role of ultrasound in both invasive and non-invasive management of FG. Materials and Methods: Two pregnant patients, during second trimester, underwent routine antenatal ultrasound revealing FG, were investigated and managed. Results: Case 1: Revealed FG with fetal hypothyroidism. Intra-amniotic injection l-thyroxine given. Follow-up ultrasound confirmed the reduction of the goiter size. At birth, thyroid dyshormogenesis was suspected and neonate discharged on 50 mcg levothyroxine/day with normal growth and development so far. Case 2: Hypothyroid mother with twin pregnancy revealed FG, in twin 1, confirmed on magnetic resonance imaging (1.5 × 1.63 cm. The other twin had no thyroid swelling. Cordocentesis confirmed hypothyroidism in twin 1. Maternal thyroxine dose increased as per biochemical parameters leading to reduction in FG size. Mother delivered preterm and none of the twins had thyroid swelling. Fetal euthyroidism was confirmed on biochemical screening. Conclusion: FG during pregnancy should be thoroughly evaluated, diagnosed and immediately treated; although in utero options for fetal hypothyroidism management are available, emphasis should be laid on non-invasive procedures. Newer and better resolution techniques in ultrasonography are more specific and at the same time are less harmful.
Our understanding of fetal circulatory physiology is based on experimental animal data, and this continues to be an important source of new insight into developmental mechanisms. A growing number of human studies have investigated the human physiology, with results that are similar but not identical to those from animal studies. It is time to appreciate these differences and base more of our clinical approach on human physiology. Accordingly, the present review focuses on distributional patterns and adaptational mechanisms that were mainly discovered by human studies. These include cardiac output, pulmonary and placental circulation, fetal brain and liver, venous return to the heart, and the fetal shunts (ductus venosus, foramen ovale and ductus arteriosus). Placental compromise induces a set of adaptational and compensational mechanisms reflecting the plasticity of the developing circulation, with both short- and long-term implications. Some of these aspects have become part of the clinical physiology of today with consequences for surveillance and treatment.
Chandraharan, Edwin; Wiberg, Nana
Fetal cardiotocography is characterized by low specificity; therefore, in an attempt to ensure fetal well-being, fetal scalp blood sampling has been recommended by most obstetric societies in the case of a non-reassuring cardiotocography. The scientific agreement on the evidence for using fetal...... scalp blood sampling to decrease the rate of operative delivery for fetal distress is ambiguous. Based on the same studies, a Cochrane review states that fetal scalp blood sampling increases the rate of instrumental delivery while decreasing neonatal acidosis, whereas the National Institute of Health...... and Clinical Excellence guideline considers that fetal scalp blood sampling decreases instrumental delivery without differences in other outcome variables. The fetal scalp is supplied by vessels outside the skull below the level of the cranial vault, which is likely to be compressed during contractions...
U.S. Department of Health & Human Services — Access to a variety of United States birth and death files including fetal deaths: Birth Files, 1968-2009; 1995-2005; Fetal death file, 1982-2005; Mortality files,...
Zywicki, Micaela; Blohowiak, Sharon E; Magness, Ronald R; Segar, Jeffrey L; Kling, Pamela J
Intrauterine growth restriction (IUGR) is interconnected with developmental programming of lifelong pathophysiology. IUGR is seen in human multifetal pregnancies, with stepwise rises in fetal numbers interfering with placental nutrient delivery. It remains unknown whether fetal blood analyses would reflect fetal nutrition, liver, and excretory function in the last trimester of human or ovine IUGR In an ovine model, we hypothesized that fetal plasma biochemical values would reflect progressive placental, fetal liver, and fetal kidney dysfunction as the number of fetuses per gestation rose. To determine fetal plasma biochemical values in singleton, twin, triplet, and quadruplet/quintuplet ovine gestation, we investigated morphometric measures and comprehensive metabolic panels with nutritional measures, liver enzymes, and placental and fetal kidney excretory measures at gestational day (GD) 130 (90% gestation). As anticipated, placental dysfunction was supported by a stepwise fall in fetal weight, fetal plasma glucose, and triglyceride levels as fetal number per ewe rose. Fetal glucose and triglycerides were directly related to fetal weight. Plasma creatinine, reflecting fetal renal excretory function, and plasma cholesterol, reflecting placental excretory function, were inversely correlated with fetal weight. Progressive biochemical disturbances and growth restriction accompanied the rise in fetal number. Understanding the compensatory and adaptive responses of growth-restricted fetuses at the biochemical level may help explain how metabolic pathways in growth restriction can be predetermined at birth. This physiological understanding is important for clinical care and generating interventional strategies to prevent altered developmental programming in multifetal gestation.
Sachs, Ulrich J
In fetal/neonatal alloimmune thrombocytopenia (FNAIT), antibodies against paternal antigens present on fetal platelets are produced by the mother. These antibodies will cross the placenta and can cause thrombocytopenia of the unborn. One severe consequence of thrombocytopenia is intracranial bleeding which may lead to death or severe sequelae. FNAIT index cases in one family are usually detected at birth only since antenatal screening programmes have not been installed so far. Subsequent pregnancies of immunized mothers may require special diagnostic and prophylactic interventions, and interdisciplinary counselling and treatment involving obstetricians, pediatricians and immunohematologists may prove useful for optimized care. This short review covers pathogenesis, clinical presentation, diagnostic, and therapeutic options in FNAIT.
MATSUDA, Yoshio; OGAWA, Masaki; KONNO, Jun; MITANI, Minoru; MATSUI, Hideo
Background To determine the major predictive factors for fetal acidemia in placental abruption. Methods A retrospective review of pregnancies with placental abruption was performed using a logistic regression model. Fetal acidemia was defined as a pH of less than 7.0 in umbilical artery. The severe abruption score, which was derived from a linear discriminant function, was calculated to determine the probability of fetal acidemia. Results Fetal acidemia was seen in 43 survivors (43/222, 19%)....
Ayşenur Cerrah Celayir
Full Text Available Fetal intervention for obstructive uropathy was first performed at the University of California, San Francisco in 1981. Since then diagnostic criteria for fetal intervention have been laid down to assist in proper patient selection. Unilateral fetal hydronephrosis doesn’t require prenatal intervention; but prenatal intervention might be required in selected cases, especially when hydronephrosis compresses adjacent organs.
Luechinger, Annemarie B.; Hadders-Algra, Mijna; Van Kan, Colette M.; de Vries, JIP
Perinatal qualitative assessment of general movements (GMs) is a tool to evaluate the integrity of the young nervous system. The aim of this investigation was to study the emergence of GMs. Fetal onset of GMs was studied sonographically in 18 fetuses during the first trimester of uncomplicated in vi
Hengstschlaeger, Markus [Medical Genetics, Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria)]. E-mail: firstname.lastname@example.org
The use of fetal magnetic resonance imaging (MRI), in addition to prenatal genetic testing and sonography, has the potential to improve prenatal diagnosis of genetic disorders. MRI plays an important role in the evaluation of fetal abnormalities and malformations. Fetal MRI often enables a differential diagnosis, a determination of the extent of the disorder, the prognosis, and an improvement in therapeutic management. For counseling of parents, as well as to basically understand how genetic aberrations affect fetal development, it is of great importance to correlate different genotypes with fetal MRI data.
Rasmussen, Ase Krogh; Sundberg, Karin; Brocks, Vibeke
Maternal overtreatment with antithyroid drugs can induce fetal goitrous hypothyroidism. This condition can have a critical effect on pregnancy outcome, as well as on fetal growth and neurological development. The purpose of this Review is to clarify if and how fetal goitrous hypothyroidism can...... be prevented, and how to react when prevention has failed. Understanding the importance of pregnancy-related changes in maternal thyroid status when treating a pregnant woman is crucial to preventing fetal goitrous hypothyroidism. Maternal levels of free T(4) are the most consistent indication of maternal...... and fetal thyroid status. In patients with fetal goitrous hypothyroidism, intra-amniotic levothyroxine injections improve fetal outcome. The best way to avoid maternal overtreatment with antithyroid drugs is to monitor closely the maternal thyroid status, especially estimates of free T(4) levels....
Full Text Available The development of Maternal-Fetal Medicine is contributing to an improvement of maternal well-being and of neonatal health, introducing a number of new and useful technologies. Advances in genomics in the field of prenatal screening and diagnosis allowed the discovery of fragments of cell-free fetal DNA in the maternal circulation and the use of chromosomal microarrays, which can test for microdeletions and microduplications in addition to aneuploidies. Color Doppler applications during pregnancy are expanding exponentially and Doppler flow velocity waveforms indices have provided important information from maternal, placental and fetal circulation with clinical implications. Ultrasound monitoring of fetal growth represents a fundamental tool to evaluate fetal wellbeing and several methods have been developed to improve fetal weight estimation accuracy. The combination of new biophysical and biochemical markers is enriching Maternal-Fetal Medicine and more research will allow to improve pregnancy outcome.
Huang, W; Deprest, J; Missant, C; Van de Velde, M
In recent years, fetal stress and analgesia draw more and more attention. Evidence that fetuses show a significant endocrinological and hemodynamical response to invasive stimuli, and that these responses can be blocked by analgesia, suggests that fetuses experience a stress response, even if this does not signify they experience "pain". Moreover, it is becoming increasingly clear that experiences of pain of a fetus will be "remembered" by the developing nervous system, perhaps for the entire life of the individual, which can probably lead to abnormal behavioural patterns or altered nociception. But up to now, the entire mechanism of fetal stress response and the optimal analgesic drug, dose and route of administration is not so clear.
Li,Hui; Wei, Jun; Ma, Ying; Shang, Tao
Objective: To study the value of detecting fetal congenital heart disease (CHD) using the five transverse planes technique of fetal echocardiography. Methods: Nine hundred and eighty-two high-risk pregnancies for fetal CHD were included in this study, the fetal heart was scanned with the five transverse planes technique of fetal echocardiography described by Yagel, autopsy was conducted when pregnancy was terminated. Blood from fetal heart was collected for fetal chromosome analysis. A close ...
Bulas, Dorothy [George Washington University Medical Center, Division of Diagnostic Imaging and Radiology, Children' s National Medical Center, Washington, DC (United States)
Spinal dysraphism or neural tube defects (NTD) encompass a heterogeneous group of congenital spinal anomalies that result from the defective closure of the neural tube early in gestation with anomalous development of the caudal cell mass. Advances in ultrasound and MRI have dramatically improved the diagnosis and therapy of spinal dysraphism and caudal spinal anomalies both prenatally and postnatally. Advances in prenatal US including high frequency linear transducers and three dimensional imaging can provide detailed information concerning spinal anomalies. MR imaging is a complementary tool that can further elucidate spine abnormalities as well as associated central nervous system and non-CNS anomalies. Recent studies have suggested that 3-D CT can help further assess fetal spine anomalies in the third trimester. With the advent of fetal therapy including surgery, accurate prenatal diagnosis of open and closed spinal dysraphism becomes critical in appropriate counselling and perinatal management. (orig.)
Full Text Available Aging is increasingly regarded as an independent risk factor for development of cardiovascular diseases such as atherosclerosis and hypertension and their complications (e.g. MI and Stroke. It is well known that vascular disease evolve over decades with progressive accumulation of cellular and extracellular materials and many inflammatory processes. Metabolic syndrome, obesity and diabetes are conventionally recognized as risk factors for development of coronary vascular disease (CVD. These conditions are known to accelerate ageing process in general and vascular ageing in particular. Adverse events during intrauterine life may programme organ growth and favour disease later in life, popularly known as, ′Barker′s Hypothesis′. The notion of fetal programming implies that during critical periods of prenatal growth, changes in the hormonal and nutritional milieu of the conceptus may alter the full expression of the fetal genome, leading to permanent effects on a range of physiological.
Kanayama, Naohiro; Niwayama, Masatsugu
The best way to assess fetal condition is to observe the oxygen status of the fetus (as well as to assess the condition of infants, children, and adults). Previously, several fetal oximeters have been developed; however, no instrument has been utilized in clinical practice because of the low-capturing rate of the fetal oxygen saturation. To overcome the problem, we developed a doctor's finger-mounted fetal tissue oximeter, whose sensor volume is one hundredth of the conventional one. Additionally, we prepared transparent gloves. The calculation algorithm of the hemoglobin concentration was derived from the light propagation analysis based on the transport theory. We measured neonatal and fetal oxygen saturation (StO2) with the new tissue oximeter. Neonatal StO was measured at any position of the head regardless of amount of hair. Neonatal StO was found to be around 77%. Fetal StO was detected in every position of the fetal head during labor regardless of the presence of labor pain. Fetal StO without labor pain was around 70% in the first stage of labor and around 60% in the second stage of labor. We concluded that our new concept of fetal tissue oximetry would be useful for detecting fetal StO in any condition of the fetus.
New contributions to the study of Corixoidea: cytogenetic characterization of three species of Sigara from Argentina and the plausible mechanisms of karyotype evolution within Nepomorpha Nuevas contribuciones al estudio de Corixoidea: caracterización citogenética de tres especies de Sigara de Argentina y los posibles mecanismos de evolución del cariotipo en Nepomorpha
María José Bressa
Full Text Available Cytogenetic studies in Heteroptera contribute to the analysis of evolutionary trends within the group. Heteroptera are characterized by the possession of holokinetic chromosomes, different sex chromosome mechanisms and a pair of m chromosomes in some species. In the present work, the male karyotype and meiosis in Sigara denseconscripta (Breddin, S. chrostowskii Jaczewski, and S. rubyae (Hungerford are described. The three species share a diploid chromosome number of 2n= 24 with a pair of m chromosomes and an XY/XX sex chromosome system. With this study the chromosome number of 30 species of Corixoidea are known and the modal karyotype is 2n= 20+2m+XY in males. The available cytogenetic information in Heteroptera led us to suggest that the presence of a pair of m chromosomes and an XY/XX sex chromosome system could be considered as plesiomorphic for Nepomorpha. The absence of m chromosomes in species of Ochteroidea and Nepoidea, and the sex chromosome systems X0 and Xn0 (male in species of Corixoidea, Naucoroidea, and Nepoidea should be considered as derived characters, which arose later in evolution.Los estudios citogenéticos en Heteroptera contribuyen al análisis de las tendencias evolutivas en el taxón. Los Heteroptera se caracterizan por poseer cromosomas holocinéticos, diferentes sistemas de cromosomas sexuales y un par de cromosomas m en algunas especies. En este trabajo describimos el cariotipo y la meiosis masculina de Sigara denseconscripta (Breddin, S. chrostowskii Jaczewski y S. rubyae (Hungerford. Las tres especies tienen un número diploide de 24, con un par de cromosomas m y un sistema de cromosomas sexuales XY/XX. Con estos resultados son 30 las especies de Corixoidea estudiadas citogenéticamente y el cariotipo modal de la superfamilia es 2n= 20+2m+XY en machos. La información citogenética disponible hasta el presente en Heteroptera nos permite sugerir que la presencia de cromosomas m y cromosomas sexuales XY/XX, ser
Martin, C.; Darnell, A.; Duran, C.; Mellado, F.; Corona, M [Corporacio Sanitaria del Parc Tauli. Sabadell (Spain)
Ultrasonography is the preferred diagnostic imaging technique for intrauterine fetal examination. Nevertheless, circumstances sometimes dictate the use of other techniques in order to analyze fetal structures. The advent of ultra rapid magnetic resonance (MR) sequencing has led to the possibility of doing MR fetal studies, since images are obtained in an extradordiarily short time and are not affected by either maternal or fetal movements. It does not employ ionizing radiations, it provides high-contrast images and it can obtain such images in any plane of space without being influenced by either the child bearer's physical characteristics of fetal position. MR provides good quality images of most fetal organs. It is extremely useful in analysing distinct structures, as well as permitting an evaluation of cervical structures, lungs, diaphragms, intra-abdominal and retroperitoneal structures, and fetal extremities. It can also provide useful information regarding the placenta,umbilical cord, amniotic fluid and uterus. The objective of this work is to describe MR technique as applied to intrauterine fetal examination, and to illustrate normal fetal anatomy as manifested by MR and its applications. (Author) 42 refs.
Tendais, Iva; Visser, Gerard H. A.; Figueiredo, Barbara; Montenegro, Nuno; Mulder, Eduard J. H.
Fetal movements and fetal heart rate (FHR) are well-established markers of fetal well-being and maturation of the fetal central nervous system. The purpose of this paper is to review and discuss the available knowledge on fetal movements and heart rate patterns in twin pregnancies. There is some evi
Sklansky, Mark; Tang, Alvin; Levy, Denis; Grossfeld, Paul; Kashani, Iraj; Shaughnessy, Robin; Rothman, Abraham
The maternal psychological impact of fetal echocardiography may be deleterious in the face of newly diagnosed congenital heart disease. This questionnaire-based study prospectively examined the psychological impact of both normal and abnormal fetal echocardiography. Normal fetal echocardiography decreased maternal anxiety, increased happiness, and increased the closeness women felt toward their unborn children. In contrast, when fetal echocardiography detected congenital heart disease, maternal anxiety typically increased, and mothers commonly felt less happy about being pregnant. However, among women who had recently delivered infants with congenital heart disease, those who had had fetal echocardiography during the pregnancy felt less responsible for their infants' defects and tended to have improved their relationships with the infants' fathers after the prenatal diagnosis of congenital heart disease. Further study of the psychological and medical impact of fetal echocardiography will be necessary to define and optimize the clinical value of this powerful diagnostic tool.
Juras, Josip; Ivanisević, Marina; Oresković, Slavko; Mihaljević, Slobodan; Vujić, Goran; Delmis, Josip
A pregnant woman with inherited thrombophilia (factor II mutation--20210A) had two late pregnancy losses. The first pregnancy was not well documented, but the second pregnancy was complicated by fetal thrombophilia and umbilical artery thrombosis, proven after fetal death. During the third pregnancy enoxaparine was introduced in the therapy and early amniocentesis was performed. Fetal thrombophilia was proven again. Early delivery was induced and performed with no complications, resulting in a live healthy infant. A history of miscarriages or recurrent fetal loss should raise suspicion of thrombophilia as a potential cause. It is debatable whether amniocentesis in pursuit of fetal thrombophilia should be performed and whether this will lead to a better perinatal outcome. When fetal thrombophilia is diagnosed, an earlier induction of delivery should be considered, taking into account the fetal extrauterine viability. The aforementioned approach of early delivery in cases of inherited fetal thrombophilia could be a possible solution for better perinatal outcomes.
... https://medlineplus.gov/news/fullstory_163096.html Fetal Alcohol Syndrome a Global Problem: Report Countries with highest alcohol use during pregnancy include Belarus, Britain, Denmark, Ireland ...
Full Text Available Fetal ascite is defined as fluid accumulation in peritoneal cavity. It can be seen as isolated disease or an early sign of hydrops fetalis. Once fetal ascite is detected, a careful examination for hydops fetalis and possible underlying disease is necessary, since its prognosis and treatment depends mostly on the cause. Non-immunologic fetal ascite is an uncommon problem occurring for many reasons, such as urinary tract obstruction, congenital infections, genetic and metabolic diseases, gastrointestinal diseases and cardiovascular diseases. Here in this report we present two isolated fetal ascite that occurred secondary to cardiac diseases.
Glenn, Orit A. [University of California, San Francisco, Department of Radiology, Neuroradiology Section, San Francisco, CA (United States)
Fetal MRI is clinically performed to evaluate the brain in cases where an abnormality is detected by prenatal sonography. These most commonly include ventriculomegaly, abnormalities of the corpus callosum, and abnormalities of the posterior fossa. Fetal MRI is also increasingly performed to evaluate fetuses who have normal brain findings on prenatal sonogram but who are at increased risk for neurodevelopmental abnormalities, such as complicated monochorionic twin pregnancies. This paper will briefly discuss the common clinical conditions imaged by fetal MRI as well as recent advances in fetal MRI research. (orig.)
Seyed Mostafa Ghavami
Full Text Available Background: The primary manifestation of cardiac tumors in embryonic period is a very rare condition. Cardiac rhabdomyomas most frequently arise in the ventricular myocardium, they may also occur in the atria and the epicardial surface. In spite of its benign nature, the critical location of the tumor inside the heart can lead to lethal arrhythmias and chamber obstruction. Multiple rhabdomyomas are strongly associated with tuberous sclerosis which is associated with mental retardation and epilepsy of variable severity. Ultrasonography as a part of routine prenatal screening, is the best method for the diagnosis of cardiac rhabdomyomas. In the review of articles published in Iran, fetal cardiac rhabdomyoma was not reported. Case presentation: We report a case of cardiac rhabdomyoma on a 24-year-old gravid 1, referred to Day Medical Imaging Center for routine evaluation of fetal abnormalities at 31 weeks of her gestational age. Ultrasonographic examination displayed a homogenous echogenic mass (13×9mm, originating from the left ventricle of the fetal heart. It was a normal pregnancy without any specific complications. Other organs of the fetus were found normal and no cardiac abnormalities were appeared. No Pericardial fluid effusion was found. The parents did not have consanguineous marriage. They did not also have any specific disease such as tuberous sclerosis. Conclusion: The clinical features of cardiac rhabdomyomas vary widely, depending on the location, size, and number of tumors in the heart. Although cardiac rhabdomyoma is a benign tumor in many affected fetuses, an early prenatal diagnosis of the tumor is of great significance in making efficient planning and providing adequate follow up visits of the patients and the complications such as, heart failure and outlet obstruction of cardiac chambers.
Adama van Scheltema, P.N.; Pasman, S.A.; Wolterbeek, R..; Deprest, J.A.; Oepkes, D.; Buck, F. De; Velde, M van de; Vandenbussche, F.P.H.A.
OBJECTIVE: To document fetal stress hormone and Doppler changes after intrauterine transfusions (IUTs) in either the intrahepatic portion of the umbilical vein (IHV) or the placental cord insertion (PCI). METHOD: Pregnant women scheduled for IUT for fetal anemia (N = 25) were included prospectively.
Chapman, Teresa; Weinberger, E. [Department of Radiology, Seattle Children' s Hospital, Seattle, WA (United States); Matesan, Manuela [University of Washington, Department of Radiology, Seattle, WA (United States); Bulas, Dorothy I. [Division of Diagnostic Imaging and Radiology, Children' s National Medical Center, Washington, DC (United States)
Fetal MRI can be performed in the second and third trimesters. During this time, the fetal brain undergoes profound structural changes. Interpretation of appropriate development might require comparison with normal age-based models. Consultation of a hard-copy atlas is limited by the inability to compare multiple ages simultaneously. To provide images of normal fetal brains from weeks 18 through 37 in a digital format that can be reviewed interactively. This will facilitate recognition of abnormal brain development. T2-W images for the atlas were obtained from fetal MR studies of normal brains scanned for other indications from 2005 to 2007. Images were oriented in standard axial, coronal and sagittal projections, with laterality established by situs. Gestational age was determined by last menstrual period, earliest US measurements and sonogram performed on the same day as the MR. The software program used for viewing the atlas, written in C, permits linked scrolling and resizing the images. Simultaneous comparison of varying gestational ages is permissible. Fetal brain images across gestational ages 18 to 37 weeks are provided as an interactive digital atlas and are available for free download. Improved interpretation of fetal brain abnormalities can be facilitated by the use of digital atlas cataloging of the normal changes throughout fetal development. Here we provide a description of the atlas and a discussion of normal fetal brain development. (orig.)
Friese, Greg; Wojciehoski, Randal F
To summarize: The best fetal protection is proper maternal use of seat belt restraints. All pregnant occupants in a motor vehicle crash require physician evaluation. Focus on maternal assessment. Maternal stability is the best indicator of fetal stability. Key treatments are high-flow oxygen, i.v. fluid loading and immobilizing in left lateral position. Evaluate the fetus after maternal stabilization.
Hornberger, L K
Maternal diabetes mellitus significantly affects the fetal heart and fetal–placental circulation in both structure and function. The influence of pre‐conceptional diabetes begins during embryonic development in the first trimester, with altered cardiac morphogenesis and placental development. It continues to have an influence on the fetal circulation through the second and third trimesters and into the perinatal and neonatal period
Mulder, E. J. H.; Derks, J. B.; de Laat, M. W. M.; Visser, G. H. A.
Objectives: A prospective study was performed to compare fetal behavioral development in healthy dichorionic twins and singletons, and identify twin intra-pair associations (synchrony) of fetal movements and rest-activity cycles using different criteria to define synchrony. Subjects and methods: Twe
Barbeiro, Fernanda Morena dos Santos; Fonseca, Sandra Costa; Tauffer, Mariana Girão; Ferreira, Mariana de Souza Santos; da Silva, Fagner Paulo; Ventura, Patrícia Mendonça; Quadros, Jesirée Iglesias
OBJECTIVE To review the frequency of and factors associated with fetal death in the Brazilian scientific literature. METHODS A systematic review of Brazilian studies on fetal deaths published between 2003 and 2013 was conducted. In total, 27 studies were analyzed; of these, 4 studies addressed the quality of data, 12 were descriptive studies, and 11 studies evaluated the factors associated with fetal death. The databases searched were PubMed and Lilacs, and data extraction and synthesis were independently performed by two or more examiners. RESULTS The level of completeness of fetal death certificates was deficient, both in the completion of variables, particularly sociodemographic variables, and in defining the underlying causes of death. Fetal deaths have decreased in Brazil; however, inequalities persist. Analysis of the causes of death indicated maternal morbidities that could be prevented and treated. The main factors associated with fetal deaths were absent or inadequate prenatal care, low education level, maternal morbidity, and adverse reproductive history. CONCLUSIONS Prenatal care should prioritize women that are most vulnerable (considering their social environment or their reproductive history and morbidities) with the aim of decreasing the fetal mortality rate in Brazil. Adequate completion of death certificates and investment in the committees that investigate fetal and infant deaths are necessary. PMID:25902565
Cohen, I. Glenn; Sayeed, Sadath Ali
In early 2010, the Nebraska state legislature passed a new abortion restricting law asserting a new, compelling state interest in preventing fetal pain. In this article, we review existing constitutional abortion doctrine and note difficulties presented by persistent legal attention to a socially derived viability construct. We then offer a substantive biological, ethical, and legal critique of the new fetal pain rationale.
Cohen, I Glenn; Sayeed, Sadath
In early 2010, the Nebraska state legislature passed a new abortion restricting law asserting a new, compelling state interest in preventing fetal pain. In this article, we review existing constitutional abortion doctrine and note difficulties presented by persistent legal attention to a socially derived viability construct. We then offer a substantive biological, ethical, and legal critique of the new fetal pain rationale.
Johnson, Johnnye S.
Maternal well-being is the key to fetal well-being. A fetus is highly vulnerable and sensitive to pain and stress, and exposure has the potential for negative developmental consequences. Childbirth educators can help raise parental awareness about the importance of the maternal environment for best outcomes in fetal development.
Lutomski, J.E.; Meaney, S.; Greene, R.A.; Ryan, A.C.; Devane, D.
BACKGROUND: Cardiotocography (CTG) records the fetal heart rate in relation to maternal uterine contractions and is one of the most common forms of fetal assessment during labour. Despite guidelines for CTG interpretation, substantial inter- and intra-observer variation in interpretation has been re
Farnam, C R
The transplant of cells from fetal tissue shows promise as a therapy for certain diseases. The use and research of fetal tissue, and methods of obtaining the tissue, have raised ethical dilemmas. Consideration must be given concerning the mother, the fetus, and the tissue recipient.
Lassen, Pernille; Sundberg, Karin; Juul, Anders
A unique case of fetal goiter accompanied by bilateral ovarian cysts in a mother treated with methimazole for Graves'disease is reported. The abnormal findings were detected by ultrasound at 31 weeks of gestation. Umbilical fetal blood sampling revealed elevated serum TSH, normal concentrations o...
Full Text Available Measuring fetal drug concentrations is extremely difficult in humans. We conducted a study in pregnant sheep to simultaneously describe maternal and fetal concentrations of propofol, a common intravenous anesthetic agent used in humans. Compared to inhalational anesthesia, propofol supplemented anesthesia lowered the dose of desflurane required to provide adequate uterine relaxation during open fetal surgery. This resulted in better intraoperative fetal cardiac outcome. This study describes maternal and fetal propofol pharmacokinetics (PK using a chronically instrumented maternal-fetal sheep model.Fetal and maternal blood samples were simultaneously collected from eight mid-gestational pregnant ewes during general anesthesia with propofol, remifentanil and desflurane. Nonlinear mixed-effects modeling was performed by using NONMEM software. Total body weight, gestational age and hemodynamic parameters were tested in the covariate analysis. The final model was validated by bootstrapping and visual predictive check.A total of 160 propofol samples were collected. A 2-compartment maternal PK model with a third fetal compartment appropriately described the data. Mean population parameter estimates for maternal propofol clearance and central volume of distribution were 4.17 L/min and 37.7 L, respectively, in a typical ewe with a median heart rate of 135 beats/min. Increase in maternal heart rate significantly correlated with increase in propofol clearance. The estimated population maternal-fetal inter-compartment clearance was 0.0138 L/min and the volume of distribution of propofol in the fetus was 0.144 L. Fetal propofol clearance was found to be almost negligible compared to maternal clearance and could not be robustly estimated.For the first time, a maternal-fetal PK model of propofol in pregnant ewes was successfully developed. This study narrows the gap in our knowledge in maternal-fetal PK model in human. Our study confirms that maternal heart
Ibarrola Lerga, Josu
El objetivo de este proyecto fin de carrera consiste en el desarrollo de un sistema de videoconferencia mediante WebRTC. Para realizar dicho desarrollo crearemos una página mediante el lenguaje de programación HTML5 y la tecnología que nos brinda WebRTC, todo ello dentro del marco de trabajo de Bootstrap, consiguiendo así una página web apta para cualquier dispositivo de visualización que se utilice. Debido a que se trata de una tecnología nueva que el autor desconoce, para pod...
Yamamoto C.,Masami; Astudillo D,Julio; Pedraza S,Daniel; Muñoz S,Hernán; Insunza F,Álvaro; Fleiderman D,José; Riveros K,Rodrigo
Antecedentes: El síndrome de transfusión feto fetal (STFF) afecta el 15% de los gemelares monocoriales y tiene una mortalidad de 90% cuando se diagnostica antes de las 26 semanas. Objetivo: Evaluar el resultado perinatal mediante fotocoagulación con láser porfetoscopia, de las anastomosis vasculares placentarias en pacientes con STFF. Método: Fotocoagulación láser por fetoscopia de 18 casos de SFF tratados en Clínica Alemana de Santiago entre los años 2005-2008. Resultados: 72,8% de los embar...
Sánchez Capel, Aurora
El objetivo de este trabajo es el estudio del paso transplacentario de sustancias de abuso durante el primer trimestre de la gestación mediante el análisis en matrices no convencionales de las principales drogas de abuso y sus metabolitos. Hemos analizado la exposición intrauterina a estas sustancias utilizando cuestionarios estructurados y la presencia de biomarcadores de exposición en la placenta y los restos fetales procedentes de 258 mujeres que interrumpieron voluntariamente su embarazo ...
Prayer, Daniela [Department of Radiodiagnostics, Medical University of Vienna (Austria)]. E-mail: email@example.com; Brugger, Peter C. [Center of Anatomy and Cell Biology, Medical University of Vienna (Austria); Kasprian, Gregor [Department of Radiodiagnostics, Medical University of Vienna (Austria); Witzani, Linde [Department of Radiodiagnostics, Medical University of Vienna (Austria); Helmer, Hanns [Department of Obstetrics and Gynecology, Medical University of Vienna (Austria); Dietrich, Wolfgang [Department of Neurosurgery, Medical University of Vienna (Austria); Eppel, Wolfgang [Department of Obstetrics and Gynecology, Medical University of Vienna (Austria); Langer, Martin [Department of Obstetrics and Gynecology, Medical University of Vienna (Austria)
Acquired fetal brain damage is suspected in cases of destruction of previously normally formed tissue, the primary cause of which is hypoxia. Fetal brain damage may occur as a consequence of acute or chronic maternal diseases, with acute diseases causing impairment of oxygen delivery to the fetal brain, and chronic diseases interfering with normal, placental development. Infections, metabolic diseases, feto-fetal transfusion syndrome, toxic agents, mechanical traumatic events, iatrogenic accidents, and space-occupying lesions may also qualify as pathologic conditions that initiate intrauterine brain damage. MR manifestations of acute fetal brain injury (such as hemorrhage or acute ischemic lesions) can easily be recognized, as they are hardly different from postnatal lesions. The availability of diffusion-weighted sequences enhances the sensitivity in recognizing acute ischemic lesions. Recent hemorrhages are usually readily depicted on T2 (*) sequences, where they display hypointense signals. Chronic fetal brain injury may be characterized by nonspecific changes that must be attributable to the presence of an acquired cerebral pathology. The workup in suspected acquired fetal brain injury also includes the assessment of extra-CNS organs that may be affected by an underlying pathology. Finally, the placenta, as the organ that mediates oxygen delivery from the maternal circulation to the fetus, must be examined on MR images.
Baschat, Ahmet A
Fetal growth restriction (FGR) can emerge as a complication of placental dysfunction and increases the risk for neurodevelopmental delay. Marked elevations of umbilical artery (UA) Doppler resistance that set the stage for cardiovascular and biophysical deterioration with subsequent preterm birth characterize early-onset FGR. Minimal, or absent UA Doppler abnormalities and isolated cerebral Doppler changes with subtle deterioration and a high risk for unanticipated term stillbirth are characteristic for late-onset FGR. Nutritional deficiency manifested in lagging head growth is the most powerful predictor of developmental delay in all forms of FGR. Extremes of blood flow resistance and cardiovascular deterioration, prematurity and intracranial hemorrhage increase the risks for psychomotor delay and cerebral palsy. In late-onset FGR, regional cerebral vascular redistribution correlates with abnormal behavioral domains. Irrespective of the phenotype of FGR, prenatal tests that provide precise and independent stratification of risks for adverse neurodevelopment have yet to be determined.
Derbyshire, S W G
The question of whether a fetus can experience pain is an immense challenge. The issue demands consideration of the physical and psychological basis of being and the relation between the two. At the center of this debate is the question of how it is that we are conscious, a question that has inspired the writing of some of our most brilliant contemporary philosophers and scientists, with one commentary suggesting surrender. In my earlier review I attempted to draw together the various strands of thinking that had attacked the question of fetal pain and relate them back to the bigger question of consciousness. In their vituperative response, Benatar and Benatar bite off my finger before looking to where I am pointing. I will examine each of their criticisms.
Burd, Larry; Klug, Marilyn G; Martsolf, John T; Kerbeshian, Jacob
Fetal alcohol syndrome (FAS) is a common developmental disorder with impairments in multiple neuropsychiatric spheres of varying severity. Few population-derived studies of the behavioral phenotype are available. The purpose of this study was to estimate the prevalence of neuropsychiatric disorders in three groups: subjects who met criteria for FAS (n=152); subjects who met criteria for partial FAS/ARND (n=150); and referred subjects who did not meet criteria for either FAS or partial FAS/ARND (n=86). Each subject had a standardized evaluation by a medical geneticist. All subjects were from North Dakota. We found increases in the prevalence rates of neuropsychiatric disorders in subjects with FAS compared to subjects with partial FAS/ARND and the lowest rates in the group that did not meet criteria for either FAS or partial FAS/ARND. Comorbid attention deficit hyperactivity disorder occurred in 73% of cases with FAS, in 72% cases with partial FAS/ARND, and in 36% subjects who did not meet criteria for either. For other neuropsychiatric disorders, a similar distribution of comorbidity was found. This study supports the concept of a continuum of impairment resulting from prenatal alcohol exposure. The presence of complex cognitive, behavioral, and physical symptomatology in the affected subjects with prenatal alcohol exposure would seem to fit well under the diagnostic rubric of fetal alcohol spectrum disorder (FASD). Diagnosis and long-term management will require increasing access to multidisciplinary child development teams including mental health professionals who treat children and adolescents. Adults will require care primarily from teams with expertise in mental health and developmental disabilities.
Ryo, Eiji; Kamata, Hideo; Seto, Michiharu
A fetal movement acceleration measurement (FMAM) recorder was developed for home monitoring of fetal movements. We provided a 32-year-old pregnant woman with the FMAM recorder to home monitor fetal movements, thereby self-recording decreased fetal movements at 30 weeks' gestation. On routine checkup, a non-stress test revealed scant fetal heart rate accelerations. At 31 weeks' gestation, the woman underwent an emergent caesarean delivery because of a non-reassuring fetal heart rate pattern, and delivered a female neonate weighing 1312 g, whose umbilical cord was slightly narrowed at the umbilicus. Our experience with the present case suggests the usefulness of the FMAM recorder.
... and the Public Identifying Alcohol-Exposed Pregnancies through Biomarkers International Research National Task Force on Fetal Alcohol ... manage high energy levels, inability to focus, or depression. Following are some examples of medications used to ...
Clausen, Frederik Banch; Damkjær, Merete Berthu; Dziegiel, Morten Hanefeld
Immunization against RhD is the major cause of hemolytic disease of the fetus and newborn (HDFN), which causes fetal or neonatal death. The introduction of postnatal immune prophylaxis in the 1960s drastically reduced immunization incidents in pregnant, D-negative women. In several countries......, antenatal prophylaxis is combined with postnatal prophylaxis to further minimize the immunization risk. Due to lack of knowledge of the fetal RhD type, antenatal prophylaxis is given to all D-negative women. In the European population, approximately 40% of pregnant women carry a D-negative fetus...... and are thus at no risk of immunization. Noninvasive fetal RhD genotyping enables antenatal prophylaxis to be targeted to only those women carrying a D-positive fetus to avoid unnecessary treatment. Based on an analysis of cell-free fetal DNA from the plasma of pregnant women, this approach has recently...
Rubesova, Erika [Stanford University, Department of Radiology, Lucile Packard Children' s Hospital, Stanford, CA (United States)
The technical quality of prenatal US and fetal MRI has significantly improved during the last decade and allows an accurate diagnosis of bowel pathology prenatally. Accurate diagnosis of bowel pathology in utero is important for parental counseling and postnatal management. It is essential to recognize the US presentation of bowel pathology in the fetus in order to refer the patient for further evaluation or follow-up. Fetal MRI has been shown to offer some advantages over US for specific bowel abnormalities. In this paper, we review the normal appearance of the fetal bowel on US and MRI as well as the typical presentations of bowel pathologies. We discuss more specifically the importance of recognizing on fetal MRI the abnormalities of size and T1-weighted signal of the meconium-filled distal bowel. (orig.)
Mosher, John C.; Flynn, Edward R.; Quinn, A.; Weir, A.; Shahani, U.; Bain, R. J. P.; Maas, P.; Donaldson, G. B.
Fetal magnetocardigraphy (fMCG) provides a unique method for noninvasive observations of the fetal heart. Electrical currents generated by excitable tissues within the fetal heart yield measurable external magnetic fields. Measurements are performed with superconducting quantum interference devices inductively coupled to magnetometer or gradiometer coils, and the resulting signals are converted to digital form in the data acquisition system. The measured fields are usually contaminated by fetal and maternal movements (usually respiration), other physiological fields such as skeletal muscle contraction, the maternal cardiac signal, and environmental electromagnetic fields. Sensitivity to relatively distant sources, both physiological and environmental, is substantially reduced by the use of magnetic gradiometers. Other contaminants may be removed by proper signal conditioning which may be automatically applied using "black box" algorithms that are transparent to the user and highly efficient. These procedures can rapidly reduce the complex signal plus noise waveforms to the desired fMCG with minimal operator interference.
Philipps, A.F. (Univ. of Connecticut Health Center, Farmington) Widness, J.A.; Garcia, J.F.; Raye, J.R.; Swartz, R.
The effects of chronic fetal glucose infusion upon fetal oxygenation and endogenous erythropoietin (Ep) production were studied using the chronically catheterized fetal lamb. Fetal glucose infusion at rates between 5 and 20 mg/kg/min resulted in sustained fetal hyperglycemia. During glucose infusion (maximal glucose concentration achieved = 55.4 +/- 3.7 mg/dl) fetal arterial oxygen contents fell from 5.8 +/- 0.9 to 4.2 +/- 1.0 ml/dl while no changes were observed in simultaneously sampled, noninfused twins. Although plasma insulin concentration rose in the infused fetuses, the elevations were inconstant and no relationship between fetal plasma insulin concentration and decrement in fetal oxygen content was evident. The changes in plasma Ep concentration were noted prior to any significant fetal metabolic acidosis (as evidence of tissue hypoxia) and no changes in plasma Ep concentration were observed in simultaneously sampled noninfused twins. No relationship was apparent between fetal arterial plasma insulin and Ep concentrations. Since neither fetal anemia nor hemodilution occurred in these preparations, glucose-induced fetal hyposemia is the likely mechanism behind elevated fetal Ep concentrations in these experiments. Similarities between this animal model and human fetuses and infants of diabetic mothers suggest that chronic in utero hypoxemia may be a common feature responsible for such diverse abnomalities as polycythemia, hyperbilirubinemia, and late fetal demise. The mechanism behind the glucose-induced fetal hypoxemia is not known.
Loren P. Thompson
Full Text Available Intrauterine stress induces increased risk of adult disease through fetal programming mechanisms. Oxidative stress can be generated by several conditions, such as, prenatal hypoxia, maternal under- and overnutrition, and excessive glucocorticoid exposure. The role of oxidant molecules as signaling factors in fetal programming via epigenetic mechanisms is discussed. By linking oxidative stress with dysregulation of specific target genes, we may be able to develop therapeutic strategies that protect against organ dysfunction in the programmed offspring.
Preeclampsia (PE) is one of the severe complications of pregnancy that leads to fetal deterioration. The aim was to survey the validity of fetal distress diagnostics in case of Doppler ultrasonic umbilical vein and arteries blood flow velocity investigation and ECG parameters analysis obtained from maternal abdominal signal before labor in preeclamptic patients. Fetal noninvasive ECG and umbilical arterial and venous Doppler investigation were performed in 120 patients at 34-40 weeks of gestation. And 30 of them had physiological gestation and were involved in Group I. In Group II 52 pregnant women with mild-moderate PE were observed. 38 patients with severe PE were monitored in Group III. The most considerable negative correlation was determined in pair Apgar score 1 versus T/QRS (R = -0.50; p < 0.05). So the increased T/QRS ratio was the most evident marker of fetal distress. Fetal noninvasive ECG showed sensitivity of 96.6% and specificity of 98.4% and, therefore, was determined as more accurate method for fetal monitoring.
Although the association of fetal growth restriction and adverse pregnancy outcomes is well known, lack of sensitivity limits its clinical value. To a large extent, this limitation is a result of traditionally used method to define growth restriction by comparing fetal or birth weight to population norms. The use of population norms, by virtue of their inability to fully consider individual variation, results in high false positive and negative rates. An alternative, calculating fetal individually optimal growth potential, based on physiological determinants of individual growth, is superior in predicting adverse outcomes of pregnancy. Impairment of fetal growth potential identifes some adverse pregnancy outcomes that are not associated with growth restrction defined by population norms. When compared with traditional population-based norms, fetal growth potential is a better predictor of several important adverse outcomes of pregnancy which include: stillbirth, neonatal mortality and morbidity, and long-term adverse neonatal outcomes like neonatal encephalopathy, cerebral palsy and cognitive abilities. Impairment of individual growth potential is also strongly associated with spontaneous preterm delivery. Although definitive interventional trials have not been conducted as yet to validate the clinical value of fetal growth potential, many observational studies, conducted in various populations, indicate its significant promise in this respect.
Rolfe, P [Oxford BioHorizons Ltd. (United Kingdom); Scopesi, F [Gaslini Institute, University of Genoa (Italy); Serra, G [Gaslini Institute, University of Genoa (Italy)
Specialised instruments have been developed to aid the care of the fetus and the newborn baby. Miniature sensors using optical, electrical, chemical, mechanical and magnetic principles have been produced for capturing key measurands. These include temperature, pressure, flow and dimension, as well as several specific molecules such as glucose, oxygen and carbon dioxide. During pregnancy ultrasound imaging and blood flow techniques provide valuable information concerning fetal abnormalities, fetal growth, fetal breathing and fetal heart rate. Signal processing and pattern recognition can be useful for deriving indicators of fetal distress and clinical status, based on biopotentials as well as ultrasound signals. Fetal pH measurement is a critical requirement during labour and delivery. The intensive care of ill preterm babies involves provision of an optimal thermal environment and respiratory support. Monitoring of blood gas and acid-base status is essential, and this involves both blood sampling for in vitro analysis as well as the use of invasive or non-invasive sensors. For the future it will be vital that the technologies used are subjected to controlled trials to establish benefit or otherwise.
Full Text Available BACKGROUND: It is widely accepted that circadian physiological rhythms of the fetus are affected by oscillators in the maternal brain that are coupled to the environmental light-dark (LD cycle. METHODOLOGY/PRINCIPAL FINDINGS: To study the link between fetal and maternal biological clocks, we investigated the effects of cycles of maternal food availability on the rhythms of Per1 gene expression in the fetal suprachiasmatic nucleus (SCN and liver using a transgenic rat model whose tissues express luciferase in vitro. Although the maternal SCN remained phase-locked to the LD cycle, maternal restricted feeding phase-advanced the fetal SCN and liver by 5 and 7 hours respectively within the 22-day pregnancy. CONCLUSIONS/SIGNIFICANCE: Our results demonstrate that maternal feeding entrains the fetal SCN and liver independently of both the maternal SCN and the LD cycle. This indicates that maternal-feeding signals can be more influential for the fetal SCN and particular organ oscillators than hormonal signals controlled by the maternal SCN, suggesting the importance of a regular maternal feeding schedule for appropriate fetal molecular clockwork during pregnancy.
Full Text Available Preeclampsia (PE is one of the severe complications of pregnancy that leads to fetal deterioration. The aim was to survey the validity of fetal distress diagnostics in case of Doppler ultrasonic umbilical vein and arteries blood flow velocity investigation and ECG parameters analysis obtained from maternal abdominal signal before labor in preeclamptic patients. Fetal noninvasive ECG and umbilical arterial and venous Doppler investigation were performed in 120 patients at 34–40 weeks of gestation. And 30 of them had physiological gestation and were involved in Group I. In Group II 52 pregnant women with mild-moderate PE were observed. 38 patients with severe PE were monitored in Group III. The most considerable negative correlation was determined in pair Apgar score 1 versus T/QRS (R=-0.50; p<0.05. So the increased T/QRS ratio was the most evident marker of fetal distress. Fetal noninvasive ECG showed sensitivity of 96.6% and specificity of 98.4% and, therefore, was determined as more accurate method for fetal monitoring.
Unüvar, Tolga; Büyükgebiz, Atilla
Endocrine disruptors are substances commonly encountered in every setting and condition in the modern world. It is virtually impossible to avoid the contact with these chemical compounds in our daily life. Molecules defined as endocrine disruptors constitute an extremely heterogeneous group and include synthetic chemicals used as industrial solvents/lubricants and their by-products. Natural chemicals found in human and animal food (phytoestrogens) also act as endocrine disruptors. Different from adults, children are not exposed only to chemical toxins in the environment but may also be exposed during their intrauterine life. Hundreds of toxic substances, which include neuro-immune and endocrine toxic chemical components that may influence the critical steps of hormonal, neurological and immunological development, may affect the fetus via the placental cord and these substances may be excreted in the meconium. Children and especially newborns are more sensitive to environmental toxins compared to adults. Metabolic pathways are immature, especially in the first months of life. The ability of the newborn to metabolize, detoxify and eliminate many toxins is different from that of the adults. Although exposures occur during fetal or neonatal period, their effects may sometimes be observed in later years. Further studies are needed to clarify the effects of these substances on the endocrine system and to provide evidence for preventive measures.
Repondek-Liberska, M; Janiak, K; Wloch, A
Ectopia cordis is an extremely rare congenital abnormality occurring in 5.5 to 7.9 per 1 million live births with high lethality. Between January 1995 and October 1997 eight cases of ectopia cordis were diagnosed at our institute before birth. On the basis of echocardiography the fetal heart anatomy was categorized as either normal heart anatomy (NHA; n = 3) or congenital heart defect (CHD; n = 5). In the majority of cases (seven of eight) other abnormalities were present. Some reports have described ectopia cordis being diagnosed in the first trimester of pregnancy. In our study group the average gestational age at diagnosis was 26 weeks. The prenatal diagnosis of isolated ectopia cordis is easy; counseling the patient, the perinatal management including term, place, and method of delivery, and optimal care of the newborn are more difficult. Ectopia cordis is a malformation that pediatricians rarely encounter, even at pediatric cardiology centers. Much more frequently it is a problem for sonographers and obstetricians; however, pediatric cardiologists should be aware of diagnostic algorithm for such cases, especially when additional abnormalities are present.
Lowery, Curtis L; Hardman, Mary P; Manning, Nirvana; Hall, R Whit; Anand, K J S; Clancy, Barbara
Pain in the developing fetus is controversial because of the difficulty in measuring and interpreting pain during gestation. It has received increased attention lately because of recently introduced legislation that would require consideration of fetal pain during intentional termination of pregnancy. During development, sensory fibers are abundant by 20 weeks; a functional spinal reflex is present by 19 weeks; connections to the thalamus are present by 20 weeks; and connections to subplate neurons are present by 17 weeks with intensive differentiation by 25 weeks. These cells are important developmentally, but decline as a result of natural apoptosis. Mature thalamocortical projections are not present until 29 to 30 weeks, which has led many to believe the fetus does not experience emotional "pain" until then. Pain requires both nociception and emotional reaction or interpretation. Nociception causes physiologic stress, which in turn causes increases in catecholamines, cortisol, and other stress hormones. Physiological stress is different from the emotional pain felt by the more mature fetus or infant, and this stress is mitigated by pain medication such as opiates. The plasticity of the developing brain makes it vulnerable to the stressors that cause long-term developmental changes, ultimately leading to adverse neurological outcomes. Whereas evidence for conscious pain perception is indirect, evidence for the subconscious incorporation of pain into neurological development and plasticity is incontrovertible. Scientific data, not religious or political conviction, should guide the desperately needed research in this field. In the meantime, it seems prudent to avoid pain during gestation.
Young, B K; Noumoff, J; Klein, S A; Katz, M
Fifty-one women in labor had continuous monitoring of fetal scalp tissue pH, fetal heart rate by ECG, and uterine contractions. A miniature pH electrode secured by a double spiral fetal ECG electrode was used for measurement of fetal pH every 15 seconds. The results were correlated with fetal scalp blood pH values obtained simultaneously. Fetal scalp sampling is intermittent, requires repeated scalp incisions, is subject to errors due to air mixing and coagulation of the blood sample, and is uncomfortable for the parturient. Placement of the tissue pH electrode allows continuous data recording with the minimum discomfort to the patient and the least number of fetal scalp incisions. Clinical use of the tissue pH electrode might be a practical alternative to fetal scalp samples, if the data obtained accurately reflect fetal status.
Behar, Joachim; Zhu, Tingting; Oster, Julien; Niksch, Alisa; Mah, Douglas Y; Chun, Terrence; Greenberg, James; Tanner, Cassandre; Harrop, Jessica; Sameni, Reza; Ward, Jay; Wolfberg, Adam J; Clifford, Gari D
Non-invasive fetal electrocardiography (NI-FECG) is a promising alternative continuous fetal monitoring method that has the potential to allow morphological analysis of the FECG. However, there are a number of challenges associated with the evaluation of morphological parameters from the NI-FECG, including low signal to noise ratio of the NI-FECG and methodological challenges for getting reference annotations and evaluating the accuracy of segmentation algorithms. This work aims to validate the measurement of the fetal QT interval in term laboring women using a NI-FECG electrocardiogram monitor. Fetal electrocardiogram data were recorded from 22 laboring women at term using the NI-FECG and an invasive fetal scalp electrode simultaneously. A total of 105 one-minute epochs were selected for analysis. Three pediatric electrophysiologists independently annotated individual waveforms and averaged waveforms from each epoch. The intervals measured on the averaged cycles taken from the NI-FECG and the fetal scalp electrode showed a close agreement; the root mean square error between all corresponding averaged NI-FECG and fetal scalp electrode beats was 13.6 ms, which is lower than the lowest adult root mean square error of 16.1 ms observed in related adult QT studies. These results provide evidence that NI-FECG technology enables accurate extraction of the fetal QT interval.
Somya Girish Goyal
Full Text Available Background: Non-stress test is an external monitoring of fetal heart rate by electrocardiograph. Although intermittent auscultation of fetal heart rate is equivalent to continuous electronic fetal monitoring in detecting fetal compromise1 but continuous electronic fetal monitoring is indicated in high risk patients women whose foetuses are at high risk for neonatal encephalopathy or cerebral palsy.2 Objective of current study was to study the efficacy and diagnostic value of non-stress Test for surveillance and its usefulness to detect fetal distress at early stage which help to decide further management in mode of delivery. Methods: Design: prospective study. NST was done in 50 high risk patients for minimum of 20 minutes and in patients with non-reactive non stress test it was continued for 40 minutes. Maternal age, parity, complications during labour, and delivery, mode of delivery, indications of caesarean section and perinatal outcome were noted. Results: Out of total 50 cases studied patient delivered vaginally were 24 and Caesarean was done in 26 cases. Most LSCS were performed due to PIH (35% and related complications like IUGR, eclampsia (10%, fetal distress, previous caesarean pregnancy, IUGR, oligohydraminos and meconium stained liquor. 52% patients were delivered by caesarean and 48% by normal delivery. Conclusions: Routine use of electronic fetal heart monitoring helped in reduction of neonatal morbidity and mortality with increased rate of caesarean section. [Int J Reprod Contracept Obstet Gynecol 2014; 3(4.000: 893-897
Schlütter, Jacob Mørup; Kirkegaard, Ida; Christensen, Connie Britta;
were then stained with a cocktail of fetal cell-specific antibodies, identified and counted. Results: Participants carrying male fetuses had higher median number of fcmbs per 30 mL blood than those carrying female fetuses (5 vs. 3, p=0.004). Exercise within 3 hours (1.5 vs. 4, p=0.02) and 24 hours (2......Introduction: We have established a robust method to specifically identify and isolate a placental fetal cell in maternal blood (fcmbs) at a gestational age of 12 weeks. The concentration of these cells, however, varies considerably among pregnant women (median 3 fcmbs/30 mL blood, range 0...... activity was obtained by a questionnaire and a structured interview. The number of fcmbs was assessed in 30 mL blood processed by a proprietary method developed in-house. Fetal cells in the blood, binding to fetal cell specific antibodies, were initially isolated by magnetic cell sorting. The fetal cells...
Full Text Available BACKGROUND : S tructural abnormalities of the heart and great vessels are fairly common congenital lab normalities with the incidenceof8 in 1000 live births. With the advent of real time scanners fetal cardia can atomy can be analyze d echocardiographically. The earlier diagnosis will make an impact on clinical management of fetus with congenital heart disease. It helps intimely triage and optimal management of specific congenital heart disease either structural , functional orarrhythmia . OBJECTIVES : This study was conducted to note the spectrum of congenital heart diseases detected on fetal echo in pregnant mothers referred with high risk for CHD sand to assess the outcome of prenatally detected congenital heart diseases. MATERIAL S AND METHODS : T he study is aprospective descriptive study conducted in a tertiary care pediatric hospital in Mumbai over period of one year . P regnant mothers were referred for fetal echo , where pregnancy was considered as high risk for CHDs due to maternal , fetalfactorsorabnormallevel 1 scan.Fetal echowas performed by a trained pediatric cardiologistat 18 to 20 week of gestation using HP sonos 2000 echocardiographicmachinewith3/3.5 Hz transducer. Cardiac lesionsandoutcome of pregnancy was noted by postnatal follow - up of patients. RESULTS : A total of 170 patients underwent fetal echo , 13 patients have not delivered and 48 were lost to follow - up. Fetal echo was normal in 130(76.4% and abnormalities were detected in 40(23.5%.Structural anomalies were seen in 24(14.1% , arrhythmia in 5(2.9% and functional abnormalities in 11(6.4%.On outcome analysis84 (77.1% arealive , IUD /terminationof pregnancyoccurred in 18(16.5% , neonatal death in 6 (5.5% , infant death in 1 (0.9%. CONCLUSIONS : All ranges of CHDs can be diagnosed by fetal echocardiography . O utcome of prenatally detected complex congenital heart disease is poor ; nonetheless earlier detection provides a n opportunity for early interventions and
Rangaswamy, N; Abdelrahim, A; Moore, R M; Uyen, L; Mercer, B M; Mansour, J M; Kumar, D; Sawady, J; Moore, J J
The purpose of this study was to determine the biomechanical characteristics of human fetal membranes (FM) throughout gestation. Biomechanical properties were determined for 115 FM of 23-41 weeks gestation using our previously described methodology. The areas of membrane immediately adjacent to the strongest and weakest tested spots were sampled for histomorphometric analysis. Clinical data on the patients whose FM were examined were also collected. FM less than 28 weeks gestation were associated with higher incidence of abruption and chorioamnionitis. Topographically FM at all gestations had heterogeneous biomechanical characteristics over their surfaces with distinct weak areas. The most premature membranes were the strongest. FM strength represented by rupture force and work to rupture decreased with increasing gestation in both weak and strong regions of FM. This decrease in FM strength was most dramatic at more than 38 weeks gestation. The FM component amnion-chorion sublayers were thinner in the weak areas compared to strong areas. Compared to term FM, preterm FM are stronger but have similar heterogeneous weak and strong areas. Following a gradual increase in FM weakness with increasing gestation, there is a major drop-off at term 38 weeks gestation. The FM weak areas are thinner than the stronger areas. Whether the difference in thickness is enough to account for the strength differences is unknown.
Kotila, Letitia E; Schoppe-Sullivan, Sarah J; Kamp Dush, Claire M
Ultrasound provides a reliable, convenient way to determine fetal sex, but not all expectant mothers pursue this knowledge. We used logistic regression to investigate whether maternal personality, parenting perfectionism, and gender role beliefs were associated with knowing fetal sex in a recent sample of first-time expectant mothers. We also tested whether conscientiousness and extraversion moderated the association between gender role beliefs and knowing fetal sex. Mothers who were more open to experience were less likely to know fetal sex, whereas mothers high in parenting perfectionism were more likely to know fetal sex. Conscientious mothers who espoused more egalitarian gender role beliefs were less likely to know fetal sex.
Buckley, Suzanne M K; Rahim, Ahad A; Chan, Jerry K Y; David, Anna L; Peebles, Donald M; Coutelle, Charles; Waddingtont, Simon N
Over the first decade of this new millennium gene therapy has demonstrated clear clinical benefits in several diseases for which conventional medicine offers no treatment. Clinical trials of gene therapy for single gene disorders have recruited predominantly young patients since older subjects may have suffered irrevocablepathological changes or may not be available because the disease is lethal relatively early in life. The concept of fetal gene therapy is an extension of this principle in that diseases in which irreversible changes occur at or beforebirth can be prevented by gene supplementation or repair in the fetus or associated maternal tissues. This article ccnsiders the enthusiasm and skepticism held for fetal gene therapy and its potential for clinical application. It coversa spectrum of candidate diseases for fetal gene therapy including Pompe disease, Gaucher disease, thalassemia, congenital protein C deficiency and cystic fibrosis. It outlines successful and not-so-successful examples of fetal gene therapy in animal models. Finally the application and potential of fetal gene transfer as a fundamental research tool for developmental biology and generation of somatic transgenic animals is surveyed.
Stubán, Norbert; Niwayama, Masatsugu
As the measuring head of a fetal pulse oximeter must be attached to the head of the fetus inside the mother's uterus during labor, testing, and developing of fetal pulse oximeters in real environment have several difficulties. A fetal phantom could enable evaluation of pulse oximeters in a simulated environment without the restrictions and difficultness of medical experiments in the labor room. Based on anatomic data we developed an adjustable fetal head phantom with three different tissue layers and artificial arteries. The phantom consisted of two arteries with an inner diameter of 0.2 and 0.4 mm. An electronically controlled pump produced pulse waves in the arteries. With the phantom we investigated the sensitivity of a custom-designed wireless pulse oximeter at different pulsation intensity and artery diameters. The results showed that the oximeter was capable of identifying 4% and 2% changes in diameter between the diastolic and systolic point in arteries of over 0.2 and 0.4 mm inner diameter, respectively. As the structure of the phantom is based on reported anatomic values, the results predict that the investigated custom-designed wireless pulse oximeter has sufficient sensitivity to detect the pulse waves and to calculate the R rate on the fetal head.
Xu, Rong; Xie, Tianliang; Ohya, Jun; Zhang, Bo; Sato, Yoshinobu; Fujie, Masakatsu G.
Recently, a minimally invasive surgery (MIS) called fetoscopic tracheal occlusion (FETO) was developed to treat severe congenital diaphragmatic hernia (CDH) via fetoscopy, by which a detachable balloon is placed into the fetal trachea for preventing pulmonary hypoplasia through increasing the pressure of the chest cavity. This surgery is so dangerous that a supporting system for navigating surgeries is deemed necessary. In this paper, to guide a surgical tool to be inserted into the fetal trachea, an automatic approach is proposed to detect and track the fetal face and mouth via fetoscopic video sequencing. More specifically, the AdaBoost algorithm is utilized as a classifier to detect the fetal face based on Haarlike features, which calculate the difference between the sums of the pixel intensities in each adjacent region at a specific location in a detection window. Then, the CamShift algorithm based on an iterative search in a color histogram is applied to track the fetal face, and the fetal mouth is fitted by an ellipse detected via an improved iterative randomized Hough transform approach. The experimental results demonstrate that the proposed automatic approach can accurately detect and track the fetal face and mouth in real-time in a fetoscopic video sequence, as well as provide an effective and timely feedback to the robot control system of the surgical tool for FETO surgeries.
Walsh, Jennifer M
Evidence for a role of vitamin D in maintaining normal glucose homeostasis is inconclusive. We sought to clarify the relationship between maternal and fetal insulin resistance and vitamin D status. This is a prospective cohort study of 60 caucasian pregnant women. Concentrations of 25-hydroxyvitamin D (25-OHD), glucose, insulin, and leptin were measured in early pregnancy and at 28 weeks. Ultrasound at 34 weeks assessed fetal anthropometry including abdominal wall width, a marker of fetal adiposity. At delivery birth weight was recorded and fetal 25-OHD, glucose, C-peptide, and leptin measured in cord blood. Insulin resistance was calculated using the Homeostasis Model Assessment (HOMA) equation. We found that those with lower 25-OHD in early pregnancy had higher HOMA indices at 28 weeks, (r = -.32, P = .02). No significant relationship existed between maternal or fetal leptin and 25-OHD, or between maternal or fetal 25-OHD and fetal anthropometry or birth weight. The incidence of vitamin D deficiency was high at each time point (15%-45%). These findings lend support to routine antenatal supplementation with vitamin D in at risk populations.
Finnemore, Anna; Groves, Alan
The fetal circulation is an entirely transient event, not replicated at any point in later life, and functionally distinct from the pediatric and adult circulations. Understanding of the physiology of the fetal circulation is vital for accurate interpretation of hemodynamic assessments in utero, but also for management of circulatory compromise in premature infants, who begin extrauterine life before the fetal circulation has finished its maturation. This review summarizes the key classical components of circulatory physiology, as well as some of the newer concepts of physiology that have been appreciated in recent years. The immature circulation has significantly altered function in all aspects of circulatory physiology. The mechanisms and significance of these differences are also discussed, as is the impact of these alterations on the circulatory transition of infants born prematurely.
Garel, Catherine [Hopital Robert Debre, Department of Paediatric Imaging, Paris (France)
MR is now routinely and widely used in fetal neuroimaging and has proven to be valuable in the detection of many cerebral lesions, either genetically determined or acquired in utero. However, its efficiency has certain limits in the detection of diffuse white-matter abnormalities, the evaluation of fibre development and the demonstration of metabolic disorders. Moreover, conventional fetal MR imaging provides only a morphological approach to the fetal brain. New techniques such as diffusion-weighted imaging, diffusion tensor imaging, proton MR spectroscopy and functional MR imaging are developing. The majority of these are not used routinely. The principles, aims, technical problems and possible applications of these techniques for imaging the fetus are discussed. (orig.)
Full Text Available Intrauterine pleural effusion of fetal lungs rarely regresses without intervention. In our case we treated a women at 32th weeks of gestation. Her pregnancy was complicated with fetal pleural effusion and polyhydramniosis. A therapeutic thoracocentesis was planned and she received two courses of betamethasone prior to procedure. On the day of planned procedure, a substantial regression of pleural effusion was observed and procedure was postponed. During her antenatal follow-up a complete regression of pleural effusion was observed. After delivery pleural effusion did not relapse. These findings hint there may be a role of antenatal steroids in treatment of fetal pleural effusion, which is known to be resistant to treatment modalities both during antenatal and postnatal period. [Cukurova Med J 2015; 40(Suppl 1: 25-28
John Edward Jones
Full Text Available Events that occur in the early fetal environment have been linked to long-term health and lifespan consequences in the adult. Intrauterine growth restriction (IUGR, which may occur as a result of nutrient insufficiency, exposure to hormones, or disruptions in placental structure or function, may induce the fetus to alter its developmental program in order to adapt to the new conditions. IUGR may result in a decrease in the expression of genes that are responsible for nephrogenesis as nutrients are rerouted to the development of more essential organs. Fetal survival under these conditions often results in low birth weight and a deficit in nephron endowment, which are associated with hypertension in adults. Interestingly, male IUGR offspring appear to be more severely affected than females, suggesting that sex hormones may be involved. The processes of fetal programming of hypertension are complex, and we are only beginning to understand the underlying mechanisms.
Reinhart, W H; Danoff, S J; King, R G; Chien, S
Rheological parameters were measured in 10 pairs of mothers and newborns. Whole blood viscosity was similar despite a higher fetal hematocrit (47.0 +/- 5.1 versus 35.5 +/- 12.0%, mean +/- SD, p less than 0.05). When the hematocrit of the suspension of red cells in plasma was adjusted to 45%, the viscosity was significantly lower in the fetal blood over a wide range of shear rates (0.52-208 S-1). The main reason for the lower viscosity in the fetal blood was the lower plasma viscosity as compared to the maternal blood (1.08 +/- 0.05 versus 1.37 +/- 0.08 centipoise, p less than 0.05); this in turn was attributable to a lower total plasma protein concentration (4.74 +/- 0.71 versus 6.47 +/- 0.64 g/dl, p less than 0.05). All protein fractions were lower in the fetal plasma. The assessment of red cell deformability by filtration through polycarbonate sieves revealed that the resistance of a fetal red cell was three times higher than that of a maternal red cell in a 2.6-micron pore, but there was no significant difference in resistance for these red cells in 6.9-micron pores. This higher filtration resistance of fetal red cells through the small pores was mainly due to their large volume (115.4 +/- 10.8 versus 93.5 +/- 5.9 fl, p less than 0.001). Measurements on membrane-free hemoglobin solutions indicated that the internal viscosity of these two types of red cells was not different.(ABSTRACT TRUNCATED AT 250 WORDS)
A Martina Messing-Jünger
Full Text Available Open spinal dysraphism is a common and clinically challenging organo-genetic malformation. Due to the well-known multi-organ affection with significant implication on the lives of patients and their families, abortion after prenatal diagnosis became reality in most parts of the world. After publication of the Management of Myelomeningocele Study (MOMS results fetal surgery seems to be a new option and a broad discussion arose regarding advantages and risks of in utero treatment of spina bifida. This paper tries to evaluate objectively the actual state of knowledge and experience. This review article gives a historical overview as well as the experimental and pathophysiological background of fetal surgery in open spinal dysraphism. Additionally clinical follow-up experience of foetoscopically treated patients are presented and discussed. After carefully outweighing all available information on fetal surgery for spina bifida, one has to conclude, in accordance with the MOMS investigators, that in utero surgery cannot be considered a standard option at present time. But there is clear evidence of the hypothesis that early closure of the spinal canal has a positive influence on spinal cord function and severity of Chiari malformation type II, has been proven. A persisting problem is the fetal risk of prematurity and the maternal risk of uterus damage. There is also evidence that due to technical restrictions, fetal closure of the spinal canal bears unsolved problems leading to a higher postnatal incidence of complication surgery. Finally, missing long-term results make a definite evaluation impossible so far. At the moment, fetal surgery in open spinal dysraphism is not a standard of care despite promising results regarding central nervous system protection due to early spinal canal closure. Many technical problems need to be solved in the future in order to make this option a safe and standard one.
Nygaard, Ulrikka; Sundberg, Karin; Nielsen, Henriette Svarre
OBJECTIVE: To evaluate OK-432, a preparation of Streptococcus pyogenes, in the treatment of early fetal chylothorax. METHODS: A prospective study of all fetuses (n=7) with persistent early chylothorax (gestational ages 16-21 weeks) referred to the tertiary center of fetal medicine in Denmark in 2...... effusions, lung hypoplasia, or hydrops. CONCLUSION: Persistent early chylothorax is a condition with a high mortality rate and no established treatment option. Use of OK-432 is a promising therapy for selected fetuses with persistent chylothorax early in the second trimester....
Avni, Fred E.; Massez, Anne; Cassart, Marie [University Clinics of Brussels - Erasme Hospital, Department of Medical Imaging, Brussels (Belgium)
Tumours of the fetal body are rare, but lesions have been reported in all spaces, especially in the mediastinum, the pericardial space, the adrenals, the kidney, and the liver. Lymphangioma and teratoma are the commonest histological types encountered, followed by cardiac rhabdomyoma. Adrenal neuroblastoma is the commonest malignant tumour. Imaging plays an essential role in the detection and work-up of these tumours. In addition to assisting clinicians it also helps in counselling parents. Most tumours are detected by antenatal US, but fetal MRI is increasingly used as it brings significant additional information in terms of tumour extent, composition and complications. (orig.)
McCann, Emma; Sweeney, Elizabeth [Royal Liverpool Children' s Hospital, Department of Clinical Genetics, Liverpool (United Kingdom); Pilling, David [Royal Liverpool Children' s Hospital, Department of Paediatric Radiology, Liverpool (United Kingdom); Hesseling, Markus; Subhedar, Nim [Liverpool Women' s Hospital, Department of Neonatology, Liverpool (United Kingdom); Roberts, Devender [Liverpool Women' s Hospital, Department of Fetal Medicine, Liverpool (United Kingdom)
The cerebellar and pontocerebellar hypoplasias present a unique challenge when detected in the developing fetus. A diverse aetiology and prognosis make counselling of these families difficult. Advances in fetal imaging allow for more accurate diagnosis and counselling, but postnatal MRI is still required. A case is presented in which cerebellar hypoplasia was detected at 20 weeks gestation. Later fetal imaging provided further information, but a diagnosis of pontomedullary disconnection was not made until the postnatal MRI scan. The clinical findings and possible causes of such pontocerebellar abnormalities are discussed. (orig.)
Gerber, Rebecca E; Bromley, Bryann; Benson, Carol B; Frates, Mary C
We present the sonographic findings of fetal renal vein thrombosis in a series of 6 patients. The mean gestational age at diagnosis was 31.2 weeks. Four cases were unilateral, and 2 were bilateral. The most common findings were renal enlargement and intrarenal vascular calcifications, followed by increased renal parenchymal echogenicity. Inferior vena cava thrombosis was found in 4 patients and common iliac vein thrombosis in 2. Fetal renal vein thrombosis is an uncommon diagnosis with characteristic sonographic findings. The presence of these findings should prompt Doppler interrogation of the renal vein and inferior vena cava to confirm the diagnosis.
Houfflin Debarge, Véronique; Dutriez, Isabelle; Pusniak, Benoit; Delarue, Eléonore; Storme, Laurent
Several situations are potentially painful for fetuses, such as malformations and invasive procedures. Nociceptive pathways are known to be functional at 26 weeks. Even if it is not possible to evaluate the fetal experience of pain, it is essential to examine its immediate and long-term consequences. As early as the beginning of the second trimester, hemodynamic and hormonal responses are observed following fetal nociceptive stimulation, In experimental studies, long-term changes have been noted in the corticotrop axis, subsequent responses to pain, and behavior after perinatal nociceptive stimulation.
Fendel, M; Fendel, H
Ultrasonography is of great importance for the prenatal diagnosis of fetal malformations and abnormalities. An early diagnosis in the second trimester is of great interest for an intrauterine or an extrauterine therapy planning (the choice of the time and mode of delivery). Defects of the neural tube including hydrocephalus, malformations of the extremities, the gastrointestinal tract, omphaloceles, the urogenital and cardiac system are described. Four cases of fetal malformations are presented: fetal myelomeningocele, hydrocephalus, bilateral hydronephrosis and lymphangioma with fetal ascites.
Govind Narayan Purohit
Full Text Available We review the causes of fetal dystocia in cows and buffalo. Two fetal causes are distinct fetal oversize and fetal abnormalities. Fetal oversize is common in heifers, cows of beef cattle breeds, prolonged gestations, increased calf birth weight, male calves and perinatal fetal death with resultant emphysema. Fetal abnormalities include monsters, fetal diseases and fetal maldispositions, and it is difficult to deliver such fetuses because of their altered shape. Although monsters are rare in cattle, a large number of monstrosities have been reported in river buffalo; yet also here, overall incidence is low. Diseases of the fetus resulting in dystocia include hydrocephalus, ascites, anasarca and hydrothorax. The most common cause of dystocia in cattle seems to be fetal maldispositions, of which limb flexion and head deviation appear to be the most frequent. We provide a brief description of the management of dystocia from different causes in cattle and buffalo. A case analysis of 192 and 112 dystocia in cattle and buffalo, respectively, at our referral center revealed that dystocia is significantly higher (P<0.05 in first and second parity cows and buffalo, and that dystocia of fetal origin is common in cows (65.62% but less frequent (40.17% in buffalo. In buffalo, the single biggest cause of dystocia was uterine torsion (53.57%. Fetal survival was significantly (P<0.05 higher both in cows and buffalo when delivery was completed within 12 h of second stage of labor.
The exposure of a developing embryo or fetus to teratogenic alkaloids from plants has the potential to cause developmental defects in livestock due to the inhibition of fetal movement by alkaloids. The mechanism behind the inhibition of fetal movement is the desensitization of fetal muscle-type nico...
... hemoglobin present. The assay may be used to detect fetal red cells in the maternal circulation or to detect... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Fetal hemoglobin assay. 864.7455 Section 864.7455...) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Hematology Kits and Packages § 864.7455 Fetal...
Full Text Available Our aim was to investigate the relation between fetal distress and oxidative stress. Fetal distress was associated with increased concentration of superoxide in the fetal blood and with significant increase of the level of H2O2 in both maternal and fetal blood. The activity of superoxide dismutase was increased roughly sixfold (p < 0.01 in the maternal [7330 ± 2240 U/g of hemoglobin in controls (C and 36811 ± 16862 U/g in fetal distress (FD] and fetal blood (C: 5930 ± 2641 U/g; FD: 41912 ± 17133 U/g. In contrast, fetal distress was related to a considerable decrease of catalase activity in both maternal (C: 26011 ± 8811 U/g; FD: 7212 ± 1270 U/g and fetal blood (C: 37194 ± 9191 U/g; FD: 6173 ± 1965 U/g. From this we concluded that in fetal distress, the maternal and fetal bloods are exposed to superoxide- and H2O2-mediated oxidative stress, which could be initiated by hypoxic conditions in the fetal blood and placenta. A tremendous increase/decrease of the activities of superoxide dismutase/catalase in the blood of women bearing a distressed fetus in comparison to healthy subjects implies that the assessment of superoxide dismutase/catalase activity could be of use for establishing a timely and accurate ante- or intrapartum diagnosis of fetal distress.
Aurioles-Garibay, Alma; Hernandez-Andrade, Edgar; Romero, Roberto; Qureshi, Faisal; Ahn, Hyunyoung; Jacques, Suzanne M; Garcia, Maynor; Yeo, Lami; Hassan, Sonia S
The lesion termed 'placental infarction hematoma' is associated with fetal death and adverse perinatal outcome. Such a lesion has been associated with a high risk of fetal death and abruption placentae. The fetal and placental hemodynamic changes associated with placental infarction hematoma have not been reported. This paper describes a case of early and severe growth restriction with preeclampsia, and progressive deterioration of the fetal and placental Doppler parameters in the presence of a placental infarction hematoma.
This essay examines three tendencies nurtured in the practices of reproductive technology - tendencies with profoundly disturbing implications for us as individuals and as social beings. They are: 1) the increasing subjectification of the fetus (that is, the increasing tendency to posit a fetal subject), 2) the increasing objectification of the gestating woman, leading to her representation as interchangeable object rather than unique subject, and 3) the increasing tendency to conceive of the fetus and the mother as social, medical, and legal antagonists. Considering the construction of fetus, mother, and the fetal/maternal relation in earlier (Western) historical periods, a contemporary work of literature, a government report, and the popular press, I argue that as the fetus is increasingly being understood as a subject, the mother is increasingly being reduced to an antagonist, an obstacle to fetal health, and an object. The essay concludes by offering some tentative conclusions about the general process of fetal subjectification in the United States and Europe.
Ben Sira, Liat; Garel, Catherine; Leitner, Yael; Gross-Tsur, Varda
Cerebral anomalies at birth account for approximately 9% of all isolated anomalies and are present in 15.9% of babies with multiple malformations and, thereby, warrant concern in antenatal diagnosis. Ultrasonography is the basic screening examination for the pregnant woman due to its efficiency, availability, low cost and real time capability. Many of the major anomalies can be diagnosed by ultrasound during the first trimester of pregnancy. However subtle abnormalities can be missed by ultrasonography or detected only in later stages of pregnancy. Fetal MRI has proved itself to be an effective adjuvant imaging tool and is indicated whenever there is a diagnostic query on ultrasound or a need to define a suspected brain anomaly. The information obtained from fetal MRI has significant implications for parental counseling regarding both the type of malformation as well as the neurological and developmental prognosis. Current indications for fetal MRI, focusing on various common fetal cerebral pathologies, will be addressed in this review.
Petersen, Olav Bjørn; David, Anna; Thomasson, Louise;
(lemon-shaped), 18.4% with aneuploidy (mostly strawberry-shaped). 19.5% were dolicocephalic, most secondary to fetal position or oligohydramnios (see table). 13 had confirmed craniosynostosis, including thanatophoric dysplasia, Craniofrontonasal dysplasia, Aperts syndrome, Baller-Gerold syndrome, I...
Conclusions: Jaundice in pregnancy has adverse fetomaternal outcome. Improvement in health awareness, education and regular antenatal checkups, early referrals result in early diagnosis and treatment of jaundice during pregnancy thus reducing maternal and fetal mortality and morbidity. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2541-2545
Norman, Andria L.; Crocker, Nicole; Mattson, Sarah N.; Riley, Edward P.
The detrimental effects of prenatal alcohol exposure on the developing brain include structural brain anomalies as well as cognitive and behavioral deficits. Initial neuroimaging studies of fetal alcohol spectrum disorders (FASD) using magnetic resonance imaging (MRI) confirmed previous autopsy reports of overall reduction in brain volume and…
Lassen, Pernille; Sundberg, Karin; Juul, Anders
by each injection and followed by a gradual reduction of fetal goiter as well as the left ovarian cyst. The right cyst ruptured spontaneously. At 36 weeks + 4 days, the patient underwent elective caesarean section and gave birth to a female, weighing 2,880 g with 1- and 5-min Apgar scores of 10...
... growth problems, Rh sensitization , or high blood pressure • Decreased movement of the fetus • Pregnancy that goes past ... on how far along you are in your pregnancy, you may have another BPP within the next ... BPP performed? The fetal heart rate is monitored in the same way it is ...
DASSEL, AC; GRAAFF, R; AARNOUDSE, JG; ELSTRODT, JM; HEIDA, P; KOELINK, MH; DEMUL, FF; GREVE, J
Transmission pulse oximetry is used for monitoring in many clinical settings. However, for fetal monitoring during labor and in situations with poor peripheral perfusion, transmission pulse oximetry cannot be used. Therefore, we developed a reflectance pulse oximeter, which uses the relative intensi
Juul, Anders; Almstrup, Kristian; Andersson, Anna-Maria
, increasing indirect evidence exists that exposure to ubiquitous endocrine disrupting chemicals, present at measurable concentrations in individuals, might affect development of human fetal testis. If confirmed, health policies to prevent male reproductive problems should not only target adult men, but also...
Crispi, Fàtima; Valenzuela‐Alcaraz, Brenda; Cruz‐Lemini, Monica
Abstract Introduction: Fetal heart evaluation with US is feasible and reproducible, although challenging due to the smallness of the heart, the high heart rate and limited access to the fetus. However, some cardiac parameters have already shown a strong correlation with outcomes and may soon be incorporated into clinical practice. Materials and Methods: Cardiac function assessment has proven utility in the differential diagnosis of cardiomyopathies or prediction of perinatal mortality in congenital heart disease. In addition, some cardiac parameters with high sensitivity such as MPI or annular peak velocities have shown promising results in monitoring and predicting outcome in intrauterine growth restriction or congenital diaphragmatic hernia. Conclusion: Cardiac function can be adequately evaluated in most fetuses when appropriate expertise, equipment and time are available. Fetal cardiac function assessment is a promising tool that may soon be incorporated into clinical practice to diagnose, monitor or predict outcome in some fetal conditions. Thus, more research is warranted to further define specific protocols for each fetal condition that may affect cardiac function. PMID:28191192
Introduction : Ultrasound and MR imaging of the fetal central nervous system (CNS) develop at an ever-increasing rate. Theoretically, the two modalities should be synergistic, but a literature review revealed the difficulties of determining the merit of either technique and revealed gaps in our know
Full Text Available Gestational diabetes mellitus (GDM is an important complication of pregnancy that poses significant threats to women and their offspring. Telomere length shortens as cellular damage increases and is associated with metabolic diseases. Telomere length in fetal leucocytes was determined in 82 infants of women with GDM (N = 82 and 65 normal pregnant women (N = 65. Women with preeclampsia (N = 45 and gestational hypertension (N = 23 were also studied. In the GDM group, telomere length was significantly shorter than normal pregnancy (P = 0.028, but there were no significant differences in fetal telomere length between preeclampsia and normal pregnancy (P = 0.841 and between gestational hypertension and normal pregnancy (P = 0.561. Regression analysis revealed that fetal telomere length was significantly associated with intrauterine exposure to GDM (P = 0.027 after adjustment for maternal age, gestational age at delivery, birth weight and fetal gender. Shortened telomere length may increase the risk of metabolic diseases in adulthood of GDM offspring.
Kavale, Kenneth A.; Karge, Belinda D.
The review examines the literature on the behaviorally teratogenic aspects of Fetal Alcohol Syndrome, including: (1) prevalence of alcohol abuse among women, (2) acute and chronic effects of alcohol on the fetus, (3) genetic susceptibility, (4) neuropathology, (5) correlative conditions, and (6) animal studies. (Author/DB)
Full Text Available Since Medawar (1953, much attention has been given to the immunological paradox of the survival and growth of the semi-allogeneic fetus in the maternal uterus. Numerous studies, mainly on the human placenta, have established fundamental mechanisms of this phenomenon; however, many aspects are still unclear and the complex process has yet to be completely defined. One of the accepted principles is that the secretion and action of mediators, i.e. cytokines, at the materno-fetal interface have a central role. Focusing on the cytokine Interleukin-1 (IL-1 the review highlights the importance of a physiological approach based on evolutionary studies in animals using similar or different reproductive strategies. Data on IL-1 in viviparity and oviparity, two reproductive strategies in which female reproductive tissues have to deal with paternal-derived antigens on sperm, fertilized eggs, and embryo, will be presented and discussed in the light of materno-fetal immuntolerance. Ovuliparity, a reproductive modality in which the eggs are released from the female reproductive tract and fertilization and embryonic development take place in the external environment will also be extensively reported as a negative control in the studies on materno-fetal immunotolerance. The evidence shown reveals that non-mammalian vertebrates with different reproductive strategies represent a good model to understand biological mechanisms allowing fetal acceptance and growth in the maternal tissues.
Roelofs, Luc A. J.; Eggink, Alex J.; de Kaa, Christina A. Hulsbergen-van; Wijnen, Rene M. H.; van Kuppevelt, Toin H.; van Moerkerk, Herman T. B.; Crevels, A. Jane; Hanssen, Alex; Lotgering, Fred K.; van den Berg, Paul P.; Feitz, Wout F. J.
Objectives: To evaluate histological changes in an animal model for bladder exstrophy and fetal repair of the bladder defect with a molecular-defined dual-layer collagen biomatrix to induce fetal bladder wall regeneration. Methods: In 12 fetal lambs the abdominal wall and bladder were opened by a mi
Spellacy, W N; Cruz, A C; Gelman, S R; Buhi, W C
Fetal movements were measured by 37 pregnant women during a 10-minute period while they were lying on their left side at various times during the day with the highest rates in the evening. Preliminary assessments of fetal movement and serum hPL levels in pregnant women suggest that the two tests might complement each other in providing more information about the status of the placenta and fetus.
J. Ruiz Carrascal
Full Text Available Se llevó a cabo la determinación de 16 hidrocarburos aromáticos policíclicos y 9 nitrosaminas en sistemas modelo de gelatina (20% w/v mediante microextración en fase sólida acoplada a un dispositivo de extracción directa y posterior análisis mediante cromatografía-gaseosa-espectrometría de masas. La extracción se llevo a cabo a 25ºC. Se extrajeron la totalidad de las nitrosaminas y 9 de los 16 hidrocarburos aromáticos policíclicos. Se evaluaron la reproducibilidad, linealidad de respuesta y límite de detección de 3 tipos de fibras estacionarias para cada tipo de compuesto. Se seleccionaron las fibras de polidimetilsiloxano 100μm y carboxen/polidimetilsiloxano 85μm, para los hidrocarburos aromáticos policiclicos y nitrosaminas, respectivamente. La microextración en fase sólida acoplada a un dispositivo de extracción directa surge como una técnica interesante para la monitorización preliminar de la presencia de estos compuestos tóxicos en alimentos sólidos, sin necesidad de toma de muestras y sin deteriorar el producto
Ahopelto, J; Hukkinen, K; Katila, T E; Laine, H; Kariniemi, V
A new method is presented for detection of the QRS complexes and the fetal heart rate from the fetal magnetocardiogram and from the fetal electrocardiogram. In the method, the amplitude, the polarity and the shape of the QRS complex are tested. By using the described equipment it is possible to detect all consecutive heart beat intervals from a fetal electrocardiogram with less than 1% error in timing. When an external fetal electrocardiogram was used for testing, generally slightly over 10% of the QRS complexes were lost since they were simultaneous with the maternal complexes. In addition, complexes were also lost due to noise.
Zhang, Jun; Sundaram, Rajeshwari; Sun, Wenyu; Troendle, James
Animal studies indicate that either the fetus or the intrauterine environment, both of which set the pattern for fetal growth, may affect the timing of parturition. The authors examined the association between fetal growth and timing of spontaneous onset of labor in humans among low-risk white US women with singleton pregnancies (1987-1991). They restricted the data to pregnancies which had a reliable date of the last menstrual period, normal fetal growth in the first half of pregnancy, and no history of or current pregnancy complications that might have impaired fetal growth (n = 3,360). Subjects received ultrasound examinations at 15-22 and 31-35 weeks' gestation. Fetal growth was adjusted for parity, fetal sex, and maternal prepregnancy weight and height. Results showed that slower or faster fetal growth in the second half of pregnancy resulted in substantially lower or higher birth weight, respectively. However, fetal growth in the second half of pregnancy, even at extremes (2 standard deviations below or above the mean), did not have a meaningful impact on the timing of parturition; neither did fetal growth acceleration or deceleration in late pregnancy. Thus, in low-risk pregnancies where fetal growth is normal in early gestation, fetal growth in the second half of pregnancy does not affect the timing of normal parturition.
Brinch, Marie; Hatt, Lotte; Singh, Ripudaman
identified by XY fluorescence in situ hybridization and confirmed by reverse-color fluorescence in situ hybridization were shot off microscope slides by laser capture microdissection. The expression pattern of a subset of expressed genes was compared between fetal cells and maternal blood cells using stem......OBJECTIVE: Different fetal cell types have been found in the maternal blood during pregnancy in the past, but fetal cells are scarce, and the proportions of the different cell types are unclear. The objective of the present study was to identify specific fetal cell markers from fetal cells found...... in the maternal blood circulation at the end of the first trimester. METHOD: Twenty-three fetal cells were isolated from maternal blood by removing the red blood cells by lysis or combining this with removal of large proportions of maternal white blood cells by magnetic-activated cell sorting. Fetal cells...
Maribel Rodríguez Matos
Full Text Available La hidropesía fetal es un grave proceso de elevada mortalidad perinatal, de etiología multifactorial, caracterizado por un síndrome edematoso generalizado, con o sin acumulación de líquido en las cavidades serosas del organismo fetal. Se presenta un caso de hidropesía fetal no inmunológica en una paciente de sexo femenino, de color de piel blanca y de 20 años de edad con enfermedad hipertensiva grave, diagnosticada mediante ultrasonido, como estudio de bienestar fetal a las 35,1 semanas de gestación, cuando fue remitida desde su área de salud por presentar cifras de tensión arterial de 160/100 mmHg. A su llegada al cuerpo de guardia de ginecobstetricia del hospital Héroes del Baire de la Isla de la Juventud se constataron cifras de 140/90 mmHg, se presentaba asintomática, por lo que se ingresó para estudio y tratamiento. Teniendo en cuenta el examen físico y el resultado del ultrasonido obstétrico, se decidió la interrupción de embarazo por cesárea de urgencia. Se recibió un recién nacido pretérmino de aspecto malformado. Se decide la presentación del caso por lo poco común de esta patología asociada a una enfermedad hipertensiva grave lo que incrementa el riesgo perinatal.
Severe fetal acidemia during labour can result in life-lasting neurological deficits, but the timely detection of this condition is often not possible. This is because the positive predictive value (PPV) of fetal heart rate (FHR) monitoring, the mainstay of fetal health surveillance during labour, to detect concerning fetal acidemia is around 50%. In fetal sheep model of human labour, we reported that severe fetal acidemia (pH
Ji Hyae Lim
Full Text Available BACKGROUND: Cell-free fetal DNA and cell-free total DNA in maternal circulation have been proposed as potential markers for noninvasive monitoring of the placental condition during the pregnancy. However, the correlation of and change in cell-free fetal DNA and cell-free total DNA in spontaneous abortion (SA with fetal chromosomal aneuploidy have not yet been reported. Therefore, we investigated cell-free fetal DNA and cell-free total DNA levels in SA women with fetal chromosomal aneuploidy. METHODOLOGY/PRINCIPAL FINDINGS: A nested case-control study was conducted with maternal plasma collected from 268 women in their first trimester of pregnancy. Subjects included 41 SA with normal fetal karyotype, 26 SA with fetal chromosomal aneuploidy, and 201 normal controls. The unmethylated PDE9A gene was used to measure the maternal plasma levels of cell-free fetal DNA. The GAPDH gene was used to measure the maternal plasma levels of cell-free total DNA. The diagnostic accuracy was measured using receiver-operating characteristic (ROC curves. Levels of cell-free fetal DNA and cell-free total DNA were significantly higher in both SA women with normal fetal karyotype and SA women with fetal chromosomal aneuploidy in comparison with the normal controls (P<0.001 in both. The correlation between cell-free fetal DNA and cell-free total DNA levels was stronger in the normal controls (r = 0.843, P<0.001 than in SA women with normal karyotype (r = 0.465, P = 0.002 and SA women with fetal chromosomal aneuploidy (r = 0.412, P = 0.037. The area under the ROC curve for cell-free fetal DNA and cell-free total DNA was 0.898 (95% CI, 0.852-0.945 and 0.939 (95% CI, 0.903-0.975, respectively. CONCLUSIONS: Significantly high levels of cell-free fetal DNA and cell-free total DNA were found in SA women with fetal chromosomal aneuploidy. Our findings suggest that cell-free fetal DNA and cell-free total DNA may be useful biomarkers for the prediction of SA
Linna Marcela Neme Ardila
Full Text Available Las mezclas asfálticas son el material más utilizado en la fabricación de pavimentos y los ensayos que permiten caracterizarlas son costosos y demorados. Por esta razón, mediante esta investigación se planteó establecer la viabilidad del uso del ensayo Fénix en mezclas asfálticas colombianas con granulometrías del Instituto de Desarrollo Urbano (IDU y del Instituto Nacional de Vías (INVIAS con diferentes características. El estudio inició con la fabricación de probetas Fénix con diferentes materiales (Agregados, asfaltos, asfaltita, pavimento asfalto reciclado (RAP, cal, cemento y su ejecución a 15 °C, una velocidad de 1 mm/min y la medición de los parámetros del ensayo. De los resultados obtenidos de resistencia a tracción, índice de rigidez a tracción e índice de energía, área elástica y área de fluencia, se estableció que el ensayo Fénix es un procedimiento eficaz, eficiente, económico, rápido y sencillo para determinar las propiedades mecánicas y dinámicas de las mezclas asfálticas estudiadas, especialmente mediante el análisis de los parámetros de las curvas carga-desplazamiento, irrelevantemente de la mezcla asfáltica fabricada.
Fanos, Vassilios; Atzori, Luigi; Makarenko, Karina; Melis, Gian Benedetto; Ferrazzi, Enrico
Metabolomics in maternal-fetal medicine is still an "embryonic" science. However, there is already an increasing interest in metabolome of normal and complicated pregnancies, and neonatal outcomes. Tissues used for metabolomics interrogations of pregnant women, fetuses and newborns are amniotic fluid, blood, plasma, cord blood, placenta, urine, and vaginal secretions. All published papers highlight the strong correlation between biomarkers found in these tissues and fetal malformations, preterm delivery, premature rupture of membranes, gestational diabetes mellitus, preeclampsia, neonatal asphyxia, and hypoxic-ischemic encephalopathy. The aim of this review is to summarize and comment on original data available in relevant published works in order to emphasize the clinical potential of metabolomics in obstetrics in the immediate future.
Philip, J; Tabor, Ann; Bang, J
The aim of the study was to investigate the rationale of the current indications for fetal chromosome analysis. 5372 women had 5423 amniocentesis performed, this group constituting a consecutive sample at the chromosome laboratory, Rigshospitalet, Copenhagen from March 1973 to September 1980 (Group...... to women having amniocentesis, although considered not to have any increased risk of fetal chromosome abnormality (1390 pregnancies, group B). They were also compared with 750 consecutive pregnancies in women 25-34 years of age, in whom all heritable diseases were excluded (group C). The risk of unbalanced...... with women without elevated risk. Spontaneous abortion rate and prematurity rate did not differ from rates expected without amniocentesis. It is concluded that current indications may be characterized as a mixture of evident high risk factors and factors with only a minor influence on risk. Indications...
苏肇伉; 周成斌; 张海波; 祝忠群
Objective To study the hormonal and metabolic responses of fetal lamb during cardiopulmonary bypass.Methods Six pregnant ewes underwent fetal cardiopulmonary bypasses with artificial oxygenators and roller pumps for 30 minutes, which maintained the blood gas value at the fetal physiological level. The fetal blood pressure, heart rate, pH value and blood lactate levels were monitored. The levels of catecholamine, cortisol and insulin were measured pre-bypass and then again 30 minutes later. The blood glucose and free fatty acid levels were monitored continuously during the bypass. Fetal hepatic PAS staining was also carried out.Results There were no changes before and during the bypass in fetal blood pressure, heart rate and blood gas. However, pH values decreased and blood lactate levels increased (P＜0.05). The fetal catecholamine and cortisol levels increased significantly (P＜0.01), while the levels of insulin did not change. The blood glucose and free fatty acid levels increased at the beginning of the bypass (P＜0.01), and then gradually slowed down during the bypass. The fetal hepatic PAS staining showed that hepatic glycogen was consumed in large amounts. After 30 minutes of bypass, the fetal lamb would not survive more than 1 hour.Conclusion The fetal lamb has a strong negative reaction to cardiopulmonary bypass.
Bourliere-Najean, B.; Russel, A.S.; Petit, P.; Devred, P. [Department of Pediatric Radiology, CHU Timone, 264 rue St. Pierre, 13385 Marseille cedex 5 (France); Panuel, M. [Department of Radiology, Hopital Nord, chemin Bourrelys, 13915 Marseille cedex 20 (France); Piercecchi-Marti, M.D.; Fredouille, C. [Department of Pathology, CHU Timone, 264 rue St. Pierre, 13385 Marseille cedex 5 (France); Sigaudy, S.; Philip, N. [Department of Genetics, CHU Timone, 264 rue St. Pierre, 13385 Marseille cedex 5 (France)
The aim of this study was to assess the value of fetal skeletal radiographs in determining the etiology of fetal death. A total of 1193 post-mortem fetal skeletal radiographs were analysed. Fetuses were classified into one of three groups (group I: abnormality diagnosed during pregnancy; group II: maternal pathology; group III: spontaneous abortion of pregnancy, IIIa before 26 weeks of gestation (WG), IIIb after 26 weeks of gestation). Face, supine and lateral skeletal views were performed. Skeletal abnormalities were detected in 33.9% of the fetuses, including 22.7% with minor abnormalities (abnormal rib number, no nasal bone ossification, amesophalangia or P2 hypoplasia of the fifth digit) and 14.5% with major abnormalities (other skeletal abnormalities). Among the fetuses with major abnormalities, 98.8% came from group I, 2.9% came from group II, 2.3% came from group IIIa and none came from group IIIb. Fetal skeletal radiographs are not useful in fetuses arising from spontaneous abortion of pregnancy without abnormality on ultrasound screening, abnormality clinical examination or in fetuses with prenatal diagnosis of chromosomal abnormality. This practice is valuable only if there is a multidisciplinary team, with all the participants (pathologists, radiologists, geneticists) knowledgeable about fetal pathology. In the absence of this multidisciplinary approach, it is easier to X-ray all fetuses to avoid misdiagnosis and the important consequences for genetic counselling. (orig.)
Cho, Jeong Yeon; Song, Mi Jin [Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of); Kim, Seoung Hyup [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)
The purposes of this study were to compare postmortem fetal MRI findings with autopsy findings and to assess whether postmortem MRI can replace autopsy. The study group consisted of 13 stillborn fetuses, seven that died immediately after birth, and five terminated because of anomalies seen on prenatal sonograms. A total 17 were male, and eight were female, and their gestational ages were from 20 to 41 (average;28.2) weeks. Spin-echo T1-and T2-weighted axial, sagittal, and coronal MR images were obtained, and autopsy findings were divided into major and minor. A major finding was defined as an anomaly or syndrome which caused fetal death or termination of the pregnancy: minor findings were classified, on the basis of gross inspection, as internal or external. MR images were retrospectively analyzed by two radiologists unaware of the autopsy findings, and by comparison with these, the postmortem MRI detection rates for major and minor findings was then determined. In seven of 25 fetuses, MR imaging revealed major findings, a dietction rate of 100%. There were two cases of anencephaly, two of trisomy-18, and one each of hydrops fetalis with large cystic hygroma, diaphragmatic hernia, and Dandy-Walker malformation. Twenty-three of 60 minor findings (38.3%) were detected by MRI. The detection rates for external and internal findings were 29.6%(8/27) and 45.5%(15/33), respectively. Although a limitation of our study is the low detection rate for minor findings, postmortem fetal MRI may help diagnose the major cause of fetal death.
Larciprete, Giovanni; Romanini, Maria Elisabetta; Arduini, Domenico; Cirese, Elio; Slowikowska-Hilczer, Jolanta; Kula, Krzysztof
We describe an unexplained case of umbilical cord segmental hemorrhage linked with meconium-stained amniotic fluid. A severely asphyxiated infant was delivered at term by Caesarean section. There were poor prognostic signs on fetal cardiotocography with rupture of membranes with meconium-stained amniotic fluid. The pathophysiologic mechanism in this case is still unknown, even if we argued a possible role of the umbilical cord shortness. PMID:23674981
By virtue of its role in nucleotide synthesis, as well as the provision of methyl groups for vital methylation reactions, one-carbon metabolism plays a crucial role in growth and development. Formate, a critical albeit neglected component of one-carbon metabolism, occurs extracellularly and may provide insights into cellular events. We examined formate metabolism in chronically cannulated fetal sheep (gestation days 119–121, equivalent to mid-third trimester in humans) and in their mothers as...
Kuwashima, Shigeko; Kaji, Yasushi
A woman was referred to our institution with an ultrasound (US) suggestive of right-sided heart in fetus at 34 weeks' gestation. Magnetic resonance (MR) imaging revealed right-sided heart, small right hemithorax, and completely absent right main bronchus and right pulmonary artery. From our experience with this case, we point out 5 important MR imaging findings needed for prenatal diagnosis of pulmonary agenesis. Fetal MR imaging also provided information about anomalies of other organs.
Jayanthi Krishnamoorthy; Anuradha Murugesan
Background: Jaundice affects a small percentage of pregnant women, yet it takes a major toll on health of both mother and fetus especially in developing countries like India. Jaundice in pregnancy carries a grave prognosis for both the fetus and the mother, and is responsible for 10% of maternal deaths. The aim of the study was to find out the effect of jaundice during pregnancy on maternal and fetal outcome. Methods: 51 pregnant women with jaundice during pregnancy attending the Institute...
Full Text Available Fetal hydantoin syndrome (FHS is a spectrum of defects caused to the developing fetus by exposure to the teratogenic effects of antiepileptic drug (AED phenytoin during pregnancy. Its clinical manifestations include limb abnormalities, ocular defects, central nervous system anomalies, intrauterine growth restriction, and hand and phalangeal anomalies. This case report presents an 8-year-old child born to an epileptic mother with a history of AED therapy, with features suggestive of FHS.
Diedrich, Justin; Drey, Eleanor
For decades, the induction of fetal demise has been used before both surgical and medical second-trimester abortion. Intracardiac potassium chloride and intrafetal or intra-amniotic digoxin injections are the pharmacologic agents used most often to induce fetal demise. In the last several years, induction of fetal demise has become more common before second-trimester abortion. The only randomized, placebo-controlled trial of induced fetal demise before surgical abortion used a 1 mg injection of intra-amniotic digoxin before surgical abortion at 20-23 weeks' gestation and found no difference in procedure duration, difficulty, estimated blood loss, pain scores or complications between groups. Inducing demise before induction terminations at near viable gestational ages to avoid signs of life at delivery is practiced widely. The role of inducing demise before dilation and evacuation (D&E) remains unclear, except for legal considerations in the United States when an intact delivery is intended. There is a discrepancy between the one published randomized trial that used 1 mg intra-amniotic digoxin that showed no improvement in D&E outcomes and observational studies using different routes, doses and pre-abortion intervals that have made claims for its use. Additional randomized trials might provide clearer evidence upon which to make further recommendations about any role of inducing demise before surgical abortion. At the current time, the Society of Family Planning recommends that pharmacokinetic studies followed by randomized controlled trials be conducted to assess the safety and efficacy of feticidal agents to improve abortion safety.
Kisilevsky, B. S.; Hains, S. M. J.; Jacquet, A.-Y.; Granier-Deferre, C.; Lecanuet, J. P.
Maturation of fetal response to music was characterized over the last trimester of pregnancy using a 5-minute piano recording of Brahms' Lullaby, played at an average of 95, 100, 105 or 110 dB (A). Within 30 seconds of the onset of the music, the youngest fetuses (28-32 weeks GA) showed a heart rate increase limited to the two highest dB levels;…
Wedegaertner, Ulrike [Department of Diagnostic and Interventional Radiology, Universitaetsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20251 Hamburg (Germany)]. E-mail: firstname.lastname@example.org; Schroeder, Hobe J. [Experimental Gynecology, Department of Obstetrics and Prenatal Medicine, Universitaetsklinikum Hamburg-Eppendorf, Hamburg (Germany); Adam, Gerhard [Department of Diagnostic and Interventional Radiology, Universitaetsklinikum Hamburg-Eppendorf, Hamburg (Germany)
Congenital diaphragmatic hernia (CDH) is associated with a high mortality, which is mainly due to pulmonary hypoplasia and secondary pulmonary hypertension. In severely affected fetuses, tracheal occlusion (TO) is performed prenatally to reverse pulmonary hypoplasia, because TO leads to accelerated lung growth. Prenatal imaging is important to identify fetuses with pulmonary hypoplasia, to diagnose high-risk fetuses who would benefit from TO, and to monitor the effect of TO after surgery. In fetal imaging, ultrasound (US) is the method of choice, because it is widely available, less expensive, and less time-consuming to perform than magnetic resonance imaging (MRI). However, there are some limitations for US in the evaluation of CDH fetuses. In those cases, MRI is helpful because of a better tissue contrast between liver and lung, which enables evaluation of liver herniation for the diagnosis of a high-risk fetus. MRI provides the ability to determine absolute lung volumes to detect lung hypoplasia. In fetal sheep with normal and hyperplastic lungs after TO, lung growth was assessed on the basis of cross-sectional US measurements, after initial lung volume determination by MRI. To monitor fetal lung growth after prenatal TO, both MRI and US seem to be useful methods.
Abdullah, Selwan B. [University of Maryland Medical Center, Diagnostic Radiology and Nuclear Medicine, Baltimore, MD (United States); University of Minnesota, Medical School, Minneapolis, MN (United States); Dietz, Kelly R.; Holm, Tara L. [University of Minnesota, Department of Radiology, Minneapolis, MN (United States)
Fetal magnetic resonance imaging (MRI) is a routinely used tool in prenatal diagnosis; however, there is a lack of studies evaluating incidental findings observed in the mother. This study describes and quantifies incidental findings observed in the mother during fetal MRI. We reviewed all fetal MRI studies at the University of Minnesota Medical Center from February 2008 to September 2014. Two pediatric radiologists retrospectively conducted a consensus evaluation. The maternal findings were categorized into neurologic, gynecologic, urinary, gastrointestinal and musculoskeletal. Hydronephrosis consistent with the stage of pregnancy was recorded but was not included as an abnormal finding. Abnormal findings were classified into three groups, depending on their clinical significance: level I (low), level II (medium) and level III (high). We evaluated 332 pregnant patients with a mean age of 29.3 years and a mean gestational age of 29 weeks. Of these, 55.4% had at least 1 incidental finding, for a total of 262 incidental maternal findings. Of the 262 abnormalities, 113 (43.1%) were neurologic, 69 were gynecologic (26.3%), 36 (13.7%) urinary, 24 (9.2%) gastrointestinal and 20 (7.6%) musculoskeletal. Of the 262 incidental findings, 237 (90.5%) were level I, 24 (9.2%) were level II and 1 (0.4%) was level III. Our results suggest that although the vast majority of incidental maternal findings are benign, more significant findings are still encountered and should be expected. (orig.)
Servaes, Sabah; Hernandez, Andrea; Gonzalez, Leonardo; Victoria, Teresa; Jaramillo, Diego; Christopher Edgar, J.; Johnson, Ann [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Johnson, Mark [Children' s Hospital of Philadelphia, Department of Fetal Surgery, Philadelphia, PA (United States)
The sensitivity and specificity of evaluating clubfoot deformity by MR in high-risk fetuses is currently unknown. To correlate fetal MRI with US in the assessment of clubfoot and to identify the MRI features most characteristic of clubfoot. With IRB approval and informed consent, the presence of fetal clubfoot was prospectively evaluated in mothers referred for MRI for a fetus with myelomeningocele. Two radiologists blind to the US results independently reviewed the MRI for the presence of clubfoot. MRI results were compared with US results obtained the same day and birth outcomes. Of 20 patients enrolled, there were 13 clubfeet. Interobserver agreement for the presence of clubfoot was 100%. The sensitivity of the MRI exam was 100% and the specificity 85.2%. A dedicated sagittal imaging plane through the ankle region allowed the most confident diagnosis; medial deviation of the foot relative to the leg was seen in all 13 fetuses with clubfoot. The correlation of fetal MRI with US in the evaluation of clubfoot yields a sensitivity of 100% and specificity of 85.2%. The sagittal plane provided the most useful information. (orig.)
Konečná, Barbora; Vlková, Barbora; Celec, Peter
Preeclampsia is an autoimmune disorder characterized by hypertension. It begins with abnormal cytotrophoblast apoptosis, which leads to inflammation and an increase in the levels of anti-angiogenic factors followed by the disruption of the angiogenic status. Increased levels of fetal DNA and RNA coming from the placenta, one of the most commonly affected organs in pregnancies complicated by preeclampsia, have been found in pregnant women with the condition. However, it remains unknown as to whether this is a cause or a consequence of preeclampsia. Few studies have been carried out on preeclampsia in which an animal model of preeclampsia was induced by an injection of different types of DNA that are mimic fetal DNA and provoke inflammation through Toll-like receptor 9 (TLR9) or cyclic guanosine monophosphate-adenosine monophosphate (cGAMP). The specific mechanisms involved in the development of preeclampsia are not yet fully understood. It is hypothesized that the presence of different fragments of fetal DNA in maternal plasma may cause for the development of preeclampsia. The function of DNase during preeclampsia also remains unresolved. Studies have suggested that its activity is decreased or the DNA is protected against its effects. Further research is required to uncover the pathogenesis of preeclampsia and focus more on the condition of patients with the condition.
Gonçalves, Nuno; Rebelo, Sandra; Tavares, Isaura
The existence of putatively painful situations to the fetus demands a careful evaluation of the issue of fetal pain. Several indirect approaches are used to evaluate the existence of fetal pain. Neurobiological studies showed that from the 30th week on, the anatomical and physiological system for pain transmission is already developed, with the connections from the periphery to the cortex being successively established. Stress responses to a painful stimulation are complex but they can be detected from the 16th week on. There is activation of the hypothalamus-pituitary-adrenal axis, autonomic nervous system and hemodynamic changes in response to nociceptive stimulation. In prematures exposed to pain there are significant increases of adrenaline, noradrenaline and cortisol, hemodynamic changes, motor reflexes and facial reactions. The changes induced by strong nociceptive stimulation of newborns have important postnatal consequences since they affect future reactions to noxious stimuli. Central sensitization and immaturity of the pain inhibitory system are the main neurobiological explanations for the increased pain. Detailed studies of the neurobiological mechanisms of the transmission of painful stimuli along with follow-up studies of the consequences of exposure to pain during the development of the fetus are necessary to fully understand fetal pain.
Pergament, Eugene; Pergament, Deborah
A broad range of testing modalities for fetal genetic disease has been established. These include carrier screening for single-gene mutations, first-trimester and second-trimester screening for chromosome abnormalities and open neural-tube defects, prenatal diagnosis by means of chorionic villus sampling and amniocentesis, and preimplantation genetic diagnosis. Reproductive decisions before and after fetal genetic counselling represent the culmination of a dynamic interaction between prospective parents, obstetrician and genetic counsellor. The decision to undergo genetic testing before and after genetic counselling is influenced by a host of interrelated factors, including patient-partner and family relationships, patient-physician communication, societal mores, religious beliefs, and the media. Because of the complexity of personal and societal factors involved, it is not surprising that genetic counselling concerning reproductive decision-making must be individualised. A limited number of principles, guidelines and standards apply when counselling about testing for fetal genetic disease. These principles are that genetic counselling should be non-directive and unbiased and that parental decisions should be supported regardless of the reproductive choice. A critical responsibility of the obstetrician and genetic counsellor is to provide accurate and objective information about the implications, advantages, disadvantages and consequences of any genetic testing applied to prospective parents and their fetuses. These principles and responsibilities will be tested as newer technologies, such as array comparative genome hybridisation, non-invasive prenatal diagnosis and sequencing of the entire genome are introduced into the field of reproductive genetics and become routine practice.
Jezová, Marta; Múcková, Katarína; Soucek, Ondrej; Feit, Josef; Vlasín, Pavel
Hypertext atlas of fetal and neonatal pathology is a free resource for pregraduate students of medicine, pathologists and other health professionals dealing with prenatal medicine. The atlas can be found at http://www.muni.cz/atlases. The access is restricted to registered users. Concise texts summarize the gross and microscopic pathology, etiology, and clinical signs of both common and rare fetal and neonatal conditions. The texts are illustrated with over 300 images that are accompanied by short comments. The atlas offers histological pictures of high quality. Virtual microscope interface is used to access the high-resolution histological images. Fetal ultrasound video clips are included. Case studies integrate clinical history, prenatal ultrasonographic examination, gross pathology and histological features. The atlas is available in English (and Czech) and equipped with an active index. The atlas is suitable both for medical students and pathologists as a teaching and reference tool. The atlas is going to be further expanded while keeping the high quality of the images.
Martyn N.J. Paley
Full Text Available We have developed a Magnetic Resonance Imaging (MRI-compatible system to enable gating of a scanner to the heartbeat of a foetus for cardiac, umbilical cord flow and other possible imaging applications. We performed radiofrequency safety testing prior to a fetal electrocardiogram (fECG gated imaging study in pregnant volunteers (n = 3. A compact monitoring device with advanced software capable of reliably detecting both the maternal electrocardiogram (mECG and fECG simultaneously was modified by the manufacturer (Monica Healthcare, Nottingham, UK to provide an external TTL trigger signal from the detected fECG which could be used to trigger a standard 1.5 T MR (GE Healthcare, Milwaukee, WI, USA gating system with suitable attenuation. The MR scanner was tested by triggering rapidly during image acquisition at a typical fetal heart rate (123 beats per minute using a simulated fECG waveform fed into the gating system. Gated MR images were also acquired from volunteers who were attending for a repeat fetal Central Nervous System (CNS examination using an additional rapid cardiac imaging sequence triggered from the measured fECG. No adverse safety effects were encountered. This is the first time fECG gating has been used with MRI and opens up a range of new possibilities to study a developing foetus.
Cadena, Alberto; Baker, Roberto J.
Vampire bats are clearly members of the family Phyllostomatidae but their affinities within the family are less obvious. Investigations into the karyotypes of the three monotypic genera (Desmodus, Diaemus and Diphylla ) were made to determine if chromosomal data might reveal the phylogenetic affinities of the subfamily Desmodinae. The karyotypes of two genera have been described. In this paper we describe the karyotype of Diphylla, discuss the intrasubfamiIial variation and compare the...
Full Text Available Progress in the fields of fetal cardiology and fetal surgery have been seen not only in singleton pregnancies but also in multiple pregnancies. Proper interpretation of prenatal echocardiography is critical to clinical decision making, family counseling and perinatal management for obstetricians, maternal fetal medicine specialists, neonatologists and pediatric cardiologists. Fetal echocardiography is one of the most challenging and time-consuming prenatal examinations to perform, especially in multiple gestations. Performing just the basic fetal exam in twin gestations may take an hour or more. Thus, it is not practical to perform this exam in all cases of multiple gestations. Therefore our review and recommendations are related to fetal echocardiography in twin gestation.
Pruetz, Jay D; Votava-Smith, Jodie; Miller, David A
Comprehensive assessment of fetal wellbeing involves monitoring of fetal growth, placental function, central venous pressure, and cardiac function. Ultrasound evaluation of the fetus using 2D, color Doppler, and pulse-wave Doppler techniques form the foundation of antenatal diagnosis of structural anomalies, rhythm abnormalities and altered fetal circulation. Accurate and timely prenatal identification of the fetus at risk is critical for appropriate parental counseling, antenatal diagnostic testing, consideration for fetal intervention, perinatal planning, and coordination of postnatal care delivery. Fetal hemodynamic monitoring and serial assessment are vital to ensuring fetal wellbeing, particularly in the setting of complex congenital anomalies. A complete hemodynamic evaluation of the fetus gives important information on the likelihood of a smooth postnatal transition and contributes to ensuring the best possible outcome for the neonate.
Kasprian, Gregor [University Clinic of Radiodiagnostics, Medical University of Vienna (Austria)]. E-mail: email@example.com; Balassy, Csilla [University Clinic of Radiodiagnostics, Medical University of Vienna (Austria); Brugger, Peter C. [Center of Anatomy and Cell Biology, Medical University of Vienna (Austria); Prayer, Daniela [University Clinic of Radiodiagnostics, Medical University of Vienna (Austria)
Normal fetal lung development is a complex process influenced by mechanical and many biochemical factors. In addition to ultrasound, fetal magnetic resonance imaging (MRI) constitutes a new method to investigate this process in vivo during the second and third trimester. The techniques of MRI volumetry, assessment of signal intensities, and MRI spectroscopy of the fetal lung have been used to analyze this process and have already been applied clinically to identify abnormal fetal lung growth. Particularly in conditions such as oligohydramnios and congenital diaphragmatic hernia (CDH), pulmonary hypoplasia may be the cause of neonatal death. A precise diagnosis and quantification of compromised fetal lung development may improve post- and perinatal management. The main events in fetal lung development are reviewed and MR volumetric data from 106 normal fetuses, as well as different examples of pathological lung growth, are provided.
Full Text Available We report a case of fetal goiter diagnosed by detailed ultrasonography. A 33-year-old woman at twenty weeks of gestation was referred to our hospital for detailed ultrasonography. A fetal goiter was identified. She was receiving propylthiouracil (PTU 100 mg daily for Graves’ disease. Amniocentesis was performed and fetal thyroid function was evaluated as normal. Her recent thyroid function tests were normal, but anti-thyroid antibodies were positive. The dose of PTU was reduced to 50 mg. However, at twenty six weeks of gestation, maternal thyroid-related autoantibodies became undetectable. A fetal magnetic resonance imaging demonstrated a slight shrinkage of the fetal goiter at 30 weeks. The fetus was delivered vaginally. Thyroid function tests of the neonate were normal, and neonatal goiter was nonpalpable. Fetal goiter is a rare disease. It can be spontaneously resolved by decreasing the maternal dose of PTU.
Ishii, Tetsuya; Eto, Koji
Since 1928, human fetal tissues and stem cells have been used worldwide to treat various conditions. Although the transplantation of the fetal midbrain substantia nigra and dopaminergic neurons in patients suffering from Parkinson's disease is particularly noteworthy, the history of other types of grafts, such as those of the fetal liver, thymus, and pancreas, should be addressed as there are many lessons to be learnt for future stem cell transplantation. This report describes previous practices and complications that led to current clinical trials of isolated fetal stem cells and embryonic stem (ES) cells. Moreover, strategies for transplantation are considered, with a particular focus on donor cells, cell processing, and the therapeutic cell niche, in addition to ethical issues associated with fetal origin. With the advent of autologous induced pluripotent stem cells and ES cells, clinical dependence on fetal transplantation is expected to gradually decline due to lasting ethical controversies, despite landmark achievements.
Tetsuya; Ishii; Koji; Eto
Since 1928, human fetal tissues and stem cells have been used worldwide to treat various conditions. Although the transplantation of the fetal midbrain substantia nigra and dopaminergic neurons in patients suffering from Parkinson’s disease is particularly noteworthy, the history of other types of grafts, such as those of the fetal liver, thymus, and pancreas, should be addressed as there are many lessons to be learnt for future stem cell transplantation. This report describes previous practices and complications that led to current clinical trials of isolated fetal stem cells and embryonic stem(ES) cells. Moreover, strategies for transplantation are considered, with a particular focus on donor cells, cell processing, and the therapeutic cell niche, in addition to ethical issues associated with fetal origin. With the advent of autologous induced pluripotent stem cells and ES cells, clinical dependence on fetal transplantation is expected to gradually decline due to lasting ethical controversies, despite landmark achievements.
José Mauro Madi
Full Text Available OBJETIVOS: avaliar os fatores de risco maternos associados à acidose fetal. MÉTODOS: estudo tipo caso-controle composto por 188 recém-nascidos, sendo que 47 compuseram o grupo casos (pH de artéria umbilical OBJECTIVES: to assess maternal risk factors associated with fetal acidosis. METHODS: a case-control type study was conducted of 188 neonates, of whom 47 comprised the case group (umbilical arterial pH <7.0 and 141 the control (umbilical arterial pH E7.1 <7.3. The study included only single-gestation neonates without congenital malformations. Both maternal and fetal variables were taken into consideration. Statistical analysis involved the calculation of the raw and adjusted Odds Ratio, Student's t-test, the chi-squared test and multivariate analysis using Enter-method non-conditional logistic regression. The level of statistical significance was set at p<0.05. RESULTS: in the case group higher percentages of caesarian sections and pre-term births were observed, involving almost five times as much intensive care and twenty-five times more likelihood of Apgar in the 5th minute <7. No association was observed between the groups and fetal presentation, mother's age, history of miscarriage, years of schooling of mother or attendance at prenatal sessions. After multivariate analysis, the only risk factors that remained significant were complications relating to the placenta or the umbilical cord. Deliveries involving complications relating to the placenta or the umbilical cord were three times more likely to involve fetal acidemia. CONCLUSIONS: acidemia among neonates was associated with a higher percentage of caesarians, premature births, a need for intensive care and treatment and an Apgar index of <7 in the 5th minute. After multivariate analysis, complications relating to premature displacement of the placenta and the umbilical cord were the only remaining risk factors associated with fetal acidemia.
Hay, W W; Sparks, J W; Quissell, B J; Battaglia, F C; Meschia, G
Fetal umbilical glucose uptake was compared with simultaneous measurements of glucose turnover and utilization rates in 12 pregnant sheep, at a mean of 137 days gestational age (range, 118-146 days). Umbilical glucose uptake was calculated by application of the Fick principle. Fetal glucose turnover rate was measured by a primed-constant infusion of [14C]- and [3H]glucose (glucose turnover rate = tracer infusion rate divided by fetal glucose sp act). The calculation of fetal glucose utilization rate required substraction of the loss of tracer to the placenta from the tracer infusion rate, thus defining the net tracer entry into the fetus for direct comparison with the net umbilical glucose uptake. In fed, normoglycemic sheep, these measurements demonstrated statistical equivalence of umbilical glucose uptake rate (4.77 mg.min-1.kg-1 +/- 0.34 SE) and glucose utilization rate ([14C]glucose, 5.58 mg.min-1.kg-1 +/- 0.54 SE; and [3H]glucose, 7.19 mg.min-1.kg-1 +/- 1.24 SE) when tested by two-way analysis of variance (P greater than 0.1). In three fasted, hypoglycemic sheep, the umbilical glucose uptake rate fell to 1.43 mg.min-1.kg-1 +/- 0.56 SE, which was considerably lower than the simultaneous glucose utilization rate ([14C]glucose, 4.78 mg.min-1.kg-1 +/- 0.48 SE; and [3H]glucose, 6.81 mg.min-1.kg-1 +/- 2.19 SE). Thus, in the normoglycemic, late-gestation fetal lamb, there appears to be little glucogenesis, whereas glucogenesis may become significant during fasting-induced fetal hypoglycemia.
Roseli Mieko Yamamoto Nomura
Full Text Available O contexto atual da atividade médica exige do obstetra e ginecologista ampla compreensão dos avanços científicos e tecnológicos de sua área. O objetivo primordial da avaliação fetal antenatal é identificar fetos de risco para eventos adversos ou para o óbito e, assim, atuar preventivamente para evitar o insucesso. O perfil biofísico fetal atinge sua máxima eficiência quando aplicado dentro do contexto clínico de cada caso. Em gestações de alto risco, a doplervelocimetria da artéria umbilical mostrou-se útil para melhorar os resultados perinatais. Na restrição de crescimento fetal por insuficiência placentária grave, antes da 34ª semana de gestação, a doplervelocimetria do ducto venoso tem sido importante instrumento na condução dos casos. Nenhum teste isoladamente é considerado o melhor na avaliação da vitalidade fetal anteparto, entretanto, a análise conjunta de todos os métodos irá propiciar melhor compreensão da resposta fetal à hipóxia.The present context of medical practice demands from the obstetrician and gynecologist broad understanding of the scientific and technological advances of the area. The main purpose of prenatal evaluation is to identify fetuses at risk for adverse events or death, for preventive action to avoid mishappenings. The determination of fetal biophysical profile reaches its maximum efficiency when applied within the clinical context of each case. In high risk gestations, the Doppler velocimetry of the umbilical artery has shown to be useful to improve perinatal outcome. In the fetal growth deficit, due to severe placentary insufficiency, Doppler velocimetry of the venous duct has been showing to be an important tool in handling of the cases before the 34th week of gestation. Although no test itself is considered the best to evaluate the fetus's prenatal vitality, the joint analysis of all methods may lead to a better understanding of the fetal response to hypoxia.
Full Text Available Background: Fetal surgery is selectively offered for severe or life-threatening fetal malformations. These infants are often born prematurely and are thus at risk for retinopathy of prematurity (ROP. It is not known whether fetal surgery confers an increased risk of developing severe ROP relative to published rates in standard premature populations ≤37 weeks of age grouped by birth weight (
Taşcı, Yasemin; Karasu, Yetkin; Erten, Ozlem; Karadağ, Burak; Göktolga, Umit
Dichorionic twin pregnancy discordant for fetal anencephaly is a serious condition that threatens the normal co-twin's life by causing polyhydramniosis, preterm labor and sudden death of one or both of the fetuses. We report a case of dichorionic twin pregnancy discordant for fetal anencephaly delivered at the 32(nd) week of gestation because of preterm labor and nonreassuring fetal monitoring. The aim of this case report is to summarize management options in this situation.
Ivanov, B; Malinova, M
The fetal circulation is different from the adult circulation. One of the quite common conditions that are challenging to the developing fetus is placental hypoxia. Regardless of its cause, placental vascular insufficiency is commonly assumed to be an important factor in the development of intrauterine growth retardation. Several mechanisms are involved in the fetal adaptation to the decompensation during hypoxemia. Doppler Ultrasound technologies can help to evaluate of the fetal wellbeing.
Nearly all pregnancies include an insignificant hemorrhage of fetal blood into the maternal circulation. In some cases, the hemorrhage is large enough to compromise the fetus, resulting in fetal demise, stillbirth, or delivery of a severely anemic infant. Unfortunately, the symptoms of a significant fetal-maternal hemorrhage can be subtle, nonspecific, and difficult to identify at the time of the event. We present the case of a severely anemic newborn who was delivered in our facility with an...
F. Tuncay Ozgunen
During the last 30 years, one of the most important instruments in diagnosis is ultrasonograph. It has an indispensible place in obstetrics. Its it possible to evaluate normal fetal anatomy, to follow-up fetal growth and to diagnose fetal congenital anomalies by ultrasonography. Central nervous system anomalies is the one of the most commonly seen and the best time for screening is between 18- and 22-week of pregnancy. In this paper, it is presented the sonographic features of some outstandin...
Full Text Available Peters’ plus syndrome is a rare but clinically recognizable autosomal recessive ocular genetic syndrome. Diagnosis during the fetal life is challenging due to the presence of nonspecific findings such as ventriculomegaly in the growth-retarded fetuses. We report the first case of fetal Peters’ plus syndrome from India, where fetal ultrasound and the family history were helpful in providing a clue to the diagnosis that was confirmed later on by the DNA analysis.
Brugger, Peter C. [Center of Anatomy and Cell Biology, Integrative Morphology Group, Medical University of Vienna, Waehringerstrasse 13, 1090 Vienna (Austria)]. E-mail: firstname.lastname@example.org; Stuhr, Fritz [Department of Radiology, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna (Austria); Lindner, Christian [Department of Radiology, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna (Austria); Prayer, Daniela [Department of Radiology, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna (Austria)
The present work reviews the basic methods of performing fetal magnetic resonance imaging (MRI). Since fetal MRI differs in many respects from a postnatal study, several factors have to be taken into account to achieve satisfying image quality. Image quality depends on adequate positioning of the pregnant woman in the magnet, use of appropriate coils and the selection of sequences. Ultrafast T2-weighted sequences are regarded as the mainstay of fetal MR-imaging. However, additional sequences, such as T1-weighted images, diffusion-weighted images, echoplanar imaging may provide further information, especially in extra- central-nervous system regions of the fetal body.
Ying WU; Feng TAO; Tao LIU; Ling ZANG; Shi-long LIU
Objectives To explore the method and operating skill of fetal echocardiography in diagnosing cardiac malposition. Methods 91 consecutive fetuses were studied (control: 50 cases, cardiac malposition : 41 cases) between 2003 and 2008. The position of fetal heart was evaluated according to the fetal posture and the visceral situs by fetal routine scan-ning. The detailed echocardiography should be performed in the differential diagnosis of cardiac lesions when the heart was found to be abnormal position. Results In the control group, all fetuses were levocardia. 39 cases of cardiac mal-positions were detected by fetal echocardiography, included 25 fetuses with dextrocardia, 6 mesocard, 5 with levover-sion of heart, 3 common heart of conjoined twins and 2 extrathorax heart. Two of dextroversion were missed by fetal routine scanning, but found by autopsy or operation after birth. Conclusions When the abnormal visceral situs was found by fetal routine scanning, there is exceedingly high incidence of cardiac malpositions. Proficiently operating skill of fetal echocardiography is helpful to detect abnormal fetal cardiac position.
WANG Guo-quan; SHAO Fu-yuan; ZHAO Ying; LIU Zhi-min
Objective: To study the distribution of 2 kinds of melatonin receptor subtypes (mtl and MT2) in human fetal brain. Methods: The fetal brain tissues were sliced and the distribution ofmelatonin receptors in human fetal brain were detected using immunohistochemistry and in situ hybridization. Results: Melatonin receptor mtl existed in the cerebellun and hypothalamus, melatonin receptor MT2 exists in hypothalamus, occipital and medulla. Conclusion: Two kinds of melatonin receptors, mtl and MT2 exist in the membrane and cytosol of brain cells, indicating that human fetal brain is a target organ of melatonin.
Kearney, K; Vigneron, N; Frischman, P; Johnson, J W
The purpose of this study was to compare ultrasonic measurements of fetal abdominal circumference to ultrasonic measurements of fetal biparietal diameter, as a means of estimating fetal body weight. Of 58 fetuses who had abdominal circumferences measured, 48 (82%) of the predicted weights were within 15% of the actual birth weights. Forty-four of the same 58 fetuses had satisfactory biparietal diameter measurements, but only 21 (48%) of the predicted weights were within 15% of the actual birthweights. Ultrasonic measurement of abdominal circumference appears to be a more reliable index of fetal body weight than other currently available techniques.
Vo, Thin; Hardy, Daniel B
Adverse events in utero can be critical in determining quality of life and overall health. It is estimated that up to 50 % of metabolic syndrome diseases can be linked to an adverse fetal environment. However, the mechanisms linking impaired fetal development to these adult diseases remain elusive. This review uncovers some of the molecular mechanisms underlying how normal physiology may be impaired in fetal and postnatal life due to maternal insults in pregnancy. By understanding the mechanisms, which include epigenetic, transcriptional, endoplasmic reticulum (ER) stress, and reactive oxygen species (ROS), we also highlight how intervention in fetal and neonatal life may be able to prevent these diseases long-term.
Lee, Keun Young; Jun, Hyun Ah; Jang, Pong Rheem; Lee, Keung Hee [Hallym University College of Medicine, Seoul (Korea, Republic of); Nagey, David A. [The Johns Hopkins University, Baltimore (United States)
The normal neonatal response to sound stimulus consists of a generalized paroxysmal startle reflex. We recently noted an increase in fetal movements, head turning, mouth opening, tongue protrusion, cheek motion, hand to head movement and fetal eye blinking subsequent to fetal vibroacoustic stimulation. These movements are thought to represent portions of a startle response. Evaluation of the fetal face is an essential part of routine sonographic examination and of a level II examination. The complexity of the face in combination with suboptimal positioning may make it difficult to obtain adequate images of the fetal mouth. The fetal mouth is especially difficult to examine if it remains closed. It appeared to us that approximately 50% of the time, fetuses may be seen touching their face and head with their hands. This action may make evaluation of the face more difficult because of the shadowing caused by the overlying bones of the hands. We hypothesized that if vibroacoustic stimulation brings about fetal mouth movement and opening and/or withdrawal of the fetal hand from the mouth, it may facilitate anatomic evaluation for cleft lip and palate. Sonographic examination of the fetal mouth is facilitated if the mouth is open or moving. This study was designed to determine whether acoustic stimulation of the fetus would cause it to move its mouth. 109 women with uncomplicated pregnancies between 20 and 39 weeks gestation consented.
Full Text Available El artículo sostiene que las exigencias técnicas del muestreo para la vigilancia epidemiológica, exigen una revisión profunda de importantes conceptos de la Teoría de la Salud. En particular, es necesario hacer énfasis en las condiciones de vida, y, más específicamente, en los ambientes o contextos en que se desarrollan los procesos reproductivos de la vida social. Pero ambos campos temáticos exigen potenciar el acceso a datos más ricos que los que aportan las fuentes tradicionales. Este enfoque de la "vigilancia epidemiológica" exige una revisión de los tipos de muestras, y esto implica revisar las interpretaciones dominantes sobre los fundamentos lógicos de las inferencias a partir de muestras. Se torna necesario dejar atrás las muestras estadísticas (aún las estratificadas y promover procedimientos del tipo de los "sitios centinelas". Esta técnica, aplicada originariamente en sociedades con sistemas estadísticos deficitarios, puede desarrollarse para constituirse en un complemento substancial del monitoreo de condiciones de vida incluso en sociedades con buenos sistemas de información. El artículo propone transformar el concepto de "sitio centinela" incorporandole el requisito de la "representatividad cualitativa" mediante muestreos finalísticos sustentados en tipologías previas de las unidades espacio-poblacionales.
Full Text Available El artículo sostiene que las exigencias técnicas del muestreo para la vigilancia epidemiológica, exigen una revisión profunda de importantes conceptos de la Teoría de la Salud. En particular, es necesario hacer énfasis en las condiciones de vida, y, más específicamente, en los ambientes o contextos en que se desarrollan los procesos reproductivos de la vida social. Pero ambos campos temáticos exigen potenciar el acceso a datos más ricos que los que aportan las fuentes tradicionales. Este enfoque de la "vigilancia epidemiológica" exige una revisión de los tipos de muestras, y esto implica revisar las interpretaciones dominantes sobre los fundamentos lógicos de las inferencias a partir de muestras. Se torna necesario dejar atrás las muestras estadísticas (aún las estratificadas y promover procedimientos del tipo de los "sitios centinelas". Esta técnica, aplicada originariamente en sociedades con sistemas estadísticos deficitarios, puede desarrollarse para constituirse en un complemento substancial del monitoreo de condiciones de vida incluso en sociedades con buenos sistemas de información. El artículo propone transformar el concepto de "sitio centinela" incorporandole el requisito de la "representatividad cualitativa" mediante muestreos finalísticos sustentados en tipologías previas de las unidades espacio-poblacionales.
Ashworth, Cheryl J; Nwagwu, Margaret O; McArdle, Harry J
This study compared maternal plasma amino acid concentrations, placental protein secretion in vitro and fetal body composition and plasma amino acid and hormone concentrations in feto-placental units from the smallest and a normally-sized fetus carried by Large White × Landrace or Meishan gilts on Day 100 of pregnancy. Compared with Large White × Landrace, Meishan placental tissue secreted more protein and Meishan fetuses contained relatively more fat and protein, but less moisture. Fetal plasma concentrations of insulin, triiodothryonine, thyroxine and insulin-like growth factor (IGF)-II were higher in Meishan than Large White × Landrace fetuses. In both breeds, fetal cortisol concentrations were inversely related to fetal size, whereas concentrations of IGF-I were higher in average-sized fetuses. Concentrations of 10 amino acids were higher in Large White × Landrace than Meishan gilts, while glutamine concentrations were higher in Meishan gilts. Concentrations of alanine, aspartic acid, glutamic acid and threonine were higher in Meishan than Large White × Landrace fetuses. Average-sized fetuses had higher concentrations of asparagine, leucine, lysine, phenylalanine, threonine, tyrosine and valine than the smallest fetus. This study revealed novel genotype and fetal size differences in porcine maternal-fetal amino acid status and fetal hormone and metabolite concentrations.
In order to search for a more reliable method of sorting fetal nucleated red blood cells (NRBCs) and DNA from maternal peripheral blood and to identify origin of NRBCs and DNA, NRBCs were isolated from peripheral blood of 88 pregnant women by density gradient centrifugation and fluorescence activated cell sorter (FACS) respectively. Nested polymerase chain reaction was used to detect normal male SRY gene from blood plasma DNA of 65 pregnant women. The results revealed that fetal NRBCs were found in 14 of 27 maternal samples by density gradient centrifugation. The number of cells was from 1 to 10. Using FACS, CD71+ cells were identified among all 61 samples. The frequency was (0. 35±0. 25)× 10-2; The detectable rate of the SRY gene of blood plasma DNA from 46 women carrying male fetuses was 65.22 % (30/46). Non-detectable rate for 19 women carrying female fetuses was 94.74 % (18/19). It was concluded that the methods of sorting fetal NRBCs and DNA have already made great progress. The methods for fetal NRBCs and plasma DNA from maternal peripheral blood to diagnose genetic diseases seem to be the best methods of noninvasive prenatal diagnosis.
Full Text Available Las arritmias fetales representan un motivo infrecuente de ingreso a la unidad de cuidados intensivos. Se presenta tres casos de gestantes entre 27 y 32 semanas, con el diagnóstico de taquiarri-tmias supraventriculares fetales sostenidas, que exhibían fracaso en el intento inicial de reversión con digoxina. Dos casos con taquicardia supraventricular respondieron favorablemente cuando se asoció flecainida. Un feto hidrópico con aleteo auricular y bloqueo 2:1 no revirtió con la asociación de flecainida ni amiodarona a la digoxina y requirió la interrupción de la gestación en la 30ª semana. El neonato presentó disfunción tiroidea transitoria atribuida a la administración de amiodarona.Fetal arrhythmia is an unusual cause of admission in critical care unit. We report three cases of pregnant patients with gestational age of 27 to 32 weeks, with diagnosis of fetal sustained supraventricular tachyarrhymias; which were resistant to digoxin as first line therapy. Two fetuses had supraventricular tachycardia and were converted with flecainide in association with digoxin. A remaining hydropic fetus suffering atrial flutter with 2:1 auriculo-ventricular conduction, failed to restore sinus rhythm with digoxin alone or in association with flecainide nor amiodarone, and required premature c-section at 30ª week of gestation. Due to amiodarone administration the neonate suffered transient neonatal hypothyroidism.
B. Löwenberg (Bob)
textabstractFetal liver cell transplantation deserves intensified interest because, according to previous experimental evidence, it may represent a useful approach to reduce or avoid severe Graft-versus-Host (GvH) reactions following treatment with allogeneic haemopoietic cell grafts. The applicatio
de Leon, Priscila Marques Moura; Campos, Vinicius Farias; Dellagostin, Odir Antônio; Deschamps, João Carlos; Seixas, Fabiana Kömmling; Collares, Tiago
In this study, polymerase chain reaction (PCR) reamplification of the first PCR product (2nd-PCR) and a qPCR assay were used to detect the sex determining region Y (SRY) gene from circulating cell-free fetal DNA (ccffDNA) in blood plasma of pregnant mares to determine fetal sex. The ccffDNA was isolated from plasma of 20 Thoroughbred mares (5-13 y old) in the final 3 mo of pregnancy (fetal sex was verified after foaling). For controls, plasma from two non-pregnant mares and two virgin mares were used, in addition to the non-template control. The 182 bp nucleotide sequence corresponding to the SRY-PCR product was confirmed by DNA sequencing. Based on SRY/PCR, 8 of 11 male and 9 of 9 female fetuses were correctly identified, resulting in a sensitivity of 72.7% (for male fetuses) and an overall accuracy of 85%. Furthermore, using SRY/2nd-PCR and qPCR techniques, sensitivity and accuracy were 90.9 and 95%, respectively. In conclusion, this study is apparently the first report of fetal sex determination in mares using ccffDNA.
M.J. Noordam (Marja); F.M.E. Hoekstra (Franciska); W.C.J. Hop (Wim); J.W. Wladimiroff (Juriy)
textabstractIn 14 normally developing term fetuses, the relationship between the blood flow velocity waveforms at cerebral arterial level (internal carotid artery, anterior, middle and posterior cerebral artery) and fetal behavioural states was studied using Doppler colour flow imaging. Behavioural
The number of hypotheses trying to decipher the etiologies of preeclampsia and fetal growth restriction (FGR) is still increasing. However, for preeclampsia the actual knowledge we have is that the placenta is a prerequisite for the development of the syndrome. The recent years have seen a shift in understanding of the causes of preeclampsia from mostly focusing on the extravillous trophoblast towards the dysregulation of villous trophoblast development and maintenance. It seems as if a failure of the villous syncytiotrophoblast differentiation results in abnormal release of non-apoptotic fragments into maternal blood. In preeclampsia such necrotic or aponecrotic fragments can be found in maternal blood systemically and seem to be causative in the development of the inflammatory response of the mother. In cases with fetal growth restriction (FGR) extravillous trophoblast fails to adequately transform uterine spiral arteries. However, in FGR cases abnormal development of villous cytotrophoblast may have an impact on fetal nutrition without the induction of an inflammatory response of the mother. It is still unclear why the villous trophoblast fails to achieve an adequate turnover both in preeclampsia and in FGR. However, the detection of new biomarkers for preeclampsia such as placental protein 13 (PP13) has helped in clarifying the issue of when the syndrome starts to develop. PP13 levels in maternal serum are significantly altered already at six to seven weeks of gestation in women subsequently developing preeclampsia. Thus, there needs to be a very early alteration of villous development in such placentas. Herein the changes in villous trophoblast in preeclampsia and FGR are compared and differences between both scenarios are presented.
Full Text Available The biological importance of calcifications occasionally noted in fetal tissues (mainly liver at autopsy or ultrasound is largely unexplored. Previous reports hint at an association to infection, circulatory compromise, malformations or chromosomal abnormalities. To identify factors associated with calcifications, we have performed a case-control study on the largest cohort of fetuses with calcifications described thus far.One-hundred and fifty-one fetuses with calcifications and 302 matched controls were selected from the archives of the Department of Pathology, Karolinska University Hospital. Chromosome analysis by karyotyping or quantitative fluorescence-polymerase chain reaction was performed. Autopsy and placenta reports were scrutinized for presence of malformations and signs of infection.Calcifications were mainly located in the liver, but also in heart, bowel, and other tissues. Fetuses with calcifications showed a significantly higher proportion of chromosomal abnormalities than controls; 50% vs. 20% (p<0.001. The most frequent aberrations among cases included trisomy 21 (33%, trisomy 18 (22%, and monosomy X (18%. A similar distribution was seen among controls. When comparing cases and controls with chromosomal abnormalities, the cases had a significantly higher prevalence of malformations (95% vs. 77%, p=0.004. Analyzed the other way around, cases with malformations had a significantly higher proportion of chromosomal abnormalities compared with controls, (66% vs. 31%, p<0.001.The presence of fetal calcifications is associated with high risk of chromosomal abnormality in combination with malformations. Identification of a calcification together with a malformation at autopsy more than doubles the probability of detecting a chromosomal abnormality, compared with identification of a malformation only. We propose that identification of a fetal tissue calcification at autopsy, and potentially also at ultrasound examination, should infer
LI Hui; WEI Jun; MA Ying; SHANG Tao
Objective: To study the value of detecting fetal congenital heart disease (CHD) using the five transverse planes technique of fetal echocardiography. Methods: Nine hundred and eighty-two high-risk pregnancies for fetal CHD were included in this study, the fetal heart was scanned with the five transverse planes technique of fetal echocardiography described by yagel, autopsy was conducted when pregnancy was terminated. Blood from fetal heart was collected for fetal chromosome analysis. A close follow-up was given for normal fetal heart pregnancies and neconatal echocardiography was performed to check the accuracy of prenatal diagnosis. Results: (1) Forty-six cases(4.68%) were found to have fetal heart abnormalities in this study, 69.56% of them were diagnosed by single four-chamber view, another 30.43% fetal CHD were found by combining other views; (2) Fotry-one parents of prenatal fetuses with CHD chose to terminate pregnancy, thirty-two of them gave consent to conduct autopsy, 93.75% of which yielded unanimous conclusion between prenatal fetal echocardiography and autopsy; (3) Thirty-two of 46 cases underwent fetal chromosome analysis, 8 cases (25%) were found to have abnormal chromosome; (4) Five cases were found to have right ventricle and atrium a little bigger than those on the left side, with the unequal condition being the same after birth, but there were no clinical manifestations and they are healthy for the time being; (5) Nine hundred and thirty-six cases were not found with abnormality in this study, but one case was diagnosed with ventricular septal defect after birth, one case was diagnosed with patent ductus arteriosus, one case had atrial septal defect after birth. Conclusions: (1) The detected CHD rate was 4.68% by screening fetal heart with five transverse planes according to Yagel's description of high risk population basis for CHD. The coinciding rate of prenatal diagnosis and autopsy was 93.75%; (2) The sensitivity of detecting fetal heart
Forhead, A J; Fowden, A L
The thyroid hormones, thyroxine (T4) and triiodothyronine (T3), are essential for normal growth and development of the fetus. Their bioavailability in utero depends on development of the fetal hypothalamic-pituitary-thyroid gland axis and the abundance of thyroid hormone transporters and deiodinases that influence tissue levels of bioactive hormone. Fetal T4 and T3 concentrations are also affected by gestational age, nutritional and endocrine conditions in utero, and placental permeability to maternal thyroid hormones, which varies among species with placental morphology. Thyroid hormones are required for the general accretion of fetal mass and to trigger discrete developmental events in the fetal brain and somatic tissues from early in gestation. They also promote terminal differentiation of fetal tissues closer to term and are important in mediating the prepartum maturational effects of the glucocorticoids that ensure neonatal viability. Thyroid hormones act directly through anabolic effects on fetal metabolism and the stimulation of fetal oxygen consumption. They also act indirectly by controlling the bioavailability and effectiveness of other hormones and growth factors that influence fetal development such as the catecholamines and insulin-like growth factors (IGFs). By regulating tissue accretion and differentiation near term, fetal thyroid hormones ensure activation of physiological processes essential for survival at birth such as pulmonary gas exchange, thermogenesis, hepatic glucogenesis, and cardiac adaptations. This review examines the developmental control of fetal T4 and T3 bioavailability and discusses the role of these hormones in fetal growth and development with particular emphasis on maturation of somatic tissues critical for survival immediately at birth.
Full Text Available "nBackground: The Biophysical Profile (BPP is a noninvasive test that predicts the presence or absence of fetal asphyxia and, ultimately, the risk of fetal death in the antenatal period. Intervention on the basis of an abnormal biophysical profile result has been reported to yield a significant reduction in prenatal mortality, and an association exists between biophysical profile scoring and a decreased cerebral palsy rate in a given population. The BPP evaluates five characteristics: fetal movement, tone, breathing, heart reactivity, and amniotic fluid (AF volume estimation. The purpose of study was to determine whether there are different degree of acidosis at which the biophysical activity (acute marker are affected. "nMethods: In a prospective study of 140 patients undergoing cesarean section before onset of labor, the fetal biophysical profile was performed 24h before the time of cesarean and was matched with cord arterial PH that was obtained from a cord segment (10-20cm that was double clamped after delivery of newborn. (using cord arterial PH less than 7.20 for the diagnosis of acidosis. "nResults: The fetal biophysical profile was found to have a significant relationship with umbilical blood PH. The sensitivity, specificity, positive predictive value, negative predictive value of fetal biophysical profile score were: 88.9%, 88.6%, 50%, 98.1%. "nConclusion: The first manifestations of fetal acidosis are nonreactive nonstress testing and fetal breathing loss; in advanced acidemia fetal movements and fetal tone are compromised. A protocol of antepartum fetal evaluation is suggested based upon the individual biophysical components rather than the score alone.
Sahar N. Saleem
Full Text Available MRI has been increasingly used for detailed visualization of the fetus in utero as well as pregnancy structures. Yet, the familiarity of radiologists and clinicians with fetal MRI is still limited. This article provides a practical approach to fetal MR imaging. Fetal MRI is an interactive scanning of the moving fetus owed to the use of fast sequences. Single-shot fast spin-echo (SSFSE T2-weighted imaging is a standard sequence. T1-weighted sequences are primarily used to demonstrate fat, calcification and hemorrhage. Balanced steady-state free-precession (SSFP, are beneficial in demonstrating fetal structures as the heart and vessels. Diffusion weighted imaging (DWI, MR spectroscopy (MRS, and diffusion tensor imaging (DTI have potential applications in fetal imaging. Knowing the developing fetal MR anatomy is essential to detect abnormalities. MR evaluation of the developing fetal brain should include recognition of the multilayered-appearance of the cerebral parenchyma, knowledge of the timing of sulci appearance, myelination and changes in ventricular size. With advanced gestation, fetal organs as lungs and kidneys show significant changes in volume and T2-signal. Through a systematic approach, the normal anatomy of the developing fetus is shown to contrast with a wide spectrum of fetal disorders. The abnormalities displayed are graded in severity from simple common lesions to more complex rare cases. Complete fetal MRI is fulfilled by careful evaluation of the placenta, umbilical cord and amniotic cavity. Accurate interpretation of fetal MRI can provide valuable information that helps prenatal counseling, facilitate management decisions, guide therapy, and support research studies.
Full Text Available Objective: In this study, we aimed to evaluate the factors that affect the accuracy of estimated fetal weight in ultrasound. Methods: This study was conducted in 3rd degree hospital antenatal outpatient clinic and perinatology inpatient clinic between June 2011 and January 2012. The data were obtained from 165 pregnant women. Inclusion criteria were; no additional diseases, giving birth within 48 hours after ultrasound. The same physician executed all ultrasound process. Age, height, weight, obstetric history and obstetric follow –up findings were recorded. Results: Fetal gender, fetal presentation, presence of meconium in amniotic fluid, maternal parity, did not significantly affect the accuracy of fetal weight estimation by ultrasound. The mean difference between estimated fetal weight and birth weight was 104.48±84 gr in nullipars and 94.2±81 gr in multipars (p=0.44; mean difference was 98.22±79 gr in male babies and 98.15±86 gr in female babies (p=0.99. Mean difference between estimated fetal weight and birth weight was 96.92±81 gr in babies with cephalic presentation and 110.9±90 gr in babies with breech presentation (p=0.53; this difference was 95.36±79 gr in babies with amniotic fluid with meconium and 98.82± 83 gr in babies with amniotic fluid without meconium (p=0.83. Conclusion: Fetal weight is estimation is one of key points in the obstetrician’s intrapartum managament. And it is important to make fetal weight estimation accurately. In our study, consistent with literature, we observed that fetal gender; meconium presence in amniotic fluid, fetal presentation, maternal parity does not significantly effect the accuracy of fetal weight estimation by ultrasound.
Mocevic, Emina; Svendsen, Susanne Wulff; Jørgensen, Kristian Tore;
OBJECTIVE: We examined the association between occupational lifting during pregnancy and risk of fetal death and preterm birth using a job exposure matrix (JEM). METHODS: For 68,086 occupationally active women in the Danish National Birth Cohort, interview information on occupational lifting...... was collected around gestational week 16. We established a JEM based on information from women, who were still pregnant when interviewed. The JEM provided mean total loads lifted per day within homogeneous exposure groups as informed by job and industry codes. All women were assigned an exposure estimate from...
Sunita B Patil
Full Text Available Polycystic kidney disease is a rare developmental anomaly inherited as autosomal dominant or autosomal recessive. It is characterized by cystic dilatation of the collecting ducts frequently associated with hepatic involvement and progression to renal failure. It is included in the differential diagnosis of cystic diseases of the kidney. We report a case of polycystic kidney disease, in 22 weeks fetus incidentally detected on routine antenatal ultrasonography and confirmed by fetal autopsy. This report elucidates the importance of early diagnosis and intervention in cystic kidney diseases.
El diazepam se absorbe rápida y completamente después de la administración oral y atraviesa la barrera placentaria; su tasa de penetración en el tejido placentario es de 31,5% a las 4 horas, su vida media es prolongada y la existencia de metabolitos activos hace que su efecto sea acumulativo. Este trabajo se realizó en un modelo in vivo, usando 10 mg/Kg/día de diazepam intramuscular, en donde se estudió el efecto del diazepam sobre el desarrollo fetal, utilizando un modelo experimental en el ...
Full Text Available Yvonne Kwun-Yue Cheng, Terence T LaoDepartment of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong KongAbstract: The prediction and management of fetal macrosomia remains an obstetric challenge. Significant maternal and neonatal complications can result from the birth of a macrosomic infant, and include prolonged labor, operative delivery, postpartum hemorrhage, perineal trauma, shoulder dystocia, birth trauma, chorioamnionitis, meconium aspiration, perinatal asphyxia, low Apgar scores, neonatal hypoglycemia, and perinatal mortality. This review article discusses these maternal and perinatal risks and the management of suspected macrosomia.Keywords: macrosomia, large for gestational age, shoulder dystocia, birth trauma, perineal tear
Stiller, R J; Ashmead, G G; Paul, D; Weiner, S
Maternal isoimmunization can result in fetal anemia. Current management of isoimmunized pregnancies involves amniocentesis and spectrophotometry. Pulsed Doppler ultrasound can provide fetal blood flow determinations from the fetal umbilical vein. A pregnancy complicated by severe rhesus isoimmunization was studied with Doppler ultrasound. Increased fetal umbilical blood flow was associated with increased fetal hemolysis. Umbilical vein blood flow decreased after intrauterine transfusion. Doppler ultrasound assessment of fetal blood flow is a useful noninvasive adjunct in isoimmunized pregnancies.
Huisman, Thierry A.G.M. [Department of Diagnostic Imaging, University Children' s Hospital Zurich, Steinwiesstr. 75, CH-8032 Zurich (Switzerland)], E-mail: email@example.com; Kellenberger, Christian J. [Department of Diagnostic Imaging, University Children' s Hospital Zurich, Steinwiesstr. 75, CH-8032 Zurich (Switzerland)
Fetal magnetic resonance imaging (MRI) is considered a valuable second line imaging tool for confirmation, completion and correction of complex fetal ultrasonography findings. Fetal MRI has proven its value in pathologies of the central nervous system. Few studies have focussed on the value of fetal MRI in abdominal pathologies. With the continuing advances in hardware and software, fetal MRI is progressively valuable in fetal abdominal pathologies. A proper knowledge of the normal fetal abdominal anatomy and signal intensities is essential. The current manuscript reviews normal fetal abdominal anatomy.
LUIS R. IZQUIERDO
Full Text Available Este trabajo compara dos técnicas de modelado de sistemas complejos: la simulación basada en agentes y la dinámica de sistemas. Esta comparación se lleva a cabo dentro del marco general del proceso de modelado científico. Los autores concluyen que la principal diferencia entre las dos metodologías se encuentra en el proceso de abstracción que cada una de ellas realiza para construir el modelo formal a partir del sistema complejo observado. Esta diferencia inicial se extiende a las restantes etapas del proceso de modelado científico. Finalmente, se indican los principales factores y las propiedades generales de un sistema complejo que hacen que una u otra técnica sea más relevante, aunque los autores destacan que, en la mayoría de los casos, modelizar un mismo sistema mediante las dos técnicas es la solución idónea.
Hui WANG; Jie PING; Ren-xiu PENG; Jiang YUE; Xue-yan XIA; Qi-xiong LI; Rui KONG; Jun-yan HONG
Aim: Fetal adrenal, which synthesizes steroid hormones, is critical to fetal growth and development. Our recent research showed that some xenobiotics could inter-fere with steroidogenesis and induce intrauterine growth retardation in rats. The study on the characteristics of biotransformation enzymes in fetal adrenals still seems to be important with respect to possible significance in xenobiotic-induced fetal development toxicity. In this study, the activities of several important xenobiotic-related phase Ⅰ and phase Ⅱ enzymes in human fetal adrenals were examined and compared with those in fetal livers. Methods: The activity and mRNA expression were determined by enzymatic analysis and RT-PCR. Results: The levels of cytochrome (CYP)2A6, CYP2E1, and CYP3A7 isozymes in fetal adrenals were 82%, 92%, and 33% of those in fetal livers, respectively. There was a good positive correlation between adrenal CYP2A6 activity and gestational time. The values of α glutathione S-transferase (GST), πGST, and μGST in adrenals were 0.5, 4.4, and 8.3-fold of those in the livers, respectively, and the activity of adrenal πGST was negatively correlated with gestational time. The uridine diphosphoglucuronyl transferase activities, which were measured using p-hydroxy-biphenyl and 7-hydroxy-4-methylcoumarin as substrates, were 9% and 3%, respectively, of those in the fetal livers. Conclusion: Our investiga-tion suggested that adrenal could be an important xenobiotic-metabolizing or-gan in fetal development and may play a potential role in xenobiotic-induced fetal development toxicity.
Belfort, M. A.; White, G. L.; Vermeulen, F. M.
Objective To evaluate whether fetal cranial shape is related to shoulder dystocia. Methods We compared shoulder dystocia cases (n = 18) with controls (normal vaginal deliveries, n = 18) in a retrospective matched- pairs observational study. Subjects were matched for known maternal and fetal risk fac
Lakhno, I V
It was performed the investigation of the fetal regulatory systems condition with the heart rate variability method application in 94 women with preeclampsia. It was established that preeclamptic patients had thrombophilia that was accompanied by increased reversible aggregation of platelets in response to low doses of ADP and collagen stimulation. The fetal deterioration in this group was characterized by decreased fetal heart rate variability fractal components with a relative predominance of the central sympathetic control circuit. The augmented sympathetic tone played the significant role in fetal rigid rhythm and decelerations appearance and has formed the fetal myocardium hypoxic injury and the suppressed sinus node response. The usage of semisynthetic diosmin 1 tablet (600 mg) 2 times daily in preeclamptic ladies has a pronounced disaggregant effect and improved fetal autonomic nervous regulation in its projections on hemodynamics. The restoration of the fetal cardiorespiratory synchronization periods has made it possible to consider that diosmine has neuroprotective effect that was directed on the fetal regulatory systems condition optimization.
Andersen, Anne-Marie Nybo; Wohlfahrt, J; Christens, P;
To estimate the association between maternal age and fetal death (spontaneous abortion, ectopic pregnancy, stillbirth), taking into account a woman's reproductive history.......To estimate the association between maternal age and fetal death (spontaneous abortion, ectopic pregnancy, stillbirth), taking into account a woman's reproductive history....
M.J. Noordam (Marja)
textabstractIn this thesis the following questions were addressed: 1. Are changes in placental vascular resistance associated with alterations in arterial down stream impedance at fetal level? To this purpose placental embolization was carried-out in the fetal lamb with subsequent Doppler velocimetr
Cannie, M.; Keyzer, F. de; Kerkhove, F. van; Meersschaert, J. [University Hospitals Leuven, Department of Radiology, Leuven (Belgium); Jani, J.; Lewi, L.; Deprest, J. [University Hospitals Leuven, Department Obstetrics and Gynaecology, Leuven (Belgium); Dymarkowski, S. [University Hospitals Leuven, Department of Radiology, Leuven (Belgium); UZ Gasthuisberg, Department of Radiology, Leuven (Belgium)
Ultrasound, which is now a widely available and generally accepted, low-cost technique with real-time properties, is the screening investigation of choice in fetal medicine. However, enthusiasm for fetal prenatal magnetic resonance imaging (MRI) is rising, because of the absence of known biological risks, the increasing ease of performing of fetal MRI and the superb contrast resolution provided. Over the last 10 years, the technology has advanced dramatically. Fast imaging sequences have allowed better MRI visualization of the unborn patient than ever before. As a consequence, experience with fetal MRI is gradually expanding. We are beginning to appreciate the clinical conditions where fetal MRI can complement the ultrasound findings. Apart from the central nervous system, MRI of the fetal lung has received the most attention. Fetal MRI can be used to assess thoracic structural anomalies, lung development as well as maturation. The introduction of fetal therapy for severe lung hypoplasia, associated with congenital diaphragmatic hernia (CDH), has recently boosted the application. This review aims to highlight MRI techniques used to image the lungs of the unborn child and to point out their strengths and limitations in specific conditions. (orig.)
McCorry, Noleen K.; Hepper, Peter G.
Habituation is the decrement in response to repeated stimulation. Fetal habituation performance may reflect the functioning of the central nervous system (CNS) prenatally. However, basic characteristics of the prenatal habituation phenomena remain unclear, such as the relationship with gestational age (GA) and fetal sex. The current study…
Klink, Jeanine Monica Maria van
An increasing number of fetal diseases are being detected prior to birth due to major improvements in prenatal ultrasound examinations and the wide implementation of screening programs. For various diseases, fetal therapy may be a life-saving option or an alternative to postnatal treatment, to preve
van Kan, C. M.; de Vries, J. I. P.; Luchinger, A. B.; Mulder, E. J. H.; Taverne, M. A. M.
Assessment of fetal motility is an approach to evaluate the development and function of the nervous system before birth. Reference values for the time of first occurrence and the incidence of normal fetal movements are indispensable for studies in which prenatal motor activity is applied as a model
Fedorkow, D M; Stewart, T J; Parboosingh, J
Decreased fetal heart rate variability was noted 90 seconds after the induction of general anesthesia with sodium thiopentone and fentanyl in a patient undergoing basket extraction of a renal calculus at 30 weeks' gestation. The fetal sleep pattern lasted for 105 minutes after the anesthetic was discontinued, 45 minutes after the mother was fully awake.
Verbeek, Renate J.; Heep, Axel; Maurits, Natalia M.; Cremer, Reinhold; Hoving, Eelco W.; Brouwer, Oebele F.; Van der Hoeven, Johannes H.; Sival, Deborah A.
AIM: Our aim was to compare the effect of prenatal endoscopic with postnatal myelomeningocele closure (fetally operated spina bifida aperta [fSBA]) versus neonatally operated spina bifida aperta [nSBA]) on segmental neurological leg condition. METHOD: Between 2003 and 2009, the fetal surgical te
Hu, Gang; Chen, Wei; Xie, Xicheng; Zhang, Hao
In order to monitor the fetus in labor, the signal characteristic from fetal scalp electrode is researched, An adaptation algorithm and a peak to peak detecting technology are adopted in signal processing, and an adaptation gain control method is used to eliminate disturber from base-line shift. A fetal ECG monitoring system is designed on the basis of C8051F020 MCU.
Clarke, Margaret E.; Gibbard, W. Benton
Fetal Alcohol Spectrum Disorders (FASD), including Fetal Alcohol Syndrome (FAS) and related disorders such as Alcohol Related Neurodevelopmental Disorder (ARND) are the most common form of developmental disability and birth defects in the western world. Early recognition and accurate diagnosis by mental health professionals remains a key issue. This article reviews history, mechanisms of alcohol exposure, epidemiology, diagnosis and management of FASD.
Full Text Available Estudaram-se os efeitos do sevofluorano sobre a freqüência cardíaca nos fetos de cadelas no terço final de gestação, mediante a mensuração da freqüência cardíaca fetal com a utilização do ultra-som. Nove cadelas, sem raça definida, entre um e cinco anos de idade, com aproximadamente 45 dias de gestação, foram anestesiadas com acepromazina (0,05mg/kg, IV, propofol (5mg/kg, IV e sevofluorano. O monitoramento da freqüência cardíaca fetal foi realizado antes da medicação pré-anestésica (M0, 15 minutos após a intubação traqueal (M1, aos 30 minutos (M2 e 60 minutos (M3 do período de manutenção anestésica. A pressão arterial sistólica (PAS, média (PAM e diastólica (PAD foram obtidas pelo método não invasivo, sendo a PAM avaliada também pelo método invasivo. Por meio do monitoramento da freqüência cardíaca fetal média não se observou diferença significativa entre M0, M1 e M2, e verificou-se elevação apenas aos 60 minutos da manutenção anestésica (M3 em relação ao M0, porém sem significado clínico. O protocolo anestésico provocou diminuição significativa da pressão sangüínea arterial materna sem alterar, porém a freqüência cardíaca dos fetos.The effect of sevoflurane on fetal heart rate of 45-day fetuses was investigated through monitoring fetal heart rate by ultrasonographic evaluation in nine adult bitches aging from 1 to 5-year-old. After sedation with acepromazine (0.05mg/kg, IV, the anesthetic induction was accomplished using propofol (5mg/kg, IV and the maintenance was kept with sevoflurane. The fetal heart rate was measured before sedation (M0, 15 minutes after endotracheal intubation (M1, at 30 (M2 and 60 minutes (M3 from the beginning of general anesthesia. The systolic, diastolic and mean blood pressures were obtained by indirect techniques, while mean blood pressure were also obtained by direct technique. The measure of fetal heart rate did not show any difference between M0, M1
Bischoff, Farideh Z; Sinacori, Mina K; Dang, Dianne D; Marquez-Do, Deborah; Horne, Cassandra; Lewis, Dorothy E; Simpson, Joe Leigh
Both intact fetal cells as well as cell-free fetal DNA are present in the maternal circulation and can be recovered for non-invasive prenatal genetic diagnosis. Although methods for enrichment and isolation of rare intact fetal cells have been challenging, diagnosis of fetal chromosomal aneuploidy including trisomy 21 in first- and second-trimester pregnancies has been achieved with a 50-75% detection rate. Similarly, cell-free fetal DNA can be reliably recovered from maternal plasma and assessed by quantitative PCR to detect fetal trisomy 21 and paternally derived single gene mutations. Real-time PCR assays are robust in detecting low-level fetal DNA concentrations, with sensitivity of approximately 95-100% and specificity near 100%. Comparing intact fetal cell versus cell-free fetal DNA methods for non-invasive prenatal screening for fetal chromosomal aneuploidy reveals that the latter is at least four times more sensitive. These preliminary results do not support a relationship between frequency of intact fetal cells and concentration of cell-free fetal DNA. The above results imply that the concentration of fetal DNA in maternal plasma may not be dependent on circulating intact fetal cells but rather be a product of growth and cellular turnover during embryonic or fetal development.
Velez-Ruiz, Naymee J; Meador, Kimford J
Many studies investigating cognitive outcomes in children of women with epilepsy report an increased risk of mental impairment. Verbal scores on neuropsychometric measures may be selectively more involved. While a variety of factors contribute to the cognitive problems of children of women with epilepsy, antiepileptic drugs (AEDs) appear to play a major role. The mechanisms by which AEDs affect neurodevelopmental outcomes remain poorly defined. Animal models suggest that AED-induced apoptosis, altered neurotransmitter environment, and impaired synaptogenesis are some of the mechanisms responsible for cognitive and behavioral teratogenesis. AEDs that are known to induce apoptosis, such as valproate, appear to affect children's neurodevelopment in a more severe fashion. Fetal valproate exposure has dose-dependent associations with reduced cognitive abilities across a range of domains, and these appear to persist at least until the age of 6. Some studies have shown neurodevelopmental deficiencies associated with the use of phenobarbital and possibly phenytoin. So far, most of the investigations available suggest that fetal exposures to lamotrigine or levetiracetam are safer with regard to cognition when compared with other AEDs. Studies on carbamazepine show contradictory results, but most information available suggests that major poor cognitive outcomes should not be attributed to this medication. Overall, children exposed to polytherapy prenatally appear to have worse cognitive and behavioral outcomes compared with children exposed to monotherapy, and with the unexposed. There is an increase risk of neurodevelopmental deficits when polytherapy involves the use of valproate versus other agents.
Breathnach, Fionnuala M
Twin growth is frequently mismatched. This review serves to explore the pathophysiologic mechanisms that underlie growth aberrations in twin gestations, the prenatal recognition of abnormal twin growth, and the critical importance of stratifying management of abnormal twin growth by chorionicity. Although poor in utero growth of both twins may reflect maternal factors resulting in global uteroplacental dysfunction, discordant twin growth may be attributed to differences in genetic potential between co-twins, placental dysfunction confined to one placenta only, or one placental territory within a shared placenta. In addition, twin-twin transfusion syndrome represents a distinct entity of which discordant growth is a common feature. Discordant growth is recognized as an independent risk factor for adverse perinatal outcome. Intertwin birth weight disparity of 18% or more should be considered to represent a discordance threshold, which serves as an independent risk factor for adverse perinatal outcome. At this cutoff, perinatal morbidity is found to increase both for the larger and the smaller twin within a discordant pair. There remains uncertainty surrounding the sonographic parameters that are most predictive of discordance. Although heightening of fetal surveillance in the face of discordant twin growth follows the principles applied to singleton gestations complicated by fetal growth restriction, the timing of intervention is largely influenced by chorionicity.
Habib, H; Hatta, T; Udagawa, J; Zhang, L; Yoshimura, Y; Otani, H
Using a mouse exo utero system to examine the effects of fetal jaw movement on the development of condylar cartilage, we assessed the effects of restraint of the animals' mouths from opening, by suture, at embryonic day (E)15.5. We hypothesized that pre-natal jaw movement is an important mechanical factor in endochondral bone formation of the mandibular condyle. Condylar cartilage was reduced in size, and the bone-cartilage margin was ill-defined in the sutured group at E18.5. Volume, total number of cells, and number of 5-bromo-2'-deoxyuridine-positive cells in the mesenchymal zone were lower in the sutured group than in the non-sutured group at E16.5 and E18.5. Hypertrophic chondrocytes were larger, whereas fewer apoptotic chondrocytes and osteoclasts were observed in the hypertrophic zone in the sutured group at E18.5. Analysis of our data revealed that restricted fetal TMJ movement influences the process of endochondral bone formation of condylar cartilage.
Wake, Marvalee H
Live-bearing has evolved in all three orders of amphibians--frogs, salamanders, and caecilians. Developing young may be either yolk dependent, or maternal nutrients may be supplied after yolk is resorbed, depending on the species. Among frogs, embryos in two distantly related lineages develop in the skin of the maternal parents' backs; they are born either as advanced larvae or fully metamorphosed froglets, depending on the species. In other frogs, and in salamanders and caecilians, viviparity is intraoviductal; one lineage of salamanders includes species that are yolk dependent and born either as larvae or metamorphs, or that practice cannibalism and are born as metamorphs. Live-bearing caecilians all, so far as is known, exhaust yolk before hatching and mothers provide nutrients during the rest of the relatively long gestation period. The developing young that have maternal nutrition have a number of heterochronic changes, such as precocious development of the feeding apparatus and the gut. Furthermore, several of the fetal adaptations, such as a specialized dentition and a prolonged metamorphosis, are homoplasious and present in members of two or all three of the amphibian orders. At the same time, we know little about the developmental and functional bases for fetal adaptations, and less about the factors that drive their evolution and facilitate their maintenance.
Akinsheye, Idowu; Alsultan, Abdulrahman; Solovieff, Nadia; Ngo, Duyen; Baldwin, Clinton T; Sebastiani, Paola; Chui, David H K; Steinberg, Martin H
Fetal hemoglobin (HbF) is the major genetic modulator of the hematologic and clinical features of sickle cell disease, an effect mediated by its exclusion from the sickle hemoglobin polymer. Fetal hemoglobin genes are genetically regulated, and the level of HbF and its distribution among sickle erythrocytes is highly variable. Some patients with sickle cell disease have exceptionally high levels of HbF that are associated with the Senegal and Saudi-Indian haplotype of the HBB-like gene cluster; some patients with different haplotypes can have similarly high HbF. In these patients, high HbF is associated with generally milder but not asymptomatic disease. Studying these persons might provide additional insights into HbF gene regulation. HbF appears to benefit some complications of disease more than others. This might be related to the premature destruction of erythrocytes that do not contain HbF, even though the total HbF concentration is high. Recent insights into HbF regulation have spurred new efforts to induce high HbF levels in sickle cell disease beyond those achievable with the current limited repertory of HbF inducers.
Full Text Available Mercury (Hg, lead (Pb, cadmium (Cd, and arsenic (As are recognized neurotoxins in children that particularly affect neurodevelopment and intellectual performance. Based on the hypothesis that the fetal basis of adult disease is fetal toxic exposure that results in adverse outcomes in adulthood, we explored the concentrations of key neurotoxins (i.e., Hg, Pb, Cd, and As in meconium to identify the risk factors associated with these concentrations. From January 2007 to December 2009, 545 mother-infant pairs were recruited. The geometric mean concentrations of Pb and As in the meconium of babies of foreign-born mothers (22.9 and 38.1 µg/kg dry weight, respectively were significantly greater than those of babies of Taiwan-born mothers (17.5 and 33.0 µg/kg dry weight, respectively. Maternal age (≥30 y, maternal education, use of traditional Chinese herbs during pregnancy, and fish cutlet consumption (≥3 meals/wk were risk factors associated with concentrations of key prenatal neurotoxins. The Taiwan government should focus more attention on providing intervention programs for immigrant mothers to help protect the health of unborn babies. Further investigation on how multiple neurotoxins influence prenatal neurodevelopment is warranted.
Full Text Available William D Longhurst,1 Jordan Ernst,2 Larry Burd3 1Center for Emergency Medicine, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH, USA; 2University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA; 3Department of Pediatrics, North Dakota Fetal Alcohol Syndrome Center, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA Background: The physiology of fetal alcohol exposure changes across gestation. Early in pregnancy placental, fetal, and amniotic fluid concentrations of alcohol exposure are equivalent. Beginning in mid-pregnancy, the maturing fetal epidermis adds keratins which decrease permeability resulting in development of a barrier between fetal circulation and the amniotic fluid. Barrier function development is essential for viability in late pregnancy and in the extra-uterine environment. In this paper we provide a selected review of the effects of barrier function on fetal alcohol exposure. Methods: We utilized a search of PubMed and Google for all years in all languages for MeSH on Demand terms: alcohol drinking, amnion, amniotic fluid, epidermis, ethanol, female, fetal development, fetus, humans, keratins, permeability, and pregnancy. We also reviewed the reference lists of relevant papers and hand-searched reference lists of textbooks for additional references. Results: By 30 gestational weeks, development of barrier function alters the pathophysiology of ethanol dispersion between the fetus and amniotic fluid. Firstly, increases in the effectiveness of barrier function decreases the rate of diffusion of alcohol from fetal circulation across fetal skin into the amniotic fluid. This reduces the volume of alcohol entering the amniotic fluid. Secondly, barrier function increases the duration of fetal exposure by decreasing the rate of alcohol diffusion from amniotic fluid back into fetal circulation. Ethanol is then transported into
Briand, Valérie; Saal, Jessica; Ghafari, Caline
BACKGROUND: Few studies have evaluated the effect of malaria on intrauterine growth restriction on the basis of the fetal growth rate, rather than just the small-for-gestational age z score. Here, we assessed the impact of malaria on IUGR, using data from a longitudinal, ultrasonography......-based follow-up study of Beninese women. METHODS: A total of 1016 women were followed up from gestational week 17 to delivery. Malaria was detected every month. Women underwent ultrasonography 4 times for gestational age determination and fetal biometry. We assessed the effect of malaria on birth weight......-for-gestational age z score (n = 735 women) and fetal growth velocity (n = 664), defined as a change in fetal weight z score over time. RESULTS: Malaria was detected in 43% of women. Fetal growth velocity was negative overall, decreasing further at the end of the third trimester. Women with ≥2 malarial parasite...
Batra, Chandar Mohan; Gupta, Vidya; Gupta, Nomeeta; Menon, P S N
Hyperthyroidism can manifest very early in fetal life (fetal thyrotoxicosis) or immediately after birth (neonatal thyrotoxicosis). The authors describe outcome of pregnancies in a woman with Graves' disease who received medical management and underwent subtotal thyroidectomy. The first pregnancy resulted in macerated stillbirth at 32 wk. Fetal tachycardia was followed by intrauterine death at 30 wk in the second pregnancy and macerated stillbirth at 26 wk in the third pregnancy. Fetal tachycardia was detected at 17 wk in the fourth pregnancy. Treatment with carbimazole along with thyroxine was followed by a live birth at 35 wk; but the baby developed severe fatal neonatal thyrotoxicosis with crisis on day 9 and died on day 12. Fetal tachycardia was noted in the fifth pregnancy as well and she was treated with carbimazole and thyroxine. She delivered a male baby at 37 wk. He developed neonatal hypothyroidism on day 8 which was controlled with thyroxine.
Nakano, S; Tashiro, C; Nishimura, M; Ueyama, H; Uchiyama, A; Kubota, A; Suehara, N
Twenty-two cases of Cesarean section due to fetal anomaly diagnosed prenatally were reviewed in terms of the anesthetic managements. In 6 cases, diazepam 0.3 mg.kg-1, which provides fetal anesthesia for surgery scheduled immediately after birth, was administered intravenously to the mothers with/without fentanyl (2 general anesthesia and 4 regional anesthesia). The diagnosis of their fetuses was congenital diaphragmatic hernia, congenital cystic adenomatoid malformation of the lung, gastroschisis or omphalocele. No fetal anesthesia was performed in the other 16 cases (15 spinal anesthesia and 1 general anesthesia). Seven of their fetuses were diagnosed as hydrops. Since the general condition of the diseased newborn is known to be deteriorated after receiving various stress and aerophagia, fetal anesthesia in Cesarean delivery has the advantage of stress reduction and prevention of aerophagia. When the newborn is considered to need immediate neonatal resuscitation or intensive care including surgery, fetal anesthesia may be a choice of anesthetic technique.
Holls III William M
Full Text Available Physician can obtain fetal heart rate, electrophysiological information, and uterine contraction activity for determining fetal status from an intrauterine catheters electrocardiogram with the maternal electrocardiogram canceled. In addition, the intrauterine catheter would allow physicians to acquire fetal status with one non-invasive to the fetus biosensor as compared to invasive to the fetus scalp electrode and intrauterine pressure catheter used currently. A real-time maternal electrocardiogram cancellation technique of the intrauterine catheters electrocardiogram will be discussed along with an analysis for the methods effectiveness with synthesized and clinical data. The positive results from an original detailed subjective and objective analysis of synthesized and clinical data clearly indicate that the maternal electrocardiogram cancellation method was found to be effective. The resulting intrauterine catheters electrocardiogram from effectively canceling the maternal electrocardiogram could be used for determining fetal heart rate, fetal electrocardiogram electrophysiological information, and uterine contraction activity.
Full Text Available Los bosques son ecosistemas fundamentales en la generación de servicios ecosistémicos y, por tanto, para el bienestar humano. El cambio global (incluyendo cambio climático y cambios en el uso del suelo puede, sin embargo, alterar la dinámica y el funcionamiento de los ecosistemas, afectando al futuro suministro de servicios ecosistémicos. La vulnerabilidad frente al cambio global depende de la exposición (magnitud del cambio, la sensibilidad (susceptibilidad al cambio, y la capacidad de adaptación (habilidad para ajustarse al cambio de las especies. En el presente trabajo presentamos diversas aproximaciones de modelización que permiten analizar los diferentes componentes de la vulnerabilidad, e incluimos ejemplos desarrollados para bosques de la península Ibérica. A pesar de estos avances, la evidencia empírica y teórica para integrar los impactos potenciales (i.e. incluyendo la exposición y la sensibilidad y la capacidad de adaptación de las especies, es escasa. Por ello, para una adecuada evaluación sería necesario me-jorar el conocimiento existente sobre la sensibilidad y capacidad de adaptación de las especies y su respuesta frente a cambios ambientales extremos (por ejemplo, mediante redes de seguimiento a largo plazo, integrando adecuadamente la información obtenida en modelos que incluyan procesos basados en diferentes niveles de organización biológica, desde procesos fisiológicos a modelos agregados de distribución de especies.
Baardman, Maria E.; Erwich, Jan Jaap H. M.; Berger, Rolf M. F.; Hofstra, Robert M. W.; Kerstjens-Frederikse, Wilhelmina S.; Luetjohann, Dieter; Plosch, Torsten; Lutjohann, D.
OBJECTIVE: Cholesterol is crucial for fetal development. To gain more insight into the origin of the fetal cholesterol pool in early human pregnancy, we determined cholesterol and its precursors in the amniotic fluid of uncomplicated, singleton human pregnancies. STUDY DESIGN: Total sterols were cha
Newnham, J P; Lam, R W; Hobel, C J; Padbury, J F; Polk, D H; Fisher, D A
We investigated circulating maternal and fetal serum concentrations of ovine placental lactogen (oPL) following single umbilical artery ligation (SUAL) at 108 to 114 days' gestation. Ovine placental lactogen was isolated and purified from placental cotyledons, and a radioimmunoassay developed using previously described methods. Intrauterine growth retardation (IUGR) was manifest as increasing fetal brain-to-liver weight ratio with increasing duration of survival following SUAL. During the first five to seven days following SUAL, circulating oPL levels in ewes with SUAL fetuses were significantly reduced when compared with levels in ewes with control fetuses. In contrast, oPL levels in SUAL fetuses were significantly increased above levels in control fetuses for the first five to seven days following surgery. Fetal ovine growth hormone levels were elevated in SUAL fetuses, while ovine prolactin levels were similar in the two groups. IUGR was associated with mild fetal acidosis and fetal plasma CAT levels which were similar in SUAL and control fetuses. No correlation was found between fetal pH or CAT and fetal oPL levels. These findings are consistent with the view that circulating levels of oPL in the mother are related to the mass of functioning trophoblast. Elevated fetal oPL levels following SUAL may result from acute placental ischaemia with alterations in placental lactogen secretion at the maternofetal interface.
Schlütter, Jacob Mørup; Kirkegaard, Ida; Petersen, Olav Bjørn
and subsequent identification. RESULTS: Participants carrying male fetuses had a higher median number of fetal cells in maternal blood than those carrying female fetuses (5 vs. 3, p = 0.04). Certain cytokines (RANTES, IL-2 and IL-5) were significantly associated with the number of fetal cells in maternal blood...
Full Text Available Introduction. It is estimated that 3-10% of infants are growth restricted. Growth disturbances may have long-term issues. Doppler allows insight into the fetal response to intrauterine stress. Objective. The aim of this study was to detect fetal compromise in intrauterine growth-restricted (IUGR fetuses by means of biophysical profile (BPP vis-а-vis Doppler velocimetry studies of the fetal umbilical artery, and to find out which of the two is a better and earlier predictor of fetal compromise. Methods. A prospective study was conducted on a total of 50 singleton pregnancies with IUGR between 28 and 42 weeks of gestation. Study patients were managed expectantly with nonstress testing and amniotic fluid assessment, BPP and Doppler velocimetry studies of the fetal umbilical artery. Results. Fetal outcome was poor in 5/50 (10% of the fetuses, defined as presence of all of the following: poor Apgar test score, neonatal intensive care unit stay, necrotizing enterocolitis, and low birth weight. Of the four with abnormal BPP, 50% had poor fetal outcomes. Out of 46 with normal BPP, 6.5% had poor fetal outcomes. Conclusion. Inference drawn from the study is that the Doppler technology provides us the opportunity for repetitive noninvasive hemodynamic monitoring in IUGR pregnancies.
Mahan, D C; Watts, M R; St-Pierre, N
Twenty-six crossbreed (Yorkshire x Landrace) sows bred to Duroc boars were used to determine fetal measurements and mineral compositions at various stages of gestation. Sows were fed a vitamin and mineral fortified 15% CP corn soybean meal gestation diet fed at 2.1 kg daily with dietary minerals meeting or in excess of NRC requirements. Sow and litter measurements were evaluated at 5 periods postcoitum (45, 62, 80, 100, 115 d). The experiment was conducted as a completely randomized design with 3 to 6 observations per mean. Uterine fluid and fetal tissue were collected upon slaughter from the sows during the first 4 measurement periods. The empty uterus and uterine fluid contents were weighed. Individual fetuses were weighed and their length measured. Neonatal pigs from 6 sows were killed by electric shock before colostrum consumption. The fetuses and neonates were subsequently frozen, ground, and analyzed for water, protein, ash, and fat. The mineral profile was determined for the entire litter by inductively coupled plasma analysis technology. The sow and litter was each considered the experimental unit for all measurements and mineral compositions with regression analysis determined from 45 to 115 d of gestation. Results demonstrated that fetal weight increased quadratically (P < 0.01) and uterine fluid increased quadratically (P < 0.01) from 45 to 62 d, but then declined to 100 d postcoitum. The water, protein, ash, and lipid content of the fetus increased quadratically (P < 0.01) from 45 to 115 d of development, with the greatest increase of each component occurring during the last 15 d of development. Each of the macro- and microminerals increased curvilinearly (P < 0.01) as fetal development progressed with approximately 50% of the total litter and fetal macro- and micromineral contents occurring during the last 15 d of gestation. These results indicate that there is a large increase in mineral contents of fetal pigs during late gestation and that there may
La chirurgia mininvasiva della mitrale mediante Port Access, risulta una delle maggiori innovazioni in cardiochirurgia in grado di migliorare gli outcome a breve medio e lungo termine se paragonata alla chirurgia convenzionale. In questo studio sono sono prese in esame le esperienze di due centri di eccellenza che hanno condotto tali interventi mediante approcci tecnici intraoperatori diversi per il clampaggio aortico: l'Endoclamp ed il clampaggio aortico transtoracico. Vengono altresì discus...
Márcia M A de Aquino
Full Text Available Apesar de 80 a 90% dos fetos mortos poderem ser eliminados espontaneamente após duas a três semanas do óbito, a indução do parto tem sido a conduta mais utilizada. O objetivo deste estudo foi avaliar os resultados da indução de parto em casos de óbito fetal intra-útero com idade gestacional a partir de 20 semanas. Foi um estudo clínico descritivo realizado no Hospital Maternidade Leonor Mendes de Barros, em São Paulo. Foram analisadas 122 gestantes com esse diagnóstico quanto às características sociodemográficas, causas de óbito fetal, antecedentes obstétricos e características do parto (forma de indução, via de parto, complicações. Os procedimentos estatísticos utilizados foram cálculo da média e desvio-padrão e chi². As principais causas identificadas de morte fetal foram hipertensão arterial e infecções. A droga mais utilizada para a indução do parto foi o misoprostol (37,7%, seguido da ocitocina (19,7%. Em 27% dos casos o trabalho de parto iniciou espontaneamente. O tempo médio de indução foi de 3 horas. A maior parte teve parto vaginal e em 9,1% a cesárea foi realizada. Concluiu-se que a indução de parto de feto morto é segura e eficaz, independentemente do método utilizado. O misoprostol, utilizado por via vaginal, é especialmente útil nos casos de colo desfavorável, por seu efeito modificador sobre ele.Although 80 to 90% of all dead fetuses may be spontaneously eliminated after two to three weeks from death, labor induction has been the mostly used management. The purpose of the current study was to evaluate the results of labor induction for pregnancies with fetal death and gestation age above 20 weeks. It was a descriptive clinical study which was performed at the Hospital e Maternidade Leonor Mendes de Barros in São Paulo, Brazil. One hundred and twenty-two pregnancies with fetal death were evaluated regarding their social and demographic characteristics, causes of fetal death, previous
I Nyoman Hariyasa Sanjaya
Full Text Available Background: Prenatal test has routinely performed in antenatal care and has become a part of the obstetric care feature in many countries. Prenatal test is divided into screening and diagnostic test. Recently, the early noninvasive method in order to found and lessen the risk factors of pregnancy loss, has been studied. One of the methods is molecular test using cffDNA which has many screening purpose such as sex determination, aneuploidy, paternal inherited genetic disorder, fetus rhesus, and performed early at 7 weeks of pregnancy. Objective: The purpose of this study is to measure diagnostic value of cffDNA in determining fetal sex prenatally. Methods: In a diagnostic test study, 18 randomized samples were selected and divided based on fetal gender confirmed at birth. The group consisted of 9 pregnant women with male babies and 9 pregnant women with female babies. CffDNA then isolated from maternal blood sample and specific region in Y chromosome termed SRY is detected by PCR and electrophoresis. The data obtained analyzed both descriptively for baseline characteristic and analytically to determine its diagnostic value. Results: This study found significant correlation between SRY detection in cffDNA with male fetal phenotype (p<0.05. The sensitivity of the method is 100% with 89% specificity. In addition, we found 9.09 values for positive likelihood ratio (LR+ and 0 for negative likelihood ratio (LR-. Moreover, the result yielded 100% positive predictive value (PPV+ and 88.8% of negative predictive value (PPV-. Conclusion: This study proofed that cffDNA have a great diagnostic value to determine fetal sex prenatally. However, further study with several group of gestational age mother and better matching is required to further confirm the diagnostic potential of cffDNA
Full Text Available La lectura y la escritura son procesos que cada día ameritan nuevos cambios y transformaciones. La propuesta de un Proyecto Pedagógico Integrador, (Fraca 2003 desarrollado con éxito en algunas instituciones venezolanas, se perfila como una alternativa significativa para el desarrollo de estos elementos. La idea o núcleo central es la integración de las diferentes asignaturas curriculares y lograr una globalización partiendo de sus objetivos y contenidos programáticos. El eje pedagógico integrador le permite al docente, evidenciar con mayor prontitud los resultados mediante actividades prácticas de lectura y escritura. Así mismo combina elementos claves del aprendizaje ausbeliano: información previa, información nueva y construcción de la información definitiva o integrada. La puesta en ejecución de las estrategias integradoras, en esta ocasión por maestros en formación (UNEG, a diferentes niños de escuelas del Estado Bolívar (Venezuela, certificando cómo la lectura y la escritura pueden tener un espacio ideal y significativo en la instrucción actual. Solo se necesita la intención, creatividad, dinamismo e ingenio. The reading and the writing plows processes that every day they require new changes and transformations. The proposal of an Integrative Pedagogic Project, (Fraca 2003 developed with success in some Venezuelan institutions; it is profiled like a significant alternative for the development of these elements. The idea or central nucleus is the integration of the different curricular subjects and to achieve a globalization leaving of its objectives and programmatic contents. The integrative pedagogic axis allows to the educational one, to evidence with more readiness the results by means of practical activities of reading and it notarizes. Likewise it combines key elements of the learning ausbeliano: previous information, new information and construction of the definitive or integrated information. The operation of
Verónica Alonso Jiménez
Full Text Available La democracia representativa como forma de gobierno, implica que el poder se ejerce por personas, que elegidas por el pueblo, actúan en su nombre y representación. El modo de participación en la elección y la manera como éstas se convierten en cargos públicos, requiere del dise- ño de instituciones que sistematicen dicha participación. La república de tipo presidencial, es una modalidad del gobierno electivo y popular, cuyo titular es el jefe del ejecutivo, electo por el pueblo o sus representantes, en donde el ejercicio del poder es limitado y mantiene un régimen de responsabilidades políticas. El diseño institucional que le corresponde a esta forma de gobierno es la parcelación del poder pú- blico en tres: poder ejecutivo, poder legislativo y poder judicial. Las ventajas políticas de este esquema es que la división de poderes, neutraliza el riesgo de caer en el autoritarismo, al impedir que el poder se concentre. La división de poderes es un dispositivo de restricción de facultades de los órganos estatales, por lo que no existe superioridad jerárquica entre los poderes, al contrario, cada órgano tiene bien delimitadas sus funciones y atribuciones, las que están reguladas por un marco jurídico común llamado Constitución. Y la división de poderes contribuye a mantener el equilibrio entre estos, mediante el llamado sistema de pesos y contrapesos. El presente trabajo se centra en el estudio de la Cámara de Diputados, considerada como una de las parcelas en las que está divida la autoridad del Estado, cuyo objetivo es la validación de los modelos teóricos en la tipificación del Congreso y la comprensión de las variables internas y externas que influyen en el comportamiento legislativo.
Yolima Ruiz Lopez
Full Text Available El objetivo de la investigación fue demostrar las modificaciones de la frecuencia cardiaca y los movimientos fetales producidas por la administración de betametasona para maduración pulmonar fetal. Se realizó una investigación de tipo explicativa, prospectiva y longitudinal con un diseño cuasi-experimental y una muestra no probabilística de 106 gestantes entre 24 y 34 semanas, con diagnóstico de amenaza de parto pretérmino tratadas con betametasona (12 mg intramuscular cada 24 horas por dos dosis que acudieron al Hospital Central “Dr. Urquinaona”. Se evaluaron los movimientos fetales y frecuencia cardiaca materna y fetal. No se encontraron diferencias significativas en la frecuencia cardiaca materna comparado con los valores iniciales (p = ns. Se observó que el valor inicial de la frecuencia cardiaca fetal fue de 135,1±9,7 latidos por minuto para aumentar luego a 137,2±8,9 latidos por minuto (p = ns para presentar un nuevo aumento hasta (142,9±9,9 latidos por minuto que fue significativo comparado con los valores iniciales (p < 0,05. Se observó una disminución significativa de movimientos fetales medidos en 30 minutos después de la primera inyección (23,1±6,0 movimientos comparado con 14,8±7,0 movimientos, para aumentar después de la segunda inyección pero aun presentando valores significativamente más bajos comparado con los valores iniciales (20,0 ±6,7 movimientos; p < 0,05. Se concluye que la administración de betametasona para maduración pulmonar fetal produce incremento significativo en la frecuencia cardiaca y reducción marcada de los movimientos fetales. Abstract Fetal heart rate and movements after betamethasone administration for fetal lung maturity The objective of research was to demonstrate fetal heart rate and movements modifications by the use of betamethasone for fetal lung maturity. An explicative, prospective and longitudinal research was done with a quasi-experimental design and a non
Full Text Available Background: Porphyromonas gingivalis as a major etiology of periodontal disease can produce virulence factor, lipopolysaccharide/LPS, which is expected to play a role in the intrauterine fetal growth. Trophoblast at the maternal-fetal interface actively participates in response to infection through the expression of a family of natural immune receptors, toll-like receptor (TLR. Purpose: the aims of study were to identify endotoxin concentration in maternal blood serum of Porphyromonas gingivalis-infected pregnant rats, to characterize the TLR-4 expression in trophoblast cells, and to determine its effect on fetal growth. Methods: Female rats were infected with live-Porphyromonas gingivalis at concentration of 2 x 109 cells/ml into subgingival sulcus area of the maxillary first molar before and/or during pregnancy. They were sacrified on 14th and 20th gestational day. Fetuses were evaluated for weight and length. Endotoxin was detected by limulus amebocyte lysate assay in the maternal blood serum. The TLR-4 expression in trophoblast cells was detected by immunohistochemistry. Fetal cerebrovascular circulation: a review of prenatal ultrasound assessment.
Antenatal intrauterine cerebrovascular events were found to play an important role in the pathogenesis of perinatal brain damage. Changes in placental vascular resistance, cardiac contractibility, vessel compliance, and blood viscosity alter the normal dynamics of fetal cerebral circulation. The circulatory mechanisms described in animal fetuses also operate in the human fetus. The isthmus of the aorta represents a watershed area reflecting the redistribution of blood during increased peripheral resistance and hypoxia. The fetal cerebrovascular system acts locally within the skull and interacts with the other components of fetal circulation to compensate by redistribution of blood in case of shortage in resources. The introduction of various sonographic techniques and the collection of data from the arterial and venous cerebral circulation have improved our understanding of the regulatory mechanisms involved in fetal cerebral hemodynamic events. Anatomical and physiological considerations of cerebral vasculature in health and disease are relevant in the research of variations in fetal brain blood perfusion. Changes in flow characteristics in fetal cerebral vasculature can be used for clinical decisions. However, caution is advised before applying research data into practice. The clinical utility is well established in situations of fetal compromise such as growth restriction and anemia.
Giussani, Dino A; Niu, Youguo; Herrera, Emilio A; Richter, Hans G; Camm, Emily J; Thakor, Avnesh S; Kane, Andrew D; Hansell, Jeremy A; Brain, Kirsty L; Skeffington, Katie L; Itani, Nozomi; Wooding, F B Peter; Cross, Christine M; Allison, Beth J
The quality of the intrauterine environment interacts with our genetic makeup to shape the risk of developing disease in later life. Fetal chronic hypoxia is a common complication of pregnancy. This chapter reviews how fetal chronic hypoxia programmes cardiac and endothelial dysfunction in the offspring in adult life and discusses the mechanisms via which this may occur. Using an integrative approach in large and small animal models at the in vivo, isolated organ, cellular and molecular levels, our programmes of work have raised the hypothesis that oxidative stress in the fetal heart and vasculature underlies the mechanism via which prenatal hypoxia programmes cardiovascular dysfunction in later life. Developmental hypoxia independent of changes in maternal nutrition promotes fetal growth restriction and induces changes in the cardiovascular, metabolic and endocrine systems of the adult offspring, which are normally associated with disease states during ageing. Treatment with antioxidants of animal pregnancies complicated with reduced oxygen delivery to the fetus prevents the alterations in fetal growth, and the cardiovascular, metabolic and endocrine dysfunction in the fetal and adult offspring. The work reviewed offers both insight into mechanisms and possible therapeutic targets for clinical intervention against the early origin of cardiometabolic disease in pregnancy complicated by fetal chronic hypoxia.
Marzbanrad, Faezeh; Kimura, Yoshitaka; Endo, Miyuki; Palaniswami, Marimuthu; Khandoker, Ahsan H
Although evidence of the short term relationship between maternal and fetal heart rates has been found in previous model-based studies, knowledge about the mechanism and patterns of the coupling during gestation is still limited. In this study, a model-free method based on Transfer Entropy (TE) was applied to quantify the maternal-fetal heart rate couplings in both directions. Furthermore, analysis of the lag at which TE was maximum and its changes throughout gestation, provided more information about the mechanism of coupling and its latency. Experimental results based on fetal electrocardiograms (fECGs) and maternal ECG showed the evidence of coupling for 62 out of 65 healthy mothers and fetuses in each direction, by statistically validating against the surrogate pairs. The fetuses were divided into three gestational age groups: early (16-25 weeks), mid (26-31 weeks) and late (32-41 weeks) gestation. The maximum TE from maternal to fetal heart rate significantly increased from early to mid gestation, while the coupling delay on both directions decreased significantly from mid to late gestation. These changes occur concomitant with the maturation of the fetal sensory and autonomic nervous systems with advancing gestational age. In conclusion, the application of TE with delays revealed detailed information about the changes in fetal-maternal heart rate coupling strength and latency throughout gestation, which could provide novel clinical markers of fetal development and well-being.
Full Text Available A basic function of fetal monitoring is an analysis of fetal cardiac action. Cardiotocography (CTG cannot provide all necessary information for assessment of the fetal condition as it is not sufficiently reliable and gives a large number of false positive results that increase the number of cesarean sections. An objective of this work was to establish CTG reliability as a method for assessment of intrapartal fetal condition. Based on CTG parameters (baseline fetal heart rate, fetal heart rate variability, oscillations and decelerations 100 pathological CTG records, collected at Obstetrics and Gynecology Department of the Tuzla University Clinic Hospital from 01.12.2004 to 05.08.2005 were identified. Using binomial distribution they were classified as non-pathological (indicating absence of asphyxia and pathological (indicating possible presence of asphyxia. After the delivery the condition of newborns was assessed according to the Apgar score. Based on comparison between certain pathological parametres of CTG records and newborns’ conditions at birth the results indicated high positive predictive values whereas sensitivity and accuracy were low. Apgar score 1. from 7 upwards was given to 96 (96% newborns whereas Apgar score 2 from 7 upwards was given to all the newborns with previous pathological CTG records. Results have confirmed that CTG can be used only as a screening method for assessment of intrapartal fetal condition.
Rudolph, A M
After birth, gas exchange is achieved in the lung, whereas prenatally it occurs in the placenta. This is associated with differences in blood flow patterns in the fetus as compared with the postnatal circulation. Congenital cardiovascular malformations are associated with haemodynamic changes in the fetus, which differ from those occurring postnatally. Obstruction to cardiac outflow may alter myocardial development, resulting in progressive ventricular hypoplasia. Alteration of oxygen content may profoundly influence pulmonary vascular and ductus arteriosus responses. Interference in blood flow and oxygen content may affect cerebral development as a result of inadequate oxygen or energy substrate supply. The circulatory effects may be gestational dependent, related to maturation of vascular responses in different organs. These prenatal influences of congenital cardiac defects may severely affect immediate, as well as longterm, postnatal prognosis and survival. This has stimulated the development of techniques for palliation of disturbed circulation during fetal life.
Onankpa BO, Ukwu E, Singh S, Adoke AU, Tahir A
Full Text Available Diprosopus is an extremely rare form of congenital anomaly that results in partial or total duplication of the face. Most cases of diprosopus are delivered as stillborn or die few moments after delivery. The aim of this report is to alert clinicians that the antenatal finding of polyhydramnious may be strongly associated with fetal diprosopus, this routine high resolution anomaly scans should be recommended to help detect such anomaly early in pregnancy. We report a case of a female neonate with partial duplication of the face (diprosopus delivered by a 39 year old booked multipara. Baby’s condition deteriorated within 24hrs with worsening respiratory distress and died on the 2nd day of life.
D'Cruz, Rebecca F.; Ng, Sher M.; Dassan, Pooja
Neurocysticercosis (NCC) is a parasitic infection with the larvae of Taenia solium from contaminated pork. It is a leading cause of seizures in the developing world. Symptoms may be secondary to live or degenerating cysts, or previous infection causing calcification or gliosis. Diagnosis is based on clinical presentation, radiological confirmation of intracranial lesions and immunological testing. Management involves symptom control with antiepileptics and antiparasitic agents. Few cases have been described of maternal NCC during pregnancy. We describe a 25-year-old female presenting to a London hospital with secondary generalized seizures. MRI of the brain confirmed a calcified lesion in the right parietal lobe, and she gave a corroborative history of NCC during her childhood in India. She was stabilized initially on antiepileptics, but during her pregnancy presented with breakthrough seizures and radiological evidence of NCC reactivation. She was managed symptomatically with antiepileptics and completed the pregnancy to term with no fetal complications. PMID:27471595
Wyllie, Robert; Kauer, Matthew; Wakai, Ronald T; Walker, Thad G
We describe an array of spin-exchange-relaxation-free optical magnetometers designed for detection of fetal magnetocardiography (fMCG). The individual magnetometers are configured with a small volume with intense optical pumping, surrounded by a large pump-free region. Spin-polarized atoms that diffuse out of the optical pumping region precess in the ambient magnetic field and are detected by a probe laser. Four such magnetometers, at the corners of a 7 cm square, are configured for gradiometry by feeding back the output of one magnetometer to a field coil to null uniform magnetic field noise at frequencies up to 200 Hz. We present the first measurements of fMCG signals using an atomic magnetometer.
Zhu, Jin Liang; Obel, Carsten; Hammer Bech, Bodil
OBJECTIVE: To examine the association between infertility, with or without treatment, and fetal growth, as well as perinatal and infant mortality. METHODS: From the Danish National Birth Cohort (1997-2003), we identified 51,041 singletons born of fertile couples (time to pregnancy 12 months or less......), 5,787 born of infertile couples conceiving naturally (time to pregnancy more than 12 months), and 4,317 born after treatment. We defined small for gestational age (SGA) as the lowest 5% of birth weight by sex and gestational age. RESULTS: Crude estimates suggested an increased risk of perinatal...... mortality and SGA among infertile couples (treated and untreated), but the odds ratios (ORs) of perinatal mortality among infertile couples were attenuated after adjustment for maternal age and body mass index (1.32, 95% confidence interval [CI] 0.95-1.84 among untreated and 1.26, 95% CI 0.86-1.85 among...
van Wieringen, Hester; Letteboer, Tom G W; Pereira, Rob Rodrigues; de Ruiter, Sanne; Balemans, Walter A F; Lindhout, Dick
Prenatal alcohol exposure may cause decreased growth of the child, congenital abnormalities, specific facial characteristics, and, most importantly, mental retardation and behavioural disorders, all known as fetal alcohol spectrum disorders (FASD). A significant number of pregnant women in the Netherlands drink alcohol, but the prevalence of FASD in our country is unknown. Repeated and high peak blood alcohol concentrations, for example in the case of binge drinking by the mother, result in more severe abnormalities; a safe limit for alcohol consumption in pregnancy cannot be defined. In 2007 and 2008, Dutch paediatricians reported a total of 56 diagnosed cases of FASD, mostly adopted and foster children. Possibly the condition has not always been diagnosed. Use of international guidelines for diagnosis by the medical profession may improve detection. The guidelines of the Canadian Public Health Agency provide a useful and generally accepted classification, with strict cut-off points to avoid overdiagnosis; attention should always be paid to the broad differential diagnosis.
Adamsbaum, Catherine; Andre, Christine; Merzoug, Valerie; Ferey, Solene [St Vincent de Paul Hospital, Department of Radiology, Paris Cedex 14 (France); Moutard, Marie Laure [St Vincent de Paul Hospital, Department of Neuropaediatrics, Paris (France); Quere, Marie Pierre [CHU, Department of Radiology, Nantes (France); Lewin, Fanny [St Vincent de Paul Hospital, Maternity Department, Paris (France); Fallet-Bianco, Catherine [Ste Anne Hospital, Department of Neuropathology, Paris (France)
MRI is a useful tool to complement US for imaging of the fetal posterior fossa (PF). In France, the discovery of a PF malformation in the fetus frequently leads to termination of pregnancy (80% in a personal series). However, despite improved accuracy in the diagnosis of PF abnormalities, prognosis remains uncertain. The first objective of this review is to document the normal MRI landmarks of the developing fetal PF. Because of their thinness, the visibility of the cerebellar fissures is dramatically delayed on MRI compared to macroscopic data. An important landmark is identification of the primary fissure of the vermis, normally seen at around 25-26 weeks' gestation (WG) on the sagittal slice, separating the larger posterior lobe from the anterior lobe (volume ratio around 2:1). The prepyramidal and secondary fissures are usually only identifiable after 32 WG and the hemispheric fissures are difficult to see until the end of pregnancy. Considering the signal changes, high signal on T2-weighted (T2-W) sequences is seen from 25 WG in the posterior part of the brain stem (tegmentum and ascending sensory tracts) related to myelination. The low signal intensities seen within the cerebellum on T2-W images correspond to high cellularity of grey matter (deep nuclei), as there is no myelination within the white matter before 38 WG. The second objective is to highlight the signs highly predictive of a poor neurological prognosis. Lack of pontine curvature or vermian agenesis without a PF cyst (small volume of PF) is greatly associated with poor neurological status. The third objective is to propose a diagnostic strategy in difficult cases where prognosis is important, e.g. the Dandy Walker continuum. (orig.)
Baker, G.A.; Browning, N.; Cohen, M.J.; Bromley, R.L.; Clayton-Smith, J.; Kalayjian, L.A.; Kanner, A.; Liporace, J.D.; Pennell, P.B.; Privitera, M.; Loring, D.W.; Labiner, David; Moon, Jennifer; Sherman, Scott; Combs Cantrell, Deborah T.; Silver, Cheryl; Goyal, Monisha; Schoenberg, Mike R.; Pack, Alison; Palmese, Christina; Echo, Joyce; Meador, Kimford J.; Loring, David; Pennell, Page; Drane, Daniel; Moore, Eugene; Denham, Megan; Epstein, Charles; Gess, Jennifer; Helmers, Sandra; Henry, Thomas; Motamedi, Gholam; Flax, Erin; Bromfield, Edward; Boyer, Katrina; Dworetzky, Barbara; Cole, Andrew; Halperin, Lucila; Shavel-Jessop, Sara; Barkley, Gregory; Moir, Barbara; Harden, Cynthia; Tamny-Young, Tara; Lee, Gregory; Cohen, Morris; Penovich, Patricia; Minter, Donna; Moore, Layne; Murdock, Kathryn; Liporace, Joyce; Wilcox, Kathryn; Kanner, Andres; Nelson, Michael N.; Rosenfeld, William; Meyer, Michelle; Clayton-Smith, Jill; Mawer, George; Kini, Usha; Martin, Roy; Privitera, Michael; Bellman, Jennifer; Ficker, David; Baade, Lyle; Liow, Kore; Baker, Gus; Booth, Alison; Bromley, Rebecca; Casswell, Miranda; Barrie, Claire; Ramsay, Eugene; Arena, Patricia; Kalayjian, Laura; Heck, Christianne; Padilla, Sonia; Miller, John; Rosenbaum, Gail; Wilensky, Alan; Constantino, Tawnya; Smith, Julien; Adab, Naghme; Veling-Warnke, Gisela; Sam, Maria; O'Donovan, Cormac; Naylor, Cecile; Nobles, Shelli; Santos, Cesar; Holmes, Gregory L.; Druzin, Maurice; Morrell, Martha; Nelson, Lorene; Finnell, Richard; Yerby, Mark; Adeli, Khosrow; Wells, Peter; Browning, Nancy; Blalock, Temperance; Crawford, Todd; Hendrickson, Linda; Jolles, Bernadette; Kunchai, Meghan Kelly; Loblein, Hayley; Ogunsola, Yinka; Russell, Steve; Winestone, Jamie; Wolff, Mark; Zaia, Phyllis; Zajdowicz, Thad
Objective: To examine outcomes at age 4.5 years and compare to earlier ages in children with fetal antiepileptic drug (AED) exposure. Methods: The NEAD Study is an ongoing prospective observational multicenter study, which enrolled pregnant women with epilepsy on AED monotherapy (1999–2004) to determine if differential long-term neurodevelopmental effects exist across 4 commonly used AEDs (carbamazepine, lamotrigine, phenytoin, or valproate). The primary outcome is IQ at 6 years of age. Planned analyses were conducted using Bayley Scales of Infant Development (BSID at age 2) and Differential Ability Scale (IQ at ages 3 and 4.5). Results: Multivariate intent-to-treat (n = 310) and completer (n = 209) analyses of age 4.5 IQ revealed significant effects for AED group. IQ for children exposed to valproate was lower than each other AED. Adjusted means (95% confidence intervals) were carbamazepine 106 (102–109), lamotrigine 106 (102–109), phenytoin 105 (102–109), valproate 96 (91–100). IQ was negatively associated with valproate dose, but not other AEDs. Maternal IQ correlated with child IQ for children exposed to the other AEDs, but not valproate. Age 4.5 IQ correlated with age 2 BSID and age 3 IQ. Frequency of marked intellectual impairment diminished with age except for valproate (10% with IQ <70 at 4.5 years). Verbal abilities were impaired for all 4 AED groups compared to nonverbal skills. Conclusions: Adverse cognitive effects of fetal valproate exposure persist to 4.5 years and are related to performances at earlier ages. Verbal abilities may be impaired by commonly used AEDs. Additional research is needed. PMID:22491865
Full Text Available The prevalence of obesity is an increasing health problem throughout the world. Maternal pre-pregnancy weight, maternal nutrition and maternal weight gain are among the factors that can cause childhood obesity. Both maternal obesity and excessive weight gain increase the risks of excessive fetal weight gain and high birth weight. Rapid weight gain during fetal period leads to changes in the newborn body composition. Specifically, the increase in body fat ratio in the early periods is associated with an increased risk of obesity in the later periods. It was reported that over-nutrition during fetal period could cause excessive food intake during postpartum period as a result of metabolic programming. By influencing the fetal metabolism and tissue development, maternal obesity and excessive weight gain change the amounts of nutrients and metabolites that pass to the fetus, thus causing excessive fetal weight gain which in turn increases the risk of obesity. Fetal over-nutrition and excessive weight gain cause permanent metabolic and physiologic changes in developing organs. While mechanisms that affect these organs are not fully understood, it is thought that the changes may occur as a result of the changes in fetal energy metabolism, appetite control, neuroendocrine functions, adipose tissue mass, epigenetic mechanisms and gene expression. In this review article, the effects of maternal body weight and weight gain on fetal development, newborn birth weight and risk of obesity were evaluated, and additionally potential mechanisms that can explain the effects of fetal over-nutrition on the risk of obesity were investigated [TAF Prev Med Bull 2014; 13(5.000: 427-434
Rafat Motavalli, Laleh; Miri Hakimabad, Hashem; Hoseinian Azghadi, Elie
Despite the concerns about prenatal exposure to ionizing radiation, the number of nuclear medicine examinations performed for pregnant women increased in the past decade. This study attempts to better quantify radiation doses due to diagnostic nuclear medicine procedures during pregnancy with the help of our recently developed 3, 6, and 9 month pregnant hybrid phantoms. The reference pregnant models represent the adult female international commission on radiological protection (ICRP) reference phantom as a base template with a fetus in her gravid uterus. Six diagnostic scintigraphy scans using different radiopharmaceuticals were selected as typical diagnostic nuclear medicine procedures. Furthermore, the biokinetic data of radioiodine was updated in this study. A compartment representing iodide in fetal thyroid was addressed explicitly in the biokinetic model. Calculations were performed using the Monte Carlo transport method. Tabulated dose coefficients for both maternal and fetal organs are provided. The comparison was made with the previously published fetal doses calculated for stylized pregnant female phantoms. In general, the fetal dose in previous studies suffers from an underestimation of up to 100% compared to fetal dose at organ level in this study. A maximum of difference in dose was observed for the fetal thyroid compared to the previous studies, in which the traditional models did not contain the fetal thyroid. Cumulated activities of major source organs are primarily responsible for the discrepancies in the organ doses. The differences in fetal dose depend on several other factors including chord length distribution between fetal organs and maternal major source organs, and anatomical differences according to gestation periods. Finally, considering the results of this study, which was based on the realistic pregnant female phantoms, a more informed evaluation of the risks and benefits of the different procedures could be made.
Vaughan, Owen R; Sferruzzi-Perri, Amanda N; Fowden, Abigail L
Stresses during pregnancy that increase maternal glucocorticoids reduce birth weight in several species. However, the role of natural glucocorticoids in the mother in fetal acquisition of nutrients for growth remains unknown. This study aimed to determine whether fetal growth was reduced as a consequence of altered amino acid supply when mice were given corticosterone in their drinking water for 5 day periods in mid to late pregnancy (day, D, 11-16 or D14-19). Compared to controls drinking tap water, fetal weight was always reduced by corticosterone. At D16, corticosterone had no effect on materno-fetal transfer of [(14)C]methylaminoisobutyric acid (MeAIB), although placental MeAIB accumulation and expression of the Slc38a1 and Slc38a2 transporters were increased. However, at D19, 3 days after treatment ended, materno-fetal transfer of MeAIB was increased by 37% (P < 0.04). During treatment at D19, placental accumulation and materno-fetal transfer of MeAIB were reduced by 40% (P < 0.01), although expression of Slc38a1 was again elevated. Permanent reductions in placental vascularity occurred during the earlier but not the later period of treatment. Placental Hsd11b2 expression, which regulates feto-placental glucocorticoid bioavailability, was also affected by treatment at D19 only. Maternal corticosterone concentrations inversely correlated with materno-fetal MeAIB clearance and fetal weight at D19 but not D16. On D19, weight gain of the maternal carcass was normal during corticosterone treatment but reduced in those mice treated from D11 to D16, in which corticosterone levels were lowest. Maternal corticosterone is, therefore, a physiological regulator of the amino acid supply for fetal growth via actions on placental phenotype.
Jakobsen, Tanja R; Clausen, Frederik B; Rode, Line;
To assess whether spontaneous preterm delivery can be predicted from the amount of cell free fetal DNA (cffDNA) as determined by routine fetal RHD genotyping at 25 weeks' gestation.......To assess whether spontaneous preterm delivery can be predicted from the amount of cell free fetal DNA (cffDNA) as determined by routine fetal RHD genotyping at 25 weeks' gestation....
Rivera-Alsina, M E; Saldana, L R; Stringer, C A
Severe maternal nutritional deprivation has been associated with intrauterine growth retardation, premature labor, and increased perinatal mortality and morbidity. The authors present four cases in which total parenteral nutrition was used successfully to support fetal growth in such diverse complications as twin pregnancy with maternal jejunoileal bypass, regional enteritis, and acute pancreatitis. Maintenance of fetal growth as evidenced by serial sonographic examination allows achievement of fetal lung maturation before delivery. In all the cases presented there was no perinatal mortality or morbidity. The main clinical implication of the report is the possible application of total parenteral nutrition to maintain adequate growth in fetuses small for gestational age because of maternal nutritional deprivation.
Yolimar Navarro Briceño; Joel Santos Bolívar; Eduardo Reyna Villasmil
La ascitis fetal esta comúnmente asociada a malformaciones gastrointestinales y urinarias, anemia, infección y anomalías cromosómicas. La ascitis fetal masiva idiopática es rara. Se reporta un caso de una embarazada de 33 años referida a las 17 semanas después que se detectó ascitis en ausencia de anomalías estructurales. La evaluación cardiaca y las pruebas diagnósticas de infecciones virales fueron negativas. A las 28 semanas se detectó ascitis masiva sin otros signos de hidrops fetal. La v...
Full Text Available Nearly all pregnancies include an insignificant hemorrhage of fetal blood into the maternal circulation. In some cases, the hemorrhage is large enough to compromise the fetus, resulting in fetal demise, stillbirth, or delivery of a severely anemic infant. Unfortunately, the symptoms of a significant fetal-maternal hemorrhage can be subtle, nonspecific, and difficult to identify at the time of the event. We present the case of a severely anemic newborn who was delivered in our facility with an extensive literature review.
F. Tuncay Ozgunen
Full Text Available During the last 30 years, one of the most important instruments in diagnosis is ultrasonograph. It has an indispensible place in obstetrics. Its it possible to evaluate normal fetal anatomy, to follow-up fetal growth and to diagnose fetal congenital anomalies by ultrasonography. Central nervous system anomalies is the one of the most commonly seen and the best time for screening is between 18- and 22-week of pregnancy. In this paper, it is presented the sonographic features of some outstanding Central Nervous System anomalies. [Archives Medical Review Journal 2003; 12(2.000: 77-89
Gláucia Rosana Guerra Benute
Full Text Available OBJETIVOS: Avaliar as estratégias de enfrentamento (coping das gestantes frente ao diagnóstico de cardiopatia fetal. MÉTODOS: Foram entrevistadas 50 gestantes que receberam o diagnóstico de cardiopatia fetal. Para a coleta de dados utilizou-se uma entrevista semidirigida e o Inventário de Estratégia de Coping. A entrevista foi realizada, em média, 22 dias após terem recebido o diagnóstico. RESULTADOS: Ao investigar como se sentiam em relação ao bebê, 56,0% relataram preocupação e fragilidade, enquanto que as demais (44,0% afirmaram estarem felizes e bem. As estratégias mais utilizadas pelas gestantes foram: resolução de problemas (73,0%, suporte social (69,1%, fuga/esquiva (62,7%, e a estratégia menos utilizada foi a de afastamento (17,3%. Constatou-se que as mulheres com companheiro, utilizaram mais a estratégia de resolução de problemas (pPURPOSE: To evaluate the coping strategies of women facing a diagnosis of fetal heart disease. METHODS: We interviewed 50 women who had received a diagnosis of fetal heart disease. For data collection we used a semi-directed and Coping Strategy Inventory. The interview was conducted, on average, 22 days after the diagnosis. RESULTS: When asked how they felt about the baby, 56.0% reported concern and fragility, while the remaining 44.0% said they were happy and well. The strategies most used by women were problem solving (73.0%, social support (69.1% and escape/avoidance (62.7%, and the least used strategy was removal (17.3%. It was found that women with partners, as well as those with 1 or 2 children, used more the problem-solving strategy (p<0.05. CONCLUSIONS: The active coping strategies, focused on problem solving and seeking social support, coupled with the responsibility and the need for specific care for the survival and welfare of the baby, brought about a closer relationship with the pregnancy, strengthening the maternal-fetal bond.
Full Text Available BACKGROUND: Multiple parameters are in use for the accurate assessment of the gestational age by ultrasound, but the literature suggests that fetal foot length can be used to estimate gestational age, when other parameters are not available for measurement. Foetal femur/ foot length ratio can help in differentiating the foeti that have dysplastic limb reduction, from those whose limbs are short because of constitutional factors/IUGR. A prospective study was done to measure the fetal foot length for gestational age and to evaluate fetal femur to foot length ratio in pregnant women of 16-37 weeks gestation. MATERIALS & METHOD: One hundred and three normal singleton pregnant women of 16-37 weeks gestation were examined for routine obstetrics ultrasound. In these patients fetal foot length measurements were taken and the gestational age was assessed. In addition, fetal femur length to foot length ratio was calculated in each patient. RESULTS/OBSERVATION: Linear relationship between foot length and gestational age was present with a R2 value of 0.90 (p < than 0.001 and the fetal femur length/foot length ratio was found to be more than or equal to 0.92.The foot length can be a reliable parameter for use in assessment of gestational age and as most skeletal dysplasias spare the feet, the fetal femur length/foot length ratio can be used to detect most skeletal dysplasia. CONCLUSIONS: Foetal foot length is a reliable parameter for assessment of gestational age and femur length/foot length ratio is approximately 1 and a ratio of < 0.92 shall be useful in the detection of most skeletal dysplasia.
Will, M.; Barnard, J.A.; Said, H.M.; Ghishan, F.K.
Maternal hydantoin ingestion during pregnancy results in a well defined clinical entity termed ''fetal hydantoin syndrome''. The clinical characteristics of this syndrome includes growth retardation, and congenital anomalies. Because folic acid is essential for protein synthesis and growth, and since hydantoin interferes with intestinal transport of folic acid, the authors postulated that part of the fetal hydantoin syndrome may be due to inhibition of placental folic acid by maternal hydantoin. Therefore, they studied in vivo placental folate transport in a well-established model for fetal hydantoin syndrome in the rat. Our results indicate that maternal hydantoin ingestion, significantly decreased fetal weight and placental and fetal uptake of folate compared to controls. To determine whether maternal hydantoin ingestion has a generalized or specific effect on placental function, they examined placental and fetal zinc transport in the same model. Our results indicate that zinc transport is not altered by hydantoin ingestion. They conclude that maternal hydantoin ingestion results in fetal growth retardation which may be due in part to inhibition of placental folate transport.
Huisman, Thierry A.G.M.; Kubik-Huch, Rahel; Marincek, Borut [Institute of Diagnostic Radiology, University Hospital, Zurich (Switzerland); Wisser, Josef [Clinic for Obstetrics, University Hospital, Zurich (Switzerland); Martin, Ernst [Department of Neuroradiology and Magnetic Resonance, University Children' s Hospital, Zurich (Switzerland)
Prenatal ultrasonography is the primary screening modality for the evaluation of fetal pathology. Ultrafast fetal MRI is a recent development that examines the fetus in utero. The short acquisition times (as short as 400 ms/slice) allow to picture freeze the fetus without the need for fetal sedation. The high spatial resolution, good contrast-to-noise ratio, and the multiplanar capabilities are especially advantageous in pathologies of the fetal central nervous system (CNS). Fetal MRI currently serves as a second-line imaging tool for complex fetal cerebral malformations and pathologies. Fetal ventriculomegaly, lesions within the posterior fossa, and abnormalities in cerebral myelination, migration, and sulcation are particularly well identified. (orig.)
Li, Jing Jing; Henwood, Tony; Van Hal, Sebastian; Charlton, Amanda
Parvovirus B19 infection causes 5% to 15% of cases of nonimmune hydrops fetalis. The aim of our study was to evaluate the use of immunohistochemistry in diagnosing parvovirus infection in fetal and placental tissue during routine fetal and perinatal autopsies. Histology slides of 20 cases of confirmed parvovirus infection were reviewed, and immunohistochemistry was applied to selected blocks of fetal and placental tissue. Immunohistochemistry was positive in all 20 cases, and histologic viral inclusions were seen in 19 cases. Immunohistochemical staining was closely correlated with histology and was more sensitive than histology in detecting virally infected cells, especially in autolyzed tissue. All cases also had confirmatory evidence of parvovirus infection by polymerase chain reaction of fetal liver and positive maternal serology, where it was available. We conclude that parvovirus immunohistochemistry is a reliable method for diagnosing parvovirus infection, especially in autolyzed tissue where histologic assessment may be suboptimal.
Jellesen, Rikke; Strandberg-Larsen, Katrine; Jørgensen, Tina;
Intrauterine exposure to artificial sex hormones such as oral contraceptives may be associated with an increased risk of fetal death. Between 1996 and 2002, a total of 92 719 women were recruited to The Danish National Birth Cohort and interviewed about exposures during pregnancy. Outcome.......2%) women took oral contraceptives during pregnancy. Use of combined oestrogen and progesterone oral contraceptives (COC) or progesterone-only oral contraceptives (POC) during pregnancy was not associated with increased hazard ratios of fetal death compared with non-users, HR 1.01 [95% CI 0.71, 1.45] and HR...... 1.37 [95% CI 0.65, 2.89] respectively. Neither use of COC nor POC prior to pregnancy was associated with fetal death. Stratification by maternal age and smoking showed elevated risks of fetal death for women contraception during pregnancy, but the interactions were...
FU Xian-hu; CHEN Han-ping
@@ The discovery of cell-free fetal DNA in maternal plasma in 1997 has opened up new possibilities for noninvasive diagnosis.1 By RT-PCR, circulating fetal DNA can be detected in the plasma of pregnant women,even in the first trimester of pregnancy,2,3 and thus can be used for noninvasive prenatal diagnosis of sex-linked disorders,4-6 the RhD status of fetuses,7 and single gene disorders such as beta-thalassaemia,8,9 congenital adrenal hyperplasia,10 and achondroplasia.11 In addition,quantitative aberrations of circulating fetal DNA may indicate various pregnancy-associated disorders,including1 Preeclampsia,12-14 preterm labor15,16 and fetal trisomy 21.17
Reece, E A; Copel, J A; Scioscia, A L; Grannum, P A; DeGennaro, N; Hobbins, J C
Current management of isoimmunization in pregnancy is predicted on the assumption that all sensitized women carry antigen-positive fetuses. In addition, management is based on indirect predictors of the magnitude of the fetal hemolytic disease. We present a preliminary report using a new approach of direct fetal blood sampling for the diagnosis and treatment of these patients. This form of evaluation provides specific information about fetal red blood cell antigen status and the degree of fetal anemia at an earlier gestational age than that validated by the Liley curves and eliminates empiricism from both the diagnosis and treatment of the isoimmunized pregnancy. The use of such a management protocol reduces the need for multiple invasive procedures in fetuses at little risk for disease and provides specific information about the status of those fetuses truly at risk.
Sival, D A
The possibility of studying fetal motor behaviour by ultrasound techniques has provoked research on its potential application for assessment of prenatal neurological conditions. The characteristics ('quality') of one particular movement pattern, the 'general movement', has been shown to be discrimin
Gau, G S; Cadle, G
Four cases of severe congenital abnormality associated with persistently low maternal serum human placental lactogen levels are described. It is thought that this pattern might act as a warning of severe fetal abnormality.
Spiller, Cassy M; Bowles, Josephine; Koopman, Peter
Fertility depends on correct regulation of meiosis, the special form of cell division that gives rise to haploid gametes. In female mammals, germ cells enter meiosis during fetal ovarian development, while germ cells in males avoid entering meiosis until puberty. Decades of research have shown that meiotic entry, and germ cell sex determination, are not initiated intrinsically within the germ cells. Instead, meiosis is induced by signals produced by the surrounding somatic cells. More recently, retinoic acid (RA), the active derivative of vitamin A, has been implicated in meiotic induction during fetal XX and postnatal XY germ cell development. Evidence for an intricate system of RA synthesis and degradation in the fetal ovary and testis has emerged, explaining past observations of infertility in vitamin A-deficient rodents. Here we review how meiosis is triggered in fetal ovarian germ cells, paying special attention to the role of RA in this process.
... https://medlineplus.gov/news/fullstory_161451.html Zika Virus Can Damage Fetal Brain Late in Pregnancy: Study ... WEDNESDAY, Oct. 12, 2016 (HealthDay News) -- The Zika virus may harm a baby's brain even if the ...
Mellor, David J; Diesch, Tamara J; Gunn, Alistair J; Bennet, Laura
Our understanding of when the fetus can experience pain has been largely shaped by neuroanatomy. However, completion of the cortical nociceptive connections just after mid-gestation is only one part of the story. In addition to critically reviewing evidence for whether the fetus is ever awake or aware, and thus able to truly experience pain, we examine the role of endogenous neuro-inhibitors, such as adenosine and pregnanolone, produced within the feto-placental unit that contribute to fetal sleep states, and thus mediate suppression of fetal awareness. The uncritical view that the nature of presumed fetal pain perception can be assessed by reference to the prematurely born infant is challenged. Rigorously controlled studies of invasive procedures and analgesia in the fetus are required to clarify the impact of fetal nociception on postnatal pain sensitivity and neural development, and the potential benefits or harm of using analgesia in this unique setting.
... toughest but most fulfilling job in the world. Parenting children with special needs, such as fetal alcohol spectrum ... about FASD can help parents understand how their children are affected, which parenting strategies work best, and how to get services ...
... html Scientists ID Key Fetal Cells Vulnerable to Zika Lab study suggests possible mechanism for birth defects ... 29, 2016 (HealthDay News) -- The devastating mosquito-borne Zika virus can infect cells that play a role ...
Background Screening for fetal trisomy 21 in the first trimester includes analysis of the serological markers pregnancy-associated plasma protein A (PAPP-A) and free beta human choriogonadotropin (free βhCG). With the recent launch of the PAPP-A free βhCG and assays on the Roche Cobas and Elecsys...... platforms, we investigated their clinical and analytical performance in samples from gestaional weeks 8+0 to 14+0. Methods. We conducted a multicenter study based on serum samples from 5397 pregnancies including 107 samples from cases of verified fetal trisomy 21 at 8 to 14 weeks of gestation. A technical...... with the standards for biochemical assays for prenatal screening set by the Fetal Medicine Foundation, with low assay imprecision, and a high clinical performance of prenatal screening for fetal trisomy in the first trimester....
Amanuma, Makoto; Hasegawa, Makoto; Enomoto, Kyoko; Watabe, Tsuneya; Heshiki, Atsuko (Saitama Medical School, Moroyama (Japan))
We examined the feasibility of fast steady-state free precession (SSFP) MR imaging with time-reversed free induction decay (FID) signal for detecting fetal abnormality. Its strong T[sub 2]-weighted contrast enabled to clearly differentiate fetal part from the amniotic fluid and detect some fluid-filled organs. Although the sequence is very sensitive to motion, short imaging time (20 seconds) with breath-holding minimized motion-related artifacts and provided high quality images. It was also possible to image repeatedly in arbitrary slice orientations within a reasonable examination time. This technique was particularly useful to demonstrate gross fetal anomalies of the body surface and central nervous system without need for a potentially harmful fetal anesthesia. However, due to poor soft tissue contrast supplemental T[sub 1]-weighted images were mandatory. (author).
van Kan, C M; de Vries, J I P; Lüchinger, A B; Mulder, E J H; Taverne, M A M
Assessment of fetal motility is an approach to evaluate the development and function of the nervous system before birth. Reference values for the time of first occurrence and the incidence of normal fetal movements are indispensable for studies in which prenatal motor activity is applied as a model to study the central and peripheral nervous systems. Studies on fetal motility have been performed in a few species, particularly in the human. The aim of the present study is to describe the ontogeny of fetal motility in the guinea pig, a precocious polytocous species. After a pilot study to establish procedures for repeated ultasonographic scanning of guinea pigs, 10 domesticated animals were scanned (5.0 or 7.5 MHz convex transducer) at 2-4 day intervals between day 24 and 63 of gestation (term age 68 days). Per animal two selected fetuses were each scanned for 15 min. Images were stored on videotape and analyzed off-line for the first onset, presence and quality of fetal movement patterns, and quantity of sideway bendings, general movements, breathing movements and periods of fetal rest. Twenty-five different movement patterns could be characterized, 6 emerging at the onset of motor activity were performed only temporarily. The very first fetal movement was observed on day 24 gestational age, and subsequently most other movements developed during a period of only 5 days. Interfetal difference in onset of the frequently occurring sideway bendings, general movements, and front and hind limb movements was only 2 days. Sideway bendings and general movements co-existed during days 29 to 43. There were developmental trends in the course of pregnancy. Sideway bendings increased rapidly between 24 and 30 days and declined hereafter. General movements and fetal breathing increased during midpregnancy and declined towards parturition. Conversely, fetal rest was observed for approximately 60% of time at midgestation and a marked increase was found towards parturition. There
The prevalence of obesity is an increasing health problem throughout the world. Maternal pre-pregnancy weight, maternal nutrition and maternal weight gain are among the factors that can cause childhood obesity. Both maternal obesity and excessive weight gain increase the risks of excessive fetal weight gain and high birth weight. Rapid weight gain during fetal period leads to changes in the newborn body composition. Specifically, the increase in body fat ratio in the early periods is associat...
Hoyer, Dirk; Zebrowski, Jan; Cysarz, Dirk; Goncalves, Hernani; Pytlik, Adelina; Amorim-Costa, Celia; Bernardes, Joao; Ayres-de-Campos, Diogo; Witte, Otto; Schleussner, Ekkehard; Stroux, Lisa; Redman, Christopher; Georgieva, Antoniya; Payne, Stephen; Clifford, Gari; Signorini, Maria; Magenes, Giovanni; Andreotti, Fernando; Malberg, Hagen; Zaunseder, Sebastian; Lakhno, Igor; Schneider, Uwe
Monitoring the fetal behavior does not only have implications for acute care but also for identifying developmental disturbances that burden the entire later life. The concept, of "fetal programming", also known as "developmental origins of adult disease hypothesis", e.g. applies for cardiovascular, metabolic, hyperkinetic, cognitive disorders. Since the autonomic nervous system is involved in all of those systems, cardiac autonomic control may provide relevant functional diagnostic and prognostic information. The fetal heart rate patterns (HRP) are one of the few functional signals in the prenatal period that relate to autonomic control and, therefore, is predestinated for its evaluation. The development of sensitive markers of fetal maturation and its disturbances requires the consideration of physiological fundamentals, recording technology and HRP parameters of autonomic control. Based on the ESGCO2016 special session on monitoring the fetal maturation we herein report the most recent results on: (i) functional fetal autonomic brain age score (fABAS), Recurrence Quantitative Analysis and Binary Symbolic Dynamics of complex HRP resolve specific maturation periods, (ii) magnetocardiography (MCG) based fABAS was validated for cardiotocography (CTG), (iii) 30 min recordings are sufficient for obtaining episodes of high variability, important for intrauterine growth restriction (IUGR) detection in handheld Doppler, (iv) novel parameters from PRSA to identify Intra IUGR fetuses, (v) Electrocardiographic (ECG) recordings allowed a stable heart beat detection in the maturation periods between 20 to 28 weeks of gestation only, (vi) correlation between maternal and fetal HRV is disturbed in pre-eclampsia. The reported novel developments significantly extend the possibilities for the established CTG methodology. Novel HRP indices improve the accuracy of assessment due to their more appropriate consideration of complex autonomic processes across the recording technologies
Huisman, Thierry A.G.M. [University Children' s Hospital, Department of Diagnostic Imaging, Zurich (Switzerland); Johns Hopkins Hospital, Division of Pediatric Radiology, Department of Radiology and Radiological Science, Baltimore, MD (United States); Arulrajah, Sahayini [Johns Hopkins Hospital, Division of Pediatric Radiology, Department of Radiology and Radiological Science, Baltimore, MD (United States); Meuli, Martin [University Children' s Hospital, Department of Surgery, Zurich (Switzerland); Brehmer, Ulrike [University Children' s Hospital, Department of Diagnostic Imaging, Zurich (Switzerland); Beinder, Ernst [University Hospital, Department of Obstetrics, Zurich (Switzerland)
Conjoined twinning is a very rare occurrence with no genetic predisposition. Twisting of conjoined twins around the axis of their connecting tissue bridge, close to the third trimester, has not been previously reported. We describe a unique case of in utero twisting of conjoined omphalopagus twins who survived without any adverse effects. Fetal US and fetal MRI played a vital role in the diagnosis and perinatal management of these twins. (orig.)
Rios M. F.
Full Text Available EI propósito de esta investigación va dirigido a establecer un modelo experimental de origen animal para profundizar en el conocimiento de los mecanismos de respuesta inmune al aloinjerto fetal y comprobar la existencia de Factores Bloqueadores (Fbs del Cultiva Mixta de Linfocitos (CML en grupos de conejas reproductoras subfértiles a quienes se les aplico dos a mas dosis de linfoterapia con el fin de analizar los efectos en la tasa de fertilidad y éxito gestacional. Se cuantificaron los Fbs mediante el CML con ayuda de la técnica no reactiva MTT-Formazan. Se pudo comprobar la existencia de Fbs en conejas reproductoras subfértiles tratadas con Linfoterapia, asf como el aumento en la tasa de fertilidad de las mismas, edemas se estableció que los Fbs de proliferación celular actúan inhibiendo el CML de otras especies. Esto nos indica claramente que el efecto inhibitorio de estos Fbs es interespecífico como se ha afirmado.
Bigelow, Timothy A.; Miller, Rita J.; Blue, James P.; O'Brien, William D.
High-intensity ultrasound has shown potential in treating many ailments requiring noninvasive tissue necrosis. However, little work has been done on using ultrasound to ablate pathologies on or near the developing fetus. For example, Congenital Cystic Adenomatoid Malformation (cyst on lungs), Sacrococcygeal Teratoma (benign tumor on tail bone), and Twin-Twin Transfusion Syndrome (one twin pumps blood to other twin) are selected problems that will potentially benefit from noninvasive ultrasound treatments. Before these applications can be explored, potential ultrasound-induced bioeffects should be understood. Specifically, ultrasound-induced hemorrhage near the fetal rat skull was investigated. An f/1 spherically focused transducer (5.1-cm focal length) was used to expose the skull of 18- to 19-day-gestation exteriorized rat fetuses. The ultrasound pulse had a center frequency of 0.92 MHz and pulse duration of 9.6 μs. The fetuses were exposed to 1 of 4 exposure conditions (denoted A, B, C, and D) in addition to a sham exposure. Three of the exposures consisted of a peak compressional pressure of 10 MPa, a peak rarefactional pressure of 6.7 MPa, and pulse repetition frequencies of 100 Hz (A), 250 Hz (B), and 500 Hz (C), corresponding to time-average intensities of 1.9 W/cm2, 4.7 W/cm2, and 9.4 W/cm2, respectively. Exposure D consisted of a peak compressional pressure of 6.7 MPa, a peak rarefactional pressure of 5.0 MPa, and a PRF of 500 Hz corresponding to a time-average intensity of 4.6 W/cm2. Hemorrhage occurrence increased slightly with increasing time-average intensity (i.e., 11% for A, 28% for B, 31% for C, and 19% for D with a 9% occurrence when the fetuses were not exposed). The low overall occurrence of hemorrhaging may be attributed to fetal motion (observed in over half of the fetuses from the backscattered echo during the exposure). The mean hemorrhage sizes were 3.1 mm2 for A, 2.5 mm2 for B, 2.7 mm2 for C, and 5.1 mm2 for D. The larger lesions at D may
Chung, M. D.; Tae, S.; Lee, H. K.; Kwon, K. H.; Chung, W. K.; Kim, K. J. [Soon Chung Hyang College Hospital, Chunan (Korea, Republic of)
The X-ray pelvimetry is widely used for investigation of fetal weight determination by measuring the size of the fetal head. The report concerns 173 cases with Colcher-Sussman method from January 1'77 to December 31'80 at Soon Chun Hyang college hospital. We measured fetal head diameter in both A-P and lateral projections. The brief results are as follows: 1)Among the total 173 cases, vaginal delivery is 88 cases and Cesarean section is 85 cases. 2) The rate of Cesarean section is increased over 35 years of age and 4,000 gm of birth weight. 3) The rate of Cesarean section is increased in abnormal presentation. 4) The relationship between the fetal head diameter and the fetal weight is more significant in A-P plus lateral projection than A-P only. 5) The average size of the fetal head is 0.8cm larger in Cesarean section than in vaginal delivery.
Corrigan, Niamh; Brazil, Derek P; McAuliffe, Fionnuala
Maternal diabetes mellitus is associated with increased teratogenesis, which can occur in pregestational type 1 and type 2 diabetes. Cardiac defects and with neural tube defects are the most common malformations observed in fetuses of pregestational diabetic mothers. The exact mechanism by which diabetes exerts its teratogenic effects and induces embryonic malformations is unclear. Whereas the sequelae of maternal pregestational diabetes, such as modulating insulin levels, altered fat levels, and increased reactive oxygen species, may play a role in fetal damage during diabetic pregnancy, hyperglycemia is thought to be the primary teratogen, causing particularly adverse effects on cardiovascular development. Fetal cardiac defects are associated with raised maternal glycosylated hemoglobin levels and are up to five times more likely in infants of mothers with pregestational diabetes compared with those without diabetes. The resulting anomalies are varied and include transposition of the great arteries, mitral and pulmonary atresia, double outlet of the right ventricle, tetralogy of Fallot, and fetal cardiomyopathy.A wide variety of rodent models have been used to study diabetic teratogenesis. Both genetic and chemically induced models of type 1 and 2 diabetes have been used to examine the effects of hyperglycemia on fetal development. Factors such as genetic background as well as confounding variables such as obesity appear to influence the severity of fetal abnormalities in mice. In this review, we will summarize recent data on fetal cardiac effects from human pregestational diabetic mothers, as well as the most relevant findings in rodent models of diabetic cardiac teratogenesis.
Ahmed, R G
Because bisphenol A (BPA) has been detected in animals, the aim of this study was to investigate the possible effects of maternal BPA exposure on the fetal endocrine system (thyroid-adipokine axis). BPA (20 or 40 μg/kg body weight) was orally administered to pregnant rats from gestation day (GD) 1-20. In both treated groups, the dams and their fetuses had lower serum thyroxine (T4) and triiodothyronine (T3) levels, and higher thyrotropin (TSH) level than control dams and fetuses at GD 20. Some histopathological changes in fetal thyroid glands were observed in both maternal BPA groups at embryonic day (ED) 20, including fibroblast proliferation, hyperplasia, luminal obliteration, oedema, and degeneration. These disorders resulted in the suppression of fetal serum growth hormone (GH), insulin growth factor-1 (IGF1) and adiponectin (ADP) levels, and the elevation of fetal serum leptin, insulin and tumor necrosis factor-alpha (TNFα) levels in both treated groups with respect to control. The depraved effects of both treated groups were associated with reduced maternal and fetal body weight compared to the control group. These alterations were dose dependent. Thus, BPA might penetrate the placental barrier and perturb the fetal thyroid adipokine axis to influence fat metabolism and the endocrine system.
Full Text Available Organoids derived from human pluripotent stem cells recapitulate the early three-dimensional organization of the human brain, but whether they establish the epigenomic and transcriptional programs essential for brain development is unknown. We compared epigenomic and regulatory features in cerebral organoids and human fetal brain, using genome-wide, base resolution DNA methylome and transcriptome sequencing. Transcriptomic dynamics in organoids faithfully modeled gene expression trajectories in early-to-mid human fetal brains. We found that early non-CG methylation accumulation at super-enhancers in both fetal brain and organoids marks forthcoming transcriptional repression in the fully developed brain. Demethylated regions (74% of 35,627 identified during organoid differentiation overlapped with fetal brain regulatory elements. Interestingly, pericentromeric repeats showed widespread demethylation in multiple types of in vitro human neural differentiation models but not in fetal brain. Our study reveals that organoids recapitulate many epigenomic features of mid-fetal human brain and also identified novel non-CG methylation signatures of brain development.
Carmen Niurka Piña Loyola
Full Text Available Background: When we are born, thymus weighs about 10 or 13 g. This organ can develop as a result of the interaction among various factors that have been classified as physiological and pathological. Some studies to establish morphological patterns of this organ have reported dissimilar results. Objective: To determine morphometric parameters of thymus and it relation with fetus weight in Cienfuegos province between the years 2003-2008. Methods: A correlational, descriptive, observational study was carried out in the period between May, 2003 and May 2008. We took a sample of thymus of 147 cases of fetal death, out of a total of 151 cases, from the 17th gestational week to the end of the gestation period. Besides, we carried out measurements of this organ such as weight, height, width, thickness and volume whose variability was analyzed in relation with fetal weight. Results: There was correspondence between the gestational age and fetal weight. The morphometric parameter of thymus augmented in relation with fetal weight, being significant for fetal weights over 1500 g, where the morphologic variables of thymus reached values two fold those of the previous range. Conclusions: The more the fetus stays in the uterus the greater is its morphological and organic development, which is related with the inherent characteristics of intrauterine development for fetal period.
Emily F. Winterbottom
Full Text Available Although considerable evidence suggests that in utero arsenic exposure affects children's health, these data are mainly from areas of the world where groundwater arsenic levels far exceed the World Health Organization limit of 10 μg/L. We, and others, have found that more common levels of in utero arsenic exposure may also impact children's health. However, the underlying molecular mechanisms are poorly understood. To address this issue, we analyzed the expression of key developmental genes in fetal placenta in a birth cohort of women using unregulated water supplies in a US region with elevated groundwater arsenic. We identified several genes whose expression associated with maternal arsenic exposure in a fetal sex-specific manner. In particular, expression of the HEDGEHOG pathway component, GLI3, in female placentae was both negatively associated with arsenic exposure and positively associated with infant birth weight. This suggests that modulation of GLI3 in the fetal placenta, and perhaps in other fetal tissues, contributes to arsenic's detrimental effects on fetal growth. We showed previously that arsenic-exposed NIH3T3 cells have reduced GLI3 repressor protein. Together, these studies identify GLI3 as a key signaling node that is affected by arsenic, mediating a subset of its effects on developmental signaling and fetal health.
Romero Gutiérrez, G; Sánchez Cortés, R; Soto Pompa, V; Rodríguez Flores, P
In a prospective study carried out in the Hospital de Gineco-Obstetricia, Centro Médico León, Instituto Mexicano del Seguro Social, 200 women with pregnancies 32-41 weeks, without risk factors, were included in order to evaluate the perinatal outcome in patients with decreased fetal movement. The sample was divided in two groups: 100 patients with decreased fetal movement (study group) and 100 patients with normal fetal movement (control group). The group of patients with decreased fetal movement had higher incidence of complications during delivery (only 35% had normal delivery), greater average of birth weight (3,412 g), more cases of meconium stained fluid (26%) and higher frequency of placental calcifications (29%) as compared with the control group (P < 0.01). In comparing newborn Apgar score and perinatal morbidity and mortality rates there were no statistical difference in both groups. It's concluded that antepartum fetal surveillance has a definite role in diminishing the morbidity and mortality rates in patients with decreased fetal movement.
Full Text Available Sonography, Maternal Serum Screening, amniocentesis, and sampling are among the techniques utilized to examine a developing fetus and diagnose fetal abnormalities in the uterus. Despite the fact that Sonography is the main technique used for imaging and monitoring, the use of Magnetic Resonance Imaging (MRI to evaluate the fetus is growing. Moreover, MRI is used for further examinations in case of abnormalities diagnosed in the ultrasound scan. MRI, in comparison with other imaging techniques, provides the advantage of fetal brain study with higher precision and quality. The first step to study the fetal brain is its extraction from the MRI of the fetal brain. Since the maternal tissue is also present in the MRI of the fetal brain tissue, and due to the differences in the adult and fetus signals of brain tissue, it is not possible to use the adult brain extraction techniques for fetus. Given that semi-automatic segmentation is a time-consuming and tedious task, the need for automatic segmentation is highlighted. This is while the development of the stages of automatic segmentation of brain structures is still a challenge to overcome. In the present paper, we review the techniques for automatic segmentation or brain extraction of fetal MRI.
Miyazaki, Osamu; Horiuchi, Tetsuya [National Center for Child Health and Development, Department of Radiology, Seatagaya-ku, Tokyo (Japan); Nishimura, Gen [Tokyo Metropolitan Children' s Medical Center, Department of Pediatric Imaging, Fuchu-shi, Tokyo (Japan); Sago, Haruhiko; Hayashi, Satoshi [National Center for Child Health and Development, Department of Perinatal Medicine and Maternal Care, Seatagaya-ku, Tokyo (Japan); Kosaki, Rika [National Center for Child Health and Development, Department of Strategic Medicine, Division of Clinical Genetics and Molecular Medicine, Seatagaya-ku, Tokyo (Japan)
Clinical use of 3D CT for fetal skeletal malformations is controversial. The purpose of this study was to evaluate the efficacy of fetal 3D CT using three protocols with different radiation doses and through comparing findings between fetal CT and conventional postnatal radiographic skeletal survey. Seventeen fetuses underwent CT for suspected skeletal dysplasia. A relay of three CT protocols with stepwise dose-reduction were used over the study period. The concordance between the CT diagnosis and the final diagnosis was assessed. Ninety-three radiological findings identifiable on radiographs were compared with CT. Fetal CT provided the correct diagnosis in all 17 fetuses, the detectability rate of cardinal findings was 93.5 %. In 59 % of the fetuses an US-based diagnosis was changed prenatally due to CT findings. The estimated fetal radiation dose in the final protocol was 3.4 mSv (50 %) of the initial protocol, and this dose reduction did not result in degraded image quality. The capability of fetal CT to delineate the skeleton was almost the same as that of postnatal skeletal survey. The perinatal management was altered due to these more specific CT findings, which aided in counseling and in the management of the pregnancy. (orig.)
OBJECTIVE: To examine the obstetric and perinatal outcomes of women presenting with reduced fetal movement (RFM) during the third trimester, specifically in relation to the diagnostic capacity of non-stress cardiotocography (CTG) used as the primary investigation in this clinical scenario. STUDY DESIGN: This was a retrospective population-based cohort study of pregnancy outcomes of all women ≥28 weeks\\' gestation with singleton pregnancies presenting during one calendar year with maternal perception of RFM, all of whom underwent CTG at presentation. Main outcome measures included: obstetric intervention (induction of labour, spontaneous vaginal delivery, operative vaginal delivery, emergency caesarean section), and perinatal outcome (subsequent perinatal death, low Apgar scores (<7(5)), neonatal resuscitation and NICU admission). RESULTS: In all, 524 women presented with RFM and a live fetus, representing 7% of the antenatal obstetric population; 284 women (54%) were nulliparous. The reassuring CTG group comprised 482 (92%) women in whom initial CTG was reassuring and 15 (3%) where a repeat tracing within 1h was reassuring. The non-reassuring\\/abnormal CTG group (n=27, 5%) either underwent emergency delivery or comprehensive serial fetal assessment; this group had significantly higher rates of emergency caesarean delivery, neonatal resuscitation and NICU admission; the incidence of small-for-gestational-age infants did not differ significantly. No perinatal death occurred in either group following CTG. CONCLUSION: Normal non-stress CTG is a reliable screening indicator of fetal wellbeing in women presenting with perception of RFM in the third trimester; abnormal pregnancy outcomes were more common when initial CTG was abnormal or persistently non-reassuring.
Leury, B J; Chandler, K D; Bird, A R; Bell, A W
Fetal glucose kinetics were measured using a combination of isotope-dilution and Fick-principle methodology in single-pregnant ewes which were either well-fed throughout, or fed at 0.3-0.4 predicted energy requirement for 7-21 d during late pregnancy. All ewes were studied while standing at rest and then while walking on a treadmill at 0.7 m/s on a 10 degree slope for 60 min. Underfed ewes suffered major decreases in fetal total disposal rate, fetal-placental transfer and umbilical net uptake of glucose, each of which were significantly related to declines in maternal and fetal blood glucose concentrations respectively. In well-fed ewes, fetal endogenous glucose production was negligible, as indicated by the similarity between fetal utilization rate (total glucose disposal rate minus placental uptake of fetal glucose) and umbilical net uptake of glucose, and by nearly identical fetal and maternal arterial blood specific radioactivities of maternally infused D-[2-3H]glucose. By contrast, in underfed ewes, fetal utilization rate greatly exceeded umbilical net uptake of glucose, and the fetal:maternal [3H]glucose specific activity ratio declined significantly, suggesting induction of a substantial rate of fetal endogenous glucogenesis. Exercise caused increases in fetal total glucose disposal rate and glycaemia in fed and underfed ewes. In underfed ewes only, this was accompanied by increased placental uptake of fetal glucose and umbilical net glucose uptake, unchanged fetal glucose utilization and decreased fetal endogenous glucose production. It is concluded that fetal gluconeogenesis makes a major contribution to fetal glucose requirements in undernourished ewes. Increased maternal supply of fetal glucose during exercise substitutes for rather than adds to fetal endogenous glucogenesis.
Veyrac, C; Couture, A; Saguintaah, M; Baud, C
We describe the magnetic resonance (MR) patterns of a variety of fetal gastrointestinal (GI) abnormalities. Thirty-two fetuses between 23 and 38 weeks' gestation with abnormal appearance of the GI tract by ultrasound underwent MR imaging with T1- and T2-weighted sequences. The MR aspect of intestinal atresia (duodenal atresia, one case; small bowel atresia, nine cases) included dilatation of the bowel loops, accurate assessment of the normal bowel distal to the atresia (except in the patient with multiple atresia and apple-peel syndrome), and micro-rectum with decreased T1 signal (except in the patient with duodenal atresia). Megacystis-microcolon-intestinal hypoperistalsis syndrome (one case) was indicated by an abnormal signal of the entire bowel and an abnormal pattern for the urinary tract. Meconium pseudocysts (two cases) were easily differentiated from enteric cysts (two cases). High anorectal malformations with (two cases) or without (one case) urinary fistula and cloacal malformation (one case) are described and MR findings are discussed. The capability of MR imaging to demonstrate the normal bowel with intraperitoneal anomalies (e.g., congenital diaphragmatic hernia, and sacrococcygeal teratoma) is emphasized. MR imaging is informative in the diagnosis of GI tract abnormalities, especially the severe malformations, with much more accuracy than sonography.
Full Text Available Sirenomelia also known as mermaid syndrome, characterized by fused lower limbs, is a lethal and rare congenital abnormality. This is an extreme example of caudal regression syndrome caused by vascular steal of single umbilical artery. Sirenomelia is found approximately one in 100,000 live births and is usually fatal because of complications associated with pulmonary hypoplasia, abnormal development of the kidneys and urinary bladder. Most of the cases are associated with maternal diabetes and single umbilical artery. We report a case of sirenomelia terminated at 21weeks of gestation due to multiple congenital abnormalities. Antenatal scan of a25-year old primi revealed a single live fetus of 21 weeks gestation with severe olighydramnios, non-visualization of kidneys and bladder and lower part of the spine. This pregnancy was terminated and the specimen sent to the department of anatomy for fetal autopsy. On external examination,a tail like rudimentary single midline lower limb without foot was noted. There were no external genitalia and anal orifice. Internal examination revealed hypoplastic lungs, atrial septal and ventricular septal defects, aberrant right subclavian artery, hypoplastic abdominal aorta distal to the single umbilical artery, complete agenesis of urinary system, rectal agenesis and rudimentary indeterminate gonads. We would like to discuss the clinical features, etio- pathogenesis and review of literature of sirenomelia. Early diagnosis and termination of this lethal congenital anomaly results in minimizing the trauma related to the termination of pregnancy at advanced gestation.
Calvo-Garcia, Maria A.; Kline-Fath, Beth M.; Patel, Manish N.; Kraus, Steven [Cincinnati Children' s Hospital Medical Center, Department of Radiology, MLC 5031, Cincinnati, OH (United States); Levitt, Marc A.; Pena, Alberto [Cincinnati Children' s Hospital Medical Center, Colorectal Center for Children, Pediatric Surgery, Cincinnati, OH (United States); Lim, Foong-Yen; Crombleholme, Timothy M. [Cincinnati Children' s Hospital Medical Center, Fetal Care Center of Cincinnati, Pediatric Surgery, Cincinnati, OH (United States); Linam, Leann E. [Arkansas Children' s Hospital, Department of Radiology, Little Rock, AR (United States)
Prenatal US detection of cloacal malformations is challenging and rarely confirms this diagnosis. To define the prenatal MRI findings in cloacal malformations. We performed a retrospective study of patients with cloacal malformations who had pre- and post-natal assessment at our institution. Fetal MRI was obtained in six singleton pregnancies between 26 and 32 weeks of gestation. Imaging analysis was focused on the distal bowel, the urinary system and the genital tract and compared with postnatal clinical, radiological and surgical diagnoses. The distal bowel was dilated and did not extend below the bladder in five fetuses. They had a long common cloacal channel (3.5-6 cm) and a rectum located over the bladder base. Only one fetus with a posterior cloacal variant had a normal rectum. Three fetuses had increased T2 signal in the bowel and two increased T1/decreased T2 signal bladder content. All had renal anomalies, four had abnormal bladders and two had hydrocolpos. Assessment of the anorectal signal and pelvic anatomy during the third trimester helps to detect cloacal malformations in the fetus. The specificity for this diagnosis was highly increased when bowel fluid or bladder meconium content was identified. (orig.)
Breysem, Luc; Mussen, E.; Demaerel, P.; Smet, M. [Department of Radiology, University Hospitals, Herestraat 49, 3000, Leuven (Belgium); Cossey, V. [Department of Pediatrics, University Hospitals, Leuven (Belgium); Voorde, W. van de [Department of Forensic Medicine, University Hospitals, Leuven (Belgium)
The purpose of this paper is to describe brain pathology in neonates after major traffic trauma in utero during the third trimester. Our patient cohort consisted of four neonates born by emergency cesarean section after car accident in the third trimester of pregnancy. The median gestational age (n=4) was 36 weeks (range: 30-38). Immediate post-natal and follow-up brain imaging consisted of cranial ultrasound (n=4), computed tomography (CT) (n=1) and post-mortem magnetic resonance imaging (MRI) (n=1). Pathology findings were correlated with the imaging findings (n=3). Cranial ultrasound demonstrated a huge subarachnoidal hemorrhage (n=1), subdural hematoma (n=1), brain edema with inversion of the diastolic flow (n=1) and severe ischemic changes (n=1). In one case, CT demonstrated the presence and extension of the subarachnoidal hemorrhage, a parietal fracture and a limited intraventricular hemorrhage. Cerebellar hemorrhage and a small cerebral frontal contusion were seen on post-mortem MRI in a child with a major subarachnoidal hemorrhage on ultrasound. None of these four children survived (three children died within 2 days and one child died after 1 month). Blunt abdominal trauma during pregnancy can cause fetal cranial injury. In our cases, skull fracture, intracranial hemorrhage and hypoxic-ischemic encephalopathy were encountered. (orig.)
K. Helen Prabha
Full Text Available Fetal Electrocardiogram Extraction (FECG identifies the congenital heart problems at the earlier stage. The major problem in the non invasive procedure is the extraction of FECG from Maternal ECG (MECG and many interferences. The proposed methods (i Combination of Adaptive Neuro Fuzzy Inference (ANFIS and Fractional spline wavelet (ii Combination of Fractional spline wavelet and ANFIS (iii Combination of ANFIS and SURE-LET and (iv Combination of SURE-LET and ANFIS remove the unwanted noises present in the FECG more effectively. This new approach extracts FECG by removing the noisy Abdominal ECG (AECG and subsequently cancels the MECG. The pure thoracic ECG (TECG or maternal ECG was used to remove noisy MECG present in the signal from abdomen signal and thereby the required noiseless FECG is extracted by means of the new approach. The excellence of the LET techniques are evaluated using Mean Square Error (MSE and Peak Signal to Noise Ratio (PSNR. The result of combination of ANFIS and SURELET gives the best result and the closest match to the simulated FECG with high PSNR and low MSE among all the proposed methods.
Polycystic ovary syndrome （PCOS） is a common endocrinedisorder that affects up to 6.8% of reproductive agewomen. Experimental research and clinical observationssuggest that PCOS may originate in the very early stagesof development, possibly even during intrauterine life.This suggests that PCOS is either genetically-transmittedor is due to epigenetic alterations that develop in theintrauterine microenvironment. Although familial casessupport the role of genetic factors, no specific geneticpattern has been defined in PCOS. Several candidategenes have been implicated in its pathogenesis, butnone can specifically be implicated in PCOS development.Hypotheses based on the impact of the intrauterineenvironment on PCOS development can be groupedinto two categories. The first is the ＂thrifty＂ phenotypehypothesis, which states that intrauterine nutritionalrestriction in fetuses causes decreased insulin secretionand, as a compensatory mechanism, insulin resistance.Additionally, an impaired nutritional environment canaffect the methylation of some specific genes, which canalso trigger PCOS. The second hypothesis postulates thatfetal exposure to excess androgen can induce changesin differentiating tissues, causing the PCOS phenotype todevelop in adult life. This review aimed to examine therole of fetal programming in development of PCOS.
Gluckman, Peter D; Hanson, Mark A; Beedle, Alan S; Raubenheimer, David
Evolutionary and developmental perspectives add considerably to our understanding of the aetiology of obesity and its related disorders. One pathway to obesity represents the maladaptive consequences of an evolutionarily preserved mechanism by which the developing mammal monitors nutritional cues from its mother and adjusts its developmental trajectory accordingly. Prediction of a nutritionally sparse environment leads to a phenotype that promotes metabolic parsimony by favouring fat deposition, insulin resistance, sarcopenia and low energy expenditure. But this adaptive mechanism evolved to accommodate gradual changes in nutritional environment; rapid transition to a situation of high energy density results in a mismatch between predicted and actual environments and increased susceptibility to metabolic disease. This pathway may also explain why breast and bottle feeding confer different risks of obesity. We discuss how early environmental signals act through epigenetic mechanisms to alter metabolic partitioning, glucocorticoid action and neuroendocrine control of appetite. A second pathway involves alterations in fetal insulin levels, as seen in gestational diabetes, leading to increased prenatal fat mass which is subsequently amplified by postnatal factors. Both classes of pathway may coexist in an individual. This developmental approach to obesity suggests that potential interventions will vary according to the target population.
Liu, Fang; Liu, Yong; Lai, Ya-Ping; Gu, Xiao-Ning; Liu, Dong-Mei; Yang, Min
Background: The offspring of women with gestational diabetes mellitus (GDM) are prone to macrosomia. However, birth weight is difficult to be correctly estimated by ultrasound because of fetal asymmetric growth characteristics. This study aimed to investigate the correlations between fetal hemodynamics, fetal growth indices in late pregnancy, and birth weight in GDM. Methods: A total of 147 women with GDM and 124 normal controls (NC) were enrolled in this study. Fetal hemodynamic indices, including the systolic/diastolic ratio (S/D), resistance index (RI), pulsatility index (PI) of umbilical artery (UA), middle cerebral artery (MCA), and renal artery (RA), were collected. Fetal growth indices, including biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length, were also measured by ultrasound. Birth weight, newborn gender, and maternal clinical data were collected. Results: The independent samples t-test showed that BPD, HC, and AC were larger in GDM than in NC (P 0.05). RA (S/D, PI, and RI) was positively correlated with birth weight in GDM (r = 0.168, 0.207, and 0.184, respectively, P 0.05). Conclusion: Fetal hemodynamic indices in late pregnancy might be helpful for estimating newborn birth weight in women with GDM. PMID:27569240
R Asadpour; MH Asadi; R JafariJoozani; GH Hamidian
Objective: To use PCR to investigate the presence of fetal SRY gene in the ovine cervical secretions and maternal blood plasma, and to assess predict fetal sex at different times of gestation in the ewe. Methods: Fetal DNA was isolated from blood plasma and cervical secretions of 32 pregnant ewes during the 6 to 21 week of gestation. Overall, 15 male and 17 female fetuses were included in this study. After DNA extraction, the PCR amplified a 280 bp fragment from the X-chromosome and a 217 bp fragment from the Y-chromosome based on a sex-related polymorphism in the amelogenin locus. Results:The presence of fetal Y-chromosome was confirmed in 11 out of 15 cervical mucus and 12 out of 15 blood plasma samples collected from sheep with male fetuses. The sensitivity and specificity of tests were 70%with false negative results. Conclusion:This is the first report on validating the presence of fetal DNA material in the ovine cervical mucus and its potential usefulness for fetal sexing.
Childs, Caroline E; Romijn, Tessa; Enke, Uta; Hoile, Samuel; Calder, Philip C
Both animal and human studies demonstrate that the docosahexaenoic acid (DHA) content of plasma and/or tissue lipids is increased during pregnancy. We hypothesised that increasing the α-linolenic acid (ALA) or longer chain (n-3) PUFA content of the maternal diet during pregnancy influences fetal fatty acid composition and the fetal immune system. Pregnant rats were fed a low-fat (LF) soybean oil diet, or high-fat (HF) soybean, linseed, salmon or sunflower oil diets from conception to 20d gestation. The ALA-rich Linseed-HF diet resulted in an equivalent eicosapentaenoic acid (EPA) status in fetal immune tissues and an equivalent DHA status in the fetal brain to that achieved with the Salmon-HF diet. An (n-3) rich maternal diet during pregnancy associated with the highest expression of CD3 (Salmon-HF) and CD8 (Linseed-HF and Salmon-HF) on fetal thymic CD3(+)CD8(+) cells. The Linseed-HF diet resulted in the highest proportion of CD161(+) cells within the fetal thymus, which correlated with the production of IL-4. These data indicate that dietary ALA supplementation may confer some of the benefits of LC (n-3) PUFA during pregnancy. This should be examined in suitably designed human studies.
Gallego Latorre, Maria Irene
En este proyecto se ha estudiado la posibilidad de extraer boro en forma de ácido bórico mediante extractantes neutros. En primer lugar se han realizado los experimentos de extracción líquido-líquido y después se han realizado pruebas de extracción mediante membranas planas soportadas. Las pruebas de extracción líquido-líquido han permitido estudiar el comportamiento del boro ante diferentes extractantes neutros (2,2,4-Trimethyl-1,3-pentanodiol , 2- Butyl-2-ethyl-1,3-p...
Nuestro trabajo está basado en la posibilidad de controlar el desarrollo asimétrico de los cartílagos de crecimiento vertebral, mediante la realización de una fisiodesis hemivertebral, con electrocoagulación, videoasistida por toracoscópica. Se realizará en cinco niveles torácicos, con un abordaje anterior mínimamente invasivo. Por lo tanto, planteamos como hipótesis de trabajo que La destrucción de las fisis de crecimiento vertebral mediante electrocoagulación, videoasistida por vía toracosc...
En líneas generales, el propósito de este proyecto, es realizar el control de la maqueta de un péndulo invertido del departamento de ESAII. Esta maqueta está compuesta por una estructura de aluminio, sobre la cual un carro se desliza sobre una superficie plana enganchado a un motor mediante una correa. En este motor se encuentra un encoder óptico, en el extremo de su eje mediante un acoplamiento. En el carro se encuentra el péndulo, el cual es doble, es decir el péndulo cuelga por delante...
Este proyecto final de carrera se centra en el control PID de temperatura de un secador convencional mediante autómatas programables conectados por Ethernet. Se busca con ello la configuración de un red de comunicaciones entre dos PLC’s industriales (Programmable Logic Controller en sus siglas en inglés) y el control de temperatura mediante un controlador PID. Los controladores lógicos programables o PLC’s son dispositivos electrónicos muy usados en automatización industrial...
Orduña Serra, Modesto; Fernández Sabaté, Alfons; Amorós, P.
Se expone la experiencia en ocho lesiones óseas tumorales y paratumorales benignas tratadas mediante legrado de la cavidad y posterior relleno mediante metilmetacrilato con contraste baritado. El seguimiento de los casos entre año y medio y once años permite que nos afirmemos en la bondad de los resultados en cuanto a función articular resistencia de la extremidad y control del tumor. Comentamos las estadísticas publicadas en las que destacan los casos de tumor de células gigantes (66 por 100...
Valenzuela Tallón, Pedro Luis
El presente trabajo pretende introducir un tema de gran controversia: el daño muscular inducido mediante ejercicio (DMIE). Se ha realizado una revisión bibliográfica de la literatura científica referente al DMIE para exponer la teoría más actual en cuanto al mecanismo que lo provoca y los cambios biológicos y funcionales producidos tras éste. El DMIE comienza como un proceso mecánico mediante el cual se dañan las estructuras de las fibras musculares, lo cual da lugar a un proceso inflamatorio...
With the latest advent of four-dimensional (4-D) ultrasound, fetal neurobehavioral or neurodevelopmental assessment can be easily and readily performed. Using this technique, typical fetal movements and behavioral patterns have become apparent in all three trimesters of pregnancy. In twin pregnancy, 4-D ultrasound facilitates the precise evaluation of inter-twin contact and intra-pair stimulation. New fetal neurobehavioral assessment tests, such as Kurjak's Antenatal Neurodevelopmental Test and the Fetal Observable Movement System, may reflect the normal and abnormal neurological development of the fetus, and will facilitate more precise assessments of fetal neurobehavior or neurodevelopment, and fetal brain and central nervous system functions. In this review article, I also discuss interesting topics regarding maternal and fetal stress, fetal pain, and fetal consciousness. Four-dimensional ultrasound has opened the door to new scientific fields, such as 'fetal neurology' and 'fetal psychology,' and fetal neurobehavioral science is at the dawn of a new era. Knowledge on fetal neurobehavior and neurodevelopment will be advanced through fetal behavioral research using this technique.
Messerschmidt, Agnes; Sauer, Alexandra; Pollak, Arnold [Medical University of Vienna, Department of Pediatrics and Adolescent Medicine, Vienna (Austria); Pataraia, Anna; Kasprian, Gregor; Weber, Michael; Prayer, Daniela [Medical University of Vienna, Department of Radiology, Vienna (Austria); Helmer, Hanns [Medical University of Vienna, Department of Obstetrics and Maternal-Fetal Medicine, Vienna (Austria); Brugger, Peter C. [Medical University of Vienna, Center of Anatomy and Cell Biology, Vienna (Austria)
Lung MRI volumetrics may be valuable for fetal assessment following early preterm premature rupture of the foetal membranes (pPROM). To evaluate the predictive value of MRI lung volumetrics after pPROM. Retrospective cohort study of 40 fetuses after pPROM in a large, tertiary, perinatal referral center. Fetuses underwent MRI lung volumetrics. Estimated lung volume was expressed as percentage of expected lung volume (our own normal references). Primary outcome was neonatal mortality due to respiratory distress before discharge from hospital. Gestational age range was 16-27 weeks. Estimated-to-expected lung volume was 73% in non-survivors and 102% in survivors (P < 0.05). There were no survivors with a lung volume less than 60% of expected. By logistic regression, mortality could be predicted with a sensitivity of 80%, specificity of 86% and accuracy of 85%. Fetal MR lung volumetrics may be useful for predicting mortality due to respiratory distress in children with early gestational pPROM. (orig.)
Yeom, Wonkyung; Paik, E Sun; An, Jung-Joo; Oh, Soo-young; Roh, Cheong-Rae; Kim, Jong-Hwa
Objective To investigate the clinical characteristics of fetal hydrops and to find the antenatal ultrasound findings predictive of adverse perinatal outcome. Methods This is a retrospective study of 42 women with fetal hydrops who delivered in a tertiary-referral center from 2005 to 2013. Fetal hydrops was defined as the presence of fluid collection in ≥2 body cavities: ascites, pleural effusion, pericardial effusion, and skin edema. Predictor variables recorded included: maternal characteristics, gestational age at diagnosis, ultrasound findings, and identifiable causes. Primary outcome variables analyzed were fetal death and neonatal death. Results The mean gestational age at diagnosis was 29.3±5.4 weeks (range, 18 to 39 weeks). The most common identifiable causes were cardiac abnormality (10), followed by syndrome (4), aneuploidy (3), congenital infection (3), twin-to-twin transfusion syndrome (3), non-cardiac anormaly (2), chorioangioma (2), inborn errors of metabolism (1), and immune hydrops by anti-E antibody isoimmunization (1). Thirteen cases had no definite identifiable causes. Three women elected termination of pregnancy. Fetal death occurred in 4 cases. Among the 35 live-born babies, only 16 survived (54.0% neonatal mortality rate). Fetal death and neonatal mortality rate was not significantly associated with Doppler velocimetry indices or location of fluid collection, but increasing numbers of fluid collection site was significantly associated with a higher risk of neonatal death. Conclusion The incidence of fetal hydrops in our retrospective study was 24.4 per 10,000 deliveries and the perinatal mortality rate was 61.9% (26/42). The number of fluid collection sites was the significant antenatal risk factor to predict neonatal death. PMID:25798421
Chung, Woong Ki; Nam, Taek Keun; Lee, Min Cheol; Ahn, Sung Ja; Song, Ju Young; Park, Seung Jin; Nah, Byung Sik [College of Medicine, Chonnam National Univ., Gwangju (Korea, Republic of)
The study was performed to investigate apoptosis by radiation in the developing fetal rat brain. Fetal brains were irradiated in utero between the 17th and 19th days of fetal life(E17-19) by linear accelerator. A dose of irradiation ranging from 1 Gy to 4 Gy was used to evaluate dose dependency. To test time dependency the rats were irradiated with 2 Gy and then the fetal brain specimens were removed at variable time course; 1, 3, 6, 12 and 24 hours after the onset of irradiation. Immunohistochemical staining using in situ TdT-mediated dUTP nick end labelling (TUNEL) technique was used for apoptotic cells. The cerebral cortex, including three zones of cortical zone (CZ), intermediate zone (IZ), and ventricular zone (VZ), was examined. TUNEL positive cells revealed typical features of apoptotic cells under light microscope in the fetal rat cerebral cortex. Apoptotic cells were not found in the cerebral cortex of non-irradiated fetal rats, but did appear in the entire cerebral cortex after 1 Gy irradiation, and were more extensive at the ventricular and intermediate zones than at the cortical zone. The extent of apoptosis was increased with increasing doses of radiation. Apoptosis reached the peak at 6 hours after the onset of 2 Gy irradiation and persisted until 24 hours. Typical morphologic features of apoptosis by irradiation were observed in the developing fetal rat cerebral cortex. It was more extensive at the ventricular and intermediate zones than at the cortical zone, which suggested that stem cells or early differentiating cells are more radiosensitive than differentiated cells of the cortical zone.
Full Text Available One of the major factors affecting nephrogenesis in utero is intrauterine growth restriction (IUGR. Few studies showed reduced weight of the fetal kidney in IUGR fetuses as compared to normally grown fetuses. Reduced blood flow to the kidneys due to fetal hypoxemia in IUGR f o etus leads to increased pulsatility index which is likely to be responsible for impaired nephrogenesis and decreased kidney volume. AIMS AND OBJECTIVE : To estimate if fetal renal artery Doppler could affect fetal renal volume in healthy and growth restricted fetuses after 26 weeks of gestation. STUDY DESIGN AND SETTING : Cross sectional study carried out in the De partment radio diagnosis, Lata M angeshkar hospital, Nagpur, Maharashtra, India. MATERIAL AND METHOD S : Total 336 patients, which consisted of 309 norma lly grown fetuses and 27 intrauterine growth restricted fetuses were included in the study. Fetal renal volume of individual kidney, combined renal volume and relative renal volumes were calculated using 2 dimensional ultrasound for normal and IUGR fetuses . Fetal renal artery parameters particularly renal arterial pulsatility index were calculated for both the groups. Correlation of fetal renal Doppler parameters with renal volume was estimated for respective groups. RESULTS: Combined kidney volume was sign ificantly reduced in growth restricted fetuses than normal fetuses i.e. mean combined kidney volume for growth restricted fetuses was 12.6cc and for normal fetuses was 19.29cc. Most of the fetal biometric indices were positively correlated with the combine d kidney volume. Increased pulsatility index was seen in growth restricted fetuses i.e. on right side 1.37+/ - 0.35 and on left 1.40+/ - 0.35 i.e. >1 while for normal fetuses was 0.88 +/ - 0.08 on either side i.e. <1. Considerable negative correlation was found between fetal renal artery pulsatility index and renal volume. CONCLUSION: Increased fetal renal artery pulsatility index in intrauterine growth
Abramowicz, Jacques S; Barnett, Stanley B; Duck, Francis A; Edmonds, Peter D; Hynynen, Kullervo H; Ziskin, Marvin C
Processes that can produce a biological effect with some degree of heating (ie, about 1 degrees C above the physiologic temperature) act via a thermal mechanism. Investigations with laboratory animals have documented that pulsed ultrasound can produce elevations of temperature and damage in biological tissues in vivo, particularly in the presence of bone (intracranial temperature elevation). Acoustic outputs used to induce these adverse bioeffects are within the diagnostic range, although exposure times are usually considerably longer than in clinical practice. Conditions present in early pregnancy, such as lack of perfusion, may favor bioeffects. Thermally induced teratogenesis has been shown in many animal studies, as well as several controlled human studies; however, human studies have not shown a causal relationship between diagnostic ultrasound exposure during pregnancy and adverse biological effects to the fetus. All human epidemiologic studies, however, were conducted with commercially available devices predating 1992, that is, with acoustic outputs not exceeding a spatial-peak temporal-average intensity of 94 mW/cm2. Current limits in the United States allow a spatial-peak temporal-average intensity of 720 mW/cm2 for fetal applications. The synergistic effect of a raised body temperature (febrile status) and ultrasound insonation has not been examined in depth. Available evidence, experimental or epidemiologic, is insufficient to conclude that there is a causal relationship between obstetric diagnostic ultrasound exposure and obvious adverse thermal effects to the fetus. However, very subtle effects cannot be ruled out and indicate a need for further research, although research in humans may be extremely difficult to realize.
Ösz Bianca Eugenia
Full Text Available The prenatal exposure to selective serotonin reuptake inhibitors (SSRIs is very controversial. There is no conclusive evidence for increased risk of malformations after SSRI use in pregnancy. The aim of the study was to determine how fluoxetine is affecting gestation and fetal development in rats. Twenty sexually mature female Wistar rats weighting between 250-260 g received 20 mg/kg body weight fluoxetine from the first day of gestation and during the entire gestation period.The drug was administered by oral route. Healthy, primipareus animals were selected along with 20 female Wistar rats, as control group. Mature males were caged with virgin females for an entire week. Rat’s behaviour during gestation, after birth and rats body weight was examined. The number of healthy pups was also noted. The females not giving birth after 21 days to any pup were anesthetized (halothane through gas scavenging apparatus untilled death and the gravid uterus were dissected out and examined. Compared to the controlled group, in which weight gain was more significant, the animals from the experimental group had a slight increase in body weight. The weight gain normally induced by gestation, is less significant in fluoxetine treated rats due to the increase serotonin levels in the brain. The uteri examination of pregnant rats showed an increase in the number of dead and resorbed rat embryos. Preclinical studies suggest that the inclusion of fluoxetine in pregnancy category C is justified and the appropriateness of its administration in pregnancy is still an unresolved issue.
ESTIMATIVA DA DATA DO PARTO EM CADELAS ROTTWEILER ATRAVÉS DA BIOMETRIA FETAL REALIZADA POR ULTRASSONOGRAFIA ESTIMATION OF PARTURITION DATE THROUGH ULTRASONOGRAPHIC FOETAL BIOMETRY IN ROTTWEILER BITCHES ESTIMACIÓN DE LA FECHA DEL PARTO EN PERRAS ROTTWEILER A TRAVÉS DE LA BIOMETRÍA FETAL REALIZADA POR EL ULTRASONIDO
Karina Costa Moreira de Melo
Full Text Available Utilizou-se a ultrassonografia neste experimento para avaliar o desenvolvimento fetal e determinar a idade gestacional em cadelas Rottweiler. Tomaram-se e avaliaram-se as medidas da vesícula embrionária/fetal (VE e do corpo fetal mediante análise de regressão, estabelecendo-se as equações de regressão linear e seus coeficientes. Os diâmetros biparietal (DBP e do abdome (DA dos fetos foram os que apresentaram os melhores resultados, considerando-se os coeficientes de correlação (0,89 e 0,90, respectivamente com a idade fetal e a facilidade de mensuração ao longo da gestação. Com base nos dados obtidos, conclui-se que é possível estimar o momento do parto em cadelas Rottweiler a partir das mensurações e equações obtidas para essa raça.
PALAVRAS-CHAVES: Cão, feto, gestação, ultrassom.
Ultrasonography was used in this study with the aim to evaluate fetal development, and to determine the gestational age of Rottweiler bitches. Measurements of embryonic vesicle (VE and fetal body were taken and evaluated by regression analysis. The linear regression equations and coefficients between gestational age and measures were established. The measures of abdominal (DA and biparietal (DBP diameters presented the best results, concerning to correlation coefficients (0.89 and 0.90, respectively and facilities on mensuration takes. It was concluded that it is feasible to predict gestational age of Rottweiler bitches taken into consideration fetal measurements and equations obtained for this breed.
KEY WORDS: Dog, fetus, gestation, ultra-sound.
El ultrasonido fue utilizado en esta investigación con el objetivo de evaluar el desarrollo fetal y determinar la edad gestacional en perras Rottweiler. Las medidas de la vesícula embrionária (VE y del cuerpo fetal fueran tomadas y evaluadas por an
Fowden, Abigail L; Forhead, Alison J
Hormones are both growth stimulatory and growth inhibitory in utero. They act as environmental and maturational signals in regulating tissue accretion and differentiation during late gestation. They ensure that fetal development is appropriate for the nutrient supply and is optimal for neonatal survival. Growth-stimulatory hormones, such as insulin, the insulin-like growth factors and the thyroid hormones, have anabolic effects on fetal metabolism and increase cellular nutrient uptake and energy production for tissue accretion. Thyroid hormones also have specific effects on tissue differentiation at key developmental milestones. Similarly, leptin appears to affect development of specific fetal tissues and may counterbalance the maturational actions of other hormones near term. Glucocorticoids inhibit growth in utero but are essential for prepartum tissue differentiation in preparation for delivery. They also affect fetal bioavailability of most of the other growth-regulatory hormones. In addition, many of these hormones alter the placental capacity to supply nutrients for fetal growth. In producing a fetoplacental epigenome specific to the prevailing intrauterine environment, hormones interact to produce phenotypical diversity with potential health consequences long after birth.
Loughran, Allister J; Tuomanen, Elaine I
Bacterial or viral infection of the mother during the course of pregnancy can cross the placenta and actively infect the fetus. However, especially for bacteria, it is more common for mothers to experience an infection that can be treated without overt fetal infection. In this setting, it is less well understood what the risk to fetal development is, particularly in terms of neurological development. This research highlight reviews recent findings indicating that bacterial components generated during infection of the mother can cross the placenta and activate the fetal innate immune system resulting in changes in the course of brain development and subsequent progression to postnatal cognitive disorders. Bacterial cell wall is a ubiquitous bacterial PAMP (pathogen-associated molecular pattern) known to activate inflammation through the stimulation of TLR2. Cell wall is released from bacteria during antibiotic treatment and new work shows that embryos exposed to cell wall from the mother demonstrate anomalous proliferation of neuronal precursor cells in a TLR2 dependent manner. Such proliferation increases the neuronal density of the cortical plate and alters brain architecture. Although there is no fetal death, subsequent cognitive development is significantly impaired. This model system suggests that bacterial infection of the mother and its treatment can impact fetal brain development and requires greater understanding to potentially eliminate a risk factor for cognitive disorders such as autism.
Full Text Available Introduction - Encephalomalacia in a developing fetus is a rare and devastating neurological finding on radiologic imaging. Maternal diabetic ketoacidosis (DKA can lead to metabolic and vascular derangements which can cause fetal encephalomalacia. Case - We report the case of a 27-year-old pregnant woman with White's Class C diabetes mellitus who presented in the 25th week of gestation with DKA. Four weeks after her discharge, marked fetal cerebral ventriculomegaly was noted on ultrasound. A subsequent fetal magnetic resonance imaging (MRI demonstrated extensive, symmetric cystic encephalomalacia, primarily involving both cerebral hemispheres. The pregnancy was continued with close fetal and maternal surveillance. The patient underwent a repeat cesarean delivery in her 37th week. The infant had a 1 month neonatal intensive care unit stay with care rendered by a multiple disciplinary team of pediatric subspecialists. The postnatal course was complicated by global hypotonia, poor feeding, delayed development and ultimately required anticonvulsants for recurrent seizures. He died at the age of 9 months from aspiration during a seizure. Discussion - Although the maternal mortality from DKA has declined, DKA still confers significant neurological fetal morbidity to its survivors.
Sookoian, Silvia; Gianotti, Tomas Fernández; Burgueño, Adriana L; Pirola, Carlos J
A growing body of evidence supports the notion that epigenetic changes such as DNA methylation and histone modifications, both involving chromatin remodeling, contribute to fetal metabolic programming. We use a combination of gene-protein enrichment analysis resources along with functional annotations and protein interaction networks for an integrative approach to understanding the mechanisms underlying fetal metabolic programming. Systems biology approaches suggested that fetal adaptation to an impaired nutritional environment presumes profound changes in gene expression that involve regulation of tissue-specific patterns of methylated cytosine residues, modulation of the histone acetylation-deacetylation switch, cell differentiation, and stem cell pluripotency. The hypothalamus and the liver seem to be differently involved. In addition, new putative explanations have emerged about the question of whether in utero overnutrition modulates fetal metabolic programming in the same fashion as that of a maternal environment of undernutrition, suggesting that the mechanisms behind these two fetal nutritional imbalances are different. In conclusion, intrauterine growth restriction is most likely to be associated with the induction of persistent changes in tissue structure and functionality. Conversely, a maternal obesogenic environment is most probably associated with metabolic reprogramming of glucose and lipid metabolism, as well as future risk of metabolic syndrome (MS), fatty liver, and insulin (INS) resistance.
Serai, Suraj D.; Merrow, Arnold C.; Kline-Fath, Beth M. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, 3333 Burnett Ave., MLC 5031, Cincinnati, OH (United States)
Fetal MRI has an increasing list of indications and is most commonly employed when anomalies detected by prenatal ultrasonography require further characterization. This may occur when sonography is technically challenging or where specific MRI findings will determine pre- and postnatal management, including critical in utero and/or peripartum interventions. In these circumstances, there are high expectations for MRI to sort out complex diagnostic dilemmas through exquisite anatomical imaging that fetal surgeons and obstetricians can comprehend and relay to their patients. These expectations, in light of evolving clinical innovations, continue to drive advances in fetal imaging. Increasing signal-to-noise ratio (SNR) is fundamental to improving MR image quality, and proper coil selection is a key component of this pursuit. Since the introduction of parallel imaging techniques, the numbers of elements in phased-array coils have been continuously increased to achieve high SNR and shorter scan times. With the invention of a digital coil platform, it is now possible to connect combinations of multiple coil elements to enhance SNR beyond the capabilities of the adult eight-channel torso-coil routinely used in fetal imaging. This paper describes the application of multi-element radiofrequency coils on a digital broadband imaging platform with unique coil combinations to perform dedicated fetal MRI. (orig.)
Huang, Qi-tao; Hang, Li-lin; Zhong, Mei; Gao, Yun-fei; Luo, Man-ling; Yu, Yan-hong
Abstract Since the evidence regarding the association between maternal hepatitis C virus (HCV) infection and impaired intrauterine fetal growth had not been conclusive, the aim of the present study was to evaluate the risk of maternal HCV infection in association with intrauterine fetal growth restriction (IUGR) and/or low birth weight infants (LBW). We performed an extensive literature search of PubMed, MEDLINE, and EMBASE through December 1, 2015. The odds ratios (ORs) of HCV infection and IUGR/LBW were calculated and reported with 95% confidence intervals (95% CIs). Statistical analysis was performed using RevMen 5.3 and Stata 10.0. Seven studies involving 4,185,414 participants and 5094 HCV infection cases were included. Significant associations between HCV infection and IUGR (OR = 1.53, 95% CI: 1.40–1.68, fixed effect model) as well as LBW were observed (OR = 1.97, 95% CI: 1.43–2.71, random effect model). The results still indicated consistencies after adjusting for multiple risk factors which could affect fetal growth, including maternal age, parity, maternal smoking, alcohol abuse, drugs abuse, coinfected with HBV/HIV and preeclampsia. Our findings suggested that maternal HCV infection was significantly associated with an increased risk of impaired intrauterine fetal growth. In clinical practice, a closer monitoring of intrauterine fetal growth by a series of ultrasound might be necessary for HCV-infected pregnant population. PMID:27583932
Full Text Available Baicalin is a flavonoid compound purified from the medicinal plant Scutellaria baicalensis Georgi and has been reported to stimulate surfactant protein (SP-A gene expression in human lung epithelial cell lines (H441. The aims of this study were to determine whether maternal baicalin treatment could increase lung surfactant production and induce lung maturation in fetal rats. This study was performed with timed pregnant Sprague-Dawley rats. One-day baicalin group mothers were injected intraperitoneally with baicalin (5 mg/kg/day on Day 18 of gestation. Two-day baicalin group mothers were injected intraperitoneally with baicalin (5 mg/kg/day on Days 17 and 18 of gestation. Control group mothers were injected with vehicle alone on Day 18 of gestation. On Day 19 of gestation, fetuses were delivered by cesarean section. Maternal treatment with 2-day baicalin significantly increased saturated phospholipid when compared with control group and total phospholipid in fetal lung tissue when compared with control and 1-day baicalin groups. Antenatal treatment with 2-day baicalin significantly increased maternal growth hormone when compared with control group. Fetal lung SP-A mRNA expression and maternal serum corticosterone levels were comparable among the three experimental groups. Maternal baicalin treatment increases pulmonary surfactant phospholipids of fetal rat lungs and the improvement was associated with increased maternal serum growth hormone. These results suggest that antenatal baicalin treatment might accelerate fetal rat lung maturation.
Understanding the physiologic and endocrinologic basis of fetal development is a major goal of perinatal biology. During the past decade a number of technological developments have allowed more precise evaluation of the fetus in utero and diagnosis of abnormalities. Despite these methodological achievements, however, there are no specific biological markers currently available to indicate that exposure to a given xenobiotic is associated with a cellular, subcellular, or pharmacodynamic event. This paper evaluates the following issues: what are some of the unique physiologic and endocrinologic features of the fetal milieu interieur. What problems are peculiar to fetal assessment. What are some examples of validated biomarkers and their applicability. What promising biomarkers are on the horizon. How may molecular probes be of value as biological markers of fetal compromise. What are some of the major research gaps and needs, and how should research priorities be set. Some of these topics are addressed. Moreover, the more general role(s) that various diagnostic methods and biological markers can have in an understanding of the regulation of fetal growth and differentiation and the role of xenobiotics in affecting the normal course of events are discussed.
Peisker, Nina; Preissel, Anne-Kathrin; Ritzmann, Mathias; Schuster, Tibor; Thomes, Rainer; Henke, Julia
The fetal stress responses in sows euthanized by electrical current during their second and last trimester of pregnancy (G1 and G2) were evaluated. Three methods of euthanasia of pregnant sows generally applicable to cases of epizootic or emergency slaughter were investigated: 1. conventional application of electrical current to the head and heart (HH); 2. application of electrical current to the head, heart and the uterus (HHU); 3. application of electrical current to the head, heart and from the upper body to the vagina (HHV). Fetuses were delivered by cesarean section at intervals of 3 to 4 minutes and remained attached to the sow by the umbilical cord. Fetal vitality, reflexes, heart rate, blood pressure, rectal body temperature, intracardial arteriovenous pCO2, pH and lactic acid were monitored for a period of 30 minutes. No method was found to kill the fetal pigs immediately. In fetuses at G1 there were no significant differences between the HH and HHU and HHV methods. Fetuses at G2 showed a significantly faster decrease in heart rate and blood pressure as well as a shorter period of time for the absence of fetal body movements and reflexes for the HHT method, compared to the other methods. Since it is not yet known to what extent the fetal pig experiences pain and suffering, the prolonged process of dying for the in utero fetus due to hypoxia which includes struggling and gasps is inconsistent with criteria for humane euthanasia and animal welfare.
Andrew J. Lewis
Full Text Available Maternal mental disorders over pregnancy show a clear influence on child development. This review is focused on the possible mechanisms by which maternal mental disorders influence fetal development via programming effects. This field is complex since mental health symptoms during pregnancy vary in type, timing and severity and maternal psychological distress is often accompanied by higher rates of smoking, alcohol use, poor diet and lifestyle. Studies are now beginning to examine fetal programming mechanisms, originally identified within the DOHaD framework, to examine how maternal mental disorders impact fetal development. Such mechanisms include hormonal priming effects such as elevated maternal glucocorticoids, alteration of placental function and perfusion, and epigenetic mechanisms. To date, mostly high prevalence mental disorders such as depression and anxiety have been investigated, but few studies employ diagnostic measures, and there is very little research examining the impact of maternal mental disorders such as schizophrenia, bipolar disorder, eating disorders and personality disorders on fetal development. The next wave of longitudinal studies need to focus on specific hypotheses driven by plausible biological mechanisms for fetal programming and follow children for a sufficient period in order to examine the early manifestations of developmental vulnerability. Intervention studies can then be targeted to altering these mechanisms of intergenerational transmission once identified.
McDonald, T J; Li, C; Vincent, S E; Nijland, M J
Experiments in several species indicate that the hippocampus influences hypothalamo-pituitary-adrenal (HPA) axis function. In fetal sheep, simultaneous ACTH and cortisol rises over the last 30 days of gestation peak at term and are necessary for birth. We hypothesized that if the fetal hippocampal formation is functional in late gestation, loss of hippocampal input to the HPA axis following fetal fornix transection would change gestation length in comparison to controls. At 118-121 days of gestation (dG), stereotaxic technique was used in fetal sheep to sham transect (SHAM; n = 8) or transect (FXTX; n = 6) the dorsal fornix at the level of the hippocampal commissure. No differences were found between SHAM and FXTX fetuses in daily hormone profiles over the last week of gestation or in gestation length (148.0 +/- 1.2 vs. 149.0 +/- 0.4 dG, respectively). We conclude that the fetal hippocampus is immature in late gestation and we speculate that an immature hippocampus is necessary for the loss of negative feedback control that gives rise to the long term, simultaneous increases in ACTH and cortisol that are indispensable for labor and delivery at term in sheep.
Lewis, Andrew J; Austin, Emma; Knapp, Rebecca; Vaiano, Tina; Galbally, Megan
Maternal mental disorders over pregnancy show a clear influence on child development. This review is focused on the possible mechanisms by which maternal mental disorders influence fetal development via programming effects. This field is complex since mental health symptoms during pregnancy vary in type, timing and severity and maternal psychological distress is often accompanied by higher rates of smoking, alcohol use, poor diet and lifestyle. Studies are now beginning to examine fetal programming mechanisms, originally identified within the DOHaD framework, to examine how maternal mental disorders impact fetal development. Such mechanisms include hormonal priming effects such as elevated maternal glucocorticoids, alteration of placental function and perfusion, and epigenetic mechanisms. To date, mostly high prevalence mental disorders such as depression and anxiety have been investigated, but few studies employ diagnostic measures, and there is very little research examining the impact of maternal mental disorders such as schizophrenia, bipolar disorder, eating disorders and personality disorders on fetal development. The next wave of longitudinal studies need to focus on specific hypotheses driven by plausible biological mechanisms for fetal programming and follow children for a sufficient period in order to examine the early manifestations of developmental vulnerability. Intervention studies can then be targeted to altering these mechanisms of intergenerational transmission once identified.
Full Text Available El presente trabajo describe un protocolo aplicado a muestras de heces de ganado bovino para el aislamiento y purificación de ooquistes de Cryptosporidium sp. y el eventual uso de los mismos para estudios genéticos mediante PCR.
Molina, Ricardo; Erra Serrabasa, Pilar; Bertrán, Enric; Jover Comas, Eric; Reyes Contreras, Carolina
Método de eliminación de trihalometanos y/o contaminantes emergentes mediante plasma. Se describe un método de eliminación de trihalometanos y contaminantes refractarios en medios acuosos mediante la aplicación directa de plasma para conseguir la degradación de los compuestos contaminantes presentes en el agua.
Manuel Recio Rodríguez
Full Text Available La resonancia magnética (RM fetal es una técnica de imagen en auge, útil en la valoración del cerebro y columna fetal. Ayuda a estudiar el desarrollo cerebral fetal y se puede realizar un diagnóstico precoz de las anomalías congénitas. La imagen de RM muestra gran resolución de contraste y permite diferenciar mejor que la ecografía entre hallazgos normales y patológicos. Además, algunas malformaciones cerebrales o lesiones destructivas ocultas en la ecografía prenatal pueden ser detectadas por RM. Revisamos las indicaciones, utilidad, seguridad, aspectos técnicos de la RM fetal y la apariencia del desarrollo cerebral fetal, y evaluamos su contribución en el diagnóstico de las patologías de las diferentes regiones cerebrales y de la patología espinal fetal.Fetal MR imaging (MRI is an increasingly available technique used to evaluate the fetal brain and spine, because it provides a unique opportunity to evaluate fetal brain development and to make an early diagnosis of congenital abnormalities. MRI allows a better differentiation between normal and abnormal signal intensity of fetal tissues due to its higher contrast resolution compared to prenatal sonography (US. Therefore, structural abnormalities such as brain malformations and destructive lesions that could be sonographically occult on prenatal sonography can be detected at fetal MRI. We review indications, utility, safety, and technical aspects of fetal MR imaging and the appearance of normal fetal brain development evaluating its contribution in the diagnosis of fetal diseases of different brain regions and spinal disorders.
Brown, Laura D; Rozance, Paul J; Thorn, Stephanie R; Friedman, Jacob E; Hay, William W
Placental insufficiency decreases fetal amino acid uptake from the placenta, plasma insulin concentrations, and protein accretion, thus compromising normal fetal growth trajectory. We tested whether acute supplementation of amino acids or insulin into the fetus with intrauterine growth restriction (IUGR) would increase net fetal protein accretion rates. Late-gestation IUGR and control (CON) fetal sheep received acute, 3-h infusions of amino acids (with euinsulinemia), insulin (with euglycemia and euaminoacidemia), or saline. Fetal leucine metabolism was measured under steady-state conditions followed by a fetal muscle biopsy to quantify insulin signaling. In CON, increasing amino acid delivery rates to the fetus by 100% increased leucine oxidation rates by 100%. In IUGR, amino acid infusion completely suppressed fetal protein breakdown rates but increased leucine oxidation rate by only 25%, resulting in increased protein accretion rates by 150%. Acute insulin infusion, however, had very little effect on amino acid delivery rates, fetal leucine disposal rates, or fetal protein accretion rates in CON or IUGR fetuses despite robust signaling of the fetal skeletal muscle insulin-signaling cascade. These results indicate that, when amino acids are given directly into the fetal circulation independently of changes in insulin concentrations, IUGR fetal sheep have suppressed protein breakdown rates, thus increasing net fetal protein accretion.
Full Text Available Objetivo. Evaluar el efecto de la maduración in vitro (MIV con suero fetal bovino (SFB sobre la actividad mitocondrial (potencial de membrana de oocitos bovinos desvitrificados. Materiales y métodos. Se recolectaron oocitos bovinos a partir de ovarios post-mortem, para su posterior MIV en medio Sintetic Oviductal Fluid Amino Acids (SOFaa en tratamientos con y sin SFB. Posteriormente, fueron destinados para su criopreservación mediante vitrificación en Open Pulled Straw (OPS. Los oocitos fueron desvitrificados y evaluados para su potencial de membrana mitocondrial mediante el uso del colorante fluorescente JC-1. Los datos fueron analizados mediante la prueba t de Student y un análisis de varianza. Resultados. Los resultados evidenciaron una diferencia estadística (p<0.05 entre los tratamientos de MIV para los niveles cuantificados de potencial de membrana mitocondrial de los oocitos desvitrificados, con promedios de 39.8 ± 2.38% y 50.3 ± 2.59% para MIV con y sin suero respectivamente. No se encontró un efecto del suero en la MIV, sobre la distribución de mitocondrias de alto potencial de membrana, sin embargo, se observó diferencia estadística (p<0.05 para este parámetro entre los oocitos frescos y desvitrificados. Conclusiones. La presencia de SFB en la MIV de oocitos bovinos, ejerció un efecto deletéreo sobre el potencial de membrana mitocondrial posterior a la criopreservación, y esta última modifica las proporciones de los patrones de distribución de mitocondrias de alto potencial de membrana de los oocitos bovinos madurados in vitro.
Nielsen, Mette Olaf; Khanal, Prabhat; Johnsen, Lærke
), which alters the way the genome becomes phenotypically expressed. In experimental studies in sheep, we have convincingly demonstrated that FP has adverse impacts on growth and development of a wide range of metabolic/endocrine systems and other body functions, which are key to farm animal productivity...... and economic efficiency. Furthermore, it is believed that FP traits can be passed on to the NeXT generations by epigenetic mechanisms. The economic consequences of FP in farm animal production have never been assessed, but the accumulating evidence suggest that the consequences of FP for farm animal...... productivity are so significant that we need to incorporate the fetal life history into future decision making tools and management strategies targeting replacement stock and the reproducing female. The management strategies and tools needed to take FP into account could be relatively simple and easily...
Andersen, Louise Bjørkholt; Jørgensen, J S; Herse, F
factor (PlGF), and sFlt-1/PlGF ratio in first and second-third trimester in women with/without preeclampsia, and the impact of fetal sex on the prognostic value of angiogenic markers for preeclampsia. STUDY DESIGN: Observational study in a prospective, population-based cohort of 2110 singleton......OBJECTIVE: Current research suggests sexual dimorphism between the male and female fetoplacental units, but with unknown relevance for preeclampsia. We investigated the association between fetal sex and concentrations of the angiogenic markers soluble Fms-like kinase 1 (sFlt-1), placental growth...... (preeclampsia cases) associated with fetal sex in adjusted analyses (psex (all, p=0.028; preeclampsia, p=0.067) In receiver operating curve analysis, prediction of early-onset preeclampsia by sFlt-1/PlGF tended to be superior...
刘俊涛; 杨佳欣; 边旭明; 张羽
Objective. Analysis of the cause of intrauterine death of one fetus of twin and to evaluate the outcome of conservative management of twin pregnancy with single fetal death. Method. A retrospective review was undertaken on PUMC hospital records of women who delivered twin between Jan. 1987 and Dec. 1998. Result. During the recent 12 years, 99 pregnant women were documented as twin pregnancies. Of the twin pregnancies during this period, 13 were complicated by a single intrauterine death. Four women suffered this complication during their first trimester. In the remain 9 cases one fetus died dm-ing second or third trimester.The cesarean section was given in three pregnant women soon after a single intrauterine death because of the survival fetal distress. No consumptive coagulopathy was apparent in all 13 pregnant women. It is wise that the pregnancy was managed conservatively, with regular coagulation parameters obtained. Condosion. Our results suptmrt conservative management in twin pregnancies complicated by single fetal death.
Full Text Available Compromised pregnancies such as those associated with gestational diabetes mellitus, intrauterine growth retardation, preeclampsia, maternal undernutrition, and maternal stress may negatively affect fetal development. Such pregnancies may induce oxidative stress to the fetus and alter fetal development through the epigenetic process that may affect development at a later stage. Melatonin is an oxidant scavenger that reverses oxidative stress during the prenatal period. Moreover, the role of melatonin in epigenetic modifications in the field of developmental programming has been studied extensively. Here, we describe the physiological function of melatonin in pregnancy and discuss the roles of melatonin in fetal programming in compromised pregnancies, focusing on its involvement in redox and epigenetic mechanisms.
Full Text Available The prolonged retention of fetal bone structure is an uncommon condition after a previous abortion.We describe two cases with fetal bone fragment amongst 3589 hysteroscopies (0.05%, who hadno complaint other than secondary infertility. In both patients, hyperechogenic areas were foundthrough transvaginal ultrasound and the bones were removed by hysteroscopy. Despite meticulousevaluation during hysteroscopy, some bones were not observed and were stable during the nextsonography. According to the formation of fetal bones after 11 weeks of pregnancy; patientswith secondary infertility who have a history of abortion that progressed beyond this time andendometrial hyperechoic areas by transvaginal ultrasound should be evaluated for any retainedfetal bone. Hysteroscopy should be performed under abdominal ultrasonography guide to ensurefetal bone tissue is entirely removed during a single surgery.
Ersoy, Ali Ozgur; Oztas, Efser; Saridogan, Erdinc; Ozler, Sibel; Danisman, Nuri
Fetal lymphangioma is a hamartomatous congenital anomaly of the lymphatic system, which is embracing the fetal skin (sometimes mucous membranes) and the subcutaneous tissue. The general consensus is that it occurs as a result of failure in lymphatic drainage. A 36-year-old pregnant woman was referred to our perinatology clinic at 22 weeks' gestation, because of a fetal right-sided axillary mass revealed by ultrasonography. The mass measuring 5x7x7cm in three dimensions had a multilocular structure without colour Doppler flow and well-circumscribed borders. Amniocentesis revealed a normal constitutional karyotyping. Lymphangioma was considered as prediagnosis. A healthy female baby weighing 3470 grams was delivered at term. Neonatal examination and the postnatal MRI confirmed the diagnosis. The baby is still on follow-up with the medical treatment of Sirolimus an anti-proliferative drug, and the mass got smaller significantly in 8 months after delivery.
Amar M Taksande
Full Text Available Pericardial effusion (PE is detectable during routine obstetric ultrasonography. PE is the result of the same mechanism that produces fetal hydrops. Structural cardiac malformations and fetal cardiac arrhythmias are the most common cause of nonimmune hydrops. A male infant weighing 2300 g was born by through elective cesarean section. Isolated large PE was detected in a fetus at 34 weeks of gestation. The women delivered a male neonate at 37 weeks period of gestation through elective cesarean section. Baby cried immediately after birth with APGAR score 7, 9, 10 at 1, 5, and 10 min, respectively. Though the mother condition was stable. The baby was shifted to special care neonatal unit in view of for respiratory distress and severe grunt. Neonatal echocardiography showed trivial tricuspid regurgitation with no PE. Most fetal PEs resolve and fetuses with isolated PEs have a good prognosis.
Full Text Available Fetal hydantoin syndrome is a rare disorder that is believed to be caused by exposure of a fetus to the anticonvulsant drug phenytoin. The classic features of fetal hydantoin syndrome include craniofacial anomalies, prenatal and postnatal growth deficiencies, underdeveloped nails of the fingers and toes, and mental retardation. Less frequently observed anomalies include cleft lip and palate, microcephaly, ocular defects, cardiovascular anomalies, hypospadias, umbilical and inguinal hernias, and significant developmental delays. Anaesthesia for incidental surgery in such a patient poses unique challenges for the anesthesiologist. We report the successful management of a 4-year-old male child with fetal hydantoin syndrome, cleft palate, spina bifida, atrial septal defect, and dextrocardia for tibialis anterior lengthening under subarachnoid block.
Neri, Caterina; Edlow, Andrea G
Maternal obesity has become a worldwide epidemic. Obesity and a high-fat diet have been shown to have deleterious effects on fetal programming, predisposing offspring to adverse cardiometabolic and neurodevelopmental outcomes. Although large epidemiological studies have shown an association between maternal obesity and adverse outcomes for offspring, the underlying mechanisms remain unclear. Molecular approaches have played a key role in elucidating the mechanistic underpinnings of fetal malprogramming in the setting of maternal obesity. These approaches include, among others, characterization of epigenetic modifications, microRNA expression, the gut microbiome, the transcriptome, and evaluation of specific mRNA expression via quantitative reverse transcription polmerase chain reaction (RT-qPCR) in fetuses and offspring of obese females. This work will review the data from animal models and human fluids/cells regarding the effects of maternal obesity on fetal and offspring neurodevelopment and cardiometabolic outcomes, with a particular focus on molecular approaches.
Objective. Analysis of the cause of intrauterine death of one fetus of twin and to evaluate the outcome of conservative management of twin pregnancy with single fetal death.Method.A retrospective review was undertaken on PUMC hospital records of women who delivered twin between Jan. 1987 and Dec. 1998.Result.During the recent 12 years, 99 pregnant women were documented as twin pregnancies. Of the twin pregnancies during this period, 13 were complicated by a single intrauterine death. Four women suffered this complication during their first trimester. In the remain 9 cases one fetus died during second or third trimester. The cesarean section was given in three pregnant women soon after a single intrauterine death because of the survival fetal distress. No consumptive coagulopathy was apparent in all 13 pregnant women. It is wise that the pregnancy was managed conservatively, with regular coagulation parameters obtained.Conclusion.Our results support conservative management in twin pregnancies complicated by single fetal death.
Driscoll, Deborah A; Gross, Susan J
Maternal serum screening for neural tube defects and fetal aneuploidy in the second trimester has been incorporated into obstetrical practice over the past two decades. Now, as a result of several multicenter trials, first trimester screening between 11 and 14 weeks has been shown to be an effective and reliable screening test for Down syndrome and trisomy 18. Benefits of first trimester screening include earlier identification of the pregnancy at risk for fetal aneuploidy and anatomic defects, in particular, cardiac anomalies, and the option of earlier diagnosis by chorionic villus sampling, if available. This policy updates the American College of Medical Genetics policy statement entitled Second Trimester Maternal Serum Screening for Fetal Open Neural Tube Defects and Aneuploidy (2004) and complements the sections of American College of Medical Genetic's Standards and Guidelines for Clinical Genetics Laboratories entitled "Prenatal screening for Down syndrome that includes first trimester biochemistry and/or ultrasound measurements."
Driscoll, Deborah A; Gross, Susan J
Maternal serum screening for neural tube defects and fetal aneuploidy in the second trimester has been incorporated into obstetrical practice over the past two decades. Now, as a result of several multicenter trials, first trimester screening between 11 and 14 weeks has been shown to be an effective and reliable screening test for Down syndrome and trisomy 18. This policy updates the American College of Medical Genetics policy statement entitled Second Trimester Maternal Serum Screening for Fetal Open Neural Tube Defects and Aneuploidy (2004), incorporates First trimester diagnosis and screening for fetal aneuploidy (2008) and complements the sections of American College of Medical Genetic's Standards and Guidelines for Clinical Genetics Laboratories entitled Prenatal Screening for Down syndrome (2005) and Prenatal Screening for Open Neural Tube Defects (2005).
T H Indu
Full Text Available Organophosphate poisoning is an important medical emergency exist in agriculture-oriented countries such as India. This case report describes the treatment strategies followed for a management of suicidal intoxication of a pregnant woman by chlorpyrifos compound at a secondary care public hospital, Udhagamandalam, India. The patient was unable to perceive fetal movements and had classic clinical symptoms of organophosphate poisoning such as excess salivation and pinpoint pupil. The patient was administered with 2 g of pralidoxime and 10 ampoules of atropine sulfate (1.2 mg each. The fetotoxic evaluation showed fetal death. The antidote given to the patient was according to the criteria given by the World Health Organization. The late admission of the patient may be considered as a reason for fetal death. Psychosocial, educational programs are highly recommended for the population in this region to reduce the number of intentional poisoning attempts.
Montoya Filardi, A; Guasp Vizcaíno, M; Gómez Fernández-Montes, J; Llorens Salvador, R
We present a case of cleidocranial dysplasia diagnosed by low-dose fetal computed tomography (CT) in the 25th week of gestation. Severe bone dysplasia was suspected because of the fetus' low percentile in long bones length and the appearance of craniosynostosis on sonography. CT found no abnormalities incompatible with life. The effective dose was 5 mSv, within the recommended range for this type of examination. Low-dose fetal CT is a new technique that makes precision study of the bony structures possible from the second trimester of pregnancy. In Spain, abortion is legal even after the 22nd week of gestation in cases of severe fetal malformations. Therefore, in cases in which severe bone dysplasia is suspected, radiologists must know the strategies for reducing the dose of radiation while maintaining sufficient diagnostic quality, and they must also know which bony structures to evaluate.
Frank D. Johnstone
Full Text Available This study investigates reports that phosphoglucomutase-1 (PGM1 phenotype is associated with fetal growth and gestation length. A total of 350 women were studied, 234 having uncomplicated pregnancies and 114 with a baby weighing greater than 90th centile, corrected for parity, gestation and fetal sex. All women had gestation confirmed by early ultrasound. Conventional cellulose acetate electrophoresis was used to distinguish the three common PGM1 phenotypes and polyacrylamide gel isoelectric focusing to distinguish the ten PGM1 SUbtypes. Neither PGM I phenotype nor SUbtype were found to be associated with gestation length or standardised birth weight. Logistic regression, where maternal age, parity, fetal sex, maternal weight, gestation and smoking were introduced as explanatory variables in addition to PGM1 phenotype testing against the dependent variables birth weight, standardised birth weight and gestation length, did not show differences related to PGM1 phenotype.
Del Giudice, Marco
Maternal stress during pregnancy has pervasive effects on the offspring's physiology and behavior, including the development of anxious, reactive temperament and increased stress responsivity. These outcomes can be seen as the result of adaptive developmental plasticity: maternal stress hormones carry useful information about the state of the external world, which can be used by the developing fetus to match its phenotype to the predicted environment. This account, however, neglects the inherent conflict of interest between mother and fetus about the outcomes of fetal programming. The aim of this paper is to extend the adaptive model of prenatal stress by framing mother-fetus interactions in an evolutionary conflict perspective. In the paper, I show how a conflict perspective provides many new insights in the functions and mechanisms of fetal programming, with particular emphasis on human pregnancy. I then take advantage of those insights to make sense of some puzzling features of maternal and fetal physiology and generate novel empirical predictions.
Dubil, Elizabeth A; Magann, Everett F
Introduction: Amniotic fluid, once thought to merely provide protection and room for necessary movement and growth for the fetus, is now understood to be a highly complex and dynamic system that is studied as a data point to interpret fetal wellbeing. Methods: Assessment of amniotic fluid volume is now routine when performing a sonographic evaluation of fetal status and is an important consideration in the assessment and management of perinatal morbidity and mortality.(1)(,)(2) In this review, we will cover the dynamics that affect amniotic fluid volume, review methods for measurement and quantification of volume, review definitions for normative data as related to neonatal outcomes, and provide evidence based guidance on the workup and management options for oligoydramnios and polyhydramnios in singleton and twin pregnancies. Conclusions: When abnormalities of fluid exist, appropriate workup to uncover the underlying etiology should be initiated as adverse fetal outcomes are sometimes associated with these variations from normalcy.
Tertti, Kristiina; Laine, Kari; Ekblad, Ulla; Rinne, Valtteri; Rönnemaa, Tapani
The purpose of the study was to examine in vivo placental transfer of metformin, its association with neonatal outcome in metformin-treated gestational diabetes (GDM) patients, and influence of metformin exposure on maternal glycemic control and weight gain. Two hundred and seventeen GDM patients were randomized to metformin or insulin in Turku University Hospital, Finland. Metformin concentrations were determined by mass spectrometry in maternal serum at 36 gestational weeks (gw) and at birth, and in umbilical cord blood. Main outcome measures were birth weight, gw at birth, umbilical artery pH and neonatal hypoglycemia, maternal weight gain, HbA1c and fructosamine concentration. Median umbilical cord/maternal serum metformin concentration ratio was 0.73. There were no differences in birth weight measured in grams or SD units (p = 0.49), or gw at birth (p always ≥0.49) between insulin- and metformin-treated patients stratified by trough metformin concentration tertiles measured at 36 gw. Rate of neonatal hypoglycemia (p = 0.92) and umbilical artery pH value (p = 0.78) was similar in insulin- and metformin-treated patients stratified by cord metformin concentration tertiles. Maternal glycemic control was similar in metformin concentration tertiles at 36 gw. Maternal weight gain was 223 g greater per week (p = 0.038) in the lowest metformin tertile compared to other tertiles combined. Maternal and fetal exposure to metformin is similar. Maternal or fetal metformin concentrations do not predict maternal glycemic control or neonatal outcome, but low maternal exposure may lead to greater maternal weight gain.
Ebensperger, Germán; Ebensperger, Renato; Herrera, Emilio A; Riquelme, Raquel A; Sanhueza, Emilia M; Lesage, Florian; Marengo, Juan J; Tejo, Rodrigo I; Llanos, Aníbal J; Reyes, Roberto V
In this study we looked for additional evidence to support the hypothesis that fetal llama reacts to hypoxaemia with adaptive brain hypometabolism. We determined fetal llama brain temperature, Na(+) and K(+) channel density and Na(+)-K(+)-ATPase activity. Additionally, we looked to see whether there were signs of cell death in the brain cortex of llama fetuses submitted to prolonged hypoxaemia. Ten fetal llamas were instrumented under general anaesthesia to measure pH, arterial blood gases, mean arterial pressure, heart rate, and brain and core temperatures. Measurements were made 1 h before and every hour during 24 h of hypoxaemia (n = 5), which was imposed by reducing maternal inspired oxygen fraction to reach a fetal arterial partial pressure of oxygen (P(a,O(2))) of about 12 mmHg. A normoxaemic group was the control (n = 5). After 24 h of hypoxaemia, we determined brain cortex Na(+)-K(+)-ATPase activity, ouabain binding, and the expression of NaV1.1, NaV1.2, NaV1.3, NaV1.6, TREK1, TRAAK and K(ATP) channels. The lack of brain cortex damage was assessed as poly ADP-ribose polymerase (PARP) proteolysis. We found a mean decrease of 0.56 degrees C in brain cortex temperature during prolonged hypoxaemia, which was accompanied by a 51% decrease in brain cortex Na(+)-K(+)-ATPase activity, and by a 44% decrease in protein content of NaV1.1, a voltage-gated Na(+) channel. These changes occurred in absence of changes in PARP protein degradation, suggesting that the cell death of the brain was not enhanced in the fetal llama during hypoxaemia. Taken together, these results provide further evidence to support the hypothesis that the fetal llama responds to prolonged hypoxaemia with adaptive brain hypometabolism, partly mediated by decreases in Na(+)-K(+)-ATPase activity and expression of NaV channels.
van Leeuwen, P.; Cysarz, D.; Lange, S.; Geue, D.; Groenemeyer, D.
Fetal heart rate complexity was examined on the basis of RR interval time series obtained in the second and third trimester of pregnancy. In each fetal RR interval time series, short term beat-to-beat heart rate changes were coded in 8bit binary sequences. Redundancies of the 28 different binary patterns were reduced by two different procedures. The complexity of these sequences was quantified using the approximate entropy (ApEn), resulting in discrete ApEn values which were used for classifying the sequences into 17 pattern sets. Also, the sequences were grouped into 20 pattern classes with respect to identity after rotation or inversion of the binary value. There was a specific, nonuniform distribution of the sequences in the pattern sets and this differed from the distribution found in surrogate data. In the course of gestation, the number of sequences increased in seven pattern sets, decreased in four and remained unchanged in six. Sequences that occurred less often over time, both regular and irregular, were characterized by patterns reflecting frequent beat-to-beat reversals in heart rate. They were also predominant in the surrogate data, suggesting that these patterns are associated with stochastic heart beat trains. Sequences that occurred more frequently over time were relatively rare in the surrogate data. Some of these sequences had a high degree of regularity and corresponded to prolonged heart rate accelerations or decelerations which may be associated with directed fetal activity or movement or baroreflex activity. Application of the pattern classes revealed that those sequences with a high degree of irregularity correspond to heart rate patterns resulting from complex physiological activity such as fetal breathing movements. The results suggest that the development of the autonomic nervous system and the emergence of fetal behavioral states lead to increases in not only irregular but also regular heart rate patterns. Using symbolic dynamics to
Full Text Available 26 years old para 1 with 26 weeks of pregnancy presented with intermittent fever. Her obstetric history included one spontaneous first trimester miscarriage and one previous Caesarean Section for meconium stained amniotic fluid. Her antenatal course was uneventful so far. On investigation she tested IgM dengue positive. Her WBC count, platelet count and coagulation profiles were within normal limits. Obstetric sonography was done which was suggestive of a single live intrauterine gestation corresponding with growth appropriate for gestational age with moderate polyhydramnios (AFI 25cms with hyperechoic cerebral cisterns suggestive of intracranial haemorrhage. Fetal MRI was done which revealed generalized atrophy of the brain parenchyma with subdural haematoma over posterior cerebral convexities extending along tentorial leaflets. Patient went into preterm labour at 27 weeks and delivered male baby of 980gms which was an intrapartum fetal demise. Fetal intracranial hemorrhage occurs in 5 in 10,000 pregnancies. Hemorrhage may occur either within the cerebral ventricles (Intraventricular haemorrhage, IVH, subdural space or infratentorial fossa. IVH are common variety and are characteristic of immature brain. IVH are subdivided according to their severity into four grades: the first three grades are limited to the ventricles, while the fourth grade includes parenchymal involvement occurring in the most severe cases. Fetal stroke is caused by antenatal hemorrhagic, ischemic or thrombotic injury. Although there is no identifiable risk factor in 50% of cases of fetal stroke, the most common maternal conditions associated with it are alloimmune thrombocytopenia and trauma. Outcome is usually poor, for those fetuses affected with high grade IVH or subdural hemorrhages. USG helps in accurate diagnosis of fetal ICH and prenatal MRI also contributes to the accuracy of diagnosis.
Mayock, Dennis E; Bennett, Rachel; Robinson, Roderick D; Gleason, Christine A
Dopamine is used clinically to stabilize mean arterial blood pressure (MAP) in sick infants. One goal of this therapeutic intervention is to maintain adequate cerebral blood flow (CBF) and perfusion pressure. High-dose intravenous dopamine has been previously demonstrated to increase cerebrovascular resistance (CVR) in near-term fetal sheep. We hypothesized that this vascular response might limit cerebral vasodilatation during acute isocapnic hypoxia. We studied nine near-term chronically catheterized unanesthetized fetal sheep. Using radiolabeled microspheres to measure fetal CBF, we calculated CVR at baseline, during fetal hypoxia, and then with the addition of an intravenous dopamine infusion at 2.5, 7.5, and 25 microg.kg(-1).min(-1) while hypoxia continued. During acute isocapnic fetal hypoxia, CBF increased 73.0 +/- 14.1% and CVR decreased 38.9 +/- 4.9% from baseline. Dopamine infusion at 2.5 and 7.5 microg.kg(-1).min(-1), begun during hypoxia, did not alter CVR or MAP, but MAP increased when dopamine infusion was increased to 25 microg.kg(-1).min(-1). Dopamine did not alter CBF or affect the CBF response to hypoxia at any dose. However, CVR increased at a dopamine infusion rate of 25 microg.kg(-1).min(-1). This increase in CVR at the highest dopamine infusion rate is likely an autoregulatory response to the increase in MAP, similar to our previous findings. Therefore, in chronically catheterized unanesthetized near-term fetal sheep, dopamine does not alter the expected cerebrovascular responses to hypoxia.
van den Driesche, Sander; Macdonald, Joni; Anderson, Richard A;
Most common male reproductive disorders are linked to lower testosterone exposure in fetal life, although the factors responsible for suppressing fetal testosterone remain largely unknown. Protracted use of acetaminophen during pregnancy is associated with increased risk of cryptorchidism in sons...
PrabhuDas, Mercy; Bonney, Elizabeth; Caron, Kathleen; Dey, Sudhansu; Erlebacher, Adrian; Fazleabas, Asgerally; Fisher, Susan; Golos, Thaddeus; Matzuk, Martin; McCune, Joseph M; Mor, Gil; Schulz, Laura; Soares, Michael; Spencer, Thomas; Strominger, Jack; Way, Sing Sing; Yoshinaga, Koji
Leaders gathered at the US National Institutes of Health in November 2014 to discuss recent advances and emerging research areas in aspects of maternal-fetal immunity that may affect fetal development and pregnancy success. PMID:25789673
Hasselby, Jane Preuss; Maroun, Lisa Leth; Federspiel, Birgitte Hartnack;
Hasselby JP, Maroun LL, Federspiel BH, Vainer B. Ghrelin in the fetal pancreas - a digital quantitation study. APMIS 2011. Ghrelin is a hormone produced by specialized neuroendocrine cells located in the fetal pancreas. In the adult, ghrelin has multiple effects, but in the fetus the role...... of ghrelin and the distribution of ghrelin-producing cells is not well documented. The aim of this study was to describe and quantitate the number of ghrelin positive cells in the pancreas during gestation. The material consisted of pancreatic tissue from 19 fetuses at different gestational ages...
Ricci, S.; Urban, G.; Vergani, P.; Paidas, M. J.; Tortoli, P.
Maternal and fetal blood circulation has been investigated for nearly a decade through ultrasound (US) techniques. Evaluation of the spectrogram related to a single sample volume has been proven valuable for the assessment of fetal well-being and for prediction of pregnancy complications. In this work, an alternative technique, called Multigate Spectral Doppler Analysis (MSDA), is proposed. In this approach, 128 sample volumes aligned along the same scan line are simultaneously investigated to detect the blood velocity profile with high resolution. Profiles obtained through MSDA reveal features not detectable with the standard US technique, thus representing a more accurate flow signature. Some preliminary illustrative results are reported here.
Jørgensen, Jan Stener; Weber, Tom
During the 1970s and 1980s, electronic fetal monitoring and fetal scalp blood sampling (FBS) were introduced without robust evidence. With a methodical review of the published literature, and using one randomized controlled trial, seven controlled studies, nine randomized studies of various...... surveillance methods and data from the Danish National Birth Registry, we have assessed the usefulness of FBS as a complementary tool to improve the specificity and sensitivity of electronic cardiotocography (CTG). Based on heterogeneous studies of modest quality with somewhat inconsistent results, we conclude...
Lykke, Jacob A; Paidas, Michael J; Triche, Elizabeth W
Low birthweight of the offspring has been associated with increased risk of early death and ischemic heart disease in the mother. However, other measurements of fetal growth than the basic birthweight are more accurate. We investigated the relation between the standardized birthweight by gestatio......Low birthweight of the offspring has been associated with increased risk of early death and ischemic heart disease in the mother. However, other measurements of fetal growth than the basic birthweight are more accurate. We investigated the relation between the standardized birthweight...... by gestational age and gender and the ponderal index and the mother's subsequent mortality and cardiovascular morbidity....
Marcia Beatriz Tartarella
Full Text Available PURPOSES: To describe ocular features, management of cataract and functional outcomes in patients with persistent fetal vasculature. METHODS: Retrospective, descriptive case series of patients with persistent fetal vasculature. Data were recorded from the Congenital Cataract Section of Federal University of São Paulo, Brazil from 2001 to 2012. All patients were evaluated for sex, age at diagnosis, systemic findings, laterality, age at surgery, and initial and final follow-up visual acuities. Follow-up and complications after cataract surgery were recorded. Ultrasound was performed in all cases and ocular eco-Doppler was performed in most. RESULTS: The study comprised 53 eyes from 46 patients. Age at diagnosis ranged from 5 days of life to 10 years-old (mean 22.7 months. Twenty-seven patients were male (58.7%. Persistent fetal vasculature was bilateral in 7 patients (15.2%. Forty-two eyes (79.2% had combined (anterior and posterior forms PFV presentation, 5 eyes (9.4% had only anterior persistent fetal vasculature presentation and 6 eyes (11.3% had posterior persistent fetal vasculature presentation. Thirty-eight eyes (71.7% were submitted to cataract surgery. Lensectomy combined with anterior vitrectomy was performed in 18 eyes (47.4%. Phacoaspiration with intraocular lens implantation was performed in 15 eyes (39.5%, and without lens implantation in 5 eyes (13.2%. Mean follow-up after surgery was 44 months. Postoperative complications were posterior synechiae (3 cases, retinal detachment (2 cases, phthisis (3 cases, posterior capsular opacification (8 cases, inflammatory pupillary membrane (5 cases, glaucoma (4 cases, intraocular lens implantation displacement (1 case and vitreous hemorrhage (2 cases. Complications were identified in 19 (50% of the 38 operated eyes. Visual acuity improved after cataract surgery in 83% of the eyes. CONCLUSIONS: Patients with persistent fetal vasculature have variable clinical presentation. There is an
Brusseau, Roland; Mizrahi-Arnaud, Arielle
Anesthesia provision for fetal intervention differs from most other anesthetic situations insofar as anesthesiologists must care for 2 or more patients-each with potentially conflicting requirements. The first is the mother who can readily indicate discomforts, can be monitored directly, and to whom drugs may be administered directly and easily. For the fetus (or fetuses), nociception must be assumed or inferred indirectly, monitoring is limited at best, and drug administration is complicated and often indirect. Fetal and maternal hemodynamic stability must be assured; and a plan to resuscitate the fetus, should problems occur during the procedure, must be developed.
Surveillance of fetal arrhythmias in the outpatient setting remains limited by lack of monitoring modalities. Despite technological advances made in the field of obstetrics, existing devices are not currently suitable to monitor fetal arrhythmias. In this report, the author describes the current and developing fetal heart rate monitoring technologies including the recent introduction of hand-held Doppler monitors for outpatient surveillance of fetal arrhythmias.
Xiao-yan SHA; Zheng-fang XIONG; Hui-shu LIU; Xiao-dan DI; Tong-hui MA
Maternal-fetal fluid balance is critical during pregnancy, and amniotic fluid is essential for fetal growth and development. The placenta plays a key role in a successful pregnancy as the interface between the mother and her fetus. Aquaporins (AQPs) form specific water channels that allow the rapid transcellular movement of water in response to osmotic/hydrostatic pressure gradients. AQPs expression in the placenta and fetal membranes may play important roles in the maternal-fetal fluid balance.
Potocnik, A J; Brakebusch, C; Fässler, R
Homing of hematopoietic stem cells (HSCs) into hematopoietic organs is a prerequisite for the establishment of hematopoiesis during embryogenesis and after bone marrow transplantation. We show that beta1 integrin-deficient HSCs from the para-aortic splanchnopleura and the fetal blood had...... hematolymphoid differentiation potential in vitro and in fetal organ cultures but were unable to seed fetal and adult hematopoietic tissues. Adult beta1 integrin null HSCs isolated from mice carrying loxP-tagged beta1 integrin alleles and ablated for beta1 integrin expression by retroviral cre transduction...... failed to engraft irradiated recipient mice. Moreover, absence of beta1 integrin resulted in sequestration of HSCs in the circulation and their reduced adhesion to endothelioma cells. These findings define beta1 integrin as an essential adhesion receptor for the homing of HSCs....
Ahmadi, Mohammad Hossein; Hantuoshzadeh, Sedigheh; Okhovat, Mohammad Ali; Nasiri, Nahid; Azarkeivan, Azita; Amirizadeh, Naser
The prenatal determination of the fetal Rh genotype could lead to a substantial reduction in the use of anti-D immunoglobulin and prevention of unnecessary exposure of pregnant women carrying RhD negative fetus. The aim of this study was fetal RHD genotyping through the analysis of cffDNA in plasma samples of RhD negative pregnant women by real-time PCR technique. In this experiment, 30 plasma samples were collected from RhD negative pregnant women. DNA were extracted and real-time PCR reactions were done by specific primers for RHD, SRY and beta-globin (GLO) genes. The Rh phenotypes of mothers and their babies were determined by agglutination method and specific anti-serums. From the 30 maternal plasma samples considered for SRY genotyping, 16 samples revealed the presence of the SRY gene. Regarding the fetal RHD genotyping, 26 samples were positive for RhD and 4 samples were negative. In all cases, the predicted RhD and SRY genotypes were in concordance with the serologically determined phenotypes. The sensitivity, specificity and precision of the fetal RHD and SRY genotyping test were calculated 100 % (p value <0.0005; K = 100 %). The present study confirms the precision of fetal RHD and SRY genotyping in maternal plasma by real-time PCR technique. This method helps RhD negative pregnant women about the appropriate use of anti-D immunoglobulin and also on the management and prevention of HDFN. However, superior and confirmatory studies are recommended before fetal RHD genotyping by real-time PCR is introduced as a non-invasive prenatal screening test.
Mark Robert Dilworth
Full Text Available Fetal growth restriction (FGR is defined as the inability of a fetus to achieve its genetic growth potential and is associated with a significantly increased risk of morbidity and mortality. Clinically, FGR is diagnosed as a fetus falling below the 5(th centile of customised growth charts. Sildenafil citrate (SC, Viagra™, a potent and selective phosphodiesterase-5 inhibitor, corrects ex vivo placental vascular dysfunction in FGR, demonstrating potential as a therapy for this condition. However, many FGR cases present without an abnormal vascular phenotype, as assessed by Doppler measures of uterine/umbilical artery blood flow velocity. Thus, we hypothesized that SC would not increase fetal growth in a mouse model of FGR, the placental-specific Igf2 knockout mouse, which has altered placental exchange capacity but normal placental blood flow. Fetal weights were increased (by 8% in P0 mice following maternal SC treatment (0.4 mg/ml via drinking water. There was also a trend towards increased placental weight in treated P0 mice (P = 0.056. Additionally, 75% of the P0 fetal weights were below the 5(th centile, the criterion used to define human FGR, of the non-treated WT fetal weights; this was reduced to 51% when dams were treated with SC. Umbilical artery and vein blood flow velocity measures confirmed the lack of an abnormal vascular phenotype in the P0 mouse; and were unaffected by SC treatment. (14C-methylaminoisobutyric acid transfer (measured to assess effects on placental nutrient transporter activity per g placenta was unaffected by SC, versus untreated, though total transfer was increased, commensurate with the trend towards larger placentas in this group. These data suggest that SC may improve fetal growth even in the absence of an abnormal placental blood flow, potentially affording use in multiple sub-populations of individuals presenting with FGR.
Pogledic, I.; Reith, W. [Universitaetsklinikum des Saarlandes, Homburg/Saar, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany); Meyberg-Solomayer, G. [Universitaetsklinikum des Saarlandes, Homburg/Saar, Klinik fuer Frauenheilkunde, Geburtsheilkunde und Reproduktionsmedizin, Homburg/Saar (Germany)
In the last decade the newest technologies, fetal magnetic resonance imaging (MRI) and 3D ultrasound, have given an insight into the minute structures of the fetal brain. However, without knowledge of the basic developmental processes the imaging is futile. Knowledge of fetal neuroanatomy corresponding to the gestational week is necessary in order to recognize pathological structures. Furthermore, a modern neuroradiologist should be acquainted with the three steps in the formation of the cerebral cortex: proliferation, migration and differentiation of neurons in order to be in a position to suspect that there is a pathology and start recognizing and discovering the abnormalities. The fetal MRI has become an important complementary method to ultrasound especially in cortical malformations when confirmation of the prenatal diagnosis is needed and additional pathologies need to be diagnosed. In this manner these two methods help in parental counseling and treatment planning. (orig.) [German] Dank neuer Technologien (z. B. fetale MRT, 3-D-Sonographie) ist es moeglich, kleinste Hirnstrukturen darzustellen. Ohne Kenntnisse der grundlegenden Entwicklungsprozesse des Gehirns waere die Bildgebung jedoch sinnlos. Um pathologische Veraenderungen zu erkennen, ist es notwendig, den Stand der fetalen Neuroanatomie in der entsprechenden Schwangerschaftswoche zu kennen. Heutzutage sollte sich ein Neuroradiologe mit den 3 Schritten der kortikalen Entwicklung - Proliferation, Migration und Differenzierung der Neuronen - vertraut machen. Nur dann wird er in der Lage sein, pathologische Veraenderungen in Betracht zu ziehen, bzw. diese zu erkennen. Die fetale MRT ist besonders wichtig, ergaenzend zur zerebralen Sonographie, zur Diagnosebestaetigung bei kortikalen Veraenderungen und Nachweis weiterer Pathologien. In dieser Kombination ermoeglichen diese Methoden eine adaequate Beratung der Eltern und Planung der Behandlung. (orig.)
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Full Text Available His.Neu.05.AllAg.Fetal_brain hg19 Histone Neural Fetal brain SRX860887,SRX860886,SR...X860885,SRX860881,SRX860879,SRX860888,SRX860880,SRX860883,SRX860884,SRX860882 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/His.Neu.05.AllAg.Fetal_brain.bed ...
Full Text Available NoD.Neu.05.AllAg.Fetal_brain hg19 No description Neural Fetal brain SRX056802,SRX14...2786,SRX142793,SRX031387,SRX031451,SRX031404,SRX031421 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/NoD.Neu.05.AllAg.Fetal_brain.bed ...
Full Text Available ALL.Neu.05.AllAg.Fetal_brain hg19 All antigens Neural Fetal brain SRX056802,SRX1427...60882 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Neu.05.AllAg.Fetal_brain.bed ...
Full Text Available DNS.Neu.50.AllAg.Fetal_brain hg19 DNase-seq Neural Fetal brain SRX040380,SRX040395,...6,SRX121278 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/DNS.Neu.50.AllAg.Fetal_brain.bed ...
Full Text Available DNS.Neu.20.AllAg.Fetal_brain hg19 DNase-seq Neural Fetal brain SRX040380,SRX040395,...6,SRX121278 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/DNS.Neu.20.AllAg.Fetal_brain.bed ...
Full Text Available His.Neu.20.AllAg.Fetal_brain hg19 Histone Neural Fetal brain SRX860887,SRX860879,SR...X860886,SRX860883,SRX860881,SRX860885,SRX860884,SRX860880,SRX860888,SRX860882 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/His.Neu.20.AllAg.Fetal_brain.bed ...
Full Text Available ALL.Neu.20.AllAg.Fetal_brain hg19 All antigens Neural Fetal brain SRX142786,SRX2096...60882 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Neu.20.AllAg.Fetal_brain.bed ...
Full Text Available ALL.Neu.50.AllAg.Fetal_brain hg19 All antigens Neural Fetal brain SRX142786,SRX2096...60880 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Neu.50.AllAg.Fetal_brain.bed ...
Full Text Available NoD.Neu.50.AllAg.Fetal_brain hg19 No description Neural Fetal brain SRX142786,SRX03...1421,SRX142793,SRX056802,SRX031451,SRX031404,SRX031387 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/NoD.Neu.50.AllAg.Fetal_brain.bed ...
Full Text Available DNS.Adp.20.AllAg.Fetal_Heart hg19 DNase-seq Adipocyte Fetal Heart SRX040387,SRX0404...0390 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/DNS.Adp.20.AllAg.Fetal_Heart.bed ...
Full Text Available NoD.Adp.05.AllAg.Fetal_Heart hg19 No description Adipocyte Fetal Heart SRX088650,SR...X088647,SRX056801,SRX031428,SRX031386,SRX031444,SRX056800 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/NoD.Adp.05.AllAg.Fetal_Heart.bed ...
Full Text Available NoD.Adp.20.AllAg.Fetal_Heart hg19 No description Adipocyte Fetal Heart SRX088650,SR...X031428,SRX031386,SRX056801,SRX031444,SRX056800,SRX088647 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/NoD.Adp.20.AllAg.Fetal_Heart.bed ...
Full Text Available DNS.Neu.05.AllAg.Fetal_brain hg19 DNase-seq Neural Fetal brain SRX040380,SRX040395,...6,SRX121278 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/DNS.Neu.05.AllAg.Fetal_brain.bed ...
Full Text Available His.Neu.50.AllAg.Fetal_brain hg19 Histone Neural Fetal brain SRX860887,SRX860879,SR...X860883,SRX860885,SRX860884,SRX860881,SRX860886,SRX860888,SRX860882,SRX860880 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/His.Neu.50.AllAg.Fetal_brain.bed ...
Full Text Available His.Liv.20.AllAg.Fetal_liver hg19 Histone Liver Fetal liver SRX860907,SRX860899,SRX...860908,SRX860905,SRX860900,SRX860906,SRX860904,SRX860903,SRX860902,SRX860901 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/His.Liv.20.AllAg.Fetal_liver.bed ...
Full Text Available ALL.Liv.05.AllAg.Fetal_liver hg19 All antigens Liver Fetal liver SRX860905,SRX86090...4,SRX860907,SRX860901,SRX860900,SRX860908,SRX860899,SRX860906,SRX860903,SRX860902 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Liv.05.AllAg.Fetal_liver.bed ...
Full Text Available ALL.Liv.20.AllAg.Fetal_liver hg19 All antigens Liver Fetal liver SRX860907,SRX86089...9,SRX860908,SRX860905,SRX860900,SRX860906,SRX860904,SRX860903,SRX860902,SRX860901 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Liv.20.AllAg.Fetal_liver.bed ...
Full Text Available ALL.Liv.10.AllAg.Fetal_liver hg19 All antigens Liver Fetal liver SRX860905,SRX86090...7,SRX860901,SRX860899,SRX860900,SRX860904,SRX860903,SRX860908,SRX860906,SRX860902 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Liv.10.AllAg.Fetal_liver.bed ...
Full Text Available His.Liv.10.AllAg.Fetal_liver hg19 Histone Liver Fetal liver SRX860905,SRX860907,SRX...860901,SRX860899,SRX860900,SRX860904,SRX860903,SRX860908,SRX860906,SRX860902 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/His.Liv.10.AllAg.Fetal_liver.bed ...
Full Text Available His.Liv.50.AllAg.Fetal_liver hg19 Histone Liver Fetal liver SRX860899,SRX860907,SRX...860905,SRX860900,SRX860903,SRX860906,SRX860904,SRX860908,SRX860902,SRX860901 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/His.Liv.50.AllAg.Fetal_liver.bed ...
Full Text Available ALL.Liv.50.AllAg.Fetal_liver hg19 All antigens Liver Fetal liver SRX860899,SRX86090...7,SRX860905,SRX860900,SRX860903,SRX860906,SRX860904,SRX860908,SRX860902,SRX860901 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Liv.50.AllAg.Fetal_liver.bed ...
Full Text Available His.Liv.05.AllAg.Fetal_liver hg19 Histone Liver Fetal liver SRX860905,SRX860904,SRX...860907,SRX860901,SRX860900,SRX860908,SRX860899,SRX860906,SRX860903,SRX860902 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/His.Liv.05.AllAg.Fetal_liver.bed ...
Spann, Marisa; Smerling, Jennifer; Gustafsson, Hanna C.; Foss, Sophie; Monk, Catherine
Measuring and understanding fetal neurodevelopment provides insight regarding the developing brain. Maternal nutrient intake and psychological stress during pregnancy each impact fetal neurodevelopment and influence childhood outcomes and are thus important factors to consider when studying fetal neurobehavioral development. The authors provide an…
Full Text Available Oth.Neu.05.AllAg.Fetal_Spinal_Cord hg19 TFs and others Neural Fetal Spinal Cord htt...p://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/Oth.Neu.05.AllAg.Fetal_Spinal_Cord.bed ...
Full Text Available Oth.Neu.20.AllAg.Fetal_Spinal_Cord hg19 TFs and others Neural Fetal Spinal Cord htt...p://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/Oth.Neu.20.AllAg.Fetal_Spinal_Cord.bed ...
Full Text Available Pol.Neu.20.AllAg.Fetal_Spinal_Cord hg19 RNA polymerase Neural Fetal Spinal Cord htt...p://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/Pol.Neu.20.AllAg.Fetal_Spinal_Cord.bed ...
Full Text Available Unc.Neu.20.AllAg.Fetal_Spinal_Cord hg19 Unclassified Neural Fetal Spinal Cord http:...//dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/Unc.Neu.20.AllAg.Fetal_Spinal_Cord.bed ...
Full Text Available DNS.Neu.50.AllAg.Fetal_Spinal_Cord hg19 DNase-seq Neural Fetal Spinal Cord SRX10098...5,SRX121287,SRX121289,SRX201826,SRX201795,SRX214047 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/DNS.Neu.50.AllAg.Fetal_Spinal_Cord.bed ...
Full Text Available Pol.Neu.10.AllAg.Fetal_Spinal_Cord hg19 RNA polymerase Neural Fetal Spinal Cord htt...p://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/Pol.Neu.10.AllAg.Fetal_Spinal_Cord.bed ...
Full Text Available ALL.Neu.20.AllAg.Fetal_Spinal_Cord hg19 All antigens Neural Fetal Spinal Cord SRX10...342316 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Neu.20.AllAg.Fetal_Spinal_Cord.bed ...
Full Text Available Unc.Neu.10.AllAg.Fetal_Spinal_Cord hg19 Unclassified Neural Fetal Spinal Cord http:...//dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/Unc.Neu.10.AllAg.Fetal_Spinal_Cord.bed ...
Full Text Available DNS.Neu.05.AllAg.Fetal_Spinal_Cord hg19 DNase-seq Neural Fetal Spinal Cord SRX10098...5,SRX121287,SRX121289,SRX201826,SRX201795,SRX214047 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/DNS.Neu.05.AllAg.Fetal_Spinal_Cord.bed ...
Full Text Available ALL.Neu.10.AllAg.Fetal_Spinal_Cord hg19 All antigens Neural Fetal Spinal Cord SRX34...342316 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Neu.10.AllAg.Fetal_Spinal_Cord.bed ...
Full Text Available Unc.Neu.05.AllAg.Fetal_Spinal_Cord hg19 Unclassified Neural Fetal Spinal Cord http:...//dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/Unc.Neu.05.AllAg.Fetal_Spinal_Cord.bed ...
Full Text Available Oth.Neu.10.AllAg.Fetal_Spinal_Cord hg19 TFs and others Neural Fetal Spinal Cord htt...p://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/Oth.Neu.10.AllAg.Fetal_Spinal_Cord.bed ...
Full Text Available DNS.Neu.10.AllAg.Fetal_Spinal_Cord hg19 DNase-seq Neural Fetal Spinal Cord SRX10098...5,SRX121287,SRX121289,SRX201826,SRX201795,SRX214047 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/DNS.Neu.10.AllAg.Fetal_Spinal_Cord.bed ...
Full Text Available Oth.Neu.50.AllAg.Fetal_Spinal_Cord hg19 TFs and others Neural Fetal Spinal Cord htt...p://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/Oth.Neu.50.AllAg.Fetal_Spinal_Cord.bed ...
Full Text Available Pol.Neu.05.AllAg.Fetal_Spinal_Cord hg19 RNA polymerase Neural Fetal Spinal Cord htt...p://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/Pol.Neu.05.AllAg.Fetal_Spinal_Cord.bed ...
Full Text Available ALL.Neu.50.AllAg.Fetal_Spinal_Cord hg19 All antigens Neural Fetal Spinal Cord SRX10...342311 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Neu.50.AllAg.Fetal_Spinal_Cord.bed ...
Full Text Available DNS.Neu.20.AllAg.Fetal_Spinal_Cord hg19 DNase-seq Neural Fetal Spinal Cord SRX10098...5,SRX121287,SRX121289,SRX201826,SRX201795,SRX214047 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/DNS.Neu.20.AllAg.Fetal_Spinal_Cord.bed ...
Full Text Available Pol.Neu.50.AllAg.Fetal_Spinal_Cord hg19 RNA polymerase Neural Fetal Spinal Cord htt...p://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/Pol.Neu.50.AllAg.Fetal_Spinal_Cord.bed ...
Full Text Available ALL.Neu.05.AllAg.Fetal_Spinal_Cord hg19 All antigens Neural Fetal Spinal Cord SRX34...342316 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Neu.05.AllAg.Fetal_Spinal_Cord.bed ...
Full Text Available Unc.Neu.50.AllAg.Fetal_Spinal_Cord hg19 Unclassified Neural Fetal Spinal Cord http:...//dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/Unc.Neu.50.AllAg.Fetal_Spinal_Cord.bed ...
... Food and Nutrition Service National Advisory Council on Maternal, Infant and Fetal Nutrition: Notice of... National Advisory Council on Maternal, Infant and Fetal Nutrition. DATES: Date and Time: July 19-21, 2011... Maternal, Infant, and Fetal Nutrition will meet to continue its study of the Special Supplemental...
Full Text Available His.Adp.10.AllAg.Fetal_Heart hg19 Histone Adipocyte Fetal Heart SRX860893,SRX860894...,SRX860897,SRX860898,SRX860889,SRX860890,SRX860896,SRX860892,SRX860895,SRX860891 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/His.Adp.10.AllAg.Fetal_Heart.bed ...
Full Text Available His.Adp.50.AllAg.Fetal_Heart hg19 Histone Adipocyte Fetal Heart SRX860893,SRX860890...,SRX860889,SRX860894,SRX860892,SRX860896,SRX860895,SRX860898,SRX860891,SRX860897 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/His.Adp.50.AllAg.Fetal_Heart.bed ...
Full Text Available His.Neu.10.AllAg.Fetal_brain hg19 Histone Neural Fetal brain SRX860887,SRX860886,SR...X860879,SRX860888,SRX860880,SRX860881,SRX860885,SRX860883,SRX860884,SRX860882 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/His.Neu.10.AllAg.Fetal_brain.bed ...
Full Text Available NoD.Kid.50.AllAg.Fetal_kidney hg19 No description Kidney Fetal kidney SRX031424,SRX...031432,SRX031435,SRX031409,SRX031418,SRX031403 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/NoD.Kid.50.AllAg.Fetal_kidney.bed ...
Full Text Available NoD.Kid.20.AllAg.Fetal_kidney hg19 No description Kidney Fetal kidney SRX031424,SRX...031432,SRX031435,SRX031418,SRX031403,SRX031409 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/NoD.Kid.20.AllAg.Fetal_kidney.bed ...
Full Text Available ALL.Kid.50.AllAg.Fetal_kidney hg19 All antigens Kidney Fetal kidney SRX031424,SRX03...X201827,SRX201196,SRX031409,SRX031418,SRX031403 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Kid.50.AllAg.Fetal_kidney.bed ...
Full Text Available ALL.Kid.20.AllAg.Fetal_kidney hg19 All antigens Kidney Fetal kidney SRX031424,SRX03...X201196,SRX201816,SRX031403,SRX031409,SRX055179 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Kid.20.AllAg.Fetal_kidney.bed ...
Full Text Available ALL.Kid.05.AllAg.Fetal_kidney hg19 All antigens Kidney Fetal kidney SRX031424,SRX03...X055179,SRX031435,SRX031418,SRX031403,SRX031409 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Kid.05.AllAg.Fetal_kidney.bed ...
Full Text Available NoD.Kid.05.AllAg.Fetal_kidney hg19 No description Kidney Fetal kidney SRX031424,SRX...031432,SRX031435,SRX031418,SRX031403,SRX031409 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/NoD.Kid.05.AllAg.Fetal_kidney.bed ...
Full Text Available ALL.Kid.10.AllAg.Fetal_kidney hg19 All antigens Kidney Fetal kidney SRX031424,SRX03...X201816,SRX031418,SRX031403,SRX031409,SRX055179 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Kid.10.AllAg.Fetal_kidney.bed ...
Full Text Available NoD.Kid.10.AllAg.Fetal_kidney hg19 No description Kidney Fetal kidney SRX031424,SRX...031432,SRX031435,SRX031418,SRX031403,SRX031409 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/NoD.Kid.10.AllAg.Fetal_kidney.bed ...
VANLITH, JMM; VISSER, GHA; MANTINGH, A; BEEKHUIS, [No Value
Objective To investigate normal fetal heart rate in early pregnancy and assess the hypothesis that abnormal fetal heart rate is associated with fetal chromosomal abnormalities. Design Prospective descriptive cross-sectional study. Setting Antenatal clinic associated to the University Clinic of Obste
VANLOON, AJ; DERKSEN, JTM; BOS, AF; ROUWE, CW
A fetal goitre is a potentially dangerous phenomenon because of mechanical obstruction and possible fetal thyroid function disorders. In this report we describe a patient with Graves' disease diagnosed in early pregnancy and treated with propylthiouracil, which resulted in a large fetal goitre and f
Full Text Available His.Adp.05.AllAg.Fetal_Heart hg19 Histone Adipocyte Fetal Heart SRX860893,SRX860894...,SRX860897,SRX860898,SRX860892,SRX860890,SRX860889,SRX860896,SRX860895,SRX860891 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/His.Adp.05.AllAg.Fetal_Heart.bed ...
Full Text Available His.Adp.20.AllAg.Fetal_Heart hg19 Histone Adipocyte Fetal Heart SRX860893,SRX860898...,SRX860890,SRX860889,SRX860894,SRX860892,SRX860896,SRX860895,SRX860891,SRX860897 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/His.Adp.20.AllAg.Fetal_Heart.bed ...
Full Text Available NoD.Myo.50.AllAg.Fetal_muscle hg19 No description Muscle Fetal muscle SRX300958,SRX...RX213495 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/NoD.Myo.50.AllAg.Fetal_muscle.bed ...
Full Text Available NoD.Myo.10.AllAg.Fetal_muscle hg19 No description Muscle Fetal muscle SRX213498,SRX...RX300949 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/NoD.Myo.10.AllAg.Fetal_muscle.bed ...
Full Text Available ALL.Myo.20.AllAg.Fetal_muscle hg19 All antigens Muscle Fetal muscle SRX100979,SRX30...,SRX213495,SRX055170,SRX213492,SRX300947,SRX055186,SRX055169,SRX300955,SRX300949,SRX213502 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Myo.20.AllAg.Fetal_muscle.bed ...
Full Text Available DNS.Myo.50.AllAg.Fetal_muscle hg19 DNase-seq Muscle Fetal muscle SRX100979,SRX10098...RX214044,SRX055170,SRX055186,SRX055169 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/DNS.Myo.50.AllAg.Fetal_muscle.bed ...
Full Text Available ALL.Myo.10.AllAg.Fetal_muscle hg19 All antigens Muscle Fetal muscle SRX213498,SRX30...,SRX121279,SRX214045,SRX214044,SRX055170,SRX055186,SRX055169,SRX300955,SRX213502,SRX300949 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Myo.10.AllAg.Fetal_muscle.bed ...
Full Text Available ALL.Myo.50.AllAg.Fetal_muscle hg19 All antigens Muscle Fetal muscle SRX100979,SRX30...,SRX300947,SRX214044,SRX055170,SRX055186,SRX055169,SRX300949,SRX300955,SRX213502,SRX213495 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Myo.50.AllAg.Fetal_muscle.bed ...
Full Text Available ALL.Myo.05.AllAg.Fetal_muscle hg19 All antigens Muscle Fetal muscle SRX213498,SRX30...,SRX300961,SRX213510,SRX121279,SRX055186,SRX214044,SRX214045,SRX300949,SRX300955,SRX213502 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Myo.05.AllAg.Fetal_muscle.bed ...
Full Text Available NoD.Myo.20.AllAg.Fetal_muscle hg19 No description Muscle Fetal muscle SRX300958,SRX...RX213502 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/NoD.Myo.20.AllAg.Fetal_muscle.bed ...
Full Text Available DNS.Myo.10.AllAg.Fetal_muscle hg19 DNase-seq Muscle Fetal muscle SRX100979,SRX10098...RX214044,SRX055170,SRX055186,SRX055169 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/DNS.Myo.10.AllAg.Fetal_muscle.bed ...
Full Text Available DNS.Myo.05.AllAg.Fetal_muscle hg19 DNase-seq Muscle Fetal muscle SRX100979,SRX10098...RX121279,SRX055186,SRX214044,SRX214045 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/DNS.Myo.05.AllAg.Fetal_muscle.bed ...
Roelofs, Luc A. J.; Eggink, Alex J.; Hulsbergen-van de Kaa, Christina A.; van den Berg, Paul P.; van Kuppevelt, Toin H.; van Moerkerk, Herman T. B.; Crevels, A. Jane; Lotgering, Fred K.; Feitz, Wout F. J.; Wijnen, Rene M. H.
We evaluated the regeneration of the abdominal wall using a dual- layer collagen biomatrix, and the protective effect on the bowel of fetal abdominal wall repair in a fetal sheep model for gastroschisis. In 14 fetal lambs, the abdominal wall was opened at 79 days' gestation, creating a gastroschisis
Full Text Available DNS.Adp.50.AllAg.Fetal_Heart hg19 DNase-seq Adipocyte Fetal Heart SRX040387,SRX0404...0390 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/DNS.Adp.50.AllAg.Fetal_Heart.bed ...
Full Text Available DNS.Lng.20.AllAg.Fetal_lung hg19 DNase-seq Lung Fetal lung SRX040403,SRX100964,SRX1...RX055191,SRX055188,SRX055187,SRX027087,SRX055198 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/DNS.Lng.20.AllAg.Fetal_lung.bed ...
Full Text Available NoD.Lng.20.AllAg.Fetal_lung hg19 No description Lung Fetal lung SRX031411,SRX040986...05 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/NoD.Lng.20.AllAg.Fetal_lung.bed ...
Full Text Available NoD.Lng.10.AllAg.Fetal_lung hg19 No description Lung Fetal lung SRX031381,SRX031411...05 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/NoD.Lng.10.AllAg.Fetal_lung.bed ...
Full Text Available ALL.Lng.20.AllAg.Fetal_lung hg19 All antigens Lung Fetal lung SRX031411,SRX040403,S...804,SRX031399,SRX031423,SRX031381,SRX056806,SRX041015,SRX031384,SRX056805 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Lng.20.AllAg.Fetal_lung.bed ...
Full Text Available DNS.Lng.10.AllAg.Fetal_lung hg19 DNase-seq Lung Fetal lung SRX040403,SRX100964,SRX1...RX201831,SRX055191,SRX027087,SRX055187,SRX055198 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/DNS.Lng.10.AllAg.Fetal_lung.bed ...
Full Text Available ALL.Lng.10.AllAg.Fetal_lung hg19 All antigens Lung Fetal lung SRX031381,SRX031411,S...187,SRX031423,SRX041015,SRX055198,SRX056806,SRX056804,SRX031384,SRX056805 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Lng.10.AllAg.Fetal_lung.bed ...
Full Text Available NoD.Lng.50.AllAg.Fetal_lung hg19 No description Lung Fetal lung SRX031411,SRX040986...05 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/NoD.Lng.50.AllAg.Fetal_lung.bed ...
Full Text Available ALL.Lng.05.AllAg.Fetal_lung hg19 All antigens Lung Fetal lung SRX031381,SRX031423,S...191,SRX055187,SRX055198,SRX031384,SRX041015,SRX056806,SRX056804,SRX056805 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/ALL.Lng.05.AllAg.Fetal_lung.bed ...
Full Text Available DNS.Lng.05.AllAg.Fetal_lung hg19 DNase-seq Lung Fetal lung SRX040403,SRX100964,SRX1...RX055188,SRX062368,SRX055191,SRX055187,SRX055198 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/DNS.Lng.05.AllAg.Fetal_lung.bed ...
Full Text Available NoD.Lng.05.AllAg.Fetal_lung hg19 No description Lung Fetal lung SRX031381,SRX031423...05 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/assembled/NoD.Lng.05.AllAg.Fetal_lung.bed ...