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Sample records for prematuro da placenta

  1. O leito placentário no descolamento prematuro da placenta

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    Mesquita Maria Rita de Souza

    2003-01-01

    Full Text Available OBJETIVO: análise histopatológica das artérias espiraladas do leito placentário em gestações complicadas pelo descolamento prematuro da placenta (DPP associado à hipertensão, comparando-as com a estrutura vascular dos leitos placentários normais. MÉTODO: a biópsia do leito placentário foi realizada em 23 gestantes com diagnóstico de descolamento prematuro de placenta associado à hipertensão (G/HA e idade gestacional maior ou igual a 28 semanas, submetidas ao parto cesáreo. O grupo controle (GC foi constituído por 30 pacientes, sem doenças, submetidas a parto cesáreo por indicação obstétrica. As variáveis histológicas selecionadas para estudo foram: padrão inalterado, modificações fisiológicas, desorganização da camada média, alterações hiperplásicas, necrose e aterose aguda. RESULTADOS: nas pacientes com DPP associado à hipertensão ocorreu uma predominância significativa de desorganização da camada média, detectada em 50% das pacientes, e de alterações hiperplásicas, em comparação ao GC, ao passo que a presença de modificações fisiológicas foi estatisticamente mais significante no GC. Achados como necrose e aterose aguda foram observados em menores proporções no G/HA, mas sem diferenças significantes entre os dois grupos. CONCLUSÕES: os achados histológicos vasculares predominantes em grávidas com diagnóstico de DPP associado à hipertensão foram desorganização da camada média e alterações hiperplásicas. A presença do padrão patológico foi significativamente maior no G/HA, sendo o mais prevalente a desorganização da camada média. Houve predomínio do padrão normal, isto é, modificações fisiológicas no GC.

  2. Cesárea prévia como fator de risco para o descolamento prematuro da placenta Previous cesarean section as a risk factor for abruptio placentae

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    Fábio Roberto Cabar

    2004-10-01

    Full Text Available OBJETIVO: investigar a relação entre o antecedente de cesárea e a ocorrência do descolamento prematuro da placenta (DPP. MÉTODOS: estudo retrospectivo em que foram avaliados os dados referentes a 6495 partos realizados no período entre abril de 2001 e janeiro de 2004. Foram adotados como critérios de inclusão: diagnóstico de DPP confirmado por exame da placenta após o parto, gestação única, peso do recém-nascido superior a 500 g e idade gestacional acima de 22 semanas e ausência de história de trauma abdominal na gestação atual. Para cada caso de DPP incluído no estudo foram selecionados cinco controles, obedecendo ao seguinte pareamento: paridade, idade gestacional (30 semanas, diagnóstico materno de síndrome hipertensiva na gestação índice, antecedente de cicatriz uterina prévia não relacionada à operação cesariana, diagnóstico de rotura prematura de membranas ou diagnóstico de polidrâmnio. A análise univariada das variáveis contínuas foi realizada utilizando-se o teste t de Student e as variáveis categóricas foram avaliadas por meio de teste exato de Fisher ou teste de chi2, com níveis descritivos (p menores que 0,05 considerados significantes. RESULTADOS: 34 casos de pacientes com diagnóstico de DPP preencheram os critérios de inclusão (incidência de 0,52%. Para o grupo controle foram selecionadas 170 pacientes que obedeceram aos critérios de pareamento propostos. No grupo de pacientes com DPP, 26,5% apresentavam antecedente de parto cesárea (9 casos, ao passo que, no grupo controle, esse antecedente foi observado em 21,2% das pacientes (36 casos. Não houve diferença estatisticamente significativa na incidência de cesárea prévia entre os dois grupos estudados (p=0,65, OR=1,34, IC 95%=0,53-3,34. CONCLUSÃO: o aspecto abordado neste estudo, isto é, a associação do DPP em pacientes com cicatriz uterina de cesárea, não pôde ser confirmado com a presente casuística.PURPOSE: to study the

  3. Variabilidade da frequência cardíaca em neonatos prematuros e de termo

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    Fabio Augusto Selig

    2011-06-01

    Full Text Available FUNDAMENTO: Várias publicações têm demonstrado a importância do sistema nervoso autônomo por meio dos componentes simpático e parassimpático na gerência da interação entre as diferentes partes do organismo humano. Esses estudos aplicaram técnicas lineares e não lineares (Teoria do Caos de avaliação em diferentes situações, doenças e faixas etárias, tendo como ferramenta a variabilidade da frequência cardíaca (VFC. OBJETIVO: Aplicar os conhecimentos das dinâmicas linear e não linear na avaliação de neonatos prematuros (NPT, analisando sua VFC e comparando com neonatos de termo (NT saudáveis. MÉTODOS: Quarenta e oito neonatos prematuros com diferentes idades gestacionais tiveram seus batimentos cardíacos captados com auxílio do equipamento Polar Advanced S810i e sua VFC obtida pelo registro dos intervalos RR. A VFC foi analisada nos domínios do tempo (SDNN, RMSSD, SD1/SD2, da frequência (VLF, LF, HF e a relação LF/HF e do caos (TAU e sua normalização [TAU(n], Expoente de Lyapunov e Entropia. Os NPT foram comparados com um grupo de 78 NT saudáveis e sem intercorrências perinatais com auxílio do teste não paramétrico de Kruskal-Wallis. RESULTADOS: Detectou-se diferença estatisticamente significante entre os grupos para todas as variáveis estudadas, tanto no domínio do tempo como nos da frequência e do caos. CONCLUSÃO: Neonatos prematuros exibem comportamento menos complexo da variabilidade da frequência cardíaca que neonatos de termo, fato comprovado nos domínios do tempo, da frequência e do caos. O estudo da variabilidade cardíaca nesse grupo pode ser considerado uma ferramenta a mais na avaliação da maturação autonômica e, consequentemente, da progressão para eutrofia.

  4. Aspectos morfológicos da placenta da preguiça, Bradypus variegatus Shinz, 1825

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    Marleyne José Afonso Accyoli Lins Amorin

    2003-01-01

    Full Text Available Estudaram-se os aspectos morfológicos da placenta e das membranas fetais de 03 placentas de bichos-preguiça (Bradypus variegatus, adultas e prenhes, originárias da Zona da Mata do Estado de Pernambuco. Essas estruturas foram obtidas de 03 fêmeas doadas pela Universidade Federal de Pernambuco, das quais duas encontravam-se congeladas e a terceira foi colhida mediante realização de cirurgia cesariana, onde mãe e feto foram preservados. Depois de descongeladas, as placentas foram fixadas em solução aquosa de formol 10,00%. Da placenta obtida da cesariana colheram-se pequenos fragmentos da região placentária e do funículo umbilical, os quais foram fixados em paraformoldeido 4,00%, tampão fosfato pH 7,4. Os fragmentos passaram pela rotina histológica, onde foram coradas em Hematoxilina e Eosina e Tricrômio de Masson. A placenta da preguiça é corioamniótica, com o cório viloso constituindo os lobos placentários, que se localizam na região fúndica do útero, e o cório liso relacionando-se com a face interna do útero. Nas placentas de final de prenhez os lobos aglomeram-se e fundem-se aumentando de tamanho, formando uma massa principal discóide, caracterizando uma placenta zonária discoidal, que se une ao feto pelo funículo umbilical, constituído por duas artérias e uma veia umbilical. Os resultados histológicos demonstraram que a placenta desses animais é labiríntica e endoteliocorial. Assim, a placenta da preguiça pode ser classificada como labiríntica, endoteliocorial, múltipla, discóide (a termo e corioamniótica.

  5. Maturação funcional da retina em bebês prematuros

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    Adriana Berezovsky

    2007-06-01

    Full Text Available A retina humana ainda não está totalmente desenvolvida no nascimento. Só após o nascimento é que ocorrem mudanças anatômicas como o aumento na densidade de cones centrais e o alongamento do segmento externo dos fotorreceptores. As mudanças funcionais que ocorrem na retina com a maturação no primeiro ano de vida podem ser avaliadas pela técnica do eletrorretinograma de campo total, que representa a atividade somada da retina distal em resposta à luz. Abordaremos aspectos da maturação funcional da retina avaliada pelo eletrorretinograma em bebês prematuros.

  6. Ser pai de recém-nascido prematuro na unidade de terapia intensiva neonatal: da parentalidade a paternidade

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    Rachel Leite de Souza Ferreira Soares

    2015-09-01

    Full Text Available ResumoObjetivo:Compreender os significados atribuídos pelo pai ao ter um filho prematuro internado na Unidade de Terapia Intensiva Neonatal.Métodos:Estudo qualitativo com abordagem etnográfica realizado em uma unidade neonatal no Rio de Janeiro. Foram entrevistados 22 homens pais que tinham o filho prematuro internado. Os dados foram coletados por meio de diário de campo, observação participante e entrevista semiestruturada.Resultados:O pai desempenha papel fundamental durante o processo reprodutivo. Coloca-se como protetor da mulher na gestação e puerpério e vivencia intensa realização ao nascimento, mesmo que prematuramente. Entretanto, ter um filho prematuro internado seja uma experiência inesperada e difícil.Conclusão:Os pais demonstraram viver a transição social e cultural da paternidade, com superação ainda tímida do modelo hegemônico. Ao mesmo tempo, entendem seu papel fundamental de provisão financeira e demonstram desejo em cuidar do seu filho. Os profissionais de saúde devem proporcionar essa aproximação para fortalecimento da paternidade.

  7. Ser pai de recém-nascido prematuro na unidade de terapia intensiva neonatal: da parentalidade a paternidade

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    Rachel Leite de Souza Ferreira Soares

    Full Text Available ResumoObjetivo:Compreender os significados atribuídos pelo pai ao ter um filho prematuro internado na Unidade de Terapia Intensiva Neonatal.Métodos:Estudo qualitativo com abordagem etnográfica realizado em uma unidade neonatal no Rio de Janeiro. Foram entrevistados 22 homens pais que tinham o filho prematuro internado. Os dados foram coletados por meio de diário de campo, observação participante e entrevista semiestruturada.Resultados:O pai desempenha papel fundamental durante o processo reprodutivo. Coloca-se como protetor da mulher na gestação e puerpério e vivencia intensa realização ao nascimento, mesmo que prematuramente. Entretanto, ter um filho prematuro internado seja uma experiência inesperada e difícil.Conclusão:Os pais demonstraram viver a transição social e cultural da paternidade, com superação ainda tímida do modelo hegemônico. Ao mesmo tempo, entendem seu papel fundamental de provisão financeira e demonstram desejo em cuidar do seu filho. Os profissionais de saúde devem proporcionar essa aproximação para fortalecimento da paternidade.

  8. Aspectos morfológicos da placenta da preguiça, Bradypus variegatus Shinz, 1825

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    Marleyne José Afonso Accyoli Lins Amorin; Maria Angélica Miglino; Adelmar Afonso Amorin Júnior; Tatiana Carlesso dos Santos

    2003-01-01

    Estudaram-se os aspectos morfológicos da placenta e das membranas fetais de 03 placentas de bichos-preguiça (Bradypus variegatus), adultas e prenhes, originárias da Zona da Mata do Estado de Pernambuco. Essas estruturas foram obtidas de 03 fêmeas doadas pela Universidade Federal de Pernambuco, das quais duas encontravam-se congeladas e a terceira foi colhida mediante realização de cirurgia cesariana, onde mãe e feto foram preservados. Depois de descongeladas, as placentas foram fixadas em sol...

  9. Amadurecimento precoce da placenta avaliada pela ultra-sonografia e prognóstico perinatal Early placental maturation evaluated by ultrasound and perinatal prognosis

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    Ana Patrícia Santos de Queiroz

    2006-03-01

    Full Text Available OBJETIVO: descrever os resultados maternos e perinatais das gestações com amadurecimento precoce da placenta detectado pela ultra-sonografia. MÉTODOS: realizou-se estudo retrospectivo, descritivo, tipo série de casos, com comparação de grupos. Foram incluídas 146 gestantes, internadas entre janeiro de 2000 e dezembro de 2002 e em cujo prontuário constavam diagnóstico de amadurecimento precoce da placenta (presença de placenta grau II antes da 32ª semana de gestação ou grau III, antes da 35ª semana de gestação e descrição das condições materno-fetais. Foram excluídas gestantes com diagnóstico de: amniorrexe prematura, gravidez múltipla, forma aguda de descolamento prematuro de placenta normoinserida e malformação fetal. As complicações clínico-obstétricas foram: doenças hipertensivas, redução do crescimento intra-uterino, alterações do volume de líquido amniótico, infecções, diabete materno, anemia falciforme, soropositividade para HIV, drogadição, litíase renal, epilepsia e asma brônquica. Pelos prontuários, foram identificadas 106 gestantes com complicações clínico-obstétricas (Gcom e 40, sem essas complicações (Gsem. Para comparação entre os grupos, empregaram-se os testes de chi2 e exato de Fisher, ao nível de significância de 0,05. RESULTADOS: o grupo Gcom apresentou maior freqüência de oligoâmnio (27,3%, restrição de crescimento intra-uterino (44,3% e cesárea antecedente ao trabalho de parto (36,8%. Comparado ao grupo Gsem, o Gcom caracterizou-se por maior incidência de óbitos fetais, prematuros (58,8 versus 40%, menor índice de Apgar de 5º minuto, peso ao nascer PURPOSE: to describe perinatal and obstetric characteristics of pregnant women with ultrasonographic early placental aging. METHODS: using a retrospective, descriptive, series of cases, with group comparison, the authors analyzed the data of 146 pregnant women, whose diagnosis of placental early aging (presence of grade

  10. Mortalidad perinatal en el parto prematuro entre 22 y 34 semanas en un hospital público de Santiago, Chile

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    Ovalle S,Alfredo; Kakarieka W,Elena; Díaz C,Marcela; García Huidobro M,Trinidad; Acuña M,María Jesús; Morong C,Carla; Abara C,Selim; Fuentes G,Ariel

    2012-01-01

    Objetivo: Conocer la mortalidad perinatal del parto prematuro y los factores de riesgo asociados, usando los datos perinatales clínicos, los resultados de laboratorio y los hallazgos patológicos del feto, neonato y placenta. Métodos: Estudio retrospectivo, cohorte de 407 nacimientos prematuros, únicos, entre 22.0 y 34.0 semanas de gestación. Se estudiaron las muertes fetales y neonatales hasta los 7 días de vida. Fallecieron 122 niños (64 muertes fetales y 58 neonatales), 78 tuvieron autopsia...

  11. ASSISTÊNCIA DE ENFERMAGEM AO PREMATURO: ALGUNS PROCEDIMENTOS BÁSICOS

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    Miriam Aparecida Barbosa Merighi

    Full Text Available São apresentados os procedimentos básicos de assistência de enfermagem ao prematuro, a saber: observação nas primeiras 24 horas de vida, hidratação, alimentação com mamadeira, alimentação por sonda nasogástrica, cuidados após a alimentação, técnica do banho na incubadora, cuidado com a pele, cuidado com o coto umbilical, cuidado do prematuro com monilíase, diarréia, vômito, problemas respiratórios, cuidado do prematuro em oxigenoterapia, limpeza e conservação da incubadora.

  12. A participação da família no cuidado ao prematuro em UTI Neonatal La participación de la familia en la asistencia al prematuro en UTI Neonatal Family participation in premature care in Neonatal ICU

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    Maria Aparecida Munhoz Gaíva

    2005-08-01

    Full Text Available Esse estudo tem como objetivo analisar a participação da família na assistência ao prematuro em uma UTI neonatal de um hospital universitário. Os dados foram coletados utilizando-se a observação participante. Os resultados mostraram que apesar da presença materna no cotidiano da internação do filho prematuro, a família não está inserida no processo de trabalho, sendo que somente a mãe participa dos cuidados. Esta participação se dá basicamente na execução dos cuidados de maternagem, principalmente na unidade de médio risco, a mãe e a família do prematuro são pouco acolhidas e não existe relação de parceria entre equipe e família, não há intervenções ampliadas da equipe em torná-la sujeito autônomo para promover a saúde e qualidade de vida do bebê.Este estudio tuvo como objetivo analizar la participación de la familia en la asistencia al prematuro en una UTI neonatal de un hospital universitario. La colecta de datos fue hecha a través de observación participante. Los resultados muestran que a pesar de la presencia materna en el cotidiano de internación del hijo prematuro, la familia no está inserida en el proceso de trabajo, siendo que solamente la madre participa de los cuidados. Esta participación ocurre básicamente en la ejecución de cuidados de maternidad, especialmente en la unidad de medio riesgo, la madre y familia del prematuro son poco acogidas y no existe parcería entre el equipo de salud y la familia, no hay intervenciones ampliadas del equipo con vistas a tornar la familia sujeto autónomo para promover la salud y cualidad de vida del bebe.This study aimed at analyzing the family participation in the premature assistance in a university hospital neonatal ICU. Data were collected from the participant observation. Results showed that despite of the mother's presence in the daily life of their premature children placed in a hospital, family isn't inserted in the work process and mothers are the

  13. Confiabilidade da análise qualitativa da ressonância magnética do encéfalo em prematuros extremos

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    Andre Dietz Furtado

    2010-12-01

    Full Text Available OBJETIVO: O objetivo deste estudo foi avaliar a confiabilidade da análise visual qualitativa dos achados de imagem de ressonância magnética (RM em recém-nascidos prematuros extremos. MATERIAIS E MÉTODOS: Uma coorte de 45 recém-nascidos de idade gestacional de 30 semanas ou menos foram inseridos neste estudo. Dois neurorradiologistas, cegos quanto aos dados clínicos, avaliaram de forma independente as RMs de crânio em relação aos seguintes achados: presença de hipersinal difuso e excessivo (DEHSI, dilatação dos ventrículos laterais, hemorragia intracraniana, áreas de sinal anormal em núcleos da base e córtex, áreas de aspecto cístico, deformidades ventriculares, dilatação do espaço subaracnóideo, leucoencefalomalácia precoce e anormalidades corticais. RESULTADOS: Quarenta e um pacientes (91,1% apresentaram exame de RM anormal. Os achados mais comuns foram DEHSI (75,6% e dilatação dos ventrículos (42,2%. A concordância interobservadores entre os dois experientes neurorradiologistas foi alta (κ > 0,60 para a maioria das alterações detectadas pela RM. O valor de kappa foi moderado (κ = 0,52 para alargamento do espaço subaracnoide e fraco (κ = 0,39 para DEHSI na substância branca. CONCLUSÃO: A avaliação qualitativa da maioria dos achados de imagem por RM de neonatos prematuros extremos foi considerada confiável, entretanto, a presença de DEHSI na substância branca demonstrou um grau de confiabilidade menor

  14. Efeitos da betametasona sobre os fetos e placentas da rata albina Effects of betamethasone on the fetuses and placentas of female albino rats

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    Eduardo de Souza

    2001-03-01

    Full Text Available Objetivos: analisar os efeitos da betametasona sobre o binômio materno-fetal da rata albina. Métodos: utilizamos 60 ratas albinas prenhes divididas ao acaso em três grupos numericamente iguais. As ratas do grupo I foram tratadas com betametasona na dose de 1 mg/kg de peso em 0,5 ml de água destilada, por via intramuscular no 11º, 12º, 18º e 19º dia de prenhez; as do grupo II receberam 0,5 ml de água destilada, por via intramuscular no 11º, 12º, 18º e 19º dia de prenhez, e as do grupo III não receberam qualquer fármaco ou veículo. O ganho de peso das matrizes foi avaliado nos dias 0, 7, 14 e 20 de prenhez, sendo que no 20º dia todos os animais foram sacrificados por decapitação. Foram quantificados o número de implantações, de reabsorções, de fetos, de placentas, de malformações maiores, de mortalidade materna e fetal, assim como o peso dos fetos e das placentas. Resultados: nossos resultados revelaram que as matrizes tratadas com betametasona apresentaram menor ganho de peso. Quanto aos fetos e as placentas do grupo tratado, observamos que os pesos foram inferiores aos dos outros grupos. A média de peso dos fetos foi de 3,20 g contra 3,75 g no grupo controle. A média de peso das placentas foi de 0,36 g no grupo tratado com betametasona contra 0,48 g no grupo controle. Todas estas diferenças foram estatisticamente significantes. Conclusões: a betametasona apresenta efeito negativo sobre o ganho de peso das matrizes, fetos e placentas, quando administrada de forma repetitiva a partir da segunda metade da prenhez.Purpose: to analyze the effect of betamethasone on the pregnancy of rats. Methods: thirty pregnant rats were divided into three groups of ten animals each. Group I -- the animals received betamethasone IM (1 mg/kg body weight, in 0.5 ml distilled water on the 11th, 12th, 18th and 19th day of pregnancy. Group II -- the rats received distilled water (0.5 ml IM on the 11th, 12th, 18th and 19th day of pregnancy

  15. Avaliação materna da dor em recém-nascidos prematuros

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    Maria Carolina Correia dos Santos

    2015-01-01

    Full Text Available Objetivo: identificar la percepción de madres sobre el dolor de hijos prematuros en Unidad de Cuidados Intensivos Neonatales. Métodos: investigación evaluativa, cuantitativa y de investigación con 19 madres de recién nacidos prematuros hospitalizados. Datos obtenidos a partir de preguntas cerradas, llenas por las madres. Resultados: de las participantes, dos (10,5% informaron que recién nacidos son incapaces de sentir dolor. De las 17 madres que dicen que el prematuro siente dolor, la mayoría (94,1% identificó el lloro como característico de sensación de dolor. Once (64,7% declararon que la crisis es un signo de dolor en recién nacido. Conclusión: para el manejo adecuado del dolor neonatal es esencial que las madres conozcan los signos de dolor en recién nacidos prematuros, y que los profesionales de salud las instruya a este reconocimiento, a través de la valoración de la presencia materna y práctica de comunicación efectiva entre profesionales y familia del recién nacido.

  16. Associação da Vaginose Bacteriana com o Parto Prematuro Espontâneo Association of Bacterial Vaginosis with Spontaneous Preterm Delivery

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    Mário Henrique Burlacchini de Carvalho

    2001-09-01

    Full Text Available Objetivo: relacionar a presença de vaginose bacteriana em gestantes com a ocorrência de parto prematuro espontâneo. Método: foram estudadas 611 gestantes do serviço pré-natal da Clínica Obstétrica do HCFMUSP. Foram incluídas gestantes com idade gestacional confirmada por ultra-sonografia no primeiro trimestre de gestação ou duas ultra-sonografias até a 20ª semana quando havia discordância da idade gestacional no primeiro exame. Os partos prematuros eletivos foram excluídos. A pesquisa da vaginose foi realizada na 23ª ou 24ª semana de gestação por meio da técnica de coloração de Gram. O pH vaginal foi pesquisado utilizando-se fita de pH Universal 0-14 produzida pela Merck. O conteúdo vaginal foi coletado com a paciente em posição ginecológica, utilizando-se espéculo não-lubrificado. O pH foi medido na parede lateral da vagina e o conteúdo para Gram foi coletado do fundo de saco vaginal utilizando-se de cotonete estéril. Resultado: das 611 gestantes envolvidas inicialmente no estudo, foram obtidos os resultados do parto em 541. A vaginose bacteriana foi diagnosticada por bacterioscopia em 19% dos casos. No grupo de gestantes com vaginose, 9,7% (10/103 evoluíram com parto prematuro, contra apenas 3,2% (14/438 no grupo negativo (p=0,008. A sensibilidade da bacterioscopia positiva para vaginose bacteriana para predição do parto prematuro foi de 41,7%, a especificidade de 82%, a acurácia de 80,2%, com taxa de falso-positivos de 18% e risco relativo de 1,8. Conclusão: a vaginose bacteriana diagnosticada pelo Gram do conteúdo vaginal representa fator de risco para o parto prematuro, com risco relativo de 1,8.Purpose: to evaluate the relationship between bacterial vaginosis (BV and spontaneous preterm delivery. Method: a total of 611 pregnant women from the general antenatal clinic of the "Clínica Obstétrica do Hospital das Clínicas da Universidade de São Paulo" were enrolled in this study. All pregnancies were

  17. PROMOÇÃO DA SAÚDE ÀS GENITORAS DE BEBÊS PREMATUROS: AÇÃO DA ENFERMAGEM NA ALTA HOSPITALAR

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    Anailza De Souza Duarte

    2010-01-01

    Full Text Available La prematuridad es la principal causa de hospitalización en las unidades neonatales configurada como problema de salud pública. Tuvo como objetivo conocer el punto de vista del equipo de enfermería sobre la ejecución de acciones con las madres ante el alta hospitalaria del prematuro. Se trata de un estudio cualitativo, llevado a cabo en un hospital de Barbalha-CE, Brasil, con doce miembros del equipo de enfermería que atienden madres de bebés prematuros en la unidad citada, en 2008. Los datos obtenidos fueron analizados mediante la categorización de las pláticas y el método de análisis de contenido. Surgieron a partir del estudio los siguientes temas: preparación materna para el alta del prematuro; orientaciones de enfermería para el cuidado con el prematuro y dificultades en la preparación de la madre para el alta del prematuro. Se comprobó que la realización de la Educación en la Salud para el alta hospitalaria del bebé prematuro es importante para el desarrollo de la confianza materna al tener que cuidar a su hijo, lo que influye en la calidad de vida después del alta hospitalaria.

  18. Identificação imuno-histoquímica de Listeria monocytogenes em placentas fixadas em formol e embebidas em parafina

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    Schwab Jussara Pires

    2003-01-01

    Full Text Available OBJETIVOS: identificar Listeria monocytogenes (Lm em placentas humanas pela técnica de imuno-histoquímica (IHQ e relacionar sua presença com as alterações histológicas encontradas com as alterações histológicas encontradas no exame convencional, com o trimestre gestacional, a idade das gestantes, casos de aborto e parto prematuro e a ocorrência de aborto habitual. MÉTODOS: um estudo retrospectivo foi realizado no setor de patologia de um hospital-escola de Porto Alegre no ano 2000. O material dos blocos de parafina de 254 placentas (exames anatomopatológicos, provenientes de aborto, de parto prematuro e de nascimento a termo, foi analisado pela técnica histológica convencional com a coloração de hematoxilina e eosina (HE. A técnica de IHQ foi realizada no material de 148 exames anatomopatológicos, que apresentaram alterações inflamatórias, hemorragia, necrose e trombose, utilizando anticorpo policlonal Rabbit A "Listeria monocytogenes" B65420R (Biodesign® na diluição 1:1000 e complexo avidina-biotina-estreptavidina. O teste c² foi aplicado para a análise estatística. RESULTADOS: a presença de Lm foi identificada em 33,7% das placentas analisadas pela técnica IHQ. Corioamnionite e vilite foram as alterações inflamatórias que estiverem associadas a diferença significativa nas placentas positivas. Lm esteve presente nas placentas de 1º, 2º e 3º trimestre gestacional. Não houve associação entre idade das gestantes, casos de aborto e/ou parto prematuro e a presença ou ausência de Lm nas placentas. Abortos habituais ocorreram em pacientes com ou sem Lm no tecido placentário. CONCLUSÃO: a técnica de IHQ pode ser utilizada para confirmar o diagnóstico histopatológico de listeriose em todos os trimestres gestacionais.

  19. Prematuros e prematuros tardios: suas diferenças e o aleitamento materno

    OpenAIRE

    Silva,Waléria Ferreira da; Guedes,Zelita Caldeira Ferreira

    2015-01-01

    Resumo:OBJETIVO:verificar se há diferenças entre recém nascidos prematuros e prematuros tardios no que se refere ao tempo de aleitamento materno e aleitamento materno exclusivo causas e consequências do desmame precoce. Ademais, foi observado o uso de oxigenoterapia e sonda para alimentação, número de sessões de fonoterapia e o tempo de internação.MÉTODOS:pesquisa de campo, de caráter exploratório e longitudinal. Participaram do estudo 82 mães de prematuros. Os dados categóricos foram resumid...

  20. El prematuro: una esperanza de vida

    OpenAIRE

    Betancur R., Diana Helena; Fundación Valle de Lili; Garzón F., Lucía

    1999-01-01

    Factores prenatales de riesgo para el feto/Alteraciones inherentes a la prematuréz/Manejo del niño prematuro/ ¿Existe relación entre la actividad física y los partos prematuros?/ ¿Cómo se puede prevenir la prematuréz?/ ¿El recién nacido prematuro puede llevar una vida normal una vez es dado de alta?/ ¿Qué tipo de alimentación deberá recibir el prematuro?/ ¿Cuándo debe usted consultar a su pediatra?

  1. PREVENCIÓN PRENATAL DE DAÑO NEUROLÓGICO EN PREMATURO EXTREMO

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    Dra. Lorena Quiroz

    2016-07-01

    Full Text Available La prevención del parto prematuro es uno de los desafíos de la obstetricia en el siglo XXI. Los prematuros tienen riesgo de morbimortalidad perinatal, sobre todos los nacidos antes de las 30 semanas, tienen mayor riesgo de lesiones neurológicas generalmente secundarias a isquemia o infección intrauterina ascendente. Existen estrategias para prevenir el daño neurológico fetal en el trabajo de parto prematuro. La administración de sulfato de magnesio endovenoso reduce en forma significativa la probabilidad de desarrollar parálisis cerebral y disfunciones motoras. También se ha mostrado la utilidad del pinzamiento tardío del cordón umbilical y la administración antenatal y postnatal de N-acetilcisteína. En estudios animales se ha observado un potencial efecto neuroprotector de stem cells mesenquimáticas, estradiol y progesterona, melatonina y creatina.

  2. Variabilidade da frequência cardíaca em neonatos prematuros e de termo Variabilidad de la frecuencia cardíaca en neonatos prematuros y de término Heart rate variability in preterm and term neonates

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    Fabio Augusto Selig

    2011-06-01

    Full Text Available FUNDAMENTO: Várias publicações têm demonstrado a importância do sistema nervoso autônomo por meio dos componentes simpático e parassimpático na gerência da interação entre as diferentes partes do organismo humano. Esses estudos aplicaram técnicas lineares e não lineares (Teoria do Caos de avaliação em diferentes situações, doenças e faixas etárias, tendo como ferramenta a variabilidade da frequência cardíaca (VFC. OBJETIVO: Aplicar os conhecimentos das dinâmicas linear e não linear na avaliação de neonatos prematuros (NPT, analisando sua VFC e comparando com neonatos de termo (NT saudáveis. MÉTODOS: Quarenta e oito neonatos prematuros com diferentes idades gestacionais tiveram seus batimentos cardíacos captados com auxílio do equipamento Polar Advanced S810i e sua VFC obtida pelo registro dos intervalos RR. A VFC foi analisada nos domínios do tempo (SDNN, RMSSD, SD1/SD2, da frequência (VLF, LF, HF e a relação LF/HF e do caos (TAU e sua normalização [TAU(n], Expoente de Lyapunov e Entropia. Os NPT foram comparados com um grupo de 78 NT saudáveis e sem intercorrências perinatais com auxílio do teste não paramétrico de Kruskal-Wallis. RESULTADOS: Detectou-se diferença estatisticamente significante entre os grupos para todas as variáveis estudadas, tanto no domínio do tempo como nos da frequência e do caos. CONCLUSÃO: Neonatos prematuros exibem comportamento menos complexo da variabilidade da frequência cardíaca que neonatos de termo, fato comprovado nos domínios do tempo, da frequência e do caos. O estudo da variabilidade cardíaca nesse grupo pode ser considerado uma ferramenta a mais na avaliação da maturação autonômica e, consequentemente, da progressão para eutrofia.FUNDAMENTO: Varias publicaciones han demostrado la importancia del sistema nervioso autónomo por medio de los componentes simpático y parasimpático en el manejo de la interacción entre las diferentes partes del organismo

  3. Óbito fetal no descolamento prematuro da placenta: comparação entre dois períodos Fetal death in placental abruption: comparison of two different time periods

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    Fábio Roberto Cabar

    2008-06-01

    Full Text Available OBJETIVOS: Comparar a incidência de descolamento prematuro da placenta (DPP, de óbito fetal e o perfil dos fatores maternos associados ao óbito fetal em casos acometidos por DPP em dois períodos, num mesmo serviço médico terciário. MÉTODOS: Avaliação retrospectiva dos casos de DPP ocorridos entre 1º de janeiro de 1994 a 31 de dezembro de 1997 (período 94-97 e 1º de abril de 2001 a 31 de março de 2005 (período 01-05, em gestações únicas com peso do recém-nascido superior a 500g e idade gestacional acima da 20ª semana. Foram analisados os fatores: idade materna, cor, antecedentes obstétricos, ocorrência de hipertensão arterial ou ruptura prematura de membranas ovulares, presença de sangramento genital, hemoâmnio, características do tônus uterino, ocorrência de CIVD, insuficiência renal, anemia puerperal, bem como a idade gestacional e peso do RN no parto. RESULTADOS: No período 94-97, foram realizados 7.692 partos e o DPP ocorreu em 0,78% (60 casos, e no período 01-05 foram 8.644 partos com 0,59% (51 casos de DPP, sem diferença significativa. No período 94-97, a proporção de casos sem sangramento genital foi significativamente maior no grupo que evoluiu com óbito fetal quando comparado aos casos cujo feto nasceu vivo (57,9% vs 22,0%; p=0,01. No período 01-05, a proporção de casos com hipertonia uterina foi significativamente maior no grupo que evoluiu com óbito fetal quando comparado aos casos com recém-nascido nativivo (66,7% vs 29,3%; p=0,04. As complicações maternas no pós-parto foram mais freqüentes nos casos de óbito fetal, em ambos os períodos 94-97 e 01-05 (31,6% vs 4,9%, p=0,009, e, 50,0% vs 5,1%, p=0,001, respectivamente. CONCLUSÃO: O DPP permanece grave problema obstétrico com conseqüências potencialmente fatais, principalmente nos casos com maior área de descolamento da placenta. Maior gravidade do quadro clínico materno é observada nos casos de óbito fetal.OBJECTIVE: To compare the

  4. Metodologia para estudo do volume e densidade absoluta da placenta humana de termo

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    Del Nero Ulisses

    2002-01-01

    Full Text Available OBJETIVO: comparar duas metodologias para o cálculo do volume placentário em gestações normais de termo: a do princípio de Arquimedes e a do volume do cilindro, para estimar a densidade absoluta da placenta. Definir a metodologia mais adequada para o cálculo do volume e densidade placentários, que se relacione com o peso e classificação do recém-nascido. MÉTODOS: foram estudadas 50 placentas provenientes de gestações de termo sem complicações e calculados o volume e a densidade absoluta placentários: a pelo princípio de Arquimedes e b na suposição de que a placenta seria uma secção de cilindro com duas alturas diferentes do bolo placentário: com a altura média e com a altura da média aritmética do centro e extremidades. As densidades absolutas placentárias foram calculadas pelo quociente entre o peso ao ar da placenta e os diferentes volumes. RESULTADOS: a maioria das gestantes eram multíparas, idade média de 25,4 anos, volume placentário médio entre 547,8 e 610 cmsuperscript three e densidade média entre 0,94 e 1,14 g/cmsuperscript three, dependendo da metodologia empregada. CONCLUSÕES: a metodologia mais adequada para estimar o volume placentário no termo foi a do princípio de Arquimedes, pela melhor correlação com o peso dos recém-nascidos, o índice placentário e a classificação do peso dos recém-nascidos em relação à idade gestacional.

  5. Efeitos da corticoterapia materna nos valores hemogasométricos de cordeiros nascidos a termo e prematuros

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    Francisco Leydson Formiga Feitosa

    Full Text Available RESUMO: O objetivo do estudo foi avaliar as variáveis hemogasométricas de cordeiros nascidos a termo e prematuros do nascimento às 48 horas de vida. Foram constituídos quatros grupos experimentais: PN (cordeiros nascidos de parto normal, n=15, média de 146 dias de gestação; PNDEX (cordeiros nascidos de parto normal, cujas mães receberam 16 mg de dexametasona aos 141 de gestação, n=8, média de 143 dias de gestação; PRE (cordeiros prematuros nascidos de cesarianas aos 138 dias de gestação, n=10 e PREDEX (cordeiros prematuros nascidos de cesarianas aos 138 dias de gestação, cujas mães receberam 16 mg de dexametasona dois dias antes do parto, n=9. Imediatamente após o nascimento, os cordeiros de todos os grupos apresentaram quadro de acidose respiratória (pH baixo e pCO2 elevada, com maior ênfase nos animais prematuros. A concentração de HCO3 - diminuiu entre 15 e 60 minutos de vida, principalmente nos grupos PRE e PREDEX, com posterior aumento no M24h. Os valores de diferença de base foram menores nos cordeiros prematuros, os quais apresentaram respiração abdominal, intensa dispneia e grande quantidade de líquido pulmonar. A estabilização do equilíbrio ácidobase ocorreu em todos os animais ao longo das primeiras 24 horas de vida. A dexametasona teve influência positiva sobre a condição clínica dos animais prematuros, resultando em adequada ventilação e perfusão tecidual, o que garantiu maior taxa de sobrevivência.

  6. Diagnósticos de enfermagem de prematuros sob cuidados intermediários Diagnósticos de enfermería de prematuros bajo la atención intermediária Nursing diagnoses of premature infant under intermediary care

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    Natália Del'Angelo

    2010-10-01

    Full Text Available O estudo teve como objetivo identificar diagnósticos de enfermagem de prematuros assistidos em uma unidade de cuidado intermediário neonatal do interior de São Paulo, Brasil. Tratou-se de um estudo retrospectivo a partir de prontuários de 118 prematuros hospitalizados. Os diagnósticos de enfermagem mais frequentes foram: Privação do Sono (83,1%, Risco de Infecção (76,3% e Processos Familiares Alterados (75,4%, pertencentes aos respectivos domínios da NANDA: atividade/repouso, segurança/proteção e relacionamentos de papel. Os resultados do estudo articularam a frequência dos diagnósticos com os domínios da NANDA aos quais pertencem, identificando limitação da abordagem dos mesmos e principais domínios apontados na sistematização da assistência ao recém-nascido prematuro em cuidado intermediário.El estudio tuvo como objetivo identificar los diagnósticos de enfermería de prematuros asistidos en una unidad de cuidado intermediario neonatal del interior de Sao Paulo, Brasil. Re realizó un estudio retrospectivo a partir de los registros hospitalarios de prematuros hospitalizados. Los diagnósticos más frecuentes fueron: Perturbación del Sueño (83,1%, Riesgo de Infección (76,3% y Alteración de los Procesos Familiares (75,4%, pertenecientes a los dominios NANDA: actividad/reposo, seguridad/protección y papel/relación, en esta orden. Los resultados del estudio articularon la frecuencia de los diagnósticos con los dominios NANDA pertenecientes, identificando limitación del abordaje de los mismos y principales dominios apuntados en la sistematización de la asistencia al recién-nascido prematuro en cuidado intermediario.The study aims at identifying nursing diagnoses of premature infants attended in a neonatal intermediary care unit in the countryside of São Paulo State, Brazil. That was a retrospective study conducted from 118 patient records of hospitalized premature infants. The most frequent nursing diagnosis were

  7. Social representations of mothers about gestational hypertension and premature birth Representaciones sociales de las madres sobre la hipertensión gestacional y parto prematuro Representações sociais de puérperas sobre as síndromes hipertensivas da gravidez e nascimento prematuro

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    Nilba Lima de Souza

    2013-06-01

    durante el embarazo (335 prematuridad (333 y UCIN (339. Estos constituyeron tres unidades temáticas: la representación de THE, prematuridad y UCIN. Las categorias muerte y aspectos negativos fueron inherentes a las tres unidades analizadas, seguidos por las estrategias de afrontamiento y las necesidades de atención actual en THE y prematuridad. CONCLUSÍON: El estudio tenía la muerte como su núcleo central, y puso de relieve los aspectos subjetivos presentes en el embarazo de alto riesgo y el ciclo de post-parto. Se espera que esta investigación contribuya a calificar la atención de enfermería para las mujeres que enfrentan el problema de los THE, de modo que puedan hacer frente con menos impacto de los efectos adversos de los embarazos de alto riesgo y el parto. OBJETIVO: identificar os significados atribuídos por puérperas às síndromes hipertensivas da gravidez e suas consequências, como o nascimento prematuro e a hospitalização do filho na unidade de terapia intensiva neonatal MÉTODO: estudo qualitativo, baseado na Teoria do Núcleo Central, com 70 mulheres que apresentaram síndrome hipertensiva da gravidez e parto prematuro. Utilizou-se a Técnica de Associação Livre de Palavras com três estímulos: pressão alta na gravidez, prematuridade e unidade de terapia intensiva neonatal. RESULTADOS: foram obtidas 1.007 evocações, assim distribuídas: pressão alta na gravidez (335 prematuridade (333 e unidade de terapia intensiva neonatal (339. Constituíram-se três unidades temáticas: representação das síndromes hipertensivas da gravidez, da prematuridade e da unidade de terapia intensiva neonatal. As categorias morte e aspectos negativos foram inerentes às três unidades analisadas, seguidas de estratégias de enfrentamento e necessidade de cuidados, presentes nas síndromes hipertensivas da gravidez e prematuridade. CONCLUSÃO: o estudo teve como núcleo central a morte, e se destacaram os aspectos subjetivos presentes no ciclo gravídico e

  8. Prevenção do Nascimento Prematuro: Importância da Monitorização das Contrações Uterinas Prevention of Preterm Birth: Role of Uterine Contraction Monitoring

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    Eduardo Sérgio Borges da Fonseca

    1999-10-01

    Full Text Available Objetivo: avaliar a relação entre alterações das contrações uterinas e parto prematuro. Metodologia: entre fevereiro de 1996 e junho de 1998, 73 gestantes com risco para o parto prematuro foram submetidas à monitorização externa das contrações uterinas, da 24ª à 34ª semana de gestação, duas vezes por semana, durante 60 minutos. O teste foi considerado positivo quando as contrações uterinas apresentavam freqüência maior ou igual a 4 contrações/hora antes da 30ª semana e a 6 contrações/hora após esta data. Resultado: foram excluídas da análise 17 pacientes (23,28% por apresentarem patologias obstétricas ou evolução desfavorável para os resultados finais. Das 56 gestantes restantes, a incidência de partos prematuros espontâneos foi de 23,21% (13/56. A freqüência média das contrações uterinas foi significativamente maior no grupo que evoluiu para o parto prematuro. O método revelou uma sensibilidade de 69,23%, uma especificidade de 86,04% e valores preditivos positivo e negativo de 60% e 90,24%, respectivamente. Conclusão: o teste negativo está associado a baixo risco de nascimento prematuro. Contudo, diante do teste positivo, torna-se necessária a associação com outros marcadores do parto prematuro para melhor identificar pacientes com risco elevado.Purpose: to evaluate the relationship between uterine contractions and premature delivery. Methods: between February 1996 and July 1998, 73 high risk pregnant women for preterm delivery, between the 24th and 34th weeks of gestation, were submitted to uterine contraction monitoring with tokodynamometers for 1 hour twice a week. The positive test was the presence of 4 contractions/h before the 30th week of gestation, and after this time, 6 contractions/h. Result: of 73 women, 17 patients (23.28% were excluded from the final analysis because they presented obstetric problems or unfavorable development for the final result. The rate of preterm delivery was 21

  9. Alta hospitalar e o cuidado do recém-nascido prematuro no domicílio: vivência materna Alta hospitalaria y el cuidado de los recién-nacidos prematuros en el hogar: experiencias de la madre Hospital and care of the premature newborn at home: maternal experiences

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    Mirna Albuquerque Frota

    2013-06-01

    Full Text Available Objetivou-se conhecer a percepção da mãe sobre a alta hospitalar e o cuidado do recém-nascido prematuro no domicílio após a primeira semana de alta. Pesquisa descritiva, de abordagem qualitativa, com uso da entrevista semiestruturada para coleta de dados, desenvolvida no ambulatório de seguimento do prematuro (follow-up do Hospital da Rede Pública Estadual de Fortaleza, em outubro e novembro de 2011. As participantes foram nove mães de recém-nascido prematuro após primeira semana de alta. Aplicou-se análise do conteúdo. Os resultados apontaram para as categorias: Orientações sobre o cuidado com o prematuro durante a alta hospitalar; Sentimentos e dificuldades com a chegada do bebê no domicílio; e Apoio familiar no cuidado do prematuro. O estudo evidenciou que algumas mães não receberam orientações da equipe multiprofissional da neonatologia acerca do cuidado bebê após alta hospitalar, reforçando que elas levam o bebê para o domicílio sem estar preparadas para a nova realidade.Dirigido a aprender acerca de la percepción de la madre sobre el alta hospitalaria y el cuidado de los recién-nacidos prematuros en el hogar después de la primera semana de alta. Enfoque descriptivo, cualitativo, con entrevistas semiestructuradas para recopilar datos, desarrollado en el ambulatorio de seguimiento del prematuro (Follow Up del Hospital de la Red Pública del Estado de Fortaleza, en octubre y noviembre de 2011. Participaron nueve madres de bebés prematuros después de la primera semana de alta. Se aplicó el análisis de contenido para la observación de los datos. Los resultados apuntan para las siguientes categorías: Orientaciones para el cuidado con los bebés prematuros durante el alta; Sentimientos y dificultades con la llegada del bebé al hogar; Apoyo familiar en el cuidado de los bebés prematuros. El estudio demostró que algunas madres no recibieron instrucciones del equipo interdisciplinario de atención de neonatolog

  10. Percepções de mães de prematuros acerca da vivência em um programa educativo Percepciones de madres de prematuros acerca de la vivencia en un programa de educación en salud Perceptions of mothers of premature babies regarding their experience with a health educational program

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    Geovana Magalhães Ferecini

    2009-06-01

    Full Text Available OBJETIVO: Analisar a percepção de mães de prematuros sobre a vivência em um Programa de Educação em Saúde utilizando metodologia participativa. MÉTODOS: Participaram 38 mães de prematuros internados em uma unidade neonatal. O Programa, visando construir conhecimentos sobre os cuidados com o prematuro, consistiu na entrega de uma cartilha educativa às mães para leitura e posterior participação em atividades grupais, fundamentadas no referencial da problematização de Paulo Freire, com estímulo à expressão das percepções acerca da vivência no Programa. Foi realizada a análise temática das falas das mães. RESULTADOS: Apreenderam-se quatro núcleos temáticos: o aprendizado proporcionado pelo Programa; a criação de possibilidades de socializar o conhecimento com a família; o Programa como espaço para descontração e escuta; e desenvolvendo o vínculo afetivo com outras mães e com a enfermeira. CONCLUSÃO: Diante dos resultados positivos deste estudo, recomenda-se que programas educativos dessa natureza e ampliados com a participação de outros membros da família do prematuro sejam implantados em outras unidades neonatais.OBJETIVO: Analizar la percepción de madres de prematuros sobre la vivencia en un Programa de Educación en Salud utilizando metodología participativa. MÉTODOS: Participaron 38 madres de prematuros internados en una unidad neonatal. El Programa, visando construir conocimientos sobre los cuidados con el prematuro, consistió en la entrega de una cartilla educativa a las madres para la lectura y posterior participación en actividades grupales, fundamentadas en el referencial de la problematización de Paulo Freire, con estímulo a la expresión de las percepciones respecto a la vivencia en el Programa. Se llevó a cabo el análisis temático de los discursos de las madres. RESULTADOS: Se construyeron cuatro núcleos temáticos: el aprendizaje proporcionado por el Programa; la creación de

  11. A pele do recém-nascido prematuro sob a a avaliação do enfermeiro: cuidado norteando a manutenção da integridade cutânea La piel del recién nacido prematuro bajo la evaluación del enfermero: el cuidado direccionado para la manutención de la integridad cutánea The skin of the premature newborn under the nurse's evaluation: orientating the manteinance of cutaneous integrity

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    Christiane Pereira Martins

    2009-10-01

    Full Text Available A prematuridade expressa relevância à saúde neonatal, demonstrando comprometimento ascendente com relação a morbimortalidade desta clientela, cuja maior incidência pode ser atribuída às práticas inadequadas com a pele do prematuro. Revisão da literatura sobre a interação benéfica entre a pele do Recém-Nascido Pré-Termo e o manuseio adequado, norteado pelo enfermeiro, que por meio da padronização dos cuidados de interferência direta e avaliação contínua da integridade cutânea e o assistir o prematuro. Divulga a importância do cuidado com a pele do Recém Nascido Prematuro, possibilitando não apenas a sobrevivência, mas a oportunidade de se integrar e desfrutar da vida com qualidade.La prematuridad expresa una relevancia para la salud neonatal, demonstando un comprometimiento ascendiente la relación de la morbimortalidade de esta clientela, cuya mayor incidencia puede ser atribuida a las prácticas inadecuadas con la piel del prematuro. Revisión de la literatura sobre la interacción beneficiosa entre la piel del recién nacido pré-termino y el manejo adecuado direccionado por el enfermero, que por medio de la padronización de los cuidados de interferencia directa y evaluación continua de la integridad cutánea y la asistencia al prematuro. Divulga la importancia del cuidado con la piel del recién nacido prematuro, posibilitando no apenas la sobreviviencía, como la oportunidad de integrar y disfrutar de la vida con cualidadThe prematurity expressed relevance to the health neonatal, demonstrating ascending compromising regarding morbi-mortality of this patients, whose larger incidence can be attributed to the inadequate practices with the skin of the premature. Revision of the literature about the beneficial interaction among the skin of premature infant newborn and the appropriate handling, orientated by the nurse, that through the standardization of the cares of direct interference and continuous evaluation of the

  12. Características estruturais maculares de olhos de pré-escolares nascidos prematuros: análise por tomografia de coerência óptica e oftalmoscopia binocular indireta

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    Lígia Beatriz Bonotto

    2013-04-01

    Full Text Available OBJETIVO: Comparar a estrutura retiniana da mácula e fóvea entre prematuros com retinopatia da prematuridade (ROP estágios II e III pós-tratamento, com ROP estágios II e III regredida espontaneamente e sem ROP, através de exames de tomografia de coerência óptica (OCT e da oftalmoscopia binocular indireta (OBI. MÉTODOS: Estudo do tipo transversal, observacional e não cego. Foram incluídas crianças prematuras nascidas entre 06/1992 e 06/2006 e examinadas entre 06/2009 e 12/2010; idade gestacional menor ou igual a 32 semanas e peso ao nascer menor ou igual a 1.599 g; com mínimo de três consultas durante o período de seleção; sem retinopatia da prematuridade ou com diagnóstico de ROP estágios II ou III em pelo menos um dos olhos com regressão espontânea ou após tratamento; máximo de seis meses de idade cronológica para o primeiro exame no serviço; idade cronológica mínima de quatro anos no período da reavaliação. Foram excluídas crianças prematuras que não compareceram ou que não tinham condições clínicas para a realização dos exames de reavaliação. Os prematuros foram divididos em três grupos: G1- com ROP pós-tratamento; G2- com ROP pós-regressão espontânea; e G3- sem ROP. Os exames realizados foram OBI e OCT. RESULTADOS: Vinte e quatro prematuros (48 olhos apresentaram os critérios exigidos para a pesquisa, com idade média cronológica entre 5 e 6 anos. À OBI, houve diferença estatística significativa para a presença de alterações na retina dos prematuros do grupo G1. No entanto estas alterações corresponderam às lesões cicatriciais deixadas pelo tratamento da ROP, sem comprometimento visível da região macular. À OCT houve diferença estatística significativa para a maior espessura foveal para os prematuros do grupo G1. Considerando-se o olho esquerdo, não houve diferença estatística significativa relacionada à espessura da fóvea entre G1 e G3. Não houve diferença entre os tr

  13. Vivências paternas durante a hospitalização do recém-nascido prematuro na Unidade de Terapia Intensiva Neonatal

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    Luciano Marques dos Santos

    2012-10-01

    Full Text Available Este estudo objetivou compreender as vivências paternas durante a hospitalização do recém-nascido prematuro na Unidade de Terapia Intensiva Neonatal de um hospital público de Feira de Santana, Bahia. Trata-se de um estudo descritivo, exploratório e qualitativo, aprovado por Comitê de Ética em Pesquisa e realizado com nove pais, na Unidade de Terapia Intensiva Neonatal de um hospital público. Os dados foram analisados através da Análise de Conteúdo, os quais apontaram que os partos prematuros causam sentimentos de surpresa, angústia e medo nos pais. É preciso repensar como ocorre a inserção dos pais do prematuro no processo de hospitalização, bem como mudanças nas rotinas estabelecidas para a visita e participação paterna no contexto do cuidado ao prematuro.

  14. Premature closure of the distal ulna in the dog. A case report; Fechamento prematuro da placa epifisária distal da ulna em um cäo. Descriçäo de um caso

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    Borges, Andréa Pacheco Batista; Araújo, Roberto Baracat de; Sampaio, Romeu; Del Carlo, Ricardo Junqueira; Pompermayer, Luiz Gonzaga

    1991-02-15

    A case of premature closure of the distal ulna in a ten-month-old crossbred dog is described. Diagnosis was suggested by clinical signs including lameness, angular deformity of the forelimb, and pain [Portuguese] Descreve-se um caso de fechamento prematuro da placa epifisária distal da ulna em um cäo sem raça definida e de aproximadamente dez meses de idade. O diagnóstico clínico baseou-se na sintomatologia de claudicaçäo, deslocamento lateral do membro torácico direito e sensibilidade dolorosa. Os exames radiográficos confirmaram o diagnóstico (AU)

  15. Tratamento do trabalho de parto prematuro Management of preterm labor

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    Roberto Eduardo Bittar

    2009-08-01

    Full Text Available O objetivo principal para o uso de uterolíticos no trabalho de parto prematuro é prolongar suficientemente a gestação para a administração materna de glicocorticoides e/ou realizar a transferência materna para um centro hospitalar terciário. As decisões sobre o uso e a escolha de uterolítico requerem o diagnóstico correto do trabalho de parto prematuro, o conhecimento da idade gestacional, das condições médicas materno-fetais, da eficácia, dos efeitos colaterais e do custo do medicamento. Todos os uterolíticos possuem efeitos colaterais e alguns deles são potencialmente letais. Os estudos sugerem que os agonistas de receptores beta-adrenérgicos, os bloqueadores de cálcio e os antagonistas de receptor de ocitocina são eficazes para prolongar a gestação por pelo menos 48 horas. Dos três agentes, o atosiban (antagonista de receptor de ocitocina possui maior segurança, embora o custo seja elevado. O sulfato de magnésio não é eficaz para prolongar a gestação e apresenta efeitos colaterais importantes. Os inibidores da ciclooxigenase também apresentam efeitos colaterais significativos. Até o momento, não há evidências suficientes para se recomendar o uso de doadores de óxido nítrico para inibir o trabalho de parto prematuro. Não existem fundamentos para o emprego de antibióticos para evitar a prematuridade diante do trabalho de parto prematuro.The main purpose of using uterulytic in preterm delivery is to prolong gestation in order to allow the administration of glucocorticoid to the mother and/or to accomplish the mother's transference to a tertiary hospital center. Decisions on uterolytic use and choice require correct diagnosis of preterm delivery, as well as the knowledge of gestational age, maternal-fetal medical condition, and medicine's efficacy, side-effects and cost. All the uterolytics have side-effects, and some of them are potentially lethal. Studies suggest that beta-adrenergic receptor agonists

  16. A experiência da família ao interagir com o recém-nascido prematuro no domicílio La experiencia de la familia al interactuar con el recién nacido prematuro en el hogar The family's experience when interacting with the premature newborn at home

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    Suely Alves Fonseca Costa

    2009-12-01

    Full Text Available Estudo qualitativo que teve o objetivo de compreender como se dá a interação da família com o recém-nascido prematuro no domicílio, nas primeiras semanas após a alta hospitalar. O Interacionismo Simbólico foi o referencial teórico, e a Teoria Fundamentada nos Dados, o metodológico. Os dados foram coletados por observação participante e entrevistas com cinco famílias. A análise comparativa dos dados permitiu compreender que ter um filho, mesmo que prematuro, significa a realização de um sonho, cuja concretização faz com que a família vivencie dias de tristeza, angústia e dor decorrentes da prematuridade e hospitalização. Com a melhora clínica do bebê, ela se prepara para assumir seu cuidado no domicílio; acolhe-o com amor e carinho; vivencia mudanças no seu modo de ser, pensar e viver e sente-se recompensada. A compreensão dessa experiência oferece subsídios para repensar a assistência de enfermagem à família no seguimento do recém-nascido prematuro.El presente estudio de tipo cualitativo tuvo por objetivo comprender la forma en que se presenta la interacción de la familia con el recién nacido prematuro atendido en el hogar, durante las primeras semanas después del alta hospitalaria. El referencial teórico de esta investigación fue el Interaccionismo Simbólico y metodológico en la Teoría Fundamentada de los Datos. Los datos fueron recolectados por medio de la observación participante y de entrevistas con cinco familias. El análisis comparativo de los datos permitió comprender que tener un hijo, aunque sea prematuro, significa la realización de un sueño, cuya concretización hace que la familia viva días de tristeza, angustia y dolor como consecuencia del nacimiento prematuro y de la hospitalización del bebé. Con la mejoría clínica del infante, la familia se prepara para asumir su cuidado en el hogar; lo acoge con amor y cariño; vivencia cambios en su modo de ser, pensar y vivir y se siente

  17. Representações de mães sobre hospitalização do filho prematuro Representaciones de las madres sobre la hospitalización del hijo prematuro Representations of mothers about the hospitalization of their premature child

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    Nilba Lima de Souza

    2009-10-01

    Full Text Available Estudo qualitativo que objetivou conhecer as representações de mães sobre a hospitalização do filho prematuro na Unidade de Terapia Intensiva Neonatal (UTIN. Inclui dezoito mães de prematuros internados na UTIN de um hospital escola em Natal (RN. Utilizou-se a entrevista semi-estruturada e na análise dos dados evidenciou-se que a hospitalização do filho é representada pelas mães por significados, sentimentos, dificuldades e incertezas. Considera-se que a prematuridade representa um desafio materno desde o momento da constatação do parto pré-termo, prosseguindo com os percalços inerentes a hospitalização e requer conhecimento, escuta e diálogo dos profissionais de saúde de forma efetiva para fortalecimento da adequação materna a prematuridade.Estudio cualitativo con el objeto de conocer las representaciones maternas sobre la hospitalización del hijo prematuro en una Unidad de Terapia Intensiva Neonatal (UTIN. Muestra de dieciocho madres de prematuros internados en la UTIN de un hospital clínico en Natal (RN. Utiliza entrevista semi-estructurada. Los datos constatan que la hospitalización del hijo supone para las madres significados, sentimientos, dificultades e incertidumbres. El parto prematuro representa un reto para la madre desde el momento de la constatación del parto pre-término, continúa con los percances inherentes la hospitalización y requiere conocimiento, escucha y diálogo por parte de los profesionales de salud con el fin de preparar a la madre para dicho parto prematuro.Qualitative study aimed at knowing the representations of mothers about the hospitalization of their premature son in a Neonatal Intensive Care Unit (NICU. The sample was composed of eighteen mothers of premature newborns hospitalized in a school hospital in Natal, Brazil. A semi-structured interview was used and data analysis showed that hospitalization of a child is represented by the mothers as meanings, feelings, difficulties and

  18. Envejecimiento prematuro de la piel

    OpenAIRE

    Calero Romero, Osmara; Quezada Rojas, Gabriela; Ramírez Rojas, Mildred; Reyes Barreto, Ivette; Centeno, Juan; Pacheco Solís, Nubia

    2009-01-01

    El envejecimiento de la piel incluye dos fenómenos diferentes: el envejecimiento verdadero o intrínseco, cambio inevitable atribuido al paso del tiempo y el prematuro que es ocasionado por la superposición a diferentes factores como la exposición solar, deficiencia de vitamina A, D, C, que asociado a otros factores forman la causa principal de este. El objetivo de nuestro estudio fue identificar los factores de riesgo que ocasionan envejecimiento prematuro de la piel en mujeres de 30-40 años ...

  19. Intervenção motora precoce ambulatorial para neonatos prematuros no controle postural = Early motor outpatient service intervention for postural control in preterm neonates

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    Almeida, Carla Skilhan de

    2008-01-01

    Full Text Available Objetivo: Verificar as aquisições motoras relacionadas ao desenvolvimento axial espontâneo não comunicativo, ou seja, controle postural e deslocamento. Isto foi feito através de um programa de intervenção motora fisioterapêutica precoce em neonatos prematuros nascidos no Hospital São Lucas - PUCRS. Materiais e Métodos: Tarefas de perseguição visual, manipulação de brinquedos e de controle postural, baseados no conceito Bobath, foram implementadas no programa interventivo. Todos os 5 prematuros que participaram deste estudo foram avaliados pelo serviço de fisioterapia por meio da Escala de Desenvolvimento do Comportamento da Criança no Primeiro Ano de Vida no ingresso do estudo e repetida a cada dois meses. Resultados: O estudo evidencia que não houve resultados estatisticamente significativos referentes às atividades posturais, de equilíbrio dinâmico e de deslocamento, mas os prematuros obtiveram progressão na classificação das avaliações. No primeiro mês da avaliação a mediana foi de 3 (classificação regular, já no terceiro e quinto mês de avaliação a mediana se manteve em 4 (classificação bom. Conclusão: A intervenção motora precoce proporcionou uma progressão na classificação da avaliação das aquisições motoras do desenvolvimento de cada prematuro, porém, não houve resultados estatisticamente significativos, referentes a atividades posturais, de equilíbrio dinâmico e de deslocamento

  20. PERCEPÇÃO DAS MÃES SOBRE ALEITAMENTO EM PREMATUROS DA UNIDADE CANGURU DE UMA MATERNIDADE DE FORTALEZA - CE

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    KARLA MARIA CARNEIRO ROLIM

    2008-01-01

    Full Text Available El objetivo de este estudio fue saber cómo perciben las madres el proceso de lactancia materna en prematuros asistidos en la Unidad Madre Canguro. Estudio descriptivo, con planteo cualitativo, realizado en una maternidad pública, en Fortaleza-CE, en el período de enero a mayo de 2007. Los sujetos sondeados fueron 10 madres que se hallaban con bebés internados en la Unidad. Se utilizó entrevista estructurada en parte, de la cual surgieron las categorías: conocimiento materno sobre el bebé prematuro, percepción de las madres sobre el método madre canguro, apreciación de las madres en amamantar un bebé prematuro y satisfacción con el servicio. El vínculo afectivo del binomio madre e hijo quedó en evidencia y, a su vez, considerado factor significativo en la recuperación del bebé.

  1. Morphological aspects of placenta of the Bradypus variegatus Shinz, 1825

    OpenAIRE

    Amorin, Marleyne José Afonso Accyoli Lins; Miglino, Maria Angélica; Amorin Júnior, Adelmar Afonso; Santos, Tatiana Carlesso dos

    2003-01-01

    Estudaram-se os aspectos morfológicos da placenta e das membranas fetais de 03 placentas de bichos-preguiça (Bradypus variegatus), adultas e prenhes, originárias da Zona da Mata do Estado de Pernambuco. Essas estruturas foram obtidas de 03 fêmeas doadas pela Universidade Federal de Pernambuco, das quais duas encontravam-se congeladas e a terceira foi colhida mediante realização de cirurgia cesariana, onde mãe e feto foram preservados. Depois de descongeladas, as placentas foram fixadas em sol...

  2. Emprego de soluções adocicadas no alívio da dor neonatal em recém-nascido prematuro: uma revisão integrativa Empleo de soluciones edulcoradas en el manejo del dolor neonatal en recién nacido prematuro: una revisión integrativa Use of sweet solutions for neonatal pain relief in premature newborns: an integrative review

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    Caroline de Oliveira Alves

    2011-12-01

    Full Text Available As experiências dolorosas repetida em recém-nascidos podem ter efeito a curto e a longo prazo, especialmente nos prematuros. Como uma medida de alívio da dor, tem sido recomendado o uso de soluções adocicadas em procedimentos dolorosos. Este estudo objetiva avaliar as evidências do efeito da sacarose e da glicose oral no alívio da dor aguda em recém-nascidos prematuros. Realizou-se uma revisão integrativa, nas bases de dados MEDLINE e LILACS, no período de 2005 a 2010, foram selecionados oito artigos. A análise destes revelou o efeito analgésico da glicose e da sacarose em procedimentos agudos. Nenhum efeito colateral foi encontrado nos recém-nascidos que receberam a glicose/sacarose. Ressalta-se a importância do uso da escala de avaliação da dor que mais se identifique com a população predominante nas unidades neonatais, que seja de fácil aplicação e manuseio pelos profissionais de saúde.Repetidas experiencias dolorosas en los recién nacidos pueden tener un efecto en el corto y largo plazo, especialmente en recién nacidos prematuros. Como una medida de aliviar el dolor, se ha recomendado el uso de soluciones azucaradas durante los procedimientos dolorosos. Así, este estudio tiene como objetivo evaluar la evidencia del efecto de la sacarosa o glucosa oral en el alivio del dolor agudo en niños recién nacidos prematuros. Se realizó una revisión integrativa en las bases de datos: MEDLINE y LILACS en el período 2005 a 2010, habiendo sido seleccionados ocho artículos. El análisis reveló el efecto analgésico de la glucosa y la sacarosa en los procedimientos agudos. No se encontró ningún efecto colateral significativo en los recién nacidos que recibieron la glucosa/sacarosa. Se resalta la importancia del uso de la escala de evaluación del dolor que más se identifique con la población predominante en la Unidad de Cuidados Intensivos Neonatales y que sea de fácil aplicación y manipulación para los profesionales

  3. Transição alimentar por via oral em prematuros de um Hospital Amigo da Criança Transición de alimentación oral en bebés prematuros en un Hospital Amigo del Niño Oral feeding transition in preterm infants in a Child-Friendly Hospital

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    Carmen Gracinda Silvan Scochi

    2010-01-01

    Full Text Available OBJETIVO: Caracterizar a transição da alimentação gástrica por via oral quanto à maturidade e peso do prematuro, vias e técnicas de administração e duração da transição até a alimentação oral exclusiva. MÉTODOS: Estudo retrospectivo com dados levantados em prontuários de 116 prematuros assistidos nas unidades de cuidados intensivos e intermediários neonatais de um hospital universitário do município de Ribeirão Preto - SP. RESULTADOS: A idade gestacional corrigida média foi de 36 semanas ao início da alimentação oral e de 37 semanas quando a alimentação ocorreu total por via oral. O peso médio foi de 1.743 gramas ao início da alimentação oral e peso médio de 1.934 gramas quando a alimentação ocorreu total por via oral. Durante o período de transição foram utilizadas uma ou mais técnicas de administração do leite. O uso da gavagem em conjunto com outras técnicas (89,5% predominou em especial, complementada pelo seio materno e copo (56,9% e a duração da transição alimentar variou de menos de 1 a 47 dias. CONCLUSÃO: A maturidade e o peso ao nascer, além das condições clínicas decorrentes dessas variáveis, podem interferir no processo de transição da alimentação láctea do prematuro. Considerando as vantagens da amamentação materna, sua prática deve ser iniciada o mais precocemente possível neste segmento populacional de risco.OBJETIVO: Caracterizar la transición de la alimentación gástrica por vía oral en lo que se refiere a: madurez y peso del prematuro, vías y técnicas de administración y, duración de la transición hasta la alimentación oral exclusiva. MÉTODOS: Es un estudio retrospectivo con datos levantados en fichas de 116 prematuros asistidos en las unidades de cuidados intensivos e intermedios neonatales de un hospital universitario del municipio de Ribeirao Preto- SP. RESULTADOS: La edad de gestación corregida promedio fue de 36 semanas en el inicio de la alimentaci

  4. Intervenções frente ao nascimento prematuro: uma revisão teórica = Interventions facing premature birth: a theoretical review

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    Brum, Evanisa Helena Maio

    2005-01-01

    Resultados e conclusões: Na saúde coletiva, a atenção aos cuidados da criança sofreu uma evolução histórica. Atualmente, observa-se uma preocupação não só em relação à criança, mas também em relação aos bebês que necessitam tratamento intensivo neonatal. Este interesse engloba tanto cuidados tecnológicos quanto o bem-estar psicobiológico e social do bebê. As intervenções com recém-nascidos prematuros internados em Unidade de Terapia Intensiva Neonatal vêm sendo consideradas positivas no campo da Saúde Coletiva, tais como os procedimentos técnicos dos profissionais que atendem os prematuros, escalas utilizadas, o modelo Touchpoints, apoio e informação aos pais

  5. A musicoterapia pode aumentar os índices de aleitamento materno entre mães de recém-nascidos prematuros: um ensaio clínico randomizado controlado

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    Martha N. S Vianna

    2011-06-01

    Full Text Available OBJETIVO: Avaliar o impacto da musicoterapia nos índices de aleitamento materno entre mães de recém-nascidos prematuros. MÉTODO: Neste ensaio clínico controlado, randomizado e aberto, mães de neonatos prematuros com peso < 1.750 g foram submetidas a sessões de musicoterapia três vezes por semana durante 60 minutos. Os desfechos foram os índices de aleitamento materno na ocasião da alta hospitalar do bebê e em consultas de seguimento (7-15 dias, 30 e 60 dias após a alta. RESULTADOS: Foram avaliadas 94 mães (48 no grupo da musicoterapia e 46 no grupo controle. O aleitamento materno foi significativamente mais frequente no grupo da musicoterapia na primeira consulta de seguimento [risco relativo (RR = 1,26; intervalo de confiança de 95% (IC95% = 1,01-1,57; p = 0,03; número necessário para tratar (NNT = 5,6]. Esse grupo também apresentou índices mais elevados de aleitamento materno na ocasião da alta do bebê (RR = 1,22; IC95% = 0,99-1,51; p = 0,06; NNT = 6,3, e 30 e 60 dias após a alta (RR = 1,21; IC95% = 0,73-5,66; p = 0,13 e RR = 1,28; IC95% = 0,95-1,71; p = 0,09, respectivamente, mas esses resultados não foram estatisticamente significativos. CONCLUSÕES: Este estudo demonstrou que a musicoterapia teve efeito significativo no aumento do índice de aleitamento materno entre mães de recém-nascidos prematuros na primeira consulta de seguimento, e uma influência positiva (embora não significativa que se estendeu até 60 dias depois da alta. A musicoterapia pode ser útil para elevar os índices de aleitamento materno entre mães de prematuros.

  6. Tecendo as teias do abandono: além das percepções das mães de bebês prematuros

    OpenAIRE

    Fernandes,Rosangela Torquato; Lamy,Zeni Carvalho; Morsch,Denise; Lamy Filho,Fernando; Coelho,Laura Fernandes

    2011-01-01

    O objetivo foi analisar a rede de eventos envolvidos na intenção de abandono de bebês prematuros por suas mães. Pesquisa qualitativa realizada com 12 mães de prematuros internados na UTIN, do HUUMI. As técnicas foram entrevistas semiestruturadas e grupo focal realizados na internação e no ambulatório de seguimento. Amostra definida pelos critérios de saturação, a partir da repetição das falas. Utilizou-se análise de conteúdo na modalidade de análise temática. Resultados evidenciaram as dificu...

  7. Papaya pulp gelling: is it premature ripening or problems of water accumulation in the apoplast? Geleificação da polpa de mamão: amadurecimento prematuro ou problemas no acúmulo de água no apoplasto?

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    Jurandi Gonçalves de Oliveira

    2010-12-01

    Full Text Available Gelled aspect in papaya fruit is typically confused with premature ripening. This research reports the characterization of this physiological disorder in the pulp of papaya fruit by measuring electrolyte leakage, Pi content, lipid peroxidation, pulp firmness, mineral contents (Ca, Mg and K - in pulp and seed tissues, and histological analysis of pulp tissue. The results showed that the gelled aspect of the papaya fruit pulp is not associated with tissue premature ripening. Data indicate a reduction of the vacuole water intake as the principal cause of the loss of cellular turgor; while the waterlogged aspect of the tissue may be due to water accumulation in the apoplast.O aspecto geleificado da polpa de mamão é constantemente confundido com amadurecimento prematuro. Este trabalho caracterizou esse distúrbio fisiológico na polpa de frutos de mamão através de medidas de liberação de eletrólitos, conteúdo de Pi, peroxidação lipídica, firmeza da polpa, condudo mineral (Ca, Mg e K - na polpa e semente e análises histológicas da polpa. Os resultados mostram que o aspecto geleificado da polpa de mamão não está associado com o amadurecimento prematuro. Os resultados indicam uma redução da entrada de água no vacúolo como a principal causa da perda de turgor celular, enquanto o aspecto encharcado da polpa pode ser devido ao acúmulo de água no apoplasto.

  8. Lesao pulmonar induzida pela ventilacao em recem-nascidos prematuros

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    Clarissa Gutierrez Carvalho

    2013-12-01

    Full Text Available A necessidade de intubação e do uso de ventilação mecânica na prematuridade está relacionada à chamada lesão pulmonar induzida pela ventilação e à consequente displasia broncopulmonar. Busca-se a melhor compreensão dos mecanismos de lesão envolvendo resposta inflamatória mediada pelas citocinas para o desenvolvimento de novas estratégias protetoras. Pesquisou-se na base de dados PubMed, incluindo artigos relevantes, os unitermos "ventilator induced lung injury preterm", "continuous positive airway pressure", "preterm" e "bronchopulmonary dysplasia". Dados e informações significativas foram compilados em tópicos, com o objetivo de formar uma visão crítica e plena acerca da lesão induzida pela ventilação e de suas consequências ao prematuro. Foi revisado o papel das citocinas pró-inflamatórias como mediadores da lesão, especialmente interleucinas 6 e 8, e fator de necrose tumoral alfa. Foram apresentadas evidências em estudos com animais e também em humanos, mostrando que breves períodos de ventilação mecânica são suficientes para a liberação dessas interleucinas inflamatórias. Também foram revisadas outras formas de ventilação mecânica e de ventilação não invasiva, como alternativas protetoras aos modos convencionais. Concluiu-se que o uso de ventilação não invasiva, a intubação com administração precoce de surfactante e a extubação rápida para CPAP nasal, além de estratégias que regulam o volume corrente evitando o volutrauma (como a ventilação com volume garantido, são medidas protetoras da lesão pulmonar induzida pela ventilação mecânica no prematuro.

  9. Dados anatômicos da placenta em caprinos estudado por injeção intravascular de neoprene

    OpenAIRE

    NEVES, Willams Costa; MIGLINO, Maria Angélica; ARRIVABENE, Mônica; CAVALCANTE FILHO, Miguel Ferreira; FEITOSA Jr., Francisco Solano

    1999-01-01

    Estudamos a placenta quanto aos seus aspectos morfológicos em 30 caprinos sem raça definida, adultos oriundos do Estado do Piauí, mediante a análise de esquemas de modelos obtidos pela injeção de látex Neoprene "650". Obtivemos 17 casos, ou seja, 56,66% de gestações únicas e 13 casos, ou seja, 43,33% de gestações gemelares. A área do hilo placentário varia de 1 a 6 cm de diâmetro e está situada no centro da placenta, região caracterizada pela apresentação do pedículo umbilical. O formato dos ...

  10. Evolução das Características Ecográficas da Placenta, da Posição e da Apresentação Fetal em Gestações Normais. Evolution of Ultrasound Characteristics of Placenta and Fetal Position and Presentation in Normal Pregnancies.

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    Maria Regina Machado Perrotti

    1999-10-01

    Full Text Available Objetivo: avaliar as características ecográficas da gestação normal, segundo o grau, a localização e a espessura placentária, a apresentação e a posição fetal ao longo da segunda metade da gestação. Métodos: estudo descritivo, incluindo no mínimo 120 medidas em cada idade gestacional, de 2.868 gestantes normais da cidade de Campinas, por meio de exame ultra-sonográfico de rotina, considerando-se os critérios de Grannum, Berkowitz, Hobbins (1979 para a classificação do grau placentário e a medida da espessura placentária no local da inserção do cordão umbilical. Resultados: a placenta grau 0 foi mais comum até 31 semanas, o grau I apresentou maior freqüência após a 32ª semana e o grau II não foi observado antes da 32ª semana. A placenta grau III foi mais freqüente a partir da 36ª semana. A espessura placentária aumentou significativamente com a gestação. As localizações mais freqüentes foram a anterior e a posterior. A apresentação cefálica foi a mais freqüente em todas as idades gestacionais, com apenas 1% de apresentações pélvicas ao termo. A posição fetal mais freqüente foi a de dorso lateral esquerda, seguida da de dorso lateral direita. Conclusões: os fatores estudados tiveram distribuição similar à esperada para populações normais e podem servir como um padrão para a população brasileira.Purpose: to evaluate the ultrasound characteristics of normal pregnancies, according to the placental maturity, local of insertion and thickness, fetal presentation and position during the second half of pregnancy. Methods: a descriptive study was perfomed, including at least 120 measures in each gestational age, in 2,868 normal pregnant women from Campinas, Brazil, studied through routine obstetric ultrasound examinations, with fetal biometry and placental evaluation, applying Grannum, Berkowitz, Hobbins (1979 criteria for placental maturity. Placental thickness was measured at the cord insertion

  11. Métodos de alimentação alternativos para recém-nascidos prematuros Métodos de alimentación alternativa para recién-nacidos prematuros Alternative feeding methods for premature newborn infants

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    Claudia Peyres Lopez

    2012-06-01

    Full Text Available OBJETIVO: Apresentar revisão de literatura sobre o uso do copo/xícara como método alternativo de alimentação para recém-nascidos prematuros e verificar se há consenso sobre sua indicação para essa população. FONTES DE DADOS: Revisão de literatura narrativa, tendo sido selecionados artigos nas bases de dados Medline, Lilacs, SciELO e Cochrane, independentemente do ano, usando descritores específicos: alimentação artificial, recém-nascido prematuro, aleitamento materno, métodos de alimentação. SÍNTESE DOS DADOS: Apesar de alguns estudos afirmarem que o método do copo/xícara é eficaz e seguro para alimentar recém-nascidos pré-termo e a termo, tais estudos não avaliam de forma objetiva o efeito do método sobre a deglutição desses pacientes. CONCLUSÕES: Verificou-se não haver consenso na literatura quanto à complementação da alimentação de recém-nascidos prematuros por meio do copo/xícara. Estudos controlados devem ser realizados com a finalidade de rever riscos e benefícios do uso de métodos alternativos na alimentação do recém-nascido prematuro.OBJETIVO: Presentar revisión de literatura sobre el uso de vaso/taza como método alternativo de alimentación para recién-nacidos prematuros y verificar si hay consenso sobre su indicación para esta población. FUENTES DE DATOS: Revisión de literatura narrativa, habiendo sido seleccionados artículos en las bases de datos Medline, Lilacs, SciELO y Cochrane, independientemente del año, usando descriptores específicos: alimentación artificial, recién-nacido prematuro, lactancia materna, métodos de alimentación. SÍNTESIS DE LOS DATOS: Aunque algunos estudios afirmen que el método vaso/taza es eficaz y seguro para alimentar a recién-nacidos pre-término y a término, tales estudios no evalúan de modo objetivo el efecto del método sobre la deglución de estos pacientes. CONCLUSIONES: Se verificó que no hay consenso en la literatura respecto a la

  12. [Leonardo da Vinci and his studies on the human fetus and the placenta].

    Science.gov (United States)

    Cataldi, L; Fanos, V

    2000-01-01

    To review the accuracy of Leonardo's anatomical studies of the female external genitalia and the foetus, particularly those concerning the umbilical cord with its blood vessels. The anatomical drawings of Leonardo da Vinci which are now stored in the Windors Castle near London were reviewed and the accuracy of the details of the genital apparatus and foetus was evaluated. A written comment characterizes many of his drawings. He described accurately the position of the uterine blood vessels and the relationship between the pelvic organs. However his drawing and description of the female external genitalia and human placenta was incorrect because his understanding of it was inadequate. He believed that the human placenta had cotyledons like that of the ungulate uterus (drown side A of sheet 19). At the top of that sheet some Leonardo's details of the anatomic relationship are shown. In our opinion, Leonardo's misunderstanding is probably because he was only able to perform one anatomical dissection of a pregnant women and foetus and therefore his knowledge was limited. The resulting documentation of the pregnant women and foetus was therefore heavily supplemented with his enormous experience in animal anatomy.

  13. Estudo comparativo do desenvolvimento sensório-motor de recém-nascidos prematuros da unidade de terapia intensiva neonatal e do método canguru - doi:10.5020/18061230.2005.p191

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    Luciana Andrade da Mota

    2012-01-01

    Full Text Available O Método Canguru é uma alternativa ao método tradicional de assistência a bebês prematuros de baixo peso, que preconiza o contato pele a pele precoce, entre mãe e filho, 24 horas por dia, garantindo-lhes estímulos sensoriais e motores e maior participação dos pais no cuidado de seu bebê. A Unidade de Terapia Intensiva (UTI Neonatal é destinada ao tratamento de recém-nascidos prematuros com algum problema ao nascer. Objetivou-se comparar o desenvolvimento sensório-motor de recém-nascidos prematuros (RNPt da UTI Neonatal e do Método Canguru. Realizou-se um estudo comparativo, prospectivo e observacional, no Hospital Geral Dr. César Cals, em Fortaleza – CE, de agosto a outubro de 2004, com 14 RNPt, sendo 07 de cada grupo, com peso inferior a 2000g e idade gestacional entre 30 e 37 semanas. A avaliação foi semanal até a alta hospitalar ou até completarem a idade corrigida de 40 semanas, pelo método Dubowitz e Amiel-Tison, com análise de tônus muscular, respostas sensório-motoras, ganho de peso e tempo de internação. Como resultado, observou-se que os bebês do Método Canguru apresentaram melhores respostas sensório-motoras, comprovadas a partir da constatação de um menor grau de estresse, melhores respostas reflexas, movimentação espontânea e tônus muscular, e menor tempo de internação, permanecendo mais tempo em estado de alerta e interagindo bem com o ambiente e a mãe. Conclui-se que o Método Canguru mostrou-se uma alternativa mais eficaz de assistência a RNPt de baixo peso, pois proporcionou melhores resultados quanto às atividades sensório-motor dos bebês, se comparados à UTI Neonatal.

  14. Lesão vascular da placenta condicionando RCIU e hidropisia fetal não imune em gestação gemelar Placental vascular lesion as cause of IUGR and nonimmune fetal hydrops in twin pregnanc

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    Nuno Ricardo Gonçalves Baptista Pereira

    2011-12-01

    Full Text Available As lesões vasculares da placenta constituem um grupo de entidades distintas, mas inter-relacionadas, em que se incluem os corioangiomas e a corangiomatose multifocal difusa. O corioangioma é uma lesão nodular expansiva com incidência de cerca de 1%. A corangiomatose multifocal difusa é rara (0,2% e predominante em placentas em idade gestacional inferior a 32 semanas. Os autores apresentam um caso de gestação gemelar monocoriônica/biamniótica, no qual um dos fetos, à 26ª semana de gestação, apresentou quadro de restrição de crescimento intrauterino, hidropisia e anemia associado à formação tumoral da placenta com vascularização aumentada verificada pela doplervelocimetria. O estudo anatomopatológico da placenta permitiu o diagnóstico de corangiomatose multifocal difusa. Este raro caso de corioangiomatose multifocal difusa com forma de apresentação pré-natal mimetizando a de um corioangioma comprova que a detecção ultrassonográfica de um tumor da placenta com vascularização aumentada deve suscitar outras hipótese diagnóstica, além do corioangioma.Placenta vascular lesions are a group of distinct yet related entities that include chorangiomas and diffuse multifocal chorangiomatosis. Chorangioma is an expansive nodular lesion with an incidence of about 1%. Diffuse multifocal chorangiomatosis is rare (0.2% and mostly seen in placentas before the 32nd gestational week. The authors present a case of a monochorionic/biamniotic twin pregnancy, in which, at the 26th gestational week, one fetus developed intrauterine growth restriction (IUGR, hydrops, and anemia associated with a tumor of the placenta with increased vascularization in the Doppler study. Pathological examination of the placenta diagnosed diffuse multifocal chorangiomatosis. This rare case report of diffuse multifocal chorangiomatosis with prenatal manifestations resembling those of a chorangioma proves that prenatal ultrasound detection of a placenta tumor

  15. Os diagnósticos de enfermagem da taxonomia da NANDA em mulheres com o filho prematuro hospitalizado e o sistema conceitual de King Los diagnosticos de enfermería de la taxonomía de la NANDA de mujeres con hijo prematuro hospitalizado y el sistema conceptual de King Nursing diagnoses from NANDA's taxonomy in women with a hospitalized preterm child and King's conceptual system

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    Cláudia Silveira Viera

    2000-12-01

    Full Text Available Os objetivos deste estudo foram identificar os diagnósticos de enfermagem em mães com o filho prematuro hospitalizado em UTI Neonatal, mediante a utilização do Sistema Conceitual de King e da Taxonomia I dos diagnósticos de enfermagem da NANDA (1999. Para tanto utilizou-se a metodologia de estudo de caso aplicada a 35 puérperas. Foram identificados oito diagnósticos de enfermagem com freqüência igual ou maior que 50%, a saber, Risco para Infecção, Risco para Injúria, Integridade Tissular Prejudicada, Manutenção da Saúde Alterada, Risco para Amamentação Ineficaz; Risco para Alteração no Desenvolvimento do Apego entre Pais e Filho; Medo; Conflito no Desempenho de Papéis dos Pais.Los objetivos de este estudio fueron: identificar los diagnósticos de enfermería de madres con hijo prematuro hospitalizado en una Unidad de Tratamiento Intensivo Neonatal mediante la utilización del Sistema Conceptual de King y la Taxonomía I de los diagnósticos de enfermeria de la NANDA (1999. Para esto se utilizó la metodología del estudio de caso a 35 puerperas. Fueron identificados ocho diagnósticos con frecuencia igual o mayor de 50%, el Riesgo para Daño, Riesgo para Lesión, Integridad del Tejido Dañada, Mantenimiento de la Salud Alterada, Riesgo para lactancia Ineficaz; Riesgo para Alteración en el Desarrollo del Apego entre Padres e Hijo; Miedo; Conflicto en el desempeño del Papel Paternal.This study aimed at identifying nursing diagnoses presented by mothers with a hospitalized preterm child in an NICU by the use of King's Conceptual System and Taxonomy I of NANDA's nursing diagnoses. The case-study methodology was applied to 35 puerperal women. Eight diagnoses were identified, the frequency of which was over 50%, as follows: Risk of Infection, Risk of Injury, Impaired Tissue Integrity, Altered Health Maintenance, Risk of Inefficient Breast-feeding; Risk of Altered Parent/Infant Attachment; Fear; Parental Role Conflict and Impaired

  16. Visión de las madres en el cuidado del hijo prematuro en el hogar Visão das mães no cuidado do filho prematuro em casa Vision of mothers in care of premature babies at home

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    Nubia Castiblanco López

    2011-07-01

    Full Text Available Objetivo: describir el significado que tiene para las madres cuidar el recién nacido prematuro en el hogar, desde su contexto cultural. Diseño: estudio de tipo cualitativo etnográfico basado en la teoría de Madeleine Leininger. Muestra: la información, obtenida de observación y 23 entrevistas a las madres en su hogar, se recolectó y se analizó según la entrevista y análisis etnográficos de James Spradley. Participantes: ocho madres de recién nacidos prematuros que asistieron a control al Programa Madre Canguro Integral, Hospital Universitario San Ignacio, entre noviembre de 2007 y mayo de 2008. Resultados: surgen dos temas: cuidados directos al recién nacido prematuro y el camino hacia la adaptación. El cuidado directo al recién nacido prematuro en el hogar significa para la madre cangurear, masajear, proteger del frío, alimentar al niño, mantener la higiene, conservar la protección del medio, dar amor, suministrar oxígeno suplementario al bebé si lo requiere y saber sobre las señales del niño. El camino hacia la adaptación materna tiene para las madres un objetivo: "criar el niño". Ellas manifiestan lo difícil que son las noches, expresan sus sentimientos y finalmente describen la adaptación materna como el acostumbrarse. Conclusión: la visión de las madres cuidando el recién nacido prematuro es universal: significa "cuidar mucho al niño" y estar pendientes; por otra parte, la connotación de cuidado es diversa porque cada madre lo cataloga, desde su propia percepción, como cuidado extremo, básico, esencial y especial. También las madres dejaron conocer creencias, valores, tradiciones y mitos.Objetivo: descrever o significado do cuidado do recém nascido prematuro em casa para as mães desde seu contexto cultural. Desenho: estudo de tipo qualitativo etnográfico baseado na teoria de Madeleine Leininger. Amostra: a informação obtida da observação e 23 entrevistas às mães em casa, a informação foi reunida

  17. A sucção não nutritiva do recém-nascido prematuro como uma tecnologia de enfermagem

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    Joice Cristina Pereira Antunes

    2013-10-01

    Full Text Available Estudo experimental com abordagem quantitativa, cujo objetivo foi demonstrar que a sucção não nutritiva é efetiva no manejo da dor durante a instalação, pela equipe de enfermagem, do CPAP nasal em recém-nascidos prematuros; e demonstrar que o uso da sucção não nutritiva, concomitantemente à instalação do CPAP nasal, pode ser considerado uma tecnologia de enfermagem. A população alvo foi constituída por 20 recém-nascidos prematuros, submetidos à instalação ou reinstalação do referido artefato, totalizando 30 procedimentos. Os recém-nascidos foram distribuídos, aleatoriamente, em dois grupos, controle e experimental, em que a sucção não nutritiva foi oferecida, o mesmo não acontecendo com o grupo controle. As reações de dor foram mensuradas pela escala de NIPS. Em 100% dos procedimentos concomitantes à sucção não nutritiva, os recém-nascidos não sentiram dor; 100% dos recém-nascidos demonstraram dor quando não era oferecida a referida sucção. Conclui-se que o procedimento pode ser classificado como uma tecnologia do cuidado de enfermagem.

  18. Prevenção do parto prematuro: emprego do toque vaginal e da ultra-sononografia transvaginal Prevention of preterm birth: use of digital examination and transvaginal ultrasonography

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    Arlete Ayako Yamasaki

    1998-07-01

    Full Text Available Objetivo: avaliar o colo uterino por meio do toque vaginal e da ultra-sonografia transvaginal em gestantes de risco elevado para o parto prematuro. Métodos: durante o período compreendido entre fevereiro de 1995 e setembro de 1997 foram acompanhadas 38 gestantes com elevado risco para o parto prematuro entre a 20ª e 36ª semana de gestação. Estas pacientes foram submetidas semanalmente ao toque vaginal e ao exame ultra-sonográfico transvaginal. O toque vaginal avaliou o colo uterino quanto a dois parâmetros: comprimento e dilatação. A ultra-sonografia transvaginal estudou o comprimento e o diâmetro anteroposterior do colo uterino. Foram analisados os comportamentos destas medidas cervicais ao longo da gestação. Os dois métodos foram comparados quanto à avaliação cervical e à acurácia no diagnóstico do parto prematuro. Resultados: a incidência de partos prematuros foi de 18,4% (7/38. As medidas do comprimento cervical obtidas pela ultra-sonografia foram sempre maiores em relação às medidas obtidas pelo toque vaginal. Mediante análise pelo teste de hipóteses foram observadas uma relação indireta entre o comprimento cervical e a idade gestacional por meio do toque e do estudo ultra-sonográfico (pObjective: to evaluate the uterine cervix by digital and transvaginal ultrasound examinations in pregnant women at high risk of having premature delivery. Methods: during the period between February 1995 and September 1997, 38 pregnant women at high risk of having premature delivery between the 20th and 36th week of gestation were examined. These patients were submitted weekly to both digital and transvaginal ultrasound examinations. The digital examination evaluated the uterine cervix using two parameters: length and dilation. The transvaginal ultrasound studied the length and the anteroposterior diameter of the uterine cervix. The behavior of these cervical measurements was analyzed throughout the pregnancies. The two methods

  19. Prevalencia de lesao do septo nasal em prematuros no uso de prongas nasais

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    Nayara Francisca Cabral de Sousa

    2013-12-01

    Full Text Available O objetivo do estudo foi investigar a prevalência e os fatores associados à lesão do septo nasal em prematuros sob uso de ventilação não invasiva. Estudo transversal, cujos dados foram coletados entre março e julho de 2012 por meio de busca em prontuários, entrevistas às mães e avaliação nasal de 47 prematuros, na Unidade Neonatal de um Hospital Universitário da cidade do Recife, Pernambuco, região nordeste do Brasil. Realizou-se análise estatística descritiva e bivariada por meio do teste qui-quadrado ou Exato de Fisher, utilizando o software SPSS. A prevalência de lesão nasal foi de 68,1%, associada ao baixo peso ao nascer e à duração do tratamento. A prevalência de lesão nasal na população estudada é elevada e associa-se ao baixo peso ao nascer e ao tempo de permanência em ventilação não invasiva. Infere-se a necessidade de ações preventivas, como cuidados de Enfermagem contínuos, adequação dos dispositivos e educação permanente em serviço.

  20. Nutrição precoce de neonatos prematuros estáveis e pequenos para a idade gestacional: um ensaio clínico randomizado

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    Shmuel Arnon

    2013-08-01

    Full Text Available OBJETIVO: Examinar o efeito da nutrição precoce sobre o tempo para atingir a nutrição completa em neonatos prematuros (PIG estáveis pequenos para a idade gestacional. MÉTODO: Os neonatos prematuros com idade gestacional inferior a 37 semanas e peso ao nascer inferior a 10% foram alocados aleatoriamente para um regime de nutrição precoce (nas primeiras 24 horas de vida ou tardia (após as primeiras 24 horas de vida. Todos os neonatos apresentaram uma evidência intrauterina de fluxo diastólico reverso ou ausente. Os neonatos incapazes de iniciar uma nutrição precoce foram excluídos. O tempo para a alimentação completa, a progressão da nutrição e morbidez correspondente foram comparados. A eletrogastrografia (EGG foi utilizada para mensurar a motilidade gástrica pré e pós-prandial no segundo e no sétimo dias após o início da nutrição. RESULTADOS: Foram incluídos 60 neonatos no estudo, sendo 30 em cada grupo. Os neonatos incluídos no regime de nutrição precoce atingiram a nutrição enteral completa antes dos neonatos do grupo de controle (98±80-157 em comparação a 172±1 23-261 horas de idade, respectivamente; p = 0,004 e recebiam alta hospitalar antes (p = 0,04. Nenhuma enterocolite necrosante (ECN foi comprovada em ambos os grupos de estudo. A motilidade gástrica melhorou no sétimo dia após o início da nutrição em ambos os grupos de estudo, sem diferença entre eles. CONCLUSÕES: Os neonatos prematuros PIG estáveis em regime de nutrição precoce atingiram alimentação enteral completa e receberam alta hospitalar significativamente antes que aqueles em regime de nutrição tardio, sem morbidez excedente.

  1. Síndrome apneico en el recién nacido prematuro

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    Solari B. Francesca, Dra.

    2013-05-01

    Full Text Available La apena del prematuro es un importante problema clínico, manifestado por un ritmo respiratorio inestable, reflejo de una inmadurez de los sistemas de control respiratorio. Esta revisión aborda definiciones, patogénesis y alternativas terapéuticas. Aún están en estudio y/o no son bien conocidos, los mecanismos neuronales que provocan apnea en el prematuro. En la reciente década, se ha conocido mejor la generación del ritmo respiratorio y su modulación en el neonato. Estos episodios de pérdida de respiración efectiva pueden conducir a cuadros de hipoxemia y bradicardia, que pueden ser lo suficientemente severos como para necesitar resucitación y el uso de ventilación asistida. La cafeína sigue siendo el principal tratamiento farmacológico. La Apnea del prematuro se resuelve típicamente con la maduración.

  2. Manuseio do canal arterial patente no prematuro com síndrome de angústia respiratória: ligadura ou indometacina?

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    Milton A Meier

    Full Text Available A presença de canal arterial patente (PCA com grande shunt sistêmico -pulmonar no prematuro com síndrome de angústia respiratória (SAR está quase sempre associada a insuficiência cardíaca, displasia broncopulmonar, enterocolite necrotizante, hemorragia intracraniana e morte. A ligadura do canal melhora a complacência pulmonar, reduz, significativamente, o tempo de assistência ventilatória e melhora 0 estado geral do paciente. Depois da introdução, nesta última década, da indometacina para a interrupção do PCA, no prematuro, vários estudos vêm procurando estabelecer as vantagens de uma forma de tratamento sobre a outra. O propósito do nosso estudo é comparar os resultados obtidos em 48 pacientes (pts. (Grupo 1 submetidos a ligadura cirúrgica, nos últimos 8 anos, com 28 pts. (Grupo 2 nos quais a indometacina foi, preferentemente, utilizada. A idade gestacional média do Grupo 1 foi de 29,13 ± 2,33 semanas (24-34 e de 28,39 ± 2,30 semanas (25-32 no Grupo 2. O peso médio foi de 954,17 ± 220,68 g (540-1750 g no Grupo 1 e de 923,21 ± 191,74 g (550-1400 g no Grupo 2. Trinta e três (60,75% dos pts. do Grupo 1 eram menores do que 1000 g (prematuros extremos, enquanto que 21 do Grupo 2 (75,0% estavam nessa condição. Nove pacientes (32,1% do Grupo 2 foram transferidos para o Grupo 1, devido ao insucesso da terapêutica com a indometacina, ou pela intolerância às doses indicadas. A ligadura foi realizada na própria unidade de terapia intensiva em 31 pts. (64,5%. A técnica empregada tem sido a de uma toracotomia póstero-lateral pequena, com preservação dos músculos do tórax e abertura pelo 3º ou 4º espaço intercostal. Por via extrapleural, o canal é alcançado e ligado com dois clips metálicos. Inicialmente, o tórax era rotineiramente drenado, apenas quando havia abertura da pleura. Mais recentemente, mesmo com a pleura aberta, somente são drenados os casos que apresentam pneumotórax prévio, ou ent

  3. Práticas da equipe de enfermagem no processo de alta do bebê pré-termo

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    Kayna Trombini Schmidt

    2013-12-01

    Full Text Available O objetivo deste estudo foi identificar as estratégias utilizadas pela equipe de enfermagem atuante na unidade neonatal de um hospital-escola, durante o preparo da família para a alta do prematuro. Trata-se de estudo descritivo, com abordagem qualitativa. Os dados foram coletados entre março e junho de 2011, por meio de observação e entrevistas semiestruturadas. Da análise dos discursos emergiram duas categorias temáticas: Orientações e estratégias profissionais no preparo da família para a alta do prematuro e Dificuldades e potencialidades no espaço da atenção neonatal. A principal estratégia referida pelos profissionais foi a inserção precoce da família no processo de cuidar; a dificuldade destacada foi a ausência dos pais durante a internação do filho. As potencialidades e limitações apontadas por este estudo revelaram que o processo da assistência é dinâmico, necessitando de constantes reajustes e adequações para atender efetiva e integralmente o bebê prematuro e sua família.

  4. Complicações materno-fetais da biópsia de vilo corial: experiência de um centro especializado do Nordeste do Brasil Fetal and maternal complications of chorionic villus sampling: results from a specialized center in the Northeast of Brazil

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    Antonio Carlos Vieira Lopes

    2007-07-01

    Full Text Available OBJETIVO: avaliar complicações maternas e fetais após realização de biópsia de vilo corial (BVC para diagnóstico pré-natal de alterações genéticas, na cidade de Salvador (BA. MÉTODOS: série de 958 gestantes de risco para cromossomopatias, submetidas à BVC realizada entre a nona e a 24ª semanas de gestação, por via transabdominal, utilizando agulha espinhal 18G 3½, guiada por ultra-sonografia, entre 1990 e 2006. As variáveis para a análise de complicações imediatas foram cólicas uterinas, hematoma subcoriônico, punção acidental da cavidade amniótica, dor no local da punção, amniorrexe, desconforto abdominal, bradicardia fetal e sangramento vaginal, e para complicações tardias, dor abdominal, sangramento vaginal, amniorrexe, infecção e abortamento espontâneo. Complicações obstétricas e fetais (parto prematuro, descolamento prematuro de placenta, placenta prévia e malformações anatômicas fetais foram também estudadas. Para análise estatística, utilizaram-se o chi² e o teste t de Student ou Mann-Whitney; o nível de significância foi 5%. RESULTADOS: a média de idade das gestantes foi 36,3±4,9 anos. Complicações imediatas foram encontradas em 182 (19% casos (cólica uterina em 14%, hematoma subcoriônico em 1,8% e punção amniótica acidental em 1,3% e tardias em 32 (3,3% casos (sangramento vaginal em 1,6%, dor abdominal em 1,4%, amniorrexe em 0,3% e aborto espontâneo em 1,6%. Não foi observado descolamento prematuro de placenta, placenta prévia ou malformação fetal. CONCLUSÕES: a BVC revelou-se procedimento simples e seguro. A BVC pode ser utilizada em gestantes que necessitam de diagnóstico pré-natal devido ao risco de anomalias genéticas.PURPOSE: to evaluate fetal maternal complications after chorionic villus sampling (CVS for prenatal diagnosis of genetic disorders in pregnant women of Salvador (BA, Brazil. METHODS: case-series study of 958 pregnancies with high risk for chromosomal

  5. Prognóstico pulmonar em prematuros Pulmonary prognosis in preterm infants

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    Luciana Friedrich

    2005-03-01

    Full Text Available OBJETIVO: O aumento da sobrevida de prematuros traz o desafio de lidar com um amplo espectro de doenças pulmonares crônicas, incluindo displasia broncopulmonar, síndrome de Wilson-Mikity e sibilância recorrente. Este artigo discute o prognóstico pulmonar clínico e funcional de prematuros na infância e na adolescência. FONTE DE DADOS: Foi realizada pesquisa no MEDLINE de publicações entre 1970 e 2004 que abordassem função e crescimento pulmonar de prematuros, bem como a evolução clínica dos mesmos. SÍNTESE DOS DADOS: Eventos pré e pós-natais como insuficiência placentária, tabagismo, infecções, oxigênio e ventilação mecânica exercem efeitos importantes no desenvolvimento pulmonar, podendo conduzir a doenças pulmonares crônicas, sendo a displasia broncopulmonar a complicação clínica mais severa. No entanto, perdas significativas de função pulmonar também podem ocorrer em prematuros sem critérios de displasia broncopulmonar e que não apresentaram doença respiratória neonatal significativa. Nestes pacientes, o impacto da prematuridade sobre o sistema respiratório é freqüentemente subestimado. Clinicamente, observa-se incidência aumentada de pneumonias e bronquiolites, re-hospitalizações por doenças respiratórias, tosse e sibilância crônicas e hiper-reatividade brônquica. Posteriormente, percebe-se uma tendência à normalização da função pulmonar, mas persistem fluxos reduzidos, menor tolerância a exercícios e hiper-reatividade brônquica. CONCLUSÕES: A prematuridade, os eventos que a provocam e as intervenções que dela decorrem alteram de maneira permanente, em maior ou menor grau, o desenvolvimento do sistema respiratório. São necessários estudos adicionais para esclarecer o efeito de cada um desses insultos perinatais no desenvolvimento do sistema respiratório.OBJECTIVE: The increased survival of preterm infants poses the challenge of dealing with a wide range of chronic pulmonary

  6. Análise morfológica da placenta da paca (Agouti paca, Linnaeus, 1766: Estudo ao microscópio de luz e à microscopia eletrônica de transmissão

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    Marina Bonatelli

    2001-01-01

    Full Text Available Foram estudados os aspectos morfológicos de nove placentas de paca (Agouti paca, L., 1766 mediante análises em microscopia de luz e eletrônica de transmissão dos fragmentos teciduais correspondentes à porção de maior conexão placentária em diferentes fêmeas gestantes, nos estágios intermediário e final da prenhez. Realizamos este estudo, pois, aliada à necessidade da procura de novas espécies que atuem como modelos experimentais adequados, havia a disponibilidade deste roedor em nosso meio; por outro lado, o melhor conhecimento dos aspectos reprodutivos destes animais oferece subsídios ao estabelecimento de criatórios racionais desta espécie, uma vez que a preservação deste vertebrado é necessária, além do grande interesse comercial em torno de sua carne. Os resultados mostraram que este roedor possui uma placenta do tipo vitelina e outra do tipo corioalantoidiana, sendo este órgão do tipo hemocorial, labiríntico, que se apresenta histologicamente composto por lóbulos divididos em três regiões distintas: o centro do lóbulo, o labirinto e o interlóbulo. Na região do centro do lóbulo, verificou-se a presença de artérias e veias; e em sua região periférica estavam presentes dois sistemas tubulares arranjados de forma paralela, onde as lacunas sangüíneas e os capilares estavam em íntimo contato, formando a região do labirinto. O interlóbulo era composto de artérias e veias. O trofoblasto era o principal componente da placenta, que, independentemente da região onde se encontrava, mostrava-se de natureza sincicial. Ultra-estruturalmente a barreira placentária da paca foi classificada como hemomonocorial.

  7. Avaliação do risco para parto prematuro espontâneo pelo comprimento do colo uterino no primeiro e segundo trimestres da gravidez Risk assessment for spontaneous preterm delivery according to cervical length in the first and second trimesters of pregnancy

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    Mário Henrique Burlacchini de Carvalho

    2002-08-01

    Full Text Available Objetivos:avaliar, no primeiro e segundo trimestres da gravidez, a correlação entre o comprimento do colo uterino e a ocorrência de parto prematuro espontâneo. Métodos:em 641 grávidas do pré-natal geral, a medida do comprimento do colo uterino foi realizada em dois momentos: entre a 11ª e a 16ª e entre a 23ª e a 24ª semana da gravidez. A avaliação do colo uterino foi feita pela ultra-sonografia transvaginal, com a grávida em posição ginecológica e tendo realizado previamente esvaziamento da bexiga. O comprimento do colo uterino foi medido linearmente do seu orifício interno ao externo. A medida do comprimento do colo uterino foi correlacionada com a idade gestacional no momento do parto. Para comparação das médias do grupo de grávidas que tiveram parto prematuro e a termo utilizamos o teste t de Student. A sensibilidade, especificidade, taxa de falso-positivos, falso-negativos e acurácia para o parto prematuro foram calculadas para os comprimentos de colo menores ou iguais a 30 mm, 25 mm e 20 mm. Resultados:a medida do comprimento do colo uterino entre a 11ª e a 16ª semana de gestação não apresentou diferença significativa entre o grupo de parto prematuro e o grupo a termo (40,6 mm e 42,7 mm, respectivamente, p=0,2459. A diferença entre os grupos, no entanto, foi significativa quando o colo foi medido entre a 23ª e a 24ª semana de gravidez (37,3 mm para o grupo que evoluiu com parto prematuro e 26,7 mm para o grupo a termo, p=0,0001, teste t de Student. Conclusões:o comprimento do colo uterino entre a 11ª e a 16ª semana de gravidez não foi significativamente diferente entre as gestantes com parto prematuro ou a termo. No entanto, na 23ª e 24ª semana esta diferença foi significativa, podendo ser um método de predição da prematuridade.Purpose: to evaluate, in the first and second trimesters of pregnancy, the correlation between cervical length and spontaneous preterm delivery. Methods: cervical length was

  8. Descolamento Crônico da Placenta: Relato de Caso Chronic Placental Abruption: A Case Report

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    Júlio César Faria Couto

    2002-01-01

    Full Text Available O descolamento crônico da placenta é um evento raro cujo diagnóstico pode ser feito precocemente utilizando-se a ultra-sonografia. Sangramento vaginal e hipertonia uterina são sinais clínicos encontrados de forma infreqüente. A fisiopatologia do descolamento crônico é pouco conhecida e a importância dos fatores de risco na sua gênese é controversa. O resultado perinatal é insatisfatório, com alta incidência de prematuridade e mortalidade fetal e neonatal. A conduta obstétrica baseia-se na idade gestacional, condições do feto e evolução do hematoma. Nós apresentamos o caso de uma gestação, complicada por descolamento crônico da placenta identificado na 14ª semana de gestação, que evoluiu com crescimento intra-uterino restrito, oligoidrâmnio e óbito neonatal.Chronic placental abruption is a rare condition that can be early detected by ultrasound. Vaginal bleeding and uterine excitability can be present in an infrequent way. Chronic placental abruption physiopathology is unknown and there are no consistent medical risks that predispose to this condition. The perinatal outcome is poor and is often associated with prematurity and fetal or perinatal death. The obstetric treatment depends on the gestational age, fetal conditions and the size of the clot. We present a case of a chronic placental abruption diagnosed in a 14-week gestation complicated by intrauterine growth retardation, oligohydramnios and perinatal death.

  9. Factores de riesgo asociados a osteopenia del prematuro en una terapia intensiva neonatal de referencia

    OpenAIRE

    MP Ríos-Moreno; MP Salinas-López ,; NB Pérez-Ornelas ,; TL Barajas-Serrano; JC Barrera-de León

    2016-01-01

    INTRODUCCIÓN: la enfermedad ósea metabólica del prematuro resulta de la desmineralización ósea. Existen factores que deben vigilarse con la finalidad de realizar diagnóstico y tratamiento temprano. OBJETIVO: determinar los factores de riesgo asociados a osteopenia en prematuros. MATERIALES Y MÉTODOS: estudio transversal comparativo de octubre del 2011 a octubre del 2013. Se incluyeron 120 prematuros < 37 semanas gestacionales, ≤ 1,500 gramos al nacer y ≥ 21 días. Diagnóstico de la enf...

  10. Aleitamento materno em prematuros: manejo clínico hospitalar Breastfeeding in premature infants: in-hospital clinical management

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    Maria Beatriz R. do Nascimento

    2004-11-01

    Full Text Available OBJETIVO: Abordar a importância do aleitamento materno e sua promoção no manejo clínico-hospitalar de recém-nascidos pré-termo. FONTE DOS DADOS: Foi realizada extensa revisão bibliográfica sobre o tópico, sendo selecionado material oriundo de livros-texto, teses, publicações de organismos nacionais e internacionais e artigos publicados selecionados a partir de pesquisa na base de dados MEDLINE referente ao período de 1990 a 2003, utilizando as palavras-chave breastfeeding and low birth weight e breastfeeding and preterm infant. Algumas referências relevantes dos trabalhos selecionados também foram utilizadas. SÍNTESE DOS DADOS: A partir da literatura levantada, verifica-se que vários aspectos tornam o leite materno particularmente adequado para a alimentação do recém-nascido prematuro. No entanto, observa-se, de modo geral, uma baixa incidência de êxito na amamentação de prematuros, especialmente em unidades neonatais de risco, apesar de haver evidências de que uma postura hospitalar favorável possibilite o aleitamento nessas crianças. CONCLUSÕES: Amamentar prematuros ainda é um desafio, mas é factível desde que haja apoio e suporte apropriados, principalmente pelos profissionais de saúde. As mães de prematuros necessitam de mais informações sobre a importância da amamentação para que possam tomar decisões sobre a nutrição dos seus filhos.OBJECTIVE: To describe the importance of breastfeeding and its promotion in the in-hospital clinical management of premature newborns. SOURCE OF DATA: The authors made an extensive literature review on the topic, including technical books, theses, publications of national and international organizations, and search on MEDLINE database (1990 to 2003, using the following key words and boolean operators: "breastfeeding AND low birth weight" and "breastfeeding AND preterm infant". Some significant references cited in the reviewed publications were used as well. SUMMARY OF THE

  11. NATOMICAL ASPECTS OF THE PLACENTA FROM ZEBU CATTLE RAISED IN THE ORIENTAL AMAZONIAN, BRAZIL ASPECTOS ANATÓMICOS DE LA PLACENTA DE ZEBUÍNOS CREADO EN EL AMAZÔNIA DEL ESTE ASPECTOS ANATÔMICOS DA PLACENTA DE ZEBUÍNOS CRIADOS NA AMAZÔNIA ORIENTAL, BRASIL.

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    Tânia Vasconcelos Cavalcante

    2009-04-01

    cuenta total de los placentônios un perno en cada estructura fue colocado individualmente , repitiendo el mismo procedimiento en ambos los cornos de los gestantes o no. Los resultados conseguidos para las 0 variables: la cantidad de los placentônios y la época de la gestación habían sido sometidas a la estadística del análisis. El total de placentônios encontrados en las 30 placentas estaba de 2651, con el promedio de 88.37 para la gestación. En el gestante uno del corno satisfecho 1602 placentônios, con el promedio de 53.40 para la placenta (60.45% y en el gestante 1048 del corno no satisfecho, con el promedio de 34.93 para la placenta (39.55%. Analizando el total de placentônios, en las diversas edades de los gestacionais, un aumento gradual en la cantidad de éstos se observa, no obstante esta correlación no es significativa estadístico (r=? 0,2. Uno concluye que la morfología de la placenta de los zebuínos creados en la región del este del Amazônia es similar de los zebuínos creados en otras regiones con diversas condiciones climáticas y circundantes, por lo tanto la placenta no se parece ser influenciada por tales factores. 

    O trabalho visa analisar as características anatômicas macroscópicas da placenta bovina, Bos taurus indicus, criados na região Oriental da Amazônia, com um perfil de rebanhos regionais mantidos nas condições ambientais e climáticas amazônicas. Coletaram-se úteros gravídicos em diferentes estágios de gestação (quatro a oito meses de vacas Zebu. Cada peça foi lavada em água corrente e seccionou-se o ligamento intercornual, para separação dos cornos uterinos.  Realizou-se uma secção dorsal ao longo da cérvix até o corpo do útero. As membranas fetais ficaram expostas e perfuradas, removendo-se os líquidos fetais e o feto

  12. Placentação em cutias (Dasyprocta aguti, CARLETON, M.D.): aspectos morfológicos

    OpenAIRE

    Rodrigues, Rosângela Felipe; Miglino, Maria Angelica; Ferraz, Rosa Helena dos Santos; Morais-Pinto, Luciano de

    2003-01-01

    A cutia é um roedor silvestre, encontrado no sul da América Central e em regiões tropicais da América do Sul, principalmente nas regiões norte, nordeste e sudeste do Brasil. Estes animais fornecem proteína de origem animal e por isso, apresentam importância sócio-econômica para as regiões do norte e nordeste do Brasil. Para o presente trabalho foram utilizadas sete placentas de cutias (Dasyprocta aguti), em diferentes fases da gestação. Nos aspectos morfológicos a placenta da cutia apresenta ...

  13. Cirurgia cardíaca fetal: características hemodinâmicas da placenta durante circulação extracorpórea Fetal cardiac surgery: hemodynamic characteristics of placenta during extracorporeal circulation

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    Renato S Assad

    1991-04-01

    Full Text Available A diminuição da perfusão placentária com conseqüente distúrbio de trocas gasosas ocorre com freqüência após a circulação extracorpórea (CEC fetal experimental. Com o objetivo de caracterizar a hemodinâmica placentária durante a CEC, foram colocadas em CEC sete placentas de ovelhas, isoladas in situ, através da canulação dos vasos umbilicais. O fluxo da CEC foi alterado de 15 a 300 ml/min/kg de peso fetal, em normotermia e hipotermia. A resistência vascular placentária (RVP permaneceu constante durante uma pressão de perfusão e fluxo da CEC acima de 40 mmHg e 150 ml/min/kg, respectivamente. Abaixo destes valores, a relação da RVP com estes dois parâmetros foi inversamente proporcional. Um maior aumento da RVP foi observado durante a hipotermia. A implicação clínica destes achados reside no fato de que a diminuição do fluxo e da pressão de perfusão placentária durante a CEC pode conduzir a um ciclo vicioso, resultando em prejuízo adicional da perfusão placentária das trocas gasosas, sendo que a hipotermia agrava ainda mais esta disfunção placentária.Decreased placental perfusion and respiratory gas exchange have been observed following experimental fetal cardiopulmonary bypass (CPB. To better characterize placental hemodynamics during CPB, 7 isolated in-situ lamb placentas were placed on a CPB circuit, using umbilical arterial and venous cannulation. Measures were taken to simulate normal placental hemodynamics. Perfusion flow rates were varied randomly from 15 to 300 ml/min/kg fetal wt. during both normothermia and hypothermia. Placental vascular resistance (PVR remained constant when perfusion pressure and flow were varied above 40 mmHg and 150 ml/min/kg respectively. Below these values, PVR varied inversely. This increase in PVR was more marked when CPB was performed with hypothermia as compared to normothermia. The clinical implications is that decreased placental flow and pressure on CPB may lead to a

  14. Early motor outpatient service intervention for postural control in preterm neonates Intervenção motora precoce ambulatorial para neonatos prematuros no controle postural

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    Clarissa Balbão Almeida

    2008-12-01

    Full Text Available Objective: To insure the motor acquisitions related to the Axial Spontaneous Not Communicative Development, which means postural control and displacement. This was done through an early motor intervention physiotherapy program in preterm neonates born at HSL-PUCRS. Materials and Methods: the interventional program included tasks of visual harassment, toys manipulation and postural control, based on Bobath concept. All five preterms who have participated in the program were evaluated by the physiotherapy service, using The Brazilian Scale of Child behavior Development in the First Year of Life, in the beginning of the study and repeated every two months. Results: The study shows no statistical significant results in relation to postural tasks, dynamic balance and displacement. However, a progression in the preterm’s classification evaluations was demonstrated. In the first month of evaluation the median was 3 (regular classification and in the third and fifth month of evaluation the median maintained in 4 (good classification. Conclusion: The early motor intervention provided a progression in the evaluation`s classification of motor acquisitions of the preterms development, however, no statistical significant results related to postural tasks, dinamic balance and displacemen was shown.Objetivo: Verificar as aquisições motoras relacionadas ao desenvolvimento axial espontâneo não comunicativo, ou seja, controle postural e deslocamento. Isto foi feito através de um programa de intervenção motora fisioterapêutica precoce em neonatos prematuros nascidos no Hospital São Lucas - PUCRS. Materiais e Métodos: Tarefas de perseguição visual, manipulação de brinquedos e de controle postural, baseados no conceito Bobath, foram implementadas no programa interventivo. Todos os 5 prematuros que participaram deste estudo foram avaliados pelo serviço de fisioterapia por meio da Escala de Desenvolvimento do Comportamento da Criança no Primeiro Ano

  15. The influence of gestational age and birth weight in the clinical assesment of the muscle tone of healthy term and preterm newborns A influência da idade gestacional e do peso ao nascimento na avaliação clínica do tono muscular de recém nascidos a termo e prematuros hígidos

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    Edla S. da Silva

    2005-12-01

    Full Text Available OBJECTIVE: To evaluate the influence of gestational age (GA and birth weight (BW in the clinical assessment of the muscle tone of healthy term and preterm newborns. METHOD: Cross sectional study. The muscle tone of healthy 42 preterm and 47 term newborns was quantified and measured with a goniometer (an instrument for measuring angles respectively between 7th-14th day of life and 24-48 hours of life. Newborns were grouped according to GA and BW and evaluated at fixed time intervals by one examiner. Preterm newborns were matched to term at 40 weeks postconceptional age (PCA. RESULTS: The evolution of muscle tone in the preterm occurred gradually, following PCA, independent of birth weight. Preterm newborns had lower scores in all muscle tone indicators when compared to term at the first assessment. Differences were observed among preterm small for GA and adequate to GA for the indicator heel to ear (pOBJETIVO: Verificar a influência da idade gestacional (IG e do peso ao nascimento (PN na avaliação do tono muscular de recém nascidos (RN a termo e prematuros hígidos. MÉTODO: Estudo transversal. O tono muscular de 42 RN prematuros e 47 termo foi quantificado e mensurado com goniômetro (instrumento para medir ângulos, respectivamente entre 7-14 dias de vida e 24-48 horas de vida. Os RN foram agrupados de acordo com IG e PN, sendo avaliados em intervalos fixos. RN prematuros foram comparados aos a termo na 40ª semana de idade concepcional (IC. RESULTADOS: A evolução do tono muscular nos RN prematuros ocorreu de forma gradual de acordo com IC e independente do PN. RN prematuros, na primeira avaliação apresentaram escores de tono muscular inferiores aos de RN a termo em todos os indicadores. Foram observadas diferenças entre RN prematuros pequenos e adequados para a IG em relação ao indicador calcanhar-orelha (p<0,001. O pareamento dos grupos na 40ª semana de IC mostra, exceto pela postura, diferença significativa entre os grupos (p< 0

  16. Assistência humanizada ao neonato prematuro e/ou de baixo peso: implantação do Método Mãe Canguru em Hospital Universitário

    OpenAIRE

    Neves,Fabrícia Adriana Mazzo; Orlandi,Márcia Helena Freire; Sekine,Cristina Yurie; Skalinski,Lacita Menezes

    2006-01-01

    Relato de experiência de enfermeiros e equipe multiprofissional no processo de implantação do Método Mãe Canguru no Hospital Universitário, da Universidade Estadual de Maringá, Paraná, em 2002, com os objetivos de: humanizar o cuidado ao recém-nascido prematuro e/ou de baixo peso, aprimorando o suporte familiar; promoção de maior nível de satisfação da equipe assistencial. O bebê fica em contato pele a pele com o peito da mãe, pai ou familiar significativo, com benefícios para seu peso, tempe...

  17. Toracotomia minimamente invasiva (miopreservadora para ligadura do canal arterial em prematuros Minimally invasive thoracotomy (muscle-sparing thoracotomy for occlusion of ductus arteriosus in preterm infants

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    Andrey José de Oliveira Monteiro

    2007-09-01

    Full Text Available OBJETIVO: Avaliar a aplicabilidade, segurança e resultados iniciais da toracotomia minimamente invasiva para ligadura do canal arterial em prematuros. MÉTODO: Entre outubro de 1991 e julho de 2003, 273 prematuros e prematuros extremos foram submetidos à ligadura cirúrgica do canal arterial por toracotomia miopreservadora, com anestesia geral, em UTI neonatal. Os dados demográficos pré-operatórios e os desfechos de mortalidade e eventos adversos foram, retrospectivamente, avaliados por meio de consulta aos prontuários. RESULTADOS: Não houve óbito relacionado com o ato operatório e 234 (86% pacientes tiveram alta hospitalar. Os 39 óbitos ocorreram entre o 1º e o 51º dias e foram atribuídos à sepse (14 pacientes, hemorragia intracraniana (11 pacientes e enterocolite necrotizante (nove pacientes, todas causas inerentes à prematuridade. Em cinco pacientes, a causa não foi adequadamente estabelecida. As complicações mais freqüentes relacionadas ao procedimento foram: pneumotórax 3,3% (nove pacientes e hemorragia 1,4% (quatro pacientes. CONCLUSÕES: A técnica de toracotomia minimamente invasiva para a ligadura do canal arterial quando realizada em prematuros e prematuros extremos é aplicável, segura, eficaz, relacionada à baixa morbidade e não depende da estrutura hospitalar local.OBJECTIVES: To analyze the feasibility, the safety, and the primary outcomes of a minimally invasive thoracotomy for the occlusion of ligamentum arteriosum (ductus arteriosus in preterm infants. METHODS: Between October 1991 and June 2003, 273 preterm infants and very low birth weight preterm infants were submitted to a surgical occlusion of the ligamentum arteriosum (ductus arteriosus through muscle-sparing thoracotomy under general anesthesia in the neonatal ICU. Pre-operative demographic data, mortality outcomes, and adverse events were retrospectively analyzed through medical records consultation. RESULTS:There were no deaths related to surgery

  18. Un gene con intrones en vez de exones / Envejecimiento Prematuro de la Piel

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    Tobías Mojica

    1996-04-01

    Full Text Available Un gene con intrones en vez de exones. La noción de que los genes son discontinuos (compuestos de exones e intrones en forma alterna y en cuya organización los exones representan regiones presentes, por medio del código genético en las proteínas, y los intrones nadie sabe todavía que representan produjo una cierta cantidad de desasosiego entre los genetistas mayores de edad, pero hoy día es ampliamente aceptada, con poco o ningún dolor, y se ha convertido en parte del cánon científico. / Envejecimiento Prematuro de la Piel. La exposición a largo plazo de la piel a la luz ultravioleta proveniente del sol resulta en daño al colágeno de la piel y a la elastina de la matriz extracelular; se cree que este daño es responsable de la apariencia típicamente arrugadita de la piel expuesta al sol por mucho tiempo (como en los vaqueros de los comerciales de la televisión.

  19. Aplicação clínica da ultrassonografia craniana com Doppler em neonatos prematuros de muito baixo peso Clinical application of transcranial Doppler ultrasonography in premature, very-low-birth-weight neonates

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    Marta Lúcia Gabriel

    2010-08-01

    Full Text Available OBJETIVO: Analisar o valor do diagnóstico precoce de alterações hemodinâmicas em hemorragias e eventos hipóxico-isquêmicos pela avaliação de imagens e mensuração do índice de resistência por meio da ultrassonografia craniana com Doppler em neonatos prematuros de muito baixo peso. MATERIAIS E MÉTODOS: Cinquenta neonatos prematuros de muito baixo peso foram submetidos a ultrassonografia craniana com Doppler com a técnica transfontanela anterior e transtemporal sequenciais. RESULTADOS: Foram detectadas alterações cerebrais em 32% dos prematuros, sendo 22% com hemorragia intracraniana, 8% com leucomalácia periventricular e 2% com toxoplasmose. Dentre os 34 casos (68%, do total de neonatos, nos quais não foram detectadas lesões cerebrais pela ultrassonografia craniana, 18 (53% apresentaram alterações no índice de resistência. O índice de resistência variou conforme a época do exame. CONCLUSÃO: Existe correlação entre a presença de alterações na hemodinâmica cerebral e subsequente desenvolvimento de hemorragias e lesões hipóxico-isquêmicas, pela mensuração do índice de resistência. Alterações do índice de resistência, embora não preditoras de morte, estão relacionadas com a gravidade do quadro clínico em neonatos prematuros de muito baixo peso.OBJECTIVE: The present study was aimed at analyzing the value of the early diagnosis of hemodynamic changes in hemorrhages and hypoxic-ischemic events in premature, very-low-birth-weight neonates through the evaluation of images and resistance index measurement by means of transcranial Doppler ultrasonography. MATERIALS AND METHODS: Fifty premature, very-low-birth-weight neonates were submitted to transcranial Doppler ultrasonography with sequential transfontanellar and transtemporal techniques. RESULTS: Cerebral abnormalities were detected in 32% of the neonates (22% with intracranial hemorrhage, 8% with periventricular leukomalacia, and 2% with toxoplasmosis

  20. Influência do local de nascimento e do transporte sobre a morbimortalidade de recém-nascidos prematuros

    Directory of Open Access Journals (Sweden)

    Breno F Araújo

    2011-06-01

    Full Text Available OBJETIVO: Verificar a influência do local de nascimento e do transporte sobre a morbimortalidade de recém-nascidos prematuros na Região Sul do Brasil. MÉTODOS: Estudo de coorte com recém-nascidos prematuros transferidos para a unidade de tratamento intensivo de referência (grupo transporte = 61, tendo sido acompanhados até a alta. Os dados sobre o atendimento no hospital de origem e transporte foram obtidos no momento da internação. Esse grupo foi comparado com neonatos da maternidade de referência, pareados por idade gestacional (grupo controle = 123, tendo como desfecho primário o óbito e desfechos secundários as alterações da glicemia, temperatura e saturação de oxigênio no momento da internação e a incidência de enterocolite necrosante, displasia broncopulmonar e sepses. Na associação entre as variáveis e o desfecho, foi utilizado o risco relativo. Foi adotado um nível de significância de α = 5% e β = 90%. RESULTADOS: A distância média percorrida foi de 91 km. A idade gestacional média foi de 34 semanas. Entre os recém-nascidos transferidos, 23% (n = 14 não tiveram atendimento pediátrico na sala de parto. No transporte, 33% dos recém-nascidos foram acompanhados por pediatra, e os equipamentos utilizados foram: incubadora (57%, bomba de infusão (13%, oxímetro (49% e aparelho para aferição da glicemia (21%. O grupo transporte apresentou maior incidência de hiperglicemia, risco relativo (RR = 3,2 (2,3-4,4, hipoglicemia, RR = 2,4 (1,4-4,0, hipertermia, RR = 2,5 (1,6-3,9, e hipoxemia, RR = 2,2 (1,6-3,0. Foram observados 18% de óbitos no grupo dos transferidos e 8,9% no grupo controle, RR = 2,0 (1,0-2,6. CONCLUSÕES: A pesquisa expõe deficiências no atendimento e transporte dos recém-nascidos, sendo necessária uma melhor organização do atendimento perinatal e do transporte na região nordeste do Rio Grande do Sul.

  1. Prevalencia de patología oftalmológica en prematuros menores de un año de edad

    OpenAIRE

    López G, Juan Pablo; Osandón V, Diego; Denk V, Oliver; Stevenon A, Ricardo; Agurto R, Ricardo; Uauy N, Andrés; Salinas G, Ricardo; Pérez R, Marcela; Cox M, Horacio; Maturana P, Andrés; Elías A, Soledad

    2012-01-01

    Objetivo: Reportar hallazgos oftalmológicos en niños prematuros examinados antes del año de edad gestacional corregida (EGC). Pacientes y Método: Revisión retrospectiva de fichas clínicas de una serie de prematuros ([peso nacimiento (PN) < 1 500 g y/o < 32 sem edad gestacional (EG)] nacidos en CAS entre 2006-2009, examinados antes del año de EGC. Se consignó EG, PN, antecedente de retinopatía del prematuro (ROP), EGC al examen, refracción, anisometropia y estrabismo. Resultados: De 149 premat...

  2. Factores de riesgo asociados a osteopenia del prematuro en una terapia intensiva neonatal de referencia

    Directory of Open Access Journals (Sweden)

    MP Ríos-Moreno

    2016-03-01

    Full Text Available INTRODUCCIÓN: la enfermedad ósea metabólica del prematuro resulta de la desmineralización ósea. Existen factores que deben vigilarse con la finalidad de realizar diagnóstico y tratamiento temprano. OBJETIVO: determinar los factores de riesgo asociados a osteopenia en prematuros. MATERIALES Y MÉTODOS: estudio transversal comparativo de octubre del 2011 a octubre del 2013. Se incluyeron 120 prematuros 900 UI/L. Factores de riesgo determinados con razón de momios (OR. Estadística inferencial con c2 y t de Student. RESULTADOS: se diagnosticó enfermedad ósea metabólica en 58 prematuros (48%, peso 1067 ± 216 gramos, edad gestacional 28 ± 1.6 semanas, edad postnatal 41 ± 15.5 días. Género masculino 32 (55%. Factores de riesgo: peso < 1,000 gramos OR 4.64, (2.13-10.10, displasia broncopulmonar moderada o severa OR 3.13 (1.44-6.81, tres o más eventos de sepsis OR 3.43 (1.62 7.28, sedación prolongada OR 4.09 (1.06-15.73 y corticoide prolongado OR 9.54 (2.06-44.16.  CONCLUSIONES: nuestros resultados muestran que los factores de riesgo para enfermedad ósea metabólica del prematuro fueron peso al nacer menor de 1,000 gramos, displasia broncopulmonar moderada o severa, tres o más eventos de sepsis, sedación y corticoides durante tiempo prolongado.

  3. Placentação em cutias (Dasyprocta aguti, CARLETON, M.D.: aspectos morfológicos

    Directory of Open Access Journals (Sweden)

    Rosângela Felipe Rodrigues

    2003-01-01

    Full Text Available A cutia é um roedor silvestre, encontrado no sul da América Central e em regiões tropicais da América do Sul, principalmente nas regiões norte, nordeste e sudeste do Brasil. Estes animais fornecem proteína de origem animal e por isso, apresentam importância sócio-econômica para as regiões do norte e nordeste do Brasil. Para o presente trabalho foram utilizadas sete placentas de cutias (Dasyprocta aguti, em diferentes fases da gestação. Nos aspectos morfológicos a placenta da cutia apresenta uma forma esférica e uma estrutura lobada estando conecta ao útero através da mesoplacenta. O fluxo sangüíneo fetal flui do interlobo para o centro do lobo, ou seja, centripetamente, enquanto que o materno flui centrifugamente.

  4. Factores de riesgo para mortalidad en prematuros de 800 a 1.000 gramos, Hospital General de Medellín, Junio 1999- diciembre 2001

    OpenAIRE

    Juan Manuel Alfaro Velásquez; Paulina Quintero; Natalia Mesa; Heidy Camargo

    2001-01-01

    Los recién nacidos prematuros y aquellos con bajo peso al nacer tienen mayor riesgo de mortalidad. Son de bajo peso si son menores de 2.500 gramos y de extremado bajo peso si son menores de 1.000 gramos. De acuerdo con la edad gestacional, es prematuro el recién nacido menor de 37 semanas y prematuro extremo el que tiene menos de 31 semanas. Los prematuros extremos generalmente pesan entre 800 y 1.200 gramos, y sus principales causas de muerte son: enfermedad de membrana hialina, inf...

  5. Vivências paternas durante a hospitalização do recém-nascido prematuro na Unidade de Terapia Intensiva Neonatal Experiencias paternas durante la hospitalización del recién nacido prematuro en la Unidad de Cuidados Intensivos Neonatal Fathers' experiences during the hospitalization of the premature newborn in the Neonatal Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Luciano Marques dos Santos

    2012-10-01

    Full Text Available Este estudo objetivou compreender as vivências paternas durante a hospitalização do recém-nascido prematuro na Unidade de Terapia Intensiva Neonatal de um hospital público de Feira de Santana, Bahia. Trata-se de um estudo descritivo, exploratório e qualitativo, aprovado por Comitê de Ética em Pesquisa e realizado com nove pais, na Unidade de Terapia Intensiva Neonatal de um hospital público. Os dados foram analisados através da Análise de Conteúdo, os quais apontaram que os partos prematuros causam sentimentos de surpresa, angústia e medo nos pais. É preciso repensar como ocorre a inserção dos pais do prematuro no processo de hospitalização, bem como mudanças nas rotinas estabelecidas para a visita e participação paterna no contexto do cuidado ao prematuro.Este estudio tuvo como objetivo comprender la experiencia de los padres durante la hospitalización de los bebés prematuros en la Unidad Neonatal de Cuidados Intensivos de un hospital público en Feira de Santana, Bahia. Se trata de un estudio descriptivo y cuantitativo, aprobado por el Comité de Ética en Investigación y actuó en la Unidad de Cuidados Intensivos Neonatales de un hospital público de Bahia, con nueve padres. Los datos fueron analizados utilizando el análisis de contenido que muestran que los nacimientos prematuros causan sentimientos de sorpresa en los padres, de dolor y de miedo. Tenemos que repensar cómo se está insertando a los padres de bebés prematuros en las cuestiones de la hospitalización y los cambios en las rutinas establecidas para la visita y la participación del padre en el contexto de la atención precoz.This study aimed to understand the fathers' experiences during the hospitalization of premature newborn in the Neonatal Intensive Care Unit at a public hospital in Feira de Santana, Bahia. This is a qualitative descriptive exploratory study that was approved by the Ethics Committee of the Faculty of Technology and Sciences, and

  6. Transfer of PAMAM dendrimers across human placenta: prospects of its use as drug carrier during pregnancy.

    Science.gov (United States)

    Menjoge, Anupa R; Rinderknecht, Amber L; Navath, Raghavendra S; Faridnia, Masoud; Kim, Chong J; Romero, Roberto; Miller, Richard K; Kannan, Rangaramanujam M

    2011-03-30

    Dendrimers offer significant potential as nanocarriers for targeted delivery of drugs and imaging agents. The objectives of this study were to evaluate the transplacental transport, kinetics and biodistribution of PAMAM dendrimers ex-vivo across the human placenta in comparison with antipyrine, a freely diffusible molecule, using dually perfused re-circulating term human placental lobules. The purpose of this study is to determine if dendrimers as drug carriers can be used to design drug delivery systems directed at selectively treating either the mother or the fetus. The transplacental transfers of fluorescently (Alexa 488) tagged PAMAM dendrimer (16 kDa) and antipyrine (188 Da) from maternal to fetal circulation were measured using HPLC/dual UV and fluorescent detector (sensitivity of 10 ng/mL for dendrimer and 100 ng/mL for antipyrine respectively). C(max) for the dendrimer-Alexa (DA) in maternal perfusate (T(max)=15 min) was 18 times higher than in the fetal perfusate and never equilibrated with the maternal perfusate during 5.5 h of perfusion (n=4). DA exhibited a measurable but low transplacental transport of 2.26±0.12 μg/mL during 5.5h, where the mean transplacental transfer was 0.84±0.11% of the total maternal concentration and the feto-maternal ratio as percent was 0.073%±0.02. The biochemical and physiological analysis of the placentae perfused with DA demonstrated normal function throughout the perfusion. The immunofluorescence histochemistry confirmed that the biodistribution of DA in perfused placenta was sparsely dispersed, and when noted was principally seen in the inter-villous spaces and outer rim of the villous branches. In a few cases, DA was found internalized and localized in nuclei and cytoplasm of syncytiotrophoblast and inside the villous core; however, DA was mostly absent from the villous capillaries. In conclusion, the PAMAM dendrimers exhibited a low rate of transfer from maternal to the fetal side across the perfused human placenta

  7. The Placenta Economy

    DEFF Research Database (Denmark)

    Kroløkke, Charlotte; Dickinson, Elizabeth; Foss, Karen A.

    2018-01-01

    This article examines the human placenta not only as a scientific, medical and biological entity but as a consumer bio-product. In the emergent placenta economy, the human placenta is exchanged and gains potentiality as food, medicine and cosmetics. Drawing on empirical research from the United......, in the emergent bio-economy, the dichotomy between the inner and the outer body is deconstructed, while the placenta gains clinical and industrial as well as affective value....

  8. Amamentação de prematuros em uma unidade neonatal: a vivência materna Lactancia de prematuros en una unidad neonatal: la vivencia maternal Premature’s breastfeed in a beonatal unit: the maternal experience

    Directory of Open Access Journals (Sweden)

    Fernanda da Rocha Gorgulho

    2008-03-01

    Full Text Available Trata-se de um estudo qualitativo, cujos objetivos foram: identificar as dificuldades maternas em amamentar/aleitar seu filho prematuro em uma Unidade Neonatal (UN, tomar conhecimento de se essa mãe se sente estimulada a amamentar seu filho prematuro nesse ambiente e descrever como essa mãe está vivenciando a amamentação de seu filho prematuro em uma UN. O cenário foi uma Unidade Neonatal localizada no Rio de Janeiro. Os sujeitos foram oito mães de prematuros. O instrumento de coleta foi a entrevista semi-estruturada, realizada nos meses de fevereiro e março de 2006. A análise foi fundamentada na técnica de conteúdo de Bardin. Emergiram cinco categorias: vivenciando uma nova e difícil experiência ao amamentar; tendo dificuldade na ordenha; tendo dificuldade em cumprir os horários das mamadas; sentindo-se apoiada pelos profissionais de saúde; e sentindo-se excessivamente orientada por esses profissionais. O estudo nos aponta a necessidade de voltarmos nosso olhar para as dificuldades maternas de acordo com suas próprias demandas, interferindo o menos possível na relação mãe e filho.Se trata de un estudio cualitativo, cuyos objetivos fueron: identificar las dificultades maternales en amamantar su hijo prematuro en una unidad neonatal (UN ; conocer si esa madre se siente estimulada a amamantar su hijo prematuro en ese ambiente; y describir como esa madre experimenta la lactancia de su hijo prematuro en una UN. El escenario fue una UN situada en la ciudad del Rio de Janeiro - Brasil. Los sujetos fueron ocho madres de prematuros. El instrumento de recolección fue la entrevista semi estructurada. Los datos fueron recolectados en los meses de febrero y marzo de 2006. El análisis fue en la Técnica de Análisis de Contenido de Bardin(1977. Emergieron cinco categorías: viviendo una nueva y difícil experiencia al amamantar; teniendo dificultad en la ordeña; teniendo dificultad para cumplir los horarios de las mamadas; sinti

  9. Validade concorrente e confiabilidade da Alberta Infant Motor Scale em lactentes nascidos prematuros Concurrent validity and reliability of the Alberta Infant Motor Scale in premature infants

    Directory of Open Access Journals (Sweden)

    Kênnea Martins Almeida

    2008-10-01

    Full Text Available OBJETIVO: Verificar a validade concorrente e a confiabilidade interobservador da Alberta Infant Motor Scale (AIMS em lactentes prematuros acompanhados no ambulatório de seguimento do Instituto Fernandes Figueira, Fundação Oswaldo Cruz (IFF/Fiocruz. MÉTODOS: Foram avaliados 88 lactentes nascidos prematuros no ambulatório de seguimento do IFF/Fiocruz entre fevereiro e dezembro de 2006. No estudo de validade concorrente, 46 lactentes com 6 (n = 26 ou 12 (n = 20 meses de idade corrigida foram avaliados pela AIMS e pela escala motora da Bayley Scales of Infant Development, 2ª edição, por dois observadores diferentes, utilizando-se o coeficiente de correlação de Pearson para análise dos resultados. No estudo de confiabilidade, 42 lactentes entre 0 e 18 meses foram avaliados pela AIMS por dois observadores diferentes, utilizando-se o intraclass correlation coefficient (ICC para análise dos resultados. RESULTADOS: No estudo de validade concorrente, a correlação encontrada entre as duas escalas foi alta (r = 0,95 e estatisticamente significativa (p OBJECTIVE: To verify the concurrent validity and interobserver reliability of the Alberta Infant Motor Scale (AIMS in premature infants followed-up at the outpatient clinic of Instituto Fernandes Figueira, Fundação Oswaldo Cruz (IFF/Fiocruz, in Rio de Janeiro, Brazil. METHODS: A total of 88 premature infants were enrolled at the follow-up clinic at IFF/Fiocruz, between February and December of 2006. For the concurrent validity study, 46 infants were assessed at either 6 (n = 26 or 12 (n = 20 months' corrected age using the AIMS and the second edition of the Bayley Scales of Infant Development, by two different observers, and applying Pearson's correlation coefficient to analyze the results. For the reliability study, 42 infants between 0 and 18 months were assessed using the Alberta Infant Motor Scale, by two different observers and the results analyzed using the intraclass correlation

  10. Uso do copo e da mamadeira e o aleitamento materno em recém-nascidos prematuros e a termo: uma revisão sistemática Cup and bottle feeding and breastfeeding in premature and term infants: a systematic review

    Directory of Open Access Journals (Sweden)

    Cínthia Tiago Paes de Almeida Pedras

    2008-03-01

    Full Text Available OBJETIVOS: revisar ensaios clínicos randomizados que avaliaram a prevalência e/ou duração do aleitamento materno na alta hospitalar e/ou durante o primeiro ano de vida, em recém-nascidos a termo ou prematuros. Foram selecionados estudos que incluíram neonatos e que receberam suplementação por copo ou por mamadeira, durante a estadia hospitalar. MÉTODOS: foram pesquisados artigos publicados em português ou inglês, no período de 1966 a 2006, nas bases de dados Medline, Lilacs e Scielo. Os seguintes termos foram utilizados: "amamentação + mamadeira" combinado com "prevalência", "métodos de alimentação", "duração", "baixo peso", "prematuro" e "recém-nascido". RESULTADOS: cinco artigos preencheram os critérios de inclusão, suas casuísticas variaram de 14 a 686 recém-nascidos, totalizando 1552 crianças. O uso do copo para a suplementação da amamentação foi associado a maior prevalência de aleitamento materno em neonatos a termo, nascidos de parto cesárea e em prematuros no momento da alta hospitalar. CONCLUSÕES: parece haver uma influência favorável do uso do copo sobre o aleitamento materno, embora a presente revisão não seja conclusiva e definitiva.OBJECTIVES: to review randomized clinical trials that investigated breastfeeding prevalence and/or duration at maternity discharge and/or during first year of life, in term or premature infants. The focus was on studies that have included neonates fed by cup or by bottle during their hospital stay. METHODS: authors examined articles published in English or Portuguese between 1996 and 2006, and included on the Medline, Lilacs and Scielo databases. The following keywords were used: "breastfeeding + bottle feeding" plus "prevalence", "feeding methods", "duration", "low birth weight", "premature" and "neonate". RESULTS: five articles met the inclusion criteria. The number of subjects covered ranged from 14 to 686, amounting to a total of 1552 infants. Cup-feeding for

  11. Perinatal outcome and near-miss morbidity between placenta previa versus abruptio placentae

    International Nuclear Information System (INIS)

    Siddique, S.A.; Tariq, G.; Sheikh, A.; Hussain, F.S.U.; Memon, K.A.

    2010-01-01

    To compare perinatal outcome and near-miss morbidities between placenta previa versus abruptio placentae in patients of antepartum haemorrhage (APH). Patients with APH diagnosed as placenta previa and abruptio placentae who delivered after 24 weeks of regnancy were selected from labour room. Outcome measures were birth weight, neonatal intensive care admission, stillbirth, perinatal mortality rates, near-miss, surgical intensive care admission, postpartum haemorrhage, hysterectomy, massive transfusion, renal failure, coagulopathy and maternal death. Stillbirth was defined as a fetus weighing greater or equal to 500 gm showing no sign of life after birth. Near-miss was defined as severe organ dysfunction which if not treated appropriately, could result in death. Descriptive statistics were calculated and chi-square was applied with significance level < 0.05. Stillbirths and perinatal mortality rates were significantly higher in abruptio placentae, 52.97% versus 18.18% and 534/1000 versus 230/1000 (p < 0.01). Near-miss cases were also significantly higher in abruptio placentae, 22.27%. Verus 11.18% (p < 0.01). Hypovolemic shock and coagulation failure were also significantly higher in abruptio placentae (p < 0.05). (author)

  12. Influência do posicionamento em prona sobre o estresse no recém-nascido prematuro avaliada pela dosagem de cortisol salivar: um estudo piloto

    Directory of Open Access Journals (Sweden)

    Maria Fernanda Cândia

    2014-04-01

    Full Text Available Objetivo: Avaliar a influência da postura em prona sobre o estresse no recém-nascido prematuro por meio da dosagem do cortisol salivar e da avaliação das respostas fisiológicas e comportamentais, antes e após o posicionamento. Métodos: Foi realizada a coleta de saliva em cada recém-nascido em dois momentos: o primeiro (correspondente ao basal, sem manipulação prévia por 40 minutos, em decúbito lateral ou supino; e o segundo, 30 minutos após o posicionamento em prona. A frequência cardíaca e respiratória, saturação periférica de oxigênio e escala de sono de Brazelton foram registradas antes, durante e ao final do posicionamento em prona. Resultados: Participaram do estudo 16 recém-nascidos prematuros (56,3% masculino com idade gestacional de 26 a 36 semanas, com 1 a 33 dias de vida, e peso variando de 935 a 3.050g ao nascimento e de 870 a 2.890g no dia da intervenção. Durante o posicionamento, seis recém-nascidos estavam em ar ambiente e os demais recebiam oxigênio suplementar. A mediana dos níveis de cortisol salivar foi menor durante o posicionamento em prona comparativamente ao basal (0,13 e 0,20; p=0,003, assim como a do escore de sono de Brazelton (p=0,02. A média da frequência respiratória foi menor após a intervenção (54,88±7,15 e 60±7,59; p=0,0004. As demais variáveis analisadas não apresentaram variação significativa. Conclusão: O posicionamento em prona diminuiu significativamente os níveis de cortisol salivar, da frequência respiratória e do escore de sono de Brazelton, sugerindo a correlação entre essa postura e a diminuição do estresse nesses recém-nascidos.

  13. Visión de las madres en el cuidado del hijo prematuro en el hogar

    OpenAIRE

    Castiblanco López, Nubia; Muñoz de Rodríguez, Lucy

    2012-01-01

    Objetivo: describir el significado que tiene para las madres cuidar el recién nacido prematuro en el hogar, desde su contexto cultural.Diseño: estudio de tipo cualitativo etnográfico basado en la teoría de Madeleine Leininger.Muestra: la información, obtenida de observación y 23 entrevistas a las madres en su hogar, se recolectó y se analizó según la entrevista y análisis etnográficos de James Spradley.Participantes: ocho madres de recién nacidos prematuros que asistieron a control al Program...

  14. [Placenta accreta--prenatal diagnosis, treatment].

    Science.gov (United States)

    Tsankova, M; Marinov, B; Bozhilov, D; Pirnareva, E

    2013-01-01

    Placenta accreta is a potentially life threatening obstetric condition that requires a multidisciplinary management. Placenta praevia and previous Cesarean section are the two most important known risk factors for placenta accreta. This study presents two patients having both of the foremention risk factors diagnosed ultrasonographically with placenta accreta in the second trimester. Ultrasound findings considered suggestive of placenta accreta are: presence of placental lacunae (vascular spaces), loss of the hyperehoic uterine serosa-bladder wall interface, loss of the retroplacental hypoechoic clear space, hypervascularity of the interface between the uterine wall and the bladder wall/isthmico-cervical zone, presence of placenta praevia, either anterior or posterior, overlying the uterine scar. Both of the cases with suspected placenta accreta ended successfully by planned preterm Cesarean hysterectomy with the placenta left in situ. Placenta accreta is a significant cause of maternal morbidity and mortality and the most common reason for urgent postpartum hysterectomy.

  15. Cuidado humanizado al neonato prematuro y familia: una perspectiva de enfermería. Unidad de cuidado intensivo neonatal. Hospital San Bartolomé. 2015.

    OpenAIRE

    Broncano Vargas, Yrma Nilda

    2016-01-01

    El objeto de estudio es el cuidado humanizado de enfermería al neonato prematuro y familia, desde la perspectiva de enfermería en la Unidad de Cuidados Intensivos Neonatal (UCIN) del Hospital San Bartolomé, Lima Perú. Objetivos: Describir y caracterizar el cuidado humanizado que brinda la enfermera al neonato prematuro y familia en la UCIN, analizar las implicancias del cuidado humanizado al recién nacido prematuro y familia en la salud neonatal. Estudio de naturaleza cualitativa, método desc...

  16. Dados anatômicos da placenta em caprinos estudado por injeção intravascular de neoprene

    Directory of Open Access Journals (Sweden)

    Willams Costa Neves

    1999-01-01

    Full Text Available Estudamos a placenta quanto aos seus aspectos morfológicos em 30 caprinos sem raça definida, adultos oriundos do Estado do Piauí, mediante a análise de esquemas de modelos obtidos pela injeção de látex Neoprene "650". Obtivemos 17 casos, ou seja, 56,66% de gestações únicas e 13 casos, ou seja, 43,33% de gestações gemelares. A área do hilo placentário varia de 1 a 6 cm de diâmetro e está situada no centro da placenta, região caracterizada pela apresentação do pedículo umbilical. O formato dos cotilédones varia de ovóide, circular, elíptica, piriforme ou reniforme, sendo que a maioria mostra-se ovóide. O número total de cotilédones em 30 gestações é igual a 3.117, sendo a média 104 cotilédones por gestação. Nas gestações únicas em 16 casos (94,11%, o corno uterino gestante apresenta maior número de cotilédones do que o corno uterino não-gestante. Nas gestações gemelares, em 7 observações (53,84%, o corno uterino esquerdo mostra maior número de cotilédones do que o corno uterino direito.

  17. Caracterização das áreas hemófagas da placenta bovina Characterization of hemophagous areas of the bovine placenta

    Directory of Open Access Journals (Sweden)

    Susana M.M. Cazerta

    2007-06-01

    Full Text Available A região específica da interface materno-fetal corresponde à zona arcada do placentônio ovino e caprino. Em pequenos ruminantes esta área é também caracterizada por sangue materno extravasado (áreas hemófagas. É possível que o ferro seja transferido para o feto por eritrofagocitose trofoblástica nestas áreas. Para investigar as áreas hemófagas na placenta bovina, foram analisados placentônios de 34 vacas zebuínas gestantes (dois a três, quatro a seis, sete a oito, e nove meses de prenhez. O material foi fixado com solução aquosa de formaldeído a 10% e paraformaldeído a 4%, em tampão fosfato, pH 7,4, 0,1M, sendo processado e corado para microscopia de luz e histoquímica. Os hematomas placentários foram observados entre o epitélio uterino e trofoblástico, a partir de três meses de prenhez. A presença de eritrócitos nas células trofoblásticas elucidou a eritrofago-citose. A reação histoquímica de Perl's permitiu provar a existência de ferro férrico no trofoblasto. A reação de PAS foi po-sitiva, marcando substância mucóide nas células epiteliais e, principalmente, nas células binucleadas do epitélio fetal. Baseando-se nas características histológicas e histoquímicas, inferimos que as áreas hemófagas são sítios importantes para a transferência de ferro na placenta bovina.The specific region of maternal fetal interface needs to be clarified and corresponds to the "arcade zone" of sheep and goat placentomes. In small ruminants that area is also characterized by macroscopic blood extravasation (hemophagous areas. This occurs possibly because the iron is transferred to the embryo by trophoblastic erytrophagocytosis in these hemophagous placental areas. In order to investigate the hemophagous placental areas in cattle, placentomes of 34 pregnant Bos indicus cows (2-3, 4-6, 7-8 and 9 months of gestation were analyzed. They were fixed by perfusion with 10% formaldehyde aqueous solution and 4

  18. MRI features of placenta accreta

    International Nuclear Information System (INIS)

    Cao Manrui; Du Mu; Huang Yi; Liu Bingguang; Zhang Fangjing; Guo Jimin; Zhu Zhijun

    2012-01-01

    Objective: To investigate the MRI features of placenta accreta. Methods: From Apr 2009 to Jun 2011, 15 patients with placenta accrete received MRI examination. In them, placenta accreta was diagnosed based on clinical manifestations or postoperative histopathology. The MR features of placenta accreta in them (study group) were retrospectively analyzed and compared with those in 15 pregnant women without placenta accreta (control group) with Fisher exact test. Results: In the 15 patients with placenta accreta,uterine bulging and (or) a focal outward contour bulge was detected in 14 patients; heterogeneous signal intensity in the placenta was detected in 15 patients; dark intraplacental bands on T 2 -weighted images was detected in 15 patients; and increased subplacental vascularity was detected in 11 patients on T 1 - weighted images. In the study group, 14 patients showed at least three of the above four features, and in all of them uterine bulging and (or) a focal outward contour bulge, heterogeneous signal intensity in the placenta and dark intraplacental bands on T 2 -weighted images were detected; one patient showed heterogeneous signal intensity in the placenta, dark intraplacental bands on T 2 -weighted images and increased subplacental vascularity. In the control group,none patient had three of the above features.Uterine bulging and (or) a focal outward contour bulge, heterogeneous signal intensity in the placenta, dark intraplacental bands on T 2 -weighted images and increased subplacental vascularity were detected in 3, 6, 3 and 4 patients (P=0.000, 0.001, 0.000 and 0.027), respectively. Conclusions: The main MRI features of placenta accreta are uterine bulging and (or) a focal outward contour bulge, heterogeneous signal intensity in the placenta and dark intraplacental bands on T 2 -weighted images Besides, increased subplacental vascularity also could provide useful information for the diagnosis of placenta accreta. (authors)

  19. The placenta in toxicology. Part III : Pathologic assessment of the placenta

    OpenAIRE

    Cline, J Mark; Dixon, Darlene; Ernerudh, Jan; Faas, Marijke M; Göhner, Claudia; Häger, Jan-Dirk; Markert, Udo R; Pfarrer, Christiane; Svensson-Arvelund, Judit; Buse, Eberhard

    2014-01-01

    This short review is derived from the peer-reviewed literature and the experience and case materials of the authors. Brief illustrated summaries are presented on the gross and histologic normal anatomy of rodent and macaque placentas, including typical organ weights, with comments on differences from the human placenta. Common incidental findings, background lesions, and induced toxic lesions are addressed, and a recommended strategy for pathologic evaluation of placentas is provided.

  20. Escalating placenta invasiveness: repeated placenta accreta at the limit of viability

    Science.gov (United States)

    Greenbaum, Shirley; Khashper, Alla; Leron, Elad; Ohana, Eric; Meirovitz, Mihai; Hershkovitz, Reli; Erez, Offer

    2016-01-01

    Placenta percreta is an obstetric condition in which the placenta invades through the myometrium. This is the most severe form of placenta accreta and may result in spontaneous uterine rupture, a rare complication that threatens the life of both mother and fetus. In this case report, we describe a 32-year-old woman in her fourth pregnancy, diagnosed with repeated placenta accreta, which was eventually complicated by spontaneous uterine rupture at 24 weeks’ gestation. This patient had a history of abnormal placentation in prior pregnancies and previous uterine injuries. This case demonstrates a pattern of escalating placental invasiveness, and raises questions regarding the process of abnormal placentation and the manifestation of uterine rupture in scarred uteri. PMID:27143953

  1. Desenvolvimento cerebral em recém-nascidos prematuros Cerebral development in preterm newborn infants

    Directory of Open Access Journals (Sweden)

    Andrea Peterson Zomignani

    2009-06-01

    Full Text Available OBJETIVO:Rever a literatura atual que aborda o crescimento e o desenvolvimento cerebral de crianças prematuras e as alterações cognitivas e motoras que podem decorrer da prematuridade. FONTES DE DADOS: Foram utilizadas as bases de dados Medline e Lilacs, selecionados artigos publicados entre os anos de 2000 e 2007 e livros-texto com conteúdo relevante. SÍNTESE DOS DADOS: A evolução do recém-nascido pré-termo diferencia-se da evolução apresentada pela população a termo. Estudos têm demonstrado que ex-prematuros apresentam alterações anatômicas cerebrais que se associam a prejuízos cognitivos. Várias regiões do sistema nervoso central (substância cinzenta, substância branca, corpo caloso, núcleo caudado, hipocampo e cerebelo têm seus volumes avaliados por neuroimagem e, apesar de resultados controversos, parecem ter desenvolvimento alterado nessa população. Diante disso, espera-se haver repercussão funcional e/ou cognitiva em crianças, adolescentes e adultos nascidos prematuramente. Ex-prematuros avaliados na infância tardia e na adolescência demonstram alterações de quociente de inteligência, memória, capacidade para cálculos e função cognitiva global. Déficits motores, na capacidade de planejamento e de associação, na coordenação motora e na atenção também foram relatados na literatura. CONCLUSÕES: A prematuridade pode levar a alterações anatômicas e estruturais do cérebro devido à interrupção das etapas de desenvolvimento pré-natal. Tais alterações podem causar déficits funcionais, tornando os ex-prematuros sujeitos a problemas cognitivos e motores, assim como suas repercussões nas atividades de vida diária, mesmo na adolescência e idade adulta.OBJECTIVE:To review the current literature about brain growth and development of premature children, as well as the motor and cognitive changes that may result from prematurity. DATA SOURCES: Medline and Lilacs were searched between 2000 and

  2. Importância clínica da dosagem de lactato e contagem de eritroblastos no sangue colhido no segmento placentário da veia umbilical para o diagnóstico de hipóxia-isquemia em prematuros Clinical value of lactate measurement and nucleated red blood cell counts in the placental segment of the umbilical vein of premature newborns for diagnosis of hypoxia-ischemia

    Directory of Open Access Journals (Sweden)

    Yvi Gea

    2007-04-01

    Full Text Available OBJETIVO: Determinar a validade clínica das dosagens de lactato e contagem de eritroblastos quando comparados com o excesso de bases (EB em sangue do segmento placentário da veia umbilical de prematuros. MÉTODOS: foram colhidas amostras de 25 prematuros, após ligadura e dequitação. Os prematuros foram seguidos até a alta. Estatística incluiu regressão linear, correlação de Spearman, curvas ROC, Teste de Fisher. RESULTADOS: Lactato mostrou boa correlação com pH e EB (p OBJECTIVE: To evaluate the clinical value of lactate measurement and nucleated red blood cell (NRBC counts when compared to base excess (BE in the blood collected from the placental segment of the umbilical vein. METHODS: 25 umbilical cords from premature babies were sampled after placental delivery and cord clamping. Babies were followed until discharge. Statistics involved linear regression, Spearman's correlation, ROC curves, and Fisher's exact test. RESULTS: The relationship between lactate in the umbilical vein blood and pH and BE was significant (p < 0.0001. A 4.04 mmol/L lactate level showed a sensitivity of 62.5% and a specificity of 94.1% in detecting pH <7.2 and BE < -10 mmol/L. NRBC counts were related to BE (p = 0.0095, but with a sensitivity of 37.5% and specificity of 82.4% in detecting BE < -10 mmol/L. CONCLUSIONS: Lactate is a valuable marker of fetal hypoxia when sampled from placental segment veins. NRBC counts demonstrated low sensitivity for the detection of acidosis.

  3. Hiperecogenicidade dos vasos talâmicos no recém-nascido prematuro Hyperechogenicity of thalamic vessels in preterm newborn infants

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    Natália Paczko

    2002-09-01

    Full Text Available Objetivo: o presente estudo procura avaliar as possíveis patologias que se manifestam associadas à hiperecogenicidade dos vasos talâmicos na ultra-sonografia cerebral, e observar a freqüência com que ocorrem. Métodos: a amostra foi constituída de 206 recém-nascidos prematuros, nascidos no Hospital de Clínicas de Porto Alegre, no período de julho de 1998 a maio de 1999. Todos realizaram a ultra-sonografia cerebral na primeira semana de vida. Foram incluídos no estudo aqueles prematuros que necessitaram de internação hospitalar, e que tiveram o termo de consentimento informado assinado por um dos responsáveis. Foram excluídos aqueles cuja ultra-sonografia cerebral evidenciava sangramento cerebral e/ou malformações congênitas associadas, e os que evoluíram para óbito antes da realização do exame. Resultados: a ultra-sonografia cerebral levou à identificação de 65 recém-nascidos prematuros com hiperecogenicidade dos vasos talâmicos e de 141 recém-nascidos prematuros sem. Conclusão: a forma de apresentação do tipo pélvica ao nascimento, a maior idade gestacional, o maior peso do recém-nascido ao nascimento e a classificação grande para a idade gestacional foram fatores de risco para a ocorrência de hiperecogenicidade dos vasos talâmicos, enquanto a presença de hipertensão materna durante o período de gestação tendeu a ser fator de proteção. Os recém-nascidos que apresentaram crises convulsivas durante o período de internação hospitalar tiveram risco 3,2 vezes maior de ter hiperecogenicidade dos vasos talâmicos, quando comparados aos que não apresentaram crises convulsivas.Objective: the aim of this study is to evaluate possible pathologies associated with hyperechogenicity of thalamic vessels (HETV, which are found on brain ultrasounds (BUS, as well as to observe the frequency of their occurrence. Methods: the sample was composed of 206 preterm newborn infants at Hospital de Clíncas de Porto Alegre

  4. Como minimizar a lesão pulmonar no prematuro extremo: propostas Strategies to minimize lung injury in extremely low birth weight infants

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    Cleide Suguihara

    2005-03-01

    Full Text Available OBJETIVO: Apresentar uma revisão das principais causas da nova displasia broncopulmonar e as estratégias utilizadas para diminuir sua incidência nos prematuros extremos. FONTES DOS DADOS: Para essa revisão, pesquisas foram feitas na MEDLINE (1996 a outubro de 2004, no Cochrane Database, em resumos da Society for Pediatric Research e recentes conferências sobre o tema. SÍNTESE DOS DADOS: A tecnologia e os novos conhecimentos científicos têm aumentado significantemente a sobrevida de prematuros extremos. Esse aumento da sobrevida resultou em aumento da incidência de displasia broncopulmonar. Atualmente, a displasia broncopulmonar é mais freqüentemente observada em recém-nascidos OBJECTIVE: To review the main causes of new bronchopulmonary dysplasia and the strategies utilized to decrease its incidence in extremely low birth weight infants. DATA SOURCES: For this review a MEDLINE search from 1966 to October 2004, the Cochrane Database, abstracts from the Society for Pediatric Research and recent meetings on the topic were used. SUMMARY OF FINDINGS: The survival of extremely low birth weight infants has increased significantly due to improvement in both scientific knowledge and technology. This improvement in survival has therefore resulted in an increased incidence of bronchopulmonary dysplasia. The characteristics of bronchopulmonary dysplasia in extremely low birth weight infants, the so called "new" bronchopulmonary dysplasia are quite different from the classic bronchopulmonary dysplasia described by Northway. This new bronchopulmonary dysplasia has a multifactorial etiology, which includes volutrauma, atelectrauma, oxygen toxicity and lung inflammation. Therapy such as prenatal corticosteroids, exogenous surfactant, nasal continuous positive airway pressure, new mechanical ventilation modalities and gentle ventilation have been used in attempts to decrease lung injury severity. CONCLUSIONS: In order to prevent lung injury in

  5. Placenta Accreta and Total Placenta Previa in the 19th Week of Pregnancy

    Science.gov (United States)

    Findeklee, S.; Costa, S. D.

    2015-01-01

    Placentation disorders are the result of impaired embedding of the placenta in the endometrium. The prevalence of these disorders is estimated to be around 0.3 %. A history of previous prior uterine surgery (especially cesarean section and curettage) is the most common risk factor. Impaired placentation is differentiated into deep placental attachment; marginal, partial and total placenta previa; and placenta accreta, increta and percreta. Treatment depends on the severity of presentation and ranges from expectant management to emergency hysterectomy. In most cases, preterm termination of pregnancy is necessary. We report here on the case of a 39-year-old woman with placenta accreta and total placenta previa who underwent hysterectomy in the 19th week of pregnancy. PMID:26366004

  6. Aumento no material fibrinoide perivilositário nas placentas de gestações com pré-eclâmpsia Increase in perivillous fibrinoid material in placentas from pregnancies with preeclampsia

    Directory of Open Access Journals (Sweden)

    Diego Agra de Souza

    2011-02-01

    Full Text Available INTRODUÇÃO: A pré-eclâmpsia responde por alta morbimortalidade no Brasil e no mundo. A sua etiologia ainda não foi totalmente esclarecida. Entre as alterações placentárias na pré-eclâmpsia citam-se: infartos, aumento de nós sinciciais, hipotrofia vilositária, espessamento da membrana basal trofoblástica e deposição de material fibrinoide. OBJETIVO: Analisar quantitativamente imagens do material fibrinoide perivilositário presente em placentas de gestações com e sem pré-eclâmpsia. MATERIAL E MÉTODOS: Foi realizado estudo de caso-controle no Serviço de Anatomia Patológica do Hospital Universitário Professor Alberto Antunes (HUPAA. Realizou-se análise histomorfométrica de 840 imagens provenientes de 14 placentas de gestações com pré-eclâmpsia (casos e 14 placentas de gestações sem pré-eclâmpsia (controles. RESULTADOS: A média da área do material fibrinoide no grupo pré-eclâmpsia foi de 168,46 pixels, e no grupo sem pré-eclâmpsia, de 89,63 pixels. Foi observada uma quantidade menor da área total dos núcleos na pré-eclâmpsia, 89,51 pixels, do que no grupo controle, 113,34 pixels. CONCLUSÃO: Nas placentas de gestações com pré-eclâmpsia a área ocupada pelo material fibrinoide está aumentada em 1,8 vez em comparação com as placentas de gestações normais. As áreas dos núcleos e citoplasmas foram maiores no grupo controle. Não houve diferença estatisticamente significativa quanto à área do estroma. Observou-se também redução do espaço ocupado pelas vilosidades na pré-eclâmpsia, sendo este fato compatível com hipotrofia vilositária.INTRODUCTION: Preeclampsia is responsible for high maternal mortality in Brazil and worldwide. Its etiology has not been fully elucidated. Placental changes in preeclampsia include: infarcts, increase in syncytial knots, villous hypotrophy, thickening of trophoblastic basement membrane and fibrin deposition. OBJECTIVE: To analyze quantitatively images of

  7. Prevalence of retinopathy of prematurity: an institutional cross-sectional study of preterm infants in Brazil Prevalencia de retinopatía del prematuro: estudio transversal institucional de niños prematuros en Brasil

    Directory of Open Access Journals (Sweden)

    João B. Fortes Filho

    2009-09-01

    Full Text Available OBJECTIVE: Retinopathy of prematurity (ROP is the leading cause of childhood blindness in most developed countries. This study aimed to verify ROP prevalence among all very low birth weight (VLBW preterm infants admitted to a level-3 teaching hospital in Porto Alegre, Rio Grande do Sul, Brazil. METHODS: Institutional cross-sectional study of 407 premature infants with birth weight OBJETIVO: La retinopatía del prematuro (RP es la principal causa de ceguera infantil en la mayoría de los países desarrollados. El objetivo de este estudio fue verificar la prevalencia de esta afección en todos los niños prematuros de muy bajo peso al nacer ingresados en un hospital docente de tercer nivel de Porto Alegre, Rio Grande do Sul, Brasil. MÉTODOS: Estudio transversal institucional de 407 niños prematuros que nacieron entre 2002 y 2007 con un peso de 1500 g o menos, o 32 semanas de edad gestacional o menos. Todos los niños tamizados para RP se examinaron después de la cuarta semana de vida y tuvieron seguimiento hasta la semana 45 de edad gestacional ajustada. La prevalencia de RP se estimó con un intervalo de confianza de 95%. RESULTADOS: De los niños tamizados, 104 (25,5% presentaron algún grado de RP en uno o ambos ojos, mientras 24 (5,8% presentaron RP grave (estadio 3 o mayor; requerían de tratamiento para evitar la pérdida de la visión, según los criterios del Estudio Multicéntrico de Crioterapia para la Retinopatía del Prematuro, CRYO-ROP, realizado en los Estados Unidos de América. Según los criterios de la Clasificación Internacional de la Retinopatía del Prematuro (ICROP, 1984/1987, la enfermedad alcanzó los estadios 1, 2 y 3 en 46 (11,3%, 34 (8,4% y 22 (5,4% niños, respectivamente. Un niño desarrolló la enfermedad hasta el estadio 4 (desprendimiento parcial de la retina y uno alcanzó el estadio 5 (desprendimiento completo de la retina, lo que representó una prevalencia general de ceguera por RP de 0,2%. CONCLUSIONES: La

  8. Placenta percreta is associated with more frequent severe maternal morbidity than placenta accreta.

    Science.gov (United States)

    Marcellin, Louis; Delorme, Pierre; Bonnet, Marie Pierre; Grange, Gilles; Kayem, Gilles; Tsatsaris, Vassilis; Goffinet, François

    2018-05-04

    Abnormally invasive placentation is the leading cause of obstetric hysterectomy and can cause poor to disastrous maternal outcomes. Most previous studies of peripartum management and maternal morbidity have included variable proportions of severe and less severe cases. The aim of this study was to compare maternal morbidity from placenta percreta and accreta. This retrospective study at a referral center in Paris includes all women with abnormally invasive placentation from 2003 to 2017. Placenta percreta and accreta were diagnosed histologically or clinically. When placenta percreta was suspected before birth, a conservative approach leaving the placenta in situ was proposed because of the intraoperative risk of cesarean delivery. When placenta accreta was suspected, parents were offered a choice of a conservative approach or an attempt to remove the placenta, to be followed in case of failure by hysterectomy. Maternal outcomes were compared between women with placenta percreta and those with placenta accreta/increta. The primary outcome measure was a composite criterion of severe acute maternal morbidity including at least one of the following: hysterectomy during cesarean delivery, delayed hysterectomy, transfusion of ≥ 10 units of packed red blood cells, septic shock, acute kidney injury, cardiovascular failure, maternal transfer to intensive care, or death. Of the 156 women included, 51 had placenta percreta and 105 placenta accreta. Abnormally invasive placentation was suspected antenatally nearly four times more frequently in the percreta than the accreta group (96.1% (49/51) vs. 25.7% (27/105), P placentation (48.7%), the rate of antenatal decisions for conservative management was higher in the percreta than the accreta group (100% (49/49) vs. 40.7% (11/27), Paccreta group (86.3% (44/51) vs. 28/105 (26.7%), P placentation diameter > 6 cm showed similar results (86.0% (43/50) vs. 48.7% (19/38), P accreta group (52.9% (27/51) vs. 20.9% (22/105), P accreta

  9. EFFECT OF PLASMAPHERESIS AND PASSAGE OF ANTI-RETINAL ANTIBODIES THROUGH THE PLACENTA IN A CASE OF NON-PARANEOPLASTIC AUTOIMMUNE RETINOPATHY.

    Science.gov (United States)

    Sierpina, David I; Skale, David M; Fan, Joseph T

    2017-01-01

    To present a case of nonparaneoplastic autoimmune retinopathy in association with myasthenia gravis in a young woman, and to report the effect of plasmapheresis as well as passage of antiretinal antibodies through the placenta. Case report. A 31-year-old woman presented with a history of myasthenia gravis and rapidly progressive vision loss at the age of 23. Funduscopic appearance and fluorescein angiographic findings on presentation were consistent with an autoimmune retinopathy. Paraneoplastic etiology was ruled out, and antiretinal antibody testing revealed positivity for autoantibodies against GAPDH, aldolase, enolase, arrestin, as well as unnamed 48-kDa and 60-kDa proteins. ARA Western Blot and immunohistochemistry profiles were unchanged by either plasmapheresis therapy or passage of serum through the maternal placenta. However, the patient's 6-month and 8-year-old daughters appeared unaffected. This is the first report of nonparaneoplastic autoimmune retinopathy associated with myasthenia gravis, although a strong history of autoimmune disorders is a known risk factor. Our patient's antiretinal antibody panel was unaffected immediately after plasmapheresis treatment. Antibodies to GAPDH and unnamed 38-kDa and 86-kDa proteins were able to pass through the placenta into the fetal circulation, although their effect on the growing fetus is not clear.

  10. Factores de riesgo para mortalidad en prematuros de 800 a 1.000 gramos, Hospital General de Medellín, Junio 1999- diciembre 2001

    Directory of Open Access Journals (Sweden)

    Juan Manuel Alfaro Velásquez

    2001-04-01

    Full Text Available

    Los recién nacidos prematuros y aquellos con bajo peso al nacer tienen mayor riesgo de mortalidad. Son de bajo peso si son menores de 2.500 gramos y de extremado bajo peso si son menores de 1.000 gramos. De acuerdo con la edad gestacional, es prematuro el recién nacido menor de 37 semanas y prematuro extremo el que tiene menos de 31 semanas. Los prematuros extremos generalmente pesan entre 800 y 1.200 gramos, y sus principales causas de muerte son: enfermedad de membrana hialina, infecciones, hipotermia, enterocolitis necrosante y trastornos metabólicos. Los factores de riesgo para un nacimiento prematuro y de bajo peso al nacer se relacionan con el matroambiente (cantidad de controles prenatales,
    escasez de nutrientes, enfermedades e infecciones maternas y drogadicción, el microambiente (anomalías uterinas, del cordón umbilical y del líquido amniótico, hemorragia del tercer trimestre y enfermedades fetales, el macroambiente (bajas condiciones socioeconómicas y el ambiente hospitalario (procedimientos
    invasivos e infección nosocomial.
    Estos neonatos tienen un pronóstico pobre: existe alta mortalidad
    neonatal, mayor morbimortalidad durante los dos primeros años de vida y minusvalía severa en algunos sobrevivientes.

     

     

  11. Escalating placenta invasiveness: repeated placenta accreta at the limit of viability

    Directory of Open Access Journals (Sweden)

    Greenbaum S

    2016-04-01

    Full Text Available Shirley Greenbaum,1 Alla Khashper,2 Elad Leron,1 Eric Ohana,1 Mihai Meirovitz,1 Reli Hershkovitz,1 Offer Erez1 1Department of Obstetrics and Gynecology, 2Department of Radiology, Soroka University Medical Center, School of Medicine, Ben-Gurion University of the Negev, Be’er Sheva, Israel Abstract: Placenta percreta is an obstetric condition in which the placenta invades through the myometrium. This is the most severe form of placenta accreta and may result in spontaneous uterine rupture, a rare complication that threatens the life of both mother and fetus. In this case report, we describe a 32-year-old woman in her fourth pregnancy, diagnosed with repeated placenta accreta, which was eventually complicated by spontaneous uterine rupture at 24 weeks’ gestation. This patient had a history of abnormal placentation in prior pregnancies and previous uterine injuries. This case demonstrates a pattern of escalating placental invasiveness, and raises questions regarding the process of abnormal placentation and the manifestation of uterine rupture in scarred uteri. Keywords: placenta percreta, uterine injury, laparoscopy, dilatation and curettage, residua, cesarean section scar, spontaneous uterine rupture

  12. Prevalência e fatores associados à prematuridade entre gestantes submetidas à inibição de trabalho de parto prematuro Prevalence and risk factors associated to preterm delivery among pregnant women submitted to preterm labor inhibition treatment

    Directory of Open Access Journals (Sweden)

    Lucila Coca Bezerra

    2006-06-01

    Full Text Available OBJETIVOS: identificar a prevalência de parto prematuro em gestantes submetidas ao tratamento de inibição de trabalho de parto prematuro e analisar os fatores associados. MÉTODOS: estudo transversal, com dados coletados de 163 prontuários de gestantes submetidas a tratamento de inibição de trabalho de parto prematuro atendidas em 1995-2000, no Hospital Universitário da Universidade de São Paulo, Brasil. A variável dependente constituiu-se na ocorrência de parto prematuro e as independentes foram: idade, escolaridade, ocupação, paridade, companheiro, tabagismo, infecção urinária prévia, número de consultas pré-natal e intervalo interpartal. A análise foi feita pelo teste de associação pelo Qui-quadrado e modelos de regressão logística univariado e múltiplo. RESULTADOS: 66,3% das gestantes tiveram filhos prematuros e, em 22,7% dos casos, o parto ocorreu antes de 34 semanas. Houve associação estatística significativa entre parto prematuro e ser nulípara e apresentar número baixo de consultas pré-natal. CONCLUSÕES: atenção especial deve ser dada às gestantes nulíparas e com número reduzido de consulta pré-natal submetidas ao tratamento de inibição de trabalho de parto prematuro, com a finalidade de prevenir esse evento.OBJECTIVES: to identify preterm delivery prevalence in pregnant women submitted to preterm delivery inhibition treatment and to analyze associated factors. METHODS: cross sectional study with data collected from 163 pregnant women medical files seen from 1995-2000 at the University Hospital of the University of São Paulo, Brazil. The dependent variable was preterm delivery and the independent ones were: age, education, job, parity, companion, smoking, prior urinary infection, number of prenatal medical visits and birth interval. Analysis was performed through association by the Chi-square test and univariate and multiple logistic regression models. RESULTS: 66.3% of the women had preterm

  13. A vivência de mães de recém-nascidos prematuros no processo de lactação e amamentação La vivencia de las madres de recién nacidos prematuros en el proceso de la lactación y de amamentación The living of preterm newborn's mother in the process of lactation and breastfeeding

    Directory of Open Access Journals (Sweden)

    Rosangela Venancio da Silva

    2009-03-01

    Full Text Available Este estudo qualitativo teve como objetivo geral compreender a vivência da amamentação de mães de recém-nascidos prematuros durante a internação de seus filhos e como objetivo específico descrever a performance de amamentação e condições de suas mamas e lactação, por ocasião da alta dos filhos. Adotaram-se o modelo Pesando Riscos e Benefícios como referencial de análise e o método do Discurso do Sujeito Coletivo para organização dos dados. Participaram do estudo 11 mulheres, mães de bebês prematuros internados na Unidade Neonatal do HU-USP. A entrevista semiestruturada possibilitou a elaboração de oito Discursos do Sujeito Coletivo listados em dois blocos com os seguintes temas: "Lactação e amamentação" e "Contexto hospitalar e doméstico", que possibilitaram de compreensão de que as mães deste estudo vivenciam um processo de avaliação contínua das condições de saúde, crescimento e desenvolvimento da criança, que contribui para sua motivação para amamentar e direciona suas ações no prosseguimento da amamentação.Este estudio cualitativo ha tenido como objetivo general, comprender la vivencia de amamentación de madres de recién nacidos prematuros, durante la internación de sus hijos y como objetivos específicos describir el desempeño de la amamantación y condiciones de sus mamas y lactación, en el momento del alta de sus hijos. Se ha adoptado el modelo: Pesando riesgos y beneficios, como referencial de análisis y el método del Discurso del Sujeto Colectivo para organización de los datos. Han participado del estudio 11 mujeres, madres de bebes prematuros, internados en La Unidad Neonatal del HU-USP. La entrevista semi estructurada ha posibilitado la elaboración de ocho Discursos del Sujeto Colectivo listados en dos bloques con los siguientes temas: Lactación y Amamantación y Contexto de hospital y doméstico, que han posibilitado comprender, que las madres de este estudio han vivenciado un

  14. A Case Report and Literature Review of Midtrimester Termination of Pregnancy Complicated by Placenta Previa and Placenta Accreta

    Directory of Open Access Journals (Sweden)

    Satoko Matsuzaki

    2015-04-01

    Full Text Available Objective - Concurrent placenta previa and placenta accreta increase the risk of massive obstetric hemorrhage. Despite extensive research on the management of placenta previa (including placenta accreta, increta, and percreta, the number and quality of previous studies are limited. We present a case of placenta accreta requiring an induced second-trimester abortion because of premature rupture of the membranes (PROM. Study Design - Case report and review of the literature. Results - A 41-year-old female presented at 20 weeks of gestation with placenta previa and PROM. Ultrasonography revealed placenta accreta with multiple placental lacunae. She then developed massive hemorrhaging just prior to a planned termination of pregnancy. We performed a hysterectomy with the intent of preserving life because of the failure of the placenta to detach and blood loss totaling 4,500 mL. Conclusion - Previous studies suggest that second-trimester pregnancy terminations in cases of placenta previa which are not complicated with placenta accreta do not have a particularly high risk of hemorrhage. However, together with our case, the literature suggests that placenta previa complicated with placenta accreta presents a significant risk of hemorrhage both during delivery and intraoperatively. Further reports are needed to evaluate the most appropriate treatment options.

  15. A Case Report and Literature Review of Midtrimester Termination of Pregnancy Complicated by Placenta Previa and Placenta Accreta.

    Science.gov (United States)

    Matsuzaki, Satoko; Matsuzaki, Shinya; Ueda, Yutaka; Tanaka, Yusuke; Kakuda, Mamoru; Kanagawa, Takeshi; Kimura, Tadashi

    2015-04-01

    Objective Concurrent placenta previa and placenta accreta increase the risk of massive obstetric hemorrhage. Despite extensive research on the management of placenta previa (including placenta accreta, increta, and percreta), the number and quality of previous studies are limited. We present a case of placenta accreta requiring an induced second-trimester abortion because of premature rupture of the membranes (PROM). Study Design Case report and review of the literature. Results A 41-year-old female presented at 20 weeks of gestation with placenta previa and PROM. Ultrasonography revealed placenta accreta with multiple placental lacunae. She then developed massive hemorrhaging just prior to a planned termination of pregnancy. We performed a hysterectomy with the intent of preserving life because of the failure of the placenta to detach and blood loss totaling 4,500 mL. Conclusion Previous studies suggest that second-trimester pregnancy terminations in cases of placenta previa which are not complicated with placenta accreta do not have a particularly high risk of hemorrhage. However, together with our case, the literature suggests that placenta previa complicated with placenta accreta presents a significant risk of hemorrhage both during delivery and intraoperatively. Further reports are needed to evaluate the most appropriate treatment options.

  16. Clinical predictors of abnormal esophageal pH monitoring in preterm infants Preditores clínicos para pHmetria esofágica anormal em prematuros

    Directory of Open Access Journals (Sweden)

    Maria Aparecida Mezzacappa

    2008-09-01

    Full Text Available BACKGROUND: Risk factors for gastroesophageal reflux disease in preterm neonates have not been yet clearly defined. AIM: To identify factors associated with increased esophageal acid exposition in preterm infants during the stay in the neonatal unit. METHODS: A case-control study in preterm infants who had undergone prolonged monitoring of distal esophageal pH, following clinical indication. Eighty-seven preterms with reflux index (percentage of total time of esophageal pHmetry >10% (cases and 87 unpaired preterms were selected with reflux index 10% in preterms were: vomiting, regurgitation, Apnea, female gender. The variables that were associated with a lower frequency of increased reflux index were: volume of enteral intake at the onset of symptoms >147 mL/kg/day, and postnatal corticoid use. CONCLUSIONS: Vomiting, regurgitation, apnea, female gender and acute respiratory distress during the first week of life were variables predictive of increased esophageal acid exposition in preterm infants with birthweight 10%.RACIONAL: Os fatores de risco para a doença pelo refluxo gastroesofágico em recém-nascidos prematuros não foram, até momento, claramente estabelecidos. OBJETIVO: Identificar fatores associados ao aumento da exposição ácida intra-esofágica em prematuros durante o período de internação em unidade neonatal. MÉTODOS: Realizou-se estudo de caso controle com prematuros que realizaram monitorização prolongada do pH esofágico por suspeita clínica de doença do refluxo. Foram selecionados 87 recém-nascidos com valor do índice de refluxo (percentual do tempo total do exame com pH abaixo de 4 >10% (casos e 87 recém-nascidos com índice de refluxo 10% foram: vômitos, regurgitações, apnéia, sexo feminino e insuficiência respiratória na 1ª semana de vida. As variáveis que se associaram a menor freqüência de índice de refluxo 147mL/kg/d e uso de corticóide pós-natal. CONCLUSÕES: Vômitos, regurgitações, apn

  17. A Case Report and Literature Review of Midtrimester Termination of Pregnancy Complicated by Placenta Previa and Placenta Accreta

    OpenAIRE

    Matsuzaki, Satoko; Matsuzaki, Shinya; Ueda, Yutaka; Tanaka, Yusuke; Kakuda, Mamoru; Kanagawa, Takeshi; Kimura, Tadashi

    2014-01-01

    Objective - Concurrent placenta previa and placenta accreta increase the risk of massive obstetric hemorrhage. Despite extensive research on the management of placenta previa (including placenta accreta, increta, and percreta), the number and quality of previous studies are limited. We present a case of placenta accreta requiring an induced second-trimester abortion because of premature rupture of the membranes (PROM). Study Design - Case report and review of the literature. Results -...

  18. Relação entre a qualidade da assistência pré-natal e a prematuridade: Uma revisão integrativa

    Directory of Open Access Journals (Sweden)

    Vanessa Andréia Wachholz

    2016-04-01

    Full Text Available A prematuridade é um dos grandes problemas de saúde pública, por contribuir fortemente para a elevada taxa de morbimortalidade infantil. Possíveis fatores de risco que colaboram para sua ocorrência têm sido investigados, dentre eles a assistência pré-natal, pois a mesma é elencada em virtude de, por meio dela, ser possível prevenir, diagnosticar e tratar eventos indesejáveis que possam resultar em danos para mãe e o recém-nascido. Objetivou-se identificar a produção cientifica sobre a associação entre a prematuridade e a qualidade da assistência pré-natal. Revisão integrativa com coleta de dados realizada de março a junho de 2014 utilizando o descritor trabalho de parto prematuro nas bases de dados Scientific Eletronic Library Online e Literatura Internacional em Ciências da Saúde. Os artigos foram organizados conforme o assunto abordado, sendo criadas três categorias: fatores de risco para o parto prematuro, prevenção ao parto prematuro e assistência pré-natal e parto prematuro. Embora tenham sido encontrados poucos estudos relacionando o parto prematuro e a realização do pré-natal, cabe ressaltar a importância da realização de uma assistência pré-natal adequada, de acordo com o que o Ministério da Saúde preconiza por meio de uma rotina mínima. Ela é importante para detectar e tratar precocemente determinadas complicações que levam, entre outros desfechos indesejáveis, ao parto prematuro. Relationship between the quality of service pre -natal and a prematurity: An integrative reviewAbstract: Prematurity is a one of the major problem of public health, for contributing to the high rate of infant morbidity and mortality. Possible risk factors that collaborate to their occurrence have been investigated, including prenatal assistance, because through it, be possible to prevent, diagnose and treat adverse events that may result in damage to mother and the newborn. The objective identify the scientific

  19. Placenta: How It Works, What's Normal

    Science.gov (United States)

    ... placental problems include placental abruption, placenta previa and placenta accreta. These conditions can cause potentially heavy vaginal bleeding. ... health care provider will recommend a C-section. Placenta accreta. This condition occurs when the blood vessels and ...

  20. Management of placenta percreta

    DEFF Research Database (Denmark)

    Clausen, Caroline; Lönn, Lars; Langhoff-Roos, Jens

    2014-01-01

    in the management of the conditions. A PubMed search was performed in April 2013 and the final review included 119 published placenta percreta cases. Conservative management, where the placenta is left in situ for resorption, seems to be associated with severe long-term complications of hemorrhage and infections......Publications on abnormally invasive placenta in general report what can be considered a mixture of the conditions true accreta, increta and percreta varieties. The aim of this review was to identify all published cases of the most severe condition, placenta percreta in order to describe...... cases for the local resection technique might in part explain the lower complication rates with that approach. Future prospective data collection activities should include intended as well as actual management, and long-term follow-up of all cases is of vital importance....

  1. Relación entre enfermedad periodontal y parto prematuro. Bajo peso al nacimiento: una revisión de la literatura

    OpenAIRE

    Flores, J.; Oteo, A.; Mateos, L.; Bascones, A.

    2004-01-01

    A pesar de los esfuerzos realizados en el control del embarazo y el parto, la frecuencia de los partos prematuros no ha disminuido en las dos últimas décadas. El parto prematuro supone una seria amenaza para la salud del recién nacido, y representa además un porcentaje muy importante de los costes destinados a la atención sanitaria perinatal. La investigación científica ha revelado diversos mecanismos por los que infecciones remotas como la enfermedad periodontal pueden participar en la patog...

  2. Postpartum MR diagnosis of retained placenta accreta

    International Nuclear Information System (INIS)

    Tanaka, Yumiko Oishi; Itai, Yuji; Shigemitsu, Sadahiko; Ichikawa, Yoshihito; Sohda, Satoshi; Yoshikawa, Hiroyuki

    2004-01-01

    Retained placenta accreta can cause catastrophic postpartum hemorrhage. This study aims to determine whether MR imaging can differentiate retained placenta accreta from postpartum hemorrhage caused by other conditions. Fourteen cases suspicious for retained placenta were examined with MR imaging. Signal intensity, the enhancing pattern of uterine contents, and flow voids within the myometrium were retrospectively studied. As hysterectomy was performed in only two cases, final diagnosis was based on clinical outcome and analysis of uterine contents. Final diagnoses were retained placenta accreta in seven cases, retained normally attached placenta in four, hematoma in two, and placental site trophoblastic tumor (PSTT) in one. All seven cases with placenta accreta had a very hyperintense area on T2-weighted images, showing transient early enhancement. None demonstrated delayed strong enhancement around the hyperintense area. In two cases with retained normally attached placenta and in both with hematomas, there were no hyperintense areas on T2-weighted images. Of these, only one showed transient early enhancement. Flow voids were observed in four cases with placenta accreta, one with normally attached placenta, and the case with PSTT. A markedly hyperintense area on T2-weighted images and transient early enhancement without delayed strong enhancement between the mass and the myometrium can indicate retained placenta accreta. (orig.)

  3. Postpartum MR diagnosis of retained placenta accreta

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Yumiko Oishi; Itai, Yuji [Department of Radiology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, 305-8575, Tsukuba, Ibaraki (Japan); Shigemitsu, Sadahiko [Department of Obstetrics and Gynecology, Ryugasaki Saiseikai General Hospital, Ryagasaki (Japan); Ichikawa, Yoshihito; Sohda, Satoshi; Yoshikawa, Hiroyuki [Department of Obstetrics and Gynecology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, 305-8575, Tsukuba, Ibaraki (Japan)

    2004-06-01

    Retained placenta accreta can cause catastrophic postpartum hemorrhage. This study aims to determine whether MR imaging can differentiate retained placenta accreta from postpartum hemorrhage caused by other conditions. Fourteen cases suspicious for retained placenta were examined with MR imaging. Signal intensity, the enhancing pattern of uterine contents, and flow voids within the myometrium were retrospectively studied. As hysterectomy was performed in only two cases, final diagnosis was based on clinical outcome and analysis of uterine contents. Final diagnoses were retained placenta accreta in seven cases, retained normally attached placenta in four, hematoma in two, and placental site trophoblastic tumor (PSTT) in one. All seven cases with placenta accreta had a very hyperintense area on T2-weighted images, showing transient early enhancement. None demonstrated delayed strong enhancement around the hyperintense area. In two cases with retained normally attached placenta and in both with hematomas, there were no hyperintense areas on T2-weighted images. Of these, only one showed transient early enhancement. Flow voids were observed in four cases with placenta accreta, one with normally attached placenta, and the case with PSTT. A markedly hyperintense area on T2-weighted images and transient early enhancement without delayed strong enhancement between the mass and the myometrium can indicate retained placenta accreta. (orig.)

  4. A experiência de tornarem-se pais de prematuro: um enfoque etnográfico La experiencia de tornarse padres de recién nacido prematuro: un enfoque etnográfico The experience of becoming parents of premature infant: an etnographic approach

    Directory of Open Access Journals (Sweden)

    Dayse Maria Rizatto Tronchin

    2005-02-01

    Full Text Available Estudo com objetivo de compreender a experiência de pais de prematuro de muito baixo peso egresso da terapia intensiva neonatal de um hospital de ensino. Como referencial metodológico foi utilizado a etnografia na perspectiva interpretativa. Os dados foram coletados por meio de observação participante e entrevista realizadas com seis casais. Da análise emergiram seis categorias e dois temas culturais: "a capacidade para tornarem-se pais: momentos de luta e crescimento" e "o cuidar e conviver com o filho". Os pais vivenciaram todo o processo permeado pela ambivalência de sentimentos onde o medo e a esperança predominaram, como experiência marcante e transformadora. Sentiram-se capacitados para cuidar da criança e reconheceram obstáculos socioculturais para desempenharem os papéis de pai e mãe.Este estudio se realizó con el objetivo de comprender la experiencia de padres de recién nacido prematuro de muy bajo peso egresado de la unidad de cuidado intensivo neonatal de un hospital de enseñanza. Como referencial metodológico se utilizó la etnografía en la perspectiva interpretativa. Los datos fueron recoletados por medio de observación participante y entrevistas realizadas a seis parejas. Del análisis emergieron seis categorías culturales que evidenciaron dos temas: "la capacidad para tornarse padres: momentos de lucha y crecimiento" y "el cuidar y convivir con el hijo". Los padres vivenciaron todo el proceso permeado por la ambivalencia de sentimientos donde el miedo y la esperanza predominaron, como experiencia marcante y transformadora. Se sintieron capacitados para cuidar al niño y reconocieron obstáculos socioculturais para desempeñar los papeles de padre y madre.The aim of this study was to understand the experience of the parents of premature newborn infant of very low birth weight, dischargedfrom Neonatal and Pediatric Intensive Care of the University Hospital. It was conducted through qualitative approach, using

  5. Early neurobehavioral development of preterm infants Desenvolvimento neurocomportamental inicial de bebês prematuros

    Directory of Open Access Journals (Sweden)

    Paula Stefaneli Ziotti Gabriel

    2013-01-01

    Full Text Available The aim of the present study was to assess the very early neurobehavioral development of preterm infants and to examine differences regarding sex. Two-hundred and two preterm infants were assessed by the Neurobehavioral Assessment of the Preterm Infant (NAPI, which was carried out at 32-37 weeks post-conceptional age in the hospital setting. The infants' performance was compared to a norm-referenced sample and a comparison between groups regarding sex was also done. In comparison to the NAPI norm-reference, the preterm infants showed less muscular tonicity on the scarf sign, less vigor and spontaneous movement, higher alertness and orientation, weaker cry, and more sleep state. There was no statistical difference between males and females preterm infants at NAPI performances.O objetivo do estudo foi avaliar o desenvolvimento neurocomportamental inicial de bebês prematuros e examinar as diferenças quanto ao sexo. Foram avaliados 202 bebês nascidos pré-termo pela Avaliação Neurocomportamental para Prematuros (NAPI, que foi realizada na fase de 32-37 semanas de idade pós-concepcional no contexto hospitalar. O desempenho dos bebês no NAPI foi comparado com a amostra de padronização do instrumento e também foi feita a comparação entre grupos diferenciados pelo sexo. Em relação à amostra de padronização, os bebês deste estudo apresentaram menor tonicidade muscular no sinal de cachecol, menor vigor e movimento espontâneo, mais alerta e orientação, choro mais fraco e mais estado de sono. Houve um padrão semelhante de desempenho neurocomportamental dos meninos e meninas nascidos prematuros.

  6. Impacto dos fatores perinatais nos déficits de crescimento de prematuros Impact of perinatal factors on growth deficits of preterm infants

    Directory of Open Access Journals (Sweden)

    Ana Lucia Goulart

    2011-06-01

    Full Text Available OBJETIVO: Analisar fatores perinatais associados a déficit de crescimento em prematuros com 1 ano de idade corrigida. MÉTODOS: Estudo de coorte de prematuros com peso ao nascer 1.500 g. A chance de C/I 1.500 g. CONCLUSÃO: Com 1 ano de idade corrigida, prematuros nascidos com peso OBJECTIVE: To review perinatal factors associated with a growth deficit in preterm infants at a corrected age of one year. METHODS: Cohort study of preterm infants with a birth weight 1,500 g. As birth length was reduced, the odds for L/A 1,500 g. CONCLUSION: At a corrected age of one year, preterm infants with a birth weight < 2,000 g were found with high growth deficits frequencies, and associated factors were variable, depending on the analyzed deficit, with intrauterine and postnatal growth restriction being outstanding predictors.

  7. Smoking and other pre-gestational risk factors for spontaneous preterm birth Tabagismo e outros fatores de risco pré-gestacional para nascimento espontâneo prematuro

    Directory of Open Access Journals (Sweden)

    Eugênio Grillo

    2011-12-01

    Full Text Available OBJECTIVES: to investigate pre-gestational risk factors for spontaneous preterm birth and, the role of smoking and its cumulative effects on prematurity. METHODS: a case-control study analyzed a data set of all births occurring in a tertiary maternity hospital between April 2002 and July 2004. Spontaneous preterm births of single and live newborns without malformations were selected as cases. Controls were all the term births of live and single newborns without malformations during the same period. Three outcomes were studied: all preterm births (OBJETIVOS: investigar fatores de risco pré-gestacional para nascimento espontâneo prematuro e o papel do tabagismo e seus efeitos cumulativos na prematuridade. MÉTODOS: um estudo transversal baseado em um banco de dados maternos e perinatais, analisou todos os nascimentos ocorridos, em um hospital terciário, no período de abril de 2002 a julho de 2004. Nascimentos prematuros, únicos e espontâneos, de nascidos vivos, sem malformações, foram selecionados como casos. Controles foram selecionados como nascidos vivos e a termo, únicos e sem malformações durante o mesmo período. Três desfechos foram estudados: todos nascimentos prematuros com menos de 37 semanas, aqueles com menos de 35 e 32 semanas de gestação. Regressão Logística foi utilizada na determinação do efeito independente de cada um dos fatores de risco. RESULTADOS: idade materna de menos de 20 anos, baixa escolaridade, baixo índice de massa corporal pré-gestacional e tabagismo se mostraram independente e significativamente associados com nascimento espontâneo e prematuro para os três desfechos. Para todos os fatores de risco, exceto tabagismo materno, as razões de chance aumentaram linearmente com o decréscimo da idade gestacional. O teste para tendência linear se mostrou significante para idade materna de menos de 20 anos e para baixo índice de massa corporal pré-gestacional. CONCLUSÕES: os efeitos cumulativos do

  8. Increased placental trophoblast inclusions in placenta accreta.

    Science.gov (United States)

    Adler, E; Madankumar, R; Rosner, M; Reznik, S E

    2014-12-01

    Trophoblast inclusions (TIs) are often found in placentas of genetically abnormal gestations. Although best documented in placentas from molar pregnancies and chromosomal aneuploidy, TIs are also associated with more subtle genetic abnormalities, and possibly autism. Less than 3% of non-aneuploid, non-accreta placentas have TIs. We hypothesize that placental genetics may play a role in the development of placenta accreta and aim to study TIs as a potential surrogate indicator of abnormal placental genetics. Forty cases of placenta accreta in the third trimester were identified in a search of the medical records at one institution. Forty two third trimester control placentas were identified by a review of consecutively received single gestation placentas with no known genetic abnormalities and no diagnosis of placenta accreta. Forty percent of cases with placenta accreta demonstrated TIs compared to 2.4% of controls. More invasive placenta accretas (increta and percreta) were more likely to demonstrate TIs than accreta (47% versus 20%). Prior cesarean delivery was more likely in accreta patients than controls (67% versus 9.5%). Placenta accreta is thought to be the result of damage to the endometrium predisposing to abnormal decidualization and invasive trophoblast growth into the myometrium. However, the etiology of accreta is incompletely understood with accreta frequently occurring in women without predisposing factors and failing to occur in predisposed patients. This study has shown that TIs are present at increased rates in cases of PA. Further studies are needed to discern what underlying pathogenic mechanisms are in common between abnormal placentation and the formation of TIs. Published by Elsevier Ltd.

  9. Placenta accreta and anesthesia: A multidisciplinary approach

    OpenAIRE

    R S Khokhar; J Baaj; M U Khan; F A Dammas; N Rashid

    2016-01-01

    Placenta accreta (an abnormally adherent placenta) is one of the two leading causes of peripartum hemorrhage and the most common indication for peripartum hysterectomy. Placenta accreta may be associated with significant maternal hemorrhage at delivery owing to the incomplete placental separation. When placenta accreta is diagnosed before delivery, a multidisciplinary approach may improve patient outcome.

  10. Placenta accreta and anesthesia: A multidisciplinary approach

    Directory of Open Access Journals (Sweden)

    R S Khokhar

    2016-01-01

    Full Text Available Placenta accreta (an abnormally adherent placenta is one of the two leading causes of peripartum hemorrhage and the most common indication for peripartum hysterectomy. Placenta accreta may be associated with significant maternal hemorrhage at delivery owing to the incomplete placental separation. When placenta accreta is diagnosed before delivery, a multidisciplinary approach may improve patient outcome.

  11. Lesao nasal precoce pelo uso da pronga nasal em recem-nascidos prematuros de muito baixo peso: estudo piloto

    Directory of Open Access Journals (Sweden)

    Nathalie Tiemi Ota

    2013-09-01

    Full Text Available OBJETIVO: Analisar, em recém-nascidos de muito baixo peso e com indicação de ventilação não invasiva via pronga nasal, a incidência do aparecimento precoce de lesão nasal. MÉTODOS: Série de casos prospectiva de nascidos com idade gestacional <37 semanas, peso <1.500g e idade pós-natal <29 dias. Os pacientes foram avaliados desde a instalação da pronga nasal até o 3o dia de uso, três vezes ao dia. Foram analisadas as condições clínicas dos pacientes, características do dispositivo e de sua aplicação. A análise inicial foi descritiva, verificando-se a prevalência de lesão nasal bem como os fatores a ela associados. Os dados categóricos foram analisados por qui-quadrado ou exato de Fisher e os dados numéricos, por teste t ou Mann-Whitney. RESULTADOS: Dezoito recém-nascidos foram incluídos, dos quais 12 (idade gestacional de 29,8±3,1 semanas, peso ao nascer de 1.070±194g e Score for Neonatal Acute Phisiology - Perinatal Extension (SNAPPE de 15,4±17,5 evoluíram com lesão nasal (Grupo Lesão e 6 (idade gestacional de 28,0±1,9 semanas, peso de 1.003±317g e SNAPPE de 26,2±7,5 não apresentaram lesão nasal (Grupo Sem Lesão. No Grupo Lesão, houve maior frequência do gênero masculino (75% versus 17%, a lesão apareceu em média após 18 horas e predominantemente no período notur no (75%. CONCLUSÃO: A incidência de lesão nasal em prematuros submetidos à ventilação não invasiva via pronga nasal foi elevada, sendo possível planejar estudo dos fatores associados, com base neste piloto.

  12. Fatores perinatais associados ao óbito precoce em prematuros nascidos nos centros da Rede Brasileira de Pesquisas Neonatais Perinatal factors associated with early deaths of preterm infants born in Brazilian Network on Neonatal Research centers

    Directory of Open Access Journals (Sweden)

    Maria Fernanda Branco de Almeida

    2008-08-01

    Full Text Available OBJETIVO: Avaliar os fatores perinatais associados ao óbito neonatal precoce em prematuros com peso ao nascer entre 400 e 1.500 g. MÉTODOS: Coorte prospectiva e multicêntrica dos nascidos vivos com idade gestacional de 23 a 33 semanas e peso de 400-1.500 g, sem malformações em oito maternidades públicas terciárias universitárias entre junho de 2004 e maio de 2005. As características maternas e neonatais e a morbidade nas primeiras 72 horas de vida foram comparadas entre os prematuros que morreram ou sobreviveram até o sexto dia de vida. As variáveis perinatais associadas ao óbito neonatal precoce foram determinadas por regressão logística. RESULTADOS: No período, 579 recém-nascidos preencheram os critérios de inclusão. O óbito precoce ocorreu em 92 (16% neonatos, variando entre as unidades de 5 a 31%, e tal diferença persistiu controlando-se por um escore de gravidade clínica (SNAPPE-II. A análise multivariada para o desfecho óbito neonatal intra-hospitalar precoce mostrou associação com: idade gestacional de 23-27 semanas (odds ratio - OR = 5,0; IC95% 2,7-9,4, ausência de hipertensão materna (OR = 1,9; IC95% 1,0-3,7, Apgar 0-6 no 5º minuto (OR = 2,8; IC95% 1,4-5,4, presença de síndrome do desconforto respiratório (OR = 3,1; IC95% 1,4-6,6 e centro em que o paciente nasceu. CONCLUSÃO: Importantes fatores associados ao óbito neonatal precoce em prematuros de muito baixo peso são passíveis de intervenção, como a melhora da vitalidade fetal ao nascer e a diminuição da incidência e gravidade da síndrome do desconforto respiratório. As diferenças de mortalidade encontradas entre os centros apontam para a necessidade de identificar as melhores práticas e adotá-las de maneira uniforme em nosso meio.OBJECTIVE:To evaluate perinatal factors associated with early neonatal death in preterm infants with birth weights (BW of 400-1,500 g. METHODS: A multicenter prospective cohort study of all infants with BW of 400

  13. [MANAGEMENT OF PLACENTA ACCRETA, DIAGNOSED BEFORE BIRTH].

    Science.gov (United States)

    Dimitrov, A; Garnizov, T; Frundeva, B; Masseva, A; Zlatkov, V

    2015-01-01

    The optimal management of placenta accreta and until now remains unclear. The reasons for this are a rarity of this condition and the considerable heterogeneity of the group under the term "placenta accreta." Total hysterectomy during caesarean section is the most common approach to a known placenta accreta. Planned or emergency perinatal hysterectomy is associated with several complications--damage to the urinary tract, relaparotomiya, massive blood transfusions and stay in ICU. The average blood loss is about 3000 ml. To reduce blood loss in perinatal hysterectomy contribute: preliminary uterine artery occlusion, istmus-coporal longitudinal hysterectomy for extraction of the fetus, placental extraction along with the uterus. To save the woman's uterus at placenta accreta are using the following methods: cutting the uterine wall on which is located the placenta, imposing single stitches covering 2-3 cm in 1 cm, around the placental area; removal of the maximum possible part of the placenta; using longitudinal hysterectomy. So far, there are no comparative studies of the efficacy of different surgical techniques to preserve the uterus cases of placenta accreta. Extraction of the placenta to be done after the administration of uterotonics and devascularization the uterus. To reduce bleeding from the uterus after removal of parts of the placenta and according to the situation can be used: x-back hemostatic sutures from internal side of the uterus, tamponade with gauze roll, balloon catheters or haemostatic mushrooms. Conservative surgical treatment of placenta accreta is not always possible. In hospital Maternity Hospital-Sofia for the period 1986-2000 there were 17 cases of placenta accreta diagnosed only at birth. Maintaining the uterus was successful in 35% of these cases.

  14. Método madre canguro manejo ambulatorio del prematuro

    Directory of Open Access Journals (Sweden)

    Edgar Rey Sanabria

    1986-07-01

    Full Text Available En el Instituto Materno Infantil (lMI, donde se atienden aproximadamente 21.000 partos cada año, hay un índice de prematuros entre e114% y eI17%. Anteriormente los prematuros eran tratados de acuerdo con las normas convencionales. La alta mortalidad, que ocurría en ese entonces, obligó al IMI a cambiar esas normas y se obtuvieron los más positivos resultados, que sobrepasan los índices de las naciones más avanzadas. La alimentación natural se inicia, ofrecida directamente par la madre, en el servicio mismo. Sin consideración del peso del pequeño, y con base únicamente en su estado clínico, el niño va con su madre para que ella lo caliente, estimule y alimente, tanto orgánica como afectivamente, en su casa. Se hacen con troles domiciliarios especiales, y además se dan conferencias educativas como parte básica del programa. En dos años de experiencia se ha demostrado: la absoluta desaparición de enfermedades como la enterocolitis necrosante, y de diarreas, sepsis y entidades bacterianas del aparato respiratorio. Igualmente hay una baja significativa del índice de abandono y de los costos hospitalarios (cama, medicación, leches especiales, papillas, etc.. Se estableció estadísticamente que la supervivencia para niños con peso inferior a 1.000 gr. pas6 de 0% a 72.3%; para niños entre 1.001 gr. y 1.500 gr. subió de 27.3% a 89.04% y para niños entre 1.501 gr. y 2.000 gr. subi6 de 81.5% a 94%.

  15. Pseudotumors of the placenta.

    Science.gov (United States)

    Bruner, Evelyn T

    2016-01-01

    The placenta is one of the most common gross pathology specimens encountered by surgical pathologists, yet primary tumors are exceptionally rare and even rarer are entities with the potential to mimic malignancy. There are many nonneoplasticmass forming lesions in the placenta that are important to be aware of as many of these can be associated with adverse outcomes in the mother and fetus. Also important are entities which may be observed microscopically in the placenta and potentially confused as a malignancy. Knowledge of these potential pitfalls is essential to avoid making an incorrect diagnosis and causing undue alarm. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Madres descubriendo el amor incondicional en el proceso adaptativo de hospitalización de su bebé prematuro

    Directory of Open Access Journals (Sweden)

    Beatriz Villamizar Carvajal

    2014-11-01

    Full Text Available Introducción: El nacimiento prematuro tiene un impacto social y emocional para la familia, por lo tanto, enfermería tiene el reto de indagar y profundizar sobre las diversas experiencias; para proponer intervenciones que favorezcan el desempeño del rol materno. Objetivo: Describir los resultados de un metaestudio sobre la adquisición del rol materno de la madre con un recién nacido prematuro hospitalizado. Materiales y Métodos: El metaestudio, involucra 3 fases analíticas: análisis metadatos, meta-método, meta-teoría, consideradas a la luz del contexto histórico, sociocultural y disciplinar. La búsqueda se realizó en: CINAHL, Medline, PsycINFO, Dissertation Abstracts. Resultados: Se incluyeron 26 investigaciones de 13 países publicadas en inglés, portugués y español (durante los años 2001-2013. Las expresiones categóricas que emergen de estas investigaciones, son: pérdida de autocontrol; experimentando dolor; buscando significado a los eventos; adaptándose a la situación; adquiriendo el rol materno y descubriendo el amor incondicional. Discusión: El metaestudio permitió el análisis crítico de la información, orientando la investigación dentro de un contexto de patrones sistemáticos, con la construcción de una alternativa de cambio del enfoque tradicional de pérdida y sufrimiento al del redescubrimiento desde la visión positiva y transformativa. Conclusiones: Reconocer la carga emocional de las madres de recién nacido prematuro obliga al equipo de salud a intervenir e idear estrategias de apoyo, para hacer menos doloroso el proceso de hospitalización de sus hijos.  Por ello el cuidado humanizado en la unidad neonatal, debe centrar sus acciones en un cuidado individual, singular, en la integralidad y respeto por la vida.Palabras clave: Maternidad, Recién Nacido Prematuro, Enfermería Neonatal. (Fuente: DeCs BIREME.Cómo citar este artículo: Villamizar B, Vargas C, Rueda E. Madres descubriendo el amor

  17. Evaluation of the virtual learning object "Diagnostic reasoning in nursing applied to preterm newborns" Evaluación del objeto virtual de aprendizaje "Raciocinio diagnóstico en enfermería aplicado al prematuro" Avaliação do objeto virtual de aprendizagem "Raciocínio diagnóstico em enfermagem aplicado ao prematuro"

    Directory of Open Access Journals (Sweden)

    Fernanda dos Santos Nogueira de Góes

    2011-08-01

    de informática. Se considera que el producto desarrollado está adecuado para ser colocado a disposición para uso en la enseñanza de estudiantes y en la educación permanente de enfermeros sobre raciocinio diagnóstico en la elaboración de Diagnósticos de Enfermería aplicados al prematuro, dentro del marco pedagógico de la problematización.Vislumbrando o potencial de uso da informática, na formação e educação permanente em enfermagem, realizou-se o presente estudo com o objetivo de avaliar objeto virtual de aprendizagem raciocínio diagnóstico em enfermagem aplicado ao prematuro, em unidade de cuidado intermediário neonatal. Trata-se de estudo descritivo sobre a avaliação da aparência e conteúdo do objeto virtual, nos aspectos relacionados à apresentação, organização, usabilidade e impressão geral. Participaram peritos das áreas de informática (12 e enfermagem (31. Cada subitem dos instrumentos continha avaliação em escala Likert e espaço para inclusão de comentários/sugestões. Todos os itens foram avaliados positivamente por mais de 80% dos avaliadores, exceto o critério densidade informacional na avaliação dos profissionais de informática. Considera-se que o produto desenvolvido está adequado para ser disponibilizado para uso no ensino de estudantes e educação permanente de enfermeiros, sobre raciocínio diagnóstico na elaboração de diagnósticos de enfermagem, aplicados ao prematuro, inserido no referencial pedagógico da problematização.

  18. Modelo predictivo de parto prematuro basado en factores de riesgo

    OpenAIRE

    Abad Chamorro, Inés

    2016-01-01

    Se entiende como parto prematuro aquel que tiene lugar antes de la semana 37 de gestación. Puede ser causado, principalmente, por una infección uterina, una rotura prematura de las membranas, una distensión uterina, o un reconocimiento inmunológico materno-fetal insuficiente. Hay toda una serie de factores de riesgo que se asocian epidemiológicamente con la prematuridad, por lo que su control o desaparición podrían disminuir la prevalencia de este hecho. El objetivo del presente estudio es di...

  19. A novel scoring system for predicting adherent placenta in women with placenta previa.

    Science.gov (United States)

    Tanimura, Kenji; Morizane, Mayumi; Deguchi, Masashi; Ebina, Yasuhiko; Tanaka, Utaru; Ueno, Yoshiko; Kitajima, Kazuhiro; Maeda, Tetsuo; Sugimura, Kazuro; Yamada, Hideto

    2018-04-01

    Placenta previa (PP) is one of the most significant risk factors for adherent placenta (AP). The aim of this study was to evaluate the diagnostic efficacy of a novel scoring system for predicting AP in pregnant women with PP. This prospective cohort study enrolled 175 women with PP. The placenta previa with adherent placenta score (PPAP score) is composed of 2 categories: (1) past history of cesarean section (CS), surgical abortion, and/or uterine surgery; and (2) ultrasonography and magnetic resonance imaging findings. Each category is graded as 0, 1, 2, or 4 points, yielding a total score between 0 and 24. When women with PP had PPAP score ≥8, they were considered to be at a high risk for AP and received placement of preoperative internal iliac artery occlusion balloon catheters. If they were found to have AP during CS, they underwent hysterectomy or placenta removal using advanced bipolar with balloon catheter occlusion. The predictive accuracy of PPAP score was evaluated. In total, 23 of the 175 women with PP were diagnosed as having AP, histopathologically or clinically. Twenty-one of 24 women with PPAP score ≥8 had AP, whereas two of 151 women with PPAP score PPAP scoring system may be useful for predicting AP in women with PP. Copyright © 2018 Elsevier Ltd. All rights reserved.

  20. Reliability of trans-abdominal ultrasonography in determining exact location of placenta in patients of placenta previa major

    International Nuclear Information System (INIS)

    Zafar, M.; Hayat, N; Gul, U.

    2017-01-01

    Objective: To determine the reliability of trans-abdominal ultrasonographical localization of placenta in cases of placenta previa major, by taking peroperative finding as gold standard. Study Design: Validation study. Place and Duration of Study: Maternity ward, Obstetrics and Gynecology department, Military Hospital Rawalpindi from 2007 to 2008. Patients and Methods: A total of 100 patients fulfilling the inclusion and exclusion criteria were recruited for the study. These patients were admitted to the maternity ward, where trans-abdominal ultrasound was performed, site of the placenta and its relation to the internal os was documented. These patients under went elective cesarean section, during which the site and relation of the placenta to the internal os was confirmed. Results: The mean age of patients was 34.23 +- 6.76 years. Transabdominal ultrasound had a sensitivity of 93.4 percent in localizing major placenta previa while the specificity was 83 percent. Positive predictive value was 94.7 percent, negative predictive value was 80 percent and accuracy 91 percent. Conclusion: Trans-abdominal ultrasound was found highly effective in diagnosing and localizing placenta previa. (author)

  1. Relação entre a Classificação Clínica de White e a Histopatologia das Placentas de Gestantes Diabéticas The Relationship between White's Classification and the Histopathological Changes in the Placentas of Diabetic Pregnant Women

    Directory of Open Access Journals (Sweden)

    Iracema de Mattos Paranhos Calderon

    2000-08-01

    Full Text Available Objetivo: analisar a relação entre a classificação clínica de White e as alterações histopatológicas de placentas de gestantes diabéticas, comparando, de forma qualitativa, as alterações histopatológicas de placentas de gestantes não-diabéticas e diabéticas gestacionais (classes A e A/B, clínicas de curta duração (classes B e C e clínicas com vasculopatia (classes D a FRH, no termo e no pré-termo, e de acordo com a qualidade do controle glicêmico na gestação. Pacientes e Métodos: foram colhidas amostras de placentas de todas as gestantes diabéticas, atendidas entre 1991 e 1996 na Maternidade do Hospital das Clínicas da Faculdade de Medicina de Botucatu, coradas pela técnica de hematoxilina-eosina e submetidas a exame histopatológico. A qualidade do controle glicêmico foi analisada pela média glicêmica da gestação e classificada em adequada e inadequada, com limite de 120 mg/dl. A idade da gestação foi individualizada em termo e pré-termo. Resultados: observou-se que 42 recém-nascidos (43,3% eram de termo e o restante, de pré-termo (56,7%. O índice de prematuridade foi maior nas diabéticas clínicas (classes B e C; D a FRH. Algumas alterações histopatológicas só foram encontradas em placentas de gestantes diabéticas: degeneração cistóide, edema corial, edema da íntima, dismaturidade, hiperplasia das células de Hofbauer, vilite, células fantasmas, dois vasos no cordão umbilical e endarterite. Conclusões: as alterações histopatológicas de placentas de gestantes com diabete gestacional (classes A e A/B, clínico de curta duração (classes B e C e clínico com vasculopatia (classes D a FRH foram semelhantes às das não-diabéticas e, portanto, independeram da classificação clínica de White. As alterações histopatológicas de placentas de gestantes diabéticas não se relacionaram com a idade gestacional ao nascimento e com a qualidade do controle glicêmico materno. A comparação entre

  2. Combinación de agentes tocolíticos para la inhibición del trabajo de parto prematuro

    Directory of Open Access Journals (Sweden)

    2014-11-01

    Conclusiones de los autores: No está claro si una combinación de fármacos tocolíticos para el trabajo de parto prematuro es más ventajosa para las embarazadas y los recién nacidos, debido a la falta de ensayos grandes bien diseñados que incluyan los resultados de interés. No hay ensayos de regímenes de combinación que utilicen los agentes tocolíticos usados con gran frecuencia como los bloqueantes de los canales de calcio (nifedipino y los antagonistas de los receptores de oxitocina (atosiban. Se necesitan ensayos adicionales antes de establecer conclusiones específicas sobre el uso del tratamiento con tocolíticos combinados para el trabajo de parto prematuro.

  3. Reproductive performance of Friesian mares after retained placenta and manual removal of the placenta

    NARCIS (Netherlands)

    Sevinga, M; Hesselink, JW; Barkema, H.W.

    2002-01-01

    Because the incidence of retained placenta in Friesian mares is estimated to be high, and no reports have been published on the reproductive performance of Friesian mares after retained placenta, we studied postpartum reproductive performance in Friesian brood mares with (n = 54) and without (n =

  4. Decellularization of placentas: establishing a protocol

    Directory of Open Access Journals (Sweden)

    L.C.P.C. Leonel

    2017-11-01

    Full Text Available Biological biomaterials for tissue engineering purposes can be produced through tissue and/or organ decellularization. The remaining extracellular matrix (ECM must be acellular and preserve its proteins and physical features. Placentas are organs of great interest because they are discarded after birth and present large amounts of ECM. Protocols for decellularization are tissue-specific and have not been established for canine placentas yet. This study aimed at analyzing a favorable method for decellularization of maternal and fetal portions of canine placentas. Canine placentas were subjected to ten preliminary tests to analyze the efficacy of parameters such as the type of detergents, freezing temperatures and perfusion. Two protocols were chosen for further analyses using histology, scanning electron microscopy, immunofluorescence and DNA quantification. Sodium dodecyl sulfate (SDS was the most effective detergent for cell removal. Freezing placentas before decellularization required longer periods of incubation in different detergents. Both perfusion and immersion methods were capable of removing cells. Placentas decellularized using Protocol I (1% SDS, 5 mM EDTA, 50 mM TRIS, and 0.5% antibiotic preserved the ECM structure better, but Protocol I was less efficient to remove cells and DNA content from the ECM than Protocol II (1% SDS, 5 mM EDTA, 0.05% trypsin, and 0.5% antibiotic.

  5. Tempo de aleitamento materno exclusivo em recém-nascidos prematuros e a termo Time of exclusive breastfeeding of preterm and term newborn babies

    Directory of Open Access Journals (Sweden)

    Waléria Ferreira da Silva

    2012-01-01

    Full Text Available OBJETIVOS: determinar o tempo de aleitamento materno exclusivo de recém nascidos prematuros e observar se estes apresentam um índice de aleitamento materno exclusivo diferente do apresentado pelo município de Maceió, na I e II Pesquisa de Prevalência de Aleitamento Materno nas Capitais Brasileiras e no Distrito Federal. Além de comparar o tempo de aleitamento materno e aleitamento materno exclusivo de recém nascidos prematuros e a termo e verificar as causas do desmame precoce e suas consequências. MÉTODO: trata-se de uma investigação de campo, de caráter exploratório e longitudinal da prevalência do aleitamento materno exclusivo de recém nascidos prematuro e à termo. RESULTADOS: o percentual de aleitamento materno e de aleitamento materno exclusivo de prematuros aos 6 meses. Houve diferença significante para a variável peso ao nascimento. Dentre as causas do desmame precoce, os fatores educacionais seguidos dos fatores culturais apareceram em maior porcentagem. Como consequência do desmame precoce a prática de hábitos orais ocorreu em 98,1% das crianças. CONCLUSÃO: as crianças prematuras permaneceram mais tempo em aleitamento materno e em aleitamento materno exclusivo que as nascidas a termo. Os fatores educacionais e culturais foram as principais causas do desmame precoce e sua consequência foi o uso de chupeta e mamadeira.PURPOSE: to determine the benefits of exclusive breastfeeding. However, only a minority of women engage in breastfeeding practices. This research is aimed to establish the time of exclusive breastfeeding as for preterm babies and observe whether they have a different level of exclusive breastfeeding in relation to the level achieved by the city of Maceió at the I and II PPAM-CDF. Additionally, other goals are to compare the breastfeeding and exclusive breastfeeding types of preterm and term newborns and determine the causes of early weaning and its consequences. METHOD: this is a field investigation

  6. Tempo de aleitamento materno exclusivo em recém-nascidos prematuros e a termo Time of exclusive breastfeeding of preterm and term newborn babies

    Directory of Open Access Journals (Sweden)

    Waléria Ferreira da Silva

    2013-02-01

    Full Text Available OBJETIVOS: determinar o tempo de aleitamento materno exclusivo de recém nascidos prematuros e observar se estes apresentam um índice de aleitamento materno exclusivo diferente do apresentado pelo município de Maceió, na I e II Pesquisa de Prevalência de Aleitamento Materno nas Capitais Brasileiras e no Distrito Federal. Além de comparar o tempo de aleitamento materno e aleitamento materno exclusivo de recém nascidos prematuros e a termo e verificar as causas do desmame precoce e suas consequências. MÉTODO: trata-se de uma investigação de campo, de caráter exploratório e longitudinal da prevalência do aleitamento materno exclusivo de recém nascidos prematuro e à termo. RESULTADOS: o percentual de aleitamento materno e de aleitamento materno exclusivo de prematuros aos 6 meses. Houve diferença significante para a variável peso ao nascimento. Dentre as causas do desmame precoce, os fatores educacionais seguidos dos fatores culturais apareceram em maior porcentagem. Como consequência do desmame precoce a prática de hábitos orais ocorreu em 98,1% das crianças. CONCLUSÃO: as crianças prematuras permaneceram mais tempo em aleitamento materno e em aleitamento materno exclusivo que as nascidas a termo. Os fatores educacionais e culturais foram as principais causas do desmame precoce e sua consequência foi o uso de chupeta e mamadeira.PURPOSE: to determine the benefits of exclusive breastfeeding. However, only a minority of women engage in breastfeeding practices. This research is aimed to establish the time of exclusive breastfeeding as for preterm babies and observe whether they have a different level of exclusive breastfeeding in relation to the level achieved by the city of Maceió at the I and II PPAM-CDF. Additionally, other goals are to compare the breastfeeding and exclusive breastfeeding types of preterm and term newborns and determine the causes of early weaning and its consequences. METHOD: this is a field investigation

  7. MENTAL HEALTH IN THE INTEGRATED CURRICULUM OF UNIFESO’S NURSING GRADUATION COURSE: DIVERSIFICATION OF SETTINGS AND LEARNING STRATEGIES

    OpenAIRE

    Albuquerque, Verônica Santos; Centro Universitário Serra dos Órgãos - UNIFESO; de Campos, José Carlos Lima; Centro Universitário Serra dos Órgãos

    2010-01-01

    RESUMOIntrodução: em 2009, no Instituto Fernandes Figueira da Fundação Oswaldo Cruz (IFF/FIOCRUZ), aconteceu o workshop internacional ser prematuro por um dia com a ilustre Raquel Tamez. O evento buscou capacitar profissionais de saúde para atuação junto ao prematuro, partindo da premissa que o cuidado prestado a esta clientela é, basicamente, cuidar do cérebro em desenvolvimento. Objetivo: descrever como aconteceu o workshop internacional “ser prematuro por um dia” com Raquel Tamez no IFF/FI...

  8. The participation of parents in the care of premature children in a neonatal unit: meanings attributed by the health team Participación de madres/padres en el cuidado del niño prematuro en la unidad neonatal: significados atribuidos por el equipo de salud Participação das mães/pais no cuidado ao filho prematuro em unidade neonatal: significados atribuídos pela equipe de saúde

    Directory of Open Access Journals (Sweden)

    Josefina Gallegos Martínez

    2007-04-01

    obstante existe interés por parte del equipo de salud en implementarla, reconociendo su importancia al favorecer en la estabilidad clínica del prematuro y en su proceso de crecimiento y desarrollo; permitiendo de esta forma, la interacción madre-hijo y el establecimiento del vínculo afectivo, así como el entrenamiento materno para la futura alta. Se percibió que la madre ayuda al equipo de enfermería brindado cuidados al niño y realizando cuidados propios de su función materna. Por otro lado, la presencia de los padres modifica el ambiente dentro de la unidad neonatal, pues interfiere con la dinámica de trabajo, genera inseguridad en el equipo por sentirse fiscalizado, así mismo, existe la preocupación por infecciones hospitalarias. Estas situaciones en conformidad con otros estudios en diversos países, nos llevan a reflexionar sobre la necesidad de fundamentar la asistencia al prematuro hacia la construcción colectiva de una filosofía de cuidado que rescate conceptos con relación a los derechos humanos, ciudadanía, vínculo y apego madre-hijo, psicología pediátrica y de esta forma, ampliar el concepto de entrenamiento en educación participativa en salud.Esse estudo tem como objetivo identificar e analisar os significados atribuídos pela equipe de saúde acerca da participação da mãe/pais no cuidado ao filho prematuro hospitalizado em um hospital público. Trata-se de um estudo com delineamento na abordagem qualitativa. Os dados foram coletados através de entrevista semi-estruturada e gravada de 23 profissionais. Os resultados mostraram que esta participação ainda é incipiente na unidade neonatal do hospital, mas há interesse da equipe de saúde em implementá-la, reconhecendo a sua importancia ao favorecer a estabilidade clínica do prematuro e seu processo de crescimento e desenvolvimento, possibilitar a interação mãe-filho e o estabelecimento do vínculo afetivo, bem como o treinamento materno para a alta do filho. Percebemos ainda, que a

  9. Representação social de pais sobre o filho prematuro na unidade de terapia intensiva neonatal Representación social de los padres sobre el hijo prematuro en la unidad de terapia intensiva neonatal Social representation of fathers regarding their premature child in the neonatal intensive care unit

    Directory of Open Access Journals (Sweden)

    Jovanka Bittencourt Leite de Carvalho

    2009-10-01

    Full Text Available Pesquisa qualitativaa que teve como objetivo conhecer a representação social do pai diante do filho prematuro. Os dados foram coletados no período de maio a junho de 2008 por meio de entrevista semi-estruturada, junto a 17 pais cujos filhos prematuros estavam internados na UTIN de duas instituições públicas de natal-RN. Os depoimentos foram tratados e analisados com base na teoria das representações sociais (TRS. Os resultados revelaram que os pais ao estarem com seus filhos internados vivenciam emoções que são traduzidas por medo, angústia, ansiedade, solidão e se entremeiam a fé, alegria e esperança. Para o pai a UTIN representa um ambiente assustador, mas necessário aos cuidados especializados requeridos pelas condições do recém nascido prematuro.Investigación cualitativa tiene como objetivo conocer la representación social del padre frente del hijo prematuro. Los datos fueron tomados en el periodo de mayo a junio de 2008 mediante entrevista semi-estructurada a 17 padres con hijos prematuros internados en la UTIN de dos instituciones públicas de Natal-RN. Las declaraciones fueron tratadas y analizadas con base en la teoría de las representaciones sociales (TRS. Los resultados revelaron que los padres al acompañar a sus hijos internados viven emociones que se traducen en miedo, angustia, ansiedad, soledad y se entreveran con fe, alegría y esperanza. Para el padre la UTIN representa un ambiente amedrentador, pero necesario.Qualitative study that aimed at understanding the social representation of a parent with a premature child. The data were collected between May and June 2008, in a semi-structured interview with 17 parents whose premature children were hospitalized in the NICU of two public institutions in Natal, Brazil. The reports were analyzed based on the Social Representations Theory (SRT. The results reveal that the hospitalization of their children causes parents to experience emotions of fear, anguish, anxiety

  10. [Management of placenta previa and accreta].

    Science.gov (United States)

    Kayem, G; Keita, H

    2014-12-01

    Produce recommendations for the management of placenta previa and placenta accrete. A literature search was conducted using Medline and the Cochrane Library over a period from 1950 to 31/12/2013. Recommendations of the latest scientific societies have also been consulted. In cases of placenta previa, if bleeding episode before 34weeks gestation occurs, a short hospitalization and tocolysis may help stop bleeding (grade C). Vaginal delivery is preferable when the distance between the internal cervical os and the placental edge is greater than 20mm. When this distance is less than 20mm, vaginal delivery is possible (professional consensus). Caesarean section is recommended in cases of placenta overlapping the internal os (professional consensus). Antenatal screening placenta accreta could improve care (EL3). Upon discovery of a placenta accreta during childbirth, it is better to avoid a forced removal of the placenta (grade C). Conservative treatment or cesarean hysterectomy are possible (grade C). The management of placental abnormalities should be planned and managed with a multidisciplinary team (professional consensus). The use of blood-saving techniques such as "cell saver" is possible in situations where early intraoperative bleeding would be>1500mL (grade C). There are no studies that have sufficient methodological value to recommend an anesthetic technique [general anaesthesia (GA) or neuraxial anaesthesia] over another in the context of placental abnormalities (grade B). When a major bleeding risk is identified, GA can be chosen in order to avoid emergency conversions in difficult conditions (professional consensus). Placental insertion abnormalities require anesthetic and obstetric coordination. Delivery must be planned in a suitable structure. Copyright © 2014. Published by Elsevier Masson SAS.

  11. Hemorragias de la segunda mitad de la gestación, estudio prospectivo en el Instituto Especializado Materno Perinatal, periodo setiembre 2004-agosto 2005

    OpenAIRE

    Oscanoa León, Aníbal Moisés

    2006-01-01

    Las HSMG son causa importante de morbimortalidad materna y perinatal especialmente en países en desarrollo y se presentan con una frecuencia entre 2 y 6 % y sus causas primarias son obstétricas, el desprendimiento prematuro de la placenta y la placenta previa. La etiología es multifactorial, pero determinadas condiciones se asocian a mayor incidencia de esta complicación como son alteraciones endometriales ó miometriales los que se dan en la edad madura, multiparidad, antecedente de cesárea...

  12. "Um sonho cortado pela metade...": estudo de caso sobre o impacto da prematuridade e da deficiência visual do bebê na parentalidade

    Directory of Open Access Journals (Sweden)

    Carla Meira Kreutz

    2013-06-01

    Full Text Available Quando a prematuridade culmina com um diagnóstico de retinopatia da prematuridade com perda da visão, os pais sofrem um duplo impacto. O presente estudo teve por objetivo investigar as reações emocionais dos pais nesse contexto e seu impacto na parentalidade. Para tanto, pais de uma menina de 13 meses foram entrevistados conjuntamente. Os dados foram examinados, utilizando-se a análise de conteúdo. Os resultados mostraram um choque dos pais com a aparência do bebê prematuro, o medo da morte do bebê, dificuldades para a compreensão do diagnóstico, negação, culpa, sentimentos hostis em relação à equipe médica e diminuição da autoeficácia do casal como pais. Por outro lado, identificou-se uma busca de reorganização do casal e alegrias frente à parentalidade.

  13. FACTORES DE RIESGO QUE INCIDEN EN LA RETINOPATÍA DEL PREMATURO EN EL SERVICIO DE NEONATOLOGÍA EN UN HOSPITAL DEL MINISTERIO DE SALUD

    OpenAIRE

    Guerrero Sausa, Mirella Raquel; Universidad Señor de Sipán; Sánchez Saavedra, Sandra Del Pilar; Universidad Señor de Sipán; Lizárraga De Maguiña, Isabel Graciela; Hospital Regional Docente Las Mercedes

    2016-01-01

    Este estudio tiene como objetivo: Determinar los Factores de Riesgo que Inciden en la Retinopatía del Prematuro en el Servicio de Neonatología del Hospital Regional Docente las Mercedes - Chiclayo 2014, es de tipo cuantitativo, diseño no experimental, descriptivo y retrospectivo, la población muestral fue de 136 recién nacidos prematuros según criterios de inclusión y exclusión. Las técnicas de recolección de datos son de análisis documental y bibliográfico, teniendo como fuentes primarias la...

  14. Utilidad de una prueba cualitativa para la detección de fibronectina fetal en secreción cervicovaginal como predictor de parto prematuro

    OpenAIRE

    L.R. López-Ocaña; F. Palacios-Torres; M.O. Coreño-Juárez; D.A. Obando-Izquierdo; E. Krug-Llamas; R.R. Villanueva-Romero; M. Rodríguez-Gutiérrez; Y.M. Gómez Alegre; M.L. Martínez Morgado

    2015-01-01

    La fibronectina fetal es una glucoproteína de la matriz extracelular que se localiza en la interfase materno-fetal de las membranas amnióticas, entre la decidua y el corion. Los niveles séricos de fibronectina fetal ≥ 50 ng/ml a partir de las 22 semanas de gestación más se han asociado con un riesgo de partos prematuros espontáneos. El parto prematuro es el nacimiento que se presenta antes de las 37 semanas de gestación, es multicausal, contribuye con un 70% de la mortalidad perinatal y su...

  15. Placenta accreta spectrum: accreta, increta, and percreta.

    Science.gov (United States)

    Silver, Robert M; Barbour, Kelli D

    2015-06-01

    Placenta accreta can lead to hemorrhage, resulting in hysterectomy, blood transfusion, multiple organ failure, and death. Accreta has been increasing steadily in incidence owing to an increase in the cesarean delivery rate. Major risk factors are placenta previa in women with prior cesarean deliveries. Obstetric ultrasonography can be used to diagnose placenta accreta antenatally, which allows for scheduled delivery in a multidisciplinary center of excellence for accreta. Controversies exist regarding optimal management, including optimal timing of delivery, surgical approach, use of adjunctive measures, and conservative (uterine-sparing) therapy. We review the definition, risk factors, diagnosis, management, and controversies regarding placenta accreta. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. PLACENTA PRAEVIA- TIMELY DECISION MANDATORY!

    Directory of Open Access Journals (Sweden)

    Kshama Kedar

    2017-11-01

    Full Text Available BACKGROUND Antepartum Haemorrhage (APH is still a grave obstetric emergency contributing to a significant amount of maternal and perinatal morbidity and mortality in our country. Placenta Praevia (PP complicates 0.33%1 to 0.55%2 of all pregnancies. This study is to evaluate how far we have come and the effect of treatment on the perinatal and maternal outcome and study the maternal and foetal outcome in placenta praevia and its prevalence in tertiary care hospital. The aim of the study is to study the maternal and foetal outcome in placenta praevia and assess the importance of early diagnosis and treatment. Objective of the study was to determine the cause of placenta praevia and assess the value of current obstetric practice in managing placenta praevia. MATERIALS AND METHODS Prospective study was carried out in a tertiary care hospital on 60 patients who presented with PP in the ANC OPD and in emergency over a period of 2 years with gestational age >28 weeks and no blood dyscrasias or bleeding source other than the uterus. RESULTS Maximum cases (69.11% were unbooked, more in multiparous (41.67% and commonly associated with previous caesarean section (41.6%. 41.46% belonged to 25-29 years of age. 56.67% were more than 36 weeks of gestation at the time of admission. Out of 60, 9 (15% had absent foetal heart sound and 6 (10% had foetal distress at time of admission. 56 (93.3 cases delivered by caesarean section, 29 (48.3% cases were elective, while 27 (45% were done in emergency. 1 (1.6% underwent caesarean hysterectomy. 16 (26.6% had PPH postoperatively managed by medical methods. 2 (3.3% had scar dehiscence and 3 (5% patients went in sepsis. Commonest complication (26.67% was anaemia. 5 (8.3% babies of placenta praevia were premature. CONCLUSION Placenta praevia constitutes 35% of the causes of placental bleeding leading to antepartum haemorrhage, which is a leading cause of maternal morbidity. Hence, timely diagnosis and intervention is of

  17. A thick placenta: a predictor of adverse pregnancy outcomes.

    Science.gov (United States)

    Miwa, Ichiro; Sase, Masakatsu; Torii, Mayumi; Sanai, Hiromi; Nakamura, Yasuhiko; Ueda, Kazuyuki

    2014-01-01

    The aim of this study is to evaluate the efficacy of an ultrasonographic measurement of placental thickness and the correlation of a thick placenta with adverse perinatal outcome. Placental thickness was measured in single gravidas, 16 to 40 weeks of gestation, between 2005 and 2009. Placentas were considered to be thick if their measured thickness were above the 95th percentile for gestational age. The incidence of thick placentas was 4.3% (138/3,183). Perinatal morbidity and neonatal conditions were worse in cases with thick placenta rather than without thick placenta. Ultrasonographic measurement of placental thickness is a simple method to estimate placental size. Thick placenta may be a useful predictor of adverse pregnancy outcomes.

  18. The cervix as a natural tamponade in postpartum hemorrhage caused by placenta previa and placenta previa accreta: a prospective study.

    Science.gov (United States)

    El Gelany, Saad A A; Abdelraheim, Ahmed R; Mohammed, Mo'men M; Gad El-Rab, Mohammed T; Yousef, Ayman M; Ibrahim, Emad M; Khalifa, Eissa M

    2015-11-11

    Placenta previa and placenta accreta carry significant maternal and fetal morbidity and mortality. Several techniques have been described in the literature for controlling massive bleeding associated with placenta previa cesarean sections. The objective of this study was to evaluate the efficacy and safety of the use of the cervix as a natural tamponade in controlling postpartum hemorrhage caused by placenta previa and placenta previa accreta. This prospective study was conducted on 40 pregnant women admitted to our hospital between June 2012 and November 2014. All participating women had one or more previous cesarean deliveries and were diagnosed with placenta previa and/or placenta previa accreta. Significant bleeding from the placental bed during cesarean section was managed by inverting the cervix into the uterine cavity and suturing the anterior and/or the posterior cervical lips into the anterior and/or posterior walls of the lower uterine segment. The technique of cervical inversion described above was successful in stopping the bleeding in 38 out of 40 patients; yielding a success rate of 95%. We resorted to hysterectomy in only two cases (5%). The mean intra-operative blood loss was 1572.5 mL, and the mean number of blood units transfused was 3.1. The mean time needed to perform the technique was 5.4 ± 0.6 min. The complications encountered were as follows: bladder injury in the two patients who underwent hysterectomy and wound infection in one patient. Postoperative fever that responded to antibiotics occurred in 1 patient. The mean duration of the postoperative hospital stay was 3.5 days This technique of using the cervix as a natural tamponade appears to be safe, simple, time-saving and potentially effective method for controlling the severe postpartum hemorrhage (PPH) caused by placenta previa/placenta previa accreta. This technique deserves to be one of the tools in the hands of obstetricians who face the life-threatening hemorrhage of placenta

  19. Differential expression of GPR30 in preeclampsia placenta tissue and normal placenta tissue and its clinical significance

    Directory of Open Access Journals (Sweden)

    Ben-Zhou Feng

    2016-04-01

    Full Text Available Objective: To study the differential expression of GPR30 in preeclampsia placenta tissue and normal placenta tissue and its clinical significance. Methods: Preeclampsia placenta tissue and normal placenta tissue were collected and GPR30 expression levels were detected; human umbilical vein endothelial cells were cultured and processed with GRP30 inhibitor and GRP30 agonist combined with hypoxia-reoxygenation respectively, and cell apoptosis as well as pro-angiogenesis molecule and apoptosis molecule contents were detected. Results: mRNA content and protein content of GRP30 in preeclampsia placenta tissue were significantly lower than those in normal placenta tissue; apoptosis rate of G15 group was significantly higher than that of control group, VEGF and bFGF contents in supernatant were significantly lower than those of control group, and mRNA contents of Bax, Caspase-3 and Caspase-9 in cells were significantly higher than those of control group; apoptosis rate of H/R group was significantly higher than that of control group, VEGF and bFGF contents in supernatant were significantly lower than those of control group, and mRNA contents of Bax, Caspase-3 and Caspase-9 in cells were significantly higher than those of control group; apoptosis rate of G1 group was significantly lower than that of H/R group, VEGF and bFGF contents in supernatant were significantly higher than those of H/R group, and mRNA contents of Bax, Caspase-3 and Caspase-9 in cells were significantly lower than those of H/R group. Conclusions: Low expression of GPR30 in placenta tissue is closely associated with the occurrence of preeclampsia, enhancing GPR function can reduce endothelial cell apoptosis and increase the contents of pro-angiogenesis factors, and it has endothelial protection effect.

  20. Failed manual removal of the placenta after vaginal delivery

    DEFF Research Database (Denmark)

    Bjurström, Johanna; Collins, Sally; Langhoff-Roos, Jens

    2018-01-01

    PURPOSE: A retained placenta after vaginal delivery where manual removal of placenta fails is a clinical challenge. We present six cases that illustrate the heterogeneity of the condition and discuss the etiology and terminology as well as the clinical management. METHODS: Members of the European...... and the UK provide examples of various treatment strategies such as ultrasound-guided vaginal removal, removal of the placenta through a hysterotomy and just leaving the placenta in situ. The placentas were all retained, but it was only possible to diagnose abnormal invasion in the one case, which had...

  1. INTRODUCTION The incidence of retained placenta varies greatly ...

    African Journals Online (AJOL)

    balance between the post-partum haemorrhage risk of leaving the placenta in ... Conclusion: Retained placenta still remains a potentially life threatening condition in ... obstetric services by high skilled health care providers in ensuring a properly conducted .... of the preterm placenta may require more uterine work and time ...

  2. Avaliação do neurodesenvolvimento de prematuros de muito baixo peso ao nascer entre 18 e 24 meses de idade corrigida pelas escalas Bayley III

    Directory of Open Access Journals (Sweden)

    Luciana Volpiano Fernandes

    2012-12-01

    Full Text Available OBJETIVO: Avaliar a prevalência de atraso e fatores associados aos escores de desenvolvimento em crianças nascidas prematuras. MÉTODOS: Estudo transversal para avaliar o desenvolvimento por escalas Bayley III, incluindo-se prematuros de muito baixo peso de 18 a 24 meses de idade corrigida, acompanhados no Ambulatório de Prematuros da instituição. Excluíram-se: malformação congênita, síndrome genética, infecção congênita sintomática ao nascimento, surdez e cegueira. As variáveis numéricas foram comparadas por teste t de Student ou Mann-Whitney, e as categóricas, por qui-quadrado ou teste exato de Fisher. Para análise dos fatores associados aos escores de desenvolvimento, utilizou-se a regressão linear, considerando-se significante p < 0,05. RESULTADOS: Das 58 crianças avaliadas, quatro (6,9% apresentaram alteração cognitiva; quatro (6,9%, motora; 17 (29,3%, de linguagem; 16 (27,6%, socioemocional; e 22 (37,9%, de comportamento adaptativo. À regressão linear múltipla, os fatores classe socioeconômica CDE (-13,27; IC95% -21,23 a -5,31 e dependência de oxigênio com 36 semanas de idade corrigida (-8,75; IC95% -17,10 a -0,39 diminuíram o escore cognitivo. A leucomalácia periventricular diminuiu o escore cognitivo (-15,21; IC95% -27,61 a -2,81, motor (-10,67; IC95% -19,74 a -1,59 e de comportamento adaptativo (-21,52; IC95% -35,60 a -7,44. O sexo feminino se associou ao maior escore motor (10,67; IC95% 2,77-12,97, de linguagem (15,74; IC95% 7,39-24,09 e socioemocional (10,27; IC95% 1,08-19,46. CONCLUSÕES: Prematuros de muito baixo peso apresentaram com maior frequência alterações na linguagem, comportamento adaptativo e socioemocional. As variáveis classe socioeconômica CDE, leucomalácia periventricular, displasia broncopulmonar e sexo masculino contribuíram para reduzir os escores de desenvolvimento.

  3. Morbilidad asociada a la edad gestacional en neonatos prematuros tardíos

    Directory of Open Access Journals (Sweden)

    Luís Alfonso Mendoza Tascón

    2012-12-01

    Full Text Available Objetivo: comparar la morbilidad a corto plazo, intervenciones, estancia hospitalaria y los costos de prematuros de 34 semanas, con prematuros mayores a 34 semanas (35-36 semanas, hospitalizados en la Unidad de Cuidados Intensivos Neonatales de la Fundación Hospital San José de Buga, Colombia, entre el 19 de septiembre de 2005 y el 18 de septiembre de 2011. Métodos: estudio de cohorte retrospectivo, con 40 recién nacidos de 34 semanas de gestación y 129 de 35-36. Se evaluaron factores materno-neonatales y terapias aplicadas. El análisis incluyó estadísticas descriptivas y análisis bivariado. Para las asociaciones se empleó el riesgo relativo con su intervalo de confianza de 95 %, así como la prueba de chi² de Pearson de independencia. Resultados: se hallaron morbilidades respiratorias en el 32,5 %, ictericia en el 29 %, morbilidades gastrointestinales en el 13,6 %, metabólicas en el 13,6 %, cardiacas en el 1,8 %, hematológicas en el 1,2 %, e hipotermia y sepsis también en el 1,2 %. La falla renal se produjo en el 0,6 %, sin diferencias estadísticas entre los 2 grupos. Se halló diferencia estadísticamente significativa (p 2 días, administración de nutrición parenteral, horas de oxigenoterapia (> 2 y 5 días, horas de ventilación mecánica y estancia prolongada (> 7 días, y fueron los neonatos de 34 semanas los más afectados. El peso, talla y perímetro cefálico al nacer y egreso, fueron menores en aquellos de 34 semanas, mientras el retardo del crecimiento intrauterino fue superior en los de 35 y 36 semanas (26,4 vs. 7,5 %; RR: 1,3; IC 95 %: 1,1-1,5; p< 0,05. La atención hospitalaria de los neonatos de 34 semanas, resulta, por tanto, ser 1,6 y 0,6 veces más costosa en dinero, que la de los de 35 y 36 semanas. Conclusiones: el prematuro tardío debe considerarse inmaduro y con riesgo de morbilidad y mortalidad. Estos tienen gran incidencia de ictericia, morbilidad respiratoria, gastrointestinal y metabólica. Pero, los

  4. Increased Levels of Cell-Free Human Placental Lactogen mRNA at 28-32 Gestational Weeks in Plasma of Pregnant Women With Placenta Previa and Invasive Placenta

    Science.gov (United States)

    Sekizawa, Akihiko; Ventura, Walter; Koide, Keiko; Hori, Kyouko; Okai, Takashi; Masashi, Yoshida; Furuya, Kenichi; Mizumoto, Yoshifumi

    2014-01-01

    We compared the levels of cell-free human placental lactogen (hPL) messenger RNA (mRNA) in maternal plasma at 28 to 32 weeks of gestation between women with diagnosis of placenta previa or invasive placenta and women with an uneventful pregnancy. Sensitivity and specificity of hPL mRNA for the prediction of invasive placenta were further explored. Plasma hPL mRNA were quantified by real-time reverse-transcriptase polymerase chain reaction in women with placenta previa (n = 13), invasive placenta (n = 5), and normal pregnancies (n = 92). Median (range) hPL mRNA was significantly higher in women with placenta previa, 782 (10-2301) copies/mL of plasma, and in those with invasive placenta, 615 (522-2102) copies/mL of plasma, when compared to normal pregnancies, 90 (4-4407) copies/mL of plasma, P < .01 and P < .05, respectively. We found a sensitivity of 100% and a specificity of 61.5% for the prediction of invasive placenta among women with placenta previa. In conclusion, expression of hPL mRNA is increased in plasma of women with placenta previa and invasive placenta at 28 to 32 weeks of gestation. PMID:23744883

  5. Cerebral abscess caused by Serratia marcescens in a premature neonate Abscesso cerebral causado por Serratia marcescens em prematuro

    Directory of Open Access Journals (Sweden)

    Tatiana Mattos Hirooka

    2007-12-01

    Full Text Available BACKGROUND: Cerebral abscesses are extremely rare in neonates. Serratia marcescens is an unusual cause of sepsis and neurological spread is especially ominous. PURPOSE: To report the case of a 34-week neonate who developed this rare condition and to discuss diagnostic and therapeutic measures. CASE REPRT: A 34-week male neonate sequentially developed respiratory distress syndrome, early sepsis and necrotizing enterocolitis; later cultures revealed S. marcescens. After deterioration, a cerebral abscess became evident, which revealed S. marcescens. Clinical improvement ensued after high-dose amikacin and meropenem. CONCLUSION: Clinical signs are often non-specific. Proper diagnostic measures, neurosurgical consultation and aggressive antibiotic therapy are essential for these high-risk neonates.INTRODUÇÃO: Abscessos cerebrais são extremamente raros em neonatos. Serratia marcescens é causadora incomum de sepse nestes pacientes e a disseminação no sistema nervoso central é grave. OBJETIVO: Relatar um prematuro de 34 semanas que desenvolveu esta condição e discutir as medidas diagnósticas e terapêuticas. RELATO DE CASO: Prematuro masculino de 34 semanas desenvolveu síndrome do desconforto respiratório, sepse neonatal e enterocolite necrotizante; hemoculturas revelaram S. marcescens. Após deterioração clínica, evidenciou-se um abscesso cerebral cuja drenagem revelou S. marcescens. Houve melhora após introdução de amicacina e meropenem. CONCLUSÃO: Os sinais clínicos são inespecíficos. Passos diagnósticos apropriados, avaliação neurocirúrgica precoce e antibioticoterapia agressiva são essenciais para estes prematuros.

  6. Assessing gene function in the ruminant placenta.

    Science.gov (United States)

    Anthony, R V; Cantlon, J D; Gates, K C; Purcell, S H; Clay, C M

    2010-01-01

    The placenta provides the means for nutrient transfer from the mother to the fetus, waste transfer from the fetus to the mother, protection of the fetus from the maternal immune system, and is an active endocrine organ. While many placental functions have been defined and investigated, assessing the function of specific genes expressed by the placenta has been problematic, since classical ablation-replacement methods are not feasible with the placenta. The pregnant sheep has been a long-standing animal model for assessing in vivo physiology during pregnancy, since surgical placement of indwelling catheters into both maternal and fetal vasculature has allowed the assessment of placental nutrient transfer and utilization, as well as placental hormone secretion, under unanesthetized-unstressed steady state sampling conditions. However, in ruminants the lack of well-characterized trophoblast cell lines and the inefficiency of creating transgenic pregnancies in ruminants have inhibited our ability to assess specific gene function. Recently, sheep and cattle primary trophoblast cell lines have been reported, and may further our ability to investigate trophoblast function and transcriptional regulation of genes expressed by the placenta. Furthermore, viral infection of the trophoectoderm layer of hatched blastocysts, as a means for placenta-specific transgenesis, holds considerable potential to assess gene function in the ruminant placenta. This approach has been used successfully to "knockdown" gene expression in the developing sheep conceptus, and has the potential for gain-of-function experiments as well. While this technology is still being developed, it may provide an efficient approach to assess specific gene function in the ruminant placenta.

  7. Morphological changes in human placenta of wet snuff users

    International Nuclear Information System (INIS)

    Ashfaq, M.; Malik, M.A.

    2008-01-01

    Wet snuff is commonly used by both males and females in different parts of Pakistan. Apart from other ingredients, tobacco is the major component of snuff. Adverse effects of smoking on morphology of human placenta have been shown by some previous studies. But snuff is not considered as dangerous as smoking during pregnancy. This study was designed to see the effects of snuff on morphology of human placenta. In present study total 80 human placentae, 40 from normal and 40 from snuff users were used. This study was carried out in the Department of Anatomy Basic Medical Sciences Institution (BSMI) Karachi. Duration of study was six months. Samples were obtained from Gynaecology and Obstetric unit-I JPMC. Placentae washed well with running tap water to remove blood clots. Umbilical cord and other membranes were removed and placenta gently squeezed to expel the foetal blood. Gross features like weight, diameters, central thickness and attachment of umbilical cord were noted in normal and snuff users' placentae. Then placentae were preserved in 10% formalin for at least five days before the sectioning for micromorphology. Placentae divided in two groups-A and B. 4 macro m thick sections of the tissue were taken on rotary microtome and stained with H and E, Mallorys trichrome and methanamine silver for different histological observations. Mircromorpholgical changes have been observed in placentae of snuff users leading to loss of functional components of placentae. This loss of functional component may have deleterious effects on outcome of pregnancy. No significant gross morphological changes were found in snuff user placentae. Wet snuff effect the micromorphology of placenta leading to loss of functional component and in turn effects the exchange of materials between mother and foetus which may leads to intrauterine growth retardation. Loss of trophoblasts may lead to hormonal imbalance necessary for normal pregnancy and this imbalance can cause premature labour

  8. Estudio de la maduración de los ritmos circadianos de temperatura y movimiento en prematuros como marcadores precoces del desarrollo neurológico

    OpenAIRE

    Fuentes Hernández, Silvia

    2017-01-01

    Objetivos: El objetivo principal es analizar los parámetros identificadores de los ritmos de temperatura y actividad en niños prematuros de 30-34 semanas y niños nacidos a término y compararlos con los resultados obtenidos mediante test psico-motores y de comportamiento a 6, 12 y 18 meses de vida, para su validación como marcadores del desarrollo neurológico en niños. Metodología: Se reclutaron 24 niños prematuros con una edad gestacional comprendida entre las 30 y 34 semanas y 37 niños recié...

  9. Utilidad de una prueba cualitativa para la detección de fibronectina fetal en secreción cervicovaginal como predictor de parto prematuro

    Directory of Open Access Journals (Sweden)

    L.R. López-Ocaña

    2015-12-01

    Existen diversos marcadores para la predicción del parto prematuro, a fin de superar las debilidades del examen obstétrico y permitir así un diagnóstico y tratamiento oportuno. Entre estos marcadores se encuentra la determinación de fibronectina fetal en secreciones vaginales, por lo que el objetivo de este estudio fue evaluar la utilidad de la fibronectina fetal como un predictor de parto prematuro en embarazadas, así como establecer la sensibilidad, especificidad y los valores predictivos de la prueba, con el propósito de valorar su uso en embarazadas con factores de riesgo en las unidades de primer nivel de atención.

  10. Conservative Management of Placenta Accreta in a Multiparous Woman

    OpenAIRE

    Jennifer C. Hunt

    2010-01-01

    Placenta accreta refers to any abnormally invasive placental implantation. Diagnosis is suspected postpartum with failed delivery of a retained placenta. Massive obstetrical hemorrhage is a known complication, often requiring peripartum hysterectomy. We report a case of presumed placenta accreta in a patient following failed manual removal of a retained placenta. We describe an attempt at conservative management with methotrexate in a stable patient desiring future fertility. Treatment was ...

  11. Placenta Praevia

    African Journals Online (AJOL)

    Department of Obstetrics & Gynaecology, Jos University Teaching Hospital, Jos ... Screening ultrasonography in women with history of multiple caesarean sections .... B. MSB. Placenta Praevia: Incidence, Risk Factors, Maternal And Fetal Outcomes In A Nigerian Teaching ... These high figures from all the centres stress the.

  12. Correlation between placenta and umbilical cord morphplogy and ...

    African Journals Online (AJOL)

    Context: The ability of the fetus to grow and thrive in-utero depends on a number of factors of which the placenta is a contributor. The umbilical cord is an essential organ connecting the fetus to the placenta and a healthy placenta is essential for good perinatal outcome. Objectives: The study aims at determining the ...

  13. Aspectos anatômicos da macro e microvascularização da placenta em ovinos (Ovis aries

    Directory of Open Access Journals (Sweden)

    Luciana Silveira Flores Schoenau

    2005-12-01

    Full Text Available Placenta possesses various essential independent vascular systems and intimately associated vascular systems, the effectiveness of which are related to the type of blood stream between the maternal and fetal circulation and, therefore, the morphology of the vascularization. The aim of this research was to study the anatomical aspects of gross and microscopic vascularization of the sheep placenta (Corriedale cross breeds and Ideal breeds, living at sea level and the systematization of the fetal vessels from umbilical funiculus until the capillary bed. The cotyledons were demonstrated to be mostly spheroids and to possess between one to four vascular in the majority and receive from one to four vascular branches in their central concavity. Anastomoses of the umbilical funiculus vessels occur only between arteries and anastomoses between the chorionic vessel branches are more frequent in veins than in the arteries.Were found 187 types of different cotyledonary-artery arrays were found. The chorionic artery leading to pregnant horn is shorter in lenght and emits fewer cotyledonary branches than the non pregnant horn. The chorionic vein is formed by the confluence of two branches and receives collateral tributary vessels that frequently are anastomosed between themselves. The microvascularization of the fetal cotyledon was studied by scanning electron microscopy and is demonstrated to possess of cylindrical villous trees with vessels and with parallel vessels and with capilarization in the villous extremities. Capillary fan-like handles and conical villous trees are also observed. The macrocospic features of the cotyledons and microscopy of the villous trees reflect the altitude in which the animals live (the 95 m above sea level.

  14. Enterocolite necrosante em recém-nascidos de muito baixo peso: a influência da nutrição enteral

    OpenAIRE

    KIMAK, Karine Santos

    2013-01-01

    A enterocolite necrosante é uma importante causa de morbimortalidade neonatal em prematuros, principalmente nos recém-nascidos de muito baixo peso. Apesar de a enterocolite necrosante apresentar etiologia multifatorial, a dieta enteral tem sido implicada como um dos principais fatores associados e não há consenso sobre quando deve ser iniciada, como deve progredir, nem a sua relação com a ocorrência da doença. Assim, este estudo teve por objetivo avaliar se o padrão da nutrição enteral influe...

  15. Steroid metabolism in the mouse placenta

    International Nuclear Information System (INIS)

    Okker-Reitsma, G.H.

    1976-01-01

    The purpose of the study described in this thesis was to investigate the capacity for steroid synthesis of the mouse placenta - especially the production of progesterone, androgens and estrogens - and to determine, if possible, the relation of steroid synthesis to special cell types. In an introductory chapter the androgen production in the mouse placenta is surveyed by means of a histochemical and bioindicator study of different stages of development of the placenta. The metabolism of [ 3 H]-dehydroepiandrosterone and [ 3 H]-progesterone by mouse placental tissue in vitro is studied. The metabolism of [ 3 H]-progesterone by the mouse fetal adrenal in vitro is also studied

  16. Complement inhibitory proteins expression in placentas of thrombophilic women Complement inhibitory proteins expression in placentas of thrombophilic women

    Directory of Open Access Journals (Sweden)

    Przemysław Krzysztof Wirstlein

    2012-10-01

    Full Text Available Factors controlling complement activation appear to exert a protective effect on pregnancy. This is
    particularly important in women with thrombophilia. The aim of this study was to determine the transcript and
    protein levels of complement decay-accelerating factor (DAF and membrane cofactor protein (MCP in the
    placentas of women with acquired and inherited thrombophilia. Also, we assessed immunohistochemistry staining
    of inhibitors of the complement cascade, DAF and MCP proteins, in the placentas of thrombophilic women.
    Placentas were collected from eight women with inherited thrombophilia and ten with acquired thrombophilia.
    The levels of DAF and MCP transcripts were evaluated by qPCR, the protein level was evaluated by Western
    blot. We observed a higher transcript (p < 0.05 and protein (p < 0.001 levels of DAF and MCP in the placentas
    of thrombophilic women than in the control group. DAF and MCP were localized on villous syncytiotrophoblast
    membranes, but the assessment of staining in all groups did not differ. The observed higher expression level of
    proteins that control activation of complement control proteins is only seemingly contradictory to the changes
    observed for example in the antiphospholipid syndrome. However, given the hitherto known biochemical changes
    associated with thrombophilia, a mechanism in which increased expression of DAF and MCP in the placentas is
    an effect of proinflammatory cytokines, which accompanies thrombophilia, is probable.Factors controlling complement activation appear to exert a protective effect on pregnancy. This is
    particularly important in women with thrombophilia. The aim of this study was to determine the transcript and
    protein levels of complement decay-accelerating factor (DAF and membrane cofactor protein (MCP in the
    placentas of women with acquired and inherited thrombophilia. Also, we assessed immunohistochemistry

  17. Placenta previa

    Science.gov (United States)

    ... cervix is the opening to the birth canal. Causes During pregnancy, the placenta moves as the womb stretches and ... care provider can diagnose this condition with a pregnancy ultrasound. ... or part of the cervix, a vaginal delivery can cause severe bleeding. This can be deadly to both ...

  18. Study of placenta of children born with congenital malformations.

    Science.gov (United States)

    Stoll, Claude; Alembik, Yves; Dott, Béatrice; Roth, Marie-Paule

    2003-01-01

    The malformations in this study were observed in a series of 279,642 consecutive births of known outcome registered in our Registry of congenital anomalies. For each case, more than 50 factors included in the registration forms were studied. One of the factors studied was the placenta. For each malformed child, a control was chosen. Cases with maternal known factors impairing placenta function, i.e. vasculopathy and diabetes, were excluded. In each category of malformations studied, the malformed children were divided into isolated and non-isolated (multiple malformed) cases. The weight of placenta of isolated cases was not lower than the weight of placenta of the controls. In contrast, the weight of placenta of the cases with non-isolated malformations was lower than the weight of placenta of the controls and of the isolated cases, for all categories of malformations but gastroschisis and omphalocele. The mean weights at birth of the cases with multiple malformations were also lower than those of the controls. The human placenta discounts a principal functional part, the maternal blood in the intervillous space. Congenital malformations may interact with this function.

  19. El primer encuentro del padre con el bebé prematuro en la Unidad de Cuidados Intensivos Neonatales

    Directory of Open Access Journals (Sweden)

    Fernanda Martins Castro

    2015-06-01

    Full Text Available Objetivo: Describir el primer encuentro del padre con el hijo en la Unidad de Cuidados Intensivos Neonatales (UCIN y analizar el significado de este momento en la perspectiva de los padres. Método: estudio cualitativo, con ocho padres de niños prematuros, a través de entrevistas semi-estructuradas. Los datos se analizaron a través del análisis temático. Resultados: Surgieron tres núcleos temáticos: "primer encuentro con hijo prematuro: sentimientos paternales y emociones", "construcción de la relación entre los profesionales y los padres de los recién nacidos a partir del primer encuentro" y reconocimiento de la paternidad en el contexto de la UCIN. Conclusión: El primer encuentro del padre con su hijo en la UCIN provoca sentimientos y sorpresa, dolor, incertidumbre, alegría y esperanza. El equipo de salud debe estar preparado para brindar apoyo emocional, información y establecer una comunicación efectiva desde la primera visita.

  20. Expression and function of endogenous retroviruses in the placenta.

    Science.gov (United States)

    Denner, Joachim

    2016-01-01

    Although the expression of endogenous retroviruses in the placenta of numerous species was observed a long time ago, their physiological function during gestation was demonstrated only very recently. Expression of retroviral envelope proteins, also called syncytins, in the placenta allows generation of the multinuclear syncytiotrophoblast as an outer cellular layer of the placenta by fusion of the trophoblast cells. This fusion process is crucial for the development of the placenta and for successful pregnancy. It is still unclear whether the immunosuppressive properties of the transmembrane envelope protein of the endogenous retroviruses expressed in the placenta contribute to immunosuppression to prevent the rejection of the semiallotransplant embryo. The presence of placenta cells expressing retroviral envelope proteins surrounded by immune cells deep in the maternal tissue supports an immunosuppressive function. It is important to emphasize that during evolution different species utilized ('enslaved') different endogenous retroviruses and that two or more endogenous retroviruses are involved in placentogenesis in each species. © 2016 APMIS. Published by John Wiley & Sons Ltd.

  1. Placenta percreta with urinary bladder involvement

    International Nuclear Information System (INIS)

    Al-Ojaimi, Eftekhar H.; Subramaniam, Balameenakshi V.

    2004-01-01

    A 37-years old Pakistani lady, who had previously undergone one cesarean delivery and one uterine curettage, was admitted to the labor ward at 29 weeks of gestation with history of sudden severe painless vaginal bleeding from a sonographically diagnosed placenta pervia. An immediate cesarean was performed and a live male infant was delivered. The placenta was morbidly adherent to the lower uterine segment and attempts at removal caused torrential bleeding, necesstiating cesarean hysterectomy. In addition, attempts to dissect the bldder from lower uterine segment was unsuccessful and, hence, the diagnosis of placenta percreta with involvement of urinary bladder was made. A modified posterior approach to the hyterectomy was carried out, with subsequent good recovery. (author)

  2. O processo de formação de conceitos e dinâmicas alternativas na construção de referenciais para a alfabetização da criança prematura

    Directory of Open Access Journals (Sweden)

    Ana Reni Goncalves

    2011-07-01

    Full Text Available O estudo de caso do processo de alfabetização de prematuro, compreende os processos evolutivos do desenvolvimento de uma criança nascida prematuramente, com ‘muito baixo peso’, que nesta fase encontra-se no período de alfabetização. Esta pesquisa apresenta a identificação de complicações tardias da prematuridade, a necessidade de intervenções de profissionais de áreas específicas e ao mesmo tempo múltiplas e dialéticas, e principalmente da referência do professor como incentivador e conhecedor das alternativas e práticas do desenvolvimento cognitivo, assim como as contribuições da neurociência aplicadas a educação, sob o enfoque biológico, neurológico e físico direcionados ao processo de alfabetização. Apresenta informações de natureza diversas sobre a criança foco de estudo, através de textos, diálogos, relatório e observações. A criança atualmente reside em Sorriso-MT, estuda em escola particular, os estudos iniciaram quando tinha seis anos e estava cursando o primeiro ano do Ensino Fundamental de Nove Anos, sendo que atualmente está com oito anos e cursa o terceiro ano do Ensino Fundamental de Nove Anos, em uma nova escola. Este estudo de caso se fundamenta teoricamente entre outros em: Ligia Rugolo, Vygotsky, Wallon, Suzana Herculano-Houzel, Jean Piaget, Gislene Oliveira. Cumprindo o objetivo da pesquisa acredita-se que os resultados serão aporte aos profissionais pedagogos que possuem alunos prematuros de baixo peso, subsídios científicos aos pais para condução de prioridades e estratégias para que seus filhos possam evoluírem no processo da construção dos saberes.Palavras-chave: educação; prematuro; criança; alfabetização.

  3. Deficiência de ferro no feto e no recém-nascido Iron deficiency in the fetus and newborn

    Directory of Open Access Journals (Sweden)

    Maria Renata T. Chopard

    2010-06-01

    Full Text Available A principal causa de anemia no feto é a doença hemolítica do recém-nascido (RN. As gestantes anêmicas na sua forma moderada não acarretam baixos estoques de ferro no concepto, porém podem evoluir para o trabalho de parto prematuro e RN com baixo peso ao nascer. O ferro é transportado para o feto por via transplacentária, principalmente durante o terceiro trimestre de gestação. A deficiência de ferro não ocorre no período neonatal, porém os prematuros e ou RN com baixo peso constituem o principal grupo de risco para desenvolver a deficiência de ferro. Nos RN nascidos a termo podemos observar uma deficiência de ferro naqueles que sofreram ressecção cirúrgica do duodeno devido à malformação congênita. A fim de evitarmos a deficiência de ferro neste grupo de risco, indica-se a suplementação de ferro a partir dos 30 dias de vida. A via de administração preferencial é a enteral, apesar de sabermos que no prematuro ocorre uma deficiência do controle da absorção do ferro. O complexo de ferro polimaltosado e o ferro aminoquelado são os de escolha para a profilaxia da deficiência de ferro em prematuros. A via endovenosa é segura e não acarreta piora das lesões causadas pela ação oxidativa do ferro em prematuros.The main cause of anemia in the fetus is hemolytic disease. Mildly anemic pregnant women may evolve with premature labor and have low birth weight babies, but the baby's iron status is not influenced by the mother's iron deficiency. Iron transportation through the placenta occurs in the third trimester of gestation and premature labor results in reduced iron stores. Iron deficiency anemia does not occur during the neonatal period, but premature and low birth weight babies are at risk of developing iron deficiency. In full-term babies iron deficiency can occur due to intestinal malformation that leads to duodenal resection. To avoid iron deficiency in at-risk babies, iron supplementation is recommended from

  4. Increase in perivillous fibrinoid material in placentas from pregnancies with preeclampsia

    OpenAIRE

    Souza, Diego Agra de; Bezerra, Antonio Fernando de Sousa; Wanderley, David Campos; Souto, Claudia Maria Barbosa

    2011-01-01

    INTRODUÇÃO: A pré-eclâmpsia responde por alta morbimortalidade no Brasil e no mundo. A sua etiologia ainda não foi totalmente esclarecida. Entre as alterações placentárias na pré-eclâmpsia citam-se: infartos, aumento de nós sinciciais, hipotrofia vilositária, espessamento da membrana basal trofoblástica e deposição de material fibrinoide. OBJETIVO: Analisar quantitativamente imagens do material fibrinoide perivilositário presente em placentas de gestações com e sem pré-eclâmpsia. MATERIAL E M...

  5. Conservative Management of Placenta Accreta in a Multiparous Woman

    Directory of Open Access Journals (Sweden)

    Jennifer C. Hunt

    2010-01-01

    Full Text Available Placenta accreta refers to any abnormally invasive placental implantation. Diagnosis is suspected postpartum with failed delivery of a retained placenta. Massive obstetrical hemorrhage is a known complication, often requiring peripartum hysterectomy. We report a case of presumed placenta accreta in a patient following failed manual removal of a retained placenta. We describe an attempt at conservative management with methotrexate in a stable patient desiring future fertility. Treatment was unsuccessful and led to the development of a disseminated intrauterine infection complicated by a bowel obstruction, requiring both a hysterectomy and small bowel resection. In hemodynamically stable patients, conservative management of placenta accreta may involve leaving placental tissue in situ with subsequent administration of methotrexate. However, ongoing close observation is required to identify complications.

  6. D2-40/podoplanin expression in the human placenta

    Science.gov (United States)

    Wang, Yuping; Sun, Jingxia; Gu, Yang; Zhao, Shuang; Groome, Lynn J.; Alexander, J. Steven

    2011-01-01

    Placental tissue expresses many lymphatic markers. The current study was undertaken to examine if D2-40/podoplanin, a lymphatic endothelial marker, was expressed in the human placentas, and how it is altered developmentally and pathologically. We studied D2-40/podoplanin and VEGFR-3 expressions in placentas from normotensive pregnancies at different gestational ages and in placentas from women with clinically defined preeclampsia. D2-40 expression in systemic lymphatic vessel endothelium served as a positive control. Protein expression for D2-40, VEGFR-3, and β-actin were determined by Western blot in placentas from normotensive (n=6) and preeclamptic (n=5) pregnancies. Our results show that D2-40/podoplanin was strongly expressed in the placenta, mainly as a network plexus pattern in the villous stroma throughout gestation. CD31 was limited to villous core fetal vessel endothelium and VEGFR-3 was found in both villous core fetal vessel endothelium and trophoblasts. D2-40/podoplanin expression was significantly decreased, and VEGFR-3 significantly increased in preeclamptic placental tissues compared to normotensive placental controls. Placental villous stroma is a reticular-like structure, and the localization of D2-40 to the stroma suggests that a lymphatic-like conductive network may exist in the human placenta. D2-40/podoplanin is an O-linked sialoglycoprotein. Although little is known regarding biological functions of sialylated glycoproteins within the placenta, placental D2-40/podoplanin may support fetal vessel angiogenesis during placenta development and reduced D2-40/podoplanin expression in preeclamptic placenta may contribute to altered interstitial fluid homeostasis and impaired angiogenesis in this pregnancy disorder. PMID:21095001

  7. Cervical Length in Patients at Risk for Placenta Accreta.

    Science.gov (United States)

    Rac, Martha W F; McIntire, Donald D; Wells, C Edward; Moschos, Elysia; Twickler, Diane D

    2017-07-01

    To evaluate cervical length measurements in women with placenta accreta compared to women with a nonadherent low-lying placenta or placenta previa and evaluate this relationship in terms of vaginal bleeding, preterm labor, and preterm birth. We conducted a retrospective cohort study between 1997 and 2011 of gravidas with more than 1 prior cesarean delivery who had a transvaginal ultrasound examination between 24 and 34 weeks for a low-lying placenta or placenta previa. Cervical length was measured from archived images in accordance with national guidelines by a single investigator, who was blinded to outcomes and ultrasound reports. The diagnosis of placental accreta was based on histologic confirmation. For study purposes, preterm birth was defined as less than 36 weeks, and cervical lengths of 3 cm or less were considered short. Standard statistical analyses were used. A total of 125 patients met inclusion criteria. The cohort was divided into patients with (n = 43 [34%]) and without (n = 82 [66%]) placenta accreta and stratified by gestational age at the ultrasound examinations. Women with placenta accreta had shorter cervical length measurements during their 32- to 34-week ultrasound examinations (mean ± SD, 3.23 ± 0.98 versus 3.95 ± 1.0 cm; P accreta had shorter cervical lengths at 32 to 34 weeks than women with a nonadherent low-lying placenta or placenta previa, but this finding did not correlate with a higher risk of vaginal bleeding or preterm labor resulting in preterm birth before 36 weeks. © 2017 by the American Institute of Ultrasound in Medicine.

  8. Exposure to air pollutants during the early weeks of pregnancy, and placenta praevia and placenta accreta in the western part of Japan.

    Science.gov (United States)

    Michikawa, Takehiro; Morokuma, Seiichi; Yamazaki, Shin; Fukushima, Kotaro; Kato, Kiyoko; Nitta, Hiroshi

    2016-01-01

    Placenta praevia is an obstetric complication involving placental implantation in the lower uterine segment. Given the suggested aetiology of placenta praevia, adverse biological effects of air pollutants, such as plasma viscosity increment, endothelial dysfunction, and systemic inflammation, have the potential to induce low implantation. We explored the association between exposure to air pollutants during the pregnancy period up to implantation, and placenta praevia, in pregnant Japanese women. The outcome also included placenta accreta, which often exists in combination with placenta praevia. From the Japan Perinatal Registry Network database, we obtained data on 40,573 singleton pregnant women in western Japan (Kyushu-Okinawa Districts) between 2005 and 2010. We assigned pollutant concentrations (suspended particulate matter [SPM], ozone, nitrogen dioxide [NO2], and sulphur dioxide [SO2]), measured at the nearest monitoring station to the respective delivery hospital of each woman. A logistic regression model was used to adjust for several covariates. The odds ratios (ORs) of placenta praevia per 10 units increase were 1.12 (95% confidence interval (CI)=1.01-1.23) for SPM over 0-4weeks of gestation, and 1.08 (1.00-1.16) for ozone. The association between exposure to NO2 and SO2, and praevia, was in the direction of increased risk. SPM exposure during 0-4weeks was associated with placenta accreta without praevia (OR=1.33, 95% CI=1.07-1.66). We found no association with exposure to air pollutants during 5-12weeks and the second trimester. Exposure to air pollutants through to implantation was positively associated with placenta praevia and accreta. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Morphological analysis of the placenta of paca (Agouti paca L., 1766): Study with light microscopy and transmission electron microscopy

    OpenAIRE

    BONATELLI, Marina; MACHADO, Márcia Rita Fernandes; CRUZ, Claudinei; MIGLINO, Maria Angélica

    2001-01-01

    Foram estudados os aspectos morfológicos de nove placentas de paca (Agouti paca, L., 1766) mediante análises em microscopia de luz e eletrônica de transmissão dos fragmentos teciduais correspondentes à porção de maior conexão placentária em diferentes fêmeas gestantes, nos estágios intermediário e final da prenhez. Realizamos este estudo, pois, aliada à necessidade da procura de novas espécies que atuem como modelos experimentais adequados, havia a disponibilidade deste roedor em nosso meio; ...

  10. Vascular corrosion casting of normal and pre-eclamptic placentas.

    Science.gov (United States)

    Yin, Geping; Chen, Ming; Li, Juan; Zhao, Xiaoli; Yang, Shujun; Li, Xiuyun; Yuan, Zheng; Wu, Aifang

    2017-12-01

    Pre-eclampsia is an important cause of maternal and fetal morbidity and mortality that is associated with decreased placental perfusion. In the present study, vascular corrosion casting was used to investigate the differences in structural changes of the fetoplacental vasculature between normal and pre-eclamptic placentas. An improved epoxy resin vascular casting technique was used in the present study. Casting media were infused into 40 normal and 40 pre-eclamptic placentas through umbilical arteries and veins in order to construct three dimensional fetoplacental vasculatures. The number of branches, diameter, morphology and peripheral artery-to-vein ratio were measured for each specimen. The results indicated that the venous system of normal placentas was divided into 5-7 grades of branches and the volume of the vascular bed was 155.5±45.3 ml. In severe pre-eclamptic placentas, the volume was 106.4±36.1 ml, which was significantly lower compared with normal placentas (P<0.01). The venous system of pre-eclamptic placentas was divided into 4-5 grades of branches, which was much more sparse compared with normal placentas. In additions, the diameters of grade 1-3 veins and grade 2-3 arteries were significantly smaller in severe pre-eclampsia (P<0.05). In conclusion, pre-eclamptic placentas displayed a decreased volume of vascular bed, smaller diameters of grade 1-3 veins and grade 2-3 arteries, and an increased peripheral artery-to-vein ratio, which may be a cause of the placental dysfunction during severe pre-eclampsia.

  11. Mothers' feelings about breastfeeding their premature babies in a rooming-in facility Sentimientos de madres al amamantar a sus bebés prematuros en sistema de alojamiento conjunto Sentimentos de mães ao amamentarem seus bebês prematuros em sistema de alojamento conjunto

    Directory of Open Access Journals (Sweden)

    Rejane Marie Barbosa Davim

    2010-09-01

    Full Text Available This study aimed at learning about the feelings experienced by mothers while breastfeeding their premature babies in a rooming-in facility, by means of individual interviews with 33 mothers during the period of February to April 2006, at a maternity hospital in Natal/RN/Brazil. The main feelings referred by the mothers regarding their inability to breastfeed their premature babies immediately after delivery were: sorrow, guilt, disappointment, frustration, insecurity, and fear of touching, holding or harming the delicate babies while breastfeeding. However, the mother-child bond that was formed when the baby was discharged from the Neonatal Intensive Care Unit and taken to the rooming-in facility was reflected by feelings of fulfillment, pride, and satisfaction at experiencing the first breastfeeding.Estudio realizado con el objetivo de conocer los sentimientos de madres al amamantar a sus bebés prematuros en Sistema de Alojamiento Conjunto, realizándose entrevistas individuales con 33 madres acompañantes en el período comprendido entre febrero y abril de 2006, en una maternidad escuela de Natal / RN / Brasil. Los principales sentimientos referidos por esas madres resultaron en tristeza, culpa, decepción, frustración, inseguridad, miedo de tocar, asegurar o hasta incluso de perjudicar a sus delicados bebés mientras eran amamantados. No obstante eso, el vínculo creado por madres y bebés cuando los mismos reciben el alta de la Unidad de Terapia Intensiva Neonatal para el Sistema de Alojamiento Conjunto, se manifiesta en los sentimientos de realización y orgullo, los cuales son determinados por la satisfacción de la primera lactancia.Estudo teve o objetivo de conhecer os sentimentos de mães ao amamentarem seus bebês prematuros em Sistema de Alojamento Conjunto. Entrevistas individuais foram realizadas com 33 mães acompanhantes no período de fevereiro a abril de 2006, em uma maternidade-escola de Natal/RN/Brasil. Os principais

  12. Reoccurrence of retained placenta at vaginal delivery

    DEFF Research Database (Denmark)

    Nikolajsen, Sys; Løkkegaard, Ellen Christine Leth; Bergholt, Thomas

    2013-01-01

    To estimate the prevalence and validate the diagnosis of retained placenta in nulliparous women and the risk of reoccurrence at subsequent vaginal delivery.......To estimate the prevalence and validate the diagnosis of retained placenta in nulliparous women and the risk of reoccurrence at subsequent vaginal delivery....

  13. Placenta Maps: In Utero Placental Health Assessment of the Human Fetus.

    Science.gov (United States)

    Miao, Haichao; Mistelbauer, Gabriel; Karimov, Alexey; Alansary, Amir; Davidson, Alice; Lloyd, David F A; Damodaram, Mellisa; Story, Lisa; Hutter, Jana; Hajnal, Joseph V; Rutherford, Mary; Preim, Bernhard; Kainz, Bernhard; Groller, M Eduard

    2017-06-01

    The human placenta is essential for the supply of the fetus. To monitor the fetal development, imaging data is acquired using (US). Although it is currently the gold-standard in fetal imaging, it might not capture certain abnormalities of the placenta. (MRI) is a safe alternative for the in utero examination while acquiring the fetus data in higher detail. Nevertheless, there is currently no established procedure for assessing the condition of the placenta and consequently the fetal health. Due to maternal respiration and inherent movements of the fetus during examination, a quantitative assessment of the placenta requires fetal motion compensation, precise placenta segmentation and a standardized visualization, which are challenging tasks. Utilizing advanced motion compensation and automatic segmentation methods to extract the highly versatile shape of the placenta, we introduce a novel visualization technique that presents the fetal and maternal side of the placenta in a standardized way. Our approach enables physicians to explore the placenta even in utero. This establishes the basis for a comparative assessment of multiple placentas to analyze possible pathologic arrangements and to support the research and understanding of this vital organ. Additionally, we propose a three-dimensional structure-aware surface slicing technique in order to explore relevant regions inside the placenta. Finally, to survey the applicability of our approach, we consulted clinical experts in prenatal diagnostics and imaging. We received mainly positive feedback, especially the applicability of our technique for research purposes was appreciated.

  14. Invasive placenta previa. Placental bulge with distorted uterine outline and uterine serosal hypervascularity at 1.5T MRI - useful features for differentiating placenta percreta from placenta accreta

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Xin; Zhang, Xinjuan; Wang, Shanshan; Shi, Honglu; Gao, Fei; Wang, Guangbin [Shandong University, Department of MR, Shandong Medical Imaging Research Institute, Jinan, Shandong (China); Shan, Ruiqin [Jinan Maternity and Child Care Hospital, Department of Obstetrics, Jinan (China); Zhao, Lianxin [Qilu Hospital of Shandong University, Department of Radiology, Jinan, Shandong (China); Song, Qingxu [Qilu Hospital of Shandong University, Department of Radiation Oncology, Jinan, Shandong (China); Zuo, Changting [Shandong Provincial Hospital Affiliated to Shandong University, Department of Obstetrics and Gynaecology, Jinan, Shandong (China); Qian, Tianyi [MR Collaborations NE Asia, Siemens Healthcare, Beijing (China); Limperopoulos, Catherine [Children' s National Health System, Division of Diagnostic Imaging and Radiology, Washington, DC (United States); George Washington University School of Medicine, Department of Radiology, Washington, DC (United States)

    2018-02-15

    To characterise MRI features of invasive placenta previa and to identify specific features for differentiating placenta percreta (PP) from placenta accreta (PA). Forty-five women with PP and 93 women with PA who underwent 1.5T placental MRI were included. Two radiologists independently evaluated the MRI features of invasive placenta previa, including our novel type of placental bulge (i.e. placental bulge type-II, characterized by placental bulge with distorted uterine outline). Pearson's chi-squared or Fisher's two-sided exact test was performed to compare the MRI features between PP and PA. Logistic stepwise regression analysis and the area under the receiver operating characteristic curve (AUC) were performed to select the optimal features for differentiating PP from PA. Significant differences were found in nine MRI features between women with PP and those with PA (P <0.05). Placental bulge type-II and uterine serosal hypervascularity were independently associated with PP (odds ratio = 48.618, P < 0.001; odds ratio = 4.165, P = 0.018 respectively), and the combination of the two MRI features to distinguish PP from PA yielded an AUC of 0.92 for its predictive performance. Placental bulge type-II and uterine serosal hypervascularity are useful MRI features for differentiating PP from PA. (orig.)

  15. Invasive placenta previa: Placental bulge with distorted uterine outline and uterine serosal hypervascularity at 1.5T MRI - useful features for differentiating placenta percreta from placenta accreta.

    Science.gov (United States)

    Chen, Xin; Shan, Ruiqin; Zhao, Lianxin; Song, Qingxu; Zuo, Changting; Zhang, Xinjuan; Wang, Shanshan; Shi, Honglu; Gao, Fei; Qian, Tianyi; Wang, Guangbin; Limperopoulos, Catherine

    2018-02-01

    To characterise MRI features of invasive placenta previa and to identify specific features for differentiating placenta percreta (PP) from placenta accreta (PA). Forty-five women with PP and 93 women with PA who underwent 1.5T placental MRI were included. Two radiologists independently evaluated the MRI features of invasive placenta previa, including our novel type of placental bulge (i.e. placental bulge type-II, characterized by placental bulge with distorted uterine outline). Pearson's chi-squared or Fisher's two-sided exact test was performed to compare the MRI features between PP and PA. Logistic stepwise regression analysis and the area under the receiver operating characteristic curve (AUC) were performed to select the optimal features for differentiating PP from PA. Significant differences were found in nine MRI features between women with PP and those with PA (P Placental bulge type-II and uterine serosal hypervascularity were independently associated with PP (odds ratio = 48.618, P Placental bulge type-II and uterine serosal hypervascularity are useful MRI features for differentiating PP from PA. • Placental bulge type-II demonstrated the strongest independent association with PP. • Uterine serosal hypervascularity is a useful feature for differentiating PP from PA. • MRI features associated with abnormal vessels increase the risk of massive haemorrhage.

  16. Invasive placenta previa. Placental bulge with distorted uterine outline and uterine serosal hypervascularity at 1.5T MRI - useful features for differentiating placenta percreta from placenta accreta

    International Nuclear Information System (INIS)

    Chen, Xin; Zhang, Xinjuan; Wang, Shanshan; Shi, Honglu; Gao, Fei; Wang, Guangbin; Shan, Ruiqin; Zhao, Lianxin; Song, Qingxu; Zuo, Changting; Qian, Tianyi; Limperopoulos, Catherine

    2018-01-01

    To characterise MRI features of invasive placenta previa and to identify specific features for differentiating placenta percreta (PP) from placenta accreta (PA). Forty-five women with PP and 93 women with PA who underwent 1.5T placental MRI were included. Two radiologists independently evaluated the MRI features of invasive placenta previa, including our novel type of placental bulge (i.e. placental bulge type-II, characterized by placental bulge with distorted uterine outline). Pearson's chi-squared or Fisher's two-sided exact test was performed to compare the MRI features between PP and PA. Logistic stepwise regression analysis and the area under the receiver operating characteristic curve (AUC) were performed to select the optimal features for differentiating PP from PA. Significant differences were found in nine MRI features between women with PP and those with PA (P <0.05). Placental bulge type-II and uterine serosal hypervascularity were independently associated with PP (odds ratio = 48.618, P < 0.001; odds ratio = 4.165, P = 0.018 respectively), and the combination of the two MRI features to distinguish PP from PA yielded an AUC of 0.92 for its predictive performance. Placental bulge type-II and uterine serosal hypervascularity are useful MRI features for differentiating PP from PA. (orig.)

  17. Isotopic location of the placenta. Experience of Lariboisiere Hospital

    International Nuclear Information System (INIS)

    Naccache, Gilbert.

    1974-01-01

    All isotopic placenta location techniques make use of the vascularisation difference between the placenta and the neighbouring tissues. The principle is based on the amount of blood in the intervillous space and the maternal blood circulation rate in the placenta area. The techniques, all based on this principle, differ by the nature of the radioelement and the performance of the instruments used. Mention is made of the qualities governing the choice of radioisotope injected, with emphasis on the need to reduce the foetal irradiation. Two kinds of scintigraphic equipment are used, one with a mobile detector moving above the woman's abdomen and the other using a fixed detector, the scintillation camera, which gives the placenta image very rapidly. The practical details of an experiment covering 49 cases of placenta location, using a scintillation camera and sup(99m)Tc-labelled red blood cells, are described in full [fr

  18. Posição prona e diminuição da assincronia toracoabdominal em recém-nascidos prematuros Prone position and reduced thoracoabdominal asynchrony in preterm newborns

    Directory of Open Access Journals (Sweden)

    Trícia G. Oliveira

    2009-10-01

    Full Text Available OBJETIVO: Avaliar a influência das posições prona e supina em recém-nascidos prematuros pós-síndrome do desconforto respiratório, respirando espontaneamente e em estado de sono ativo, sobre variáveis de padrão respiratório, movimento toracoabdominal e saturação periférica da hemoglobina pelo oxigênio. MÉTODOS: Estudo quase experimental. Doze prematuros com peso > 1.000 g no momento do estudo foram estudados nas duas posições, em ordem randomizada. A pletismografia respiratória por indutância foi utilizada para avaliação do padrão respiratório (volume corrente, frequência respiratória, ventilação minuto, fluxo inspiratório médio e do movimento toracoabdominal (índice de trabalho respiratório, relação de fase inspiratória, relação de fase expiratória, relação de fase respiratória total e ângulo de fase. A oximetria de pulso registrou a saturação periférica de oxigênio. Para a análise estatística foram realizados os testes t de Student para amostras pareadas ou Wilcoxon. Foi considerado significativo p OBJECTIVE: To assess the effect of prone and supine positions on breathing pattern variables, thoracoabdominal motion and peripheral oxygen saturation of hemoglobin of premature newborn infants recovering from respiratory distress syndrome, while breathing spontaneously and in rapid eye movement sleep. METHODS: This was a quasi-experimental study. Twelve preterms weighing > 1,000 g at enrollment were studied in both positions, in random order. Respiratory inductive plethysmography was used to analyze breathing pattern (tidal volume, respiratory rate, minute ventilation, mean inspiratory flow and thoracoabdominal motion (labored breathing index, phase relation in inspiration, phase relation in expiration, phase relation in total breath and phase angle. Pulse oximetry was used to evaluate peripheral oxygen saturation. Student's t test for paired samples or the Wilcoxon test were used for statistical

  19. Uso da tecnologia como ferramenta de avaliação no cuidado clínico de recém-nascidos prematuros Use of technology as an evaluation tool of clinical care in preterm newborns

    Directory of Open Access Journals (Sweden)

    Izabel Mendes

    2006-10-01

    Full Text Available OBJETIVO: Analisar a aplicação do Neonatal Therapeutic Intervention Scoring System (NTISS como um instrumento capaz de quantificar a utilização de tecnologias nas práticas assistenciais de unidades de terapia intensiva neonatal, no sentido de detectar variações nos cuidados ao recém-nascido de alto risco. MÉTODOS: Foi realizado um estudo observacional prospectivo descritivo da intensidade de tecnologias em duas unidades de terapia intensiva neonatal, sendo uma pública e uma privada. O NTISS foi calculado diariamente até a alta ou óbito dos recém-nascidos prematuros com idade gestacional igual ou inferior a 32 semanas de idade gestacional. Obtivemos dados sobre as condições clínicas pré-natais, de nascimento, da admissão e das morbidades apresentadas durante a internação. O ajuste de risco dos recém-nascidos prematuros foi obtido por meio do Score for Neonatal Acute Physiology, Perinatal Extension, Version II (SNAPPE-II. Para a análise descritiva, realizamos testes t de Student, qui-quadrado, exato de Fisher e Mann-Whitney/Wilcoxon. Este estudo foi aprovado pelo comitê de ética e pesquisa. RESULTADOS: Foram avaliados 44 recém-nascidos admitidos na unidade pública e 52 na unidade privada. Na admissão, o escore de gravidade (SNAPPE-II e o NTISS total foram estatisticamente semelhantes em ambas as unidades. A curva de utilização de tecnologias apresentou padrão de queda gradual e progressiva para as duas unidades até o 31º dia. A partir desse dia, enquanto a unidade privada manteve a tendência de queda, a unidade pública mostrou um incremento significativo do NTISS total. Os pacientes da unidade pública desenvolveram mais morbidades do que os da unidade privada. CONCLUSÃO: Pacientes com quadros clínicos semelhantes podem ser tratados com diferentes intensidades de utilização de tecnologias. Isso pode ter impacto direto em morbidades e em custos assistenciais. O NTISS permitiu a monitorização da assistência e

  20. Conservative surgical management of placenta accreta: a report of 3 cases.

    Science.gov (United States)

    Pliskow, Steven; Dai, Xiaorong; Kohner, Andrew; Kapnick, Jason

    2009-10-01

    Placenta accreta is often diagnosed at the time of delivery and is a cause of postpartum hemorrhage, morbidity and mortality. The standard treatment for placenta accreta is hysterectomy to avoid acute blood loss and shock. A conservative surgical approach to the treatment of placenta accreta will allow immediate cure while preserving the patient's future fertility. A 39-year-old woman with placenta accreta diagnosed at the time of vaginal delivery was successfully treated with resection of the placental implantation site. A 33-year-old woman and a 35-year-old woman with placenta accreta/increta diagnosed at the time of cesarean section were successfully treated with resection of the placental implantation site. One patient has since conceived and given birth. Placenta accreta and placenta increta can be safely and successfully treated, in some well-selected cases, by resection of the placental implantation site and uterine repair. This conservative surgical management provides immediate therapy, reduces blood loss and preserves fertility.

  1. MRI of placenta percreta: differentiation from other entities of placental adhesive disorder.

    Science.gov (United States)

    Thiravit, Shanigarn; Lapatikarn, Sukanya; Muangsomboon, Kobkun; Suvannarerg, Voraparee; Thiravit, Phakphoom; Korpraphong, Pornpim

    2017-01-01

    To retrospectively review the MRI findings of placenta percreta and identify those helpful for differentiation from non-placenta percreta. The MRI images of 21 patients with a preliminary diagnosis of placental adhesive disorder scanned between 2005 and 2014 were evaluated. Radiologists blinded to the final diagnosis evaluated six previously described MRI findings of placenta adhesive disorder. The sensitivity, specificity, accuracy, negative predictive value (NPV), and positive predictive value (PPV) of MRI for the diagnosis of placenta percreta were also calculated. The study included 12 cases of placenta percreta and 9 cases of non-placenta percreta. Invasion of placental tissue outside the uterus was found only in placenta percreta (p = 0.045; sensitivity 41.7 %; specificity 100 %). All placenta percreta cases also had a moderate to marked degree of heterogeneous placental signal intensity (p = 0.063; sensitivity 100 %; specificity 33.3 %). The size of the dark bands on T2-weighted imaging, and the presence of disorganized intra-placental vessels, showed no statistically significant difference between placenta percreta and non-placenta percreta. The sensitivity, specificity, NPV, PPV, and accuracy of MRI for detection of placenta percreta were 91.7, 44, 80, 68, and 71.4 %, respectively. MRI is recommended for the evaluation of placenta percreta, with the most specific signs including the invasion of placental tissue outside the uterus on B-FFE sequences, and consideration of the degree of placental signal heterogeneity. The size of the T2 dark band alone, or bizarre disorganized intra-placental vessels, did not correlate with the severity of invasion.

  2. Abnormal labyrinthine zone in the Hectd1-null placenta.

    Science.gov (United States)

    Sarkar, Anjali A; Sabatino, Julia A; Sugrue, Kelsey F; Zohn, Irene E

    2016-02-01

    The labyrinthine zone of the placenta is where exchange of nutrients and waste occurs between maternal and fetal circulations. Proper development of the placental labyrinth is essential for successful growth of the developing fetus and abnormalities in placental development are associated with intrauterine growth restriction (IUGR), preeclampsia and fetal demise. Our previous studies demonstrate that Hectd1 is essential for development of the junctional and labyrinthine zones of the placenta. Here we further characterize labyrinthine zone defects in the Hectd1 mutant placenta. The structure of the mutant placenta was compared to wildtype littermates using histological methods. The expression of cell type specific markers was examined by immunohistochemistry and in situ hybridization. Hectd1 is expressed in the labyrinthine zone throughout development and the protein is enriched in syncytiotrophoblast layer type I cells (SynT-I) and Sinusoidal Trophoblast Giant cells (S-TGCs) in the mature placenta. Mutation of Hectd1 results in pale placentas with frequent hemorrhages along with gross abnormalities in the structure of the labyrinthine zone including a smaller overall volume and a poorly elaborated fetal vasculature that contain fewer fetal blood cells. Examination of molecular markers of labyrinthine trophoblast cell types reveals increased Dlx3 positive cells and Syna positive SynT-I cells, along with decreased Hand1 and Ctsq positive sinusoidal trophoblast giant cells (S-TGCs). Together these defects indicate that Hectd1 is required for development of the labyrinthine zonethe mouse placenta. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Per operative discovery of Placenta Praevia Percreta: A case report ...

    African Journals Online (AJOL)

    Placenta percreta is a rare pathological entity with challenging diagnostic and therapeutic requirements especially for resource limited settings. We present here the case of a 40 year old woman with a per operative diagnosis of placenta accreta during a caesarian section indicated for placenta praevia. We highlight the ...

  4. Angiogenic factor imbalance precedes complement deposition in placentae of the BPH/5 model of preeclampsia.

    Science.gov (United States)

    Sones, Jennifer L; Merriam, Audrey A; Seffens, Angelina; Brown-Grant, Dex-Ann; Butler, Scott D; Zhao, Anna M; Xu, Xinjing; Shawber, Carrie J; Grenier, Jennifer K; Douglas, Nataki C

    2018-05-01

    Preeclampsia (PE), a hypertensive disorder of pregnancy, is a leading cause of maternal and fetal morbidity and mortality. Although the etiology is unknown, PE is thought to be caused by defective implantation and decidualization in pregnancy. Pregnant blood pressure high (BPH)/5 mice spontaneously develop placentopathies and maternal features of human PE. We hypothesized that BPH/5 implantation sites have transcriptomic alterations. Next-generation RNA sequencing of implantation sites at peak decidualization, embryonic day (E)7.5, revealed complement gene up-regulation in BPH/5 vs. controls. In BPH/5, expression of complement factor 3 was increased around the decidual vasculature of E7.5 implantation sites and in the trophoblast giant cell layer of E10.5 placentae. Altered expression of VEGF pathway genes in E5.5 BPH/5 implantation sites preceded complement dysregulation, which correlated with abnormal vasculature and increased placental growth factor mRNA and VEGF 164 expression at E7.5. By E10.5, proangiogenic genes were down-regulated, whereas antiangiogenic sFlt-1 was up-regulated in BPH/5 placentae. We found that early local misexpression of VEGF genes and abnormal decidual vasculature preceded sFlt-1 overexpression and increased complement deposition in BPH/5 placentae. Our findings suggest that abnormal decidual angiogenesis precedes complement activation, which in turn contributes to the aberrant trophoblast invasion and poor placentation that underlie PE.-Sones, J. L., Merriam, A. A., Seffens, A., Brown-Grant, D.-A., Butler, S. D., Zhao, A. M., Xu, X., Shawber, C. J., Grenier, J. K., Douglas, N. C. Angiogenic factor imbalance precedes complement deposition in placentae of the BPH/5 model of preeclampsia.

  5. The role of shear wave elastography in the assessment of placenta previa-accreta.

    Science.gov (United States)

    Alıcı Davutoglu, Ebru; Ariöz Habibi, Hatice; Ozel, Ayşegül; Yuksel, Mehmet Aytac; Adaletli, Ibrahim; Madazlı, Riza

    2018-06-01

    To evaluate the value of shear wave elastography (SWE) in the prediction of morbidly adherent placenta. Forty-three women with normal placental location and 26 women with anteriorly localized placenta previa were recruited for this case-control study. Placental elasticity values in both the groups were determined by SWE imaging. SWE values were higher in the placenta previa group in all regions than in normal localized placentas (p  .05). Placental stiffness is significantly higher in placenta previa than normal localized placentas. However, we could not demonstrate any statistically significant difference in the elasticity values between the placenta previa with and without accreta.

  6. Comparação entre a frequência de positividade do questionário T-ACE entre mães de recém-nascidos de termo e prematuros

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    Inês Maria Crespo Gutierrez Pardo

    2013-12-01

    Full Text Available Objetivos: os objetivos deste estudo foram verificar a frequência de positividade do T-ACE questionário durante a gravidez de mães de recém-nascidos prematuros comparados com as de termo, e avaliar a associação de álcool referido pelo teste com o tabagismo materno e paterno. Métodos: estudo tipo observacional, transversal, com recrutamento de forma sequencial de 142 puérperas de uma maternidade pública. Foram aplicados: entrevista para coleta de dados clínicos e sociodemográficos e T-ACE questionário. Os recém-nascidos de termo e prematuros destas mulheres foram avaliados em relação ao peso, comprimento e perímetro cefálico ao nascimento. Estudo aprovado pelo comitê de Ética local e a participação das mulheres foi mediante assinatura do termo de consentimento livre e esclarecido. A análise dos dados foi realizada usando o programa SPSS, sendo adotado nível de significância de 5%. Resultados: das puérperas entrevistadas 21,1% foram consideradas consumidoras de álcool pelo T-ACE questionário. Quando divididas entre puérperas de partos de termo e prematuros, encontraram-se 21% de positividade do T-ACE teste no grupo de termo e 21,3% no grupo dos prematuros (p = 0,98. Houve importante associação entre positividade do T-ACE questionário e tabagismo materno e paterno durante a gestação (p = 0,04. Conclusões: cerca de duas em cada dez gestantes apresentaram teste T-ACE positivo, sem diferença entre o grupo de parto de termo e prematuros. A associação encontrada entre o consumo de álcool e fumo durante a gravidez sugere a importância do rastreamento rotineiro do T-ACE questionário, tendo em vista que esses dois agentes potencializam efeitos adversos no feto.

  7. Apoptose e expressão de Bcl-2 e das caspases 3 e 8 em placenta bovina, em diferentes estádios de gestação Apoptosis and expression of Bcl-2 and caspases 3 and 8 in placenta of cows at different pregnancy stages

    Directory of Open Access Journals (Sweden)

    K.K.O.L. Meça

    2010-04-01

    Full Text Available Apoptose e seus mecanismos reguladores são eventos fisiológicos cruciais para a manutenção da homeostase placentária, e o desequilíbrio desses processos pode comprometer a função placentária e, consequentemente, o sucesso da gravidez. Neste estudo, investigou-se a apoptose utilizando-se histomorfometria em lâminas coradas em HE e submetidas à reação de TUNEL. Além disso, avaliou-se a expressão de Bcl-2 e das caspases 8 e 3, pela reação de polimerase em cadeia em tempo real, em placentas saudáveis em diferentes estádios de gestação. Amostras de placentônios de vacas com quatro, seis e nove meses de gestação foram colhidas e processadas. O índice apoptótico aumentou progressivamente com o avanço da gestação. Tanto o Bcl-2 quanto as caspases 3 e 8 foram expressas nos três períodos estudados, sendo a expressão de Bcl-2 menor que a de caspase 8, que é menor que a de caspase 3. Estes resultados indicam que essas moléculas estão envolvidas na via apoptótica ativada na maturação placentária, exibindo um padrão de expressão ao longo da gestação e contribuindo para o equilíbrio fisiológico da celularidade e renovação celular na placenta bovina.Apoptosis and its regulating mechanisms are crucial physiological events for the maintenance of the placental homostasis; and disequilibrium of these processes may compromise placental function and the success of the pregnancy. In this study, apoptosis was investigated by histomorphometry using slides stained with HE and TUNEL reaction. Besides that, Bcl-2 and caspases 8 and 3 expression were evaluated by real time polymerase chain reaction in healthy placentas under different gestacional ages. Samples of placentones of cows at 4th, 6th, and 9th months of gestation were harvested and processed. The apoptotic index gradually increased with the advance of the gestation. Bcl-2 and caspases 3 and 8 were expressed in all the studied periods, being the expression of Bcl-2

  8. Relationship between first trimester aneuploidy screening test serum analytes and placenta accreta.

    Science.gov (United States)

    Büke, Barış; Akkaya, Hatice; Demir, Sibel; Sağol, Sermet; Şimşek, Deniz; Başol, Güneş; Barutçuoğlu, Burcu

    2018-01-01

    The aim of this study is to determine whether there is a relationship between first trimester serum pregnancy-associated plasma protein A (PAPP-A) and free beta human chorionic gonadotropin (fβhCG) MoM values and placenta accreta in women who had placenta previa. A total of 88 patients with placenta previa who had first trimester aneuploidy screening test results were enrolled in the study. Nineteen of these patients were also diagnosed with placenta accreta. As probable markers of excessive placental invasion, serum PAPP-A and fβhCG MoM values were compared in two groups with and without placenta accreta. Patients with placenta accreta had higher statistically significant serum PAPP-A (1.20 versus 0.865, respectively, p = 0.045) and fβhCG MoM (1.42 versus 0.93, respectively, p = 0.042) values than patients without accreta. Higher first trimester serum PAPP-A and fβhCG MoM values seem to be associated with placenta accreta in women with placenta previa. Further studies are needed to use these promising additional tools for early detection of placenta accreta.

  9. The Placenta: Applications in Orthopaedic Sports Medicine.

    Science.gov (United States)

    McIntyre, James Alexander; Jones, Ian A; Danilkovich, Alla; Vangsness, C Thomas

    2018-01-01

    Placenta has a long history of use for treating burns and wounds. It is a rich source of collagen and other extracellular matrix proteins, tissue reparative growth factors, and stem cells, including mesenchymal stem cells (MSCs). Recent data show its therapeutic potential for orthopaedic sports medicine indications. To provide orthopaedic surgeons with an anatomic description of the placenta, to characterize its cellular composition, and to review the literature reporting the use of placenta-derived cells and placental tissue allografts for orthopaedic sports medicine indications in animal models and in humans. Systematic review. Using a total of 63 keyword combinations, the PubMed and MEDLINE databases were searched for published articles describing the use of placental cells and/or tissue for orthopaedic sports medicine indications. Information was collected on placental tissue type, indications, animal model, study design, treatment regimen, safety, and efficacy outcomes. Results were categorized by indication and subcategorized by animal model. Outcomes for 29 animal studies and 6 human studies reporting the use of placenta-derived therapeutics were generally positive; however, the placental tissue source, clinical indication, and administration route were highly variable across these studies. Fourteen animal studies described the use of placental tissue for tendon injuries, 13 studies for osteoarthritis or articular cartilage injuries, 3 for ligament injuries, and 1 for synovitis. Both placenta-derived culture-expanded cells (epithelial cells or MSCs) and placental tissue allografts were used in animal studies. In all human studies, commercial placental allografts were used. Five of 6 human studies examined the treatment of foot and ankle pathological conditions, and 1 studied the treatment of knee osteoarthritis. A review of the small number of reported studies revealed a high degree of variability in placental cell types, placental tissue preparation, routes

  10. Ultrasound detection of placenta accreta in the first trimester of pregnancy

    OpenAIRE

    Fatemeh Rahimi-Sharbaf; Ashraf Jamal; Elaheh Mesdaghinia; Masoumeh Abedzadeh- Kalahroudi; Shirin Niroomanesh; Fatemeh Atoof

    2014-01-01

    Background: Placenta accreta is considered a life-threatening condition and the main cause of maternal mortality. Prenatal diagnosis of placenta accreta usually is made by clinical presentation, imaging studies like ultrasound and MRI in the second and third trimester. Objective: To determine accuracy of ultrasound findings for placenta accreta in the first trimester of pregnancy. Materials and Methods: In a longitudinal study 323 high risk patients for placenta accreta were assessed. The eli...

  11. Aspectos morfológicos do saco vitelino em roedores da subordem Hystricomorpha: paca (Agouti paca e cutia (Dasyprocta aguti Morphological aspects of yolk sac from rodents of Hystricomorpha subordem: paca (Agouti paca and agouti (Dasyprocta aguti

    Directory of Open Access Journals (Sweden)

    Rogério Arcuri Conceição

    2008-05-01

    Full Text Available Este trabalho visou caracterizar macro e microscopicamente o saco vitelino em pacas (Agouti paca e cutias (Dasyprocta aguti no início de gestação. Três embriões/fetos de pacas e três de cutias foram utilizados para a análise do saco vitelino, durante as fases iniciais de gestação. Fragmentos do saco vitelino foram removidos do embrião/feto e rotineiramente processados para inclusão em parafina (técnica histológica rotineira e em resina Spurr (análise ultra-estrutural. Macroscopicamente, a placenta vitelínica em ambas as espécies inseria-se na superfície da placenta principal, com suas margens projetando-se completamente sobre o embrião/fetos. Na microscopia de luz, a placenta vitelínica apresentava-se constituída pelo epitélio endodérmico e um mesenquima com inúmeros vasos vitelínicos. Ultraestruturalmente, a placenta vitelínica visceral da paca era formada por células endodérmicas com núcleos na região mediana e da cutia por núcleos dispostos apicalmente; outra característica foi o grande número de mitocôndrias, vesículas de conteúdo eletrodenso e com microvilosidades. Com base nos resultados concluímos, que (1 a placenta vitelínica das duas espécies apresenta inserção na superfície da placenta principal; (2 a placenta vitelínica de paca se apóia na membrana de Reichert, diferentemente da cutia, que não possui tal membrana; (3 o cório e alantóide apresentam-se fusionados, formando a placenta corioalantoídea; e (4 o saco vitelino em ambas as espécies é invertido e vascularizado.The study aimed to characterize gross and microscopic features of the yolk sac in paca (Agouti paca and agouti (Dasyprocta aguti in early gestation. Fragments of the yolk sac of 3 paca and 3 agouti fetuses at early gestation were taken and processed for histological and ultrastructural analyses. Gross features of the vitelline placenta in both species showed its insertion over the main placenta surface and projections to

  12. Placenta accreta: pathogenesis of a 20th century iatrogenic uterine disease.

    Science.gov (United States)

    Jauniaux, E; Jurkovic, D

    2012-04-01

    Placenta accreta refers to different grades of abnormal placental attachment to the uterine wall, which are characterised by invasion of trophoblast into the myometrium. Placenta accreta has only been described and studied by pathologists for less than a century. The fact that the first detailed description of a placenta accreta happened within a couple of decades of major changes in the caesarean surgical techniques is highly suggestive of a direct relationship between prior uterine surgery and abnormal placenta adherence. Several concepts have been proposed to explain the abnormal placentation in placenta accreta including a primary defect of the trophoblast function, a secondary basalis defect due to a failure of normal decidualization and more recently an abnormal vascularisation and tissue oxygenation of the scar area. The vast majority of placenta accreta are found in women presenting with a previous history of caesarean section and a placenta praevia. Recent epidemiological studies have also found that the strongest risk factor for placenta praevia is a prior caesarean section suggesting that a failure of decidualization in the area of a previous uterine scar can have an impact on both implantation and placentation. Ultrasound studies of uterine caesarean section scar have shown that large and deep myometrial defects are often associated with absence of re-epithelialisation of the scar area. These findings support the concept of a primary deciduo-myometrium defect in placenta accreta, exposing the myometrium and its vasculature below the junctional zone to the migrating trophoblast. The loss of this normal plane of cleavage and the excessive vascular remodelling of the radial and arcuate arteries can explain the in-vivo findings and the clinical consequence of placenta accreta. Overall these data support the concept that abnormal decidualization and trophoblastic changes of the placental bed in placenta accreta are secondary to the uterine scar and thus

  13. Factores asociados a asfixia perinatal en un hospital de Callao, Perú

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    F. Romero

    2016-06-01

    Conclusiones: En el hospital nacional estudiado, los principales factores de riesgo para la asfixia perinatal fueron el desprendimiento prematuro de placenta, el trabajo de parto prolongado, la corioamnionitis, la preeclampsia, la restricción de crecimiento intrauterino y recién nacido pretérmino. Los factores protectores para la asfixia perinatal fueron el grado de instrucción superior y el control prenatal adecuado.

  14. Influence of intracranial hemorrhage and neonatal seizures on the neurological and psychomotor development of premature infants at Hospital de Clínicas de Porto Alegre, Brazil Influência da hemorragia intracraniana e crises neonatais sobre o desenvolvimento neurológico e psicomotor de recém-nascidos prematuros no Hospital de Clínicas de Porto Alegre, Brasil

    Directory of Open Access Journals (Sweden)

    Lygia Ohlweiler

    2003-12-01

    Full Text Available This study compared the results of neurodevelopmental examination at 6 months' corrected age of premature infants with neonatal seizures and/or intracranial hemorrhage and normal premature infants. There was a statistically significant correlation (p=0.000007 between intracranial hemorrhage and seizures in the group of 68 premature infants seen in the neurodevelopmental outpatient service at Hospital de Clínicas de Porto Alegre, Brazil. Intracranial hemorrhage was significantly associated with multiparity (p=0.02. The neurodevelopmental examination at 6 months' corrected age revealed that patients who suffered neonatal intracranial hemorrhage and/or seizures had inappropriate muscle tone, strength and reflexes, as well as delay in head control. Conclusion: we compared the results of neurodevelopmental examinations of two groups of premature infants at 6 months' corrected age. The difference in neurological development at 6 months' corrected age was statistically significant when comparison was corrected for premature infants who had neonatal seizures and periventricular hemorrhage.Este estudo comparou os resultados do exame do desenvolvimento neuropsicomotor aos seis meses de idade corrigida de lactentes prematuros com crises neonatais e/ou hemorragia intracraniana com lactentes prematuros sem estas intercorrências. Houve uma correlação estatisticamente significativa (p=0.000007 entre hemorragia intracraniana e crises neonatais no grupo de 68 lactentes prematuros vistos no ambulatório de neurodesenvolvimento do Hospital de Clínicas de Porto Alegre, Brasil. Hemorragia intracraniana foi significativamente associada com multiparidade (p=0.02. O exame do desenvolvimento neuropsicomotor aos 6 meses de idade corrigida mostrou que pacientes que sofreram hemorragia intracraniana neonatal e/ou crises neonatais tiveram tônus, forças e reflexos inapropriados, bem como atraso no controle do sustento cefálico. Conclusões: Comparamos os resultados

  15. Peripartal leukogram in cows with and without retained placenta

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    Lužajić Tijana

    2014-01-01

    Full Text Available The aim of this study was to investigate whether prepartal leukogram in cows with retained placenta could indicate the presence of subclinical systemic inflammatory response before the onset of disease. After calving, sixteen highly pregnant Holstein cows, aged 3 to 9 years, without clinical signs of the disease prior to calving were divided into two groups: the first group (n=9 were animals without retained placenta, or any visible inflammation after birth; the second group (n=7 were cows with retained placenta. Blood was sampled three times before parturition, at intervals of one week, and once 24 hours after birth. The number of total leukocytes, segmented and non segmented neutrophilic granulocytes (NG, lymphocytes and monocytes were determined by standard laboratory techniques. The results have shown that in the group of cows with retained placenta the number of mature neutrophils was slightly elevated in the third, second and last week before calving, and equal number of non segmented neutrophils in regard to the group with no retention. The results have also shown that, in both groups of cows, 24 hours after calving, the number of total leukocytes and the number of segmented neutrophils decreased, but the number of the non segmented neutrophils increased. Based on this, we can conclude that cows with retained placenta had no systemic inflammatory response during three weeks prepartal period, but 24 hours after calving, systemic inflammatory response was documented in all the cows. Moreover, the intensity of inflammatory response in cows with retained placenta was not more pronounced in comparison to cows without retained placenta. [Projekat Ministarstva nauke Republike Srbije, br. 175061

  16. Interventions for suspected placenta praevia.

    Science.gov (United States)

    Neilson, J P

    2003-01-01

    Because placenta praevia is implanted unusually low in the uterus, it may cause major, and/or repeated, antepartum haemorrhage. The traditional policy of care of women with symptomatic placenta praevia includes prolonged stay in hospital and delivery by caesarean section. To assess the impact of any clinical intervention applied specifically because of a perceived likelihood that a pregnant woman might have placenta praevia. A comprehensive electronic search was performed to identify relevant literature. Searched databases included the Trials Register maintained by the Cochrane Pregnancy and Childbirth Group (August 2002), and the Cochrane Controlled Trials Register (The Cochrane Library, Issue 2, 2002). Any controlled clinical trial that has assessed the impact of an intervention in women diagnosed as having, or being likely to have, placenta praevia. Data were extracted, unblinded, by the author without consideration of results. Three trials were included, involving a total of 114 women. Both tested interventions (home versus hospitalisation and cervical cerclage versus no cerclage) were associated with reduced lengths of stay in hospital antenatally: weighted mean difference (WMD) respectively -18.50 days (95% confidence interval (CI) -26.83 to -10.17), -4.80 days (95% CI -6.37 to -3.23). Otherwise, there was little evidence of any clear advantage or disadvantage to a policy of home versus hospital care. The one woman who had a haemorrhage severe enough to require immediate transfusion and delivery was in the home care group. Cervical cerclage may reduce the risk of delivery before 34 weeks: relative risk (RR) 0.45 (95% CI 0.23 to 0.87), or the birth of a baby weighing less than two kilograms RR 0.34 (0.14 to 0.83) or having a low five minute Apgar score RR 0.19 (0.04 to 1.00). In general, these possible benefits were more evident in the trial of lower methodological quality. There are insufficient data from trials to recommend any change in clinical practice

  17. Histopathological, Ultrastructural and Apoptotic Changes in Diabetic Rat Placenta

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    Mehmet Gül

    2015-09-01

    Full Text Available Background: The exchange of substances between mother and fetus via the placenta plays a vital role during development. A number of developmental disorders in the fetus and placenta are observed during diabetic pregnancies. Diabetes, together with placental apoptosis, can lead to developmental and functional disorders. Aims: Histological, ultrastructural and apoptotic changes were investigated in the placenta of streptozotocin (STZ induced diabetic rats. Study Design: Animal experimentation. Methods: In this study, a total of 12 female Wistar Albino rats (control (n=6 and diabetic (n=6 were used. Rats in the diabetic group, following the administration of a single dose of STZ, showed blood glucose levels higher than 200 mg/dL after 72 hours. When pregnancy was detected after the rats were bred, two pieces of placenta and the fetuses were collected on the 20th day of pregnancy by cesarean incision under ketamine/xylazine anesthesia from in four rats from the control and diabetic groups. Placenta tissues were processed for light microscopy and transmission electron microscopy (TEM. Hematoxylin-eosin (HE and periodic acid Schiff-diastase (PAS-D staining for light microscopic and caspase-3 staining for immunohistochemical investigations were performed for each placenta. Electron microscopy was performed on thin sections contrasted with uranyl acetate and lead nitrate. Results: Weight gain in the placenta and fetuses of diabetic rats and thinning of the decidual layer, thickening of the hemal membrane, apoptotic bodies, congestion in intervillous spaces, increased PAS-D staining in decidual cells and caspase-3 immunoreactivity were observed in the diabetic group. After the ultrastructural examination, the apoptotic appearance of the nuclei of trophoblastic cells, edema and intracytoplasmic vacuolization, glycogen accumulation, dilation of the endoplasmic reticulum and myelin figures were observed. In addition, capillary basement membrane thickening

  18. Kinetics of silica nanoparticles in the human placenta

    DEFF Research Database (Denmark)

    Poulsen, Marie Sønnegaard; Mose, Tina; Maroun, Lisa Leth

    2015-01-01

    choriocarcinoma cell line and the ex vivo perfused human placenta. Nanotoxicity in BeWo cells was examined by the MTT assay which demonstrated decreased cell viability at concentrations >100 µg/mL. In the placental perfusion experiments, antipyrine crossed the placenta rapidly, with a foetal:maternal ratio of 0...

  19. The recurrence risk of placenta accreta following uterine conserving management.

    Science.gov (United States)

    Cunningham, K M; Anwar, A; Lindow, S W

    2015-01-01

    Placenta accreta is a condition of abnormal placental attachment that was usually treated by hysterectomy. Techniques to conserve the uterus are now commonly used and series of subsequent pregnancy outcomes have been reported. The recurrence risk of placenta accreta is now a relevant detail and is currently not known. This work was performed to calculate the recurrence risk by reviewing the published literature. A literature search using the terms "placenta accreta", "placenta percreta", "placenta increta", "abnormal placental attachment" and "placental attachment disorder" followed by hand-searching identified 6 papers that contained data concerning recurrence of placenta accreta in subsequent pregnancies following initial conservative treatment. Overall 407 pregnancies were recorded and 85.7% of women reported achieved a subsequent pregnancy following conservative treatment. The risk of recurrence of placental attachment disorder in a subsequent pregnancy was 19.9% (weighted mean, 95% CI 12.2-27.7). The recurrence risk of placental attachment disorder following uterine conservation treatments is 20% . This risk should be discussed with women with an antenatal diagnosis of a placental attachment disorder who may be considering uterine conservation in order to retain the option of a future pregnancy.

  20. Desafios atuais da pesquisa em toxicologia: Avaliação da toxicidade de nanomateriais manufaturados para o desenvolvimento

    Directory of Open Access Journals (Sweden)

    Isabella Fernandes Delgado

    2013-11-01

    Full Text Available Nanomateriais são partículas ou fibras que possuem pelo menos uma das três dimensões na faixa de tamanho entre 1 e 100 nm. Em virtude das suas propriedades físico-químicas ímpares as nano partículas têm uma variedade de usos na indústria e cada vez mais fazem parte do nosso cotidiano. Entretanto, apesar do número crescente de produtos da nanotecnologia chegando ao mercado, a avaliação dos riscos das NPs para saúde está na sua infância. Os efeitos nocivos das NPs sobre o desenvolvimento pré-natal tem sido ainda menos investigados. Este artigo sumariza a literatura sobre os efeitos das NPs sobre o desenvolvimento. Os estudos são em geral muito recentes e incluem experimentos ex vivo empregando invertebrados e vertebrados não-mamíferos, ensaios in vitro (células tronco embrionárias de camundongos e in vivo em roedores. Muito pouco tem sido publicado a respeito dos efeitos das NPs na placenta e sobre a passagem das NPs da mãe para o embrião e feto humanos. Algumas limitações dos ensaios ex vivo e in vitro para evidenciar potenciais perigos das NPs para o desenvolvimento prenatal humano são discutidas nesta revisão. As diferenças de estrutura e função entre a placenta de roedores e a placenta humana no período inicial da gravidez e a possível relevância delas para a transferencia transplacentária de NPs também são comentadas.

  1. A rare case report of hysterotomy for retained placenta accreta in bicornuate uterus

    OpenAIRE

    Reena Sharma; Amit Gupta; Usha K. Chaudhary; Ajay Sharma; Arvind Kumar

    2015-01-01

    Retained placenta is a common third stage complication. Placenta accreta is due to abnormal invasive placental implantation. Many cases of Post-partum haemorrhage (PPH) are caused by placenta accreta and may lead to peripartum hysterectomy. We here report a case of placenta accreta in a patient following two failed attempts of manual removal of retained placenta followed by conservative management with methotrexate in stable patient. Both attempts were unsuccessful and led to septicaemia, req...

  2. Bladder Saving Hysterectomy for Placenta Praevia Percreta | Dahiya ...

    African Journals Online (AJOL)

    Background: Placenta accreta is an abnormally firm attachment of placental villi to the uterine wall, which may cause postpartum hemorrhage. Placenta Percreta with invasion of the urinary bladder is a rare condition, which carries a high morbidity and mortality risk for mother and fetus. Case Report: The present case is of ...

  3. Myostatin in the placentae of pregnancies complicated with gestational diabetes mellitus.

    Science.gov (United States)

    Peiris, H N; Lappas, M; Georgiou, H M; Vaswani, K; Salomon, C; Rice, G E; Mitchell, M D

    2015-01-01

    Gestational diabetes mellitus (GDM) is characterised by maternal glucose intolerance and insulin resistance during pregnancy. Myostatin, initially identified as a negative regulator of muscle development may also function in the regulation of placental development and glucose uptake. Myostatin expression in placentae of GDM complicated pregnancies is unknown. However, higher myostatin levels occur in placentae of pregnancies complicated with preeclampsia. We hypothesise that myostatin will be differentially expressed in GDM complicated pregnancies. Myostatin concentrations (ELISA) were evaluated in plasma of presymptomatic women who later developed GDM and compared to plasma of normal glucose tolerant (NGT) women. Furthermore, myostatin protein expression (Western blot) was studied in placentae of pregnant women with GDM (treated with diet or insulin) compared to placentae of NGT women. No significant difference in myostatin concentration was seen in plasma of pre-symptomatic GDM women compared to NGT women. In placenta significant differences in myostatin protein expressions (higher precursor; p myostatin dimer expression (p Myostatin expression in placental tissue is altered under stress conditions (e.g. obesity and abnormal glucose metabolism) found in pregnancies complicated with GDM. We hypothesise that myostatin is active in these placentae and could affect glucose homoeostasis and/or cytokine production thereby altering the function of the placenta. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Ultrasound detection of placenta accreta in the first trimester of pregnancy.

    Science.gov (United States)

    Rahimi-Sharbaf, Fatemeh; Jamal, Ashraf; Mesdaghinia, Elaheh; Abedzadeh-Kalahroudi, Masoumeh; Niroomanesh, Shirin; Atoof, Fatemeh

    2014-06-01

    Placenta accreta is considered a life-threatening condition and the main cause of maternal mortality. Prenatal diagnosis of placenta accreta usually is made by clinical presentation, imaging studies like ultrasound and MRI in the second and third trimester. To determine accuracy of ultrasound findings for placenta accreta in the first trimester of pregnancy. In a longitudinal study 323 high risk patients for placenta accreta were assessed. The eligible women were examined by vaginal and abdominal ultrasound for gestational sac and placental localization and they were followed up until the end of pregnancy. The ultrasound findings were compared with histopathological examinations as a gold standard. The sensitivity, specificity, positive and negative predictive value of ultrasound were estimated for the first trimester and compared with other 2 trimesters in the case of repeated ultrasound examination. Ultrasound examinations in the first trimester revealed that 28 cases had the findings in favor of placenta accreta which ultimately was confirmed in 7 cases. The ultrasound sensitivity and specificity for detecting placenta accreta in the first trimester was 41% [95% CI: 16.2-62.7] and 88% [95% CI: 88.2-94.6] respectively. Ultrasound screening for placenta accreta in the first trimester of pregnancy could not achieve the high sensitivity as second and third trimester of pregnancy.

  5. Eficacia del paracetamol intravenoso para el cierre del conducto arterioso en recién nacidos prematuros

    OpenAIRE

    Carrillo-Arteaga, Henry Sergio; Valencia-Avendaño, Jessica; Oliveros-Ruiz, Lucía

    2015-01-01

    Antecedentes: los inhibidores de la ciclooxigenasa, como la indometacina y el ibuprofeno, que se utilizan para el cierre del conducto arterioso tienen efectos adversos significativos en el recién nacido, por lo que es importante explorar nuevas alternativas de tratamiento eficaces y seguras. Una de ellas podría ser el paracetamol intravenoso. Objetivo: evaluar la eficacia y seguridad del paracetamol intravenoso para el cierre del conducto arterioso en recién nacidos prematuros. Material y mét...

  6. O alojamento de mães de recém-nascidos prematuros: uma contribuição para a ação da enfermagem Alojamiento para madres de recién nacidos prematuros: un aporte a la acción de la enfermería The accommodation for mothers of preterm newborns: a contribution to the Nursing action

    Directory of Open Access Journals (Sweden)

    Bárbara Bertolossi Marta de Araújo

    2010-06-01

    Full Text Available O estudo teve o objetivo de apreender o "motivo porquê" de a mãe permanecer na unidade hospitalar durante a internação do filho prematuro na Unidade de Terapia Intensiva Neonatal. Foi realizado com 12 mães de recém-nascidos prematuros, em um hospital maternidade municipal do Rio de Janeiro, em 2007. Adotou-se como suporte metodológico a Fenomenologia Sociológica de Alfred Schutz. A Entrevista Fenomenológica foi a técnica utilizada para captar o contexto vivencial das mães na unidade hospitalar, compreendendo que a sua permanência está ligada à ação de cumprir seu papel de ser mãe. A vivência das mulheres é retratada como um processo difícil, triste e conflituoso. Concluímos que as mães atualmente estão presentes, mas não estão inseridas nesta realidade intensiva. Dessa forma, entendemos que é necessário mudar esse paradigma intensivista incorporando o cuidado humanizado, inserindo a mãe e sua família no ambiente neonatal.El presente estudio tuvo como objetivo comprender la razón por la cual la madre permanece en el hospital durante la hospitalización del bebé prematuro en la unidad de cuidados intensivos neonatal. La investigación se realizó con un grupo de 12 madres de recién nacidos prematuros en un hospital municipal de maternidad en Río de Janeiro en el aòo de 2007. Como base metodológica se utilizó la sociología fenomenológica de Alfred Schutz. La técnica de la entrevista fenomenológica fue aplicada para captar el contexto de vida de las madres durante su estancia en el hospital. Esto nos permitió entender que su presencia está ligada a la acción de cumplir con su papel de madre. La experiencia de estas mujeres se presenta como un proceso difícil, triste y polémico. Llegamos a la conclusión de que a pesar de que estas madres están presentes, no están siendo incluidas en esta realidad intensiva. Por lo tanto, creemos que es necesario cambiar este paradigma de la incorporación de cuidados

  7. Intrapartal resection of the bicornuete uterus for placenta membranacea percreta

    Directory of Open Access Journals (Sweden)

    Sparić Radmila

    2007-01-01

    Full Text Available Placenta membranacea is a rare anomaly characterized by failure of villous atrophy during early gestation, and 30% of cases involve some form of placental adherence. Placenta percreta is infrequent, but life-threatening condition. Antenatal diagnosis of these placental anomalies is very difficult, but essential for reduction of the number and extent of possible complications. A 19-year-old primigravida was referred to us with 31- week pregnancy complicated by preeclampsia. Upon admission, ultrasound scan revealed eutrophic fetus in breech presentation, without any signs of retroplacental clot. At laparotomy, hemoperitoneum without any trophoblastic tissue emerging to the peritoneal cavity was found and placental abruption with uteroplacental apoplexy was suspected. In addition, unicervical symmetric bicornuate uterus with pregnancy in the left uterine horn was found. The lower segment uterine section was performed and 1800 grams live baby was delivered. Delivery of the placenta was unusually difficult. It was very large and densely adherent to the posterior uterine wall, which appeared to be composed of serosa in that area only. After removal of placenta, the hemorrhage could not be controlled, and resection of the left uterine horn was performed. Placenta accreta, increta and percreta ought to be considered in all cases of uterine anomalies in pregnancy and in cases of prenatal diagnosis of placenta membranacea.

  8. Tratamento da persistência de canal arterial em recém-nascidos prematuros: análise clínica e cirúrgica Patent ductus arteriosus treatment in the premature newborn: clinical and surgical analisys

    Directory of Open Access Journals (Sweden)

    Rafael Fagionato Locali

    2008-05-01

    Full Text Available FUNDAMENTO: O tratamento cirúrgico da persistência de canal arterial é indicado quando a intervenção clínica fracassa. No entanto, esse tratamento não é livre de complicações. OBJETIVO: Analisar aspectos clínicos e cirúrgicos envolvidos no tratamento da persistência do canal arterial, em recém-nascidos prematuros. MÉTODOS: No período de janeiro de 2000 a junho de 2006, foram analisados 22 recém-nascidos prematuros submetidos a tratamento cirúrgico para persistência de canal arterial. Do total de pacientes, 77,3% eram do sexo feminino, com peso médio ao nascimento de 952,5 g e idade gestacional média de 27 semanas. O uso de agentes vasoativos, indometacina, parâmetros ecocardiográficos e complicações, nos períodos pré e pós-operatórios, foi avaliado. RESULTADOS: Na casuística avaliada, 59,1% dos pacientes necessitaram de intubação orotraqueal ao nascimento; 77,3%, de surfactante; e 59,1% usaram agentes vasoativos no pré-operatório. O número médio de aplicações de indometacina foi de 3,4, com dosagem variando de 0,1 a 0,25 mg/kg/dia. O calibre médio do canal arterial foi de 1,96 mm. O procedimento cirúrgico foi realizado por abordagem extrapleural em 59,1% dos casos, e no pós-operatório o tempo médio de intubação foi de 30,9 dias, com emprego de agentes vasoativos em 50% dos pacientes. Observaram-se 18,1% de complicações pós-operatórias não-fatais. CONCLUSÃO: Mais da metade dos pacientes necessitou de intubação orotraqueal ao nascimento, emprego de surfactante e agentes vasoativos no período pré-operatório. Houve maior prevalência de abordagem extrapleural durante o ato operatório. No período pós-operatório, houve menor demanda de agentes vasoativos e não houve óbitos diretamente relacionados ao procedimento cirúrgico.BACKGROUND: The surgical treatment of patency ductus arteriosus is indicated when the clinical intervention fails. However, this treatment may have some complications

  9. Endothelial and lipoprotein lipases in human and mouse placenta

    DEFF Research Database (Denmark)

    Lindegaard, Marie L S; Olivecrona, Gunilla; Christoffersen, Christina

    2005-01-01

    Placenta expresses various lipase activities. However, a detailed characterization of the involved genes and proteins is lacking. In this study, we compared the expression of endothelial lipase (EL) and LPL in human term placenta. When placental protein extracts were separated by heparin-Sepharos...

  10. COMPARISON OF ULTRASONOGRAPHIC PLACENTA EXAMINATION WITH PATHOHISTOLOGIC VERIFICATION OF FETAL ANOMALIES

    Directory of Open Access Journals (Sweden)

    Dragan Loncar

    2007-04-01

    Full Text Available Ultrasonographic diagnostics is a sovereign diagnostic method of discovering disorders in growth and development of embryo. The main aim of this research is The Comparison of Ultrasonographic Placenta Examination with Pathohistologic Treatment of Placenta considering those pregnancies previously verified to have embryo anomalies and which were ended by the procedure of feticide. During the period of 2001 – 2004, 15 pregnant women, with gestation between the 24th and 28th week, were hospitalized in our clinic. Ultrasonographic placenta examination was carried out during the expertise sonography immediately before deciding to commit feticide. The descriptive medical findings were divided into the clinical entities estimating the continuity of basal body, insertion, volume, and echo-structure of placenta substance. The procedure of feticide was carried out in regular treatments using intracardial application of 7,4 % KCl or transabdominal, intra-amnial instillation of 20 % NaCl under the control of ultrasound.The patients with the embryo anomalies were divided into three groups:I – the group with the diagnosis of embryo hydrocephalusII – the group with the diagnosis of other anomalies of growth of embryo's CNSIII – the group of patients with other embryo anomaliesPathohistologic placenta examinations were carried out in the Department of Pathology and Forensic Medicine in CC Kragujevac.The ultrasonographic placenta finding of the patients with the different embryo anomalies was not statistically very different (x2 – test; p=0,073. However, besides the lack of significant difference, what is reasonable considering the size of the sample, we notice quite different ultrasonographic findings of the placenta examination of the patients having the embryo with hydrocephalus in comparison to those patients having the other embryo anomalies of CNS. The ultrasonographic placenta examination of the patients having the other embryo anomalies was

  11. NURSING AND SKIN CARE(LESS OF PREMATURE

    Directory of Open Access Journals (Sweden)

    Bárbara Bertolossi Marta de Araújo

    2012-09-01

    Full Text Available Objetivo: Refletir sobre a assistência de enfermagem nos cuidados com a pele do prematuro, a partir da análise da literatura científica nacional e internacional acerca dessa temática e discutir os benefícios e os malefícios desse cuidado. Métodos: Trata-se de uma revisão bibliográfica sobre a assistência de enfermagem nos cuidados com a pele do neonato prematuro. Os dados analisados foram publicações dos últimos dez anos nas bases de dados: MEDLINE, LILACS e BDENF. Foi adotada a análise de conteúdo modalidade temática. Resultados: Foram originados 4 categorias: A fisiologia da pele do recém nascido e suas particularidades; Os cuidados de Enfermagem na pele do neonato prematuro: Benefícios e Malefícios; Fatores agressivos a pele do neonato e suas conseqüências; Medidas de promoção da integridade da pele. Conclusão: Observamos se tratar de uma temática relativamente recente e complexa para a enfermagem neonatal com poucas pesquisas realizadas por esses profissionais. Descritores: Pele; Neonato; Neonatologia; Enfermagem.

  12. Tumorigenic Factor CRIPTO-1 Is Immunolocalized in Extravillous Cytotrophoblast in Placenta Creta

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    Carla Letícia Bandeira

    2014-01-01

    Full Text Available CRIPTO-(CR1 is a protein associated with tumorigenesis and metastasis. Here we demonstrate that CR-1 expression in normal and creta placentas is associated with various degrees of uterine invasion. Cytokeratin (CK and CR-1 protein expression was visualized by immunohistochemical staining of formalin-fixed, paraffin-embedded placental specimens (control placentas, n=9; accreta, n=6; increta, n=10; percreta, n=15. The pattern of extravillous trophoblast (EVT cell morphology was distinctive in creta placentas: densely-compacted cell columns and large star-shaped cells with a typically migratory phenotype, not common among third trimester control placentas. Quantification revealed higher CR-1 immunoreactivities in accreta (P=0.001, increta (P=0.0002, and percreta placentas (P=0.001 than in controls. In contrast to controls, there was a significant positive relationship between CR-1 and CK reactivity in all creta placentas (accreta, P=0.02; increta, P=0.0001, and percreta, P=0.025. This study demonstrated CR-1 expression in the placental bed, its increased expression in creta placentas, and EVT cells as the main CR-1-producing cell type. Morphological examination revealed an immature and invasive trophoblast profile in creta placentas, suggesting impairment of the trophoblast differentiation pathway. These findings provide important new insights into the pathophysiology of abnormal creta placentation and its gestational consequences.

  13. Conservative Management of Placenta Accreta/Increta after Vaginal Birth

    Science.gov (United States)

    Peiffer, S.; Reinhard, J.; Reitter, A.; Louwen, F.

    2012-01-01

    Aim: Aim of the study was to show that conservative management with preservation of the uterus and of fertility is possible in patients with placenta accreta/increta after vaginal delivery. Method: A retrospective analysis of patients with placental attachment disorders after vaginal delivery was done in a perinatal centre between November 2009 and April 2011. The patient collective was identified using the ICD-10 codes for placenta accreta/increta/percreta, and patient records were analysed for risk factors, maternal morbidity, preservation of the uterus and of fertility, and neonatal outcome. Results: Three cases of placenta increta were identified in the last 1.5 years out of a total of 1457 vaginal deliveries, and all 3 cases were treated conservatively. Mean maternal age was 35.3 years; gestational age ranged from 39 to 41 weeks, and mean duration between delivery of the child and delivery of the placenta was 44.67 days (range: 14–100 days). Two patients developed symptoms of endomyometritis, including fever, leukocytosis and increased CRP levels. All 3 women were successfully managed with preservation of the uterus. Conclusion: In selected cases with placenta accreta/increta after vaginal delivery, it is possible to avoid surgical procedures, particularly hysterectomy procedures, and successfully manage these patients conservatively with preservation of the uterus. PMID:25308979

  14. Maternal Buprenorphine Dose, Placenta Buprenorphine and Metabolite Concentrations and Neonatal Outcomes

    Science.gov (United States)

    Concheiro, Marta; Jones, Hendreé E.; Johnson, Rolley E.; Choo, Robin; Shakleya, Diaa M.; Huestis, Marilyn A.

    2010-01-01

    Buprenorphine is approved as pharmacotherapy for opioid dependence in non-pregnant patients in multiple countries, and is currently under investigation for pregnant women in the US and Europe. This research evaluates the disposition of buprenorphine, opiates, cocaine, and metabolites in 5 term placentas from a US cohort. Placenta and matched meconium concentrations were compared, and relationships between maternal buprenorphine dose, placenta concentrations, and neonatal outcomes following controlled administration during gestation were investigated. Buprenorphine and/or metabolites were detected in all placenta specimens and were uniformly distributed across this tissue (CV<27.5%, 4 locations), except for buprenorphine in 3 placentas. In 2 of these, buprenorphine was not detected in some locations and, in the 3rd placenta, was totally absent. Median (range) concentrations were buprenorphine 1.6ng/g (not detected to 3.2), norbuprenorphine 14.9ng/g (6.2 to 24.2), buprenorphine-glucuronide 3ng/g (1.3 to 5.0) and norbuprenorphine-glucuronide 14.7ng/g (11.4 to 25.8). Placenta is a potential alternative matrix for detecting in utero buprenorphine exposure, but at lower concentrations (15–70 fold) than in meconium. Statistically significant correlations were observed for mean maternal daily dose from enrollment to delivery and placenta buprenorphine-glucuronide concentration, and for norbuprenorphine-glucuronide concentrations and time to neonatal abstinence syndrome (NAS) onset and duration, and for norbuprenorphine/norbuprenorphine-glucuronide ratio and maximum NAS score, and newborn length. Analysis of buprenorphine and metabolites in this alternative matrix, an abundant waste product available at the time of delivery, may be valuable for prediction of neonatal outcomes for clinicians treating newborns of buprenorphine-exposed women. PMID:20216119

  15. Relación entre enfermedad periodontal y parto prematuro. Bajo peso al nacimiento: una revisión de la literatura The relationship between periodontal disease and preterm low birth weight: a literature review

    OpenAIRE

    J. Flores; A. Oteo; L. Mateos; A. Bascones

    2004-01-01

    A pesar de los esfuerzos realizados en el control del embarazo y el parto, la frecuencia de los partos prematuros no ha disminuido en las dos últimas décadas. El parto prematuro supone una seria amenaza para la salud del recién nacido, y representa además un porcentaje muy importante de los costes destinados a la atención sanitaria perinatal. La investigación científica ha revelado diversos mecanismos por los que infecciones remotas como la enfermedad periodontal pueden participar en la patog...

  16. Noninvasive monitoring of placenta-specific transgene expression by bioluminescence imaging.

    Directory of Open Access Journals (Sweden)

    Xiujun Fan

    Full Text Available BACKGROUND: Placental dysfunction underlies numerous complications of pregnancy. A major obstacle to understanding the roles of potential mediators of placental pathology has been the absence of suitable methods for tissue-specific gene manipulation and sensitive assays for studying gene functions in the placentas of intact animals. We describe a sensitive and noninvasive method of repetitively tracking placenta-specific gene expression throughout pregnancy using lentivirus-mediated transduction of optical reporter genes in mouse blastocysts. METHODOLOGY/PRINCIPAL FINDINGS: Zona-free blastocysts were incubated with lentivirus expressing firefly luciferase (Fluc and Tomato fluorescent fusion protein for trophectoderm-specific infection and transplanted into day 3 pseudopregnant recipients (GD3. Animals were examined for Fluc expression by live bioluminescence imaging (BLI at different points during pregnancy, and the placentas were examined for tomato expression in different cell types on GD18. In another set of experiments, blastocysts with maximum photon fluxes in the range of 2.0E+4 to 6.0E+4 p/s/cm(2/sr were transferred. Fluc expression was detectable in all surrogate dams by day 5 of pregnancy by live imaging, and the signal increased dramatically thereafter each day until GD12, reaching a peak at GD16 and maintaining that level through GD18. All of the placentas, but none of the fetuses, analyzed on GD18 by BLI showed different degrees of Fluc expression. However, only placentas of dams transferred with selected blastocysts showed uniform photon distribution with no significant variability of photon intensity among placentas of the same litter. Tomato expression in the placentas was limited to only trophoblast cell lineages. CONCLUSIONS/SIGNIFICANCE: These results, for the first time, demonstrate the feasibility of selecting lentivirally-transduced blastocysts for uniform gene expression in all placentas of the same litter and early

  17. Morbidly Adherent Placenta: Interprofessional Management Strategies for the Intrapartum Period.

    Science.gov (United States)

    Baird, Suzanne McMurtry; Troiano, Nan H; Kennedy, Margaret Betsy Babb

    "Morbidly adherent placenta" is a term that describes the continuum of placenta accreta, increta, and percreta. The incidence of this type of abnormal placentation has increased significantly over recent decades. The reason is probably multifactorial but, partly, because of factors such as the increasing number of cesarean births. Women at greatest risk are those who have myometrial damage caused by a previous cesarean birth, with either anterior or posterior placenta previa overlying the uterine scar. This condition poses significant risks of morbidity and/or mortality to the pregnant woman and her fetus. A multidisciplinary approach to care throughout pregnancy is essential. This article describes the classification of morbidly adherent placenta, risk factors, methods of diagnosis, potential maternal and fetal complications, and intrapartum clinical management strategies to optimize outcomes.

  18. Can venous ProBNP levels predict placenta accreta?

    Science.gov (United States)

    Ersoy, Ali Ozgur; Oztas, Efser; Ozler, Sibel; Ersoy, Ebru; Erkenekli, Kudret; Uygur, Dilek; Caglar, Ali Turhan; Danisman, Nuri

    2016-12-01

    Placenta previa (PP) is a potential life-threatening pregnancy complication. Pro-brain natriuretic peptide (ProBNP), creatine kinase (CK), cardiac form of CK (CK-MB) and Troponin I are circulatory biomarkers related to cardiac functions. We aimed to determine whether these biomarkers are related to PP and placenta accreta. In this case-control study, fifty-four pregnant women who attended our tertiary care center for perinatology with the diagnosis of PP totalis, and of them, 14 patients with placenta accreta were recruited as the study groups. Forty-six uncomplicated control patients who were matched for age, BMI were also included. Maternal venous ProBNP, CK, CK-MB and Troponin I levels were compared between the three groups. Obstetric history characteristics were comparable among groups, generally. CK and CK-MB levels were similar among three groups. Troponin I levels in the previa and accreta groups were significantly higher than the controls. ProBNP levels in the accreta group were significantly higher than other two groups. The multivariate regression model revealed that ProBNP could predict placental adhesion anomalies. Troponin I and ProBNP levels in PP cases were higher than controls and ProBNP could predict placenta accreta.

  19. Placenta accreta: diagnosis, management and the molecular biology of the morbidly adherent placenta.

    Science.gov (United States)

    Goh, William A; Zalud, Ivica

    2016-01-01

    Placenta accreta is now the chief cause of postpartum hemorrhage resulting in maternal and neonatal morbidity. Prenatal diagnosis decreases blood loss at delivery and intra and post-partum complications. Ultrasound is critical for diagnosis and MRI is a complementary tool when the diagnosis is uncertain. Peripartum hysterectomy has been the standard of therapy but conservative management is increasingly being used. The etiology of accreta is due to a deficiency of maternal decidua resulting in placental invasion into the uterine myometrium. The molecular basis for the development of invasive placentation is yet to be elucidated but may involve abnormal paracrine/autocrine signaling between the deficient maternal decidua and the trophoblastic tissue. The interaction of hormones such as Relaxin which is abundant in maternal decidua and insulin-like 4, an insulin-like peptide found in placental trophoblastic tissue may play role in the formation of placenta accreta.

  20. Association of placenta praevia with repeat cesarean section in ...

    African Journals Online (AJOL)

    Background: Several risk factors for placenta praevia exist, including previous cesarean section(C/S). This association has been investigated long time ago, however in this hospital there is no documented evidence. This study was done to assess the risk of placenta praevia based on number of previous cesarean sections.

  1. Placenta previa; MRI as an adjunct to ultrasound in assessment of suspected placental invasion

    Directory of Open Access Journals (Sweden)

    Asmaa M. Abdel Magied

    2018-03-01

    Full Text Available Objective: Evaluate adding MRI to ultrasound in imaging of placenta previa with suspected placenta accreta. Patients and methods: evaluation of 23 pregnant females presenting with placenta previa was done. The age ranged from 20 to 39 years (mean = 30.9. All of the patients were subjected to ultrasonography (US and magnetic resonance imaging (MRI of the pelvis at gestational age of 25–37 weeks prior to elective delivery. Results: 11 out of 23 patients were proved placenta accreta based on surgical and pathological reports. US suggested diagnosis of placenta previa/accreta in 8 patients and placenta previa without accreta in 15 cases. 7/8 was true positive (87.5% & one was false positive (12.5% with sensitivity 63.64%, accuracy 78.26%, and specificity 91.67%. MRI has suggested diagnosis of placenta previa/accreta in 8/23 & placenta previa with no accreta in 15/23 patients. MRI was found to give true positive results in 8/8 patients proved to be accreta. MRI gave true negative in 12 patients (80% & false negative in 3 (20% with sensitivity 72.73%, accuracy 86.96%, and specificity 100%. Conclusion: Combining MRI and ultra sound provide more diagnostic information and may reduce unnecessary interventions with favorable outcome. Keywords: Ultra sound, MRI, Placenta previa, Placenta accreta

  2. Placenta-derived exosomes: potential biomarkers of preeclampsia.

    Science.gov (United States)

    Pillay, Preenan; Moodley, Kogi; Moodley, Jagidesa; Mackraj, Irene

    2017-01-01

    Preeclampsia remains a leading cause of maternal and fetal mortality, due to ineffective treatment and diagnostic strategies, compounded by the lack of clarity on the etiology of the disorder. Although several clinical and biological markers of preeclampsia have been evaluated, they have proven to be ineffective in providing a definitive diagnosis during the various stages of the disorder. Exosomes have emerged as ideal biomarkers of pathological states, such as cancer, and have more recently gained interest in pregnancy-related complications, due to their role in cellular communication in normal and complicated pregnancies. This occurs as a result of the specific placenta-derived exosomal molecular cargo, which may be involved in normal pregnancy-associated immunological events, such as the maintenance of maternal-fetal tolerance. This review provides perspectives on placenta-derived exosomes as possible biomarkers for the diagnosis/prognosis of preeclampsia. Using keywords, online databases were searched to identify relevant publications to review the potential use of placenta-derived exosomes as biomarkers of preeclampsia.

  3. Macroscopic and histological characteristics of retained placenta: A prospectively collected case-control study.

    Science.gov (United States)

    Endler, Margit; Saltvedt, Sissel; Papadogiannakis, Nikos

    2016-05-01

    Retained placenta is a potentially fatal obstetric disorder due to postpartum hemorrhage, its pathophysiology is however unknown. We aimed to assess if retained placenta was associated with increased macroscopic and histological signs of placental maternal underperfusion, a pattern otherwise seen in preeclampsia and other disorders of defective placentation. This was a case-control study of retained (n = 49) and non-retained (n = 47) placentas, collected from full-term singleton and otherwise healthy pregnancies, carried out at a tertiary level obstetric department. Macroscopic and histological analysis was performed. Signs of maternal placental underperfusion and signs of placental inflammation, fetal vascular thrombo-occlusive disease and increased placental attachment were recorded in a primary and secondary analysis respectively. Variables were compared groupwise using unconditional logistic regression or comparison of median or mean values. Compared to non-retained placentas retained placentas had a significantly smaller surface area (p = 0.05), were more oblong in shape (OR 5.24 95% CI:1.34-20.21) and showed overall more signs of maternal underperfusion (OR 2.52 95% CI: 1.07-5.87). There was no significant difference in signs of placental inflammation, fetal vascular thrombo-occlusive disease or placenta accreta but basal plate myometrial fibers were more common among retained placentas. In regard to shape, surface area and histological signs of maternal placental underperfusion, retained placentas showed a histological pattern similar to that seen in preeclamptic placentas. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Fertility and obstetric outcome after conservative management of placenta accreta.

    Science.gov (United States)

    Provansal, Magali; Courbiere, Blandine; Agostini, Aubert; D'Ercole, Claude; Boubli, Léon; Bretelle, Florence

    2010-05-01

    To determine the fertility and obstetric outcomes after conservative management of placenta accreta. A retrospective observational cohort study of all identified cases of placenta accreta from 1993 to 2007 in 2 tertiary university hospitals in France. For patients treated conservatively, maternal and fetal morbidity, reproductive function, fertility, and subsequent pregnancies were recorded. During the study period, 46 patients were treated by conservative management; 6 patients underwent a secondary hysterectomy. Of the remaining 40 patients, 35 were followed up for a median of 65 months (range 18-156 months). Patients resumed their menstrual cycles after a median of 130 days (range 48-176 days). Menses were irregular in 11 patients (31%), but none had amenorrhea. Twelve of the 14 patients desiring another pregnancy achieved a total of 15 pregnancies; 2 patients had recurrent placenta accreta. Five spontaneous abortions and 1 termination of pregnancy occurred during the first trimester. The median term at delivery was 37 weeks (range, 35-40 weeks). Four patients delivered prematurely. Conservative management of placenta accreta can preserve fertility, although the risk of recurrent placenta accreta appears to be high. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  5. The association between maternal smoking and placenta abruption: a meta-analysis.

    Science.gov (United States)

    Shobeiri, Fatemeh; Masoumi, Seyedeh Zahra; Jenabi, Ensiyeh

    2017-08-01

    Several epidemiological studies have determined that maternal smoking can increase the risk of placenta abruption. To date, only a meta-analysis has been performed for assessing the relationship between smoking and placenta abruption. This meta-analysis was conducted to estimate the association between smoking and the risk of placenta abruption. A literature search was conducted in major databases such as PubMed, Web of Science, and Scopus from the earliest possible year to April 2016. The heterogeneity across studies was explored by Q-test and I 2 statistic. The publication bias was assessed using Begg's and Egger's tests. The results were reported using odds ratio (OR) estimate with its 95% confidence intervals (CI) using a random effects model. The literature search yielded 1167 publications until April 2016 with 4 309 610 participants. Based on OR estimates obtained from case-control and cohort studies, there was a significant association between smoking and placenta abruption (1.80; 95% CI: 1.75, 1.85). Based on the results of cohort studies, smoking and placenta abruption had a significant association (relative risk ratio: 1.65; 95% CI: 1.51, 1.80). Based on reports in epidemiological studies, we showed that smoking is a risk factor for placenta abruption.

  6. Impacto do monitoramento telefônico de gestantes na prevalência da prematuridade e análise dos fatores de risco associados em Piracicaba, São Paulo, Brasil

    Directory of Open Access Journals (Sweden)

    Rogerio Antonio Tuon

    2016-01-01

    Full Text Available Resumo: Objetivou-se verificar o impacto do monitoramento telefônico na prevalência da prematuridade e identificar os fatores de risco associados ao parto prematuro através de estudo transversal, de universo de gestantes monitoradas nos anos de 2010, 2011 e 2012 (n = 2.739. Utilizou-se estimação de modelos de regressão logística múltipla hierarquizada, considerando permanência no modelo p ≤ 0,05. A prevalência de prematuridade foi de 8,34% nas gestantes monitoradas e de 10,18% nas não monitoradas (p = 0,0058, sendo inversamente proporcional ao número de monitoramentos (p < 0,0001. As variáveis associadas foram: idade materna menor que 19 anos, antecedentes de dois ou mais filhos mortos, gestação múltipla, diabetes e hipertensão arterial, menor número de monitoramentos telefônicos, atividades laborais em pé e/ou carga de peso, fumo, número de consultas pré-natal, sem ultrassonografia, diabetes gestacional, gravidez múltipla e anomalia fetal. Com custos baixos, a estratégia demonstrou ser efetiva na redução da ocorrência do parto prematuro.

  7. [Severe Adverse Pregnancy Outcomes in Placenta Previa and Prior Cesarean Delivery].

    Science.gov (United States)

    Zhou, Mi; Chen, Meng; Zhang, Li; He, Guo-Lin; He, Lei; Wei, Qiang; Li, Tao; Liu, Xing-Hui

    2017-09-01

    To investigate the severe adverse pregnancy outcomes in pregnancies with placenta previa and prior cesarean delivery and its risk factors. This retrospective casecontrol study reviewed all pregnancies with placenta previa and prior cesarean delivery delivered by repeat cesarean section in our institution between January 2005 and June 2015,and investigated the incidence of severe adverse pregnancy outcome. A composite of severe adverse pregnancy outcomes (including transfusion of 10 units or more red blood cells,maternal ICU admission,unanticipated injuries,repeat operation,hysterectomy,and maternal death) and other maternal and neonatal outcomes were described. Univariate and multivariable logistic regression analysis were used to quantify the effects of risk factors on severe adverse pregnancy outcomes. There were 478 women with placenta previa and prior cesarean delivery in our hospital over the last decade. The average age of them was 32.5±4.8 years old,most women were beyond 30 years old,the average gravidity and parity were 4 and 1,131 cases (27.4%) had severe adverse pregnancy outcomes. Transfusion of 10 units or more red blood cells happened in 75 cases (15.7%,75/478); 44 cases (9.2%,44/478) necessitated maternal ICU admission; unanticipated bladder injury occurred in 11 cases,but non ureter or bowel injury happened; All 4 repeat operations were due to delayed hemorrhage after conservative management during cesarean delivery,and an emergent hysterectomy was performed for all of the 4 cases. Hysterectomy (107 cases,22.4%) was the most common severe adverse pregnancy outcome. Among all 311 morbidly adherent placenta cases finally confirmed by pathological or surgical findings or both,only 172 (55.3%) were suspected before delivery. Multivariable logistic regression analysis showed that the risk of severe adverse pregnancy outcomes was significantly increased by pernicious placenta previa (i.e. anterior placenta overlying the prior cesarean scar),suspicion of

  8. Placenta accreta spectrum: pathophysiology and evidence-based anatomy for prenatal ultrasound imaging.

    Science.gov (United States)

    Jauniaux, Eric; Collins, Sally; Burton, Graham J

    2018-01-01

    Placenta accreta spectrum is a complex obstetric complication associated with high maternal morbidity. It is a relatively new disorder of placentation, and is the consequence of damage to the endometrium-myometrial interface of the uterine wall. When first described 80 years ago, it mainly occurred after manual removal of the placenta, uterine curettage, or endometritis. Superficial damage leads primarily to an abnormally adherent placenta, and is diagnosed as the complete or partial absence of the decidua on histology. Today, the main cause of placenta accreta spectrum is uterine surgery and, in particular, uterine scar secondary to cesarean delivery. In the absence of endometrial reepithelialization of the scar area the trophoblast and villous tissue can invade deeply within the myometrium, including its circulation, and reach the surrounding pelvic organs. The cellular changes in the trophoblast observed in placenta accreta spectrum are probably secondary to the unusual myometrial environment in which it develops, and not a primary defect of trophoblast biology leading to excessive invasion of the myometrium. Placenta accreta spectrum was separated by pathologists into 3 categories: placenta creta when the villi simply adhere to the myometrium, placenta increta when the villi invade the myometrium, and placenta percreta where the villi invade the full thickness of the myometrium. Several prenatal ultrasound signs of placenta accreta spectrum were reported over the last 35 years, principally the disappearance of the normal uteroplacental interface (clear zone), extreme thinning of the underlying myometrium, and vascular changes within the placenta (lacunae) and placental bed (hypervascularity). The pathophysiological basis of these signs is due to permanent damage of the uterine wall as far as the serosa, with placental tissue reaching the deep uterine circulation. Adherent and invasive placentation may coexist in the same placental bed and evolve with advancing

  9. Oxygen diffusive conductance in placentae from control and diabetic women

    DEFF Research Database (Denmark)

    Mayhew, T M; Sørensen, Flemming Brandt; Klebe, J G

    1993-01-01

    . maternal erythrocytes and plasma, villous trophoblast, villous stroma, fetal plasma and fetal erythrocytes. From partial conductances and birthweights, total and specific conductances for each placenta were determined. No differences were detected between diabetic placentae in different classes (A, B, C, D...

  10. Evaluation of glycosaminoglycans and heparanase in placentas of women with preeclampsia.

    Science.gov (United States)

    Famá, Eduardo Augusto Brosco; Souza, Renan Salvioni; Melo, Carina Mucciolo; Melo Pompei, Luciano; Pinhal, Maria Aparecida Silva

    2014-11-01

    Preeclampsia is a multisystem disorder whose etiology remains unclear. It is already known that circulation of soluble fms-like tyrosine kinase-1 (sFlt-1) is directly involved in pre-eclampsia development. However, the molecular mechanisms involved with sFlt-1 shedding are still unidentified. We identified, quantified glycosaminoglycans and determined the enzymatic activity of heparanase in placentas of women with preeclampsia, in order to possibly explain if these compounds could be related to cellular processes involved with preeclampsia. A total of 45 samples collected from placentas, 15 samples from placentas of preeclampsia women and 30 samples from non-affected women. Heparan sulfate and dermatan sulfate were identified and quantified by agarose gel electrophoresis, whilst hyaluronic acid was quantified by an ELISA like assay. Heparanase activity was determined using biotynilated heparan sulfate as substrate. The results showed that dermatan sulfate (P=0.019), heparan sulfate levels (P=0.015) and heparanase activity (P=0.006) in preeclampsia were significantly higher than in the control group. There was no significant difference between the groups for hyaluronic acid expression in placentas (P=0.110). The present study is the first to demonstrate directly the increase of heparan sulfate in human placentas from patients with preeclampsia, suggesting that endogenous heparan sulfate could be involved in the release of sFlt-1 from placenta, increasing the level of circulating sFlt-1. Alterations of extracellular matrix components in placentas with preeclampsia raise the possibility that heparan sulfate released by heparanase is involved in mechanisms of preeclampsia development. Published by Elsevier B.V.

  11. Desenvolvimento de prematuros com baixo peso ao nascer nos primeiros dois anos de vida Development of low birth weight preterm infants during the first two years of life

    Directory of Open Access Journals (Sweden)

    Cristiane Alves da Silva

    2011-09-01

    Full Text Available OBJETIVO: Analisar e descrever o desenvolvimento neuropsicomotor de prematuros com baixo peso ao nascer nos dois primeiros anos de vida. MÉTODOS: Estudo transversal realizado com prematuros entre quatro e 24 meses, no Ambulatório de Alto Risco Neonatal do Hospital Universitário da Universidade Federal de Santa Catarina, avaliados em três momentos: 8, 11 e 14 meses de idade cronológica. A amostra, composta inicialmente por 69 indivíduos, teve caráter intencional, segundo os critérios de inclusão e exclusão estabelecidos. A Escala de Brunet e Lèzine foi usada para avaliar o desenvolvimento nas seguintes áreas: coordenação óculo-motriz, linguagem, postura e sociabilidade. Os dados foram analisados por meio de estatística descritiva e inferencial. RESULTADOS: A idade gestacional média foi de 31 semanas e o peso ao nascer foi de 1236g. O quociente de desenvolvimento global apresentou melhora da primeira para a última avaliação, alcançando 85% de escores dentro da normalidade na terceira avaliação. As áreas específicas da coordenação óculo-motriz e da linguagem tiveram os piores resultados iniciais, contrapondo-se à postural, que apresentou os melhores escores. Foi encontrada correlação entre o peso ao nascer e as áreas da postura, linguagem e sociabilidade na primeira avaliação e sociabilidade e coordenação óculo-motriz na terceira avaliação. CONCLUSÕES: O desenvolvimento neuropsicomotor desta população apresentou déficits mais evidentes nos primeiros meses de vida. Embora o seguimento não tenha mostrado diferenças estatísticas entre a primeira e a última avaliação, houve melhora em todas as áreas do desenvolvimento.OBJECTIVE: To analyze and describe the neuropsychomotor development of low birth weight preterm infants in the first two years of life. METHODS: This cross-sectional study enrolled preterm infants between 4 and 24 months old at the follow up clinic of Universidade Federal de Santa Catarina

  12. Expression of human placental lactogen and variant growth hormone genes in placentas.

    Science.gov (United States)

    Martinez-Rodriguez, H G; Guerra-Rodriguez, N E; Iturbe-Cantu, M A; Martinez-Torres, A; Barrera-Saldaña, H A

    1997-01-01

    Previous studies comparing the expression levels of human placental lactogen (hPL) genes have shown varying results, due to, perhaps, the fact that in all of them only one placenta was being analyzed. Here, the expression of hPL and growth hormone variant (hGH-V) genes in fifteen term placentas was comparatively analyzed at the RNA level, using reverse transcription coupled to polymerase chain reaction (RT-PCR). The abundance of the combined RNA transcripts derived from these genes varied from one placenta to another. The authors found that hPL-4 transcripts were more abundant than those of hPL-3 in most samples (ratios from 1:1 to 6:1), transcripts from the putative hPL-1 pseudogene were more abundant at the unprocessed stage while those of the hGH-V gene were mostly processed. Again, the authors of this study observed wide variation from placenta to placenta in the abundance of both of these types of transcripts. The same was observed when a group of six placentas from abortuses and nine from pregnancies complicated by preclampsia, diabetes and hypertension was studied. The authors conclude that the disagreeing results reported in the literature which are not in agreement concerning the expression levels of hPL genes could be explained by normal variations of their expression levels among the different placentas analyzed.

  13. Participation in environmental health research by placenta donation - a perception study

    DEFF Research Database (Denmark)

    Lind, Uffe; Mose, Tina; Knudsen, Lisbeth E

    2007-01-01

    background information but no follow up. METHODS: Nineteen semi-structured qualitative interviews were conducted with participants in the placenta perfusion study after donation of placenta. Observation studies were made of recruitment sessions. RESULTS: The interviewed participants are generally in favour......, but trust is something which needs to be created through "trust-work". Face-to-face interaction, written information material and informed consent forms play important parts in creating trusting relationships in medical research. CONCLUSION: Medical research ethics do not only amount to specific types......BACKGROUND: Much environmental health research depends on human volunteers participating with biological samples. The perception study explores why and how people participate in a placenta perfusion study in Copenhagen. The participation implies donation of the placenta after birth and some...

  14. Risk Factors and Consequent Outcomes of Placenta Previa: Report From a Referral Center

    Directory of Open Access Journals (Sweden)

    Soraya Saleh Gargari

    2016-12-01

    Full Text Available  Because of an unknown factor, the frequency of complicated pregnancy with placenta previa has been raised during past decade. This study was designed to deepen our understanding of risk factors and outcomes of placenta previa in our country. This study investigated 694 cases of placenta previa comparing with 600 healthy pregnant women with not overlie placenta in two referral and tertiary Obstetrics and Gynecological Hospital in Iran on the basis of the clinical and para-clinical analysis, in order to find the probable risk factors for occurrence of placenta previa and its effect on maternal and neonatal complications. The most important risk factor for the occurrence of placenta previa was advanced maternal age (P<0.001 and history of stillbirth (OR=117.2, CI=58.3-236.0. In the other hand, the most substantial outcome of this disorder was a reduction of gestational age (P<0.001 and low birth weight neonatally (P<0.001. The conservative follow-up should be programmed for women with placenta previa based on the type of risk factors which can provide the best possible management to decrease the morbidity and mortality of their related complications.

  15. The association between uterine leiomyoma and placenta abruption: A meta-analysis.

    Science.gov (United States)

    Jenabi, Ensiyeh; Ebrahimzadeh Zagami, Samira

    2017-11-01

    Some epidemiological studies have found that uterine leiomyoma can increase the risk of placenta abruption. To date, the meta-analysis has not been performed for assessing the relationship between uterine leiomyoma and placenta abruption. This meta-analysis was conducted to estimate the association between uterine leiomyoma and the risk of placenta abruption. A literature search was conducted out in major databases PubMed, Web of Science, and Scopus from the earliest possible year to October 2016. The heterogeneity across studies was explored by Q-test and I 2 statistic. The publication bias was assessed by Begg's and Egger's tests. The results were showed using odds ratio (OR) estimate with its 95% confidence intervals (CI) using a random-effects model. The literature search included 953 articles until October 2016 with 232,024 participants. Based on OR estimates obtained from case-control and cohort studies, there was significant association between uterine leiomyoma and placenta abruption (2.63; 95% CI: 1.38, 3.88). We showed based on reports in observational studies that uterine leiomyoma is a risk factor for placenta abruption.

  16. Hemoperitoneum Caused by Placenta Percreta in the Third Trimester of Pregnancy

    Directory of Open Access Journals (Sweden)

    Maryam Asgharnia

    2009-06-01

    Full Text Available The placental adhesive disorders such as placenta accreta andplacenta percreta are the rare causes of serious obstetric hemorrhages.They are associated with high maternal morbidity andmortality. Placenta percreta is usually diagnosed in the thirdtrimester of pregnancy as a massive postpartum hemorrhagewhen an attempt to remove the placenta reveals lack of acleavage plane. Here we report an unusual presentation of placentapercreta as hemoperitoneum and hemorrhagic shock inthe third trimester of pregnancy. A 33-year-old woman wasadmitted to hospital at the 35th weeks of gestation with abdominalpain and hemorrhagic shock. Laparotomy was immediatelyperformed because of intra-abdominal bleeding. Uponinspection, a posterior laceration of the uterus was noted.Pathologic investigation of the uterus showed placenta percreta.The patient recovered uneventfully. Spontaneous ruptureof the uterus can be occured in the absence of uterinetrauma. In the differential diagnosis of a pregnant woman presentingwith hypotension, abdominal pain, and fetal death, ruptureof the uterus caused by placenta percreta should be considered.Rapid diagnosis, blood transfusion, and emergency laparotomyare the key steps in successful management.

  17. Ultrasound predictors of placental invasion: the Placenta Accreta Index.

    Science.gov (United States)

    Rac, Martha W F; Dashe, Jodi S; Wells, C Edward; Moschos, Elysia; McIntire, Donald D; Twickler, Diane M

    2015-03-01

    We sought to apply a standardized evaluation of ultrasound parameters for the prediction of placental invasion in a high-risk population. This was a retrospective review of gravidas with ≥1 prior cesarean delivery who received an ultrasound diagnosis of placenta previa or low-lying placenta in the third trimester at our institution from 1997 through 2011. Sonographic images were reviewed by an investigator blinded to pregnancy outcome and sonography reports. Parameters assessed included loss of retroplacental clear zone, irregularity and width of uterine-bladder interface, smallest myometrial thickness, presence of lacunar spaces, and bridging vessels. Diagnosis of placental invasion was based on histologic confirmation. Statistical analyses were performed using linear logistic regression and multiparametric analyses to generate a predictive equation evaluated using a receiver operating characteristic curve. Of 184 gravidas who met inclusion criteria, 54 (29%) had invasion confirmed on hysterectomy specimen. All sonographic parameters were associated with placental invasion (P placental location, yielded an area under the curve of 0.87 (95% confidence interval, 0.80-0.95). Using logistic regression, a predictive equation was generated, termed the "Placenta Accreta Index." Each parameter was weighted to create a 9-point scale in which a score of 0-9 provided a probability of invasion that ranged from 2-96%, respectively. Assignment of the Placenta Accreta Index may be helpful in predicting individual patient risk for morbidly adherent placenta. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. INCIDENCE OF ABRUPTIO PLACENTAE IN PREECLAMPSIA IN A RURAL TERTIARY CARE HOSPITAL

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    Ratna Bulusu

    2016-11-01

    Full Text Available BACKGROUND Preeclampsia is a pregnancy specific disorder commonly defined as de novo hypertension and proteinuria after 20 weeks of gestational age. It occurs in 3-5% of pregnancies and is still a major cause of both foetal and maternal morbidity and mortality worldwide. One of the most serious and dreaded complication of preeclampsia is abruptio placentae. Placental separation from its implantation site before delivery of the foetus has been called abruption placentae or accidental haemorrhage. Various studies have shown that there is 2-2.5 fold increase in incidence of abruption in hypertensive disorder of pregnancy. The aim of the study is to study the incidence of abruptio placentae in women with preeclampsia. MATERIALS AND METHODS 100 pregnant women with preeclampsia attending the antenatal OPD as well as admitted to the antenatal ward and labour room fulfilling the inclusion criteria were enrolled in the study. The incidence of abruption placenta among these 100 women was studied. RESULTS Among the 100 women with preeclampsia enrolled in the study, abruptio placentae was noted in 14 women (14%. Maternal complications were seen in the form of anaemia (78.57%, need for blood transfusion (57.14%, shock (28.57%, postpartum haemorrhage (14.28% and puerperal sepsis (7.14%. Perinatal complications were seen in the form of low birth weight (57.14%, prematurity (35.71%, NICU admission (71.43% and intrauterine death (28.57%. CONCLUSION Abruptio placentae affects approximately 1% of all deliveries. However, the incidence significantly increases in cases of preeclampsia and other hypertensive disorders of pregnancy. Association of abruptio placentae in cases of preeclampsia varies from 10-50%. In our study, incidence of abruption placenta in preeclampsia is 14%.

  19. Prototype and Chimera-Type Galectins in Placentas with Spontaneous and Recurrent Miscarriages.

    Science.gov (United States)

    Unverdorben, Laura; Haufe, Thomas; Santoso, Laura; Hofmann, Simone; Jeschke, Udo; Hutter, Stefan

    2016-04-28

    Galectins are galactose binding proteins and, in addition, factors for a wide range of pathologies in pregnancy. We have analyzed the expression of prototype (gal-1, -2, -7, -10) and chimera-type (gal-3) galectins in the placenta in cases of spontaneous abortions (SPA) and recurrent abortions (RA) in the first trimester. Fifteen placental samples from healthy pregnancies were used as a control group. Nine placentas were examined for spontaneous abortions, and 12 placentas for recurrent abortions. For differentiation and evaluation of different cell types of galectin-expression in the decidua, immunofluorescence was used. For all investigated prototype galectins (gal-1, -2, -7, -10) in SPA and RA placenta trophoblast cells the expression is significantly decreased. In the decidua/extravillous trophoblast only gal-2 expression was significantly lowered, which could be connected to its role in angiogenesis. In trophoblasts in first-trimester placentas and in cases of SPA and RA, prototype galectins are altered in the same way. We suspect prototype galectins have a similar function in placental tissue because of their common biochemical structure. Expression of galectin 3 as a chimera type galectin was not found to be significantly altered in abortive placentas.

  20. Risk factors for placenta praevia in Southern Nigeria | Eniola | East ...

    African Journals Online (AJOL)

    Design: A prospective case control study. Setting: A tertiary center - Obafemi Awolowo ... Conclusions: From our study, the risk factors for placenta praevia are a history of retained placenta, previous caesarean section, previous abortion, grand multiparity and maternal age over 35 years. (East African Medical Journal: 2002 ...

  1. Tratamento do canal arterial persistente em neonatos prematuros: análise de 18 casos Treatment of patent ductus arteriosus in neonate premature: analysis of 18 cases

    Directory of Open Access Journals (Sweden)

    Wagner Ciongoli

    1993-12-01

    Full Text Available A presente investigação tem o propósito de analisar, retrospectivamente, os resultados obtidos em 18 pacientes neonatos prematuros, submetidos a operação para oclusão da PCA, no período entre julho de 1990 e dezembro de 1993 (42 meses, sendo 12 (66,6% pacientes do sexo feminino, com idade que variou entre 10 e 44 (20,8±8,3 dias, idade gestacional entre 26 e 28 (27,2±0,9 semanas. No dia da operação o peso dos pacientes esteve compreendido entre 700 e 1380 (985,8±181,6 gramas. A insuficiência respiratória aguda ocorreu em todos os pacientes sendo a principal indicação cirúrgica, estando em 6 (33,3% pacientes associada à insuficiência cardíaca congestiva. A indometacina endovenosa foi utilizada no período pré-operatório em 9 (50% pacientes na tentativa de se obter o fechamento farmacológico, sem sucesso, do canal arterial e apesar de não influenciar nos resultados pós-operatórios, apresentou como principal efeito secundário a redução significativa da diurese (p 40% 60% (p=0,033. O período de internação hospitalar variou de 43 a 157 (96,0±24,8 dias. Não houve mortalidade operatória, observando-se ainda baixa morbidade com este método. As causas de óbito, no período pós-operatório, não estiveram relacionadas com o tratamento cirúrgico. Pode-se concluir que a ligadura cirúrgica da PCA, nos pacientes neonatos e prematuros, é método eficaz e seguro podendo ser praticado com baixa morbidade e mortalidade.The purpose of our study was to analyse the results obtained in 18 neonate premature patients who underwent surgical closure of the patent ductus arteriosus, between July 1990 and December 1993 (42 months. Twelve (66.6% patients were female, with age between 10 and 44 (20.8±8.3 days, gestacional age ranged from 26 to 28 (27.2±0.9 weeks. In the surgery day the birth weight was between 700 and 1380 (985.8 ±181.6 grams. Acute respiratory insufficiency was present in all patients, as the principal surgical

  2. Another look at ultrasound and magnetic resonance imaging for diagnosis of placenta accreta.

    Science.gov (United States)

    Budorick, Nancy E; Figueroa, Reinaldo; Vizcarra, Michael; Shin, James

    2017-10-01

    To compare the ability of magnetic resonance imaging (MRI) and ultrasound (US) in the diagnosis of placenta accreta, to examine the success of various sonographic and MRI features to correctly predict invasive placenta, and to define a specific role for MRI in placenta accreta. After Institutional Review Board approval, a blinded retrospective review was undertaken of US and MRI findings from 45 patients who had an obstetrical US and placental MRI between August 2006 and January 2012. Correlation with clinical history and pathologic findings was performed. US and MRI had similar sensitivity, specificity and positive and negative predictive values for placenta accreta. The best predictors of invasion by US were loss of the myometrial mantle, increased intraplacental vascularity and loss of the bladder wall echogenicity. The best predictors of invasion by MRI were loss of retroplacental myometrial mantle, a heterogeneous placenta, and intraplacental hemorrhage. Body mass index (BMI) did not affect the ability to make a diagnosis by either US or MRI. MRI proved effective in better evaluation of a posterior placenta with suspicion of placenta accreta. There was modality disagreement in 11 of 45 cases and MRI was correct in 9 of these 11 cases, all true negative (TN) cases. MRI should be considered in any case with posterior placenta previa and suspicion of accreta, in any case with clinical suspicion for accreta and discordant US findings, and in any case in which percreta is suspected.

  3. Evolution of the placenta during the early radiation of placental mammals

    DEFF Research Database (Denmark)

    Mess, Andrea; Carter, Anthony M

    2007-01-01

    The chorioallantoic placenta is an organ of gaseous exchange that exhibits a high degree of structural diversity. One factor determining oxygen transfer across the placenta, the diffusion distance, is in part dependent on the number of cell layers separating maternal from fetal blood. This interh......The chorioallantoic placenta is an organ of gaseous exchange that exhibits a high degree of structural diversity. One factor determining oxygen transfer across the placenta, the diffusion distance, is in part dependent on the number of cell layers separating maternal from fetal blood...... of placental mammals, derived from molecular phylogenetics. We show that epitheliochorial placentation, the least invasive type, is a derived state and discuss factors that may have determined its evolution with reference to conflict theory, as applied to the allocation of resources between mother and fetus...

  4. Transplacental transfer of nitrosodimethylamine in perfused human placenta.

    OpenAIRE

    Annola, K.; Heikkinen, A.T.; Partanen, H.; Woodhouse, H.; Segerback, D.; Vahakangas, K.

    2009-01-01

    Nitrosodimethylamine (NDMA) is a carcinogenic compound present in tobacco smoke and food such as cured meat, smoked fish and beer. The O(6)-methylguanine formed in human cord blood in mothers highly exposed to such products implicates NDMA exposure of the fetus. Dual recirculating human placental perfusion was used to get direct evidence of the transplacental transfer of NDMA and DNA adduct formation in perfused human placenta. Eleven placentas from normal full-term pregnancies were collected...

  5. A Case of Placenta Increta Mimicking Submucous Leiomyoma

    Directory of Open Access Journals (Sweden)

    Ali Ekiz

    2014-01-01

    Full Text Available In recent years with the increase in cesarean section rates, the frequency of placenta accreta cases rises. It causes 33–50% of all emergency peripartum hysterectomies. We present a 42-year-old case who was caught with early postpartum hemorrhage due to retained placental products. The ultrasonography showed a 65 × 84 mm mass in the uterine cavity after the delivery. Due to presence of early postpartum hemorrhage which needs transfusion, an intervention decision was made. The patient underwent curettage but the mass could not be removed so that placental retention was ruled out. Submucous leiomyoma was made as first-prediagnosis. Hysterectomy operation was performed as a curative treatment. Placenta increta diagnosis was made as a final diagnosis with pathological examination. As a result, placental attachment disorders may be overlooked if it is not a placenta previa case.

  6. Early Developmental and Evolutionary Origins of Gene Body DNA Methylation Patterns in Mammalian Placentas.

    Directory of Open Access Journals (Sweden)

    Diane I Schroeder

    2015-08-01

    Full Text Available Over the last 20-80 million years the mammalian placenta has taken on a variety of morphologies through both divergent and convergent evolution. Recently we have shown that the human placenta genome has a unique epigenetic pattern of large partially methylated domains (PMDs and highly methylated domains (HMDs with gene body DNA methylation positively correlating with level of gene expression. In order to determine the evolutionary conservation of DNA methylation patterns and transcriptional regulatory programs in the placenta, we performed a genome-wide methylome (MethylC-seq analysis of human, rhesus macaque, squirrel monkey, mouse, dog, horse, and cow placentas as well as opossum extraembryonic membrane. We found that, similar to human placenta, mammalian placentas and opossum extraembryonic membrane have globally lower levels of methylation compared to somatic tissues. Higher relative gene body methylation was the conserved feature across all mammalian placentas, despite differences in PMD/HMDs and absolute methylation levels. Specifically, higher methylation over the bodies of genes involved in mitosis, vesicle-mediated transport, protein phosphorylation, and chromatin modification was observed compared with the rest of the genome. As in human placenta, higher methylation is associated with higher gene expression and is predictive of genic location across species. Analysis of DNA methylation in oocytes and preimplantation embryos shows a conserved pattern of gene body methylation similar to the placenta. Intriguingly, mouse and cow oocytes and mouse early embryos have PMD/HMDs but their placentas do not, suggesting that PMD/HMDs are a feature of early preimplantation methylation patterns that become lost during placental development in some species and following implantation of the embryo.

  7. Placenta-derived exosomes: potential biomarkers of preeclampsia

    Directory of Open Access Journals (Sweden)

    Pillay P

    2017-10-01

    Full Text Available Preenan Pillay,1,2 Kogi Moodley,1 Jagidesa Moodley,3 Irene Mackraj3 1Discipline of Human Physiology, Nelson R Mandela School of Medicine, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa; 2Pearson Institute of Higher Education, Midrand, South Africa; 3Women’s Health and HIV Research Group, Nelson R Mandela School of Medicine, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa Abstract: Preeclampsia remains a leading cause of maternal and fetal mortality, due to ineffective treatment and diagnostic strategies, compounded by the lack of clarity on the etiology of the disorder. Although several clinical and biological markers of preeclampsia have been evaluated, they have proven to be ineffective in providing a definitive diagnosis during the various stages of the disorder. Exosomes have emerged as ideal biomarkers of pathological states, such as cancer, and have more recently gained interest in pregnancy-related complications, due to their role in cellular communication in normal and complicated pregnancies. This occurs as a result of the specific placenta-derived exosomal molecular cargo, which may be involved in normal pregnancy-associated immunological events, such as the maintenance of maternal–fetal tolerance. This review provides perspectives on placenta-derived exosomes as possible biomarkers for the diagnosis/prognosis of preeclampsia. Using keywords, online databases were searched to identify relevant publications to review the potential use of placenta-derived exosomes as biomarkers of preeclampsia. Keywords: placenta-derived exosomes, preeclampsia, biomarkers

  8. Tecendo as teias do abandono: além das percepções das mães de bebês prematuros Weaving the web of abandonment: beyond the perceptions of mothers of preterm infants

    Directory of Open Access Journals (Sweden)

    Rosangela Torquato Fernandes

    2011-10-01

    Full Text Available O objetivo foi analisar a rede de eventos envolvidos na intenção de abandono de bebês prematuros por suas mães. Pesquisa qualitativa realizada com 12 mães de prematuros internados na UTIN, do HUUMI. As técnicas foram entrevistas semiestruturadas e grupo focal realizados na internação e no ambulatório de seguimento. Amostra definida pelos critérios de saturação, a partir da repetição das falas. Utilizou-se análise de conteúdo na modalidade de análise temática. Resultados evidenciaram as dificuldades em ser mãe de prematuros e diversas formas de abandono em suas histórias de vida: abandono familiar, abandono social, abandono do companheiro que podem ter contribuído para a manifestação da intenção de abandono e/ou negligência materna. O abandono familiar materno foi evidenciado na infância, adolescência, na gravidez e no período de internação do bebê. Destacando-se a percepção do cuidado como obrigação materna, levando à construção do tipo idealizado de que boa mãe é a que cuida e não abandona. Redes de suporte podem empoderá-las facilitando a construção de vínculos e levando ao desejo de não abandonar. Conclui-se que existe uma rede de eventos e fenômenos sociais, familiares e políticos que contribuem para a intenção ou a efetiva realização do abandono. A mãe abandonada pode ser uma mãe abandonante.The scope of this study was to analyze the events involved in preterm infant abandonment by their mothers. A qualitative study was carried out with 12 mothers of preterm infants interned in the NICU of the Federal University of Maranhão - Brazil. The techniques were semi-structured interviews and a focus group performed during internment and in follow-up in the outpatient unit. The sample was defined according to saturation criteria. Content analysis was utilized by thematic scrutiny. The results showed several modes of abandonment in the mothers' life history: abandonment by relatives, social

  9. Zika virus and placenta

    Institute of Scientific and Technical Information of China (English)

    Beuy Joob; Viroj Wiwanitkit

    2016-01-01

    Zika virus infection is the new arboviral infection problem. The serious outcome of infection and induction of abnormal infant become the big issue in reproductive medicine. The pathogenesis and pathology of the placenta in the affected case is an interesting issue. Here, the authors focus and discuss on this topic in this short article.

  10. Manual Removal of the Placenta after Vaginal Delivery: An Unsolved Problem in Obstetrics

    Science.gov (United States)

    Zimmermann, Roland

    2014-01-01

    The third stage of labor is associated with considerable maternal morbidity and mortality. The major complication is postpartum hemorrhage (PPH), which is the leading cause of maternal morbidity and mortality worldwide. Whereas in the event of PPH due to atony of the uterus there exist numerous treatment guidelines; for the management of retained placenta the general consensus is more difficult to establish. Active management of the third stage of labour is generally accepted as standard of care as already its duration is contributing to the risk of PPH. Despite scant evidence it is commonly advised that if the placenta has not been expelled 30 minutes after delivery, manual removal of the placenta should be carried out under anaesthesia. Pathologic adhesion of the placenta in the low risk situation usually is diagnosed at the time of delivery; therefore a pre- or intrapartum screening opportunity for placenta accreta would be desirable. But diagnosis of abnormalities of placentation other than placenta previa remains a challenge. Nevertheless the use of ultrasound and doppler sonography might be helpful in the third stage of labor. An improvement might be the implementation of standardized operating procedures for retained placenta which could contribute to a reduction of maternal morbidity. PMID:24812585

  11. Economic and reproductive consequences of retained placenta in dairy cattle.

    NARCIS (Netherlands)

    Joosten, I.; Stelwagen, J.; Dijkhuizen, A.A.

    1988-01-01

    The financial losses due to retained placenta in Dutch dairy cattle were estimated by using two different methods of calculation. A data-set containing the birth records of 160,188 Meuse-Rhine-Yssel cows provided data on the reproductive performance of cows with and without retained placenta. The

  12. Topical application of recombinant activated factor VII during cesarean delivery for placenta previa.

    Science.gov (United States)

    Schjoldager, Birgit T B G; Mikkelsen, Emmeli; Lykke, Malene R; Præst, Jørgen; Hvas, Anne-Mette; Heslet, Lars; Secher, Niels J; Salvig, Jannie D; Uldbjerg, Niels

    2017-06-01

    During cesarean delivery in patients with placenta previa, hemorrhaging after removal of the placenta is often challenging. In this condition, the extraordinarily high concentration of tissue factor at the placenta site may constitute a principle of treatment as it activates coagulation very effectively. The presumption, however, is that tissue factor is bound to activated factor VII. We hypothesized that topical application of recombinant activated factor VII at the placenta site reduces bleeding without affecting intravascular coagulation. We included 5 cases with planned cesarean delivery for placenta previa. After removal of the placenta, the surgeon applied a swab soaked in recombinant activated factor VII containing saline (1 mg in 246 mL) to the placenta site for 2 minutes; this treatment was repeated once if the bleeding did not decrease sufficiently. We documented the treatment on video recordings and measured blood loss. Furthermore, we determined hemoglobin concentration, platelet count, international normalized ratio, activated partial thrombin time, fibrinogen (functional), factor VII:clot, and thrombin generation in peripheral blood prior to and 15 minutes after removal of the placenta. We also tested these blood coagulation variables in 5 women with cesarean delivery planned for other reasons. Mann-Whitney test was used for unpaired data. In all 5 cases, the uterotomy was closed under practically dry conditions and the median blood loss was 490 (range 300-800) mL. There were no adverse effects of recombinant activated factor VII and we did not measure factor VII to enter the circulation. Neither did we observe changes in thrombin generation, fibrinogen, activated partial thrombin time, international normalized ratio, and platelet count in the peripheral circulation (all P values >.20). This study indicates that in patients with placenta previa, topical recombinant activated factor VII may diminish bleeding from the placenta site without initiation

  13. The Case Report of Trigger Finger Improved with Hominis Placenta Pharmacopuncture Treatment

    Directory of Open Access Journals (Sweden)

    Jeong-Won Kim

    2010-12-01

    Full Text Available Objectives : The Purpose of this study is to investigate and report the effectiveness of Hominis Placenta using Pharmacopuncture treatment for trigger finger. Methods : 3 Patients are admitted at Dept. of Oriental Rehabilitation, Bu-Chun Jaseng Oriental Medicine Hospital, diagnosed as Trigger finger and treated with Hominis Placenta Pharmacopuncture. Each cases are measured and assessed by Quinnell's classification of triggering and VAS (Visual Analogue Scale scores. Results : 3 Patients of trigger finger have a different kind of cause and fingers lesion they have, but nodules are not significantly found up, so we could classify all of 3 patients to diffuse type. After treatment of Hominis placenta Pharmacopuncture, spontaneous pain and tenderness, grades of triggering are decreased significantly. We would expect that Hominis placenta Pharmacopuncture has a effect on degenerative diseases of diffuse type's tendon sheath. Conclusions : Trigger finger is generally divided into two stages, inflammatory and degenerative stage, and when degenerative stage, Hominis placenta pharmacopuncture appears to be effective.

  14. Nitrate Promotes Capsaicin Accumulation in Capsicum chinense Immobilized Placentas

    Directory of Open Access Journals (Sweden)

    Jeanny G. Aldana-Iuit

    2015-01-01

    Full Text Available In chili pepper’s pods, placental tissue is responsible for the synthesis of capsaicinoids (CAPs, the compounds behind their typical hot flavor or pungency, which are synthesized from phenylalanine and branched amino acids. Placental tissue sections from Habanero peppers (Capsicum chinense Jacq. were immobilized in a calcium alginate matrix and cultured in vitro, either continuously for 28 days or during two 14-day subculture periods. Immobilized placental tissue remained viable and metabolically active for up to 21 days, indicating its ability to interact with media components. CAPs contents abruptly decreased during the first 7 days in culture, probably due to structural damage to the placenta as revealed by scanning electron microcopy. CAPs levels remained low throughout the entire culture period, even though a slight recovery was noted in subcultured placentas. However, doubling the medium’s nitrate content (from 40 to 80 mM resulted in an important increment, reaching values similar to those of intact pod’s placentas. These data suggest that isolated pepper placentas cultured in vitro remain metabolically active and are capable of metabolizing inorganic nitrogen sources, first into amino acids and, then, channeling them to CAP synthesis.

  15. Real increasing incidence of hysterectomy for placenta accreta following previous caesarean section.

    LENUS (Irish Health Repository)

    Higgins, Mary F

    2013-11-01

    Placenta accreta, morbid adherence to the uterus to the myometrium, is commonest in association with placenta previa in women previously delivered by caesarean section (CS). It has become proportionally a greater cause of major maternal morbidity and mortality as the frequency of other serious obstetric complications has declined. The aim of this study was to examine the incidence of placenta accreta in the context of a rising caesarean delivery rate.

  16. Antenatal Sonographic Diagnosis and Clinical Significance of Placenta Previa Accreta after Cesarean Section.

    Science.gov (United States)

    Liu, Zhen-Zhen; Wei, Yao; Wang, Ruo-Jiao; Xu, Wen; Shi, Zhi-Min; Dai, Qing

    2017-10-30

    Objective To investigate the clinical and antenatal sonographic characteristics of placenta previa accreta after cesarean section. Methods The data of 21 inpatients diagnosed as placenta previa accreta after cesarean section in PUMC Hospital from 2006 to 2016 were retrospectively reviewed. The clinical and ultrasound features were recorded and compared among three placental accreta groups,including placenta accrete group(n=5),increta group(n=12),and percreta group(n=4). The relationship between the placental thickness at the uterine anterior lower segment level and the blood loss of the following cesarean section was tested. Results Of 21 patients,placenta previa was diagnosed by ultrasound in 20 cases(95.2%) and placenta previa accreta was diagnosed in 9 cases(42.9%). Antenatal ultrasound findings included following signs:loss of "clear zone"(15/18,83.3%),myometrial thinning(12/18,66.7%),abnormal placental lacunae(12/19,63.2%),bladder wall interruption(2/18,11.1%),and uterovesical hypervascularity(4/9,44.4%). Myometrial thinning(J-T=64.000,P=0.036),abnormal placental lacunae(J-T=74.500,P=0.032) and the placental thickness at the uterine anterior lower segment level(U=83.000,P=0.010) showed significant difference among different placenta accreta groups. Placental thickness at the uterine anterior lower segment level showed linear correlation with the blood loss of the following cesarean section(r=0.669,P=0.002). The blood loss of the following cesarean section showed significant difference among different placenta accreta groups(U=118.500,P=0.000). Conclusions The clinical and sonographic manifestations of placenta previa accreta after cesarean section show a spectrum of demographic characteristics. The measurement of thickness of placenta at the anterior lower segment may help the evaluation of the clinical prognosis of this special pathology.

  17. A reanimação do prematuro extremo em sala de parto: controvérsias Controversies about the resuscitation of extremely preterm infants in the delivery room

    Directory of Open Access Journals (Sweden)

    Maria Fernanda Branco de Almeida

    2005-03-01

    Full Text Available OBJETIVO: Relatar as principais controvérsias quanto aos procedimentos atualmente realizados na reanimação de recém-nascidos de extremo baixo peso na sala de parto. FONTES DOS DADOS: Revisão sistemática dos artigos incluídos em MEDLINE, SciELO e Cochrane Library e dos temas livres publicados em congressos internacionais e nacionais, utilizando-se as palavras-chave reanimação, asfixia e recém-nascido. SÍNTESE DOS DADOS: As principais controvérsias incluem aspectos relacionados à oxigenação e à ventilação do prematuro de extremo baixo peso ao nascimento. Os efeitos da administração de oxigênio em concentrações entre 21% e 100% precisam ser investigados. Os parâmetros adequados de pressão inspiratória, volume pulmonar e pressão expiratória final positiva necessitam ser estabelecidos com a finalidade de minimizar o barotrauma e o volutrauma. Os benefícios da aplicação da pressão positiva contínua de vias aéreas por via nasal também precisam ser bem determinados através de ensaios clínicos randomizados. Além disso, reanimadores manuais devem ser desenvolvidos para otimizar a administração desses parâmetros e minimizar a lesão pulmonar no início da vida extra-uterina. Estudos clínicos sobre a administração ao nascimento de adrenalina, expansores de volume e bicarbonato de sódio são inexistentes em prematuros de muito baixo peso. Adicionalmente, o principal dilema ético envolve a decisão conjunta entre os profissionais e os pais de não iniciar a reanimação na dependência da idade gestacional. CONCLUSÕES: A conduta atualmente vigente poderá ser modificada a partir dos resultados de ensaios clínicos randomizados e controlados, em conjunto com a avaliação do desenvolvimento, realizados em recém-nascidos de extremo baixo peso submetidos à reanimação na sala de parto.OBJECTIVE: To describe the main controversies about resuscitation procedures performed in extremely low birth weight infants in

  18. [Histopathological changes in human placentas related to hypertensive disorders].

    Science.gov (United States)

    Artico, Luciano Guimarães; Madi, José Mauro; Godoy, Alessandra Eifler Guerra; Coelho, Celso Piccoli; Rombaldi, Renato Luís; Artico, Graziela Rech

    2009-01-01

    to determine the prevalence of histopathological changes, in human placentas, related to hypertensive syndromes. a transversal study that compares histopathological changes identified in 43 placentae from hypertensive pregnant women (HypPr), with the ones from 33 placentae from normotensive pregnant women (NorPr). The weight, volume and macroscopic and microscopic occurrence of infarctions, clots, hematomas, atherosis (partial obliteration, thickness of layers and presence of blood vessels hyalinization) and Tenney-Parker changes (absent, discreet and prominent), as well as the locating of infarctions and clots (central, peripheral or the association of both) have been analyzed. The chi2 and t Student tests have been used for the statistical analysis, as well as medians, standard deviations and ratios. It has been considered as significant, p<0.05. the macroscopic study of HypPr placentae have presented lower weight (461.1 versus 572.1 g) and volume (437.4 versus 542.0 cm(3)), higher infarction (51.2 versus 45.5%; p<0.05: OR=1.15) and clots (51.2 versus 15.1%; p<0.05; OR=5.4) ratios, as compared to the NorPr's. In the HypPr and NorPr, microscopic clots have occurred in 83.7 versus 45.5% (p<0.05; OR=4.3), respectively. Atherosis and Tenney-Parker changes have been statistically associated to the hypertensive syndromes (p<0.05). the obtained data allow us to associate lower placentary weight and volume, higher ratio of macro and microscopic infarction, clots, atherosis and Tenney-Parker changes to placentae of gestations occurring with hypertensive syndromes.

  19. Delivery of placenta before baby in ruptured uterus | Ameh | Annals ...

    African Journals Online (AJOL)

    An unusual case of ruptured uterus characterized by spontaneous delivery of the placenta while the foetus is retained in the abdomen is presented. The management and prevention of ruptured uterus in Sub- Saharan Africa is discussed. Key Words: Delivery of placenta, ruptured uterus. Annals of African Medicine Vol.3(3) ...

  20. Participation in environmental health research by placenta donation - a perception study.

    Science.gov (United States)

    Lind, Uffe; Mose, Tina; Knudsen, Lisbeth E

    2007-11-22

    Much environmental health research depends on human volunteers participating with biological samples. The perception study explores why and how people participate in a placenta perfusion study in Copenhagen. The participation implies donation of the placenta after birth and some background information but no follow up. Nineteen semi-structured qualitative interviews were conducted with participants in the placenta perfusion study after donation of placenta. Observation studies were made of recruitment sessions. The interviewed participants are generally in favour of medical research. They participated in the placenta perfusion study due to a belief that societal progress follows medical research. They also felt that participating was a way of giving something back to the Danish health care system. The participants have trust in medical science and scientists, but trust is something which needs to be created through "trust-work". Face-to-face interaction, written information material and informed consent forms play important parts in creating trusting relationships in medical research. Medical research ethics do not only amount to specific types of written information material but should also be seen as a number of trust making performances involving researchers as well as research participants.

  1. Anesthesia for cesarean section in pregnancies complicated by placenta previa

    International Nuclear Information System (INIS)

    Imarengiaye, Charles O.; Osaigbovo, Etinosa P.; Tudjegbe, Sampson O.

    2008-01-01

    Objective was to evaluate the factors affecting the choice of anesthetic technique for cesarean section in women with placenta previa. In this retrospective study, the records of the labor Ward Theatre of the University of Benin Teaching Hospital, Benin City, Nigeria were examined from January 2000 to December 2004 to identify all the women who had cesarean section for placenta previa. The patient's socio-demographic characteristics, type of placenta previa, anesthesia technique, estimated blood loss, maternal and fetal outcomes were recorded. One hundred and twenty-six patients had cesarean section for placenta previa, however, only 81 patients 64.3% were available for analysis. General anesthesia was administered to 52/81 patients 64.2% and 29/81 patients 35.8% received spinal anesthesia. A history of antepartum bleeding was recorded in 61.7% n=50. Of 31 patients without antepartum hemorrhage APH, 15/31 had general anesthesia and 16/31 had spinal anesthesia. The patients who had APH, 37/50 had general anesthesia and 1/50 had spinal anesthesia. There was an increased chance of using general anesthesia and if APH were present p=0.03, odds ratio=3.1, 95% confidence interval=1.2-7.7. Spinal anesthesia may useful in patients with placenta previa. The presence of APH may encourage the use of general anesthesia for cesarean delivery. (author)

  2. Evaluation of placenta in foetal demise and foetal growth restriction.

    Science.gov (United States)

    Ch, Ujwala; Guruvare, Shyamala; Bhat, Sudha S; Rai, Lavanya; Rao, Sugandhi

    2013-11-01

    The study objective was to evaluate the pathological changes of the placenta in foetal death and foetal growth restriction and to find correlation of the findings with clinical causes. Prospective study at a tertiary care hospital. Gross and histopathological examinations of the placentae were carried out in pregnancies with foetal demise (IUD) and Foetal Growth Restriction (FGR). SPSS, version 11.5. Placentae of twenty seven women with foetal demise and of equal number of women with foetal growth restriction were studied. Placental weight was less than 10(th) percentile in 61.5% women in IUD group and in 93% women in the FGR group. Gross examination of placentae showed abnormalities in 12 (44%) women of IUD group and in 16 (59%) women of FGR group. Histopathological abnormalities were observed in 74.1% women of the IUD group and in 66.7% women of FGR group. Placental histopathology correlated with clinical risk factors in 60% women of IUD group and in 40% women of FGR group. Among the women with no clinically explainable cause for IUD and FGR, 86% and 57% had placental histopathological abnormalities respectively. The histopathological abnormalities of the placenta can be used to document the clinical causes of foetal demise and growth restriction; it may explain the causes in cases of clinically unexplained foetal demise and foetal growth restriction.

  3. Contribution of placenta accreta to the incidence of postpartum hemorrhage and severe postpartum hemorrhage.

    Science.gov (United States)

    Mehrabadi, Azar; Hutcheon, Jennifer A; Liu, Shiliang; Bartholomew, Sharon; Kramer, Michael S; Liston, Robert M; Joseph, K S

    2015-04-01

    To quantify the contribution of placenta accreta to the rate of postpartum hemorrhage and severe postpartum hemorrhage. All hospital deliveries in Canada (excluding Quebec) for the years 2009 and 2010 (N=570,637) were included in a retrospective cohort study using data from the Canadian Institute for Health Information. Placenta accreta included placental adhesion to the uterine wall, musculature, and surrounding organs (accreta, increta, or percreta). Severe postpartum hemorrhage included postpartum hemorrhage with blood transfusion, hysterectomy, or other procedures to control bleeding (including uterine suturing and ligation or embolization of pelvic arteries). Rates, rate ratios, population-attributable fractions (ie, incidence of postpartum hemorrhage attributable to placenta accreta), and 95% confidence intervals (CIs) were estimated. Logistic regression was used to quantify associations between placenta accreta and risk factors. The incidence of placenta accreta was 14.4 (95% CI 13.4-15.4) per 10,000 deliveries (819 cases among 570,637 deliveries), whereas the incidence of placenta accreta with postpartum hemorrhage was 7.2 (95% CI 6.5-8.0) per 10,000 deliveries. Postpartum hemorrhage among women with placenta accreta was predominantly third-stage hemorrhage (41% of all cases). Although placenta accreta was strongly associated with postpartum hemorrhage (rate ratio 8.3, 95% CI 7.7-8.9), its low frequency resulted in a small population-attributable fraction (1.0%, 95% CI 0.93-1.16). However, the strong association between placenta accreta and postpartum hemorrhage with hysterectomy (rate ratio 286, 95% CI 226-361) resulted in a population-attributable fraction of 29.0% (95% CI 24.3-34.3). Placenta accreta is too infrequent to account for the recent temporal increase in postpartum hemorrhage but contributes substantially to the proportion of postpartum hemorrhage with hysterectomy.

  4. Decreased placental and maternal serum TRAIL-R2 levels are associated with placenta accreta.

    Science.gov (United States)

    Oztas, Efser; Ozler, Sibel; Ersoy, Ali Ozgur; Ersoy, Ebru; Caglar, Ali Turhan; Uygur, Dilek; Yucel, Aykan; Ergin, Merve; Danisman, Nuri

    2016-03-01

    TNF-related apoptosis-inducing ligand receptor-2 (TRAIL-R2) is produced both by decidual and trophoblast cells during pregnancy and known to participate in apoptosis. In this study, we aimed to determine and to compare maternal serum and placental TRAIL-R2 levels in patients with placenta accreta, non-adherent placenta previa and in healthy pregnancies. We also aimed to analyze the association of placenta accreta with the occurrence of previous C-sections. A total of 82 pregnant women were enrolled in this case-control study (27 placenta accreta patients, 26 non-adherent placenta previa patients and 29 age-, and BMI-matched healthy, uncomplicated pregnant controls). TRAIL-R2 levels were studied in both maternal serum and placental tissue homogenates. Determining the best predictor(s) which discriminate placenta accreta was analyzed by multiple logistic regression analyses. Adjusted odds ratios and 95% confidence intervals were also calculated. Both placental and serum TRAIL-R2 levels were significantly lower in placenta accreta group (median 34.82 pg/mg and 19.85 pg/mL, respectively) when compared with both non-adherent placenta previa (median 39.24 pg/mg and 25.99 pg/mL, respectively) and the control groups (median 41.62 pg/mg and 25.87 pg/mL, respectively) (p Placental TRAIL-R2 levels and previous cesarean section were found to be significantly associated with placenta accreta (OR: 0.934 95% CI 0.883-0.987, p = 0.016 and OR:7.725 95% CI: 2.717-21.965, p Placental and serum TRAIL-R2 levels were positively correlated. Decreased levels of placental TRAIL-R2 and previous history of cesarean section were found to be significantly associated with placenta accreta, suggesting a possible role of apoptosis in abnormal trophoblast invasion. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Transfer RNA methylases in rat placenta

    International Nuclear Information System (INIS)

    Jagtiani, S.K.; Narurkar, L.M.; Narurkar, M.V.

    1977-01-01

    Presence of tRNA methylases (5-adenosylmethionine : tRNA methyltransferases) was demonstrated at various stages of gestation in rat placenta, the enzyme being 50-100% higher than that of adult rat liver during early gestation. Placental tRNA methylases were shown to differ from those of liver in the extent of methylation. Glycine methyltransferase (S-adenosylmethionine : glycine methyltransferase), a regulatory enzyme in adult rat liver, was absent in placenta throughout gestation. The placental tRNA methylases could be inhibited in vitro by semipurified glycine methyltransferase from adult rat liver. The high placental tRNA methylase activity was comparable with the inhibitor-free enzyme activity of the adult rat liver. S-adenosyl-[Me- 14 C]-methionine was used in the investigation. (author)

  6. Measurement of elasticity of normal placenta using the Virtual Touch quantification technique

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Size; Nan, Ruixia; Cui, Xiao Jing; Liang, Xian; Zhao, Yanan [Dept. of Ultrasound, Affiliated Hospital of Hainan Medical College, Haikou (China); Li, Yueping [Dept. of Obstetrics and Gynecology, Affiliated Hospital of Hainan Medical College, Haikou (China)

    2016-07-15

    The aim of this study was to measure the elasticity of normal placentas using the Virtual Touch quantification (VTQ) technique. This study was approved by the Institutional Ethics Committee. Fifty randomly selected, healthy pregnant women in their second trimester and 50 randomly selected, healthy pregnant women in their third trimester with a single fetus were included, and their placentas underwent VTQ through shear wave velocity (SWV) measurements. The measurements were performed at different locations to sample different areas of the placenta. Measurements were performed 3-4 times in each location, the mean shear wave velocities were calculated without the highest and lowest values of measurements in each region, and the results were compared. The SWV of the placenta was 0.983±0.260 m/sec, and the minimal and maximal speed was 0.63 m/sec and 1.84 m/sec, respectively. There was no significant difference between the second and third trimester of VTQ of the placenta in terms of SWV (0.978±0.255 m/sec vs. 0.987±0.266 m/sec, P=0.711). The maternal age between second and third trimester was 27.9±4.3 years and 29.2±4.4 years, respectively; there was no significant difference between them (P=0.159). The results of this study show that the SWV of normal placenta tissue is 0.983±0.260 m/sec, it has little variation between the second and third trimesters, and the VTQ technique may potentially play an additional role in placenta evaluation.

  7. Measurement of elasticity of normal placenta using the Virtual Touch quantification technique

    International Nuclear Information System (INIS)

    Wu, Size; Nan, Ruixia; Cui, Xiao Jing; Liang, Xian; Zhao, Yanan; Li, Yueping

    2016-01-01

    The aim of this study was to measure the elasticity of normal placentas using the Virtual Touch quantification (VTQ) technique. This study was approved by the Institutional Ethics Committee. Fifty randomly selected, healthy pregnant women in their second trimester and 50 randomly selected, healthy pregnant women in their third trimester with a single fetus were included, and their placentas underwent VTQ through shear wave velocity (SWV) measurements. The measurements were performed at different locations to sample different areas of the placenta. Measurements were performed 3-4 times in each location, the mean shear wave velocities were calculated without the highest and lowest values of measurements in each region, and the results were compared. The SWV of the placenta was 0.983±0.260 m/sec, and the minimal and maximal speed was 0.63 m/sec and 1.84 m/sec, respectively. There was no significant difference between the second and third trimester of VTQ of the placenta in terms of SWV (0.978±0.255 m/sec vs. 0.987±0.266 m/sec, P=0.711). The maternal age between second and third trimester was 27.9±4.3 years and 29.2±4.4 years, respectively; there was no significant difference between them (P=0.159). The results of this study show that the SWV of normal placenta tissue is 0.983±0.260 m/sec, it has little variation between the second and third trimesters, and the VTQ technique may potentially play an additional role in placenta evaluation

  8. [Placenta accreta: can prenatal diagnosis be performed? Ultrasound and MRI interests. About 27 cases].

    Science.gov (United States)

    Bauwens, J; Coulon, C; Azaïs, H; Bigot, J; Houfflin-Debarge, V

    2014-05-01

    To list ultrasonography signs identified when a placenta accreta is suspected. Secondary objectives are to analyze the relevance of diagnosis with ultrasonography and magnetic resonance imaging, and to know diagnosis circumstances in order to identify main risk factors. We present a monocentric retrospective study. All the cases of placentas accreta, observed from 2005 to 2010 at Lille University Hospital (France), have been included. Twenty-seven patients had a placenta accreta during this period. There was an antenatal suspicion for 22 cases and 21 were confirmed after delivery. Six cases were discovered per-partum. Diagnosis was suspected after metrorrhagia for 41% of women. In case of antenatal diagnosis, 100% of the patients had an anterior placenta praevia and an uterine scare. Fifty percent of the placentas accreta diagnosed per-partum were posterior. The most frequently ultrasonography signs are "intra-placental lacuna" (85.7%), "abnormal vascularization" (71.4%), "loss of normal hypoechoic retroplacental myometrial zone" (66.7%), "irregularity of the vesical wall" (66.7%). Sensibility of ultrasonography screening is 78%. Twenty-one magnetic resonance imaging examinations executed secondarily confirmed the diagnosis in 66.7% of the cases. Ultrasonography is a relevant exam for the diagnosis of placenta accreta. Posterior placenta should not be forsaken. Anterior placenta praevia in multiparous patients with a uterine scare should be a warning. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  9. Programa mãe-canguru e a relação mãe-bebê: pesquisa qualitativa na rede pública de Betim El programa madre-canguro y la relación madre-bebé: pesquisa cualitativade en la red pública de Betim Kangaroo mother program and the relationship mother-baby: qualitative research in a public maternity of Betim city

    Directory of Open Access Journals (Sweden)

    Jacqueline de Oliveira Moreira

    2009-09-01

    Full Text Available Esse texto aborda os resultados de uma pesquisa qualitativa financiada pela FAPEMIG/PUC - Minas que tem como objetivo investigar os efeitos do método "canguru" na relação entre mãe e bebê prematuro. A pesquisa de campo teve seus dados coletados através de entrevistas semiestruturadas junto às mães de bebês prematuros egressas do programa Canguru da Maternidade Municipal Aideé Conroy Espejo, de Betim. Utilizamos a análise de conteúdo por categorias temáticas para a análise dos dados. Os resultados apontam a complexidade da maternidade no interior da prematuridade, atravessada pela vivência de trauma, pelo medo de perder o bebê, pela visão da fragilidade da criança. Nesse contexto, o programa mãe-canguru possibilita efetivamente a conexão entre mãe e bebê prematuro, colaborando para a vinculação da díade. Concluímos ainda que a mãe, os familiares e a equipe podem constituir um ambiente facilitador a partir do momento em que assumam uma postura ativa na mediação da relação do prematuro com o mundo.Este texto enfoca los resultados de la pesquisa cualitativa financiada pela FAPEMIG / PUC - Minas que tiene como objetivo investigar los efectos del 'método Canguro' en la relación entre madre y bebé prematuro. La pesquisa de campo tuvo sus datos colectados a través de entrevistas semi-estructuradas junto a las madres de bebés prematuros egresas del Programa Ganguro de la Maternidad Municipal Aideé Conroy Espejo, de Betim, Minas Gerais, Brasil. Utilizamos el análisis de contenido por categorías temáticas para el estudio de los datos. Los resultados apuntan para la complejidad de la maternidad en el interior de la prematuridad, atravesada por la vivencia de trauma, por el miedo de perder el bebé, por la visión de la fragilidad del niño. En este contexto, el Programa Madre-canguro posibilita efectivamente la conexión entre madre y bebé prematuro, colaborando para la vinculación de la díada. Concluimos, adem

  10. MATERNAL AND PERINATAL OUTCOME IN ABRUPTIO PLACENTA

    Directory of Open Access Journals (Sweden)

    Prabha Janakiram

    2017-08-01

    Full Text Available BACKGROUND Antepartum Haemorrhage (APH is the leading cause of vaginal bleeding. It is also the important cause of maternal morbidity as well as perinatal morbidity. APH is defined as bleeding per vagina occurring after 28 weeks of gestation and before the birth of the baby. Among APH, abruptio placenta and placenta previa are the leading cause that endanger the life of the mother and a great risk to high unfavourable perinatal outcome. Placental abruption is the bleeding from the premature separation of the normally implanted placenta after 20 weeks of gestations and prior to the birth of the foetus/foetuses. It is the major contribution of obstetric haemorrhage and complicates 0.8 to 1% of pregnancies worldwide. Placental abruption is the premature separation of implanted placenta before the delivery of foetus/foetuses. The aim of the study is to analyse the risk factors associated with abruption and hence methods can be formulated to prevent maternal mortality and morbidity. MATERIALS AND METHODS The present study is a retrospective study and was done in the Department of Obstetrics and Gynaecology from July to December, 2016, for a period of 6 months in the year 2016 at Government K.A.P.V. Medical College, Trichy, South India. RESULTS The total number of abruption placenta cases reported during the study period- June 2016 to November 2016 were 40. The total number of livebirth during same period was 5,348. The stillbirth rate was 42.5% and neonatal death rate was 22.5%. Clinical information were collected, maternal age, parity, gestational age at parity, prior history of abruption, clinical presentation like pain, bleeding, type of abruption like concealed or revealed amount of retroplacental clots and its size and degree of abruption associated with hypertensive disorders, mode of delivery, abruption-delivery interval, maternal complications, requirement of blood transfusions and immediate neonatal outcome. The results of studies were

  11. [Accuracy of placenta accreta prenatal diagnosis by ultrasound and MRI in a high-risk population].

    Science.gov (United States)

    Daney de Marcillac, F; Molière, S; Pinton, A; Weingertner, A-S; Fritz, G; Viville, B; Roedlich, M-N; Gaudineau, A; Sananes, N; Favre, R; Nisand, I; Langer, B

    2016-02-01

    Main objective was to compare accuracy of ultrasonography and MRI for antenatal diagnosis of placenta accreta. Secondary objectives were to specify the most common sonographic and RMI signs associated with diagnosis of placenta accreta. This retrospective study used data collected from all potential cases of placenta accreta (patients with an anterior placenta praevia with history of scarred uterus) admitted from 01/2010 to 12/2014 in a level III maternity unit in Strasbourg, France. High-risk patients beneficiated antenatally from ultrasonography and MRI. Sonographic signs registered were: abnormal placental lacunae, increased vascularity on color Doppler, absence of the retroplacental clear space, interrupted bladder line. MRI signs registered were: abnormal uterine bulging, intraplacental bands of low signal intensity on T2-weighted images, increased vascularity, heterogeneous signal of the placenta on T2-weighed, interrupted bladder line, protrusion of the placenta into the cervix. Diagnosis of placenta accreta was confirmed histologically after hysterectomy or clinically in case of successful conservative treatment. Twenty-two potential cases of placenta accreta were referred to our center and underwent both ultrasonography and MRI. All cases of placenta accreta had a placenta praevia associated with history of scarred uterus. Sensibility and specificity for ultrasonography were, respectively, 0.92 and 0.67, for MRI 0.84 and 0.78 without significant difference (p>0.05). The most relevant signs associated with diagnosis of placenta accreta in ultrasonography were increased vascularity on color Doppler (sensibility 0.85/specificity 0.78), abnormal placental lacunae (sensibility 0.92/specificity 0.55) and loss of retroplacental clear space (sensibility 0.76/specificity 1.0). The most relevant signs in MRI were: abnormal uterine bulging (sensitivity 0.92/specificity 0.89), dark intraplacental bands on T2-weighted images (sensitivity 0.83/specificity 0.80) or

  12. Magnetic resonance imaging of the normal placenta

    International Nuclear Information System (INIS)

    Blaicher, Wibke; Brugger, Peter C.; Mittermayer, Christoph; Schwindt, Jens; Deutinger, Josef; Bernaschek, Gerhard; Prayer, Daniela

    2006-01-01

    The goal of this study was to provide a representative description of the normal placenta with contrast medium-free magnetic resonance imaging (MRI) in order to determine a standard of reference. One hundred consecutive singleton pregnancies were investigated by MRI without application of a contrast medium. The mean gestational age (GA) at the time of investigation was 29.5 weeks (range 19-40). Patients with suspected utero-placental insufficiency (UPI) or placental anomalies were excluded. Signal intensities were assessed and correlated with the respective GA. Antenatal MRI without contrast medium was able to depict placental status and morphological changes during gestation. A regular homogeneous structure was found in weeks 19-23. Subsequently, sporadic, slightly marked lobules appeared, which increased in number and markedness with ongoing gestation. Stratification of the lobules was observed after 36 weeks. The ratio of placental and amniotic fluid signal intensities decreased significantly with higher GA and with placental grading. MRI is well suited as an imaging method for the placenta. Our data may be used as a reference in the assessment of the placenta on MRI, and may have further clinical impact with respect to the determination of UPI

  13. Magnetic resonance imaging of the normal placenta

    Energy Technology Data Exchange (ETDEWEB)

    Blaicher, Wibke [Department of Gynecology and Obstetrics, University Hospital Vienna (Austria)]. E-mail: wibke.blaicher@meduniwien.ac.at; Brugger, Peter C. [Center of Anatomy and Cell Biology, University Hospital of Vienna (Austria); Mittermayer, Christoph [Department of Pediatrics, Division of Neonatology and Intensive Care, University Hospital of Vienna (Austria); Schwindt, Jens [Department of Pediatrics, Division of Neonatology and Intensive Care, University Hospital of Vienna (Austria); Deutinger, Josef [Department of Gynecology and Obstetrics, University Hospital Vienna (Austria); Bernaschek, Gerhard [Department of Gynecology and Obstetrics, University Hospital Vienna (Austria); Prayer, Daniela [Department of Radiology, Division of Neuroradiology, University Hospital of Vienna (Austria)

    2006-02-15

    The goal of this study was to provide a representative description of the normal placenta with contrast medium-free magnetic resonance imaging (MRI) in order to determine a standard of reference. One hundred consecutive singleton pregnancies were investigated by MRI without application of a contrast medium. The mean gestational age (GA) at the time of investigation was 29.5 weeks (range 19-40). Patients with suspected utero-placental insufficiency (UPI) or placental anomalies were excluded. Signal intensities were assessed and correlated with the respective GA. Antenatal MRI without contrast medium was able to depict placental status and morphological changes during gestation. A regular homogeneous structure was found in weeks 19-23. Subsequently, sporadic, slightly marked lobules appeared, which increased in number and markedness with ongoing gestation. Stratification of the lobules was observed after 36 weeks. The ratio of placental and amniotic fluid signal intensities decreased significantly with higher GA and with placental grading. MRI is well suited as an imaging method for the placenta. Our data may be used as a reference in the assessment of the placenta on MRI, and may have further clinical impact with respect to the determination of UPI.

  14. Placenta paraaortic with bladder invasion: A plea for multidisciplinary approach

    International Nuclear Information System (INIS)

    Shawish, Fahmy M. I.; Hammad, Fayez T.; Kazim, Essa M.

    2007-01-01

    Placenta previa percreta with the urinary bladder invasion is a rare but potentially lethal condition. It has an increasing clinical significance due to its association with previous cesarean sections and uterine curettage. Herein, we report on a patient with placenta percreta and bladder invasion, who presented with hematuria and in whom delivery was delayed to almost full term highlighting the potential catastrophic results and the need for a multidisciplinary approach with the need to involve surgeons who are familiar with vascular and urologic surgery. We also present an elegant MRI of placenta percreta invading the urinary bladder, which shows that MRI is potentially an excellent diagnostic diagnostic modality in this difficult condition. (author)

  15. A 3D co-culture microtissue model of the human placenta for nanotoxicity assessment

    DEFF Research Database (Denmark)

    Muoth, Carina; Wichser, Adrian; Monopoli, Marco

    2016-01-01

    and functionality of the placental tissue. The effects of NPs on the human placenta are not well studied or understood, and predictive in vitro placenta models to achieve mechanistic insights on NP-placenta interactions are essentially lacking. Using the scaffold-free hanging drop technology, we developed a well...

  16. Gluconeogenesis in rat placenta during foetal development

    Energy Technology Data Exchange (ETDEWEB)

    Bagewadikar, R S; Sharma, C; Nadkarni, G B [Bhabha Atomic Research Centre, Bombay (India). Biochemistry and Food Technology Div.

    1977-01-01

    Variations in glycogen levels in rat placenta have been correlated with gluconeogenesis in this tissue. Placental homogenate could synthesize substantial amounts of glucose from L-alanine-U-/sup 14/C in early pregnancy. This has been substantiated by the observed enhancement in the activities of glucose 6-phosphatase, fructose 1, 6-diphosphatase and phosphoenolpyruvate carboxykinase. Gluconeogenic activity in placenta could proceed till the foetal liver was able to take over this function. The increase or decrease in placental glycogen is concomitant with glycogen synthetase, but not phosphorylase, activity. The reversible catalytic properties of placental aldolase also show subtle functional changes during and late phases of gestation.

  17. Gluconeogenesis in rat placenta during foetal development

    International Nuclear Information System (INIS)

    Bagewadikar, R.S.; Sharma, C.; Nadkarni, G.B.

    1977-01-01

    Variations in glycogen levels in rat placenta have been correlated with gluconeogenesis in this tissue. Placental homogenate could synthesize substantial amounts of glucose from L-alanine-U- 14 C in early pregnancy. This has been substantiated by the observed enhancement in the activities of glucose 6-phosphatase, fructose 1, 6-diphosphatase and phosphoenolpyruvate carboxykinase. Gluconeogenic activity in placenta could proceed till the foetal liver was able to take over this function. The increase or decrease in placental glycogen is concomitant with glycogen synthetase, but not phosphorylase, activity. The reversible catalytic properties of placental aldolase also show subtle functional changes during and late phases of gestation. (author)

  18. Placenta previa and risk of major congenital malformations among singleton births in Finland.

    Science.gov (United States)

    Kancherla, Vijaya; Räisänen, Sari; Gissler, Mika; Kramer, Michael R; Heinonen, Seppo

    2015-06-01

    Placenta previa has been associated with adverse birth outcomes, but its association with congenital malformations is inconclusive. We examined the association between placenta previa and major congenital malformations among singleton births in Finland. We performed a retrospective population register-based study on all singletons born at or after 22+0 weeks of gestation in Finland during 2000 to 2010. We linked three national health registers: the Finnish Medical Birth Register, the Hospital Discharge Register, and the Register of Congenital Malformations, and examined several demographic and clinical characteristics among women with and without placenta previa, in association with major congenital malformations. We estimated adjusted odds ratios and 95% confidence intervals using multivariable logistic regression models. The prevalence of placenta previa was estimated as 2.65 per 1000 singleton births in Finland (95% confidence interval, 2.53-2.79). Overall, 6.2% of women with placenta previa delivered a singleton infant with a major congenital malformation, compared with 3.8% of unaffected women (p ≤ 0.001). Placenta previa was positively associated with almost 1.6-fold increased risk of major congenital malformations in the offspring, after controlling for maternal age, parity, fetal sex, smoking, socio-economic status, chorionic villus biopsy, In vitro fertilization, pre-existing diabetes, depression, preeclampsia, and prior caesarean section (adjusted odds ratio = 1.55; 95% confidence interval, 1.27-1.90). Using a large population-based study, we found that placenta previa was weakly, but significantly associated with an increased risk of major congenital malformations in singleton births. Future studies should examine the association between placenta previa and individual types of congenital malformations, specifically in high-risk pregnancies. © 2015 Wiley Periodicals, Inc.

  19. A comparison of morbidity associated with placenta previa with and without previous caesarean sections

    International Nuclear Information System (INIS)

    Baqai, S.; Siraj, A.; Noor, N.

    2018-01-01

    To compare the morbidity associated with placenta previa with and without previous caesarean sections. Study Design: Retrospective comparative study. Place and Duration of Study: From March 2014 till March 2016 in the department of Obstetrics and Gynaecology at PNS Shifa hospital Karachi. Material and Methods: After the approval from hospital ethical committee, antenatal patients with singleton pregnancy of gestational age >32 weeks, in the age group of 20-40 years diagnosed to have placenta previa included in the study. All patients with twin pregnancy less than 20 years and more than 40 years of age were excluded. The records of all patients fulfilling the inclusion criteria were reviewed. Data had been collected for demographic and maternal variables, placenta previa, history of previous lower segment caesarean section (LSCS), complications associated with placenta previa and techniques used to control blood loss were recorded. Results: During the study period, 6879 patients were delivered in PNS Shifa, out of these, 2060 (29.9%) had caesarean section out of these, 47.3% patients had previous history of LSCS. Thirty three (1.6%) patients were diagnosed to have placenta previa and frequency of placenta previa was significantly higher in patients with previous history of LSCS than previous normal delivery of LSCS i.e. 22 vs. 11 (p=0.023). It was observed that the frequency of morbidly adherent placenta (MAP) and Intensive care unit (ICU) stay were significantly higher in patients with previous history of LSCS than previous history of normal delivery. Conclusion: Frequency of placenta previa was significantly higher in patients with history of LSCS. Also placenta previa remains a major risk factor for various maternal complications. (author)

  20. Influência da posição prona na oxigenação, frequência respiratória e na força muscular nos recém-nascidos pré-termo em desmame da ventilação mecânica

    OpenAIRE

    Malagoli, Rita de Cássia; Santos, Fabiana Fagundes A.; Oliveira, Eduardo Araújo; Bouzada, Maria Cândida F.

    2012-01-01

    OBJETIVO: Verificar a influência do posicionamento do recém-nascido prematuro sobre a força da musculatura respiratória, oxigenação e frequência respiratória. MÉTODOS: Estudo transversal com amostra pareada de recém-nascidos com idade gestacional inferior a 34 semanas, intubados, em processo final de desmame de ventilação mecânica. Foram excluídos aqueles com malformações, síndromes genéticas, doenças neuromusculares, traqueostomizados e em pós-operatório de cirurgias abdominais ou torácicas....

  1. Induced abortion and placenta complications in the subsequent pregnancy

    DEFF Research Database (Denmark)

    Zhou, Wei Jin; Nielsen, Gunnar Lauge; Larsen, Helle

    2001-01-01

    Background. To study the risk of placenta complications following an induced abortion as a function of the interpregnancy interval. Methods. This study is based on three Danish national registries; the Medical Birth Registry, the Hospital Discharge Registry, and the Induced Abortion Registry. All...... primigravida women from 1980 to 1982 were identified in these three registries. A total of 15,727 women who terminated the pregnancy with a first trimester induced abortion were selected to the abortion cohort, and 46,026 women who did not terminate the pregnancy with an induced abortion constituted...... or the Medical Birth Registry records. Results. A slightly higher risk of placenta complications following an abortion was found. Retained placenta occurred more frequently in women with one, two or more previous abortions, compared with women without any previous abortion of similar gravidity. Adjusting...

  2. Measurement of elasticity of normal placenta using the Virtual Touch quantification technique

    Directory of Open Access Journals (Sweden)

    Size Wu

    2016-07-01

    Full Text Available Purpose: The aim of this study was to measure the elasticity of normal placentas using the Virtual Touch quantification (VTQ technique. Methods: This study was approved by the Institutional Ethics Committee. Fifty randomly selected, healthy pregnant women in their second trimester and 50 randomly selected, healthy pregnant women in their third trimester with a single fetus were included, and their placentas underwent VTQ through shear wave velocity (SWV measurements. The measurements were performed at different locations to sample different areas of the placenta. Measurements were performed 3-4 times in each location, the mean shear wave velocities were calculated without the highest and lowest values of measurements in each region, and the results were compared. Results: The SWV of the placenta was 0.983±0.260 m/sec, and the minimal and maximal speed was 0.63 m/sec and 1.84 m/sec, respectively. There was no significant difference between the second and third trimester of VTQ of the placenta in terms of SWV (0.978±0.255 m/sec vs. 0.987±0.266 m/sec, P=0.711. The maternal age between second and third trimester was 27.9±4.3 years and 29.2±4.4 years, respectively; there was no significant difference between them (P=0.159. Conclusion: The results of this study show that the SWV of normal placenta tissue is 0.983±0.260 m/sec, it has little variation between the second and third trimesters, and the VTQ technique may potentially play an additional role in placenta evaluation.

  3. Residential proximity to major roads and placenta/birth weight ratio.

    Science.gov (United States)

    Yorifuji, Takashi; Naruse, Hiroo; Kashima, Saori; Murakoshi, Takeshi; Tsuda, Toshihide; Doi, Hiroyuki; Kawachi, Ichiro

    2012-01-01

    Exposure to air pollution has been demonstrated to increase the risk of preterm birth and low birth weight. We examined whether proximity to major roads (as a marker of exposure to air pollution) is associated with increased placenta/birth weight ratio (as a biomarker of the placental transport function). Data on parental characteristics and birth outcomes were extracted from the database maintained by a major hospital in Shizuoka Prefecture, Japan. We restricted the analysis to mothers who delivered liveborn single births from 1997 to 2008 (n = 14,189). Using geocoded residential information, each birth was classified according to proximity to major roads. We examined the association between proximity to major roads and the placenta/birth weight ratio, using multiple linear regression. Proximity to major roads was associated with higher placenta/birth weight ratio. After adjusting for potential confounders, living within 200 m of a major road increased the ratio by 0.48% (95% CI = 0.15 to 0. 80). In addition, proximity to major roads was associated with lower placenta weight and birth weight. These observed associations were stronger among participants living closer to major roads. Exposure to traffic-related air pollution is associated with higher placenta/birth weight ratio. Impaired placental oxygen and nutrient transport function might be a mechanism for explaining the observed association between air pollution and low birth weight as well as preterm birth. Copyright © 2011 Elsevier B.V. All rights reserved.

  4. Gray scale and Doppler ultrasound in placenta accreta: Optimization of ultrasound signs

    OpenAIRE

    Mohamed Shawky; Essam AbouBieh; Alaa Masood

    2016-01-01

    Aim of work: To optimize ultrasound and Doppler signs in placenta accreta, and to clarify sensitivity and specificity. Patients & methods: This study included 50 pregnant women. The examinations were done in private center from January 2013 to November 2013. Patients have anterior low lying placenta or anterior placenta previa with history of previous CS. US was done using curvilinear or endovaginal transducer at frequency 3–5 MHz and 3–9 MHz. Results: This study included 50 pregnants w...

  5. Is human placenta proteoglycan remodeling involved in pre-eclampsia?

    OpenAIRE

    Warda, Mohamad; Zhang, Fuming; Radwan, Moustafa; Zhang, Zhenqing; Kim, Nari; Kim, Young Nam; Linhardt, Robert J.; Han, Jin

    2007-01-01

    Impaired placento-fetal communication is a coherent symptom of exaggerated pre-eclampsia. The impact of the cellular expression of different glycosaminoglycans (GAGs) in this event on the placenta in pre-eclampsia is still obscure. This is the first study aimed at discovering the relationship between structural alterations of different sulfated GAGs at the molecular level and the development of pre-eclampsia in inflicted placenta. Sulfated GAGs were isolated and purified from control and pre-...

  6. Utility of ultrasound and magnetic resonance imaging in prenatal diagnosis of placenta accreta: A prospective study

    International Nuclear Information System (INIS)

    Satija, Bhawna; Kumar, Sanyal; Wadhwa, Leena; Gupta, Taru; Kohli, Supreethi; Chandoke, Rajkumar; Gupta, Pratibha

    2015-01-01

    Placenta accreta is the abnormal adherence of the placenta to the uterine wall and the most common cause for emergency postpartum hysterectomy. Accurate prenatal diagnosis of affected pregnancies allows optimal obstetric management. To summarize our experience in the antenatal diagnosis of placenta accreta on imaging in a tertiary care setup. To compare the accuracy of ultrasound (USG) with color Doppler (CDUS) and magnetic resonance imaging (MRI) in prenatal diagnosis of placenta accreta. Prospective study in a tertiary care setup. A prospective study was conducted on pregnant females with high clinical risk of placenta accreta. Antenatal diagnosis was established based on CDUS and MRI. The imaging findings were compared with final diagnosis at the time of delivery and/or pathologic examination. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for both CDUS and MRI. The sensitivity and specificity values of USG and MRI were compared by the McNemar test. Thirty patients at risk of placenta accreta underwent both CDUS and MRI. Eight cases of placenta accreta were identified (3 vera, 4 increta, and 1 percreta). All patients had history of previous cesarean section. Placenta previa was present in seven out of eight patients. USG correctly identified the presence of placenta accreta in seven out of eight patients (87.5% sensitivity) and the absence of placenta accreta in 19 out of 22 patients (86.4% specificity). MRI correctly identified the presence of placenta accreta in 6 out of 8 patients (75.0% sensitivity) and absence of placenta accreta in 17 out of 22 patients (77.3% specificity). There were no statistical differences in sensitivity (P = 1.00) and specificity (P = 0.687) between USG and MRI. Both USG and MRI have fairly good sensitivity for prenatal diagnosis of placenta accreta; however, specificity does not appear to be as good as reported in other studies. Both modalities have complimentary

  7. The role of prenatal alcohol exposure in abruptio placentae | du Toit ...

    African Journals Online (AJOL)

    Objective. To investigate the association between preconception and prenatal alcohol use and abruptio placentae. Methods. A case-control study of women with the clinical diagnosis of abruptio placentae, 65 cases and 66 controls, at Tygerberg Academic Hospital, Western Cape, South Africa. Women in whom a ...

  8. Hexachlorocyclohexanes (HCHs) in placenta and umbilical cord blood and dietary intake for women in Beijing, China

    International Nuclear Information System (INIS)

    Yu, Yanxin; Wang, Bin; Wang, Xilong; Wang, Rong; Wang, Wentao; Shen, Guofeng; Shen, Huizhong; Li, Wei; Wong, Minghong; Liu, Wenxin; Tao, Shu

    2013-01-01

    Placenta and umbilical cord blood are important media for investigating maternal–fetal exposure to environmental pollutants. Historically hexachlorocyclohexanes (HCHs) were once widely-used in China. In this study, residues of HCHs were measured in placenta and umbilical cord blood samples for 40 women from Beijing. The measured median values of HCHs were 62.0 and 68.8 ng/g fat in placenta and umbilical cord blood, respectively. Concentrations of HCHs in placenta and umbilical cord blood of urban cohort were higher than those of rural group due to enhanced consumption of fish, meat, and milk. Residues of HCHs in placenta were significantly correlated with total food consumption, dietary intake, and maternal age, and could be predicted using the parameters dependent upon ingestion of meat and milk. The transplacental exposure of fetuses to HCHs was revealed by a close association between the residual levels in the paired placenta and the paired umbilical cord blood samples. -- Highlights: •Medians of HCH in placenta and umbilical cord blood of 40 puerperal women from Beijing were 62.0 and 68.8 ng/g⋅fat. •HCHs in placenta and umbilical cord blood of urban cohort were higher than those of rural one. •HCH residues in placenta were significantly correlated with total food consumption, daily dietary intake, and maternal age. •The transplacental exposure of fetus to HCHs was revealed. -- HCHs in placenta of women in Beijing were significantly correlated with total food consumption, dietary intake, and maternal age

  9. Alterações histopatológicas em placentas humanas relacionadas às síndromes hipertensivas Histopathological changes in human placentas related to hypertensive disorders

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    Luciano Guimarães Artico

    2009-01-01

    Full Text Available OBJETIVO: determinar a prevalência de alterações histopatológicas em placentas humanas, relacionadas às síndromes hipertensivas. MÉTODOS: estudo de corte transversal, que comparou as alterações histopatológicas identificadas em 43 placentas oriundas de gestantes do grupo de hipertensas (GrHip com as de 33 placentas de gestantes do grupo de normotensas (GrNor. Foram analisados o peso, volume e ocorrência macro e microscópica de infartos, coágulos, hematomas, aterose (obliteração parcial, espessamento de camadas e presença de vasos hialinizados e alterações de Tenney-Parker (ausentes, discretas e proeminentes, bem como a localização de infartos e coágulos (central, periférico ou associação de ambos. Para a análise estatística foram usados os testes do χ2 e t de Student, bem como médias, desvios padrões e percentuais. Considerou-se como significante um pPURPOSE: to determine the prevalence of histopathological changes, in human placentas, related to hypertensive syndromes. METHODS: a transversal study that compares histopathological changes identified in 43 placentae from hypertensive pregnant women (HypPr, with the ones from 33 placentae from normotensive pregnant women (NorPr. The weight, volume and macroscopic and microscopic occurrence of infarctions, clots, hematomas, atherosis (partial obliteration, thickness of layers and presence of blood vessels hyalinization and Tenney-Parker changes (absent, discreet and prominent, as well as the locating of infarctions and clots (central, peripheral or the association of both have been analyzed. The χ2 and t Student tests have been used for the statistical analysis, as well as medians, standard deviations and ratios. It has been considered as significant, p<0.05. RESULTS: the macroscopic study of HypPr placentae have presented lower weight (461.1 versus 572.1 g and volume (437.4 versus 542.0 cm³, higher infarction (51.2 versus 45.5%; p<0.05: OR=1.15 and clots (51.2 versus

  10. An appraisal of retained placentae in ibadan: a five year review.

    Science.gov (United States)

    Obajimi, G O; Roberts, A O; Aimakhu, C O; Bello, F A; Olayemi, O

    2009-06-01

    To determine the frequency of retained placenta at the University College Hospital Ibadan (UCH). and to describe the socio-demographic characteristics of the patients and examine the risk factors predisposing to retained placenta. This is a descriptive study covering a period of 5 years from January 1(st) 2002 to December 31(st) 2006. During the study period, 4980 deliveries took place at the University College Hospital, Ibadan and 106 cases of retained placenta were managed making the incidence 2.13 per cent of all births. During the five year period, there were 106 patients with retained placenta; of these, 90 (84.9%) case notes were available for analysis. The mean age was 29.37 ± 4.99 years. First and second Para accounted for 52 per cent of the patients. Majority of the patient were unbooked for antenatal care in UCH with booked patients accounting for 27.8 per cent of the cases. The mean gestational age at delivery was 34.29 ± 6.02. Three patients presented to the hospital in shock of which 2 died on account of severe haemorrhagic shock. Fifty-eight patients (64.8%) presented with anaemia (packed cell volume less than 30 per cent) and 35 patients (38.8%) had blood transfusion ranging between 1-4 pints. 1 patient required hysterectomy on account of morbidly adherent placenta. Eleven patients (12.2%) had placenta retention in the past, 28 patients (31%) had a previous dilatation and curettage, 14 patients (15.5%) had previous caesarean sections and 47 patients (41.3%) had no known predisposing factors. Retained placenta still remains a potentially life threatening condition in the tropics due to the associated haemorrhage, and other complications related to its removal. The incidence and severity may be decreased by health education, women empowerment and the provision of facilities for essential obstetric services by high skilled health care providers in ensuring a properly conducted delivery with active management of the third stage of labour.

  11. Eficacia de leche materna extraída versus sacarosa oral para la analgesia en neonatos pretérminos sometidos a venopunción.

    OpenAIRE

    Collados Gómez, Laura

    2017-01-01

    Tesis Doctoral leída en la Universidad Rey Juan Carlos de Madrid en 2015. Directores de la Tesis: Rodrigo Jiménez García y Ana María García Pozo Los nacimientos prematuros debido a su alta incidencia pueden considerarse un problema de salud publica, por su alto impacto en la morbimortalidad y en la calidad de vida en etapas infantiles y adulta. El dolor es definido por la Internacional Association for the Study of Pain como una experiencia sensitiva y emocional desagradable oca...

  12. Aquisição de habilidades motoras até a marcha independente em prematuros de muito baixo peso Acquisition of motor abilities up to independent walking in very low birth weight preterm infants

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    Sandra C. P. Volpi

    2010-04-01

    Full Text Available OBJETIVO: Determinar as idades cronológica e corrigida de aquisição das habilidades motoras até a marcha independente em prematuros de muito baixo peso e avaliar até quando é necessário o uso da idade corrigida. MÉTODOS: Estudo longitudinal de prematuros OBJECTIVE: To determine chronological and corrected ages at acquisition of motor abilities up to unaided walking in very low weight preterms and to determine up to what point it is necessary to use corrected age. METHODS: This was a longitudinal study of preterms with birth weight < 1,500 g and gestational age < 34 weeks, free from neurosensory sequelae, selected at the high-risk infants follow-up clinic at the Hospital das Clínicas, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP in Botucatu, Brazil, between 1998 to 2003, and assessed every 2 months until acquisition of unaided walking. RESULTS: Nine percent of the 155 preterms recruited were excluded from the study, leaving a total of 143 patients. The mean gestational age was 30±2 weeks, birth weight was 1,130±222 g, 59% were female and 44% were small for gestational age. Preterms achieved head control in their second month, could sit unaided at 7 months and walked at 12.8 months' corrected age, corresponding to the 4th, 9th and 15th months of chronological age. There were significant differences between chronological age and corrected age for all motor abilities. Preterms who were small for their gestational age acquired motor abilities later, but still within expected limits. CONCLUSIONS: Very low weight preterms, free from neurosensory disorders, acquired their motor abilities within the ranges expected for their corrected ages. Corrected age should be used until unaided walking is achieved.

  13. Placenta Prévia: Fatores de risco para o Acretismo Placenta Previa: Risk Factors for Accretion

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    Maria Regina Torloni

    2001-08-01

    Full Text Available Objetivo: investigação dos fatores de risco associados ao acretismo em pacientes com placenta prévia (PP. Métodos: foi realizada uma análise retrospectiva caso-controle de todos os prontuários de pacientes com diagnóstico de PP que tiveram seus partos na Maternidade Escola Vila Nova Cachoeirinha (São Paulo entre 1986 e 1998. O grupo com acretismo foi comparado ao grupo sem acretismo quanto à idade, paridade, antecedentes de abortamentos, curetagens e cesarianas, o tipo de PP e a área predominante de inserção placentária. Para avaliar a associação entre a variável dependente (acretismo placentário e as variáveis independentes (características maternas e placentária foram utilizados o teste do chi², análise univariada e multivariada, considerando-se significantes os valores de p Purpose: to investigate risk factors associated with accretion in placenta previa (PP patients. Methods: this was a retrospective case-control study of all the records of patients who delivered between 1986-1998 at Maternidade Escola de Vila Nova Cachoeirinha (São Paulo with a diagnosis of placenta previa. The groups with and without accretion were compared regarding age, parity, previous history of miscarriage, curettage and cesarean section, type of PP and predominant area of placental attachment. Possible associations between the dependent (accretion and independent (maternal and placental characteristics variables were evaluated using the chi² test, univariate and multivariate analyses. Results: reviewing 245 cases of PP, two risk factors were significantly associated with accretion: central placenta previa (odds ratio (OR: 2.93 and two or more previous cesarean sections(OR: 2.54. Based on these data, a predictive model was constructed, according to which a patient with central PP and two more previous cesarean sections has a 44.4% risk for accretion. Conclusions: results of the current study may help obstetricians in the classification of their

  14. Creatine biosynthesis and transport by the term human placenta.

    Science.gov (United States)

    Ellery, Stacey J; Della Gatta, Paul A; Bruce, Clinton R; Kowalski, Greg M; Davies-Tuck, Miranda; Mockler, Joanne C; Murthi, Padma; Walker, David W; Snow, Rod J; Dickinson, Hayley

    2017-04-01

    Creatine is an amino acid derivative that is involved in preserving ATP homeostasis. Previous studies suggest an important role for the creatine kinase circuit for placental ATP turnover. Creatine is obtained from both the diet and endogenous synthesis, usually along the renal-hepatic axis. However, some tissues with a high-energy demand have an inherent capacity to synthesise creatine. In this study, we determined if the term human placenta has the enzymatic machinary to synthesise creatine. Eleven placentae were collected following elective term caesarean section. Samples from the 4 quadrants of each placenta were either fixed in formalin or frozen. qPCR was used to determine the mRNA expression of the creatine synthesising enzymes arginine:glycine amidinotransferase (AGAT) and guanidinoacetate methyltransferase (GAMT), and the creatine transporter (SLC6A8). Protein expression of AGAT and GAMT was quantified by Western blot, and observations of cell localisation of AGAT, GAMT and SLC6A8 made with immunohistochemistry. Synthesis of guanidinoacetate (GAA; creatine precursor) and creatine in placental homogenates was determined via GC-MS and HPLC, respectively. AGAT, GAMT and SLC6A8 mRNA and protein were detected in the human placenta. AGAT staining was identified in stromal and endothelial cells of the fetal capillaries. GAMT and SLC6A8 staining was localised to the syncytiotrophoblast of the fetal villi. Ex vivo, tissue homogenates produce both GAA (4.6 nmol mg protein -1 h -1 ) and creatine (52.8 nmol mg protein -1 h -1 ). The term human placenta has the capacity to synthesise creatine. These data present a new understanding of placental energy metabolism. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Prevalence and correlates of preterm labor among young parturient women attending public hospitals in Brazil Prevalencia y factores correlativos del parto prematuro en las jóvenes parturientas que acuden a los hospitales públicos del Brasil

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    Angélica E. Miranda

    2012-11-01

    Full Text Available OBJECTIVE: To determine the prevalence of and risk factors for preterm labor (OBJETIVO: Determinar la prevalencia y los factores de riesgo de parto prematuro (menos de 37 semanas de gestación en las jóvenes embarazadas del Brasil. MÉTODOS: Se llevó a cabo un estudio transversal a escala nacional en jóvenes parturientas de 15 a 24 años de edad que acudieron a las maternidades públicas brasileñas en el 2009. Los entrevistadores administraron cuestionarios al ingresar la parturienta en la maternidad (o poco después de parto, si las mujeres participantes tenían demasiado dolor como para responder durante el trabajo del parto. Las participantes respondieron a un cuestionario que recopilaba datos demográficos, conductuales y clínicos. RESULTADOS: Se incluyeron en el estudio un total de 2 071 (86,3% parturientas de las 2 400 invitadas a participar. La media de edad fue de 20,2 años (desviación estándar [SD]: 2,7 y el promedio de años de enseñanza escolar fue de 8 (SD: 2,4. Se produjo un parto prematuro en 450 mujeres (21,7%. La proporción más alta de parto prematuro (36,1% se observó en la región del Norte y la proporción más baja (6,9% en la región del Sur. En el modelo final de regresión logística con variables múltiples, el vivir en la región del Norte (razón de posibilidades [OR]: 1,43; intervalo de confianza [IC] de 95%: 1,28-1,59; el tener ingresos mensuales inferiores a dos veces el salario mínimo brasileño (OR: 1,27, IC de 95%: 1,01-1,60; el haber sido víctima de violencia doméstica (OR: 2,27, IC de 95%: 1,23-4,18; y el haber recibido una atención prenatal inadecuada (OR: 3,17, IC de 95%: 2,54-3,97 seguían siendo factores correlativos significativos de parto prematuro en esta población. CONCLUSIONES: Los resultados muestran una alta prevalencia del parto prematuro en las mujeres jóvenes del Brasil. El parto prematuro presenta una etiología multifactorial. Se deben destinar más recursos de salud p

  16. Growth and maturation of villi in placentae from well-controlled diabetic women

    DEFF Research Database (Denmark)

    Mayhew, T M; Sørensen, Flemming Brandt; Klebe, J G

    1994-01-01

    Placentae from controls and two groups of diabetic women (one White classes A, B, C and the other classes D, F/R) were collected at 37-42 weeks of gestation. Tissue sections were analysed using stereological methods in order to quantify the growth and maturational status of villi. Birth and place......Placentae from controls and two groups of diabetic women (one White classes A, B, C and the other classes D, F/R) were collected at 37-42 weeks of gestation. Tissue sections were analysed using stereological methods in order to quantify the growth and maturational status of villi. Birth...... with group, mode of delivery and sex of newborn as the principal effects. Mean weights were similar in controls and diabetic groups. Diabetic placentae had a more voluminous fetal capillary bed of greater length, diameter and surface area. In addition, the diffusion distances across fetal plasma (erythrocyte...... on the fetal side of the diabetic placenta. They show that changes can affect the placentae of appropriate-for-age as well as large-for-age babies and provide no evidence that they increase with the severity and duration of diabetes....

  17. Revisión Bibliográfica: Relación de la subunidad beta de gonadotropina corionica humana, testosterona libre y sexo fetal con el desarrollo de preeclampsia.

    OpenAIRE

    Francisco A. Yegüez M; Olivar C. Castejón; Marisol García de Yegüez

    2007-01-01

    La hipertensión arterial que complica al embarazo, constituye una patología compleja que comprende entidades clínicas como la preeclampsia (PE), eclampsia (E) y síndrome de HELLP. En su etiopatogenia se imbrican innumerables factores conducentes a disfunción endotelial que desencadena una cascada de manifestacionesclínicas que generan un gran impacto en la salud materno fetal: restricción del crecimiento fetal, parto prematuro y/o asfixia perinatal, abruptio placentae, hemorragias maternas in...

  18. Uso do fluconazol endovenoso no tratamento da endoftalmite fúngica endógena: relato de caso Intravenous fluconazole use in the treatment of fungic endogenous endophthalmitis: case report

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    Patrícia de Freitas Dotto

    2005-08-01

    Full Text Available Os autores descrevem um caso de endoftalmite endógena por Candida albicans, em recém-nascido prematuro, refratária ao tratamento com anfotericina B endovenosa e que apresentou resolução com o uso do fluconazol endovenoso. Ressaltam ainda os aspectos clínicos da endoftalmite endógena por Candida albicans por meio de revisão da literatura.The authors describe a case of endogenous Candida albicans endophthalmitis in one extremely low birth-weight newborn refractory to endovenous amphotericin B treatment that presented resolution with the use of endovenous fluconazole. Clinical aspects of endogenous Candida albicans endophthalmitis are also pointed out by a review of the literature.

  19. Magnetic resonance imaging of placenta accreta

    Science.gov (United States)

    Varghese, Binoj; Singh, Navdeep; George, Regi A.N; Gilvaz, Sareena

    2013-01-01

    Placenta accreta (PA) is a severe pregnancy complication which occurs when the chorionic villi (CV) invade the myometrium abnormally. Optimal management requires accurate prenatal diagnosis. Ultrasonography (USG) and magnetic resonance imaging (MRI) are the modalities for prenatal diagnosis of PA, although USG remains the primary investigation of choice. MRI is a complementary technique and reserved for further characterization when USG is inconclusive or incomplete. Breath-hold T2-weighted half-Fourier rapid acquisition with relaxation enhancement (RARE) and balanced steady-state free precession imaging in the three orthogonal planes is the key MRI technique. Markedly heterogeneous placenta, thick intraplacental dark bands on half-Fourier acquisition single-shot turbo spin-echo (HASTE), and disorganized abnormal intraplacental vascularity are the cardinal MRI features of PA. MRI is less reliable in differentiating between different degrees of placental invasion, especially between accreta vera and increta. PMID:24604945

  20. Magnetic resonance imaging of placenta accreta

    International Nuclear Information System (INIS)

    Varghese, Binoj; Singh, Navdeep; George, Regi A.N; Gilvaz, Sareena

    2013-01-01

    Placenta accreta (PA) is a severe pregnancy complication which occurs when the chorionic villi (CV) invade the myometrium abnormally. Optimal management requires accurate prenatal diagnosis. Ultrasonography (USG) and magnetic resonance imaging (MRI) are the modalities for prenatal diagnosis of PA, although USG remains the primary investigation of choice. MRI is a complementary technique and reserved for further characterization when USG is inconclusive or incomplete. Breath-hold T2-weighted half-Fourier rapid acquisition with relaxation enhancement (RARE) and balanced steady-state free precession imaging in the three orthogonal planes is the key MRI technique. Markedly heterogeneous placenta, thick intraplacental dark bands on half-Fourier acquisition single-shot turbo spin-echo (HASTE), and disorganized abnormal intraplacental vascularity are the cardinal MRI features of PA. MRI is less reliable in differentiating between different degrees of placental invasion, especially between accreta vera and increta

  1. Gray scale and Doppler ultrasound in placenta accreta: Optimization of ultrasound signs

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    Mohamed Shawky

    2016-09-01

    Conclusion: Ultrasound and Doppler examinations of placenta have signs highly suggestive of placenta accreta due to high sensitivity and specificity with placental lacunae of turbulent flow and retro-placental myometrial thickness ⩽1 mm are of the highest specificity.

  2. Assessment of total placenta previa by magnetic resonance imaging and ultrasonography to detect placenta accreta and its variants.

    Science.gov (United States)

    Peker, Nuri; Turan, Volkan; Ergenoglu, Mete; Yeniel, Ozgur; Sever, Ahmet; Kazandi, Mert; Zekioglu, Osman

    2013-03-01

    To evaluate the importance of ultrasonography (US) and magnetic resonance imaging (MRI) in detecting placental adherence defects. Patients diagnozed with total placenta previa (n = 40) in whom hysterectomy was performed due to placental adherence defects (n = 20) or in whom the placenta detached spontaneously after a Cesarean delivery (n = 20) were included into the study between June 2008 and January 2011, at the Department of Obstetrics and Gynecology Ege University (lzmir Turkey). Gray-scale US was used to check for any placental lacunae, sub-placental sonolucent spaces or a placental mass invading the vesicouterine plane and bladder Intra-placental lacunar turbulent blood flow and an increase in vascularization in the vesicouterine plane were evaluated with color Doppler mode. Subsequently all patients had MRI and the results were compared with the histopathologic examinations. The sensitivity of MRI for diagnosis of placental adherence defects before the operation was 95%, with a specificity of 95%. In the presence of at least one diagnostic criterion, the sensitivity and specificity of US were 87.5% and 100% respectively, while the sensitivity of color Doppler US was 62.5% with a specificity of 100%. Currently MRI appears to be the gold standard for the diagnosis of placenta accreta. None of the ultrasonographic criteria is solely sufficient to diagnose placental adherence defects, however they assist in the diagnostic process.

  3. Placenta accreta located in the posterior wall of the uterus: a case report

    OpenAIRE

    Ozler, Sibel; Oztas, Efser; Kadioglu, Nezaket; Sirvan, Levent; Uzunlar, Ozlem; Caglar, Turhan

    2016-01-01

    Abnormal invasive implantation of the placenta is thought to occur as a result of the defect in the decidua basalis of the women who have a history of cesarean delivery. Massive obstetric hemorrhage incidence is increased in placenta accreta cases. Although ultrasonographic and doppler examinations, and magnetic resonance imaging (MRI) are widely used, the diagnosis of placenta accreta in the early pregnancy weeks is poor. Therefore, the presence of life-threatening vaginal bleeding in the ea...

  4. Clearance of α-aminoisobutyric acid during in-situ perfusion of the guinea pig placenta

    International Nuclear Information System (INIS)

    Kelman, B.J.; Sikov, M.R.

    1983-05-01

    Extensive investigation of the transport of α-aminoisobutyric acid (AIB; a nonmetabolized amino acid) has shown that AIB is actively transported from mother to fetus across the hemochorial placenta of the guinea pig. As a step towards clarifying the relative rolls of active and passive movements of amino acids across the placenta, it would be useful to obtain concurrent measurements of transplacental movements of a substance which crosses the placenta rapidly by simple diffusion (water) and of a substance which is actively transported across the placenta (AIB). In our study, placentas from guinea pigs between 59 and 61 days of gestation were perfused in situ through cannulated umbilical vessels with the maternal circulation left intact. Tritiated water and 14 C-AIB were injected into a maternal jugular vein and maternal blood samples were obtained at 1 to 10 minute intervals; perfusate samples were collected sequentially after one pass through the placenta. Clearance of 14 C-AIB from mother to fetus (AIB/sub MF/) and AIB concentrations in placental tissue, maternal plasma, and perfusate were consistent in magnitude with data obtained by other invetigators who have clearly shown an active transport of AIB in the placenta. On the other hand, in this study AIB/sub MF/ ranged from approximately 50% to 96% of the clearance of 3 H-labeled water from mother to fetus (T/sub MF/) and that changes in AIB/sub MF/ correlated closely with changes in T/sub MF/ in all perfusions. Thus, it appears that AIB/sub MF/ closely paralleled T/sub MF/ and these data suggest that a relatively large component of AIB/sub MF/ is of passive origin in the in situ placenta

  5. Socioeconomic inequality in preterm birth in four Brazilian birth cohort studies

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    Ana Daniela Izoton de Sadovsky

    2018-01-01

    Full Text Available Objective: To analyze economic inequality (absolute and relative due to family income in relation to the occurrence of preterm births in Southern Brazil. Methods: Four birth cohort studies were conducted in the years 1982, 1993, 2004, and 2011. The main exposure was monthly family income and the primary outcome was preterm birth. The inequalities were calculated using the slope index of inequality and the relative index of inequality, adjusted for maternal skin color, education, age, and marital status. Results: The prevalence of preterm births increased from 5.8% to approximately 14% (p-trend < 0.001. Late preterm births comprised the highest proportion among the preterm births in all studies, although their rates decreased over the years. The analysis on the slope index of inequality demonstrated that income inequality arose in the 1993, 2004, and 2011 studies. After adjustment, only the 2004 study maintained the difference between the poorest and the richest subjects, which was 6.3 percentage points. The relative index of inequality showed that, in all studies, the poorest mothers were more likely to have preterm newborns than the richest. After adjustment for confounding factors, it was observed that the poorest mothers only had a greater chance of this outcome in 2004. Conclusion: In a final model, economic inequalities resulting from income were found in relation to preterm births only in 2004, although a higher prevalence of prematurity continued to be observed in the poorest population, in all the studies. Resumo: Objetivo: Analisar a iniquidade econômica (absoluta e relativa decorrente da renda familiar na ocorrência de prematuros no Sul do Brasil. Métodos: Foram realizados quatro estudos do tipo coorte de nascimentos nos anos de 1982, 1993, 2004 e 2011. A exposição principal foi a renda familiar mensal e o desfecho foi nascer prematuro. Foram calculadas as iniquidades através do slope index of inequality e o relative index of

  6. Placenta Accreta at 15 Weeks of Gestational Age and Uterus Preservation with Hysterectomy Abortion

    Directory of Open Access Journals (Sweden)

    Farahnaz Farzaneh

    2017-10-01

    Full Text Available Placenta accrete refers to an abnormality of placental implantation in which the anchoring placental villi attached to myometrium rather than decidua resulting in a morbidity adherent placenta. Placenta increta (chorionic villi penetrate into the myometrium and placenta percreta (chorionic villi penetrate through the myometrium to the uterine serosa or adjacent organs are related, but more severe, abnormalities of placental implantation. The pathogenesis is primarily attributed to defective decasualization of the implantation site. Placenta accreta has been recognized mostly in the third trimester however may also present in second trimester. It has very heavy, life-threatening hemorrhage to both the mother and fetus. The authors’ report a patient with two previous cesarean deliveries, who had been referred for pregnancy termination from Iranian legal medicine organization with 15 weeks of gestational age and placenta acctera. In this patient, uterus preservation and hysterectomy abortion was performed. The case totally lost 1500 cc blood and she was discharged from hospital two days later, with feeling of well- being. We have examined this patient after 1.5 months, she wasn’t vaginal bleeding and the uterus was in the pelvic and serum BHCG (with titer was negative.

  7. Efficacy and Safety of Prophylactic Uterine Artery Embolization in Pregnancy Termination with Placenta Previa

    Energy Technology Data Exchange (ETDEWEB)

    Pei, Renguang, E-mail: mediprg@bjmu.edu.cn; Wang, Guoxiang; Wang, Heping; Huang, Xinyu; Yan, Xiaoxing; Yang, Xiaohua [Yijishan Hospital of Wannan Medical College, Department of Interventional Therapy (China)

    2017-03-15

    PurposeTo appraise the efficacy and safety of prophylactic uterine artery embolization in pregnancy termination with placenta previa.MethodsA cohort of 54 consecutive patients with placenta previa underwent prophylactic uterine artery embolization before vaginal delivery from February 2012 to March 2015. Vaginal delivery was attempted in all patients. Cesarean section or hysterectomy was introduced when vaginal delivery failed.ResultsVaginal delivery succeeded in 50 patients (93.6%) and failed in 4 patients (6.4%), thereupon converted to cesarean delivery. No patients resorted to hysterectomy. Six patients (11.1%) underwent blood transfusion. None of clinical characteristics, including maternal age, gestational age, history of abortion, history of cesarean delivery, and volume of vaginal bleeding, was significantly associated with complete placenta previa (P > 0.05). However, patients with complete placenta previa had a significantly lower successful rate of vaginal delivery than did patients without complete placenta previa (81 vs 100%, P = 0.038). The rate of complications was 3.7%. No major complications were observed.ConclusionUterine artery embolization is an effective and safe technique to assist pregnancy termination with placenta previa, which may lower the risk of cesarean section, hysterectomy, and blood transfusion.

  8. Efficacy and Safety of Prophylactic Uterine Artery Embolization in Pregnancy Termination with Placenta Previa

    International Nuclear Information System (INIS)

    Pei, Renguang; Wang, Guoxiang; Wang, Heping; Huang, Xinyu; Yan, Xiaoxing; Yang, Xiaohua

    2017-01-01

    PurposeTo appraise the efficacy and safety of prophylactic uterine artery embolization in pregnancy termination with placenta previa.MethodsA cohort of 54 consecutive patients with placenta previa underwent prophylactic uterine artery embolization before vaginal delivery from February 2012 to March 2015. Vaginal delivery was attempted in all patients. Cesarean section or hysterectomy was introduced when vaginal delivery failed.ResultsVaginal delivery succeeded in 50 patients (93.6%) and failed in 4 patients (6.4%), thereupon converted to cesarean delivery. No patients resorted to hysterectomy. Six patients (11.1%) underwent blood transfusion. None of clinical characteristics, including maternal age, gestational age, history of abortion, history of cesarean delivery, and volume of vaginal bleeding, was significantly associated with complete placenta previa (P > 0.05). However, patients with complete placenta previa had a significantly lower successful rate of vaginal delivery than did patients without complete placenta previa (81 vs 100%, P = 0.038). The rate of complications was 3.7%. No major complications were observed.ConclusionUterine artery embolization is an effective and safe technique to assist pregnancy termination with placenta previa, which may lower the risk of cesarean section, hysterectomy, and blood transfusion.

  9. DNA methylation of amino acid transporter genes in the human placenta.

    Science.gov (United States)

    Simner, C; Novakovic, B; Lillycrop, K A; Bell, C G; Harvey, N C; Cooper, C; Saffery, R; Lewis, R M; Cleal, J K

    2017-12-01

    Placental transfer of amino acids via amino acid transporters is essential for fetal growth. Little is known about the epigenetic regulation of amino acid transporters in placenta. This study investigates the DNA methylation status of amino acid transporters and their expression across gestation in human placenta. BeWo cells were treated with 5-aza-2'-deoxycytidine to inhibit methylation and assess the effects on amino acid transporter gene expression. The DNA methylation levels of amino acid transporter genes in human placenta were determined across gestation using DNA methylation array data. Placental amino acid transporter gene expression across gestation was also analysed using data from publically available Gene Expression Omnibus data sets. The expression levels of these transporters at term were established using RNA sequencing data. Inhibition of DNA methylation in BeWo cells demonstrated that expression of specific amino acid transporters can be inversely associated with DNA methylation. Amino acid transporters expressed in term placenta generally showed low levels of promoter DNA methylation. Transporters with little or no expression in term placenta tended to be more highly methylated at gene promoter regions. The transporter genes SLC1A2, SLC1A3, SLC1A4, SLC7A5, SLC7A11 and SLC7A10 had significant changes in enhancer DNA methylation across gestation, as well as gene expression changes across gestation. This study implicates DNA methylation in the regulation of amino acid transporter gene expression. However, in human placenta, DNA methylation of these genes remains low across gestation and does not always play an obvious role in regulating gene expression, despite clear evidence for differential expression as gestation proceeds. Copyright © 2017. Published by Elsevier Ltd.

  10. Impact of antenatal diagnosis and management strategies in morbidly adherent placenta

    International Nuclear Information System (INIS)

    Choudry, A.; Choudry, H.; Shukr, I.; Ahmad, S

    2011-01-01

    Objectives: To study the pattern, demography and management options in placenta accreta in a tertiary care centre. Duration and settings: January 1, 2004 to August 15, 2008 at Military Hospital, Rawalpindi and between Sep 1, 2008 to Oct 30, 2009 at Combined Military Hospital, Multan. Patients and Methods All cases of placenta accreta seen during the study period were included in the study. Placenta accreta was defined as placenta being adherent to uterine wall without easy separation. Patient's demography, presence or absence of prenatal diagnosis and the management strategy i.e. conservative or otherwise was documented on a proforma. Success or failure of surgical approach used was noted. Assessment of maternal morbidity in the form of amount of blood/blood product transfused and early and late complications was made and compared with other cases that were antenatally diagnosed or were undiagnosed. Results: A total of 28 cases were analyzed during study period. The incidence of placenta accreta was 6.3/10000. Mean maternal age was 30.7 years. Placenta praevia obstetrical hysterectomy was performed in 17(61%) cases and had to be backed up by internal iliac artery ligation in 7(25%) Requirement for blood transfusion in antenatally diagnosed cases was almost 50% less than those of undiagnosed cases and the same was true for fresh frozen plasma (3.75 +- 4.18 versus 6.75 +- 5.41), platelet transfusion (P=0.04), stay in intensive care unit (1.56 +- 1.82 versus 3.41 +- 3.28)and use of mechanical ventilation (7% versus 11%). There was no mortality in this series. Conclusions: Intra-operative internal iliac artery ligation reduces blood loss before and after hysterectomy and should be done in cases with placents accreta to reduce morbidity and mortality. (author)

  11. An appraisal of retained placentae in Ibadan: a five year review ...

    African Journals Online (AJOL)

    During the study period, 4980 deliveries took place at the University College Hospital, Ibadan and 106 cases of retained placenta were managed making the incidence 2.13 per cent of all births. Results: During the five year period, there were 106 patients with retained placenta; of these, 90 (84.9%) case notes were ...

  12. Salud respiratoria en prematuros tardíos, 32-35 semanas de edad gestacional. Seguimiento en edad preescolar y escolar.

    OpenAIRE

    Morata Alba, Júlia

    2015-01-01

    Como se describe en múltiples trabajos, la prevalencia de enfermedades respiratorias inmediatas y tardías en los nacidos prematuramente, es mayor que en los nacidos a término (RNAT). En las últimas décadas, dada la cada vez más numerosa tasa de nacimientos prematuros, se ha observado un incremento de este tipo de estudios, centrándose fundamentalmente en los grandes pretérmino o en los recién nacidos (RN) que presentan algún tipo de enfermedad pulmonar desde los primeros días de vida. En...

  13. Secuelas del neurodesarrollo de recién nacidos prematuros de extremadamente bajo peso y de muy bajo peso a los dos años de edad, egresados de la Unidad de Cuidados Intensivos Neonatales del Hospital Nacional Edgardo Rebagliati Martins 2009-2014

    OpenAIRE

    Fernández Sierra, Carmen; Matzumura Kasano, Juan; Gutiérrez Crespo, Hugo; Zamudio Eslava, Luisa; Melgarejo García, Giannina

    2017-01-01

    Objetivo: Describir las secuelas del neurodesarrollo de los recién nacidos prematuros de extremadamente bajo peso y de muy bajo peso a los dos años de edad, egresados de la Unidad de Cuidados Intensivos Neonatales del Hospital Nacional Edgardo Rebagliati Martins. Materiales y métodos: Estudio descriptivo, retrospectivo, transversal en una población de 190 prematuros de extremadamente bajo peso y de muy bajo peso que nacieron durante enero 2009 a junio del 2014, egresados de la Unidad de Cuida...

  14. Marcadores de estrés oxidativo en placentas de gestantes añosas

    Directory of Open Access Journals (Sweden)

    Silvia Suárez

    2007-12-01

    Full Text Available Introducción: Un factor de riesgo alto ginecoobstétrico que contribuye a la morbimortalidad materna perinatal es la edad materna mayor de 35 años. Es posible que el estado oxidativo en la placenta de la gestante añosa sea mayor a la de la gestante no añosa. Objetivo: Evaluar el estado oxidativo de la placenta en gestantes mayores de 35 años. Diseño: Estudio observacional y transversal. Lugar: Hospital Nacional Docente Materno Infantil San Bartolomé y Centro de Investigación de Bioquímica y Nutrición de la Universidad Nacional Mayor de San Marcos. Material biológico: 28 placentas de gestantes de 35 años o más y 28 placentas de gestantes de menos de 35 años, obtenidas de partos vaginales a término. Intervenciones: La muestra de placenta se homogenizó al 10% con buffer fosfato 10 mM, pH 7,4, se centrifugó a 2000 rpm por 5’. Parte del sobrenadante se usó para analizar lipoperoxidación y glutatión (GSH; el sobrenadante restante fue centrifugado a 42 000 rpm por 1 hora, para medir actividad de superóxido dismutasa (SOD. Principales medidas de resultados: Estado oxidativo de placentas obtenidas de mujeres añosas y no añosas. Resultados: La actividad de la SOD y el contenido de GSH placentarios en añosas fue 43,52 U/g de tejido y 4,67 µmol/mL x 10-²; para el grupo control fueron 54,13 U/g de tejido y 6,02 µmol/mL x 10-², respectivamente; en ambos hubo significancia estadística (p < 0,05. La medición de TBARS (lipoperoxidación no mostró diferencias significativas. Conclusiones: Las placentas obtenidas de mujeres añosas muestran menor capacidad de defensa antioxidante frente a las placentas obtenidas de mujeres no añosas.

  15. Complicações obstétricas em gestações com feto portador de anomalia incompatível com a sobrevida neonatal Complicaciones obstétricas en gestaciones con feto portador de anomalía incompatible con la sobrevivencia neonatal Obstetric complications in pregnancies with fetal anomalies incompatible with neonatal survival

    Directory of Open Access Journals (Sweden)

    Danila Cristina Paquier Sala

    2010-10-01

    Full Text Available OBJETIVO: Descrever as complicações obstétricas mais comuns encontradas nos períodos gestacional, parto e puerpério imediato de gestantes com fetos portadores de anomalias incompatíveis com a vida. MÉTODOS: Estudo descritivo, onde avaliou-se 78 prontuários de pacientes atendidas no pré-natal da Disciplina de Medicina Fetal da Universidade Federal de São Paulo que tiveram partos nessa mesma instituição, entre 2000 e 2006. RESULTADOS: As principais complicações obstétricas identificadas foram:variação do volume de líquido amniótico em 68%; abortamento, parto pré-termo e a gravidez prolongada estiveram presentes em 6,4%, 55,1% e 3,8% das gestações, respectivamente; óbito fetal intra-uterino em 17,9%; descolamento prematuro da placenta ocorreu em 6,4% e histerectomia em 2,6%. CONCLUSÃO: Estes resultados sugerem aumento de risco materno em gestações com fetos portadores de anomalias graves, fato que demonstra necessidade de avaliação especializada caso a caso.OBJETIVO: Describir las complicaciones obstétricas más comunes encontradas en los períodos de gestación, parto y puerperio inmediato de embarazadas con fetos portadores de anomalías incompatibles con la vida. MÉTODOS: Se trata de un estudio descriptivo, que evaluó 78 fichas médicas de pacientes atendidos en el prenatal de la Disciplina de Medicina Fetal de la Universidad Federal de Sao Paulo que tuvieron partos en esa misma institución, entre 2000 y 2006. RESULTADOS: Las principales complicaciones obstétricas identificadas fueron: variación del volumen de líquido amniótico en 68%; abortamiento, parto pre-término y embarazo prolongado estuvieron presentes en 6,4%, 55,1% y 3,8% de las gestaciones, respectivamente; muerte fetal intra-uterina en 17,9%; desprendimiento prematuro de la placenta ocurrió en 6,4% e histerectomía en 2,6%. CONCLUSIÓN: Éstos resultados sugieren un aumento del riesgo materno en gestaciones con fetos portadores de anomal

  16. Organochlorine pesticide residues in human breast milk and placenta in Tohoku, Japan

    Energy Technology Data Exchange (ETDEWEB)

    Nakai, K.; Suzuki, K.; Oka, T.; Sugawara, N.; Ohba, T.; Kameo, S.; Satoh, H. [Environmental Heath Sciences, Tohoku Univ. Graduate School of Medicine, Sendai (Japan); Nakamura, T.; Saitoh, Y. [Miyagi Prefectural Inst. of Piblic Health and Environment (Japan); Okamura, K. [Dept. of Obstetrics, Tohoku Univ. Graduate School of Medicine, Sendai (Japan)

    2004-09-15

    Recently, we have started a birth cohort study to examine the effects of exposure to persistent organochemical pollutants and heavy metals on neurodevelopment in Japanese children, The Tohoku Study of Child Development. In this cohort study, biological samples, including maternal peripheral blood, cord blood, placenta, cord tissue, and breast milk have been collected from more than six hundred mother-infant pairs for chemical determinations. The growth of infants has been monitored using neurodevelopmental tests, including the Brazelton Neonatal Behavioral Assessment Scale, the Bayley Scale of Infant Development, the Kyoto Scale of Psychological Development, and others. Exposures to dioxin and related compounds, polychlorinated biphenyls, methylmercury, and several heavy metals were assessed. Additionally, since perinatal exposure to organochlorine pesticides may affect the neurodevelopment of children, we examined the effects of those pesticides in the cohort study. In the present study, several organochlorine pesticides were analyzed in human breast milk and placenta from 20 mothers to identify the major pesticide compounds found in the cohort subjects. The relationship between pesticides in breast milk and the placenta was analyzed to examine the utilization of the placenta as the material for exposure assessment. Some information regarding the factors affecting the contamination of breast milk and the placenta with organochlorine pesticides are also discussed.

  17. Magnetic resonance imaging of placenta accreta

    Directory of Open Access Journals (Sweden)

    Binoj Varghese

    2013-01-01

    Full Text Available Placenta accreta (PA is a severe pregnancy complication which occurs when the chorionic villi (CV invade the myometrium abnormally. Optimal management requires accurate prenatal diagnosis. Ultrasonography (USG and magnetic resonance imaging (MRI are the modalities for prenatal diagnosis of PA, although USG remains the primary investigation of choice. MRI is a complementary technique and reserved for further characterization when USG is inconclusive or incomplete. Breath-hold T2-weighted half-Fourier rapid acquisition with relaxation enhancement (RARE and balanced steady-state free precession imaging in the three orthogonal planes is the key MRI technique. Markedly heterogeneous placenta, thick intraplacental dark bands on half-Fourier acquisition single-shot turbo spin-echo (HASTE, and disorganized abnormal intraplacental vascularity are the cardinal MRI features of PA. MRI is less reliable in differentiating between different degrees of placental invasion, especially between accreta vera and increta.

  18. Management of Placenta Invasion Anomaly and Cesarean Hysterectomy: Eight-year Experience of A Tertiary Center

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    İbrahim Kalelioğllu

    2013-09-01

    Full Text Available Objective: We aimed to present our experience with the management of placenta invasion anomaly by reviewing clinical and operative features of the cases of cesarean hysterectomy performed due to placenta invasion anomaly. Methods: In this retropective study, the charts of all patients who underwent cesarean hysterectomy with an indication of placenta invasion anomaly in Istanbul Faculty of Medicine Department of Obstetrics and Gynecology between 2005 and 2012 were reviewed. Results: In this period a total of 85 patients underwent cesarean hysterectomy. 81 (95.3% cases had experienced at least one cesarean delivery before. Majority of the operations (82.4% were performed in elective conditions. In 16 (18.8% cases bilateral hypogastric artery ligation was carried out because of profuse bleeding. There were no mortalities in the intra- or postoperative period. In 18 (21.2% cases, intraoperative urology consultation was needed. Full- thickness bladder laceration occured in 17 patients, and partial cyctectomy was performed in one patient due to the placenta percreata invading posterior wall of the bladder. Transfusion was needed in 72 (84.7% cases during and 50 (58.8% patients after operation. Dilutional trombocytopenia developed in 17 (20% patients due to massive transfusion. Histopathologically the diganosis was placenta accreata in 55 (64.7%, placenta increata in 1 (1.2% and placenta percreata in 25 (29.4% patients. The incidence of placenta invasion anomaly rose from 0.2% (7/3435 in 2005-2006 up to 0.8% (37/4344 in 2011-2012. Conclusion: The incidence of placenta invasion anomaly is increasing progressively. Cesarean hysterectomy being its classical treatment is an operation with a high risk of morbidity and it should be performed by experienced teams after appropriate preparations in tertiary centers where multidiciplinary approach is possible.

  19. Treatment of retained placenta with misoprostol: a randomised controlled trial in a low-resource setting (Tanzania

    Directory of Open Access Journals (Sweden)

    Fauteck Heiner

    2009-10-01

    Full Text Available Abstract Background Retained placenta is one of the common causes of maternal mortality in developing countries where access to appropriate obstetrical care is limited. Current treatment of retained placenta is manual removal of the placenta under anaesthesia, which can only take place in larger health care facilities. Medical treatment of retained placenta with prostaglandins E1 (misoprostol could be cost-effective and easy-to-use and could be a life-saving option in many low-resource settings. The aim of this study is to assess the efficacy and safety of sublingually administered misoprostol in women with retained placenta in a low resource setting. Methods Design: Multicentered randomised, double-blind, placebo-controlled trial, to be conducted in 5 hospitals in Tanzania, Africa. Inclusion criteria: Women with retained placenta, at a gestational age of 28 weeks or more and blood loss less than 750 ml, 30 minutes after delivery of the newborn despite active management of third stage of labour. Trial Entry & Randomisation & Study Medication: After obtaining informed consent, eligible women will be allocated randomly to the treatment groups using numbered envelopes that will be randomized in variable blocks containing identical capsules with either 800 microgram of misoprostol or placebo. The drugs will be given sublingually. The women, maternal care providers and researchers will be blinded to treatment allocation. Sample Size: 117 women, to show a 40% reduction in manual removals of the placenta (p = 0.05, 80% power. The randomization will be misoprostol: placebo = 2:1 Primary Study Outcome: Expulsion of the placenta without manual removal. Secondary outcome is the number of blood transfusions. Discussion This is a protocol for a randomized trial in a low resource setting to assess if medical treatment of women with retained placenta with misoprostol reduces the incidence of manual removal of the placenta. Clinical Trial Registration Current

  20. Cell-free placental mRNA in maternal plasma to predict placental invasion in patients with placenta accreta.

    Science.gov (United States)

    El Behery, Manal M; Rasha L, Etewa; El Alfy, Yehya

    2010-04-01

    To evaluate whether measuring cell-free placental mRNA in maternal plasma improves the diagnostic accuracy of ultrasound and color Doppler in detecting placental invasion in patients at risk for placenta accreta. Thirty-five singleton pregnant women of more than 28 weeks of gestation and at risk for placenta accreta underwent ultrasound and color Doppler assessment. Cell-free placental mRNA in maternal plasma was measured using real-time reverse-transcription polymerase chain reaction. Patients were classified into 2 groups based on the findings at cesarean delivery and histological examination: women with placenta accreta (n=7) and women without placenta accreta (n=28). The median MoM (multiples of the median) value of cell-free placental mRNA was significantly higher in patients with placenta accreta than in those without placenta accreta (6.50 vs 2.60; Pplacental mRNA was significantly elevated in patients with placenta increta and percreta than in those with simple accreta. Six false-positive results were found on ultrasound, all from patients without placenta accreta and an insignificant rise in cell-free placental mRNA levels. Measuring cell-free placental mRNA in maternal plasma may increase the accuracy of ultrasound and color Doppler in prenatal prediction of placental invasion in patients with suspected placenta accreta. Copyright 2009 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  1. O sentido do ser-mãe-que-tem-a-possibilidade-de-tocar-o-filho-prematuro na unidade intensiva: contribuições para a enfermagem neonatal El significado de ser la madre-que-tiene-la-posibilidad-de-tocar-al-hijo-prematuro en la unidad de cuidados intensivos: contribuciones para la enfermería neonatal The meaning of being the mother-that-has-the-possibility-to-touch-the-premature-baby in the intensive unit: contributions for the neonatal nursing

    Directory of Open Access Journals (Sweden)

    Rita de Cássia de Jesus Melo

    2012-06-01

    Full Text Available Estudo na abordagem teórico-metodológica heideggeriana com o objetivo de desvelar o sentido do ser-mãe que tem a possibilidade de tocar o filho prematuro na UTIN. Após aprovação foi desenvolvida entrevista fenomenológica com nove mulheres-mães. A análise compreensiva constituiu oito unidades de significação, e a hermenêutica permitiu desvelar o movimento existencial do sermãe em sua cotidianidade, nos modos de ser da inautenticidade e impessoalidade, movida pelo falatório, ambiguidade e temor, modos de ocupação. Ao compreender como sua a possibilidade de ter um filho prematuro, toca-o cautelosamente e cuidadosamente, transita para um entendimento no qual não mais se ocupa, se preo-cupa. Ao pre-ocupar, o ser-mãe estabelece a possibilidade de ser-aí-com-o-filho. Foi possível entender este modo de ser mãe, no qual passa por estágios antes de ver o bebê como seu e confiar em si. Possibilitar que toque seu filho, compreendendo-a em sua individualidade, singularidade, mostrou-se como um cuidado ao RNP em sua complexidade como ser-aí.Estudio en el enfoque teórico-metodológico heideggeriana con el objetivo de revelar el sentido del ser la madre que tiene la possibilidad de tocar el hijo prematuro en una Unidad de Cuidados Intensivos Neonatal. Después de la aprobación, fue desarrollada una entrevista fenomenológica con nueve madres. El análisis comprehensivo constituyó ocho unidades de significación, la hermenéutica permitió revelar el movimiento existencial del ser madre en su cotidianidad, en los modos de ser de la falta de autenticidad e impersonalidad, movida por el chisme, la ambigüedad y miedo, modos de ocupación. Al comprender como de ella la posibilidad de tener un bebé prematuro, lo toca con cautela y cuidado, transita para un entendimiento en el cual no más se ocupa, se preocupa. Al preocuparse, el ser madre establece la posibilidad de ser-ahí-con-el-hijo. Fue posible entender este modo de ser madre, que

  2. Hemorragia intraventricular en el neonato prematuro Intraventricular hemorrage in preterm infants

    Directory of Open Access Journals (Sweden)

    José William Cornejo Ochoa

    2005-01-01

    Full Text Available La hemorragia intraventricular (HIV es la principal complicación neurológica en los prematuros; consiste en sangrado de la matriz germinal y las regiones periventriculares del cerebro. Su frecuencia y gravedad aumentan en la medida en que es menor el peso al nacimiento; se la halla entre 10 y 20% de los neonatos de 1.000-1.500 gramos y hasta en 70% en los menores de 700 gramos; se presenta en 85% de las veces en las primeras 72 horas posparto y en 95% ya es evidente al finalizar la primera semana; son múltiples los factores maternos y fetales que se han encontrado asociados con el aumento o disminución de su frecuencia, además del uso de algunos medicamentos. Se han propuesto diversos mecanismos fisiopatogénicos asociados a la inmadurez neurológica para explicar la aparición de la HIV. Las manifestaciones clínicas son variables en cuanto a presentación y evolución. La confirmación diagnóstica, la clasificación y el pronóstico se basan en la ecografía transfontanelar. La principal medida preventiva es la disminución de la frecuencia del parto prematuro; los resultados de otras medidas como el uso prenatal y posnatal de algunos medicamentos para evitarla y tratarla han sido variables. El pronóstico depende de la extensión de la hemorragia, del desarrollo de leucomalacia periventricular y del grado de dilatación ventricular. Neonatal intraventricular hemorrage (IVH is the main neurological complication in preterm infants involving bleeding into the germinal matrix and the periventricular brain areas. Its incidence and severity are greater with lower birthweigth: from 10-20% in 1.000-1.500 g babies to 70% in those less than 700 g. Most often (85% it appears during the first 72 hours after birth and almost 95% of the cases are evident by the end of the first week of life. Many maternal and fetal risk factors are associated with the risk of neonatal IVH. Diferent pathogenic mechanisms associated with an immature central nervous

  3. Scaling of the surface vasculature on the human placenta

    Science.gov (United States)

    Leonard, A. S.; Lee, J.; Schubert, D.; Croen, L. A.; Fallin, M. D.; Newschaffer, C. J.; Walker, C. K.; Salafia, C. M.; Morgan, S. P.; Vvedensky, D. D.

    2017-10-01

    The networks of veins and arteries on the chorionic plate of the human placenta are analyzed in terms of Voronoi cells derived from these networks. Two groups of placentas from the United States are studied: a population cohort with no prescreening, and a cohort from newborns with an elevated risk of developing autistic spectrum disorder. Scaled distributions of the Voronoi cell areas in the two cohorts collapse onto a single distribution, indicating common mechanisms for the formation of the complete vasculatures, but which have different levels of activity in the two cohorts.

  4. Endoplasmic reticulum stress is induced in the human placenta during labour.

    Science.gov (United States)

    Veerbeek, J H W; Tissot Van Patot, M C; Burton, G J; Yung, H W

    2015-01-01

    Placental endoplasmic reticulum (ER) stress has been postulated in the pathophysiology of pre-eclampsia (PE) and intrauterine growth restriction (IUGR), but its activation remains elusive. Oxidative stress induced by ischaemia/hypoxia-reoxygenation activates ER stress in vitro. Here, we explored whether exposure to labour represents an in vivo model for the study of acute placental ER stress. ER stress markers, GRP78, P-eIF2α and XBP-1, were significantly higher in laboured placentas than in Caesarean-delivered controls localised mainly in the syncytiotrophoblast. The similarities to changes observed in PE/IUGR placentas suggest exposure to labour can be used to investigate induction of ER stress in pathological placentas. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Aumento no material fibrinoide perivilositário nas placentas de gestações com pré-eclâmpsia

    OpenAIRE

    Souza,Diego Agra de; Bezerra,Antonio Fernando de Sousa; Wanderley,David Campos; Souto,Claudia Maria Barbosa

    2011-01-01

    INTRODUÇÃO: A pré-eclâmpsia responde por alta morbimortalidade no Brasil e no mundo. A sua etiologia ainda não foi totalmente esclarecida. Entre as alterações placentárias na pré-eclâmpsia citam-se: infartos, aumento de nós sinciciais, hipotrofia vilositária, espessamento da membrana basal trofoblástica e deposição de material fibrinoide. OBJETIVO: Analisar quantitativamente imagens do material fibrinoide perivilositário presente em placentas de gestações com e sem pré-eclâmpsia. MATERIAL E M...

  6. Leaving the placenta in situ versus conservative and radical surgery in the treatment of placenta accreta spectrum disorders.

    Science.gov (United States)

    Kutuk, Mehmet S; Ak, Mehmet; Ozgun, Mahmut T

    2018-03-01

    To compare different treatment methods in the management of placenta accreta spectrum (PAS) disorders. In a retrospective cohort study, medical records were retrieved for patients who underwent elective surgery at 24 weeks of pregnancy or more after a diagnosis of PAS disorder (creta, increta, or percreta) at a center in Turkey between May 2, 2010, and August 10, 2016. The final analysis included patients whose diagnosis was confirmed intraoperatively and for whom complete data were available. Patients were divided into three groups: group 1 included those who underwent hysterectomy without placental removal, group 2 included patients whose placenta was left in situ, and group 3 included those who underwent placental removal and conservative surgery. Among 79 included patients (33 creta, 18 increta, 28 percreta), 27 (34%) were in group 1, 15 (19%) in group 2, and 37 (47%) in group 3. Total blood loss and the amounts of blood products transfused were lowest in group 2; significant differences between groups were noted (all P ≤ 0.001). Surgical complication rates were similar between groups (4/27 [15%], 1/15 [7%], and 11/37 [30%], respectively; P=0.119). Overall uterine preservation rates were not significantly different between groups 2 and 3 (14/15 [93%] vs 33/37 [89%]; P>0.99). Leaving the placenta in situ could become the treatment of choice for PAS disorders. © 2017 International Federation of Gynecology and Obstetrics.

  7. Clinics in diagnostic imaging (133). Retained placenta from an intra-abdominal pregnancy.

    Science.gov (United States)

    Win, T; Tang, P H; Lim, T Y

    2011-01-01

    A 29-year-old Indonesian woman presented with abdominal pain seven months after an intra-abdominal pregnancy. Ultrasonography revealed a cystic mass in the pelvis and magnetic resonance imaging showed an umbilical stump within it, indicating a retained placenta. This was removed surgically, and on histology, an infarcted placenta was confirmed.

  8. Cesarean scar pregnancy and early placenta accreta share common histology.

    Science.gov (United States)

    Timor-Tritsch, I E; Monteagudo, A; Cali, G; Palacios-Jaraquemada, J M; Maymon, R; Arslan, A A; Patil, N; Popiolek, D; Mittal, K R

    2014-04-01

    To determine, by evaluation of histological slides, images and descriptions of early (second-trimester) placenta accreta (EPA) and placental implantation in cases of Cesarean scar pregnancy (CSP), whether these are pathologically indistinguishable and whether they both represent different stages in the disease continuum leading to morbidly adherent placenta in the third trimester. The database of a previously published review of CSP and EPA was used to identify articles with histopathological descriptions and electronic images for pathological review. When possible, microscopic slides and/or paraffin blocks were obtained from the original researchers. We also included from our own institutions cases of CSP and EPA for which pathology specimens were available. Two pathologists examined all the material independently and, blinded to each other's findings, provided a pathological diagnosis based on microscopic appearance. Interobserver agreement in diagnosis was determined. Forty articles were identified, which included 31 cases of CSP and 13 cases of EPA containing histopathological descriptions and/or images of the pathology. We additionally included six cases of CSP and eight cases of EPA from our own institutions, giving a total of 58 cases available for histological evaluation (37 CSP and 21 EPA) containing clear definitions of morbidly adherent placenta. In the 29 cases for which images/slides were available for histopathological evaluation, both pathologists attested to the various degrees of myometrial and/or scar tissue invasion by placental villi with scant or no intervening decidua, consistent with the classic definition of morbidly adherent placenta. Based on the reviewed material, cases with a diagnosis of EPA and those with a diagnosis of CSP showed identical histopathological features. Interobserver correlation was high (kappa = 0.93). EPA and placental implantation in CSP are histopathologically indistinguishable and may represent different stages in

  9. Incidence and Risk Factors for Placenta Accreta/Increta/Percreta in the UK: A National Case-Control Study

    Science.gov (United States)

    Fitzpatrick, Kathryn E.; Sellers, Susan; Spark, Patsy; Kurinczuk, Jennifer J.; Brocklehurst, Peter; Knight, Marian

    2012-01-01

    Background Placenta accreta/increta/percreta is associated with major pregnancy complications and is thought to be becoming more common. The aims of this study were to estimate the incidence of placenta accreta/increta/percreta in the UK and to investigate and quantify the associated risk factors. Methods A national case-control study using the UK Obstetric Surveillance System was undertaken, including 134 women diagnosed with placenta accreta/increta/percreta between May 2010 and April 2011 and 256 control women. Results The estimated incidence of placenta accreta/increta/percreta was 1.7 per 10,000 maternities overall; 577 per 10,000 in women with both a previous caesarean delivery and placenta praevia. Women who had a previous caesarean delivery (adjusted odds ratio (aOR) 14.41, 95%CI 5.63–36.85), other previous uterine surgery (aOR 3.40, 95%CI 1.30–8.91), an IVF pregnancy (aOR 32.13, 95%CI 2.03–509.23) and placenta praevia diagnosed antepartum (aOR 65.02, 95%CI 16.58–254.96) had raised odds of having placenta accreta/increta/percreta. There was also a raised odds of placenta accreta/increta/percreta associated with older maternal age in women without a previous caesarean delivery (aOR 1.30, 95%CI 1.13–1.50 for every one year increase in age). Conclusions Women with both a prior caesarean delivery and placenta praevia have a high incidence of placenta accreta/increta/percreta. There is a need to maintain a high index of suspicion of abnormal placental invasion in such women and preparations for delivery should be made accordingly. PMID:23300807

  10. Incidence and risk factors for placenta accreta/increta/percreta in the UK: a national case-control study.

    Directory of Open Access Journals (Sweden)

    Kathryn E Fitzpatrick

    Full Text Available Placenta accreta/increta/percreta is associated with major pregnancy complications and is thought to be becoming more common. The aims of this study were to estimate the incidence of placenta accreta/increta/percreta in the UK and to investigate and quantify the associated risk factors.A national case-control study using the UK Obstetric Surveillance System was undertaken, including 134 women diagnosed with placenta accreta/increta/percreta between May 2010 and April 2011 and 256 control women.The estimated incidence of placenta accreta/increta/percreta was 1.7 per 10,000 maternities overall; 577 per 10,000 in women with both a previous caesarean delivery and placenta praevia. Women who had a previous caesarean delivery (adjusted odds ratio (aOR 14.41, 95%CI 5.63-36.85, other previous uterine surgery (aOR 3.40, 95%CI 1.30-8.91, an IVF pregnancy (aOR 32.13, 95%CI 2.03-509.23 and placenta praevia diagnosed antepartum (aOR 65.02, 95%CI 16.58-254.96 had raised odds of having placenta accreta/increta/percreta. There was also a raised odds of placenta accreta/increta/percreta associated with older maternal age in women without a previous caesarean delivery (aOR 1.30, 95%CI 1.13-1.50 for every one year increase in age.Women with both a prior caesarean delivery and placenta praevia have a high incidence of placenta accreta/increta/percreta. There is a need to maintain a high index of suspicion of abnormal placental invasion in such women and preparations for delivery should be made accordingly.

  11. Management of Amniotic Sheet with a Hammock-like Placenta

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    Liangcheng Wang

    2016-09-01

    Full Text Available An amniotic sheet is a septation in the amniotic cavity with a perforation that allows amniotic fluid to pass through. Although the incidence of abnormal placental implantation is higher in such cases, the management recommendations remain unclear. We report a case of an amniotic sheet with a hammock-like placenta located in the center of the uterine cavity. A 25-year-old woman with a history of two dilation and curettage procedures was found to have an amniotic cavity separated by a septum that contained part of the placenta. At gestational Week 32, magnetic resonance images revealed that the placenta was attached from the anterior to posterior uterine walls and resembled a hammock hanging in the center of the uterus. Subsequently, continuous intravenous administration of ritodrine hydrochloride and magnesium sulfate were given. The pregnancy was extended to Week 36. Elective cesarean section was performed, and a 3212-g female infant was delivered. Thus, owing to the risk of umbilical cord complications and placental injury secondary to premature rupture of membranes, aggressive and careful perinatal management is required in such cases.

  12. Trophoblast cells of ruminant placentas - A mini review

    International Nuclear Information System (INIS)

    Igwebuike, U.M.

    2004-09-01

    Understanding of ruminant placental structure and function is essential for veterinarians and researchers. The ruminant placenta is classified as cotyledonary and synepitheliochorial on the bases of its gross anatomical features and histological characteristics respectively. The richly vascularized embryonic chorioallantois is lined on its outer surface by cells of the trophectodermal epithelium. These cells which assume specialized functions are referred to as trophoblast cells. Two morphologically and functionally distinct cell types have been recognized in the trophectoderm of the placenta of ruminant animals. These are the mononucleate trophoblast cells and the binucleate trophoblast cells. The occurrence, morphological characteristics, and specialized functions of these trophoblast cells, in relation to conceptus nutrition and survival in utero are discussed in this review. (author)

  13. Assistência humanizada ao neonato prematuro e/ou de baixo peso: implantação do Método Mãe Canguru em Hospital Universitário Asistencia humanizada al recién nacido prematuro y/o de bajo peso: implantación del Método Madre Canguro en el Hospital Universitario Humanized assistence to premature and/or low weigh newborn: implantation of Kangaroo-Mother Method at a University Hospital

    Directory of Open Access Journals (Sweden)

    Fabrícia Adriana Mazzo Neves

    2006-09-01

    Full Text Available Relato de experiência de enfermeiros e equipe multiprofissional no processo de implantação do Método Mãe Canguru no Hospital Universitário, da Universidade Estadual de Maringá, Paraná, em 2002, com os objetivos de: humanizar o cuidado ao recém-nascido prematuro e/ou de baixo peso, aprimorando o suporte familiar; promoção de maior nível de satisfação da equipe assistencial. O bebê fica em contato pele a pele com o peito da mãe, pai ou familiar significativo, com benefícios para seu peso, temperatura, afetividade, aleitamento materno, além da provável redução no tempo de internação e risco de infecção. Capacitada pelo Ministério da Saúde, uma equipe passou à implantação e multiplicação do Método; elaborado um Projeto de Extensão institucional, multiprofissional, como organizador e integrador do ensino à assistência. Dificuldades encontradas foram em relação à associação entre tecnologia, relacionamento interpessoal e entre as diversas áreas, cuidado humano e participação familiar.Se trata del relato de experiencia de enfermeros y grupo multiprofesional en el proceso de implantación del Método Madre Canguro en el Hospital Universitario, de la Universidad Estatal de Maringá, Paraná, en el 2002, con los objetivos de: humanizar el cuidado al recién nacido prematuro o bajo peso, mejorando el soporte familiar, promoción de mayor nivel de satisfacción del grupo asistencial. El bebé permanece en contacto piel a piel con el pecho de la madre, padre o familiar significativo, con beneficios para el peso, temperatura, afecto, amamantamiento, además de la probable reducción en el tiempo de internamiento y riesgos de infección. Capacitado por el Ministerio de Salud, un grupo pasó a la implantación y multiplicación del Método; elaborado un Proyecto de Extensión institucional multiprofesional como organizador e integrador de la enseñanza y asistencia. Fueron encontradas dificultades en relación a la

  14. Retenção de placenta no proteinograma de vacas Holandesas

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    João Paulo Elsen Saut

    2014-09-01

    Full Text Available Com o objetivo de avaliar a influência da retenção de placenta (RP no proteinograma de fêmeas bovinas da raça Holandesa, de propriedades comerciais, foram utilizadas 129 vacas com RP e 145 vacas com parto e pós-parto fisiológicos e sem nenhum tratamento no período avaliado. As amostras de sangue foram divididas nos momentos: 1odia pós-parto (DPP, 2o-3o, 4o-5o, 6o-7o, 8o-14o, 15o-29o, 30o-59o e 60o-90o DPP. O fracionamento das proteínas foi realizado por eletroforese em fita de acetato de celulose e em gel de poliacrilamida, contendo dodecil sulfato de sódio (SDS-PAGE, nas quais se avaliou o comportamento de 19 bandas proteicas identificadas pelos respectivos pesos moleculares, que variaram entre 23KDa e 187KDa. Não houve influência da RP na proteína sérica total e gamaglobulinas. A albumina sérica permaneceu abaixo dos valores de referência até os 90DPP nos animais com RP. Concluiu-se que vacas Holandesas com RP apresentam um quadro de normoproteinemia com hipoalbuminemia e aumento das frações alfaglobulinas e betaglobulinas até os 90DPP, presença de resposta inflamatória de fase aguda positiva pelo significativo aumento de haptoglobina, ceruloplasmina, glicoproteína ácida, e de fase aguda negativa pela diminuição de albumina na primeira semana pós-parto.

  15. Decreased oxidative stress may contribute to the disease process in placenta accreta

    Science.gov (United States)

    Öztaş, Efser; Özler, Sibel; Ergin, Merve; Erel, Özcan; Gümüş Güler, Başak; Çağlar, Ali Turhan; Yücel, Aykan; Uygur, Dilek; Danışman, Nuri

    2017-08-23

    Background/aim: The main aim of this study was to investigate serum total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), and arylesterase levels in pregnant women with placenta accreta and to compare those with age-matched healthy pregnant women. Materials and methods: A total of 27 pregnant women who had clinically and pathologically proven placenta accreta and 30 age- and BMI- matched healthy pregnant women were enrolled in this case control study. Maternal serum TOS, TAS, OSI, and arylesterase levels were evaluated using logistic regression analysis to determine if there was an association with abnormal placental invasion or not. Results: Decreased OSI (OR= 0.999, 95%CI: 0.998-1.000, P = 0.035) and increased arylesterase levels (OR= 0.981, 95%CI: 0.970-0.993, P = 0.001) were significantly associated with the presence of placenta accreta. Maternal serum TOS, TAS, OSI, and arylesterase levels were not predictive for adverse perinatal outcomes (P > 0.05). Conclusions: Decreased OSI and increased arylesterase levels are significantly associated with placenta accreta and may contribute to the abnormal invasion process.

  16. Fatores prognósticos para o desenvolvimento cognitivo de prematuros de muito baixo peso

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    Maria Dalva Barbosa Baker Méio

    2003-06-01

    Full Text Available OBJETIVO: Crianças prematuras, de muito baixo peso, podem apresentar alterações em seu desenvolvimento cognitivo. No Brasil, pouco se conhece sobre a evolução dessas crianças na idade pré-escolar. O objetivo do estudo foi descrever o desenvolvimento cognitivo de uma população de recém-nascidos prematuros de muito baixo peso e verificar possíveis fatores prognósticos para desenvolvimento cognitivo anormal. MÉTODOS: Um estudo de coorte foi realizado com uma população de crianças pré-escolares, nascidas prematuras, de muito baixo peso, entre janeiro de 1991 e setembro de 1993. O desenvolvimento cognitivo foi avaliado por meio do teste WPPSI-R (Wechsler Preschool and Primary Intelligence Scales aplicado por psicólogas, utilizando dois pontos de corte para definição de anormalidade: escores abaixo de 1 e 2, desvios padrões da média (DP. RESULTADOS: Foram avaliadas 79 crianças de quatro a cinco anos de idade. A média do escore total do teste WIPPSI-R foi de 75,6 (±11,9. A incidência de escore total anormal foi de 77,2% e de 32,9% (1DP e 2 DP, respectivamente. Após o ajuste por "tipo de parto", ser pequeno para a idade gestacional (OR=6,19; IC95% 1,60-23,86, ultra-som transfontanela anormal (OR=5,90; IC95% 1,04-9,83 e ser do sexo masculino (OR=3,20; IC 95% 1,32-26,35 foram os fatores que predisseram escore total <70 (2 DP. CONCLUSÃO: Houve maior comprometimento do desenvolvimento cognitivo nas crianças estudadas do que o descrito na literatura. Ser pequeno para idade gestacional, ultra-som transfontanela anormal e sexo masculino foram fatores prognósticos de pior evolução.

  17. Escala de riesgo Aristóteles como factor predictor de mortalidad en el cierre quirúrgico de persistencia de ductus arterioso en prematuros

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    Antonio Jimenez-Aceituna

    2017-07-01

    Conclusiones: La mortalidad asociada al cierre quirúrgico del ductus persistente depende más del estado de prematuridad que de la cirugía, siendo la escala Aristóteles el factor más útil para determinar el grado de prematuridad y predecir la mortalidad hospitalaria. Los prematuros con 15 o más puntos en esta escala tuvieron una mayor mortalidad, para los que se propone un manejo conservador.

  18. Uterine and placenta characteristics during early vascular development in the pig from day 22 to 42 of gestation.

    Science.gov (United States)

    Wright, Elane C; Miles, Jeremy R; Lents, Clay A; Rempel, Lea A

    2016-01-01

    Insufficient placenta development is one of the primary causes of fetal death and reduced fetal growth after 35 days of gestation. Between day 22 and 42 the placenta consists of a central highly vascular placenta (HVP), adjacent to the fetus, a less vascular placenta (LVP), on either side of the fetus, and necrotic tips (NT). The objective of this study was to comprehensively evaluate uterine-placenta characteristics during early gestation in the gilt and determine time points and physiological changes. Gilts (n=25) were artificially inseminated at first detection of estrus (day 0) and 24h later, and harvested at 22, 27, 32, 37 or 42 days of gestation. Litter size, 12.1±3.4, was similar for all days of gestation. Fetal and placenta weight increased with day of gestation. The greatest increase in placenta weight occurred between 37 and 42 days of gestation. The LVP zones had no measurable fold formation until day 27. Necrotic tips became apparent after 27 days of gestation. Unoccupied areas of the uterus developed folds with changes in endometrial cell size and morphology from day 32 to 42 of gestation. Limited changes occurred in either fetal growth or placenta weight from day 27 through 32 of gestation; however, significant morphological changes occur at the maternal-fetal interface, demonstrating the dynamic architecture of the developing porcine placenta during early gestation. This work establishes fundamental time points in placenta development corresponding to fetal growth and microfold formation that may influence fetal growth and impact fetal survival. Published by Elsevier B.V.

  19. The placenta shed from goats with classical scrapie is infectious to goat kids and lambs.

    Science.gov (United States)

    Schneider, David A; Madsen-Bouterse, Sally A; Zhuang, Dongyue; Truscott, Thomas C; Dassanayake, Rohana P; O'Rourke, Katherine I

    2015-08-01

    The placenta of domestic sheep plays a key role in horizontal transmission of classical scrapie. Domestic goats are frequently raised with sheep and are susceptible to classical scrapie, yet potential routes of transmission from goats to sheep are not fully defined. Sparse accumulation of disease-associated prion protein in cotyledons casts doubt about the role of the goat's placenta. Thus, relevant to mixed-herd management and scrapie-eradication efforts worldwide, we determined if the goat's placenta contains prions orally infectious to goat kids and lambs. A pooled cotyledon homogenate, prepared from the shed placenta of a goat with naturally acquired classical scrapie disease, was used to orally inoculate scrapie-naïve prion genotype-matched goat kids and scrapie-susceptible lambs raised separately in a scrapie-free environment. Transmission was detected in all four goats and in two of four sheep, which importantly identifies the goat's placenta as a risk for horizontal transmission to sheep and other goats.

  20. Maternal plasma levels of cell-free β-HCG mRNA as a prenatal diagnostic indicator of placenta accrete.

    Science.gov (United States)

    Zhou, J; Li, J; Yan, P; Ye, Y H; Peng, W; Wang, S; Wang, X Tong

    2014-09-01

    Several biomarkers, including maternal serum creatinine kinase and α-fetoprotein, have been described as potential tools for the diagnosis of placental abnormalities. This study aimed to determine whether maternal plasma mRNA levels of the β subunit of human chorionic gonadotropin (β-HCG) could predict placenta accreta prenatally. Sixty-eight singleton pregnant women with prior cesarean deliveries (CDs) were classified into three groups: normal placentation (35 women, control group); placenta previa alone (21 women, placenta previa group); and both placenta previa and placenta accreta (12 women, placenta previa/accreta group). Maternal plasma concentrations of cell-free β-HCG mRNA were measured by real-time reverse-transcription polymerase chain reaction and were expressed as multiples of the median (MoM). Cell-free β-HCG mRNA concentrations (MoM, range) were significantly higher in women with placenta accreta (3.65, 2.78-7.19) than in women with placenta previa (0.94, 0.00-2.97) or normal placentation (1.00, 0.00-2.69) (Steel-Dwass test, P accreta group, the concentration of cell-free β-HCG mRNA was significantly higher among women who underwent CDs with hysterectomy (4.41, 3.49-7.19) than among women whose CDs did not result in hysterectomy (3.20, 2.78-3.70) (Mann-Whitney U test, P = 0.012). An increased level of cell-free β-HCG mRNA in the maternal plasma of women with placenta accreta may arise from direct uteroplacental transfer of cell-free placental mRNA molecules. The concentration of cell-free β-HCG mRNA in maternal plasma may be applicable to the prenatal diagnosis of placenta accreta, especially to identify women with placenta accreta likely to require hysterectomy. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. A placenta clinic approach to the diagnosis and management of fetal growth restriction.

    Science.gov (United States)

    Kingdom, John C; Audette, Melanie C; Hobson, Sebastian R; Windrim, Rory C; Morgen, Eric

    2018-02-01

    Effective detection and management of fetal growth restriction is relevant to all obstetric care providers. Models of best practice to care for these patients and their families continue to evolve. Since much of the disease burden in fetal growth restriction originates in the placenta, the concept of a multidisciplinary placenta clinic program, managed primarily within a maternal-fetal medicine division, has gained popularity. In this context, fetal growth restriction is merely one of many placenta-related disorders that can benefit from an interdisciplinary approach, incorporating expertise from specialist perinatal ultrasound and magnetic resonance imaging, reproductive genetics, neonatal pediatrics, internal medicine subspecialties, perinatal pathology, and nursing. The accurate diagnosis and prognosis for women with fetal growth restriction is established by comprehensive clinical review and detailed sonographic evaluation of the fetus, combined with uterine artery Doppler and morphologic assessment of the placenta. Diagnostic accuracy for placenta-mediated fetal growth restriction may be enhanced by quantification of maternal serum biomarkers including placenta growth factor alone or combined with soluble fms-like tyrosine kinase-1. Uterine artery Doppler is typically abnormal in most instances of early-onset fetal growth restriction and is associated with coexistent preeclampsia and underlying maternal vascular malperfusion pathology of the placenta. By contrast, rare but potentially more serious underlying placental diagnoses, such as massive perivillous fibrinoid deposition, chronic histiocytic intervillositis, or fetal thrombotic vasculopathy, may be associated with normal uterine artery Doppler waveforms. Despite minor variations in placental size, shape, and cord insertion, placental function remains, largely normal in the general population. Consequently, morphologic assessment of the placenta is not currently incorporated into current screening

  2. Dianthus chinensis L.: The Structural Difference between Vascular Bundles in the Placenta and Ovary Wall Suggests Their Different Origin.

    Science.gov (United States)

    Guo, Xue-Min; Yu, Ying-Ying; Bai, Lan; Gao, Rong-Fu

    2017-01-01

    Dianthus chinensis is a perennial herbaceous plant with great ornamental, botanical, ecological, and medicinal value. The pistil of D. chinensis is composed of two fused carpels with free central placenta and two separate styles. The placenta is a columnar structure extending about two-thirds the length of the maturing fruit, which is typical of the Caryophyllaceous. Traditionally, free central placenta is thought to have evolved from axial placenta by septal disappearance, and axial placenta to have occurred through fusion of conduplicate carpels with marginal placenta. However, the traditional opinion is becoming more and more inconsistent with the new data gained in recent research of angiosperm systematics. To clarify the origin of D. chinensis pistil, the present anatomical study was carried out. The results show that the vascular system of placenta is independent to that of the ovary wall in D. chinensis . Moreover, in the central part of placenta there are one or two amphicribral bundles, and correspondingly numerous ones in the pistil which supply the ovules/seeds. It is obvious that the central amphicribral bundles in placenta are comparable to the counterparts in branches but not to those in leaves or their derivatives. Therefore, it is reasonable to deduce that the placenta of D. chinensis was not derived from conduplicate carpels through fusion of collateral vascular bundles, and actually a floral axis with ovules/seeds laterally adhering. On the contrary, the ovary wall was the lateral appendages of the floral axis. The result of the present study is completely in agreement with Unifying Theory, in which the placenta is taken as an ovule-bearing branch. Except for D. chinensis , the similar vascular organization has been observed in placenta of numerous isolated taxa. But till now, it is uncertain that whether this vascular organization pattern is popular in the whole angiosperms or not. More intensive and extensive investigations are needed.

  3. Retained placenta in Friesian mares : reproductive performance after foal heat breeding versus breeding in a subsequent heat

    NARCIS (Netherlands)

    Sevinga, M; Hesselink, JW; Barkema, H.W.

    2001-01-01

    Postpartum reproductive performance was studied in 54 Friesian brood mares with and 50 without retained placenta. Retained placenta was defined as failure to expel all fetal membranes within 3 hours after the delivery of the foal. The group of mares with retained placenta was subdivided into mares

  4. Does the presence of placental basal plate myometrial fibres increase the risk of subsequent morbidly adherent placenta: a case-control study.

    Science.gov (United States)

    Miller, E S; Linn, R L; Ernst, L M

    2016-12-01

    Antenatal diagnosis of morbidly adherent placenta has been shown to improve outcomes, but existing predictors lack sensitivity. Our objective was to determine whether the presence of myometrial fibres attached to the placental basal plate (BPMYO) in an antecedent pregnancy is associated with subsequent morbidly adherent placenta. A case-control study. Departments of Obstetrics and Gynecology and Pathology, Northwestern University, Chicago, IL, USA. Women who had at least two pregnancies with placental pathological evaluation. Cases were defined as women with evidence of morbidly adherent placenta (both clinically and pathologically) in their most recent pregnancy whereas women without evidence of morbidly adherent placenta served as controls. Pathological specimens of placentas from previous pregnancies were evaluated for BPMYO. The presence of BPMYO on a previous placenta was evaluated to determine whether it could be used to improve the antenatal diagnosis of morbidly adherent placenta. Of the 25 cases of morbidly adherent placenta, 19 (76%) had BPMYO present on their previous placenta compared with 41 (41%) of controls (odds ratio 4.8, 95% CI 1.8-13.0). Adding BPMYO to a regression including other risk factors for morbidly adherent placenta (i.e. maternal age, number of previous caesarean sections, placenta praevia, previous multiple gestation, any previous curettage, and ultrasonographic suspicion of placenta accreta) significantly improved the sensitivity of antenatal diagnosis of morbidly adherent placenta (61% versus 39%, P placental pathology is associated with an increased risk of morbidly adherent placenta in a subsequent pregnancy. These findings may shed light on the pathophysiology of accreta and inform future research on predictors of accreta. Previous basal plate myometrium improves the ability to detect subsequent morbidly adherent placenta. © 2015 Royal College of Obstetricians and Gynaecologists.

  5. [The conservative treatment of placenta accreta. A clinical case report].

    Science.gov (United States)

    Artuso, A; Rocchi, B; Garbo, S; Baudino, G; Repetti, F

    1993-09-01

    The following description is a clinical case of placenta accreta and its conservative treatment. According to some authors, abnormal adhesion of the placenta depends on the alteration of the equilibrium between the trophoblastic tissue invasion and the reaction of the decidua. Consequently we have various degrees of penetration of the myometrium by chorionic villi into areas of deficit, sparse or absent decidua. Whatever the pathogenetic mechanism, the final clinical picture is slight to deep penetration of the trophoblastic tissue into the uterine wall. That causes absence of the normal plane of cleavage between placenta and maternal decidua, no spontaneous placental detachment during the third stage of labour and no possible manual removal. The patient, primigravida, was admitted at the 36th Week of gestation with PROM and physiologically delivered a neonate weighing 1820 g, after she spontaneously began labour. The newborn was admitted in the neonatal-pathology ward because it was premature although the Apgar score at 1-5 minutes after birth was 5-9. Placental ejection was awaited for 1 hour, then manual exploration of the uterine cavity was undertaken. The normal plane of cleavage between placental tissue and decidua was absent and therefore manual extraction of the placenta was impossible. Surgery was stopped and, after informed consensus was obtained from the patient, a conservative treatment was tried. After cutting the umbilical cord as short as possible and checking for vaginal bleeding, the patient was moved to obstetrics ward.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Transverse uterine fundal incision for placenta praevia with accreta, involving the entire anterior uterine wall: a case series.

    Science.gov (United States)

    Kotsuji, F; Nishijima, K; Kurokawa, T; Yoshida, Y; Sekiya, T; Banzai, M; Minakami, H; Udagawa, Y

    2013-08-01

    To determine the feasibility and safety of transverse fundal incision with manual placental removal in women with placenta praevia and possible placenta accreta. Case series. Four level-three Japanese obstetric centres. Thirty-four women with prior caesarean section and placenta praevia that widely covers the anterior uterine wall, in whom placenta accreta cannot be ruled out. A transverse fundal incision was performed at the time of caesarean section and manual placental removal was attempted under direct observation. Operative fluid loss. The total volume of fluid lost during our operative procedure compares favourably with the volume lost during our routine transverse lower-segment caesarean sections performed in patients without placenta praevia or accreta. The average fluid loss was 1370 g. No patients required transfer to intensive care, and there were no cases of fetal anaemia. This procedure has the potential to reduce the heavy bleeding that arises from caesarean deliveries in women with placenta praevia and placenta accreta. © 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2013 RCOG.

  7. Structure and Steroidogenesis of the Placenta in the Antarctic Minke Whale (Balaenoptera bonaerensis)

    Science.gov (United States)

    SASAKI, Motoki; AMANO, Yoko; HAYAKAWA, Daisuke; TSUBOTA, Toshio; ISHIKAWA, Hajime; MOGOE, Toshihiro; OHSUMI, Seiji; TETSUKA, Masafumi; MIYAMOTO, Akio; FUKUI, Yutaka; BUDIPITOJO, Teguh; KITAMURA, Nobuo

    2012-01-01

    Abstract There are few reports describing the structure and function of the whale placenta with the advance of pregnancy. In this study, therefore, the placenta and nonpregnant uterus of the Antarctic minke whale were observed morphologically and immunohistochemically. Placentas and nonpregnant uteri were collected from the 15th, 16th and 18th Japanese Whale Research Programme with Special Permit in the Antarctic (JARPA) and 1st JARPA II organized by the Institute of Cetacean Research in Tokyo, Japan. In the macro- and microscopic observations, the placenta of the Antarctic minke whale was a diffuse and epitheliochorial placenta. The chorion was interdigitated to the endometrium by primary, secondary and tertiary villi, which contained no specialized trophoblast cells such as binucleate cells, and the interdigitation became complicated with the progress of gestation. Furthermore, fetal and maternal blood vessels indented deeply into the trophoblast cells and endometrial epithelium respectively with fetal growth. The minke whale placenta showed a fold-like shape as opposed to a finger-like shape. In both nonpregnant and pregnant uteri, many uterine glands were distributed. The uterine glands in the superficial layer of the pregnant endometrium had a wide lumen and large epithelial cells as compared with those in the deep layer. On the other hand, in the nonpregnant endometrium, the uterine glands had a narrower lumen and smaller epithelial cells than in the pregnant endometrium. In immunohistochemical detection, immunoreactivity for P450scc was detected in most trophoblast cells, but not in nonpregnant uteri, suggesting that trophoblast epithelial cells synthesized and secreted the sex steroid hormones and/or their precursors to maintain the pregnancy in the Antarctic minke whale. PMID:23269486

  8. Branchial placenta in the viviparous teleost Ilyodon whitei (Goodeidae).

    Science.gov (United States)

    Uribe, Mari Carmen; De la Rosa-Cruz, Gabino; García-Alarcón, Adriana

    2014-12-01

    Intraluminal gestation, as it occurs in viviparous goodeids, allows a wide diversity of embryo-maternal metabolic exchanges. The branchial placenta occurs in embryos developing in intraluminal gestation when ovarian folds enter through the operculum, into the branchial chamber. The maternal ovarian folds may extend to the embryonic pharyngeal cavity. A branchial placenta has been observed in few viviparous teleosts, and there are not previous histological analyses. This study analysis the histological structure in the goodeid Ilyodon whitei. The moterno ovarian folds extend through the embryonic operculum and reach near the gills, occupying part of the branchial chamber. These folds extend also into the pharyngeal cavity. In some regions, the epithelia of the ovarian folds and embryo were in apposition, developing a placental structure in which, maternal and embryonic capillaries lie in close proximity. The maternal epithelium has desquamated cells which may enter through the branchial chamber to the pharyngeal cavity and the alimentary tract. The complex processes that occur in the ovaries of viviparous teleosts, and its diverse adaptations for viviparity, as the presence of branchial placenta, are relevant in the study of the evolution of vertebrate viviparity. © 2014 Wiley Periodicals, Inc.

  9. Impact of maternal diabetes type 1 on proliferative potential, differentiation and apoptotic activity in villous capillaries of term placenta.

    Science.gov (United States)

    Jirkovská, Marie; Kučera, Tomáš; Dvořáková, Veronika; Jadrníček, Martin; Moravcová, Milena; Žižka, Zdeněk; Krejčí, Vratislav

    2016-04-01

    Maternal diabetes mellitus changes morphology and impairs function of placental capillaries. Here, quantitative parameters characterizing cell proliferation using detection of Ki67, differentiation reflected by nestin expression and apoptosis in placental capillary bed with active caspase 3 as a marker were compared in normal term placentas and placentas from pregnancies complicated by Type 1 maternal diabetes mellitus. Specimens of sixteen diabetic placentas and eight control placentas were collected by systematic uniform random sampling. Immunohistochemical detections of Ki67, nestin, and active caspase 3 were performed in histological sections of five haphazardly chosen blocks per placenta. Twenty fields of view per section, i.e. one hundred fields of view per placenta, were used for analysis of proliferation as well as of apoptosis, and in approximately 70 capillary cross-sections per placenta the nestin-positive segments of their circumference were measured. The percentage of Ki67-positive cells counted in the capillary wall was significantly lower in diabetic group. The counts of Ki67-labelled nuclei per villous area unit were significantly lower in cytotrophoblast and capillary wall of terminal villi in diabetic placenta. The proportion of nestin-labeled segments of capillary circumference was significantly higher in placentas of diabetic group. No differences in the numbers of apoptotic cells were found between studied groups. The results show that the term placenta in Type 1 diabetes has lower potential to enlarge the surface area of structures involved in maternofetal transport, and that the villous capillary bed displays delayed differentiation. Those factors may participate in decreased ability of diabetic placenta to comply with fetal requirements in the final stage of pregnancy. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Placenta Increta after First-Trimester Dilatation and Curettage Manifesting as an Unusual Uterine Mass: Magnetic Resonance Findings

    Energy Technology Data Exchange (ETDEWEB)

    Ju, W.; Kim, S.C. [Dept. of Obstetrics and Gynecology, and Medical Research Inst., School of Medicine, Ewha Womens Univ., Seoul (Korea)

    2007-10-15

    Placenta increta during the first trimester of pregnancy is extremely rare. Only a few cases of placenta accreta during the latter half of pregnancy manifesting as a uterine mass have been published. This report describes a case of placenta increta that caused prolonged bleeding after a first-trimester abortion, and was identified by magnetic resonance imaging (MRI) as a heterogeneous mass in the myometrium. This is the first report of a placenta increta detected as a uterine mass after first-trimester dilatation and curettage, and its MRI findings.

  11. The Effects of the Hominis Placenta Herbal acupuncture on Sleep pattern disturbance

    Directory of Open Access Journals (Sweden)

    Youn Hyoun-min

    2005-02-01

    Full Text Available Objective : This study has been designed and performed to identify the effects of Hominis Placenta herbal acupuncture which is usually used in reducing sleep pattern disturbances. Methods : The study subjects studied included 48 patients who were admitted in hospital located in Pusan, and they were classified into 2 groups : 25 patients in the experimental group who injected Hominis Placenta herbal acupuncture and 23 patients in the control group who were treated by acupuncture. The both group injected on GB20, GB12 and HT7 for 5 days without medicine. The sleep pattern disturbance score was measured by using 15 questions according to Korean Sleep Scale A(Oh, Jin Joo. Song, Mi Soon. Kim, Shin Mi. 1998. Results & conclusions : The sleep pattern disturbance score of the experimental group who injected Hominis Placenta herbal acupuncture was significantly lower than that of the control group. (t= 7.00 p= .00 These results provided that Hominis Placenta herbal acupuncture of GB20, GB12 and HT7 was effective for relieving sleep pattern disturbances, it is need more sample's number and more treatmentt's duration.

  12. Development of the Human Placenta and Fetal Heart: Synergic or Independent?

    Directory of Open Access Journals (Sweden)

    Graham J. Burton

    2018-04-01

    Full Text Available The placenta is the largest fetal organ, and toward the end of pregnancy the umbilical circulation receives at least 40% of the biventricular cardiac output. It is not surprising, therefore, that there are likely to be close haemodynamic links between the development of the placenta and the fetal heart. Development of the placenta is precocious, and in advance of that of the fetus. The placenta undergoes considerable remodeling at the end of the first trimester of pregnancy, and its vasculature is capable of adapting to environmental conditions and to variations in the blood supply received from the mother. There are two components to the placental membranes to consider, the secondary yolk sac and the chorioallantoic placenta. The yolk sac is the first of the extraembryonic membranes to be vascularized, and condensations in the mesenchyme at ~17 days post-conception (p.c. give rise to endothelial and erythroid precursors. A network of blood vessels is established ~24 days p.c., with the vitelline vein draining through the region of the developing liver into the sinus venosus. Gestational sacs of early pregnancy failures often display aberrant development of the yolk sac, which is likely to be secondary to abnormal fetal development. Vasculogenesis occurs in the villous mesenchyme of the chorioallantoic placenta at a similarly early stage. Nucleated erythrocytes occupy the lumens of the placental capillaries and end-diastolic flow is absent in the umbilical arterial circulation throughout most of the first trimester, indicating a high resistance to blood flow. Resistance begins to fall in the umbilico-placental circulation around 12–14 weeks. During normal early pregnancy the placental capillary network is plastic, and considerable remodeling occurs in response to the local oxygen concentration, and in particular to oxidative stress. In pregnancies complicated by preeclampsia and/or fetal growth restriction, utero-placental malperfusion induces

  13. Manuseio do canal arterial patente no prematuro com síndrome de angústia respiratória: ligadura ou indometacina? Management of patent ductus arteriosus in the premature infant: ligation or indomethacin?

    Directory of Open Access Journals (Sweden)

    Milton A Meier

    1989-04-01

    Full Text Available A presença de canal arterial patente (PCA com grande shunt sistêmico -pulmonar no prematuro com síndrome de angústia respiratória (SAR está quase sempre associada a insuficiência cardíaca, displasia broncopulmonar, enterocolite necrotizante, hemorragia intracraniana e morte. A ligadura do canal melhora a complacência pulmonar, reduz, significativamente, o tempo de assistência ventilatória e melhora 0 estado geral do paciente. Depois da introdução, nesta última década, da indometacina para a interrupção do PCA, no prematuro, vários estudos vêm procurando estabelecer as vantagens de uma forma de tratamento sobre a outra. O propósito do nosso estudo é comparar os resultados obtidos em 48 pacientes (pts. (Grupo 1 submetidos a ligadura cirúrgica, nos últimos 8 anos, com 28 pts. (Grupo 2 nos quais a indometacina foi, preferentemente, utilizada. A idade gestacional média do Grupo 1 foi de 29,13 ± 2,33 semanas (24-34 e de 28,39 ± 2,30 semanas (25-32 no Grupo 2. O peso médio foi de 954,17 ± 220,68 g (540-1750 g no Grupo 1 e de 923,21 ± 191,74 g (550-1400 g no Grupo 2. Trinta e três (60,75% dos pts. do Grupo 1 eram menores do que 1000 g (prematuros extremos, enquanto que 21 do Grupo 2 (75,0% estavam nessa condição. Nove pacientes (32,1% do Grupo 2 foram transferidos para o Grupo 1, devido ao insucesso da terapêutica com a indometacina, ou pela intolerância às doses indicadas. A ligadura foi realizada na própria unidade de terapia intensiva em 31 pts. (64,5%. A técnica empregada tem sido a de uma toracotomia póstero-lateral pequena, com preservação dos músculos do tórax e abertura pelo 3º ou 4º espaço intercostal. Por via extrapleural, o canal é alcançado e ligado com dois clips metálicos. Inicialmente, o tórax era rotineiramente drenado, apenas quando havia abertura da pleura. Mais recentemente, mesmo com a pleura aberta, somente são drenados os casos que apresentam pneumotórax prévio, ou ent

  14. Morbidade respiratória no primeiro ano de vida de prematuros egressos de uma unidade pública de tratamento intensivo neonatal

    OpenAIRE

    Mello,Rosane R. de; Dutra,Maria Virgínia P.; Lopes,José Maria de A.

    2004-01-01

    OBJETIVO: Verificar a incidência de morbidade respiratória no primeiro ano de vida de prematuros de muito baixo peso e verificar se existe diferença na incidência de morbidade respiratória no primeiro ano de vida segundo os fatores de risco neonatais. MÉTODOS: O desenho foi de coorte prospectivo. Foram estudados neonatos com peso de nascimento inferior a 1.500 g e idade gestacional inferior a 34 semanas nascidos entre 1998 e 2000. As crianças foram acompanhadas mensalmente no Ambulatório de S...

  15. Metabolic development of the porcine placenta in response to alterations in maternal or fetal homeostasis

    International Nuclear Information System (INIS)

    Namsey, T.G.; kasser, T.R.; Hausman, G.J.; Martin, R.J.

    1986-01-01

    Porcine placenta has been utilized as a model for elucidating contributions of both fetal and maternal tissues to metabolic activity of the placenta in response to a variety of stresses. Alloxan diabetes, food restriction and genetic obesity all produced alterations in placental metablolism with differences in responses of fetal and maternal placentas. Further analysis of nutrient untilization by the placenta produced dramatic differences in the partitioning of substrates by fetal and maternal tissues during placental development. Metabolic activity of maternal tissue contributed to overall placental metabolic activity to a greater degree than fetal tissue. However, experiments with in utero fetal decapitation indicated that some of differences between fetal and maternal placental metabolic activity may be due to the influence of fetal regulatory mechanisms. Maternal endometrium plays a critical role in metabolic response of uteroplacenta and thus availability of nutrients to the fetus and fetal placenta. Differences in metabolic development of fetal and maternal tissues suggested that regulation of placental metabolism may originate from fetal as well as maternal sources

  16. Placenta expresses anti-Müllerian hormone and its receptor: Sex-related difference in fetal membranes.

    Science.gov (United States)

    Novembri, R; Funghi, L; Voltolini, C; Belmonte, G; Vannuccini, S; Torricelli, M; Petraglia, F

    2015-07-01

    Anti-Müllerian hormone (AMH) is a member of the transforming growth factor-β superfamily, playing a role in sexual differentiation and recruitment. Since a correlation exists between AMH serum levels in cord blood and fetal sex, the present study aimed to identify mRNA and protein expression of AMH and AMHRII in placenta and fetal membranes according to fetal sex. Placenta and fetal membranes samples (n = 40) were collected from women with singleton uncomplicated pregnancies at term. Identification of AMH protein in placenta and fetal membranes was carried out by immunohistochemistry and AMH and AMHRII protein localization by immunofluorescence, while mRNA expression was assessed by quantitative real-time PCR. AMH and AMHRII mRNAs were expressed by placenta and fetal membranes at term, without any significant difference between males and females. Placental immunostaining showed a syncytial localization of AMH without sex-related differences; while fetal membranes immunostaining was significantly more intense in male than in female fetuses (p membranes. The present study for the first time demonstrated that human placenta and fetal membranes expresses and co-localizes AMH and AMHRII. Although no sex-related difference was found for the mRNA expression both in placenta and fetal membranes, a most intense staining for AMH in male fetal membranes supports AMH as a gender specific hormone. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Evolution of the Placenta in Eutherian Mammals

    DEFF Research Database (Denmark)

    Carter, Anthony Michael; Mess, A

    2007-01-01

    of eutherian mammals had an endotheliochorial placenta or a haemochorial one. Research has been stimulated by improved understanding of the relations between the orders of mammals provided by molecular phylogenetics. In part, the uncertainties arise from doubt about how to root the mammalian tree. Resolution...

  18. Innate immune function in placenta and cord blood of hepatitis C--seropositive mother-infant dyads.

    Science.gov (United States)

    Hurtado, Christine Waasdorp; Golden-Mason, Lucy; Brocato, Megan; Krull, Mona; Narkewicz, Michael R; Rosen, Hugo R

    2010-08-30

    Vertical transmission accounts for the majority of pediatric cases of hepatitis C viral (HCV) infection. In contrast to the adult population who develop persistent viremia in approximately 80% of cases following exposure, the rate of mother-to-child transmission (2-6%) is strikingly low. Protection from vertical transmission likely requires the coordination of multiple components of the immune system. Placenta and decidua provide a direct connection between mother and infant. We hypothesized that innate immune responses would differ across the three compartments (decidua, placenta and cord blood) and that hepatitis C exposure would modify innate immunity in these tissues. The study was comprised of HCV-infected and healthy control mother and infant pairs from whom cord blood, placenta and decidua were collected with isolation of mononuclear cells. Multiparameter flow cytometry was performed to assess the phenotype, intracellular cytokine production and cytotoxicity of the cells. In keeping with a model where the maternal-fetal interface provides antiviral protection, we found a gradient in proportional frequencies of NKT and gammadelta-T cells being higher in placenta than cord blood. Cytotoxicity of NK and NKT cells was enhanced in placenta and placental NKT cytotoxicity was further increased by HCV infection. HCV exposure had multiple effects on innate cells including a decrease in activation markers (CD69, TRAIL and NKp44) on NK cells and a decrease in plasmacytoid dendritic cells in both placenta and cord blood of exposed infants. In summary, the placenta represents an active innate immunological organ that provides antiviral protection against HCV transmission in the majority of cases; the increased incidence in preterm labor previously described in HCV-seropositive mothers may be related to enhanced cytotoxicity of NKT cells.

  19. Roles of microRNA-34a in the pathogenesis of placenta accreta.

    Science.gov (United States)

    Umemura, Kota; Ishioka, Shin-Ichi; Endo, Toshiaki; Ezaka, Yoshiaki; Takahashi, Madoka; Saito, Tsuyoshi

    2013-01-01

    MicroRNA-34a (miR-34a) is associated with invasion and metastasis of various cancers. The trophoblastic cells of placenta accreta invade into the myometrium in a similar way to the invasion of cancers. We studied the roles of miR-34a in the pathogenesis of placenta accreta. The human choriocarcinoma cell line JAR was used for in vitro experiments as a model of trophoblasts, and placental tissues from the operative specimen of patients with or without placenta accreta were used for experiments in vivo. Morpholino antisense oligomer against miR-34a (miR-34a Morpho/AS) was added to JAR, and the expression of miR-34a and plasminogen activator inhibitor-1 (PAI-1) was determined by real time PCR. The effects of antisense, interleukin (IL)-6 and IL-8 in the process of invasion were studied with an invasion assay. Expression of miR-34a in vivo was studied with the use of fluorescent in situ hybridization (FISH). Expression of miR-34a was inhibited by 65% with the administration of antisense, and a slight increase in miR-34a expression was observed with the addition of IL-6 and IL-8. PAI-1 expression decreased with the addition of IL-6 and IL-8, and increased with the administration of antisense. There was an increase in invasive capacity through the inhibition of miR-34a expression. Strong FISH expression of miR-34a was observed in trophoblast cells of non-placenta accreta, and a clear decrease in miR-34a expression was observed in those of placenta accreta. Expression of miR-34a was downregulated in placenta accreta. In vitro experiments also showed that the invasive potential of JAR increased by suppressing miR-34a, probably through the expression of PAI-1. © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.

  20. Alimentación del recién nacido prematuro: lactancia materna vs. leche de fórmula. Bancos de leche

    OpenAIRE

    Mendoza Vicente, Irene

    2015-01-01

    La leche materna es, por excelencia, el mejor alimento para los recién nacidos y más aún para los prematuros, ya que supone un factor de protección frente a las infecciones y la enterocolitis necrotizante, además se tolera mejor, aporta defensas y contribuye a un mejor desarrollo cerebral del bebé. Ha sido redescubierta como uno de los factores claves en mejorar los resultados de estos recién nacidos pretérmino y es reconocida como un estándar de calidad para su cuidado en las Unidades de Neo...

  1. Efficacy of Intrauterine Bakri Balloon Tamponade in Cesarean Section for Placenta Previa Patients.

    Directory of Open Access Journals (Sweden)

    Hee Young Cho

    Full Text Available The aims of this study were to analyze the predictive factors for the use of intrauterine balloon insertion and to evaluate the efficacy and factors affecting failure of uterine tamponade with a Bakri balloon during cesarean section for abnormal placentation.We reviewed the medical records of 137 patients who underwent elective cesarean section for placenta previa between July 2009 and March 2014. Cesarean section and Bakri balloon insertion were performed by a single qualified surgeon. The Bakri balloon was applied when blood loss during cesarean delivery exceeded 1,000 mL.Sixty-four patients (46.7% required uterine balloon tamponade during cesarean section due to postpartum bleeding from the lower uterine segment, of whom 50 (78.1% had placenta previa totalis. The overall success rate was 75% (48/64 for placenta previa patients. Previous cesarean section history, anterior placenta, peripartum platelet count, and disseminated intravascular coagulopathy all significantly differed according to balloon success or failure (all p<0.05. The drainage amount over 1 hour was 500 mL (20-1200 mL in the balloon failure group and 60 mL (5-500 mL in the balloon success group (p<0.01.Intrauterine tamponade with a Bakri balloon is an adequate adjunct management for postpartum hemorrhage following cesarean section for placenta previa to preserve the uterus. This method is simple to apply, non-invasive, and inexpensive. However, possible factors related to failure of Bakri balloon tamponade for placenta previa patients such as prior cesarean section history, anterior placentation, thrombocytopenia, presence of DIC at the time of catheter insertion, and catheter drainage volume more than 500 mL within 1 hour of catheter placement should be recognized, and the next-line management should be prepared in advance.

  2. Role of the placenta in fetal programming: underlying mechanisms and potential interventional approaches.

    Science.gov (United States)

    Jansson, Thomas; Powell, Theresa L

    2007-07-01

    Adverse influences during fetal life alter the structure and function of distinct cells, organ systems or homoeostatic pathways, thereby 'programming' the individual for an increased risk of developing cardiovascular disease and diabetes in adult life. Fetal programming can be caused by a number of different perturbations in the maternal compartment, such as altered maternal nutrition and reduced utero-placental blood flow; however, the underlying mechanisms remain to be fully established. Perturbations in the maternal environment must be transmitted across the placenta in order to affect the fetus. Here, we review recent insights into how the placenta responds to changes in the maternal environment and discuss possible mechanisms by which the placenta mediates fetal programming. In IUGR (intrauterine growth restriction) pregnancies, the increased placental vascular resistance subjects the fetal heart to increased work load, representing a possible direct link between altered placental structure and fetal programming of cardiovascular disease. A decreased activity of placental 11beta-HSD-2 (type 2 isoform of 11beta-hydroxysteroid dehydrogenase) activity can increase fetal exposure to maternal cortisol, which programmes the fetus for later hypertension and metabolic disease. The placenta appears to function as a nutrient sensor regulating nutrient transport according to the ability of the maternal supply line to deliver nutrients. By directly regulating fetal nutrient supply and fetal growth, the placenta plays a central role in fetal programming. Furthermore, perturbations in the maternal compartment may affect the methylation status of placental genes and increase placental oxidative/nitrative stress, resulting in changes in placental function. Intervention strategies targeting the placenta in order to prevent or alleviate altered fetal growth and/or fetal programming include altering placental growth and nutrient transport by maternally administered IGFs (insulin

  3. Gestation Related Gene Expression of the Endocannabinoid Pathway in Rat Placenta

    Directory of Open Access Journals (Sweden)

    Kanchan Vaswani

    2015-01-01

    Full Text Available Mammalian placentation is a vital facet of the development of a healthy and viable offspring. Throughout gestation the placenta changes to accommodate, provide for, and meet the demands of a growing fetus. Gestational gene expression is a crucial part of placenta development. The endocannabinoid pathway is activated in the placenta and decidual tissues throughout pregnancy and aberrant endocannabinoid signaling during the period of placental development has been associated with pregnancy disorders. In this study, the gene expression of eight endocannabinoid system enzymes was investigated throughout gestation. Rat placentae were obtained at E14.25, E15.25, E17.25, and E20, RNA was extracted, and microarray was performed. Gene expression of enzymes Faah, Mgll, Plcd4, Pld1, Nat1, Daglα, and Ptgs2 was studied (cohort 1, microarray. Biological replication of the results was performed by qPCR (cohort 2. Four genes showed differential expression (Mgll, Plcd4, Ptgs2, and Pld1, from mid to late gestation. Genes positively associated with gestational age were Ptgs2, Mgll, and Pld1, while Plcd4 was downregulated. This is the first comprehensive study that has investigated endocannabinoid pathway gene expression during rat pregnancy. This study provides the framework for future studies that investigate the role of endocannabinoid system during pregnancy.

  4. Flame retardants in placenta and breast milk and cryptorchidism in newborn boys

    DEFF Research Database (Denmark)

    Main, Katharina Maria; Kiviranta, Hannu; Virtanen, Helena Eeva

    2007-01-01

    of PBDEs in breast milk was significantly higher in boys with cryptorchidism than in controls (sum of BDEs 47, 153, 99, 100, 28, 66, and 154: median, 4.16 vs. 3.16 ng/g fat; p luteinizing hormone (p ..., 1997-2001, all boys were examined for cryptorchidism. We analyzed whole placentas (for 95 cryptorchid/185 healthy boys) and individual breast milk samples (62/68) for 14 PBDEs and infant serum samples for gonadotropins, sex-hormone binding globulin, testosterone, and inhibin B. RESULTS: In 86 placenta-milk...... pairs, placenta PBDE concentrations in fat were lower than in breast milk, and a larger number of congeners were nondetectable. There was no significant difference between boys with and without cryptorchidism for individual congeners, the sum of 5 most prevalent, or all 14 congeners. The concentration...

  5. Purification and partial characterization of peroxidase from human term placenta of non-smokers: metabolism of benzo(a)pyrene-7, 8-dihydrodiol.

    Science.gov (United States)

    Madhavan, N D; Naidu, K A

    2000-01-01

    Peroxidase (Donor: H(2)O(2)oxidoreductase EC 1.11.1.7) from human term placentae of non-smokers was purified to homogeneity by a combination of NH(4)Cl extraction, affinity chromatography, (NH(4))(2)SO(4)precipitation, ion-exchange and gel filtration chromatography. The homogeneity of purified human placental peroxidase (HTPP) was confirmed by gel filtration, reverse phase high performance liquid chromatography (HPLC) and SDS-PAGE. Peroxidase was found to be a membrane bound enzyme. A high concentration of NH(4)Cl (1.2 m) was needed to extract and solublize the enzyme. Removal of the salt resulted in irreversible precipitation of the enzyme. The protein exhibited a molecular mass of 126 000 kDa according to gel filtration and approximately 60 000 kDa by SDS-PAGE, indicating that the peroxidase is a homodimer. The purified peroxidase showed an optimum pH range of 7 to 8.5 and the K(m)for H(2)O(2)and guaiacol were found to be 0.08 m m and 10.0 m m, respectively. The purified peroxidase oxidized several substrates, namely potassium iodide, tetramethyl benzidine, guaiacol, ortho dianisidne and tyrosine. The enzyme was resistant to thermal denaturation up to 70 degrees C and also to chaotropic agents, guanidinium chloride and urea. Spectral properties indicated the presence of Soret band at 433 which shifted to 451 nm on complexation with cyanide. The circular dichroism studies showed that HTPP has a predominantly helical secondary structure. The enzyme showed similarities to the myeloperoxidase with regard to spectral and catalytical properties but differed significantly in amino acid composition, the R(z)value and molecular mass. Purified HTPP differed from eosinophil peroxidase in all physico-chemical properties indicating that it is not of eosinophil origin, but may represent a distinct, constitutive peroxidase in human placenta. Further, purified peroxidase catalyzed oxidation of benzo(a)pyrene-7, 8-dihydrodiol in presence of tyrosine and hydrogen peroxide to BP

  6. Pregnancy Complicated with Maternal Pulmonary Hypertension and Placenta Accreta

    Directory of Open Access Journals (Sweden)

    Jeng-Hsiu Hung

    2007-06-01

    Full Text Available Pregnancy is contraindicated in cases of maternal pulmonary hypertension, a highly morbid disease affecting young women of childbearing age. The rate of heart failure increases gradually with the severity of pulmonary hypertension. In certain instances, the severity of maternal pulmonary hypertension in rheumatic heart diseases can be higher than in congenital heart diseases. Placenta accreta is an important cause of bleeding in the second half of pregnancy and in labor. In severe cases, hysterectomy is the only way to manage the bleeding during cesarean section. A 33-year-old gravida, G2P0AA1, suffering from rheumatic heart disease with mitral valve stenosis and pulmonary hypertension, was referred to our high-risk pregnancy center at 10+3 weeks of gestation due to lower abdominal pain and brownish vaginal bleeding. She had received 2 mitral valve replacements in Shenzhen, China, at the ages of 22 and 26, respectively. Ultrasound scan of the abdomen at 12+2 gestational weeks showed that the internal cervix was completely covered with the placenta, and a retroplacental hypoechoic space measuring 35 × 13 mm was observed at the upper posterior margin of the placenta. On color Doppler scan, an area of lacunar lake flow was observed in the hypoechoic space of the placenta and a spiral artery with low blood flow resistance was detected. The pulsation of the placental flow was synchronized with the maternal pulse rate. Team specialists, including neonatologists, pulmonary physicians, pediatric cardiologists, hema-tologists, anesthesiologists, psychiatrists and social workers, as well as high-risk obstetricians were consulted in an effort to minimize fetal and maternal morbidity and mortality. At 29+2 weeks, the patient developed preeclampsia and delivered a healthy newborn by cesarean section, the uterus being preserved by square compression sutures. The gravida tolerated the procedures and was discharged in stable condition.

  7. Rising frequency of placenta previa and associated morbidity in women with previous casearean section

    International Nuclear Information System (INIS)

    Akhter, F.; Nawaz, Q.; Mushtaq, Q.U.A.

    2015-01-01

    To determine rising frequency of placenta previa and its associated morbidity in women with previous caesarean section. Study Design: Cross sectional study. Place and Duration of Study: This study was conducted in the Department of Obstetrics and Gynecology at CMH Kohat from Jul 2010 to Jun 2011. Patients and Methods: This study included all pregnant women undergoing repeat caesarean sections. Of these, total 74 patients were admitted with placenta previa. The frequency and associated morbidity were determined. Results: In our study 74 patients with placenta previa were included. 71.62% were less than 35 yrs of age, while 28.38% were equal to or more than 35 years. The gestational age at presentation was 24-36 weeks in 74.3% and 37 + weeks in 5.7% at presentation, 89% patients were symptomatic and 11% were asympyomatic. The morbidities observed were placenta accrete 47%, urinary tract trauma in 63.51%, caesarean hysterectomy in 62.16%, post operative febrile morbidity in 77.03%, maternal mortality was nil, paralytic ileus in 28.38%, PPH in 82.43%, surgical site infection in 16.21%. Conclusion: Frequency of placenta previa and its associated morbidity was raised due to repeated caesarean section rate which must be reduced to decrease maternal morbidity and mortality. (author)

  8. Analysis of placenta vascularization in patients with uterine altered artery Doppler flow velocity exams.

    Science.gov (United States)

    Gilio, Daniel Bruno; Miranda Corrêa, Rosana Rosa; Souza de Oliveira Guimarães, Camila; Peres, Luiz Cesar; Marques Salge, Ana Karina; Cavellani, Camila Lourencini; de Paula Antunes Teixeira, Vicente; Costa da Cunha Castro, Eumenia

    2009-08-01

    One of the frequent questions in obstetric practice is to determine placental vascular changes that may account for abnormal Doppler flow velocity alterations in maternal uterine vessels from women and fetuses without pregnancy pathology. A retrospective morphometric study was realized using 27 placentas from patients submitted for Doppler flow velocity exam during pregnancy. The placentas were morphologically examined using hematoxylin-eosin staining. Measurements of villi were made with the use of a video camera coupled to a common light microscope and a computer with automatic image analyzing software. Of the 27 placentas, 13 (48%) were of patients showing unaltered Doppler and 14 (52%) showing altered Doppler. The number of stem villi vessels was significantly larger in the placentas of patients with Doppler exam alterations (P = 0.003). This group also presented greater stem villi vessel thickness, although without significant difference. The number of intermediary and terminal villi vessels was greater in the placentas of patients with altered Doppler exams (P < 0.001), and a greater terminal villi area was observed in these cases (P < 0.001). The morphological proof that uterine artery Doppler flow velocity exam alterations are associated with placental vascular alterations demonstrates the importance of this exam during prenatal care, even in the absence of maternal-fetal alterations.

  9. Research on human placenta-derived mesenchymal stem cells ...

    African Journals Online (AJOL)

    Research on human placenta-derived mesenchymal stem cells transfected with pIRES2-EGFP-VEGF165 using liposome. ... African Journal of Biotechnology. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue ...

  10. The invasive phenotype of placenta accreta extravillous trophoblasts associates with loss of E-cadherin.

    Science.gov (United States)

    Duzyj, C M; Buhimschi, I A; Motawea, H; Laky, C A; Cozzini, G; Zhao, G; Funai, E F; Buhimschi, C S

    2015-06-01

    Epithelial-to-mesenchymal transition (EMT) is a process of molecular and phenotypic epithelial cell alteration promoting invasiveness. Loss of E-cadherin (E-CAD), a transmembrane protein involved in cell adhesion, is a marker of EMT. Proteolysis into N- and C-terminus fragments by ADAM10 and presenilin-1 (PSEN-1) generates soluble (sE-CAD) and transcriptionally active forms. We studied the protein expression patterns of E-CAD in the serum and placenta of women with histologically-confirmed over-invasive placentation. The patterns of expression and levels of sE-CAD were analyzed by Western blot, immunoassay, and immunoprecipitation. Tissue immunostaining for E-CAD, cytokeratin-7 (epithelial marker), vimentin (mesenchymal marker), ADAM10, PSEN-1 and β-catenin expression were investigated in parallel. N-terminus cleaved 80 kDa sE-CAD fragments were present in serum of pregnant women with gestational age regulation of the circulatory levels. Women with advanced trophoblast invasion did not display circulatory levels of sE-CAD different from those of women with normal placentation. Histologically, extravillous trophoblasts (EVT) closer to the placental-myometrial interface demonstrated less E-CAD staining than those found deeper in the myometrium. These cells expressed both vimentin and cytokeratin, an additional feature of EMT. EVT of placentas with advanced invasion displayed intracellular E-CAD C-terminus immunoreactivity predominating over that of the extracellular N-terminus, a pattern consistent with preferential PSEN-1 processing. Local processing of E-CAD may be an important molecular mechanism controlling the invasive phenotype of accreta EVT. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Incidência de reinternação de prematuros com muito baixo peso nascidos em um hospital universitário Incidencia de rehospitalización de prematuros con muy bajo peso nacidos en un hospital universitario Incidence of re-admissions of newborns with very low weight born in a university hospital

    Directory of Open Access Journals (Sweden)

    Letícia Mayumi Hayakawa

    2010-06-01

    Full Text Available Este estudo investigou a incidência de reinternação e os fatores associados em prematuros nascidos com muito baixo peso em um hospital universitário. Trata-se de um estudo descritivo, quantitativo com os neonatos menores de 1.500 g que nasceram em 2006 e receberam alta até dezembro do mesmo ano e foram seguidos até os 6 meses de vida. Os dados foram obtidos de fichas de atendimento no seguimento ambulatorial dos prematuros e contato telefônico com as mães. Dos 53 bebês estudados, 30,2% foram reinternados, 7,5% foram a óbito e 56,3% das reinternações foram por afecções respiratórias. Dos reinternados, 68,7% haviam permanecido mais de 60 dias na Unidade de Terapia Intensiva Neonatal; 68,7% estavam desmamados na reinternação; 37,5% dos reinternados não estavam em acompanhamento ambulatorial, enquanto apenas 19,8% dos que seguiam em acompanhamento foram reinternados. A incidência de reinternação apresentou associação estatística com o município de origem (p=0,007.Este estudio investigó la incidencia de rehospitalización y los factores asociados a prematuros nacidos con muy bajo peso en un hospital universitario. Es un estudio descriptivo-cuantitativo con los neonatos menores de 1500g nacidos en 2006 y que recibieron alta hasta diciembre de ese año. Todos fueron acompañados hasta los seis meses de vida. Se colectaron los datos en fichas de atención ambulatorio de los prematuros y contacto telefónico con las madres. De los 53 bebés estudiados, un 30,2% fue reinternado, un 7,5% murió y un 56,3% de las reinternaciones ocurrió debido a afecciones respiratorias. De los reinternados, un 68,7% permaneció más de 60 días en la Unidad de Cuidados Intensivos Neonatal; un 68,7% estaba desmamado en la reinternación; un 37,5% no estaba en acompañamiento ambulatorio. Sólo un 19,8% de los que seguían en acompañamiento fue reinternado. La incidencia de reinternación presentó una asociación estadística con el municipio de

  12. CUIDANDO UN HIJO PREMATURO EN CASA: DEL TEMOR Y LA DUDA A LA CONFIANZA

    Directory of Open Access Journals (Sweden)

    Melva Patricia Ocampo González

    2014-01-01

    Full Text Available Ser madre es el resultado de un proceso que implica desarrollar una fuerte identidad maternal, este inicia en la gestación y abarca incluso los primeros meses de vida del hijo. Este proceso se nutre de la constante interacción madre-hijo. Para conocer las vivencias de las madres de niños prematuros que han requerido hospitalización, al asumir el cuidado de ellos en casa, se realizó un estudio fenomenológico con participación de diez madres. Los hallazgos indican que la separación de la diada durante la hospitalización impone limitaciones, que impiden que la mujer asuma con tranquilidad y alegría el nuevo rol. Es importante empoderar al personal de enfermería de las unidades neonatales para implementar estrategias de contacto temprano y continuo madre-hijo, que apoyen a las mujeres en el proceso de convertirse en madres.

  13. [Two- and three-dimensional power Doppler ultrasound in the follow-up of placenta accreta treated conservatively].

    Science.gov (United States)

    Roulot, A; Barranger, E; Morel, O; Soyer, P; Héquet, D

    2015-02-01

    To determinate the potential of 2D and 3D-ultrasound in the follow-up of patients with placenta accreta treated conservatively. Seven patients with placenta accreta treated conservatively during June 2007 and September 2009 were included. The follow-up consisted in clinical examination and 2D/3D-ultrasound once a month. Criteria studied included clinical outcome, echogenicity at 2D-ultrasound, vascularisation at colour Doppler, Mean Grey at 3D-ultrasound and vascularisation, flow and perfusion index. Seven women with invasive placenta (3 placentas accreta and 2 percreta) were studied. The mean follow-up was 228 days [75-369]. Mean delay for complete elimination of residual placenta was 280 days [120-365]. The two main results were: presence of an increased anechogenicpart in residual placenta before complete resorption for all patients; a systematic and concomitant stop of genital haemorrhage and vascularisation at colour Doppler. High degrees of variability in parameters measured at 3D-ultrasound were observed between patients so that correlations with clinical outcome were found. Long and regular follow-up is essential after conservative management but the role of 3D-ultrasound compared to 2D-ultrasound was not demonstrated in this study. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  14. Characterization and partial purification of phospholipase D from human placenta

    DEFF Research Database (Denmark)

    Vinggaard, Anne Marie; Hansen, Harald S.

    1995-01-01

    We report the existence in the human placenta of a phosphatidylcholine- hydrolyzing phospholipase D (PLD) activity, which has been characterized and partially purified. Triton X-100 effectively solubilized PLD from the particulate fraction of human placenta in a dose-dependent manner. However......, Triton X-100 caused decreasing enzyme activities. Maximum transphosphatidylation was obtained with 2% ethanol. The enzyme was found to have a pH optimum of 7.0-7.5 and an apparent K(m) of 33 mol% (or 0.8 mM). Ca and Mg was not required for the enzyme activity. Addition of phosphatidyl-4,5-bisphosphate...

  15. The Clinical Study about Honilirls Placenta Herbal Acupuncture on Bell's Palsy

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    Lee Chae-Woo

    2005-12-01

    Full Text Available Objectives : This study has been designed and performed to identify the effect on Bell's palsy according to the injection of herbal medicine induced from the Hominis Placenta. Methods : We measured the facial palsy changes of the patients who were admitted for Bell's palsy in the Oriental Medical hospital of Dongeui medical center from 03-01-2004 to 07-31-2004. Bell's palsy patients were divided into two groups. One group(A group was injected with Hominis Placenta herbal acupuncture. The other group(B group was injected with normal saline. Then effects of these treatment was evaluated by Yanagihara's unweighted grading system. Results : A group was marked more higher than B group in treatment outcome. we discovered that it is significant differences between two groups after 4 week. Conclusions : These results provided that A group is more effective than B group. For clearly proving the effect of Hominis Placenta herbal acupuncture on Bell's palsy, it is need more sample's number and more treatment's duration.

  16. Retrotransposon hypomethylation in melanoma and expression of a placenta-specific gene.

    Directory of Open Access Journals (Sweden)

    Erin C Macaulay

    Full Text Available In the human placenta, DNA hypomethylation permits the expression of retrotransposon-derived genes that are normally silenced by methylation in somatic tissues. We previously identified hypomethylation of a retrotransposon-derived transcript of the voltage-gated potassium channel gene KCNH5 that is expressed only in human placenta. However, an RNA sequence from this placental-specific transcript has been reported in melanoma. This study examined the promoter methylation and expression of the retrotransposon-derived KCNH5 transcript in 25 melanoma cell lines to determine whether the acquisition of 'placental' epigenetic marks is a feature of melanoma. Methylation and gene expression analysis revealed hypomethylation of this retrotransposon in melanoma cell lines, particularly in those samples that express the placental KCNH5 transcript. Therefore we propose that hypomethylation of the placental-specific KCNH5 promoter is frequently associated with KCNH5 expression in melanoma cells. Our findings show that melanoma can develop hypomethylation of a retrotransposon-derived gene; a characteristic notably shared with the normal placenta.

  17. Differential Proteome Analysis of the Preeclamptic Placenta Using Optimized Protein Extraction

    Directory of Open Access Journals (Sweden)

    Magnus Centlow

    2010-01-01

    Full Text Available The human placenta is a difficult tissue to work with using proteomic technology since it contains large amounts of lipids and glycogen. Both lipids and glycogen are known to interfere with the first step in the two-dimensional polyacrylamide gel electrophoresis (2D-PAGE, the isoelectric focusing. In order to gain the best possible protein separation on 2D-PAGE, an optimized sample preparation protocol for placental proteins was developed. Two different buffers, urea/CHAPS and Hepes, were used for solubilization in combination with six different precipitation methods. The removal of glycogen from the samples by centrifugation was crucial for the final proteome maps. Solubilization with urea/CHAPS in combination with dichloromethane/methanol or acidified acetone proved to be the best precipitation procedures. When applied to clinical placenta samples apolipoprotein A1 was found to be accumulated in the preeclamptic placenta, where it may either have a nutritional effect or act as a modifier of signal transduction.

  18. A danish national cohort study on neonatal outcome in singleton pregnancies with placenta previa

    DEFF Research Database (Denmark)

    Nørgaard, Lone N; Pinborg, Anja; Lidegaard, Ojvind

    2012-01-01

    . Main outcome measures. Gestational age, birthweight, Apgar score after 5min, stillbirth, neonatal mortality and admittance to neonatal intensive care unit. Results. The incidence of placenta previa in Denmark was 0.54% in 2006. Neonates born after pregnancies with placenta previa had a higher risk...... of being born at a gestational age below 37 weeks (OR 8.6; 95% CI 7.5-9.9), having Apgar score =7 at 5 min (OR 2.7; 95% CI 2.0-3.7), being transferred to neonatal intensive care unit (OR 4.3; 95% CI 3.8-4.9) and for stillbirth and neonatal mortality combined (OR 1.8; 95% CI 1.1-3.0), compared to neonates...... born in pregnancies without placenta previa. No increased risk of being small-for-gestational age was found (OR 1.0; 95% CI 1.0-1.2). Conclusion. When adjusting for confounders neonates born after pregnancies with placenta previa had a significantly higher risk of being born preterm, having a low Apgar...

  19. Septic Shock after Conservative Management for Placenta Accreta

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    Ying-Cheng Chiang

    2006-03-01

    Conclusion: At present, there is no consensus about the optimal treatment for placenta accreta. Conservative treatment appears to be an alternative in selected patients, but the complications such as sepsis should be carefully identified and appropriately managed.

  20. The sick placenta - the role of malaria

    NARCIS (Netherlands)

    Brabin, B. J.; Romagosa, C.; Abdelgalil, S.; Menéndez, C.; Verhoeff, F. H.; McGready, R.; Fletcher, K. A.; Owens, S.; D'Alessandro, U.; Nosten, F.; Fischer, P. R.; Ordi, J.

    2004-01-01

    The human placenta is an ideal site for the accumulation of Plasmodium falciparum malaria parasites, and as a consequence serious health problems arise for the mother and her baby. The pathogenesis of placental malaria is only partially understood, but it is clear that it leads to a distinct

  1. Retained placenta of dairy cows associated with managemental factors in Rajshahi, Bangladesh

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    K. M. Mozaffor Hossain

    2013-08-01

    Full Text Available Aim: The incidence of retained placenta of dairy cows in relation to individual animal level and farm management factors such as farm type, farm size, housing system, floor type, feed quality, time of parturition, farming experience of farmer and delivery pattern of cows was determined. Materials and Methods: A total 1205 parturated dairy cows conducted in nine upazilas and four Metro Thana of Rajshahi district during July 2010 to June 2011for attainment of the result. Individual animal and farm management factors associated with retained placenta were recorded in a structured questionnaire through face-to-face farmer's interview and reviewing farm records. The raw data were compiled and statistical SPSS program to analyze to obtained result. Results: The overall incidence of retained placenta was 13.4%. The incidence was significantly higher in Local × Sahiwal genotype (4.6% and late delivery (longer gestation period (80% than their counter groups (p<0.05. The large farm (6.0% had higher incidence and had no significant effect than medium and individual household. Similarly animals housed in Tin shed building with poor ventilation facilities (6.6%, animal housed in unscientific concrete floor (6.8%, animals mostly grassed along with small amount of straw supplied (5.4% and a farmer had less than one year farming experience (5.3% had not significant statistically show higher incidence of retained placenta. Conclusion: The local genotype; mini farm; supplied better feed quality; vast farming experience of farmer and normal delivery with eutocia had less chance of retained placenta of dairy cows. [Vet World 2013; 6(4.000: 180-184

  2. Differential Expression of Growth-, Angiogenesis- and Invasion-Related Factors in The Development of Placenta Accreta

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    Jenn-Jhy Tseng

    2006-06-01

    Full Text Available Placenta accreta is the major cause of maternal death complicated by massive peripartum hemorrhage. Its development is traditionally considered to be related to a decidual defect caused by previous cesarean deliveries or uterine curettages. Usually, placental villi firmly adhere to the superficial myometrium and deeply invade, or even penetrate, the uterine wall. Abnormal uteroplacental neovascularization is another characteristic. Therefore, we hypothesized that placenta accreta develops as a result of abnormal expressions of growth-, angiogenesis- and invasion-related factors in trophoblast populations. We have found, in pregnancies complicated by placenta accreta: upregulated epidermal growth factor receptor and downregulated c-erbB-2 oncoprotein in syncytiotrophoblasts; downregulated vasculoendothelial growth factor receptor-2 expression in syncytiotrophoblasts and increased vasculoendothelial growth factor in placental lysates; and downregulated Tie-2 expression in syncytiotrophoblasts and enhanced angiopoietin-2 level in placental lysates. However, matrix metalloproteinase expression was not upregulated, so the association of these invasion-related molecules with placenta accreta is less likely. Taken together, these findings imply that complex factors, either alone or in combination, might be responsible for the development of placenta accreta. Further studies are needed to understand the signaling pathways and possible genetic events.

  3. Prenatal ultrasound diagnosis and outcome of placenta previa accreta after cesarean delivery: a systematic review and meta-analysis.

    Science.gov (United States)

    Jauniaux, Eric; Bhide, Amar

    2017-07-01

    Women with a history of previous cesarean delivery, presenting with a placenta previa, have become the largest group with the highest risk for placenta previa accreta. The objective of the study was to evaluate the accuracy of ultrasound imaging in the prenatal diagnosis of placenta accreta and the impact of the depth of villous invasion on management in women presenting with placenta previa or low-lying placenta and with 1 or more prior cesarean deliveries. We searched PubMed, Google Scholar, clinicalTrials.gov, and MEDLINE for studies published between 1982 and November 2016. Criteria for the study were cohort studies that provided data on previous mode of delivery, placenta previa, or low-lying placenta on prenatal ultrasound imaging and pregnancy outcome. The initial search identified 171 records, of which 5 retrospective and 9 prospective cohort studies were eligible for inclusion in the quantitative analysis. The studies were scored on methodological quality using the Quality Assessment of Diagnostic Accuracy Studies tool. The 14 cohort studies included 3889 pregnancies presenting with placenta previa or low-lying placenta and 1 or more prior cesarean deliveries screened for placenta accreta. There were 328 cases of placenta previa accreta (8.4%), of which 298 (90.9%) were diagnosed prenatally by ultrasound. The incidence of placenta previa accreta was 4.1% in women with 1 prior cesarean and 13.3% in women with ≥2 previous cesarean deliveries. The pooled performance of ultrasound for the antenatal detection of placenta previa accreta was higher in prospective than retrospective studies, with a diagnostic odds ratios of 228.5 (95% confidence interval, 67.2-776.9) and 80.8 (95% confidence interval, 13.0-501.4), respectively. Only 2 studies provided detailed data on the relationship between the depth of villous invasion and the number of previous cesarean deliveries, independently of the depth of the villous invasion. A cesarean hysterectomy was performed in

  4. Biological Activities of Hominis Placenta Herbal Acupuncture prepared by Hydrochloric Acid Hydrolysis

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    Geun-young Seo

    2010-06-01

    Full Text Available Reactive Oxygen Species(ROS are continuously produced at a high rate as a by-product of aerobic metabolism. Since tissue damage by free radical increases with age, the reactive oxygen species(ROS such as hydrogen peroxide(H2O2, nitric oxide(NO. Several lines of evidence provided that ROS appears to cause to develop aging-related various diseases such as cancer, arthritis, cardiovascular disease. In this study, we have conducted to investigate the biological activities of Hominis Placenta Herbal Acupuncture by measuring total polyphenol content, DPPH radical scavenging, ABTS radical scavenging, Superoxide dismutase(SOD-like activity, Nitrite scavenging ability in vitro. The total polyphenol contents of Hominis Placenta Herbal Acupuncture was 24.6㎖/㎖. Elctron donation ability on DPPH was 49.4%. The 2,2'-azinobis-3-ehtlbezothiazoline-6-sulfonic acid radical decolorization (ABTS was 50.01%, similar to the DPPH free radical scavenging. The superoxide dismutase (SOD-like activities of hominis placenta herbal acupuncture was 50.876%. The nitrite scavenging abilities at pH 1.5, pH 3.0, pH 6.0 were 52.8%, 29.4%, 15.4%, respectively; these abilities decreased as pH increased. We conclude that Hominis Placenta Herbal Acupuncture may be useful as potential sources of antioxidant.

  5. Caesium transfer to placenta, urine and human milk

    International Nuclear Information System (INIS)

    Risica, S.; Rogani, A.; Tancredi, F.; Grisanti, A.; Grisanti, G.; Baronciani, D.; Del Prete, A.; Zanini, R.

    1997-01-01

    After the Chernobyl accident few measurements on radioactive contamination of maternal milk, placenta and urine of nursing mothers were carried out. Two previous studies on breast milk contamination were conducted in different Italian areas by the Physics Department of the National Institute of Health (Laboratorio di Fisica, Istituto Superiore di Sanita). In the first study conducted in collaboration with the Epidemiological Unit of the Lazio District, I-131, Cs-134 and Cs-137 concentrations were measured in mixed breast milk samples pooled from 5-10 women in the first week after delivery, from May 1986 to December 1987, in the Rome area. The second research was conducted, in collaboration with the Lecco Hospital, in 1989 on a group of women living in the Como Lake area (Lombardia), which was one of the areas of Northern Italy most heavily affected by Chernobyl fallout, because of intensive rainfall in the first few days after the accident. The specific diet and caesium content in maternal milk were studied recruiting pregnant women at the ''respiratory autogen training'' course. In this case, Cs-l37, Cs-134 and K-40 concentration in placenta and urine of the mothers under study had also been measured. Aim of this paper is to discuss these data and investigate the relationship between Cs-137 contamination of maternal milk, placenta and urine as a contribution to a better understanding of caesium metabolism in pregnant and nursing women

  6. Prácticas de cuidado con el recién nacido prematuro o bajo peso, que ofrecen las madres en el hogar

    OpenAIRE

    Pava Laguna, Carolina

    2013-01-01

    Objetivo: Describir las prácticas de cuidado con el recién nacido prematuro o bajo peso, que ofrecen las madres en el hogar, una vez son dados de alta de las Unidades de cuidado neonatal de Pereira. Metodología: estudio cualitativo, con método de etnoenfermería, muestreo por saturación. La información fue aportada a través de 21 entrevista semiestructurada realizadas a siete (7) informantes claves, madres que cumplían los criterios de inclusión y por cinco (5) informantes generales, enfermera...

  7. The Programming Power of the Placenta

    Science.gov (United States)

    Sferruzzi-Perri, Amanda N.; Camm, Emily J.

    2016-01-01

    Size at birth is a critical determinant of life expectancy, and is dependent primarily on the placental supply of nutrients. However, the placenta is not just a passive organ for the materno-fetal transfer of nutrients and oxygen. Studies show that the placenta can adapt morphologically and functionally to optimize substrate supply, and thus fetal growth, under adverse intrauterine conditions. These adaptations help meet the fetal drive for growth, and their effectiveness will determine the amount and relative proportions of specific metabolic substrates supplied to the fetus at different stages of development. This flow of nutrients will ultimately program physiological systems at the gene, cell, tissue, organ, and system levels, and inadequacies can cause permanent structural and functional changes that lead to overt disease, particularly with increasing age. This review examines the environmental regulation of the placental phenotype with particular emphasis on the impact of maternal nutritional challenges and oxygen scarcity in mice, rats and guinea pigs. It also focuses on the effects of such conditions on fetal growth and the developmental programming of disease postnatally. A challenge for future research is to link placental structure and function with clinical phenotypes in the offspring. PMID:27014074

  8. Intervenciones con padres y los bebés prematuros admitidos en la uti neonatal: una revisión sistemática

    Directory of Open Access Journals (Sweden)

    Márcia Schaefer Márcia

    2017-05-01

    Full Text Available Este estudio es una revisión sistemática de la literatura acerca de intervenciones facilitadoras del vínculo padre-hijo celebrada con padres y bebés prematuros hospitalizados en Unidad de Cuidados Intensivos Neonatales, publicados en los últimos diez años. Fueron utilizados como términos de búsqueda “intervenciones and bebés prematuros and unidad de cuidados intensivos” y sus traducciones al inglés, incluyendo artículos empíricos, disponibles en su totalidad y publicados en inglés, portugués o español, que surge de la medicina, psicología, enfermería, psiquiatría o multidisciplinaria. Se analizaron los resultados por medio de diez categorías: tipos de publicación, año de publicación, continente y país de origen, investigadores académicos, idioma predominante en las publicaciones, objetivos del estudio, diseño, participantes, herramientas e intervenciones usadas, resultados. Se encontraron once artículos publicados principalmente en revistas médicas, compuestos por autores multidisciplinares, de diseño cuantitativo, y la díada madre-hijo como participante. No hubo artículos de solamente psicólogos, que compusieron dos estudios multidisciplinares, que muestra la necesidad de una comprensión de este fenómeno, ya que las repercusiones de los primeros eslabones de la evolución general de los individuos están profundamente cubiertos en psicología

  9. A semiótica de um enterro prematuro: o feminismo em uma era pós-feminista The semiotics of pemature burial: feminism in a postfeminist age

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    Mary Hawkesworth

    2006-12-01

    Full Text Available Neste artigo, exploro as representações da morte do feminismo para compreender os significados maiores que cercam as declarações do fim simbólico do feminismo. Começarei investigando dois mecanismos pelos quais a morte do feminismo é produzida para expor os valores implícitos dos tanatófilos do feminismo. Depois considerarei versões rivais dos "signos da morte", de forma a explorar como as suposições peculiares sobre a ontologia do feminismo estão presas a formas específicas de morte metafórica. Dado o tipo particular de distorção implicada no enterro prematuro de um feminismo global florescente, a seção final do artigo situa o contemporâneo dobrar dos sinos pela morte do feminismo no contexto de uma história gendrada de práticas de enterro em vida. Através da escavação e da interpretação de tais práticas arcaicas, relacionarei o enterro retórico do feminismo contemporâneo a um esforço contínuo para minar as lutas feministas por justiça social.In this article, I will explore how the death of feminism is represented in order to plumb the larger meanings embedded in proclamations of feminism's symbolic death. I will begin by investigating two mechanisms by which feminism's death has been produced to unearth the tacit values of feminism's morticians. I will then consider competing accounts of the "signs of death" in order to explore how particular assumptions about the ontology of feminism are tied to specific forms of metaphorical death. Given the particular kind of distortion involved in the premature burial of a thriving global feminism, the final section of the article situates contemporary feminism's death knell in the context of a gendered history of live burial practices. By excavating and interpreting such archaic practices, I will link the rhetorical burial of contemporary feminism to an ongoing effort to undermine feminist struggles for social justice.

  10. Placenta Percreta Invading Broad Ligament and Parametrium in a Woman with Two Previous Cesarean Sections: A Case Report

    Directory of Open Access Journals (Sweden)

    Mansoureh Vahdat

    2012-01-01

    Full Text Available Introduction. The incidence of placenta accreta has dramatically increased due to increasing caesarean section rate all over the world. Placenta percreta is the most severe form of placenta accretes. It frequently results in maternal morbidity and mortality mainly caused by massive obstetric hemorrhage or emergency hysterectomy. Percreta invading into the broad ligament has rarely been previously reported. Case presenting. We presented a case of placenta percreta invading left broad ligament and parametrium in a woman with two previous cesarean sections, which led to massive intraoperative hemorrhage during hysterectomy and transient ischemic encephalopathy. Conclusion. In cases of parametrial involvement, it would be more difficult to decide whether to remove placenta or leave it in site. In surgical removal neither local excision of placental bed and uterine repair nor traditional hysterectomy is adequate if parametrium invaded by placenta. We suggest delayed elective hysterectomy in such cases. So, pregnancy-induced pelvic congestion would be decreased, we can gather an expert team of gynecologists, urologists, and vascular surgeons, we could get plenty of blood products, and we may have the chance to administer methotrexate.

  11. Retrospective analysis of obstetric and anesthetic management of patients with placenta accreta spectrum disorders.

    Science.gov (United States)

    Riveros-Perez, Efrain; Wood, Cristina

    2018-03-01

    To assess the management and maternal outcomes of placenta accreta spectrum (PAS) disorders. A retrospective chart review was conducted of patients diagnosed with PAS disorders (placenta creta, increta, or percreta) who were treated at a US tertiary care center between February 1, 2011, and January 31, 2016. Obstetric management, anesthetic management, and maternal outcomes were analyzed. A total of 43 cases were identified; placenta previa was diagnosed among 33 (77%). Median age was 33 years (range 23-42). Median blood loss was 1500 mL (interquartile range 1000-2500); blood loss was greatest among the 10 patients with placenta percreta (3250 mL, interquartile range 2200-6000). Transfusion of blood products was necessary among 14 (33%) patients, with no difference in frequency according to the degree of placental invasion (P=0.107). Surgical complications occurred among 10 (23%) patients. Overall, 30 (70%) patients received combined spinal-epidural plus general anesthesia, 4 (9%) received only general anesthesia, and 9 (21%) underwent surgery with combined spinal-epidural anesthesia. One patient experienced difficult airway and another experienced accidental dural puncture. Placenta previa and accreta coexist in many patients, leading to substantial bleeding related to the degree of myometrial invasion. An interdisciplinary team approach plus the use of combined spinal-epidural anesthesia, transitioning to general anesthesia, were advisable and safe. © 2017 International Federation of Gynecology and Obstetrics.

  12. Uterine artery embolization for the management of secondary postpartum haemorrhage associated with placenta accreta

    International Nuclear Information System (INIS)

    Li, X.; Wang, Z.; Chen, J.; Shi, H.; Zhang, X.; Pan, J.; Liu, W.; Yang, N.; Jin, Z.; Lang, J.

    2012-01-01

    Aim: To evaluate the efficacy and safety of uterine artery embolization for the management of secondary postpartum haemorrhage associated with placenta accreta. Materials and methods: Between January 2005 and August 2011, 45 women with placenta accreta, which was discovered during delivery, were managed conservatively in Peking Union Medical College Hospital. They did not experience severe bleeding during delivery. Ten patients (mean age 31 ± 6.4 years) developed secondary postpartum haemorrhage and underwent uterine artery embolization. The complications, control of haemorrhage, and outcome of the placenta left inside the uterus were retrospectively reviewed. Results: All patients underwent transcatheter embolization of bilateral uterine arteries. The median time between delivery and uterine artery embolization was 11 days (range 3–76 days). The technical success rate of embolization was 100%. Bleeding was controlled in all patients during follow-up (11 ± 6.9 months; range 3–24 months), and no further bleeding occurred. One patient developed lower-extremity deep venous thrombosis after uterine artery embolization, and no other major complications occurred. The placentae that were left inside the uteri gradually decreased in size during follow-up, except in one case. Nine patients resumed normal menstruation. One patient subsequently became pregnant and had an uneventful intrauterine pregnancy carried to term. Conclusion: Uterine artery embolization is safe and effective for the management of secondary postpartum haemorrhage associated with placenta accreta.

  13. Aspectos morfológicos dos hematomas placentários da placenta do búfalo (Bubalus bubalis bubalis -- Linnaeus, 1758

    Directory of Open Access Journals (Sweden)

    Flávia Thomaz Verechia Pereira

    2001-01-01

    Full Text Available Os hematomas placentários executam funções desconhecidas em várias espécies. Na ovelha, estas estruturas ocorrem na zona arcada do placentônio (topos dos septos maternos, região onde ocorre a eritrofagocitose trofoblástica. A função real do hematoma é desconhecida na espécie bufalina, a qual é muito importante no nosso estudo. Há grande possibilidade de transferência de ferro para o feto através destas estruturas, que ocorrem por extravasamento de sangue materno em determinadas regiões dos vilos (junção materno-fetal. Foram usadas placentas de búfalos entre 4-5, 7-8, 9-10 meses de prenhez, imediatamente após sacrifício e fixadas por perfusão de vasos uterinos com paraformaldeído a 4% em 0,1M em tampão fosfato; após a perfusão, os placentônios foram fixados por imersão para microscopia de luz. Depois de 24 horas, as amostras foram cortadas e processadas para inclusão em "paraplast" e "historesina" e coradas pelos métodos de HE, azul de Toluidina, reações de Perls e PAS e tricromos de Gomori e Mallory. Os hematomas estavam presentes em determinadas regiões do placentônio, nos quais havia áreas hemorrágicas entre o epitélio uterino e o trofoblástico, nas placentas de 7-8 e 9-10 meses de prenhez. Células sangüíneas maternas foram encontradas nas células trofoblásticas, elucidando a eritrofagocitose.

  14. Risk factors for unscheduled delivery in patients with placenta accreta.

    Science.gov (United States)

    Bowman, Zachary S; Manuck, Tracy A; Eller, Alexandra G; Simons, Marilee; Silver, Robert M

    2014-03-01

    Patients with suspected placenta accreta have improved outcomes with scheduled delivery. Our objective was to identify risk factors for unscheduled delivery in patients with suspected placenta accreta. This was a cohort study of women with antenatally suspected placenta accreta. Women who delivered prior to a planned delivery date were compared with women who had a scheduled delivery. Data were analyzed using a Student t test, χ(2), logistic regression, and survival analyses. Variables included in the analyses were episodes of antenatal vaginal bleeding, preterm premature rupture of membranes (PPROM), uterine contractions, prior cesarean deliveries, interpregnancy interval, parity, and patient demographic factors. A value of P accreta were identified. Thirty-eight (49.4%) had an unscheduled delivery. Demographics were similar between groups. Unscheduled patients delivered earlier (mean 32.3 vs 35.7 weeks, P accreta, those with antenatal vaginal bleeding were more likely to require unscheduled delivery. This risk increases further in the setting of PPROM and/or uterine contractions. These clinical factors should be considered when determining the optimal delivery gestational age for women with placental accreta. Copyright © 2014 Mosby, Inc. All rights reserved.

  15. Comparative proteomics analysis of placenta from pregnant women with intrahepatic cholestasis of pregnancy.

    Science.gov (United States)

    Zhang, Ting; Guo, Yueshuai; Guo, Xuejiang; Zhou, Tao; Chen, Daozhen; Xiang, Jingying; Zhou, Zuomin

    2013-01-01

    Intrahepatic cholestasis of pregnancy (ICP) usually occurs in the third trimester and associated with increased risks in fetal complications. Currently, the exact cause of this disease is unknown. In this study we aim to investigate the potential proteins in placenta, which may participate in the molecular mechanisms of ICP-related fetal complications using iTRAQ-based proteomics approach. The iTRAQ analysis combined with liquid chromatography-tandem mass spectrometry (LC-MS/MS) was performed to separate differentially expressed placental proteins from 4 pregnant women with ICP and 4 healthy pregnant women. Bioinformatics analysis was used to find the relative processes that these differentially expressed proteins were involved in. Three apoptosis related proteins ERp29, PRDX6 and MPO that resulted from iTRAQ-based proteomics were further verified in placenta by Western blotting and immunohistochemistry. Placental apoptosis was also detected by TUNEL assay. Proteomics results showed there were 38 differentially expressed proteins from pregnant women with ICP and healthy pregnant women, 29 were upregulated and 9 were downregulated in placenta from pregnant women with ICP. Bioinformatics analysis showed most of the identified proteins was functionally related to specific cell processes, including apoptosis, oxidative stress, lipid metabolism. The expression levels of ERp29, PRDX6 and MPO were consistent with the proteomics data. The apoptosis index in placenta from ICP patients was significantly increased. This preliminary work provides a better understanding of the proteomic alterations of placenta from pregnant women with ICP and may provide us some new insights into the pathophysiology and potential novel treatment targets for ICP.

  16. Grey-scale and colour Doppler ultrasound versus magnetic resonance imaging for the prenatal diagnosis of placenta accreta.

    Science.gov (United States)

    Rezk, Mohamed Abd-Allah; Shawky, Mohamed

    2016-01-01

    To assess the effectiveness of grey-scale and colour Doppler ultrasound (US) versus magnetic resonance imaging (MRI) for the prenatal diagnosis of placenta accreta. A prospective observational study including a total of 74 patients with placenta previa and previous uterine scar (n = 74). Grey-scale and colour Doppler US was done followed by MRI by different observers to diagnose adherent placenta. Test validity of US and MRI were calculated. Maternal morbidity and mortality were also assessed. A total of 53 patients confirmed to have placenta accreta at operation. The overall sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of US was 94.34, 91.67, 96.15 and 88% compared to 96.08, 87.50, 94.23 and 91.3% for MRI, respectively. The most relevant US sign was turbulent blood flow by colour Doppler, while dark intra-placental band was the most sensitive MRI sign. Venous thromboembolism (1.3%), bladder injury (29.7%), ureteric injury (18.9%), postoperative fever (10.8%), admission to ICU (50%) and re-operation (31.1%). Placenta accreta can be successfully diagnosed by grey-scale and colour Doppler US. MRI would be more likely suggested for either posteriorly or laterally situated placenta previa in order to exclude placental invasion.

  17. PLACENTA ACCRETA AND THE DEVELOPING WORLD – A REVIEW

    African Journals Online (AJOL)

    2010-12-12

    Dec 12, 2010 ... Conclusion: Optimal treatment of women with placenta accreta requires .... vascular endothelial damage which occurs with aging, .... been described as a potentially easier alternative to ... thereby leading to its necrosis.

  18. Placenta as a source of hematopoietic stem cells

    NARCIS (Netherlands)

    E.A. Dzierzak (Elaine); C. Robin (Catherine)

    2010-01-01

    textabstractThe placenta is a large, highly vascularised hematopoietic tissue that functions during the embryonic and foetal development of eutherian mammals. Although recognised as the interface tissue important in the exchange of oxygen, nutrients and waste products between the foetus and mother,

  19. Placenta Praevia: Incidence, Risk Factors, Maternal and Fetal ...

    African Journals Online (AJOL)

    Maternal complications included post-partum anaemia, postpartum haemorrhage & operative site infection. There were two maternal deaths (1.48%) and the perinatal mortality rate was 18.7%. Conclusion: The incidence of Placenta praevia was relatively high and associated with high maternal and perinatal complications.

  20. Modeling the variability of shapes of a human placenta.

    Science.gov (United States)

    Yampolsky, M; Salafia, C M; Shlakhter, O; Haas, D; Eucker, B; Thorp, J

    2008-09-01

    Placentas are generally round/oval in shape, but "irregular" shapes are common. In the Collaborative Perinatal Project data, irregular shapes were associated with lower birth weight for placental weight, suggesting variably shaped placentas have altered function. (I) Using a 3D one-parameter model of placental vascular growth based on Diffusion Limited Aggregation (an accepted model for generating highly branched fractals), models were run with a branching density growth parameter either fixed or perturbed at either 5-7% or 50% of model growth. (II) In a data set with detailed measures of 1207 placental perimeters, radial standard deviations of placental shapes were calculated from the umbilical cord insertion, and from the centroid of the shape (a biologically arbitrary point). These two were compared to the difference between the observed scaling exponent and the Kleiber scaling exponent (0.75), considered optimal for vascular fractal transport systems. Spearman's rank correlation considered pcentroid) was associated with differences from the Kleiber exponent (p=0.006). A dynamical DLA model recapitulates multilobate and "star" placental shapes via changing fractal branching density. We suggest that (1) irregular placental outlines reflect deformation of the underlying placental fractal vascular network, (2) such irregularities in placental outline indicate sub-optimal branching structure of the vascular tree, and (3) this accounts for the lower birth weight observed in non-round/oval placentas in the Collaborative Perinatal Project.

  1. Symbol "&" suture to control atonic postpartum hemorrhage with placenta previa accreta.

    Science.gov (United States)

    Li, Guang Tai; Li, Xiao Fan; Liu, Ya Jing; Li, Wei; Xu, Hong Mei

    2015-02-01

    To evaluate the efficacy and safety of a symbol "&" compression suture technique in controlling severe atonic postpartum hemorrhage with placenta previa accreta during cesarean delivery. Nine women with heavy postpartum bleeding from uterine inertia and placenta previa percret, which did not react to conventional initial management protocols, were underwent the suture in the shape of symbol "&" in China Meitan General Hospital. The suture procedure was to staple the anterior and posterior walls (of the lower uterine segment as well as corpus uterus) together using number 1 chromic catgut, with a cross at about 2 cm above the upper boundary of lower uterine segment. Symbol "&" compression suture was capable of stanching the postpartum hemorrhage immediately in all nine women. None of these patients developed complications related to this method. Subsequent pregnancies after the suture were occurred in two women and delivered with repeat cesarean section. Symbol "&" compression suture is a simple, safe and highly effective technique to control the treatment-resistant uterine atonic bleeding, particularly in previous cesarean scar at lower segment and placenta previa accreta.

  2. Educação em saúde e a família do bebê prematuro: uma revisão integrativa Educación en salud y la familia del bebé prematuro: una revisión integrativa Health education and the family of the premature baby: an integrative review

    Directory of Open Access Journals (Sweden)

    Lucilei Cristina Chiodi

    2012-01-01

    Full Text Available OBJETIVO: Identificar as necessidades de educação em saúde da família do recém-nascido pré-termo. MÉTODOS: Revisão integrativa de literatura, com buscas nas bases de dados PubMED e Literatura Latino-Americana e do Caribe em Ciências da Saúde, entre 1999 e 2011, e com uso dos descritores (prematuro, enfermagem neonatal, cuidados de enfermagem e alta hospitalar em inglês, espanhol e português. RESULTADOS: Os dez estudos selecionados foram categorizados em três temáticas: a participação nos cuidados do filho, o preparo para a alta hospitalar e uso de material educativo. A maioria das atividades de educação em saúde é direcionada às mães e está relacionada aos cuidados básicos diários e, ainda, é incipiente a participação nestas atividades, a fim de promover o vínculo e aumentar a confiança no cuidado. CONCLUSÃO: Observou-se a necessidade de elaborar estratégias, embasadas nas metodologias ativas de aprendizagem, auxiliadas por materiais educacionais que facilitem a inserção dos pais na unidade neonatal e nos cuidados com seu filho.OBJETIVO: Identificar las necesidades de educación en salud de la familia del recién nacido pretérmino. MÉTODOS: Revisión integrativa de literatura, con búsqueda en las bases de datos PubMED y Literatura Latino-Americana y del Caribe en Ciencias de la Salud entre 1999 y 2011, y con el uso de los descriptores (prematuro, enfermería neonatal, cuidados de enfermería y alta hospitalaria en inglés, español y portugués. RESULTADOS: Los diez estudios seleccionados fueron categorizados en tres temáticas: la participación en los cuidados del hijo, la preparación para el alta hospitalaria y uso de material educativo. La mayoría de las actividades de educación en salud está direccionada a las madres y está relacionada a los cuidados básicos diarios y, aun, es incipiente la participación en esas actividades, a fin de promover el vínculo y aumentar la confianza en el cuidado

  3. Endovascular Interventions for the Morbidly Adherent Placenta

    Directory of Open Access Journals (Sweden)

    Claire Kaufman

    2018-05-01

    Full Text Available Morbidly adherent placentas are a spectrum of abnormalities ranging from placental invasion of the myometrium to invasion past the myometrium and muscular layers into adjacent structures. This entity is becoming more prevalent recently with increased number of cesarean deliveries. Given the high risk of morbidity and mortality, this was traditionally treated with pre-term planned cesarean hysterectomy. However, recently, uterine preservation techniques have been implemented for those women wishing to preserve future fertility or their uterus. Early identification is crucial as studies have shown better outcomes for women treated at tertiary care facilities by a dedicated multidisciplinary team. Interventional radiologists are frequently included in the care of these patients as there are several different endovascular techniques which can be implemented to decrease morbidity in these patients both in conjunction with cesarean hysterectomy and in the setting of uterine preservation. This article will review the spectrum of morbidly adherent placentas, imaging, as well as the surgical and endovascular interventions implemented in the care of these complex patients.

  4. Transplacental pharmacokinetics of diclofenac in perfused human placenta.

    Science.gov (United States)

    Shintaku, Kyohei; Hori, Satoko; Tsujimoto, Masayuki; Nagata, Hideaki; Satoh, Shoji; Tsukimori, Kiyomi; Nakano, Hitoo; Fujii, Tomoyuki; Taketani, Yuji; Ohtani, Hisakazu; Sawada, Yasufumi

    2009-05-01

    The aims of this study were to evaluate the transplacental transfer properties of diclofenac and to determine the effect of L-lactic acid on the transplacental transfer of diclofenac. The maternal and fetal vessels of human placenta were perfused in a single-pass mode with a solution containing diclofenac and antipyrine. The transplacental pharmacokinetic model was fitted to the time profiles of the drug concentrations in the effluent and placenta to obtain transplacental pharmacokinetic parameters. In addition, chloride ion in the perfusate was partially replaced with L-lactic acid to see the change in the transplacental transfer properties of diclofenac. The TPT(ss) value (ratio of the rate of amount transferred across the placenta to that infused in the steady state) of diclofenac was 2.22%, which was approximately one-third that of antipyrine and was significantly reduced in the presence of L-lactic acid. The transplacental pharmacokinetic model could adequately explain the transplacental transfer of diclofenac with influx clearances from maternal and fetal perfusates to placental tissue of 0.276 and 0.0345 ml/min/g cotyledon and efflux rate constants from placental tissue to maternal and fetal perfusates of 0.406 and 0.0337 min(-1), respectively. By taking into account protein binding, the placental tissue/plasma concentration ratio in humans for diclofenac was estimated to be 0.108 ml/g of cotyledon and was smaller than that of antipyrine. In conclusion, human placental perfusion and transplacental pharmacokinetic modeling allowed us to determine the transplacental transfer properties of diclofenac quantitatively. Diclofenac may share transplacental transfer system(s) with L-lactic acid.

  5. LABOUR TERMINATION AND PERINATAL OUTCOME IN PREGNANT WOMEN WITH PLACENTA ABRUPTION WITH PPROM AND PROM

    Directory of Open Access Journals (Sweden)

    Ranko Kutlesic

    2007-10-01

    Full Text Available Placenta abruption is an obstetric accident which endangers life and health of both mother and embryo. It is one of the most serious obstetric complications, whose incidence ranges from 4.9-12.9 per 1,000 labours, and according to frequency, it represents the second cause of perinatal death. Retrospective analysis included the interval from 1996 to 2005. Total number of labours was analyzed and it was 32358. In addition, the number of labours complicated by placenta abruption was analyzed, and it was 119 or 0.37%. It analyzed the incidence of placenta abruption according to age of pregnancy and the integrity of embryonic membranes. It is established that there is no statistically significant difference in the incidence of placenta abruption appearing in pregnant women, with and without the disruption of embryonic membranes. The age of pregnant women was also analyzed, and it was found out that the pregnant women with placenta abruption and PPROM were 5 years older than those with placenta abruption without PPROM, and that this difference was very significant. Disruption duration was analyzed as well as the time from the first uterus bleeding to labour. The difference between PPROM and PROM duration was statistically significant, as well as the difference in duration between spontaneous and artificial rupture of embryonic membranes. The way of labour termination was analyzed in pregnant women with verified placenta abruption. In 80% of pregnant women, the labour was terminated by Caesarian section, and only 20% by vaginal labour. Also, the perinatal outcome was analyzed, according to Apgar score in the first and fifth minute. Apgar score showed that out of the total number of abruptions, 7 neonatuses was born dead (11.66%, 13 (21.66% was born in good condition (Apgar score>7, 26 (43.33% was marked with 4-7, while 14 (23.33% was in hard asphyxia (Apgar score 1-5.

  6. Liquido cefalorraqueano no récem-nascido pré-termo sadio

    Directory of Open Access Journals (Sweden)

    F. A. C. V. Vaz

    1977-09-01

    Full Text Available Estudo da composição do LCR de 54 recém-nascidos prematuros sadios no segundo dia de vida. Os prematuros estudados precediam de gestações sem inter-corrências com parto não-traumático, apresentavam Apgar entre 6 e 9 aos 5 minutos de vida e não apresentavam anormalidades quanto ao exame clínico, neurológico, hematimétrico e gasométrico. Da composição do LCR foram estu-dades a citometria e as concentrações de proteínas totais, glicose, bilirrubina e hemoglobina. As estimativas encontradas permitem aceitar como limites das variações fisiológicas da composição do LCR do RN-PT os seguintes valores: leucócitos até 16 por mm ³; hemácias até 1.280 por mm3; proteínas totais até 300 mg/100 ml; bilirrubina de 10 a 80 µM/l; hemoglobina até 8 µM/l; glicose: cerca de 2/3 da concentração no sangue. Em relação à composição do LCR de 79 recém-nascidos normais a termo, avaliada mediante os mesmos métodos e no mesmo laboratório, são significativamente maiores as concentrações de proteínas totais e de bilirrubina, bem como estar presente a hemoglobina, pigmento não demonstrado no recém-nascido a termo. É discutida a importância da imaturidade da barreira hêmato-liquórica quanto às características do LCR apontadas, considerando-se encontrar-se ela ainda menos diferenciada no recém-nascido prematuro que no recém-nascido a termo.

  7. Eficiência do CCB na resistência da madeira de algaroba (Prosopis juliflora (Sw. D.C. em ensaio de apodrecimento acelerado Efficiency of CCB on resistance of Prosopis juliflora (Sw. D.C. wood in accelerated laboratory test decay

    Directory of Open Access Journals (Sweden)

    Ildefonso Egydio Coutinho Ramos

    2006-10-01

    Full Text Available O objetivo da pesquisa foi avaliar o efeito do preservativo "Osmose CCB" na resistência da madeira de algaroba (Prosopis juliflora (Sw D.C. ao fungo Postia placenta, em condições de laboratório. Peças roliças de algaroba foram tratadas pelo método de substituição da seiva por transpiração radial, em soluções de 1, 2 e 3% de ingredientes ativos de CCB, durante 3, 6, 9, 12 e 15 dias. Das peças tratadas foram retirados discos em três posições (50 cm da base, meio do comprimento e topo da peça, em que foram analisadas a penetração e retenção do CCB, bem como a resistência ao fungo Postia placenta. Observou-se melhor penetração e retenção nas peças submetidas a 2% de ingredientes ativos. A penetração e retenção do CCB, assim como a resistência conferida à madeira, de modo geral, decresceram da base para o topo das peças. O tratamento preservativo conferiu às peças de algaroba uma alta resistência ao fungo P. placenta. Isso não ocorreu apenas nas amostras provenientes do topo (submetidas a 1% de CCB e 15 dias de tratamento; 2% e 9 dias; 3% e 3, 12 e 15 dias e meio das peças (3% de CCB e 3 e 12 dias de tratamento, que foram classificadas como resistentes.The objective of research was to analyze the "Osmose CCB" preservative efficiency to improve the wood Prosopis juliflora (Sw D.C. resistance to Postia placenta fungus. In order to meet the objectives proposed, round pieces of P. juliflora were treated by sap displaced method in 1; 2 and 3% of active ingredients of CCB solutions, by 3, 6, 9, 12 and 15 days. Wood disks were obtained at three positions (50 cm from the base, middle and top of the treated pieces. CCB penetration and retention were analyzed at these positions, as well as the resistance to P. placenta fungus (accelerated laboratory test decay It was found better penetration and retention in pieces submitted to 2% of CCB solutions. The CCB penetration and retention, as well as the resistance of treated

  8. Smoking specifically induces metallothionein-2 isoform in human placenta at term

    International Nuclear Information System (INIS)

    Ronco, Ana Maria; Garrido, Fernando; Llanos, Miguel N.

    2006-01-01

    Recently, we reported the presence of higher levels of metallothionein (MT) in placentas of smokers compared to non-smokers. In the present study, we designed experiments to separate and evaluate two isoforms of MT (MT-1 and MT-2) in placentas of smokers and non-smokers. Metallothionein was extracted and separated by ion-exchange high performance liquid chromatography (HPLC), previous saturation with cadmium chloride. Two peaks eluting at 6 and 12.5 min, corresponding to MT-1 and MT-2, respectively, were obtained. Metallothionein present in both peaks was identified by Western blot analysis using a monoclonal antibody directed against MT-1 and MT-2. Each isoform concentration was calculated after measuring its cadmium content by atomic absorption spectrometry with inductively coupled-plasma. In placentas of smokers, MT-2 levels increased by seven-fold compared to non-smokers, whereas MT-1 was not changed. Total placental cadmium and zinc concentrations, determined by atomic absorption spectrometry and neutron activation analysis, respectively, were higher in smokers. Metallothioneins levels were clearly in excess to bind all cadmium ions present in placentas. However, most of placental zinc remains unbound to MTs, although as much as twice zinc ions could be bound to MT in smokers. In conclusion, MT-2 is the main isoform induced by smoking, suggesting that this isoform could be involved in placental cadmium and zinc retention. This fact, which could contribute to reduce the transference of zinc to the fetus, may be associated to detrimental effects on fetal growth and development

  9. Mitochondrial pathway of apoptosis and related proteins in placenta ...

    African Journals Online (AJOL)

    eclampsia (PE).This study aimed at evaluating the mitochondrial pathway of apoptosis in placenta of pregnant women with pre-eclampsia and correlate it with severity and pregnancy outcome . Apoptosis was assessed by measuring DNA ...

  10. Extracción de un catéter fracturado mediante cateterismo cardíaco intervencionista en un paciente prematuro de 1 600 g

    Directory of Open Access Journals (Sweden)

    Francisco Javier Ozores Suárez

    2011-06-01

    Full Text Available Se documenta el caso de un paciente de 1 mes de edad, prematuro, con peso de 1 600 g, cuyo catéter epicutáneo se fracturó y desplazó hasta ubicarse en la porción distal en la rama izquierda de la arteria pulmonar. El catéter se extrajo por vía femoral mediante un procedimiento de cateterismo cardíaco intervencionista, con lo que se demostró la efectividad de dicho procedimiento ante este tipo de complicación.

  11. Placenta accreta: MRI antenatal diagnosis and surgical correlation.

    Science.gov (United States)

    Ha, T P; Li, K C

    1998-01-01

    We describe a case of a placenta previa accreta that was diagnosed antenatally by MRI with subsequent surgical confirmation. We show the advantages of ultrafast MRI single shot (SS) fast spin echo (FSE) techniques for accurate diagnosis with minimal scan time and fetal motion artifacts.

  12. Changes in mitochondrial respiration in the human placenta over gestation.

    Science.gov (United States)

    Holland, Olivia J; Hickey, Anthony J R; Alvsaker, Anna; Moran, Stephanie; Hedges, Christopher; Chamley, Lawrence W; Perkins, Anthony V

    2017-09-01

    Placental mitochondria are subjected to micro-environmental changes throughout gestation, in particular large variations in oxygen. How placental mitochondrial respiration adapts to changing oxygen concentrations remains unexplored. Additionally, placental tissue is often studied in culture; however, the effect of culture on placental mitochondria is unclear. Placental tissue was obtained from first trimester and term (laboured and non-laboured) pregnancies, and selectively permeabilized to access mitochondria. Respirometry was used to compare respiration states and substrate use in mitochondria. Additionally, explants of placental tissue were cultured for four, 12, 24, 48, or 96 h and respiration measured. Mitochondrial respiration decreased at 11 weeks compared to earlier gestations (p = 0.05-0.001), and mitochondrial content increased at 12-13 weeks compared to 7-10 weeks (p = 0.042). In term placentae, oxidative phosphorylation (OXPHOS) through mitochondrial complex IV (p Respiration was increased (p ≤ 0.006-0.001) in laboured compared to non-laboured placenta. After four hours of culture, respiration was depressed compared to fresh tissue from the same placenta and continued to decline with time in culture. Markers of apoptosis were increased, while markers of autophagy, mitochondrial biogenesis, and mitochondrial membrane potential were decreased after four hours of culture. Respiration and mitochondrial content alter over gestation/with labour. Decreased respiration at 11 weeks and increased mitochondrial content at 12-13 weeks may relate to onset of maternal blood flow, and increased respiration as a result of labour may be an adaptation to ischaemia-reperfusion. At term, mitochondria were more susceptible to changes in respiratory function relative to first trimester when cultured in vitro, perhaps reflecting changes in metabolic demands as gestation progresses. Metabolic plasticity of placental mitochondria has relevance to placenta

  13. Produção da proteína recombinante anexina V humana em cultivos de Escherichia coli em batelada alimentada

    OpenAIRE

    Marder, Laura Schirmbeck

    2013-01-01

    A Anexina V é uma proteína humana endógena dependente de Ca+2, com peso molecular de 35,8 kDa, amplamente distribuída intracelularmente em altas concentrações na placenta e em concentrações mais baixas nas células endoteliais, renais, miocárdicas, epiteliais, esqueléticas musculares, eritrócitos, plaquetas e monócitos. Apresenta como principal característica a capacidade de se ligar à fosfatidilserina, um fosfolipídeo presente na camada interna da bicamada lipídica, que durante a apoptose cel...

  14. Placenta praevia: review of clinical presentation and management in a Nigerian teaching hospital.

    Science.gov (United States)

    Ikechebelu, J I; Onwusulu, D N

    2007-01-01

    The study aims at reviewing the clinical presentation and management of placenta praevia in a tertiary health facility. This is a retrospective study of 59 cases of placenta praevia managed at the Nnamdi Azikiwe University Teaching Hospital, Nnewi from January 1997 to December 2001. The case records of 44 of the patients were obtained from the hospital medical records department and analysed. During the five year period, there were 3565 deliveries and 59 cases of placenta praevia giving an incidence of 1.65%. Thirty four (77.3%) occurred in women aged 35 years and below. The commonest was type 111 (12 cases; 27.3%) followed by type IV (10 cases; 22.7%). Previous uterine scar was associated with 22 (50.0%) cases. Age had no statistically significant effect on the prevalence. The commonest GA range at presentation (13; 29.6%) and at delivery (18; 40.9%) was 37-40 weeks. The commonest mode of presentation was antepartum haemorrhage (34; 77.3%) followed by abnormal lie and malpresentation (4 each; 9.1%). The average admission delivery interval was one week in 33 (75.0%) cases and only two (4.5%) received blood transfusion. Forty (90.9%) women had caesarean delivery while 12 (27.3%) babies were of low birth weight. There were only 2 (4.5%) fetal deaths and one (2.3%) caesarean hysterectomy. The commonest predisposing factor to placenta praevia in this study is previous uterine scar. Judicious use of caesarean section especially in the primigravida will help reduce the incidence of placenta praevia. Also a screening ultrasonography at 34-36 weeks gestation (especially in women with previously scarred uterus) is recommended.

  15. Management Outcomes of Abruptio Placentae at Nnamdi Azikiwe ...

    African Journals Online (AJOL)

    BACKGROUND: The objective of this study is to determine incidence, risk factors and management outcomes of abruptio placentae (AP) and comparing them with cases without AP who delivered within the same period. METHODS: A 10 year retrospective study of AP managed at Nnamdi Azikiwe University Teaching ...

  16. Sclerotherapy with 6% polidocanol solution in patients with placenta accreta.

    Science.gov (United States)

    Malagón Reyes, Ricardo Mauricio; Castorena de Ávila, Rubén; Ángeles Vázquez, María de Jesús; Núñez Monteagudo, César Augusto; Mendieta Zerón, Hugo

    2016-10-01

    Placenta accreta is one of the main obstetrical complications worldwide. The aim of this study was to report the experience of managing placenta accreta with a 6% polidocanol solution sclerotherapy. We selected patients between 37 weeks of gestation and 38 weeks of gestation, diagnosed with placenta accreta, treated at the Maternal Perinatal Hospital "Monica Pretelini Sáenz", Toluca, Mexico, during the period from November 2013 to August 2014. The surgical technique has two steps: (1) fundic-arciform caesarean section followed by a 6% polidocanol sclerosing solution through a 6Fr neonatal feeding tube upon its reaching the placental bed; (2) total abdominal hysterectomy with internal hypogastric artery ligation. Data were collected from 11 patients with a mean age of 33.9 years (range, 26-42 years) and 2.8±0.6 days of hospitalization in the obstetrical intensive care unit. The majority of patients were classified as having pregnancies at an advanced age. All women were multigravidas. Bleeding volume exhibited a range between 2.5 L and 3 L without any case of neonatal death but one mother died because of coagulopathy. We conclude that the technique that we are reporting is feasible for implementation in obstetric hospitals, with technical and economic feasibility. Copyright © 2016. Published by Elsevier B.V.

  17. Placenta accreta and the developing world--a review.

    Science.gov (United States)

    Umezurike, C C; Feyi-Waboso, P A

    2010-12-01

    The rising Caesarean section rate in the developing world implies that the incidence of placenta accreta might be on the increase and this might worsen the maternal mortality burden. To draw the attention of Obstetricians and other relevant professionals to this emerging but challenging trend. Original research findings and reviews published in the English literature. Additional information was obtained from texts and electronic books such as CD ROMS. Online searches of electronic database (Medline, Pubmed and Embase), requests for reprints from corresponding authors and institutional/private subscriptions. Information obtained was categorised accordingly. Optimal treatment of women with placenta accreta requires recognition of the clinical risk factors, accurate pre-operative diagnosis and meticulous planning to ensure safety at the time of delivery. In view of the rising incidence of this condition, and the absence of a highly reliable antenatal diagnostic method especially in developing countries, a high index of suspicion and advanced preparation is required to reduce its associated maternal morbidity and mortality.

  18. Microvascularization on collared peccary placenta

    DEFF Research Database (Denmark)

    Santos, Tatiana Carlesso; Oliveira, Moacir Franco; Dantzer, Vibeke

    2012-01-01

    and fetal compartments of the placentae. The immunolocalization of vimentin in the vascular endothelium and in the smooth muscle cells of blood vessels showed indented capillaries along the uterine epithelium and the trophoblast at the sides of complementary maternal and fetal microfolds, or rugae...... into a microvascular network wall in a basket-like fashion. At the base of these baskets venules were formed. On the fetal side, arterioles branched centrally in the fetal rugae into a capillary network in a bulbous form, complementary to the opposite maternal depressions forming the baskets. At the base...

  19. Suppression by ellagic acid of 60Co-irradiation-induced lipid peroxidation in placenta and fetus of rats

    International Nuclear Information System (INIS)

    Oku, Hirotsugu

    1992-01-01

    The effect of ellagic acid, a component of Eucalyptus maculata, on lipid peroxidation was examined in placenta and fetus of pregnant rats irradiated with 60 Co. The increase in lipid peroxide levels by the irradiation of the placenta and fetus brain as well as those of the serum and organs of mother was suppressed by treatment of the mother rats with ellagic acid. This suppressing effect found in placenta and fetus was significantly correlated with that found in mother rats. Moreover, ellagic acid suppressed the morphological changes such as degeneration in the endothelial cells of placenta and liver cells of fetus caused by the irradiation and improved the survival rate after the irradiation. These suppressing effects of ellagic acid were approximately the same as those of α-tocopherol. (author)

  20. Review: Public perspectives on the utilization of human placentas in scientific research and medicine.

    Science.gov (United States)

    Yoshizawa, R S

    2013-01-01

    Placental tissues are frequently utilized by scientists studying pregnancy and reproduction and in diverse fields including immunology, stem cell research, genetics, cancer research, and tissue engineering, as well as by clinicians in many therapies. Though the utilization of the human placenta in science and medicine has benefitted many people, little is known about public perspectives of this phenomenon. This review addresses placental donation, collection, and utilization in science and medicine, focusing on public perspectives. Cultural values and traditions, ethical paradigms and concerns, public understandings of science and medicine, and political considerations may impact perceptions of the utilization of the placenta in science and medicine, but systematic study is lacking. It is argued that knowledge of public views gained from empirical investigation may underpin the development of collection protocols and research projects that are more responsive to public will, spur more extensive utilization in science and medicine of this unique organ, and/or aid in the realization of the mobilization of knowledge about the placenta for clinical and educational ends. New avenues for research on public perspectives of the placenta are proposed. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. El sentido de vida de las madres de niños prematuros internados en unidad de Cuidados intensivos neonatales (UCIN

    Directory of Open Access Journals (Sweden)

    María Celeste Gómez

    2016-01-01

    Full Text Available La prematuridad es una problemática que se encuentra en aumento a nivel mundial. En Argentina 8 de cada 100 bebés nacen antes de tiempo, de ahí la importancia de sensibilizar a la población sobre este tema. Para la logoterapia la motivación básica y propia del ser humano es su orientación fundamental hacia el sentido, es de- cir, el encontrar y descubrir un porqué y para qué. Tener en cuenta la dimensión existencial de la persona es una forma de acercarnos al problema. Por tal motivo el objetivo del trabajo que se in forma fue relacionar el sentido de vida develado por las madres de niños que se encuentran internados en Unidad de Cuidados Intensivos Neona- tales (UCIN debido a su nacimiento prematuro con dos factores; por un lado con la capacidad que ellas mismas refieren para informarse adecuadamente acerca de la situación de su hijo y por el otro, con su vinculación con situaciones límite vividas durante el embarazo. Se realizó un estudio experimental con 30 madres de niños prematuros que han pasado por una internación en UCIN en tres instituciones hospitalarias. Se construyó un instrumento con formato de entrevista semidirigida llamado Vivencia de Madres de Niños Nacidos Prematuramente. Los resultados demuestran que las madres con mayor capacidad para solicitar información sobre la situación de sus hijos son las que pudieron dar respuestas acerca de la pregunta sobre el sentido que esta situación les permitía descubrir. En un porcentaje menor pudieron relacionarse las respuestas con situaciones límites vividas con anterioridad.

  2. Epoxiconazole-induced degeneration in rat placenta and the effects of estradiol supplementation.

    Science.gov (United States)

    Rey Moreno, Maria Cecilia; Fussell, Karma C; Gröters, Sibylle; Schneider, Steffen; Strauss, Volker; Stinchcombe, Stefan; Fegert, Ivana; Veras, Mariana; van Ravenzwaay, Bennard

    2013-06-01

    Epoxiconazole (CAS-No. 133855-98-8) was recently shown to cause both a marked depletion of maternal estradiol blood levels and a significantly increased incidence of late fetal mortality when administered to pregnant rats throughout gestation (GD 7-18 or 21); estradiol supplementation prevented this epoxiconazole effect in rats (Stinchcombe et al., 2013), indicating that epoxiconazole-mediated estradiol depletion is a critical key event for induction of late fetal resorptions in rats. For further elucidation of the mode of action, the placentas from these modified prenatal developmental toxicity experiments with 23 and 50 mg/kg bw/d epoxiconazole were subjected to a detailed histopathological examination. This revealed dose-dependent placental degeneration characterized by cystic dilation of maternal sinuses in the labyrinth, leading to rupture of the interhemal membrane. Concomitant degeneration occurred in the trophospongium. Both placentas supporting live fetuses and late fetal resorptions were affected; the highest degree of severity was observed in placentas with late resorptions. Placental degeneration correlated with a severe decline in maternal serum estradiol concentration. Supplementation with 0.5 and 1.0 μg of the synthetic estrogen estradiol cyclopentylpropionate per day reduced the severity of the degeneration in placentas with live fetuses. The present study demonstrates that both the placental degeneration and the increased incidence of late fetal resorptions are due to decreased levels of estrogen, since estrogen supplementation ameliorates the former and abolishes the latter. © 2013 Wiley Periodicals, Inc.

  3. Effects of indomethacin, NS-398 (a selective prostaglandin H synthase-2 inhibitor) and protein synthesis inhibitors on prostaglandin production by the guinea-pig placenta.

    Science.gov (United States)

    Aitken, H; Poyser, N L

    2001-01-01

    The outputs of PGF(2 alpha), PGE2 and 6-keto-PGF(1 alpha)were similar from the day 22 guinea-pig placenta and sub-placenta in culture, except for PGE2 output from the sub-placenta which was lower. Between days 22 and 29 of pregnancy, the outputs of PGF(2 alpha), PGE2 and 6-keto-PGF(1 alpha)during the initial 2 h culture period increased 6.9-, 1.1- and 3.2-fold, respectively, from the placenta, and 2.1-, 1.4- and 2.2-fold, respectively, from the sub-placenta. Therefore, there was a relatively specific increase in PGF(2 alpha)production by the guinea-pig placenta between days 22 and 29 of pregnancy. The output of PGFM from the cultured placenta also increased between days 22 and 29, indicating that the increase in PGF(2 alpha)output was due to increased synthesis rather than to decreased metabolism. By comparing the amounts of prostaglandins produced by tissue homogenates during a 1 h incubation period, it appears that there is approximately a 2-fold increase in the amount of prostaglandin H synthase (PGHS) present in the guinea-pig placenta between days 22 and 29. NS-398 (a specific inhibitor of PGHS-2) and indomethacin (an inhibitor of both PGHS-1 and PGHS-2) both inhibited prostaglandin production by homogenates of day 22 and day 29 placenta. Indomethacin was more effective than NS-398, except for their actions on PGF(2 alpha)production by the day 29 placenta where indomethacin and NS-398 were equiactive. Indomethacin and NS-398 were both very effective at inhibiting the outputs of PGF(2 alpha), PGE2 and 6-keto-PGF(1 alpha)from the day 22 and day 29 placenta and sub-placenta in culture, indicating that prostaglandin production by the guinea-pig placenta and sub-placenta in culture is largely dependent upon the activity of PGHS-2. The high production of PGF(2 alpha)by the day 29 placenta is not dependent on the continual synthesis of fresh protein(s), as inhibitors of protein synthesis did not reduce PGF(2 alpha)output from the day 29 guinea-pig placenta in culture

  4. The human placenta from heavy smokers: evaluation of vasoactive peptides by immunohistochemistry

    DEFF Research Database (Denmark)

    Clausen, H V; Larsen, L Grupe; Jørgensen, A

    2007-01-01

    The study aimed to demonstrate the expression of nitric oxide converting enzyme, nitric oxide synthase (e-NOS), and endothelin-1 (Et-1) in formalin-fixed paraffin-embedded placental tissue, and to demonstrate a difference in staining intensity between heavy smokers and non-smokers. Term placentas...... from pregnancies from otherwise healthy women smoking 15 or more cigarettes per day (heavy smokers) and term placentas from a matching group of non-smokers were included. The antibodies for Et-1 and e-NOS are recommended for cryostat sections. We evaluated the antibodies on paraffin-embedded tissue...

  5. Developmental peculiarities in placentae of ovine uniparental conceptuses.

    Directory of Open Access Journals (Sweden)

    Roberta Arena

    Full Text Available Genomic imprinting is an epigenetic phenomenon regulating mono-allelic expression of genes depending on their parental origin. Defective genomic imprinting is involved in several placental disorders, such as intrauterine growth restriction and pre-eclampsia. Uniparental embryos, having maternal-only or paternal-only genomes (parthenogenotes [PAR] and androgenotes [AND], respectively, are useful models to study placentation. The aim of this work was to reveal the effect of parental genome (maternal and paternal on placentation. To do this, uniparental (AND and PAR and biparental (CTR in vitro produced sheep embryos transferred to recipient females were collected at day 20 of pregnancy and their placentae were analyzed. qPCR analysis showed that imprinted genes (H19, IGF2R and DLK1 were expressed accordingly to their parental origin while the expression f DNA methyltransferases ( was disregulated, especially in PAR (P < 0.05. AND placentae were significantly hypomethylated compared to both PAR and CTR (P = 0.023. Chorion-allantoid of AND showed impaired development of vessels and reduced mRNA expression of vasculogenetic factors (ANG2 P = 0.05; VEGFR2 P< 0.001; TIE2 P < 0.001. Morphologically, PAR placentae were characterized by abnormal structure of the trophoectodermal epithelium and reduced total number (P<0.03 of Trophoblastic Binucleate Cells. A reduced implantation rate of both classes of uniparental embryos (P<0.03 was also noted. Our results provide new insights into the characterization of uniparental embryos and demonstrate the complementary role of parental genomes for the correct establishment of pregnancy. Thus, our findings may suggest new targets to improve our understanding of the origin of imprinting-related placental dysfunction.

  6. Landscape of transcriptional deregulations in the preeclamptic placenta.

    Directory of Open Access Journals (Sweden)

    Daniel Vaiman

    Full Text Available Preeclampsia is a pregnancy disease affecting 5 to 8% of pregnant women and a leading cause of both maternal and fetal mortality and morbidity. Because of a default in the process of implantation, the placenta of preeclamptic women undergoes insufficient vascularization. This results in placental ischemia, inflammation and subsequent release of placental debris and vasoactive factors in the maternal circulation causing a systemic endothelial activation. Several microarray studies have analyzed the transcriptome of the preeclamptic placentas to identify genes which could be involved in placental dysfunction. In this study, we compared the data from publicly available microarray analyses to obtain a consensus list of modified genes. This allowed to identify consistently modified genes in the preeclamptic placenta. Of these, 67 were up-regulated and 31 down-regulated. Assuming that changes in the transcription level of co-expressed genes may result from the coordinated action of a limited number of transcription factors, we looked for over-represented putative transcription factor binding sites in the promoters of these genes. Indeed, we found that the promoters of up-regulated genes are enriched in putative binding sites for NFkB, CREB, ANRT, REEB1, SP1, and AP-2. In the promoters of down-regulated genes, the most prevalent putative binding sites are those of MZF-1, NFYA, E2F1 and MEF2A. These transcriptions factors are known to regulate specific biological pathways such as cell responses to inflammation, hypoxia, DNA damage and proliferation. We discuss here the molecular mechanisms of action of these transcription factors and how they can be related to the placental dysfunction in the context of preeclampsia.

  7. The human placenta--an alternative for studying foetal exposure

    DEFF Research Database (Denmark)

    Myren, Maja; Mose, Tina; Mathiesen, Line

    2007-01-01

    Pregnant women are daily exposed to a wide selection of foreign substances. Sources are as different as lifestyle factors (smoking, daily care products, alcohol consumption, etc.), maternal medication or occupational/environmental exposures. The placenta provides the link between mother and foetus......, and though its main task is to act as a barrier and transport nutrients and oxygen to the foetus, many foreign compounds are transported across the placenta to some degree and may therefore influence the unborn child. Foetal exposures to environmental and medicinal products may have impact on the growth...... of the foetus (e.g. cigarette smoke) and development of the foetal organs (e.g. methylmercury and thalidomide). The scope of this review is to give insight to the placental anatomy, development and function. Furthermore, the compounds physical properties and the transfer mechanism across the placental barrier...

  8. Gadd45 α expression in preeclampsia placenta and the effect of Gadd45 α on trophoblast HTR8/Svneo

    Directory of Open Access Journals (Sweden)

    Li Wang

    2016-01-01

    Full Text Available Objective: To study the expression of Gadd45 α in preeclampsia placenta and the regulating effect of Gadd45 α knockdown on trophoblast HTR8/Svneo. Methods: Preeclampsia placenta tissue and normal placenta tissue were collected, and mRNA contents and protein contents of Gadd45 α were detected by fluorescent quantitative PCR and Western blotting respectively; trophoblast cells HTR8/Svneo were cultured and after transfection of Gadd45 α siRNA, cell invasion ability and expression of invasion-assiotiated molecules were detected. Results: mRNA content and protein content of Gadd45 α in preeclampsia placenta tissue were higher than those in normal placenta tissue; after transfection of Gadd45 α siRNA, mRNA content and protein content of Gadd45 α in HTR8/Svneo cells significantly decreased, and the number of invasive cells as well as expression of MMP1, MMP2, MMP3 and MMP9 significantly increased. Conclusion: The expression of Gadd45 α in preeclampsia placenta abnormally increases; inhibting the expression of Gadd45 α in trophoblasts HTR8/Svneo can promote invasion and increase the expression of MMPs molecules.

  9. Cadmium-induced teratogenicity: Association with ROS-mediated endoplasmic reticulum stress in placenta

    International Nuclear Information System (INIS)

    Wang, Zhen; Wang, Hua; Xu, Zhong Mei; Ji, Yan-Li; Chen, Yuan-Hua; Zhang, Zhi-Hui; Zhang, Cheng; Meng, Xiu-Hong; Zhao, Mei; Xu, De-Xiang

    2012-01-01

    The placenta is essential for sustaining the growth of the fetus. An increased endoplasmic reticulum (ER) stress has been associated with the impaired placental and fetal development. Cadmium (Cd) is a potent teratogen that caused fetal malformation and growth restriction. The present study investigated the effects of maternal Cd exposure on placental and fetal development. The pregnant mice were intraperitoneally injected with CdCl 2 (4.5 mg/kg) on gestational day 9. As expected, maternal Cd exposure during early limb development significantly increased the incidences of forelimb ectrodactyly in fetuses. An obvious impairment in the labyrinth, a highly developed tissue of blood vessels, was observed in placenta of mice treated with CdCl 2 . In addition, maternal Cd exposure markedly repressed cell proliferation and increased apoptosis in placenta. An additional experiment showed that maternal Cd exposure significantly upregulated the expression of GRP78, an ER chaperone. Moreover, maternal Cd exposure induced the phosphorylation of placental eIF2α, a downstream molecule of PERK signaling. In addition, maternal Cd exposure significantly increased the level of placental CHOP, another target of PERK signaling, indicating that the unfolded protein response (UPR) signaling was activated in placenta of mice treated with CdCl 2 . Interestingly, alpha-phenyl-N-t-butylnitrone, a free radical spin-trapping agent, significantly alleviated Cd-induced placental ER stress and UPR. Taken together, these results suggest that reactive oxygen species (ROS)-mediated ER stress might be involved in Cd-induced impairment on placental and fetal development. Antioxidants may be used as pharmacological agents to protect against Cd-induced fetal malformation and growth restriction. -- Highlights: ► Cd induces fetal malformation and growth restriction. ► Cd induced placental ER stress and UPR. ► PBN alleviates Cd-induced ER stress and UPR in placenta. ► ROS-mediated ER stress might

  10. Sucção do recém-nascido prematuro: comparação do método Mãe-Canguru com os cuidados tradicionais Suckling of the premature newborn child: comparison between the Kangaroo Mother method with traditional care

    Directory of Open Access Journals (Sweden)

    Izabella Santos Nogueira de Andrade

    2005-03-01

    Full Text Available OBJETIVOS: comparar o processo de sucção em recém-nascidos prematuros incluídos no método Mãe-Canguru com recém-nascidos submetidos aos cuidados tradicionais. MÉTODOS: foram selecionados 30 recém-nascidos prematuros com idade gestacional entre 30 e 35 semanas. A amostra foi constituída de dois grupos: Grupo 1, composto por 16 recém-nascidos inseridos no Alojamento Mãe-Canguru da Maternidade Escola Assis Chateaubriand e Grupo 2, constituído por 14 recém-nascidos submetidos aos cuidados tradicionais, ou seja, Berçário de Médio Risco do Hospital Geral de Fortaleza. Todos os recém-nascidos foram avaliados, submetidos à intervenção fonoaudiológica e reavaliados durante a alta hospitalar. RESULTADOS: no Grupo 1 houve uma melhora significativa em relação ao estado comportamental, sinais de estresse, coordenação e ritmo de sucção. O tempo de permanência hospitalar foi consideravelmente menor. No Grupo 2 foi verificada uma melhora significativa em relação à coordenação entre sucção, deglutição e respiração. CONCLUSÕES: os recém-nascidos de ambos os grupos foram beneficiados com a intervenção fonoaudiológica, no entanto, os melhores resultados foram referentes ao método Mãe-Canguru. Verificou-se que esse método constitui uma ótima alternativa para países em desenvolvimento, pois contribui para a efetividade da amamentação, diminuindo o tempo de permanência hospitalar, acarretando menores custos para a saúde pública.OBJECTIVES: to compare premature newborns' suction in the Mother-Kangoroo method with newborns submitted to traditional care. METHODS: thirty premature newborns with gestational age between 30 and 35 weeks were selected. The samples were comprised of two groups: Group 1: 16 newborns of the Mother Kangoroo Ward of the Maternity School Assis Chateaubriand and Group 2: formed by 14 newborns submitted to traditional care, i.e. Medium Risk Nursery of the General Hospital of Fortaleza. All

  11. Glucocorticoid stimulates expression of corticotropin-releasing hormone gene in human placenta

    International Nuclear Information System (INIS)

    Robinson, B.G.; Emanuel, R.L.; Frim, D.M.; Majzoub, J.A.

    1988-01-01

    Primary cultures of purified human cytotrophoblasts have been used to examine the expression of the corticotropin-releasing hormone (CRH) gene in placenta. The authors report here that glucocorticoids stimulate placental CRH synthesis and secretion in primary cultures of human placenta. This stimulation is in contrast to the glucocorticoid suppression of CRH expression in hypothalamus. The positive regulation of CRH by glucocorticoids suggests that the rise in CRH preceding parturition could result from the previously described rise in fetal glucocorticoids. Furthermore, this increase in placental CRH could stimulate, via adrenocorticotropic hormone, a further rise in fetal glucocorticoids, completing a positive feedback loop that would be terminated by delivery

  12. Maternal obesity alters brain derived neurotrophic factor (BDNF) signaling in the placenta in a sexually dimorphic manner.

    Science.gov (United States)

    Prince, Calais S; Maloyan, Alina; Myatt, Leslie

    2017-01-01

    Obesity is a major clinical problem in obstetrics being associated with adverse pregnancy outcomes and fetal programming. Brain derived neurotrophic factor (BDNF), a validated miR-210 target, is necessary for placental development, fetal growth, glucose metabolism, and energy homeostasis. Plasma BDNF levels are reduced in obese individuals; however, placental BDNF has yet to be studied in the context of maternal obesity. In this study, we investigated the effect of maternal obesity and sexual dimorphism on placental BDNF signaling. BDNF signaling was measured in placentas from lean (pre-pregnancy BMI 30) women at term without medical complications that delivered via cesarean section without labor. MiRNA-210, BDNF mRNA, proBDNF, and mature BDNF were measured by RT - PCR, ELISA, and Western blot. Downstream signaling via TRKB (BDNF receptor) was measured using Western blot. Maternal obesity was associated with increased miRNA-210 and decreased BDNF mRNA in placentas from female fetuses, and decreased proBDNF in placentas from male fetuses. We also identified decreased mature BDNF in placentas from male fetuses when compared to female fetuses. Mir-210 expression was negatively correlated with mature BDNF protein. TRKB phosphorylated at tyrosine 817, not tyrosine 515, was increased in placentas from obese women. Maternal obesity was associated with increased phosphorylation of MAPK p38 in placentas from male fetuses, but not phosphorylation of ERK p42/44. BDNF regulation is complex and highly regulated. Pre-pregnancy/early maternal obesity adversely affects BDNF/TRKB signaling in the placenta in a sexually dimorphic manner. These data collectively suggest that induction of placental TRKB signaling could ameliorate the placental OB phenotype, thus improving perinatal outcome. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Cigarette smoking during pregnancy regulates the expression of specific nicotinic acetylcholine receptor (nAChR) subunits in the human placenta

    Energy Technology Data Exchange (ETDEWEB)

    Machaalani, R., E-mail: rita.machaalani@sydney.edu.au [Department of Medicine, The University of Sydney, NSW 2006 (Australia); Bosch Institute, The University of Sydney, NSW 2006 (Australia); The Children' s Hospital at Westmead, NSW 2145 (Australia); Ghazavi, E. [Bosch Institute, The University of Sydney, NSW 2006 (Australia); School of Medical Sciences (Pharmacology), The University of Sydney, NSW 2006 (Australia); Hinton, T. [School of Medical Sciences (Pharmacology), The University of Sydney, NSW 2006 (Australia); Waters, K.A. [Department of Medicine, The University of Sydney, NSW 2006 (Australia); The Children' s Hospital at Westmead, NSW 2145 (Australia); Hennessy, A. [School of Medicine, University of Western Sydn