WorldWideScience

Sample records for hemoglobina fetal na

  1. Analise molecular de deficiencias genicas associadas a persistencia hereditaria de hemoglobina fetal e delta beta talassemias

    OpenAIRE

    Tiago Gomes de Andrade

    2002-01-01

    Resumo: Persistência Hereditária de Hemoglobina Fetal (PHHF) consiste num grupo heterogêneo de desordens hereditárias, clinicamente benignas, onde ocorrem falhas na mudança perinatal normal de hemoglobina fetal para hemoglobina adulta, resultando em altos níveis de Hb F durante a vida adulta. Suas alterações moleculares correspondem a desordens no grupo de genes p, sendo divididas em duas categorias: as formas delecionais e as substituições de um nuc1eotídeo. Um total de seis delecões relacio...

  2. Análise quantitativa e molecular de hemoglobina fetal em indivíduos da população brasileira

    Directory of Open Access Journals (Sweden)

    Zamaro Paula J. A.

    2003-01-01

    Full Text Available A hemoglobina fetal - Hb F, formada por duas cadeias gama e duas cadeias alfa, é característica do período fetal do desenvolvimento, tendo sua síntese diminuída no período pós-natal. Em algumas alterações hereditárias, a Hb F permanece aumentada, como nas delta-beta talassemia, beta talassemia e persistência hereditária de Hb F (PHHF. A síntese da globina gama também pode ser estimulada por fatores externos como leucemias, transplantes de medula óssea, induções químicas, dentre outros. Através da observação de Hb F aumentada em doadores de sangue por procedimentos eletroforéticos objetivou-se avaliar a quantidade de Hb F em amostras de sangue de candidatos à doação, visando estabelecer seus limites de normalidade na população de São José do Rio Preto e região, por meio de desnaturação alcalina e cromatografia líquida de alta pressão (HPLC, comparar as metodologias aplicadas e, nos indivíduos com Hb F aumentada, realizar estudos moleculares para identificar as mutações que alteram a expressão dos genes gama. Foram analisadas 208 amostras de sangue, sendo 119 de candidatos à doação e 89 de indivíduos sem sintomas de anemia ou achados hematológicos e com Hb F aumentada como grupo comparativo. Das 119 amostras de candidatos à doação, 110 foram utilizadas para traçar o perfil de normalidade de Hb F, comparando-se as metodologias de desnaturação alcalina e HPLC, onde se obteve a média de 1,48% e de 0,6%, respectivamente. A análise estatística por regressão linear mostrou diferença significativa na comparação entre as duas metodologias aplicadas, sendo a HPLC mais precisa para a quantificação de Hb F. Foram observados nos testes de rastreamento de hemoglobinas anormais nestas 110 amostras de sangue: 16,4% de alfa talassemia, 0,9% com Hb F aumentada, 0,9% com beta talassemia e 0,9% com hemoglobina variante de cadeia delta. Os outros nove doadores de sangue apresentaram Hb F acima de 10% em

  3. Estudo de polimorfismos associados ao aumento da expressão de Hemoglobina Fetal (HbF)

    OpenAIRE

    Pereira, Clara Inês Antunes

    2013-01-01

    Dissertação de mestrado em Biologia, apresentada ao Departamento Ciências da Vida da Faculdade de Ciências e Tecnologia da Universidade de Coimbra. Hemoglobinopatias devidas a mutações no gene β-globínico são responsáveis por doenças monogénicas muito comuns no mundo, nomeadamente drepanocitose e β-talassemia. A forma de hemoglobina presente em maiores concentrações no adulto (cerca de 95%) é a hemoglobina A (HbA; α2β2), estando presentes em menor percentagem a hemoglobina A2 (HBA2; α2δ...

  4. Las variantes genéticas asociadas con niveles de hemoglobina fetal señalan diversos orígenes étnicos en pacientes colombianos con anemia falciforme

    Directory of Open Access Journals (Sweden)

    Cristian Fong

    2015-09-01

    Full Text Available Introducción. La hemoglobina fetal es un importante factor modulador de la gravedad de la anemia falciforme, cuya expresión está muy condicionada por el factor genético. Los loci asociados con el incremento de la hemoglobina fetal pueden presentar frecuencias alélicas específicas para cada población. Objetivo. Investigar la presencia y el efecto de las variantes genéticas rs11886868, rs9399137, rs4895441 y rs7482144 asociadas con la persistencia de hemoglobina fetal, en 60 pacientes colombianos con anemia falciforme. Materiales y métodos. Se hizo la genotipificación de los polimorfismos de nucleótido simple (Single Nucleotide Polymorphisms, SNP mediante la técnica de polimorfismos de longitud de fragmentos de restricción (Restriction Fragment Length Polymorphisms, RFLP y el procedimiento TaqMan. La hemoglobina fetal (HbF se cuantificó utilizando la técnica de desnaturalización alcalina de la oxihemoglobina. Las frecuencias genotípicas se compararon con las reportadas en poblaciones de referencia global. Resultados. Se observaron variantes genéticas ya reportadas para aumento de HbF en los cuatro SNP. La asociación genética entre los SNP y el incremento de la HbF no alcanzó significancia estadística. La frecuencia de estos alelos reflejó la siguiente composición específica en esta muestra de pacientes colombianos: una gran prevalencia de rs7482144-‘A’, lo que indica que el origen de la mutación para la anemia falciforme es África occidental, y una gran frecuencia de rs4895441-‘G’ y rs11886868-‘C’, lo que denota la influencia significativa del origen genético amerindio. Conclusión. Los resultados evidenciaron que la población con anemia falciforme de Colombia no tiene un único origen genético, sino que existen dos (africano y amerindio. Esta situación genética única ofrece la oportunidad de llevar a cabo un estudio más amplio de estos loci a nivel molecular. Se espera que el estudio de pacientes

  5. Influência do tipo de aleitamento materno e da presença de anemia na mãe na concentração de hemoglobina aos 6 meses de idade

    OpenAIRE

    Teixeira, Maria de Lourdes P. D.; Lira, Pedro I. C.; Coutinho, Sonia B.; Eickmann, Sophie H.; Lima, Marília de C

    2010-01-01

    OBJETIVO: Verificar a influência do tipo de aleitamento materno e da presença de anemia na mãe no nível de hemoglobina de lactentes aos 6 meses de idade. MÉTODOS: Estudo transversal, aninhado em estudo de intervenção de base comunitária, randomizado, controlado, que objetivou aumentar a duração do aleitamento materno exclusivo nos primeiros 6 meses de vida. O estudo foi realizado em quatro cidades do estado de Pernambuco, sendo os recém-nascidos recrutados no período de março a agosto de 2001...

  6. Prevalência das hemoglobinas S e C em heterozigose em duas comunidades de povos de Terreiros na cidade de Teresina, Piauí

    Directory of Open Access Journals (Sweden)

    Leonardo Ferreira Soares

    2015-09-01

    Full Text Available Doença hereditária de maior prevalência no Brasil e no mundo, a doença falciforme é considerada problema de saúde pública. Indivíduos que apresentam a HbS em homozigose (SS evidenciam uma condição grave da doença, enquanto indivíduos com a HbS em heterozigose AS e AC (traço falciforme, não apresentam manifestações clínicas, conferindo uma vida normal ao seu portador. O presente estudo objetivou fornecer subsídios para a consolidação do Programa Estadual da Doença Falciforme no estado do Piauí, apresentando a prevalência da doença falciforme e a sua herança genética em 62 indivíduos frequentadores de terreiros de Umbanda. A determinação das hemoglobinas variantes foi realizada por cromatografia líquida de alta performance (HPLC, utilizando o analisador de hemoglobinas Variant-II (Biorad. O estudo evidenciou a presença das hemoglobinas Hb AS (N=4 6,5%; Hb AC (N=3 4,8%; Hb SC (N=2 3,2%. Dos 62 indivíduos pesquisados com Hemoglobinas variantes, 19 eram do sexo masculino, enquanto 43 eram do sexo feminino. Apresentaram hemoglobinas variantes 7 mulheres e 2 homens. A maioria da população estudada estava constituída por pessoas negras (87%, seguido por pardos (8% e brancos (5%. A soma da porcentagem de negros e pardos é de 95%. O presente estudo piloto corrobora a hipótese da prevalência elevada da doença falciforme e da sua herança genética na população negra do estado do Piauí, necessitando da sua continuidade, com cobertura de maior quantidade do universo de terreiros, aliada a ações de atenção à saúde.Palavras-chaves: Doença falciforme. Anemia falciforme. Traço falciforme. ABSTRACTPrevalence of hemoglobins S and C in heterozygous in two communities of Umbanda Temple in the city of Teresina, Piauí, BrazilHereditary disease most prevalent in Brazil and worldwide, sickle cell disease is considered a public health problem. Individuals who present in homozygous HbS (SS show a severe condition of

  7. Correlação entre os índices dopplervelocimétricos da veia cava inferior e ducto venoso e a concentração de hemoglobina do cordão em fetos de gestantes isoimunizadas

    Directory of Open Access Journals (Sweden)

    Taveira Marcos Roberto

    2003-01-01

    Full Text Available OBJETIVO: o objetivo principal desse estudo foi verificar se existe correlação entre os índices dopplervelocimétricos da veia cava inferior e do ducto venoso e a concentração sérica da hemoglobina fetal. MÉTODOS: estudo transversal e prospectivo, realizado entre janeiro de 1998 e junho de 2001. Foram acompanhadas 31 gestantes isoimunizadas com resultado do teste de Coombs indireto maior que 1:8, que foram submetidas à pesquisa de hemólise fetal. Quando foram indicadas as transfusões intra-uterinas intravasculares, a hemoglobina do cordão foi dosada no início do procedimento. Nos demais casos, a hemoglobina do cordão foi mensurada no momento do parto, sempre por cesariana eletiva. Obteve-se um total de 74 procedimentos estudados, definidos como sendo cada transfusão intra-uterina precedida pela dopplervelocimetria venosa. A mensuração da concentração da hemoglobina fetal foi realizada no Hemocue® (B-Hemoglobin Photometer Hemocue AB; Angelholm, Sweden, dispositivo usado para a determinação quantitativa de hemoglobina no sangue. A dopplervelocimetria da cava inferior e do ducto venoso foi realizada antecedendo a coleta do sangue fetal, sempre em intervalo de tempo inferior a 24 horas. Os índices dopplervelocimétricos estudados foram o índice de pulsatilidade para veias (IPV, o índice do pico de velocidade para veias (IPVV e a relação entre o pico de velocidade durante a fase de contração atrial e o pico de velocidade na sístole ventricular (relação CA/SV ou índice de pré-carga, na veia cava inferior, e o IPV, IPVV e a relação entre os picos de velocidade da sístole ventricular e da contração atrial (relação SV/CA, no ducto venoso. Foi realizado estudo de correlação entre a dopplervelocimetria da veia cava inferior e do ducto venoso e a hemoglobina do cordão, pela técnica de regressão linear simples. Realizou-se também estudo de associação entre os índices dopplervelocimétricos do compartimento

  8. Estudo da Influência do Tempo de Laqueação do Cordão Umbilical na Concentração de Hematócrito, Hemoglobina e Bilirrubina

    OpenAIRE

    Chaves Thomaz, Débora Marchetti; Ralhares, Durval Batista

    2014-01-01

    Objetivo: Verificar a influência do tempo de laqueação do cordão umbilical na concentração de hematócrito, hemoglobina e btlirrubinas indireta em recém-nascidos de termo.Métodos: 90 recém-nascidos de termo saudáveis foram distribuídos igualmenle em 3 grupos de acordo com o tempo de laqueação do cordão umbilical (Grupo I -20 segundos. Grupo II - 30 segundos e Grupo III - 40 segundos) e acompanhados por 48 horas por avaliação Clinica e laboratorial. Foram colhidas amostras de sangue do cordão u...

  9. Influência do tipo de aleitamento materno e da presença de anemia na mãe na concentração de hemoglobina aos 6 meses de idade Influence of breastfeeding type and maternal anemia on hemoglobin concentration in 6-month-old infants

    Directory of Open Access Journals (Sweden)

    Maria de Lourdes P. D. Teixeira

    2010-02-01

    Full Text Available OBJETIVO: Verificar a influência do tipo de aleitamento materno e da presença de anemia na mãe no nível de hemoglobina de lactentes aos 6 meses de idade. MÉTODOS: Estudo transversal, aninhado em estudo de intervenção de base comunitária, randomizado, controlado, que objetivou aumentar a duração do aleitamento materno exclusivo nos primeiros 6 meses de vida. O estudo foi realizado em quatro cidades do estado de Pernambuco, sendo os recém-nascidos recrutados no período de março a agosto de 2001. Seis meses após o parto, avaliou-se a concentração da hemoglobina de 330 mães/lactentes e o tipo de aleitamento. A identificação dos fatores que, de modo independente, contribuíram na concentração de hemoglobina das crianças foi realizada utilizando análise de regressão linear multivariada. RESULTADOS: O tipo de aleitamento não influenciou a concentração de hemoglobina na amostra como um todo. No entanto, ao se analisar o grupo de crianças em aleitamento exclusivo/predominante, verificou-se uma diferença significante na mediana da hemoglobina de 0,7 g/dL em detrimento das filhas de mães anêmicas. A hemoglobina materna, o tipo de piso da residência, o tipo de parto e o peso ao nascer contribuíram significantemente na variação da concentração de hemoglobina das crianças. CONCLUSÕES: Ao contrário do observado em relação ao tipo de aleitamento materno, a anemia materna exerceu influência sobre os valores de hemoglobina de lactentes aos 6 meses, mesmo quando consideradas apenas as crianças em aleitamento exclusivo/predominante, apontando para a necessidade de prevenção da anemia materna antes da concepção, durante a gravidez e na lactação.OBJECTIVE: To verify the influence of breastfeeding type and of maternal anemia on hemoglobin concentration in 6-month-old infants. METHODS: This was a cross-sectional study nested in a community-based, randomized and controlled intervention study that aimed to prolong the

  10. Delivery assistance in fetal macrosomia Assistência ao parto na macrossomia fetal

    Directory of Open Access Journals (Sweden)

    Renato Augusto Moreira de Sá

    2003-12-01

    Full Text Available OBJECTIVES: to evaluate delivery assistance in fetal macrosomia. METHODS: this was a hospital-based cohort study of consecutive births at a tertiary perinatal center from January 1, 1996 to October 31, 1999. A total of 5261 pregnancies met the inclusion criteria which were singleton pregnancies with minimal birth weight of 1000 g. Fetal macrosomia was defined as birth weight of 4000 g or more. We studied the mode of delivery, the newborn condition at birth, considered low when the Apgar scored below seven in the first or fifth minute, and the presence of abnormalities that could indicate a Caesarian section (disproportion, uterine dysfunction, prolonged second period of birth and fetal distress. RESULTS: 296 (5,6% of the babies were macrosomic. Macrosomia was a risk factor for Caesarian section (RR = 1,59, p OBJETIVOS: avaliar a assistência ao parto na macrossomia fetal. MÉTODOS: Estudo do tipo coorte realizado em centro perinatal terciário no período de 1 de janeiro de 1996 a 31 de outubro de 1999. Foram selecionadas 5261 gestações de acordo com os critérios de inclusão, que foram: gestação única e peso mínimo ao nascimento de 1000 g. A macrossomia fetal foi definida como peso ao nascimento acima de 4000 g. Estudamos a via de parto, as condições ao nascimento, Apgar baixo quando inferior a sete no primeiro e quinto minutos e as anormalidades que serviram de indicação para cesariana (desproporção, distocia uterina, segundo período prolongado e sofrimento fetal. RESULTADOS: 296 (5,6% dos conceptos eram macrossômicos. Macrossomia foi fator de risco para cesariana (RR = 1,59, p <0,001 e para parto operatório vaginal (RR = 1,12 p <0,001. As condições do recém-nascido não foram piores nos fetos macrossômicos. Houve correlação positiva entre macrossomia fetal e desproporção mas não para distocia uterina, prolongamento do segundo período ou sofrimento fetal. CONCLUSÕES: Houve maior número de indicações de cesariana

  11. Cambios en las concentraciones de retinol, hemoglobina y ferritina en niños palúdicos colombianos

    Directory of Open Access Journals (Sweden)

    Rosa Magdalena Uscátegui

    2009-06-01

    Conclusión. El día 30, la hemoglobina y el retinol aumentaron, y la proteína C reactiva y la ferritina disminuyeron. El suplemento de retinol y antiparasitarios simultáneos previno la reducción de hemoglobina al día 8, sin afectar los cambios en otras variables.

  12. A importância da eletroforese de hemoglobina na orientação genética para síndrome falciforme

    Directory of Open Access Journals (Sweden)

    Júlio Boschini Filho

    2016-10-01

    Full Text Available Introdução: As hemoglobinopatias são distúrbios genéticos, em geral de herança recessiva. O diagnóstico precoce possibilita o aconselhamento genético com finalidade de orientar a respeito do planejamento familiar, ajudando a entender como a hereditariedade pode colaborar para a ocorrência ou risco de recorrência de doenças genéticas, como é o caso da síndrome falciforme. Objetivo: realizar a orientação e o encaminhamento para aconselhamento genético dos pacientes que foram diagnosticados com síndrome falciforme e em seus familiares, visando a prevenção da recorrência da doença nas próximas gerações. Casuística e método: consistiu na entrevista e orientação para os portadores da síndrome falciforme. Usamos como método de diagnóstico a eletroforese alcalina (pH 8,6 para caracterização do tipo de hemoglobinopatia. Resultado: observamos que ainda existe pouca compreensão dos pacientes e dos seus familiares sobre sua patologia e mecanismo de transmissão. Vimos que 25% dos familiares de primeiro não possuem conhecimento sobre portar um tipo de síndrome falcêmica. Conclusão: o desconhecimento da doença impede uma prevenção eficaz, o que acarreta altos custos para o Governo e para Saúde na questão do tratamento das Síndromes Falciformes, permitindo recorrência da morbidade. Por esse motivo, é fundamental que esse tipo de serviço seja amplificado.

  13. Diagnóstico não invasivo da anemia fetal pela medida do pico de velocidade sistólica na dopplervelocimetria da artéria cerebral média Noninvasive fetal anemia diagnosis by middle cerebral artery peak systolic velocity waveform measurement

    Directory of Open Access Journals (Sweden)

    Marcos Roberto Taveira

    2004-09-01

    Full Text Available OBJETIVO: avaliar se existe associação entre a medida do pico de velocidade sistólica (PVS na dopplervelocimetria da artéria cerebral média (ACM e a concentração de hemoglobina fetal e determinar a sua capacidade diagnóstica. MÉTODOS: entre janeiro de 2000 e maio de 2003, 44 gestantes isoimunizadas foram submetidas a transfusão intra-uterina. Realizou-se estudo dopplervelocimétrico da ACM antes de cada transfusão fetal, sempre com intervalo inferior a 3 horas, antecedendo o procedimento. O PVS da ACM foi considerado alterado quando seu valor era superior a 1,5 múltiplo da mediana para a respectiva idade gestacional. A concentração de hemoglobina do cordão foi aferida antes de se iniciar a infusão de sangue, realizada no Hemocue® (B-Hemoglobin Photometer Hemocue AB; Angelholm, Sweden. O estudo estatístico foi feito pelo teste do chi2 e também foram calculados os valores de sensibilidade, especificidade, valores preditivos positivo e negativo. RESULTADOS: foram realizados 83 procedimentos, sendo que em 33 a hemoglobina fetal era inferior a 10,0 g/dL. Houve associação significativa entre as variáveis estudadas, pPURPOSE: to assess the correlation between middle cerebral artery peak systolic velocity and umbilical cord blood hemoglobin concentration and to determine its diagnostic value. PATIENTS AND METHODS: a cross-sectional prospective study was performed from January 2000 to May 2003. Forty-four isoimmunized pregnant women underwent a protocol for the identification of fetal hemolysis. When intrauterine transfusions were indicated, the umbilical cord blood hemoglobin concentration was measured at the beginning of the procedure. Each intrauterine transfusion preceded by Doppler velocimetry of the middle cerebral artery was regarded as one case, summing up eighty-three procedures. In all cases, the middle cerebral artery Doppler examinations were performed within the three hours preceding fetal blood sample collection. The

  14. Trauma na gestante: análise da mortalidade materna e fetal

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Corsi

    Full Text Available Foram analisadas retrospectivamente 26 pacientes gestantes traumatizadas, num período de nove anos. A média de idade foi 23,7 anos (16-42. A idade gestacional variou de dez a quarenta semanas (média 21,5 semanas; a maioria (46,1% no segundo trimestre. O mecanismo predominante (65,3% foi o trauma abdominal fechado por acidente automobilístico (atropelamento ou colisão. Na admissão, oito (30,7% pacientes apresentavam alterações hemodinâmicas. Seis doentes (23,0% apresentavam sangramento vaginal e, destas, quatro estavam hemodinamicamente normais. Analisamos a mortalidade materna, a mortalidade fetal e suas causas. Comparamos também a mediana dos valores do RTS e TRISS entre os grupos, sobrevida materno-fetal, sobrevida materna e óbito materno-fetal. Todas as gestantes admitidas com sangramento vaginal apresentaram óbito fetal. A mortalidade materna foi de 11,5%, por choque hemorrágico. A mortalidade fetal foi de 30,7%, sendo que 37,5% destes óbitos foram provocados pela morte materna. A principal causa de mortalidade fetal foi o descolamento de placenta (50,0%. Os índices de trauma, RTS e TRISS, foram significativamente menor (p=0,0025 e p<0,0001 no grupo óbito materno-fetal, porém esses índices não apresentaram valor prognóstico na mortalidade fetal.

  15. Hemoglobinas anormais e dificuldade diagnóstica Abnormal hemoglobins

    Directory of Open Access Journals (Sweden)

    Guilherme G. Leoneli

    2000-12-01

    Full Text Available As hemoglobinas humanas, com padrão de herança definido geneticamente, apresentam variações polimórficas características dentro de nossa população, na dependência dos grupos raciais que formam cada região. Aparecem sob a forma de variantes de hemoglobinas ou talassemias, sendo mais freqüentes, no Brasil, os tipos variantes S e C e as talassemias alfa e beta, todas na forma heterozigota. Durante o ano de 1999, amostras de sangue de 506 indivíduos com anemia a esclarecer ou que já passaram por alguma triagem de hemoglobinopatias foram encaminhadas ao Centro de Referência de Hemoglobinas da UNESP, para confirmação diagnóstica e submetidas a procedimentos eletroforéticos, análises bioquímicas e citológicas, para caracterização das hemoglobinas anormais. O objetivo do presente estudo foi verificar quais tipos de hemoglobinas anormais apresentam maior dificuldade diagnóstica. As amostras foram provenientes de 24 cidades de doze estados. Os resultados mostraram que 354 indivíduos (69,96% apresentaram hemoglobinas anormais, sendo 30 Hb AS (5,93%, 5 Hb AC (0,98%, 76 sugestivos de talassemia alfa heterozigota (15,02%, 134 sugestivos de talassemia beta heterozigota (26,48% e 109 com outras formas de hemoglobinas anormais (21,54%, que incluem variantes raras e interações de diferentes formas de talassemias e hemoglobinas variantes. Concluiu-se que, apesar da melhoria técnica oferecida atualmente e a constante formação de recursos humanos capacitados, as talassemias em sua forma heterozigota (210 indivíduos -- 41,50% são responsáveis pela maior dificuldade diagnóstica, seguido da caracterização de variantes raras e formas interativas de hemoglobinopatias (109 indivíduos -- 21,54%, sugerindo que se deve aumentar a capacidade de formação de pessoal e as informações a respeito destas alterações genéticas em nossa população.The human hemoglobins, with genetically defined inheritance patterns, have shown

  16. A influ??ncia da coca??na no crescimento e desenvolvimento fetal e neonatal

    OpenAIRE

    Barbosa, J??ssica Lustosa Cabral

    2015-01-01

    Introdu????o: Pesquisas cient??ficas evidenciam uma associa????o entre a ingest??o de coca??na por gestantes e nutrizes, e a m?? forma????o fetal. Objetivo: O estudo tem como objetivo analisar as evid??ncias cient??ficas que sustentam a hip??tese de que o uso de coca??na pode ser prejudicial ao desenvolvimento infantil. M??todo: O estudo consiste em uma revis??o de literatura baseada em artigos cient??ficos buscados nas bases de dados Bireme, Lilacs, Pubmed, Scielo e Google acad??mico, por me...

  17. Fatores determinantes dos níveis de hemoglobina em crianças aos 12 meses de vida na Zona da Mata Meridional de Pernambuco Determinant factors of haemoglobin levels in 12 months old infants in the South of the Zona da Mata of Pernambuco

    Directory of Open Access Journals (Sweden)

    Ana Claudia V. M. de S. Lima

    2004-03-01

    Full Text Available OBJETIVOS: avaliar os fatores determinantes dos níveis de hemoglobina de crianças aos 12 meses de vida, em quatro municípios da Zona da Mata Meridional de Pernambuco. MÉTODOS: estudo transversal, realizado em uma sub-amostra de 245 lactentes, pertencentes a uma coorte de 652 crianças. A coleta de dados foi realizada no período de janeiro a agosto de 1999. RESULTADOS: a prevalência de anemia foi de 73,2%, sendo a média de hemoglobina de 9,8 g/dL (DP = 1,6 g/dL. A análise de variância apresentou uma associação estatisticamente significante entre níveis de hemoglobina e escolaridade materna, posse de televisão no domicílio, peso ao nascer, duração do aleitamento materno exclusivo, ocorrência de diarréia e estado nutricional segundo os índices peso/idade e comprimento/idade. A análise de regressão linear múltipla mostrou que as condições socioeconômicas, o peso ao nascer, a duração do aleitamento materno exclusivo e a ocorrência de diarréia tiveram um impacto significante na variação dos níveis de hemoglobina. CONCLUSÕES: os resultados confirmam ser a anemia um relevante problema de saúde pública, especialmente em lactentes, tendo múltiplos fatores que contribuem para o seu surgimento, sendo necessário, portanto, identificar os mais importantes para serem levados em consideração nos programas de saúde da criança.OBJECTIVES: to evaluate factors determining hemoglobin levels in 12 months old infants living in four small towns located in the South of Pernambuco. METHODS: a cross-sectional study conducted in a sub-sample of 245 infants belonging to a cohort of 652 children. Data collection was performed from January to August 1999. RESULTS: the prevalence of anemia was 73.2% and mean hemoglobin level 9.8 g/dL (SD = 1.6 g/dL. Variance analysis indicated a significant association between hemoglobin levels and maternal education, absence of a television set at home, birth weight, duration of exclusive breast

  18. Haplotipos del gen de la globina beta en portadores de hemoglobina S en Colombia

    Directory of Open Access Journals (Sweden)

    Claudia Liliana Durán

    2012-03-01

    Resultados. Los haplotipos de la hemoglobina S encontrados con mayor frecuencia en la muestra analizada son de origen africano y su orden de aparición fue mayor para el haplotipo Bantú (36,4 %, seguido por Senegal (30,3 %, Benín (21,2 % y Camerún (12,1 %. La electroforesis de hemoglobina confirmó el fenotipo AS; la dosificación de hemoglobina fetal mostró niveles por debajo de 1 % y los parámetros hematológicos analizados mostraron valores normales en el 100 % de los individuos. Conclusión. Los haplotipos de la HbS encontrados con mayor frecuencia en la muestra estudiada eran de origen africano y su distribución variaba de acuerdo con el lugar de prodedencia del individuo. La mayor frecuencia correspodió al haplotipo Bantú.   DOI: http://dx.doi.org/10.7705/biomedica.v32i1.600

  19. Caracterización de alteraciones en la molécula de hemoglobina en afrodescendientes colombianos

    OpenAIRE

    Castillo, Martha; Oliveros, Ana Lucia

    2014-01-01

    Objetivo: caracterizar alteraciones de la molécula de hemoglobina en afrodescendiente entre 18 a 50 años, a través de hemograma, estudio de sangre periférico, proteína C Reactiva, ferritina sérica, receptor soluble de transferrina sRTf y electroforesis de Hemoglobina. Materiales y métodos: Esta investigación contó con un total de 56 muestras:10 hombres y 46 mujeres.Resultados: La población en estudio perteneciente al distrito de Aguablanca en la Ciudad de Cali presentó alteraciones en la cade...

  20. Enfrentamento da morte fetal pela enfermagem na abordagem disposicional e na Teoria Motivacional do Coping

    OpenAIRE

    Cravinho,Camilla Ramos Medalane; Cunha,Ana Cristina Barros da

    2015-01-01

    O enfrentamento (coping) tem sido entendido como uma ação autorregulatória de ajuste ao desequilíbrio provocado pelo estressor, sempre com função adaptativa, ainda que a estratégia de enfrentamento não seja resolutiva. Duas abordagens têm esta definição em comum - a Abordagem Disposicional e a Teoria Motivacional do Coping. Visando a estudar o copingda morte fetal, 36 profissionais de enfermagem de dois hospitais públicos responderam, individualmente, o Inventário COPE com 60 itens e uma Entr...

  1. Diagnóstico laboratorial de hemoglobinas semelhantes à HbS Laboratorial diagnosis for hemoglobin like HbS

    Directory of Open Access Journals (Sweden)

    Paula Juliana Antoniazzo Zamaro

    2002-01-01

    Full Text Available A hemoglobina S (HbS está presente na população brasileira com prevalência variável, dependente dos grupos raciais formadores de cada região. A migração eletroforética em pH alcalino apresenta similaridade com outras hemoglobinas, e estudos complementares para sua correta caracterização são necessários. No presente estudo objetivamos traçar um fluxograma com as metodologias disponíveis para a caracterização da hemoglobina S e das hemoglobinas que apresentam migração semelhante em pH alcalino. No período de janeiro a junho de 2000, analisamos amostras de sangue com suspeita de hemoglobina S encaminhadas ao Laboratório de Hemoglobinas da Unesp. Caracterizamos diferentes mutantes e formas interativas com hemoglobina S, por procedimentos eletroforéticos, em variados pH, análises citológicas e testes bioquímicos específicos. Os procedimentos de análise aplicados resultaram em orientação fornecida aos laboratórios de rotina sobre como proceder no diagnóstico laboratorial destas alterações de hemoglobina. Desta forma contribuímos para um melhor conhecimento sobre a variabilidade genética das hemoglobinas em nossa população, auxiliando no acompanhamento clínico e no aconselhamento genético das hemoglobinopatias com fisiopatologia relacionada à alteração.The hemoglobin S is presented at Brazilian population with variable prevalence dependent of constitutive racial groups in each region. The electrophoretic migration on alkaline pH showed similarities with another hemoglobins. Complementary studies to the correct caracterization becomes necessary. At the present study we aimed make a fluxogram with the avaliable methodologies for the caracterization of hemoglobin S and hemoglobins that present similar migration on alkaline pH. During the period of January to June, 2000, we had analised blood samples with suspicious hemoglobin S sent to the Laboratory of Hemoglobins, Unesp. Were caracterized different mutants and

  2. Consumo de semente de linhaça durante a lactação afeta peso e nível de hemoglobina na prole de ratas Maternal consumption of flaxseed during lactation affects weight and hemoglobin level of offspring in rats

    Directory of Open Access Journals (Sweden)

    Ludmila F. M. F. Cardozo

    2010-04-01

    Full Text Available OBJETIVO: Avaliar os efeitos do consumo da semente de linhaça durante a lactação sobre o peso corporal, indicadores hematológicos e massa de gordura visceral dos filhotes de ratas na idade adulta. MÉTODOS: Foram utilizadas 16 ratas Wistar que, após o parto, foram divididas em dois grupos que receberam, durante a lactação, as seguintes dietas: grupo-controle (GC, ração à base de caseína, e grupo linhaça (GL, ração à base de caseína contendo 25% de semente de linhaça. Ao desmame, os filhotes machos passaram a receber ração comercial até a idade adulta, quando foram sacrificados aos 170 dias de vida para coleta de sangue e avaliação da massa de gordura visceral. RESULTADOS: Foi encontrado menor peso corporal da prole do GL (GL = 42,69±3,06 g; GC = 47,31±4,72 g; p = 0,036 ao desmame. Aos 170 dias de idade foram observados menores valores na hemoglobina do GL (GL = 12,30±1,28 g/dL; GC = 13,88±0,91 g/dL; p = 0,02. Não foram verificadas diferenças estatísticas na massa de gordura visceral entre os grupos. CONCLUSÕES: O consumo materno da ração à base de semente de linhaça durante a lactação promoveu menor peso ao desmame e níveis menores de hemoglobina na idade adulta quando comparados ao GC.OBJECTIVE: To investigate the effects of maternal flaxseed consumption during lactation on the body weight, hematological indicators and visceral fat mass of male offspring in adulthood. METHODS: Sixteen female Wistar rats were divided into two groups after giving birth. During lactation the control group (CG was fed a casein-based diet and the flaxseed group (FG was fed a casein-based diet containing 25% flaxseed. After weaning, male offspring were fed on commercial chow until adulthood and euthanized at 170 days for blood collection and visceral fat mass assessment. RESULTS: Offspring of rats in the FG had lower body weight (FG = 42.69±3.06 g; CG = 47.31±4.72 g; p = 0.036 at weaning. At 170 days, lower hemoglobin levels

  3. Amplificação gênica alelo-específica na caracterização das hemoglobinas S, C e D e as interações entre elas e talassemias beta Allele-specific genic amplification in the characterization of hemoglobins S, C, D and interactions among them and with beta thalassemia

    Directory of Open Access Journals (Sweden)

    Luciane Cristina Bertholo

    2006-08-01

    Full Text Available INTRODUÇÃO: As hemoglobinopatias resultam de alterações hereditárias, sendo prevalentes em muitas regiões do mundo, mas atingem a população brasileira de forma significativa. Elas são decorrentes de alterações em genes estruturais responsáveis pelo aparecimento das hemoglobinas variantes e/ou em genes reguladores, resultando nas talassemias. A identificação dessas patologias tem sido rotineiramente realizada por procedimentos eletroforéticos, contudo nossa experiência laboratorial evidencia que as mesmas nem sempre apresentam resoluções suficientes para a correta caracterização da mutação. CASUÍSTICAS E MÉTODOS: O propósito deste trabalho foi estabelecer uma metodologia válida para a caracterização das hemoglobinas S, C e D em homozigose ou heterozigose, e suas possíveis interações, baseada na amplificação gênica alelo-específica (PCR-AE com a utilização de primers sense, antisense e primers que se acoplam na posição do alelo mutante e na respectiva posição do alelo normal. RESULTADOS E DISCUSSÃO: Os resultados evidenciaram a validade dessa metodologia na caracterização das mutações, sendo esse procedimento de fácil realização, reprodutível e possível de ser aplicado em um significativo número de amostras.BRACKGROUND: The hemoglobinopathies are a group of hereditary hemoglobin disorders in worldwide distribution, affecting Brazilian population significantly; they are decurrent of alterations in structural genes, responsible for hemoglobin variants, and/or in regulatory genes, resulting the thalassemia. These disorders have been identified in most cases by electrophoretics procedures, and our laboratory experience points out that sometimes they do not obtain enough resolution for a right characterization of mutation. MATERIAL AND METHOD: The objective of this study was to establish a valid laboratory methodology for the characterization of hemoglobins S, C and D in homozygous or heterozygous and

  4. Efeito da icterícia obstrutiva na fertilidade, morfologia ovariana e desenvolvimento fetal em ratas Effect of jaundice on fertility, ovarian morphology and fetal development in rats

    Directory of Open Access Journals (Sweden)

    Vivian Resende

    2008-09-01

    Full Text Available Avaliou-se o efeito da icterícia obstrutiva na capacidade reprodutiva, morfologia ovariana e desenvolvimento fetal em ratas, utilizando 53 ratas sexualmente maduras, distribuídas em dois grupos: grupo 1 (n = 28 - ligadura do ducto biliopancreático e grupo 2 (n = 25 - controle. Pode-se concluir que, em presença de hiperbilirrubinemia, a fertilização é viável, a capacidade reprodutiva é muito reduzida, os ciclos estrais tornam-se irregulares, o epitélio vaginal permanece cornificado, os corpos lúteos ovarianos regridem, os corpos lúteos gravídicos não são alterados, aumentando progressivamente durante a prenhez, e o desenvolvimento fetal é gravemente alterado.The effect of jaundice on the reproductive capacity, ovarian morphology and fetal development in rats was assessed in 53 sexually mature rats divided into two groups: group 1 (n = 28 - submitted to ligature of the biliopancreatic duct and group 2 (n = 25 - control - submitted only to sham operation. In jaundice rats fertilization is viable, the reproductive capacity is intensive reduced, the estrus cycles becomes irregular, the corpi lutea is presented in regression, the gravidic lutea is not modified increasing gradually during the pregnancy and the fetal development is seriously impaired.

  5. Perfil Biofísico Fetal na Ruptura Prematura das Membranas Fetal Biophysical Profile in Premature Rupture of the Membranes

    Directory of Open Access Journals (Sweden)

    Vardeli Alves de Moraes

    2000-05-01

    Full Text Available Objetivo: avaliar as modificações decorrentes da ruptura prematura das membranas sobre as variáveis do perfil biofísico fetal comparando-as às encontradas em gestantes com membranas íntegras. No grupo com ruptura prematura das membranas foi analisada, ainda, a associação das variáveis biofísicas com os índices de Apgar no 1º e 5º minutos e com a presença ou não de corioamnionite clínica e infecção neonatal. Pacientes e Métodos: em estudo prospectivo foram realizados 112 perfis biofísicos fetais em 60 gestantes com ruptura prematura das membranas entre a 28ª e a 40ª semana de gestação, sendo que apenas o último perfil biofísico fetal foi analisado e comparado com 60 perfis biofísicos fetais de gestantes com idades gestacionais idênticas às do grupo estudo e com membranas íntegras. Resultados: a análise estatística revelou que a ruptura prematura das membranas diminuiu a reatividade fetal, não interferiu nos movimentos corpóreos fetais, diminuiu a freqüência dos movimentos respiratórios fetais, não determinou modificações no tônus fetal e diminuiu consideravelmente o índice de líquido amniótico. Quanto à predição de corioamnionite e infecção neonatal, o perfil biofísico fetal não demonstrou ter validade estatisticamente significativa; no entanto, quando as variáveis biofísicas estavam presentes, ficou demonstrada de forma evidente a correlação com a ausência de corioamnionite e infecção neonatal. O resultado do último perfil biofísico fetal associou-se significativamente com o índice de Apgar no 5º minuto. Conclusão: o perfil biofísico fetal deve ser utilizado rotineiramente em gestantes com ruptura prematura das membranas com o propósito de se avaliar a vitalidade fetal e para se detectarem os fetos com menor probabilidade de infecção, principalmente aqueles com idades gestacionais abaixo da 34ª semana, nos quais se toma a conduta conservadora.Purpose: to evaluate the

  6. The impact of laser therapy on fetal growth discordance in twin-to-twin transfusion syndrome O impacto da terapia a laser no crescimento fetal na sindrome de transfusão feto-fetal

    Directory of Open Access Journals (Sweden)

    Renato A. Moreira de Sa

    2005-09-01

    Full Text Available OBJECTIVES: to evaluate the impact of laser therapy on inter-twin discordance in twin-to-twin transfusion syndrome (TTTS. METHODS: biparietal diameter (BPD, head circumference (HC, abdominal circumference (AC, femur length (FL and estimated fetal weight were prospectively collected during a five-year period (1999 to 2004. The inter-twin discordance was expressed as a percentage of the largest twin's measurements. The measurements were made the day before laser, twice following laser and after delivery. The mean values of discordance in measurements and in fetal weight were calculated. ANOVA was used to compare mean values. RESULTS: the mean (SD discordance for BPD, HC, AC, FL and estimated fetal weight the day before laser were 8.53% (5.28, 8.75% (2.76, 16.19% (4.85, 12.92% (5.13 and 28.50% (6.46 respectively. At the at 2nd ultrasound assessment after surgery were 4.37% (3.55, 3.73% (2.71, 8.90% (4.42, 6.61% (4.99 and 19.11% (8.01 respectively; and at birth the weight discordance was 18.55% (8.74. There was a significant decrease in discordance for HC and AC for each ultrasound assessment. CONCLUSIONS: there was a decrease in fetal growth discordance following laser therapy in TTTS. These changes might be related to re-adaptation of blood flow following laser therapy.OBJETIVOS: avaliar impacto da terapia a laser no crescimento fetal na Sindrome de transfusão feto-fetal (STFF. MÉTODOS: diâmetro biparietal (DBP, circunferência cefálica (CC e abdominal (CA, comprimento do fêmur (CF e peso fetal foram colhidos prospectivamente no período de cinco anos (1999 a 2004. A discordância entre os gêmeos foi expressa como porcentagem da medida do maior. As medidas foram feitas um dia antes do laser, duas vezes após e depois do nascimento. A cada exame e pós-parto foram calculadas médias das discordâncias entre medidas e peso fetal. ANOVA foi usada para comparar as médias. RESULTADOS: a discordância média (SD para DBP, CC, CA, CF e peso fetal

  7. Retorno venoso na avaliação da função cardíaca fetal

    OpenAIRE

    Macedo, Alexandra Matias Pereira da Cunha Coelho de

    2000-01-01

    A utilização do efeito Doppler a nível clínico permitiu o estudo não invasivo das velocidades de fluxo sanguíneo no feto humano em diferentes territórios vasculares. O significado clínico pouco consistente das alterações encontradas a nível arterial e intracardíaco na caracterização do comprometimento fetal, determinaram a procura de outros territórios onde se pudesse, de forma mais fidedigna e clinicamente mais relevante, identificar sinais antecipatórios de deterioração fetal. Um desses ter...

  8. Haemoglobin polimorphism in sheep (“Ovis aries”, L.: evaluation of genotype and frequency of animals breeder in Bahia State, Brazil Polimorfismo da hemoglobina de ovinos ("Ovis aries", L.: determinação do tipo e da freqüência em animais criados no Estado da Bahia

    Directory of Open Access Journals (Sweden)

    Adriana da Silva Rodrigues Cavacanti

    2009-09-01

    mais rápida e a Hb-AB, com a presença dos dois alelos, formada pela banda lenta e a rápida. As freqüências genotípicas observadas foram: Hb-AA 49,0% (145/296, Hb-AB 39,18% (116/296 e Hb-BB 11,82% (35/296. Os animais das raças Santa Inês, Rabo Largo e Morada Nova, apresentaram todos os tipos de hemoglobina identificados; nos ovinos da raça Dorper apenas foi identificado o genótipo Hb-AA e nos indivíduos resultantes de cruzamento não foi observado o tipo Hb-BB. As freqüências gênicas dos alelos HbA e HbB foram, respectivamente, igual a 0,69% e 0,31%. Não foi observada a hemoglobina fetal e o polimorfismo da hemoglobina foi verificado na população de ovinos avaliada onde o homozigoto Hb-AA foi tipo predominante.

  9. Avaliar a correlação entre a concentração da hemoglobina e a medida ecográfica do diâmetro biventricular externo em fetos anêmicos de gestantes isoimunizadas

    Directory of Open Access Journals (Sweden)

    Rodrigues Rosangela Lopes Miranda

    2005-01-01

    Full Text Available OBJETIVO: Verificar se existe correlação significativa entre a medida ecográfica do diâmetro biventricular externo e a concentração sérica da hemoglobina fetal pré-transfusional e se essa medida ecográfica poderá vir a ser utilizada como marcador não invasivo da anemia fetal. MÉTODOS: Estudo transversal prospectivo, no qual foram selecionadas 65 cordocenteses realizadas em 36 fetos anêmicos de mães portadoras de isoimunização pelo fator Rh. Obteve-se a medida do diâmetro biventricular externo (DBVE, por meio do modo M, utilizando-se aparelho de ultra-som convencional. Anterior à transfusão foi obtida amostra de 0,5ml de sangue fetal, para dosagem da hemoglobina, sendo a medida imediatamente realizada através de espectrofotometria, no equipamento Hemocue®. Como análise estatística foi utilizada a regressão dos mínimos quadrados, aceitando-se p<0,05 e análise multivariada. RESULTADOS: Foram observadas correlação inversa entre a concentração da hemoglobina no sangue fetal no momento prévio à transfusão e a medida do DBVE e correlação direta entre a medida do DBVE e a idade gestacional, e, também, através da análise multivariada que, à medida que a concentração de hemoglobina fetal cai, o DBVE aumenta, independentemente da influência da idade gestacional nesse parâmetro. CONCLUSÃO: Existe correlação inversa entre a concentração da hemoglobina no sangue fetal e a medida do DBVE, independente da idade gestacional. Os achados sugerem que o DBVE poderá vir a ser um marcador ecográfico de predição do nível de hemoglobina de fetos de gestantes isoimunizadas.

  10. Anemia intrahospitalaria y descenso de hemoglobina en pacientes internados

    Directory of Open Access Journals (Sweden)

    Carina V. Gianserra

    2011-06-01

    Full Text Available Es frecuente observar el desarrollo de anemia durante la internación, especialmente en pacientes graves. Esto se ha relacionado a extracciones de laboratorio. Pocos estudios evaluaron su prevalencia y factores asociados en pacientes internados en sala general. El objetivo fue determinar la prevalencia, características y factores clínicos asociados a anemia intrahospitalaria y descenso de hemoglobina en pacientes internados. Se efectuó un estudio transversal, prospectivo, descriptivo. Se analizaron 192 internaciones consecutivas en sala general. Se determinó aquellas que presentaron un descenso del valor de hemoglobina = 2 g/dl y se analizaron factores de riesgo asociados. Presentaron anemia 139 pacientes (72.4%, 89 (46.4% al ingreso y 50 (26% durante la internación. Se presentaron 47 casos de descenso de hemoglobina = 2 g/dl (24.47%, en los que se observaron los valores más bajos de hematocrito y hemoglobina al alta (p = 0.01, hidratación parenteral con mayor volumen (p = 0.01 y estadías hospitalarias más prolongadas (p = 0.0001. En el análisis univariado las variables leucocitosis = 11 000mm³ (OR; IC95%: 2.02; 1.03-4; p = 0.01, días de internación = 7 (OR; IC95%: 3.39; 1.62-7.09; p = 0.0006, hidratación parenteral = 1500 ml/día (OR; IC95%: 2.47; 1.06-6.4; p = 0.01, vía central (OR; IC95%: 10.29; 1.75-108.07, p = 0.003 y anemia intrahospitalaria (OR; IC95%: 7.06; 3.41-15.83; p = 0.00000004 fueron estadísticamente significativos como factores de riesgo para descenso de hemoglobina = 2 g/dl. En el análisis multivariado las variables leucocitosis = 11 000 mm³ (OR; IC95%:2.45; 1.14-5.27; p = 0.02; días de internación = 7 (OR; IC95%: 5.15; 2.19-12.07; p = 0.0002; hidratación parenteral = 1500 ml/día (OR; IC95%: 2.95; 1.13-7.72; p = 0.02 y vía central (OR; IC95%:8.82; 1.37-56.82; p = 0.02 fueron factores predictivos independientes de descenso de hemoglobina = 2 g/dl. La anemia intrahospitalaria tuvo una elevada prevalencia. La

  11. ÁLCOOL E GRAVIDEZ: INFLUÊNCIA NA MORFOLOGIA FETAL

    Directory of Open Access Journals (Sweden)

    Fernanda Sardinha de Abreu Tacon

    2017-07-01

    Full Text Available Objective: knowing the risk factors may help in the elaboration of counseling programs for pregnant women and better conduct for health professionals, mainly due to the fact that their use is often concealed, making it difficult to follow. Data sourse: this systematic review study searched the Bireme, Scielo, PubMed, Lilacs and Site Up to Date databases. The selection took into account the titles and abstracts related to the subject, from 2010 to 2017, using the descriptors alcohol / ethanol, pregnancy / pregnancy and fetal development / fetal morphology. We found 70 articles, of these were selected 35, the most recent and high theoretical content required for the construction of the text. Data synthesis: through this analysis, we observed the need for early identification of alcohol consumption in pregnancy, not only the maternal report. Conclusions: therefore, new research in the area is necessary for better prevention and adaptation of the patient after a diagnosis of Fetal Alcohol Spectrum Disorders and to adopt prophylactic measures in order to protect the fetus and pregnant women, contributing to the improvement of public health

  12. Importância da hemoglobina glicada no controle do diabetes mellitus e na avaliação de risco das complicações crônicas Glycohemoglobin importance in the diabetes mellitus control and in the risk evaluation of chronic complications

    Directory of Open Access Journals (Sweden)

    Nairo Massakazu Sumita

    2008-06-01

    Full Text Available O diabetes mellitus (DM continua sendo objeto de pesquisa, dadas as constantes informações que os estudos clínicos e os novos recursos laboratoriais incorporam à prática médica a cada dia e com maiores rapidez e eficiência. Níveis glicêmicos persistentemente elevados são danosos ao organismo e o descontrole prolongado resulta em complicações, incluindo danos em diversos tecidos, perda da função normal e falência de vários órgãos. Para o acompanhamento do portador de DM, a hemoglobina glicada (A1C tem se firmado como ferramenta útil depois de ter sido validada pelos dois estudos clínicos mais importantes sobre a avaliação do impacto do rígido controle glicêmico sobre a incidência e a progressão das complicações do diabetes: o Diabetes Control and Complications Trial (DCCT, 1993 e o United Kingdom Prospective Diabetes Study (UKPDS, 1998. Essas pesquisas demonstraram que manter o nível de A1C abaixo de 7% reduz o risco de desenvolvimento das complicações dessa doença. O Grupo Interdisciplinar de Padronização da Hemoglobina Glicada - A1C, criado pela associação de diversas sociedades científicas e farmacêuticas do Brasil, publicou, em 2004, um documento de posicionamento oficial acerca da importância da A1C para a avaliação do controle glicêmico, abordando os principais aspectos clínicos e laboratoriais, incluindo as condições de variação pré-analítica e analítica. Foram estabelecidas as recomendações a respeito das indicações do teste e dos valores ideais de controle para adultos, crianças e idosos. Segundo este posicionamento, os testes de A1C devem ser realizados pelo menos duas vezes ao ano por todos os portadores de DM. Quando os resultados não forem adequados e/ou forem realizadas alterações no esquema terapêutico, a dosagem deve ser feita depois de três meses. A dosagem está indicada tanto para os portadores de diabetes mellitus tipo 1 (DM1 quanto tipo 2 (DM2, sendo que a meta a ser

  13. Perfil Biofísico Fetal na Ruptura Prematura das Membranas

    OpenAIRE

    Moraes,Vardeli Alves de; Kulay Jr.,Luis; Bertini,Anna Maria

    2000-01-01

    Objetivo: avaliar as modificações decorrentes da ruptura prematura das membranas sobre as variáveis do perfil biofísico fetal comparando-as às encontradas em gestantes com membranas íntegras. No grupo com ruptura prematura das membranas foi analisada, ainda, a associação das variáveis biofísicas com os índices de Apgar no 1º e 5º minutos e com a presença ou não de corioamnionite clínica e infecção neonatal. Pacientes e Métodos: em estudo prospectivo foram realizados 112 perfis biofísicos feta...

  14. Asma na gestação: efeitos na vitalidade fetal, complicações maternas e perinatais Asthma during pregnancy: effects on fetal well-being, and maternal and perinatal complications

    Directory of Open Access Journals (Sweden)

    Renata Franco Pimentel Mendes

    2013-04-01

    Full Text Available OBJETIVO: Avaliar os efeitos da asma materna sobre a gravidez, analisando as repercussões da gravidade da doença no comprometimento do bem-estar fetal, bem como as complicações maternas e perinatais associadas. MÉTODOS: Foi realizado estudo retrospectivo de 117 gestações complicadas pela asma materna e sem outras comorbidades, no período de janeiro de 2005 a dezembro de 2010. Os critérios de inclusão foram: gestação única; diagnóstico de asma prévio à gestação; início do pré-natal antes da 28ª semana de gravidez; parto realizado na instituição; peso do recém-nascido acima de 500g e idade gestacional no parto acima de 22 semanas; ausência de malformações fetais ou anomalias cromossômicas; ausência de comorbidades maternas. A gravidade da asma foi classificada em intermitente, persistente leve, persistente moderada, persistente grave. Foram analisados os resultados do perfil biofísico fetal e da dopplervelocimetria de artéria umbilical realizados até 14 dias antes do parto. RESULTADOS: Do total de 117 gestantes asmáticas analisadas: 41 (35,0% eram intermitentes, 33 (28,2% persistentes leves, 21 (17,9% persistentes moderadas e 22 (18,8% persistentes graves. Não houve diferença significativa entre os grupos quanto ao tipo de parto: a cesárea foi realizada em 65,8% dos casos, a corticoterapia materna no momento do parto em 20,5%, a idade gestacional no parto apresentou média de 38,6 semanas (DP 1,9 semanas e o peso ao nascimento apresentou média de 3056 g (DP 581 g. O perfil biofísico fetal realizado no período anteparto (n = 90, 76,9% apresentou resultado normal (8 ou 10 em 99% dos casos. A dopplervelocimetria de artéria umbilical foi avaliada em 23,9% (n = 28 das gestantes, e apresentou-se normal em 100% dos casos. O uso de corticoterapia sistêmica foi significativamente (pOBJECTIVE: To assess the effects of maternal asthma on pregnancy, analyzing the consequences of the severity of the disease in the

  15. Bioquímica en la vida diaria: el equilibrio químico y la función transportadora de la hemoglobina

    OpenAIRE

    Orfa Rojas, María; Echeverría Palacio, Carlos Mario; Ramírez Grueso, Raúl; Coba Torres, Kelly

    2010-01-01

    La hemoglobina es una proteína sanguínea que puede transportar oxígeno, un gas insoluble en medio acuoso, llevándolo a las diferentes partes del organismo en donde es requerido para su buen funcionamiento, así como productos metabólicos como el CO2 y el hidrógeno, para su excreción. Estos procesos se ven condicionados por factores como el pH, la concentración de BPG, las presiones parciales de O2 y CO2, la cooperatividad de la unión entre la hemoglobina y esos compuestos y los cambios conform...

  16. Curva de hemoglobina em um grupo de gestantes normais Hemoglobin curve in a normal pregnant women group

    Directory of Open Access Journals (Sweden)

    Pedro Augusto Marcondes de Almeida

    1973-09-01

    Full Text Available Através das dosagens de hemoglobina realizadas em várias épocas da gravidez, em 701 gestantes sem suplementação de ferro escolhidas por amostragem casual simples de um universo de 7050 no período de 1947 a 1969, foi construída uma curva com as taxas médias de hemoglobina, que evidenciou uma queda que atinge o máximo por volta do 7.° mês de gravidez e elevando-se a partir desta época. A partir dela foi construída uma curva operacional e discutida a sua importância no diagnóstico e conduta frente a anemia na gravidez.Through hemoglobin determinations made in various stages of pregnancy, in 701 pregnant women with no iron supplementation ad hoc chosen out of a number of 7050 in the period from 1947 to 1969, a curve was constructed with the average rate of hemoglobin, which gave evidence of a drop that reaches its maximum around the 7th month of pregnancy and rises from that moment on. From this a working graph was built up and then it was discussed its importance in the diagnostic and treatment in anemia in pregnancy.

  17. Hipertireoidismo na gravidez: repercussões materno-fetais Hyperthyroidism during pregnancy: maternal-fetal outcomes

    Directory of Open Access Journals (Sweden)

    Amanda Tavares Pinheiro

    2008-09-01

    Full Text Available OBJETIVO: avaliar a experiência do Hospital das Clínicas da Faculdade de Medicina de Botucatu da Universidade Estadual Paulista "Júlio de Mesquita Filho", no acompanhamento de gestantes com hipertireoidismo. MÉTODOS: foram estudadas, retrospectivamente, 60 pacientes, divididas em grupos com hipertireoidismo compensado (GHC=24 e com hipertireoidismo descompensado (GHD=36 e comparadas quanto a características clínico-laboratoriais e intercorrências. Para análise dos resultados, foram utilizados o teste t de Student, as tabelas de contingência, regressão linear múltipla e regressão logística múltipla, com nível de significância de 5,0%. RESULTADOS: propiltiouracil (PTU foi usado por 94,0% do GHD e 42,0% do GHC (pPURPOSE: to evaluate the experience of Hospital das Clínicas da Faculdade de Medicina de Botucatu da Universidade Estadual Paulista "Júlio de Mesquita Filho", in the follow-up of pregnant women with hyperthyroidism. METHODS: Sixty patients, divided in groups with compensated hyperthyroidism (CHG=24 and with uncompensated hyperthyroidism (UHG=36 were retrospectively studied and compared concerning clinical-laboratorial characteristics and intercurrences. The t-Student test, contingency tables, multiple linear regression and multiple logistic regression with significance level at 5.0% were used. RESULTS: propylthiouracil (PTU was used by 94.0% of UHG and by 42.0% of CHG (p<0.0001; maternal complications close to delivery have occurred in 20.6% of UHG and in 11.8% of CHG, and UHG presented three fetal deaths, influenced by the mother age, higher level of T4L (lT4L and of PTU dose (PTUd in the third trimester (p=0.007; restriction of intra-uterine growth, influenced by lT4L and PTUd in the third trimester has occurred in nine UHG and in three CHG cases, and oligoamnios has occurred in 12 patients (83.3% of UGH and 16.7% of CGH, influenced by age and lT4L in the third trimester (p=0.04; the gestational age at delivery was 34.4

  18. Peso corporal, indices cardiacos, hematocrito y hemoglobina en dos lineas comerciales de pavos

    National Research Council Canada - National Science Library

    Terry M., Veronica K; Figueroa T., Edgardo; Fuentes N., Nadia E; Ayon S., Milder; Guzman G., Jhon; Carcelen C., Fernando

    2012-01-01

    El presente estudio tuvo como objetivo comparar el peso corporal, asi como indices cardiacos, hematocrito y hemoglobina como indicadores de trabajo cardiaco de dos lineas de pavos de engorde criados a nivel del mar...

  19. Rompiendo un mito en el control de la hemoglobina/hematocrito postransfusion

    National Research Council Canada - National Science Library

    Pardo, Juan Mauricio; Panqueva Martinez, Uriel; Fernanda Espinosa, Angela

    2010-01-01

    Habitualmente se ha solicitado la hemoglobina/hematocrito despues de las seis horas como parametro para evaluar el resultado terapeutico de la transfusion sin que exista evidencia clara para hacerlo. Palabras clave...

  20. Influencia del hematocrito en el tiempo de relajacion de eritrocitos y soluciones de hemoglobinas

    National Research Council Canada - National Science Library

    Mengana-Torres, Yulianela; Fernandez-Garcia, Adolfo

    2012-01-01

    En este trabajo se hizo una evaluacion de la influencia del hematocrito en la preparacion de muestras de paquetes de globulos rojos y solucion de hemoglobinas para buscar la relacion de los parametros...

  1. Polimorfismo da hemoglobina de bubalinos (Bubalis bubalis da raça Murrah criados no Estado de São Paulo, Brasil

    Directory of Open Access Journals (Sweden)

    A. M. F. Rosenfeld

    2006-03-01

    Full Text Available Os tipos de hemoglobina foram determinados em 41 amostras de sangue de bubalinos sadios da raça Murrah, criados no município de Roseira, no Estado de São Paulo, sendo cinco animais machos e 36 fêmeas. As amostras sangüíneas foram colhidas por venipunção da jugular, em tubos contendo EDTA e a determinação dos tipos de hemoglobina foi realizada pela técnica de eletroforese alcalina em acetato de celulose, utilizando-se o Tris-EDTA-Borato (pH 8,6 como solução tampão. Duas bandas de migração relativas aos alelos HbA e HbB foram observadas, identificando-se dois genótipos Hb-AA e Hb-AB e as suas freqüências na população avaliada foram: 95,1% dos bubalinos apresentaram o tipo heterozigoto Hb-AB e 4,9% o tipo homozigoto Hb-AA. O polimorfismo da hemoglobina foi observado nos bubalinos e o genótipo heterozigoto Hb-AB foi o mais freqüente.

  2. Associação entre a antropometria e a leptina circulante nos compartimentos materno, fetal e placentário, na gravidez normal Association between anthropometry and circulating leptin in maternal, fetal and placental compartments, in healthy pregnancy

    Directory of Open Access Journals (Sweden)

    Flávia Cipriano Castro

    2004-10-01

    Full Text Available OBJETIVO: avaliar a importância da leptina materna e fetal circulantes na gestação saudável por meio da avaliação de sua associação com variáveis antropométricas materna, placentária e fetal ao nascimento e as relações entre os compartimentos avaliados. MÉTODOS: em estudo transversal foi incluída amostra de 33 gestações únicas, a termo, com fetos saudáveis. As variáveis avaliadas foram idade materna, peso materno, índice de massa corporal, peso do recém-nascido, peso placentário e índice placentário. Amostras de sangue materno foram obtidas imediatamente antes do parto e em sangue do cordão umbilical ao nascimento. A dosagem da leptina sérica foi realizada por meio de radioimunoensaio convencional. As relações entre as concentrações de leptina sérica materna e da artéria e veia umbilicais com as variáveis de estudo foram verificadas através da regressão linear. RESULTADOS: a leptina foi detectada no sangue de todas as 33 gestantes e seus respectivos recém-nascidos, sendo a concentração no sangue materno (17,1±1,77 ng/ml superior à dos vasos umbilicais (veia 9,0±1,16 ng/mL; artéria 8,2±1,02 ng/mL, pPURPOSE: to evaluate the importance of circulating maternal and fetal leptin in the healthy gestation, using its association with maternal, placental and fetal anthropometric variables, obtained at birth, and the relationship between the evaluated compartments. METHODS: in a transversal study a population of 33 single, healthy and term gestations was studied. The evaluated variables were maternal age, maternal weight, body mass index (BMF, weight of the newborn, placental weight, and placental index. Samples of maternal blood were immediately obtained before birth and from fetal umbilical cord blood at birth. Determination of serum leptin was performed using conventional radioimmunoassay. The relationships between serum leptin concentrations in maternal blood, umbilical artery and vein and the studied

  3. Primer caso de hemoglobina Köln (codon98 GTG>ATG) en Costa Rica

    OpenAIRE

    Walter Cartín; Carlos Suárez; Luis Mora; Kathia Valverde; Berta Valverde; Evan Jensen; Gabriela Abarca; Rafael Jiménez

    2010-01-01

    La exposición a ciertos medicamentos puede provocar anemia hemolítica con presencia de cuerpos de Heinz en sangre periférica. Esta anemia puede presentarse por sobredosis de medicamentos, tanto en individuos sanos como en personas con deficiencias enzimáticas como la glucosa-6-fosfato deshidrogenasa, o en presencia de hemoglobinas inestables. Este reporte muestra un caso de anemia hemolítica con cuerpos de Heinz, debido a la presencia de una hemoglobina inestable, cuyos estudios moleculares y...

  4. Bases moleculares das hemoglobinas variantes e talassemias no Rio Grande do Sul

    OpenAIRE

    Sandrine Comparsi Wagner

    2010-01-01

    Hemoglobinopatias são alterações nos genes das globinas que determinam hemoglobinas variantes e/ou talassemias, com manifestações clínicas variáveis em seus portadores. Estudos realizados no Brasil mostram alta prevalência de heterozigotos para Hb S e Hb C, além das talassemias α e β. Considerando-se essa alta frequência populacional e a constituição étnica do sul do país, este trabalho teve como objetivo determinar as bases moleculares das hemoglobinas variantes e talassemias no Rio Grande d...

  5. Enfermedad por Hemoglobina H: primer caso de la variante de hemoglobina H tipo (-α3.7/ --SEA) en Costa Rica.

    OpenAIRE

    Walter Cartín-Sánchez; Kathia Valverde-Muñoz; Carlos Suárez-Vargas; Jorge López-Villegas

    2010-01-01

    La enfermedad por Hemoglobina H es la forma más común de talasemia intermedia y posee muchas características que requieren cuidadosa consideración en su manejo clínico. En la mayoría de los casos, la enfermedad por Hemoglobina H resulta de un estado doble heterocigoto producido por una deleción tipo α0 que remueve ambos genes de α-globina en uno de los cromosoma 16 y de una deleción tipo α+ en uno de los genes de α-globina en el otro cromosoma 16, resultando en una condiciσn tipo (--/-α). El ...

  6. Genética molecular de las hemoglobinas bacterianas: estructura, regulación y función

    Directory of Open Access Journals (Sweden)

    Elizabeth Hernández Urzúa

    2004-01-01

    Full Text Available Las hemoglobinas se definen como aquellas hemoproteínas que unen reversiblemente el oxígeno. Estas proteínas se encuentran distribuidas en plantas, protozoarios, hongos y bacterias. Las hemoglobinas presentes en los microorganismos se han dividido en tres grupos. En el primer grupo se encuentran aquellas hemoproteínas que presentan un solo dominio con el grupo hemo, por ejemplo la hemoglobina de Vitreoscilla. En el segundo se encuentran aquellas hemoglobinas que presentan dos diferentes dominios, el primer dominio con el grupo hemo el cual es homólogo a la hemoglobina de Vitreoscilla y un segundo dominio con actividad de reductasa el cual es homólogo a la familia de las proteínas ferrodoxín NADP- reductasas (FNR, a éstas hemoglobinas se les conoce como flavohemoglobinas, un ejemplo es Hmp, la flavohemoglobina de Escherichia coli, ésta fue la primera flavohemoglobina estudiada a nivel molecular. En el tercer grupo se encuentran las hemoglobinas truncadas, éstas son proteínas pequeñas de 20 a 30 aminoácidos en donde se encuentra el dominio hemo. Poco se sabe acerca de la función de estas hemoglobinas, pero se ha reportado su participación en la protección y destoxificación del óxido nítrico.

  7. Hemoglobinas anormales en una población estudiantil universitaria

    OpenAIRE

    Sáenz, German F.; Arroyo, Guido; Alvarado, Ma. de los Ángeles; Montero, Gerardo; Jiménez, Javier; Valenciano, Eliécer

    2016-01-01

    Abnormal hemoglobins were found in 1.26% of 500 University of Costa Rica freshmen (1.06% A-S phenotype and 0.20% A-C) . An important factor is the discovery of 0.24% of abnormal hemoglobins, primarily due the S gene, in Caucasian Costa Rican students, or 0.5 % if three cases, apparently corresponding to a heterozygote beta thalassemia with a high F hemoglobin ( delta-beta variant), are included. Two asymptoma tic heterozygote phenotypes of persistent fetal hemoglobin (one in a white student a...

  8. Prospective study of fetal hydronephrosis diagnosed by ultrasound- contribution to prevent renal damage in childhood; Estudo prospectivo da hidronefrose fetal diagnosticada por ultra-som: uma contribuicao na prevencao ao dano renal na infancia

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Eduardo A.; Cabral, Antonio Carlos V.; Leite, Henrique V.; Filgueiras, Teresa F.; Oliveira, Raquel B.B.; Vilasboas, Aranai S.; Tiburcio, Arthur E.L.; Diniz, Jose Silveiro S. [Minas Gerais Univ., Belo Horizonte, MG (Brazil). Hospital de Clinicas

    1998-03-01

    Newborns with anomalies of the urinary tract detected by fetal echography were investigated. The purpose was to identify prevalent uropathies, clinical outcome and variables of prognostic significance in patients with fetal hydronephrosis. The patients were investigated by ultrasound, micturating cystourethrography and radionuclide imaging, after beginning of chemoprophylaxis. Renal function and urinary tract infection were also studied. Eight-three patients were included in this study, 54(65,1%) of these were boys. Postnatal predominant diagnosis were pelviureteric junction obstruction (3,3%) and multicytic kidney (15,7%). Follow-up average was 35 {+-} 2.5 months. Renal function deteriored in 8 children during follow-up. Worse prognosis was associated with prenatal diagnosis before third trimester of gestation, bilateral uropathy, oligohydrammios, abnormal palpable kidney or bladder, abnormal renal function on admission and urethral obstruction. (author) 40 refs., 3 figs.

  9. Haplotipos de la hemoglobina S: importancia epidemiológica, antropológica y clínica

    Directory of Open Access Journals (Sweden)

    Walter E. Rodríguez Romero

    1998-01-01

    Full Text Available La relación entre la drepanocitosis y los diferentes haplotipos del gen que codifica la subunidad betas de la globina ha permitido llegar a entender mejor las manifestaciones clínicas de aquella enfermedad. El uso de mejores técnicas de laboratorio permite descartar la presencia de otros factores hereditarios capaces de ocultar el verdadero genotipo hemoglobínico. La heterogeneidad clínica de la drepanocitosis, afección caracterizada por la presencia de una hemoglobina anormal denominada HbS, depende de las concentraciones de hemoglobina fetal (HbF, la razón de cadenas Ggamma a cadenas Agamma en la molécula de globina, las concentraciones de 2,3-difosfoglicerato, la presencia de mutaciones ligadas, los haplotipos del gen betas, la presencia simultánea de alfa-talasemia, y factores ambientales. En particular, los polimorfismos Senegal y árabe-saudí o indio del conglomerado de genes que codifican la subunidad betas se asocian con una evolución clínica menos grave, mientras que los haplotipos de la República Centroafricana (CAR o Bantú, Camerún y Benín se asocian con drepanocitosis grave. De todos, el haplotipo CAR es el de peor pronóstico (concentraciones de HbF de menos de 12% y razón de Ggamma:Agamma propia de la edad adulta. Estos polimorfismos del ácido desoxirribonucleico, una vez caracterizados, adquieren enorme importancia como marcadores antropológicos y genéticos. En las Américas, los haplotipos betas permiten entender mejor las raíces ancestrales africanas de las poblaciones de raza negra. Se ha comprobado la presencia de variedad genética no solo entre las diferentes poblaciones negras de las Américas, sino también dentro de un mismo país, como se observa en Costa Rica.

  10. Epigenética na programação fetal por restrição proteica gestacional : perfil de expressão de microRNAs no ventrículo esquerdo cardíaco

    OpenAIRE

    Heloisa Balan Assalin

    2016-01-01

    Resumo: Fatores nutricionais maternos são determinantes na plasticidade fetal e estão associados à fisiopatologia de doenças cardiovasculares na prole adulta. O modelo experimental de restrição proteica gestacional está relacionado ao baixo peso ao nascimento e ao desenvolvimento de alterações cardíacas e hipertensão no adulto. Diversos mecanismos, como a menor disponibilidade de substrato e a superexposição fetal aos glicocorticoides maternos, estão envolvidos nas alterações decorrentes da r...

  11. Hemoglobin polymorphism in Hampshire Down sheep herd/ Polimorfismo de hemoglobina em rebanho de ovinos Hampshire Down

    Directory of Open Access Journals (Sweden)

    Silvia Manduca Trapp

    Full Text Available The present study aimed to determine the types of hemoglobin in Hampshire Down crossbreed sheep, and verify that this locus is in Hardy-Weinberg equilibrium. There have been collected 46 blood samples of healthy Hampshire Down crossbreed sheep. These samples were used to separate the hemoglobin per electrophoresis. The electrophoresis of the hemoglobin revealed a slow band characterized as hemoglobin A (HbAA, a fast band characterized as hemoglobin B (HbBB and two bands in the heterozygous hemoglobin A and B (HbAB. The HbAB type was the most frequently one, followed by hemoglobin A (HbAA and B (HbBB. The genotypic frequency of individuals BB, AB and AA were 36,95; 54,35 and 8,70% respectively. The allelic frequency of A and B were respectively 35,87% and 64,13%.. The qui square test (?2 = 0.859 and p = 0.6509 confirmed that the tested locus is in Hardy-Weinberg equilibrium.O presente trabalho teve como objetivo determinar os tipos de hemoglobinas em ovinos Hampshire Down e verificar se este locus encontra-se em equilíbrio de Hardy-Weinberg. Foram coletadas 46 amostras de sangue de ovinos Hampshire Down, considerados clinicamente sadios. Estas amostras foram utilizadas para a separação das hemoglobinas por eletroforese. A eletroforese das hemoglobinas revelou uma banda lenta caracterizada como hemoglobina B (HbBB, uma banda rápida caracterizada como hemoglobina A (HbAA e duas bandas no heterozigoto para hemoglobinas A e B (HbAB. A variante HbAB foi a mais freqüentemente encontrada, seguida pela hemoglobina A (HbAA e B (HbBB. A freqüência genotípica dos indivíduos BB, AB e AA foram 36,95; 54,35 e 8,70% respectivamente. A freqüência alélica de A e B foram respectivamente 35,87% e 64,13%. Pelo teste do qui-quadrado realizado (?2 = 0,859 e p=0,6509 confirmou-se que o locus testado está em equilíbrio de Hardy-Weinberg.

  12. Hemoglobina materna en la salud perinatal y materna en la altura: implicancias en la región andina Mother’s hemoglobin in perinatal and mother health in the highlands: implications in the andean region

    Directory of Open Access Journals (Sweden)

    Gustavo F. Gonzales

    2012-12-01

    Full Text Available Esta revisión analiza la importancia del valor de la hemoglobina en la gestante, y su implicancia sobre el embarazo. Discute el uso de combustible de biomasa y la repercusión en el peso del recién nacido, los valores de hemoglobina materna y el riesgo de muerte fetal tardía, parto pretérmino y nacer pequeño para la edad gestacional. Asimismo, se aborda la necesidad de corregir el punto de corte de los valores de hemoglobina para definir anemia en la altura. La evidencia actual sugiere no corregirla, así también, la suplementación de hierro a las gestantes debería ser dirigida a los casos de anemia moderada o severa. Se discute si se debería reorientar la suplementación de hierro a niños de 6 a menos de 36 meses de edad.This review analyzes the importance of hemoglobin levels in pregnant women and its implications in pregnancy. It discuss the use of biomass fuel for cooking and the impact on birthweight, maternal hemoglobin levels and the risk of late fetal death, pre-term delivery, and small for gestational age. Furthermore, the need to correct the cut-off points of hemoglobin level to define anemia at high altitudes is addressed. Current evidence suggests that corrections should not be made and iron supplements should be given to pregnant mothers with moderate or severe anemia. It is discussed whether iron supplementation should change its target population from pregnant women to infants aged 6 to 36 months.

  13. Fetal Research

    Science.gov (United States)

    Hansen, John T.; Sladek, John R.

    1989-11-01

    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.

  14. Avaliação da Velocidade Média na Aorta Torácica Descendente em Fetos com Anemia

    Directory of Open Access Journals (Sweden)

    Taveira Marcos Roberto

    2001-01-01

    Full Text Available Objetivo: verificar se existe correlação significativa entre a velocidade média na dopplerfluxometria da artéria aorta torácica descendente e o grau de anemia fetal. Métodos: estudo prospectivo, transversal, no qual foram analisados 66 fetos de gestantes isoimunizadas, em que se realizou a cordocentese para a realização de transfusões intra-uterinas pela via intravascular (66,7%. Nos fetos que foram submetidos à transfusão intra-uterina pela via intraperitoneal, ou naqueles casos em que não houve necessidade de tratamento intra-uterino (33,3%, a determinação da concentração de hemoglobina do cordão foi realizada pela punção do cordão umbilical, no momento da interrupção da gestação. Neste grupo de fetos estudados, foi realizado exame dopplerfluxométrico da artéria aorta torácica descendente, sendo calculada a velocidade média de fluxo. Foi realizado estudo de associação entre as variáveis. Foram também calculados os valores de sensibilidade, especificidade, valores preditivos positivo e negativo. Resultados: observou-se correlação significativa e inversa entre a velocidade média na artéria aorta torácica descendente e o nível de hemoglobina fetal. A velocidade média na dopplerfluxometria da artéria aorta torácica descendente apresentou sensibilidade de 47,5% para anemia fetal moderada (Hg<10 g/dL, com o teste exato de Fisher apresentando valor de p<0,01, e de 54,5% para anemia fetal grave (Hg<7,0 g/dL, com um valor de p=0,01. Conclusões: houve associação significativa entre a velocidade média na aorta torácica descendente e o grau de diagnóstico de anemia fetal.

  15. HEMOGLOBINA GLICADA E FRUTOSAMINA EM CÃES COM DIABETES MELLITUS

    OpenAIRE

    Beltrame, Olair Carlos; Locatelli-Dittrich, Rosangela; Laskoski, Luciane Maria; Patricio, Lia Fordiani Lenati; Medeiros, Nina da Cunha; Koch, Marília Oliveira

    2015-01-01

    Resumo O Diabetes mellitus (DM) ocorre com frequência em cães, sendo a glicemia o teste laboratorial de confirmação. O diagnóstico e monitoramento em pessoas são realizados pelas concentrações de hemoglobina glicada e frutosamina. O objetivo deste estudo foi diagnosticar a DM em 19 cães, com avaliação das concentrações da glicose sérica, hemoglobina glicada e frutosamina. Seis cães com DM e em tratamento com insulina foram acompanhados por um período de doze meses, com as mesmas avaliações he...

  16. Níveis de hemoglobina, aleitamento materno e regime alimentar no primeiro ano de vida

    OpenAIRE

    Assis, Ana Marlucia de Oliveira; Gaudenzi, Edileuza Nunes; Gomes, Gecynalda; Ribeiro,Rita de Cássia; Szarfarc,Sophia Cornbluth; Souza, Sonia Buongermino de

    2004-01-01

    p.543-551,v.38,n.4 OBJETIVO: Identificar a relação entre os níveis de hemoglobina e o consumo de leite materno, alimentos complementares e líquidos não nutritivos no primeiro ano de vida. MÉTODOS: Estudo transversal envolvendo 553 crianças menores de 12 meses de vida, que freqüentavam os serviços públicos de saúde. A concentração de hemoglobina foi avaliada pelo método cianometahemoglobina, usando-se o sistema HemoCue. Utilizou-se a técnica da regressão linear múltipla para avaliar as ...

  17. Influência da icterícia obstrutiva na capacidade reprodutiva, desenvolvimento fetal e morfologia ovariana em ratas

    Directory of Open Access Journals (Sweden)

    Vivian Resende

    Full Text Available OBJETIVO: Estudar a influência da icterícia obstrutiva sobre a capacidade reprodutiva e desenvolvimento fetal em ratas. MÉTODOS: Foram utilizadas 60 ratas sexualmente maduras e sabidamente férteis distribuídas em dois grupos: grupo 1 (n=30- submetidas a ligadura do ducto biliopancreático e grupo 2 (n=30 -controles. A partir do 23? dia pós-operatório, as ratas foram acasaladas e seus ciclos estrais avaliados diariamente por meio de esfregaços vaginais, que permitiram determinar o dia da cópula e a idade gestacional em que foram mortas. Realizou-se estudo histológico dos corpos lúteos nos ovários de todas as ratas e analisou-se macroscopicamente a morfologia externa dos fetos. RESULTADOS: Observou-se que 23 ratas controle (92% e 11 ratas ictéricas (39,3% desenvolveram prenhez (p=0,0002. As 17 ratas com hiperbilirrubinemia e sem prenhez (60,7% apresentaram somente corpos lúteos com aspecto involutivo em seus ovários e sofreram modificações em seus ciclos estrais, permanecendo vários dias em proestro ou estro. As ratas prenhes com hiperbilirrubinemia não apresentaram alterações em seus corpos lúteos, porém os seus fetos eram anormais. CONCLUSÃO: Em presença de hiperbilirrubinemia, a fertilização é viável, a capacidade reprodutiva é muito reduzida, os ciclos estrais tornam-se irregulares, o epitélio vaginal permanece cornificado, os corpos lúteos ovarianos regridem, os corpos lúteos gravídicos não são alterados aumentando progressivamente durante a prenhez e o desenvolvimento fetal é gravemente alterado.

  18. Alterações na gasometria de fetos aloimunizados após procedimento de transfusão intra-uterina

    Directory of Open Access Journals (Sweden)

    Nomura Roseli Mieko Yamamoto

    2003-01-01

    Full Text Available OBJETIVO: este estudo, realizado em gestações com aloimunização pelo fator Rh, tem como objetivo descrever as alterações gasométricas e do equilíbrio ácido-básico fetal antes e após transfusões intra-uterinas (TIU. MÉTODO: no período de junho de 2001 a outubro de 2001, antes e após a TIU em fetos de gestantes aloimunizadas, foram avaliados prospectivamente a gasometria e o equilíbrio ácido-básico no sangue da veia umbilical. As medidas foram realizadas em 8 amostras de sangue de 5 fetos. O sangue fetal foi obtido por cordocentese da veia umbilical antes e após TIU. Os resultados obtidos foram comparados com a expansão volêmica na TIU, a idade gestacional no procedimento, o peso fetal estimado pela ultra-sonografia e as variações da hemoglobina fetal (g/dL. RESULTADOS: em todos os casos foi observada queda nos valores do pH, com redução média de 0,09 (DP=0,02. A hemoglobina fetal apresentou aumento médio de 8,4 g/dL (DP=2,9 g/dL. Foi constatada também variação negativa da pO2 (média = -1,28 mmHg na concentração de HCO3_ (média = _2,25 mEq/l. Houve aumento da pCO2 (média = 3,2 mmHg e redução nos valores do excesso de bases (média = -3,75. CONCLUSÃO: a análise das gasometrias permite concluir que o procedimento de TIU acompanha-se de queda nos valores do pH de sangue de veia umbilical, demonstrando haver acidemia fetal relativa após o procedimento.

  19. HEMOGLOBINA GLICOSILADA COMO ELEMENTO PRONÓSTICO EN LAS COMPLICACIONES MACROVASCULARES DE LA DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    Agnes Fajardo Matarrita

    2012-04-01

    Full Text Available En este artículo se discute la información obtenida respecto del cuidado enfermero brindado a personas portadoras de Diabetes Mellitus tipo 2 relacionada con la elevación de la hemoglobina glicolisada (Hba1c como factor pronóstico para el desarrollo de complicaciones. Se realizó una búsqueda de la mejor información científica disponible para construir el estado de la cuestión. Posteriormente, se estableció una pregunta en formato PICO (pacientes, intervención, comparación, observación y se procedió a establecer estrategias de búsqueda en las diferentes bases de datos sugeridas en el Curso de Práctica Clínica de Enfermería Basada en la Evidencia impartido por CIEBE-CR, entre las que se encuentran PUBMED, EBSCO HOST, principalmente. El análisis crítico se llevó a cabo mediante las recomendaciones que brinda CASPe y se comparó con la práctica realizada en el Hospital de la Anexión. El control intensivo de la glicemia, el cual incluye agentes orales, la insulina y la intervención cardiovascular múltiple reflejada en hemoglobinas glicosilada menores a 7, indicó que existía una evidente disminución en la incidencia de eventos macrovasculares mayores tales como el infarto agudo al miocardio, el ictus no fatal y el accidente vascular cerebral. De acuerdo con la evidencia, mantener la hemoglobina glicosilada dentro de parámetros normales disminuye el riesgo de sufrir complicaciones macrovasculares de esta patología en comparación con aquellos pacientes que manejan hemoglobina glicosiladaalta.

  20. Razão peso/perímetro cefálico ao nascer na avaliação do crescimento fetal

    Directory of Open Access Journals (Sweden)

    Fabiana Cristina Lima da Silva Pastich Gonçalves

    2015-09-01

    Full Text Available Objetivou-se utilizar a razão peso/perímetro cefálico ao nascer para avaliar o crescimento fetal. Foi realizado um estudo de coorte retrospectiva na Zona da Mata de Pernambuco, Brasil, com 915 crianças nascidas a termo. As medidas antropométricas da criança, assistência pré-natal, fumo durante a gestação, renda familiar, escolaridade e estado nutricional materno foram coletados nas primeiras 24 horas pós-parto. As crianças foram classificadas em proporcionais (razão peso/perímetro cefálico ≥ 0,90 e desproporcionais (< 0,90. Recém-nascidos de mães fumantes, com menor idade, sem consulta pré-natal, baixos IMC, altura e prega cutânea tricipital apresentaram menores médias da razão peso/perímetro cefálico. As médias do peso, comprimento, perímetros cefálico e torácico, circunferência braquial e prega cutânea tricipital foram menores entre as crianças classificadas como desproporcionais, por meio da razão peso/perímetro cefálico, ajustadas pelo sexo da criança. Conclui-se que a razão peso/perímetro cefálico e peso ao nascer são importantes indicadores do crescimento fetal.

  1. Caraterização molecular e funcional de variantes alfa de hemoglobina identificadas no Centro Hospitalar e Universitário de Coimbra

    OpenAIRE

    Gameiro, Mariline da Silva

    2012-01-01

    Dissertação de mestrado em Bioquímica apresentada ao Departamento Ciências da Vida da Faculdade de Ciências e Tecnologia da Universidade de Coimbra, realizada sob a orientação de Maria Celeste Sena São Miguel Bento Lago de Queiroz e Ângelo José Ribeiro Tom. A hemoglobina é uma proteína tetramérica constituída por dois pares de cadeias globínicas e quatro grupos heme. A sua principal função é realizar o transporte de moléculas de oxigénio dos pulmões para os restantes tecidos do corpo...

  2. A restrição do crescimento fetal influencia a composição corporal na idade escolar?

    Directory of Open Access Journals (Sweden)

    Marilia C. Lima

    2011-02-01

    Full Text Available OBJETIVO: Verificar a influência do baixo peso de crianças nascidas a termo sobre a composição corporal na idade escolar. MÉTODO: Este estudo consistiu de um corte transversal aninhado em uma coorte de 375 crianças recrutadas ao nascimento em 1993-1994 no estado de Pernambuco. Aos 8 anos de idade, 213 crianças tiveram a composição corporal avaliada através da mensuração da espessura das pregas cutâneas tricipital e subescapular e da circunferência do braço. A regressão linear multivariada foi utilizada para identificar a influência do baixo peso ao nascer, das condições socioeconômicas, do estado nutricional materno e morbidade da criança na prega cutânea tricipital. RESULTADOS: As médias das pregas cutâneas tricipital e subescapular, da circunferência do braço e das áreas muscular e de gordura do braço foram menores nas crianças nascidas com baixo peso em relação às nascidas com peso adequado; no entanto, essas diferenças não foram estatisticamente significantes. Na análise de regressão linear multivariada, as variáveis socioeconômicas explicaram o maior percentual da variação da prega cutânea tricipital (12,3%, especialmente a renda familiar per capita (9,1%, seguida da ocorrência de anemia e da hospitalização anterior, que juntas explicaram 5,6%, e do índice de massa corporal materna, que contribuiu com 2,4% dessa variação. O baixo peso ao nascer não influenciou no depósito de gordura subcutânea tricipital nessa faixa etária. CONCLUSÃO: Os fatores socioeconômicos e a morbidade anterior da criança apresentaram uma maior influência na composição corporal de escolares nascidos a termo em detrimento do baixo peso ao nascer.

  3. Dopplervelocimetria da artéria cerebral média fetal e outros parâmetros de vitalidade fetal na sobrevida neonatal em gestações com insuficiência placentária

    Directory of Open Access Journals (Sweden)

    Roseli Mieko Yamamoto Nomura

    2013-08-01

    Full Text Available OBJETIVO: Estudar a dopplervelocimetria da artéria cerebral média fetal em gestações complicadas pela insuficiência placentária e verificar o seu papel no prognóstico de sobrevida neonatal. MÉTODOS: Trata-se de estudo prospectivo de 93 gestantes com diagnóstico de insuficiência placentária estabelecida antes da 34ª semana. A insuficiência placentária foi caracterizada pelo Doppler de artéria umbilical (AU alterado (> p95. Foram analisados os seguintes parâmetros: índice de pulsatilidade (IP da artéria umbilical (AU, IP da artéria cerebral média (ACM, relação cerebroplacentária -RCP(IP-ACM/IP-AU, pico de velocidade sistólicada ACM (PVS-ACM e IP para veias (IPV do ducto venoso (DV. Os parâmetros foram analisados pelos valores absolutos, em escores zeta (desvios padrão a partir da média ou múltiplos da mediana (MoM. O desfecho investigado foi o óbito neonatal no período de internação após o nascimento. RESULTADOS: Nas 93 gestações analisadas, ocorreram 25 (26,9% óbitos neonatais. No grupo que evoluiu com óbito neonatal, quando comparado com o grupo com sobrevida, houve associação significativa com o diagnóstico de diástole zero ou reversa (88% vs. 23,6%, p < 0,001, com maior mediana do IP da AU (2,9 vs. 1,7, p < 0,001 e seu escore zeta (10,4 vs. 4,9, p < 0,001; maior valor do PVS-ACM MoM (1,4 vs. 1,1, p = 0,012; menor valor da RCP (0,4 vs. 0,7, p < 0,001; maior valor do IPV-DV (1,2 vs. 0,8, p < 0,001 e no escore zeta do DV (3,6 vs.0,6, p<0,001. Na regressão logística, as variáveis independentes para a prediçãodoóbito neonatal foram a idade gestacional no parto (OR = 0,45; IC95% 0,3 a 0,7, p < 0,001 e o escore zeta do IP-AU (OR 1,14, IC95% 1,0 a 1,3, p = 0,046. CONCLUSÃO: Apesar da associação verificada pela análise univariada entre a morte neonatal e os parâmetros da dopplervelocimetria cerebral fetal, a análise multivariada identificou a prematuridadeeograude insuficiência da circula

  4. Hemoglobinas anormales en la población neonatal de Costa Rica

    Directory of Open Access Journals (Sweden)

    Gabriela Abarca

    2008-09-01

    Full Text Available Se han analizado un total de 70 943 muestras de sangre total en papel filtro S&S 903 de neonatos de Costa Rica (octubre 2005 a Octubre 2006 con el fin de detectar variantes de hemoglobina mediante la técnica de isoelectroenfoque. Se detectaron 891 casos con alguna variante para una frecuencia de 1/79. Se clasifican 5 casos homocigotos para hemoglobina S (anemia drepanocítica o anemia falciforme y un caso doble heterocigoto para SC. En este estudio se demuestra que las variantes fenotípicas de hemoglobina S como la C, se encuentran distribuidas por todo el país con algunas diferencias locales, razón por la cual es importante que la prevención de nuevos casos se realicé a través de nuestro Programa Nacional de Tamizaje de Hemoglobinas junto con un Programa Nacional interdisciplinario de Educación para el portador del rasgo (AS/AC como, para el enfermo y su familia; al igual que la instauración de programas dirigidos a médicos generales y enfermeras en todas las regiones de salud del país, para asegurar consejo genético a portadores y enfermos, y a la vez, mejorar los sistemas de tratamiento a los pacientes para reducir la morbi -mortalidad.Abnormal haemoglobins in the newborn human population of Costa Rica. Hemoglobinopathies are hereditary autosomic recessive diseases. A total of 70 943 samples of whole blood collected by heel prick in filter paper (S&S 903 from throughout Costa Rica (October 2005-October 2006 were analyzed to detect variants of hemoglobin by the iso-electric focusing technique. Eight hundred ninety one cases presented some variant, for a frecuency of 1/79. Five cases are homozygous for hemoglobin S (sickle cell disease and one shows the double heterozygous genotype SC. in this study the S and C variants of hemoglobin, although with some local differences, are widespread all over the country. Thus, the prevention of new cases is important through the testing of hemoglobin in the Costa Rican National Newborn Screening

  5. Niveles de hemoglobina glicosilada en pacientes con periodontitis crónica

    OpenAIRE

    Velásquez Machuca, Victor Eder; Universidad Nacional Mayor de San Marcos, Facultad de Odontología; Alejandro Estrada, Andrew; Universidad Nacional Mayor de San Marcos, Facultad de Odontología; Espinoza Escajadillo, Sofía; Universidad Nacional Mayor de San Marcos, Facultad de Odontología; García Linares, Sixto

    2017-01-01

    Objetivo: Evaluar si existe relación entre el nivel de hemoglobina glicosilada y la presencia de periodon-titis crónica. Materiales y método: se evaluaron 77 pacientes, agrupados en función a si presentaban o no periodontitis crónica. Los datos fueron recolectados en una ficha donde se consideró edad, género, índice de masa corporal (IMC) y antecedentes de dislipidemias, se llenaron los periodontogramas para establecer al grupo de pertenencia de los pacientes, se les envió a laboratorio clíni...

  6. Fetal Polydactyly

    National Research Council Canada - National Science Library

    Filges, Isabel; Kang, Anjeung; Hench, Jürgen; Wenzel, Friedel; Bruder, Elisabeth; Miny, Peter; Tercanli, Sevgi

    2011-01-01

    Records of 24 pregnancies with fetal polydactyly were reviewed for the type of polydactyly, family history, associated sonographic findings, genetic testing, and postnatal/postmortem examination findings...

  7. Enfermedad por Hemoglobina H: primer caso de la variante de hemoglobina H tipo (-α3.7/ --SEA) en Costa Rica. Hemoglobin H Disease: First Case of Hemoglobin H Variant Type (-α<3.7/ --SEA) in Costa Rica

    OpenAIRE

    Walter Cartín-Sánchez; Kathia Valverde-Muñoz; Carlos Suárez-Vargas; Jorge López-Villegas

    2010-01-01

    La enfermedad por Hemoglobina H es la forma más común de talasemia intermedia y posee muchas características que requieren cuidadosa consideración en su manejo clínico. En la mayoría de los casos, la enfermedad por Hemoglobina H resulta de un estado doble heterocigoto producido por una deleción tipo α0 que remueve ambos genes de α-globina en uno de los cromosoma 16 y de una deleción tipo α+ en uno de los genes de α-globina en el otro cromosoma 16, resultando en una condici...

  8. Efeitos da estimulação vibro-acústica na velocidade do sangue da artéria cerebral média e na freqüência cardíaca fetal: 1. entre a 35ª e 41ª semanas de gestação The effect of vibratory acoustic stimulation on fetal middle cerebral artery impedance and instantaneous fetal heart rate: 1. a transversal study on fetuses with 35 to 41 weeks of gestational age

    Directory of Open Access Journals (Sweden)

    Ivo Behle

    1999-01-01

    Full Text Available RESUMO Objetivos: estudar, em fetos hígidos, quais são as respostas da freqüência cardíaca fetal basal e da resistência na artéria cerebral média à estimulação vibro-acústica padronizada. Métodos: em estado comportamental de hipo ou de inatividade fetal (apnéia e ausência de movimentos corpóreos, mediu-se o índice de pulsatilidade (IP da artéria cerebral média (ACM, bem como calculou-se a freqüência cardíaca fetal basal (FCFB pela análise da onda espectral, antes e após a aplicação de estímulo vibro-acústico (EVA por 3 segundos. Foram empregados ecógrafos de alta resolução, com Doppler pulsado e mapeamento a cores. A fonte sonora emitia som com 400 a 40.000 Hz, sob forma de varredura, com pressão sonora de 65 a 110 dB. Resultados: a média da FCFB pré-estímulo foi 139 bpm, com desvio padrão de 3,14 bpm. A média da FCFB pós-estímulo foi 153 bpm, com desvio padrão de 7,23 bpm (pSUMMARY Purpose: to examine the response of the fetal heart rate (FHR and middle cerebral artery resistance (MCA PI to vibratory stimulation (VAS in normal human fetuses. Methods: when the fetuses were without activity (in apnea and without corporal movements, we obtained baseline measurements of MCA PI and FHR before and after the application of a 3-sec vibratory acoustic stimulus. Real time ultrasonography with pulsed wave and color Doppler imaging was used for the execution of the study. The VAS was performed using a bicycle horn with 400 to 4000 Hz and sound pressure was 65 to 110 dB. Results: the FHR before VAS was 139 ± 3.14 bpm and after VAS was 153 ± 7.23 bpm (p<0.0001. The MCA PI rate before VAS was 1.84 ± 0.07 and after VAS was 1.56 ± 0.04 (p<0.001. In all cases we observed a fetal response with vigorous corporal movements, FHR rise and MCA PI reduction after VAS. Conclusions: we conclude that VAS, in human fetuses near term, for 3 sec as described in this study, determines some response, with increase in FHR and corporal

  9. Fetal Abuse.

    Science.gov (United States)

    Kent, Lindsey; And Others

    1997-01-01

    Five cases of fetal abuse by mothers suffering from depression are discussed. Four of the women had unplanned pregnancies and had considered termination of the pregnancy. Other factors associated with fetal abuse include pregnancy denial, pregnancy ambivalence, previous postpartum depression, and difficulties in relationships. Vigilance for…

  10. Influencia del ejercicio físico aeróbico durante el embarazo en los niveles de hemoglobina y de hierro maternos. (Influence of the physical aerobic exercise during pregnancy in the maternal haemoglobin and iron levels.

    Directory of Open Access Journals (Sweden)

    James Stirling

    2008-04-01

    Full Text Available Resumen Son bien conocidos los efectos beneficiosos que el ejercicio físico tiene sobre la salud en general, aunque no se cuenta con la misma información cuando se desarrolla durante el embarazo. La mayor incertidumbre es saber si pueden coexistir ambos procesos, ejercicio y embarazo, sin conflictos materno-fetales y sin resultados del embarazo alterados. Especialmente cuando día a día, son más las mujeres que desean continuar ejercitándose de alguna forma, durante su embarazo. El objetivo de este trabajo es conocer la influencia del ejercicio físico aeróbico moderado desarrollado durante el segundo y tercer trimestres en los niveles de hemoglobina y de hierro maternos. Material y métodos: Se llevó acabo un estudio experimental que incluyó un total de 142 gestantes. Grupo casos: integrado por 72 mujeres. Grupo control: integrado por 70 mujeres. Los parámetros maternos estudiados fueron: niveles de hierro, nivel de hemoglobina previo al parto, edad gestacional, tipo de parto. Fetales: Peso de nacimiento, talla, perímetro craneal, test de Apgar (1´y 5´. Resultados: No se encontraron diferencias significativas a nivel estadístico entre ambos grupos (p menor que 0,05, el grupo de casos (ejercicio presento medias similares en los niveles de hemoglobina: 12.1 ± 0.8 y de hierro: 65.90 ± 7.1; que el grupo de control: hemoglobina: 12.3 ± 0.8 y hierro: 66.42 ± 8.4. El peso de nacimiento fue inferior en el grupo de casos dentro de valores normales (-142.1 grs.. Conclusión: El ejercicio aeróbico moderado desarrollado durante el segundo y tercer trimestre de embarazo parece no alterar los niveles de hierro y hemoglobina maternos. Abstract They are very well-known the beneficial effects that the physical exercise has about the health in general, although it is not had the same information when it refers to a pro- cess of remarkable importance: the pregnancy. The biggest uncertainty is to know if both processes, exercise and pregnancy can

  11. Triagem de hemoglobinopatias e avaliação da degeneração oxidativa da hemoglobina em trabalhadores portadores do traço falciforme (HbAS, expostos a riscos ocupacionais Screening of abnormal hemoglobin and the evaluation of oxidative degeneration of hemoglobin among workers with the sickle cell trait (HbAS, exposed to occupational hazards

    Directory of Open Access Journals (Sweden)

    Isaac L. Silva Filho

    2005-09-01

    Full Text Available Desde os anos 40, quando foram realizados os primeiros trabalhos de triagem para hemoglobinas anormais na população brasileira, tem sido descrita uma elevada prevalência destas em nosso meio, especialmente a hemoglobina S que, a despeito da heterogeneidade de sua distribuição geográfica, quase sempre é a mais freqüente nas diversas regiões estudadas. Aliado a este fato, estudos recentes têm demonstrado uma maior susceptibilidade desta a oxidação, tornando-a mais sensível ao estresse oxidativo que a hemoglobina normal (HbAA, mesmo em se tratando de portadores heterozigotos (HbAS. Tendo em vista que algumas substâncias químicas são comprovadamente meta-hemoglobinizantes, que alguns fatores ambientais podem influenciar na morbidade da anemia falciforme e também o pouco e controverso conhecimento de que se dispõe a respeito de portadores do traço falciforme, este estudo, além da pesquisa de hemo-globinas anormais, avaliou também a degeneração oxidativa da hemoglobina, através da pesquisa de corpos de Heinz e dosagem de meta-hemoglobina em uma população de trabalhadores portadores do traço falciforme, expostos a riscos ocupacionais. Foram triadas 2.190 amostras sangüíneas entre Outubro de 1999 e Dezembro de 2001. A população estudada foi constituída de trabalhadores de ambos os sexos com idades variando entre 18 e 76 anos. Os resultados evidenciaram 4,7% portadores de hemoglobinas anormais na população analisada, sendo que a hemoglobina S foi a mais freqüente - 3,2% (71. Trabalhadores portadores do traço falciforme apresentaram uma chance 14 vezes maior de possuírem valores aumentados de meta-hemoglobina em relação aos trabalhadores com genótipo AA, porém, esta diferença não foi estatisticamente significativa.Hemoglobinopathies are frequent hereditary diseases in Brazilian population and have been a public health problem. This study reports the screening of abnormal hemoglobin among Fiocruz`s employees, as

  12. Desempenho intelectual na exposição alcoólica fetal: relato de série de 10 casos

    Directory of Open Access Journals (Sweden)

    Vanessa Karam de Lima Ferreira

    2013-09-01

    Full Text Available OBJETIVO: Descrever o desempenho intelectual em uma amostra de crianças e adolescentes que sofreram exposição pré-natal ao álcool. MÉTODOS: Este estudo se constitui em uma série de casos, composta por 10 sujeitos entre 6 e 16 anos, com histórico de exposição alcoólica fetal. Esses sujeitos foram submetidos a uma avaliação médica para serem caracterizados como amostra clínica, respeitando critérios de inclusão e exclusão previamente estabelecidos. O desempenho intelectual da amostra foi estudado por meio dos instrumentos: Escala de Inteligência Wechsler para Criança (WISC-III e Teste Matrizes Progressivas de Raven. RESULTADOS: A amostra foi caracterizada com desempenho médio inferior pela WISC-III. No Teste Raven, a amostra apresentou desempenho intelectualmente médio. Entre todos os índices da WISC-III, Resistência à Distração apresentou-se mais prejudicado. Os subtestes Aritmética e Arranjo de Figuras apresentaram resultados mais prejudicados comparados ao desempenho obtido nos outros subtestes. O prejuízo dessas funções pode trazer como consequência secundária e dificuldades no aprendizado e na interação social e impactar o desenvolvimento desses jovens. CONCLUSÕES: Os resultados encontrados nesta série de 10 casos foram comparados àqueles descritos em estudos nacionais e internacionais. O prejuízo cognitivo causado pelo uso do álcool na gestação pode se manifestar em crianças em idade escolar por meio da dificuldade de aprendizagem e da dificuldade de estabelecer interações sociais. Dessa forma, a exposição pré-natal ao álcool torna-se um problema de saúde pública, que precisa de maior atenção das políticas públicas nacionais para a realização de identificação e intervenção precoce.

  13. Fetal Macrosomia

    Science.gov (United States)

    ... identification of fetal macrosomia useful? European Journal of Obstetrics & Gynecology and Reproductive Biology. 2012;161:170. Negrato CA, et al. Adverse pregnancy outcomes in women with diabetes. 2012;4:41. Frequently ...

  14. Fetal Macrosomia

    Science.gov (United States)

    ... lifestyle counts Fetal macrosomia Symptoms & causes Diagnosis & treatment Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  15. Ascitis fetal masiva idiopática aislada

    Directory of Open Access Journals (Sweden)

    Yolimar Navarro Briceño

    2016-08-01

    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.

  16. Laser for the treatment of twin to twin transfusion syndrome Laser na terapia da síndrome de transfusão feto-fetal

    Directory of Open Access Journals (Sweden)

    Denise Araújo Lapa Pedreira

    2005-12-01

    Full Text Available PURPOSE: To report the initial experience in our country with a new technique for twin to twin transfusion syndrome (TTTS treatment, using laser to coagulate the placental vessels responsible for the twin transfusion during gestation. METHODS: Prospective study of eight cases diagnosed with TTTS evaluated in our service from january 2001 to june 2005. Through percutaneous introduction of a 2,0mm diameter fetoscope in the uterine cavity, placental surface vessels where directly visualized. Those identified as responsible for the transfusion were laser coagulated. The procedure combines ultrasonography and fetoscopy, in a so-called sonoendoscopic technique (FETENDO. RESULTS: Among the eight pregnancies evaluated, five cases were submitted to the procedure (10 fetuses. All fetuses survived for at least five weeks after surgery. A total of eight fetuses were born alive and five survived the neonatal period. In a 18 months follow-up after birth, all five are still alive and well and their mean age is now 10,6 months. The total survival rate was 50% and in three pregnancies, at least one fetus survived. CONCLUSIONS: Laser fetoscopy is actually the "gold-standard" treatment of TTTS. Nevertheless is a sophisticated technique that epends of proper training. Our service is the first in our country to offer this therapeutic technique. Our success rate is comparable with the international literature.OBJETIVO: Nosso objetivo é relatar a experiência inicial no país com uma nova técnica de tratamento para a síndrome de transfusão feto-fetal (STT, onde se utiliza o raio laser para coagulação dos vasos placentários responsáveis pela transfusão entre gêmeos durante a gravidez. MÉTODOS: Estudo prospectivo de 8 casos com diagnóstico de STT avaliados pelo nosso serviço de janeiro de 2001 a junho de 2005. Introduzindo-se um fetoscópio de 2,0 mm de diâmetro na cavidade uterina, por via percutânea, foram diretamente visualizados os vasos da superf

  17. Dopplervelocimetria do ducto venoso na predição da acidemia fetal Ductus venosus Doppler velocimetry to predict acidemia at birth in pregnancies with placental insufficiency

    Directory of Open Access Journals (Sweden)

    Francisco Herlânio C. Carvalho

    2005-08-01

    Full Text Available OBJETIVOS: Investigar a possibilidade da predição da acidemia no nascimento mediante dopplervelocimetria do ducto venoso e definir qual o melhor parâmetro e seus pontos de corte nessa predição em gestações com insuficiência placentária. MÉTODOS: Trata-se de estudo transversal e prospectivo que analisou 47 gestações únicas com insuficiência placentária e idade gestacional superior a 26 semanas, realizado no Hospital São Paulo (UNIFESP e na Maternidade-Escola Assis Chateaubriand (UFC. A insuficiência placentária foi diagnosticada quando o índice de pulsatilidade da artéria umbilical encontrava-se acima do percentil 95 para a idade gestacional estimada. Fetos com anomalias estruturais ou cromossômicas foram excluídos. O doppler foi realizado a menos de 24 horas do parto. A amostra de sangue da artéria umbilical foi coletada imediatamente após o nascimento para análise da gasometria. Diagnosticou-se acidemia quando o pH encontrava-se abaixo de 7,20 na ausência de trabalho de parto e abaixo de 7,15 quando parto vaginal. Foram consideradas patológicas as acidemias metabólicas ou mistas. Construiu-se curva ROC para as velocidades S, D e A e para o IPV e as relações S/A e (S-A/S do DV (variáveis independentes e acidemia (variável dependente. O teste de MacNemar foi utilizado para comparar os parâmetros entre si. RESULTADOS: As velocidades absolutas S, D e A mostraram ser pobres preditoras da acidemia no nascimento. O IPV mostrou ser bom preditor de acidemia (área sob a curva ROC 0,79, p=0,003. As relações S/A e (S-A/S também mostraram ser boas preditoras da acidemia (área sob a curva ROC 0,818, p=0,001. Os pontos de corte calculados foram: IPV = 0,76, S/A = 2,67 e (S-A/S = 0,63. CONCLUSÕES: Os índices ângulo-independentes do doppler do DV mostraram excelente correlação com acidemia no nascimento nesta população. Não houve diferença estatisticamene significativa entre estes parâmetros.OBJETIVES: To

  18. Brida amniótica envolvendo o cordão umbilical na gravidez de termo, com sobrevida fetal. Revisão de literatura

    Directory of Open Access Journals (Sweden)

    Joe Luiz Vieira Garcia Novo

    2007-05-01

    Full Text Available Os AA reviram a literatura de gravidez de termo associada á brida amniótica envolvendo o cordão umbilical, acompanhada de sobrevida fetal. Relatam à raridade desta patologia, associada ao alto obituário fetal intragestacional (90%, causada, em geral, pelos transtornos circulatórios ao concepto. A sobrevida fetal é observada em apenas 10% dos casos, aos quais se soma o novo caso apresentado neste estudo. O propósito deste trabalho, além de relatar o raro caso enfocado, é lembrar que o diagnóstico precoce de patologias intragestacionais, com certeza irão melhorar os resultados perinatais.

  19. Concentração de hemoglobina e anemia em crianças no Estado de Pernambuco, Brasil: fatores sócio-econômicos e de consumo alimentar associados

    Directory of Open Access Journals (Sweden)

    Oliveira Maria Alice Araújo

    2006-01-01

    Full Text Available Este estudo teve como objetivo avaliar a associação entre a concentração de hemoglobina e prevalência de anemia com variáveis sócio-econômicas e de consumo alimentar. O estudo seccional, realizado em Pernambuco, Brasil, no ano 1997, utilizou a amostragem em três estágios. A amostra compreendeu 746 crianças de 6-59 meses, nas quais foram realizados dosagem de hemoglobina e inquérito dietético recordatório de 24 horas. A prevalência de anemia foi de 40,6%, sendo maior no Interior Rural e diminuindo com o aumento da idade, da renda e da escolaridade materna. A maioria das crianças (88,9% consumia leite de vaca. A anemia apresentou tendência de aumento com a elevação da proporção de calorias do leite e de redução com o aumento da densidade de ferro (total, heme e não-heme. A idade da criança, a área geográfica, a renda familiar per capita, a escolaridade materna, a densidade de ferro e a proporção de calorias do leite de vaca na dieta são fatores determinantes da anemia no grupo estudado.

  20. Exames de imagem na avaliação de anomalias urológicas em lactentes com hidronefrose fetal: avanços e controvérsias

    Directory of Open Access Journals (Sweden)

    Cristiane Santos Dias

    2012-12-01

    Full Text Available Avanços recentes no diagnóstico pré-natal têm permitido o aprimoramento da detecção e o manejo das anormalidades do trato urinário. A ultrassonografia pré-natal permite o reconhecimento de anormalidades urológicas que somente seriam identificadas tardiamente, após o aparecimento de sintomas ou complicações. A uretrocistografia miccional pode ser reservada para casos selecionados. Exames de medicina nuclear devem ser realizados em casos de hidronefrose moderada e grave. O estudo consistiu de uma revisão da literatura atual sobre a abordagem pós-natal da hidronefrose fetal. Os dados obtidos foram confrontados com a experiência da Unidade de Nefrologia Pediátrica do HC/UFMG na conduta e no seguimento de crianças com diagnóstico de uropatias detectadas na investigação de hidronefrose fetal.

  1. Haplotipos de la hemoglobina S: importancia epidemiológica, antropológica y clínica S hemoglobin haplotypes: their epidemiologic, anthropologic, and clinical significance

    Directory of Open Access Journals (Sweden)

    Walter E. Rodríguez Romero

    1998-01-01

    Full Text Available La relación entre la drepanocitosis y los diferentes haplotipos del gen que codifica la subunidad betas de la globina ha permitido llegar a entender mejor las manifestaciones clínicas de aquella enfermedad. El uso de mejores técnicas de laboratorio permite descartar la presencia de otros factores hereditarios capaces de ocultar el verdadero genotipo hemoglobínico. La heterogeneidad clínica de la drepanocitosis, afección caracterizada por la presencia de una hemoglobina anormal denominada HbS, depende de las concentraciones de hemoglobina fetal (HbF, la razón de cadenas Ggamma a cadenas Agamma en la molécula de globina, las concentraciones de 2,3-difosfoglicerato, la presencia de mutaciones ligadas, los haplotipos del gen betas, la presencia simultánea de alfa-talasemia, y factores ambientales. En particular, los polimorfismos Senegal y árabe-saudí o indio del conglomerado de genes que codifican la subunidad betas se asocian con una evolución clínica menos grave, mientras que los haplotipos de la República Centroafricana (CAR o Bantú, Camerún y Benín se asocian con drepanocitosis grave. De todos, el haplotipo CAR es el de peor pronóstico (concentraciones de HbF de menos de 12% y razón de Ggamma:Agamma propia de la edad adulta. Estos polimorfismos del ácido desoxirribonucleico, una vez caracterizados, adquieren enorme importancia como marcadores antropológicos y genéticos. En las Américas, los haplotipos betas permiten entender mejor las raíces ancestrales africanas de las poblaciones de raza negra. Se ha comprobado la presencia de variedad genética no solo entre las diferentes poblaciones negras de las Américas, sino también dentro de un mismo país, como se observa en Costa Rica.The link between betas-gene haplotypes and sickle cell anemia has permitted a better understanding of the biological manifestations of this disease. The use of better laboratory methods can help rule out other hereditary factors that can

  2. Prevalência de talassemias e hemoglobinas variantes no estado de Goiás, Brasil Prevalence of thalassemias and variant hemoglobins in the state of Goiás, Brazil

    Directory of Open Access Journals (Sweden)

    Paulo Roberto de Melo-Reis

    2006-12-01

    Full Text Available As anemias hereditárias, em especial as talassemias e hemoglobinas (Hb variantes, são as mais comuns das alterações genéticas humanas; sua freqüência na população brasileira é muito variável, dependendo dos grupos raciais formadores de cada região. O povoamento de Goiás, que teve início logo após o seu descobrimento, em 1726, motivado pela procura de ouro, foi composto principalmente por portugueses e escravos africanos, contexto que favoreceu a mestiçagem entre eles. Considerando que esses povos apresentam genes para as hemoglobinas anormais com freqüências variadas, é esperado que se encontrem essas alterações genéticas na nossa população. O objetivo deste trabalho foi avaliar a prevalência de talassemias e hemoglobinas variantes na população de Goiás. Para isso a casuística foi composta por 404 alunos participantes dos diversos cursos da Universidade Católica de Goiás (UCG, oriundos de 55 cidades do estado de Goiás. A prevalência de anemia hereditária por talassemias e hemoglobinas variantes em Goiás foi de 10,1%, cuja ordem decrescente foi a seguinte: talassemia alfa heterozigótica (5,2%, heterozigose para hemoglobina S (Hb AS (2,2%, heterozigose para hemoglobina C (Hb AC (1%, talassemia beta menor (0,7%, associação entre talassemia alfa e heterozigose para Hb S (0,5%, associação entre talassemia alfa e heterozigose para Hb C (0,3% e heterozigose para hemoglobina D (Hb AD (0,3%. Nenhum caso de homozigose foi encontrado no presente estudo. Este trabalho demonstrou a dispersão dos genes para Hb S, Hb C e Hb D, bem como de talassemias alfa e beta em uma população do estado de Goiás. Por essa razão, concluímos que é importante realizar programas com maior abrangência da população para estudo da epidemiologia das talassemias e hemoglobinas variantes no estado de Goiás.The hereditary anemias, especially the thalassemies and hemoglobinopathies are the most common human genetic abnormalities. Their

  3. The value of fetal ultrasonography and magnetic resonance imaging in the assessment of diaphragmatic hernias; O valor da ultra-sonografia e da ressonancia magnetica fetal na avaliacao das hernias diafragmaticas

    Energy Technology Data Exchange (ETDEWEB)

    Amim, Bruno [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil). Curso de Pos-graduacao em Radiologia]. E-mail: brunoamim@gmail.com; Werner Junior, Heron; Daltron, Pedro Augusto; Antunes, Erika; Fazecas, Tatiana; Rodrigues, Leise; Domingues, Romeu Cortes [Clinica de Diagnostico por Imagem (CDPI), Rio de Janeiro, RJ (Brazil); Guerra, Fernando [Instituto Fernandes Figueira, Rio de Janeiro, RJ (Brazil); Marchiori, Edson [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil); Gasparetto, Emerson Leandro [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil)

    2008-01-15

    To demonstrate the relevance of ultrasonography and magnetic resonance imaging findings in the prenatal characterization and prognostic evaluation in cases of congenital diaphragmatic hernia. Materials And Methods: Fourteen pregnant women (mean gestational age = 28.7 weeks) who had undergone ultrasonography for suspicion of fetuses with congenital diaphragmatic hernia were assessed by means of magnetic resonance imaging on a 1.5 tesla equipment, following the standard protocol. Two radiologists evaluated the images and the findings were defined by consensus. Results: Twelve fetuses had left diaphragmatic hernia and two, right diaphragmatic hernia. Ultrasonography showed the fetal liver inside the thorax of five fetuses (three with left diaphragmatic hernia, and two with right diaphragmatic hernia) and magnetic resonance imaging in eight fetuses (six with left diaphragmatic hernia, and two with right diaphragmatic hernia). Stomach and small bowel loop herniation was observed in all of the fetuses with left diaphragmatic hernia (n = 12) at both magnetic resonance imaging and ultrasonography. Eight fetuses (seven with left diaphragmatic hernia and one with right diaphragmatic hernia) survived after surgical treatment. Conclusion: Ultrasonography and magnetic resonance imaging are complementary imaging methods in the evaluation of congenital diaphragmatic hernia. Magnetic resonance imaging is a helpful diagnostic method complementary to ultrasonography for evaluation of the fetal liver positioning, considering its relevance as a prognostic factor in cases of congenital diaphragmatic hernia. (author)

  4. Fetal pain

    NARCIS (Netherlands)

    Adama van Scheltema, Phebe

    2011-01-01

    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),

  5. Estudo comparativo entre metodologias de triagem para detecção de hemoglobina S em bancos de sangue Comparative study between methods of screening for detection of hemoglobin S in the blood banks

    Directory of Open Access Journals (Sweden)

    Letícia Loi Giovelli

    2011-04-01

    Full Text Available INTRODUÇÃO: O traço falciforme é a presença em heterozigose da hemoglobina S (HbS. A partir de junho de 2004, por meio da RDC 153/04, tornou-se obrigatória a triagem de hemoglobinas anormais em doadores de sangue. OBJETIVO: O objetivo deste estudo foi a comparação de diferentes metodologias de triagem utilizadas nos bancos de sangue para a detecção da HbS. Material e método: No período de abril de 2007 a abril de 2008, foram realizados três métodos de detecção de HbS em 4.108 doadores de sangue aptos que se apresentaram ao banco de sangue do Hospital Universitário de Santa Maria (HUSM. O estudo comparativo entre as metodologias incluiu os testes de solubilidade e de gel-centrifugação, tendo como referência de positividade a presença de HbS na eletroforese de hemoglobina. RESULTADOS: Dos 4.108 doadores estudados, 23 (0,56% apresentaram resultado positivo para HbS e dois (0,05% para HbC. Das amostras positivas para HbS detectadas por eletroforese qualitativa, 22 (95,6% foram detectadas pelo teste de solubilidade e 20 (86,9% pelo de gel-centrifugação. CONCLUSÃO: A eletroforese de hemoglobinas representou a melhor metodologia na identificação de hemoglobinas variantes e, portanto, deve ser valorizada quando se trata de diagnóstico para triagens em bancos de sangue pelo seu grau de sensibilidade, minimizando ao máximo os resultados falsos negativos e garantindo a qualidade do sangue que estará sendo utilizado.INTRODUCTION: The sickle cell trait is the presence of hemoglobin S (HbS in heterozygosity. According to RDC regulation 153/04, abnormal hemoglobin screening has become mandatory in blood donation samples since June 2004. OBJECTIVE: The aim of this study was to compare different screening methods used in blood banks for HbS detection. Material and method: From April 2007 to April 2008, three HbS detection methods were applied in 4,108 suitable blood samples from the blood bank of the University Hospital of Santa

  6. Ferropenia en niños de 6 a 24 meses de edad con hemoglobina normal

    Directory of Open Access Journals (Sweden)

    Marlen Ruiz González

    2002-04-01

    Full Text Available Se realizó un estudio a 55 niños de 6 a 24 meses de edad con hemoglobina normal con el objetivo de detectar precozmente la ferropenia y de identificar los factores que pueden contribuir a su aparición. Para esto se utilizó la determinación de protoporfirina eritrocitaria libre (PEL por punción digital. Teniendo en cuenta que esta no solo se eleva en la ferropenia, sino también en otras patologías como la intoxicación plúmbica, se le realizó a todo niño con protoporfirina elevada, coproporfirina III y ácido delta amino levulínico (ALA en orina. Además, se aplicó una encuesta donde se recogieron los posibles factores que de alguna forma pudieran provocar la ferropenia. Se encontraron 16 niños (29,1 % con PEL elevada, que coincidieron con el uso de lactancia artificial o mixta, exceso en la ingestión de leche y una alimentación inadecuada. Se concluyó que la PEL es una prueba útil para detectar la ferropenia en etapas tempranas, y que esta se relaciona con hábitos alimentarios incorrectos, lo cual puede ser solucionado con una mejor orientación a nivel de la Atención Primaria.

  7. Prevalência da hemoglobina S no Estado do Paraná, Brasil, obtida pela triagem neonatal Prevalence of hemoglobin S in the State of Paraná, Brazil, based on neonatal screening

    Directory of Open Access Journals (Sweden)

    Alexandra M. Watanabe

    2008-05-01

    Full Text Available O Ministério da Saúde instituiu o Programa Nacional de Triagem Neonatal através da Portaria nº. 822/GM, incluindo a pesquisa das hemoglobinopatias nos recém-nascidos. No Paraná, é realizada pela Fundação Ecumênica de Proteção ao Excepcional. Determinou-se a prevalência da hemoglobina S em homozigose, heterozigose e Sbeta-talassemia no estado. O sangue coletado em papel filtro foi examinado por focalização isoelétrica e cromatografia líquida de alta precisão (HPLC. De janeiro de 2002 a dezembro de 2004, foram triados 548.810 recém-nascidos e detectados 21 recém-nascidos com os resultados FS, dois FSA e/ou FS e quatro FSA. Após exames confirmatórios aos seis meses de idade, 12 foram definidos como anemia falciforme, com prevalência de 2,2:100 mil recém-nascidos; a interação Sbeta-talassemia foi confirmada em quinze (2,7:100 mil recém-nascidos; e 8.321 recém-nascidos foram diagnosticados como heterozigotos para HbS (1.500:100 mil recém-nascidos. A prevalência da HbS no Paraná é menor do que nas regiões Centro-Oeste, Norte e Nordeste do país. Origem étnica da população, óbitos fetais e casamentos preferenciais podem estar contribuindo para não haver maior número de homozigotos no estado. A interação Sbeta-talassemia sugere presença de povos euro-mediterrâneos na miscigenação dessa população.The Brazilian Ministry of Health created the National Neonatal Screening Program under ruling no. 822/2001, including neonatal screening for hemoglobinopathies. In the State of Paraná, neonatal screening is conducted by the Ecumenical Foundation for the Protection of the Handicapped. The prevalence rates were determined for homozygous and heterozygous hemoglobin S and Sbeta-thalassemia. Blood samples drawn on filter paper were examined by isoelectric focusing (IEF and high-performance liquid chromatography (HPLC. From January 2002 to December 2004, 548,810 newborns were screened, with the detection of 21 with FS

  8. Fetal syringomyelia

    OpenAIRE

    Guo, Anne; Chitayat, David; Blaser, Susan; Keating, Sarah; Shannon, Patrick

    2014-01-01

    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 vernicomyel...

  9. Muerte fetal

    Directory of Open Access Journals (Sweden)

    G. Andrés Pons, DR

    2014-11-01

    Full Text Available La muerte fetal es un evento poco frecuente pero de gran repercusión afectiva para los padres involucrados y su entorno. En el presente artículo revisaremos la epidemiología, las causas, orientaremos a los médicos en los pasos a seguir para realizar adecuadamente el estudio, la resolución del embarazo y el manejo del embarazo siguiente junto con las estrategias para prevenirlo.

  10. Muerte fetal

    OpenAIRE

    Andrés Pons, G.; Eduardo Sepúlveda, S.; Juan Luis Leiva, B.; Gustavo Rencoret, P.; Alfredo Germain, A.

    2014-01-01

    La muerte fetal es un evento poco frecuente pero de gran repercusión afectiva para los padres involucrados y su entorno. En el presente artículo revisaremos la epidemiología, las causas, orientaremos a los médicos en los pasos a seguir para realizar adecuadamente el estudio, la resolución del embarazo y el manejo del embarazo siguiente junto con las estrategias para prevenirlo.

  11. Ubicación altitudinal del umbral hipóxico para la masa total de hemoglobina en poblaciones colombianas

    OpenAIRE

    Benavides Pinzón, William Fernando

    2013-01-01

    El presente estudio pretende determinar la altura sobre el nivel del mar y el grado de hipoxia ambiental a partir del cual grupos de colombianos adultos saludables (nativos y/o residentes de la altura) incrementan la Masa Total de Hemoglobina referida al peso corporal (Hbtot), la cual se determinó por el método de re-inhalación del Monóxido de Carbono (CO) en cuatro localidades. Se examinaron 99 hombres y 104 mujeres (edad promedio de 21,07 ± 2,9 años para hombres y 21,26 ± 2,8...

  12. Seguridad alimentaria, crecimiento y niveles de vitamina A, hemoglobina y zinc en ninos preescolares del nordeste de Brasil

    OpenAIRE

    Dixis Figueroa Pedraza; Daiane de Queiroz; Adriana de Azevedo Paiva; Maria Auxiliadora Lins da Cunha; Zilka Nanes Lima

    2014-01-01

    El presente estudio buscó analizar la asociación entre la (in)seguridad alimentaria y el estado nutricional de niños preescolares asistidos en jardines infantiles. La seguridad alimentaria fue evaluada a través de la Escala Brasileña de Inseguridad Alimentaria (EBIA). El estado nutricional se evaluó a través del peso/edad, talla/edad, hemoglobina, retinol sérico y zinc sérico. Fueron encontradas prevalencias de déficit de estatura (6,2%), déficit de peso/edad (2,1%), deficiencia de vitamina A...

  13. Prevalência de talassemias e hemoglobinas variantes em pacientes portadores de lúpus eritematoso sistêmico Prevalence of thalassemias and variant hemoglobins in patients with systemic lupus erythematosus

    Directory of Open Access Journals (Sweden)

    Frank S. Castro

    2008-02-01

    Full Text Available O lúpus eritematoso sistêmico (LES é uma doença tipicamente multigênica e multifatorial, com grande complexidade clínica e fisiopatológica. As causas do LES não são totalmente conhecidas, mas sabe-se que fatores ambientais e genéticos estão envolvidos. Dentre as várias manifestações clínicas observadas em pacientes com LES, as anemias chamam a atenção principalmente quando se observa nesse estudo uma prevalência de 52,5% dos pacientes com índices hematimétricos sugestivos de anemias. Embora a anemia geralmente já seja observada em pacientes com LES, estudos sobre a prevalência de anemias hereditárias, especialmente as hemoglobinopatias na população com LES, não têm sido conduzidos. O objetivo desse trabalho foi o de avaliar a prevalência das hemoglobinopatias e talassemia em pacientes portadores de LES. Para isso, foram estudadas 80 amostras de sangue de pacientes portadores de lúpus atendidos no ambulatório do Hospital das Clínicas de Goiânia. Foram utilizados testes laboratoriais não moleculares para a detecção das hemoglobinopatias. A freqüência das alterações da hemoglobina foi de 10,0%, encontradas em oito pacientes. Dessas alterações, a mais prevalente foi a talassemia alfa, encontrada em quatro pacientes, correspondendo a uma freqüência de 5,0% da população estudada. Depois, foi o heterozigoto para a hemoglobina S, encontrada em dois pacientes, correspondendo a 2,5% da população, e também outro heterozigoto para a hemoglobina C, encontrada em um paciente, correspondendo a 1,25%, e um paciente com beta talassemia menor, correspondendo a 1,25%. Nenhum caso de homozigose foi encontrado no presente estudo. Este trabalho demonstrou que não houve diferença na prevalência dos distúrbios da hemoglobina entre a população em geral e os portadores de LES.Systemic lupus erythematosus (SLE is a typically multigenic and multifatorial disease with remarkable clinical and pathogenic complexities. The

  14. Medio ambiente fetal Fetal environment

    Directory of Open Access Journals (Sweden)

    César Bernardo Ospina Arcila

    1996-04-01

    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.

  15. Indicación temprana de electroforesis de hemoglobina a gestantes de Ciudad de La Habana

    Directory of Open Access Journals (Sweden)

    Marcos Raúl Martín Ruiz

    2000-06-01

    Full Text Available Con el propósito de lograr la detección temprana de parejas de alto riesgo de tener hijos con anemia falciforme en una edad gestacional lo más temprana posible, se estableció en el sistema nacional de salud en 1991-92 que el pesquisaje de hemoglobinas anormales en gestantes se hiciera en la captación del embarazo. Para evaluar la medida se consideraron 9 424 indicaciones de 80 áreas de salud de Ciudad de La Habana en 1999, con un 86,5 % de indicaciones tempranas globalmente, mientras que en 1992 fue 46,4 %. En la distribución de áreas de salud por intervalos según porcentaje de indicación temprana, se encontró: 75 al 84 %: 26 áreas de salud (32,5 %; 85-89 %: 29 (36,3 %; 90-94 %: 25 (31,3 %; y 95 % y más: ninguno. Se muestra en los resultados una notable mejoría en el cumplimiento de la medida. Todavía es necesario mejorar la divulgación y principalmente en áreas de salud todavía con insuficiencias.In order to detect as early as possible those couples at high risk for having children with sickle cell anemia, it was established in the national health system in l991-92 that the screening of abnormal hemoglobins in pregnant women should be made at the time of catchment. To evaluate the measure 9 424 indications of 80 health areas in Havana City were evaluated in l999, with 86,5% of early indications, whereas in l992 it was 46,4%. In the distribution of health areas by intervals according to the percentage of early indication the following results were obtained: 75-84%: 26 health areas (32,5%; 85-89%: 29 (36,3%; 90-94%: 25 (31,3% and 95% and over: none. It is observed a significant improvement concerning the fulfillment of this measure. It is still necessary to enhance spreading, mainly in those health areas with deficiencies

  16. On the fetal magnetocardiogram

    NARCIS (Netherlands)

    Peters, M.J.; Stinstra, J.G.; van den Broek, S.P.; van den Broek, S.P.; Huirne, J.A.F.; ter Brake, Hermanus J.M.; Rogalla, Horst

    1998-01-01

    Fetal magnetocardiography is a non-invasive technique for studying the electrical activity of the fetal heart. Fetal magnetocardiograms (fMCG) can be used to diagnose and classify fetal cardiac arrhythmias reliably. An averaged fMCG shows a QRS-complex, a P-wave, and a T-wave. However, it is still

  17. Seguridad alimentaria, crecimiento y niveles de vitamina A, hemoglobina y zinc en ninos preescolares del nordeste de Brasil

    Directory of Open Access Journals (Sweden)

    Dixis Figueroa Pedraza

    2014-02-01

    Full Text Available El presente estudio buscó analizar la asociación entre la (inseguridad alimentaria y el estado nutricional de niños preescolares asistidos en jardines infantiles. La seguridad alimentaria fue evaluada a través de la Escala Brasileña de Inseguridad Alimentaria (EBIA. El estado nutricional se evaluó a través del peso/edad, talla/edad, hemoglobina, retinol sérico y zinc sérico. Fueron encontradas prevalencias de déficit de estatura (6,2%, déficit de peso/edad (2,1%, deficiencia de vitamina A (24,4%, anemia (15,5% y deficiencia de zinc (15,0%. La inseguridad alimentaria familiar fue caracterizada en 64,2% de las familias predominando la forma leve (32,6%. El estudio concluye que la inseguridad alimentaria estimada por la EBIA no se asoció a los Escore-z de crecimiento ni a las concentraciones de retinol sérico, hemoglobina y zinc sérico.

  18. Prevalencia de los patrones electroforéticos de hemoglobina analizados en el CIHATA durante el período 2011-2013

    OpenAIRE

    Solano Vargas, Mariela; Salazar Sánchez, Lizbeth; Buzano Vargas, Lisa; Suárez Sánchez, María José

    2015-01-01

    Las hemoglobinopatías son alteraciones de las cadenas de globina que componen la hemoglobina, dentro de las alteraciones más comunes destacan las talasemias y la drepanocitosis. En el CIHATA se realizó un estudio retrospectivo de las muestras analizadas por electroforesis de hemoglobina durante el período 2011-2013, en donde se obtuvo un total de 2345 muestras analizadas, de las cuáles el patrón electroforético más frecuente fue el de Hb AA2, con un valor A2 promedio de (4.8±0.8%), compatible...

  19. Prevalencia de los patrones electroforéticos de hemoglobina analizados en el CIHATA durante el período 2011-2013.

    OpenAIRE

    Solano Vargas, Marianela; Salazar Sánzhez, Lizbeth; Buzano Vargas, Lisa

    2014-01-01

    Las hemoglobinopatías son alteraciones de las cadenas de globina que componen la hemoglobina, dentro de las alteraciones más comunes destacan las talasemias y la drepanocitosis. En el CIHATA se realizó un estudio retrospectivo de las muestras analizadas por electroforesis de hemoglobina durante el período 2011-2013, en donde se obtuvo un total de 2345 muestras analizadas, de las cuáles el patrón electroforético más frecuente fue el de Hb AA2, con un valor de A2 promedio de (4.8±0.8)%, compati...

  20. Cálculo do volume de sangue necessário para a correção da anemia fetal em gestantes isoimunizadas Blood volume calculation required for the correction of fetal anemia in pregnant women with alloimmunization

    Directory of Open Access Journals (Sweden)

    Mônica Deolindo Santiago

    2008-04-01

    Full Text Available OBJETIVO: obter uma equação capaz de estimar o volume de concentrado de hemácias a ser infundido para correção da anemia em fetos de gestantes portadoras de isoimunização pelo fator Rh, baseado em parâmetros alcançados durante a cordocentese prévia à transfusão intra-uterina. MÉTODOS: em estudo transversal, foram analisadas 89 transfusões intra-uterinas para correção de anemia em 48 fetos acompanhados no Centro de Medicina Fetal do Hospital das Clínicas da Universidade Federal de Minas Gerais. A idade gestacional mediana, no momento da cordocentese, foi de 29 semanas e a média de procedimentos por feto foi de 2,1. A hemoglobina fetal foi dosada antes e após a cordocentese, sendo verificado o volume de concentrado de hemácias transfundido. Para determinação de uma fórmula para estimar o volume sanguíneo necessário para correção da anemia fetal, tomou-se como base o volume necessário para elevar em 1 g% a hemoglobina fetal (diferença entre a concentração de hemoglobina final e a inicial, dividida pelo volume transfundido e o volume de quanto seria necessário para se atingir 14 g%, em análise de regressão múltipla. RESULTADOS: a concentração da hemoglobina pré-transfusional variou entre 2,3 e 15,7 g%. A prevalência de anemia fetal (HbPURPOSE: to obtain an equation to estimate the volume of red blood cells concentrate to be infused to correct anemia in fetuses of pregnant women with Rh factor isoimmunization, based in parameters obtained along the cordocentesis previous to intrauterine transfusion. METHODS: a transversal study analyzing 89 intrauterine transfusions to correct anemia in 48 fetuses followed-up in the Centro de Medicina Fetal do Hospital das Clínicas da Universidade de Minas Gerais. The median gestational age at the cordocentesis was 29 weeks and the average number of procedures was 2.1. Fetal hemoglobin was assayed before and after cordocentesis, leading to the volume of transfused red blood

  1. Efeito da duração da amamentação exclusiva e mista sobre os níveis de hemoglobina nos primeiros seis meses de vida: um estudo de seguimento Effect of length of exclusive breastfeeding and mixed feeding on hemoglobin levels in the first six months of life: a follow-up study

    Directory of Open Access Journals (Sweden)

    Andréa Silva de Oliveira

    2010-02-01

    Full Text Available O objetivo deste estudo foi avaliar o efeito da duração da amamentação exclusiva e mista sobre os níveis de hemoglobina de lactentes. Trata-se de um estudo de seguimento com seis meses de duração, envolvendo 150 crianças nascidas na maternidade de Mutuípe, Bahia, Brasil. Mensalmente, as crianças eram submetidas ao exame de sangue para avaliação dos níveis de hemoglobina e realizava-se coleta de dados de consumo alimentar. Foram obtidos, ainda, dados obstétricos e sócio-econômicos. Utilizou-se o modelo linear de efeitos mistos para investigar as associações de interesse. Ao final do seguimento, a perda amostral foi de 15,3%, e detectou-se uma prevalência de 71,7% de anemia. Constatou-se um incremento de 0,091g/dL nos níveis de hemoglobina a cada mês de duração de aleitamento materno exclusivo (p = 0,031, enquanto, a cada mês de duração de aleitamento materno misto, os níveis de hemoglobina declinaram em 0,097g/dL (p = 0,017. Concluiu-se que as práticas alimentares inadequadas parecem estar diretamente envolvidas na etiologia da deficiência nutricional de ferro nesse período da vida.This six-month follow-up study aimed to assessing the effect of length of both exclusive breastfeeding and mixed feeding on hemoglobin levels in 150 infants born at the Mutuípe maternity facility in Bahia State, Brazil. Blood tests were performed monthly to assess the hemoglobin levels, at which time data were gathered on food intake. Obstetric and socioeconomic data were also collected. The linear mixed effects model was used to investigate the target associations. Loss to follow-up was 15.3%, and anemia prevalence was 71.7%. An increase of 0.091g/dL (p = 0.031 in hemoglobin levels was found for each month of exclusive breastfeeding, while a decrease of 0.097g/dL (p = 0.017 was shown for each month of mixed feeding. In conclusion, inadequate food practices appear to be directly involved in the etiology of iron deficiency anemia during

  2. Fetal Cardiac Interventions

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2015-04-01

    Full Text Available The present article aims to highlight fetal cardiac interventions (FCIs in terms of indications, strategies, and fetal prognoses. FCIs of the early years were predominantly pharmacological therapies for fetal arrhythmia or heart block. A transplacental transmission of therapeutic agents has now become the main route of pharmacological FCIs. There have been various FCI strategies, which can be categorized into three types: pharmacological, open FCIs, and closed FCIs. Rather than as a routine management for materno-fetal cardiac disorders, however, FCIs are only applied in those fetal cardiac disorders that are at an increased risk of mortality and morbidity and warrant an interventional therapy. Pharmacological FCIs have been well applied in fetal arrhythmias but require further investigations for novel therapeutic agents. The development of open FCI in humans is an issue for the long run. Closed FCIs may largely rely on advanced imaging techniques. Hybrid FCIs might be the future goal in the treatment of fetal heart diseases.

  3. Efetividade de diferentes estratégias de intervenção com ferro nos níveis de hemoglobina e ferritina em escolares de Teresina, Piauí, Brasil Effectiveness of different iron supplementation strategies on hemoglobin and ferritin levels among schoolchildren in Teresina, Piauí State, Brazil

    Directory of Open Access Journals (Sweden)

    Marize Melo dos Santos

    2007-07-01

    Full Text Available O estudo avaliou o efeito das intervenções com sulfato ferroso e com ferro bisglicina quelato nas concentrações de hemoglobina e ferritina sérica em escolares de 7-11 anos, de ambos os sexos, de Teresina, Piauí, Brasil. Foi desenvolvido ensaio clínico-comunitário, randomizado, envolvendo 138 escolares, com níveis de hemoglobina 0,05 na comparação intergrupos. Nenhum impacto foi observado (p > 0,05 nas reservas corporais de ferro. Entretanto, escolares que apresentaram depleção das reservas corporais de ferro ( 0,05 entre os grupos de tratamento. Os resultados confirmam a efetividade das intervenções e ratificam o uso do esquema semanal com sulfato ferroso e com ferro bisglicina quelato no tratamento da deficiência do mineral e da anemia ferropriva.This study evaluated the effectiveness of supplementation with ferrous sulfate and iron bis-glycinate chelate on hemoglobin and serum ferritin levels among schoolchildren (7-11 years of both sexes. A randomized community-based trial including 138 anemic children (hemoglobin 0.05. No effect was observed on body iron for either intervention (p > 0.05. Children with depleted iron stores ( 0.05 was observed. The results confirm the effectiveness of the iron supplementation interventions and corroborate the use of iron salts or ferrous bisglycinate chelate on a weekly basis to overcome iron deficiency and anemia.

  4. Estudo genético-epidemiológico da hemoglobina S em uma população do Sudeste do Brasil Genetic-epidemiological study of hemoglobin S in a population from Southeastern Brazil

    Directory of Open Access Journals (Sweden)

    Antonio S. Ramalho

    2008-04-01

    Full Text Available A anemia falciforme, expressão clínica dos homozigotos do gene da hemoglobina S, é a doença hereditária mais freqüente no Brasil. Apesar disso, a metodologia genético-epidemiológica raramente é usada nos estudos brasileiros sobre essa alteração. No presente estudo foram analisados, por meio de um software específico, os dados de 817 heterozigotos do gene da HbS (513 homens e 304 mulheres, não consangüíneos, com idades entre 18 e 65 anos, detectados voluntariamente na cidade de Campinas, SP, Sudeste do Brasil. A constituição genômica caucasóide, negróide e indígena foi avaliada na amostra de portadores da hemoglobina S através do estudo das freqüências alélicas do sistema sangüíneo ABO e comparada com a observada na população geral da mesma cidade. A análise dos dados demonstrou que 52% dos portadores da HbS tiveram sua ancestralidade africana evidenciada pelo seu fenótipo e que 36% dos indivíduos eram procedentes do Nordeste do Brasil, sobretudo da Bahia (15%. Essa imigração interna tende a diminuir a proporção do haplótipo Bantu da hemoglobina S (mais grave na região de Campinas, aumentando a proporção do haplótipo Benin (mais benigno. A amostra possui um componente gênico negróide de 45%, caucasóide de 41%, e indígena de 14%. Essa composição genômica é significativamente diferente da observada na população geral da mesma cidade, apresentando uma participação gênica maior de negróides e de indígenas (influência da imigração nordestina e menor de caucasóides. A imigração nordestina e a miscigenação alteraram significativamente o perfil genético-epidemiológico dos portadores da hemoglobina S na região de Campinas, SP.Sickle cell anemia, the clinical expression of individuals homozygous for the hemoglobin S gene, is the most frequent hereditary disease in Brazil. Nevertheless, a genetic-epidemiological approach is rarely used in Brazilian studies related to this alteration. In the

  5. Restrição materna de polifenóis e dinâmica ductal fetal na gestação normal: um ensaio clínico aberto

    Directory of Open Access Journals (Sweden)

    Paulo Zielinsky

    2013-09-01

    Full Text Available FUNDAMENTOS: Recentemente demonstramos reversão da constrição ductal fetal após redução da ingesta materna de alimentos ricos em polifenóis (ARP, por sua ação inibidora da síntese das prostaglandinas. OBJETIVOS: Testar a hipótese de que fetos normais no 3º trimestre também melhoram a dinâmica ductal após restrição materna de polifenóis. MÉTODOS: Ensaio clínico aberto com 46 fetos com idade gestacional (IG > 28 semanas submetidos a dois estudos Dopplerecocardiográficos com intervalo de duas semanas, sendo os examinadores cegados para os hábitos alimentares maternos. Um questionário de frequência alimentar validado para esse objetivo foi aplicado e uma dieta com alimentos pobres em polifenóis (< 30 mg/100 mg foi orientada. Um grupo controle de 26 fetos no 3º trimestre foi submetido ao mesmo protocolo. Utilizou-se o teste-t para amostras independentes. RESULTADOS: A IG média foi 33 ± 2 semanas. A média do consumo materno diário de polifenóis (CMDP foi 1277 mg, caindo para 126 mg após orientação (p = 0,0001. Ocorreu diminuição significativa nas Velocidades Ductais Sistólica (VSD e Diastólica (VDD e na relação dos diâmetros ventriculares (VD/VE, assim como aumento do índice de pulsatilidade (IP [VSD = 1,2 ± 0,4 m/s (0,7-1,6 para 0,9 ± 0,3 m/s (0,6-1,3 (p = 0,018;VDD = 0,21 ± 0,09 m/s (0,15-0,32 para 0,18 ± 0,06 m/s (0,11-0,25 (p = 0,016; relação VD/VE = 1,3 ± 0,2 (0,9-1,4 para 1,1 ± 0,2 (0,8 - 1,3 (p = 0,004; IP do ducto = 2,2 ± 0,03 (2,0-2,7 para 2,4 ± 0,4 (2,2-2,9 (p = 0,04]. A IG média dos controles foi de 32 ± 4 semanas, não ocorrendo diferenças significativas no CMDP, nas velocidades ductais, no IP do ducto e na relação VD/VE. CONCLUSÃO: A restrição da ingesta de alimentos ricos em polifenóis no 3º trimestre por duas semanas melhora a dinâmica do fluxo no ducto arterioso fetal e as dimensões do VD.

  6. Insulinoterapia na prenhez de ratas diabéticas: repercussões fetais e placentárias Effect of insulin therapy in on pregnancy of diabetic rats: fetal and placental repercussions

    Directory of Open Access Journals (Sweden)

    Marilza V.C. Rudge

    1998-02-01

    Full Text Available O objetivo deste trabalho foi estudar as repercussões feto-placentárias da insulinoterapia na prenhez de ratas diabéticas. A droga diabetogênica foi aloxana na dose de 42 mg/kg de peso por via intravenosa. Formaram-se cinco grupos experimentais: controle (G1, n=12; diabete moderado não-tratado (G2, n=10; diabete moderado tratado com insulina (G3, n=11; diabete grave não-tratado (G4, n=12 e diabete grave tratado com insulina (G5, n=10. Foram obtidos 634 recém-nascidos e respectivas placentas. O resultado perinatal do tratamento com insulina teve relação direta com a qualidade do controle glicêmico. O tratamento inadequado do diabete moderado determinou níveis de hiperglicemia moderada nos recém-nascidos, não interferiu com o peso corporal dos filhotes e diminuiu a proporção de recém-nascidos grandes para a idade da prenhez (GIP. O controle adequado do diabete grave normalizou a glicemia dos recém-nascidos, aumentou o peso dos filhotes e diminuiu a proporção de recém-nascidos pequenos para a idade da prenhez (PIP. A administração de doses adequadas de insulina no grupo de ratas diabéticas grave diminuiu o peso das placentas mas sem modificar o índice placentário.Fetal and placental effects of insulin therapy on pregnancy of diabetic rats were studied. Alloxan was administered intravenously at the dose of 42 mg/kg of body weight. Five experimental groups were formed: control (G1, n=12, non-treated rats with moderate diabetes (G2, n=10, insulin-treated rats with moderate diabetes (G3, n=11,non-treated rats with severe diabetes (G4, n=12 and insulin-treated rats with severe diabetes (G5, n=10. Six hundred and thirty-four newborn rats and placentas wereprocured. The perinatal result of insulin therapy was directly related to the quality of glycemia control. Thus, inadequate control of moderate diabetes produced levels of moderate hyperglycemia, did not interfere with the newborn rats' body weight and decreased the proportion

  7. Niveles de hemoglobina preoperatorios y desenlaces en los pacientes llevados a cirugía cardiovascular, revisión sistemática y metaanálisis

    National Research Council Canada - National Science Library

    Oliveros Rodríguez, Henry; Beltrán Linares, Édgar

    2012-01-01

    Metodos: Se realizo una revision sistematica y un metaanalisis de los estudios observacionales de cohorte y de casos y controles que exploraron la asociacion entre los niveles de hemoglobina prequirurgica...

  8. Avaliação semiológica da palidez: concordância entre observadores e comparação com níveis séricos de hemoglobina Clinical evaluation of the paleness: agreement between observers and comparison with hemoglobin levels

    Directory of Open Access Journals (Sweden)

    Rosemeri Maurici da Silva

    2010-01-01

    Full Text Available INTRODUÇÃO: A palidez é caracterizada pelo descoramento da pele e mucosas, decorrente da pouca quantidade de hemoglobina circulante. OBJETIVO: O objetivo é comparar o grau de palidez, estratificada em cruzes, com os níveis séricos de hemoglobina, e avaliar o grau de concordância entre observadores. MÉTODOS: Foram avaliados, no período de fevereiro a abril de 2009, por meio de estudo transversal observacional, os indivíduos com idade superior a 18 anos internados em um hospital no sul do estado de Santa Catarina, para os quais haviam sido solicitadas dosagens de hemoglobina. Os pacientes foram avaliados por dois observadores (médicos e estudantes de medicina quanto à presença e grau de palidez (de ausente a ++++/4 na conjuntiva ocular. O índice de concordância Kappa foi utilizado para avaliar a concordância entre observadores. Foram avaliados 96 pacientes, caucasianos, com idade média de 57,7 anos, sendo 45,8% do gênero masculino e 54,2% do gênero feminino. RESULTADOS: A comparação entre os níveis médios de hemoglobina com a palidez graduada em cruzes não apresentou diferença estatisticamente significativa para os profissionais medicos, sendo a diferença significativa para os estudantes de medicina. O índice de concordância Kappa entre os observadores foi baixo. CONCLUSÃO: Esta pesquisa demonstrou que não houve boa concordância entre os observadores na avaliação de palidez estratificada em cruzes, sendo a avaliação mais fidedigna com relação aos níveis séricos de hemoglobina entre os profissionais médicos.INTRODUCTION: Pallor is characterized by discoloring of the skin and mucous membranes due to a reduction in the amount of circulating hemoglobin. The objective of this study was to compare the degree of pallor, stratified using crosses, with hemoglobin levels and to evaluate the correlation between observers. METHOD: From February to April 2009, an observational cross-sectional study was carried out of

  9. Programa de prevención de anemia falciforme (III: La electroforesis de hemoglobina: indicación e interpretación

    Directory of Open Access Journals (Sweden)

    Marcos Raúl Martín Ruiz

    1996-04-01

    Full Text Available Se presenta una guía práctica para la indicación de electroforesis de hemoglobina, utilizada en el pesquisaje de hemoglobinas anormales en el Programa de Prevención de Anemia Falciforme, actualmente vigente en Cuba, así como la interpretación del fenotipo y el riesgo de tener hijos afectados con hemoglobinopatías SS y SC.A practical guide is presented for the indication of hemoglobin electrophoresis used in the screening of abnormal hemoglobins in the Programme for Prevention of Sickle Cell Anemia, standing in Cuba at present, as well as the interpretation of phenotype and the risk of having children with hemoglobinopathies SS or SC.

  10. Manuseio de grave diminuição de hemoglobina em paciente jovem, testemunha de Jeová, submetido à proctocolectomia total: relato de caso Manoseo de grave disminución de hemoglobina en paciente joven, testigo de Jehová, sometido a la proctocolectomia total: relato de caso Extreme intraoperative hemodilution in Jehovah’s witness patient submitted total proctocolectomy: case report

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Imbelloni

    2005-10-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Os riscos de transfusão homóloga de sangue são bem conhecidos e alguns pacientes recusam esta transfusão por motivos religiosos. O objetivo foi relatar um caso de proctocolectomia total em Testemunha de Jeová onde o nível de hemoglobina foi de 4 g/dL. RELATO DO CASO: Paciente do sexo masculino, 17 anos, história de polipose intestinal familiar. Iniciada aos oito anos, caracterizada por sangramento. Aos 13 anos colectomia total. Aos 17 anos proctocolectomia total. Preparado com eritropoietina, ácido fólico, infusão de ferro e vitamina B12. Hemograma revelou: hemácias 4.200.000/mm³, hemoglobina 10,5 g/dL e hematócrito de 37%. Plaquetas 273.000/mm³, tempo de protrombina normal. Monitorização com PANI, oximetria de pulso, capnografia e ECG continuamente. Anestesia com propofol, sufentanil, pancurônio e enflurano em circuito fechado. Infusão de 7.000 mL de solução de Ringer com lactato e 150 mL de albumina humana a 20%. Diurese de 2.900 mL. Duração de 10 horas e 30 minutos. Na UTI Ht de 20%, hemácias 2.300.000/mm³, Hb de 4,2 g/dL e mantido com propofol e atracúrio. Exame no dia seguinte revelou: Ht de 18%, hemácias de 2.050.000/mm³, Hb de 4 g/dL. Extubado 18 horas após o término da cirurgia. Segundo dia encaminhado para o quarto. Quarto dia iniciada alimentação por via oral. Alta hospitalar no décimo dia de PO. No 30º PO Ht de 35%, hemácias de 4.000.000/mm³ e Hb de 9,5 g/dL. Seis meses após, fechamento da ileostomia. Submetido a 12 cirurgias sem transfusão sangüínea. CONCLUSÕES: Um planejamento de toda a equipe (clínico, cirurgião, anestesiologista e médicos de terapia intensiva permite realizar procedimentos cirúrgicos associados com importantes perdas sangüíneas, sem administração de sangue.JUSTIFICATIVA Y OBJETIVOS: Los riesgos de transfusión homóloga de sangre son bien conocidos y algunos pacientes recusan esta transfusión por motivos religiosos. El objetivo fue relatar

  11. Mother-to-child transmission of different HIV-1 subtypes among ARV Naïve infected pregnant women in Nigeria Transmissão materno-fetal de diferentes subtipos de HIV-1 entre gestantes infectadas na Nigéria

    Directory of Open Access Journals (Sweden)

    G.N. Odaibo

    2006-04-01

    Full Text Available The rate of mother-to-child transmission (MTCT of HIV as well as the implications of the circulating multiple subtypes to MTCT in Nigeria are not known. This study was therefore undertaken to determine the differential rates of MTCT of HIV-1 subtypes detected among infected pregnant women before ARV intervention therapy became available in Nigeria. Twenty of the HIV-positive women who signed the informed consent form during pregnancy brought their babies for follow-up testing at age 18-24 months. Plasma samples from both mother and baby were tested for HIV antibody at the Department of Virology, UCH, Ibadan, Nigeria. All positive samples (plasma and peripheral blood mononuclear cells - PBMCs were shipped to the Institute of Tropical Medicine, Antwerp, Belgium, where the subtype of the infecting virus was determined using the HMA technique. Overall, a mother-to-child HIV transmission rate of 45% was found in this cohort. Specifically, 36.4%, 66.7% and 100% of the women infected with HIV-1 CRF02 (IbNg, G and B, respectively, transmitted the virus to their babies. As far as it can be ascertained, this is the first report on the rate of MTCT of HIV in Nigeria. The findings reported in this paper will form a useful reference for assessment of currently available therapeutic intervention of MTCT in the country.A taxa de transmissão materno-fetal (MTCT do HIV bem como as implicações dos múltiplos subtipos circulantes para MTCT na Nigéria não são conhecidos. Este estudo foi realizado para determinar as diferentes taxas de MTCT dos subtipos de HIV-1 detectados entre gestantes infectadas antes que a administração da terapia ARV estivesse disponível na Nigéria. Vinte das mulheres HIV positivas que assinaram o consentimento durante a gravidez trouxeram seus filhos para seguimento na idade de 18-24 meses. Amostras de plasma de ambos, mãe e filho foram testadas para anticorpos HIV no Departamento de Virologia, UCH, Ibadan, Nigéria. Todas as

  12. Accounting for Fetal Origins

    DEFF Research Database (Denmark)

    Dalgaard, Carl-Johan Lars; Hansen, Casper Worm; Strulik, Holger

    2017-01-01

    The Fetal Origins hypothesis has received considerable empirical support, both within epidemiology and economics. The present study compares the ability of two rival theoretical frameworks in accounting for the kind of path dependence implied by the Fetal Origins Hypothesis. We argue that while...

  13. Fetal scalp pH testing

    Science.gov (United States)

    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 ...

  14. Efeitos da redução ou substituição do soro fetal bovino por outros compostos na maturação in vitro de oócitos bovinos

    Directory of Open Access Journals (Sweden)

    Maite Del Collado

    2014-07-01

    Full Text Available A utilização do soro fetal bovino (SFB, embora bastante disseminada na produção in vitro (PIV de embriões bovinos, apresenta limitações por ser um meio indefinido e por causar efeitos que prejudicam a qualidade desses embriões. Por esse motivo, nos últimos anos, grande parte das pesquisas relacionadas à PIV está voltada para a substituição do SFB por outros compostos nos meios de cultura. No presente estudo, foram utilizados como compostos protéicos a albumina sérica bovina livre de ácidos graxos (BSA-FAF e um produto comercial denominado fluido embriônico (FE de maneira isolada ou em diferentes combinações e concentrações, com objetivo de substituir ou diminuir a concentração do SFB durante a maturação in vitro (MIV. Para isso, oócitos bovinos foram maturados in vitro nos seguintes grupos (G que foram delineados de acordo com a suplementação protéica recebida: G1 (controle = 10% de SFB, G2 = 8mg/mL de BSA-FAF, G3 = 10% de FE, G4 = 6mg/mL de BSA-FAF + 5% de SFB, G5 = 6mg/mL de BSA-FAF + 3,5% de SFB + 1,5% de FE, G6 = 6mg/mL de BSA-FAF + 1,5% de SFB + 3,5% de FE, G7 = 6mg/mL de BSA-FAF + 5% de FE e G8 = 5% de SFB + 5% de FE. Após 24 horas de MIV, os oócitos foram classificados de acordo com a progressão meiótica e migração dos grânulos corticais (GC. As taxas de maturação foram avaliadas pelo teste do Qui-Quadrado (χ² ou, quando apropriado, pelo teste exato de Fisher, e para o estudo dos efeitos dos suplementos foram realizados contrastes ortogonais. O grupo suplementado com BSA-FAF (G2 mostrou diminuição na taxa de oócitos que atingiram MII (75% em comparação aos grupos G1, G4, G5 e G8 (88,9%, 89,6%, 87% e 86,8%, respectivamente, sem diferir do do G3 (79,8%, G6 (82,9% e G7 (82,9%. Ademais, o G3 também apresentou diminuição na taxa de maturação nuclear quando comparado ao G4. Quanto à maturação citoplasmática, nos grupos G2, G7, G6 e G3, houve redução (p<0,05 das taxas para 43,9%, 43,2%, 43

  15. Traço falciforme: heterozigose para hemoglobina S Sickle cell trait: heterozygous for the hemoglobin S

    Directory of Open Access Journals (Sweden)

    Mitiko Murao

    2007-09-01

    Full Text Available A hemoglobina S (HbS é uma das alterações hematológicas hereditárias de maior freqüência. No Brasil, a prevalência do traço falciforme (HbAS varia de 2% a 8%. Com esta freqüência gênica, estima-se, no Brasil, a existência de mais de dois milhões de portadores do traço falciforme. Diferentemente dos portadores em homozigose para a Hb S (Hb SS, os indivíduos com traço falciforme não apresentam sintomas vaso-oclusivos sob condições fisiológicas. Alguns sinais clínicos associados ao traço falciforme somente ocorrem sob condições que propiciam o processo de falcização, como hipóxia, acidose e desidratação. A expectativa de vida é semelhante ao do resto da população. Assim, a condição de portador assintomático não deve ter nenhum impacto no estilo e qualidade de vida.Hemoglobin S (HbS is one of the most common hereditary hematological alterations. In Brazil, the frequency of the sickle cell trait (HbAS varies from 2% to 8%. Thus, there is an estimate of more than two million carriers of the HbAS sickle cell trait in Brazil. Different to homozygous carriers for Hb S (Hb SS, individuals with the sickle cell trait do not present with vaso-occlusive symptoms under physiologic conditions. Some clinical signals associated to the sickle cell trait only occur under conditions that favor the sickling process, including hypoxia, acidosis and dehydration. Life expectancy is similar to the general population. Hence, the condition of asymptomatic carrier should not affect the style and quality of life.

  16. Fetal heart rate monitoring.

    Science.gov (United States)

    Nageotte, Michael P

    2015-06-01

    Electronic fetal heart rate monitoring is a widely utilized means of assessment of fetal status during labor. Whereas little evidence exists regarding efficacy, this modality continues to be used extensively in every modern labor and delivery unit in developed countries. It is of importance that all providers of health care to the woman in labor and her newborn have a clear understanding of the basic pathophysiology of fetal heart rate monitoring and an appreciation for labor course and concerns as they arise in order to optimize outcomes and patient safety. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Prevalência de anemia na artrite reumatoide

    Directory of Open Access Journals (Sweden)

    Smyrnova Ganna

    2014-07-01

    Full Text Available Objetivos: O objetivo desse estudo foi avaliar a prevalência de anemia em pacientes com artrite reumatoide (AR. Pacientes e métodos: 89 pacientes que satisfaziam os critérios do American College of Rheumatology (ACR para AR foram incluídos nesse estudo. A duração média da doença foi 10,9±8,8 anos. Todos os pacientes foram medicados com metotrexato (10,5±5,5 mg/semana em combinação com ácido fólico. Hormônios esteroides foram receitados para 92% dos pacientes (19,3±3,8 mg/dia.Velocidade de hemossedimentação (VHS, níveis de hemoglobina, proteína C reativa (PCR, fator de necrose tumoral alfa (TNFα e interleucina-1 beta (IL1β foram avaliados em todos os pacientes. Os critérios da Organização Mundial da Saúde (OMS para anemia utilizam um limiar para hemoglobina de <120 g/L para mulheres e de <130 g/L para homens. Resultados: Anemia foi observada em 57 (64% dos pacientes (1º grupo; os demais pacientes (2º grupo tinham níveis normais de hemoglobina (135,5±10,7 g/L. A duração e a atividade de AR foram significativamente maiores (p<0,05 no 1º versus 2º grupo. Os níveis médios de VHS, PCR, TNFα e IL-1β estavam significativamente aumentados (p<0,05 no 1º versus 2º grupo. Foram observadas correlações negativas entre o nível de hemoglobina e as concentrações de VHS, PCR, TNFα e IL-1β. Conclusão: Esse estudo demonstrou pela primeira vez que, na Ucrânia, 46% dos pacientes com AR apresentavam anemia. Um nível reduzido de hemoglobina foi associado à atividade intensa da doença.

  18. Fetal Alcohol Spectrum Disorders

    Science.gov (United States)

    Alcohol can harm your baby at any stage during a pregnancy. That includes the earliest stages, before ... can cause a group of conditions called fetal alcohol spectrum disorders (FASDs). Children who are born with ...

  19. Challenge of Fetal Mortality

    Science.gov (United States)

    ... Ordering Information Printed Publications Birth, Death, Marriage and Divorce Certificates Government Printing Office Bookstore How to Order ... this page Key findings What is the impact of fetal mortality on U.S. families? What is ...

  20. Fetal and neonatal thyrotoxicosis

    Directory of Open Access Journals (Sweden)

    Chandar Mohan Batra

    2013-01-01

    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.

  1. Variabilidad de los niveles de hemoglobina en pacientes tratados con agentes estimulantes de la eritropoyesis en pre-diálisis

    OpenAIRE

    Bonafont Pujol, Xavier

    2016-01-01

    La variabilidad de los niveles de hemoglobina (Hb) está relacionada con la mortalidad y la morbilidad en los pacientes en hemodiálisis tratados con agentes estimulantes de la eritropoyesis (AEE). La evidencia científica sobre los efectos de la variabilidad de Hb en los pacientes en prediálisis tratados con AEE es escasa e incompleta. OBJETIVOS: El objetivo principal de este estudio es determinar la influencia de la variabilidad de los niveles Hb con la mortalidad y la morbilidad de los p...

  2. Niveles de hemoglobina y puntajes de ingreso, en los alumnos ingresantes 2011 de la Facultad de Medicina Humana de la Universidad Nacional Mayor de San Marcos

    OpenAIRE

    Troncoso, Luzmila; Centro de Investigación de Bioquímica y Nutrición, Facultad de Medicina, UNMSM; Palomino, Felio; Centro de Investigación de Bioquímica y Nutrición, Facultad de Medicina, UNMSM; Oliveira, Gisela; Centro de Investigación de Bioquímica y Nutrición, Facultad de Medicina, UNMSM; Escudero, Gudelia; Centro de Investigación de Bioquímica y Nutrición, Facultad de Medicina, UNMSM; Flores, Juana; Centro de Investigación de Bioquímica y Nutrición, Facultad de Medicina, UNMSM; Aranda, Carmen; Centro de Investigación de Bioquímica y Nutrición, Facultad de Medicina, UNMSM; Vargas, Yorita; Centro de Investigación de Bioquímica y Nutrición, Facultad de Medicina,

    2013-01-01

    Objetivos: Determinar el nivel de hemoglobina y el puntaje de ingreso de los alumnos ingresantes 2011 de la Facultad de Medicina Humana de la UNMSM. Diseño: Descriptivo, observacional. Institución: Centro de Investigación de Bioquímica y Nutrición, Facultad de Medicina, UNMSM. Participantes: Alumnos de las EAP de Enfermería y Nutrición de la Facultad de Medicina de la UNMSM. Intervenciones: Participaron voluntariamente 45 alumnos de las EAP de Enfermería y Nutrición de la Facultad de Medicina...

  3. Status do ferro no atleta de canoagem durante a época desportiva : correlação com hemoglobina e massa magra

    OpenAIRE

    Lopes, Marta Sofia Ferreira Soares Borges

    2016-01-01

    Trabalho final de mestrado integrado em Medicina área cientifica de Medicina Desportiva, apresentado à Faculdade de Medicina da Universidade de Coimbra O ferro é um nutriente essencial tanto no transporte de oxigénio para os tecidos mediante a hemoglobina (Hb) como no metabolismo oxidativo do músculo esquelético (mioglobina). Assim, tendo em conta a elevada exigência desportiva dos atletas de alta competição, o défice de ferro é uma alteração importante para o atleta de alta compe...

  4. Avaliação da vitalidade fetal anteparto Antenatal fetal surveillance

    Directory of Open Access Journals (Sweden)

    Roseli Mieko Yamamoto Nomura

    2009-10-01

    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.

  5. Magnesium and fetal growth

    Energy Technology Data Exchange (ETDEWEB)

    Weaver, K.

    1988-01-01

    Fetal growth retardation and premature labor are major problems in perinatal medicine today and account for a great deal of the observed fetal morbidity. While the neonatal death rate has steadily declined over the past decade, there has been a lack of concommitant decrease in these two leading problems. Magnesium (Mg/sup ++/) plays a major role in both of these areas of concern. The fact that it is used as a treatment for premature labor has led investigators to look at low Mg/sup ++/ as a possible cause of this poorly understood phenomenon. The second major cause of small for gestational age infants is intrauterine growth retardation, a condition which may be of either fetal or maternal origin. In either case, Mg/sup ++/ may be implicated since it exerts a strong influence on the underlying pathophysiology of placental failure and maternal hypertension. Both of these conditions are mediated by vascular and platelet hyperactivity as well as by and increase in the ration of thromboxane to prostacyclin. Studies in both the human and animal species are beginning to show how Mg/sup ++/ interacts in these conditions to produce such a damaging fetal outcome. The recent use of Doppler velocimetry of the developing fetus has shown reduced fetal vascular and maternal uterine vascular compliance as early as 14 weeks of gestation in those who would be so affected.

  6. Primer caso de hemoglobina Köln (codon98 GTG>ATG) en Costa Rica First case of hemoglobin Köln (codon98 GTG>ATG) in Costa Rica

    OpenAIRE

    Walter Cartín; Carlos Suárez; Luis Mora; Kathia Valverde; Berta Valverde; Evan Jensen; Gabriela Abarca; Rafael Jiménez

    2010-01-01

    La exposición a ciertos medicamentos puede provocar anemia hemolítica con presencia de cuerpos de Heinz en sangre periférica. Esta anemia puede presentarse por sobredosis de medicamentos, tanto en individuos sanos como en personas con deficiencias enzimáticas como la glucosa-6-fosfato deshidrogenasa, o en presencia de hemoglobinas inestables. Este reporte muestra un caso de anemia hemolítica con cuerpos de Heinz, debido a la presencia de una hemoglobina inestable, cuyos estudios moleculares y...

  7. Análisis de las hemoglobinas glucosiladas de los pacientes diabéticos diagnosticados del 2006 al 2008 en el Hospital Nacional de Niños

    OpenAIRE

    Karla Morales-Navarro; Erick Richmond -Padilla; Roberto Bogarín -Solano; Orlando Jaramillo-Lines

    2011-01-01

    Objetivo: La hemoglobina glucosilada se ha utilizado como una de las principales herramientas para monitorear el adecuado control de la diabetes. El estudio tiene por objetivo describir los valores de hemoglobina glucosilada de los pacientes diabéticos diagnosticados durante el período 2006-2008, en control en el Hospital Nacional de Niños. Métodos: Estudio observacional descriptivo de 115 pacientes diabéticos en control en el Hospital Nacional Niños, diagnosticados en el período 2006-2008. S...

  8. Investigação bibliográfica sobre a hemoglobina S de 1976 a 2007 Investigación bibliográfica sobre la hemoglobina S de 1976 a 2007 Bibliographic investigation of hemoglobin S from 1976 to 2007

    Directory of Open Access Journals (Sweden)

    Denise Rodrigues Holsbach

    2010-01-01

    Full Text Available OBJETIVO: Buscar na literatura aspectos epidemiológicos explorados sobre a hemoglobina S. MÉTODOS: Trata-se de um levantamento bibliográfico nas bases de dados Medline e Lilacs. Também foi feita uma busca não eletrônica, em publicações de 1976 a 2007. RESULTADOS: Os resultados mostraram que, dos 21 artigos selecionados, 7 (33,3% foram publicados entre 1976 e 2000, 10 (47,7% entre 2001 e 2004 e 4 (19% entre 2005 e 2007. Com relação aos descritores, três referências (14%, são da área da enfermagem, descrevem o quadro clínico e a fisiopatologia, sendo que uma delas sistematiza a assistência à clientela com anemia falciforme à luz do referencial de adaptação de Roy; 11 (52% destacaram estudos epidemiológicos e a distribuição mundial; e sete (34% contemplaram diagnóstico médico, triagem neonatal e programas voltados à população falcêmica no Brasil. CONCLUSÃO: Os resultados apontam a necessidade de investigação nessa área pelos profissionais de saúde, principalmente os da área da enfermagem, em relação aos cuidados de prevenção, promoção e reabilitação dos pacientes falcêmicos.OBJETIVO: Buscar en la literatura aspectos epidemiológicos explorados sobre la hemoglobina S. MÉTODOS: Se trata de un levantamiento bibliográfico en las bases de datos Medline y Lilacs. También se hizo una búsqueda no electrónica, en publicaciones de 1976 a 2007. RESULTADOS: Los resultados mostraron que, de los 21 artículos seleccionados, 7 (33,3% fueron publicados entre 1976 y 2000, 10 (47,7% entre 2001 y 2004 y 4 (19% entre 2005 y 2007. Con relación a los descriptores, tres referencias (14% son del área de enfermería, describen el cuadro clínico y la fisiopatología, siendo que una de ellas sistematiza la asistencia a la clientela con anemia falciforme bajo el marco teórico de adaptación de Roy; 11 (52% destacaron estudios epidemiológicos y la distribución mundial; y siete (34% contemplaron el diagnóstico médico, la

  9. Níveis de hemoglobina, aleitamento materno e regime alimentar no primeiro ano de vida Hemoglobin concentration, breastfeeding and complementary feeding in the first year of life

    Directory of Open Access Journals (Sweden)

    Ana Marlúcia Oliveira Assis

    2004-08-01

    Full Text Available OBJETIVO: Identificar a relação entre os níveis de hemoglobina e o consumo de leite materno, alimentos complementares e líquidos não nutritivos no primeiro ano de vida. MÉTODOS: Estudo transversal envolvendo 553 crianças menores de 12 meses de vida, que freqüentavam os serviços públicos de saúde. A concentração de hemoglobina foi avaliada pelo método cianometahemoglobina, usando-se o sistema HemoCue. Utilizou-se a técnica da regressão linear múltipla para avaliar as associações de interesse. RESULTADOS: Níveis de hemoglobina compatíveis com a anemia foram identificados em 62,8% das crianças investigadas, com maior ocorrência naquelas de seis a 12 meses de idade (72,6%. O aleitamento materno exclusivo nos primeiros seis meses de vida assegurou os mais elevados níveis de hemoglobina. Os demais regimes alimentares declinaram de maneira diferenciada os níveis de hemoglobina, que se tornaram compatíveis com a anemia quando o regime de aleitamento artificial foi adotado (p=0,009. O consumo de chá e/ou água declinou em 0,76 g/dl (pOBJECTIVE: To assess the relationship between hemoglobin concentration and breastfeeding and complementary feeding during the first years of life. METHODS: Cross-sectional study with 553 children under age 12 months, who attended public healthcare facilities. Hemoglobin concentration was measured by the cyanmethaemoglobin method, using the HemoCue system. Associations of interest were analyzed through multiple linear regression. RESULTS: Hemoglobin concentrations compatible with anemia were identified in 62.8% of the children studied, with greater occurrence among the 6-12 months age group (72.6%. Exclusive breastfeeding during the first six months of life was associated with the highest levels of hemoglobin. The remaining feeding regimes were associated with different levels of reduction in hemoglobin levels, which became compatible with anemia in children fed with formula (p=0,009. Tea and

  10. Feto portador de síndrome de turner e tetralogia de fallot associadas à elevação de alfafetoproteína materna Fetal turner syndrome and tetralogy of fallot associated with elevated maternal serum alpha-fetoprotein levels

    Directory of Open Access Journals (Sweden)

    Eduardo Vieira Neto

    1998-06-01

    Full Text Available A síndrome de Turner fetal e suas complicações, a hidropisia e o higroma cístico, podem produzir alteração dos marcadores bioquímicos de soro materno inicialmente utilizados no rastreamento de síndrome de Down e de defeitos de tubo neural (DTN. Os autores relatam o caso de uma gestante de 37 anos, que foi rastreada para síndrome de Down e DTN no início do 2º trimestre. Foi constatado aumento da alfafetoproteína de soro materno (MSAFP e o rastreamento foi considerado positivo para DTN. Foi realizado exame ultra-sonográfico tridimensional, que não demonstrou nenhuma anormalidade fetal ou placentária, caracterizando o caso como elevação idiopática de MSAFP. No 3º trimestre, a gravidez evoluiu com acentuada oligoidrâmnia e alteração do fluxo uteroplacentário, obrigando à instituição de terapia com corticosteróides e parto cesáreo na 34ª semana gestacional. O concepto do sexo feminino foi encaminhado à UTI neonatal, onde foram diagnosticadas tetralogia de Fallot e síndrome de Turner. Esse caso incentivou os autores a rever a literatura sobre marcadores bioquímicos de soro materno na síndrome de Turner e nas malformações cardíacas congênitas. Ao final, propõe-se um protocolo para elevação idiopática de MSAFP.Turner syndrome and its complications, hydrops and cystic hygroma, can produce alterations in maternal serum biochemical markers used in screening for Down's syndrome and neural tube defects (NTD. The authors report the case of a 37-year-old pregnant woman, screened for Down's syndrome and NTD in the second trimester of pregnancy. The maternal serum alpha-fetoprotein (MSAFP level was increased and the test was considered screen positive for NTD. A three-dimensional ultrasound investigation was performed, but no fetal or placental anomalies were found, indicating a case of unexplained increased msafp. In the third trimester severe oligohydramnios and disturbances in uteroplacental arterial circulation

  11. Hemoglobina Köln diagnosticada em programa de triagem neonatal em São José do Rio Preto, SP Köln Hemoglobin found in Neonatal Screening Program in São José do Rio Preto, São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Emanuele C. Schiaveto

    2002-03-01

    Full Text Available Alterações genéticas em que a mutação de aminoácidos nas globinas afeta a estrutura da molécula tornando-a instável são classificadas como hemoglobinas instáveis. Devido à grande diversidade dos pontos de mutações por substituições e deleções de aminoácidos, as formas de instabilização se apresentam muito variadas. A hemoglobina Köln é a variante instável descrita com maior freqüência na literatura e a terceira descoberta no Brasil, as outras são Hb Niterói e Hb Hasharon. Anemia moderada, icterícia e presença de urina escura caracterizam as manifestações clínicas da Hb Köln. Em programa de triagem neonatal identificamos uma criança com suspeita de heterozigose para hemoglobina Köln, confirmada por procedimentos eletroforéticos e HPLC. Avaliações por diferentes metodologias laboratoriais e estudo familiar auxiliam no diagnóstico precoce, possibilitando minimizar os sintomas decorrentes da hemoglobina anormal e a realização do aconselhamento genético e educacional destas alterações hereditárias.Hemoglobinopathies are a diverse group of inherited recessive disorders that include thalassemias and sickle cell disease. They were the first genetic diseases to be characterized at the molecular level and consequently have been used repeatedly as a prototype for the development of new techniques of mutation detection. A major group of the structural hemoglobins exhibit the property of instability in solution, resulting from their altered molecular structures. Mutation of amino acids in the globin affects the structure of the molecule turning it unstable and they are classified as unstable hemoglobins. Due to the great diversity of the mutation points, substitutions and deletions of amino acids, the unstable forms are very varied. Hemoglobin Köln is the unstable variant most described in literature and the third discovered in Brazil, the others are Hb Niterói and Hb Hasharon. Moderate anemia, jaundice and the

  12. Efetividade do aconselhamento nutricional da Pastoral da Criança sobre a variação de hemoglobina entre menores de seis anos de idade Effectiveness of nutritional counseling provided by the Children's Mission on hemoglobin variation in under-six children

    Directory of Open Access Journals (Sweden)

    Iná dos Santos

    2005-02-01

    Full Text Available Para avaliar a efetividade do treinamento das líderes da Pastoral da Criança em aconselhamento nutricional sobre a variação da hemoglobina entre menores de seis anos, foi realizada uma intervenção comunitária. Por sorteio, uma das duas áreas de ação da Pastoral da Criança em Pelotas, Rio Grande do Sul, Brasil, foi selecionada e as líderes treinadas (Grupo Intervenção. A outra área constituiu o Grupo Controle. Após consentimento, a mãe foi entrevistada sobre a família, saúde e alimentação da criança. A hemoglobina foi medida com fotômetro portátil ao ingressar no estudo e após seis meses. O desfecho foi a variação da hemoglobina, da primeira para a segunda medida. Ingressaram 183 crianças intervenção e 179 crianças controle, comparáveis quanto ao sexo, idade, características ao nascer, aporte de ferro e nível médio de hemoglobina. Na análise ajustada, a variação no grupo intervenção foi 0,18 ± 0,27g/dl maior do que no controle. Embora a diferença entre os grupos não fosse estatisticamente significativa, a variação foi positiva no grupo intervenção e negativa no grupo controle, sugerindo benefício do treinamento.A community intervention was conducted to evaluate the effectiveness of leadership training in the Children's Mission (of the Brazilian Catholic Church for providing nutritional counseling on hemoglobin variation in children less than six years of age. Two areas of activity by the Children's Mission in Pelotas, Rio Grande do Sul State, Brazil, were randomly selected and the leaders in one were trained (intervention group. The other area constituted the control group. After providing consent, mothers were interviewed concerning the family and the child's health and eating. Hemoglobin was measured with a portable photometer upon entry into the study and at six months. The outcome variable was hemoglobin variation between the first and second measurements. The study included 183 intervention

  13. Fetal fluid and protein dynamics

    NARCIS (Netherlands)

    Pasman, Suzanne

    2010-01-01

    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

  14. Anemia intrahospitalaria y descenso de hemoglobina en pacientes internados Hospital-acquired anemia and decrease of hemoglobin levels in hospitalized patients

    Directory of Open Access Journals (Sweden)

    Carina V. Gianserra

    2011-06-01

    Full Text Available Es frecuente observar el desarrollo de anemia durante la internación, especialmente en pacientes graves. Esto se ha relacionado a extracciones de laboratorio. Pocos estudios evaluaron su prevalencia y factores asociados en pacientes internados en sala general. El objetivo fue determinar la prevalencia, características y factores clínicos asociados a anemia intrahospitalaria y descenso de hemoglobina en pacientes internados. Se efectuó un estudio transversal, prospectivo, descriptivo. Se analizaron 192 internaciones consecutivas en sala general. Se determinó aquellas que presentaron un descenso del valor de hemoglobina = 2 g/dl y se analizaron factores de riesgo asociados. Presentaron anemia 139 pacientes (72.4%, 89 (46.4% al ingreso y 50 (26% durante la internación. Se presentaron 47 casos de descenso de hemoglobina = 2 g/dl (24.47%, en los que se observaron los valores más bajos de hematocrito y hemoglobina al alta (p = 0.01, hidratación parenteral con mayor volumen (p = 0.01 y estadías hospitalarias más prolongadas (p = 0.0001. En el análisis univariado las variables leucocitosis = 11 000mm³ (OR; IC95%: 2.02; 1.03-4; p = 0.01, días de internación = 7 (OR; IC95%: 3.39; 1.62-7.09; p = 0.0006, hidratación parenteral = 1500 ml/día (OR; IC95%: 2.47; 1.06-6.4; p = 0.01, vía central (OR; IC95%: 10.29; 1.75-108.07, p = 0.003 y anemia intrahospitalaria (OR; IC95%: 7.06; 3.41-15.83; p = 0.00000004 fueron estadísticamente significativos como factores de riesgo para descenso de hemoglobina = 2 g/dl. En el análisis multivariado las variables leucocitosis = 11 000 mm³ (OR; IC95%:2.45; 1.14-5.27; p = 0.02; días de internación = 7 (OR; IC95%: 5.15; 2.19-12.07; p = 0.0002; hidratación parenteral = 1500 ml/día (OR; IC95%: 2.95; 1.13-7.72; p = 0.02 y vía central (OR; IC95%:8.82; 1.37-56.82; p = 0.02 fueron factores predictivos independientes de descenso de hemoglobina = 2 g/dl. La anemia intrahospitalaria tuvo una elevada prevalencia. La

  15. Fetal Alcohol Exposure

    Science.gov (United States)

    ... categories: 4 » Fetal Alcohol Syndrome (FAS) » Partial FAS (pFAS) » Alcohol-Related Neurodevelopmental Disorder (ARND) » Alcohol-Related Birth ... either prenatally, after birth, or both Partial FAS (pFAS) Partial FAS (pFAS) involves prenatal alcohol exposure, and ...

  16. Fetal Alcohol Syndrome.

    Science.gov (United States)

    Zerrer, Peggy

    The paper reviews Fetal Alcohol Syndrome (FAS), a series of effects seen in children whose mothers drink alcohol to excess during pregnancy. The identification of FAS and its recognition as a major health problem in need of prevention are traced. Characteristics of children with FAS are described and resultant growth retardation, abnormal physical…

  17. Intrapartum fetal surveillance : Monitoring fetal oxygenation with fetal blood sampling and umbilical cord blood analysis

    NARCIS (Netherlands)

    van den Berg, P; Slager, E; Fauser, B; VanGeijn, H; Brolmann, H; Vervest, H

    2005-01-01

    Although electronic fetal heart rate monitoring remains the most popular technique for fetal surveillance during labour, there is much concern about the ever rising Caesarean section rate, probably partly due to this practice. Fetal blood sampling is still the gold standard when it comes to

  18. Stillbirth and fetal growth restriction.

    Science.gov (United States)

    Bukowski, Radek

    2010-09-01

    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.

  19. Fetal drug therapy.

    OpenAIRE

    Evans, M I; Pryde, P G; Reichler, A; Bardicef, M; Johnson, M P

    1993-01-01

    Fetal drug therapy encompasses several areas, including the prevention of external genital masculinization in 21-hydroxylase deficiency syndrome (congenital adrenal hyperplasia), biochemical amelioration of methylmalonic acidemia, and biotin-responsive multiple carboxylase deficiency. The correction of cardiac arrhythmias has become relatively commonplace, and a reduction in the risks of neural tube defects is now possible with the use of preconceptual and early conceptual folic acid. Similar...

  20. Development of nanobiomarkers for use in sickle cell anemia; Desenvolvimento de nanomarcadores para serem utilizados na marcacao de hemoglobinas S (anemia falciforme)

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Elen Goncalves dos

    2009-07-01

    Luminescent materials, such as the rare earth's complex, can be used as markers in cytology and immunology, being also used as luminescent bio markers, once the development of these nano materials create new possibilities to many fields, particularly in diagnostic medicine. Besides, it establishes one kind of fluorescent probes, for which there are no equivalent organic molecules. Due to its potential in market's application, the objective of this work was to develop luminescent materials, allowing the use of these super molecules of lanthanides as markers for the detection of Sickle Cell Disease (HbS). Six luminescent markers were developed and marked on rare's earth base. The main methodology used for the detection of HbS was fluoroimmunoassay, which is already used in investigation of enzymes, antibodies, cells, hormones, and so on. During this work, absorption's spectrum in the infrared by Fourier's Transform (FTIR) was also used to detect the HbS. The studied methods were applied for the diagnosis of this disease, which has genetic origin, very typical of the hemoglobin-pathology group and considered to be a public health problem in Brazil (ANVISA). When early diagnosed, Sickle Cell Disease (SCD) has a significant decrease in morbidity and mortality. Comparing the obtained results to the already known methodologies, it was possible to conclude that they are viable methods to detect HbS. Besides, when totally developed, these methods will contribute to the production of Sickle Cell Anemia's diagnostic, and they will have impact in Sao Paulo state's public measures, as well as in Brazil's ones. (author)

  1. Intrapartum fetal monitoring.

    Science.gov (United States)

    Cahill, Alison G; Spain, Janine

    2015-06-01

    Intrapartum fetal monitoring to assess fetal well-being during the labor and delivery process has been a central component of intrapartum care for decades. Today, electronic fetal monitoring (EFM) is the most common method used to assess the fetus during labor without substantial evidence to suggest a benefit. A Cochrane review of 13 trials, which included over 37,000 women, found that continuous EFM provided no significant improvement in perinatal death rate [risk ratio (RR) 0.86; 95% confidence interval (CI), 0.59-1.23] or cerebral palsy rate (RR 1.75; 95% CI, 0.84-3.63) as compared with intermittent auscultation; however, there was a significant decrease in neonatal seizures (RR 0.50; 95% CI, 0.31-0.80). In addition, there was a significant increase in cesarean delivery (RR 1.63; 95% CI, 1.29-2.07) and operative vaginal delivery (RR 1.15; 95% CI, 1.01-1.33). Despite the lack of scientific support to suggest that EFM reduces adverse neonatal outcomes, its use is almost universal in the hospital setting and very likely has contributed to the rise in cesarean rate.

  2. Fetal Alcohol Spectrum Disorders.

    Science.gov (United States)

    Williams, Janet F; Smith, Vincent C

    2015-11-01

    Prenatal exposure to alcohol can damage the developing fetus and is the leading preventable cause of birth defects and intellectual and neurodevelopmental disabilities. In 1973, fetal alcohol syndrome was first described as a specific cluster of birth defects resulting from alcohol exposure in utero. Subsequently, research unequivocally revealed that prenatal alcohol exposure causes a broad range of adverse developmental effects. Fetal alcohol spectrum disorder (FASD) is the general term that encompasses the range of adverse effects associated with prenatal alcohol exposure. The diagnostic criteria for fetal alcohol syndrome are specific, and comprehensive efforts are ongoing to establish definitive criteria for diagnosing the other FASDs. A large and growing body of research has led to evidence-based FASD education of professionals and the public, broader prevention initiatives, and recommended treatment approaches based on the following premises:▪ Alcohol-related birth defects and developmental disabilities are completely preventable when pregnant women abstain from alcohol use.▪ Neurocognitive and behavioral problems resulting from prenatal alcohol exposure are lifelong.▪ Early recognition, diagnosis, and therapy for any condition along the FASD continuum can result in improved outcomes.▪ During pregnancy:◦no amount of alcohol intake should be considered safe;◦there is no safe trimester to drink alcohol;◦all forms of alcohol, such as beer, wine, and liquor, pose similar risk; and◦binge drinking poses dose-related risk to the developing fetus. Copyright © 2015 by the American Academy of Pediatrics.

  3. Biosynthetic cellulose induces the formation of a neoduramater following pre-natal correction of meningomyelocele in fetal sheep A celulose biossintética induz a formação de uma neoduramáter na correção antenatal da meningomielocele em fetos de ovelhas

    Directory of Open Access Journals (Sweden)

    Rita de Cássia Sanchez e Oliveira

    2007-06-01

    Full Text Available PURPOSE: The aim of this study was to compare the effectiveness of two dura-mater substitutes, namely human acellular dermal matrix (HADM and biosynthetic cellulose (BC, in repairing, in utero, surgically-induced meningomyelocele (MMC in fetal sheep. METHODS: A neural tube defect was created at 74-77 days gestation in 36 fetal sheep. They were divided into 3 groups, the control group that did not receive pre-natal corrective surgery, and the other two groups that received corrective surgery using HADM (Group A or BC (Group B. Both materials were used as a dura-mater substitutes between the neural tissue and the sutured skin. Correction was performed at gestation day 100 and the fetuses were maintained in utero until term. Sheep were sacrificed on gestation day 140. The fetal spine was submitted to macro and microscopic analysis. At microscopy, adherence of the material to the skin and neural tissue was analyzed. RESULTS: In the initial phase (pilot, experimentally-induced MMC was performed on 11 fetuses and 4 survived (37%. In the second phase (study, 25 fetuses received surgery and 17 survived (68%. In the study group, 6 fetuses did not undergo repair (control group, 11 cases were submitted to corrective surgery (experimental group and one fetal loss occurred. Of the surviving cases in the experimental group, 4 constituted Group A and 6 in Group B. Macroscopically, skin and underlying tissues where easily displaced from the BC in all cases it was used; in contrast, HADM adhered to these tissues. To compare the adherence, 4 cases from Group A and 4 in Group B were studied. We observed adherence, host cell migration and vessel proliferation into the HADM all sections from Group A and this aspect was not present in any cases in Group B (p OBJETIVO: Estudar os efeitos do emprego de dois materiais consideravelmente diferentes quanto à origem e custo na correção intra-uterina da meningomielocele criada experimentalmente em feto de ovino. M

  4. Intervalos de referência do pico de velocidade sistólica da artéria cerebral média fetal na população brasileira Nomogram of fetal middle cerebral artery peak systolic velocity in a Brazilian population

    Directory of Open Access Journals (Sweden)

    Luciano Marcondes Machado Nardozza

    2008-12-01

    Full Text Available OBJETIVO: Determinar uma curva de referência baseada em múltiplos da mediana para o pico de velocidade sistólica da artéria cerebral média fetal. MATERIAIS E MÉTODOS: Realizou-se estudo de corte transversal com 143 gestantes normais entre 23 e 35 semanas. Realizou-se varredura bidimensional em corte axial do crânio fetal, incluindo os tálamos e o septo pelúcido, e em seguida acionou-se o modo color Doppler, visualizando-se a artéria cerebral média. O Doppler pulsátil foi disposto próximo à origem deste vaso, utilizando-se ângulo de insonação de menos de 20°. Para avaliar a correlação do pico de velocidade sistólica da artéria cerebral média com a idade gestacional, utilizou-se o coeficiente de correlação de Person (r. Por meio de modelos de regressão, construiu-se uma tabela de múltiplos da mediana para o pico de velocidade sistólica da artéria cerebral média em cada idade gestacional avaliada, e adicionalmente determinaram-se valores de referência para essa variável. RESULTADOS: Observou-se forte correlação entre o pico de velocidade sistólica da artéria cerebral média e a idade gestacional (r = 0,70; p = 0,001. Determinaram-se valores do pico de velocidade sistólica da artéria cerebral média para os seguintes múltiplos da mediana: 1,0; 1,29; 1,5; 1,55. Determinaram-se os percentis 2,5 e 97,5 para o pico de velocidade sistólica da artéria cerebral média, variando de 24,33 cm²/s a 78,36 cm²/s. CONCLUSÃO: Um nomograma do pico de velocidade sistólica da artéria cerebral média fetal foi determinado.OBJECTIVE: To determine a reference curve for the peak systolic velocity of fetal middle cerebral artery. MATERIALS AND METHODS: The authors developed a cross-sectional study with 143 healthy pregnant women between the 23rd and 35th gestational weeks. A bidimensional axial scan of the fetal skull was performed, including the thalami and pellucid septum. Subsequently, the middle cerebral artery was

  5. Fetal vibroacoustic stimulation for facilitation of tests of fetal wellbeing.

    Science.gov (United States)

    Tan, Kelvin H; Smyth, Rebecca M D; Wei, Xing

    2013-12-07

    Acoustic stimulation of the fetus has been suggested to improve the efficiency of antepartum fetal heart rate testing. To assess the advantages and disadvantages of the use of fetal vibroacoustic stimulation in conjunction with tests of fetal wellbeing. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2013). All published and unpublished randomised controlled trials assessing the merits of the use of fetal vibroacoustic stimulation in conjunction with tests of fetal wellbeing. All review authors independently extracted data and assessed trial quality. Authors of published and unpublished trials were contacted for further information. Altogether 12 trials with a total of 6822 participants were included. Fetal vibroacoustic stimulation reduced the incidence of non-reactive antenatal cardiotocography test (nine trials; average risk ratio (RR) 0.62, 95% confidence interval (CI) 0.48 to 0.81). Vibroacoustic stimulation compared with mock stimulation evoked significantly more fetal movements when used in conjunction with fetal heart rate testing (one trial, RR 0.23, 95% CI 0.18 to 0.29). Vibroacoustic stimulation offers benefits by decreasing the incidence of non-reactive cardiotocography and reducing the testing time. Further randomised trials should be encouraged to determine not only the optimum intensity, frequency, duration and position of the vibroacoustic stimulation, but also to evaluate the efficacy, predictive reliability, safety and perinatal outcome of these stimuli with cardiotocography and other tests of fetal wellbeing.

  6. Aleitamento materno e níveis de hemoglobina em crianças menores de 2 anos em município do estado de São Paulo, Brasil Breastfeeding and hemoglobin concentration in children under 2 years of age in a municipality of São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Luciane Simões Duarte

    2007-04-01

    Full Text Available OBJETIVO: Avaliar a relação entre aleitamento materno e níveis de hemoglobina em crianças menores de 2 anos residentes na cidade de Itupeva, SP, Brasil. MÉTODOS: Estudo transversal de base populacional, realizado em amostra representativa de 254 crianças menores de 2 anos, selecionadas aleatoriamente na área urbana de Itupeva, SP, por procedimento de amostragem por conglomerados em 3 etapas. O aleitamento materno foi classificado utilizando-se as recomendações da Organização Mundial da Saúde e a hemoglobina foi determinada em hemoglobinômetro portátil (HemoCue. Para o diagnóstico, utilizou-se o ponto de corte de 11,0g/dL. RESULTADOS: A prevalência de anemia foi de 41,7%. Anemia foi mais freqüente entre os menores de 6 meses que não se encontravam em aleitamento materno (pOBJECTIVE: The objective of this study is to assess the relationship between breastfeeding and hemoglobin concentration in children under 2 years of age in Itupeva City, SP, Brazil. METHODS: This cross-sectional population-based study was carried out in a representative sample of 254 children under 2 years of age randomly selected in the urban area of Itupeva, SP. The sampling process was done in three stages. The recommendations made by the World Health Organization were used to classify breastfeeding. Hemoglobin concentration was measured by the cyanmethemoglobin method, using the HemoCue system and anemia was defined when hemoglobin concentration was below 11.0g/dL. RESULTS: The prevalence of anemia was 41.7%. Anemia was more frequent among children who were weaned before 6 months (p<0.05. The mean hemoglobin levels of breastfed children were significantly higher among children under 6 months (p<0.05. Children who were exclusively or predominantly breastfed in the first six months of life had higher mean hemoglobin levels than the remaining children (12.3g/dL versus 10.99g/dL; p=0.022. CONCLUSIONS: The results suggest that partial or total substitution of

  7. Cirugía fetal

    Directory of Open Access Journals (Sweden)

    DR. B. Juan Luis Leiva

    2014-11-01

    Full Text Available El campo de la cirugía fetal es de reciente comienzo y rápida evolución. Con el avance en las herramientas de diagnóstico antenatal, la capacidad de diagnóstico de condiciones fetales susceptibles de ser tratadas in utero ha dado paso a una serie de procedimientos destinados a dar solución a situaciones que, de no ser por estas intervenciones, terminarían en un resultado adverso perinatal. Las técnicas descritas para la terapia fetal incluyen procedimientos percutáneos guiados por ultrasonido, cirugía fetal abierta y cirugía mínimamente invasiva. En este artículo se presentan las diversas condiciones fetales tributarias de cirugía fetal y se discuten las opciones terapéuticas actuales para cada una.

  8. Dosagem de folatos maternos e fetais, séricos e eritrocitários em malformações por defeito de fechamento do tubo neural no feto Maternal and fetal serum and red blood cell folate levels in pregnancies complicated by neural tube defects

    Directory of Open Access Journals (Sweden)

    Victor Bunduki

    1998-07-01

    Full Text Available Objetivos: avaliar os níveis de folatos maternos e fetais gestações com malformações por defeitos de fechamento do tubo neural (DFTN. Métodos: o estudo foi do tipo caso-controle, no qual 14 casos de fetos com DFTN (grupo estudo e 14 casos de fetos com outras malformações (grupo controle foram estudados em gestantes de baixo risco para DFTN. Propusemo-nos a dosar o ácido fólico, na sua forma total e metilada, nos compartimentos fetal e materno, utilizando dosagens séricas e tissulares (eritrocitárias, assim como o volume corpuscular médio, o hematócrito e a hemoglobina. As coletas foram realizadas imediatamente antes da interrupção da gestação. Os resultados nos dois grupos foram comparados pelo teste t de Student, método de amostras pareados pela idade gestacional. Resultados: não se encontrou diferença nas taxas de folatos fetais e nos parâmetros hematológicos dos fetos, entre os dois grupos. Por outro lado, taxas anormalmente baixas de folatos foram encontradas nos eritrócitos das mães portadoras de fetos com DFTN, tanto para as formas totais(293,9 ng/mL contra 399,1 ng/mL no grupo controle, p=0,01 quanto para as formas metiladas (201,9 ng/mL contra 314,0 ng/mL para o grupo controle, p=0,02. Os folatos séricos maternos não se mostraram diferentes nos grupos estudo e controle. Conclusão: este estudo demonstrou que há uma menor taxa de folatos intratissulares, nas mães de fetos acometidos por DFTN, porém com taxas de folatos séricos semelhantes em relação ao grupo controle.Objective: to analyze maternal and fetal folate status in cases of neural tube defects (NTD. Methods: a case-control study was designed with 14 cases of fetuses with neural tube defects (study group and 14 cases of fetuses with other unrelated malformations (control group gestational age matched, in low-risk pregnant women. Both total and methylated folic acid levels in fetal and maternal compartments using serum and tissular (red blood cells

  9. Hypoxia and Fetal Heart Development

    OpenAIRE

    Patterson, A.J.; Zhang, L

    2010-01-01

    Fetal hearts show a remarkable ability to develop under hypoxic conditions. The metabolic flexibility of fetal hearts allows sustained development under low oxygen conditions. In fact, hypoxia is critical for proper myocardial formation. Particularly, hypoxia inducible factor 1 (HIF-1) and vascular endothelial growth factor play central roles in hypoxia-dependent signaling in fetal heart formation, impacting embryonic outflow track remodeling and coronary vessel growth. Although HIF is not th...

  10. MRI of the fetal spine

    Energy Technology Data Exchange (ETDEWEB)

    Simon, Erin M. [Departement of Radiology, Children' s Hospital of Philadelphia, PA (United States)

    2004-09-01

    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.)

  11. Fetal heart rate variation after corticosteroids for fetal maturation

    NARCIS (Netherlands)

    Knaven, Olga; Ganzevoort, Wessel; de Boer, Marjon; Wolf, Hans

    2017-01-01

    Introduction: Several studies report a decrease of fetal heart rate (FHR) short-term variation (STV) after corticosteroids for improvement of fetal maturity and advice not to deliver a fetus for low STV within 2-3 days after corticosteroids. However, literature is not unanimous in this respect. This

  12. Effect of fetal breathing movements on fetal cardiac hemodynamics

    NARCIS (Netherlands)

    K. van der Mooren (K.); J.W. Wladimiroff (Juriy); Th. Stijnen (Theo)

    1991-01-01

    markdownabstract__Abstract__ Maximum flow velocity waveforms were studied at atrioventricular and outflow tract level in 12 cases during fetal breathing activity and in 12 cases during fetal apnea matched for maternal and gestational age and maternal parity. Gestational age ranged between 27 and

  13. Fetal Alcohol Syndrome and Fetal Alcohol Effects in Child Development.

    Science.gov (United States)

    Pancratz, Diane R.

    This literature review defines Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE) and considers their causes, diagnoses, prevalence, and educational ramifications. Effects of alcohol during each of the trimesters of pregnancy are summarized. Specific diagnostic characteristics of FAS are listed: (1) growth deficiency, (2) a…

  14. Fetal Tachyarrhythmia - Part II: Treatment

    Directory of Open Access Journals (Sweden)

    Martijn A. Oudijk

    2004-10-01

    Full Text Available The decision to initiate pharmacological intervention in case of fetal tachycardia depends on several factors and must be weighed against possible maternal and/or fetal adverse effects inherent to the use of antiarrhythmics. First, the seriousness of the fetal condition must be recognized. Many studies have shown that in case of fetal tachycardia, there is a significant predisposition to congestive heart failure and subsequent development of fetal hydrops and even sudden cardiac death1,2,3 Secondly, predictors of congestive heart failure have been suggested in several studies, such as the percentage of time that the tachycardia is present, the gestational age at which the tachycardia occurs4, the ventricular rate5 and the site of origin of the tachycardia6. However, the sensitivity of these predictors is low and they are therefore clinically not very useful. In addition, hemodynamic compromise may occur in less than 24 - 48 hours as has been shown in the fetal lamb7 and in tachycardic fetuses8,9. On the other hand, spontaneous resolution of the tachycardia has also been described10. Thirdly, transplacental management of fetuses with tricuspid regurgitation11, congestive heart failure or fetal hydrops is difficult12,13, probably as a result of limited transplacental transfer of the antiarrhythmic drug14,15. In case of fetal hydrops, conversion rates are decreased and time to conversion is increased13. Treatment of sustained fetal tachycardia is therefore to be preferred above expectant management, although some centers oppose this regimen and suggest that in cases with (intermittent fetal SVT not complicated by congestive heart failure or fetal hydrops, conservative management and close surveillance might be a reasonable alternative16,17,18.

  15. HEPATITIS ALOINMUNE FETAL

    Directory of Open Access Journals (Sweden)

    Fernando Álvarez C., Dr.

    2015-07-01

    Full Text Available La hepatitis aloinmune fetal, conocida anteriormente como hemocromatosis neonatal, ha demostrado en los últimos años ser una enfermedad completamente distinta a la hemocromatosis del adulto, tanto en su etiología como en su la fisiopatología. Este conocimiento abre nuevas perspectivas tanto en la prevención de la enfermedad en futuros embarazos, así como en el tratamiento con inmunoglobulina endovenosa en la madre durante el embarazo y eventualmente el tratamiento postnatal, en el que el trasplante de hígado juega un rol primordial.

  16. Clinical implications of fetal magnetocardiography

    NARCIS (Netherlands)

    Quartero, H.W.P.; Stinstra, J.G.; Golbach, E.G.M.; Meijboom, E.J.; Peters, M.J.

    2002-01-01

    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

  17. Fetal and embryonic hemoglobins in erythroblasts from fetal blood and fetal cells enriched from maternal blood in fetal anemia.

    Science.gov (United States)

    Al-Mufti, R; Hambley, H; Farzaneh, F; Nicolaides, K H

    2001-12-01

    To determine whether there is a delay or reversal in switch mechanisms from embryonic (e and z) to fetal (g) hemoglobins accompanying the erythroblastosis of anemic fetuses and whether an increased erythroblast count in fetal blood is associated with an increase in feto-maternal cell trafficking. Fetal and maternal blood samples were obtained from 10 cases with rhesus isoimmunization and 2 cases with maternal Parvo-B19 virus at 19-33 weeks' gestation. Blood samples were also taken as controls from 61 fetuses and 86 mothers. Fetal erythroblasts were isolated by triple density gradient centrifugation and magnetic cell sorting with CD71 antibody. Fluorescent antibodies were used to immuno-stain for zeta (z), epsilon (e) and gamma (g) hemoglobin chains. In the maternal samples, fluorescence in situ hybridization (FISH) for X and Y chromosomes was also carried out to confirm the presence and proportion of the enriched fetal cells from maternal blood. In both fetal and maternal blood the percentage of erythroblasts positive for g-globin chain was significantly higher in the anemic fetuses compared to the controls (fetal blood, pmaternal blood, pmaternal samples of anemic fetuses compared to normal controls (pfetal hemoglobin chains. Severe fetal anemia is associated with an increase in feto-maternal cell trafficking.

  18. Impact of fetal echocardiography

    Directory of Open Access Journals (Sweden)

    Simpson John

    2009-01-01

    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.

  19. Fetal habituation to vibroacoustic stimulation in relation to fetal states and fetal heart rate parameters.

    Science.gov (United States)

    van Heteren, C F; Boekkooi, P F; Jongsma, H W; Nijhuis, J G

    2001-03-01

    Fetal habituation to repeated stimulation has the potential to become a tool in the assessment of fetal condition and of the function of the fetal central nervous system (CNS). However, the influence of fetal quiescence and activity on habituation remains to be clarified. We studied habituation and the influence of fetal state and fetal heart rate (FHR) parameters on habituation in healthy term fetuses. We studied habituation in 37 healthy fetuses in two tests with an interval of 10 min. The vibroacoustic stimuli were applied to the maternal abdomen above the fetal legs for a period of 1 s every 30 s. A fetal trunk movement within 1 s after stimulation was defined as a positive response. Habituation rate is defined as the number of stimuli applied before an observed non-response to four consecutive stimuli. The FHR patterns (FHRP) of the 10 min observation period before and after the tests were visually classified. Fetal states were defined according to the FHRP. Baseline FHR, FHR variability and the number of accelerations were calculated in a subgroup of 25 fetuses. Of the 32 fetuses that responded normally during the first test, 26 habituated and six had persistent responses. The median habituation rate decreased significantly in the second test (P=0.001). There was no difference in habituation rate between fetuses that where initially in a quiet state and those in an active state. The FHR parameters before the first test and the difference between these FHR parameters before and after the test did not correlate with the habituation rate. Although the majority of healthy fetuses was able to habituate, the interfetal variability in habituation performance is such that testing of habituation seems not to be a sensitive tool for the assessment of the fetal CNS. This variability is neither the result of differences in fetal state nor of the various FHR parameters before testing, nor of the difference in change of FHR parameters arising from stimulation.

  20. Fetal and Maternal Outcomes in Pregnancies Complicated with Fetal Macrosomia

    Science.gov (United States)

    Alsammani, Mohamed Alkahatim; Ahmed, Salah Roshdy

    2012-01-01

    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. PMID:22754881

  1. Maternal-fetal interactions in fetal cardiac surgery.

    Science.gov (United States)

    Eghtesady, Pirooz; Sedgwick, Joseph A; Schenbeck, Jennifer L; Lam, Christopher; Lombardi, John; Ferguson, Robert; Gardner, Aimee; McNamara, Jerri; Manning, Peter

    2006-01-01

    We examined potential maternal-fetal interactions during fetal cardiopulmonary bypass. these interactions, not previously described, may significantly influence attempts at fetal cardiac surgery. Eight fetal sheep underwent cardiopulmonary bypass (5 singletons, 3 twins; 100-109 days) for 60 minutes using a centrifugal microcircuit (20 mL prime), and the placenta as oxygenator. We measured maternal hemodynamics, arterial blood gases, and changes in blood flow to the gravid uterus using bilateral uterine artery flow probes. Maternal measurements were correlated to fetal hemodynamics, blood gases, and umbilical blood flows. After bypass, fetuses were followed for 60 minutes. Decreases in uterine blood flow occurred without changes in maternal hemodynamics or arterial blood gases, but were associated with worsening fetal arterial blood gases (pH decreased from 7.2 +/- 0.2 to 7.0 +/- 0.1, partial pressure of carbon dioxide increased 45.6% and partial pressure of oxygen decreased 15.4%). Changes in maternal hemodynamics (decreased systolic blood pressure [17.5%, SD = 11] and decreased diastolic blood pressure [20.3%, SD = 15]) were only noted when uterine blood flows decreased by greater than 38.2% (SD = 26). Correction of maternal hypocalcemia (0.89 g/dL, SD = 0.1) led to improved uterine artery flows (28.3% increase, SD = 30). Finally, fetal sternotomy, cannulation, and cardiopulmonary bypass each decreased uterine artery flows by 27.5% (SD = 18), 31.0% (SD = 26), and 39.7% (SD = 25), respectively. Similar changes were not observed in the nonbypass twin. Significant changes in uterine blood flow can occur during fetal cardiopulmonary bypass support without apparent changes in maternal hemodynamics or arterial blood gases. These changes imply a unique transplacental maternal-fetal interaction. Limited data from the twin fetus suggest a localized mechanism involving only the segment of placenta exposed to extracorporeal circulation.

  2. Identificação e caracterização de variantes novas e raras da hemoglobina humana Identification of characterization of novel and rare variants of human hemoglobin

    Directory of Open Access Journals (Sweden)

    Elza M. Kimura

    2008-08-01

    Full Text Available As anormalidades estruturais da hemoglobina estão entre as doenças genéticas mais comumente encontradas nas populações humanas. O Laboratório de Hemoglobinopatias do Departamento de Patologia Clínica da Faculdade de Ciências Médicas da Universidade Estadual de Campinas - Unicamp, localizado em Campinas, no estado de São Paulo, região Sudeste do Brasil, realizou, em seus 27 anos de existência, cerca de 130.000 diagnósticos. Entre as variantes estruturais detectadas, as hemoglobinas S, C e D-Punjab foram, como esperado, as mais freqüentes, porém um número expressivo de outras hemoglobinas anômalas, novas e raras, também foi encontrado. Esses achados estão sumarizados no presente artigo.Hemoglobin structural abnormalities are among the most commonly found human genetic diseases. The Laboratory of Hemoglobinopathies in the Clinical Pathology Department of the Medical Sciences School of the State University in Campinas - Unicamp, São Paulo, Southeastern Brazil, carried out, in its 27 years of activity, about 130,000 diagnoses. As expected, hemoglobins S, C and D were the most frequently observed variants, but an expressive number of other abnormal, novel and rare hemoglobins, was also detected. These findings are summarized in the present article.

  3. Fetal Sex Differences in Intrapartum Electronic Fetal Monitoring.

    Science.gov (United States)

    Porter, Anne C; Triebwasser, Jourdan E; Tuuli, Methodius; Caughey, Aaron B; Macones, George A; Cahill, Alison G

    2016-07-01

    Objective The article aimed to estimate differences in electronic fetal monitoring (EFM) patterns in term gestations attributable to fetal sex. Study Design We conducted a prospective cohort study of consecutive, singleton, nonanomalous, term gestations that labored during admission. EFM characteristics in the 30 minutes prior to delivery were evaluated. Logistic regression models estimated adjusted risks for EFM features by sex. To further estimate the impact of sex, we limited the analysis to gestations without composite morbidity (morbidity defined as arterial cord pH fetal sex. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  4. MR evaluation of fetal demise

    Energy Technology Data Exchange (ETDEWEB)

    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)

    2011-07-15

    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.)

  5. Fetal stem-cell transplantation.

    Science.gov (United States)

    Tiblad, Eleonor; Westgren, Magnus

    2008-02-01

    Fetal stem-cell transplantation is an attractive approach to the treatment of a variety of hematological, metabolic and immunological diseases before birth. The possibility of delivering a large number of cells in an early stage of life, and of taking advantage of normal fetal stem-cell migration and development, is promising. During fetal life, the capacity to mount an immune response to allogeneic cells is impaired compared with adult life. This provides an opportunity to induce tolerance to alloantigens without the need for myeloablation, although there are possible immune barriers to foreign cells in the fetus.

  6. The Danish fetal medicine database

    DEFF Research Database (Denmark)

    Ekelund, Charlotte Kvist; Kopp, Tine Iskov; Tabor, Ann

    2016-01-01

    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...

  7. Fetal MRI: A pictorial essay.

    Science.gov (United States)

    Rathee, Sapna; Joshi, Priscilla; Kelkar, Abhimanyu; Seth, Nagesh

    2016-01-01

    Ultrasonography (USG) is the primary method for antenatal fetal evaluation. However, fetal magnetic resonance imaging (MRI) has now become a valuable adjunct to USG in confirming/excluding suspected abnormalities and in the detection of additional abnormalities, thus changing the outcome of pregnancy and optimizing perinatal management. With the development of ultrafast sequences, fetal MRI has made remarkable progress in recent times. In this pictorial essay, we illustrate a spectrum of structural abnormalities affecting the central nervous system, thorax, genitourinary and gastrointestinal tract, as well as miscellaneous anomalies. Anomalies in twin gestations and placental abnormalities have also been included.

  8. The Danish Fetal Medicine database

    DEFF Research Database (Denmark)

    Ekelund, Charlotte; Kopp, Tine Iskov; Tabor, Ann

    2016-01-01

    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...

  9. DIABETES MELLITUS: AVALIAÇÃO E CONTROLE ATRAVÉS DA GLICEMIA EM JEJUM E HEMOGLOBINA GLICADA

    Directory of Open Access Journals (Sweden)

    Rodrigo Cimino Sá

    2014-08-01

    Full Text Available O Diabetes mellitus é desencadeado quando a produção ou ação de insulina tornam-se deficientes gerando sintomas e complicações crônicas sérias, tratando-se atualmente de um problema de saúde pública mundial. O objetivo foi realizar estudo das concentrações séricas das glicemias em jejum, A1C e estimativas dos níveis de glicose média baseados nos valores da A1C de pacientes diabéticos atendidos em um laboratório do município de São José dos Campos-SP. Durante o período de setembro a outubro de 2012, foram analisados os resultados dos exames de glicemia em jejum e A1C de 3.149 pacientes na faixa etária entre 30 a 69 anos, e com base nessas informações calculou-se a glicose média estimada de cada paciente através da equação: 28,7 × A1C - 46,7. Pacientes não-diabéticos foram 62,2%, de risco ou pré-diabéticos 11,2% e diabéticos 26,6%. Discussão. No grupo de diabéticos, os valores da glicemia em jejum, A1C e glicose média calculada se correlacionaram, demonstrando que quanto maiores as taxas da glicemia em jejum, maior será a estimativa da glicose média e, consequentemente, o nível de A1C. A média dos níveis glicêmicos entre 100 a 125 mg/dL deve ser uma meta aos pacientes diabéticos, condição fundamental na prevenção de riscos e complicações inerentes à doença.

  10. Difficult Decisions: Fetal Cell Transplants.

    Science.gov (United States)

    Slesnick, Irwin L.; Parakh, Jal S.

    1990-01-01

    Background information, techniques used, and details of the issues involved in the controversial issue of fetal cell transplantation are discussed. Questions for use in class discussion are provided. Suggestions for beginning a discussion are provided with accompanying questions. (CW)

  11. Fetal programming of renal function.

    Science.gov (United States)

    Dötsch, Jörg; Plank, Christian; Amann, Kerstin

    2012-04-01

    Results from large epidemiological studies suggest a clear relation between low birth weight and adverse renal outcome evident as early as during childhood. Such adverse outcomes may include glomerular disease, hypertension, and renal failure and contribute to a phenomenon called fetal programming. Other factors potentially leading to an adverse renal outcome following fetal programming are maternal diabetes mellitus, smoking, salt overload, and use of glucocorticoids during pregnancy. However, clinical data on the latter are scarce. Here, we discuss potential underlying mechanisms of fetal programming, including reduced nephron number via diminished nephrogenesis and other renal (e.g., via the intrarenal renin-angiotensin-aldosterone system) and non-renal (e.g., changes in endothelial function) alterations. It appears likely that the outcomes of fetal programming may be influenced or modified postnatally, for example, by the amount of nutrients given at critical times.

  12. Epigenetic regulation and fetal programming.

    Science.gov (United States)

    Gicquel, Christine; El-Osta, Assam; Le Bouc, Yves

    2008-02-01

    Fetal programming encompasses the role of developmental plasticity in response to environmental and nutritional signals during early life and its potential adverse consequences (risk of cardiovascular, metabolic and behavioural diseases) in later life. The first studies in this field highlighted an association between poor fetal growth and chronic adult diseases. However, environmental signals during early life may lead to adverse long-term effects independently of obvious effects on fetal growth. Adverse long-term effects reflect a mismatch between early (fetal and neonatal) environmental conditions and the conditions that the individual will confront later in life. The mechanisms underlying this risk remain unclear. However, experimental data in rodents and recent observations in humans suggest that epigenetic changes in regulatory genes and growth-related genes play a significant role in fetal programming. Improvements in our understanding of the biochemical and molecular mechanisms at play in fetal programming would make it possible to identify biomarkers for detecting infants at high risk of adult-onset diseases. Such improvements should also lead to the development of preventive and therapeutic strategies.

  13. [Monitoring of labor by fetal pulse oximetry in a case of fetal atrial-ventricular block].

    Science.gov (United States)

    Boudineau, M; Fondevila, M; Winer, N; Caroit, Y; Boog, G

    1997-01-01

    We present our experience with fetal pulse oximetry during labor monitoring in a case of fetal atrio-ventricular block. Fetal pulse oximetry is a recent technique of fetal monitoring. It is based on the photometric properties of hemoglobin and reduced hemoglobin. The continuous and noninvasive method measured fetal saturation in oxygen. It can detect fetal hypoxia, cause of acute suffering. Saturation was continuously greater than 40%. Spontaneous delivery raised no problem, either for the fetus or the mother.

  14. Screening for fetal aneuploidy.

    Science.gov (United States)

    Rink, Britton D; Norton, Mary E

    2016-02-01

    Screening is currently recommended in pregnancy for a number of genetic disorders, chromosomal aneuploidy, and structural birth defects in the fetus regardless of maternal age or family history. There is an overwhelming array of sonographic and maternal serum-based options available for carrying out aneuploidy risk assessment in the first and/or second trimester. As with any screening test, the patient should be made aware that a "negative" test or "normal" ultrasound does not guarantee a healthy baby and a "positive" test does not mean the fetus has the condition. The woman should have both pre- and post-test counseling to discuss the benefits, limitations, and options for additional testing. Rapid advancements of genetic technologies have made it possible to screen for the common aneuploidies traditionally associated with advanced maternal age with improved levels of accuracy beyond serum and ultrasound based testing. Prenatal screening for fetal genetic disorders with cell-free DNA has transformed prenatal care with yet unanswered questions related to the financial, ethical, and appropriate application in the provision of prenatal risk assessment. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Hemoglobina y testosterona: importancia en la aclimatación y adaptación a la altura Hemoglobin and testosterone: importance on high altitude acclimatization and adaptation

    Directory of Open Access Journals (Sweden)

    Gustavo F. Gonzales

    2011-03-01

    Full Text Available Los diferentes tipos de mecanismos que emplea el organismo cuando se enfrenta a una situación de hipoxia incluyen la acomodación, la aclimatación y la adaptación. La acomodación es la respuesta inicial a la exposición aguda a la hipoxia de altura y se caracteriza por aumento de la ventilación y de la frecuencia cardiaca. La aclimatación se presenta en los individuos que están temporalmente expuestos a la altura y, que en cierto grado, les permite tolerar la altura. En esta fase hay un incremento en la eritropoyesis, se incrementa la concentración de hemoglobina y mejora la capacidad de transporte de oxígeno. La adaptación es el proceso de aclimatación natural donde entra en juego las variaciones genéticas y la aclimatación que les permiten a los individuos vivir sin dificultad en la altura. La testosterona es una hormona que regula la eritropoyesis y la ventilación, podría estar asociada con los procesos de aclimatación y adaptación a la altura. La eritrocitosis excesiva que conduce al mal de montaña crónico es causada por una baja saturación arterial de oxígeno, una ineficiencia ventilatoria y reducida respuesta ventilatoria a la hipoxia. La testosterona se incrementa en la exposición aguda en la altura y en los nativos de altura con eritrocitosis excesiva. Los resultados de las investigaciones actuales permitirían concluir que el incremento de la testosterona y de la hemoglobina son buenas para la aclimatación adquirida pues mejoran el transporte de oxígeno pero no para la adaptación a la altura, dado que valores altos de testosterona en suero se asocian con eritrocitosis excesiva.The different types of response mechanisms that the organism uses when exposed to hypoxia include accommodation, acclimatization and adaptation. Accommodation is the initial response to acute exposure to high altitude hypoxia and is characterized by an increase in ventilation and heart rate. Acclimatization is observed in individuals

  16. Programa de prevención de anemia falciforme (I: Evaluación de la indicación de electroforesis de hemoglobina

    Directory of Open Access Journals (Sweden)

    Raúl Martín Ruiz

    1996-04-01

    Full Text Available Con el propósito de lograr la detección de parejas de alto riesgo para anemia falciforme, con una edad gestacional lo más temprana posible, se estableció en Ciudad de La Habana en 1991 y 1992 que la indicación de electroforesis de hemoglobina a las gestantes se hiciera en el momento de la captación del embarazo. Se analiza el cumplimiento de la medida en 72 policlínicos durante el último trimestre de 1992, mediante una revisión de las indicaciones. Las indicaciones con menos de 13 semanas de edad gestacional (indicaciones tempranas fueron el 43,4 % de un total de 3 416. Treinta y dos policlínicos (44,4 % no llegaron al 50 % de indicaciones tempranas, otras 32 estaban en el intervalo 50 y 74 % y sólo 8 (11,1 % alcanzaron al menos el 75 %. Concluimos que la implantación de la medida requiere más divulgación dirigida a los facultativos del nivel primario.Indication of hemoglobin electrophoresis at the first prenatal visit was stablished in Havana City in 1991 and 1992 with the purpose of detecting high risk couples for sickle cell anemia, as early as possible during pregnancy. The accomplishment of this measure is analyzed in 72 polyclinics in the last trimester of 1992, by checking the indications. Indications with less than 13 weeks of pregnancy (early indications represented 43,4 % of a total of 3 416. Thirty two polyclinics 44,4 % did not reach 50 % of early indications, other 32 were between 50 and 74 %, and only 8 (11,1 % amounted to at least 75 %. We conclude that to put into practice this measure more diffusion is necessary among primary health care level physicians

  17. Efeito do sulfato de magnésio sobre o índice de pulsatilidade das artérias uterinas, umbilical e cerebral média fetal de acordo com a persistência da incisura protodiastólica da artéria uterina na pré-eclâmpsia grave Effect of magnesium sulfate on pulsatility index of uterine, umbilical and fetal middle cerebral arteries according to the persistence of bilateral diastolic notch of uterine arteries in patients with severe preeclampsia

    Directory of Open Access Journals (Sweden)

    Alex Sandro Rolland Souza

    2009-02-01

    Full Text Available OBJETIVO: avaliar o efeito do sulfato de magnésio sobre o índice de pulsatilidade (IP das artérias uterinas, umbilicais e cerebral média fetal, de acordo com a persistência ou não da incisura protodiastólica bilateral das artérias uterinas na pré-eclâmpsia grave. MÉTODOS: foi desenvolvido um estudo do tipo coorte, incluindo 40 gestantes com pré-eclâmpsia grave, das quais 23 apresentavam incisura protodiastólica bilateral e 17, incisura ausente/unilateral. As pacientes foram submetidas a doplervelocimetria antes e depois de 20 minutos da administração intravenosa de 6 g do sulfato de magnésio. O exame foi realizado com a paciente em posição semi-Fowler, obtendo-se os sonogramas durante a inatividade fetal, em períodos de apneia e ausência de contrações uterinas. Todos os exames foram realizados por dois pesquisadores, considerando a média como resultado final. A comparação dos IP antes e depois do sulfato de magnésio em cada grupo foi realizada pelo teste de Wilcoxon. A diferença das duas medidas (antes e depois do sulfato de magnésio foi comparada entre os grupos (incisura bilateral e incisura ausente/unilateral utilizando-se o teste de Mann-Whitney. RESULTADOS: houve um aumento significativo da frequência cardíaca materna e uma diminuição da pressão arterial materna e da mediana dos IP das duas artérias uterinas e da artéria cerebral média fetal depois da utilização do sulfato de magnésio em ambos os grupos. Houve redução significativa do IP da artéria uterina esquerda e da artéria umbilical apenas no grupo com incisura protodiastólica unilateral/ausente. No entanto, não foram encontradas diferenças significativas em relação ao IP da artéria uterina direita e relação umbilical/cerebral antes e depois do sulfato de magnésio em cada grupo. Não se encontrou diferença entre os grupos, antes e depois do sulfato de magnésio, para nenhum dos desfechos estudados. CONCLUSÕES: após a administra

  18. Rebozo Technique for Fetal Malposition in Labor.

    Science.gov (United States)

    Cohen, Susanna R; Thomas, Celeste R

    2015-01-01

    Fetal occiput posterior position is associated with increased maternal and fetal morbidities. Currently, clinicians have limited evidence-based techniques or tools to remedy fetal occiput posterior position. The traditional Mexican rebozo technique of pelvic massage, sifting, or jiggling offers a potentially valuable tool to help correct fetal malposition. This article reviews the adaptation of 3 rebozo techniques that can be used in labor to encourage optimum fetal positioning; outlines hospital considerations for safety, fetal heart rate monitoring, and universal precautions; and reviews the implementation plan to introduce and sustain use of the rebozo in a large academic medical center. © 2015 by the American College of Nurse-Midwives.

  19. Fetal electrocardiogram (ECG) for fetal monitoring during labour.

    Science.gov (United States)

    Neilson, James P

    2015-12-21

    Hypoxaemia during labour can alter the shape of the fetal electrocardiogram (ECG) waveform, notably the relation of the PR to RR intervals, and elevation or depression of the ST segment. Technical systems have therefore been developed to monitor the fetal ECG during labour as an adjunct to continuous electronic fetal heart rate monitoring with the aim of improving fetal outcome and minimising unnecessary obstetric interference. To compare the effects of analysis of fetal ECG waveforms during labour with alternative methods of fetal monitoring. The Cochrane Pregnancy and Childbirth Group's Trials Register (latest search 23 September 2015) and reference lists of retrieved studies. Randomised trials comparing fetal ECG waveform analysis with alternative methods of fetal monitoring during labour. One review author independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. One review author assessed the quality of the evidence using the GRADE approach. Seven trials (27,403 women) were included: six trials of ST waveform analysis (26,446 women) and one trial of PR interval analysis (957 women). The trials were generally at low risk of bias for most domains and the quality of evidence for ST waveform analysis trials was graded moderate to high. In comparison to continuous electronic fetal heart rate monitoring alone, the use of adjunctive ST waveform analysis made no obvious difference to primary outcomes: births by caesarean section (risk ratio (RR) 1.02, 95% confidence interval (CI) 0.96 to 1.08; six trials, 26,446 women; high quality evidence); the number of babies with severe metabolic acidosis at birth (cord arterial pH less than 7.05 and base deficit greater than 12 mmol/L) (average RR 0.72, 95% CI 0.43 to 1.20; six trials, 25,682 babies; moderate quality evidence); or babies with neonatal encephalopathy (RR 0.61, 95% CI 0.30 to 1.22; six trials, 26,410 babies; high quality evidence). There were, however, on average

  20. Fetal maceration and retention of fetal bones in a mare.

    Science.gov (United States)

    Burns, T E; Card, C E

    2000-09-15

    A 19-year-old Quarter Horse mare was evaluated because of bloody vaginal discharge that was apparent immediately following breeding. On transrectal ultrasonography, it was evident that the uterus was filled with fluid containing echogenic particles; linear hyperechoic structures were also visible. Endoscopy was performed, which revealed a number of bones adhered to the cranial wall and floor of the right uterine horn as well as purulent fluid in both uterine horns. Bacterial endometritis and fetal maceration were diagnosed. The mare was treated with antibiotics, and the fetal bones were manually removed from the uterus. Fetal maceration with intrauterine retention of bones is rare in mares. Use of hysteroscopy supplements ultrasonography in the diagnosis of uncommon conditions of the uterus. Macerated bones may be adhered to the endometrium, thereby requiring manual removal.

  1. Fetal Programming and Cardiovascular Pathology

    Science.gov (United States)

    Alexander, Barbara T.; Dasinger, John Henry; Intapad, Suttira

    2016-01-01

    Low birth weight serves as a crude proxy for impaired growth during fetal life and indicates a failure for the fetus to achieve its full growth potential. Low birth weight can occur in response to numerous etiologies that include complications during pregnancy, poor prenatal care, parental smoking, maternal alcohol consumption or stress. Numerous epidemiological and experimental studies demonstrate that birth weight is inversely associated with blood pressure and coronary heart disease. Sex and age impact the developmental programming of hypertension. In addition, impaired growth during fetal life also programs enhanced vulnerability to a secondary insult. Macrosomia, which occurs in response to maternal obesity, diabetes and excessive weight gain during gestation, is also associated with increased cardiovascular risk. Yet, the exact mechanisms that permanently change the structure, physiology and endocrine health of an individual across their lifespan following altered growth during fetal life are not entirely clear. Transmission of increased risk from one generation to the next in the absence of an additional prenatal insult indicates an important role for epigenetic processes. Experimental studies also indicate that the sympathetic nervous system, the renin angiotensin system, increased production of oxidative stress and increased endothelin play an important role in the developmental programming of blood pressure in later life. Thus, this review will highlight how adverse influences during fetal life and early development program an increased risk for cardiovascular disease including high blood pressure and provide an overview of the underlying mechanisms that contribute to the fetal origins of cardiovascular pathology. PMID:25880521

  2. [Fetal echocardiography efficiency. Clinical experience].

    Science.gov (United States)

    San Luis Miranda, Raúl; Arias Monroy, Laura Guadalupe; Gutiérrez González, Gladis Alicia; León Avila, José Luis; Cruz Rodríguez, Armando; Osornio Correa, Porfirio Rafael

    2008-12-01

    Congenital heart disease diagnostic has a high diagnostic precision with fetal echocardiography. This study has been reported in populations with high risk and with a sensibility of 86 to 99% and specificity of 91 to 100%. To know sensibility and specificity of fetal echocardiography in high-risk pregnancies, and to describe types and frequency of congenital heart disease in utero. 229 files of pregnant women with high-risk factors, more than 15 weeks of gestation, and at birth cardiovascular exam were analyzed. This analysis was made by means of simple frequencies, sensibility, specificity, positive and negative predictive value, and truth index calculation. We found 62 (27%) cases with fetal heart disease. Mean of maternal age was 27 +/- 5.5 years, and of gestational age 31 +/- 5 weeks. Risk factors that require study were: four-chamber abnormality in routine ultrasound, dysmorphy, fetal bradicardia, and poll and oligohydramnios. There were 55 (88.7%) high-risk heart diseases, and most frequent were Ebstein's anomaly, unique ventricle, hypoplastic left ventricle syndrome, and tumors. Sensibility was 98.41%, specificity was 97.59%, positive prognostic value was 97.59%, and negative prognostic value was 99.39%. Fetal echocardiography has a high diagnosis certainty in our hospital unit, thus, it has to be a normal prenatal exam in pregnant women with high-risk factors.

  3. Fetal programming and cardiovascular pathology.

    Science.gov (United States)

    Alexander, Barbara T; Dasinger, John Henry; Intapad, Suttira

    2015-04-01

    Low birth weight serves as a crude proxy for impaired growth during fetal life and indicates a failure for the fetus to achieve its full growth potential. Low birth weight can occur in response to numerous etiologies that include complications during pregnancy, poor prenatal care, parental smoking, maternal alcohol consumption, or stress. Numerous epidemiological and experimental studies demonstrate that birth weight is inversely associated with blood pressure and coronary heart disease. Sex and age impact the developmental programming of hypertension. In addition, impaired growth during fetal life also programs enhanced vulnerability to a secondary insult. Macrosomia, which occurs in response to maternal obesity, diabetes, and excessive weight gain during gestation, is also associated with increased cardiovascular risk. Yet, the exact mechanisms that permanently change the structure, physiology, and endocrine health of an individual across their lifespan following altered growth during fetal life are not entirely clear. Transmission of increased risk from one generation to the next in the absence of an additional prenatal insult indicates an important role for epigenetic processes. Experimental studies also indicate that the sympathetic nervous system, the renin angiotensin system, increased production of oxidative stress, and increased endothelin play an important role in the developmental programming of blood pressure in later life. Thus, this review will highlight how adverse influences during fetal life and early development program an increased risk for cardiovascular disease including high blood pressure and provide an overview of the underlying mechanisms that contribute to the fetal origins of cardiovascular pathology. © 2015 American Physiological Society.

  4. Two cases of fetal goiter

    Directory of Open Access Journals (Sweden)

    Ashish Saini

    2012-01-01

    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.

  5. The Danish Fetal Medicine Database

    DEFF Research Database (Denmark)

    Ekelund, Charlotte K; Petersen, Olav B; Jørgensen, Finn S

    2015-01-01

    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...... MEASURES: Screening performance was assessed for the years 2008-2012 by calculating detection rates and screen-positive rates. RESULTS: A total of 268 342 first-trimester risk assessments for trisomy 21 were performed in singleton pregnancies. Participation rate in first-trimester screening was >90...

  6. Optimización de la hemoglobina preoperatoria en cirugía ortopédica mayor utilizando hierro intravenoso con o sin eritropoyetina. Estudio epidemiológico

    OpenAIRE

    Basora Macaya, Misericordia; Colomina Soler, M. J. (María José); Tio, M.; Mora, Lidia; Sánchez-Etayo, G.; Salazar, F.; Ciércoles, E.; Paños, M.; Guerrero, E.; Berge, R.

    2015-01-01

    Objetivo: Evaluar la efectividad del tratamiento con hierro intravenoso, solo o asociado a eritropoyetina (rHuEPO), mediante el incremento de hemoglobina (Hb). Como objetivo secundario se analizó la relación del incremento de Hb con los parámetros utilizados para evaluar la anemia. Material y método: Estudio observacional retrospectivo realizado en 2 centros entre enero de 2005 y diciembre de 2009. Se incluyeron pacientes sometidos a cirugía ortopédica electiva con déficit de hierro y que fue...

  7. Correlación entre niveles de hemoglobina, volumen corpuscular medio y percentiles de peso y talla para la edad de alumnos de dos escuelas fiscales de la ciudad de Guayaquil, durante el período 2009 - 2010

    OpenAIRE

    Nicolalde Sánchez, Geovana

    2013-01-01

    La desnutrición a nivel mundial es un problema aún vigente siendo en nuestro país una realidad poco estudiada y reportada, por lo que se diseñó el presente estudio. Objetivo: determinar la prevalencia de anemia microcítica en niños de edad escolar y su relación con parámetros de crecimiento pondoestatural. Hipótesis: los niños con niveles de hemoglobina menor al percentil 5 tienen indicadores de crecimiento también inferiores a dicho percentil. Diseño: estudio epidemiológico, desc...

  8. Efecto del Tratamiento con hierro y ácido fólico sobre la concentración de hemoglobina y los índices eritrocitarios secundarios en niños con anemia en Cartagena de Indias

    OpenAIRE

    Herrera Amador, Carlos

    2015-01-01

    Tesis (Magister en Bioquímica Clínica).-- Universidad de San Buenaventura, Departamento De Ciencias de la Salud, Maestría en Bioquímica Clínica, 2013 El Hierro y el Ácido fólico son requerimientos esenciales para el organismo, porque se utilizan en la síntesis de hemoglobina, mioglobina y en los procesos de multiplicación celular de la línea eritroide. Se obtienen a través de los alimentos como carnes rojas, pollo, pescado, vegetales de hoja verde y frutas, son absorbidos en mayor cantidad...

  9. Níveis séricos de hemoglobina em adolescentes segundo estágio de maturação sexual Hemoglobin serum levels in adolescents according to sexual maturation stage

    Directory of Open Access Journals (Sweden)

    Maria Fernanda Petroli Frutuoso

    2003-06-01

    Full Text Available A adolescência constitui etapa de risco para o desenvolvimento da anemia ferropriva, uma vez que ocorre aumento da necessidade de ferro decorrente do crescimento estatural e da maturação biológica. Estudaram-se 130 adolescentes, de ambos os sexos, para verificar os valores de hemoglobina sérica em diferentes fases de maturação sexual. Utilizou-se o método de fotometria para dosar a hemoglobina sérica e realizou-se auto-avaliação do estágio de maturação sexual com base nos critérios de Tanner. Os níveis médios de hemoglobina foram semelhantes entre sexos, bem como entre meninas que menstruavam ou não. O nível médio de hemoglobina foi de 13,3g/dL tanto para os meninos como para as meninas (p=0,64, com desvios-padrão de 1,12 e de 0,83, respectivamente. Entre os adolescentes estudados, 7,7% tinham anemia ferropriva. Recomenda-se atenção ao grupo de adolescentes, devido ao aumento da necessidade de ferro durante o estirão de crescimento, principalmente entre as meninas, aumentando a suscetibilidade à anemia.During adolescence, the risk of development of iron-deficiency anemia is higher because of the growth spurt and the sexual maturation which increase the iron requirement. One hundred and thirty adolescents (males and females were studied, in order to assess the serum hemoglobin values in different sexual maturation stages. The photometric method was used and a self-evaluation of the sexual maturation stage based on Tanner's criteria was applied. The average hemoglobin values were similar for both sexes, as well for girls who had menstruated or not. The average hemoglobin values were 13.3 (s.d. 1.12g/dL for males and 13.3 (s.d. 0.83g/dL for females (p=0.64. Among the studied adolescents, 7.7% had iron-deficiency anemia. Due to the iron requirement increase during the growth spurt, mainly in females, and the higher susceptibility to iron deficiency anemia, special attention to the adolescents is recommended.

  10. Fetal scalp blood sampling during labor

    DEFF Research Database (Denmark)

    Chandraharan, Edwin; Wiberg, Nana

    2014-01-01

    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...

  11. Awareness of fetal echo in Indian scenario

    Directory of Open Access Journals (Sweden)

    Dhanya Warrier

    2012-01-01

    Conclusions: The awareness of fetal echocardiography, an important tool in reducing the incidence of complex CHD, thereby impacting public health, is alarmingly low in the population studied. Appropriate action to increase awareness of fetal echocardiography needs to be looked into.

  12. Births and deaths including fetal deaths

    Data.gov (United States)

    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,...

  13. Electronic fetal monitoring of the preterm fetus.

    Science.gov (United States)

    Baird, Suzanne McMurtry; Ruth, Donna Jean

    2002-06-01

    Following an analysis of the literature, this article reviews the current practices, guidelines, and recommendations for electronic fetal monitoring of the preterm fetus. The physiologic aspects of fetal heart rate control, electronic fetal monitor parameters, and differences between the preterm and term fetus are discussed. Clearly identified is the need for clinical research regarding electronic fetal monitoring of the preterm fetus to establish evidence-based practice guidelines.

  14. Primary care fetal assessment - low-cost fetal arousal testing

    African Journals Online (AJOL)

    lid and allow it to snap back, producing a sound. The tests with the cans were classified according to whether the sound made was 'rattling' or resonant, and whether the opener was depressed gently or completely (fable I). Table I. Fetal acoustic stimulation testing with an empty soft- drink can - simulated intra-uterine sound ...

  15. Fetal Alcohol Syndrome and Fetal Alcohol Effects: Principles for Educators.

    Science.gov (United States)

    Burgess,Donna M.; Streissguth, Ann P.

    1992-01-01

    Fetal alcohol syndrome (FAS), the leading cause of mental retardation, often goes unrecognized because of social and emotional taboos about alcohol and alcoholism. This article describes medical and behavioral characteristics of FAS children and describes guiding principles for educators, based on early intervention, teaching communication and…

  16. Sotalol in the treatment of fetal dysrhythmias

    NARCIS (Netherlands)

    Oudijk, M. A.; Michon, M. M.; Kleinman, C. S.; Kapusta, L.; Stoutenbeek, P.; Visser, G. H.; Meijboom, E. J.

    2000-01-01

    Background-Fetal tachycardia may cause hydrops fetalis and lead to fetal death. No unanimity of opinion exists regarding the optimum treatment. This study evaluates our experience with transplacental sotalol therapy to treat fetal tachycardias in terms of safety and efficacy. Methods and Results-The

  17. Fetal Heart Rate Monitoring during Labor

    Science.gov (United States)

    ... of monitoring? • How is auscultation performed? • How is electronic fetal monitoring performed? • How is external monitoring performed? • How is ... method of periodically listening to the fetal heartbeat. Electronic fetal monitoring is a procedure in which instruments are used ...

  18. Practice Bulletin No. 173: Fetal Macrosomia.

    Science.gov (United States)

    2016-11-01

    Suspected fetal macrosomia is encountered commonly in obstetric practice. As birth weight increases, the likelihood of labor abnormalities, shoulder dystocia, birth trauma, and permanent injury to the neonate increases. The purpose of this document is to quantify those risks, address the accuracy and limitations of methods for estimating fetal weight, and suggest clinical management for a pregnancy with suspected fetal macrosomia.

  19. Fetal behavior and the cardiovascular-system

    NARCIS (Netherlands)

    Visser, G. H. A.

    With increasing gestation both in the human and in animals clear fetal behavioural state cycles develop. Fetal heart rate patterns are closely related to the phenomenon of behavioural state. In this review article fetal heart rate patterns will be analysed in relation to particular behavioural

  20. Programa de prevención de anemia falciforme (II: Evaluación del seguimiento de gestantes con hemoglobinas anormales

    Directory of Open Access Journals (Sweden)

    MarcosRaúl Martín Ruiz

    1996-04-01

    Full Text Available Algunos aspectos del Programa Cubano de Prevención de Anemia Falciforme fueron analizados en Ciudad de La Habana durante 1992. Todas las gestantes detectadas con hemoglobinas anormales fueron citadas por telegrama para explicarles el significado del hallazgo. El 62,2 % acudió con prontitud a la citación. El 21,6 % vino más tardíamente y se requirieron otros mecanismos de comunicación. El 16,2 % no acudió. Todas las gestantes que asistieron, aceptaron recibir asesoramiento genético y se hizo el seguimiento de los casos. El 47,6 % concluyó el estudio del cónyuge en tiempo útil para optar por diagnóstico prenatal. Los resultados muestran la necesidad de reducir la edad gestacional en que se determina el riesgo de la pareja. Ello sería posible mediante el pesquisaje en la primera consulta prenatal, métodos más eficientes en comunicar con las gestantes positivas, y más agilidad en la realización de los análisis y en informar los resultados.Some aspects of the Cuban Programme for Prevention of Sickle Cell Anemia were analyze in Havana City during 1992. All pregnants detected with abnormal hemoglobins received an appointment by telegram to get an explanation about the significance of findings; 62,2 % attended promptly to the appointment; 21,6 % came later, making necessary the use of other mechanisms of communication with pregnants; and 16,2 % never attended. All pregnants who went to the appointment accepted genetic counseling and were followed up. Only 47,6 % concluded testing of partner early enough for consideration of prenatal diagnosis. The results showed the need to reduce gestational age in order to determine the risk of the couple. This is possible by screaning pregnants at the first prenatal visit, by using more efficient methods for contacting with positive women, and by doing the test and informing the results faster.

  1. Fatores maternos associados ao peso fetal estimado pela ultra-sonografia Maternal factors associated with fetal weight estimated by ultrasonography

    Directory of Open Access Journals (Sweden)

    Adriana Suely de Oliveira Melo

    2008-09-01

    Full Text Available OBJETIVO: avaliar o efeito de variáveis maternas, socioeconômicas e obstétricas, assim como a presença de incisuras na 20ª e na 24ª semana, sobre o peso fetal estimado no final da gravidez (36ª semana em gestantes atendidas pelo Programa Saúde da Família em uma cidade do interior do Nordeste do Brasil. MÉTODOS: estudo longitudinal incluindo 137 gestantes. As gestantes foram acompanhadas a cada quatro semanas para aferição das condições clínicas, socioeconômicas e obstétricas, incluindo o peso materno. As artérias uterinas foram avaliadas pelo Doppler na 20ª e 24ª semana, o peso fetal e o índice de líquido amniótico (ILA foram determinados na 36ª semana. O estado nutricional materno inicial foi determinado pelo índice de massa corpórea (IMC, classificando-se as gestantes como com baixo peso, eutróficas, com sobrepeso e obesas. O ganho ponderal durante a gestação foi avaliado de acordo com o estado nutricional inicial, sendo ao final do segundo e terceiro trimestre classificado em ganho ponderal insuficiente, adequado e excessivo. Foi realizada análise de variância para avaliar a associação do peso fetal estimado na 36ª semana com as variáveis preditoras, ajustada por regressão linear múltipla. RESULTADOS: observou-se associação entre peso fetal estimado na 36ª semana e idade da mãe (p=0,02, trabalho materno (p=0,02, estado nutricional inicial (p=0,04, ganho ponderal no segundo trimestre (p=0,01, presença de incisuras nas artérias uterinas (p=0,02 e ILA (p=0,007. Os principais fatores associados ao peso fetal estimado na 36ª semana, após a análise de regressão múltipla, foram: IMC no início da gravidez, ganho ponderal no segundo trimestre, ILA e tabagismo. CONCLUSÕES: o peso fetal no presente estudo associou-se positivamente ao estado nutricional materno inicial, ao ganho ponderal no segundo trimestre, ao volume do líquido amniótico e negativamente ao hábito de tabagismo.PURPOSE: to evaluate the

  2. Fetal brain monitoring: Future applications

    NARCIS (Netherlands)

    de Vries, J.I.

    2006-01-01

    Future application of fetal brain monitoring is explored by selecting and analysing articles for information on types of brain damage that can be monitored, where in the brain this can be done, how long after the risk exposure, and with what method of investigation. A limited number of-mainly-case

  3. Accidental Haemorrhage and Fetal Prognosis

    African Journals Online (AJOL)

    1974-04-17

    Apr 17, 1974 ... perinatal mortality associated with accidental haemorrhage. The importance of clinical signs in determining fetal prognosis is discussed. A suggested clinical approach to cases of accidental haemorrhage, where on admission the fetus is found to be alive in utero, is given. S. Afr. Med. l., 48, 764 (1974).

  4. Ultrasonic prediction of fetal mass

    African Journals Online (AJOL)

    1983-02-19

    Feb 19, 1983 ... The assessment of gestational age and fetal weight forms an integral part of present-day antenatal care. Birth mass has a major influence on perinatal .... The average estimated mass was 3223 g with a standard deviation of 502 g. In summary, it can be stated that the estimates were in close agreement with ...

  5. Hypoxia and Fetal Heart Development

    Science.gov (United States)

    Patterson, A.J.; Zhang, L

    2010-01-01

    Fetal hearts show a remarkable ability to develop under hypoxic conditions. The metabolic flexibility of fetal hearts allows sustained development under low oxygen conditions. In fact, hypoxia is critical for proper myocardial formation. Particularly, hypoxia inducible factor 1 (HIF-1) and vascular endothelial growth factor play central roles in hypoxia-dependent signaling in fetal heart formation, impacting embryonic outflow track remodeling and coronary vessel growth. Although HIF is not the only gene involved in adaptation to hypoxia, its role places it as a central figure in orchestrating events needed for adaptation to hypoxic stress. Although “normal” hypoxia (lower oxygen tension in the fetus as compared with the adult) is essential in heart formation, further abnormal hypoxia in utero adversely affects cardiogenesis. Prenatal hypoxia alters myocardial structure and causes a decline in cardiac performance. Not only are the effects of hypoxia apparent during the perinatal period, but prolonged hypoxia in utero also causes fetal programming of abnormality in the heart’s development. The altered expression pattern of cardioprotective genes such as protein kinase c epsilon, heat shock protein 70, and endothelial nitric oxide synthase, likely predispose the developing heart to increased vulnerability to ischemia and reperfusion injury later in life. The events underlying the long-term changes in gene expression are not clear, but likely involve variation in epigenetic regulation. PMID:20712587

  6. Fetal programming of neuropsychiatric disorders.

    Science.gov (United States)

    Faa, Gavino; Manchia, Mirko; Pintus, Roberta; Gerosa, Clara; Marcialis, Maria Antonietta; Fanos, Vassilios

    2016-09-01

    Starting from the Developmental Origins of Health and Disease (DOHaD) hypotheses proposed by David Barker, namely fetal programming, in the past years, there is a growing evidence of the major role played by epigenetic factors during the intrauterine life and the perinatal period. Furthermore, it has been assessed that these factors can affect the health status in infancy and even in adulthood. In this review, we focus our attention on the fetal programming of the brain, analyzing the most recent literature concerning the epigenetic factors that can influence the development of neuropsychiatric disorders such as bipolar disorders, major depressive disorders, and schizophrenia. The perinatal epigenetic factors have been divided in two main groups: maternal factors and fetal factors. The maternal factors include diet, smoking, alcoholism, hypertension, malnutrition, trace elements, stress, diabetes, substance abuse, and exposure to environmental toxicants, while the fetal factors include hypoxia/asphyxia, placental insufficiency, prematurity, low birth weight, drugs administered to the mother or to the baby, and all factors causing intrauterine growth restriction. A better comprehension of the possible mechanisms underlying the pathogenesis of these diseases may help researchers and clinicians develop new diagnostic tools and treatments to offer these patients a tailored medical treatment strategy to improve their quality of life. Birth Defects Research (Part C) 108:207-223, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  7. Fetal Alcohol Syndrome Resource Guide.

    Science.gov (United States)

    All Indian Pueblo Council, Albuquerque, NM.

    The guide was developed to assist professionals working with American Indian people as a resource in obtaining printed and non-printed materials on Fetal Alcohol Syndrome. The resource guide is divided into the following sections: films (4), books (5), bibliographies (2), pamphlets (16), posters (5), slides (2), training curriculum (3), and…

  8. Taquiarritmias supraventriculares no feto. Experiência de uma unidade de referência em cardiologia fetal Fetal supraventricular tachyarrhythmias. Experience of a fetal cardiology reference center

    Directory of Open Access Journals (Sweden)

    Paulo Zielinsky

    1998-05-01

    Full Text Available OBJETIVO: Avaliar a forma de apresentação, diagnóstico e tratamento das taquiarritmias supraventriculares fetais, através do relato de uma série de casos acompanhados em um centro terciário de cardiologia fetal. MÉTODOS: São descritos 25 casos de taquiarritmia supraventricular diagnosticados intra-útero, no período de janeiro/89 a outubro/97, em uma população compreendendo 3117 gestantes. RESULTADOS: Foram diagnosticados 17 casos de taquiarritmia supraventricular e 8 casos de flutter atrial fetal. As idades gestacionais variaram de 26 a 40 semanas. Doze fetos apresentavam hidropisia no momento do diagnóstico (6 com taquicardia supraventricular (TSV e 6 com flutter atrial. Quatro fetos com TSV apresentavam cardiopatias estruturais (dois casos de anomalia de Ebstein e dois com comunicação interventricular. Todos os fetos foram internados na Unidade de Cardiologia Fetal para monitorização e tratamento. Entre os 17 fetos com TSV, 12 apresentaram reversão da arritmia após administração de digoxina, mas esta medida não foi eficaz em nenhum paciente com flutter. Dois pacientes com TSV e seis com flutter necessitaram interrupção da gestação para cardioversão elétrica pós-natal. A mortalidade foi de 3/17 no grupo da TSV (incluindo dois pacientes com anomalia de Ebstein e de 0/8 no grupo com flutter. CONCLUSÃO: As taquiarritmias supraventriculares fetais são eventos raros na população geral. Entretanto, podem provocar insuficiência cardíaca e óbito intra-uterino. Como a resposta ao tratamento é satisfatória, tornam-se de extrema importância o diagnóstico precoce e o tratamento adequado.PURPOSE: To describe the presentation, diagnosis and treatment of fetal supraventricular tachyarrhythmias in a series of fetuses followed in a tertiary Fetal Cardiology Center. METHODS: Twenty-five fetuses with diagnosis of supraventricular tachyarrhytmia were reported from January 1989 to October 1997, among 3117 pregnant women

  9. Unsupervised fetal cortical surface parcellation

    Science.gov (United States)

    Dahdouh, Sonia; Limperopoulos, Catherine

    2016-03-01

    At the core of many neuro-imaging studies, atlas-based brain parcellations are used for example to study normal brain evolution across the lifespan. These atlases rely on the assumption that the same anatomical features are present on all subjects to be studied and that these features are stable enough to allow meaningful comparisons between different brain surfaces and structures These methods, however, often fail when applied to fetal MRI data, due to the lack of consistent anatomical features present across gestation. This paper presents a novel surface-based fetal cortical parcellation framework which attempts to circumvent the lack of consistent anatomical features by proposing a brain parcellation scheme that is based solely on learned geometrical features. A mesh signature incorporating both extrinsic and intrinsic geometrical features is proposed and used in a clustering scheme to define a parcellation of the fetal brain. This parcellation is then learned using a Random Forest (RF) based learning approach and then further refined in an alpha-expansion graph-cut scheme. Based on the votes obtained by the RF inference procedure, a probability map is computed and used as a data term in the graph-cut procedure. The smoothness term is defined by learning a transition matrix based on the dihedral angles of the faces. Qualitative and quantitative results on a cohort of both healthy and high-risk fetuses are presented. Both visual and quantitative assessments show good results demonstrating a reliable method for fetal brain data and the possibility of obtaining a parcellation of the fetal cortical surfaces using only geometrical features.

  10. Análisis de las hemoglobinas glucosiladas de los pacientes diabéticos diagnosticados del 2006 al 2008 en el Hospital Nacional de Niños Glycated Hemoglobin Analysis of Diabetic Patients Diagnosed from 2006 to 2008 at the National Children’s Hospital

    OpenAIRE

    Karla Morales-Navarro; Erick Richmond -Padilla; Roberto Bogarín -Solano; Orlando Jaramillo-Lines

    2011-01-01

    Objetivo: La hemoglobina glucosilada se ha utilizado como una de las principales herramientas para monitorear el adecuado control de la diabetes. El estudio tiene por objetivo describir los valores de hemoglobina glucosilada de los pacientes diabéticos diagnosticados durante el período 2006-2008, en control en el Hospital Nacional de Niños. Métodos: Estudio observacional descriptivo de 115 pacientes diabéticos en control en el Hospital Nacional Niños, diagnosticados en el período 2006-2008. S...

  11. ST analysis of fetal electrocardiography in labor.

    Science.gov (United States)

    Amer-Wåhlin, I; Maršál, K

    2011-02-01

    Since its introduction more than 40 years ago, electronic fetal monitoring has become widely used for intrapartum surveillance to determine fetal wellbeing in labor. Although fetal hypoxia and acidosis are reflected in changes in fetal heart rate, there is no evidence that cardiotocography has been effective in reducing neonatal morbidity related to fetal distress occurring during labor. Indeed the specificity of this tool is poor and in many instances the incorporation of electronic fetal monitoring into intrapartum care has merely led to an increase in medical intervention rather than an improvement in neonatal outcome. Fetal electrocardiography (ECG) analysis provides an additional method for assessing the response of the fetus to hypoxia and in particular to the development of metabolic acidosis. ST changes in the fetal ECG can be quantified with computational analysis, reducing subjective interpretation that has been problematic with traditional electronic fetal monitoring. Formal algorithms indicating appropriate points for intervention in labor have been designed. The fetal ECG has been shown to be a useful adjunct to traditional electronic fetal monitoring in several randomized controlled trials with evidence of reduced rates of neonatal encephalopathy and reduced rates of obstetric intervention. Copyright © 2010 Elsevier Ltd. All rights reserved.

  12. Antithyroid drug-induced fetal goitrous hypothyroidism

    DEFF Research Database (Denmark)

    Bliddal, Sofie; Rasmussen, Ase Krogh; Sundberg, Karin

    2011-01-01

    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....

  13. Maternal buprenorphine treatment and fetal neurobehavioral development.

    Science.gov (United States)

    Jansson, Lauren M; Velez, Martha; McConnell, Krystle; Spencer, Nancy; Tuten, Michelle; Jones, Hendree E; King, Van L; Gandotra, Neeraj; Milio, Lorraine A; Voegtline, Kristin; DiPietro, Janet A

    2017-05-01

    Gestational opioid use/misuse is escalating in the United States; however, little is understood about the fetal effects of medications used to treat maternal opioid use disorders. The purpose of this study was to determine the effect of maternal buprenorphine administration on longitudinal fetal neurobehavioral development. Forty-nine buprenorphine-maintained women who attended a substance use disorder treatment facility with generally uncomplicated pregnancies underwent fetal monitoring for 60 minutes at times of trough and peak maternal buprenorphine levels. Data were collected at 24, 28, 32, and 36 weeks gestation. Fetal neurobehavioral indicators (ie, heart rate, motor activity, and their integration [fetal movement-fetal heart rate coupling]) were collected via an actocardiograph, digitized and quantified. Longitudinal data analysis relied on hierarchic linear modeling. Fetal heart rate, heart rate variability, and heart rate accelerations were significantly reduced at peak vs trough maternal buprenorphine levels. Effects were significant either by or after 28 weeks gestation and tended to intensify with advancing gestation. Fetal motor activity and fetal movement-fetal heart rate coupling were depressed from peak to trough at 36 weeks gestation. Polysubstance exposure did not significantly affect fetal neurobehavioral parameters, with the exception that fetuses of heavier smokers moved significantly less than those of lighter smokers at 36 weeks gestation. By the end of gestation, higher maternal buprenorphine dose was related to depression of baseline fetal cardiac measures at trough. Maternal buprenorphine administration has acute suppressive effects on fetal heart rate and movement, and the magnitude of these effects increases as gestation progresses. Higher dose (≥13 mg) appears to exert greater depressive effects on measures of fetal heart rate and variability. These findings should be balanced against comparisons to gestational methadone effects

  14. Fetal cerebral ventriculomegaly - additional malformations, chromosomal anomalies and fetal outcome

    OpenAIRE

    Langolf, Olga

    2010-01-01

    Fetal cerebral ventriculomegaly is defined as sonographically measured ventricular width of at least 10 mm in the atrium from 13 weeks of gestation till term, measured perpendicular to the long axis of the cerebral lateral ventricles. Our data are derived from the Center for Prenatal Diagnosis, Kurfürstendamm 199, Berlin. The fetuses were examined between 1/1/1998 and 7/31/2006. All ultrasound examinations were performed by gynecologists specialized in prenatal diagnosis. 27 645 fetuse...

  15. Fetal myocardial performance (Tei) index in fetal hemoglobin Bart's disease.

    Science.gov (United States)

    Luewan, S; Tongprasert, F; Srisupundit, K; Tongsong, T

    2013-08-01

    To assess the effectiveness of Tei index in differentiating fetal Hb Bart's disease in pregnancies at risk in the first half of pregnancy. Pregnancies meeting the inclusion criteria were consecutively recruited to the study. The inclusion criteria were as follows: 1) singleton pregnancies, 2) gestational age of 12 - 20 weeks, 3) at risk of Hb Bart's disease, 4) confirmed fetal diagnosis of Hb Bart's disease. Fetuses with frank hydrops fetalis or fetuses with chromosomal abnormalities or structural anomalies were excluded. Tei index was performed and immediately recorded before invasive prenatal diagnosis was performed. Of 152 fetuses, 50 were finally proven to be affected by Hb Bart disease, and the remainder was unaffected. Mean (± SD) Tei index were 0.48 ± 0.07 and 0.54 ± 0.08 in group of unaffected and affected fetuses, respectively. The mean difference was 0.05 which was statistically significant (p Hb Bart's disease was significantly higher than that in normal fetuses implying that Tei index may be a novel useful and non-invasive tool for early detection of fetal Hb Bart's disease among pregnancies at risk. © Georg Thieme Verlag KG Stuttgart · New York.

  16. Ocorrência de hemoglobina S no estado de Mato Grosso do Sul, Brasil Occurrence of hemoglobin S in Mato Grosso do Sul state, Brazil

    Directory of Open Access Journals (Sweden)

    Denise Rodrigues Holsbach

    2008-08-01

    Full Text Available INTRODUÇÃO: As hemoglobinopatias são as alterações genéticas mais comuns no homem, sendo a hemoglobina (Hb S a mais freqüente entre todas. Sua ocorrência no estado de Mato Grosso do Sul ainda não foi sistematicamente avaliada. OBJETIVOS: Caracterizar a ocorrência de Hb S por genótipos, sexo, idade no momento do diagnóstico, índice de cobertura e prevalência em Mato Grosso do Sul. MATERIAL E MÉTODO: Estudo retrospectivo, transversal e descritivo, desenvolvido com os resultados de triagem neonatal para hemoglobinopatias, utilizando a técnica de cromatografia líquida de alta pressão, no Instituto de Pesquisas, Ensino e Diagnósticos da Associação de Pais e Amigos dos Excepcionais (IPED/APAE de Mato Grosso do Sul em 2000-2005. RESULTADOS: De 190.809 indivíduos triados, 2.624 (1,38% encontraram-se alterados, correspondendo a 2.385 neonatos e 239 crianças maiores de 28 dias. Não houve diferença entre os sexos, sendo 1.335 do sexo feminino e 1.289 do masculino. Os genótipos alterados encontrados foram traço falciforme (FAS [99,16%] e doenças falciformes (FS [0,61%] e FSC [0,23%]. CONCLUSÃO: Esse primeiro estudo de triagem realizado no estado de Mato Grosso do Sul mostra que o programa desenvolvido pelo IPED/APAE está se solidificando no estado e avançando em relação ao índice de cobertura da população e ao diagnóstico precoce. Esses indicadores podem embasar ações preventivas (aconselhamento genético e estudos familiares e assistenciais (tratamento ambulatorial contínuo, que visam à redução da morbimortalidade de indivíduos acometidos por essas afecções no estado.BACKGROUND: Hemoglobinopathies are the most common genetic disorders in humans and Hb S is the most frequent among them. Its occurrence in the state of Mato Grosso do Sul has not been systematically analyzed yet. OBJECTIVES: To describe the occurrence of hemoglobin S according to genotypes, gender, age at the moment of diagnosis, cover index and

  17. Defeitos de parede abdominal fetal : resultados do Programa de Medicina Fetal do CAISM-UNICAMP em dez anos

    OpenAIRE

    Luciana Briganti

    2007-01-01

    Resumo: Introdução: As malformações de parede abdominal fetal ocorrem entre a quinta e a décima semanas de idade gestacional, devido a falhas na seqüência normal do desenvolvimento embrionário. Costumam ser diagnosticadas precocemente com o uso da ultra-sonografia, geralmente por volta de doze semanas de gestação. A gastrosquise e a onfalocele são os defeitos mais comuns da parede abdominal. A gastrosquise, em geral, ocorre isoladamente, enquanto a onfalocele apresenta maior incidência com o ...

  18. Fetal evaluation of spine dysraphism

    Energy Technology Data Exchange (ETDEWEB)

    Bulas, Dorothy [George Washington University Medical Center, Division of Diagnostic Imaging and Radiology, Children' s National Medical Center, Washington, DC (United States)

    2010-06-15

    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.)

  19. Fetal origin of vascular aging

    Directory of Open Access Journals (Sweden)

    Shailesh Pitale

    2011-01-01

    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.

  20. Idiopathic polyhydramnios and fetal gender.

    Science.gov (United States)

    Stanescu, A D; Banica, R; Olaru, G; Ghinda, E; Birdir, Cahit

    2015-05-01

    To determine the relationship between idiopathic polyhydramnios and fetal gender in the absence of fetal or maternal abnormalities. This was a retrospective population-based register study. 295 women with singleton pregnancies complicated by idiopathic polyhydramnios (amniotic fluid index (AFI) higher than 24 cm) who were delivered at our institution from January 2002 till December 2012 were included. Only pregnancies with an uncomplicated outcome were accepted in this study. The incidence of the male to female fetuses was compared with the one in the general population. Among pregnancies complicated by idiopathic polyhydramnios, the following gender distribution was found: 72.9% male and 37.1% female. The distribution in the general population was 51.5% female and 48.5% male. The mean AFI was significantly increased in male fetuses (p polyhydramnios is more frequent in male normal fetuses than in female ones.

  1. Fetal growth and developmental programming.

    Science.gov (United States)

    Galjaard, Sander; Devlieger, Roland; Van Assche, Frans A

    2013-01-01

    The environment in utero and in early neonatal life may induce a permanent response in the fetus and the newborn, leading to enhanced susceptibility to later diseases. This review concentrates on the role and mechanisms of events during the antenatal and immediate postnatal period resulting in later life diseases, concentrating on abnormal growth patterns of the fetus. Fetal overgrowth is related to exposure to a diabetic intra uterine environment, increasing the vulnerability to transgenerational obesity and hence an increased sensitivity to more diabetic mothers. This effect has been supported by animal data. Fetal growth restriction is complex due to malnutrition in utero, catch up growth due to a high caloric intake and low physical activity in later life. Metabolic changes and a transgenerational effect of intra uterine malnutrition has been supported by animal data. In recent years the discovery of alterations of the genome due to different influences during embryonic life, called epigenetics, has led to the phenomenon of fetal programming resulting in changing transgenerational metabolic effects.

  2. Fetal programming in meat production.

    Science.gov (United States)

    Du, Min; Wang, Bo; Fu, Xing; Yang, Qiyuan; Zhu, Mei-Jun

    2015-11-01

    Nutrient fluctuations during the fetal stage affects fetal development, which has long-term impacts on the production efficiency and quality of meat. During the early development, a pool of mesenchymal progenitor cells proliferate and then diverge into either myogenic or adipogenic/fibrogenic lineages. Myogenic progenitor cells further develop into muscle fibers and satellite cells, while adipogenic/fibrogenic lineage cells develop into adipocytes, fibroblasts and resident fibro-adipogenic progenitor cells. Enhancing the proliferation and myogenic commitment of progenitor cells during fetal development enhances muscle growth and lean production in offspring. On the other hand, promoting the adipogenic differentiation of adipogenic/fibrogenic progenitor cells inside the muscle increases intramuscular adipocytes and reduces connective tissue, which improves meat marbling and tenderness. Available studies in mammalian livestock, including cattle, sheep and pigs, clearly show the link between maternal nutrition and the quantity and quality of meat production. Similarly, chicken muscle fibers develop before hatching and, thus, egg and yolk sizes and hatching temperature affect long-term growth performance and meat production of chicken. On the contrary, because fishes are able to generate new muscle fibers lifelong, the impact of early nutrition on fish growth performance is expected to be minor, which requires further studies. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Fetal magnetic resonance: technique applications and normal fetal anatomy; Resonance magnetica fetal: tecnica aplicaciones y anatomia normal del feto

    Energy Technology Data Exchange (ETDEWEB)

    Martin, C.; Darnell, A.; Duran, C.; Mellado, F.; Corona, M [Corporacio Sanitaria del Parc Tauli. Sabadell (Spain)

    2003-07-01

    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.

  4. Effect of a beverage fortified with evaporated sugarcane juice on hemoglobin levels in preschool children Efecto de una bebida fortificada con jugo de caña condensado sobre los niveles de hemoglobina en niños preescolares

    Directory of Open Access Journals (Sweden)

    Francisco P. Arcanjo

    2009-10-01

    Full Text Available The study objective was to measure the effect of consumption of a beverage mixed with a high-iron sweetener (evaporated sugarcane juice known as rapadura on hemoglobin levels in preschool children, and to compare it with the effect of consuming the same beverage sweetened with refined sugar. Research consisted of a 12-week randomized, controlled double-blind trial conducted in 2007 at a state-run school in Sobral, Brazil, among children aged 2-3 years. The study sample was divided into two groups-one consuming cashew juice mixed with 25 g of rapadura and 40 mg of ascorbic acid (per 200-mL serving, and another consuming the same quantity of juice and ascorbic acid sweetened with 25 g of standard refined sugar. A significant statistical increase in hemoglobin was observed in the group consuming the rapadura-fortified beverage. It was therefore concluded that consumption of rapadura increased hemoglobin and thus reduced iron deficiency anemia in preschool children.El objetivo de este estudio fue evaluar el efecto del consumo de una bebida mezclada con un edulcorante de alto contenido en hierro (jugo de caña condensado, conocido como rapadura sobre los niveles de hemoglobina en niños preescolares y compararlo con el efecto de consumir la misma bebida endulzada con azúcar refinada. Se realizó un estudio aleatorizado, controlado y con doble enmascaramiento durante 12 semanas de 2007 en una escuela estatal de Sobral, Brasil. La muestra compuesta por niños de 2 a 3 años se dividió en dos grupos: uno consumió jugo de marañón con 25 g de rapadura y 40 mg de ácido ascórbico (por porción de 200 mL y otro que consumió la misma cantidad de jugo con 25 g de azúcar refinada estándar. Se observó un aumento significativo de la hemoglobina en el grupo que consumió la bebida fortificada con rapadura. Se concluye, por tanto, que el consumo de rapadura elevó los niveles de hemoglobina, con lo que se puede reducir la anemia por deficiencia de hierro

  5. Fetal alcohol exposure: consequences, diagnosis, and treatment.

    Science.gov (United States)

    Pruett, Dawn; Waterman, Emily Hubbard; Caughey, Aaron B

    2013-01-01

    Maternal alcohol use during pregnancy is prevalent, with as many as 12% of pregnant women consuming alcohol. Alcohol intake may vary from an occasional drink, to weekly binge drinking, to chronic alcohol use throughout pregnancy. Whereas there are certain known consequences from fetal alcohol exposure, such as fetal alcohol syndrome, other effects are less well defined. Craniofacial dysmorphologies, abnormalities of organ systems, behavioral and intellectual deficits, and fetal death have all been attributed to maternal alcohol consumption. This review article considers the theoretical mechanisms of how alcohol affects the fetus, including the variable susceptibility to fetal alcohol exposure and the implications of ethanol dose and timing of exposure. Criteria for diagnosis of fetal alcohol syndrome are discussed, as well as new methods for early detection of maternal alcohol use and fetal alcohol exposure, such as the use of fatty acid ethyl esters. Finally, current and novel treatment strategies, both in utero and post utero, are reviewed.

  6. Glycemic control and fetal abdominal circumference

    Directory of Open Access Journals (Sweden)

    S Gopinath

    2012-01-01

    Full Text Available Aim: To study about the correlation between the glycemic status and increase in fetal abdominal circumference in gestational diabetes patients and its relationship with fetal birth weight. Materials and Methods: Seventy-five gestational diabetes mellitus (GDM patients were taken up for study with duly informed consent and suggested for anthropometry profile and glycemic profile with HbA1C. Fetal abdominal circumference was measured during routine scans. The patients were followed up till delivery and the fetal birth was noted. Inclusion Criteria: Seventy-five gestational diabetic mothers who have attended a secondary level diabetic clinic and on regular follow-up were included in the study. Exclusion Criteria: Pre-GDM mothers, patients with co-morbid disease were excluded from the study. Expected Results: Fetal abdominal circumference correlated well with fluctuating glycemic control and fetal birth weight.

  7. Fetal macrosomia as an important indicator of fetal malformation syndrome: ultrasonic findings of two cases

    NARCIS (Netherlands)

    EA Pley; PA de Jong; MD E.J.M. Wouters

    1989-01-01

    Two extraordinary cases of fetal macrosomia are presented. It is discussed that extreme fetal growth should raise the suspicion of a malformation syndrome and deserves thorough antenatal ultrasonographic examination.

  8. Altered fetal growth, placental abnormalities, and stillbirth.

    Science.gov (United States)

    Bukowski, Radek; Hansen, Nellie I; Pinar, Halit; Willinger, Marian; Reddy, Uma M; Parker, Corette B; Silver, Robert M; Dudley, Donald J; Stoll, Barbara J; Saade, George R; Koch, Matthew A; Hogue, Carol; Varner, Michael W; Conway, Deborah L; Coustan, Donald; Goldenberg, Robert L

    2017-01-01

    Worldwide, stillbirth is one of the leading causes of death. Altered fetal growth and placental abnormalities are the strongest and most prevalent known risk factors for stillbirth. The aim of this study was to identify patterns of association between placental abnormalities, fetal growth, and stillbirth. Population-based case-control study of all stillbirths and a representative sample of live births in 59 hospitals in 5 geographic areas in the U.S. Fetal growth abnormalities were categorized as small (90th percentile) for gestational age at death (stillbirth) or delivery (live birth) using a published algorithm. Placental examination by perinatal pathologists was performed using a standardized protocol. Data were weighted to account for the sampling design. Among 319 singleton stillbirths and 1119 singleton live births at ≥24 weeks at death or delivery respectively, 25 placental findings were investigated. Fifteen findings were significantly associated with stillbirth. Ten of the 15 were also associated with fetal growth abnormalities (single umbilical artery; velamentous insertion; terminal villous immaturity; retroplacental hematoma; parenchymal infarction; intraparenchymal thrombus; avascular villi; placental edema; placental weight; ratio birth weight/placental weight) while 5 of the 15 associated with stillbirth were not associated with fetal growth abnormalities (acute chorioamnionitis of placental membranes; acute chorioamionitis of chorionic plate; chorionic plate vascular degenerative changes; perivillous, intervillous fibrin, fibrinoid deposition; fetal vascular thrombi in the chorionic plate). Five patterns were observed: placental findings associated with (1) stillbirth but not fetal growth abnormalities; (2) fetal growth abnormalities in stillbirths only; (3) fetal growth abnormalities in live births only; (4) fetal growth abnormalities in stillbirths and live births in a similar manner; (5) a different pattern of fetal growth abnormalities in

  9. Altered fetal growth, placental abnormalities, and stillbirth.

    Directory of Open Access Journals (Sweden)

    Radek Bukowski

    Full Text Available Worldwide, stillbirth is one of the leading causes of death. Altered fetal growth and placental abnormalities are the strongest and most prevalent known risk factors for stillbirth. The aim of this study was to identify patterns of association between placental abnormalities, fetal growth, and stillbirth.Population-based case-control study of all stillbirths and a representative sample of live births in 59 hospitals in 5 geographic areas in the U.S. Fetal growth abnormalities were categorized as small (90th percentile for gestational age at death (stillbirth or delivery (live birth using a published algorithm. Placental examination by perinatal pathologists was performed using a standardized protocol. Data were weighted to account for the sampling design. Among 319 singleton stillbirths and 1119 singleton live births at ≥24 weeks at death or delivery respectively, 25 placental findings were investigated. Fifteen findings were significantly associated with stillbirth. Ten of the 15 were also associated with fetal growth abnormalities (single umbilical artery; velamentous insertion; terminal villous immaturity; retroplacental hematoma; parenchymal infarction; intraparenchymal thrombus; avascular villi; placental edema; placental weight; ratio birth weight/placental weight while 5 of the 15 associated with stillbirth were not associated with fetal growth abnormalities (acute chorioamnionitis of placental membranes; acute chorioamionitis of chorionic plate; chorionic plate vascular degenerative changes; perivillous, intervillous fibrin, fibrinoid deposition; fetal vascular thrombi in the chorionic plate. Five patterns were observed: placental findings associated with (1 stillbirth but not fetal growth abnormalities; (2 fetal growth abnormalities in stillbirths only; (3 fetal growth abnormalities in live births only; (4 fetal growth abnormalities in stillbirths and live births in a similar manner; (5 a different pattern of fetal growth

  10. Increasing fetal ovine number per gestation alters fetal plasma clinical chemistry values.

    Science.gov (United States)

    Zywicki, Micaela; Blohowiak, Sharon E; Magness, Ronald R; Segar, Jeffrey L; Kling, Pamela J

    2016-08-01

    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. © 2016 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.

  11. A importância da determinação da hemoglobina glicada no monitoramento das complicações crônicas do diabetes mellitus The importance of glycated hemoglobin determination in the management of chronic complications associated with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Andreza Fabro de Bem

    2006-06-01

    Full Text Available O diabetes é uma situação clínica muito freqüente que envolve cerca de 7% da população mundial. Por essa razão muitos esforços têm sido empregados na implementação de métodos de monitoramento e no desenvolvimento de terapias efetivas para o seu controle. A hemoglobina glicada (HbA1c é o teste mais indicado na quantificação do risco de complicações crônicas em pacientes diabéticos. O Diabetes Control and Complications Trial (DCCT e o United Kingdom Prospective Diabetes Study (UKPDS concluíram que o risco de complicações em pacientes diabéticos é diretamente proporcional ao controle glicêmico, determinado através dos níveis de HbA1c. A medida exata e precisa da HbA1c é uma questão importante para os laboratórios clínicos, sendo que vários fatores podem afetar as determinações, levando a resultados equivocados. O objetivo deste estudo é demonstrar os diferentes métodos para a quantificação da HbA1c, bem como discutir os problemas mais freqüentes de padronização dessa determinação.Diabetes is a widespread disease, involving about 7% of the entire world population. For this reason, many efforts have been devoted to the wide application of valid monitoring procedures and to the development of effective therapeutic approaches. Glycated hemoglobin (HbA1c is the pre-eminent factor for quantifying the risk of chronic complications in patients with diabetes. The Diabetes Control and Complications Trial (DCCT and United Kingdom Prospective Diabetes Study (UKPDS, demonstrated conclusively that risks for complications in patients with diabetes are directly related to glycemic control, as measured by glycated hemoglobin (HbA1c. Accurate determination of HbA1c is an important issue for clinical laboratories and several factors may affect and lead to erroneous results. The main objective of this study is to show the different methods for glycated hemoglobin quantification and to discuss the most frequent problems of

  12. Electronic fetal monitoring: family medicine obstetrics.

    Science.gov (United States)

    Rodney, John R M; Huntley, Benjamin J F; Rodney, Wm Macmillan

    2012-03-01

    Electronic fetal monitoring assesses fetal health during the prenatal and intrapartum process. Intermittent auscultation does not detect key elements of fetal risk, such as beat-to-beat variability. Family medicine obstetric fellowships have contributed new knowledge to this process by articulating a method of analysis that builds on evidence-based recommendations from the American College of Obstetrics and Gynecology as well as the National Institute of Child Health and Development. This article summarizes the development, interpretation, and management of electronic fetal heart rate patterns and tracings. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. Normal MR imaging of fetal organs

    Energy Technology Data Exchange (ETDEWEB)

    Kawabata, Ichiro; Tamaya, Teruhiko (Gifu Univ. (Japan). Faculty of Medicine)

    1990-12-01

    MR imaging has recently been used in medical scene, especially in obstetrics. The definite prenatal diagnosis of fetal anomaly using MR imaging has proved to be useful. But MR imaging of normal fetal organs remains to be understood. There have been not complete systemical research works about normal fetus by MR imaging, up to date. MR imaging on 25 pregnant cases were carried out to get the definite diagnosis of the possible fetal anomalies. MR imaging in fetus is usually disturbed by fetal movement. Generally, diazepam to mother or muscle relaxants to fetus have been used in given cases in order to obtain good quality of imaging. Mothers were requested to walk around the lobby in hospital before examination and fetal movement was decreased, resulting in 85% good imaging. The understanding of normal findings of fetal organs by MR imagings is important for diagnosis of the fetal anomalies. For example, brain and bowel showed high signals in T{sub 1} weighted images. Lung showed high signal in T{sub 2} weighted images. Liver was demonstrated clearly in T{sub 1} weighted images and proton density images. Heart and vessels showed low signals because of flow void phenomenon. Thus, it is necessary to detect and diagnose fetal anomalies after understanding the normal findings of fetal organs in MR imaging. (author).

  14. Fetal motor activity and maternal cortisol

    Science.gov (United States)

    DiPietro, Janet A.; Kivlighan, Katie T.; Costigan, Kathleen A.; Laudenslager, Mark L.

    2009-01-01

    The contemporaneous association between maternal salivary cortisol and fetal motor activity was examined at 32 and 36 weeks gestation. Higher maternal cortisol was positively associated with the amplitude of fetal motor activity at 32 weeks, r(48) = .39, p activity were more common in fetuses of women with higher cortisol, Mann-Whitney U = 58.5. There were no sex differences in fetal motor activity, but the associations between maternal cortisol and fetal motor amplitude and overall movement were significantly stronger for male than female fetuses. PMID:19630038

  15. Fetal Alcohol Syndrome: Facts and Prevention.

    Science.gov (United States)

    Shelton, Maria; Cook, Martha

    1993-01-01

    This article provides a brief introduction to fetal alcohol syndrome (FAS) including characteristics, incidence, current government programs, successful local programs, and implications for school administrators. (DB)

  16. Fetal Endoscopic Surgery for Spina Bifida

    Science.gov (United States)

    2017-10-16

    Neural Tube Defects; Spina Bifida, Open; Myelomeningocele; Fetal Disease; Hydrocephalus; Chiari Malformation Type 2; Congenital Abnormality; Surgery; Maternal, Uterus or Pelvic Organs, Affecting Fetus

  17. Fetal supraventricular tachyarrhythmias. Experience of a fetal cardiology reference center

    OpenAIRE

    Paulo Zielinsky; Dillenburg, Rejane F.; Gustavo G. Lima; Zimmer, Lúcia P.

    1998-01-01

    Objetivo - Avaliar a forma de apresentação, diagnóstico e tratamento das taquiarritmias supraventriculares fetais, através do relato de uma série de casos acompanhados em um centro terciário de cardiologia fetal. Métodos - São descritos 25 casos de taquiarritmia supraventricular diagnosticados intra-útero, no período de janeiro/89 a outubro/97, em uma população compreendendo 3117 gestantes. Resultados - Foram diagnosticados 17 casos de taquiarritmia supraventricular e 8 casos de flutter atria...

  18. Determinación de la acidificación permisible a la sangre bovina para la cuantificación de hemoglobina mediante la técnica de drabkin

    OpenAIRE

    Maritza González-Pérez; Raúl González-Hernández; Yenisleidy Revilla-Fernández; Orestes Mayo-Abad

    2012-01-01

    La técnica de Drabkin es la más comúnmente empleada dentro del laboratorio clínico para la cuantificación de la hemoglobina (Hb) en la sangre.El autor de la técnica original estableció su realización a pH 7,2 debido a la dilución de la sangre que se produce por los reactivos empleados en ella, puesto que su pH original está entre 7,3 y 7,4 y su utilización solo se limita a este fin. En muchos trabajos de investigación, se emplea la sangre bovina como materia prima, para el aislamiento y extra...

  19. Placental fetal vascular thrombosis lesions and maternal thrombophilia

    NARCIS (Netherlands)

    Beeksma, F. A.; Erwich, J. J. H. M.; Khong, T. Y.

    Aims: Following intrauterine fetal death (IUFD), the placental fetal vessels undergo regressive changes. These changes are virtually indistinguishable from lesions that are the result of fetal vascular thrombosis (FVT). This study investigated the relation between these lesions and maternal

  20. Köln's unstable hemoglobin: case report and literature review Hemoglobina instável de Köln: relato de caso e revisão de literatura

    Directory of Open Access Journals (Sweden)

    Sandra Pscheidt

    2003-01-01

    Full Text Available Unstable hemoglobins are a group of genetic variants of hemoglobins caused by the mutation of amino acids into alpha and beta globins and, depending on the points and types of mutation, the result can vary from no clinical symptomatology to severe hemolytic anemia. On the present report, we study the case of a female patient who showed a very exuberant hematological picture for the red series, which suggests hemoglobinic changes; this was confirmed following the conduction of the protocol established by Laboratório Médico Santa Luzia for the study of hemoglobinopathies and which was then sent for a reference laboratory: C.D.A. Naoun Laboratórios de Análises ClínicasAs hemoglobinas instáveis constituem um grupo de variantes genéticas de hemoglobinas causadas pela mutação de aminoácidos nas globinas alfa e beta e, dependendo dos pontos e dos tipos de mutações ocorridos, o resultado pode ser de nenhuma sintomatologia clínica até anemias hemolíticas graves. No presente relato, estudamos o caso de uma paciente que apresentava um quadro hematológico de série vermelha bastante exuberante, sugestivo de alteração hemoglobínica, o que foi confirmado após realização do protocolo estabelecido pelo Laboratório Médico Santa Luzia para estudo de hemoglobinopatias e posteriormente enviado para o laboratório de referência C.D.A. Naoun Laboratórios de Análises Clínicas.

  1. The use of fetal Doppler in obstetrics.

    Science.gov (United States)

    Gagnon, Robert; Van den Hof, Michiel

    2003-07-01

    To develop national guidelines on the use of fetal Doppler in obstetrics. Whether umbilical cord artery, umbilical cord venous, ductus venosus, and middle cerebral artery Doppler are useful in assessing fetal health. Prediction of adverse perinatal outcome or prediction of fetal anemia. MEDLINE search and review of bibliographies in identified articles. The evidence was reviewed by the Diagnostic Imaging Committee and the principal authors. A quality of evidence assessment was undertaken as outlined in the report of the Canadian Task Force on the Periodic Health Examination. Intrauterine growth restriction complicates 5% to 10% of all pregnancies and up to 30% of multiple pregnancies. In 60% of these pregnancies, the primary cause is placental insufficiency. Improvement in the identification of the fetus at risk of intrauterine demise may lead to more successful management strategies. Management of fetal red blood cell isoimmunization requires a prediction of fetal anemia. If invasive procedures to predict fetal anemia can be replaced with noninvasive tests, fetal morbidity and mortality can be reduced. 1. Umbilical artery Doppler should be available for assessment of the fetal-placental circulation in pregnant women with suspected severe placental insufficiency. (I-A) 2. Depending on other clinical factors, reduced, absent, or reversed umbilical artery end-diastolic flow is an indication for enhanced fetal surveillance or delivery. If delivery is delayed to enhance fetal lung maturity with maternal administration of glucocorticoid, intensive fetal surveillance until delivery is suggested for those fetuses with reversed end-diastolic flow. (II-1B) 3. Umbilical artery Doppler should not be used as a screening tool in healthy pregnancies, as it has not been shown to be of value in this group. (I-A) 4. Umbilical venous double pulsations, in the presence of abnormal umbilical artery Doppler waveforms, necessitate a detailed assessment of fetal health status. (II-3B) 5

  2. Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorders.

    Science.gov (United States)

    Denny, LeeAnne; Coles, Sarah; Blitz, Robin

    2017-10-15

    Fetal alcohol syndrome (FAS) and fetal alcohol spectrum disorders (FASD) result from intrauterine exposure to alcohol and are the most common nonheritable causes of intellectual disability. The percentage of women who drink or binge drink during pregnancy has increased since 2012. FAS is commonly missed or misdiagnosed, preventing affected children from receiving needed services in a timely fashion. Diagnosis is based on the presence of the following clinical features, all of which must be present: prenatal and/or postnatal growth retardation, facial dysmorphology, central nervous system dysfunction, and neurobehavioral disabilities. FASD is a broader diagnosis that encompasses patients with FAS and others who are affected by prenatal alcohol exposure but do not meet the full criteria for FAS. Management is multidisciplinary and includes managing comorbid conditions, providing nutritional support, managing behavioral problems and educational difficulties, referring patients for habilitative therapies, and educating parents. The Centers for Disease Control and Prevention and other organizations recognize no safe amount of alcohol consumption during pregnancy and recommend complete abstinence from alcohol. All women should be screened for alcohol use during preconception counseling and prenatal care, and alcohol use should be addressed with brief interventions.

  3. Luteoma-induced fetal virilization.

    Science.gov (United States)

    Ugaki, Hiromi; Enomoto, Takayuki; Tokugawa, Yoshihiro; Kimura, Tadashi

    2009-10-01

    A pregnancy luteoma represents an unusual response of ovarian stromal cells to the altered hormonal levels of pregnancy. It is a distinctive non-neoplastic lesion characterized by solid proliferations of luteinized cells resulting in a tumor-like ovarian enlargement. Most patients are asymptomatic; the ovarian enlargement is usually discovered incidentally at cesarean section or during postpartum tubal ligation. We report a typical case that we found at cesarean section to be associated with a virilized infant who manifested clitoromegaly and labial fusion. We detected an increased level of testosterone in the maternal patient. We concluded that the ovarian luteoma induced the fetal virilization.

  4. Regulación de la concentración de hemoglobina en la policitemia de altura: modelo matemático

    Directory of Open Access Journals (Sweden)

    1990-01-01

    Full Text Available LA REGULATION DE LA CONCENTRATION DE L’HEMOGLOBINE DANS LA POLYCYTHEMIE D’ALTITUDE: UN MODELE MATHEMATIQUE. Un modèle mathématique a été développé pour étudier la corrélation fonctionnelle entre la concentration d’hémoglobine (Hb et la pression veineuse moyenne du O2 (PvO2 a différentes altitudes. Le modèle combine l’équation de convection de Fick pour le transport du O2, avec l’équation de Hill pour l’affinité Hb-O2 et avec l’équation empirique qui relie la Hb avec la pression artérielle de O2 (PaO2 chez les natifs andins. Le modèle prédit la fonction adaptative de Hb jusqu’à une altitude maximale de 3400 m une valeur adaptative limitée du flux sanguin en haute altitude que la régulation homéostatique de la Hb est à son maximum au niveau de la mer et diminue en altitude que la PvO2 rénale est plus sensible à une chute de la PaO2 que la PvO2 corporelle, ce qui correspond au rôle du rein dans la production d’érithropoïétine. Le modèle a prouvé son utilité dans l’enseignement de la physiologie du transport du O2 dans des conditions normoxiques et hypoxiques. Se ha desarrollado un modelo matemático para estudiar la correlación funcional entre la concentración de hemoglobina (HB y la presión venosa media de O2 (PvO2 a diferentes alturas. El modelo combina la ecuación de convección de Fick para el transporte de O2, con la ecuación de Hill para la afinidad de Hb-O2 y con una ecuación empírica que relaciona la HB con la presión de 02 arterial (PaO2 en nativos andinos. El modelo predice la función adaptativa de Hb hasta un máximo de 3400 m de altura el limitado valor adaptativo del flujo sanguíneo en las grandes alturas que la regulación homeostática de la HB es máxima a nivel del mar y disminuye en la altura que el PvO2 renal es más sensible a una caída del PaO2 que el PvO2 corporal, lo que coincide con el papel del riñón en la producción de eritropoyetina. El modelo ha probado su utilidad

  5. Fetal extraperitoneal rectal perforation: a case report

    African Journals Online (AJOL)

    Fetal extraperitoneal rectal perforation is a very rare condition, but prompt diagnosis and appropriate treatment produce overall good outcome. Its etiology and pathophysiology are poorly understood. Only 16 cases have been reported worldwide. We report another case of fetal extraperitoneal rectal perforation managed by ...

  6. Pathophysiology of Increased Fetal Nuchal Translucency Thickness

    Directory of Open Access Journals (Sweden)

    Chih-Ping Chen

    2010-06-01

    Full Text Available Increased fetal nuchal translucency thickness is associated with trisomy 13, trisomy 18, trisomy 21, Turner syndrome, other sex chromosome abnormalities, as well as many fetal anomalies and genetic syndromes. This article provides a comprehensive review of the cardinal proposed pathophysiology including altered composition of the extracellular matrix, abnormalities of the heart and great arteries, and disturbed or delayed lymphatic development.

  7. [Evolution of electronic fetal monitoring in labor].

    Science.gov (United States)

    Dell'Anna, A; Portuesi, A; Angioli, R

    2014-04-01

    Intrapartum fetal hypoxia remains an important cause of neonatal permanent handicap and death, and in many cases it is related to lack of optimal fetal surveillance. In the last 40 years cardiotocography (CTG) has been routinely used for fetal monitoring yet this technique lacks reproducibility and its interpretation by healthcare professionals remains an important variable. Indeed, this technology not only does not improve clinically important outcomes, but also, on the contrary, leads to an increase in the number of caesarean sections carried out. Recent research has focused the attention on specific components of electronic fetal monitoring (EFM) tracings, such as ST-segment analysis (STAN) or fetal pulse oximetry (FPO). Fetal ST-segment analysis and pulse oximetry provide important parameters when used in addition to CTG, but their combined use obviously does not eliminate CTG interpretation limits. Although continuous electronic fetal monitoring is now ubiquitously utilized in modern practice, risks and benefits associated with its use are worth analysing. The analysis of the research and clinical practices carried out in the past several decades may provide useful insights into the current use of electronic fetal monitoring and new system associated procedures (STAN and FPO), which have influenced what has now become a routine modern obstetric practice.

  8. Obesity's impact on intrapartum electronic fetal monitoring.

    Science.gov (United States)

    Brocato, Brian; Lewis, David; Mulekar, Madhuri; Baker, Susan

    2017-09-17

    The objective of this study is to evaluate the impact maternal obesity has on the percentage of unmonitored electronic fetal monitoring (EFM). Women undergoing induction of labor at term were categorized into three groups: Group 1 (body mass index (BMI) fetal distress is present.

  9. Ultrasonic Diagnosis of Fetal Ascites and Toxoplasmosis

    DEFF Research Database (Denmark)

    Blaakær, Jan

    1986-01-01

    The ultrasonic diagnosis of fetal ascites caused by Toxoplasma Gondii is presented. When a diagnosis of fetal ascites without obvious etiological malformation is established, toxoplasmosis should be suspected. A serological test should be performed, in view of the possibility of antenatal treatment...

  10. Expert systems for fetal assessment in labour

    NARCIS (Netherlands)

    Lutomski, J.E.; Meaney, S.; Greene, R.A.; Ryan, A.C.; Devane, D.

    2015-01-01

    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

  11. Tocolytics for suspected intrapartum fetal distress.

    Science.gov (United States)

    Kulier, R; Hofmeyr, G J

    2000-01-01

    Prophylactic tocolysis with betamimetics and other agents has become widespread as a treatment for fetal distress. Uterine relaxation may improve placental blood flow and therefore fetal oxygenation. However there may also be adverse maternal cardiovascular effects. The objective of this review was to assess the effects of tocolytic therapy for suspected fetal distress on fetal, maternal and perinatal outcomes. We searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register. Date of last search: February 1999. Randomised trials comparing tocolytic therapy with no treatment or treatment with another tocolytic agent for suspected fetal distress. Two reviewers assessed trial quality and extracted data. Three studies were included. Compared with no treatment, there were fewer failed improvements in fetal heart rate abnormalities with tocolytic therapy (relative risk 0.26, 95% 0.13 to 0.53). Betamimetic therapy compared with magnesium sulphate showed a non-significant trend towards reduced uterine activity (relative risk 0.07, 95% confidence interval 0.00 to 1.10). Betamimetic therapy appears to be able to reduce the number of fetal heart rate abnormalities and perhaps reduce uterine activity. However there is not enough evidence based on clinically important outcomes to evaluate the use of betamimetics for suspected fetal distress.

  12. Fetal Alcohol Syndrome: An International Concern.

    Science.gov (United States)

    Asetoyer, Charon

    1987-01-01

    Describes Fetal Alcohol Effects (FAE) and Fetal Alcohol Syndrome (FAS) in infants, caused by mothers' consumption of alcohol during pregnancy. Both disabilities found in relatively high proportions of American Indian children. Discusses impact of disabilities on education. Discusses parent education programs in United States and abroad. (TES)

  13. Can Fetal Macrosomia be Prevented? | Inegbenebor | International ...

    African Journals Online (AJOL)

    Fetal macrosomia is an obstetric complication that makes child birth hazardous to women in labor, and sometimes an enigma to medical practitioners. It tasks the skills of obstetricians and places a burden on human and material medical resources. There is therefore a need for the prevention of fetal macrosomia in order to ...

  14. The World Health Organization Fetal Growth Charts

    DEFF Research Database (Denmark)

    Kiserud, Torvid; Piaggio, Gilda; Carroli, Guillermo

    2017-01-01

    BACKGROUND: Perinatal mortality and morbidity continue to be major global health challenges strongly associated with prematurity and reduced fetal growth, an issue of further interest given the mounting evidence that fetal growth in general is linked to degrees of risk of common noncommunicable...

  15. Determinação de HbA1c por CLAE: interferência de variantes de hemoglobinas S e C e alta concentração de HbF HbA1c determination by HPLC: interference of hemoglobin variants HbS, HbC and HbF high concentration

    Directory of Open Access Journals (Sweden)

    Maria das Graças Santos Menezes

    2012-10-01

    Full Text Available INTRODUÇÃO: O diabetes mellitus (DM é considerado um problema importante de saúde pública; possui prevalência elevada e nos últimos anos observa-se aumento progressivo na sua incidência. OBJETIVO: verificar possíveis variações na concentração de hemoglobina (Hb glicada (HbA1c na presença de Hbs S e C e avaliar o impacto da redução da HbA1c na avaliação clínica e no monitoramento do paciente diabético. MATERIAL E MÉTODOS: Foram incluídos no estudo, 150 indivíduos diabéticos oriundos da cidade de Salvador, Bahia, de ambos os gêneros, com idade média de 56 anos. Foram determinadas a glicemia de jejum e a HbA1c por metodologia de oxidase-peroxidase e cromatografia líquida de alta eficiência (CLAE, respectivamente. RESULTADOS: Foram observadas variações na concentração da HbA1c em função da presença de variantes de Hb, como 7,85%, AA; 7,30%, AS e 7,15%, AC. DISCUSSÃO E CONCLUSÃO: A metodologia analítica a ser utilizada para determinação de HbA1c deve ser escolhida com base nas características gerais da população atendida e nas comorbidades associadas, pois a presença de Hbs S e C ocasiona reduções significativas de glicação. Essa redução pode levar a interpretações clínicas inadequadas relativas ao controle glicêmico dos pacientes.INTRODUCTION: Diabetes mellitus (DM is considered an important public health problem. It is highly prevalent and its incidence has progressively increased in recent years. OBJECTIVE: To verify possible variations of glycated hemoglobin (HbA1c concentration in the presence of Hb S and Hb C and to evaluate the impact of HbA1c reduction on clinical evaluation and monitoring of diabetic patients. MATERIAL AND METHODS: This study comprised 150 diabetic individuals from Salvador city, Bahia, from both genders and average age of 56 years old. Fast blood glucose and HbA1c were determined by oxidase-peroxidase and high-performance liquid chromatography (HPLC methods, respectively

  16. Fetal neonatal hyperthyroidism: diagnostic and therapeutic approachment

    Science.gov (United States)

    Kurtoğlu, Selim; Özdemir, Ahmet

    2017-01-01

    Fetal and neonatal hyperthyroidism may occur in mothers with Graves’ disease. Fetal thyrotoxicosis manifestation is observed with the transition of TSH receptor stimulating antibodies to the fetus from the 17th–20th weeks of pregnancy and with the fetal TSH receptors becoming responsive after 20 weeks. The diagnosis is confirmed by fetal tachycardia, goiter and bone age advancement in pregnancy and maternal treatment is conducted in accordance. The probability of neonatal hyperthyroidism is high in the babies of mothers that have ongoing antithyroid requirement and higher antibody levels in the last months of pregnancy. Clinical manifestation may be delayed by 7–17 days because of the antithyroid drugs taken by the mother. Neonatal hyperthyroidism symptoms can be confused with sepsis and congenital viral infections. Herein, the diagnosis and therapeutic approach are reviewed in cases of fetal neonatal hyperthyroidism. PMID:28439194

  17. Fetal response to induced maternal emotions.

    Science.gov (United States)

    Araki, Miyuki; Nishitani, Shota; Ushimaru, Keisho; Masuzaki, Hideaki; Oishi, Kazuyo; Shinohara, Kazuyuki

    2010-05-01

    This study investigated the relationship between fetal movements and acute maternal emotional changes during pregnancy. Two empirically validated feature film clips were used for the external generation of two subjectively and facially well-characterized target emotions: happiness and sadness. We simultaneously monitored separate fetal arm, leg, and trunk movements by means of two ultrasound apparatuses while maternal emotions were manipulated by film clip presentation. The number of fetal arm movements, but not the duration, was increased when pregnant women were being shown a happy film. Both the number and the duration of fetal arm movements decreased with the sad film presentation. Neither the presentation of happiness nor the presentation of sadness affected fetal leg or trunk movements. These findings suggest that induced emotions in pregnant women primarily affect arm movements of their fetuses, and that positive and negative emotions have the opposite effects on fetus movement.

  18. Development of the human fetal testis.

    Science.gov (United States)

    O'Shaughnessy, Peter J; Fowler, Paul A

    2014-05-01

    Masculinisation and adult fertility in the male are dependent on appropriate fetal endocrine programming. There is also now increasing evidence to indicate that the same mechanisms which regulate masculinisation also affect the general wellbeing of males throughout their life and, particularly, during ageing. Testosterone, secreted by the fetal testes, is the main factor regulating these processes and an understanding of fetal testis development in the human male is essential if we are to prevent adult reproductive disorders. This review focuses on what is known about human testis development and describes the effects of maternal smoking, a surrogate of possible xenotoxicant exposure on fetal testis and fetal liver function. Copyright © 2014. Published by Elsevier Masson SAS.

  19. Propofol Pharmacokinetics and Estimation of Fetal Propofol Exposure during Mid-Gestational Fetal Surgery: A Maternal-Fetal Sheep Model

    Science.gov (United States)

    Niu, Jing; Venkatasubramanian, Raja; Vinks, Alexander A.; Sadhasivam, Senthilkumar

    2016-01-01

    Background 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. Methods 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. Results 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. Conclusions 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

  20. Regenerative healing following fetal myocardial infarction

    Science.gov (United States)

    Herdrich, Benjamin J.; Danzer, Enrico; Davey, Marcus G.; Allukian, Myron; Englefield, Virginia; Gorman, Joseph H.; Gorman, Robert C.; Liechty, Kenneth W.

    2010-01-01

    Objectives The adult response to myocardial infarction results in inflammation, scar formation, left ventricular dilatation, and loss of regional and global function. Regenerative scarless healing has been demonstrated in fetal dermis and tendon and is associated with diminished inflammation. We hypothesized that following fetal myocardial infarction there would be minimal inflammation, regenerative healing, and preservation of function. Methods Anteroapical myocardial infarction encompassing 20% of the left ventricle were created in adult or early gestation fetal sheep. Myocardial function was serially assessed using quantitative echocardiography. Infarct architecture was examined histologically for evidence of scar formation. Cellular inflammation, cellular proliferation, and apoptosis were assessed using immunohistochemistry. Results In the adult sheep 4 weeks following myocardial infarction, there was a significant decline in ejection fraction (41±7.4% to 26±7.4%, p<0.05), and the akinetic myocardial segment increased in size (6.9±0.8 cm to 7.9±1.1 cm, p<0.05). In contrast, there was no decline in the fetal ejection fraction (53±8.1% to 55±8.8%) and no akinetic fetal myocardial segment 4 weeks post-infarction. The fetal infarcts lacked an inflammatory cell infiltrate and healed with minimal fibrosis, compared to the adults. Fetal infarcts also demonstrated BrdU+ proliferating cells, including cardiomyocytes, within the infarct. Conclusions These data demonstrate that the fetal response to myocardial infarction is dramatically different than the adult and is characterized by minimal inflammation, lack of fibrosis, myocardial proliferation, and restoration of cardiac function. Diminished inflammation is associated with fetal regenerative cardiac healing following injury. Understanding the mechanisms involved in fetal myocardial regeneration may lead to applications to alter the adult response following myocardial infarction. PMID:20452780

  1. Three unrelated perturbations similarly uncouple fluid, bulk-membrane, and receptor endosomal flow in rat fetal fibroblasts

    NARCIS (Netherlands)

    Cupers, P; Veithen, A; Hoekstra, D; Baudhuin, P; Courtoy, PJ

    1997-01-01

    We have compared the effects of three perturbations (treatment with 2 mu M monensin, potassium depletion, and incubation in 0.35 M NaCl) on recycling of internalized fluid-phase, bulk-membrane, and receptor-mediated tracers in rat fetal fibroblasts. Monensin accelerated 2-fold the regurgitation of

  2. Hypoxia: From Placental Development to Fetal Programming.

    Science.gov (United States)

    Fajersztajn, Lais; Veras, Mariana Matera

    2017-10-16

    Hypoxia may influence normal and different pathological processes. Low oxygenation activates a variety of responses, many of them regulated by hypoxia-inducible factor 1 complex, which is mostly involved in cellular control of O 2 consumption and delivery, inhibition of growth and development, and promotion of anaerobic metabolism. Hypoxia plays a significant physiological role in fetal development; it is involved in different embryonic processes, for example, placentation, angiogenesis, and hematopoiesis. More recently, fetal hypoxia has been associated directly or indirectly with fetal programming of heart, brain, and kidney function and metabolism in adulthood. In this review, the role of hypoxia in fetal development, placentation, and fetal programming is summarized. Hypoxia is a basic mechanism involved in different pregnancy disorders and fetal health developmental complications. Although there are scientific data showing that hypoxia mediates changes in the growth trajectory of the fetus, modulates gene expression by epigenetic mechanisms, and determines the health status later in adulthood, more mechanistic studies are needed. Furthermore, if we consider that intrauterine hypoxia is not a rare event, and can be a consequence of unavoidable exposures to air pollution, nutritional deficiencies, obesity, and other very common conditions (drug addiction and stress), the health of future generations may be damaged and the incidence of some diseases will markedly increase as a consequence of disturbed fetal programming. Birth Defects Research 109:1377-1385, 2017.© 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  3. MRI of fetal acquired brain lesions

    Energy Technology Data Exchange (ETDEWEB)

    Prayer, Daniela [Department of Radiodiagnostics, Medical University of Vienna (Austria)]. E-mail: daniela.prayer@meduniwien.ac.at; 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)

    2006-02-15

    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.

  4. Fetal Primary Cardiac Tumors During Perinatal Period

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2017-06-01

    Full Text Available Fetal primary cardiac tumors are rare, but they may cause complications, which are sometimes life threatening, including arrhythmias, hydrops fetalis, ventricular outflow/inflow obstruction, cardiac failure, and even sudden death. Among fetal primary cardiac tumors, rhabdomyomas are most common, followed by teratomas, fibromas, hemangiomas, and myxomas. Everolimus, a mammalian target of rapamycin inhibitor, has been reported to be an effective drug to cause tumor remission in three neonates with multiple cardiac rhabdomyomas. Neonatal cardiac surgery for the resection of primary cardiac tumors found by fetal echocardiography has been reported sporadically. However, open fetal surgery for pericardial teratoma resection, which was performed successfully via a fetal median sternotomy in one case report, could be a promising intervention to rescue these patients with large pericardial effusions. These recent achievements undoubtedly encourage further development in early management of fetal cardiac tumors. Owing to the rarity of fetal primary cardiac tumors, relevant information in terms of prenatal diagnosis, treatment, and prognosis remains to be clarified.

  5. [FETAL PROGRAMMING OF METABOLIC DISORDERS].

    Science.gov (United States)

    Varadinova, M R; Metodieva, R; Boyadzhieva, N

    2015-01-01

    Our knowledge of fetal programming has developed notably over the years and recent data suggest that an unbalanced diet prior and during pregnancy can have early-onset and long-lasting consequences on the health of the offspring. Specific negative influences of high dietary glucose and lipid consumption, as well as undernutrition, are associated with development of metabolic syndrome, insulin resistance and diabetes in the offspring. The mechanisms underlying the effects of maternal hyperglycemia on the fetus may involve structural, metabolic and epigenetic changes. The aim of this review is to illustrate how adverse intrauterine environment may influence molecular modifications in the fetus and cause epigenetic alterations in particular. It has been demonstrated that prenatal epigenetic modifications may be linked to the pathogenesis and progression of the adult chronic disorders. Studies on epigenetic alterations will contribute to a better understanding of the long-term effects of in utero exposure and may open new perspectives for disease prevention and treatment.

  6. Clinical experience with the Hewlett-Packard M-1350A fetal monitor: correlation of Doppler-detected fetal body movements with fetal heart rate parameters and perinatal outcome.

    Science.gov (United States)

    Devoe, L; Boehm, F; Paul, R; Frigoletto, F; Penso, C; Goldenberg, R; Rayburn, W; Smith, C

    1994-02-01

    Our purpose was to correlate measures of Doppler-detected fetal movements with standard fetal heart rate parameters and perinatal outcomes. This prospective, multiinstitutional trial used the Hewlett-Packard M1350A monitor to record simultaneous fetal heart rate baseline, variability, accelerations, decelerations, and number of fetal movements, and duration and percent of total time. These data were compared at 10- and 30-minute intervals during nonstress tests and were correlated with fetal heart rate baseline parameters and maternally perceived fetal movements and with outcomes of infants delivered within 7 days of the last test. At six centers 1704 actocardiograms from 884 third-trimester patients were analyzed. Doppler-detected fetal movement counts, durations, and percent of total time correlated weakly with all baseline fetal heart rate parameters (all values < 0.20). All fetal movement parameters increased significantly in successive 10-minute blocks and in periods of increased or normal fetal heart rate variability compared with those with fetal heart rate variability. The sensitivity, specificity, and predictive values of the percent of total movement time were comparable to those of standard nonstress test parameters. The risk of poor perinatal outcomes after nonreactive nonstress tests was lower in cases with fetal movements than in those without. Doppler actocardiography may help to discriminate fetal states during antepartum testing. It may prevent inappropriate diagnosis of fetal compromise when the nonstress test is nonreactive or nonreassuring.

  7. Correlation of ultrasonographic estimated fetal weight with actual ...

    African Journals Online (AJOL)

    Background: Sonographic fetal weight estimation is an important component of antenatal care. Aim: To sonographically estimate fetal ... estimation is known to be an important component of standard antenatal care.3 Fetal weight is one ..... Raman S, Urquhart R, Yusof M. Clinical versus ul- trasound estimation of fetal weight.

  8. Fetal goiter and bilateral ovarian cysts

    DEFF Research Database (Denmark)

    Lassen, Pernille; Sundberg, Karin; Juul, Anders

    2008-01-01

    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....... The thyroid gland appeared normal in size, and cord blood TSH and free T 4 were both within normal limits. At ultrasound control 6 days later, the right ovarian cyst was not visible, while the left cyst was still present. Thus, our report supports previous findings that fetal goiter can be treated...

  9. Fetal Heart Monitoring From Maternal ECG

    Directory of Open Access Journals (Sweden)

    M. Manikandan

    2015-08-01

    Full Text Available Observing fetal health is very important for mothers and the fetus well-being. Most of the conditions can be monitored via ECG so Fetal ECG extraction plays an important role. Extracting Fetal ECG implies filtering maternal ECG and other artifacts and due to the presence of reference signal which is mothers ECG from chest adaptive filter is used much often. This paper proposes adaptive noise cancellation technique using LMS algorithm and heart rate detection algorithm. The method can also be used for a model based design to achieve result on hardware platform.

  10. Fetal movement counting--effects on maternal-fetal attachment: a multicenter randomized controlled trial.

    Science.gov (United States)

    Saastad, Eli; Israel, Pravin; Ahlborg, Tone; Gunnes, Nina; Frøen, J Frederik

    2011-12-01

      Women presenting with decreased fetal movement have an increased risk of adverse pregnancy outcomes. Fetal movement counting may be associated with improvement in maternal-fetal attachment, which in turn, improves pregnancy outcome and postnatal mother-infant attachment. The study aim was to test whether maternal-fetal attachment differed between groups of mothers who systematically performed fetal movement counting and mothers who followed standard antenatal care where routine fetal movement counting was discouraged.   In a multicenter, randomized trial, 1,123 women were assigned to either systematic fetal movement counting from pregnancy week 28 or to standard antenatal care. This study sample included primarily white, cohabiting, nonsmoking, and relatively well-educated women. The outcome measure was maternal-fetal attachment, measured by using the Prenatal Attachment Inventory. Analysis was by intention-to-treat.   No difference was found between the groups in the scores on prenatal attachment; the means and standard deviations were 59.54 (9.39) and 59.34 (9.75) [corrected] for the intervention and the control groups, respectively (p = 0.747). The mean difference between the groups was 0.20 (95% CI: -1.02-1.42) [corrected].   Fetal movement counting in the third trimester does not stimulate antenatal maternal-fetal attachment. This result differs from a previous study where fetal movement counting improved maternal-fetal attachment. Further research with a focus on possible mediating factors such as levels of stress, concern, and other psychological factors is required. © 2011, Copyright the Authors. Journal compilation © 2011, Wiley Periodicals, Inc.

  11. Real-Time Automatic Fetal Brain Extraction in Fetal MRI by Deep Learning

    OpenAIRE

    Salehi, Seyed Sadegh Mohseni; Hashemi, Seyed Raein; Velasco-Annis, Clemente; Ouaalam, Abdelhakim; Estroff, Judy A.; Erdogmus, Deniz; Warfield, Simon K.; Gholipour, Ali

    2017-01-01

    Brain segmentation is a fundamental first step in neuroimage analysis. In the case of fetal MRI, it is particularly challenging and important due to the arbitrary orientation of the fetus, organs that surround the fetal head, and intermittent fetal motion. Several promising methods have been proposed but are limited in their performance in challenging cases and in real-time segmentation. We aimed to develop a fully automatic segmentation method that independently segments sections of the feta...

  12. Fetal Heart Rate Pattern Notification Guidelines and Suggested Management Algorithm for Intrapartum Electronic Fetal Heart Rate Monitoring

    OpenAIRE

    Downs, Thomas; Zlomke, Evelyn

    2007-01-01

    Context: Numerous randomized controlled trials have demonstrated limited efficacy of intrapartum fetal heart rate monitoring in improving fetal outcome. A potential reason is the wide variability in clinical decision making seen with its use. Standardizing management of variant intrapartum fetal heart rate tracings may reduce this variability and lead to improvement in fetal outcome.

  13. [Relationship of prenatal stress and depression to maternal-fetal attachment and fetal growth].

    Science.gov (United States)

    Kwon, Mi-Kyung; Bang, Kyung-Sook

    2011-04-01

    Prenatal depression is associated with potential negative consequences for the mother and infant. The purpose of this study was to examine pregnant women's stress, and depression and their impact on maternal-fetal attachment and fetal growth. Data were collected by means of a questionnaire and fetal sonogram from a convenience sample of 166 pregnant women. Women who have a low educational level, poor health and are dissatisfied with their marriage showed low maternal-fetal attachment. Prenatal depression had significant correlations with length of pregnancy and level of stress. Even though correlation between maternal stress and fetal weight (r=-.15, p=.099) and correlation between maternal depression and maternal-fetal attachment (r=-.13, p=.095) were not statistically significant, the impact of the prenatal psychological state of mothers can not be ignored as it relates to fetal health. Maternal-fetal attachment and fetal growth can be affected by maternal emotional state, including stress or depression. These findings suggest that primary care nurses in hospitals and public health centers should provide prenatal depression screening and nursing intervention programs for management and prevention of prenatal stress and depression.

  14. Maternal plasma fetal DNA fractions in pregnancies with low and high risks for fetal chromosomal aneuploidies.

    Directory of Open Access Journals (Sweden)

    Irena Hudecova

    Full Text Available Recently published international guidelines recommend the clinical use of noninvasive prenatal test (NIPT for aneuploidy screening only among pregnant women whose fetuses are deemed at high risk. The applicability of NIPT to aneuploidy screening among average risk pregnancies requires additional supportive evidence. A key determinant of the reliability of aneuploidy NIPT is the fetal DNA fraction in maternal plasma. In this report, we investigated if differences in fetal DNA fractions existed between different pregnancy risk groups. One hundred and ninety-five singleton pregnancies with male fetuses divided into 3 groups according to first trimester screening parameters were examined for fetal DNA percentage by counting Y chromosome DNA sequences using massively parallel sequencing. Fetal DNA fractions were compared between risk groups and assessed for correlations with first trimester screening parameters. There was no statistically significant difference in fetal DNA fractions across the high, intermediate and low risk groups. Fetal DNA fraction showed a strong negative correlation with maternal weight. Fetal DNA fraction also showed weak but significant correlations with gestational age, crown-rump length, multiple of medians of free β-subunit of human chorionic gonadotropin and pregnancy-associated plasma protein A. Similar fetal DNA fractions in maternal plasma between high, intermediate and low risk pregnant women is a precondition for uniform performance of the aneuploidy NIPTs for the general population. This study thus shows that the aneuploidy screening by NIPT is likely to offer similar analytical reliability without respect to the a priori fetal aneuploidy risk.

  15. Fetal cell-free DNA fraction in maternal plasma is affected by fetal trisomy.

    Science.gov (United States)

    Suzumori, Nobuhiro; Ebara, Takeshi; Yamada, Takahiro; Samura, Osamu; Yotsumoto, Junko; Nishiyama, Miyuki; Miura, Kiyonori; Sawai, Hideaki; Murotsuki, Jun; Kitagawa, Michihiro; Kamei, Yoshimasa; Masuzaki, Hideaki; Hirahara, Fumiki; Saldivar, Juan-Sebastian; Dharajiya, Nilesh; Sago, Haruhiko; Sekizawa, Akihiko

    2016-07-01

    The purpose of this noninvasive prenatal testing (NIPT) study was to compare the fetal fraction of singleton gestations by gestational age, maternal characteristics and chromosome-specific aneuploidies as indicated by z-scores. This study was a multicenter prospective cohort study. Test data were collected from women who underwent NIPT by the massively parallel sequencing method. We used sequencing-based fetal fraction calculations in which we estimated fetal DNA fraction by simply counting the number of reads aligned within specific autosomal regions and applying a weighting scheme derived from a multivariate model. Relationships between fetal fractions and gestational age, maternal weight and height, and z-scores for chromosomes 21, 18 and 13 were assessed. A total of 7740 pregnant women enrolled in the study, of which 6993 met the study criteria. As expected, fetal fraction was inversely correlated with maternal weight (P<0.001). The median fetal fraction of samples with euploid result (n=6850) and trisomy 21 (n=70) were 13.7% and 13.6%, respectively. In contrast, the median fetal fraction values for samples with trisomies 18 (n=35) and 13 (n=9) were 11.0% and 8.0%, respectively. The fetal fraction of samples with trisomy 21 NIPT result is comparable to that of samples with euploid result. However, the fetal fractions of samples with trisomies 13 and 18 are significantly lower compared with that of euploid result. We conclude that it may make detecting these two trisomies more challenging.

  16. Effect of clorophilic juice from germinated corn on seric lipids, hemoglobin, and uric acid Efecto del germinado de maíz sobre el perfil lipídico, la hemoglobina y la uricemia

    Directory of Open Access Journals (Sweden)

    María Luisa Bravo Aguiar

    1998-01-01

    Full Text Available The effect was studied of clorophilic juice from germinated corn on blood seric lipids, uric acid, glucose, hemoglobine and hematocrite. Nine adults with average age 44 years and who presented hypertriglyceridemia received daily 30 ml doses of the juice during 2 months. Initial average concentrations in mg/dl were 6.9 (uric acid, 259 (triglycerides and 199 (total cholesterol; they decreased progressively and significantly at 30, 45 and 60 days of treatment reaching values of 5.0, 171 and 169 respectively (p:0.01 0,0.015 and 0.034. Hemoglobin increased significantly (p:0.008. This natural treatment could be useful in regulating blood lipids and other biologic risk factors for coronary arteriosclerosis, without the toxic efects shown by some lipid control drugs. Se investigó el efecto del jugo clorofílico de germinado de maíz, con una dosis de 30 ml diarios durante dos meses, sobre el perfil lipídico, la glicemia, la uricemia, la hemoglobina y el hematocrito, en nueve adultos con edad promedio de 44 años y que presentaban hipertrigliceridemia como trastorno principal. Las concentraciones promedio iniciales en mgl dl que eran de 6.9 (ácido úrico, 259 (triglicéridos y 199 (colesterol total descendieron en forma progresiva y significativa a los 30, 45 y 60 días de tratamiento hasta valores respectivos de 5.0, 171 y 169 (p = 0.010,0.015 y 0.034 respectivamente. La hemoglobina ascendió de manera progresiva y significativa (p = 0.008 durante el experimento. Este tratamiento natural podría ser útil en la regulación de los lípidos sanguíneos y otros factores biológicos de riesgo para el desarrollo de ateromatosis coronaría, sin los efectos tóxicos que se han demostrado con algunas drogas hipolipemiantes.

  17. Frecuencia de la hemoglobina S en cinco poblaciones mexicanas y su importancia en la salud pública Hemoglobin S frequency in five Mexican populations and its importance in public health

    Directory of Open Access Journals (Sweden)

    Rosenda I Peñaloza-Espinosa

    2008-08-01

    Full Text Available OBJETIVO: Informar la frecuencia de heterocigotos para la hemoglobina S (HbS en cinco poblaciones mexicanas y el haplotipo en cinco muestras con HbS y subrayar su relevancia en la salud pública. MATERIAL Y MÉTODOS: Se tomó una muestra de sangre periférica en 162 individuos no relacionados provenientes de tres poblaciones nahuas (Atocpan y Tlacotenco, DF, e Ixhuatlancillo, Veracruz, y en 131 mestizos (Coyolillo y Poza Rica, Veracruz, previo consentimiento informado. Se determinó el tipo de hemoglobina por electroforesis y se extrajo el DNA de leucocitos de cinco muestras en las que se determinó el haplotipo por PCR y corte con restrictasas. RESULTADOS: Entre los nahuas se reconoció un heterocigoto HbAS (0.6% y 18 en mestizos (13.7%. Se identificaron cuatro haplotipos Bantu y uno Benin. CONCLUSIONES: Estos hallazgos son importantes en términos de la salud pública en poblaciones con alta frecuencia de HbS, para dar información y consejo genético a los portadores y la atención médica oportuna y adecuada a los pacientes.OBJECTIVE: To provide information regarding the heterozygote frequency for hemoglobin S (HbS in five Mexican populations, the Haplotype in five S chromosomes, and underscore its importance for public health. MATERIAL AND METHODS: A total of 162 samples from three Nahua populations (Atocpan and Tlacotenco, DF, and Ixhuatlancillo, Veracruz and 131 from mestizo populations (Coyolillo and Poza Rica, Veracruz were studied after obtaining informed consent. The hemoglobin type was determined by electrophoresis, and DNA in leucocytes was obtained from five HbS samples. The haplotype was determined by PCR and cut with restrictases, according to literature. RESULTS:We found one heterozygote for hemoglobin S (0.6% among Nahua and 18 among Mestizo groups (13.7%. Four haplotypes were Bantu and one was Benin. CONCLUSIONS: These findings are important to public health for populations with a high frequency of HbS, to inform and provide

  18. Orientação para aplicação de sais de ferro, em gestantes, segundo o uso de curva operacional de hemoglobina ("Curva de uma grama" The use of an hemoglobin operational curve ("One gram curve" for the iron therapy of pregnant women

    Directory of Open Access Journals (Sweden)

    Cyro Ciari Jr.

    1973-12-01

    Full Text Available Através das dosagens de hemoglobina realizadas em várias épocas da gravidez, em 553 gestantes, retiradas por amostragem casual simples de um universo de 8120 gestantes no período de 1947 a 1971, testou-se a aplicabilidade da curva de hemoglobina e sua importância em relação ao diagnóstico, conduta e controle do tratamento de pacientes com anemia ferropriva.Through hemoglobin determinations carried out in several phases of pregnancy, in 553 pregnant women casually chosen out of a number of 8120 within the period of 1947 to 1971, it was tested the feasibility of the hemoglobin curve previously constructed and its importance regarding diagnosis and control of treatment in patients with iron deficiency anemia.

  19. Noninvasive fetal RhD genotyping

    DEFF Research Database (Denmark)

    Clausen, Frederik Banch; Damkjær, Merete Berthu; Dziegiel, Morten Hanefeld

    2014-01-01

    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...

  20. [Quality and effectiveness of electronic fetal monitoring].

    Science.gov (United States)

    Biringer, K; Danko, J

    2011-12-01

    To evaluate effectiveness of electronic fetal monitoring methods during labor. A case series study. Department of Gynecology and Obstetrics, Jessenius Faculty of Medicine, Comenius University, Martin, Slovak Republic. We followed 112 fetuses with simultaneous continuous monitoring (cardiotocography (CTG), intrapartal fetal pulse oxymetry (IFPO), and analysis of ST segment in fetal electrocardiogram (STAN)) during labor. We determined the effective time for every diagnostic tool. histograms, Kolmogorov-Smirnov test, Spearman's coefficient; significance (alfa): p STAN > IFPO (94.8% +/- 15.1% vs. 90.4% +/- 18.3% vs. 87.4% +/- 21.2%). STAN was the most effective tool in the second stage of labor (91.3% +/- 9.4%). The most effective fetal monitoring tool is CTG. However STAN is the best diagnostic method in the second stage of labor, because of its bio-signal quality.

  1. Fetal surveillance and outcome in postterm pregnancy

    OpenAIRE

    Kitlinski, Margareta

    2007-01-01

    To minimize the risk of short-term and long-term morbidity and mortality among children born postterm, studies were performed to evaluate the fetal surveillance program. (1) Male-fetus pregnancies were at an increased risk

  2. Fetal hypoxia and programming of matrix metalloproteinases.

    Science.gov (United States)

    Tong, Wenni; Zhang, Lubo

    2012-02-01

    Fetal hypoxia adversely affects the brain and heart development, yet the mechanisms responsible remain elusive. Recent studies indicate an important role of the extracellular matrix in fetal development and tissue remodeling. The matrix metalloproteinases (MMPs) and their endogenous inhibitors, tissue inhibitors of metalloproteinases (TIMPs) have been implicated in a variety of physiological and pathological processes in the cardiovascular and central nervous systems. This review summarizes current knowledge of the mechanisms by which fetal hypoxia induces the imbalance of MMPs, TIMPs and collagen expression patterns, resulting in growth restriction and aberrant tissue remodeling in the developing heart and brain. Collectively, this information could lead to the development of preventive diagnoses and therapeutic strategies in the fetal programming of cardiovascular and neurological disorders. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. Fetal Alcohol Spectrum Disorders (FASDs): Treatments

    Science.gov (United States)

    ... receive such services. Loving, nurturing, and stable home environment Children with FASDs can be more sensitive than other ... E., & Schwartz, L. (2012). Neurocognitive habilitation therapy for children with fetal ... Journal of Occupational Therapy, 66, 24-34. Top of ...

  4. Fetal Alcohol Spectrum Disorders (FASDs): Diagnosis

    Science.gov (United States)

    ... Form Controls Cancel Submit Search the CDC Fetal Alcohol Spectrum Disorders (FASDs) Note: Javascript is disabled or ... About CDC.gov . FASD Homepage Facts Secondary Conditions Alcohol Use in Pregnancy Questions & Answers Quiz Interventions Alcohol ...

  5. Gestações complicadas por sífilis materna e óbito fetal Pregnancies complicated by maternal syphilis and fetal death

    Directory of Open Access Journals (Sweden)

    Maria Isabel do Nascimento

    2012-02-01

    Full Text Available OBJETIVO: Descrever as características de gestações complicadas por sífilis materna e óbito fetal. MÉTODOS: Foi feito um estudo retrospectivo descritivo conduzido por revisão de prontuários de 48 gestantes com sífilis materna e desfecho de óbito fetal, admitidas no período 2005-2008, no Hospital Geral de Nova Iguaçu, Baixada Fluminense, Estado do Rio de Janeiro. O peso ao nascer >500 g e o óbito fetal documentado por declaração de óbito foram os critérios de inclusão. Os seguintes aspectos foram analisados: sociodemográficos, antecedentes reprodutivos, aspectos da gestação atual, cuidados de pré-natal, realização e resultados do teste Venereal Disease Research Laboratory (VDRL, presença de intercorrências na gestação, além da sífilis, sendo as mortes fetais classificadas como materna, placentária ou fetal. Os resultados foram apresentados por porcentagem, média, desvio padrão (DP e valor máximo e mínimo. RESULTADOS: A média de idade materna foi de 22,7 anos (DP=0,9 anos e pelo menos metade das pacientes tinham baixo grau de escolaridade. Na admissão hospitalar, 68,8% do grupo se encontrava no terceiro trimestre e com média de idade gestacional de 29,2 semanas (DP=0,5; mais de 50% estava em trabalho de parto. A grande maioria dos casos de óbito fetal (93% ocorreu antes da hospitalização materna. Entre as pacientes que frequentaram o pré-natal (54,2%, 30,8% não realizaram o VDRL, 30,8 e 15,4% tiveram resultado reativo e não-reativo, respectivamente e nenhuma teve mais de um VDRL no pré-natal. No momento do parto, a maioria das pacientes (95,8% realizou o VDRL. No geral, a titulação do VDRL variou de 1:1 a 1:512, predominando titulações >1:4 (91,7%. Em 23% dos casos foram encontradas outras condições relacionadas ao óbito fetal, além da sífilis. CONCLUSÕES: A infecção foi a principal causa clinicamente identificada do decesso fetal nesta série de casos. O desfecho de feto morto ocorreu no pr

  6. Erythropoietin elevation in the chronically hyperglycemic fetal lamb

    Energy Technology Data Exchange (ETDEWEB)

    Philipps, A.F. (Univ. of Connecticut Health Center, Farmington) Widness, J.A.; Garcia, J.F.; Raye, J.R.; Swartz, R.

    1982-05-01

    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.

  7. Triploidia fetal associada à diminuição da subunidade beta e do estriol não-conjugado no soro materno Fetal triploidy associated with low levels of unconjugated estriol and beta-subunit in maternal serum

    Directory of Open Access Journals (Sweden)

    Eduardo Vieira Neto

    1999-05-01

    Full Text Available Relatamos um caso de triploidia fetal não-molar detectada na 20ª semana gestacional por cordocentese realizada em razão de estudo ultra-sonográfico que revelou retardo do crescimento intra-uterino e grave oligoidrâmnio. Na 19ª semana foram verificados acentuada diminuição da subunidade beta livre da gonadotrofina coriônica humana e do estriol não-conjugado e níveis de alfa-fetoproteína normais, apontando para um risco aumentado de síndrome de Edwards. Houve morte fetal um dia após a cordocentese e a resolução do caso foi por parto vaginal induzido com misoprostol e ocitocina, sob analgesia peridural. Estudo cromossômico das células sangüíneas fetais revelou o cariótipo 69,XXX. O grave retardo do crescimento intra-uterino, a macrocefalia, constatada no estudo anatomopatológico do feto, e os níveis muito baixos de hCG e de estriol não-conjugado sugerem um caso de triploidia por diginia, fertilização de um óvulo diplóide por um espermatozóide haplóide.We report a case of nonmolar fetal triploidy detected by fetal blood sampling at 20 weeks of gestation, performed as an investigation of intrauterine growth retardation and severe oligohydramnios found by ultrasound scan. At 19 weeks of gestation very low levels of maternal free serum beta-subunit of human chorionic gonadotropin and unconjugated estriol, and normal levels of alpha-fetoprotein were found, which were interpreted as a high risk of fetal Edwards syndrome. Fetal death supervened the day after fetal blood sampling, and the pregnancy was terminated by vaginal delivery induced by misoprostol and oxytocin, under epidural anesthesia. Chromosome study of the fetal blood cells showed a 69,XXX karyotype. The severe intrauterine growth retardation and macrocephaly noted on pathological review plus the very low levels of hCG and unconjugated estriol suggest a fetal gynoid triploidy case, caused by the fertilization of a diploid egg by a haploid sperm.

  8. Fetal MR imaging of Kniest dysplasia

    Energy Technology Data Exchange (ETDEWEB)

    Yazici, Zeynep [Uludag University, Faculty of Medicine, Department of Radiology, Gorukle (Turkey); Kline-Fath, Beth M.; Laor, Tal [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Tinkle, Bradley T. [Cincinnati Children' s Hospital Medical Center, Division of Human Genetics, Cincinnati, OH (United States)

    2010-03-15

    We present a case of Kniest dysplasia, a rare form of the type II collagenopathies, with prenatal MRI. Sonography revealed only short limbs in the fetus. Fetal MRI findings included enlarged hyaline cartilaginous structures with abnormally high T2 signal intensity, delayed ossification of the pubic and ischial bones, and platyspondyly. By delineating the cartilaginous abnormalities, fetal MRI can contribute to the prenatal diagnosis of chondrodysplasias. (orig.)

  9. Impact of Oxidative Stress in Fetal Programming

    OpenAIRE

    Thompson, Loren P.; Yazan Al-Hasan

    2012-01-01

    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 pr...

  10. Fetal Alcohol Exposure: The Common Toll

    OpenAIRE

    Nakhoul, Marie R; Seif, Karl E; Haddad, Natasha; Haddad, Georges E

    2017-01-01

    Alcohol has always been present in human life, and currently it is estimated that 50% of women of childbearing age consume alcohol. It has become increasingly clear over the last years that alcohol exposure during fetal development can have detrimental effects on various organ systems, and these effects are exerted by alcohol through multiple means, including effects on free radical formation, cellular apoptosis, as well as gene expression. Fetal alcohol exposure can lead to a spectrum of sho...

  11. Epidemiology of fetal death in Latin America.

    Science.gov (United States)

    Conde-Agudelo, A; Belizán, J M; Díaz-Rossello, J L

    2000-05-01

    To identify risk factors associated with fetal death, and to measure the rate and the risk of fetal death in a large cohort of Latin American women. We analyzed 837,232 singleton births recorded in the Perinatal Information System Database of the Latin American Center for Perinatology and Human Development (CLAP) between 1985 and 1997. The risk factors analyzed included fetal factors and maternal sociodemographic, obstetric, and clinical characteristics. Adjusted relative risks were obtained, after adjustment for potential confounding factors, through multiple logistic regression models based on the method of generalized estimating equations. There were 14,713 fetal deaths (rate=17.6 per 1000 births). The fetal death risk increased exponentially as pregnancy advanced. Thirty-seven percent of all fetal deaths occurred at term, and 64% were antepartum. The main risk factors associated with fetal death were lack of antenatal care (adjusted relative risk [aRR]=4.26; 95% confidence interval, 3.84-4.71) and small for gestational age (aRR=3.26; 95% CI, 3.13-3.40). In addition, the risk of death during the intrapartum period was almost tenfold higher for fetuses in noncephalic presentations. Other risk factors associated with stillbirth were: third trimester bleeding, eclampsia, chronic hypertension, preeclampsia, syphilis, gestational diabetes mellitus, Rh isoimmunization, interpregnancy interval or =4, maternal age > or =35 years, illiteracy, premature rupture of membranes, body mass index > or =29.0, maternal anemia, previous abortion, and previous adverse perinatal outcomes. There are several preventable factors that should be dealt with in order to reduce the gap in fetal mortality between Latin America and developed countries.

  12. Biomedical Instruments for Fetal and Neonatal Surveillance

    Energy Technology Data Exchange (ETDEWEB)

    Rolfe, P [Oxford BioHorizons Ltd. (United Kingdom); Scopesi, F [Gaslini Institute, University of Genoa (Italy); Serra, G [Gaslini Institute, University of Genoa (Italy)

    2006-10-15

    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.

  13. Maternal feeding controls fetal biological clock.

    Directory of Open Access Journals (Sweden)

    Hidenobu Ohta

    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.

  14. Biomedical Instruments for Fetal and Neonatal Surveillance

    Science.gov (United States)

    Rolfe, P.; Scopesi, F.; Serra, G.

    2006-10-01

    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.

  15. Isolated single umbilical artery and fetal karyotype.

    Science.gov (United States)

    Dagklis, T; Defigueiredo, D; Staboulidou, I; Casagrandi, D; Nicolaides, K H

    2010-09-01

    To determine the need for fetal karyotyping in cases of an isolated single umbilical artery (SUA) identified during the second-trimester routine anomaly scan. All patients booked for antenatal care and delivery in our hospital are offered two ultrasound scans in pregnancy, one at 11-13 weeks' gestation as part of screening for chromosomal defects and another at 20-23 weeks for detailed fetal examination. In addition we examine patients referred from other hospitals because of suspected fetal abnormalities during their routine second-trimester scan. We performed a search of the database to retrieve all cases with an SUA and reviewed the ultrasound findings, fetal karyotype and pregnancy outcome. There were 643 cases with SUA, including 424 (65.9%) where the condition was isolated, 133 (20.7%) with one major fetal defect and 86 (13.4%) with multiple defects. The incidence of chromosomal abnormalities was 0% in the isolated SUA group, 3.7% in those with one defect and 50.7% in those with multiple defects. The commonest chromosomal abnormalities were trisomy 18, trisomy 13 and triploidy, which together accounted for 82.9% of cases. The finding of an SUA should prompt the sonographer to search for fetal defects and if these are found the risk for chromosomal abnormalities is increased. In cases of apparently isolated SUA there is no evidence of increased risk of chromosomal abnormalities. (c) 2010 ISUOG. Published by John Wiley & Sons, Ltd.

  16. The Use of Fetal Noninvasive Electrocardiography

    Directory of Open Access Journals (Sweden)

    Igor Lakhno

    2016-01-01

    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.

  17. Apego materno-fetal, ansiedade e depressão em gestantes com gravidez normal e de risco: estudo comparativo

    OpenAIRE

    SAVIANI-ZEOTI,Fernanda; PETEAN,Eucia Beatriz Lopes

    2015-01-01

    Este estudo teve como objetivo verificar as possíveis diferenças nos comportamentos de apego materno-fetal, bem como nos níveis de ansiedade e depressão apresentados por gestantes com e sem risco na gravidez, durante o segundo trimestre gestacional. Participaram da pesquisa 25 mulheres com gravidez sem risco e 23 com gravidez de risco, sendo que quatro delas tiveram fetos malformados. A Escala de Apego Materno-fetal e os Inventários de Ansiedade e Depressão de Beck foram utilizados. Os result...

  18. Desenvolvimento em um biogradiômetro multicanal supercondutor com SQUIDs DC para registro de medidas de magnetocardiografia fetal

    OpenAIRE

    Matheus Sacilotto de Moura

    2011-01-01

    Neste projeto trabalhou-se no desenvolvimento de uma nova instrumentação para registrar medidas de campos magnéticos de origem biológica baseados em sensores SQUID e sistemas auxiliares, com o objetivo de usar este arranjo na aquisição de medidas de magnetocardiografia fetal (MCGf), que consiste no registro dos campos magnéticos gerados pela atividade cardíaca fetal, refletindo seus processos eletrofisiológicos. Esta técnica biomagnética além de ser bastante precisa para obter medidas de camp...

  19. Three-dimensional fetal cephalometry.

    Science.gov (United States)

    Bettega, G; Chenin, M; Sadek, H; Cinquin, P; Lebeau, J; Coulomb, M; Raphaël, B

    1996-11-01

    Craniofacial growth has been the subject of numerous studies in which different techniques have been elaborated aiming to model this dynamic phenomenon in a rational manner. One of the methods employed is cephalometric analysis applied to the fetus. Generally, however, these studies are confined to the exploration of a single spatial plane (sagittal plane), whose orientation is never defined in a rigorous and perfectly reproducible manner. Thus, none of these analyses offers a formal growth model. This has led us to propose a new method of fetal cephalometric study taking into account criteria for proper reproducible analysis: spatial exploration of the head performed through three-dimensional tomodensitometric images and precise location of landmarks and reproducibility of the orientation of each image, which is assured by reference to the vestibular orientation (based on the external semicircular canals), as has been described by Girard and Perez and further developed by Fenart. When the labyrinth is developed, this orientation does not change during the growth stages of the head, even with craniofacial deformities. This permits application of this orientation on fetuses and the superposition of images of different subjects. The methodology is presented using two normal human fetuses, and the advantages of this computerized tool are discussed.

  20. Teratoma cervical fetal gigante: ruptura e hemorragia intraútero

    Directory of Open Access Journals (Sweden)

    Stephanie Caroline Barbosa Bologna

    2014-10-01

    Full Text Available Teratomas são tumores originários de células totipotentes e constituídos de tecidos derivados de mais de uma camada de células germinativas, e ocorrem de 1:20-40 mil nascidos vivos sendo que 3 % apenas ocorrem na região cervical. Comumente localizados na região sacrococcígea, ovários, testículos, mediastino anterior, mas são raros na região cervical. O diagnóstico pré-natal e feito pela ultrassonografia ou ressonância magnética quando da necessidade de intervenção cirúrgica ao nascimento. A intervenção extraútero durante o parto (EXIT, vem sendo utilizada em casos de tumorações cervicais gigantes para fetos com potencial de obstrução da via aérea ao nascimento, tentando a intubação oro-traqueal, fazendo também broncoscopia ou até a traqueostomia enquanto a oxigenação fetal é mantida pela circulação uteroplacentária. Além das dificuldades para se obter uma via aérea adequada na ocasião do parto, devido à grande dimensão do tumor, este pode sofrer ruptura intratumoral e hemorragia grave, podendo levar o feto à morte. O presente relato tem o objetivo de descrever o caso de um feto de 20 semanas com tumoração cervical gigante cuja imagem ultrassonográfica sugeria ser um Teratoma em toda região cervical anterior. Houve início do trabalho de parto chegando à dilatação do colo uterino de 8 cm com 27 semanas de gestação e durante o parto foi identificada grande ruptura tumoral intraútero com intensa hemorragia para a cavidade amniótica e óbito fetal.

  1. Characterization of fetal body movement recorded by the Hewlett-Packard M-1350-A fetal monitor.

    Science.gov (United States)

    Melendez, T D; Rayburn, W F; Smith, C V

    1992-09-01

    The purpose of this study was to evaluate the ability of a commercially available monitor, the Hewlett-Packard M-1350-A fetal monitor, to record and discriminate between various fetal body movements. Twenty-four patients between 29 and 42 weeks' gestation were monitored over a 20 to 30 minute period simultaneously by the Hewlett-Packard instrument and ultrasonography. All 593 single or clustered fetal movements recorded by the monitor were seen ultrasonographically as being extremity movements that were either isolated or combined with trunk motion. Discriminating between these two types of movements was not possible on the basis of the duration of recorded movements. All adequate fetal heart rate accelerations were attributed to combined trunk and extremity movements. Detection of fetal hiccups was less exact, and recording of fetal hand, mouth, breathing, and rapid eye movements was beyond the sensitivity of the monitor. Signal artifacts were attributable to either motion of the maternal abdomen or Doppler transducer and became less of a problem with experience. Fetal extremity movements were recorded with accuracy by this new fetal monitor.

  2. Intrapartum fetal monitoring by ST-analysis of the fetal ECG

    NARCIS (Netherlands)

    Westerhuis, M.E.M.H.

    2010-01-01

    Objective Intrapartum fetal monitoring aims to identify fetuses at risk for neonatal and long-term injury due to asphyxia. To serve this purpose, cardiotocography (CTG) combined with ST-analysis of the fetal electrocardiogram (ECG), which is a relatively new method, may be used. The main aim of this

  3. Fetal Alcohol Syndrome and Fetal Alcohol Effects-- Support for Teachers and Families.

    Science.gov (United States)

    Duckworth, Susanna V.; Norton, Terry L.

    2000-01-01

    Reviews genesis of fetal alcohol syndrome and fetal alcohol effects in children. Identifies physical characteristics and behavioral indicators found and provides three checklists of observable signs for both disorders. Recommends seven steps for educators to follow in seeking assistance with these conditions. (DLH)

  4. Preschool Teacher Attitude and Knowledge Regarding Fetal Alcohol Syndrome and Fetal Alcohol Effects.

    Science.gov (United States)

    Mack, Faite R-P.

    The Centers for Disease Control estimate that each year more than 8,000 Fetal Alcohol Syndrome (FAS) babies are born, and that many more babies go undiagnosed with Fetal Alcohol Effects (FAE), a less severe condition. FAS and FAE have been identified as major contributors to poor memory, shorter attention spans, lower IQs, diminished achievement…

  5. Long QT Syndrome–Associated Mutations in Intrauterine Fetal Death

    Science.gov (United States)

    Crotti, Lia; Tester, David J.; White, Wendy M.; Bartos, Daniel C.; Insolia, Roberto; Besana, Alessandra; Kunic, Jennifer D.; Will, Melissa L.; Velasco, Ellyn J.; Bair, Jennifer J.; Ghidoni, Alice; Cetin, Irene; Van Dyke, Daniel L.; Wick, Myra J.; Brost, Brian; Delisle, Brian P.; Facchinetti, Fabio; George, Alfred L.; Schwartz, Peter J.; Ackerman, Michael J.

    2013-01-01

    Importance Intrauterine fetal death or stillbirth occurs in approximately 1 out of every 160 pregnancies and accounts for 50% of all perinatal deaths. Postmortem evaluation fails to elucidate an underlying cause in many cases. Long QT syndrome (LQTS) may contribute to this problem. Objective To determine the spectrum and prevalence of mutations in the 3 most common LQTS susceptible genes (KCNQ1, KCNH2, and SCN5A) for a cohort of unexplained cases. Design, Setting, and Patients In this case series, retrospective postmortem genetic testing was conducted on a convenience sample of 91 unexplained intrauterine fetal deaths (mean [SD] estimated gestational age at fetal death, 26.3 [8.7] weeks) that were collected from 2006-2012 by the Mayo Clinic, Rochester, Minnesota, or the Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. More than 1300 ostensibly healthy individuals served as controls. In addition, publicly available exome databases were assessed for the general population frequency of identified genetic variants. Main Outcomes and Measures Comprehensive mutational analyses of KCNQ1 (KV7.1, LQTS type 1), KCNH2 (HERG/KV11.1, LQTS type 2), and SCN5A (NaV1.5, LQTS type 3) were performed using denaturing high-performance liquid chromatography and direct DNA sequencing on genomic DNA extracted from decedent tissue. Functional analyses of novel mutations were performed using heterologous expression and patch-clamp recording. Results The 3 putative LQTS susceptibility missense mutations (KCNQ1, p.A283T; KCNQ1, p.R397W; and KCNH2[1b], p.R25W), with a heterozygous frequency of less than 0.05% in more than 10000 publicly available exomes and absent in more than 1000 ethnically similar control patients, were discovered in 3 intrauterine fetal deaths (3.3% [95% CI, 0.68%-9.3%]). Both KV7.1-A283T (16-week male) and KV7.1-R397W (16-week female) mutations were associated with marked KV7.1 loss-of-function consistent with in utero LQTS type 1, whereas the HERG1b-R25W mutation

  6. Fetal primary hydrothorax with spontaneous resolution

    Directory of Open Access Journals (Sweden)

    Vera Trocado

    2017-07-01

    Full Text Available Fetal primary hydrothorax is a rare congenital anomaly with an estimated incidence of 1:10.000–15.000 pregnancies, with an unpredictable clinical course, ranging from spontaneous resolution to fetal death. We present a case of a unilateral fetal pleural effusion identified at 35th gestational week. A 37 year-old woman (G2P1 presented to our routine term pregnancy evaluation. The pregnancy had been otherwise uneventful. At ecographic evaluation a large anechogenic fluid collection was identified in the right fetal hemithorax, with atelectasis of right lung, displacing the heart and mediastinal structures to the contralateral hemithorax. Hydramnios was also identified. No other structural abnormalities were detected, as no signs of hydrops. Fetal biometry was compatible with gestational age. Fetal ecochardiogram was structurally and functionally normal. Doppler evaluation of the peak systolic velocity in the middle cerebral artery was normal. Screening for congenital infections was negative. Complete blood cell count, blood type and antibody screening rulled-out immune hydrops. Karyotype analysis was not performed as family decision. Serial ecographic re-evaluations showed a progressive volume decrease and at the 38th week there was total resolution of the effusion. A C-section was performed at the 39th week. A live female infant was born weighing 3205 g, with no need of ventilatory support. One year post-partum follow-up evaluation confirmed the child was healthy. Spontaneous regression has been reported to occur in 9–22% of primary fetal hydrothoraxes, but the features predicting a better prognosis remain difficult to define. Unilateral effusion, spontaneous resolution and absence of hydrops at the age of diagnosis seem to be indicators of better outcome.

  7. Lactate metabolism in the fetal rabbit lung

    Energy Technology Data Exchange (ETDEWEB)

    Engle, M.J.; Brown, D.J.; Dooley, M.

    1986-05-01

    Lactate is frequently overlooked as a potential substrate for the fetal lung, even though it is present in the fetal circulation in concentrations as high as 8 mM. These high concentrations, coupled with the relatively low levels of glucose in the fetal blood, may indicate that lactate can substitute for glucose in pulmonary energy generation and phospholipid synthesis. A series of experiments was therefore undertaken in order to investigate the role of lactate in perinatal pulmonary development. Explants from 30 day gestation fetal rabbit lungs were incubated in Krebs-Ringer bicarbonate buffer supplemented with 3 mM (U-/sup 14/C)-glucose and varying levels of lactate. In the absence of medium lactate, fetal rabbit lung explants were capable of producing lactate at a rate of approximately 200 etamoles/mg protein/hour. The addition of lactate to the bathing medium immediately reduced net lactate production and above 4 mM, fetal rabbit lung explants became net utilizers of lactate. Media lactate concentrations of 2.5 mM, 5 mM and 10 mM also decreased glucose incorporation into total tissue disaturated phosphatidylcholine by approximately 20%, 35%, and 45%, respectively. Glucose incorporation into surfactant phosphatidylcholine was also reduced by approximately 50%, when lactate was present in the incubation medium at a concentration of 5 mM. Additional experiments also revealed that fetal lung lactate dehydrogenase activity was almost twice that found in the adult rabbit lung. These data indicate that lactate may be an important carbon source for the developing lung and could be a significant component in the manufacture of surfactant phosphatidylcholine during late gestation.

  8. Genetic variations and normal fetal growth.

    Science.gov (United States)

    Dunger, D B; Petry, C J; Ong, K K

    2006-01-01

    Size at birth is said to be a highly heritable trait, with an estimated 30-70% of the variability a result of genetics. Data from family studies may be confounded, however, by potential interactions between fetal genes and the maternal uterine environment. Overall, the maternal environment tends to restrain fetal growth, and this is most evident in first pregnancies. Restraint of fetal growth appears to be inherited through the maternal line. Potential genetic candidates include the mitochondrial DNA 16189 variant, and common variants of exclusively maternally expressed genes, such as H19, which have been associated with size at birth. Maternal blood glucose levels and blood pressure are also correlated with size at birth, but the degree to which these changes relate to genetic variation in the mother is unclear. Elegant studies in mouse knockout models and rare genetic variants in humans have highlighted the importance of insulin-like growth factor I (IGF-I), IGF-II, insulin and their respective receptors in determining fetal growth. However, data linking common variation in the genes that regulate these proteins and receptors with size at birth are few and inconsistent. Interestingly, common variation in the insulin gene (INS) variable number tandem repeats, which regulates the transcription of insulin and IGF-II, has been associated with size at birth, largely in second and subsequent pregnancies, where maternal restraint is least evident. This suggests that fetal genes, and in particular paternally expressed genes, may have significant effects on fetal growth during pregnancies where maternal restraint of fetal growth is less evident. Copyright 2006 S. Karger AG, Basel.

  9. Relationship of unkeratinized skin to bovine fetal mummification: an hypothesis.

    Science.gov (United States)

    Hubbert, W T

    1974-04-01

    Evidence is reviewed in support of the hypothesis that immature unkeratinized fetal skin must be present if bovine fetal mummification is to occur. The reduction in fetal and amniotic fluid is considered to be the result of intrafetal (fetal death) or prefetal (caruncular damage) effects on the normal net fluid flow from the maternal circulation through the fetal circulation and then across the fetal skin into the amniotic cavity. As the skin is keratinized permeability is reduced drastically thus limiting fluid loss from the fetus.

  10. Intrauterine management of fetal supraventricular tachycardia (SVT) with cardiac failure.

    Science.gov (United States)

    Muniswaran, G; Japaraj, R P; Asri Ranga, A R; Cheong, H K

    2015-12-01

    Fetal arrhythmias are not uncommon in pregnancy. The diagnosis can be established on routine ultrasound scan. Fetal supraventricular tachycardia (SVT) is the most common cause of fetal tachycardia. If left undiagnosed and untreated, these fetuses may develop cardiac failure, hydrops fetalis and eventually death. We report two fetuses diagnosed antenatally to have fetal SVT. Both fetuses were in cardiac failure and were successfully treated with maternal administration of antiarrhythmic medications. Digoxin, and in severe instances, a combination with flecanaide significantly improved fetal outcomes and prevented fetal mortality. The long term prognosis of such patients are good.

  11. Avaliação da vitalidade fetal em gestações complicadas pela plaquetopenia materna moderada ou grave Assessment of fetal well-being in pregnancies complicated by maternal moderate to severe thrombocytopenia

    Directory of Open Access Journals (Sweden)

    Roseli Mieko Yamamoto Nomura

    2011-10-01

    Full Text Available OBJETIVO: Analisar os resultados da avaliação da vitalidade fetal em gestações complicadas por plaquetopenia materna moderada ou grave. MÉTODOS: No período de abril de 2001 a julho de 2011, foram analisados, retrospectivamente, os dados de prontuários de 96 gestantes com diagnóstico de plaquetopenia na gestação. Foram analisados os seguintes exames de avaliação da vitalidade fetal realizados no período anteparto: cardiotocografia, perfil biofísico fetal, índice de líquido amniótico e doplervelocimetria das artérias umbilicais. RESULTADOS: Foram analisadas 96 gestações com os seguintes diagnósticos: plaquetopenia gestacional (n=37, 38,5%, hiperesplenismo (n=32, 33,3%, púrpura trombocitopenica imune (PTI, n=14, 14,6%, plaquetopenia imune secundária (n=6, 6,3%, aplasia medular (n=3, 3,1% e outros (n=4, 4,1%. A cardiotocografia apresentou resultado normal em 94% dos casos, o perfil biofísico fetal com índice 8 ou 10 em 96,9% e o índice de líquido amniótico >5,0 cm em 89,6%. A doplervelocimetria da artéria umbilical apresentou resultado normal em 96,9%. Na análise dos principais grupos de plaquetopenia, constatou-se que o diagnóstico de oligohidrâmnio foi significativamente mais frequente no grupo com PTI (28,6% quando comparado aos demais (gestacional: 5,4% e hiperesplenismo: 9,4%, p=0,04. CONCLUSÕES: O presente estudo permitiu concluir que, nas gestações complicadas pela plaquetopenia materna moderada ou grave, apesar do bem-estar fetal manter-se preservado na grande maioria dos casos, em gestantes com PTI é importante o seguimento da vitalidade fetal com ênfase na avaliação do volume de líquido amniótico, devido à sua associação com a oligohidramnia.PURPOSE: To analyze the results of assessment of fetal well-being in pregnancies complicated by moderate or severe maternal thrombocytopenia. METHODS: Data from April 2001 to July 2011 of 96 women with a diagnosis of thrombocytopenia in pregnancy were

  12. Occupational lifting, fetal death and preterm birth

    DEFF Research Database (Denmark)

    Mocevic, Emina; Svendsen, Susanne Wulff; Jørgensen, Kristian Tore

    2014-01-01

    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...... the JEM. We used Cox regression models with gestational age as underlying time variable and adjustment for covariates. RESULTS: We observed 2,717 fetal deaths and 3,128 preterm births within the study cohort. No exposure-response relation was observed for fetal death, but for women with a prior fetal...... death, we found a hazard ratio (HR) of 2.87 (95% CI 1.37, 6.01) for stillbirth (fetal death ≥22 completed gestational weeks) among those who lifted >200 kg/day. For preterm birth, we found an exposure-response relation for primigravid women, reaching a HR of 1.43 (95% CI 1.13, 1.80) for total loads >200...

  13. Intrapartum fetal scalp lactate sampling for fetal assessment in the presence of a non-reassuring fetal heart rate trace.

    Science.gov (United States)

    East, Christine E; Leader, Leo R; Sheehan, Penelope; Henshall, Naomi E; Colditz, Paul B; Lau, Rosalind

    2015-05-01

    Fetal scalp blood sampling for lactate estimation may be considered following identification of an abnormal or non-reassuring fetal heart rate pattern. The smaller volume of blood required for this test, compared with the more traditional pH estimation, may improve sampling rates. The appropriate use of this practice mandates systematic review of its safety and clinical effectiveness prior to widespread introduction. To evaluate the effectiveness and risks of fetal scalp lactate sampling in the assessment of fetal well-being during labour, compared with no testing or alternative testing. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2015). All published and unpublished randomised and quasi-randomised trials that compared fetal scalp lactate testing with no testing or alternative testing to evaluate fetal status in the presence of a non-reassuring cardiotocograph during labour. We used the standard methodological procedures of the Cochrane Pregnancy and Childbirth Group. Two review authors independently assessed the studies. The search identified two completed randomised controlled trials (RCTs) and two ongoing trials. The two published RCTs considered outcomes for 3348 mother-baby pairs allocated to either lactate or pH estimation of fetal blood samples when clinically indicated in labour. Overall, the published RCTs were of low or unclear risk of bias. There was a high risk of performance bias, because it would not have been feasible to blind clinicians or participants.No statistically significant between-group differences were found for neonatal encephalopathy (risk ratio (RR) 1.00, 95% confidence interval (CI) 0.32 to 3.09, one study, 2992 infants) or death. No studies reported neonatal seizures. We had planned to report death with other morbidities, for example, neonatal encephalopathy; however, the data were not available in a format suitable for this, therefore death due to congenital abnormality was considered alone

  14. Correlações entre medidas ultra-sonográficas do coração e o déficit de hemoglobina em fetos de gestantes isoimunizadas

    OpenAIRE

    Marilia Zicker Hanan

    2007-01-01

    Introdução: a doença hemolítica perinatal (DHPN), secundária à sensibilização materna por antígenos eritrocitários, representa não só a causa principal, mas, sobretudo, causa evitável de anemia fetal e neonatal. Para o acompanhamento e tratamento adequados da DHPN, é necessário o diagnóstico preciso do grau de anemia fetal. A busca atual por métodos diagnósticos não invasivos de anemia fetal visa à redução dos riscos e do agravamento da sensibilização materna associados aos procedimentos i...

  15. The relationship between maternal and fetal vitamin D, insulin resistance, and fetal growth.

    LENUS (Irish Health Repository)

    Walsh, Jennifer M

    2013-05-01

    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.

  16. Fetal anaemia as a cause of fetal injury: diagnosis and management.

    Science.gov (United States)

    Chan, Lin Wai; Lau, Tze Kin; Chung, Tony Kwok Hung

    2006-04-01

    This review provides up-to-date information on the diagnosis and management of fetal anaemia. Exciting advances in the field of red blood cell isoimmunization are phasing out the need for invasive procedures. Rhesus blood group genotyping using fetal DNA in maternal plasma has been introduced into clinical practice with remarkable success. The role of middle cerebral artery peak systolic velocity in screening for fetal anaemia has been confirmed in various causes of fetal anaemia. A recent review of a successful Iran national screening programme for thalassaemia provided a timely and valuable educational opportunity. The value of intrauterine transfusion as a treatment for fetal anaemia was demonstrated by both high success rate and low procedure-related pregnancy loss rate. Fetal anaemia is one of the severe fetal conditions that affect the worldwide population. Rhesus isoimmunization remains an important health issue despite the recommendation for anti-D immunoglobulin prophylaxis and injection after sensitizing events. Noninvasive ultrasound diagnostic methods have replaced traditional invasive procedures in the assessment of fetus at risk of anaemia due to various causes, including red blood cell isoimmunization, parvovirus B19 infection and thalassaemia. The increased availability of intrauterine transfusion will help to improve the prognosis of these anaemic fetuses.

  17. Automatic real-time tracking of fetal mouth in fetoscopic video sequence for supporting fetal surgeries

    Science.gov (United States)

    Xu, Rong; Xie, Tianliang; Ohya, Jun; Zhang, Bo; Sato, Yoshinobu; Fujie, Masakatsu G.

    2013-03-01

    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.

  18. Fetal magnetic resonance imaging of thoracic and abdominal malformations; Fetale Magnetresonanztomographie thorakaler und abdomineller Malformationen

    Energy Technology Data Exchange (ETDEWEB)

    Woitek, R.; Asenbaum, U.; Furtner, J.; Prayer, D. [Medizinische Universitaet Wien, Abteilung fuer Neuroradiologie und Muskuloskelettale Radiologie, Universitaetsklinik fuer Radiodiagnostik, Wien (Austria); Brugger, P.C. [Medizinische Universitaet Wien, Zentrum fuer Anatomie und Zellbiologie, Wien (Austria)

    2013-02-15

    Diagnosis and differential diagnosis of fetal thoracic and abdominal malformations. Ultrasound and magnetic resonance imaging (MRI). In cases of suspected pathologies based on fetal ultrasound MRI can be used for more detailed examinations and can be of assistance in the differential diagnostic process. Improved imaging of anatomical structures and of the composition of different tissues by the use of different MRI sequences. Fetal MRI has become a part of clinical routine in thoracic and abdominal malformations and is the basis for scientific research in this field. In cases of thoracic or abdominal malformations fetal MRI provides important information additional to ultrasound to improve diagnostic accuracy, prognostic evaluation and surgical planning. (orig.) [German] Diagnose und Differenzialdiagnose fetaler thorakaler und abdomineller Malformationen. Ultraschall, MRT. MRT zur weiteren Abklaerung und genaueren Differenzierung bei vielen im Ultraschall gestellten Verdachtsdiagnosen. Verbesserte anatomische Darstellung mittels MRT und Darstellung unterschiedlicher Gewebezusammensetzung mittels verschiedener MR-Sequenzen. Die fetale MRT ist bei der angegebenen Fragestellung in die klinische Routine eingegangen und liefert weiterhin die Basis fuer wissenschaftliche Untersuchungen in diesem Bereich. Die fetale MRT liefert beim Vorliegen thorakaler oder abdomineller Malformationen komplementaer zum Ultraschall wichtige Zusatzinformationen, um die diagnostische Genauigkeit zu erhoehen, die Prognoseabschaetzung zu verbessern und ggf. eine bessere chirurgische Planung zu ermoeglichen. (orig.)

  19. Mechanisms of Fetal Programming in Hypertension

    Directory of Open Access Journals (Sweden)

    John Edward Jones

    2012-01-01

    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.

  20. An advanced method in fetal phonocardiography.

    Science.gov (United States)

    Várady, Péter; Wildt, Ludwig; Benyó, Zoltán; Hein, Achim

    2003-07-01

    The long-term variability of the fetal heart rate (FHR) provides valuable information on the fetal health status. The routine clinical FHR measurements are usually carried out by the means of ultrasound cardiography. Although the frequent FHR monitoring is recommendable, the high quality ultrasound devices are so expensive that they are not available for home care use. The passive and fully non-invasive acoustic recording called phonocardiography, provides an alternative low-cost measurement method. Unfortunately, the acoustic signal recorded on the maternal abdominal surface is heavily loaded by noise, thus the determination of the FHR raises serious signal processing issues. The development of an accurate and robust fetal phonocardiograph has been since long researched. This paper presents a novel two-channel phonocardiographic device and an advanced signal processing method for determination of the FHR. The developed system provided 83% accuracy compared to the simultaneously recorded reference ultrasound measurements.

  1. Glucocorticoids and fetal programming part 1: Outcomes.

    Science.gov (United States)

    Moisiadis, Vasilis G; Matthews, Stephen G

    2014-07-01

    Fetal development is a critical period for shaping the lifelong health of an individual. However, the fetus is susceptible to internal and external stimuli that can lead to adverse long-term health consequences. Glucocorticoids are an important developmental switch, driving changes in gene regulation that are necessary for normal growth and maturation. The fetal hypothalamic-pituitary-adrenal (HPA) axis is particularly susceptible to long-term programming by glucocorticoids; these effects can persist throughout the life of an organism. Dysfunction of the HPA axis as a result of fetal programming has been associated with impaired brain growth, altered behaviour and increased susceptibility to chronic disease (such as metabolic and cardiovascular disease). Moreover, the effects of glucocorticoid-mediated programming are evident in subsequent generations, and transmission of these changes can occur through both maternal and paternal lineages.

  2. Fetal programming and eating disorder risk.

    Science.gov (United States)

    Jones, Candace; Pearce, Brad; Barrera, Ingrid; Mummert, Amanda

    2017-09-07

    Fetal programming describes the process by which environmental stimuli impact fetal development to influence disease development later in life. Our analysis summarizes evidence for the role of fetal programming in eating disorder etiology through review of studies demonstrating specific obstetric complications and later eating risk of anorexia or bulimia. Using Pubmed, we found thirteen studies investigating obstetric factors and eating disorder risk published between 1999 and 2016. We then discuss modifiable maternal risk factors, including nutrition and stress, that influence anorexia or bulimia risk of their offspring. Translation of these findings applies to preventative strategies by health organizations and physicians to provide optimal health for mothers and their children to prevent development of medical and psychiatric illnesses. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Updates in fetal spina bifida repair.

    Science.gov (United States)

    Blumenfeld, Yair J; Belfort, Michael A

    2018-04-01

    To examine updates in fetal spina bifida surgical repair, as well as promising results emerging from translational medicine. Although the Management of Myelomeningocele Study sponsored by the National Institutes of Health helped establish the neonatal benefits of prenatal spina bifida repair via uterine hysterotomy, also known as 'open' fetal surgery, fetoscopic approaches may yield better maternal and obstetric outcomes. Spina bifida is a severe congenital malformation associated with significant neonatal and childhood morbidity and mortality. Although 'open' fetal spina bifida repair has become the standard prenatal surgical approach due to proven neonatal benefit, this approach is associated with significant maternal and obstetric risks. Recent developments from multidisciplinary clinical and translational research have highlighted the potential for novel fetoscopic surgical approaches to decrease maternal morbidity and reduce obstetric risks. Moreover, novel stem cell therapies coupled with in-utero medical approaches targeting the pathophysiological pathways associated with spina bifida are likely to make additional significant impact.

  4. Case Studies in Electronic Fetal Heart Rate Monitoring

    OpenAIRE

    Yee, J.; Parboosingh, I.J.

    1986-01-01

    Subtle changes in the characteristics of the fetal heart rate are currently used to assess the condition of the fetus in late pregnancy and during labour. The authors present three case studies of fetal heart rate monitoring.

  5. Andreas Vesalius (1514-1564), Padua, and the fetal "shunts".

    Science.gov (United States)

    Dunn, P M

    2003-03-01

    Three remarkable medical anatomists working in Padua during the 16th century described the anatomy of the fetal cardiovascular system, thus laying the foundation for William Harvey's discovery and description of the fetal circulation in the following century.

  6. Magnetic resonance imaging of the fetal brain.

    Science.gov (United States)

    Tee, L Mf; Kan, E Yl; Cheung, J Cy; Leung, W C

    2016-06-01

    This review covers the recent literature on fetal brain magnetic resonance imaging, with emphasis on techniques, advances, common indications, and safety. We conducted a search of MEDLINE for articles published after 2010. The search terms used were "(fetal OR foetal OR fetus OR foetus) AND (MR OR MRI OR [magnetic resonance]) AND (brain OR cerebral)". Consensus statements from major authorities were also included. As a result, 44 relevant articles were included and formed the basis of this review. One major challenge is fetal motion that is largely overcome by ultra-fast sequences. Currently, single-shot fast spin-echo T2-weighted imaging remains the mainstay for motion resistance and anatomical delineation. Recently, a snap-shot inversion recovery sequence has enabled robust T1-weighted images to be obtained, which is previously a challenge for standard gradient-echo acquisitions. Fetal diffusion-weighted imaging, diffusion tensor imaging, and magnetic resonance spectroscopy are also being developed. With multiplanar capabilities, superior contrast resolution and field of view, magnetic resonance imaging does not have the limitations of sonography, and can provide additional important information. Common indications include ventriculomegaly, callosum and posterior fossa abnormalities, and twin complications. There are safety concerns about magnetic resonance-induced heating and acoustic damage but current literature showed no conclusive evidence of deleterious fetal effects. The American College of Radiology guideline states that pregnant patients can be accepted to undergo magnetic resonance imaging at any stage of pregnancy if risk-benefit ratio to patients warrants that the study be performed. Magnetic resonance imaging of the fetal brain is a safe and powerful adjunct to sonography in prenatal diagnosis. It can provide additional information that aids clinical management, prognostication, and counselling.

  7. Role of fetal surgery in spinal dysraphism

    Directory of Open Access Journals (Sweden)

    A Martina Messing-Jünger

    2013-01-01

    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.

  8. Fetal movements: What are we telling women?

    Science.gov (United States)

    Warland, Jane; Glover, Pauline

    2017-02-01

    Information that women receive about the importance of monitoring fetal movements and what to do if there are changes is inconsistent and may not be evidence based. This paper reports a summary of the kind of messages a group of South Australian midwives (n=72) currently give pregnant women. Comment data from two questions in a larger survey asking (1) what information midwives routinely provide to women about fetal movements and (2) their practice regarding advice they give to women reporting reduced fetal movements. Data were analysed using summative content analysis. Four main recurring words and phrases were identified. With respect to information midwives give all women about monitoring fetal movements, recurring words were "10", "normal", "kick charts" and "when to contact" their care-provider. Recurrent words and phrases arising from answers to the second question about advice midwives give to women reporting reduced fetal movement were "ask questions," "suggest fluids," "monitor at home and call back" or "come in for assessment". These findings suggest that a group of South Australian midwives are providing pregnant women with inconsistent information, often in conflict with best practice evidence. As giving correct, evidence based information about what to do in the event of an episode of reduced fetal movement may be a matter of life or death for the unborn baby it is important that midwives use existing guidelines in order to deliver consistent information which is based on current evidence to women in their care. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  9. Human Fetal Brain Connectome: Structural Network Development from Middle Fetal Stage to Birth.

    Science.gov (United States)

    Song, Limei; Mishra, Virendra; Ouyang, Minhui; Peng, Qinmu; Slinger, Michelle; Liu, Shuwei; Huang, Hao

    2017-01-01

    Complicated molecular and cellular processes take place in a spatiotemporally heterogeneous and precisely regulated pattern in the human fetal brain, yielding not only dramatic morphological and microstructural changes, but also macroscale connectomic transitions. As the underlying substrate of the fetal brain structural network, both dynamic neuronal migration pathways and rapid developing fetal white matter (WM) fibers could fundamentally reshape early fetal brain connectome. Quantifying structural connectome development can not only shed light on the brain reconfiguration in this critical yet rarely studied developmental period, but also reveal alterations of the connectome under neuropathological conditions. However, transition of the structural connectome from the mid-fetal stage to birth is not yet known. The contribution of different types of neural fibers to the structural network in the mid-fetal brain is not known, either. In this study, diffusion tensor magnetic resonance imaging (DT-MRI or DTI) of 10 fetal brain specimens at the age of 20 postmenstrual weeks (PMW), 12 in vivo brains at 35 PMW, and 12 in vivo brains at term (40 PMW) were acquired. The structural connectome of each brain was established with evenly parcellated cortical regions as network nodes and traced fiber pathways based on DTI tractography as network edges. Two groups of fibers were categorized based on the fiber terminal locations in the cerebral wall in the 20 PMW fetal brains. We found that fetal brain networks become stronger and more efficient during 20-40 PMW. Furthermore, network strength and global efficiency increase more rapidly during 20-35 PMW than during 35-40 PMW. Visualization of the whole brain fiber distribution by the lengths suggested that the network reconfiguration in this developmental period could be associated with a significant increase of major long association WM fibers. In addition, non-WM neural fibers could be a major contributor to the structural

  10. Fetal fat measurement by magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Deans, H.E.; Smith, F.W.; Law, A.N. (Royal Infirmary, Aberdeen (UK)); Lloyd, D.J.; Sutherland, H.W. (Aberdeen Maternity Hospital (UK))

    1989-07-01

    A method to assess the average percentage of fetal fat with respect to other fetal tissue is described. This method was then used to assess the percentage of fat in 13 normal fetuses who had a magnetic resonance imaging (MRI) examination late in pregnancy (38-41 weeks). The scans of a further 13 fetuses of diabetic mothers and one case of intrauterine growth retardation (IUGR), all of whom had MRI examinations in the last 3 years, were reviewed and similar calculations were carried out. Whilst the percentage fat range in the normal group was large, it was still possible to discern a difference between the normal, diabetic and IUGR cases. (author).

  11. Fetal tachyarrhythmia associated with vibroacoustic stimulation.

    Science.gov (United States)

    Laventhal, Naomi T; Dildy, Gary A; Belfort, Michael A

    2003-05-01

    Vibroacoustic stimulation is commonly used in antepartum fetal testing and has known benefits. Although the procedure has been deemed safe, questions have been raised as to potentially adverse effects, and the adult cardiology literature identifies a link between abrupt sound stimulation and severe tachyarrhythmias. A fetus with premature atrial contractions converted to supraventricular tachycardia immediately after vibroacoustic stimulation. The tachyarrhythmia spontaneously reverted to baseline after 4 minutes. The infant was treated for junctional reentry tachycardia at birth. Although the cardiac effects of vibroacoustic stimulation have previously been characterized as benign, the use of this modality may warrant restriction in the setting of known fetal arrhythmias.

  12. Fetal MRI of the urinary system

    Energy Technology Data Exchange (ETDEWEB)

    Hoermann, Marcus [Department of Radiodiagnostics, Medical University of Vienna, Waehringerguertel 18-20, A-1090 Vienna (Austria)]. E-mail: marcus.hoermann@meduniwien.ac.at; Brugger, Peter C. [Center of Anatomy and Cell Biology, Medical University of Vienna (Austria); Balassy, Csilla [Department of Radiodiagnostics, Medical University of Vienna, Waehringerguertel 18-20, A-1090 Vienna (Austria); Witzani, Linde [Department of Radiodiagnostics, Medical University of Vienna, Waehringerguertel 18-20, A-1090 Vienna (Austria); Prayer, Daniela [Department of Radiodiagnostics, Medical University of Vienna, Waehringerguertel 18-20, A-1090 Vienna (Austria)

    2006-02-15

    The assessment of the urinary system is typically performed by ultrasound. Nevertheless, an ultrasound may be inconclusive in fetuses with renal diseases that result in anhydramnios or oligohydramnios. In such cases, and in other cases in which ultrasound is limited, further investigation with MR should be considered. In the following article, we will provide an overview of the most commonly encountered disorders of the urinary system and their appearance on fetal MR imaging. Fetal MR imaging can accurately diagnose a wide variety of urinary tract disorders and must be seen as a valuable complementary tool to ultrasound in the assessment of the urinary system, particularly in cases of inconclusive ultrasound findings.

  13. Fluoxetine during pregnancy: impact on fetal development.

    Science.gov (United States)

    Morrison, Janna L; Riggs, K Wayne; Rurak, Dan W

    2005-01-01

    Women are at greatest risk of suffering from depression during the childbearing years and thus may either become pregnant while taking an antidepressant or may require a prescription for one during pregnancy. The antidepressant fluoxetine (FX) is a selective serotonin reuptake inhibitor (SSRI), which increases serotonin neurotransmission. Serotonin is involved in the regulation of a variety of physiological systems, including the sleep-wake cycle, circadian rhythms and the hypothalamic-pituitary-adrenal axis. Each of these systems also plays an important role in fetal development. Compared with other antidepressant drugs, the SSRIs, such as FX, have fewer side effects. Because of this, they are now frequently prescribed, especially during pregnancy. Clinical studies suggest poor neonatal outcome after exposure to FX in utero. Recent studies in the sheep fetus describe the physiological effects of in utero exposure to FX with an 8 day infusion during late gestation in the sheep. This is a useful model for determining the effects of FX on fetal physiology. The fetus can be studied for weeks in its normal intrauterine environment with serial sampling of blood, thus permitting detailed studies of drug disposition in both mother and fetus combined with monitoring of fetal behavioural state and cardiovascular function. Fluoxetine causes an acute increase in plasma serotonin levels, leading to a transient reduction in uterine blood flow. This, in turn, reduces the delivery of oxygen and nutrients to the fetus, thereby presenting a mechanism for reducing growth and/or eliciting preterm delivery. Moreover, because FX crosses the placenta, the fetus is exposed directly to FX, as well as to the effects of the drug on the mother. Fluoxetine increases high-voltage/non-rapid eye movement behavioural state in the fetus after both acute and chronic exposure and, thus, may interfere with normal fetal neurodevelopment. Fluoxetine also alters hypothalamic function in the adult and

  14. [A Danish fetal alcohol spectrum disorders definition].

    Science.gov (United States)

    Broccia, Marcella; Vikre-Jørgensen, Jennifer; Rausgaard, Nete Lundager Klokker

    2017-08-07

    The Danish Paediatric Society presents the first Danish definition of fetal alcohol spectrum disorders (FASD) in a new guideline. FASD is an umbrella term for conditions caused by prenatal alcohol exposure. To varying degrees, fetal alcohol damages manifest as physical defects, characteristic facial features and poor growth, as well as behavioural and cognitive disorders. It requires both somatic and psychological evaluation to identify these damages. Early diagnosis and identification of problems are important for prognosis as professional care has a positive preventive effect on comorbidities.

  15. Tumours of the fetal body: a review

    Energy Technology Data Exchange (ETDEWEB)

    Avni, Fred E.; Massez, Anne; Cassart, Marie [University Clinics of Brussels - Erasme Hospital, Department of Medical Imaging, Brussels (Belgium)

    2009-11-15

    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.)

  16. Pontomedullary disconnection: fetal and neonatal considerations

    Energy Technology Data Exchange (ETDEWEB)

    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)

    2005-08-01

    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.)

  17. Fetal encephalopathy after maternal anaphylaxis. Case report.

    Science.gov (United States)

    Luciano, R; Zuppa, A A; Maragliano, G; Gallini, F; Tortorolo, G

    1997-01-01

    Fetal hypoxic-ischemic encephalopathy can be diagnosed at birth by means of cerebral ultrasound scanning. The morphological appearance of the lesions depends on the time elapsed between the insult and examination of the brain. We report a case of a neonate affected by multicystic encephalomalacia and corpus callosum atrophy attributable to an episode of maternal anaphylactic shock which occurred at 27 weeks of gestation following intravenous iron injection. The diagnosis was made by means of a cerebral ultrasound scan performed at birth and confirmed by magnetic resonance. This case demonstrates that maternal severe acute hypotension during pregnancy can cause fetal cerebral damage similar to the hypoxicischemic injuries occurring in the perinatal period.

  18. New treatment of early fetal chylothorax

    DEFF Research Database (Denmark)

    Nygaard, Ulrikka; Sundberg, Karin; Nielsen, Henriette Svarre

    2007-01-01

    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...... 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....

  19. Association between maternal-fetal genetic histocompatibility and maternal undernutrition in mice: influence on intrauterine growth Associação entre histocompatibilidade genética materno-fetal e desnutrição materna em camundongos: influência no crescimento fetal

    Directory of Open Access Journals (Sweden)

    Celso M. Rebello

    2006-04-01

    Full Text Available OBJECTIVE: The purpose of this study was to evaluate the effects of maternal-fetal genetic histocompatibility and the association of that condition with maternal undernutrition regarding fetal growth and litter size. STUDY DESIGN: Fetuses that were either syngeneic or allogeneic with the mothers were bred, using mice of well-defined syngeneic strains (A/J and Balb/c. Pregnant mice were fed using either unrestricted normal diet with 22% protein, consumed ad libitum, or a diet containing 14% protein, with intake restricted to 70% of that consumed by the unrestricted group. At the end of gestation, the number of fetoplacental units and fetal losses, the fetal and placental weight, and the weights of fetal brain and liver were recorded. RESULTS: Fetuses from undernourished mothers showed a reduction in body, placental, and brain weight (P OBJETIVO: Avaliar os efeitos da histocompatibilidade genética materno-fetal e sua associação com a desnutrição materna em relação ao crescimento fetal e número de fetos. MÉTODOS: Fetos singênicos ou alogênicos em relação às respectivas mães foram obtidos através de cruzamentos de camundongos com linhagens genéticas bem definidas (A/J e Balb/c. As fêmeas grávidas foram alimentadas ad libitum com dieta normal contendo 22% de proteínas ou dieta com restrição, contendo 14% de proteína e aporte máximo de 70% do total consumido pelo grupo em dieta livre. No final da gestação, o número de unidades feto-placentárias e de perdas fetais, o peso da placenta e do feto, assim como o peso do cérebro e do fígado foram anotados. RESULTADOS: Os fetos das mães submetidas à desnutrição mostraram redução no peso corpóreo, placentário e cerebral (p<0.01, sendo que a associação entre a compatibilidade genética materno-fetal resultou em maior restrição ao crescimento fetal (p<0.01. Foi observada uma redução no número de fetos viáveis por fêmea entre os animais do grupo de restri

  20. Impact of preoperative levels of hemoglobin and albumin on the survival of pancreatic carcinoma Impacto de los niveles preoperatorios de hemoglobina y albúmina en la supervivencia del carcinoma de páncreas

    Directory of Open Access Journals (Sweden)

    J. Ruiz-Tovar

    2010-11-01

    áncreas entre 1999 y 2003, para identificar posibles factores pronósticos. Resultados: De los 59 pacientes, 32 eran varones y 27 mujeres, con una edad media de 63,8 años. Todos los pacientes fueron operados, realizándose cirugía paliativa en el 32% y resección tumoral en el 68%, incluyendo duodenopancreatectomías cefálicas en el 51% y pancreatectomías distales en el 17%. La mediana de supervivencia global fue de 14 meses (intervalo 1-110. Observamos que los niveles preoperatorios de hemoglobina inferiores a 12 g/dl (p = 0,0006 y de albúmina sérica por debajo de 2,8 g/dl (p = 0,021 se asocian a menor supervivencia global. Conclusión: Los niveles preoperatorios de hemoglobina y albúmina pueden ser indicadores pronósticos en el cáncer de páncreas.

  1. Fetal macrosomia: Obstetric outcome of 311 cases in UNTH, Enugu ...

    African Journals Online (AJOL)

    Background: In modern obstetrics, fetal macrosomia is a major contributor to obstetric morbidity. It is an important cause of perinatal morbidity and mortality. Aim: This study aims to determine the maternal characteristics, fetal and neonatal complications associated with fetal macrosomia, and its contribution to obstetric ...

  2. Fetal Ascites and Second Trimester Maternal Hepatitis C Virus Infection

    Directory of Open Access Journals (Sweden)

    Pei-Ying Ling

    2006-09-01

    Conclusion: Second trimester perinatal HCV infection with possible CMV coinfection associated with fetal ascites is a rare event. Fetal therapy resulting in a successful outcome has not been reported. Prompt fetal therapy with paracentesis in this case led to the delivery of a healthy term liveborn baby with anti-HCV seropositivity.

  3. 21 CFR 884.2600 - Fetal cardiac monitor.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Fetal cardiac monitor. 884.2600 Section 884.2600 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... § 884.2600 Fetal cardiac monitor. (a) Identification. A fetal cardiac monitor is a device used to...

  4. Extraction of fetal electrocardiogram (ECG) by extended state ...

    Indian Academy of Sciences (India)

    Fetal heart rate (FHR) monitoring is a routine work for obtaining significant information about the fetal condition during pregnancy and labor. During pregnancy, the motivation for monitoring the fetal is to recognize pathological conditions, typically asphyxia with sufficient warning to enable intervention by the clinician.

  5. Fetal gender determination through Y-STR analysis of maternal ...

    African Journals Online (AJOL)

    Fetal gender determination through Y-STR analysis of maternal plasma during the third trimester of pregnancy. ... fetal gender determination during the third trimester of pregnancy, in addition to its significance in forensic casework. Keywords: Fetal gender; Maternal plasma; Y-STR analysis; Pregnancy; Forensic casework ...

  6. Fetal Alcohol Syndrome: A Guide for Families and Communities.

    Science.gov (United States)

    Streissguth, Ann

    The 14 chapters of this book review the research and offer guidelines for intervention with infants and children having fetal alcohol syndrome or fetal alcohol effects (FAS/FAE). Chapters are grouped into five sections on the diseases of fetal alcohol, the science of FAS, a life-span approach to FAS, preparing people with FAS for life in the…

  7. 21 CFR 884.2620 - Fetal electroencephalographic monitor.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Fetal electroencephalographic monitor. 884.2620... Devices § 884.2620 Fetal electroencephalographic monitor. (a) Identification. A fetal electroencephalographic monitor is a device used to detect, measure, and record in graphic form (by means of one or more...

  8. Perspectives of fetal dystocia in cattle and buffalo

    Directory of Open Access Journals (Sweden)

    Govind Narayan Purohit

    2012-04-01

    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.

  9. Oxidative Stress in Fetal Distress: Potential Prospects for Diagnosis

    Directory of Open Access Journals (Sweden)

    Saša Raicevic

    2010-01-01

    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.

  10. Longitudinal study of computerized cardiotocography in early fetal growth restriction

    NARCIS (Netherlands)

    Wolf, H.; Arabin, B.; Lees, Christoph C.; Oepkes, D.; Prefumo, Federico; Thilaganathan, B.; Todros, T.; Visser, G.H.A.; Bilardo, Caterina M.; Derks, J. B.|info:eu-repo/dai/nl/148835163; Diemert, A.; Duvekot, Johannes J.; Ferrazzi, E.; Frusca, T.; Hecher, K.; Marlow, N.; Martinelli, P.; Ostermayer, E.; Papageorghiou, Aris T.; Scheepers, Hubertina C. J.; Schlembach, D.; Schneider, K. T M; Valcamonico, A.; van Wassenaer-Leemhuis, A.; Ganzevoort, W.; Aktas, Ayse; Borgione, Silvia; Brezinka, Christoph; Calvert, Sandra; Chaoui, Rabih; Cornette, Jerome M J; Diehl, Thilo; van Eyck, Jim; Fratelli, Nicola; van Haastert, Inge Lot; Johnson, Samantha; Lobmaier, Silvia; Lopriore, Enrico; Mansi, Giuseppina; Missfelder-Lobos, Hannah; Martelli, Paola; Maso, Gianpaolo; Maurer-Fellbaum, Ute; Van Charante, Nico Mensing; De Tollenaer, Susanne Mulder; Moore, Tamanna; Napolitano, Raffaele; Oberto, Manuela; Ogge, Giovanna; van der Post, Joris Am; Preston, Lucy; Raimondi, Francesco; Reiss, Irwin K M; Rigano, Serena; Schuit, Ewoud|info:eu-repo/dai/nl/341652385; Skabar, Aldo; Spaanderman, Marc E.; Weisglas-Kuperus, Nynke; Zimmermann, Andrea

    2017-01-01

    Objectives: To explore whether, in early fetal growth restriction (FGR), the longitudinal pattern of fetal heart rate (FHR) short-term variation (STV) can be used to identify imminent fetal distress and whether abnormalities of FHR recordings are associated with 2-year infant outcome. Methods: The

  11. Longitudinal study of computerized cardiotocography in early fetal growth restriction

    NARCIS (Netherlands)

    Wolf, H.; Arabin, B.; Lees, C. C.; Oepkes, D.; Prefumo, F.; Thilaganathan, B.; Todros, T.; Visser, G. H. A.; Bilardo, C. M.; Derks, J. B.; Diemert, A.; Duvekot, J. J.; Ferrazzi, E.; Frusca, T.; Hecher, K.; Marlow, N.; Martinelli, P.; Ostermayer, E.; Papageorghiou, A. T.; Scheepers, H. C. J.; Schlembach, D.; Schneider, K. T. M.; Valcamonico, A.; Van Wassenaer-Leemhuis, A.; Ganzevoort, W.

    Objectives: To explore whether, in early fetal growth restriction (FGR), the longitudinal pattern of fetal heart rate (FHR) short-term variation (STV) can be used to identify imminent fetal distress and whether abnormalities of FHR recordings are associated with 2-year infant outcome. Methods: The

  12. Prenatal diagnosis of a placental infarction hematoma associated with fetal growth restriction, preeclampsia and fetal death: clinicopathological correlation.

    Science.gov (United States)

    Aurioles-Garibay, Alma; Hernandez-Andrade, Edgar; Romero, Roberto; Qureshi, Faisal; Ahn, Hyunyoung; Jacques, Suzanne M; Garcia, Maynor; Yeo, Lami; Hassan, Sonia S

    2014-01-01

    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.

  13. The controversy about controls for fetal blood group genotyping by cell-free fetal DNA in maternal plasma

    NARCIS (Netherlands)

    Scheffer, Peter G.; de Haas, Masja; van der Schoot, C. Ellen

    2011-01-01

    Fetal blood group genotyping using cell-free fetal DNA from maternal plasma is routinely performed in alloimmunized women and has been introduced for targeted antenatal anti-D prophylaxis. The necessity to control for extraction of fetal DNA in these tests is questioned by many. This review

  14. [Obstetric management of fetal growth retardation].

    Science.gov (United States)

    Zollner, U; Rehn, M; Girschick, G; Dietl, J

    2011-04-01

    Intrauterine growth restriction (IGUR) can have different etiologies, but placental insufficiency is the clinically most relevant. Fetuses with IUGR have a significantly higher morbidity and mortality than normally grown fetuses of the same gestational age. It is important to distinguish a growth restricted fetus from a normal, small fetus and from a fetus being small because of a disease, e.g., an aneuploidy. This differentiation requires the knowledge of the gestational age and the use of multiple imaging modalities. Serial assessments of fetal growth by ultrasound are necessary to recognize declining growth. Doppler sonography can detect changes in the uteroplacentar and the fetal perfusion. Blood vessels of clinical relevance are the uterine arteries, the umbilical artery, the middle cerebral artery and the ductus venosus. When no fetal anomalies can be detected, fetal growth is parallel to the percentiles and Doppler sonography measurements are normal, IUGR is unlikely. In most IUGR fetuses, a typical sequence of circulatory changes and ultrasound findings can be observed. As there is no evidence-based treatment option for IUGR until now, obstetric management consists in defining the optimal time of delivery. This means weighing the risks of prematurity against the risks of a potentially hostile intrauterine environment. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Management of Fetal and Neonatal Graves' Disease.

    Science.gov (United States)

    Léger, Juliane

    2017-01-01

    Fetal and neonatal autoimmune hyperthyroidism is a rare, serious but transient disorder. Early diagnosis and treatment are key objectives for an optimal prognosis and the well-being of the child. This review focuses on the management of these patients during the fetal and neonatal periods. We propose a diagnostic algorithm for high-risk pregnancies in mothers with current or past hyperthyroidism related to Graves' disease, involving repeated fetal thyroid gland assessments from 20 weeks of gestation onwards and maternal serum thyroid-stimulating hormone receptor antibody (TRAb) determination, with close monitoring if TRAb levels exceed 2 to 3 times the upper limit of the normal range. In fetuses with goiter, the main clinical issue is determining whether the cause is (1) maternal antithyroid drug (ATD) treatment that is appropriate for achieving normal maternal thyroid function but inappropriate and excessive for the fetus, resulting in hypothyroidism and necessitating a decrease in the ATD dose during pregnancy, or (2) the presence of TRAbs resulting in fetal thyroid stimulation and hyperthyroidism, requiring an increase in the maternal ATD dose. Methimazole/carbimazole treatment should be initiated as soon as possible during the neonatal period, carefully managed and maintained over a period of 1-3 months and then stopped when TRAb is no longer detectable in serum. © 2016 S. Karger AG, Basel.

  16. CORD PROLAPSE, ASSOCIATED FACTORS AND FETAL OUTCOME

    African Journals Online (AJOL)

    there were a total of 6924 deliveries amongst which 47 were complicated by umbilical cord prolapse (2.8 per 1000 deliveries). Among the women with cord ... Artificial rupture of membranes was carried out in 40.4%. This study shows ... no fetal heart tones and only 31.8% of the babies were alive after five minutes. Several ...

  17. Macrosomia - maternal and fetal risk factors

    African Journals Online (AJOL)

    of the high perinatal mortality and morbidity rates, as well as maternal morbidity, are discussed. S Afr Med J 1995; 85: 43-46. Little attention has been paid to fetal macrosomia in black. African populations, despite the fact that as a high-risk factor in pregnancy and delivery macrosomia probably deserves as much attention as ...

  18. Octreotide therapy and restricted fetal growth

    DEFF Research Database (Denmark)

    Geilswijk, Marianne; Andersen, Lise Lotte Torvin; Frost, Morten

    2017-01-01

    . During the second pregnancy with a viable fetus, blood glucose levels were managed through dietary intervention alone. Thus, the patient was advised to take small but frequent meals high in fiber and low in carbohydrates. Throughout pregnancy, no incidences of severe hypoglycemia occurred and fetal...

  19. Fetal goiter and bilateral ovarian cysts

    DEFF Research Database (Denmark)

    Lassen, Pernille; Sundberg, Karin; Juul, Anders

    2008-01-01

    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...

  20. National Organization on Fetal Alcohol Syndrome

    Science.gov (United States)

    ... on Fetal Alcohol Syndrome - (800) 66-NOFAS Twitter Facebook Instagram LinkedIn YouTube RSS Prenatal Alcohol Exposure. No safe ... and adults. DONATE Powered by RJD Solutions Twitter Facebook Instagram LinkedIn YouTube RSS Back to Top

  1. Fetal Alcohol Syndrome: Research Review and Implications.

    Science.gov (United States)

    Griesbach, Linda Sue; Polloway, Edward A.

    Research on fetal alcohol syndrome is reviewed, with particular emphasis on the implications of the syndrome for the development of mental retardation and other handicapping conditions. Attention is given to historical aspects; epidemiology; physiological and behavioral characteristics; and concerns related to diagnosis, prevention, and…

  2. Fetal Alcohol Syndrome: A Behavioral Teratology.

    Science.gov (United States)

    Kavale, Kenneth A.; Karge, Belinda D.

    1986-01-01

    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)

  3. Full and Incomplete Fetal Alcohol Syndrome

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2004-11-01

    Full Text Available The clinical features and hospitalization rates of children with full or incomplete fetal alcohol syndrome (FAS were compared in retrospective case-controlled studies of affected Northern Plains American Indian children attending Aberdeen Area Indian Health Service hospitals, South Dakota.

  4. Fetal Alcohol Syndrome: Implications for Educators.

    Science.gov (United States)

    Ackerman, Margaret E.

    This paper provides a discussion of definitions, historical precursors, and prevalence figures for children with fetal alcohol syndrome (FAS) and highlights relevant medical and behavioral characteristics. It also addresses the educational implications of working with children with FAS in terms of instruction and curriculum. Educators are urged…

  5. Fetal Alcohol Syndrome: Implications and Counseling Considerations.

    Science.gov (United States)

    Elliott, David J.; Johnson, Norbert

    1983-01-01

    Presents special considerations in counseling fetal alcohol syndrome children and their mothers. Preventive counseling must begin before conception. Adequate education, counseling, testing, treatment, and followup of patients and their families is essential to reduce or eliminate problems associated with maternal alcohol abuse. (JAC)

  6. Fetal Alcohol Syndrome (FAS)--A Review.

    Science.gov (United States)

    Holzman, Ian R.

    1982-01-01

    At least 30 percent of newborn children of alcoholic mothers are affected severely by the fetal alcohol syndrome and 40-45 percent show some stigmata. Risks to offspring of mothers who drink occasionally or binge drink are not clear, but the danger is probably greatest in the first trimester of pregnancy. (CMG)

  7. Neuroimaging and Fetal Alcohol Spectrum Disorders

    Science.gov (United States)

    Norman, Andria L.; Crocker, Nicole; Mattson, Sarah N.; Riley, Edward P.

    2009-01-01

    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…

  8. Abnormal fetal head shape: aetiology and management

    DEFF Research Database (Denmark)

    Petersen, Olav Bjørn; David, Anna; Thomasson, Louise

    2007-01-01

    (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...

  9. Indicators of fetal and infant health outcomes

    NARCIS (Netherlands)

    Buitendijk, Simone; Zeitlin, Jennifer; Cuttini, Marina; Langhoff-Roos, Jens; Bottu, Jean

    2003-01-01

    OBJECTIVE: To assess the ability of the member states of the European Union to produce the indicators recommended by the PERISTAT project on perinatal health indicators and to provide an overview of fetal and infant health outcomes for these countries according to the information now available.

  10. Predictive Models for Normal Fetal Cardiac Structures.

    Science.gov (United States)

    Krishnan, Anita; Pike, Jodi I; McCarter, Robert; Fulgium, Amanda L; Wilson, Emmanuel; Donofrio, Mary T; Sable, Craig A

    2016-12-01

    Clinicians rely on age- and size-specific measures of cardiac structures to diagnose cardiac disease. No universally accepted normative data exist for fetal cardiac structures, and most fetal cardiac centers do not use the same standards. The aim of this study was to derive predictive models for Z scores for 13 commonly evaluated fetal cardiac structures using a large heterogeneous population of fetuses without structural cardiac defects. The study used archived normal fetal echocardiograms in representative fetuses aged 12 to 39 weeks. Thirteen cardiac dimensions were remeasured by a blinded echocardiographer from digitally stored clips. Studies with inadequate imaging views were excluded. Regression models were developed to relate each dimension to estimated gestational age (EGA) by dates, biparietal diameter, femur length, and estimated fetal weight by the Hadlock formula. Dimension outcomes were transformed (e.g., using the logarithm or square root) as necessary to meet the normality assumption. Higher order terms, quadratic or cubic, were added as needed to improve model fit. Information criteria and adjusted R 2 values were used to guide final model selection. Each Z-score equation is based on measurements derived from 296 to 414 unique fetuses. EGA yielded the best predictive model for the majority of dimensions; adjusted R 2 values ranged from 0.72 to 0.893. However, each of the other highly correlated (r > 0.94) biometric parameters was an acceptable surrogate for EGA. In most cases, the best fitting model included squared and cubic terms to introduce curvilinearity. For each dimension, models based on EGA provided the best fit for determining normal measurements of fetal cardiac structures. Nevertheless, other biometric parameters, including femur length, biparietal diameter, and estimated fetal weight provided results that were nearly as good. Comprehensive Z-score results are available on the basis of highly predictive models derived from gestational

  11. TERRAIN: FETAL GROWTH TELEHEALTH SYSTEM BASED ON 2D FETAL HEAD IMAGE USING RANDOMIZED HOUGH TRANSFORM

    Directory of Open Access Journals (Sweden)

    Robeth Rahmatullah

    2014-08-01

    Full Text Available Abstract Intrauterine growth restriction (IUGR is one of many fetal abnormalities, which has high contribution on maternal mortality rate and perinatal mortality rate in Indonesia. Apparently, IUGR impact can be reduced if only the symptoms are detected earlier and the correct treatment is applied. However, fetal growth detection and monitoring process in Indonesia is obstructed because the number of physicians is very limited and ultrasonography (USG devices are expensive. Moreover, both the physicians and USG devices are only available in big cities. To answer those problems, this research proposed an intelligent system that can provide fetal growth telemonitoring in rural areas. This system consists of three components: portable USG device, mobile application which is developed using Android operating system, and server application which is developed using Django. The main feature of this system is automatic fetal head parameter detection and its ability to operate in the limited internet access environment. In this system, automatic fetal head parameter detection uses RHT method to approximate fetal head’s ellipse shape. Experiment result shows that RHT detection ability with ∆ellipse average of 79.564 and running time average of 0.373 second.

  12. The hidden maternal-fetal interface: events involving the lymphoid organs in maternal-fetal tolerance

    Science.gov (United States)

    Taglauer, Elizabeth S.; Adams Waldorf, Kristina M.; Petroff, Margaret G.

    2010-01-01

    The genetic disparity between the mother and fetus has long enticed immunologists to search for mechanisms of maternal tolerance to fetal antigens. The study of antigen-specific tolerance in murine and human pregnancy has gained new momentum in recent years through the focus on antigen-presenting cells, uterine lymphatics and fetal antigen-specific maternal T cell responses. In mice, we now know that these responses occur within the secondary lymphoid structures as they can be conveniently tracked through the use of defined, often transgenic fetal antigens and maternal T cell receptors. Although the secondary lymphoid organs are sites of both immunization and tolerization to antigens, the immunological processes that occur in response to fetal antigens during the healthy pregnancy must invariably lead to tolerance. The molecular properties of these maternal-fetal tolerogenic interactions are still being unraveled, and are likely to be greatly influenced by tissue-specific microenvironments and the hormonal milieu of pregnancy. In this article, we discuss the events leading to antigen-specific maternal tolerance, including the trafficking of fetal antigens to secondary lymphoid organs, the properties of the antigen-presenting cells that display them to maternal T lymphocytes, and the nature of the ensuing tolerogenic response. Experimental data generated from human biological specimens as well as murine transgenic models are considered. PMID:19876825

  13. Fetal MRI improves diagnostic accuracy in patients referred to a fetal center for suspected esophageal atresia.

    Science.gov (United States)

    Ethun, Cecilia G; Fallon, Sara C; Cassady, Christopher I; Mehollin-Ray, Amy R; Olutoye, Oluyinka O; Zamora, Irving J; Lee, Timothy C; Welty, Stephen E; Cass, Darrell L

    2014-05-01

    The purpose of this study was to describe prenatal imaging characteristics and outcomes of fetuses with suspected esophageal atresia (EA) in order to improve prenatal diagnosis, counseling, and management. The medical records of all patients referred to our multidisciplinary fetal center for suspected EA from January 2003 to April 2013 were reviewed retrospectively. Thirty-three patients were referred with a prenatal diagnosis of possible EA. Following fetal center evaluation with MRI, EA was deemed unlikely in 6 (18%) fetuses. Of 27 fetuses in whom EA could not be excluded, EA was confirmed postnatally in 15 (56%), excluded in 7 (26%), and unconfirmed in 5 (3 fetal losses; 2 lost to follow-up). Imaging characteristics on fetal MRI associated with the highest positive predictive values (PPV) were an esophageal pouch (100%) and a small stomach (75%). The finding of polyhydramnios had high sensitivity (93%) but low specificity (31%) and PPV (61%) for a diagnosis of EA. Prenatal imaging and fetal center evaluation correctly identify the presence or absence of esophageal atresia in 78% of patients referred on suspicion of this condition. The presence of an esophageal pouch on fetal MRI has significant predictive value for EA. These data may assist with evidence-based prenatal family counseling. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Fetal eye movements on magnetic resonance imaging.

    Science.gov (United States)

    Woitek, Ramona; Kasprian, Gregor; Lindner, Christian; Stuhr, Fritz; Weber, Michael; Schöpf, Veronika; Brugger, Peter C; Asenbaum, Ulrika; Furtner, Julia; Bettelheim, Dieter; Seidl, Rainer; Prayer, Daniela

    2013-01-01

    Eye movements are the physical expression of upper fetal brainstem function. Our aim was to identify and differentiate specific types of fetal eye movement patterns using dynamic MRI sequences. Their occurrence as well as the presence of conjugated eyeball motion and consistently parallel eyeball position was systematically analyzed. Dynamic SSFP sequences were acquired in 72 singleton fetuses (17-40 GW, three age groups [17-23 GW, 24-32 GW, 33-40 GW]). Fetal eye movements were evaluated according to a modified classification originally published by Birnholz (1981): Type 0: no eye movements; Type I: single transient deviations; Type Ia: fast deviation, slower reposition; Type Ib: fast deviation, fast reposition; Type II: single prolonged eye movements; Type III: complex sequences; and Type IV: nystagmoid. In 95.8% of fetuses, the evaluation of eye movements was possible using MRI, with a mean acquisition time of 70 seconds. Due to head motion, 4.2% of the fetuses and 20.1% of all dynamic SSFP sequences were excluded. Eye movements were observed in 45 fetuses (65.2%). Significant differences between the age groups were found for Type I (p = 0.03), Type Ia (p = 0.031), and Type IV eye movements (p = 0.033). Consistently parallel bulbs were found in 27.3-45%. In human fetuses, different eye movement patterns can be identified and described by MRI in utero. In addition to the originally classified eye movement patterns, a novel subtype has been observed, which apparently characterizes an important step in fetal brainstem development. We evaluated, for the first time, eyeball position in fetuses. Ultimately, the assessment of fetal eye movements by MRI yields the potential to identify early signs of brainstem dysfunction, as encountered in brain malformations such as Chiari II or molar tooth malformations.

  15. Fluconazole treatment of intrauterine Candida albicans infection in fetal sheep.

    Science.gov (United States)

    Maneenil, Gunlawadee; Payne, Matthew S; Senthamarai Kannan, Paranthaman; Kallapur, Suhas G; Kramer, Boris W; Newnham, John P; Miura, Yuichiro; Jobe, Alan H; Kemp, Matthew W

    2015-06-01

    Intrauterine Candida albicans infection causes severe fetal inflammatory responses and fetal injury in an ovine model. We hypothesized that intra-amniotic antifungal therapy with fluconazole would decrease the adverse fetal effects of intra-amniotic C. albicans in sheep. Sheep received an intra-amniotic injection of 10(7) colony-forming units C. albicans. After 2 d, animals were then randomized to: (i) intra-amniotic and fetal intraperitoneal saline with delivery after 24 h (3 d C. albicans group); (ii) intra-amniotic and fetal intraperitoneal injections of fluconazole with delivery after either 24 h (3 d C. albicans plus 1 d fluconazole group) or 72 h (5 d C. albicans plus 3 d fluconazole group). Controls received intra-amniotic injections of saline followed by intra-amniotic and fetal intraperitoneal fluconazole injections. Intra-amniotic C. albicans caused severe fetal inflammatory responses characterized by decreases in lymphocytes and platelets, an increase in posterior mediastinal lymph node weight and proinflammatory mRNA responses in the fetal lung, liver, and spleen. Fluconazole treatment temporarily decreased the pulmonary and chorioamnion inflammatory responses. The severe fetal inflammatory responses caused by intra-amniotic C. albicans infection were transiently decreased with fluconazole. A timely fetal delivery of antimicrobial agents may prevent fetal injury associated with intrauterine infection.

  16. Ultrasound Presentation of a Disseminated Fetal and Neonatal Rhabdoid Tumor

    Directory of Open Access Journals (Sweden)

    Yolaine Joueidi

    2018-01-01

    Full Text Available This is a case report of a disseminated fetal rhabdoid tumor discovered at 32 weeks of gestation in a 29-year-old woman on immunosuppressive therapy. The mother consulted for a decrease in fetal movement. Fetal ultrasound showed signs of a disseminated tumor affecting the left armpit, liver, spleen, and limbs. A caesarian section was performed because of signs of fetal distress. Immunohistochemical analysis of a fetal biopsy showed deletion of the SMARCB1 gene. Pathological analysis of the placenta showed a rhabdoid tumor invading both fetal and maternal compartments. The mother underwent a whole-body MRI, and no metastasis was found. To the best of our knowledge, this is the first report of a disseminated rhabdoid tumor invading both fetal and maternal compartments.

  17. Automated Fetal Heart Rate Analysis in Labor: Decelerations and Overshoots

    Science.gov (United States)

    Georgieva, A. E.; Payne, S. J.; Moulden, M.; Redman, C. W. G.

    2010-10-01

    Electronic fetal heart rate (FHR) recording is a standard way of monitoring fetal health in labor. Decelerations and accelerations usually indicate fetal distress and normality respectively. But one type of acceleration may differ, namely an overshoot that may atypically reflect fetal stress. Here we describe a new method for detecting decelerations, accelerations and overshoots as part of a novel system for computerized FHR analysis (OxSyS). There was poor agreement between clinicians when identifying these FHR features visually, which precluded setting a gold standard of interpretation. We therefore introduced `modified' Sensitivity (SE°) and `modified' Positive Predictive Value (PPV°) as appropriate performance measures with which the algorithm was optimized. The relation between overshoots and fetal compromise in labor was studied in 15 cases and 15 controls. Overshoots showed promise as an indicator of fetal compromise. Unlike ordinary accelerations, overshoots cannot be considered to be reassuring features of fetal health.

  18. Fetal monitoring during nonobstetric surgery: revisiting guidelines: a case report.

    Science.gov (United States)

    Rothschild, Tod J; Morel, Bruce; Pace, Benjamin; Fuks, Aleksandr M

    2015-01-01

    Nonobstetric surgery during pregnancy is not an infrequent occurrence. Guidelines for fetal monitoring during nonobstetric surgery are limited. We describe a case of appendectomy during third trimester, complicated by in utero fetal demise (IUFD). A 30-year-old, Caucasian woman underwent open appendectomy for suspected acute appendicitis. The procedure was complicated by IUFD. Fetal monitoring was done prior to but not during surgery. Guidelines for fetal monitoring were revised, recommending continuous electronic fetal monitoring when possible during third trimester nonobstetric surgery after appropriate patient counseling. A subsequent series of 5 uncomplicated appendectomies demonstrated no difficulty in implementing these guidelines. Continuous electronic fetal monitoring during third trimester nonobstetric surgery should be available and implemented after appropriate patient counseling. This approach reduces the risk of fetal mortality.

  19. Fatores de risco para morte fetal no município de Pato Branco (Brasil Factores de riesgo para muerte fetal en el municipio de Pato Branco (Brasil Risk factors for fetal death in the city of Pato Branco (Brazil

    Directory of Open Access Journals (Sweden)

    Letícia de Lima Trindade

    2011-11-01

    Full Text Available Objetivo. Descrever os fatores de risco para mortalidade fetal na cidade de Pato Branco (Brasil. Metodologia. Realizou-se um estudo descritivo, no qual foram analisados os casos de nascidos mortos de 2000 a 2008 na cidade de Pato Branco. A informação foi obtida do Sistema de Informação de Mortalidade. Resultados. Registraram-se 91 mortes fetais no período estudado para uma taxa média de 9.27 por mil nascidos vivos. Os principais fatores de risco de origem maternos foram: placenta prévia (38.5%, hipertensão induzida na gravidez (13.2%, idade de 21 a 30 anos (40.7%, ter três e menos anos de escolaridade (25.7% e a ocupação de dona de casa (34.1%. Para os fetos, o único fator de risco registrado foi o sexo, no que o masculino contribuiu o 52.7% das mortes. Conclusão. Identificaram-se alguns fatores de risco previsíveis que é necessário intervir com o fim de reduzir a mortalidade fetal no município.Objetivo. Describir los factores de riesgo para natimortalidad en la ciudad de Pato Branco (Brasil. Metodología. Se realizó un estudio descriptivo, en el cual fueron analizados los casos de nacidos muertos de 2000 a 2008 en la ciudad de Pato Branco. La información fue obtenida del Sistema de Información de Mortalidad. Resultados. Se registraron 91 muertes fetales en el periodo estudiado para una tasa media de 9.27 por mil nacidos vivos. Los principales factores de riesgo de origen maternos fueron: placenta previa e hipertensión inducida en el embarazo como complicaciones del embarazo (38.5% y 13.2%, edad de 21 a 30 años (40.7%, baja escolaridad (25.7% y como ocupación de ama de casa (34.1%. Para los fetos, el único factor de riesgo registrado fue el sexo: el masculino aportó el 52.7% de las muertes. Conclusión. Se identificaron algunos factores de riesgo prevenibles que merecen intervención con el fin de reducir la natimortalidad en el municipio.Objective. To describe risk factors for fetal mortality in the city of Pato Branco

  20. Maternal undernutrition and the offspring kidney: from fetal to adult life

    Directory of Open Access Journals (Sweden)

    F.F. Mesquita

    2010-11-01

    Full Text Available Maternal dietary protein restriction during pregnancy is associated with low fetal birth weight and leads to renal morphological and physiological changes. Different mechanisms can contribute to this phenotype: exposure to fetal glucocorticoid, alterations in the components of the renin-angiotensin system, apoptosis, and DNA methylation. A low-protein diet during gestation decreases the activity of placental 11ß-hydroxysteroid dehydrogenase, exposing the fetus to glucocorticoids and resetting the hypothalamic-pituitary-adrenal axis in the offspring. The abnormal function/expression of type 1 (AT1R or type 2 (AT2R AngII receptors during any period of life may be the consequence or cause of renal adaptation. AT1R is up-regulated, compared with control, on the first day after birth of offspring born to low-protein diet mothers, but this protein appears to be down-regulated by 12 days of age and thereafter. In these offspring, AT2R expression differs from control at 1 day of age, but is also down-regulated thereafter, with low nephron numbers at all ages: from the fetal period, at the end of nephron formation, and during adulthood. However, during adulthood, the glomerular filtration rate is not altered, due to glomerulus and podocyte hypertrophy. Kidney tubule transporters are regulated by physiological mechanisms; Na+/K+-ATPase is inhibited by AngII and, in this model, the down-regulated AngII receptors fail to inhibit Na+/K+-ATPase, leading to increased Na+ reabsorption, contributing to the hypertensive status. We also considered the modulation of pro-apoptotic and anti-apoptotic factors during nephrogenesis, since organogenesis depends upon a tight balance between proliferation, differentiation and cell death.

  1. Fetal microglial in vitro phenotype depends on prior in vivo inflammation

    Directory of Open Access Journals (Sweden)

    Mingju eCao

    2015-08-01

    Full Text Available Objective. Neuroinflammation in utero may result in life-long neurological disabilities. The molecular mechanisms whereby microglia contribute to this response remain incompletely understood. Methods. Lipopolysaccharide (LPS or saline were administered intravenously to non-anesthetized chronically instrumented near-term fetal sheep to model fetal inflammation in vivo. Microglia were then isolated from in vivo LPS and saline (naïve exposed animals. To mimic the second hit of neuroinflammation, these microglia were then re-exposed to LPS in vitro. Cytokine responses were measured in vivo and subsequently in vitro in the primary microglia cultures derived from these animals. We sequenced the whole transcriptome of naïve and second hit microglia and profiled their genetic expression to define molecular pathways disrupted during neuroinflammation.Results. In vivo LPS exposure resulted in IL-6 increase in fetal plasma 3 h post LPS exposure. Even though not histologically apparent, microglia acquired a pro-inflammatory phenotype in vivo that was sustained and amplified in vitro upon second hit LPS exposure as measured by IL-1β response in vitro and RNAseq analyses. While NFKB and Jak-Stat inflammatory pathways were up regulated in naïve microglia, heme oxygenase 1 (HMOX1 and Fructose-1,6-bisphosphatase (FBP genes were uniquely differentially expressed in the second hit microglia. Microglial calreticulin/LRP genes implicated in microglia-neuronal communication relevant for the neuronal development were up regulated in second hit microglia.Discussion. We identified a unique HMOX1down and FBPup phenotype of microglia exposed to the double-hit suggesting interplay of inflammatory and metabolic pathways as a memory of prior inflammatory insult. These findings suggest new therapeutic targets for early postnatal intervention to prevent brain injury.

  2. Diagnóstico precoce da restrição do crescimento fetal pela estimativa ultra-sonográfica do peso fetal Early diagnosis of intra-uterine growth restriction by ultrasonographic estimation of fetal weight

    Directory of Open Access Journals (Sweden)

    Maria Marta Martins

    2005-02-01

    Full Text Available OBJETIVOS: Com a finalidade da atuação pré-natal oportuna e diminuição da morbiletalidade perinatal e tardia, este estudo se propôs a avaliar a evolução do peso fetal determinado pela ecografia entre a 25ª e 27ª semanas de gestação, estabelecer valores de corte de peso fetal úteis no diagnóstico do pequeno para esta época da gestação e propor modelo matemático para reconhecer a probabilidade de ocorrência de recém-nascido pequeno para a idade gestacional (PIG. MÉTODOS: Avaliaram-se 85 recém-nascidos, 35 pequenos e 50 adequados para a idade gestacional (AIG. As mães haviam feito o pré-natal no serviço, eram hígidas ou apresentavam hipertensão arterial crônica como única doença, sem história de vícios, fetos gemelares ou malformados. Todas realizaram exames ultra-sonográficos na 25ª e 27ª semanas para cálculo do peso fetal. RESULTADOS: O ganho de peso ecográfico fetal entre a 25ª e a 27ª semanas de gestação foi menor no grupo PIG havendo desaceleração do crescimento em relação ao grupo AIG. Os valores de corte de pesos ecográficos fetais foram de 775 gramas e 1015 gramas para a 25ª e 27ª semanas, respectivamente Obteve-se modelo matemático útil para quantificar a probabilidade de crescimento intra-uterino inadequado.OBJECTIVE: Aiming to reduce the perinatal and late morbidity and lethality through opportune prenatal intervention, this study proposed to sequentially evaluate the echographic fetal weight at the 25th and 27th weeks of gestation, establishing cut-off values for echographic fetal weight useful in the diagnosis of small-for-gestational-age at this gestation time, and developing a mathematical model able to recognize the probability of a newborn small-for- gestational-age. METHODS: Eighty-five newborns were evaluated, 35 small and 50 adequate for gestational age. The mothers who underwent prenatal care at our Instituition were healthy or presented chronic arterial hypertension as the only

  3. Prenatal sonographic measurement of the fetal thyroid gland

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Young Cheol; Kim, Young Hwa; Cho, Won Soo; Bae, Won Kyung; Kim, Il Young [Chunan Hospital, Soonchunhyang University College of Medicine, Chunan (Korea, Republic of)

    2001-03-15

    To investigate whether the fetal thyroid gland could be examined by prenatal ultrasonography and to established the normal range of fetal thyroid width according to the gestational age. The width of the fetal thyroid was determined by prenatal ultrasonography from 118 pregnant women. Three of the mothers had current or previous thyroid disease and the widths of the fetal thyroid were determined from 115 normal subjects. The width of the fetal thyroid was defined by a maximum transverse distance of the thyroid gland between two carotid arteries on transverse scan of the fetal neck. We analyzed the cause of non-measurable cases. The width of the fetal thyroid and Neo-TSH were compared in 19 subjects, including 3 subjects will current or previous thyroid disease. We could measure the fetal thyroid widths in 95 cases (80%). The fetal thyroid widths of mothers without current or previous thyroid disease was 0.9-2.36 cm,which showed linear correlation with gestational age (Y=0.0506 X + 0.0439, r{sup 2}=0.5661). Causes of non-measurable cases were neck flexion (65%), prone position (22%), and overlapped fetal neck by arm or shoulder (13%). Of the 19 neonates with Neo-TSH level, one case had a mother with a thyroid disease and showed increased width of the fetal and high Neo-TSH. The fetal thyroid was measured in 80% of prenatal ultrasonography and the width of the fetal thyroid showed linear correlated with gestational age. We assumed that the width of the thyroid could be useful for diagnosing fetal thyroid disorder when maternal thyroid disease exists.

  4. Estimativa do Peso Fetal: Comparação Entre um Método Clínico e a Ultra-Sonografia Estimation of Fetal Weight: Comparison Between a Clinical Method and Ultrasonography

    Directory of Open Access Journals (Sweden)

    Alexandre Faisal Cury

    1998-12-01

    Full Text Available Objetivo: avaliar a validade da estimativa do peso fetal por método baseado na altura uterina - regra de Johnson. Métodos: foram estudadas 101 gestantes e seus recém-nascidos (RN, estimando-se o peso fetal pela utilização da regra de Johnson adaptada, que consiste em aplicação clínica de modelo matemático para cálculo do peso fetal baseado na altura uterina e na altura da apresentação fetal. O peso estimado foi obtido no dia do parto e foi comparado com o peso observado ao nascer, que constituiu o controle da análise da validade do método empregado. Na mesma data foi realizada ultra-sonografia obstétrica (US detalhada, que inclui cálculo do peso fetal pela aplicação das tabelas de Sheppard, e este peso, estimado pela US, foi comparado ao peso observado ao nascer. Resultados: os resultados destas comparações mostraram que a estimativa clínica empregada nesta casuística tem valor semelhante à US para avaliação do peso ao nascer: a margem de acerto do método clínico com variações de 5%, 10% e 15% entre peso estimado e peso observado foi de 55,3%, 73% e 86,7% respectivamente, e, para o US, de 60,7%, 75,4% e 91,1%, respectivamente. Conclusões:quando comparados, estes valores não se mostraram diferentes do ponto de vista estatístico, permitindo concluir-se que a avaliação clínica mostra acurácia semelhante à da US para o cálculo do peso ao nascer.Purpose: to assess the validity of fetal weight estimation by a method based on uterine height -- Johnson's rule. Methods: one hundred and one pregnant women and their newborn children were studied. The fetal weight was estimated using an adaptation of Johnson's rule, which consists of the clinical application of a mathematical model to calculate the fetal weight based on the uterine height and the height of fetal presentation. The estimated weight was obtained on the day of delivery and was compared to the weight observed after birth. This, in turn, was the control of

  5. Freqüência Cardíaca Fetal durante o Primeiro Trimestre da Gestação Fetal Heart Rate in the First Trimester of Pregnancy

    Directory of Open Access Journals (Sweden)

    Heverton Pettersen

    2001-10-01

    Full Text Available Objetivos: estabelecer curva de normalidade da freqüência cardíaca fetal (FCF entre a 10ª e a 14ª semana de gestação. Métodos: a FCF foi avaliada em 1078 fetos entre 10 e 14 semanas de gestação. Para uma melhor correlação da FCF com a idade gestacional, os fetos foram divididos em quatro grupos de acordo com a idade gestacional: Grupo I (10 semanas, Grupo II (11 semanas, Grupo III (12 semanas e Grupo IV (13 semanas. Por meio de corte sagital, o coração fetal foi visualizado e o registro da FCF foi realizado usando Modo-B e Modo-M em tempo real. Calculou-se a FCF média eletronicamente por meio da colocação dos cálipers que registravam 3 ciclos consecutivos. Resultados: a FCF variou entre 136 e 178 bpm entre os 1078 fetos estudados. Construiu-se uma curva de normalidade estabelecendo-se a mediana e os percentis 5 e 95 da FCF para cada grupo. No Grupo I a FCF variou de 158 a 184 bpm; no Grupo II, de 155 a 175 bpm; no Grupo III, de 152 a 172 bpm; no Grupo IV, de 149 a 168 bpm. Houve diminuição progressiva e significativa da FCF com o avanço da idade gestacional durante o período estudado. Conclusões: a avaliação da FCF no primeiro trimestre de gestação é um procedimento simples e que deve ser analisado não só na sua forma qualitativa (batimentos cardíacos fetais rítmicos mas também na sua forma quantitativa, já que trabalhos publicados mostram a sua relação com o prognóstico fetal.Purpose: to determine normal ranges for fetal heart rate (FHR between the 10th and 14th week of pregnancy. Methods: a total of 1078 fetuses within a crown-rump length (CRL from the 10th to the 14th week of pregnancy were evaluated. The fetuses were divided into 4 groups: Group I (10 weeks, Group II (11 weeks, Group III (12 weeks, Group IV (13 weeks. The fetal heart was seen using B-mode/M-mode at a sagital plane and FHR was recorded. FHR was electronically calculated using calipers within 3 consecutive cycles without fetal moveiments

  6. Cell-free fetal DNA and cell-free total DNA levels in spontaneous abortion with fetal chromosomal aneuploidy.

    Directory of Open Access Journals (Sweden)

    Ji Hyae Lim

    Full Text Available 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.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.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 with fetal chromosomal aneuploidy, regardless of fetal

  7. Fetal Axillary Cystic Hygroma; a case report and review

    Directory of Open Access Journals (Sweden)

    Osman Temizkan

    2011-10-01

    Full Text Available The Cystic Hygroma (CH is a lymphatic malformation occurring different parts of fetal body, typically in the region of the fetal neck and axillary, abdominal wall, mediastinal, inguinal and retroperitoneal areas. CH has been associated with fetal aneuploidy, hydrops fetalis, structural malformations and intrauterine fetal death. A 24-years-old gravida 1, para 1 was admitted to our hospital at 28 weeks of gestation. Ultrasonographic examination determined 28 weeks of gestation, singleton, alive fetus who had a mass derived from the right axillary region which was extending to the anterior and posterior thoracic wall with fluid-filled cavities about 12 cm in size. There was no evidence of intrathorasic or intraabdominal extension of mass. Cordocentesis was performed and karyotype examination was normal 46 XY. The fetal demise was found after the first visit. The patient was delivered vaginally after labor induction with oxytocin infusion. The fetal autopsy confirmed the diagnosis of CH. The fetal CH carries high risk of aneuploidy and fetal malformations. Patients that have been diagnosed with CH in antenatal follow-ups should be assessed in terms of other anomalies. Fetal karyotyping should be done and the patient should be monitored for fetal hydrops. The birth should be planned in a multidisciplinary hospital and as neonatal resuscitation could be needed, pediatricians should be consulted.

  8. A literature update on maternal-fetal attachment.

    Science.gov (United States)

    Alhusen, Jeanne L

    2008-01-01

    To critically review and synthesize original research published since 2000 designed to measure factors that influence maternal-fetal attachment. EBSCOhost Research Databases that included PubMed, CINAHL Plus, PsycINFO, and SCOPUS were searched for journal articles published in the past 7 years (2000-2007) that examined variables thought to increase, decrease, or cause no change in level of maternal-fetal attachment. Keyword searches included maternal-fetal attachment, parental attachment, and prenatal attachment. Twenty-two studies were selected that met the inclusion criteria of original research, clear delineation of the measurement of maternal-fetal attachment, measurement of maternal-fetal attachment during pregnancy, and inclusion of women or couples, or both. Studies measuring maternal-fetal attachment included a broad range of variables as potential risk or protective factors, or both. Factors associated with higher levels of maternal-fetal attachment included family support, greater psychological well-being, and having an ultrasound performed. Factors such as depression, substance abuse, and higher anxiety levels were associated with lower levels of maternal-fetal attachment. The large majority of studies reviewed were limited by small, homogenous samples deemed insufficient to detect significant differences, inconsistent measurement of maternal-fetal attachment during gestational periods, and cross-sectional designs. Further research is essential to identify factors influencing maternal-fetal attachment. Specifically, research needs to be conducted on larger sample sizes of greater racial and ethnic diversity.

  9. Correlation of sole prenatal indication to fetal chromosomal karyotype abnormality

    Directory of Open Access Journals (Sweden)

    Ying XU

    2017-04-01

    Full Text Available Objective  To analysis the clinical high risk factors for fetal chromosomal abnormalities. Methods  Amniocentesis, chromosomal karyotype analysis and other related methods were performed on 4829 pregnant women, who presented sole indication of prenatal diagnosis such as advanced age, high risk factors and fetal ultrasound abnormalities, for analyzing the correlations of those women to the incidence of fetal chromosomal abnormalities. Results  The detection rates of abnormal karyotype were 5.0% (57/1143, 1.7% (40/2367 and 4.3% (57/1319 in the older women group (age>35, abnormal maternal serological screening group and abnormal fetal ultrasound finding group, respectively. The detection rats of karyotype abnormality were 6.9% (23/333 in women with fetal congenital heart diseases, 8.5% (20/234 in those with abnormal amniotic fluid, 1.1% (1/89 in those with fetal ventriculomegaly, 1.1% (10/898 in those with fetal intracardiac hyperechogenicity, 5.9% (2/34 in those with fetal choroid cyst and 5.6% (1/18 in those with fetal renal pelvis broadening. Conclusion  The pregnant women with age>35, fetal sonographic structural anomalies or two or more soft marker abnormalities should be prenatally diagnosed and doing the genetic counseling combined with the family history. DOI: 10.11855/j.issn.0577-7402.2017.02.14

  10. Effects of experience on fetal voice recognition.

    Science.gov (United States)

    Kisilevsky, Barbara S; Hains, Sylvia M J; Lee, Kang; Xie, Xing; Huang, Hefeng; Ye, Hai Hui; Zhang, Ke; Wang, Zengping

    2003-05-01

    The ability of human fetuses to recognize their own mother's voice was examined. Sixty term fetuses were assigned to one of two conditions during which they were exposed to a tape recording of their mother or a female stranger reading a passage. Voice stimuli were delivered through a loudspeaker held approximately 10 cm above the maternal abdomen and played at an average of 95 dB SPL. Each condition consisted of three 2-min periods: no stimulus, voice (mother or stranger), and no stimulus. Fetal heart rate increased in response to the mother's voice and decreased in response to the stranger's; both responses were sustained for 4 min. The finding of differential behavior in response to a familiar versus a novel voice provides evidence that experience influences fetal voice processing. It supports an epigenetic model of speech perception, presuming an interaction between genetic expression of neural development and species-specific experience.

  11. Comparison of fetal and postnatal echocardiography results

    Directory of Open Access Journals (Sweden)

    A. A. Sokolov

    2014-01-01

    Full Text Available The analysis of echocardiography results in 394 fetuses and 570 neonates showed the high accuracy of prenatal diagnosis of congenital heart disease (CHD in a specialized cardiac surgery facihty. The accuracy of critical CHD identification at the unspeciahzed stage of fetal diagnosis was 50%. Heart defects, such as aortic coarctation, interrupted aortic arch, and total anomalous pulmonary venous drainage, turned out to be most difficult for prenatal diagnosis (at all stages. There were no problems in the prenatal diagnosis of the following defects: tetralogy of Fallot, all types of single ventricle defect, and atrioventricular septal defect. The discordances between the diagnosis of CHD by fetal echocardiography at an obstetric stage and that in a specialized cardiology facihty were mostly due to the inaccurate description of all components of complex heart defects.

  12. Metabolomics Application in Maternal-Fetal Medicine

    Directory of Open Access Journals (Sweden)

    Vassilios Fanos

    2013-01-01

    Full Text Available 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.

  13. Fetal programming and gestational diabetes mellitus.

    Science.gov (United States)

    Monteiro, Lara J; Norman, Jane E; Rice, Gregory E; Illanes, Sebastián E

    2016-12-01

    Gestational diabetes mellitus is defined by new-onset glucose intolerance during pregnancy. About 2-5% of all pregnant women develop gestational diabetes during their pregnancies and the prevalence has increased considerably during the last decade. This metabolic condition is manifested when pancreatic β-cells lose their ability to compensate for increased insulin resistance during pregnancy, however, the pathogenesis of the disease remains largely unknown. Gestational diabetes is strongly associated with adverse pregnancy outcome as well as with long-term adverse effects on the offspring which likely occurs due to epigenetic modifications of the fetal genome. In the current review we address gestational diabetes and the short and long term complications for both mothers and offspring focusing on the importance of fetal programming in conferring risk of developing diseases in adulthood. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Fetal chromosome analysis: screening for chromosome disease?

    DEFF Research Database (Denmark)

    Philip, J; Tabor, Ann; Bang, J

    1983-01-01

    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...... A + B). Pregnant women 35 years of age, women who previously had a chromosomally abnormal child, families with translocation carriers or other heritable chromosomal disease, families where the father was 50 years or more and women in families with a history of Down's syndrome (group A), were compared...... 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...

  15. Fetal microchimerism in breast and colon cancer

    DEFF Research Database (Denmark)

    Kamper-Jørgensen, M; Biggar, R J; Stamper, Casey L

    2011-01-01

    microchimerism predicts risk for developing breast cancer is unknown. FMc was evaluated in buffy coat cells from presumed healthy women who later developed breast cancer or colon cancer, a cancer in which prior pregnancy appears protective but has different associations with endocrine risk factors. METHODS......1574 Background: Cells acquired by a woman from her baby that durably persist in her blood and tissues is known as fetal microchimerism (FMc). In women with breast cancer, frequency and quantity of FMc in blood and breast tissue is reduced compared to healthy women. Whether the absence of fetal....... DNA from repository buffy coat specimens was tested for male FMc with quantitative PCR targeting the DYS14gene on the Y chromosome. For this analysis, 89 women who developed breast cancer and 67 women who developed colon cancer were evaluable for FMc. Results were compared to 272 women who remained...

  16. Placental adaptations to the maternal-fetal environment: implications for fetal growth and developmental programming.

    Science.gov (United States)

    Sandovici, Ionel; Hoelle, Katharina; Angiolini, Emily; Constância, Miguel

    2012-07-01

    The placenta is a transient organ found in eutherian mammals that evolved primarily to provide nutrients for the developing fetus. The placenta exchanges a wide array of nutrients, endocrine signals, cytokines and growth factors with the mother and the fetus, thereby regulating intrauterine development. Recent studies show that the placenta is not just a passive organ mediating maternal-fetal exchange. It can adapt its capacity to supply nutrients in response to intrinsic and extrinsic variations in the maternal-fetal environment. These dynamic adaptations are thought to occur to maximize fetal growth and viability at birth in the prevailing conditions in utero. However, some of these adaptations may also affect the development of individual fetal tissues, with patho-physiological consequences long after birth. Here, this review summarizes current knowledge on the causes, possible mechanisms and consequences of placental adaptive responses, with a focus on the regulation of transporter-mediated processes for nutrients. This review also highlights the emerging roles that imprinted genes and epigenetic mechanisms of gene regulation may play in placental adaptations to the maternal-fetal environment. Copyright © 2012 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  17. Value of fetal skeletal radiographs in the diagnosis of fetal death

    Energy Technology Data Exchange (ETDEWEB)

    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)

    2003-05-01

    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.)

  18. Fluoxetine effect on gestation and fetal development

    OpenAIRE

    Ösz Bianca Eugenia; Vari C. E.; Dogaru Maria

    2014-01-01

    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 ad...

  19. Fetal programming of the metabolic syndrome

    Directory of Open Access Journals (Sweden)

    Aleksandra Marciniak

    2017-04-01

    Full Text Available Prenatal development is currently recognized as a critical period in the etiology of human diseases. This is particularly so when an unfavorable environment interacts with a genetic predisposition. The fetal programming concept suggests that maternal nutritional imbalance and metabolic disturbances may have a persistent and intergenerational effect on the health of offspring and on the risk of diseases such as obesity, diabetes, and cardiovascular diseases.

  20. Normal renal development investigated with fetal MRI

    Energy Technology Data Exchange (ETDEWEB)

    Witzani, Linde [Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)]. E-mail: linde.witzani@aon.at; Brugger, Peter Christian [Center of Anatomy and Cell Biology, Integrative Morphology Group, Medical University of Vienna, Waehringerstrasse 13, A-1090 Vienna (Austria); Hoermann, Marcus [Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Kasprian, Gregor [Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Csapone-Balassy, Csilla [Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Prayer, Daniela [Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)

    2006-02-15

    Objective: To evaluate age-dependent changes in fetal kidney measurements with MRI. Patients and methods: Fetal MRI examinations were used to study the kidney length (218 fetuses), signal intensities of renal tissue, renal pelvis, and liver tissue on T2-weighted images (223 fetuses), and the whole-kidney apparent diffusion coefficient (107 fetuses). A 1.5 T superconducting unit with a phased array coil was used in patients from 16 to 39 weeks' gestation. The imaging protocol included T2-weighted single-shot fast spin-echo, T2-weighted balanced angiography and diffusion-weighted sequences. Slice thickness ranged from 3 to 5 mm. Results: Fetal kidney length as a function of gestational age was expressed by the linear regression: kidney length (mm) = 0.190 x gestational age (d) - 8.034 (R {sup 2} 0.883, p < 0.001). Paired t-test analysis showed a highly statistically significant difference between the ratio of renal tissue signal intensity to renal pelvis signal intensity and the ratio of liver signal intensity to renal pelvis signal intensity on T2-weighted images (t = -50.963, d.f. = 162, p < 0.001), with renal tissue hyperintense to liver tissue. The apparent diffusion coefficient in relation to gestational age was described by the equation: ADC ({mu}m{sup 2}/s) = 0.0302 x square (gestational age (d)) - 14.202 x gestational age (d) + 2728.6 (R {sup 2} = 0.225, p < 0.001). Conclusion: The length, signal intensity on T2-weighted images, and apparent diffusion coefficient of the fetal kidney change significantly with gestational age. The presented data may help in the prenatal diagnosis of renal anomalies.

  1. Perinatal (fetal and neonatal) astrocytoma: a review

    OpenAIRE

    Isaacs, Hart

    2016-01-01

    Introduction The purpose of this review is to document the various types of astrocytoma that occur in the fetus and neonate, their locations, initial findings, pathology, and outcome. Data are presented that show which patients are likely to survive or benefit from treatment compared with those who are unlikely to respond. Materials and methods One hundred one fetal and neonatal tumors were collected from the literature for study. Results Macrocephaly and an intracranial mass were the most co...

  2. Endoscopic coverage of fetal myelomeningocele in utero.

    Science.gov (United States)

    Bruner, J P; Richards, W O; Tulipan, N B; Arney, T L

    1999-01-01

    Our goal was to evaluate the safety and efficacy of minimally invasive surgery for the coverage of myelomeningocele in utero. Women in the mid-second trimester of a pregnancy complicated by fetal myelomeningocele were offered an experimental procedure designed to prevent ongoing exposure of the spinal cord to the intrauterine environment. The procedure consisted of maternal laparotomy while the patient was under both general and epidural anesthesia, with exposure of the gravid uterus. Endoscopic ports were placed for camera and operating instruments. Amniotic fluid was removed and replaced with carbon dioxide. The fetus was then positioned and a maternal split-thickness skin graft was placed over the exposed spinal cord or neural elements. The skin graft and a covering of Surgicel Absorbable Hemostat were attached with fibrin glue prepared from autologous cryoprecipitate. Four fetuses with open myelomeningocele underwent endoscopic coverage of the spinal lesion between 22 weeks 3 days and 24 weeks 3 days of gestation. One infant, delivered by planned cesarean section at 35 weeks' gestation after demonstration of fetal lung maturity, is almost 3 years old. A second infant was delivered by cesarean section at 28 weeks after preterm labor and is now almost 6 months old. Both survivors manifest only mild motor and somatosensory deficits. One fetus who was delivered 1 week after operation after development of amnionitis died in the delivery room of extreme prematurity. The final fetus died intraoperatively from abruptio placentae. Minimally invasive fetal surgery appears to constitute a feasible approach to nonlethal fetal malformations that result in progressive and disabling organ damage.

  3. White noise does not induce fetal sleep.

    Science.gov (United States)

    Zimmer, E Z; Jakobi, P; Talmon, R; Shenhav, R; Weissman, A

    1993-01-01

    White noise has been shown to induce sleep in newborns. We sought to examine whether this type of sound will also induce a quiet state in the fetus. Twenty-two fetuses at 36-41 weeks of gestation were exposed to white noise during an active state. The sound was delivered for 5 min at an intensity of 100 dB. No significant change in fetal activity was noted following the sound.

  4. Management of antenatally detected fetal airway obstruction.

    Science.gov (United States)

    Walker, Paul; Cassey, John; O'callaghan, Stephen

    2005-06-01

    Five cases of antenatally diagnosed fetal airway obstruction have been cared for at the John Hunter Children's Hospital, Newcastle, Australia. A multidisciplinary team manages them during the perinatal period. We present our technique at the time of delivery, which aims to afford us the greatest flexibility in managing both the mother, her child's airway, and the underlying lesion. We begin with an ex utero intrapartum technique (EXIT) and favor routine rigid bronchoscopy to secure the neonate's airway without preliminary attempts at endotracheal intubation.

  5. Persistence of phencyclidine in fetal brain

    OpenAIRE

    Ahmad,G; Halsall, LC; Bondy, SC

    1987-01-01

    Phencyclidine residues were found in the brains of rat pups of mothers dosed with this drug during pregnancy. These levels were significant at times after dosing when maternal levels of phencyclidine in serum or brain were low or undetectable. The persistence of this compound in fetal serum was also not prolonged. Maternal ingestion of PCP for a relatively brief time may result in an extended exposure of the developing nervous system. © 1987.

  6. Animal models in fetal medicine and obstetrics

    DEFF Research Database (Denmark)

    Dahl Andersen, Maria; Alstrup, Aage Kristian Olsen; Duvald, Christina Søndergaard

    2017-01-01

    Animal models remain essential to understand the fundamental mechanisms occurring in fetal medicine and obstetric diseases, such as intrauterine growth restriction, preeclampsia and gestational diabetes. These vary regarding the employed method used for induction of the disease, and vary regarding....... The ability to employ non-invasively diagnostics varies among species, specifically for ultrasound and MRI procedures. Management of feeding, handling, care and anesthesia are particularly important factors in the pregnant animal....

  7. Can postmortem fetal MR imaging replace autopsy?

    Energy Technology Data Exchange (ETDEWEB)

    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)

    2001-02-01

    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.

  8. Maternal hurricane exposure and fetal distress risk.

    Science.gov (United States)

    Zahran, Sammy; Snodgrass, Jeffrey G; Peek, Lori; Weiler, Stephan

    2010-10-01

    Logistic regression and spatial analytic techniques are used to model fetal distress risk as a function of maternal exposure to Hurricane Andrew. First, monthly time series compare the proportion of infants born distressed in hurricane affected and unaffected areas. Second, resident births are analyzed in Miami-Dade and Broward counties, before, during, and after Hurricane Andrew. Third, resident births are analyzed in all Florida locales with 100,000 or more persons, comparing exposed and unexposed gravid females. Fourth, resident births are analyzed along Hurricane Andrew's path from southern Florida to northeast Mississippi. Results show that fetal distress risk increases significantly with maternal exposure to Hurricane Andrew in second and third trimesters, adjusting for known risk factors. Distress risk also correlates with the destructive path of Hurricane Andrew, with higher incidences of fetal distress found in areas of highest exposure intensity. Hurricane exposed African-American mothers were more likely to birth distressed infants. The policy implications of in utero costs of natural disaster exposure are discussed. © 2010 Society for Risk Analysis.

  9. Effects of Cremation on Fetal Bones.

    Science.gov (United States)

    Zana, Michela; Magli, Francesca; Mazzucchi, Alessandra; Castoldi, Elisa; Gibelli, Daniele; Caccia, Giulia; Cornacchia, Francesca; Gaudio, Daniel A; Mattia, Mirko; Cattaneo, Cristina

    2017-09-01

    The charring process is a weak point of anthropological analysis as it changes bone morphology and reduces information obtainable, specially in fetuses. This experiment aims at verifying the conservation of fetal bones after cremation. A total of 3138 fetuses of unknown sex and age were used, deriving from legal and therapeutic abortions from different hospitals of Milan. Cremations took place in modern crematoria. Nine cremation events were analyzed, each ranging from 57 to 915 simultaneously cremated fetuses. During the cremations, 4356 skeletal remains were recovered, 3756 of which (86.2%) were morphologically distinguishable. All types of fetal skeletal elements were found, with the exception of some cranial bones. Only 3.4% of individuals could be detected after the cremation process, because of the prevalence of abortions under 12 lunar weeks. All fire alterations were observed and the results were statistically analyzed. This pilot study confirmed the possibility of preservation of fetal skeletal elements after cremation. © 2017 American Academy of Forensic Sciences.

  10. Fetal MRI of clubfoot associated with myelomeningocele

    Energy Technology Data Exchange (ETDEWEB)

    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)

    2010-12-15

    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.)

  11. New perspectives in electronic fetal surveillance.

    Science.gov (United States)

    Hamilton, Emily F; Warrick, Philip A

    2013-01-01

    Despite its recognized limitations, fetal heart rate monitoring is a mainstay of intrapartum care. Although the basic technology in standard electronic fetal monitors has changed little in recent decades, clinical behavior in response to heart rate monitoring has changed considerably. In addition to clearly defined nomenclature and clinical guidelines, there is an increased awareness that environmental and human factors can impair clinical judgment, resulting in delayed intervention and, consequently, birth-related injury. This review examines three essential steps that affect clinical outcome: (1) signal acquisition, (2) associations with physiological outcome, and (3) clinical intervention. Only the third step is directly responsible for changing clinical outcome. However, timely initiation of interventions is dependent upon the second step, which is dependent upon the fi rst step. Thus, deficiencies at each step tend to accumulate and contribute to the worsening of overall clinical outcome. This review article summarizes advances occurring at each step. The synergy and convergence of innovations in engineering, mathematics, and behavioral science shows considerable promise in intrapartum fetal surveillance.

  12. Revisiting the argument from fetal potential

    Directory of Open Access Journals (Sweden)

    Manninen Bertha

    2007-05-01

    Full Text Available Abstract One of the most famous, and most derided, arguments against the morality of abortion is the argument from potential, which maintains that the fetus' potential to become a person and enjoy the valuable life common to persons, entails that its destruction is prima facie morally impermissible. In this paper, I will revisit and offer a defense of the argument from potential. First, I will criticize the classical arguments proffered against the importance of fetal potential, specifically the arguments put forth by philosophers Peter Singer and David Boonin, by carefully unpacking the claims made in these arguments and illustrating why they are flawed. Secondly, I will maintain that fetal potential is morally relevant when it comes to the morality of abortion, but that it must be accorded a proper place in the argument. This proper place, however, cannot be found until we first answer a very important and complex question: we must first address the issue of personal identity, and when the fetus becomes the type of being who is relevantly identical to a future person. I will illustrate why the question of fetal potential can only be meaningfully addressed after we have first answered the question of personal identity and how it relates to the human fetus.

  13. Role of fetal DNA in preeclampsia (review).

    Science.gov (United States)

    Konečná, Barbora; Vlková, Barbora; Celec, Peter

    2015-02-01

    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.

  14. Elevated fetal steroidogenic activity in autism

    Science.gov (United States)

    Baron-Cohen, S; Auyeung, B; Nørgaard-Pedersen, B; Hougaard, D M; Abdallah, M W; Melgaard, L; Cohen, A S; Chakrabarti, B; Ruta, L; Lombardo, M V

    2015-01-01

    Autism affects males more than females, giving rise to the idea that the influence of steroid hormones on early fetal brain development may be one important early biological risk factor. Utilizing the Danish Historic Birth Cohort and Danish Psychiatric Central Register, we identified all amniotic fluid samples of males born between 1993 and 1999 who later received ICD-10 (International Classification of Diseases, 10th Revision) diagnoses of autism, Asperger syndrome or PDD-NOS (pervasive developmental disorder not otherwise specified) (n=128) compared with matched typically developing controls. Concentration levels of Δ4 sex steroids (progesterone, 17α-hydroxy-progesterone, androstenedione and testosterone) and cortisol were measured with liquid chromatography tandem mass spectrometry. All hormones were positively associated with each other and principal component analysis confirmed that one generalized latent steroidogenic factor was driving much of the variation in the data. The autism group showed elevations across all hormones on this latent generalized steroidogenic factor (Cohen's d=0.37, P=0.0009) and this elevation was uniform across ICD-10 diagnostic label. These results provide the first direct evidence of elevated fetal steroidogenic activity in autism. Such elevations may be important as epigenetic fetal programming mechanisms and may interact with other important pathophysiological factors in autism. PMID:24888361

  15. Magnetic resonance imaging of fetal pelvic cysts.

    Science.gov (United States)

    Archontaki, Styliani; Vial, Yvan; Hanquinet, Sylviane; Meuli, Reto; Alamo, Leonor

    2016-12-01

    The detection of fetal anomalies has improved in the last years as a result of the generalization of ultrasound pregnancy screening exams. The presence of a cystic imaging in the fetal pelvis is a relatively common finding, which can correspond to a real congenital cystic lesion or result from the anomalous liquid accumulation in a whole pelvic organ, mainly the urinary bladder, the uterus, or the vagina. In selected cases with poor prognosis and/or inconclusive echographic findings, magnetic resonance may bring additional information in terms of the characterization, anatomical location, and real extension of the pathology. This pictorial essay describes the normal pelvic fetal anatomy, as well as the most common pelvic cysts. It also describes the causes of an anomalous distension of the whole pelvic organs detected in utero, with emphasis on prenatal magnetic resonance imaging exams. Moreover, it proposes practical teaching points to reduce the differential diagnosis of these lesions based on the sex of the fetus, the division of the pelvis in anatomical spaces, and the imaging findings of the pathology. Finally, it discusses the real utility of complementary MRI.

  16. Fetal programming of schizophrenia: select mechanisms.

    Science.gov (United States)

    Debnath, Monojit; Venkatasubramanian, Ganesan; Berk, Michael

    2015-02-01

    Mounting evidence indicates that schizophrenia is associated with adverse intrauterine experiences. An adverse or suboptimal fetal environment can cause irreversible changes in brain that can subsequently exert long-lasting effects through resetting a diverse array of biological systems including endocrine, immune and nervous. It is evident from animal and imaging studies that subtle variations in the intrauterine environment can cause recognizable differences in brain structure and cognitive functions in the offspring. A wide variety of environmental factors may play a role in precipitating the emergent developmental dysregulation and the consequent evolution of psychiatric traits in early adulthood by inducing inflammatory, oxidative and nitrosative stress (IO&NS) pathways, mitochondrial dysfunction, apoptosis, and epigenetic dysregulation. However, the precise mechanisms behind such relationships and the specificity of the risk factors for schizophrenia remain exploratory. Considering the paucity of knowledge on fetal programming of schizophrenia, it is timely to consolidate the recent advances in the field and put forward an integrated overview of the mechanisms associated with fetal origin of schizophrenia. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Do fatty acids affect fetal programming?

    Science.gov (United States)

    Kabaran, Seray; Besler, H Tanju

    2015-08-13

    In this study discussed the primary and regulatory roles of fatty acids, and investigated the affects of fatty acids on metabolic programming. Review of the literature was carried out on three electronic databases to assess the roles of fatty acids in metabolic programming. All abstracts and full-text articles were examined, and the most relevant articles were selected for screening and inclusion in this review. The mother's nutritional environment during fetal period has important effects on long term health. Fatty acids play a primary role in growth and development. Alterations in fatty acid intake in the fetal period may increase the risk of obesity and metabolic disorders in later life. Maternal fatty acid intakes during pregnancy and lactation are passed to the fetus and the newborn via the placenta and breast milk, respectively. Imbalances in fatty acid intake during the fetal period change the fatty acid composition of membrane phospholipids, which can cause structural and functional problems in cells. Additionally, the metabolic and neuroendocrine environments of the fetus and the newborn play key roles in the regulation of energy balance. Imbalances in fatty acid intake during pregnancy and lactation may result in permanent changes in appetite control, neuroendocrine function and energy metabolism in the fetus, leading to metabolic programming. Further studies are needed to determine the role of fatty acid intake in metabolic programming.

  18. Fetal MRI: incidental findings in the mother

    Energy Technology Data Exchange (ETDEWEB)

    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)

    2016-11-15

    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.)

  19. Fetal microchimerism in human brain tumors.

    Science.gov (United States)

    Broestl, Lauren; Rubin, Joshua B; Dahiya, Sonika

    2017-09-18

    Sex differences in cancer incidence and survival, including central nervous system tumors, are well documented. Multiple mechanisms contribute to sex differences in health and disease. Recently, the presence of fetal-in-maternal microchimeric cells has been shown to have prognostic significance in breast and colorectal cancers. The frequency and potential role of these cells has not been investigated in brain tumors. We therefore selected two common primary adult brain tumors for this purpose: meningioma, which is sex hormone responsive and has a higher incidence in women, and glioblastoma, which is sex hormone independent and occurs more commonly in men. Quantitative PCR was used to detect the presence of male DNA in tumor samples from women with a positive history of male pregnancy and a diagnosis of either glioblastoma or meningioma. Fluorescence in situ hybridization for the X and Y chromosomes was used to verify the existence of intact male cells within tumor tissue. Fetal microchimerism was found in approximately 80% of glioblastoma cases and 50% of meningioma cases. No correlations were identified between the presence of microchimerism and commonly used clinical or molecular diagnostic features of disease. The impact of fetal microchimeric cells should be evaluated prospectively. © 2017 International Society of Neuropathology.

  20. [Fetal ventriculogram in rhesus immunization. Various aspects].

    Science.gov (United States)

    Eisenberg de Smoler, P; Munguia, C D; Dominguez, J A; Lindig, M; Karchmer, S

    1975-01-01

    We considered it useful to attempt to diagnose fetal distress or fetal heart failure in hydropic fetuses using external electrodes with a feto-maternal electrocardiographic machine. The pathological tracings that we obtained have been compared with tracings from a normal pregnancy. The authors have not been able to find that there is a significant difference between the electric axes of normal fetuses and pathological fetuses. In fact in both groups we have found as many normal axes with right deviation as with left deviation. In any case we have found that low voltage ventriculograms with a triangular shape have been more common in hydropic fetuses than in the control group. We do not think that this method will be of any use in diagnosing chronic fetal distress of heart failure. All the same we think that we should devote our attention particularly to those patients that have low voltage ventriculograms of triangular shape. We would like to thank Dr Mario Villamichel for his advice and commentary on the manuscript as well as Dr Luis Senties, the Chef de Service of the Department of Isoimmunisation.

  1. Fetal MRI in experimental tracheal occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Wedegaertner, Ulrike [Department of Diagnostic and Interventional Radiology, Universitaetsklinikum Hamburg-Eppendorf, Martinistrasse 52, 20251 Hamburg (Germany)]. E-mail: wedegaer@uke.uni-hamburg.de; 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)

    2006-02-15

    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.

  2. Avaliação da maturidade fetal em gestações de alto risco: análise dos resultados de acordo com a idade gestacional Assessment of fetal maturity in high risk pregnancies: analysis according to gestational age

    Directory of Open Access Journals (Sweden)

    R.M.Y. NOMURA

    2001-12-01

    Full Text Available OBJETIVO: Estudar a avaliação da maturidade fetal em gestações de alto risco e analisar os resultados neonatais. MÉTODOS: Entre julho de 1998 e agosto de 1999 foram realizadas, no Setor de Vitalidade Fetal da Clínica Obstétrica do HC-FMUSP, 180 amniocenteses para avaliação da maturidade fetal, sendo realizados os testes de Clements em três tubos e a contagem de células orangiófilas coradas com Azul de Nilo a 0,1%. Os resultados perinatais foram correlacionados com a maturidade fetal em 75 casos cujo parto ocorreu até sete dias após a punção. RESULTADOS: Na macroscopia, 91% das amostras apresentavam líquido amniótico claro, 3,3% meconial e 5,6% hemorrágico. A maturidade foi observada em 28% dos exames realizados. Na avaliação dos resultados perinatais, quando a maturidade estava ausente, a necessidade de intubação do recém-nascido ocorreu em três casos (13% e nos fetos maduros isto ocorreu em um caso (2,5% (pBACKGROUND: To study, in high risk pregnancies, the results of fetal maturity evaluation, and analyze the perinatal results. METHODS: Between July 1998 and August 1999, 180 amniocentesis were performed at the Fetal Surveillance Unit to assess fetal maturity. The amniotic fluid exams included Shake Test and orange cells counting. The perinatal results were correlated to fetal maturity in the 75 cases that delivery occurred until 7days after the amniotic fluid analysis. RESULTS: The macroscopic aspects showed 91% of clear amniotic fluid 33% of hemorragic, and 3.3% of meconial fluid. The fetal maturity was evidenced at 28% of analyzed exams. When the fetus was immature, 13% of newborn required artificial ventilation at birth and 65% were allocated at the neonatal intensive care unit. Between the mature fetuses, only one (2.5% required artificial ventilation at birth and 10% were allocated at the neonatal intensive care unit (p<0.05. CONCLUSIONS: The fetal maturity was associated to less newborn interventions. Between the

  3. Efeitos da ingestão de glicose sobre a circulação materno-fetal Materno-fetal hemodynamic repercussion of glucose ingestion

    Directory of Open Access Journals (Sweden)

    Rose Mary de Castro Ranciaro

    2006-12-01

    Full Text Available OBJETIVOS: analisar o efeito da glicose na hemodinâmica materno-fetal pela avaliação doplervelocimétrica da circulação materno-fetal e fetoplacentária. MÉTODOS: trata-se de estudo realizado por único observador, no qual foram incluídas 31 gestantes clinicamente sadias entre a 28ª e a 36ª semana. Os parâmetros foram avaliados imediatamente antes e 60 minutos após a ingestão de 50 g de glicose. Foram utilizados como critérios de inclusão a avaliação clínica e laboratorial normal, a presença de feto único, a idade gestacional entre a 28ª e a 36ª semana de gestação confirmada por exame de ultra-sonografia e/ou a data da última menstruação, a glicemia de jejum menor ou igual a 110 mg/dL e o teste de sobrecarga após 50 g de glicose menor de 140 mg/dL. Como critérios de exclusão, adotaram-se a presença de malformação ou alterações de desenvolvimento fetal, o trabalho de parto, os antecedentes familiares de diabetes, as patologias próprias ou intercorrentes à gestação e o uso de fumo, álcool ou outras drogas. Foram avaliados os vasos maternos da artéria carótida comum e artérias uterinas, os vasos placentários da artéria umbilical e os vasos fetais da artéria cerebral média e aorta abdominal. Foram analisados os seguintes parâmetros em cada vaso: índice de resistência, índice de pulsatilidade, velocidade sistólica máxima, velocidade diastólica final e tempo de aceleração. A freqüência cardíaca fetal foi avaliada pelo modo M da ultra-sonografia. Para análise estatística foi utilizado o teste t de Student quando a variável diferença de antes e depois da ingestão de glicose apresentou distribuição normal no teste de Kolmogorov-Smirnov. Quando a normalidade foi rejeitada, utilizamos o teste não-paramétrico de Wilcoxon, com o nível de significância sempre estabelecido de pPURPOSE: to analyze the effect of glucose in the materno-fetal hemodynamics through dopplervelocimetric assessment of

  4. Mecanismo de centralização: da insuficiência placentária à adaptação circulatória fetal Brain sparing effect: from placental insufficiency to fetal circulatory adaptation

    Directory of Open Access Journals (Sweden)

    Juliana Marques Simões Villas-Bôas

    2008-07-01

    Full Text Available A aplicação e o desenvolvimento da doplervelocimetria obstétrica apresentam base para conhecimento da insuficiência placentária e comprovam o comportamento dinâmico da circulação fetal em regime de hipóxia. Na prática clínica, tornou-se quase rotineira a necessidade de se avaliar a hemodinâmica em três territórios vasculares envolvidos na gestação: artérias uterinas, umbilical e cerebral média. Em linhas gerais, a artéria cerebral expressa o balanço entre a oferta de oxigênio nas uterinas e a captação pelas umbilicais. Atualmente, quando este balanço é desfavorável, procura-se ainda conhecer a reserva cardíaca fetal pelo estudo do ducto venoso. Contudo, precisar e interpretar índices de resistência vascular nem sempre é tarefa fácil. O ponto de partida é ter em mente os fundamentos sobre os quais se assenta o papel da doplervelocimetria para a avaliação do bem-estar fetal.The application and development of obstetric Dopplervelocimetry provide a basis for the investigation of placental insufficiency and demonstrate the dynamic behavior of fetal circulation during hypoxia. In clinical practice, assessing hemodynamics in three vascular regions involved in pregnancy, namely the uterine, umbilical and middle cerebral arteries, has become routine. Roughly, the cerebral artery expresses the balance between uterine artery oxygen supply and umbilical artery oxygen uptake. Currently, when such balance is unfavorable, the fetal cardiac reserve is investigated by assessing the venous duct. However, determining and interpreting vascular resistance indexes is not an easy task. The starting point is to know the physiopathology of placental insufficiency and fetal circulatory adaptation through which Doppler confirmed its role in the assessment of fetal well-being.

  5. Avaliação Ultra-Sonográfica do Crescimento Fetal com uso do Diâmetro Transverso do Cerebelo Ultrasonographic Evaluation of Fetal Growth with the use of the Transverse Cerebellar Diameter

    Directory of Open Access Journals (Sweden)

    Luiz Nery

    2000-06-01

    Full Text Available Objetivo: avaliar a eficácia do diâmetro transverso do cerebelo (DTC, por meio da ultra-sonografia, na evolução do crescimento fetal e relacioná-lo com a idade gestacional, diâmetro biparietal (DBP, circunferência cefálica (CC, circunferência abdominal (CA e comprimento do fêmur (CF. Métodos: foi realizado um estudo prospectivo e longitudinal com 254 gestantes consideradas de baixo risco, com idade gestacional de 20 a 40 semanas. Somente 55 gestantes foram incluídas no estudo, segurados os critérios de inclusão e exclusão. Todos os exames, ou seja, as 217 avaliações ultra-sonográficas foram realizadas pelo autor (LN, sendo no mínimo três e no máximo seis exames para cada gestante, com intervalo de uma a cinco semanas. Foram estabelecidos padrões de normalidade entre os percentis 10 e 90 para cada idade gestacional, com confirmação após o parto. Resultados: o diâmetro transverso do cerebelo apresentou uma boa correlação com a idade gestacional, tanto como variável dependente (R² = 0,90, como variável independente (R² = 0,92. Uma correlação significativa na avaliação do crescimento fetal foi encontrada entre o DTC e os vários parâmetros fetais: DBP e CC (R² = 0,92, CF (R² = 0,90 e CA (R² = 0,89. Conclusões: o diâmetro transverso do cerebelo é um parâmetro que deve ser utilizado no acompanhamento do desenvolvimento e do crescimento fetal devido a sua curva de crescimento de padrão ascendente. Qualquer alteração para mais ou menos na curva de crescimento pode ser útil na detecção dos desvios do crescimento fetal.Purpose: to evaluate the effectiveness of the transverse cerebellar diameter (TCD, by ultrasonography, in the evolution of the fetal growth, and to relate it to gestational age, biparietal diameter (BPD, head circumference (HC, abdominal circumference (AC and femur length (FL. Method: a prospective and longitudinal study was performed on 254 pregnant women considered of low risk, with a

  6. Ultrasound for fetal assessment in early pregnancy

    Science.gov (United States)

    Whitworth, Melissa; Bricker, Leanne; Neilson, James P; Dowswell, Therese

    2014-01-01

    Background Diagnostic ultrasound is a sophisticated electronic technology, which utilises pulses of high frequency sound to produce an image. Diagnostic ultrasound examination may be employed in a variety of specific circumstances during pregnancy such as after clinical complications, or where there are concerns about fetal growth. Because adverse outcomes may also occur in pregnancies without clear risk factors, assumptions have been made that routine ultrasound in all pregnancies will prove beneficial by enabling earlier detection and improved management of pregnancy complications. Routine screening may be planned for early pregnancy, late gestation, or both. The focus of this review is routine early pregnancy ultrasound. Objectives To assess whether routine early pregnancy ultrasound for fetal assessment (i.e. its use as a screening technique) influences the diagnosis of fetal malformations, multiple pregnancies, the rate of clinical interventions, and the incidence of adverse fetal outcome when compared with the selective use of early pregnancy ultrasound (for specific indications). Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (September 2009). Selection criteria Published, unpublished, and ongoing randomised controlled trials that compared outcomes in women who experienced routine versus selective early pregnancy ultrasound (i.e. less than 24 weeks’ gestation). We have included quasi-randomised trials. Data collection and analysis Two review authors independently extracted data for each included study. We used the Review Manager software to enter and analyse data. Main results Routine/revealed ultrasound versus selective ultrasound/concealed: 11 trials including 37505 women. Ultrasound for fetal assessment in early pregnancy reduces the failure to detect multiple pregnancy by 24 weeks’ gestation (risk ratio (RR) 0.07, 95% confidence interval (CI) 0.03 to 0.17). Routine scan is associated with a reduction in

  7. Recommendations for fetal echocardiography in twin pregnancy in 2016

    Directory of Open Access Journals (Sweden)

    Leszczyńska Katarzyna

    2016-01-01

    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.

  8. Fetal stem cell transplantation: Past, present, and future.

    Science.gov (United States)

    Ishii, Tetsuya; Eto, Koji

    2014-09-26

    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.

  9. MRI of normal and pathological fetal lung development

    Energy Technology Data Exchange (ETDEWEB)

    Kasprian, Gregor [University Clinic of Radiodiagnostics, Medical University of Vienna (Austria)]. E-mail: gregor.kasprian@meduniwien.ac.at; 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)

    2006-02-15

    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.

  10. Increased fetal myocardial sensitivity to insulin-stimulated glucose metabolism during ovine fetal growth restriction.

    Science.gov (United States)

    Barry, James S; Rozance, Paul J; Brown, Laura D; Anthony, Russell V; Thornburg, Kent L; Hay, William W

    2016-04-01

    Unlike other visceral organs, myocardial weight is maintained in relation to fetal body weight in intrauterine growth restriction (IUGR) fetal sheep despite hypoinsulinemia and global nutrient restriction. We designed experiments in fetal sheep with placental insufficiency and restricted growth to determine basal and insulin-stimulated myocardial glucose and oxygen metabolism and test the hypothesis that myocardial insulin sensitivity would be increased in the IUGR heart. IUGR was induced by maternal hyperthermia during gestation. Control (C) and IUGR fetal myocardial metabolism were measured at baseline and under acute hyperinsulinemic/euglycemic clamp conditions at 128-132 days gestation using fluorescent microspheres to determine myocardial blood flow. Fetal body and heart weights were reduced by 33% (P = 0.008) and 30% (P = 0.027), respectively. Heart weight to body weight ratios were not different. Basal left ventricular (LV) myocardial blood flow per gram of LV tissue was maintained in IUGR fetuses compared to controls. Insulin increased LV myocardial blood flow by ∼38% (P IUGR fetuses was 73% greater than controls. Similar to previous reports testing acute hypoxia, LV blood flow was inversely related to arterial oxygen concentration (r(2 )= 0.71) in both control and IUGR animals. Basal LV myocardial glucose delivery and uptake rates were not different between IUGR and control fetuses. Insulin increased LV myocardial glucose delivery (by 40%) and uptake (by 78%) (P IUGR fetuses compared to controls. During basal and hyperinsulinemic-euglycemic clamp conditions LV myocardial oxygen delivery, oxygen uptake, and oxygen extraction efficiency were not different between groups. These novel results demonstrate that the fetal heart exposed to nutrient and oxygen deprivation from placental insufficiency appears to maintain myocardial energy supply in the IUGR condition via increased glucose uptake and metabolic response to insulin, which support

  11. Fatores de risco maternos associados à acidose fetal Maternal risk factors associated with fetal acidosis

    Directory of Open Access Journals (Sweden)

    José Mauro Madi

    2010-09-01

    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.

  12. Non-invasive prenatal diagnosis of fetal RhD by using free fetal DNA.

    Science.gov (United States)

    Gönenç, G; Işçi, H; Yiğiter, A B; Hançer, V; Büyükdoğan, M; Güdücü, N; Dünder, I

    2015-01-01

    Anti-D immunoglobulin is applied to all pregnant women having RhD incompatibility to prevent hemolytic disease of the newborn. The aim of this study is to determine fetal RhD status in the Rh incompatible pregnancies with an non-invasive technique; free fetal DNA isolation from maternal circulation. In the case of Rh incompatibility especially with a history of previous fetal anemia, it can be beneficial to know Rh status antenatally in terms of monitoring fetuses with Rh positive [RhD(+)] status consciously. Total free DNA was isolated in 50 Rh negative [RhD(-)] pregnant women, who had RhD alloimmunisation with their husbands. The gene in isolated DNA was investigated with TagMan prob and real time PCR by using primers belonging to exon 7 of the RhD gene. The authors analyzed 50 RhD(-) women by using quantitative real time PCR technique. Five of them were RhD(-) and the rest of them were found to be RhD(+). After birth one of the infants who were analyzed as RhD(+) were found to be RhD(-). The detection of fetal RhD status by using a non-invasive method from maternal circulation was found to be possible. Assessing fetal RhD status non-invasively by using free fetal DNA in maternal blood will be cost-efficient, avoiding unnecessary indirect Coombs test and unnecessary Rhogam applications that is used in RH incompatible pregnancies. This study will throw a fresh light on prenatal diagnosis.

  13. Ultrasound for fetal assessment in early pregnancy.

    Science.gov (United States)

    Whitworth, Melissa; Bricker, Leanne; Mullan, Clare

    2015-07-14

    Diagnostic ultrasound is a sophisticated electronic technology, which utilises pulses of high-frequency sound to produce an image. Diagnostic ultrasound examination may be employed in a variety of specific circumstances during pregnancy such as after clinical complications, or where there are concerns about fetal growth. Because adverse outcomes may also occur in pregnancies without clear risk factors, assumptions have been made that routine ultrasound in all pregnancies will prove beneficial by enabling earlier detection and improved management of pregnancy complications. Routine screening may be planned for early pregnancy, late gestation, or both. The focus of this review is routine early pregnancy ultrasound. To assess whether routine early pregnancy ultrasound for fetal assessment (i.e. its use as a screening technique) influences the diagnosis of fetal malformations, multiple pregnancies, the rate of clinical interventions, and the incidence of adverse fetal outcome when compared with the selective use of early pregnancy ultrasound (for specific indications). We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 March 2015) and reference lists of retrieved studies. Published, unpublished, and ongoing randomised controlled trials that compared outcomes in women who experienced routine versus selective early pregnancy ultrasound (i.e. less than 24 weeks' gestation). We have included quasi-randomised trials. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We used the Review Manager software to enter and analyse data. Routine/revealed ultrasound versus selective ultrasound/concealed: 11 trials including 37,505 women. Ultrasound for fetal assessment in early pregnancy reduces the failure to detect multiple pregnancy by 24 weeks' gestation (risk ratio (RR) 0.07, 95% confidence interval (CI) 0.03 to 0.17; participants = 295; studies = 7), moderate quality of

  14. Taquiarritmias supraventriculares fetales refractarias al tratamiento inicial Fetal supraventricular tachyarrhythmias refractory to initial therapy

    OpenAIRE

    Eduardo Malvino; Mario C. Bruno; Juan P. Gallo; Juan C. Medrano; Daniel Ferrante

    2005-01-01

    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 fl...

  15. Malnutrition during fetal life, fetal programming and implications for farm aninals productivity

    DEFF Research Database (Denmark)

    Nielsen, Mette Olaf; Khanal, Prabhat; Johnsen, Lærke

    the ability of an individual to respond to and cope with the postnatal environment. Since then, it has been clearly demonstrated that malnourishment during fetal life can predispose to a wide range of developmental disorders and diseases later in life. This is due to a phenomenon termed fetal programming (FP...... 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...

  16. Fetal pulse oximetry: duration of desaturation and intrapartum outcome.

    Science.gov (United States)

    Bloom, S L; Swindle, R G; McIntire, D D; Leveno, K J

    1999-06-01

    To analyze labor outcomes in relation to masked fetal arterial oxyhemoglobin saturation values above or below 30%. Consenting gravidas with uncomplicated pregnancies at or beyond 36 weeks' gestation underwent continuous fetal pulse oximetry. Pregnancy outcomes were compared between two groups: women with fetuses with at least one epoch of arterial oxyhemoglobin saturation below 30% (10 seconds or longer) and women with fetuses without such an episode. We also attempted to ascertain whether duration of saturation below 30% correlated with fetal compromise. We measured arterial oxyhemoglobin saturation in 129 fetuses, 69 (53%) of whom had at least one epoch of saturation below 30%. There were no statistically significant differences in labor and delivery outcomes between the high-saturation and low-saturation groups (eg, cesarean delivery: 13 versus 9%, P = .41; umbilical artery [UA] pH less than 7.20: 10 versus 9%, P > .999). However, as duration of fetal arterial oxyhemoglobin saturation below 30% increased from 10 seconds to longer than 9 consecutive minutes, the incidence of fetal compromise (considered present when at least one of the following criteria was met: cesarean delivery for nonreassuring fetal heart rate pattern, UA pH less than 7.20, admission to the special care nursery, or 5-minute Apgar score not more than 3) increased significantly (P = .002). The threshold duration of fetal arterial oxyhemoglobin saturation below 30% associated with increased fetal compromise was 2 minutes. Transient fetal arterial oxyhemoglobin saturation values below 30% are common during normal labor and did not predict fetal compromise. Fetal arterial oxyhemoglobin saturation values less than 30% for 2 minutes or longer might be associated with fetal compromise.

  17. In vitro assessment of mouse fetal abdominal aortic vascular function

    OpenAIRE

    Renshall, Lewis J.; Dilworth, Mark R.; Greenwood, Susan L.; Sibley, Colin P.; Wareing, Mark

    2014-01-01

    Fetal growth restriction (FGR) affects 3?8% of human pregnancies. Mouse models have provided important etiological data on FGR; they permit the assessment of treatment strategies on the physiological function of both mother and her developing offspring. Our study aimed to 1) develop a method to assess vascular function in fetal mice and 2) as a proof of principle ascertain whether a high dose of sildenafil citrate (SC; Viagra) administered to the pregnant dam affected fetal vascular reactivit...

  18. Clinical characteristics and perinatal outcome of fetal hydrops

    OpenAIRE

    Yeom, Wonkyung; Paik, E Sun; An, Jung-Joo; Oh, Soo-young; Choi, Suk-Joo; Roh, Cheong-Rae; Kim, Jong-Hwa

    2015-01-01

    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 characteris...

  19. Uterine Rupture and Fetal Maceration in an Indian Mongrel Bitch

    Directory of Open Access Journals (Sweden)

    Deepti Bodh

    2014-01-01

    Full Text Available Uterine rupture and fetal maceration in an 11 year old mongrel bitch was diagnosed via lateral abdominal radiography and ventral midline laparotomy. The treatment of choice in cases of uterine rupture and fetal maceration is bilateral ovariohysterectomy along with plenty of intravenous fluid therapy and broad spectrum antibiotics. Incidences of uterine rupture and fetal maceration can be prevented by timely recognition of early signs of obstetrical-related complications and use of proper obstetrical techniques.

  20. Relações entre a saúde mental da gestante e o apego materno-fetal Relations between pregnant women's mental health and maternal-fetal attachment

    Directory of Open Access Journals (Sweden)

    Patrícia Alvarenga

    2012-12-01

    Full Text Available O estudo investigou as relações entre variáveis sociodemográficas, saúde mental da gestante e o apego materno-fetal no terceiro trimestre de gestação. Participaram do estudo 261 gestantes selecionadas através de amostragem por acessibilidade em quatro maternidades públicas. As gestantes responderam individualmente uma ficha de dados sociodemográficos, a Escala de Apego Materno-Fetal e o SRQ-20. A análise de regressão revelou que o número de filhos (4% e a saúde mental materna (4,2% explicaram parte da variância no apego materno-fetal. A escolaridade da mãe e do pai não esteve associada a essa variável. O modelo de regressão múltipla considerando os quatro fatores analisados, explicou 8,2% da variância nos escores de apego materno-fetal. Discutem-se as implicações dessas variáveis na formação do vínculo da mãe com o bebê durante a gestação.This study investigated the relations among sociodemographic variables, pregnant women mental health, and maternal-fetal attachment in the third trimester of pregnancy. Participants were 261 pregnant women recruited from public maternity wards using a convenience sampling technique. Each pregnant woman completed a sociodemographic data form, the Maternal-Fetal Attachment Scale, and the SRQ-20. Regression analysis revealed that the number of children (4% and mothers' mental health (4.2% accounted for part of the variance in maternal-fetal attachment scores. Father's and mother's schooling was not associated with this variable. Taking the four analyzed factors into account, a multiple regression model accounted for 8.2% of the variance in the maternal-fetal attachment scores. The implications of these variables for mother-infant bonding during pregnancy are discussed.

  1. Association of gestational age with the option of pregnancy termination for fetal abnormalities incompatible with neonatal survival.

    Science.gov (United States)

    Westphal, Flavia; Fustinoni, Suzete Maria; Pinto, Vânia Lopes; Melo, Patrícia de Souza; Abrahão, Anelise Riedel

    2016-01-01

    To identify the profile of women seen in a Fetal Medicine unit, diagnosed with fetal abnormality incompatible with neonatal survival in their current pregnancy, and to check the association of gestational age upon diagnosis with the option of pregnancy termination. This is a retrospective cohort study carried out in the Fetal Medicine Outpatients Clinic of a university hospital, in the city of São Paulo (SP), Brazil, using medical records of pregnant women with fetus presenting abnormalities incompatible with neonatal survival. The sample comprised 94 medical records. The Statistical Package for the Social Sciences (SPSS), version 19, was used for the data statistical analysis. The population of the study included young adult women, who had complete or incomplete high school education, employed, with family income of one to three minimum wages, single, nonsmokers, who did not drink alcoholic beverages or used illicit drugs. Women with more advanced gestational age upon fetal diagnosis (p=0.0066) and/or upon admission to the specialized unit (p=0.0018) presented a lower percentage of termination of pregnancy. Due to characteristics different from those classically considered as of high gestational risk, these women might not be easily identified during the classification of gestational risk, what may contribute to a late diagnosis of fetal diseases. Early diagnosis enables access to specialized multiprofessional care in the proper time for couple's counseling on the possibility of requesting legal authorization for pregnancy termination. Identificar o perfil de mulheres atendidas em um serviço de Medicina Fetal, que receberam diagnóstico de anomalia fetal incompatível com a sobrevida neonatal na gestação atual, e verificar a associação da idade gestacional no diagnóstico com a opção pela interrupção da gravidez. Trata-se de um estudo de coorte retrospectivo, realizado no ambulatório de Medicina Fetal de um hospital universitário da cidade de S

  2. Electronic fetal heart rate monitoring: where are we now?

    Science.gov (United States)

    Chez, Bonnie Flood; Baird, Suzanne McMurtry

    2011-01-01

    Electronic fetal heart rate monitoring (EFM) continues to be the primary method utilized for fetal assessment in the United States. Standardization of nomenclature associated with this perinatal technology has evolved over the past 40 years such that the current nomenclature recommended by the National Institute of Child Health and Human Development (NICHD) has been adopted by professional perinatal organizations as the agreed-upon method for professional communication and documentation. Current research continues to focus on the optimal management of intrapartum fetal heart rate tracings. The clinical controversies and challenges related to electronic fetal heart rate monitoring continue to evolve.

  3. Fetal assessment for anesthesiologists: are you evaluating the other patient?

    Science.gov (United States)

    Moaveni, Daria M; Birnbach, David J; Ranasinghe, J Sudharma; Yasin, Salih Y

    2013-06-01

    Suboptimal communication between anesthesiologists and obstetricians can be associated with unintended poor maternal and neonatal outcomes, especially for emergency cesarean deliveries. Obstetricians use the results of antepartum and intrapartum fetal assessments to assess fetal well-being and to make decisions about the timing and method of delivery. Because abnormal results may lead to the need for urgent or emergency cesarean deliveries, these decisions may directly impact anesthetic care. Lack of familiarity with fetal assessments and the significance of the results may thus hinder the communication necessary for optimal patient care. In this review article, we discuss the current antepartum and intrapartum fetal assessment modalities, including the nonstress test, biophysical profile, Doppler velocimetry, electronic fetal heart rate monitoring, fetal electrocardiogram (STAN-ST waveform analysis), and fetal pulse oximetry. The physiologic basis behind these modalities and the available evidence regarding their utility in clinical practice are also reviewed. The 2008 National Institute of Child Health and Human Development workshop report on electronic fetal monitoring categories, which are incorporated into the American College of Obstetricians and Gynecologists guidelines for intrapartum care, is examined. The implications of test interpretation to the practice of obstetric anesthesiology is also discussed. Anesthesia provider understanding of fetal assessment modalities is essential in improving communication with obstetricians and improving the planning of cesarean deliveries for high-risk obstetric patients.

  4. Detailed multigrade evaluation of fetal disorders with the quantified actocardiogram.

    Science.gov (United States)

    Maeda, Kazuo; Iwabe, Tomio; Yoshida, Souichi; Ito, Takashi; Minagawa, Yukihisa; Morokuma, Seiichi; Pooh, Ritsuko K; Fuchiwaki, Taisuke

    2009-01-01

    To evaluate fetal disorders using detailed quantitative values from the actocardiogram (ACG) involving simultaneous tracing of ultrasonic Doppler fetal movement bursts and fetal heart rate (FHR). Duration of FHR accelerations and fetal movement bursts were measured manually in 20 common fetal disorders. The severity of the fetal disorder was estimated using the FHR acceleration duration to movement burst ratio (A/B ratio) and 10-0 clinical severity ranks derived from the A/B ratio. The correlation of the A/B ratio and 1 and 5 min Apgar scores, as well as numerically expressed long-term outcomes were studied. A/B ratios were significantly correlated with the 1 and 5 min Apgar scores and the numerically evaluated long-term outcomes. Controversial cases of FHR pattern were more easily understood using the A/B ratio. The 10-0 severity derived from the A/B ratio was useful in clinical fetal studies. Common fetal disorders were evaluated quantitatively and in more detail using the A/B ratio from the actocardiogram than when using common binary good or bad evaluation. The A/B ratio was useful in outcome estimation, where the prognostic capability of the A/B ratio was confirmed by significant correlation with 1 and 5 min Apgar scores and long-term outcomes of fetal disorders.

  5. Maternal obesity and fetal metabolic programming: a fertile epigenetic soil

    National Research Council Canada - National Science Library

    Heerwagen, Margaret J R; Miller, Melissa R; Barbour, Linda A; Friedman, Jacob E

    2010-01-01

    .... In addition to maternal glucose, hyperlipidemia and inflammation may contribute to the childhood obesity epidemic through fetal metabolic programming, the mechanisms of which are not well understood...

  6. Fetal metabolic programming and epigenetic modifications: a systems biology approach

    National Research Council Canada - National Science Library

    Sookoian, Silvia; Gianotti, Tomas Fernández; Burgueño, Adriana L; Pirola, Carlos J

    2013-01-01

    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...

  7. The use of acoustic stimulation to inspect the fetal mouth

    Energy Technology Data Exchange (ETDEWEB)

    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)

    2000-12-15

    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.

  8. Fetal Gender and Several Cytokines Are Associated with the Number of Fetal Cells in Maternal Blood - An Observational Study

    DEFF Research Database (Denmark)

    Schlütter, Jacob Mørup; Kirkegaard, Ida; Petersen, Olav Bjørn

    2014-01-01

    OBJECTIVE: To identify factors influencing the number of fetal cells in maternal blood. METHODS: A total of 57 pregnant women at a gestational age of weeks 11-14 were included. The number of fetal cells in maternal blood was assessed in 30 ml of blood using specific markers for both enrichment...... 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....... CONCLUSION: The number of fetal cells in maternal blood is associated with certain cytokines and fetal gender....

  9. Determinação ultra-sonográfica do sexo fetal pela medida dos ângulos do apêndice genital Sonographic determination of fetal gender by measurement of the angles of the genital tubercle

    Directory of Open Access Journals (Sweden)

    Victor Bunduki

    2005-06-01

    Full Text Available OBJETIVO: avaliar a acurácia da ultra-sonografia para predição do sexo fetal entre a 11ª e a 13ª semana e 6 dias por meio da medida dos ângulos anterior e posterior do apêndice genital. MÉTODOS: os ângulos anterior e posterior do apêndice genital foram medidos em corte sagital de 455 fetos entre a 11ª e a 13ª semana e 6 dias. A probabilidade de predição correta do sexo fetal (confirmado após o nascimento foi categorizada de acordo com a medida dos ângulos, idade gestacional e comprimento crânio-caudal. Os pontos de corte de melhor acurácia para predizer o sexo fetal foram obtidos por meio de curva ROC. A variação interobservador foi avaliada pelo método de Bland-Altman. RESULTADOS: a taxa de predição correta do sexo fetal se elevou com a idade gestacional e comprimento crânio-nádegas. Utilizando o ponto de corte de 42 graus para o ângulo anterior (curva ROC, a predição correta do sexo fetal ocorreu em 72% dos fetos da 11ª à 11ª semana e 6 dias, 86% da 12ª à 12ª semana e 6 dias e 88% da 13ª à 13ª semana e 6 dias. As taxas de predição obtidas com o ângulo posterior (ponto de corte de 24 graus foram, respectivamente: 70, 87 e 87%. A avaliação da variação interobservador revelou diferença média entre medidas pareadas de 15,7 e 9 graus para as medidas dos ângulos posterior e anterior, respectivamente. CONCLUSÃO: a acurácia da medida dos ângulos do apêndice genital na predição do sexo fetal foi elevada a partir da 12ª semana de gestação mas ainda insuficiente para sua aplicação em gestações com risco de doenças graves ligadas ao cromossomo X.PURPOSE: to evaluate the accuracy of fetal gender prediction at 11 to 13 weeks and 6 days by measuring the anterior and posterior genital tubercle angles. MESTHODS: the anterior and posterior genital tubercle angles were measured in a midsagittal plane in 455 fetuses from 11 to 13 weeks and 6 days. The probability of a correct fetal sex prediction

  10. Influence of fetal blood flow redistribution on fetal and childhood growth and fat distribution: the Generation R Study.

    Science.gov (United States)

    Kooijman, M N; Gaillard, R; Reiss, Ikm; Hofman, A; Steegers, Eap; Jaddoe, Vwv

    2016-12-01

    A suboptimal intrauterine environment leads to fetal blood flow redistribution and fetal growth restriction. Not much is known about childhood growth consequences. We examined the associations of fetal blood flow redistribution with birth outcomes, and repeatedly measured fetal and childhood growth and fat mass measures. Prospective cohort study. Population-based. One thousand one hundred and ninety-five pregnant women and their children. We measured umbilical and cerebral artery blood flow at a gestational age of 30.3 weeks (95% range, 28.5-32.6 weeks). A higher umbilical/cerebral (U/C) pulsatility index ratio is an indicator of preferential blood flow to the brain cerebral circulation at the expense of the lower body parts. Fetal and childhood growth were repeatedly measured from the third trimester until childhood. We measured the total body fat mass, lean fat mass and android/gynoid fat mass ratio by dual-energy X-ray absorptiometry and preperitoneal fat by ultrasound at 6 years. A higher fetal U/C ratio was associated with increased risks of preterm birth and small size for gestational age at birth [odds ratios, 1.41 (95% confidence interval, 1.08-1.85) and 1.63 (95% confidence interval, 1.21-2.19), respectively, per SDS increase in U/C ratio]. Longitudinal growth analyses showed that a higher fetal U/C ratio was associated with persistently lower head circumference, length and weight from third trimester fetal life until childhood (all P ratio was not associated with total body and abdominal fat measures at 6 years. Our results suggest that fetal blood flow redistribution affects fetal development and has persistent consequences for childhood growth. Fetal blood flow redistribution affects fetal development and has persistent consequences for childhood growth. © 2016 Royal College of Obstetricians and Gynaecologists.

  11. Fetal intervention increases maternal T cell awareness of the foreign conceptus and can lead to immune-mediated fetal demise.

    Science.gov (United States)

    Wegorzewska, Marta; Nijagal, Amar; Wong, Charissa M; Le, Tom; Lescano, Ninnia; Tang, Qizhi; MacKenzie, Tippi C

    2014-02-15

    Fetal interventions to diagnose and treat congenital anomalies are growing in popularity but often lead to preterm labor. The possible contribution of the maternal adaptive immune system to postsurgical pregnancy complications has not been explored. We recently showed that fetal intervention in mice increases maternal T cell trafficking into the fetus and hypothesized that this process also may lead to increased maternal T cell recognition of the foreign conceptus and subsequent breakdown in maternal-fetal tolerance. In this study, we show that fetal intervention in mice results in accumulation of maternal T cells in the uterus and that these activated cells can produce effector cytokines. In adoptive transfer experiments, maternal T cells specific for a fetal alloantigen proliferate after fetal intervention, escape apoptosis, and become enriched compared with endogenous T cells in the uterus and uterine-draining lymph nodes. Finally, we demonstrate that such activation and accumulation can have a functional consequence: in utero transplantation of hematopoietic cells carrying the fetal alloantigen leads to enhanced demise of semiallogeneic fetuses within a litter. We further show that maternal T cells are necessary for this phenomenon. These results suggest that fetal intervention enhances maternal T cell recognition of the fetus and that T cell activation may be a culprit in postsurgical pregnancy complications. Our results have clinical implications for understanding and preventing complications associated with fetal surgery such as preterm labor.

  12. Fetal response to maternal hunger and satiation - novel finding from a qualitative descriptive study of maternal perception of fetal movements.

    Science.gov (United States)

    Bradford, Billie; Maude, Robyn

    2014-08-26

    Maternal perception of decreased fetal movements is a specific indicator of fetal compromise, notably in the context of poor fetal growth. There is currently no agreed numerical definition of decreased fetal movements, with the subjective perception of a decrease on the part of the mother being the most significant definition clinically. Both qualitative and quantitative aspects of fetal activity may be important in identifying the compromised fetus.Yet, how pregnant women perceive and describe fetal activity is under-investigated by qualitative means. The aim of this study was to explore normal fetal activity, through first-hand descriptive accounts by pregnant women. Using qualitative descriptive methodology, interviews were conducted with 19 low-risk women experiencing their first pregnancy, at two timepoints in their third trimester. Interview transcripts were later analysed using qualitative content analysis and patterns of fetal activity identified were then considered along-side the characteristics of the women and their birth outcomes. This paper focuses on a novel finding; the description by pregnant women of fetal behaviour indicative of hunger and satiation. Full findings will be presented in later papers. Most participants (74% 14 of 19) indicated mealtimes were a time of increased fetal activity. Eight participants provided detailed descriptions of increased activity around meals, with seven (37% 7 of 19) of these specifying increased fetal activity prior to meals or in the context of their own hunger. These movements were interpreted as a fetal demand for food often prompting the mother to eat. Interestingly, the women who described increased fetal activity in the context of hunger subsequently gave birth to smaller infants (mean difference 364 gm) than those who did not describe a fetal response to hunger. Food seeking behaviour may have a pre-birth origin. Maternal-fetal interaction around mealtimes could constitute an endocrine mediated

  13. Influencia del ejercicio físico aeróbico durante el embarazo en los niveles de hemoglobina y de hierro maternos = Influence of physical aerobic exercise during pregnancy on the maternal haemoglobin and iron levels.

    OpenAIRE

    Barakat Carballo, Ruben; Stirling, James

    2008-01-01

    Son bien conocidos los efectos beneficiosos que el ejercicio físico tiene sobre la salud en general, aunque no se cuenta con la misma información cuando se desarrolla durante el embarazo. La mayor incertidumbre es saber si pueden coexistir ambos procesos, ejercicio y embarazo, sin conflictos materno-fetales y sin resultados del embarazo alterados. Especialmente cuando día a día, son más las mujeres que desean continuar ejercitándose de alguna forma, durante su embarazo. El objetivo de este tr...

  14. A study on maternal-fetal attachment in pregnant women undergoing fetal echocardiography

    Directory of Open Access Journals (Sweden)

    Concetta Polizzi

    2017-03-01

    Full Text Available Purpose: To investigate the possible effects of the fetal echocardiography experience on the prenatal attachment process. The predictive effect of specific women’s psychological variables will be explored as well.Design and methods: This between groups study involved 85 women with pregnancy at risk who underwent the fetal echocardiography, and 83 women who were about to undergo the morphological scan. The tools employed were: the Prenatal Attachment Inventory (P.A.I. to explore the maternal-fetal attachment; the Maternity Social Support Scale to investigate the woman perception of being socially supported during pregnancy; both the Big Five Questionnaire and the FACES III to explore the personality traits of pregnant women and their perception of their couple relationship functioning.Findings: The outcomes of ANOVA do not show statistically significant differences between the two groups of the mothers-to-be with regard to the scores of the P.A.I. (F = .017; p = .897; η2 = .000, while the regression analysis of the possible effect of the maternal psychological variables on the mother-fetus relationship shows a statistically significant result only with regard to the “social support” variable (r2 = .061; df = 80; p = .025.Conclusions: It would seem that the process of the prenatal attachment develops independently whether the woman has to undergo a first level screening or a second level examination such as the fetal echocardiography.

  15. Fetal liver cell transplantation : role and nature of the fetal haemopoietic stem cell

    NARCIS (Netherlands)

    B. Löwenberg (Bob)

    1975-01-01

    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

  16. A Comparative Study on Fetal Heart Rates Estimated from Fetal Phonography and Cardiotocography

    Science.gov (United States)

    Ibrahim, Emad A.; Al Awar, Shamsa; Balayah, Zuhur H.; Hadjileontiadis, Leontios J.; Khandoker, Ahsan H.

    2017-01-01

    The aim of this study is to investigate that fetal heart rates (fHR) extracted from fetal phonocardiography (fPCG) could convey similar information of fHR from cardiotocography (CTG). Four-channel fPCG sensors made of low cost (34 weeks of gestation). A novel multi-lag covariance matrix-based eigenvalue decomposition technique was used to separate maternal breathing, fetal heart sounds (fHS) and maternal heart sounds (mHS) from abdominal phonogram signals. Prior to the fHR estimation, the fPCG signals were denoised using a multi-resolution wavelet-based filter. The proposed source separation technique was first tested in separating sources from synthetically mixed signals and then on raw abdominal phonogram signals. fHR signals extracted from fPCG signals were validated using simultaneous recorded CTG-based fHR recordings.The experimental results have shown that the fHR derived from the acquired fPCG can be used to detect periods of acceleration and deceleration, which are critical indication of the fetus' well-being. Moreover, a comparative analysis demonstrated that fHRs from CTG and fPCG signals were in good agreement (Bland Altman plot has mean = −0.21 BPM and ±2 SD = ±3) with statistical significance (p monitoring tool for fetal well-being. PMID:29089896

  17. Taquiarritmias supraventriculares fetales refractarias al tratamiento inicial Fetal supraventricular tachyarrhythmias refractory to initial therapy

    Directory of Open Access Journals (Sweden)

    Eduardo Malvino

    2005-04-01

    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.

  18. The number of fetal cells in maternal blood is associated to exercise and fetal gender

    DEFF Research Database (Denmark)

    Schlütter, Jacob Mørup; Kirkegaard, Ida; Christensen, Connie Britta

    -18), which is a challenge for the implementation of the method for prenatal diagnostic purposes. We conducted a study to identify factors influencing the number of fcmbs at a gestational age of 11-14 weeks. Methods: 59 pregnant women at weeks 11-14 were included, and information about lifestyle and daily...... 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...... 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...

  19. Predicting intrapartum fetal compromise using the fetal cerebro-umbilical ratio.

    Science.gov (United States)

    Sabdia, S; Greer, R M; Prior, T; Kumar, S

    2015-05-01

    The aim of this study was to explore the association between the cerebro-umbilical ratio measured at 35-37 weeks and intrapartum fetal compromise. This retrospective cross sectional study was conducted at the Mater Mothers' Hospital in Brisbane, Australia. Maternal demographics and fetal Doppler indices at 35-37 weeks gestation for 1381 women were correlated with intrapartum and neonatal outcomes. Babies born by caesarean section or instrumental delivery for fetal compromise had the lowest median cerebro-umbilical ratio 1.60 (IQR 1.22-2.08) compared to all other delivery groups (vaginal delivery, emergency delivery for failure to progress, emergency caesarean section for other reasons or elective caesarean section). The percentage of infants with a cerebro-umbilical ratio cerebro-umbilical ratio between the 10th-90th centile and 9.6% of infants with a cerebro-umbilical ratio > 90th centile required delivery for the same indication (p cerebro-umbilical ratio was associated with an increased risk of emergency delivery for fetal compromise, OR 2.03 (95% CI 1.41-2.92), p cerebro-umbilical ratio measured at 35-37 weeks is associated with a greater risk of intrapartum compromise. This is a relatively simple technique which could be used to risk stratify women in diverse healthcare settings. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Abnormal fetal movements, micrognathia and pulmonary hypoplasia: a case report. Abnormal fetal movements

    Directory of Open Access Journals (Sweden)

    Morokuma Seiichi

    2010-08-01

    Full Text Available Abstract Background Micrognathia is a facial malformation characterized by mandibular hypoplasia and a small, receding chin that fails to maintain the tongue in a forward position. We previously reported a system of prenatal screening that we developed to identify fetuses with compromised central nervous system function by observing fetal behavior. In this paper we report the case of a preterm infant with micrognathia and pulmonary hypoplasia who presented abnormal fetal movements. Case presentation A 27-year-old Japanese primigravida at 33 weeks of gestation was referred to our hospital. Ultrasonographic examination revealed clinical polyhydramnios. Micrognathia was evident on midsagittal and 3 D scan. The lung area was less than the mean -2.0 standard deviations for the gestational age. The infant had mandibular hypoplasia and glossoptosis. After emergency cesarean delivery for non-reasuring fetal status, required immediate tracheostomy and cardiopulmonary resuscitation with mechanical ventilatory support. However, the infant's cardiopulmonary condition did not improve and she died 21 hours after birth. Conclusions The findings of our ultrasound exam are suggestive of brain dysfunction. The observation of fetal behavior appears to be effective for the prediction of prognosis of cases with micrognathia.

  1. Bilateral Fetal Hydrothorax Requiring Intrauterine Fetal Thoracoamniotic Shunts: Anesthetic Considerations and Management

    Directory of Open Access Journals (Sweden)

    John J. Hache

    2009-01-01

    Full Text Available After prenatal diagnosis of bilateral fetal hydrothorax, ascites, and polyhydramnios, bilateral thoracoamniotic shunts were placed at 29 weeks gestation using an ultrasound-guided, minimally invasive technique. Anesthetic care was managed using intravenous sedation and local anesthesia infiltration. The anesthetic considerations for such procedures are discussed.

  2. Fetal Alcohol Syndrome and Fetal Alcohol and Other Drug Effects. A Guide for Teachers.

    Science.gov (United States)

    New Jersey State Dept. of Education, Trenton. Div. of General Academic Education.

    This curriculum guide on Fetal Alcohol Syndrome (FAS) is intended to help meet New Jersey secondary-level learning objectives in the area of chemical health education. The guide is organized into six sections, each with a conceptual statement, content outline, specific objectives, and lesson plans. The six sections and corresponding major concepts…

  3. Early pregnancy maternal and fetal angiogenic factors and fetal and childhood growth: the Generation R Study.

    Science.gov (United States)

    Bergen, N E; Bouwland-Both, M I; Steegers-Theunissen, R P M; Hofman, A; Russcher, H; Lindemans, J; Jaddoe, V W V; Steegers, E A P

    2015-06-01

    What are the effects of maternal and fetal soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF) concentrations on fetal and childhood growth patterns? An angiogenic profile that is characterized by both low early pregnancy maternal sFlt-1 and PlGF concentrations and higher sFlt-1 concentrations, lower PlGF concentrations or a higher sFlt-1:PlGF ratio in umbilical cord blood is associated with a reduced fetal and childhood growth. An imbalance in maternal and fetal sFlt-1 and PlGF concentrations has been suggested to affect pregnancy outcomes. However, their effects on longitudinal fetal and childhood growth remain largely unknown. This study was performed in 5980 mothers and 4108 of their children, participating in the Generation R Study; a population-based prospective cohort study from fetal life onwards in Rotterdam, the Netherlands (2001-2005). Blood samples were obtained from mothers in early and mid-pregnancy and from the umbilical vein at delivery. Fetal and childhood growth characteristics (weight and length) were measured repeatedly by ultrasound and physical examinations until the age of 6 years. We assessed the associations of maternal and fetal angiogenic factors with fetal and childhood growth using repeated measurement regression models. Logistic regression models were used to determine associations between angiogenic factors and small for gestational age at birth (SGA). Compared with early pregnancy maternal sFlt-1 concentrations in the lowest quintile, early pregnancy maternal sFlt-1 concentrations in the highest quintile were associated with a higher fetal weight growth resulting in a higher birthweight (difference in birthweight 0.33 standard deviation score (SDS); 95% Confidence Interval (CI) 0.25-0.41), a lower risk of SGA (Odds Ratio (OR) 0.36; 95% CI 0.27-0.48) and a subsequent higher weight growth until the age of 6 years. Early pregnancy maternal PlGF concentrations in the lowest quintile were associated with a

  4. Doppler colour flow imaging of fetal intracerebral arteries relative to fetal behavioural states in normal pregnancy

    NARCIS (Netherlands)

    M.J. Noordam (Marja); F.M.E. Hoekstra (Franciska); W.C.J. Hop (Wim); J.W. Wladimiroff (Juriy)

    1994-01-01

    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

  5. Evaluation of vaccination with Neospora caninum protein for prevention of fetal loss associated with experimentally induced neosporosis in sheep.

    Science.gov (United States)

    Jenkins, Mark C; Tuo, Wenbin; Dubey, J P

    2004-10-01

    To evaluate the immunologic response of a killed tachyzoite vaccine against Neospora caninum and its effectiveness in preventing fetal loss associated with experimentally induced neosporosis in sheep. 30 Dorset ewes. Ewes were randomly allocated to receive vaccination on days 1 and 60 of the study with a killed N caninum tachyzoite preparation in a commercially available adjuvant or a saline-adjuvant mixture. A ram was placed on pasture with the ewes from days 15 to 60. Blood was collected from ewes before primary and booster vaccinations and prior to experimental challenge with N caninum tachyzoite performed on day 90; sera were assessed via Neospora agglutination (NA) and immunofluorescence antibody (IFA) assays. Blood was collected from lambs before they suckled, and sera were tested for antibodies against N caninum. Of the 14 vaccinated ewes that became pregnant, 12 gave birth to live-born lambs; in contrast, 5 of 11 pregnant control ewes gave birth to live-born lambs. Whereas vaccination improved fetal survival in pregnant ewes challenged with N caninum tachyzoites, it did not appear to have any appreciable effect on transmission of N caninum to offspring, as indicated by results of NA and IFA assays. The N caninum tachyzoite vaccine used in this study appeared to provide protection against fetal loss associated with experimentally induced neosporosis in a high proportion of pregnant ewes.

  6. Cord blood copeptin concentrations in fetal macrosomia.

    Science.gov (United States)

    Briana, Despina D; Baka, Stavroula; Boutsikou, Maria; Boutsikou, Theodora; Xagorari, Marieta; Gourgiotis, Dimitrios; Malamitsi-Puchner, Ariadne

    2016-01-01

    Excessive fetal growth is associated with increased adiposity and reduced insulin sensitivity at birth. Copeptin, a surrogate marker of arginine vasopressin (AVP) secretion, is upregulated in states of hyperinsulinemia and is considered one of the mediators of insulin resistance. We aimed to investigate cord blood concentrations of copeptin (C-terminal fragment of AVP pro-hormone) in healthy large-for-gestational-age (LGA) infants at term. This prospective study was conducted on 30 LGA (n=30) and 20 appropriate-for-gestational-age (AGA, n=20) singleton full-term healthy infants. Cord blood copeptin and insulin concentrations were determined by ELISA and IRMA, respectively. Infants were classified as LGA or AGA, based on customized birth-weight standards adjusted for significant determinants of fetal growth. Cord blood copeptin concentrations were similar in LGA cases, compared to AGA controls, after adjusting for delivery mode. However, in the LGA group, cord blood copeptin concentrations positively correlated with birth-weight (r=0.422, p=0.020). In the AGA group, cord blood copeptin concentrations were elevated in cases of vaginal delivery vs elective cesarean section (p=0.003). Cord blood insulin concentrations were higher in LGA cases, compared to AGA controls (p=0.036). No association was recorded between cord blood copeptin concentrations and maternal age, parity, gestational age or fetal gender in both groups. Cord blood copeptin concentrations may not be up-regulated in non-distressed LGA infants. However, the positive correlation between cord blood copeptin concentrations and birth-weight in the LGA group may point to the documented association between AVP release and increased fat deposition. Vaginal delivery vs elective cesarean section is accompanied by a marked stress-related increase of cord blood copeptin concentrations. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. [Maternal-placental interactions and fetal programming].

    Science.gov (United States)

    Kadyrov, M; Moser, G; Rath, W; Kweider, N; Wruck, C J; Pufe, T; Huppertz, B

    2013-06-01

    Pregnancy-related complications not only represent a risk for maternal and fetal morbidity and mortality, but are also a risk for several diseases later in life. Many epidemiological studies have shown clear associations between an adverse intrauterine environment and an increased risk of diabetes, hypertension, cardiovascular disease, depression, obesity, and other chronic diseases in the adult. Some of these syndromes could be prevented by avoiding adverse stimuli or insults including psychological stress during pregnancy, intake of drugs, insufficient diet and substandard working conditions. Hence, all of these stimuli have the potential to alter health later in life. The placenta plays a key role in regulating the nutrient supply to the fetus and producing hormones that control the fetal as well as the maternal metabolism. Thus, any factor or stimulus that alters the function of the hormone producing placental trophoblast will provoke critical alterations of placental function and hence could induce programming of the fetus. The factors that change placental development may interfere with nutrient and oxygen supply to the fetus. This may be achieved by a direct disturbance of the placental barrier or more indirectly by, e. g., disturbing trophoblast invasion. For both path-ways, the respective pathologies are known: while preeclampsia is caused by alterations of the villous trophoblast, intra-uterine growth restriction is caused by insufficient invasion of the extravillous trophoblast. In both cases the effect can be undernutrition and/or fetal hypoxia, both of which adversely affect organ development, especially of brain and heart. However, the mechanisms responsible for disturbances of trophoblast differentiation and function remain elusive. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Factors Affecting Estimated Fetal Weight Measured by Ultrasound

    Directory of Open Access Journals (Sweden)

    Hasan Energin

    2016-06-01

    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.

  9. Fetal MRI in the evaluation of intrauterine myelomeningocele.

    Science.gov (United States)

    Mangels, K J; Tulipan, N; Tsao, L Y; Alarcon, J; Bruner, J P

    2000-03-01

    Accurate fetal imaging is essential to the practice of maternal-fetal medicine. While ultrasonography has been the traditional mainstay of fetal imaging, its ability to resolve critical features of central nervous system (CNS) anatomy remains limited. As interest in intrauterine therapy for myelomeningocele has increased, so has the need for more accurate, noninvasive imaging of the CNS. Fetal magnetic resonance imaging (MRI) promises to fill the gap left by ultrasound. Thirty-seven MRI scans of fetuses previously diagnosed with myelomeningocele were reviewed by 2 neuroradiologists. The ability of fetal MRI to resolve the commonest CNS stigmata of spina bifida, and the incidence and extent of interobserver error, was assessed. In 4 cases, postnatal MRIs were also available. These were compared to the corresponding fetal studies. The imaging quality with the technique used in this study was excellent, even without the use of maternal or fetal sedation. There were no complications, and the imaging times were minimal. Interobserver error was minimal with respect to the evaluation of ventricular dilatation and hindbrain herniation, but moderate in the description and location of the spinal lesion. As had previously been documented with ultrasonography, a reduction was seen in hindbrain herniation when comparing pre- and postnatal MRIs. It is concluded that fetal MRI is an effective, noninvasive means of assessing fetal CNS anatomy. Its ability to resolve posterior fossa anatomy is superior to ultrasonography while, with respect to the evaluation of hydrocephalus and the level and nature of the spinal lesion, it may be equivalent to inferior. Inclusion of the fetal MRI into the standard diagnostic armamentarium will probably await the next major advance in speed and resolution. It is conceivable that, with further advances, MRI might supplant ultrasonography as the diagnostic tool of choice for evaluation of fetal anomalies including myelomeningocele. Copyright 2000 S

  10. Fetal MRI: An approach to practice: A review

    Directory of Open Access Journals (Sweden)

    Sahar N. Saleem

    2014-09-01

    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.

  11. STUDIES IN FETAL BEHAVIOR: REVISITED, RENEWED, AND REIMAGINED.

    Science.gov (United States)

    DiPietro, Janet A; Costigan, Kathleen A; Voegtline, Kristin M

    2015-09-01

    Among the earliest volumes of this monograph series was a report by Lester Sontag and colleagues, of the esteemed Fels Institute, on the heart rate of the human fetus as an expression of the developing nervous system. Here, some 75 years later, we commemorate this work and provide historical and contemporary context on knowledge regarding fetal development, as well as results from our own research. These are based on synchronized monitoring of maternal and fetal parameters assessed between 24 and 36 weeks gestation on 740 maternal-fetal pairs compiled from eight separate longitudinal studies, which commenced in the early 1990s. Data include maternal heart rate, respiratory sinus arrhythmia, and electrodrmal activity and fetal heartrate, motor activity, and their integration. Hierarchical linear modeling of developmental trajectories reveals that the fetus develops in predictable ways consistent with advancing parasympathetic regulation. Findings also include:within-fetus stability (i.e., preservation of rank ordering over time) for heart rate, motor, and coupling measures; a transitional period of decelerating development near 30 weeks gestation; sex differences in fetal heart rate measures but not in most fetal motor activity measures; modest correspondence in fetal neurodevelopment among siblings as compared to unrelated fetuses; and deviations from normative fetal development in fetuses affected by intrauterine growth restriction and other conditions. Maternal parameters also change during this period of gestation and there is evidence that fetal sex and individual variation in fetal neurobehavior influence maternal physio-logical processes and the local intrauterine context. Results are discussed within the framework of neuromaturation, the emergence of individual differences, and the bidirectional nature of the maternal-fetal relationship.We pose a number of open questions for future research. Although the human fetus remains just out of reach, new

  12. Studies in Fetal Behavior: Revisited, Renewed, and Reimagined

    Science.gov (United States)

    DiPietro, Janet A.; Costigan, Kathleen A.; Voegtline, Kristin M.

    2016-01-01

    Among the earliest volumes of this Monograph series was a report by Lester Sontag and colleagues, of the esteemed Fels Institute, on the heart rate of the human fetus as an expression of the developing nervous system. Here, some 75 years later, we commemorate this work and provide historical and contemporary context on knowledge regarding fetal development, as well as results from our own research. These are based on synchronized monitoring of maternal and fetal parameters assessed between 24 and 36 weeks gestation on 740 maternal-fetal pairs compiled from eight separate longitudinal studies, which commenced in the early 1990s. Data include maternal heart rate, respiratory sinus arrhythmia, and electrodermal activity and fetal heart rate, motor activity, and their integration. Hierarchical linear modeling of developmental trajectories reveals that the fetus develops in predictable ways consistent with advancing parasympathetic regulation. Findings also include: within-fetus stability (i.e., preservation of rank ordering over time) for heart rate, motor, and coupling measures; a transitional period of decelerating development near 30 weeks gestation; sex differences in fetal heart rate measures but not in most fetal motor activity measures; modest correspondence in fetal neurodevelopment among siblings as compared to unrelated fetuses; and deviations from normative fetal development in fetuses affected by intrauterine growth restriction and other conditions. Maternal parameters also change during this period of gestation and there is evidence that fetal sex and individual variation in fetal neurobehavior influence maternal physiological processes and the local intrauterine context. Results are discussed within the framework of neuromaturation, the emergence of individual differences, and the bidirectional nature of the maternal-fetal relationship. We pose a number of open questions for future research. Although the human fetus remains just out of reach, new

  13. Influência do Tabagismo no Sistema Vascular Materno-fetal: estudo com Dopplervelocimetria Effect of Cigarette Smoking on Maternal-fetal Blood Flow: Doppler Velocimetry Study

    Directory of Open Access Journals (Sweden)

    Gilberto Rodrigues Pinto

    2000-12-01

    Full Text Available Objetivo: avaliar a influência do tabagismo materno na dinâmica vascular materno-fetal, por meio da dopplervelocimetria obstétrica das artérias uterinas, umbilical e cerebral média. Métodos: estudo prospectivo em 42 gestantes saudáveis, sendo 20 fumantes e 22 não-fumantes. Foram realizadas ultra-sonografias para determinar o tempo de gestação e exame de dopplervelocimetria pulsátil das artérias uterinas, umbilical e cerebral média nas 24ª, 28ª, 32ª e 36ª semana para avaliar o fluxo vascular materno-fetal. As fumantes foram orientadas a não fumar por pelo menos 2 horas antes do exame. Resultados: o índice de resistência (IR médio das artérias uterinas D e E foi maior no grupo de fumantes na 36ª semana com média de 0,50 e desvio padrão de 0,034. O índice de pulsatilidade (IP da artéria umbilical foi maior no grupo de fumantes na 28ª semana [x (DP = 1,135 (0,182], p = 0,008; o IP da artéria cerebral média (ACM não se mostrou diferente entre os grupos, porém, a relação IP ACM/umbilical foi menor no grupo de fumantes, na 32ª semana [x (DP = 1,9 (0,291], p = 0,027 e na 36ª semana [x (DP = 1,850 (0,465], p = 0,014. Conclusões: os índices de dopplervelocimetria mostraram que no grupo de fumantes há aumento na resistência da circulação útero-placentária e feto-placentária, associado a concomitante diminuição na resistência da ACM, mimetizando uma tendência do tabagismo levar à hipóxia crônica do feto.Purpose: to evaluate the influence of cigarette smoking on uteroplacental, fetoplacental and fetal blood flow by obstetric Doppler velocimetry of the uterine, umbilical and middle cerebral arteries. Method: a prospective study with 42 healthy pregnant women, 20 of whom were smokers and 24 nonsmokers. Ultrasound was performed initially to determine the gestation time. The pregnant women next underwent pulsed and color Doppler velocimetry of the uterine, umbilical and middle cerebral arteries at the 24th, 28

  14. Fetal polycystic kidney disease: Pathological overview

    Directory of Open Access Journals (Sweden)

    Sunita B Patil

    2013-01-01

    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.

  15. Electronic Fetal Monitoring: A Defense Lawyer's View.

    Science.gov (United States)

    Sartwelle, Thomas P

    2012-01-01

    Electronic fetal monitoring (EFM) has been used for four decades, after its introduction without clinical trials. EFM spawned a birth injury litigation crisis centered on the myth that it predicts cerebral palsy (CP). The myth has resulted in lottery-like judgments against physicians. The American Congress of Obstetricians and Gynecologists (ACOG) and sister organizations worldwide have the power to halt EFM's clinical proliferation and the undeserved litigation verdicts against physicians unjustly blamed for causing CP. This power has been unused. If ACOG and other organizations would declare EFM unreliable, it could change the clinical standard of care and alleviate the CP-EFM malpractice lottery.

  16. Sotalol in the Treatment of Fetal Tachyarrhythmia

    OpenAIRE

    Rebelo, M.; Macedo, AJ; Nogueira, G.; Trigo, C; Kaku, S

    2006-01-01

    A taquicardia fetal é uma situação rara, que, quando mantida coloca em risco a vida do feto. O modo de tratamento não é consensual, existindo várias modalidades farmacológicas. O objectivo deste estudo foi avaliar a eficácia e segurança do sotalol no tratamento de taquicardias fetais. Material e métodos: Estudo retrospectivo, com base nos registos de consulta e entrevista às mães dos fetos com taquicardia supraventricular, referenciados ao Serviço de Cardiologia Pediát...

  17. Fetal MCG with Atomic Magnetometer Array

    Science.gov (United States)

    Deland, Zack; Bulatowicz, Michael D.; Sulai, Ibrahim A.; Wahl, Colin P.; Wakai, Ronald T.; Walker, Thad G.

    2016-05-01

    We present results on the development of 87Rb atomic magnetometers for the detection of a fetal magnetocardiogram (fMCG). Operating in the spin-exchange relaxation free (SERF) regime, the magnetometers' sensitivities are reported at the 1 fT /√{ Hz } level. Environmental common-mode noise, including the field from the maternal heart, can be suppressed by operating the magnetometers in a gradiometric configuration. We report on schemes from implementing such gradiometers along with recent fMCG measurements. This work is supported by the National Institutes of Health.

  18. Fetal Kidney Anomalies: Next Generation Sequencing

    DEFF Research Database (Denmark)

    Rasmussen, Maria; Sunde, Lone; Nielsen, Marlene Louise

    with prenatally detected kidney anomalies in order to uncover genetic explanations and assess recurrence risk. Also, we aim to study the relation between genetic findings and post mortem kidney histology. Methods The study comprises fetuses diagnosed prenatally with bilateral kidney anomalies that have undergone...... in the nephronophthisis associated gene, TMEM67 and six fetuses had mutations in kidney developmental genes. For these fetuses kidney histology is presented. Conclusion and Perspectives In eight (14%) fetuses we identified a likely genetic cause of the kidney anomalies. Ten fetuses from eight families, in which...... no mutations were identified, have been selected for exome sequencing in order to uncover novel genes associated to fetal kidney anomalies....

  19. Multicystic encephalomalacia due to fetal viral encephalitis.

    Science.gov (United States)

    Lyen, K R; Lingam, S; Butterfill, A M; Marshall, W C; Dobbing, C J; Lee, D S

    1981-09-01

    Two children, aged 2 weeks and 2 months, with multicystic encephalomalacia aer described. Although computerized tomography (CT) scan was used for the diagnosis, the value of the simple method of transillumination is stressed. The mother of one child had mumps with meningitis at 26 weeks' gestation. The other child had an echovirus 11 isolated from the cerebrospinal fluid and herpesvirus hominis (HVH) from the skin at 8 weeks. We speculate that the changes in the brains of these babies may be due to the respective viruses causing a fetal encephalitis.

  20. Prevalência de hemoglobina S em recém-nascidos de Fortaleza: importância da investigação neonatal The prevalence of hemoglobin S in newborns from Fortaleza, Brazil: the importance of neonatal research

    Directory of Open Access Journals (Sweden)

    Luciano Silveira Pinheiro

    2006-02-01

    Full Text Available OBJETIVOS: avaliar a prevalência de hemoglobina S (HbS, traços falciformes em recém-nascidos, por meio de investigação clínico-laboratorial. MÉTODOS: foi elaborado protocolo que estabelece a coleta de 10 ml de sangue de segmento de cordão umbilical, após ser ligado e seccionado pelo obstetra em seguida ao parto, sendo as amostras introduzidas em um tubo contendo EDTA a 5% e submetidas a estudo cromatográfico líquido de alta resolução (high-performance liquid chromatography. Preenchia-se também protocolo clínico mediante entrevista com a puérpera, analisava-se o seu prontuário e efetuava-se o exame físico do recém-nascido. As variáveis analisadas foram peso do recém-nascido, sexo, Apgar no primeiro minuto e cor da mãe. A análise estatística foi baseada no programa Epi-Info versão 6.0, utilizando-se o teste t de Student, considerando-se o nível de significância de pPURPOSE: to evaluate the prevalence of hemoglobin S (HbS in newborns, through clinical investigation and laboratory data. METHODS: a protocol established the drawing of 10 mL blood from the umbilical cord after its ligature and section, immediately after birth. The samples were kept in a tube with 5% EDTA and then submitted to high-performance liquid chromatography. The study included a clinical record taken from an interview with the mother, her physical and biochemical condition, as well as that of her newborn. Main criteria were newborn's weight, sex, first minute Apgar, and the mother's color. Statistical analysis was based on the Epi-Info 6.0 program and performed by Student's t test, with the level of significance set at p<0.05. RESULTS: from August 2001 to September 2002, 389 umbilical cord blood samples showed HbS in 16 newborn babies (4.1%. Fifteen of these presented sickle-cell traits (HbS and the other had a diagnostic hypothesis of sickle-cell anemia (HbSS. Hemoglobinopathy prevailed among male babies. No significant difference was observed between

  1. Hemoglobin measured by Hemocue and a reference method in venous and capillary blood: a validation study Hemoglobina medida por Hemocue y por un método de referencia en sangre venosa y capilar: estudio de validación

    Directory of Open Access Journals (Sweden)

    Lynnette Neufeld

    2002-06-01

    Full Text Available Objective. To assess the comparability of hemoglobin concentration (Hb in venous and capillary blood measured by Hemocue and an automated spectrophotometer (Celldyn and to document the influence of type of blood (capillary or venous and analysis method on anemia prevalence estimates. Material and Methods. Between February and May 2000, capillary and venous samples were collected from 72 adults and children at Hospital del Niño Morelense (Morelos State Children's Hospital in Cuernavaca, Morelos, Mexico, and assessed for Hb using the Hemocue and Celldyn methods. Estimated Hb levels were compared using the concordance correlation coefficient and Student's t test for paired data. The sensitivity and specificity for anemia diagnosis were estimated and compared between type of blood and method of assessment. Results. Capillary blood had higher Hb (+0.5g/dl than venous blood in adults and children, as did samples assessed by Celldyn compared to Hemocue (+0.3g/dl. Specificity to detect anemia was adequate (>0.90 but sensitivity was low for capillary blood assessed by Hemocue (Objetivo. Evaluar la comparabilidad de la concentración de hemoglobina (Hb en sangre venosa y capilar medida por Hemocue y por espectrofotómetro automatizado (Celldyn, así como documentar la influencia del tipo de sangre (capilar o venosa y del método de análisis sobre la prevalencia de anemia. Material y métodos. De febrero a mayo de 2000, se recolectaron muestras de sangre capilar y venosa en 72 adultos y niños en el Hospital del Niño Morelense, Cuernavaca, Morelos, México. Se determinaron los niveles de Hb con los métodos Hemocue y Celldyn. Las cifras de Hb estimadas se compararon con el coeficiente de concordancia y la prueba pareada de t de Student. También se comparó la sensibilidad y especificidad para el diagnóstico de anemia, utilizando sangre de los dos tipos y métodos de análisis. Resultados. La Hb fue mayor en sangre capilar comparada con sangre venosa

  2. RSR13 e modificação alostérica da afinidade hemoglobina-oxigênio: abuso entre atletas RSR13 and allosteric change in the hemoglobin-oxygen afinity: abuse among athletes

    Directory of Open Access Journals (Sweden)

    Antonio Claudio Lucas da Nóbrega

    2002-02-01

    Full Text Available O ácido metilpropiônico (RSR13 é um modificador alostérico da hemoglobina, com a qual se liga de forma não-covalente, diminuindo sua afinidade pelo oxigênio de modo dose-dependente e, conseqüentemente, aumentando a oxigenação periférica. O objetivo deste artigo é apresentar brevemente as evidências científicas acerca das características farmacológicas e funcionais, indicações médicas e efeitos adversos do uso do RSR13 por atletas, a mais recente alternativa de aumento artificial do desempenho. Estudos experimentais preliminares verificaram algum efeito positivo do RSR13 sobre a recuperação do miocárdio isquêmico e sobre a extensão da isquemia cerebral, mas as principais indicações estudadas atualmente são a cirurgia com hipotermia e cardioplegia durante circulação extracorpórea e o uso como agente coadjuvante potenciador da radioterapia para certos tumores sólidos. Somente um estudo em modelo canino mostrou aumento do consumo máximo de oxigênio em músculo isolado, não existindo evidências de que o RSR13 possa efetivamente melhorar o desempenho em humanos. Em realidade, já foram descritos efeitos adversos, como diminuição da perfusão sanguínea, elevação da pressão arterial e diminuição da função renal. Antecipando o potencial aumento da utilização do RSR13 por atletas, métodos já foram desenvolvidos para sua detecção em amostras de urina humana.Methylpropionic acid (RSR13 is an allosteric hemoglobin modifier to which it binds in a non-covalent manner, reducing its affinity to oxygen in a dose-dependent fashion, and consequently, increasing peripheral oxygenation. The purpose of this article is to briefly present scientific evidence concerning pharmacological and functional characteristics, medical indications, and adverse effects of RSR13 use by athletes, the most recent alternative to enhance performance artificially. Preliminary experimental studies have verified some positive effect of RSR13

  3. Gestational Age Estimation Based on Fetal Pelvimetry on Fetal Ultrasound in Iraqi Women

    Directory of Open Access Journals (Sweden)

    Sattar Razzaq Al-Esawi

    2016-08-01

    Full Text Available Ultrasound is an integral part of obstetric practice, and assessment of gestational age (GA is a central element of obstetric ultrasonography. Sonographic estimation of GA is derived from calculations based on fetal measurements. Numerous equations for GA calculation from fetal biometry have been adopted in routine practice. This study reports a new method of estimating GA in the second and third trimester using interischial distance (IID, the distance between the two ischial primary ossification centers, on fetal ultrasound. Four hundred women with uncomplicated normal singleton pregnancies from 16 weeks to term were examined. Standard fetal obstetric ultrasound was done measuring biparietal diameter (BPD and femur length (FL for each fetus. The IID, in millimeters, was correlated with the GA in weeks based upon the BPD and FL individually, and the BPD and FL together. Statistical analysis showed strong correlation between the IID and GA calculated from the FL with correlation coefficient (r =0.989, P < 0.001. Strong linear correlation was also found between the IID and GA based upon BPD and BPD+FL. Further statistical analysis using regression equations also showed that the IID was slightly wider in female fetuses, but this difference was not statistically significant. Resulting from this analysis, we have arrived at an easy-to-use equation: GA Weeks = (IID mm + 8 ±1 week. We feel this method can be especially applicable in the developing world, where midwives may not have access to software for fetal biometry in their basic handheld ultrasound machines. Even more sophisticated machines may not come with loaded software for obstetrics analysis. There are several limitations to this study, discussed below. We recommend further studies correlating the IID with other biometric parameters.

  4. Diferencias entre la hemoglobina observada y estimada por hematocrito y su importancia en el diagnóstico de anemia en población costera venezolana: análisis del segundo estudio nacional de crecimiento y desarrollo humano (SENACREDH Differences between observed and estimated by hematocrit hemoglobin and its relevance in the diagnosis of anemia among coastal population in Venezuela: analysis of the second national study of human growth and development (SENACREDH

    Directory of Open Access Journals (Sweden)

    Jessica Flores-Torres

    2011-03-01

    Full Text Available Objetivos. Evaluar las diferencias entre el valor de hemoglobina observada y el valor estimado a partir del hematocrito en el marco del Segundo Estudio Nacional de Crecimiento y Desarrollo Humano de la Población Venezolana (SENACREDH en el eje centro norte costero del país. Materiales y métodos. Por medio de un muestreo probabilístico multietápico por conglomerados se seleccionó un total de 6004 sujetos que representan 7 286 781 habitantes del eje Centro Norte Costero (Vargas, Carabobo, Distrito Capital, Aragua y Miranda. Se compararon medias de la hemoglobina observada y hemoglobina estimada (hematocrito/3, usando la prueba t para muestras relacionadas. Se realizaron regresiones lineales entre hemoglobina observada y hematocrito. Resultados. Se observó que el promedio de las diferencias entre la asignadas a la hemoglobina observada y la estimada por el hematocrito fue de -0,3446 ± 0,0002 (pObjectives. To evaluate the differences between the observed hemoglobin levels and those estimated based on hematocrit in the context of the 2nd National Study of Human Growth and Development of the Venezuelan Population (SENACREDH. Materials and methods. 6,004 individuals were chosen by a probabilistic multistage cluster sampling representing 7,286,781 inhabitants from North Central Coastal area (Vargas, Carabobo, Capital District, Aragua and Miranda. Means of observed and estimated hemoglobin (hematocrit/3 were compared, using t test for related samples and linear regression. Results. Mean difference between the values of observed and estimated hemoglobin was -0.3446 ±0.0002 (p<0.001; significantly overestimating the hemoglobin values. Regression models of hemoglobin on hematocrit showed an r2=0,87. In order to correct the estimation, we propose a new formula for calculating hemoglobin based on haematocrit values: estimated hemoglobin=(Haematocrit/3.135+ 0.257. Conclusions: There is an overestimation of hemoglobin levels from hematocrit levels and

  5. fetal outcomes among grand multiparous and multiparous women in ...

    African Journals Online (AJOL)

    2013-03-03

    Mar 3, 2013 ... post partum period and data on fetal outcomes filled in the questionnaires and data sheets. The data collected included social demographic characteristics like age, level of education, marital status and religion, Obstetric factors like number of. ANC visits, fetal outcome variables like birth weight. (in grams) ...

  6. Near-term fetal response to maternal spoken voice.

    Science.gov (United States)

    Voegtline, Kristin M; Costigan, Kathleen A; Pater, Heather A; DiPietro, Janet A

    2013-12-01

    Knowledge about prenatal learning has been largely predicated on the observation that newborns appear to recognize the maternal voice. Few studies have examined the process underlying this phenomenon; that is, whether and how the fetus responds to maternal voice in situ. Fetal heart rate and motor activity were recorded at 36 weeks gestation (n = 69) while pregnant women read aloud from a neutral passage. Compared to a baseline period, fetuses responded with a decrease in motor activity in the 10 s following onset of maternal speech and a trend level decelerative heart rate response, consistent with an orienting response. Subsequent analyses revealed that the fetal response was modified by both maternal and fetal factors. Fetuses of women who were previously awake and talking (n = 40) showed an orienting response to onset of maternal reading aloud, while fetuses of mothers who had previously been resting and silent (n = 29) responded with elevated heart rate and increased movement. The magnitude of the fetal response was further dependent on baseline fetal heart rate variability such that largest response was demonstrated by fetuses with low variability of mothers who were previously resting and silent. Results indicate that fetal responsivity is affected by both maternal and fetal state and have implications for understanding fetal learning of the maternal voice under naturalistic conditions. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Maternal age and fetal loss: population based register linkage study

    DEFF Research Database (Denmark)

    Andersen, Anne-Marie Nybo; Wohlfahrt, J; Christens, P

    2000-01-01

    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....

  8. Ontogeny of fetal movements in the guinea pig

    NARCIS (Netherlands)

    van Kan, C.M.; de Vries, J.I.; Luchinger, A.B.; Mulder, E.J.; Taverne, M.A.

    2009-01-01

    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

  9. Fetal hemoglobin during infancy and in sickle cell adults | Edoh ...

    African Journals Online (AJOL)

    Background: Fetal hemoglobin has been implicated in the modulation of sickle cell crisis though it is functional during infancy. Objective: The purpose of this study was to determine the waning time of fetal hemoglobin (HbF) and its persistence in later life. Method: Ninety infants aged 0-12 months, admitted at hospital, were ...

  10. ORIGINAL ARTICLE CASE SERIES Fetal MRI for characterising a ...

    African Journals Online (AJOL)

    Introduction. Prenatal ultrasound (US) is the investigation of choice when screening for fetal abnormalities. When an intracranial abnormality is detected on US specifically within the posterior fossa, a fetal MRI is the next investigation of choice, to accurately characterise and diagnose the abnormality. In the developing world ...

  11. Maternal-fetal attachment and prenatal diagnosis of heart disease.

    Science.gov (United States)

    Ruschel, Patricia; Zielinsky, Paulo; Grings, Cristiane; Pimentel, Julia; Azevedo, Liege; Paniagua, Rafaele; Nicoloso, Luiz H

    2014-03-01

    To test the hypothesis that there are differences in the level of maternal-fetal attachment before and after fetal echocardiography in the presence or absence of cardiac abnormalities. Cohort study in which the mothers responded to a validated Maternal-Fetal Attachment Scale. The study compared a group of pregnant women with diagnosis of fetal heart disease (FHD) with a group without this diagnosis ("no fetal heart disease" - NFHD). 197 pregnant women were included, 96 FHD and 101 NFHD. Maternal-fetal attachment at the initial and final periods showed no significant baseline differences between groups (p=0.081). At the final period, migration from medium to high level of attachment was significantly higher in FHD (p=0.017). Transition from medium to high levels comparing the initial and final periods was more pronounced in FHD (p=0.009). Diagnosis of fetal heart disease increases the level of maternal-fetal attachment. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  12. [Fetal phonocardiography: new application of an old method].

    Science.gov (United States)

    Hodoniczki, L; Pál, A; Kovács, L

    1998-06-21

    Cardiotocography plays an important role in the assessment of the fetal condition. Phonocardiography, abdominal electrocardiography and ultrasound cardiography are the three methods for external fetal cardiography. The authors summarize their observations in the analysis of 980 antepartum cardiotocograms made by a phonocardiograph. They conclude, that this phonocardiograph is cheap, reliable, handling can easily attach, and makes possible twenty-four hours home-monitoring.

  13. Extraction of fetal electrocardiogram (ECG) by extended state ...

    Indian Academy of Sciences (India)

    Fetal electrocardiogram (ECG) gives information about the health status of fetus and so, an early diagnosis of any cardiac defect before delivery increases the effectiveness of appropriate treatment. In this paper, authors investigate the use of adaptive neuro-fuzzy inference system (ANFIS) with extended Kalman filter for fetal ...

  14. Materno-Fetal Haematological Relationship In Malaria At Mongomo ...

    African Journals Online (AJOL)

    This study is aimed to determine the effects of maternal and fetal parasitaemia on maternal and fetal haemoglobin. A nine-month (January - September 1997) prospective study was carried out at the labour unit of the Regional Hospital in Mongomo, Guinea Equatoria. One hundred and twenty-four patients with singleton ...

  15. Fetal scalp blood sampling in labor - a review

    DEFF Research Database (Denmark)

    Jørgensen, Jan Stener; Weber, Tom

    2014-01-01

    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 surve...

  16. Validity of common ultrasound methods of fetal weight estimation in ...

    African Journals Online (AJOL)

    Abstract. Background: Accuracy of some ultrasound equations used in our locality for fetal weight estimation is doubtful. Objective: To assess the accuracy of common ultrasound equations used for fetal weight estimation. Subjects and Methods: A longitudinal study was conducted on selected Nigerian obstetric population at ...

  17. Growth and development symposium: Fetal programming in animal agriculture

    Science.gov (United States)

    Fetal programming is the ability to improve animal production and well-being by altering the maternal environment and holds enormous challenges and great opportunities for researchers and the animal industry. A symposium was held to provide an overview of current knowledge of fetal programming in re...

  18. Reduced fetal androgen exposure compromises Leydig cell function in adulthood

    NARCIS (Netherlands)

    Teerds, K.J.; Keijer, J.

    2015-01-01

    Disruption of normal fetal development can influence functioning of organs and cells in adulthood. Circumstantial evidence suggests that subtle reductions in fetal androgen production may be the cause of adult male reproductive disorders due to reduced testosterone production. The mechanisms through

  19. Sex differences in the fetal programming of hypertension.

    Science.gov (United States)

    Grigore, Daniela; Ojeda, Norma B; Alexander, Barbara T

    2008-01-01

    Numerous clinical and experimental studies support the hypothesis that the intrauterine environment is an important determinant of cardiovascular disease and hypertension. This review examined the mechanisms linking an adverse fetal environment and increased risk for chronic disease in adulthood with an emphasis on gender differences and the role of sex hormones in mediating sexual dimorphism in response to a suboptimal fetal environment. This review focuses on current findings from the PubMed database regarding animal models of fetal programming of hypertension, sex differences in phenotypic outcomes, and potential mechanisms in offspring of mothers exposed to an adverse insult during gestation. For the years 1988 to 2007, the database was searched using the following terms: fetal programming, intrauterine growth restriction, low birth weight, sex differences, estradiol, testosterone, high blood pressure, and hypertension. The mechanisms involved in the fetal programming of adult disease are multifactorial and include alterations in the regulatory systems affecting the long-tterm control of arterial pressure. Sex differences have been observed in animal models of fetal programming, and recent studies suggest that sex hormones may modulate activity of regulatory systems, leading to a lower incidence of hypertension and vascular dysfunction in females compared with males. Animal models of fetal programming provide critical support for the inverse relationship between birth weight and blood pressure. Experimental models demonstrate that sex differences are observed in the pathophysiologic response to an adverse fetal environment. A role for sex hormone involvement is strongly suggested,with modulation of the renin-angiotensin system as a possible mechanism.

  20. Diverse Placental Pathologies as the Main Causes of Fetal Death

    NARCIS (Netherlands)

    Korteweg, Fleurisca J.; Erwich, Jan Jaap H. M.; Holm, Jozien P.; Ravise, Joke M.; van der Meer, Jan; Veeger, Nic J. G. M.; Timmer, Albertus; van der, Meer J.

    2009-01-01

    OBJECTIVE: To estimate the occurrence of placental causes of fetal death in relation to different gestational ages and their clinical manifestations during pregnancy. METHODS: In a prospective cohort study conducted from 2002 to 2006, we studied 750 couples with singleton intrauterine fetal death