WorldWideScience

Sample records for trimester nuchal translucency

  1. Nuchal translucency and first trimester risk assessment: a systematic review.

    Science.gov (United States)

    Sheppard, Celeste; Platt, Lawrence D

    2007-06-01

    First-trimester risk assessment for fetal aneuploidy using nuchal translucency (NT) measurement is rapidly gaining popularity in the United States. In combination with maternal serum markers in the first trimester, the screening performance is exceptionally good, with detection rates of more than 80% at a screen positive rate of 5%. Recently, the method has been validated for screening for Down syndrome and other aneuploidies in multicenter trials in the United States and elsewhere. Compliance with established criteria for measurement of the NT is essential to achieve uniform reliability and high screening test sensitivity. There is an international consensus about the importance of specific training in the NT examination, conformity to standards of NT measurement, and regular audit for quality assurance. In the United States, the Nuchal Translucency Quality Review program has been developed to administer credentialing and quality review for registered practitioners. The Nuchal Translucency Quality Review credentials signify the proficiency of the sonographer or sonologist in NT measurement and participation in a regular quality assurance audit. We encourage accreditation of clinical sites offering first-trimester risk assessment to ensure the highest quality care.

  2. Nuchal translucency thickness and outcome in chromosome translocation diagnosed in the first trimester.

    Science.gov (United States)

    Sepulveda, W; Be, C; Youlton, R; Carstens, E; Reyes, M

    2001-09-01

    In order to determine the significance of nuchal translucency thickness on the subsequent natural history of first-trimester fetuses with a chromosome translocation, seven consecutive cases diagnosed between 11 and 13 weeks of gestation were reviewed. Nuchal translucency measurements were successfully obtained before chorionic villus sampling (CVS) in all cases. Three fetuses had an unbalanced translocation and all were associated with increased nuchal translucency and multiple anomalies at the detailed second-trimester scan. There were no survivors in this group. The remaining four fetuses had a balanced translocation; all had normal nuchal translucency thickness and no structural anomalies were detected in the second trimester. Three of these fetuses were born at > or =35 weeks of gestation and were phenotypically normal. However, an unexpected single fetal demise occurred in a dichorionic twin pregnancy at 28 weeks of gestation. It is concluded that nuchal translucency measurements provide important prognostic information on pregnancy outcome in first-trimester fetuses with a chromosome translocation. In parents with a known balanced translocation, the detection of increased nuchal translucency at 11-14 weeks of gestation is associated with unbalanced translocations, structural anomalies and poor pregnancy outcome. Copyright 2001 John Wiley & Sons, Ltd.

  3. Quality Assessment of Fetal Nuchal Translucency Measurements in the First Trimester of Pregnancy

    Czech Academy of Sciences Publication Activity Database

    Hynek, M.; Stejskal, D.; Zvárová, Jana

    2011-01-01

    Roč. 7, č. 1 (2011), s. 22-32 ISSN 1801-5603 Institutional research plan: CEZ:AV0Z10300504 Keywords : nuchal translucency * control chart * statistical process control * cumulative sum * exponentially weighted moving average * prenatal screening Subject RIV: IN - Informatics, Computer Science http://www.ejbi.eu/images/2011-1/Hynek_en.pdf

  4. Nuchal translucency beyond Down syndrome screening

    NARCIS (Netherlands)

    Timmerman, E.

    2013-01-01

    Nuchal translucency (NT) goes far beyond Down syndrome screening. An enlarged NT is associated with a wide range of structural and genetic anomalies. A detailed first trimester scan is an important step in screening for those anomalies and in individual risk assessment. All pregnant women should be

  5. Impact of chorionicity on first-trimester nuchal translucency screening in ART twin pregnancies.

    Science.gov (United States)

    Flöck, A; Reinsberg, J; Berg, C; Gembruch, U; Geipel, A

    2013-08-01

    Nuchal translucency (NT) measurement in assisted reproduction treatment (ART) twins is less extensively investigated. Therefore, the present study compared NT measurements of spontaneously conceived twins with ART twins in dichorionic (DC) and monochorionic (MC) pregnancies. Retrospective analysis of 706 unaffected twins between 11 + 0 and 13 + 6 weeks conceived either spontaneously (n = 362) or with ART (n = 344). The group with spontaneous conception included 234 DC (64.6%) and 128 MC (35.4%) pregnancies. In the ART group, 326 were DC (94.7%) and 18 were MC (5.3%). NT values were transformed into multiples of median (MoM). In the DC group, no significant differences between ART and spontaneously conceived twins (NT MoM 1.06 ± 0.28 vs 1.03 ± 0.29; p > 0.05) were observed. NT MoM of MC ART twins was higher compared with spontaneous MC twins (1.23 ± 0.82 vs 0.99 ± 0.27; p = 0.011). Although the incidence of twin-to-twin transfusion syndrome (TTTS) was higher among ART twins (11.1% vs 4.7%), inter-twin NT difference was similar between pregnancies with TTTS (0.42 ± 0.21) or without (0.40 ± 0.71). Measurement of NT thickness in DC ART twins achieves comparable results with twins conceived spontaneously. Conclusions in MC twins are limited; however, higher NT MoM was not related to TTTS or selective intrauterine growth restriction. © 2013 John Wiley & Sons, Ltd.

  6. Impact of a shift in nuchal translucency measurements on the detection rate of first-trimester Down syndrome screening: A population-based study.

    Science.gov (United States)

    Fries, Nicolas; Salomon, Laurent J; Muller, Françoise; Dreux, Sophie; Houfflin-Debarge, Véronique; Coquel, Philippe; Kleinfinger, Pascale; Dommergues, Marc

    2018-01-01

    To assess the distribution of nuchal translucency (NT) measurements following a national policy without credentialing and its impact on first-trimester Down syndrome screening (DSS) detection rate. All first-trimester DSS data recorded in France (2010-2014) were collected by the laboratories in charge via an Internet database (https://www.bionuqual.org/echo.php). There was no minimal requirement for image quality to allow sonographers to enter the screening process. A subgroup of DSS with complete DS follow-up corresponded to 1614 sonographers. Based on the distribution of maternal age, DS detection rate was calculated and split as a function of the distribution of NT multiple of the median (MoM). Four thousand nine hundred forty-three sonographers performed 2,337,372 NT measurements. Median NT expressed in MoM was 0.83. Screenings with complete follow-up consisted of 197,417 screenings, in which DSS detection rates were respectively 70.4%, 70.9%, 79.4%, 87.7%, and 79.5% for the following median NT MoM ranges: 0.99 (trend χ = 12.21; P = .0158). In France, following a policy of quality assessment without standardized credentialing, the distribution of NT measurements did not fit the expected distribution. Down syndrome detection rate was 10% lower in screenings by sonographers with a median NT < 0.80 MoM. © 2017 John Wiley & Sons, Ltd.

  7. Association of maternal serum PAPP-A levels, nuchal translucency and crown-rump length in first trimester with adverse pregnancy outcomes: retrospective cohort study.

    Science.gov (United States)

    Bilagi, Ashwini; Burke, Danielle L; Riley, Richard D; Mills, Ian; Kilby, Mark D; Katie Morris, R

    2017-07-01

    Are first trimester serum pregnancy-associated plasma protein-A (PAPP-A), nuchal translucency (NT) and crown-rump length (CRL) prognostic factors for adverse pregnancy outcomes? Retrospective cohort, women, singleton pregnancies (UK 2011-2015). Unadjusted and multivariable logistic regression. small for gestational age (SGA), pre-eclampsia (PE), preterm birth (PTB), miscarriage, stillbirth, perinatal mortality and neonatal death (NND). A total of 12 592 pregnancies: 852 (6.8%) PTB, 352 (2.8%) PE, 1824 (14.5%) SGA, 73 (0.6%) miscarriages, 37(0.3%) stillbirths, 73 perinatal deaths (0.6%) and 38 (0.30%) NND. Multivariable analysis: lower odds of SGA [adjusted odds ratio (aOR) 0.88 (95% CI 0.85,0.91)], PTB [0.92 (95%CI 0.88,0.97)], PE [0.91 (95% CI 0.85,0.97)] and stillbirth [0.71 (95% CI 0.52,0.98)] as PAPP-A increases. Lower odds of SGA [aOR 0.79 (95% CI 0.70,0.89)] but higher odds of miscarriage [aOR 1.75 95% CI (1.12,2.72)] as NT increases, and lower odds of stillbirth as CRL increases [aOR 0.94 95% CI (0.89,0.99)]. Multivariable analysis of three factors together demonstrated strong associations: a) PAPP-A, NT, CRL and SGA, b) PAPP-A and PTB, c) PAPP-A, CRL and PE, d) NT and miscarriage. Pregnancy-associated plasma protein-A, NT and CRL are independent prognostic factors for adverse pregnancy outcomes, particularly PAPP-A and SGA with lower PAPP-A associated with increased risk. © 2017 John Wiley & Sons, Ltd. © 2017 John Wiley & Sons, Ltd.

  8. Pregnancy Outcome of Abnormal Nuchal Translucency: A Systematic Review.

    Science.gov (United States)

    Roozbeh, Nasibeh; Azizi, Maryam; Darvish, Leili

    2017-03-01

    Nuchal Translucency (NT) is the sonographic form of subcutaneous gathering of liquid behind the foetal neck in the first trimester of pregnancy. There is association of increased NT with chromosomal and non-chromosomal abnormalities. The purpose of this systemic review was to review the pregnancy outcome of abnormal nuchal translucency. The present systematic review was conducted by searching English language articles from sources such as International Medical Sciences, Medline, Web of science, Scopus, Google Scholar, PubMed, Index Copernicus, DOAJ, EBSCO-CINAHL. Persian articles were searched from Iranmedex and SID sources. Related key words were "outcome", "pregnancy", "abnormal", and "Nuchal Translucency" (NT). All, randomized, descriptive, analytic-descriptive, case control study conducted during 1997-2015 were included. Including duplicate articles, 95 related articles were found. After reviewing article titles, 30 unrelated article and abstracts were removed, and 65 articles were evaluated of which 30 articles were duplicate. Finally 22 articles were selected for final analysis. Exclusion criteria were, case studies and reports and quasi experimental designs. This evaluation has optioned negative relationship between nuchal translucency and pregnancy result. Rate of cardiac, chromosomal and other defects are correlated with increased NT≥2.5mm. Cardiac disease which were associated to the increased NT are heart murmur, systolic organic murmur, Atrial Septal Defect (ASD), Ventricular Septal Defect (VSD), tricuspid valve insufficiency and pulmonary valve insufficiency, Inferior Vena Cava (IVC) and Patent Ductus Arteriosus (PDA). The most common problems that related with increased NT were allergic symptoms. According to this systematic review, increased NT is associated with various foetal defects. To verify the presence of malformations, birth defect consultations with a perinatologist and additional tests are required.

  9. Quality assessment in prospective nuchal translucency screening for Down syndrome

    DEFF Research Database (Denmark)

    Wøjdemann, K R; Christiansen, M; Sundberg, K

    2001-01-01

    OBJECTIVES: To develop and apply a quality control system in a Down syndrome screening study using nuchal translucency as an interventional marker. METHODS: In a prospective Down syndrome screening study fetal nuchal translucency thickness was measured in 9236 of the 10 045 examined pregnancies...

  10. Increased nuchal translucency thickness and the risk of neurodevelopmental disorders

    DEFF Research Database (Denmark)

    Hellmuth, Signe G; Pedersen, L H; Miltoft, Caroline B

    2016-01-01

    spectrum disorders (ASD), cerebral palsy, epilepsy and febrile seizures was obtained from national patient registries. RESULTS: There was no excess risk of neurodevelopmental disorders among euploid children with first-trimester NT 95(th) -99(th) percentile. For children with NT > 99(th) percentile...... in the risk of cerebral palsy (OR, 1.91 (95% CI, 0.61-5.95), 0.47%), epilepsy (OR, 1.51 (95% CI, 0.63-3.66), 0.78%) or febrile seizures (OR, 0.72 (95% CI, 0.44-1.16), 2.65%). CONCLUSIONS: In a large unselected cohort of euploid children, there was no increased risk of neurodevelopmental disorders among those......OBJECTIVE: To investigate the association between fetal nuchal translucency (NT) thickness and neurodevelopmental disorders in euploid children. METHODS: This study included 222 505 euploid children who had undergone routine first-trimester screening during fetal life. Children were divided...

  11. Quality management of nuchal translucency ultrasound measurement in Australia.

    Science.gov (United States)

    Nisbet, Debbie; Robertson, Ann; Mannil, Blessy; Pincham, Vanessa; Mclennan, Andrew

    2018-02-22

    Nuchal translucency measurement has an established role in first trimester screening. Accurate measurement requires that technical guidelines are followed. Performance can be monitored by auditing the distribution of measurements obtained in a series of cases. The primary aim is to develop an accessible, theory-based educational program for individuals whose distribution of measurements at audit falls outside an acceptable range, and assess operator performance following this intervention. Operators whose nuchal translucency measurement distributions fall outside a normal range (38-65% above the median) were expected to undergo a teleconference tutorial. Accessible from anywhere in Australia, the one hour tutorials were run by a senior sonographer (to explain technical ultrasound aspects) and the audit program manager (to explain the audit process). In 2011, 83 operators attended the teleconference tutorials. Compared to a random comparison group of operators meeting standard in 2011, teleconference tutorial attendees were significantly more likely to: (i) operate in rural or regional, rather than metropolitan, centres (P = 0.001); (ii) be less experienced (P audit cycle and was maintained over subsequent years. The mean percentage of the study cohort reaching standard over the five-year audit was 77.8% which was not statistically different from the average for the comparison cohort of all other audited operators (79.3%; P = 0.61). Teleconference tutorials are a convenient, accessible and effective way to obtain immediate and sustained improvement in operator performance. © 2018 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  12. Nuchal translucency measurements are highly correlated in both mono- and dichorionic twin pairs

    DEFF Research Database (Denmark)

    Wøjdemann, Karen R; Larsen, Severin Olesen; Shalmi, Anne-Cathrine

    2006-01-01

    OBJECTIVES: To establish the distribution of serological and ultrasound first-trimester Down syndrome markers in twins and identify correlations of significance for risk calculation. METHODS: Nuchal translucency (NT), PAPP-A and betahCG data were extracted from 181 twin pregnancies (31 mono- and ...

  13. Detection of Fetal Abnormalities Based on Three Dimensional Nuchal Translucency

    CERN Document Server

    Lai, Khin Wee

    2013-01-01

    Ultrasound (US) prenatal screening has been proposed as the most effective technique for Trisomy 21 early assessment. Assessment of Nuchal Translucency (NT) offers promising non-invasive method for fetal abnormalities detection up to 75%. Nevertheless, current clinician practice of NT examination by locating the sonogram calipers on 2D US image requires highly trained and competent operators by adhering to a standard tedious protocol; therefore it is prone to errors and hence it decreases the reliability in intra- and inter-observer repeatability. This Brief provides the basic knowledge regarding Trisomy 21 diseases and its existing detection methods. The restrictions and disadvantages of each method are discussed accordingly. Therefore, a non-invasive early detection method using 3D ultrasound reconstruction of Nuchal Translucency is introduced. This new method for 3D NT assessments has an edge over the previous 2D methods, and entails the composite function in visualizing the explicit internal marker struct...

  14. Why increased nuchal translucency is associated with congenital heart disease: a systematic review on genetic mechanisms

    NARCIS (Netherlands)

    Burger, N.B.; Bekker, M.N.; Groot, C.J. de; Christoffels, V.M.; Haak, M.C.

    2015-01-01

    This overview provides insight into the underlying genetic mechanism of the high incidence of cardiac defects in fetuses with increased nuchal translucency (NT). Nuchal edema, the morphological equivalent of increased NT, is likely to result from abnormal lymphatic development and is strongly

  15. [Risk assessment for fetal trisomy 21 based on nuchal translucency measurement and biochemical screening at 11-13 weeks.].

    Science.gov (United States)

    Harðardóttir, H

    2001-05-01

    Screening for fetal aneuploidy during the first trimester using fetal nuchal translucency measurement and maternal serum free ss-hCG (ss-human chorionic gonadotropin) and PAPP-A (pregnancy associated plasma protein A) is commonly practised. An approach with a one stop clinic for assessment of risk for fetal anomalies, where pre-test counseling, blood test, ultrasound and post-test counseling is offered in one hour visit is described. Based on maternal age, biochemistry and fetal nuchal translucency measurement an estimated risk for fetal trisomies 13,18 and 21 is calculated. The main benefit of this approach in screening for fetal aneuploidy is the short turnaround time, with immediate results and a low screen positive rate. This approach leads to diagnosis of the majority (95%) of fetal aneuploidy cases. If screening is positive a diagnostic test is available with chorionic villous sampling or amniocentesis. In Iceland, fetal karyotyping is offered to women 35 years and older and performed during the second trimester, but by using this approach prenatal diagnosis can be moved to the first trimester and also offered to women of all ages. A screening approach with a series of steps from 10-15 weeks, including maternal blood test at 10 and again at 15 weeks, as well as an ultrasound and nuchal translucency measurement at 11-13 weeks, with integrated results at 15+ weeks has been proposed. This method offers even lower screen positive rate (1%) while detection rates of fetal aneuploides are high (>90%) but it requires four visits instead of one and the prolonged approach is likely to cause excess anxiety for the parents to be. If all women are to be offered prenatal sreening in the first trimester the structure of prenatal care in Iceland needs some modifications including scheduling the first prenatal visit at 8-10 weeks and teaching healthcare providers counseling regarding prenatal testing.

  16. Exponentially Weighted Moving Average Chart as a Suitable Tool for Nuchal Translucency Quality Review

    Czech Academy of Sciences Publication Activity Database

    Hynek, M.; Smetanová, D.; Stejskal, D.; Zvárová, Jana

    2014-01-01

    Roč. 34, č. 4 (2014), s. 367-376 ISSN 0197-3851 Institutional support: RVO:67985807 Keywords : nuchal translucency * exponentially weighted moving average model * statistics Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 3.268, year: 2014

  17. Aberrant lymphatic development in euploid fetuses with increased nuchal translucency including Noonan syndrome.

    NARCIS (Netherlands)

    Mooij, Y.M. de; Akker, N.M. van den; Bekker, M.N.; Bartelings, M.M.; Vugt, J.M.G. van; Gittenberger-de Groot, A.C.

    2011-01-01

    OBJECTIVE: Increased nuchal translucency in the human fetus is associated with aneuploidy, structural malformations and several syndromes such as Noonan syndrome. In 60-70% of the Noonan syndrome cases, a gene mutation can be demonstrated. Previous research showed that aneuploid fetuses with

  18. WAVELET ANALYSIS AND NEURAL NETWORK CLASSIFIERS TO DETECT MID-SAGITTAL SECTIONS FOR NUCHAL TRANSLUCENCY MEASUREMENT

    Directory of Open Access Journals (Sweden)

    Giuseppa Sciortino

    2016-04-01

    Full Text Available We propose a methodology to support the physician in the automatic identification of mid-sagittal sections of the fetus in ultrasound videos acquired during the first trimester of pregnancy. A good mid-sagittal section is a key requirement to make the correct measurement of nuchal translucency which is one of the main marker for screening of chromosomal defects such as trisomy 13, 18 and 21. NT measurement is beyond the scope of this article. The proposed methodology is mainly based on wavelet analysis and neural network classifiers to detect the jawbone and on radial symmetry analysis to detect the choroid plexus. Those steps allow to identify the frames which represent correct mid-sagittal sections to be processed. The performance of the proposed methodology was analyzed on 3000 random frames uniformly extracted from 10 real clinical ultrasound videos. With respect to a ground-truth provided by an expert physician, we obtained a true positive, a true negative and a balanced accuracy equal to 87.26%, 94.98% and 91.12% respectively.

  19. Screening for trisomy 21 based on maternal age, nuchal translucency measurement, first trimester biochemistry and quantitative and qualitative assessment of the flow in the DV - the assessment of efficacy.

    Science.gov (United States)

    Czuba, Bartosz; Zarotyński, Dariusz; Dubiel, Mariusz; Borowski, Dariusz; Węgrzyn, Piotr; Cnota, Wojciech; Reska-Nycz, Małgorzata; Mączka, Marek; Wielgoś, Mirosław; Sodowski, Krzysztof; Serafin, Dawid; Kubaty, Anna; Bręborowicz, Grzegorz H

    2017-01-01

    The aim of the study was to compare effects of addition of two methods of ductus venosus (DV) flow assessment: qualitative - the assessment of shape of the A-wave (positive or negative), and quantitative - based on the pulsatility index for veins (DVPI) to the basic screening for trisomy 21 at 11 to 13 + 6 weeks of pregnancy. The ultrasound examination was performed in 8230 fetuses in singleton pregnancies at 11- -13 + 6 wks, as a part of a routine screening for chromosomal defects. In DV A-wave was assessed and DVPI was calculated. After the scan blood sample was taken for first trimester biochemistry (BC). Risk for chromosomal defects was calculated and high-risk patients were offered an invasive test for karyotyping. Basic screening with following combination of markers: MA, NT and BC provided lowest detection rate (DR) 87.50% for FPR = 6.94%. After adding qualitative DV A-wave assessment DR increased to 88.75% for FPR = 5.65%. The best DR = 93.75% for FPR = 5.55% was achieved when quantitative DVPI was added. The application of the Receiver Operating Curves curve confirmed validity of the addition of DV flow assessment to the screening model. The highest diagnostic power of the test was achieved when DVPI was added, with the ROC AUC of 0.974. The assessment of DV flow performed at 11-13 + 6 weeks increases DR for trisomy 21 and reduces FPR. The screening model based on the quantitative DV flow analysis (DVPI) gives better results compared to the qualitative flow assessment.

  20. Dysmorphic choroid plexuses and hydrocephalus associated with increased nuchal translucency: early ultrasound markers of de novo thanatophoric dysplasia type II with cloverleaf skull (Kleeblattschaedel).

    Science.gov (United States)

    Tonni, Gabriele; Palmisano, Marcella; Ginocchi, Vladimiro; Ventura, Alessandro; Baldi, Maurizia; Baffico, Ave Maria

    2014-11-01

    Prenatal diagnosis of thanatophoric dysplasia (TD) type II presenting in the first trimester with increased nuchal translucency (NT) and cloverleaf skull (Kleeblattschaedel) have been scantly reported in the medical record. Abnormal choroid plexus has been seen in association with fetal anomalies. Here we described a case of increased NT associated with indented choroid plexuses, early onset hydrocephalus and cloverleaf skull in a fetus subsequently diagnosed at early second trimester to carry a de novo mutation encoding for TD type II. The findings of dysmorphic choroid plexus, early onset hydrocephalus and cloverleaf skull at first trimester scan may be early, useful ultrasound markers of TD type II. Molecular analysis to control for possible overlapping syndromes were performed and resulted negative. Postmortem X-ray and 3D-CT scan confirmed the cloverleaf skull, narrow thorax, straight femur with rhizomelic shortening of the limbs and the presence of a communicating hydrocephalus. © 2014 Japanese Teratology Society.

  1. Quality of nuchal translucency measurements correlates with broader aspects of program rigor and culture of excellence.

    Science.gov (United States)

    Evans, Mark I; Krantz, David A; Hallahan, Terrence; Sherwin, John; Britt, David W

    2013-01-01

    To determine if nuchal translucency (NT) quality correlates with the extent to which clinics vary in rigor and quality control. We correlated NT performance quality (bias and precision) of 246,000 patients with two alternative measures of clinic culture - % of cases for whom nasal bone (NB) measurements were performed and % of requisitions correctly filled for race-ethnicity and weight. When requisition errors occurred in 5% (33%), the curve lowered to 0.93 MoM (p 90%, MoM was 0.99 compared to those quality exists independent of individual variation in NT quality, and two divergent indices of program rigor are associated with NT quality. Quality control must be program wide, and to effect continued improvement in the quality of NT results across time, the cultures of clinics must become a target for intervention. Copyright © 2013 S. Karger AG, Basel.

  2. Presenting and discussing nuchal translucency screening for fetal abnormality in the UK.

    Science.gov (United States)

    Pilnick, Alison M; Fraser, Diane M; James, David K

    2004-03-01

    to investigate the relationship between information giving by midwives and decision-making by women offered nuchal translucency (NT) screening. To establish how risk figures are discussed in practice, with the intention of relating this to the existing, and often critical, literature on women's accounts of antenatal screening. a qualitative study following women through the process of being offered and deciding to undergo NT screening. Tape recording of consultations, analysed in their entirety, was combined with post-screening interviews. a large teaching hospital in the UK. fourteen pregnant women eligible for NT screening at the time of recruitment. (i) tape recordings of consultations between community midwives and pregnant women where nuchal translucency screening was offered; (ii) tape recordings of consultations between hospital midwives and pregnant women immediately post-screening; (iii) individual face-to-face interviews with pregnant women between two and six weeks after the screening, carried out by the first author. NT screening was in general well received, particularly by those women who had undergone serum screening with previous pregnancies. However, communicating the nature of a risk figure is an interactionally complex process. A large amount of interactional work is required by midwives both before and after screening to ensure that women comprehend this information. Despite the emphasis placed in these consultations on understanding the purpose of NT screening and the status of the results, women often framed their decision to undergo NT screening in terms of it being a formality, or of presuming that all was well. This sometimes created practical and personal difficulties in terms of decision-making. previous sociological and psychological research has tended to be critical of midwives in terms of ensuring informed choice in screening, but this research is often based on post hoc accounts. Examining actual consultations with these accounts

  3. Screening for aneuploidies by maternal age, fetal nuchal translucency and maternal serum biochemistry at 11-13+6 gestational weeks

    Directory of Open Access Journals (Sweden)

    Karadžov-Orlić Nataša

    2012-01-01

    Full Text Available Introduction. Aneuploidies are the major cause of perinatal death and early psychophysical disorders. Objective. In this study, we analyzed detection and false-positive rates of screening for aneuploidies in the first trimester by the combination of maternal age, fetal nuchal translucency (NT thickness and maternal serum free beta-human chorionic gonadotrophin (β-hCG, and pregnancy-associated plasma protein-A (PAPP-A at 11-13+6 weeks of gestation, using the appropriate software developed by the Fetal Medicine Foundation. Methods. Our screening study for aneuploidies analyzed 4172 singleton pregnancies from January 2006 to December 2010. The sensitivities and false-positive rates using the combined aneuploidies determination for the risk cut-off of 1:275 were evaluated. Results. In the trisomy 21 pregnancies, the fetal NT was higher than 95th centile, in 72.8%, serum free b-hCG concentration it was above the 95th centile in 55% and serum PAPP-A was below the 5th centile in 47% of the cases. In the trisomy 18 and 13, the fetal NT was above 95th centile in 66.6% and 44.4% of the cases, respectively. The serum free b-hCG concentration was above the 95th centile in 0 and 10%, but serum PAPP-A was below 5th centile in 80.9% and 88.8% of pregnancies. In the trisomy 21 pregnancies the median free beta-hCG was 2.3 MoM and the median PAPP-A was 0.45 MoM. Chromosomal abnormalities were detected in 169 fetuses: trisomy 21 (97, Turner syndrome (19, trisomy 18 (28, trisomy 13 (11 and others (14. Detection rate of combined screening for aneuploides were 86.0% with false positive rate of 5.3% (mean age 33±4.9 years, >35 years in 35% of pregnancies. Conclusion. Our study suggests that the strategy of first-trimester combined screening of biochemical values and ultrasonographic parameters at 12 gestational weeks identifies higher percentage of aneuploidies with a lower false-positive rate than a single parameter strategy.

  4. Nuchal translucency measurement, free β-hCG and PAPP-A concentrations in IVF/ICSI pregnancies: systematic review and meta-analysis.

    Science.gov (United States)

    Cavoretto, Paolo; Giorgione, Veronica; Cipriani, Sonia; Viganò, Paola; Candiani, Massimo; Inversetti, Annalisa; Ricci, Elena; Parazzini, Fabio

    2017-06-01

    So far, data on the effect of assisted reproductive technologies (ART) on the components of first trimester combined screening for Down syndrome are still controversial. A systematic search of the literature was performed in order to identify the effect of ART, particularly in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) with fresh embryo transfer, on the nuchal translucency, free beta-human chorionic gonadotrophin and pregnancy-associated plasma protein-A measurements. Moreover, a meta-analysis and a descriptive graphical representation of the ratios between ART and spontaneous pregnancies (controls) values of median of the multiple of median (m 0 MoM) were performed. Free beta-human chorionic gonadotrophin test showed slightly higher values in the ICSI group than controls (RR = 1.09, 95%CI: 1.03-1.16) but not in the IVF group (RR = 1.03, 95%CI: 0.94-1.12). Pregnancy-associated plasma protein-A values for IVF/ICSI, IVF and ICSI showed lower values in comparison with controls (RR, 95%CI 0.85, 0.80-0.90; 0.82, 0.74-0.89 and 0.83, 0.79-0.86, respectively). The nuchal translucency measurement did not show any statistical differences between study groups (IVF and ICSI) and controls (RR = 1.00, 95%CI: 0.94-1.08 and RR = 1.01, 95%CI: 0.97-1.05, respectively). These results may be due to alterations in the placentation of ART pregnancies. Differentiating further subgroups of ART pregnancies may explain the differences in biomarker concentrations, in prenatal behavior and in obstetric outcomes between ART and spontaneous pregnancies. © 2017 John Wiley & Sons, Ltd. © 2017 John Wiley & Sons, Ltd.

  5. Effect of deviation of nuchal translucency measurements on the performance of screening for trisomy 21.

    Science.gov (United States)

    Kagan, K O; Wright, D; Etchegaray, A; Zhou, Y; Nicolaides, K H

    2009-06-01

    To examine the effect of deviations in median nuchal translucency thickness (NT) and the spread in measurements on the performance of screening for trisomy 21 by maternal age and fetal NT, and by maternal age, fetal NT and maternal serum biochemistry. We simulated the NT and multiples of the median values for pregnancy-associated plasma protein-A (PAPP-A) and free beta-human chorionic gonadotropin (beta-hCG) for 500 000 euploid and 500 000 trisomy 21 pregnancies at 12 weeks of gestation. Detection rates for trisomy 21 and false-positive rates were calculated without adjustments in NT and by adding or subtracting values ranging from 0.1 to 1.0 mm to each observed measurement. In addition, the effects of variation in the scatter of NT measurements were examined by applying a multiplicative factor ranging from 0.5 to 2 to the SD. The detection rate of trisomy 21 for a fixed false-positive rate of 3% in screening by maternal age and fetal NT was 72%, and in screening by maternal age, fetal NT and serum free beta-hCG and PAPP-A it was 86%. A consistent underestimate or overestimate in the measured NT reduced the detection rate of trisomy 21 for a fixed-false positive rate. At a fixed screen-positive cut-off an underestimate in fetal NT reduced the detection rate whereas an overestimate in NT increased the false-positive rate. A widening in the scatter of measurements had only a small impact on the detection rate but it caused a major increase in the false-positive rate. High performance of screening necessitates appropriate measurement of fetal NT. This paper demonstrates the effect of deviations in the median and SD of NT from the expected on the performance of screening and can form the basis of audit of results of individual sonographers. (c) 2009 ISUOG.

  6. Disappearance of enlarged nuchal translucency before 14 weeks' gestation: relationship with chromosomal abnormalities and pregnancy outcome.

    Science.gov (United States)

    Müller, M A; Pajkrt, E; Bleker, O P; Bonsel, G J; Bilardo, C M

    2004-08-01

    The aim of this study was to investigate the natural course of enlarged nuchal translucency (NT) and to determine if its disappearance before 14 weeks' gestation is a favorable prognostic sign in relation to fetal karyotype and pregnancy outcome. A total of 147 women with increased NT (> 95th centile) at first measurement were included in this study. A second measurement was performed in all cases, at an interval of at least 2 days. Both measurements were taken between 10 + 3 and 14 + 0 weeks. All women underwent chorionic villus sampling or amniocentesis for subsequent karyotyping. In those women with a normal karyotype, a fetal anomaly scan was performed at 20 weeks' gestation. Pregnancy outcome was recorded in all cases. The finding of persistent or disappearing NT enlargement was analyzed in relation to fetal karyotype and pregnancy outcome. Of the 147 paired measurements, NT remained enlarged at the second measurement in 121 (82%) cases. An abnormal karyotype was found in 35% of these cases. In 26 (18%) fetuses the NT measurement was found to be below the 95th percentile at the second measurement and in only two of them an abnormal karyotype was found (8%). In the 103 chromosomally normal fetuses an adverse outcome (i.e. fetal loss or structural defects) was recorded in 22 fetuses with persistent enlargement (28%) and in four fetuses with disappearing enlargement (17%). Disappearance of an enlarged NT before 14 weeks' gestation is not a rare phenomenon and seems to be a favorable prognostic sign with respect to fetal karyotype. Overall, no significant difference in pregnancy outcome was found between chromosomally normal fetuses with persisting or disappearing NT enlargement. Copyright 2004 ISUOG

  7. O papel da translucência nucal no rastreamento de cardiopatias congênitas The role of nuchal translucency in the screening for congenital heart defects

    Directory of Open Access Journals (Sweden)

    Rafael Frederico Bruns

    2006-09-01

    Full Text Available OBJETIVO: Avaliar a acurácia da medida da translucência nucal (TN entre onze e treze semanas e seis dias como marcador ultra-sonográfico para rastreamento de cardiopatias congênitas (CC. MÉTODOS: Estudo multicêntrico retrospectivo, no qual foram analisadas gestações únicas de fetos euplóides. A medida da TN foi realizada no exame de primeiro trimestre quando os fetos tinham entre 45 e 84 mm de comprimento cabeça-nádega (CCN, segundo os critérios estabelecidos pela Fetal Medicine Foundation. Os casos foram seguidos até um mês após o parto para avaliar a presença de CC. RESULTADOS: Foram analisadas 3.664 gestações, das quais vinte recém-nascidos apresentaram alguma cardiopatia congênita até o primeiro mês de vida (prevalência de 0,55%. A mediana da TN nos fetos com CC foi de 1,70 mm e nos fetos sem CC foi de 1,60 mm; entretanto, não houve diferença significativa entre as duas medianas (Teste de Mann-Whitney, p>0,05. A sensibilidade da TN na detecção de CC variou de 15% a 20%, com probabilidade de falso-positivos de 86,4% a 97,9%, dependendo do ponto de corte utilizado. A razão de chance para CC foi alta, quando comparada com as indicações clássicas de ecocardiografia fetal, variando de 4,7 a 33,7, de acordo com o ponto de corte utilizado. CONCLUSÃO: Apesar da baixa sensibilidade do teste, a TN aumentada é um importante fator de risco para CC, devendo ser incluída na estratégia do seu rastreamento pré-natal.OBJECTIVE: Assess the accuracy of the nuchal translucency (NT measurement between 11 and 13 weeks and 6 days of gestation as a sonographic marker to screen for congenital heart defects (CHD. METHODS: Multicentric retrospective study, analyzing single pregnancies from euploid fetuses. NT measurement was performed in the first trimester, when fetuses had from 45 to 84 mm of crown-rump length (CRL, according to the criteria established by the Fetal Medicine Foundation. Cases were followed until 1 month after

  8. Fetal cor triatriatum dexter: a report of two cases associated with nuchal edema in early second trimester

    DEFF Research Database (Denmark)

    Maroun, L.L.; Graem, N.; Skibsted, L.

    2008-01-01

    Two early-2nd-trimester fetuses were aborted as a result of nuchal edema and suspected severe heart malformation. At autopsy one fetus demonstrated nuchal edema, mild hydronephrosis, and cor triatriatum dexter associated with ventricular septal defect and tubular hypoplasia of the aortic arch....... The other fetus demonstrated severe nuchal edema, and cor triatriatum dexter was the only malformation. Cor triatriatum dexter is a rare cardiac malformation characterized by division of the right atrium into 2 compartments by a usually fenestrated membrane representing remnants of the right valve...

  9. Prospective audit of a one-centre combined nuchal translucency and triple test programme for the detection of trisomy 21.

    Science.gov (United States)

    Babbur, Vijayalakshmi; Lees, Christoph C; Goodburn, Sandra F; Morris, Nigel; Breeze, Andrew C G; Hackett, Gerald A

    2005-06-01

    To determine detection and false-positive rates for trisomy 21 using two-stage combined nuchal translucency (NT) and triple testing, whilst disclosing abnormal nuchal measurements at the scan. A prospective audit in a UK women's hospital, of 3188 women with singleton pregnancies, requesting screening for trisomy 21. Median age was 37 years (range 19-46). Women were offered NT screening at 11 to 14 weeks. Those with NT > or =3 mm were offered chorionic villus sampling. Those declining CVS, and those with NT risk of trisomy 21 > or = 1:250, based on age, NT, and triple test results were offered amniocentesis. Using a 3-mm NT 'cut-off' identified 16/25 cases of trisomy 21 (64%; 95% CI 38.8, 78.9). Of 2725 women who had a combined nuchal plus triple test assessment, 79 (2.6%) had a > or = 1:250 term risk of trisomy 21. Forty (1.3%) had amniocentesis identifying 6/9 remaining cases (67%:95% CI:27.9, 92.5). Overall, the detection rate was 88% (95% CI:68.8, 97.5) for a 4.8% FPR. For the screened population, to achieve an 88% detection rate using the triple test alone, the predicted FPR would be 20%. Conversely, for an FPR of 4.8% using the triple test alone, the detection rate would be only 60%. In a high-risk group, the combination of NT with triple test offers detection of trisomy 21 at least equivalent to either test, while allowing disclosure of an abnormal NT at the scan and reducing the FPR. Importantly, the FPR is less than 5%, considerably lower than expected for triple test alone for this population.

  10. Molecular genetic characterization of a prenatally detected de novo interstitial deletion of chromosome 2q (2q31.1-q32.1 encompassing HOXD13, ZNF385B and ZNF804A associated with syndactyly and increased first-trimester nuchal translucency

    Directory of Open Access Journals (Sweden)

    Chih-Ping Chen

    2017-06-01

    Conclusion: Fetuses with an interstitial deletion of 2q31.1-q32.1 may be associated with increased first-trimester NT. Haploinsufficiency of HOXD13 is associated with syndactyly. Genomic microarray is useful in detecting subtle chromosomal abnormalities in fetuses with increased NT and normal karyotype.

  11. Brain stem/brain stem occipital bone ratio and the four-line view in nuchal translucency images of fetuses with open spina bifida.

    Science.gov (United States)

    Iuculano, Ambra; Zoppi, Maria Angelica; Piras, Alessandra; Arras, Maurizio; Monni, Giovanni

    2014-09-10

    Abstract Objective: Brain stem depth/brain stem occipital bone distance (BS/BSOB ratio) and the four-line view, in images obtained for nuchal translucency (NT) screening in fetuses with open spina bifida (OSB). Methods: Single center, retrospective study based on the assessment of NT screening images of fetuses with OSB. A ratio between the BS depth and the BSOB distance was calculated (BS/BSOB ratio) and the four-line view observed, and the sensitivity for a BS/BSOB ratio superior/equal to 1, and for the lack of detection of the four-line view were calculated. Results: There were 17 cases of prenatal diagnosis OSB. In six cases, the suspicion on OSB was raised during NT screening, in six cases, the diagnosis was made before 20 weeks and in five cases during anomaly scan. The BS/BSOB ratio was superior/equal to 1 in all 17 cases, and three lines, were visualized in 15/17 images of the OSB cases, being the sensitivity 100% (95% CI, 81 to 100%) and 88% (95% CI, 65 to 96%). Conclusion: Assessment of BS/BSOB ratio and four-line view in NT images is feasible detecting affected by OSB with high sensitivity. The presence of associated anomalies or of an enlarged NT enhances the early detection.

  12. First-trimester combined screening for Down syndrome

    DEFF Research Database (Denmark)

    Pihl, Kasper; Sørensen, Tina Lindvig; Nørgaard Pedersen, Bent

    2008-01-01

    OBJECTIVE: To establish the relationship between the first-trimester screening markers [pregnancy-associated plasma protein A (PAPP-A), free human chorionic gonadotrophin-beta (beta-hCG), nuchal translucency (NT)], the Down syndrome (DS) risk estimate, and the adverse outcomes such as low birth w...

  13. Anomalias e prognóstico fetal associados à translucência nucal aumentada e cariótipo anormal Fetal abnormalities and prognosis associated with increased nuchal translucency and abnormal karyotype

    Directory of Open Access Journals (Sweden)

    Fátima Aparecida Targino Saldanha

    2009-01-01

    Full Text Available OBJETIVO: Descrever a frequência de anomalias cromossômicas em fetos com translucência nucal (TN aumentada, e a frequência de malformações estruturais, a evolução e o resultado da gestação nos fetos com TN aumentada e cariótipo anormal. MÉTODOS: Estudo retrospectivo envolvendo 246 casos com medida da TN acima do percentil 95º para a idade gestacional, com cariótipo fetal conhecido ou avaliação clínica das crianças no período pós-natal. Os casos foram acompanhados no setor de Medicina Fetal do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. RESULTADOS: O resultado do cariótipo fetal esteve alterado em 14,2% dos casos. O acompanhamento dessas gestações revelou anormalidade estruturais em 80,8% dos fetos, sendo as anormalidades cardíacas as mais comuns (61,5%. Resultados gestacionais adversos, como abortamento, óbitos intraútero e neonatal ocorreram em 76,5% dos fetos. CONCLUSÃO: Translucência nucal aumentada, entre 11 - 13 semanas e 6 dias, é importante marcador de anomalias cromossômicas fetais e malformações estruturais fetais, principalmente cardíacas. Diante deste achado, há aumento do risco de abortamento, óbito intrauterino e neonatal para estas gestações.OBJECTIVES: This study aimed to evaluate the incidence of chromosomal abnormalities in fetuses with increased nuchal translucency (NT measurement. Incidence of structural abnormalities and pregnancy outcome was also described in fetuses with increased NT and abnormal karyotype. METHODS: This was a retrospective study involving 246 fetuses with increased NT and known karyotype followed at the Fetal Medicine Unit, Hospital das Clínicas, São Paulo University Medical School. RESULTS: Fetal karyotype was abnormal in 14.2% of the cases. Ultrasound anomaly scan and specialized echocardiographic studies in these cases showed fetal structural abnormalities in 80.8% and cardiac defects were found in 61.5% of the fetuses. Pregnancy

  14. First-trimester risk calculation for trisomy 13, 18, and 21: comparison of the screening efficiency between 2 locally developed programs and commercial software

    DEFF Research Database (Denmark)

    Sørensen, Steen; Momsen, Günther; Sundberg, Karin

    2011-01-01

    Reliable individual risk calculation for trisomy (T) 13, 18, and 21 in first-trimester screening depends on good estimates of the medians for fetal nuchal translucency thickness (NT), free β-subunit of human chorionic gonadotropin (hCGβ), and pregnancy-associated plasma protein-A (PAPP-A) in mate......Reliable individual risk calculation for trisomy (T) 13, 18, and 21 in first-trimester screening depends on good estimates of the medians for fetal nuchal translucency thickness (NT), free β-subunit of human chorionic gonadotropin (hCGβ), and pregnancy-associated plasma protein-A (PAPP...

  15. First-trimester screening markers are altered in pregnancies conceived after IVF/ICSI

    DEFF Research Database (Denmark)

    Gjerris, A C; Loft, A; Pinborg, A

    2009-01-01

    .0%). CONCLUSIONS: It seems advisable to use a population of IVF/ICSI pregnancies to establish median curves for the first-trimester serum screening parameters and perhaps also for nuchal translucency thickness. However, care must be taken, as different ART treatment methods and aspects of medical history seem...

  16. Gender impact on first trimester markers in Down syndrome screening

    DEFF Research Database (Denmark)

    Larsen, Severin Olesen; Wøjdemann, Karen R; Shalmi, Anne-Cathrine

    2002-01-01

    The influence of fetal gender on the level in the first trimester of the serological markers alpha-fetoprotein (AFP), pregnancy-associated plasma protein-A (PAPP-A) and free beta human chorionic gonadotropin (betahCG) and on nuchal translucency is described for 2637 singleton pregnancies with nor......The influence of fetal gender on the level in the first trimester of the serological markers alpha-fetoprotein (AFP), pregnancy-associated plasma protein-A (PAPP-A) and free beta human chorionic gonadotropin (betahCG) and on nuchal translucency is described for 2637 singleton pregnancies...... with normal outcome. Mean log MoM values for pregnancies with female and male fetuses were calculated using regression of log marker values on gestational age expressed as crown rump length and on maternal weight. A pronounced gender impact was found for free betahCG, being 16% higher for female than for male...

  17. A comparison of the impact of screen-positive results obtained from ultrasound and biochemical screening for Down syndrome in the first trimester : a pilot study

    NARCIS (Netherlands)

    Weinans, M.J.; Kooij, L.; Muller, M.A.; Bilardo, K.M.; van Lith, J.M.; Tymstra, T.

    2004-01-01

    OBJECTIVE: To compare the experiences of women who received a screen-positive test result for Down syndrome after nuchal translucency screening or after biochemical screening in the first trimester of pregnancy in the Netherlands. METHOD: Semi-quantitative questionnaires were sent to 40 women with a

  18. A prospective study evaluating the performance of first trimester combined screening for trisomy 21 using repeated sampling of the maternal serum markers PAPP-A and free β-hCG

    DEFF Research Database (Denmark)

    Ekelund, Charlotte Kvist; Wright, Dave; Ball, Susan

    2012-01-01

    OBJECTIVE: To prospectively evaluate the performance of first-trimester combined screening for trisomy 21 using the biochemical markers pregnancy-associated plasma protein-A (PAPP-A) and free beta-human chorionic gonadotropin (free β-hCG) obtained before and at the time of the nuchal translucency...

  19. Combined first- and second-trimester screening for Down syndrome

    DEFF Research Database (Denmark)

    Rode, Line; Wøjdemann, Karen R; Shalmi, Anne-Cathrine

    2003-01-01

    and their correlations, derived from our normal material and Down syndrome cases from the literature. RESULTS: Using a fixed screen-positive rate (SPR) of 5%, the first-trimester combined test [nuchal translucency (NT), PAPP-A and free beta-hCG] yielded a detection rate (DR) of 76%, and the integrated test (NT, PAPP......%. CONCLUSION: These results suggest that proMBP may be an important new marker in Down syndrome screening and, in particular, a good substitute for inhibin A....

  20. First-trimester screening for chromosomal abnormalities: advantages of an instant results approach.

    Science.gov (United States)

    Norton, Mary E

    2010-09-01

    Protocols that include first trimester screening for fetal chromosome abnormalities have become standard of care throughout the United States. Earlier screening allows for first trimester diagnostic testing in cases found to be at increased risk. However, first trimester screening requires coordination of the nuchal translucency ultrasound screening (NT) and biochemical screening, during early, specific, narrow, but slightly different gestational age ranges. Instant results can often be provided at the time of the NT ultrasound if preceded by the programs that perform the biochemical analyses; this optimizes the benefits of the first trimester approach while improving efficiency and communication with the patient. This article discusses the benefits and logistics of such an approach. Copyright 2010 Elsevier Inc. All rights reserved.

  1. Sonographic detection of open spina bifida in the first trimester: review of the literature.

    Science.gov (United States)

    Meller, César; Aiello, Horacio; Otaño, Lucas

    2017-07-01

    In the beginnings, sonographic diagnosis of open spina bifida (OSB) relied on the meticulous scanning of the fetal vertebrae for abnormalities but many defects were missed. After the mid-1980s, however, with the description of the intracranial findings in the second trimester (the "lemon sign" and the "banana sign"), the prenatal diagnosis of OSB was enhanced. In the last 2 decades, there has been widespread uptake of routine ultrasound examination in the first trimester of pregnancy with the purpose of the measurement of fetal crown-rump length to determine gestational age, to screen for trisomy 21 and other aneuploidies, mainly with the nuchal translucency, and for diagnosis of many major abnormalities. Many papers were published focusing on early diagnosis of myelomeningocele (MMC), and the objective of this review is to summarize the different techniques described regarding prenatal diagnosis of OSB in the first trimester of pregnancy.

  2. A re-assessment of biochemical marker distributions in T21 affected and unaffected twin pregnancies in the first trimester

    DEFF Research Database (Denmark)

    Madsen, Helen Nordahl; Ball, Susan; Wright, Dave

    2011-01-01

    OBJECTIVE: To estimate the difference between levels of the two biochemical markers pregnancy-associated plasma protein-A (PAPP-A) and maternal serum free β-human chorionic gonadotropin (free β-hCG) in twin pregnancies relative to singleton pregnancies and establish an improved screening procedure...... of the biochemical markers were calculated. Detection rates and false-positive rates were estimated for screening tests incorporating nuchal translucency and maternal age, with and without biochemistry. RESULTS: Medians for the two biochemical markers for monochorionic and dichorionic twins in unaffected pregnancies......-trimester screening for chromosomal abnormalities in twins to a level comparable with that in singleton pregnancies....

  3. Is MSAFP still a useful test for detecting open neural tube defects and ventral wall defects in the era of first-trimester and early second-trimester fetal anatomical ultrasounds?

    Science.gov (United States)

    Roman, Ashley S; Gupta, Simi; Fox, Nathan S; Saltzman, Daniel; Klauser, Chad K; Rebarber, Andrei

    2015-01-01

    To evaluate whether maternal serum α-fetoprotein (MSAFP) improves the detection rate for open neural tube defects (ONTDs) and ventral wall defects (VWD) in patients undergoing first-trimester and early second-trimester fetal anatomical survey. A cohort of women undergoing screening between 2005 and 2012 was identified. All patients were offered an ultrasound at between 11 weeks and 13 weeks and 6 days of gestational age for nuchal translucency/fetal anatomy followed by an early second-trimester ultrasound at between 15 weeks and 17 weeks and 6 days of gestational age for fetal anatomy and MSAFP screening. All cases of ONTD and VWD were identified via query of billing and reporting software. Sensitivity and specificity for detection of ONTD/VWD were calculated, and groups were compared using the Fisher exact test, with p met the criteria for inclusion. Overall, 15 cases of ONTD and 17 cases of VWD were identified; 100% of cases were diagnosed by ultrasound prior to 18 weeks' gestation; none were diagnosed via MSAFP screening (p < 0.001). First-trimester and early second-trimester ultrasound had 100% sensitivity and 100% specificity for diagnosing ONTD/VWD. Ultrasound for fetal anatomy during the first and early second trimester detected 100% of ONTD/VWD in our population. MSAFP is not useful as a screening tool for ONTD and VWD in the setting of this ultrasound screening protocol. © 2014 S. Karger AG, Basel.

  4. Sirenomelia with oligodactylia: early ultrasonographic and hysteroscopic embryoscopic diagnosis during the first trimester of gestation.

    Science.gov (United States)

    Clemente, Claudia Maria; Farina, Marco; Cianci, Antonio; Iraci Sareri, Marco

    2010-01-01

    The case we describe reports the early sonographic findings of sirenomelia with oligodactylia at 9 weeks of gestation by transvaginal two-dimensional color Doppler ultrasonography imaging and its confirmation by hysteroscopic embryoscopy at 12 weeks to further characterize the findings. The embryo showed increased nuchal translucency and fused lower limbs with a large intra-abdominal vessel and two-vessel umbilical cords. The pregnancy was terminated by medical abortion induction after the patient viewed the embryoscopic images. Diagnosis is commonly made later in the second trimester of pregnancy, oligohydramnios being a warning signal, which usually makes the diagnosis difficult. Survival, only possible in the absence of renal agenesis, is extremely rare. In view of the extremely poor prognosis, early diagnosis allows for earlier counseling and less traumatic therapeutic termination of pregnancy. Copyright 2010 S. Karger AG, Basel.

  5. The Importance of a Late First Trimester Placental Sonogram in Patients at Risk of Abnormal Placentation

    Directory of Open Access Journals (Sweden)

    Felipe Moretti

    2014-01-01

    Full Text Available Background. Placenta accreta is a potentially life-threatening obstetrical condition and is responsible for many emergency Caesarean hysterectomies. Early prenatal diagnosis may help minimize maternal morbidity and mortality. This report highlights risk factors, early diagnostic findings and complications associated with placenta accreta, and the role of first trimester sonography in diagnosis. Case. A 38-year-old pregnant woman, G2P1L1 with history of one previous Caesarean section, presented with vaginal bleeding at 13 weeks’ gestation. Ultrasound examination was highly suspicious of placenta previa with accreta. During an earlier 12-week scan for nuchal translucency measurement, the placenta was suboptimally visualized. She was counselled regarding potential maternal and fetal complications as well as management options. At 33 weeks’ gestation Caesarean hysterectomy was performed due to vaginal bleeding. Conclusion. Early ultrasound screening in high-risk patients may be advantageous in order to identify placenta accreta and conduct appropriate patient counseling regarding risks and management options.

  6. Technical standards and guidelines: prenatal screening for Down syndrome that includes first-trimester biochemistry and/or ultrasound measurements.

    Science.gov (United States)

    Palomaki, Glenn E; Lee, Jo Ellen S; Canick, Jacob A; McDowell, Geraldine A; Donnenfeld, Alan E

    2009-09-01

    This statement is intended to augment the current general ACMG Standards and Guidelines for Clinical Genetics Laboratories and to address guidelines specific to first-trimester screening for Down syndrome. The aim is to provide the laboratory the necessary information to ensure accurate and reliable Down syndrome screening results given a screening protocol (e.g., combined first trimester and integrated testing). Information about various test combinations and their expected performance are provided, but other issues such as availability of reagents, patient interest in early test results, access to open neural tube defect screening, and availability of chorionic villus sampling are all contextual factors in deciding which screening protocol(s) will be selected by individual health care providers. Individual laboratories are responsible for meeting the quality assurance standards described by the Clinical Laboratory Improvement Act, the College of American Pathologists, and other regulatory agencies, with respect to appropriate sample documentation, assay validation, general proficiency, and quality control measures. These guidelines address first-trimester screening that includes ultrasound measurement and interpretation of nuchal translucency thickness and protocols that combine markers from both the first and second trimesters. Laboratories can use their professional judgment to make modification or additions.

  7. Improved detection rate of structural abnormalities in the first trimester using an extended examination protocol.

    Science.gov (United States)

    Iliescu, D; Tudorache, S; Comanescu, A; Antsaklis, P; Cotarcea, S; Novac, L; Cernea, N; Antsaklis, A

    2013-09-01

    To assess the potential of first-trimester sonography in the detection of fetal abnormalities using an extended protocol that is achievable with reasonable resources of time, personnel and ultrasound equipment. This was a prospective two-center 2-year study of 5472 consecutive unselected pregnant women examined at 12 to 13 + 6 gestational weeks. Women were examined using an extended morphogenetic ultrasound protocol that, in addition to the basic evaluation, involved a color Doppler cardiac sweep and identification of early contingent markers for major abnormalities. The prevalence of lethal and severe malformations was 1.39%. The first-trimester scan identified 40.6% of the cases detected overall and 76.3% of major structural defects. The first-trimester detection rate (DR) for major congenital heart disease (either isolated or associated with extracardiac abnormalities) was 90% and that for major central nervous system anomalies was 69.5%. In fetuses with increased nuchal translucency (NT), the first-trimester DR for major anomalies was 96%, and in fetuses with normal NT it was 66.7%. Most (67.1%) cases with major abnormalities presented with normal NT. A detailed first-trimester anomaly scan using an extended protocol is an efficient screening method to detect major fetal structural abnormalities in low-risk pregnancies. It is feasible at 12 to 13 + 6 weeks with ultrasound equipment and personnel already used for routine first-trimester screening. Rate of detection of severe malformations is greater in early- than in mid-pregnancy and on postnatal evaluation. Early heart investigation could be improved by an extended protocol involving use of color Doppler. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.

  8. [First trimester screening for Down syndrome at Prima facie. A 6-year survey].

    Science.gov (United States)

    Roth, P; Bernard, J-P; Meyer, V; Beaujard, M-P; Salomon, L-J; Ville, Y

    2016-02-01

    To evaluate the results of screening for trisomy 21 by the combined risk of first trimester (as defined by the decree of June 23, 2009) in the Prima facie structure. Single center study involving all patients that were seen for first trimester screening at Prima facie with singleton living pregnancy, not obtained by embryo donation, between 1 January 2009 and 31 December 2014. Eighteen thousand two hundred and fifty-one patients were included, of which underwent screening for trisomy 21 by the combined risk. One thousand and forty-six (6.1%) had a calculated risk higher than 1/250. Seventy-five were affected by trisomy 21, of whom 65 in the high risk group. The sensitivity and specificity of screening are 86.7% and 94.4%. The median nuchal translucency was 0.98 MoM. Screening for trisomy 21 by calculating the combined risk of first trimester enabled to detect 86.7% of trisomy 21 with a false positive rate of 5.6%. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  9. Advances in prenatal screening for Down syndrome: II first trimester testing, integrated testing, and future directions.

    Science.gov (United States)

    Benn, Peter A

    2002-10-01

    The acceptability of prenatal screening and diagnosis of Down syndrome is dependent, in part, on the gestational age at which the testing is offered. First trimester screening could be advantageous if it has sufficient efficacy and can be effectively delivered. Two first trimester maternal serum screening markers, pregnancy-associated plasma protein-A (PAPP-A) and free beta-human chorionic gonadotropin (beta-hCG), are useful for identifying women at increased risk for fetal Down syndrome. In addition, measurement of an enlarged thickness of the subcutaneous fluid-filled space at the back of the neck of the developing fetus (referred to as nuchal translucency or NT) has been demonstrated to be an indicator for these high-risk pregnancies. When these three parameters are combined, estimates for Down syndrome efficacy exceed those currently attainable in the second trimester. Women who are screen-positive in the first trimester can elect to receive cytogenetic testing of a chorionic villus biopsy. The first trimester tests could also, theoretically, be combined with the second trimester maternal serum screening tests (integrated screening) to obtain even higher levels of efficacy. There are, however, several practical limitations to first trimester and integrated screening. These include scheduling of testing within relatively narrow gestational age intervals, availability of appropriately trained ultrasonographers for NT measurement, risks associated with chorionic villus biopsy, and costs. There is also increasing evidence that an enlarged NT measurement is indicative of a high risk for spontaneous abortion and for fetal abnormalities that are not detectable by cytogenetic analysis. Women whose fetuses show enlarged NT, therefore, need first trimester counseling regarding their Down syndrome risks and the possibility of other adverse pregnancy outcomes. Follow-up ultrasound and fetal echocardiography in the second trimester are also indicated. First trimester

  10. An economic evaluation of first-trimester genetic sonography for prenatal detection of Down syndrome.

    Science.gov (United States)

    Vintzileos, A M; Ananth, C V; Fisher, A J; Smulian, J C; Day-Salvatore, D; Beazoglou, T

    1998-04-01

    To determine 1) the diagnostic accuracy requirements of first-trimester genetic sonography from the cost-benefit point of view and 2) the economic impact of first-trimester genetic sonography for the United States on the basis of the accuracy of previously published studies. A cost-benefit equation was developed on the basis of the hypothesis that the cost of chorionic villus sampling (CVS) in pregnant women with advanced maternal age (at least 35 years old) should be at least equal to the cost of genetic sonography with CVS used only for those with abnormal ultrasound results. The components of the equation included the diagnostic accuracy of genetic ultrasound (sensitivity and specificity for detecting Down syndrome), the costs of the CVS package and genetic ultrasound, and the lifetime cost of Down syndrome cases. First-trimester genetic sonography was found to be beneficial if the overall sensitivity for detecting Down syndrome was greater than 70%, and even then, the cost-benefit ratio depended on the corresponding false-positive rate. The required minimum ultrasound sensitivity varied according to the maternal age-specific prevalence of Down syndrome and ranged between 40% (for women 35 years old) to 96% (for women 44 years old). Of eight published cohorts using nuchal translucency thickness for genetic sonography, five had accuracies of genetic ultrasound compatible with net benefits. The benefits of first-trimester genetic sonography depend on its diagnostic accuracy. First-trimester genetic sonography has the potential for annual savings of 22 million dollars in the United States.

  11. Variation of Ultrasound Findings in the First Trimester Examination of Recurrent Cases With Trisomy 21

    Science.gov (United States)

    Daniilidis, Aggelos; Balaouras, Dimitrios; Chitzios, Dimitrios; Balaouras, Georgios; Capilna, Mihai; Asimakopoulos, Efstratios

    2015-01-01

    Increased nuchal translucency (NT) is present in about 50% of cases with trisomy 21. Very often the nuchal edema evolves in hydrops fetalis until the second trimester. Furthermore, a small amount of cases with a normal NT and trisomy 21 exhibit anatomical anomalies. We present a case of a 21-year-old woman, nulliparous, with a history of one termination of pregnancy and a smoking quitter. The prenatal control was negative for TORCH. During the first trimester scan on the 13th week, the NT was found 2.7 mm, the ductus venosus Doppler was normal, and the nasal bone was present. Hydrops fetalis was present though, and the parents were advised for chorionic villus sampling (CVS), but they opted for termination of pregnancy. The molecular control by QF-PCR showed normal karyotype for 13 and 18, a male fetus, but non-dysjunction trisomy 21 was present. Parental karyotype was advised, but they refused to perform it. One year later, the couple had another pregnancy. On the 12th week scan, the NT was found 1.0 mm, the ductus venosus Doppler was normal, and the nasal bone was present, but encephalocele was also found, and the parents consented again for termination of pregnancy. The new molecular control showed the same results. This time parental karyotype was performed. The father had a normal one, whereas the mother showed reversed p11 and q13 zones in chromosome 2. Genetical consulting and prenatal cytological control was advised in before next pregnancy. PMID:25883716

  12. Retrospective study evaluating the performance of a first-trimester combined screening for trisomy 21 in an Italian unselected population

    Science.gov (United States)

    Padula, Francesco; Cignini, Pietro; Giannarelli, Diana; Brizzi, Cristiana; Coco, Claudio; D’Emidio, Laura; Giorgio, Elsa; Giorlandino, Maurizio; Mangiafico, Lucia; Mastrandrea, Marialuisa; Milite, Vincenzo; Mobili, Luisa; Nanni, Cinzia; Raffio, Raffaella; Taramanni, Cinzia; Vigna, Roberto; Mesoraca, Alvaro; Bizzoco, Domenico; Gabrielli, Ivan; Di Giacomo, Gianluca; Barone, Maria Antonietta; Cima, Antonella; Giorlandino, Francesca Romana; Emili, Sabrina; Cupellaro, Marina; Giorlandino, Claudio

    2014-01-01

    Objectives to assess the performance of a combined first-trimester screening for trisomy 21 in an unselected Italian population referred to a specialized private center for prenatal medicine. Methods a retrospective validation of first-trimester screening algorithms [risk calculation based on maternal age and nuchal translucency (NT) alone, maternal age and serum parameters (free β-hCG and PAPP-A) alone and a combination of both] for fetal aneuploidies evaluated in an unselected Italian population at Artemisia Fetal-Maternal Medical Centre in Rome. All measurements were performed between 11+0 and 13+6 weeks of gestation, between April 2007 and December 2008. Results of 3,610 single fetuses included in the study, we had a complete follow-up on 2,984. Fourteen of 17 cases of trisomy 21 were detected when a cut-off of 1:300 was applied [detection rate (DR) 82.4%, 95% confidence interval (CI) 64.2–100; false-positive rate (FPR) 4.7%, 95% CI 3.9–5.4; false-negative rate (FNR) 17.6%, 95% CI 0–35.8%]. Conclusion in our study population the detection rate for trisomy 21, using the combined risk calculation based on maternal age, fetal NT, maternal PAPP-A and free β-hCG levels, was superior to the application of either parameter alone. The algorithm has been validated for first trimester screening in the Italian population. PMID:26266002

  13. Critical congenital heart defects and abnormal levels of routinely collected first- and second-trimester biomarkers.

    Science.gov (United States)

    Borelli, Melissa; Baer, Rebecca J; Chambers, Christina D; Smith, Tyler C; Jelliffe-Pawlowski, Laura L

    2017-02-01

    We examined the association between maternal characteristics, routinely collected first- and second-trimester biomarkers and the risk of having an infant with a critical congenital heart defect (CCHD). Included were women who participated in the California Prenatal Screening Program who had nuchal translucency (NT) measurement and first- and second-trimester serum screening. All pregnancies ended in a live birth of an infant without aneuploidy or a neural tube defect. Poisson regression analyses were used to estimate the relative risk and 95% confidence interval of a CCHD by maternal characteristics, first- and second-trimester serum biomarkers or NT measurements. The sample included 118,194 mother-infant pairs; 284 infants had a CCHD. Women with preexisting diabetes were three-times as likely to have an infant with a CCHD. After adjusting for preexisting diabetes, women with first-trimester human chorionic gonatotropin (hCG) measurement <10th centile were 1.6-times as likely to have an infant with a CCHD (P = 0.011). Women with a NT measurement ≥95th centile were at two- to threefold higher risk of having an infant with a CCHD (P's = 0.004-0.007). Pregnancies with two risk factors for an infant with a CCHD were 5.6-times more likely to have an infant with a CCHD than women with no identified risk factors (P < 0.001). Despite the increased risk, performance testing demonstrated low sensitivity and specificity for screening use of these risk factors. Of the women with an infant with a CCHD, only 21.8% had an identified risk factor. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  14. Translucent insulating building envelope

    DEFF Research Database (Denmark)

    Rahbek, Jens Eg

    1997-01-01

    A new type of translucent insulating material has been tested. This material is made of Celulose-Acetat and have a honey-comb structure. The material has a high solar transmittance and is highly insulating. The material is relatively cheap to produce. Danish Title: Translucent isolerende klimaskærm....

  15. Performance of third-trimester ultrasound for prediction of small-for-gestational-age neonates and evaluation of contingency screening policies.

    Science.gov (United States)

    Souka, A P; Papastefanou, I; Pilalis, A; Michalitsi, V; Kassanos, D

    2012-05-01

    To assess the performance of third-trimester fetal biometry and fetal Doppler studies for the prediction of small-for-gestational-age (SGA) neonates, and to explore contingency strategies using a first-trimester prediction model based on maternal and fetal parameters and third-trimester ultrasound. This was an observational cross-sectional study of uncomplicated singleton pregnancies. Risk assessment for chromosomal abnormality was carried out in 4702 pregnancies using a combination of ultrasound markers (fetal nuchal translucency thickness (NT) and nasal bone assessment) and biochemistry (free beta-human chorionic gonadotropin (β-hCG) and pregnancy-associated plasma protein-A (PAPP-A)) at 11 to 13 + 6 weeks. Maternal demographic characteristics and method of conception were recorded. Third-trimester (30-34 weeks) fetal biometry (biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL)) and umbilical artery (UA) and middle cerebral artery Doppler studies were performed routinely in a subgroup (n = 2310). Reference ranges for birth weight were constructed using the cohort of 4702 women, and neonates were classified as small (SGA, ≤ 5th centile) or appropriate (AGA) for gestational age. First-trimester, third-trimester and integrated first- and third-trimester prediction models for SGA were constructed using regression analysis and three different contingency strategies of rescanning in the third trimester were investigated. According to the areas under the receiver-operating characteristics curves (AUCs), AC (AUC = 0.85) and ultrasound-estimated fetal weight (EFW, AUC = 0.87) were equally good predictors of SGA. The model was marginally improved by the addition of UA Doppler, smoking status and first-trimester indices (free β-hCG and PAPP-A multiples of the median) (combined model, AUC = 0.88), but the difference was not statistically significant. A contingency strategy of rescanning 50% of the population in the

  16. First-trimester screening in pregnancies conceived by assisted reproductive technology: significance of gestational dating by oocyte retrieval or sonographic measurement of crown-rump length

    DEFF Research Database (Denmark)

    Gjerris, A.C.; Loft, A.; Pinborg, A.

    2008-01-01

    OBJECTIVES: To evaluate, in pregnancies conceived by assisted reproductive technology, whether determination of gestational age (GA) by date of oocyte aspiration (DOA) or crown-rump length (CRL) at first-trimester screening influences the distribution of serum and sonographic markers or the perfo......OBJECTIVES: To evaluate, in pregnancies conceived by assisted reproductive technology, whether determination of gestational age (GA) by date of oocyte aspiration (DOA) or crown-rump length (CRL) at first-trimester screening influences the distribution of serum and sonographic markers...... or the performance of first-trimester screening for chromosomal abnormalities. METHODS: GA was calculated using either DOA or CRL at blood sampling and nuchal translucency thickness (NT) measurement in 729 singleton pregnancies conceived by in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI......). Weight-corrected log multiples of the median (MoM) marker distributions specific for IVF pregnancy were established using multiple log regression and compared for DOA- and CRL-based GA calculation. RESULTS: GA determined by CRL was significantly larger, albeit slightly, than was GA determined by DOA...

  17. Translucency and Strength of High Translucency Monolithic Zirconium Oxide Materials

    Science.gov (United States)

    2016-05-17

    Zirconium -Oxide Materials presented at/published to the Journal of General Dentistry with MDWI 41-108, and has been assigned local file #16208. 2...Zirconia-Oxide Materials 6. TITLE OF MATERIAL TO BE PUBLISHED OR PRESENTED: Translucency and Strength of High-Translucency Monolithic Zirconium -Oxide...OBSOLETE 48. DATE Page 3 of 3 Pages Translucency and Strength of High-Translucency Monolithic Zirconium -Oxide Materials Abstract Dental materials

  18. Translucency and Strength of High-Translucency Monolithic Zirconium-Oxide Materials

    Science.gov (United States)

    2016-05-12

    Capt Todd D. Church APPROVED: Translucency and Strength of High-Translucency Monolithic Zirconium -Oxide Materials C~t) Kraig/[ Vandewalle Date...copyrighted material in the thesis/dissertation manuscript entitled: "Translucency arid Strength of High-Translucency Monolithic Zirconium -Oxide...Translucency Monolithic Zirconium -Oxide Materials Abstract Dental materials manufacturers have developed more translucent monolithic zirconium oxide

  19. The prognostic value of the nuchal cord prenatal diagnosis

    African Journals Online (AJOL)

    2009-08-28

    Aug 28, 2009 ... Andres RL, Lewandowski MS, Peltier MR. Markers of chronic hypoxia in pregnancies complicated by nuchal cord. Am J Obstet Gynecol 2004; 191(6): S134. 14. Peregrine E, O'Brien P, Jauniaux E. Ultrasound detection of nuchal cord prior to labor induction and the risk of Cesarean section. Ultrasound ...

  20. A Case of Enlarged Intracranial Translucency in a Fetus with Blake’s Pouch Cyst

    Directory of Open Access Journals (Sweden)

    Ambra Iuculano

    2014-01-01

    Full Text Available The intracranial translucency (IT is a recently introduced marker of open spina bifida (OSB. In this study, we describe a case of a fetus affected by Blake’s pouch cyst which showed alterations of BS/BSOB ratio at the first trimester screening.

  1. Improved first-trimester Down syndrome screening performance by lowering the false-positive rate: a prospective study of 9941 low-risk women

    DEFF Research Database (Denmark)

    Wøjdemann, K R; Shalmi, A C; Christiansen, M

    2005-01-01

    OBJECTIVE: To determine the performance of screening for Down syndrome (DS) and other major chromosomal abnormalities using nuchal translucency (NT), free beta-human chorionic gonadotropin (beta-hCG) and pregnancy-associated plasma protein-A (PAPP-A) in a prospective study of a non...

  2. Diprosopus associated with neural tube defect and facial cleft in the first trimester.

    Science.gov (United States)

    Bulbul, Y; Drummond, C L; Hillion, Y; Bidat, L; Ville, Y

    2004-01-01

    We report a case of diprosopus presenting with increased nuchal translucency of 5.3 mm at 14 weeks of gestation. Ultrasonographically, the fetus presented with micrognathia, anterior indentation of the cephalic pole, abnormal cerebral hemispheres with a cystic 4th ventricle and angulation of the spine. The fetal karyotype was normal (46,XX). Following termination of pregnancy, postmortem examination established the diagnosis of diprosopus tetraophthalmus with facial cleft of the 2 faces. Copyright 2004 S. Karger AG, Basel

  3. Is there any relationship between low PAPP-A levels and measures of umbilical vein and placental thickness during first trimester of pregnancy?

    Science.gov (United States)

    Uysal, Gulsum; Tutus, Sadan; Cagli, Fulya; Adiguzel, Cevdet

    2017-01-01

    Low pregnancy-associated plasma protein A (PAPP-A) level is associated with adverse perinatal outcomes. The purpose of this study was to evaluate relationship between umbilical cord diameter (UCD), umbilical vein and artery diameters (UVD, UAD), placental thickness, and PAPP-A level at gestational age of between 11 and 14 weeks. UCD, UVD, UAD, and placental thickness of 246 women were assessed during ultrasound examination at between 11 and 14 weeks of gestation, as well as measurement of nuchal translucency (NT) and crown-rump length (CRL). Patients were divided into 2 groups according to PAPP-A percentile. Group 1 comprised 23 patients who had low PAPP-A (0.44 MoM, >10 th percentile. Calipers used for measurement were placed inner edge to inner edge of echogenic boundaries of the vessel. Largest sections of all vessels (UV and both arteries) were evaluated. Thickest part of the placenta was used for placental thickness measurement. Narrow UCD (<4.5±0.6 mm) was associated with low PAPP-A level (p=0.02). There was no significant difference in UVD, UAD, or placental thickness between groups. There was no significant difference in gestational age, CRL, or NT between groups. Fetal birth weight was significantly lower in Group 1 (p=0.03). Closer attention to women with low-risk, healthy pregnancies and low PAPP-A level in first trimester screening results is recommended. They should be routinely screened for background medical risk factors and umbilical cord morphology in first trimester scan.

  4. Basic heart examination: feasibility study of first-trimester systematic simplified fetal echocardiography.

    Science.gov (United States)

    Quarello, E; Lafouge, A; Fries, N; Salomon, L J

    2017-02-01

    First-trimester fetal cardiac screening examinations in low-risk populations should not have to meet the specifications required for high-risk populations. Our aim was to evaluate a simplified fetal echocardiographic ('basic heart') examination for early detection of severe congenital heart defects in a low-risk population. This was a first-trimester national 'flash study', performed over a 2-week period. Each observer was requested to perform simplified echocardiography without modifying the time and methods deemed necessary for the routine first-trimester ultrasound examination, in fetuses with crown-rump length between 45 and 84 mm. This basic heart assessment used targeted cross-sections of the four-chamber view (4CV) and of the three vessels and trachea (3VT) view, using color and/or directional power Doppler. All examinations were then reviewed offline and scored for quality by a qualified expert. Sixty observers performed a total of 597 first-trimester ultrasound examinations, each performing an average of 10 (range, 1-26) procedures. Examinations were conducted transabdominally (79%; 472/597), transvaginally (3%; 17/597) or both (18%; 108/597). In 8% (45/597) of cases, the fetal back was anterior, in 18% (108/597) it was on the left side, in 63% (377/597) it was posterior and in 11% (67/597) it was on the right side. It became clear during scoring by the expert that, unlike the Herman quality score for nuchal translucency measurement, it was difficult to assess the quality of these images without taking into account normality of the heart itself. Analysis of scores showed that the 4CV was obtained successfully and was deemed normal in 86% (512/597) of the patients, in 7% (41/597) it was deemed technically infeasible and in 7% (44/597) it was deemed feasible but atypical, which may have been due to the presence of an abnormality or to poor quality of the image. The 3VT view was obtained successfully and was normal in 79% (472/597) of the patients, in 13

  5. Effect of core/veneer thickness ratio and veneer translucency on absolute and relative translucency of CAD-On restorations

    Directory of Open Access Journals (Sweden)

    Mennatallah Mohie el-Din Wahba, (BDS, MSc

    2017-06-01

    Conclusions: Only veneer translucency had significant effect over contrast ratio values, while on the other hand, absolute translucency values were significantly affected by the core/veneer thickness ratio, veneer translucency and interaction between them. It was clear that absolute translucency measurements showed higher translucency values for the restorations than contrast ratio measurements.

  6. Is Nuchal Cord a Perfect Scapegoat: A Retrospective Analysis from ...

    African Journals Online (AJOL)

    Mubeen

    considered as significant. Results: The nuchal cord group did not have any significant difference in the mode of delivery or fetal .... at risk of umbilical cord compression compensation, are hiccups ... Staying in touch with the journal. 1) Table of ...

  7. Study on the nuchal ligament ossification on lateral cephalometric radiograph

    International Nuclear Information System (INIS)

    An, Chang Hyeon

    2009-01-01

    The purpose of this study was to assess the prevalence and radiographic characteristics of the nuchal ligament ossification on lateral cephalometric radiographs in Koreans. I review and interpreted the lateral cephalometric radiographs from 4,558 patients (1,857 males and 2,701 females, age range from 2 to 79 years) who visited the Kyungpook National University Dental Hospital from January 1, 2008 to February 3, 2009. I grouped the shapes of nuchal ligament ossification as round, rod-like, and segmented shape. And localized the ossification as the involvement of anterior cervical vertebral body. The data were analyzed by using chi-squared test with two-tailed and at a 5% significance level. Among those who showed the nuchal ligament ossification, the mean age of the 143 males was 51.1 and that of the 97 females was 48.0 years. It was not observed completely below teens, and was observed 1% in twenties, 6.1% in thirties, 18.6% in forties, and 26.3% over fifties. It was significantly prevalent in older age group (P<0.01) and in males than females among the same age group (P<0.05). The shapes of nuchal ligament ossification were as follows in order of frequency : rod-like (49.2%), round (30.4%), and segmented (20.4%). The highest involvement of ossification was found at the level of C5 (67.9%), C4 (29.2%), C6 (22.9%), C3 (3.3%), C7 (2.9%), C2 (0.8%), and C1 (0.4%). The nuchal ligament ossifications on lateral cephalometric radiographs were showed as round, rodlike, or segmented shape. The nuchal ligament ossification is often observed after the age of 40 and is observed more frequently in males than females. The highest shape of nuchal ligament ossification was rod-like shape and the highest involvement of cervical spine was C5.

  8. Genetics Home Reference: trisomy 18

    Science.gov (United States)

    ... Hallahan T, Jackson L; First Trimester Maternal Serum Biochemistry and Fetal Nuchal Translucency Screening (BUN) Study Group. ... not be used as a substitute for professional medical care or advice. Users with questions about a ...

  9. Diffuse and goniochromatic reflectance of translucent materials

    Science.gov (United States)

    Chirdon, William M.

    Although the mechanical stability of dental restorations remains a priority, research is currently being pursued to improve the esthetics of restorations. This includes the technology of color matching and the general understanding of the appearance of natural teeth. Before the appearance of natural teeth can be mimicked, it must first be reduced to quantifiable parameters. Teeth and dental restorations typically have their appearance defined by their three-dimensional color, which then becomes the basis for appearance matching. However, standard color measurements cannot account for differences in translucency between materials, while a human observer readily can. Furthermore, teeth are translucent, multi-layered, biological composites that have aligned microstructures. These translucent layers and aligned microstructure make the color dependant upon the observation angle---a property known as goniochromism. This research shows how translucent materials exhibit significant goniochromatic behaviors. Since the translucency typically results in goniochromatic behavior, goniochromatic behavior is thought to be how translucency is perceived, and consequently, how color matching in translucent materials can potentially fail to match the appearance. To better understand the causes of goniochromism, fiber filler alignment, layering, and specularly reflecting backings were investigated as mechanisms of goniochromism. These same three mechanisms are also likely to affect the diffuse reflectance of translucent materials, which were also quantitatively studied. Another particularly odd property of human enamel is its ability to produce multiple-slit, Fraunhofer diffraction patterns, which this work reproduced using aligned, E-glass-fiber composites.

  10. Early Biochemical Screening for Fetal Aneuploidy in the First Trimester

    DEFF Research Database (Denmark)

    Tørring, Niels

    2013-01-01

    Background Screening for fetal trisomy 21 in the first trimester includes analysis of the serological markers pregnancy-associated plasma protein A (PAPP-A) and free beta human choriogonadotropin (free βhCG). With the recent launch of the PAPP-A free βhCG and assays on the Roche Cobas and Elecsys...... assays showed slopes of 0.94 and 0.95 and Pearson’s correlation of r = 0.981 and r = 0.987 respectively. Similar comparison to AutoDELFIA PerkinElmer Perkin gave slopes of 0,83 (free βhCG) and 1.20 (PAPP-A). With a cut off at 1:300 the overall sensitivity of the first trimester screening including nuchal...

  11. Targeted ultrasound examination and DNA testing for Noonan syndrome, in fetuses with increased nuchal translucency and normal karyotype

    NARCIS (Netherlands)

    Bakker, M.; Pajkrt, E.; Mathijssen, I. B.; Bilardo, C. M.

    2011-01-01

    OBJECTIVE: To define sonographic criteria that may improve the prenatal diagnosis of Noonan syndrome by targeted DNA testing. METHODS: We searched our Fetal Medicine Unit records for all cases with a final diagnosis of Noonan syndrome. A literature review was undertaken to identify the sonographic

  12. Targeted ultrasound examination and DNA testing for Noonan syndrome, in fetuses with increased nuchal translucency and normal karyotype

    NARCIS (Netherlands)

    Bakker, Merel; Pajkrt, E.; Mathijssen, I. B.; Bilardo, C. M.

    Objective To define sonographic criteria that may improve the prenatal diagnosis of Noonan syndrome by targeted DNA testing. Methods We searched our Fetal Medicine Unit records for all cases with a final diagnosis of Noonan syndrome. A literature review was undertaken to identify the sonographic

  13. Maternal Smoking, Obesity and Male Fetal Sex Predispose to a Large Nuchal Translucency Thickness in Healthy Fetuses

    DEFF Research Database (Denmark)

    Pedersen, Nina Gros; Rode, L; Ekelund, Christer

    2010-01-01

    to multiples of the median (MoM(NT)) using a previously reported linear regression analysis. Results: The odds ratio (OR) for MoM(NT) >95th centile was 1.5 (95% CI 1.2-1.9) for smokers compared to nonsmokers and 1.4 (95% CI 1.1-1.7) for male fetuses compared to female fetuses. Obese women (BMI >/=30) had...... an increased OR for a large NT of 1.7 (95% CI 1.2-2.6) compared to normal weight women. Obese smokers carrying a male fetus had an OR of 4.2 (95% CI 1.7-10.1) of a MoM(NT) >95th centile compared to normal weight nonsmoking women with a female fetus. The effects of smoking, obesity status and fetal sex were...... independent of each other. Conclusions: Smoking, obesity and male sex are associated to a MoM(NT) >95th centile. This may affect screening performance and entail unnecessary anxiety in these women. Further investigations, including fetuses with adverse outcome, are needed....

  14. Maternal Smoking, Obesity and Male Fetal Sex Predispose to a Large Nuchal Translucency Thickness in Healthy Fetuses

    DEFF Research Database (Denmark)

    Pedersen, Nina Gros; Rode, Line; Ekelund, Christer

    2011-01-01

    to multiples of the median (MoM(NT)) using a previously reported linear regression analysis. Results: The odds ratio (OR) for MoM(NT) >95th centile was 1.5 (95% CI 1.2-1.9) for smokers compared to nonsmokers and 1.4 (95% CI 1.1-1.7) for male fetuses compared to female fetuses. Obese women (BMI >/=30) had...... an increased OR for a large NT of 1.7 (95% CI 1.2-2.6) compared to normal weight women. Obese smokers carrying a male fetus had an OR of 4.2 (95% CI 1.7-10.1) of a MoM(NT) >95th centile compared to normal weight nonsmoking women with a female fetus. The effects of smoking, obesity status and fetal sex were...... independent of each other. Conclusions: Smoking, obesity and male sex are associated to a MoM(NT) >95th centile. This may affect screening performance and entail unnecessary anxiety in these women. Further investigations, including fetuses with adverse outcome, are needed....

  15. PAHs in Translucent Interstellar Clouds

    Science.gov (United States)

    Salama, Farid; Galazutdinov, G.; Krelowski, J.; Biennier, L.; Beletsky, Y.; Song, I.

    2011-05-01

    We discuss the proposal of relating the origin of some of the diffuse interstellar bands (DIBs) to neutral polycyclic aromatic hydrocarbons (PAHs) present in translucent interstellar clouds. The spectra of several cold, isolated gas-phase PAHs have been measured in the laboratory under experimental conditions that mimic the interstellar conditions and are compared with an extensive set of astronomical spectra of reddened, early type stars. This comparison provides - for the first time - accurate upper limits for the abundances of specific PAH molecules along specific lines-of-sight. Something that is not attainable from IR observations alone. The comparison of these unique laboratory data with high resolution, high S/N ratio astronomical observations leads to two major findings: (1) a finding specific to the individual molecules that were probed in this study and, which leads to the clear and unambiguous conclusion that the abundance of these specific neutral PAHs must be very low in the individual translucent interstellar clouds that were probed in this survey (PAH features remain below the level of detection) and, (2) a general finding that neutral PAHs exhibit intrinsic band profiles that are similar to the profile of the narrow DIBs indicating that the carriers of the narrow DIBs must have close molecular structure and characteristics. This study is the first quantitative survey of neutral PAHs in the optical range and it opens the way for unambiguous quantitative searches of PAHs in a variety of interstellar and circumstellar environments. // Reference: F. Salama et al. (2011) ApJ. 728 (1), 154 // Acknowledgements: F.S. acknowledges the support of the NASA's Space Mission Directorate APRA Program. J.K. acknowledges the financial support of the Polish State (grant N203 012 32/1550). The authors are deeply grateful to the ESO archive as well as to the ESO staff members for their active support.

  16. Translucency of dental ceramics with different thicknesses.

    Science.gov (United States)

    Wang, Fu; Takahashi, Hidekazu; Iwasaki, Naohiko

    2013-07-01

    The increased use of esthetic restorations requires an improved understanding of the translucent characteristics of ceramic materials. Ceramic translucency has been considered to be dependent on composition and thickness, but less information is available about the translucent characteristics of these materials, especially at different thicknesses. The purpose of this study was to investigate the relationship between translucency and the thickness of different dental ceramics. Six disk-shaped specimens of 8 glass ceramics (IPS e.max Press HO, MO, LT, HT, IPS e.max CAD LT, MO, AvanteZ Dentin, and Trans) and 5 specimens of 5 zirconia ceramics (Cercon Base, Zenotec Zr Bridge, Lava Standard, Lava Standard FS3, and Lava Plus High Translucency) were prepared following the manufacturers' instructions and ground to a predetermined thickness with a grinding machine. A spectrophotometer was used to measure the translucency parameters (TP) of the glass ceramics, which ranged from 2.0 to 0.6 mm, and of the zirconia ceramics, which ranged from 1.0 to 0.4 mm. The relationship between the thickness and TP of each material was evaluated using a regression analysis (α=.05). The TP values of the glass ceramics ranged from 2.2 to 25.3 and the zirconia ceramics from 5.5 to 15.1. There was an increase in the TP with a decrease in thickness, but the amount of change was material dependent. An exponential relationship with statistical significance (Pceramics and zirconia ceramics. The translucency of dental ceramics was significantly influenced by both material and thickness. The translucency of all materials increased exponentially as the thickness decreased. All of the zirconia ceramics evaluated in the present study showed some degree of translucency, which was less sensitive to thickness compared to that of the glass ceramics. Copyright © 2013 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

  17. Nuchal crest avulsion fracture in 2 horses : a cause of headshaking : clinical communication

    Directory of Open Access Journals (Sweden)

    A. Voigt

    2009-05-01

    Full Text Available The medical records of 2 Thoroughbred horses that developed headshaking after blunt trauma to the occipital region are reviewed. The history, signalment, clinical signs, diagnostic methods, diagnosis and treatment were recorded in each case. Both horses displayed headshaking, while one horse repeatedly lifted its upper lip and pawed excessively at the ground. In both horses, diagnostic imaging of the occipital region revealed avulsion fragments of the nuchal crest and a nuchal desmitis in association with hyperfibrinogenaemia. The presence of an avulsion fragment of the nuchal crest with associated nuchal desmitis should be considered in horses presenting with headshaking and may respond favourably to conservative therapy.

  18. GENERATION OF TRANSLUCENT LANGUAGE BY SUPERIMPOSITION OPERATION

    Directory of Open Access Journals (Sweden)

    C Annal Deva Priya Darshini

    2017-07-01

    Full Text Available We have introduced a new operation called the superimposition operation. The translucent language generated by a given superimposition operation and a language L is the set of words generated by the superimposition of any two words in L. In this paper we study the properties of translucent languages. We also introduce a variant of the operation called Superimposition under control. We examine the properties of languages under this operation

  19. Application of Neural Networks for classification of Patau, Edwards, Down, Turner and Klinefelter Syndrome based on first trimester maternal serum screening data, ultrasonographic findings and patient demographics.

    Science.gov (United States)

    Catic, Aida; Gurbeta, Lejla; Kurtovic-Kozaric, Amina; Mehmedbasic, Senad; Badnjevic, Almir

    2018-02-13

    The usage of Artificial Neural Networks (ANNs) for genome-enabled classifications and establishing genome-phenotype correlations have been investigated more extensively over the past few years. The reason for this is that ANNs are good approximates of complex functions, so classification can be performed without the need for explicitly defined input-output model. This engineering tool can be applied for optimization of existing methods for disease/syndrome classification. Cytogenetic and molecular analyses are the most frequent tests used in prenatal diagnostic for the early detection of Turner, Klinefelter, Patau, Edwards and Down syndrome. These procedures can be lengthy, repetitive; and often employ invasive techniques so a robust automated method for classifying and reporting prenatal diagnostics would greatly help the clinicians with their routine work. The database consisted of data collected from 2500 pregnant woman that came to the Institute of Gynecology, Infertility and Perinatology "Mehmedbasic" for routine antenatal care between January 2000 and December 2016. During first trimester all women were subject to screening test where values of maternal serum pregnancy-associated plasma protein A (PAPP-A) and free beta human chorionic gonadotropin (β-hCG) were measured. Also, fetal nuchal translucency thickness and the presence or absence of the nasal bone was observed using ultrasound. The architectures of linear feedforward and feedback neural networks were investigated for various training data distributions and number of neurons in hidden layer. Feedback neural network architecture out performed feedforward neural network architecture in predictive ability for all five aneuploidy prenatal syndrome classes. Feedforward neural network with 15 neurons in hidden layer achieved classification sensitivity of 92.00%. Classification sensitivity of feedback (Elman's) neural network was 99.00%. Average accuracy of feedforward neural network was 89.6% and for

  20. Antenatal Diagnosis and Management of Nuchal Cystic Hygroma: A ...

    African Journals Online (AJOL)

    the outcomes of such pregnancies. A relatively ... hygroma diagnosed in the second trimester of pregnancy with the aid of ... our service for late threatening abortion at 16 weeks of an ... hydramnios and preeclampsia may complicate conditions.

  1. Effect of accelerated aging on translucency of monolithic zirconia

    Directory of Open Access Journals (Sweden)

    O. Abdelbary

    2016-12-01

    Conclusion: Thickness of zirconia has significant effect on translucency. Aging has significant effect on thinner sections of zirconia. More research is required on zirconia towards making the material more translucent for its potential use as esthetic monolithic restoration.

  2. First-trimester screening for trisomies 18 and 13, triploidy and Turner syndrome by detailed early anomaly scan.

    Science.gov (United States)

    Wagner, P; Sonek, J; Hoopmann, M; Abele, H; Kagan, K O

    2016-10-01

    To examine the performance of first-trimester ultrasound screening for trisomies 18 and 13, triploidy and Turner syndrome based on fetal nuchal translucency thickness (NT), additional fetal ultrasound markers including anatomy of the nasal bone (NB), blood flow across the tricuspid valve (TV) and through the ductus venosus (DV) and a detailed fetal anomaly scan at 11-13 weeks' gestation. This was a retrospective case-matched study involving pregnant women at 11-13 weeks' gestation. The study population consisted of fetuses with trisomy 18, trisomy 13, triploidy or Turner syndrome. For each fetus with an abnormal karyotype, 50 randomly selected euploid fetuses were added to the study population. In all cases, the crown-rump length and NT were measured. In addition NB, TV flow and DV flow were examined. The summed risk for trisomies 21, 18 and 13 was computed based on: first, maternal age (MA); second, MA and fetal NT; third, MA, NT and one of the markers NB, TV flow or DV flow; fourth, MA, NT and all these markers combined; fifth, MA, NT and fetal anomalies; and, finally, MA, NT, all markers and fetal anomalies. The study population consisted of 4550 euploid and 91 aneuploid fetuses. Median NT was 1.8 mm in euploid fetuses and 4.8, 6.8, 1.8 and 10.0 mm in fetuses with trisomy 18, trisomy 13, triploidy and Turner syndrome, respectively. The NB, TV flow and DV flow were abnormal in 48 (1.1%), 34 (0.7%) and 99 (2.2%) euploid fetuses, respectively, and in 42 (46.2%), 31 (34.1%) and 62 (68.1%) aneuploid fetuses, respectively. At least one defect was found in 60 (1.3%) euploid and in 76 (83.5%) aneuploid fetuses. For a false-positive rate of 3%, the detection rate for screening based on MA and fetal NT was 75.8%. It increased to 84.6-86.8% when including one of the additional ultrasound markers and it was 90.1% when all three markers were included. When screening was based on MA, fetal NT and a detailed anomaly scan, the detection rate was 94.5% and increased to 95

  3. Optical dynamic deformation measurements at translucent materials.

    Science.gov (United States)

    Philipp, Katrin; Koukourakis, Nektarios; Kuschmierz, Robert; Leithold, Christoph; Fischer, Andreas; Czarske, Jürgen

    2015-02-15

    Due to their high stiffness-to-weight ratio, glass fiber-reinforced polymers are an attractive material for rotors, e.g., in the aerospace industry. A fundamental understanding of the material behavior requires non-contact, in-situ dynamic deformation measurements. The high surface speeds and particularly the translucence of the material limit the usability of conventional optical measurement techniques. We demonstrate that the laser Doppler distance sensor provides a powerful and reliable tool for monitoring radial expansion at fast rotating translucent materials. We find that backscattering in material volume does not lead to secondary signals as surface scattering results in degradation of the measurement volume inside the translucent medium. This ensures that the acquired signal contains information of the rotor surface only, as long as the sample surface is rough enough. Dynamic deformation measurements of fast-rotating fiber-reinforced polymer composite rotors with surface speeds of more than 300 m/s underline the potential of the laser Doppler sensor.

  4. Relationship between Color and Translucency of Multishaded Dental Composite Resins

    Directory of Open Access Journals (Sweden)

    Homan Naeimi Akbar

    2012-01-01

    Full Text Available The aim of the present study was to compare the translucency of different shades of two highly aesthetic multilayered restorative composite resins. In total nine shades from Esthet.X and ten shades from Filtek Supreme composite resins were chosen. Discs of each shade were prepared (N=3 and light-cured. Total and diffuse transmittance values for each sample were measured. Statistical analysis showed that the opaque dentine shades of both composites were the least translucent and the enamel shades had the highest translucency. There was a significant decrease in translucency from A2 to C2 of regular body shades and also from A4 to C4 of opaque dentine shades of Esthet.X composite resin. Grey enamel shade had a significantly higher diffuse translucency compared to clear and yellow enamel shades. There was a significant decrease in translucency from A2B to D2B and also in diffuse translucency from A4D to C6D shades of Filtek Supreme composite resin. It can be concluded that the color of the composite resins tested in this study had a significant effect on their translucency. Information on the translucency of different shades of composite resins can be very useful for the clinicians in achieving optimal esthetic restorative outcome.

  5. Diagnosis and management of cranial and caudal nuchal bursitis in four horses.

    Science.gov (United States)

    García-López, José M; Jenei, Thomas; Chope, Kate; Bubeck, Kirstin A

    2010-10-01

    4 horses with a history of neck pain, abnormal head carriage, and related inability to perform were examined. Cranial nuchal bursitis was diagnosed in 2 horses, and caudal nuchal bursitis was diagnosed in the other 2. All 4 horses had prominent swelling in the region between the frontal bone and temporal fossa (ie, the poll) and abnormal head carriage. Ultrasonographic examination revealed fluid distention and synovial thickening of the cranial or caudal nuchal bursa in all 4 horses. Ultrasonography-guided aspiration of the affected region was performed successfully in 3 horses. Radiography revealed bony remodeling and mineralization over the dorsal aspect of the atlas in 1 horse and a radiolucency at the axis in another. Nuclear scintigraphy revealed an increase in radioisotope uptake at the level of C2 in 1 horse. Although a septic process was considered among the differential diagnoses in all horses, a septic process could only be confirmed in 1 horse. All horses were refractory to conservative management consisting of intrabursal injection of anti-inflammatory medications. Bursoscopic debridement and lavage of the affected bursae resulted in resolution of the clinical signs in all horses, and they all returned to their intended use. Cranial and caudal nuchal bursitis, of nonseptic or septic origin, should be considered as a differential diagnosis in horses with head and neck pain. Horses undergoing surgical intervention consisting of nuchal bursoscopy have the opportunity to return to their original degree of exercise.

  6. IVF culture medium affects human intrauterine growth as early as the second trimester of pregnancy.

    Science.gov (United States)

    Nelissen, Ewka C M; Van Montfoort, Aafke P A; Smits, Luc J M; Menheere, Paul P C A; Evers, Johannes L H; Coonen, Edith; Derhaag, Josien G; Peeters, Louis L; Coumans, Audrey B; Dumoulin, John C M

    2013-08-01

    When does a difference in human intrauterine growth of singletons conceived after IVF and embryo culture in two different culture media appear? Differences in fetal development after culture of embryos in one of two IVF media were apparent as early as the second trimester of pregnancy. Abnormal fetal growth patterns are a major risk factor for the development of chronic diseases in adult life. Previously, we have shown that the medium used for culturing embryos during the first few days after fertilization significantly affects the birthweight of the resulting human singletons. The exact onset of this growth difference was unknown. In this retrospective cohort study, all 294 singleton live births after fresh embryo transfer in the period July 2003 to December 2006 were included. These embryos originated from IVF treatments that were part of a previously described clinical trial. Embryos were allocated to culture in either Vitrolife or Cook commercially available sequential culture media. We analysed ultrasound examinations at 8 (n = 290), 12 (n = 83) and 20 weeks' (n = 206) gestation and used first-trimester serum markers [pregnancy-associated plasma protein-A (PAPP-A) and free β-hCG]. Differences between study groups were tested by the Student's t-test, χ(2) test or Fisher's exact test, and linear multivariable regression analysis to adjust for possible confounders (for example, parity, gestational age at the time of ultrasound and fetal gender). A total of 294 singleton pregnancies (Vitrolife group nVL = 168, Cook group: nC = 126) from 294 couples were included. At 8 weeks' gestation, there was no difference between crown-rump length-based and ovum retrieval-based gestational age (ΔGA) (nVL = 163, nC = 122, adjusted mean difference, -0.04 days, P = 0.84). A total of 83 women underwent first-trimester screening at 12 weeks' gestation (nVL = 45, nC = 38). ΔGA, nuchal translucency (multiples of median, MoM) and PAPP-A (MoM) did not differ between the study

  7. Human perception of dental porcelain translucency correlated to spectrophotometric measurements.

    Science.gov (United States)

    Liu, Min-Chieh; Aquilino, Steven A; Lund, Peter S; Vargas, Marcos A; Diaz-Arnold, Ana M; Gratton, David G; Qian, Fang

    2010-04-01

    This study evaluated the relationship between instrumental measurements and subjective visual assessment of differences in dental porcelain translucency. Unshaded feldspathic porcelain was used with controlled amounts of tin oxide to create two groups of 12-mm diameter disks with incremental changes in opacity. Contrast ratio (CR = Yb/Yw) was determined with a spectrophotometer, and used as a measure of porcelain translucency (Group A = 0.20 to 0.40; Group B = 0.6-0.8). Within each group, there were 14 specimens with 11 CRs. Three observer groups (first year dental students, residents, faculty with >10 years of shade matching experience) were recruited to assess the translucency between porcelain disks under two lighting conditions (reflected light, transmitted light). Each subject's ability to distinguish between specimens of differing translucency was determined. Descriptive statistics and three-way ANOVA followed by a post-hoc Tukey-Kramer test were used to evaluate the translucency perception threshold (TPT) of subjects (alpha= 0.05). The overall mean TPT (DeltaC) was 0.07, while 50% of the subjects could perceive a 0.06 CR difference between porcelain specimens. Three-way ANOVA revealed a significant difference in translucency perception among the observer groups (p or =10 years) significantly improved the ability to perceive differences in translucency; however, neither the viewing condition nor porcelain opacity affected the perceived translucency threshold.

  8. Trimester in Acquabox

    Directory of Open Access Journals (Sweden)

    Helena Eflerová

    2012-01-01

    Full Text Available Trimester in Acquabox (2010 is a live performance by Czech-British artist Helena Eflerová, which was originally exhibited at the Para Haus exhibition in São Paulo, Brazil. The audience is invited to view a narrative journey representing a metaphor of the foetus' development in the womb, and to share the experience with the performer, exploring an underwater weightless habitat. This collective experience of viewing such an intimate performance proposes questions around the personal experience of early childhood and motherhood. It questions the development of the foetus, its capacity of memory, its happy and traumatic experiences in the womb, and the after-effect on postnatal life. http://podcast.ulcc.ac.uk/accounts/BirkbeckCollege/mamsie/trimester_in_acquabox.mov

  9. Effect of hydrothermal treatment on light transmission of translucent zirconias.

    Science.gov (United States)

    Putra, Armand; Chung, Kwok-Hung; Flinn, Brian D; Kuykendall, Tuesday; Zheng, Cheng; Harada, Kosuke; Raigrodski, Ariel J

    2017-09-01

    Studies of the light transmission of translucent zirconias after hydrothermal treatment are limited. The purpose of this in vitro study was to evaluate the effect of hydrothermal treatment on the light transmission of translucent zirconias for monolithic restorations. Four commercially available zirconia products, BruxZir Anterior Solid Zirconia (BruxAnt, BA), Lava Plus High Translucency (LPHT), Katana Zirconia Super Translucent (KST), and Katana Zirconia Ultra Translucent (KUT) were assessed and 1 type of lithium disilicate, e.max Press LT (LDLT) was used as a control. Plate specimens, 20×20×1 mm (n=80) for the translucency assessment were sectioned from postsintered zirconia bulk materials and ground with a #400-grit diamond wheel and coolant. The specimens were placed under hydrothermal conditions of 134°C at 0.2 MPa (n=5 per group at 0, 5, 50, and 100 hours). Percentage of total transmittance of light (T t %) of each specimen was measured using a spectrophotometer with an integrating sphere. X-ray diffraction analyses were used to measure tetragonal-monoclinic phase transformation. Surfaces were examined by scanning electron microscopy and energy dispersive spectrometry. Data were analyzed using 2-way ANOVA followed by the Tukey test (α=.05). The T t % ranged from 6.5% to 28.3%. Group LDLT obtained significantly higher transmittance than other tested groups, whereas groups KST and KUT had significantly higher T t % than groups BA and LPHT (Phydrothermal treatment for all tested translucent zirconias and a lithium disilicate glass-ceramic control. Hydrothermal treatment had minimal effects on the translucency of translucent zirconias. The tetragonal-monoclinic phase transformation rate of translucent zirconias was found to be low, except in group LPHT. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  10. Multivariate analysis identifies the estradiol level at ovulation triggering as an independent predictor of the first trimester pregnancy-associated plasma protein-A level in IVF/ICSI pregnancies.

    Science.gov (United States)

    Giorgetti, C; Vanden Meerschaut, F; De Roo, C; Saunier, O; Quarello, E; Hairion, D; Penaranda, G; Chabert-Orsini, V; De Sutter, P

    2013-10-01

    Can independent predictors of pregnancy-associated plasma protein-A (PAPP-A) levels be identified in a group of women who conceived following IVF/ICSI? The significantly decreased PAPP-A level in IVF and ICSI pregnancies compared with non-IVF/ICSI pregnancies was correlated strongly with the serum estradiol (E2) level at ovulation triggering. The first trimester prenatal combined screening test for fetal aneuploidies in pregnancies conceived following assisted reproduction techniques (ART) is complicated by an alteration of the maternal biomarkers free β-hCG and PAPP-A, causing a higher false-positive rate compared with pregnancies which are conceived naturally. The use of controlled ovarian stimulation prior to IVF/ICSI is suggested to be the principle reason for these alterations of biomarkers in ART pregnancies. Between January 2010 and December 2011, 1474 women who conceived naturally and 374 women who conceived following IVF (n = 89), ICSI (n = 204) or intrauterine insemination (IUI, n = 81) were included in this retrospective study. Only singleton pregnancies were eligible for this study. For all women, serum analysis was performed in the same clinical laboratory. Measurement of nuchal translucency (NT) thickness was performed by four physicians belonging to the same infertility centre. First-trimester combined screening test of aneuploidy parameters (maternal age, PAPP-A and free β-hCG, NT thickness) were compared between non-ART and ART (IVF, ICSI and IUI) singleton pregnancies. Next, a minimal threshold E2 level at ovulation triggering was suggested for IVF/ICSI pregnancies above which the PAPP-A levels were significantly decreased compared with non-ART pregnancies. Finally, a multivariate analysis was performed to reveal independent predictors of PAPP-A level in IVF/ICSI pregnancies. We showed a decrease of the multiple of the median (MoM) PAPP-A level in IVF and ICSI singleton pregnancies compared with non-ART singleton pregnancies (P IVF and ICSI

  11. Second trimester abortions in India.

    Science.gov (United States)

    Dalvie, Suchitra S

    2008-05-01

    This article gives an overview of what is known about second trimester abortions in India, including the reasons why women seek abortions in the second trimester, the influence of abortion law and policy, surgical and medical methods used, both safe and unsafe, availability of services, requirements for second trimester service delivery, and barriers women experience in accessing second trimester services. Based on personal experiences and personal communications from other doctors since 1993, when I began working as an abortion provider, the practical realities of second trimester abortion and case histories of women seeking second trimester abortion are also described. Recommendations include expanding the cadre of service providers to non-allopathic clinicians and trained nurses, introducing second trimester medical abortion into the public health system, replacing ethacridine lactate with mifepristone-misoprostol, values clarification among providers to challenge stigma and poor treatment of women seeking second trimester abortion, and raising awareness that abortion is legal in the second trimester and is mostly not requested for reasons of sex selection.

  12. The Translucency Effect of Different Colored Resin Cements used ...

    African Journals Online (AJOL)

    2018-01-30

    Jan 30, 2018 ... color of resin cements and zirconia cores on the translucency parameter (TP) of the restoration that ... physical, mechanical, and esthetic properties. One of the ..... Raptis NV, Michalakis KX, Hirayama H. Optical behavior of.

  13. Translucency of Zirconia Ceramics before and after Artificial Aging.

    Science.gov (United States)

    Walczak, Katarzyna; Meißner, Heike; Range, Ursula; Sakkas, Andreas; Boening, Klaus; Wieckiewicz, Mieszko; Konstantinidis, Ioannis

    2018-03-11

    The aging of zirconia ceramics (Y-TZP) is associated with tetragonal to monoclinic phase transformation. This change in microstructure may affect the optical properties of the ceramic. This study examines the effect of aging on the translucency of different zirconia materials. 120 disc-shaped specimens were fabricated from four zirconia materials: Cercon ht white, BruxZir Solid Zirconia, Zenostar T0, Lava Plus (n = 30 per group). Accelerated aging was performed in a steam autoclave (134°C, 0.2 MPa, 5 hours). CIELab coordinates (L*, a*, b*) and luminous reflectance (Y) were measured with a spectrophotometer before and after aging. Contrast ratio (CR) and translucency parameter (TP) were calculated from the L*, a*, b*, and Y tristimulus values. The general linear model (Bonferroni adjusted) was used to compare both parameters before and after aging, as well as between the different zirconia materials (p ≤ 0.05). CR and TP differed significantly before and after aging in all groups tested. Before aging, Zenostar T showed the highest and Lava Plus showed the lowest translucency. After aging, Cercon ht and Zenostar T showed the highest and BruxZir and Lava Plus the lowest translucency. Aging reduced the translucency in all specimens tested. Furthermore, translucency differed between the zirconia brands tested. Nevertheless, the differences were below the detectability threshold of the human eye. The aging process can influence the translucency and thus the esthetic outcome of zirconia restorations; however, the changes in translucency were minimal and probably undetectable by the human eye. © 2018 by the American College of Prosthodontists.

  14. Optical Fibres in the Modeling of Translucent Concrete Blocks

    OpenAIRE

    M.N.V.Padma Bhushan, D.Johnson, Md. Afzal Basheer Pasha And Ms. K. Prasanthi

    2013-01-01

    Translucent concrete is a concrete based material with light-transmissive properties, obtained due to embedded light optical elements like Optical fibers in it. Light is conducted through the stone from one end to the other. This results into a certain light pattern on the other surface, depending on the fibre structure. Optical fibres transmit light so effectively that there is virtually no loss of light conducted through the fibres. Our paper deals with the modelling of such translucent or ...

  15. Prenatal diagnostics in TESA/PESA pregnancies in Denmark 1995-2007: a shift from invasive procedures to nuchal translucency examination

    DEFF Research Database (Denmark)

    Fedder, Jens; Erb, Karin; Humaidan, Peter

    2011-01-01

    Evidently, children born after intracytoplasmic sperm injection (ICSI) are at an increased risk of having sex chromosomal abnormalities. Here we evaluate the change in methods used for prenatal diagnostics in patients having ICSI with epididymal or testicular sperm from the introduction of the pr...

  16. Neuroimaging parameters in early open spina bifida detection. Further benefit in first trimester screening?

    Science.gov (United States)

    Iliescu, D; Comănescu, A; Antsaklis, P; Tudorache, Stefania; Ghiluşi, Mirela; Comănescu, Violeta; Paulescu, Daniela; Ceauşu, Iuliana; Antsaklis, A; Novac, Liliana; Cernea, N

    2011-01-01

    Morphological investigation of the central nervous system (CNS) in fetuses with positive markers for open spina bifida (OSB) detection, visualized by ultrasound during the first trimester of pregnancy. Data from fetuses that underwent routine first trimester ultrasound scan in our center during September 2007-March 2011 and presented abnormal aspects of the fourth ventricle, also referred as intracranial translucency (IT), provided the morphological support to evaluate CNS features. A neuro-histological study of posterior cerebral fossa illustrated anatomical features of the structures involved in the sonographic first trimester detection of neural tube defects. Abnormal IT aspects were found in OSB cases examined in the first trimester, but also in other severe cerebral abnormalities. Brain stem antero-posterior diameter (BS) and brain stem to occipital bone (BSOB) ratio may be more specific for OSB detection. Correlations between histological aspects of posterior brain fossa and ultrasound standard assessment have been made; highlighting the anatomical features involved by the new techniques developed for OSB early detection. Preliminary results show that modern sonographic protocols are capable to detect abnormalities in the morphometry of the posterior brain. First trimester fourth ventricle abnormalities should be followed by careful CNS evaluation because are likely to appear in OSB affected fetuses, but also in other CNS severe anomalies; in such cases, normal BS and BSOB ratio may serve as indirect argument for spine integrity, if specificity is confirmed in large series of fetuses.

  17. Translucent zirconia in the ceramic scenario for monolithic restorations: A flexural strength and translucency comparison test.

    Science.gov (United States)

    Carrabba, Michele; Keeling, Andrew J; Aziz, Aziz; Vichi, Alessandro; Fabian Fonzar, Riccardo; Wood, David; Ferrari, Marco

    2017-05-01

    To compare three different compositions of Yttria-Tetragonal Zirconia Polycrystal (Y-TZP) ceramic and a lithium disilicate ceramic in terms of flexural strength and translucency. Three zirconia materials of different composition and translucency, Aadva ST [ST], Aadva EI [EI] and Aadva NT [NT](GC Tech, Leuven, Belgium) were cut with a slow speed diamond saw into beams and tabs in order to obtain, after sintering, dimensions of 1.2×4.0×15.0mm and 15.0×15.0×1.0mm respectively. Blocks of IPS e.max CAD LT were cut and crystallized in the same shapes and dimensions and used as a reference group [LD]. Beams (n=15) were tested in a universal testing machine for three-point bending strength. Critical fracture load was recorded in N, flexural strength (σ in MPa), Weibull modulus (m) and Weibull characteristic strength (σ 0 in MPa) were then calculated. Tabs (n=10) were measured with a spectrophotometer equipped with an integrating sphere. Contrast Ratios were calculated as CR=Yb/Yw. SEM of thermally etched samples coupled with lineal line analysis (n=6) was used to measure the tested zirconia grain size. Data were statistically analyzed. Differences in translucency, flexural strength and grain size were found to be statistically significant. CR increased and flexural strength decreased in the following order ST(σ 1215±190MPa, CR 0.74±0.01)>EI(σ 983±182MPa, CR 0.69±0.01)>NT(σ 539±66MPa, CR 0.65±0.01)>LD (σ 377±39Mpa, CR 0.56±0.02). The average grain size was different for the three zirconia samples with NT(558±38nm)>ST(445±34nm)>EI(284±11nm). The zirconia composition heavily influenced both the flexural strength and the translucency. Different percentages of Yittria and Alumina result in new materials with intermediate properties in between the conventional zirconia and lithium disilicate. Clinical indications for Zirconia Aadva NT should be limited up to three-unit span bridges. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Fluorescent nanodiamonds embedded in biocompatible translucent shells.

    Science.gov (United States)

    Rehor, Ivan; Slegerova, Jitka; Kucka, Jan; Proks, Vladimir; Petrakova, Vladimira; Adam, Marie-Pierre; Treussart, François; Turner, Stuart; Bals, Sara; Sacha, Pavel; Ledvina, Miroslav; Wen, Amy M; Steinmetz, Nicole F; Cigler, Petr

    2014-03-26

    High pressure high temperature (HPHT) nanodiamonds (NDs) represent extremely promising materials for construction of fluorescent nanoprobes and nanosensors. However, some properties of bare NDs limit their direct use in these applications: they precipitate in biological solutions, only a limited set of bio-orthogonal conjugation techniques is available and the accessible material is greatly polydisperse in shape. In this work, we encapsulate bright 30-nm fluorescent nanodiamonds (FNDs) in 10-20-nm thick translucent (i.e., not altering FND fluorescence) silica shells, yielding monodisperse near-spherical particles of mean diameter 66 nm. High yield modification of the shells with PEG chains stabilizes the particles in ionic solutions, making them applicable in biological environments. We further modify the opposite ends of PEG chains with fluorescent dyes or vectoring peptide using click chemistry. High conversion of this bio-orthogonal coupling yielded circa 2000 dye or peptide molecules on a single FND. We demonstrate the superior properties of these particles by in vitro interaction with human prostate cancer cells: while bare nanodiamonds strongly aggregate in the buffer and adsorb onto the cell membrane, the shell encapsulated NDs do not adsorb nonspecifically and they penetrate inside the cells. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  19. Prenatal 3- and 4-dimensional Ultrasonographic Findings of Giant Fetal Nuchal Hemangioma

    Directory of Open Access Journals (Sweden)

    Jenn-Jhy Tseng

    2007-10-01

    Full Text Available A precise prenatal diagnosis of hemangioma may be uncertain although a variety of the antenatal appearances on 2-dimensional sonography have been reported. A 27-year-old primigravida was referred at 32 weeks of gestation for evaluation of a fetal nuchal mass. Two-dimensional sonography showed an extracranial mixed echogenic mass (65 × 54 × 59 mm occupying the posterior neck. Color Doppler imaging revealed intense hypervascularization. Three-dimensional (3D and 4-dimensional (4D sonography showed that the mass was lobulated, with a lumpy internal structure. Nuchal hemangioma was further confirmed by clinical examination and postnatal magnetic resonance imaging. The tumor began to regress in size when the infant was 7 months old. Prenatal 3D/4D ultrasound techniques could be considered as complementary diagnostic tools for such a tumor. They have the advantages of providing accurate and inexpensive virtual reality images through more realistic interactions with the virtualized in utero condition.

  20. The influence of image setting on intracranial translucency measurement by manual and semi-automated system.

    Science.gov (United States)

    Zhen, Li; Yang, Xin; Ting, Yuen Ha; Chen, Min; Leung, Tak Yeung

    2013-09-01

    To investigate the agreement between manual and semi-automated system and the effect of different image settings on intracranial translucency (IT) measurement. A prospective study was conducted on 55 women carrying singleton pregnancy who attended first trimester Down syndrome screening. IT was measured both manually and by semi-automated system at the same default image setting. The IT measurements were then repeated with the post-processing changes in the image setting one at a time. The difference in IT measurements between the altered and the original images were assessed. Intracranial translucency was successfully measured on 55 images both manually and by semi-automated method. There was strong agreement in IT measurements between the two methods with a mean difference (manual minus semi-automated) of 0.011 mm (95% confidence interval--0.052 mm-0.094 mm). There were statistically significant variations in both manual and semi-automated IT measurement after changing the Gain and the Contrast. The greatest changes occurred when the Contrast was reduced to 1 (IT reduced by 0.591 mm in semi-automated; 0.565 mm in manual), followed by when the Gain was increased to 15 (IT reduced by 0.424 mm in semi-automated; 0.524 mm in manual). The image settings may affect IT identification and measurement. Increased Gain and reduced Contrast are the most influential factors and may cause under-measurement of IT. © 2013 John Wiley & Sons, Ltd.

  1. Toxin ophthalmia caused by nuchal gland secretion of the Taiwan tiger keelback (Rhabdophis tigrinus formosanus

    Directory of Open Access Journals (Sweden)

    Yen-Chia Chen

    2014-10-01

    Full Text Available Rhabdophis tigrinus is a common colubrid snake that can be found in an extensive geographical region in East Asia. It consists of two subspecies: R.t. tigrinus (yamakagashi and R.t. formosanus (Taiwan tiger keelback. R. tigrinus possesses two different sets of poisonous glands: the Duvernoy's glands in the maxilla, and the nuchal glands in the dorsal skin of the neck. We report the first case in current English literature of toxin ophthalmia caused by the nuchal gland secretion of R.t. formosanus. The patient was a 40-year-old man whose right eye was sprayed by the nuchal gland fluid of R.t. formosanus. He presented with symptoms of foreign body sensation, progressive burning pain, and blurred vision. Ophthalmologic examination revealed diffuse superficial punctate keratitis, corneal stromal edema with Descemet folds, and conjunctival congestion. The patient responded well to topical treatment with a corticosteroid, antihistamine, and antibiotic, and had a favorable clinical course and outcome.

  2. Prenatal Care: Second Trimester Visits

    Science.gov (United States)

    ... Pregnancy week by week During the second trimester, prenatal care includes routine lab tests and measurements of your ... too. By Mayo Clinic Staff The goal of prenatal care is to ensure that you and your baby ...

  3. Prenatal Care: Third Trimester Visits

    Science.gov (United States)

    ... Pregnancy week by week During the third trimester, prenatal care might include vaginal exams to check the baby's position. By Mayo Clinic Staff Prenatal care is an important part of a healthy pregnancy, ...

  4. DoubleFace: Adjustable translucent system to improve thermal comfort

    Directory of Open Access Journals (Sweden)

    Michela Turrin

    2014-11-01

    Full Text Available The DoubleFace project aims at developing a new product that passively improves thermal comfort of indoor and semi-indoor spaces by means of lightweight materials for latent heat storage, while simultaneously allowing daylight to pass through as much as possible. Specifically, the project aims at designing and prototyping an adjustable translucent modular system featuring thermal insulation and thermal absorption in a calibrated manner, which is adjustable according to different heat loads during summer- and wintertime. The output consists of a proof of concept, a series of performance simulations and measurement and a prototype of an adjustable thermal mass system based on lightweight and translucent materials: phase-changing materials (PCM for latent heat storage and translucent aerogel particles for thermal insulation.

  5. Novel Translucent and Strong Submicron Alumina Ceramics for Dental Restorations.

    Science.gov (United States)

    Zhao, M; Sun, Y; Zhang, J; Zhang, Y

    2018-03-01

    An ideal ceramic restorative material should possess excellent aesthetic and mechanical properties. We hypothesize that the high translucency and strength of polycrystalline ceramics can be achieved through microstructural tailoring. The aim of this study is to demonstrate the superior optical and mechanical properties of a new class of submicron grain-sized alumina ceramics relative to the current state-of-the-art dental ceramic materials. The translucency, the in-line transmission ( T IT ) in particular, of these submicron alumina ceramics has been examined with the Rayleigh-Gans-Debye light-scattering model. The theoretical predictions related very well with the measured T IT values. The translucency parameter ( TP) and contrast ratio ( CR) of the newly developed aluminas were measured with a reflectance spectrophotometer on a black-and-white background. For comparison, the T IT , TP, and CR values for a variety of dental ceramics, mostly measured in-house but also cited from the literature, were included. The flexural strength of the aluminas was determined with the 4-point bending test. Our findings have shown that for polycrystalline alumina ceramics, an average grain size ceramic and zirconias, including the most translucent cubic-containing zirconias. The strength of these submicron grain-sized aluminas was significantly higher than that of the cubic-containing zirconia (e.g., Zpex Smile) and lithia-based glass-ceramics (e.g., IPS e.max CAD HT). A coarse-grained alumina could also reach a translucency level comparable to that of dental porcelain. However, the relatively low strength of this material has limited its clinical indications to structurally less demanding applications, such as orthodontic brackets. With a combined high strength and translucency, the newly developed submicron grain-sized alumina may be considered a suitable material for dental restorations.

  6. The Gas-Grain Chemistry of Galactic Translucent Clouds

    Science.gov (United States)

    Maffucci, Dominique M.; Herbst, Eric

    2016-01-01

    We employ a combination of traditional and modified rate equation approaches to simulate the time-dependent gas-grain chemistry that pertains to molecular species observed in absorption in Galactic translucent clouds towards Sgr B2(N). We solve the kinetic rate laws over a range of relevant physical conditions (gas and grain temperatures, particle density, visual extinction, cosmic ray ionization rate) characteristic of translucent clouds by implementing a new grid module that allows for parallelization of the astrochemical simulations. Gas-phase and grain-surface synthetic pathways, chemical timescales, and associated physical sensitivities are discussed for selected classes of species including the cyanopolyynes, complex cyanides, and simple aldehydes.

  7. Utilization of waste glass in translucent and photocatalytic concrete

    NARCIS (Netherlands)

    Spiesz, P.; Rouvas, S.; Brouwers, H.J.H.

    2016-01-01

    Abstract This article addresses the development of a translucent and air purifying concrete containing waste glass. The concrete composition was optimized applying the modified Andreasen & Andersen model to obtain a densely packed system of granular ingredients. Both untreated (unwashed) and washed

  8. Interstellar C2, CH, and CN in translucent molecular clouds

    NARCIS (Netherlands)

    Dishoeck, van E.F.; Black, J.H.

    1989-01-01

    Optical absorption-line techniques have been applied to the study of a number of translucent molecular clouds in which the total column densities are large enough that substantial molecular abundances can be maintained. Results are presented for a survey of absorption lines of interstellar C2, CH,

  9. TransCut: interactive rendering of translucent cutouts.

    Science.gov (United States)

    Li, Dongping; Sun, Xin; Ren, Zhong; Lin, Stephen; Tong, Yiying; Guo, Baining; Zhou, Kun

    2013-03-01

    We present TransCut, a technique for interactive rendering of translucent objects undergoing fracturing and cutting operations. As the object is fractured or cut open, the user can directly examine and intuitively understand the complex translucent interior, as well as edit material properties through painting on cross sections and recombining the broken pieces—all with immediate and realistic visual feedback. This new mode of interaction with translucent volumes is made possible with two technical contributions. The first is a novel solver for the diffusion equation (DE) over a tetrahedral mesh that produces high-quality results comparable to the state-of-art finite element method (FEM) of Arbree et al. but at substantially higher speeds. This accuracy and efficiency is obtained by computing the discrete divergences of the diffusion equation and constructing the DE matrix using analytic formulas derived for linear finite elements. The second contribution is a multiresolution algorithm to significantly accelerate our DE solver while adapting to the frequent changes in topological structure of dynamic objects. The entire multiresolution DE solver is highly parallel and easily implemented on the GPU. We believe TransCut provides a novel visual effect for heterogeneous translucent objects undergoing fracturing and cutting operations.

  10. The Translucency Effect of Different Colored Resin Cements used ...

    African Journals Online (AJOL)

    Purpose: The purpose of this study was to evaluate the effect of the different color of resin cements and zirconia cores on the translucency parameter (TP) of the restoration that simulates the implant‑supported fixed prosthesis using titanium base on the bottom. Materials and Methods: Zirconia core plates (Zr‑Zahn) were ...

  11. ATOMIC AND MOLECULAR CARBON AS A TRACER OF TRANSLUCENT CLOUDS

    International Nuclear Information System (INIS)

    Burgh, Eric B.; France, Kevin; Jenkins, Edward B.

    2010-01-01

    Using archival, high-resolution far-ultraviolet Hubble Space Telescope/Space Telescope Imaging Spectrograph spectra of 34 Galactic O and B stars, we measure C I column densities and compare them with measurements from the literature of CO and H 2 with regard to understanding the presence of translucent clouds along the line of sight. We find that the CO/H 2 and CO/C I ratios provide good discriminators for the presence of translucent material, and both increase as a function of molecular fraction, f N = 2N(H 2 )/N(H). We suggest that sightlines with values below CO/H 2 ∼10 -6 and CO/C I ∼1 contain mostly diffuse molecular clouds, while those with values above sample clouds in the transition region between diffuse and dark. These discriminating values are also consistent with the change in slope of the CO versus H 2 correlation near the column density at which CO shielding becomes important, as evidenced by the change in photochemistry regime studied by Sheffer et al. Based on the lack of correlation of the presence of translucent material with traditional measures of extinction, we recommend defining 'translucent clouds' based on the molecular content rather than line-of-sight extinction properties.

  12. First trimester diagnosis of sirenomelia.

    Science.gov (United States)

    Van Keirsbilck, J; Cannie, M; Robrechts, C; de Ravel, T; Dymarkowski, S; Van den Bosch, T; Van Schoubroeck, D

    2006-08-01

    We present a case of sirenomelia diagnosed on a first trimester ultrasound at 10 weeks' gestation and confirmed on 3D-ultrasound and MRI. The pregnancy was terminated at 15 gestational weeks and the post-mortem examination, including RX and microscopy, is presented. The sirenomelia sequence is a rare and lethal anomaly characterized by fusion, rotation, hypotrophy or atrophy of the lower limbs and severe urogenital abnormalities leading to oligohydramnios in the second half of pregnancy. Our case illustrates that the diagnosis of sirenomelia can be reliably made in the first trimester.

  13. Homology of the enigmatic nuchal bone reveals novel reorganization of the shoulder girdle in the evolution of the turtle shell.

    Science.gov (United States)

    Lyson, Tyler R; Bhullar, Bhart-Anjan S; Bever, Gabe S; Joyce, Walter G; de Queiroz, Kevin; Abzhanov, Arhat; Gauthier, Jacques A

    2013-01-01

    The turtle shell represents a unique modification of the ancestral tetrapod body plan. The homologies of its approximately 50 bones have been the subject of debate for more than 200 years. Although most of those homologies are now firmly established, the evolutionary origin of the dorsal median nuchal bone of the carapace remains unresolved. We propose a novel hypothesis in which the nuchal is derived from the paired, laterally positioned cleithra-dorsal elements of the ancestral tetrapod pectoral girdle that are otherwise retained among extant tetrapods only in frogs. This hypothesis is supported by origin of the nuchal as paired, mesenchymal condensations likely derived from the neural crest followed by a unique two-stage pattern of ossification. Further support is drawn from the establishment of the nuchal as part of a highly conserved "muscle scaffold" wherein the cleithrum (and its evolutionary derivatives) serves as the origin of the Musculus trapezius. Identification of the nuchal as fused cleithra is congruent with its general spatial relationships to other elements of the shoulder girdle in the adult morphology of extant turtles, and it is further supported by patterns of connectivity and transformations documented by critical fossils from the turtle stem group. The cleithral derivation of the nuchal implies an anatomical reorganization of the pectoral girdle in which the dermal portion of the girdle was transformed from a continuous lateral-ventral arc into separate dorsal and ventral components. This transformation involved the reduction and eventual loss of the scapular rami of the clavicles along with the dorsal and superficial migration of the cleithra, which then fused with one another and became incorporated into the carapace. © 2013 Wiley Periodicals, Inc.

  14. Translucency changes of direct esthetic restorative materials after curing, aging and treatment

    Directory of Open Access Journals (Sweden)

    Yong-Keun Lee

    2016-11-01

    Full Text Available The purpose of this article was to review the changes in translucency of direct esthetic restorative materials after curing, aging and treatment. As a criterion for the evaluation of clinical translucency changes, visual perceptibility threshold in translucency parameter difference (ΔTP of 2 was used. Translucency changes after curing were perceivable depending on experimental methods and products (largest ΔTP in resin composites = 15.9. Translucency changes after aging were reported as either relatively stable or showed perceivable changes by aging protocols (largest ΔTP in resin composites = -3.8. Translucency changes after curing, aging and treatment were perceivable in several products and experimental methods. Therefore, shade matching of direct esthetic materials should be performed considering these instabilities of translucency in direct esthetic materials.

  15. First Trimester Listeria monocytogenes Septicemia

    NARCIS (Netherlands)

    Goddijn, M.; Schipper, H. G.; Spanjaard, L.; Wolf, H.

    1997-01-01

    Background: Little is known about fetal outcome after Listeria monocytogenes septicemia in the first trimester of pregnancy.Case: A primigravida with L. monocytogenes septicemia at 9 weeks gestation was treated with amoxicillin. At 40 weeks gestation a healthy female infant was born.Conclusion: This

  16. First trimester bleeding and maternal cardiovascular morbidity

    DEFF Research Database (Denmark)

    Lykke, Jacob A; Langhoff-Roos, Jens

    2012-01-01

    First trimester bleeding without miscarriage is a risk factor for complications later in the pregnancy, such as preterm delivery. Also, first trimester miscarriage has been linked to subsequent maternal ischemic heart disease. We investigated the link between maternal cardiovascular disease prior...... to and subsequent to first trimester bleeding without miscarriage....

  17. Bereiding en eigenschappen van translucent gamma-aluminium oxynitride

    NARCIS (Netherlands)

    Willems, H.X.; With, de G.; Metselaar, R.

    1993-01-01

    The phase diagram of the Al2O3-AlN system in the vicinity of the Alon phase field was established, and Alon was found to be unstable below 1640 Deg; below this temp., Alon could be stabilized by adding MgO. Translucent Alons contg. 67.5, 73, and 77.5 mol% Al2O3 were prepd., and a no. of elec.,

  18. Ceramic materials for porcelain veneers: part II. Effect of material, shade, and thickness on translucency.

    Science.gov (United States)

    Barizon, Karine T L; Bergeron, Cathia; Vargas, Marcos A; Qian, Fang; Cobb, Deborah S; Gratton, David G; Geraldeli, Saulo

    2014-10-01

    Information regarding the differences in translucency among new ceramic systems is lacking. The purpose of this study was to compare the relative translucency of the different types of ceramic systems indicated for porcelain veneers and to evaluate the effect of shade and thickness on translucency. Disk specimens 13 mm in diameter and 0.7-mm thick were fabricated for the following 9 materials (n=5): VITA VM9, IPS Empress Esthetic, VITA PM9, Vitablocks Mark II, Kavo Everest G-Blank, IPS Empress CAD, IPS e.max CAD, IPS e.maxPress, and Lava Zirconia. VITA VM9 served as the positive control and Lava as the negative control. The disks were fabricated with the shade that corresponds to A1. For IPS e.maxPress, additional disks were made with different shades (BL2, BL4, A1, B1, O1, O2, V1, V2, V3), thickness (0.3 mm), and translucencies (high translucency, low translucency). Color coordinates (CIE L∗ a∗ b∗) were measured with a tristimulus colorimeter. The translucency parameter was calculated from the color difference of the material on a black versus a white background. One-way ANOVA, the post hoc Tukey honestly significant difference, and the Ryan-Einot-Gabriel-Welsch multiple range tests were used to analyze the data (α=.05). Statistically significant differences in the translucency parameter were found among porcelains (PPM9, Empress Esthetic>Empress CAD>Mark II, Everest, e.max CAD>e.max Press>Lava. Significant differences also were noted when different shades and thickness were compared (Pceramic systems designed for porcelain veneers present varying degrees of translucency. The thickness and shade of lithium disilicate ceramic affect its translucency. Shade affects translucency parameter less than thickness. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  19. Hyperforin accumulates in the translucent glands of Hypericum perforatum

    DEFF Research Database (Denmark)

    Soelberg, Jens; Jørgensen, Lise Bolt; Jäger, Anna K

    2007-01-01

    BACKGROUND AND AIMS: Hypericum perforatum contains the therapeutically important compounds hypericin and hyperforin. Hypericin is known to accumulate in the dark glands. This investigation aimed to determine the accumulation site of hyperforin. METHODS: Dark and translucent glands as well as non......-secretory tissue in leaves were manually isolated under the microscope. Hyperforin content was quantified by UV HPLC. Secretory structures were surveyed anatomically. KEY RESULTS: The hyperforin content of intact leaves was found to be about 3 mg g(-1) fresh tissue, whereas a content of about 7 mg g(-1) fresh...

  20. The Use of Newer High Translucency Zirconia in Aesthetic Zone

    Directory of Open Access Journals (Sweden)

    Zishan Dangra

    2014-01-01

    Full Text Available Loss of anterior tooth causes aesthetic and functional disharmony. Although no restorative material can approach the appearance of intact tooth enamel, glass ceramic, at the increased risk of brittle fracture, can mimic original tooth color better than the other restorative options. The newest zirconia material comes with unparalleled individualization in aesthetics and optimal physical properties. One of the basic principles of tooth preparation is conservation of tooth structure. This clinical report describes the replacement of maxillary and mandibular incisor with latest generation zirconia adhesive fixed partial denture. The authors have achieved unmatched aesthetics with newer high translucency zirconia.

  1. Through the Frosted Glass: Security Problems in a Translucent UI

    OpenAIRE

    Renkema-Padmos, Arne; Baum, Jerome

    2014-01-01

    Translucency is now a common design element in at least one popular mobile operating system. This raises security concerns as it can make it harder for users to correctly identify and interpret trusted interaction elements. In this paper, we demonstrate this security problem using the example of the Safari browser in the latest iOS version on Apple tablets and phones (iOS7), and discuss technical challenges of an attack as well as solutions to these challenges. We conclude with a survey-based...

  2. Modelling RGB colour aspects and translucency of fresh-cut tomatoes

    NARCIS (Netherlands)

    Moreira Lana, M.; Tijskens, L.M.M.; Kooten, van O.

    2006-01-01

    Translucency is one of the major problems in fresh-cut fruit. This phenomenon seriously limits the use of fruit by the fresh-cut industries. Techniques for measuring translucency in this kind of product are not readily available. As a consequence, the processes that are important in the development

  3. Translucent Players: Explaining Cooperative Behavior in Social Dilemmas

    Directory of Open Access Journals (Sweden)

    Valerio Capraro

    2016-06-01

    Full Text Available In the last few decades, numerous experiments have shown that humans do not always behave so as to maximize their material payoff. Cooperative behavior when non-cooperation is a dominant strategy (with respect to the material payoffs is particularly puzzling. Here we propose a novel approach to explain cooperation, assuming what Halpern and Pass call translucent players. Typically, players are assumed to be opaque, in the sense that a deviation by one player in a normal-form game does not affect the strategies used by other players. But a player may believe that if he switches from one strategy to another, the fact that he chooses to switch may be visible to the other players. For example, if he chooses to defect in Prisoner's Dilemma, the other player may sense his guilt. We show that by assuming translucent players, we can recover many of the regularities observed in human behavior in well-studied games such as Prisoner's Dilemma, Traveler's Dilemma, Bertrand Competition, and the Public Goods game.

  4. Regulation of elastin synthesis in developing sheep nuchal ligament by elastin mRNA levels

    International Nuclear Information System (INIS)

    Davidson, J.M.; Smith, K.; Shibahara, S.; Tolstoshev, P.; Crystal, R.G.

    1982-01-01

    Levels of elastin production in explant culture of fetal sheep nuchal ligament and corresponding levels of translatable elastin mRNA were determined in parallel studies during a period of rapid growth of the embryo. The identity of the explant culture and cell-free proucts was confirmed by peptide mapping, immunoprecipitation, and the characteristic lack of histidine and methionine. Elastin production was quantitated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and radioimmune precipitation. The translation products could be labeled with methionine only when NH 2 -terminally donated as f-Met-tRNA/sup Met//sub f/. Explant cultures showed a large rise in elastin production from 70 days after conception to 150 days after conception. Cell free translation of RNA demonstrated a parallel in elastin mRNA levels and in elastin mRNA per cell. It appears, therefore, that the marked emphasis the differentiating muchal ligament places on elastin production is modulated, at least in part, by the quantities of available elastin in mRNA

  5. Diagnosis of sirenomelia in the first trimester.

    Science.gov (United States)

    Singh, Chanchal; Lodha, Pooja; Arora, Deepshikha; Prabhu Sharma, Akshatha; Kaul, Anita

    2014-01-01

    Sirenomelia or "mermaid syndrome" is a rare congenital abnormality with an incidence of 1 in 60,000. We report a case diagnosed in the first trimester using two-dimensional, three-dimensional, and color Doppler ultrasound. With increasing emphasis on early diagnosis of fetal abnormalities, this case highlights the importance of looking for anomalies in the first trimester itself. In fact, the diagnosis of sirenomelia should be easier in the first trimester as severe oligohydramnios in later gestation hampers vision. © 2013 Wiley Periodicals, Inc.

  6. Investigating the real translucency of the endodontic fiber posts

    Science.gov (United States)

    Camilotti, Fernando; Bonardi, Cláudia; Somer, Aloisi; Novatski, Andressa; Szesz, Anna Luiza; Loguércio, Alessandro Dourado; Kniphoff da Cruz, Gerson

    2018-02-01

    Researchers have been investigating the light intensity scattered by a translucent fiber post with application in dentistry by different methods. In this work, we introduce a new system capable to record a light scattered profile, step-by-step, as a function of the length of the translucent fiber post. To support our studies, an extensive characterization of the system was carried out and this is presented and discussed here. The system was implemented using the phase sensitive detection. The equipment measures the light scattered without the need of any preparing parts and the fiber post is fixed directly in the fiber post holder becoming ready for measurement. Measures can be recorded with a spatial resolution smaller than 0.01 mm throughout the length of the fiber post being investigated. The system was implemented by using a photomultiplier tube that improves sensitivity for the optical detection. The recorded result is a signal directly proportional to the scattered light and it allows us to obtain a normalized profile that can be used as a map of the scattered light of the fiber post in study. Furthermore, we are able to demonstrate a low intensity of light in the tip region of the fiber post, along with the dependency of the light attenuation with the fiber post body volume and shape. This new system will certainly contribute to achieve better results in fiber post designing and in restoration of endodontic treated teeth because it provides a more well-founded choice of the fiber post to be used, and of the time of exposure to the curing light.

  7. Investigating the real translucency of the endodontic fiber posts

    Directory of Open Access Journals (Sweden)

    Fernando Camilotti

    2018-02-01

    Full Text Available Researchers have been investigating the light intensity scattered by a translucent fiber post with application in dentistry by different methods. In this work, we introduce a new system capable to record a light scattered profile, step-by-step, as a function of the length of the translucent fiber post. To support our studies, an extensive characterization of the system was carried out and this is presented and discussed here. The system was implemented using the phase sensitive detection. The equipment measures the light scattered without the need of any preparing parts and the fiber post is fixed directly in the fiber post holder becoming ready for measurement. Measures can be recorded with a spatial resolution smaller than 0.01 mm throughout the length of the fiber post being investigated. The system was implemented by using a photomultiplier tube that improves sensitivity for the optical detection. The recorded result is a signal directly proportional to the scattered light and it allows us to obtain a normalized profile that can be used as a map of the scattered light of the fiber post in study. Furthermore, we are able to demonstrate a low intensity of light in the tip region of the fiber post, along with the dependency of the light attenuation with the fiber post body volume and shape. This new system will certainly contribute to achieve better results in fiber post designing and in restoration of endodontic treated teeth because it provides a more well-founded choice of the fiber post to be used, and of the time of exposure to the curing light.

  8. Prenatal care in your second trimester

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000557.htm Prenatal care in your second trimester To use the sharing ... Gregory KD, Ramos DE, Jauniaux ERM. Preconception and prenatal care. In: Gabbe SG, Niebyl JR, Simpson JL, et ...

  9. Prenatal care in your third trimester

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000558.htm Prenatal care in your third trimester To use the sharing ... Gregory KD, Ramos DE, Jauniaux ERM. Preconception and prenatal care. In: Gabbe SG, Niebyl JR, Simpson JL, et ...

  10. Applications of Doppler in the first trimester

    International Nuclear Information System (INIS)

    Taylor, K.J.W.; Ramirez, B.; Grannum, P.

    1986-01-01

    Fifty patients have been studied by duplex Doppler US imaging in the first trimester. In normal gestations, luteal flow, characterized by a low pulsatility index (PI), can be seen in at least one ovary. Failure to detect luteal flow indicates a nonviable pregnancy. Six ectopic pregnancies demonstrated luteal flow and extrauterine heartbeat, detected by Doppler US. High PI values in the uterine artery are seen in the first trimester. Low PI values in the uterine arteries were found in patients with trophoblastic disease

  11. Additive colours approach for dental ceramics translucency characteristics made from Sumatra and Java natural sands

    Science.gov (United States)

    Takarini, V.; Gunawan, J.; Hasratiningsih, Z.; Rudyawan, A.

    2018-04-01

    Translucency is one of dental ceramics desirable aesthetic characteristics, which can be used as an indirect restoration. Dental ceramics can also be made using Computed Aided Design/Computer Aided Manufacturing (CAD/CAM) unit that can create variety blocks as an ingot into a customized restoration. This paper presents the results of self-synthesized porcelain blocks generated from natural sand of Sumatera and Java Islands to promote national independency. This research aims to determine the translucency of dental ceramics made from Indonesia’s natural sand. Six samples each of two different synthesized temperatures, 1150 °C and 1200 °C, were made. To analyse translucency of the sample, their image was taken in bright light background in a black box, then additive green and blue colours histogram channel with range 0 (opaque) to 255 (transparent) were evaluated using Matlab R2015B. The result revealed that mean of green peaks on 1150 °C has an average translucency value of 41%, compared to 34% of blue peaks. Lower percentage of translucency, 31% and 25% on the green and blue channel respectively were attained in samples synthesized in 1200 °C. These suggest that 1150 °C is the optimum temperature for translucency for these ceramic samples from natural sands as they contain leucite crystals shown by the XRD analyses as a result of silica-undersaturated mixture indicated by the Electron Dispersive Spectroscopy. SEM (Scanning Electron Microscope) results show remnant of air pocket in the samples sintered at higher temperature.In conclusion, natural sand from Sumatera and Java can be considered as reliable, cheap basic material options in developing self-synthesized dental ceramics with a desirable translucency. These preliminary results indicate that better balance between strength and translucency could potentially be achieved by making nano-sized dental ceramics.

  12. Blue emission of Eu{sup 2+}-doped translucent alumina

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Yan [Kazuo Inamori School of Engineering, New York State College of Ceramics, Alfred University, Alfred, NY 14802 (United States); Wei, Hua [Scintillation Materials Research Center, University of Tennessee, Knoxville 37996 (United States); Zhang, Lihua; Kisslinger, Kim [Center for Functional Nanomaterials, Brookhaven National Laboratory, Upton, NY 11973-5000 (United States); Melcher, Charles L. [Scintillation Materials Research Center, University of Tennessee, Knoxville 37996 (United States); Wu, Yiquan, E-mail: wuy@alfred.edu [Kazuo Inamori School of Engineering, New York State College of Ceramics, Alfred University, Alfred, NY 14802 (United States)

    2015-12-15

    Inorganic scintillators are very important in medical and industrial measuring systems in the detection and measurement of ionizing radiation. In addition to Ce{sup 3+}, a widely used dopant ion in oxide scintillators, divalent Europium (Eu{sup 2+}) has shown promise as a high-luminescence, fast-response luminescence center useful in the detection of ionizing radiation. In this research, aluminum oxide (Al{sub 2}O{sub 3}) was studied as a host material for the divalent europium ion. Polycrystalline samples of Eu{sup 2+}-doped translucent Al{sub 2}O{sub 3} were fabricated, and room temperature luminescence behavior was observed. Al{sub 2}O{sub 3} ceramics doped with 0.1 at% Eu{sup 2+} were fabricated with a relative density of 99.75% theoretical density and in-line transmittance of 22% at a wavelength of 800 nm. The ceramics were processed by a gel-casting method, followed by sintering under high vacuum. The gelling agent, a copolymer of isobutylene and maleic anhydride, is marketed under the commercial name ISOBAM, and has the advantage of simultaneously acting as both a gelling agent and as a dispersant. The microstructure and composition of the vacuum-sintered Eu{sup 2+}:Al{sub 2}O{sub 3} were characterized by Scanning Electric Microscopy (SEM), Transmission Electron Microscopy (TEM), and Energy-dispersive X-ray spectroscopy (EDS). The phase composition was determined by X-ray diffraction measurements (XRD) combined with Rietveld analysis. The photoluminescence behavior of the Eu{sup 2+}:Al{sub 2}O{sub 3} was characterized using UV light as the excitation source, which emitted blue emission at 440 nm. The radio-luminescence of Eu{sup 2+}:Al{sub 2}O{sub 3} was investigated by illumination with X-ray radiation, showing three emission bands at 376 nm, 575 nm and 698 nm. Multiple level traps at different depths were detected in the Eu{sup 2+}:Al{sub 2}O{sub 3} by employing thermoluminescence measurements. - Highlights: • Eu{sup 2+} : Al{sub 2}O{sub 3} was

  13. Nuchal Skinfold Thickness: A Novel Parameter for Assessment of Body Composition in Childhood Craniopharyngioma

    Science.gov (United States)

    Sterkenburg, Anthe S.; Hoffmann, Anika; Reichel, Julia; Lohle, Kristin; Eveslage, Maria; Warmuth-Metz, Monika

    2016-01-01

    Context: Hypothalamic obesity, cardiovascular disease (CVD), and relapse/progression have a major impact on prognosis in childhood-onset craniopharyngioma (CP). We analyzed nuchal skinfold thickness (NST) on magnetic resonance imaging performed for follow-up monitoring as a novel parameter for body composition (BC) and CVD in CP. Objective: The objective of the study was to identify the association of NST with body mass index (BMI), waist to height ratio (WHtR), functional capacity, and blood pressure (BP) in CP and controls. Design: This was a cross-sectional and longitudinal prospective study in CP patients. Setting: The study was conducted at HIT-Endo, KRANIOPHARYNGEOM 2000/2007. Patients: Participants included 94 CP patients and 75 controls. Interventions: There were no interventions. Main Outcome Measures: Association of NST with BC and BP in 43 CP and 43 controls was measured. Results: NST correlated with BMI SD score (SDS; r = 0.78; P < .001; n = 169) and WHtR (r = 0.85; P < .001; n = 86) in the total cohort and CP patients (NST-BMI SDS: r = 0.77, P < .001, n = 94); NST-WHtR: r = 0.835, P < .001, n=43) and controls (NST-BMI SDS: r = 0.792, P < .001, n = 75; NST-WHtR: r = 0.671, P < .001, n = 43). In CP, systolic BP correlated with NST (r = 0.575, P < .001), BMI SDS (r = 0.434, P = .004), and WHtR (r = 0.386, P = .011). Similar results were observed for diastolic BP in CP. In multivariate analyses, NST had a predictive value for hypertension in postpubertal CP and controls (odds ratio 6.98, 95% confidence interval [1.65, 29.5], P = .008). During a longitudinal follow-up, changes in NST correlated with changes in BMI SDS (P < .001) and WHtR (P = .01) but not with changes in BP and functional capacity. Conclusions: Because monitoring of magnetic resonance imaging and BC is essential for follow-up in CP, NST could serve as a novel and clinically relevant parameter for longitudinal assessment of BC and CVD risk in CP. PMID:27680877

  14. First-trimester emergencies: a radiologist's perspective.

    Science.gov (United States)

    Phillips, Catherine H; Wortman, Jeremy R; Ginsburg, Elizabeth S; Sodickson, Aaron D; Doubilet, Peter M; Khurana, Bharti

    2018-02-01

    The purpose of this article is to help the practitioner ensure early diagnosis and response to emergencies in the first trimester by reviewing anatomy of the developing embryo, highlighting the sonographic appearance of common first-trimester emergencies, and discussing key management pathways for treating emergent cases. First-trimester fetal development is a stepwise process that can be challenging to evaluate in the emergency department (ED) setting. This is due, in part, to the complex anatomy of early pregnancy, subtlety of the sonographic findings, and the fact that fewer than half of patients with ectopic pregnancy present with the classic clinical findings of a positive pregnancy test, vaginal bleeding, pelvic pain, and tender adnexa. Ultrasound (US) has been the primary approach to diagnostic imaging of first-trimester emergencies, with magnetic resonance imaging (MRI) and computed tomography (CT) playing a supportive role in a small minority of cases. Familiarity with the sonographic findings diagnostic of and suspicious for early pregnancy failure, ectopic pregnancy, retained products of conception, gestational trophoblastic disease, failed intrauterine devices, and complications associated with assisted reproductive technology (ART) is critical for any emergency radiologist. Evaluation of first-trimester emergencies is challenging, and knowledge of key imaging findings and familiarity with management pathways are needed to ensure early diagnosis and response.

  15. Effect of Accelerated Artificial Aging on Translucency of Methacrylate and Silorane-Based Composite Resins.

    Science.gov (United States)

    Shirinzad, Mehdi; Rezaei-Soufi, Loghman; Mirtorabi, Maryam Sadat; Vahdatinia, Farshid

    2016-03-01

    Composite restorations must have tooth-like optical properties namely color and translucency and maintain them for a long time. This study aimed to compare the effect of accelerated artificial aging (AAA) on the translucency of three methacrylate-based composites (Filtek Z250, Filtek Z250XT and Filtek Z350XT) and one silorane-based composite resin (Filtek P90). For this in vitro study, 56 composite discs were fabricated (n=14 for each group). Using scanning spectrophotometer, CIE L*a*b* parameters and translucency of each specimen were measured at 24 hours and after AAA for 384 hours. Data were analyzed using one-way ANOVA, Tukey's test and paired t-test at P=0.05 level of significance. The mean (±standard deviation) translucency parameter for Filtek Z250, Filtek Z250XT, Filtek Z350XT and Filtek P90 was 5.67±0.64, 4.59±0.77, 7.87±0.82 and 4.21±0.71 before AAA and 4.25±0.615, 3.53±0.73, 5.94±0.57 and 4.12±0.54 after AAA, respectively. After aging, the translucency of methacrylate-based composites decreased significantly (P0.05). The AAA significantly decreased the translucency of methacrylate-based composites (Filtek Z250, Filtek Z250XT and Filtek Z350XT) but no change occurred in the translucency of Filtek P90 silorane-based composite.

  16. Optimal compliance for amblyopia therapy: occlusion with a translucent tape on the lens.

    Science.gov (United States)

    Beneish, Raquel G; Polomeno, Robert C; Flanders, Michael E; Koenekoop, Robert K

    2009-10-01

    To demonstrate that optimal compliance to amblyopia therapy and a better visual outcome can be achieved by occluding the lens over the preferred eye with a translucent tape. Prospective study of amblyopic children. Eighty-four amblyopic children recruited from 2000 to 2006 at the Montreal Children's Vision Centre. A group of bilateral ametropes (mean age 3.8 years) were treated with glasses and occlusion of the sound eye with a translucent tape on the lens over the preferred eye, or an adhesive patch. The translucent tape reduced vision to hand motion at 0.3 m in the sound eye. Patients were divided into 2 groups depending on the treatment received. Group 1 (n = 36) was occluded with a translucent tape, and group 2 (n = 48) with a conventional adhesive patch, later replaced by the translucent tape. Twenty-five previously reported patients, treated with the conventional adhesive patch only, were used as controls (group 3). The mean amblyopic visual acuity was 20/100-2. Compliance was good in 36 patients (group 1), and was poor or deteriorated in 24/48 patients (group 2). Substituting the adhesive patch with a translucent tape permitted uninterrupted and prolonged occlusion, with a successful visual outcome. The amblyopic eye achieved a significantly better final vision (20/30+2; groups 1+2) than the controls (20/40+1; group 3) (p = 0.04). Sixty-four (76.19%) patients achieved >or=20/30. The translucent tape optimizes compliance and yields better vision by lengthening the duration of occlusion therapy and reducing the number of treatment failures due to noncompliance.

  17. Diagnosis and prediction of parental origin of triploidies by fetal nuchal translucency and maternal serum free beta-hCG and PAPP-A at 11-14 weeks of gestation

    DEFF Research Database (Denmark)

    Barken, Sidsel Svennekjær; Skibsted, L.; Jensen, Lars Nimb

    2008-01-01

    consent, quantitative fluorescence polymerase chain reaction analysis was performed on the five cases where we received blood from both parents and tissue from fetuses. In four cases the origin of the triploidy was paternal and in one maternal, in accordance with previous findings in type I and type II...... triploidies. Finding triploidy is possible by risk assessment (ultrasound and double test), and thereby women may have the opportunity for early termination of pregnancy Udgivelsesdato: 2008...

  18. Spectrophotometric assessment of the effects of 10% carbamide peroxide on enamel translucency

    Directory of Open Access Journals (Sweden)

    Glauco Fioranelli Vieira

    2008-03-01

    Full Text Available Tooth shade results from the interaction between enamel color, enamel translucency and dentine color. A change in any of these parameters will change a tooth’s color. The objective of this study was to evaluate the changes occurring in enamel translucency during a tooth whitening process. Fourteen human tooth enamel fragments, with a mean thickness of 0.96 mm (± 0.3 mm, were subjected to a bleaching agent (10% carbamide peroxide 8 hours per day for 28 days. The enamel fragment translucency was measured by a computer controlled spectrophotometer before and after the bleaching agent applications in accordance with ANSI Z80.3-1986 - American National Standard for Ophthalmics - nonprescription sunglasses and fashion eyewear-requirements. The measurements were statistically compared by the Mann-Whitney non-parametric test. A decrease was observed in the translucency of all specimens and, consequently, there was a decrease in transmittance values for all samples. It was observed that the bleaching procedure significantly changes the enamel translucency, making it more opaque.

  19. Exercise in Pregnancy: First Trimester Risks

    DEFF Research Database (Denmark)

    Hegaard, Hanne K.; Ersbøll, Anne S; Damm, Peter

    2016-01-01

    in the first trimester and the risk of miscarriage. A systematic review based on the EMBASE and PUBMED databases was conducted and 5 studies assessing the association between early pregnancy exercise and miscarriage were identified. Diverging findings were reported making no clear conclusion possible. New...

  20. First trimester prediction of maternal glycemic status.

    Science.gov (United States)

    Gabbay-Benziv, Rinat; Doyle, Lauren E; Blitzer, Miriam; Baschat, Ahmet A

    2015-05-01

    To predict gestational diabetes mellitus (GDM) or normoglycemic status using first trimester maternal characteristics. We used data from a prospective cohort study. First trimester maternal characteristics were compared between women with and without GDM. Association of these variables with sugar values at glucose challenge test (GCT) and subsequent GDM was tested to identify key parameters. A predictive algorithm for GDM was developed and receiver operating characteristics (ROC) statistics was used to derive the optimal risk score. We defined normoglycemic state, when GCT and all four sugar values at oral glucose tolerance test, whenever obtained, were normal. Using same statistical approach, we developed an algorithm to predict the normoglycemic state. Maternal age, race, prior GDM, first trimester BMI, and systolic blood pressure (SBP) were all significantly associated with GDM. Age, BMI, and SBP were also associated with GCT values. The logistic regression analysis constructed equation and the calculated risk score yielded sensitivity, specificity, positive predictive value, and negative predictive value of 85%, 62%, 13.8%, and 98.3% for a cut-off value of 0.042, respectively (ROC-AUC - area under the curve 0.819, CI - confidence interval 0.769-0.868). The model constructed for normoglycemia prediction demonstrated lower performance (ROC-AUC 0.707, CI 0.668-0.746). GDM prediction can be achieved during the first trimester encounter by integration of maternal characteristics and basic measurements while normoglycemic status prediction is less effective.

  1. Estrogen Levels in the three Trimesters

    African Journals Online (AJOL)

    estrogen levels in first, second and third trimesters of pregnant albino rats. MATERIALS AND METHODS. TEST SUBJECTS. 20 female albino rats and 6 male albino rats, with initial weight of 165-180g were purchase from the animal house of Department of Animal and. Environmental Biology , University of Benin,. Benin city ...

  2. Translucent Radiosity: Efficiently Combining Diffuse Inter-Reflection and Subsurface Scattering.

    Science.gov (United States)

    Sheng, Yu; Shi, Yulong; Wang, Lili; Narasimhan, Srinivasa G

    2014-07-01

    It is hard to efficiently model the light transport in scenes with translucent objects for interactive applications. The inter-reflection between objects and their environments and the subsurface scattering through the materials intertwine to produce visual effects like color bleeding, light glows, and soft shading. Monte-Carlo based approaches have demonstrated impressive results but are computationally expensive, and faster approaches model either only inter-reflection or only subsurface scattering. In this paper, we present a simple analytic model that combines diffuse inter-reflection and isotropic subsurface scattering. Our approach extends the classical work in radiosity by including a subsurface scattering matrix that operates in conjunction with the traditional form factor matrix. This subsurface scattering matrix can be constructed using analytic, measurement-based or simulation-based models and can capture both homogeneous and heterogeneous translucencies. Using a fast iterative solution to radiosity, we demonstrate scene relighting and dynamically varying object translucencies at near interactive rates.

  3. Comparative study of age estimation using dentinal translucency by digital and conventional methods

    Science.gov (United States)

    Bommannavar, Sushma; Kulkarni, Meena

    2015-01-01

    Introduction: Estimating age using the dentition plays a significant role in identification of the individual in forensic cases. Teeth are one of the most durable and strongest structures in the human body. The morphology and arrangement of teeth vary from person-to-person and is unique to an individual as are the fingerprints. Therefore, the use of dentition is the method of choice in the identification of the unknown. Root dentin translucency is considered to be one of the best parameters for dental age estimation. Traditionally, root dentin translucency was measured using calipers. Recently, the use of custom built software programs have been proposed for the same. Objectives: The present study describes a method to measure root dentin translucency on sectioned teeth using a custom built software program Adobe Photoshop 7.0 version (Adobe system Inc, Mountain View California). Materials and Methods: A total of 50 single rooted teeth were sectioned longitudinally to derive a 0.25 mm uniform thickness and the root dentin translucency was measured using digital and caliper methods and compared. The Gustafson's morphohistologic approach is used in this study. Results: Correlation coefficients of translucency measurements to age were statistically significant for both the methods (P < 0.125) and linear regression equations derived from both methods revealed better ability of the digital method to assess age. Conclusion: The custom built software program used in the present study is commercially available and widely used image editing software. Furthermore, this method is easy to use and less time consuming. The measurements obtained using this method are more precise and thus help in more accurate age estimation. Considering these benefits, the present study recommends the use of digital method to assess translucency for age estimation. PMID:25709325

  4. First trimester growth restriction and uterine artery blood flow in the second trimester as predictors of adverse pregnancy outcome

    DEFF Research Database (Denmark)

    Pedersen, N G; Sperling, L; Wøjdemann, K R

    2013-01-01

    To investigate if fetuses with first trimester growth restriction have poorer perfusion of the placenta compared to a control group, and to investigate whether first trimester growth restriction in combination with poor flow in the uterine arteries in the second trimester can be used to predict...

  5. Translucence in dental prosthesis based on zirconia ceramics: effect of the sintering parameters

    International Nuclear Information System (INIS)

    Santos, C.

    2011-01-01

    In this work the translucence of Zirconia dental ceramics was evaluated as function of sintering conditions (temperature and isothermal holding time). Samples with 15x15x1mm, were sintered at 1450 to 1600 deg C, with holding of 2h or 4h. Sintered samples were characterized by relative density, crystalline phases and microstructural aspects. Full density was obtained in samples sintered at 1530 and 1600 deg C, which presented higher grain sizes. Na increasing of translucence was observed in samples sintered at 1530 and 1600, correlating these properties with increasing of density and grain size of the samples. (author)

  6. Strength, toughness and aging stability of highly-translucent Y-TZP ceramics for dental restorations.

    Science.gov (United States)

    Zhang, Fei; Inokoshi, Masanao; Batuk, Maria; Hadermann, Joke; Naert, Ignace; Van Meerbeek, Bart; Vleugels, Jef

    2016-12-01

    The aim was to evaluate the optical properties, mechanical properties and aging stability of yttria-stabilized zirconia with different compositions, highlighting the influence of the alumina addition, Y 2 O 3 content and La 2 O 3 doping on the translucency. Five different Y-TZP zirconia powders (3 commercially available and 2 experimentally modified) were sintered under the same conditions and characterized by X-ray diffraction with Rietveld analysis and scanning electron microscopy (SEM). Translucency (n=6/group) was measured with a color meter, allowing to calculate the translucency parameter (TP) and the contrast ratio (CR). Mechanical properties were appraised with four-point bending strength (n=10), single edge V-notched beam (SEVNB) fracture toughness (n=8) and Vickers hardness (n=10). The aging stability was evaluated by measuring the tetragonal to monoclinic transformation (n=3) after accelerated hydrothermal aging in steam at 134°C, and the transformation curves were fitted by the Mehl-Avrami-Johnson (MAJ) equation. Data were analyzed by one-way ANOVA, followed by Tukey's HSD test (α=0.05). Lowering the alumina content below 0.25wt.% avoided the formation of alumina particles and therefore increased the translucency of 3Y-TZP ceramics, but the hydrothermal aging stability was reduced. A higher yttria content (5mol%) introduced about 50% cubic zirconia phase and gave rise to the most translucent and aging-resistant Y-TZP ceramics, but the fracture toughness and strength were considerably sacrificed. 0.2mol% La 2 O 3 doping of 3Y-TZP tailored the grain boundary chemistry and significantly improved the aging resistance and translucency. Although the translucency improvement by La 2 O 3 doping was less effective than for introducing a substantial amount of cubic zirconia, this strategy was able to maintain the mechanical properties of typical 3Y-TZP ceramics. Three different approaches were compared to improve the translucency of 3Y-TZP ceramics. Copyright

  7. The translucency of dental composites investigated by UV-VIS spectroscopy

    International Nuclear Information System (INIS)

    Dumitrescu, L. Silaghi; Pastrav, O.; Prejmerean, C.; Prodan, D.; Boboia, S.; Codruta, S.; Moldovan, M.

    2013-01-01

    Translucency is the property of a material to partially transmit and diffuse incident light, and can be described as a partial opacity or a state between complete opacity and complete transparency. The purpose of this study is to evaluate the translucency index of resin composites according to their chemical structure and to the light source used for curing. Our study was achieved on four commercial composite samples (30 mm × 2 mm) cured with two different lamps (Optilux - halogen bulb and Ultralight - LED). Measurements were made with a UV-VIS spectrophotometer, and the reflection spectrum was recorded in the 380-770 nm region on white and black, compared with a SPECTRALON standard white. For all materials cured with the LED lamp on the glossy sides, the best results were given by Tetric Evo Ceram followed by Filtek Supreme, Restacril RO and Premise. The measurements made on samples cured with an Optilux lamp, to the smooth and rough sides of the samples, revealed that the highest index of translucency is provided by Tetric Evo Ceram on the smooth side, followed by Filtek Supreme, Restacril RO and Premises. We can say that the translucency of the composites is mostly determined by the chemical composition of the material, which is observed from transmittance values recorded for each sample, and by the source of radiation applied on the sample

  8. The translucency of dental composites investigated by UV-VIS spectroscopy

    Science.gov (United States)

    Dumitrescu, L. Silaghi; Pastrav, O.; Prejmerean, C.; Prodan, D.; Boboia, S.; Codruta, S.; Moldovan, M.

    2013-11-01

    Translucency is the property of a material to partially transmit and diffuse incident light, and can be described as a partial opacity or a state between complete opacity and complete transparency. The purpose of this study is to evaluate the translucency index of resin composites according to their chemical structure and to the light source used for curing. Our study was achieved on four commercial composite samples (30 mm × 2 mm) cured with two different lamps (Optilux - halogen bulb and Ultralight - LED). Measurements were made with a UV-VIS spectrophotometer, and the reflection spectrum was recorded in the 380-770 nm region on white and black, compared with a SPECTRALON standard white. For all materials cured with the LED lamp on the glossy sides, the best results were given by Tetric Evo Ceram followed by Filtek Supreme, RestacrilRO and Premise. The measurements made on samples cured with an Optilux lamp, to the smooth and rough sides of the samples, revealed that the highest index of translucency is provided by Tetric Evo Ceram on the smooth side, followed by Filtek Supreme, RestacrilRO and Premises. We can say that the translucency of the composites is mostly determined by the chemical composition of the material, which is observed from transmittance values recorded for each sample, and by the source of radiation applied on the sample.

  9. Application of Kubelka - Munk analysis to the study of translucency in fresh-cut tomato

    NARCIS (Netherlands)

    Lana, M.M.; Hogenkamp, M.; Koehorst, R.B.M.

    2006-01-01

    In order to assess the development of translucency in fresh-cut tomato (Lycopersicum esculentum cv. Belissimo) during refrigerated storage, two experiments were conducted. In the first one, tomato slices obtained from fruits at breaker and at red stage were stored at 5 ± 0.5 °C and monitored at

  10. Effect of Translucency on Transparency and Symbol Learning for Children with and without Cerebral Palsy

    Science.gov (United States)

    Huang, Chih-Hsiung; Chen, Ming-Chung

    2011-01-01

    Based on the concept of iconicity, the iconicity hypothesis was emphasized for decades. The aims of this study were to explore the effect of translucency on transparency and symbol learning for children with and without cerebral palsy. Twenty children with cerebral palsy and forty typical peers participated in the study. Ten symbols with high…

  11. Effects and properties of radiation interaction with semi-transparent and translucent materials

    International Nuclear Information System (INIS)

    Keppeler, R.O.; Corbella, O.D.

    1980-01-01

    A systematic study to characterized materials employed in solar collectors, is presented here. The experimental data consists of transmitance τ(Θ,λ) and directional monochromatic reflectance π(θ,λ) as well as the values of hemispheric transmitance of translucent plastic materials. (author) [pt

  12. Translucency, opalescence and light transmission characteristics of light-cured resin composites.

    Science.gov (United States)

    Arimoto, Ayako; Nakajima, Masatoshi; Hosaka, Keiichi; Nishimura, Kozo; Ikeda, Masaomi; Foxton, Richard M; Tagami, Junji

    2010-11-01

    To evaluate the translucency, opalescence and light transmission characteristics of resin composites with different thicknesses. Disks of three resin composites (Estelite∑, Beautifil II, Clearfil Majesty) of A2 shade were prepared in diameter of 10mm with various thicknesses (0.5mm, 1.0mm and 2.0mm). Color was measured according to CIELAB color scale on a reflection spectrophotometer and a color haze meter, and translucency parameter (TP) and opalescence parameter (OP) were calculated. Using the distribution graphs of transmitted light intensity on a goniophotometer, diffusion factor (DF) as an indicator for a diffuse transmission property and peak gain (G0) for a straight-line transmission property were calculated. The TP and G0 values significantly decreased in the order: 0.5mm>1.0mm>2.0mm thickness (popalescence (OP) of resin composites had a significant correlation with a diffuse transmission property (DF). When more than 1.0mm thickness of resin composites, translucency and opalescence were influenced by the thickness, in which translucency significantly decreased and opalescence significantly increased. Copyright © 2010 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  13. Influence of resin cement shade on the color and translucency of ceramic veneers

    Science.gov (United States)

    HERNANDES, Daiana Kelly Lopes; ARRAIS, Cesar Augusto Galvão; de LIMA, Erick; CESAR, Paulo Francisco; RODRIGUES, José Augusto

    2016-01-01

    ABSTRACT Objective This in vitro study evaluated the effect of two different shades of resin cement (RC- A1 and A3) layer on color change, translucency parameter (TP), and chroma of low (LT) and high (HT) translucent reinforced lithium disilicate ceramic laminates. Material and Methods One dual-cured RC (Variolink II, A1- and A3-shade, Ivoclar Vivadent) was applied to 1-mm thick ceramic discs to create thin RC films (100 µm thick) under the ceramics. The RC was exposed to light from a LED curing unit. Color change (ΔE) of ceramic discs was measured according to CIEL*a*b* system with a standard illuminant D65 in reflectance mode in a spectrophotometer, operating in the light range of 360-740 nm, equipped with an integrating sphere. The color difference between black (B) and white (W) background readings was used for TP analysis, while chroma was calculated by the formula C* ab=(a*2+b*2)½. ΔE of 3.3 was set as the threshold of clinically unacceptable. The results were evaluated by two-way ANOVA followed by Tukey's post hoc test. Results HT ceramics showed higher ΔE and higher TP than LT ceramics. A3-shade RC promoted higher ΔE than A1-shade cement, regardless of the ceramic translucency. No significant difference in TP was noted between ceramic discs with A1- and those with A3-shade cement. Ceramic with underlying RC showed lower TP than discs without RC. HT ceramics showed lower chroma than LT ceramics, regardless of the resin cement shade. The presence of A3-shade RC resulted in higher chroma than the presence of A1-shade RC. Conclusions Darker underlying RC layer promoted more pronounced changes in ceramic translucency, chroma, and shade of high translucent ceramic veneers. These differences may not be clinically differentiable. PMID:27556211

  14. Influence of resin cement shade on the color and translucency of ceramic veneers

    Directory of Open Access Journals (Sweden)

    Daiana Kelly Lopes HERNANDES

    Full Text Available ABSTRACT Objective This in vitro study evaluated the effect of two different shades of resin cement (RC- A1 and A3 layer on color change, translucency parameter (TP, and chroma of low (LT and high (HT translucent reinforced lithium disilicate ceramic laminates. Material and Methods One dual-cured RC (Variolink II, A1- and A3-shade, Ivoclar Vivadent was applied to 1-mm thick ceramic discs to create thin RC films (100 µm thick under the ceramics. The RC was exposed to light from a LED curing unit. Color change (ΔE of ceramic discs was measured according to CIEL*a*b* system with a standard illuminant D65 in reflectance mode in a spectrophotometer, operating in the light range of 360-740 nm, equipped with an integrating sphere. The color difference between black (B and white (W background readings was used for TP analysis, while chroma was calculated by the formula C*ab=(a*2+b*2½. ΔE of 3.3 was set as the threshold of clinically unacceptable. The results were evaluated by two-way ANOVA followed by Tukey's post hoc test. Results HT ceramics showed higher ΔE and higher TP than LT ceramics. A3-shade RC promoted higher ΔE than A1-shade cement, regardless of the ceramic translucency. No significant difference in TP was noted between ceramic discs with A1- and those with A3-shade cement. Ceramic with underlying RC showed lower TP than discs without RC. HT ceramics showed lower chroma than LT ceramics, regardless of the resin cement shade. The presence of A3-shade RC resulted in higher chroma than the presence of A1-shade RC. Conclusions Darker underlying RC layer promoted more pronounced changes in ceramic translucency, chroma, and shade of high translucent ceramic veneers. These differences may not be clinically differentiable.

  15. Influence of Bleaching Agents on Color and Translucency of Aged Resin Composites.

    Science.gov (United States)

    Lago, Maristela; Mozzaquatro, Lisandra R; Rodrigues, Camila; Kaizer, Marina R; Mallmann, André; Jacques, Letícia B

    2017-09-01

    Evaluate the influence of two bleaching agents (16% carbamide peroxide-CP and 35% hydrogen peroxide-HP) on color and translucency of one resin composite (Filtek Z350 XT) in two opacities (enamel and dentin) previously aged in deionized water or red wine. Sixty specimens of each material were divided in two groups (n = 30): aged in water or red wine for 14 days. Then the specimens were divided in three subgroups (n = 10): control/no treatment, treated with 16% carbamide peroxide (Mix Night), treated with 35% hydrogen peroxide (Mix One). Color readings were performed 24 hours after polishing (baseline); after the 14 days of aging; and after bleaching treatment. Color coordinates CIE L*a*b* were measured using a spectrophotometer (SP60 X-Rite). Color change (CIEDE2000) and translucency parameter were calculated. Data were analyzed with repeated measures two-way ANOVA, and Student-Newman-Keuls tests (5%). Bleaching decreased color change in stained resin composites (aged in red wine), whereas increased it in non-stained enamel resin composites (aged in water). CP had better bleaching results with stained resin composites than HP. Translucency of non-stained dentin resin composite decreased with aging, but did not change with bleaching. For stained resin composites, aging caused reduced translucency, whereas bleaching increased it. Effective bleaching of discolored resin composites aged in an acidic and alcoholic media rich in staining agents was achieved, improving color and translucency. Carbamide peroxide showed better performance than hydrogen peroxide for the bleaching of stained resin composites. (J Esthet Restor Dent 29:368-377, 2017). © 2016 Wiley Periodicals, Inc.

  16. Translucency and masking properties of two ceramic materials for heat-press technology.

    Science.gov (United States)

    Șoim, Alexandra; Strîmbu, Maria; Burde, Alexandru V; Culic, Bogdan; Dudea, Diana; Gasparik, Cristina

    2018-03-01

    To assess the translucency of two pressable ceramics and to analyze their masking property when placed on different tooth-shaded backgrounds. Thirty discs (1-mm thickness) were fabricated using two pressable ceramics (shade/translucency): 1M1T/HT, 1M2T/HT, 2M2T (VITA PM9), and A1LT/HT, B1LT/HT, A2LT (e.max Press). Color measurements of discs were performed with a dental spectrophotometer on tooth-colored backgrounds (A1/A2/A3/A3.5/A4), and black and white backings. The masking property was calculated as the color difference (CIEDE2000) between parameters of discs on control (A1, A2) and test backgrounds (A3, A3.5, A4). One-way ANOVA was used for assessing differences in translucency parameter (TP) between ceramics. Two-way ANOVA was used for detecting differences among groups when measured over tooth-shaded backgrounds (α = 0.05, Bonferroni correction). TP ranged between 14.96 (B1LT) and 25.18 (1M1HT). A significant difference in TP was found between tested ceramics (F = 949.949, P  .05), 1M1T, A1HT and B1HT (P > .05), 1M2T, 2M2T, and A2HT (P > .05). A significant interaction effect of underlying background on color of ceramic discs was found (F = 107.994, P ceramics. Except A1LT, all ceramic materials evaluated showed poor masking properties on A4 background. Highly translucent ceramics should be wisely used for restoring the appearance of dental structures since background color has a large effect upon these materials. The more recently introduced pressable ceramics showed high levels of translucency. © 2018 Wiley Periodicals, Inc.

  17. Influence of resin cement shade on the color and translucency of ceramic veneers.

    Science.gov (United States)

    Hernandes, Daiana Kelly Lopes; Arrais, Cesar Augusto Galvão; Lima, Erick de; Cesar, Paulo Francisco; Rodrigues, José Augusto

    2016-01-01

    This in vitro study evaluated the effect of two different shades of resin cement (RC- A1 and A3) layer on color change, translucency parameter (TP), and chroma of low (LT) and high (HT) translucent reinforced lithium disilicate ceramic laminates. One dual-cured RC (Variolink II, A1- and A3-shade, Ivoclar Vivadent) was applied to 1-mm thick ceramic discs to create thin RC films (100 µm thick) under the ceramics. The RC was exposed to light from a LED curing unit. Color change (ΔE) of ceramic discs was measured according to CIEL*a*b* system with a standard illuminant D65 in reflectance mode in a spectrophotometer, operating in the light range of 360-740 nm, equipped with an integrating sphere. The color difference between black (B) and white (W) background readings was used for TP analysis, while chroma was calculated by the formula C*ab=(a*2+b*2)½. ΔE of 3.3 was set as the threshold of clinically unacceptable. The results were evaluated by two-way ANOVA followed by Tukey's post hoc test. HT ceramics showed higher ΔE and higher TP than LT ceramics. A3-shade RC promoted higher ΔE than A1-shade cement, regardless of the ceramic translucency. No significant difference in TP was noted between ceramic discs with A1- and those with A3-shade cement. Ceramic with underlying RC showed lower TP than discs without RC. HT ceramics showed lower chroma than LT ceramics, regardless of the resin cement shade. The presence of A3-shade RC resulted in higher chroma than the presence of A1-shade RC. Darker underlying RC layer promoted more pronounced changes in ceramic translucency, chroma, and shade of high translucent ceramic veneers. These differences may not be clinically differentiable.

  18. Leptin in first trimester pregnancy serum

    DEFF Research Database (Denmark)

    Hedley, Paula; Pihl, Kasper; Krebs, Lone

    2009-01-01

    and its relation to fetal growth disturbances were examined in this study. The study is a case-control study with 36 small-for-gestational-age (SGA) (pregnancies and 108 appropriate-for-gestational-age (AGA) (> or =5th percentile) pregnancies. The groups were matched by maternal age...... maternal BMI. There was no significant difference in maternal serum leptin concentrations between SGA and AGA pregnancies. In conclusion, SGA pregnancies are not associated with a lower maternal serum leptin concentration in first trimester. The maternal serum leptin concentration is largely determined...

  19. Bionics in textiles: flexible and translucent thermal insulations for solar thermal applications.

    Science.gov (United States)

    Stegmaier, Thomas; Linke, Michael; Planck, Heinrich

    2009-05-13

    Solar thermal collectors used at present consist of rigid and heavy materials, which are the reasons for their immobility. Based on the solar function of polar bear fur and skin, new collector systems are in development, which are flexible and mobile. The developed transparent heat insulation material consists of a spacer textile based on translucent polymer fibres coated with transparent silicone rubber. For incident light of the visible spectrum the system is translucent, but impermeable for ultraviolet radiation. Owing to its structure it shows a reduced heat loss by convection. Heat loss by the emission of long-wave radiation can be prevented by a suitable low-emission coating. Suitable treatment of the silicone surface protects it against soiling. In combination with further insulation materials and flow systems, complete flexible solar collector systems are in development.

  20. Nanocellulose-based Translucent Diffuser for Optoelectronic Device Applications with Dramatic Improvement of Light Coupling.

    Science.gov (United States)

    Wu, Wei; Tassi, Nancy G; Zhu, Hongli; Fang, Zhiqiang; Hu, Liangbing

    2015-12-09

    Nanocellulose is a biogenerated and biorenewable organic material. Using a process based on 2,2,6,6-tetramethylpiperidine-1-oxyl (TEMPO)/NaClO/NaBr system, a highly translucent and light-diffusive film consisting of many layers of nanocellulose fibers and wood pulp microfibers was made. The film demonstrates a combination of large optical transmittance of ∼90% and tunable diffuse transmission of up to ∼78% across the visible and near-infrared spectra. The detailed characterizations of the film indicate the combination of high optical transmittance and haze is due to the film's large packing density and microstructured surface. The superior optical properties make the film a translucent light diffuser and applicable for improving the efficiencies of optoelectronic devices such as thin-film silicon solar cells and organic light-emitting devices.

  1. Integrated Thermal-Energy Analysis of Innovative Translucent White Marble for Building Envelope Application

    OpenAIRE

    Federica Rosso; Anna Laura Pisello; Franco Cotana; Marco Ferrero

    2014-01-01

    Marble is a natural material, used in the construction field since antiquity. It has always been used to communicate monumentality and solidity. Nowadays new technologies permit marble to express new languages: particularly, translucent marble technology overturns the concept of solidity. The main issue to address is the lack of thermal-energy performance of such a thin stone layer as the only facade component. Conversely, Bianco Carrara and Statuario marbles, for instance, have intrinsic be...

  2. Long-term microwaving of denture base materials: effects on dimensional, color and translucency stability

    Directory of Open Access Journals (Sweden)

    Nick POLYCHRONAKIS

    2018-06-01

    Full Text Available Abstract While the combined effect of microwave irradiation with cleansing solutions on denture base materials has been investigated, the effects of only using microwave irradiation and, more importantly, in a long-term basis, was not studied yet. Objective The purpose of this study was to evaluate the effect of a long-term repeated microwaving on the dimensional, color and translucency stability of acrylic and polyamide denture base materials. Material and Methods Thirty two specimens (32 mm x 10 mm x 2.5 mm from polyamide (Valplast and PMMA (Vertex Rapid Simplified denture base materials were made. Eight specimens from each material were immersed in distilled water (control and 8 were subjected to microwave exposure at 450 W for 3 minutes for a period simulating 224 days of daily disinfection. Linear dimension, color change (ΔE* and translucency parameter (TP were measured at baseline and after certain intervals up to 224 cycles of immersion, using a digital calliper and a portable colorimeter. The results were analysed using two-way repeated measures ANOVA to estimate possible differences among predetermined cycles and material type. Regression analysis was also performed to estimate the trend of changes with time. Statistical evaluations performed at a significance level of 5%. Results Data analysis showed significant changes in length at baseline with an increasing number of cycles (p0.05. TP decreased similarly in both materials following microwave action but in a significantly higher level for Valplast (p<0.001. Conclusions The results indicated that long-term repeated microwaving affects linear dimensional, color and translucency changes of both materials. Differences between PMMA and polyamide material were noted only in dimension and translucency changes.

  3. First-trimester vaginal bleeding and complications later in pregnancy

    DEFF Research Database (Denmark)

    Lykke, Jacob Alexander; Dideriksen, Katrine Lehrmann; Lidegaard, Øjvind

    2010-01-01

    To evaluate the association of first-trimester bleeding without miscarriage and complications later in the first pregnancy as well as in the next pregnancy.......To evaluate the association of first-trimester bleeding without miscarriage and complications later in the first pregnancy as well as in the next pregnancy....

  4. The Determinants and Outcomes of Second Trimester Abortion at ...

    African Journals Online (AJOL)

    Background: Mid trimester abortion constitutes 10-15% of all induced abortions worldwide and accounts for the majority of complications. In Africa, studies demonstrating the proportion of second trimester abortions are few. However to appropriately intervene with a view to reducing the morbidity and mortality due to mid ...

  5. Influence of optical properties of esthetic brackets (color, translucence, and fluorescence) on visual perception.

    Science.gov (United States)

    Lopes Filho, Hibernon; Maia, Lúcio E G; Araújo, Marcus Vinicius A; Ruellas, Antônio Carlos O

    2012-04-01

    The aims of this study were to evaluate the optical properties of esthetic brackets and determine their influence on visual perception. Eighty esthetic brackets of 16 commercial brands were tested. The color and translucency of the brackets, as well as the color of the maxillary central incisors of 40 subjects, were measured with a spectrophotometer. The fluorescence of the brackets was determined by duly calibrated appraisers. The color differences between the brands of brackets and the teeth were calculated. Data were analyzed by using 1-way analysis of variance; the Scheffé multiple comparison test was used to establish the difference between brands of brackets, (α = 0.05). The color parameters L ∗ a ∗ b ∗ of nontranslucent brackets ranged from 49.4 to 86.0, -1.6 to 3.0, and 1.9 to 14.6, respectively. The direct transmission of light ranged from 0.0% to 38.8% transmittance. No bracket showed fluorescence. The color and translucency, as well as the color difference, of the brackets were influenced by brand (P perception; translucent brackets and the nontranslucent InVu (TP Orthodontics, LaPorte, Ind) brackets were less visually perceptible. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  6. Effect of Home Bleaching on the Translucency of CAD/CAM Systems.

    Science.gov (United States)

    Karci, Muhammet; Demir, Necla

    2017-11-10

    To evaluate the effect of a home bleaching agent (Opalescence PF) on the translucency of CAD/CAM ceramic systems. The 28 sintered ceramic specimens (IPS Empress CAD and IPS e.max CAD; 15 mm long, 10 mm wide, 1 mm thick) were divided into two subgroups as control and bleaching groups (n = 7). Carbamide peroxide (CP), 16%, home bleaching agent was applied onto the surface of each specimen for 6 hours per day for 7 days. A spectrophotometer (VITA Easyshade Advance) was used to measure the CIE L * a * b * coordinates and the reflectance value (Y) of the specimens on white and black backgrounds. The translucency parameter (TP), contrast ratio (CR), and opalescence parameter (OP) of the specimens were calculated. The data were statistically analyzed using Kolmogorov-Smirnov, one-way ANOVA, Tukey's test, and Pearson's correlation. Statistically significant differences in the TP values after 16% CP bleaching treatment were observed (p ˂ 0.05); however, no significant differences were found in the OP and CR values after the surface treatment (p ˃ 0.05). According to our study, patients who have all-ceramic restorations in their mouths should be careful when using home bleaching agents, because whitening agents can affect the translucency of all-ceramic restorations such as e.max CAD and Empress CAD. © 2017 by the American College of Prosthodontists.

  7. Comparison of stabilities in translucency, fluorescence and opalescence of direct and indirect composite resins.

    Science.gov (United States)

    Yu, Bin; Lee, Young-Keun

    2013-01-01

    To evaluate translucency, fluorescence and opalescence stabilities of direct and indirect composite resins after aging. One direct (16 shades) and two indirect composite resins (16 and 26 shades) were investigated. Resins were filled in a mold (1 mm thick) and light cured; post-curings were performed for indirect resins. Color was measured before and after 5,000 cycles of thermocycling on a reflection spectrophotometer in reflectance and transmittance modes to calculate parameters for translucency (TP), fluorescence (FL) and opalescence (OP). Differences in the changes of TP, FL and OP after aging by the type of resin were determined by t test, and those were also determined by one-way ANOVA with the factor of the brand or the shade group (P resins; and were -2.0 to 1.8, -0.9 to 0.4 and -2.9 to 3.7, respectively, for indirect resins. Changes in TP were not significantly different by the type of resin, but those in FL and OP were different (P = 0.05). Changes in optical parameters were influenced by the brand or the shade group of the resins (P resins varied depending on type, brand or shade group. Aging significantly affected fluorescence and opalescence, but not translucency, of indirect resins compared to those of direct resins.

  8. Systematic approach to preparing ceramic-glass composites with high translucency for dental restorations.

    Science.gov (United States)

    Yoshimura, Humberto N; Chimanski, Afonso; Cesar, Paulo F

    2015-10-01

    Ceramic composites are promising materials for dental restorations. However, it is difficult to prepare highly translucent composites due to the light scattering that occurs in multiphase ceramics. The objective of this work was to verify the effectiveness of a systematic approach in designing specific glass compositions with target properties in order to prepare glass infiltrated ceramic composites with high translucency. First it was necessary to calculate from literature data the viscosity of glass at the infiltration temperature using the SciGlass software. Then, a glass composition was designed for targeted viscosity and refractive index. The glass of the system SiO2-B2O3-Al2O3-La2O3-TiO2 prepared by melting the oxide raw materials was spontaneously infiltrated into porous alumina preforms at 1200°C. The optical properties were evaluated using a refractometer and a spectrophotometer. The absorption and scattering coefficients were calculated using the Kubelka-Munk model. The light transmittance of prepared composite was significantly higher than a commercial ceramic-glass composite, due to the matching of glass and preform refractive indexes which decreased the scattering, and also to the decrease in absorption coefficient. The proposed systematic approach was efficient for development of glass infiltrated ceramic composites with high translucency, which benefits include the better aesthetic performance of the final prosthesis. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  9. First-Trimester Exposure to Methylphenidate

    DEFF Research Database (Denmark)

    Pottegård, Anton; Hallas, Jesper; Andersen, Jon T

    2014-01-01

    conducted this study to estimate the risk of major congenital malformations following first-trimester in utero exposure to methylphenidate. METHOD: Data from 2005 to 2012 were extracted from the Danish National Patient Register, the Danish National Prescription Registry, the Medical Birth Registry...... subjects with respect to maternal age, smoking status, body mass index, length of education, calendar year of completion of pregnancy, and concomitant use of antipsychotics, antidepressants, anxiolytics, and nonsteroidal anti-inflammatory drugs. RESULTS: We included 222 exposed and 2,220 unexposed...... pregnancies in the analysis. There was no statistically significant increase in major malformations (point prevalence ratio = 0.8; 95% CI, 0.3-1.8) or cardiac malformations (point prevalence ratio = 0.9; 95% CI, 0.2-3.0). Sensitivity analyses using different definitions of exposure or previous users...

  10. The efficacy of ultrasound-guided extracorporeal shockwave therapy in patients with cervical spondylosis and nuchal ligament calcification

    Directory of Open Access Journals (Sweden)

    Tz-Yan Lin

    2015-07-01

    Full Text Available We investigated the effects of extracorporeal shockwave therapy (ESWT on the rehabilitation of cervical spondylosis with nuchal ligament (NL calcification under X-ray and ultrasound guidance. Sixty patients with cervical spondylosis and calcification of NL were selected and randomly assigned to three groups: A, B, and C. Patients in Group A received rehabilitation with 20 minutes of hot packs and underwent 15 minutes of intermittent cervical traction three times/week for 6 weeks. Patients in Group B received the same rehabilitation as those in Group A and ESWT (2000 impulses, 0.27 mJ/mm2 over the calcified NL guided by X-ray image. Patients in Group C received the same treatment as those in Group B, but the ESWT was guided by musculoskeletal sonography. The therapeutic effects were evaluated by: changes in range of motion (ROM of the cervical spine including flexion, extension, lateral bending, and rotation; visual analog pain scale; and Neck Disability Index before and after treatment and at follow up 3 months later. We found a significant reduction in pain in each treated group after treatment and at follow up. However, patients in Groups B and C showed more improvements in ROM and neck pain relief after treatment and a decrease in Neck Disability Index. Furthermore, patients in Group C showed better cervical ROM at follow up than Group B. ESWT is an adjuvant treatment in the management of cervical spondylosis with calcification of NL and ultrasound-guided ESWT results in more functional improvements.

  11. Waterproof and translucent wings at the same time: problems and solutions in butterflies.

    Science.gov (United States)

    Goodwyn, Pablo Perez; Maezono, Yasunori; Hosoda, Naoe; Fujisaki, Kenji

    2009-07-01

    Although the colour of butterflies attracts the most attention, the waterproofing properties of their wings are also extremely interesting. Most butterfly wings are considered "super-hydrophobic" because the contact angle (CA) with a water drop exceeds 150 degrees. Usually, butterfly wings are covered with strongly overlapping scales; however, in the case of transparent or translucent wings, scale cover is reduced; thus, the hydrophobicity could be affected. Here, we present a comparative analysis of wing hydrophobicity and its dependence on morphology for two species with translucent wings Parantica sita (Nymphalidae) and Parnassius glacialis (Papilionidae). These species have very different life histories: P. sita lives for up to 6 months as an adult and migrates over long distance, whereas P. glacialis lives for less than 1 month and does not migrate. We measured the water CA and analysed wing morphology with scanning electron microscopy and atomic force microscopy. P. sita has super-hydrophobic wing surfaces, with CA > 160 degrees, whereas P. glacialis did not (CA = 100-135 degrees). Specialised scales were found on the translucent portions of P. sita wings. These scales were ovoid and much thinner than common scales, erect at about 30 degrees, and leaving up to 80% of the wing surface uncovered. The underlying bare wing surface had a remarkable pattern of ridges and knobs. P. glacialis also had over 80% of the wing surface uncovered, but the scales were either setae-like or spade-like. The bare surface of the wing had an irregular wavy smooth pattern. We suggest a mode of action that allows this super-hydrophobic effect with an incompletely covered wing surface. The scales bend, but do not collapse, under the pressure of a water droplet, and the elastic recovery of the structure at the borders of the droplet allows a high apparent CA. Thus, P. sita can be translucent without losing its waterproof properties. This characteristic is likely necessary for the long

  12. The Effect of Lithium Disilicate Ceramic Thickness and Translucency on Shear Bond Strength of Light-cured Resin Cement

    Directory of Open Access Journals (Sweden)

    Mohammad Javad Moghaddas

    2017-09-01

    Full Text Available Introduction: To achieve acceptable clinical performance, a ceramic veneer must be bonded to enamel by well-polymerized resin cement. Among different factors, thickness and translucency of the ceramic may affect the resin cement polymerization. Thus, the current study evaluated the effect of the thickness and translucency of lithium disilicate ceramic on light-cured resin cement bond strength to enamel. Methods: In this laboratory study, 208 sound bovine incisors were equally divided into 16 groups (n = 13. The lithium disilicate ceramic cubes in four thicknesses (0.4, 0.6, 0.8 and 1 mm with four translucencies (high and medium opaque, high and low translucent were fabricated and bonded to prepared enamel surfaces using a light-cured translucent resin cement according to manufacturer recommendations. After 5000 cycles of thermocycling, the bonded specimens were placed in a universal testing machine and loaded to the point of fracture. To determine the mode of failure, each sample was observed under a stereomicroscope. Data were recorded and analyzed by Shapiro-Wilk test and two-way analysis of variance (ANOVA. Results: The ceramic thickness and translucency could not significantly affect shear bond strength (SBS of resin cement to enamel (p = 0.17 and p = 0.097, respectively.  The Adhesive and ceramic cohesive failures were reported as the maximum and minimum mode of failure, respectively. Conclusion: The SBS of the light-cured resin cement bonding to enamel and lithium disilicate ceramic was not affected by the translucency of ceramics having a thickness of less than 1 mm.

  13. Effect of water storage on the translucency of silorane-based and dimethacrylate-based composite resins with fibres.

    Science.gov (United States)

    Ozakar Ilday, Nurcan; Celik, Neslihan; Bayindir, Yusuf Ziya; Seven, Nilgün

    2014-06-01

    The purposes of this study were (1) to determine the translucency of silorane and dimethacrylate-based composite resins and (2) to evaluate the effect of water storage and reinforcement with fibre on the translucency of composite resins. Two light-cured composite resins (A2 shade), Filtek Silorane (silorane-based composite) and Valux Plus (dimethacrylate-based composite), were used in this study. The first group was used as the control with no reinforcements, the second was reinforced with polyethylene (Ribbond THM) and the third was reinforced with a glass fibre (Everstick Net) for each composite resin. Colour measurements were measured against white and black backgrounds with a Shadepilot (Degu Dent Gmbh, Hanau, Germany) spectrophotometer and recorded under a D65 light source, which reflects daylight. CIELAB parameters of each specimen were recorded at baseline and at 24 h, 168 h and 504 h. Translucency of materials was calculated using the translucency parameter (TP) formula. Data were analyzed using repeated measures ANOVA and LSD post hoc tests (α=0.05). The highest baseline TP value was in the Valux Plus/non-fibre reinforced group (14.06±1) and the lowest in the Filtek Silorane/Ribond THM group (8.98±1.11). Repeated measures ANOVA revealed significant effects from the factors storage time, composite resin, composite resin×storage time and fibre×time (p=0.047; p=0.001; p=0.013; p=0.022, respectively). Within the limitations of the study, we concluded that inclusion of polyethylene and glass fibres did not alter the translucency of the different-based composite resins. The longest storage time resulted in the greatest change in translucency values of Filtek Silorane composite resins. Considering the translucencies of composites with different formulations in the selection of composite resins for aesthetic restorations is important in terms of obtaining optimal aesthetic outcomes. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Prospective validation of first-trimester combined screening for trisomy 21.

    Science.gov (United States)

    Kagan, K O; Etchegaray, A; Zhou, Y; Wright, D; Nicolaides, K H

    2009-07-01

    To examine the performance of the new algorithm in screening for trisomy 21 by a combination of maternal age, fetal nuchal translucency (NT) and maternal serum free beta-human chorionic gonadotropin (beta-hCG) and pregnancy-associated plasma protein-A (PAPP-A). This was a prospective screening study for trisomy 21 in singleton pregnancies at 11 + 0 to 13 + 6 weeks of gestation using an algorithm combining maternal age, fetal NT thickness based on the mixture model for the assessment of NT, and maternal serum free beta-hCG and PAPP-A based on a multiple regression model for the assessment of serum biochemistry. The NT measurements were performed by 60 operators who had obtained The Fetal Medicine Foundation certificate of competence in the 11-13-week scan. The study population consisted of 19 614 pregnancies with a normal karyotype or delivery of a phenotypically normal baby (euploid group) and 122 cases of trisomy 21. In the euploid fetuses the NT was above the previously defined 50(th), 95(th) and 99(th) centiles in 10 033 (51.2%), 618 (3.2%) and 123 (0.6%) cases and the respective values for trisomy 21 were 117 (95.9%), 94 (77.0%) and 57 (46.7%). The median fetal NT was within 0.1 mm of the expected in 47 (78.3%) of the 60 sonographers and within 0.2 mm in all. In the euploid fetuses the median free beta-hCG was 1.0 (range, 0.1-29.4) multiples of the median (MoM) and the median PAPP-A was 1.0 (range, 0.2-3.3) MoM. The median MoM values were 1.0 or close to 1.0 MoM for each subgroup of pregnancy characteristics, including gestations of 11, 12 and 13 weeks, maternal weight of 80 kg, different ethnic origins, cigarette smokers and non-smokers, natural conception and in vitro fertilization. For a false-positive rate of 3%, the detection rate of trisomy 21 in screening by maternal age and fetal NT was 81% (95% CI, 73-89%), by maternal age and maternal serum biochemistry it was 63% (95% CI, 56-72%) and by combined screening based on maternal age, fetal NT and maternal

  15. [A cohort study on association between the first trimester phthalates exposure and fasting blood glucose level in the third trimester].

    Science.gov (United States)

    Zhang, Y W; Gao, H; Huang, K; Xu, Y Y; Sheng, J; Tao, F B

    2017-03-10

    Objective: To examine the association between the phthalate exposure in the first trimester and fasting blood glucose level or gestational diabetes mellitus (GDM) in the third trimester in pregnant women. Methods: A total of 3 474 pregnant women, receiving their prenatal examination in Ma' anshan Maternal and Child Health-Care Hospital of Anhui province, were selected from May 2013 to September 2014. Questionnaires were used to collect the information about their socio-demographic characteristics, clinical characteristics and GDM diagnostic results in the first, second and third trimesters. Urine samples and fasting venous blood samples were collected. Concentrations of 7 kinds of phthalate metabolites in urine samples were detected by solid phase extraction-high performance liquid chromatography-tandem mass spectrometry (SPE-HPLC-MS/MS), and multiple linear regression model was used for statistical analyses. Logistic regression analysis on the risk of the first trimester phthalate exposure for GDM in the third trimester was conducted. Results: The prevalence of GDM in this study was 12.8%, monomethyl phthalate (MMP), monoethyl phthalate (MEP), mono-n-butyl phthalate (MBP), monobenzyl phthalate (MBzP) and mono-(2-ethyl-5-oxohexyl) phthalate (MEHHP) exposure levels were positively correlated with the fasting blood glucose level in the third trimester ( P levels were negatively correlated with the fasting blood glucose level in the third trimester ( P blood glucose level in both normal group and GDM group. However, MMP, MEP, MBP, MBzP, MEHP and MEOHP exposure levels had influences on the third trimester fasting blood glucose level in normal group but not in GDM group. MMP and MBP exposure might increase the risk of GDM, but MEOHP exposure might reduce the risk of GDM. Conclusion: The phthalate exposure in the first trimester might be associated with the fasting blood glucose level in the third trimester, MMP, MEP, MBP, MBzP and MEHHP concentrations were positively

  16. Translucency and masking ability of various composite resins at different thicknesses.

    Science.gov (United States)

    Darabi, Farideh; Radafshar, Golpar; Tavangar, Maryam; Davaloo, Reza; Khosravian, Aref; Mirfarhadi, Nastaran

    2014-09-01

    Optical properties of the composite resins, concerning their translucency and thickness, are affected by discolored tooth structure or inherent darkness of the oral cavity. This study aimed to compare the translucency parameter (TP) of five different composite resins in different thicknesses and to evaluate their masking ability in black backgrounds. Five brands of composite resins; Gradia (GC) and Crystalline (Confi-dental) in opaque A2 (OA2), Vit-l-escence (Ultradent) in opaque snow (OS), Herculite XRV (Kerr) and Opallis (FGM) in dentin A2 (DA2) shades were selected to enroll the study. Color coordinates of each composite were determined at 0.5, 1, and 1.5 mm thicknesses on a white backing, the backing of material itself and a black backing were calculated by using a spectrophotometer to evaluate the translucency parameter (TP) of the study materials. The masking ability was also calculated from the specimens on the material itself and on black backing. The values under 2 were estimated as imperceptible. One-way ANOVA, T-test and Tukey HSD were employed for statistical analysis. The masking ability values, recorded for the 1.5 mm-thick specimens, were in the range of imperceptible except for the Herculite. There was no difference in TP values of the materials at 1.5 mm thickness. Opaque snow shade of Vit-l-escence and opaque A2 shade of Gradia showed lower TP values in comparison with the other 1 and 0.5 mm-thick materials and this difference was statistically significant (pcomposite resins could not mask the black background color.

  17. First Trimester Fetal Gender Assignment by Ultrasound

    Directory of Open Access Journals (Sweden)

    Sabahattin Altunyurt

    2010-03-01

    Full Text Available Objective: To investigate the efficiency of genital tubercule angle on detecting fetal gender in first trimester by ultrasonography. Material-Method: Fetal sex assignment by ultrasound was carried out in 172 pregnancies at 11-13+6 weeks between 2007 June and 2007 December. Gestational age was determined by the measurement of crown-rump length (CRL. The ultrasound predictions were compared with actual sex at birth. Mid-sagittal planes of a section of the fetal genital tubercle were performed to identify the gender. Results: 155 of 172 patients’ data were achieved. The overall success rate was 92.3 % in sonographic assignment of fetal sex. The correct assignment rate in female fetuses was significantly higher than males (95.9 % - 88.8 % [p=0,001]. The correct identification of fetal sex improved with advancing gestational age from 89.3 % between 11-11+6 weeks, 92.5 % between 12-12+6 weeks and 93.4 % between 13-13+6 weeks (p=0,96. Conclusion: The fetal sex assignment by ultrasonography between 11-13+6 weeks had high success rate. The sensitivity of fetal sex assignment was not affected with fetus position and gestational age.

  18. The Application of First‑Trimester Volumetry in Predicting Pregnancy ...

    African Journals Online (AJOL)

    Rawal MY, Malhotra N. Ultrasonography in Early Intrauterine pregnancy. ... Leung KY, Ma Teresa, Lau BY, Chen M. First trimester ultrasound volumetry: .... Ghosh A, Tang MH, Lam YH, Fung E, Chan V. Ultrasound measurement of placental ...

  19. Oxidative Stress Parameters as Markers of the different Trimesters in ...

    African Journals Online (AJOL)

    ADOWIE PERE

    functions accompanied by a high metabolic demand and elevated requirements for ... trimester (18.2mmole/ml) compared to the non-pregnant controls ... Maternal hormonal changes ... this increased energy requirement during pregnancy,.

  20. La Noche de la Ciudad Translúcida. /The night on the translucent nigth.

    OpenAIRE

    Florsheim, Shimrit

    2005-01-01

    Se presenta la innovación del Hormigón Translúcido, analizando sus posibilidades en arquitectura y urbanismo, además de mostrar sus ventajas en beneficio del ahorro energético y calidad de vida de los habitantes./The following article presents a creation never seen before: the invention of the translucent concrete. This article analyzes its contribution to Architecture and Urbanism of these days, considering its advantages related with the energy saving and the life quality of the citizens.

  1. La Noche de la Ciudad Translúcida. /The night on the translucent nigth.

    Directory of Open Access Journals (Sweden)

    Florsheim, Shimrit

    2005-06-01

    Full Text Available Se presenta la innovación del Hormigón Translúcido, analizando sus posibilidades en arquitectura y urbanismo, además de mostrar sus ventajas en beneficio del ahorro energético y calidad de vida de los habitantes./The following article presents a creation never seen before: the invention of the translucent concrete. This article analyzes its contribution to Architecture and Urbanism of these days, considering its advantages related with the energy saving and the life quality of the citizens.

  2. Translucency of zirconia copings made with different CAD/CAM systems.

    Science.gov (United States)

    Baldissara, Paolo; Llukacej, Altin; Ciocca, Leonardo; Valandro, Felipe L; Scotti, Roberto

    2010-07-01

    Zirconia cores are reported to be less translucent than glass, lithium disilicate, or alumina cores. This could affect the esthetic appearance and the clinical choices made when using zirconia-based restorations. The purpose of this in vitro study was to evaluate the translucency of zirconia copings for single crowns fabricated using different CAD/CAM systems, using lithium disilicate glass ceramic as a control. Using impressions made from a stainless steel complete-crown master die, 9 stone cast replicas were fabricated, numbered, and distributed into 8 ceramic ZrO(2) CAD/CAM system groups (Lava Frame 0.3 and 0.5, IPS e.max ZirCAD, VITA YZ, Procera AllZircon, Digizon, DC Zircon, and Cercon Base) and to a lithium disilicate glass-ceramic control group (IPS e.max Press) using a simple computer-generated randomization method. From each die, the manufacturer's authorized milling centers supplied 5 copings per group without applying any dying technique to the ceramic base material. The copings were prepared to allow for a 40-mum cement layer and were of different thicknesses according to system specifications. Translucency was measured by the direct transmission method with a digital photoradiometer mounted in a dark chamber. The light source was a 150-W halogen lamp beam. Measurements were repeated 3 times for each specimen. Data obtained were analyzed using 1-way ANOVA and the Bonferroni multiple comparison test (alpha=.05). Among ZrO(2) copings, Lava (0.3 mm and 0.5 mm thick) showed the highest (Plight flow units (3.572 + or - 018 x 10(3) lx and 3.181 + or - 0.13 x 10(3) lx, respectively). These values represent 71.7% and 63.9%, respectively, of the glass-ceramic control group (4.98 x 10(3) lx). All ZrO(2) copings demonstrated different levels of light transmission, with the 2 Lava specimens showing the highest values. Translucency of zirconia copings was significantly lower (P=.001) than that of the lithium disilicate glass-ceramic control. Copyright 2010 The

  3. Relative translucency of six all-ceramic systems. Part II: core and veneer materials.

    Science.gov (United States)

    Heffernan, Michael J; Aquilino, Steven A; Diaz-Arnold, Ana M; Haselton, Debra R; Stanford, Clark M; Vargas, Marcos A

    2002-07-01

    STATEMENT OF PROBLEM All-ceramic core materials with various strengthening compositions have a range of translucencies. It is unknown whether translucency differs when all-ceramic materials are fabricated similarly to the clinical restoration with a veneered core material. This study compared the translucency of 6 all-ceramic materials veneered and glazed at clinically appropriate thicknesses. Core specimens (n = 5 per group) of Empress dentin, Empress 2 dentin, In-Ceram Alumina, In-Ceram Spinell, In-Ceram Zirconia, and Procera AllCeram were fabricated as described in Part I of this study and veneered with their corresponding dentin porcelain to a final thickness of 1.47 +/- 0.01 mm. These specimens were compared with veneered Vitadur Alpha opaque dentin (as a standard), a clear glass disc (positive control), and a high-noble metal-ceramic alloy (Porc. 52 SF) veneered with Vitadur Omega dentin (negative control). Specimen reflectance was measured with an integrating sphere attached to a spectrophotometer across the visible spectrum (380 to 700 nm); 0-degree illumination and diffuse viewing geometry were used. Measurements were repeated after a glazing cycle. Contrast ratios were calculated from the luminous reflectance (Y) of the specimens with a black (Yb) and a white backing (Yw) to give Yb/Yw with CIE illuminant D65 and a 2-degree observer function (0.0 = transparent, 1.0 = opaque). One-way analysis of variance and Tukey's multiple-comparison test were used to analyze the data (P<.05). Significant differences in contrast ratios were found among the ceramic systems tested when they were veneered (P<.0001) and after the glazing cycle (P<.0001). Significant changes in contrast ratios (P<.0001) also were identified when the veneered specimens were glazed. Within the limitations of this study, a range of translucency was identified in the veneered all-ceramic systems tested. Such variability may affect their ability to match natural teeth. The glazing cycle resulted

  4. COSMIC ORIGINS SPECTROGRAPH OBSERVATIONS OF TRANSLUCENT CLOUDS: Cyg OB2 8A

    International Nuclear Information System (INIS)

    Snow, Theodore P.; Destree, Joshua D.; Burgh, Eric B.; Ferguson, Ryan M.; Danforth, Charles W.; Cordiner, Martin

    2010-01-01

    Data from the Cosmic Origins Spectrograph (COS) are presented for the first highly reddened target (Cyg OB2 8A) under the COS Science Team's guaranteed time allocation. Column densities of ionic, atomic, and molecular species are reported and implications are discussed. Data from Cyg OB2 8A demonstrate the ability to analyze highly reddened interstellar sight lines with the COS that were unavailable to previous UV instruments. Measured column densities indicate that the Cyg OB2 8A line of sight contains multiple diffuse clouds rather than a dominant translucent cloud.

  5. Monolithic translucent BaMgAl10O17:Eu2+ phosphors for laser-driven solid state lighting

    Directory of Open Access Journals (Sweden)

    Clayton Cozzan

    2016-10-01

    Full Text Available With high power light emitting diodes and laser diodes being explored for white light generation and visible light communication, thermally robust encapsulation schemes for color-converting inorganic phosphors are essential. In the current work, the canonical blue-emitting phosphor, high purity Eu-doped BaMgAl10O17, has been prepared using microwave-assisted heating (25 min and densified into translucent ceramic phosphor monoliths using spark plasma sintering (30 min. The resulting translucent ceramic monoliths convert UV laser light to blue light with the same efficiency as the starting powder and provide superior thermal management in comparison with silicone encapsulation.

  6. First Observation of the Submillimeter Polarization Spectrum in a Translucent Molecular Cloud

    Science.gov (United States)

    Ashton, Peter C.; Ade, Peter A. R.; Angilè, Francesco E.; Benton, Steven J.; Devlin, Mark J.; Dober, Bradley; Fissel, Laura M.; Fukui, Yasuo; Galitzki, Nicholas; Gandilo, Natalie N.; Klein, Jeffrey; Korotkov, Andrei L.; Li, Zhi-Yun; Martin, Peter G.; Matthews, Tristan G.; Moncelsi, Lorenzo; Nakamura, Fumitaka; Netterfield, Calvin B.; Novak, Giles; Pascale, Enzo; Poidevin, Frédérick; Santos, Fabio P.; Savini, Giorgio; Scott, Douglas; Shariff, Jamil A.; Soler, Juan D.; Thomas, Nicholas E.; Tucker, Carole E.; Tucker, Gregory S.; Ward-Thompson, Derek

    2018-04-01

    Polarized emission from aligned dust is a crucial tool for studies of magnetism in the ISM, but a troublesome contaminant for studies of cosmic microwave background polarization. In each case, an understanding of the significance of the polarization signal requires well-calibrated physical models of dust grains. Despite decades of progress in theory and observation, polarized dust models remain largely underconstrained. During its 2012 flight, the balloon-borne telescope BLASTPol obtained simultaneous broadband polarimetric maps of a translucent molecular cloud at 250, 350, and 500 μm. Combining these data with polarimetry from the Planck 850 μm band, we have produced a submillimeter polarization spectrum, the first for a cloud of this type. We find the polarization degree to be largely constant across the four bands. This result introduces a new observable with the potential to place strong empirical constraints on ISM dust polarization models in a previously inaccessible density regime. Compared to models by Draine & Fraisse, our result disfavors two of their models for which all polarization arises due only to aligned silicate grains. By creating simple models for polarized emission in a translucent cloud, we verify that extinction within the cloud should have only a small effect on the polarization spectrum shape, compared to the diffuse ISM. Thus, we expect the measured polarization spectrum to be a valid check on diffuse ISM dust models. The general flatness of the observed polarization spectrum suggests a challenge to models where temperature and alignment degree are strongly correlated across major dust components.

  7. Integrated Thermal-Energy Analysis of Innovative Translucent White Marble for Building Envelope Application

    Directory of Open Access Journals (Sweden)

    Federica Rosso

    2014-08-01

    Full Text Available Marble is a natural material, used in the construction field since antiquity. It has always been used to communicate monumentality and solidity. Nowadays new technologies permit marble to express new languages: particularly, translucent marble technology overturns the concept of solidity. The main issue to address is the lack of thermal-energy performance of such a thin stone layer as the only facade component. Conversely, Bianco Carrara and Statuario marbles, for instance, have intrinsic benefits as natural cool materials, due to their high solar reflectance and thermal emissivity. Thus, this paper analyzes the thermal-energy and environmental behavior of marble facade for a new designed building in New York City. An integrated analysis of the energy performance of the marble skin is performed through a preliminary experimental characterization, carried out for two different types of naturally white marble, for comparative purposes. Then, a dynamic simulation model of the building is developed to evaluate year-round benefits and drawbacks of the translucent marble envelope in terms of indoor thermal comfort and air-conditioning requirement. The analysis showed how the proposed marble facade is able to decrease the energy requirement for cooling up to 6%, demonstrating possible relevant perspectives for marble-based facades, even in energy-efficient buildings.

  8. Effects of surface treatments on the translucency, opalescence, and surface texture of dental monolithic zirconia ceramics.

    Science.gov (United States)

    Kim, Hee-Kyung; Kim, Sung-Hun; Lee, Jai-Bong; Ha, Seung-Ryong

    2016-06-01

    Surface polishing or glazing may increase the appearance of depth of monolithic zirconia restorations. The purpose of this in vitro study was to investigate the effects of surface treatments on the translucency, opalescence, and surface texture of dental monolithic zirconia ceramics. Forty-five monolithic zirconia specimens (16.3×16.4×2.0 mm) were divided into groups I to V, according to the number of colorings each received. Each group was then divided into 3 subgroups (n=3) according to the surface treatment: N=no treatment; P=polished; and G=glazed. CIElab color coordinates were obtained relative to D65 on a reflection spectrophotometer. The translucency parameter (TP) and opalescence parameter (OP) were calculated. One specimen per subgroups I and V was selected for evaluation of surface roughness (Ra) and was examined with scanning electron microscopy (SEM). Data were analyzed with 2-way ANOVA and pairwise comparisons (α=.05). Statistical powers were verified to evaluate results (α=.05). The interaction effects of surface treatments combined with the number of colorings were significant for TP, OP, and Ra (P.05), whereas glazing significantly decreased OP and Ra in most groups. SEM images demonstrated that surface treatments affected the surface texture of monolithic zirconia ceramics. Surface treatments combined with coloring strongly affect the surface texture of dental monolithic zirconia ceramics. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  9. [Aging of silorane- and methacrylate-based composite resins: effects on color and translucency].

    Science.gov (United States)

    Liu, Chang; Pan, Jie; Lin, Hong; Shen, Song

    2015-10-01

    To evaluate the color stability and translucency of silorane-based low shrinkage composite after in vitro aging procedures of thermal cycling and water storage respectively, and to compare with those of conventional methacrylate-based posterior composite. Three light-cured composite resins, dimethacrylate-based composite A (Filtek™ Z350), B (Filtek™ P60) and silorane-based composite C (Filtek™ P90), were tested in this study. Ten specimens (10 mm in diameter, 1 mm in height) of each composite were prepared. The ten specimens in each group were then divided into two subgroups (n = 5). One subgroup underwent thermal cycling [(5.0 ± 0.5)~(55.0 ± 1.0) °C, 10 000 cycles] and the other was stored in 37 C° distilled water for 180 days. With a spectrophotometer, the CIE L * a * b * parameters of the specimens were tested before and after artificial aging against white, medium grey and black backgrounds, respectively. △E, TP and △TP were calculated and data were analyzed using independent-samples t test and partial analysis (P composite showed color alteration above the clinically acceptable levels (△E > 3.3), and also showed higher △E with a statistically significant difference in comparison with the other composites (B and C) (P composite C showed more alteration compared with composite B (P composite underwent greater alteration with regard to color stability and translucency.

  10. Influence of surface sealant on the translucency of composite resin: effect of immersion time and immersion media

    Directory of Open Access Journals (Sweden)

    Patrícia Petromilli Nordi Sasso Garcia

    2008-06-01

    Full Text Available This study evaluated the effect of surface sealant on the translucency of composite resin immersed in different solutions. The study involved the following materials: Charisma, Fortify and coffee, Coca-Cola®, tea and artificial saliva as solutions. Sixty-four specimens (n = 8 were manufactured and immersed in artificial saliva at 37 ± 1 °C. Samples were immersed in the solutions for three times a day and re-immersed in artificial saliva until the translucency readings. The measurements were carried out at nine times: T1 - 24 hours after specimen preparation, T2 - 24 hours after immersion in the solutions, T3 - 48 hours and T4 to T9 - 7, 14, 21, 30, 60 and 90 days, respectively, after immersion. The translucency values were measured using a JOUAN device. The results were subjected to ANOVA and Tukey's test at 5%. The surface sealant was not able to protect the composite resin against staining, the coffee showed the strongest staining action, followed by tea and regarding immersion time, a significant alteration was noted in the translucency of composite resin after 21 days.

  11. Translucency and color match with a shade guide of esthetic brackets with the aid of a spectroradiometer.

    Science.gov (United States)

    Lee, Yong-Keun; Bin, Yu

    2016-01-01

    Since the color of esthetic brackets should match that of teeth, the aims of this study were to determine the color and translucency of esthetic brackets by means of the clinically relevant use of a spectroradiometer, and to compare the color of brackets with that of a commercial shade guide. The color of central and tie-wing regions of four plastic and four ceramic brackets was measured according to the CIE L*a*b* color scale over white and black backgrounds. Brackets were classified into five groups based on their composition. The color of Vitapan Classical Shade Guide tabs was also measured. Translucency parameter (TP) and contrast ratio (CR) were calculated to determine translucency. Color differences between brackets and the shade guide tabs were 10.4 - 34.5 ∆E*ab units. TP and CR values for the central region were 16.4 - 27.7 and 0.38 - 0.58, whereas for the tie-wings they were 24.0 - 39.9 and 0.25 - 0.45, respectively. The color coordinates, TP and CR values were significantly influenced by bracket composition and brand (p brackets investigated herein showed unacceptable color differences (∆E*ab > 5.5) compared with the shade guide tabs. Differences in the translucency of brackets by brand were within the visually perceptible range (∆CR > 0.07). Therefore, brackets showing the best matching performance for each case should be selected considering esthetic and functional demands.

  12. Radiographic analysis of the correlation between ossification of the nuchal ligament and sagittal alignment and segmental stability of the cervical spine in patients with cervical spondylotic myelopathy.

    Science.gov (United States)

    Ying, Jinwei; Teng, Honglin; Qian, Yunfan; Hu, Yingying; Wen, Tianyong; Ruan, Dike; Zhu, Minyu

    2018-01-01

    Background Ossification of the nuchal ligament (ONL) caused by chronic injury to the nuchal ligament (NL) is very common in instability-related cervical disorders. Purpose To determine possible correlations between ONL, sagittal alignment, and segmental stability of the cervical spine. Material and Methods Seventy-three patients with cervical spondylotic myelopathy (CSM) and ONL (ONL group) and 118 patients with CSM only (control group) were recruited. Radiographic data included the characteristics of ONL, sagittal alignment and segmental stability, and ossification of the posterior longitudinal ligament (OPLL). We performed comparisons in terms of radiographic parameters between the ONL and control groups. The correlations between ONL size, cervical sagittal alignment, and segmental stability were analyzed. Multivariate logistic regression was used to identify the independent risk factors of the development of ONL. Results C2-C7 sagittal vertical axis (SVA), T1 slope (T1S), T1S minus cervical lordosis (T1S-CL) on the lateral plain, angular displacement (AD), and horizontal displacement (HD) on the dynamic radiograph increased significantly in the ONL group compared with the control group. The size of ONL significantly correlated with C2-C7 SVA, T1S, AD, and HD. The incidence of ONL was higher in patients with OPLL and segmental instability. Cervical instability, sagittal malalignment, and OPLL were independent predictors of the development of ONL through multivariate analysis. Conclusion Patients with ONL are more likely to have abnormal sagittal alignment and instability of the cervical spine. Thus, increased awareness and appreciation of this often-overlooked radiographic finding is warranted during diagnosis and treatment of instability-related cervical pathologies and injuries.

  13. Characterization of Conventional and High-Translucency Y-TZP Dental Ceramics Submitted to Air Abrasion.

    Science.gov (United States)

    Tostes, Bhenya Ottoni; Guimarães, Renato Bastos; Noronha-Filho, Jaime Dutra; Botelho, Glauco Dos Santos; Guimarães, José Guilherme Antunes; Silva, Eduardo Moreira da

    2017-01-01

    This study evaluated the effect of air-abrasion on t®m phase transformation, roughness, topography and the elemental composition of three Y-TZP (Yttria-stabilized tetragonal zirconia polycrystal) dental ceramics: two conventional (Lava Frame and IPS ZirCad) and one with high-translucency (Lava Plus). Plates obtained from sintered blocks of each ceramic were divided into four groups: AS (as-sintered); 30 (air-abrasion with 30 mm Si-coated Al2O3 particles); 50 (air-abrasion with 50 mm Al2O3 particles) and 150 (air-abrasion with 150 mm Al2O3 particles). After the treatments, the plates were submitted to X-ray diffractometry; 3-D profilometry and SEM/EDS. The AS surfaces were composed of Zr and t phases. All treatments produced t®m phase transformation in the ceramics. The diameter of air-abrasion particles influenced the roughness (150>50>30>AS) and the topography. SEM analysis showed that the three treatments produced groove-shaped microretentions on the ceramic surfaces, which increased with the diameter of air-abrasion particles. EDS showed a decrease in Zr content along with the emergence of O and Al elements after air-abrasion. Presence of Si was also detected on the plates air-abraded with 30 mm Si-coated Al2O3 particles. It was concluded that irrespective of the type and diameter of the particles, air-abrasion produced t®m phase transformation, increased the roughness and changed the elemental composition of the three Y-TZP dental ceramics. Lava Plus also behaved similarly to the conventional Y-TZP ceramics, indicating that this high translucency ceramic could be more suitable to build monolithic ceramic restorations in the aesthetic restorative dentistry field.

  14. TEMPERATURE SPECTRA OF INTERSTELLAR DUST GRAINS HEATED BY COSMIC RAYS. I. TRANSLUCENT CLOUDS

    Energy Technology Data Exchange (ETDEWEB)

    Kalvāns, Juris, E-mail: juris.kalvans@venta.lv [Engineering Research Institute “Ventspils International Radio Astronomy Center” of Ventspils University College, Inzenieru 101, Ventspils, LV-3601 (Latvia)

    2016-06-01

    Heating of whole interstellar dust grains by cosmic-ray (CR) particles affects the gas–grain chemistry in molecular clouds by promoting molecule desorption, diffusion, and chemical reactions on grain surfaces. The frequency of such heating, f{sub T}, s{sup −1}, determines how often a certain temperature T{sub CR}, K, is reached for grains hit by CR particles. This study aims to provide astrochemists with a comprehensive and updated data set on CR-induced whole-grain heating. We present calculations of f{sub T} and T{sub CR} spectra for bare olivine grains with radius a of 0.05, 0.1, and 0.2 μ m and such grains covered with ice mantles of thickness 0.1 a and 0.3 a . Grain shape and structure effects are considered, as well as 30 CR elemental constituents with an updated energy spectrum corresponding to a translucent cloud with A{sub V} = 2 mag. Energy deposition by CRs in grain material was calculated with the srim program. We report full T{sub CR} spectra for all nine grain types and consider initial grain temperatures of 10 K and 20 K. We also provide frequencies for a range of minimum T{sub CR} values. The calculated data set can be simply and flexibly implemented in astrochemical models. The results show that, in the case of translucent clouds, the currently adopted rate for heating of whole grains to temperatures in excess of 70 K is underestimated by approximately two orders of magnitude in astrochemical numerical simulations. Additionally, grains are heated by CRs to modest temperatures (20–30 K) with intervals of a few years, which reduces the possibility of ice chemical explosions.

  15. The effects of different opacifiers on the translucency of experimental dental composite resins.

    Science.gov (United States)

    Haas, Karine; Azhar, Gulelala; Wood, Duncan J; Moharamzadeh, Keyvan; van Noort, Richard

    2017-08-01

    The aim of this study was to evaluate the effects of different opacifiers on the translucency of experimental dental composite-resins. Three metal oxides that are used as opacifiers were tested in this study: titanium oxide (TiO 2 ), aluminium oxide (Al 2 O 3 ) and zirconium oxide (ZrO 2 ). Experimental composite-resins were fabricated containing 25wt.% urethane dimethacrylate (UDMA)-based resin matrix and 75% total filler including different concentrations of metal oxides (0, 0.25, 0.5, 0.75 and 1wt.%) blended into silane treated barium-silicate filler. The specimens (15.5mm diameter and 1mm thickness) were light-cured and tested in the transmittance mode using a UV/VIS spectrophotometer at wavelengths from 380 to 700nm under a standard illuminant D65. The color differences (ΔE* ab) between different concentrations of opacifiers were also measured in transmittance mode based on their Lab values. Statistical analysis by ANOVA and Tukey's test showed a significant decrease (pcomposite-resins. There was a linear correlation between different concentrations of TiO 2 and Al 2 O 3 and total transmittance. Total transmittance was also found to be wavelength dependent. The color differences for the concentrations of 0-1wt.% of the opacifiers were above 1 ΔE* unit, with Al 2 O 3 showing the smallest color shift. The type and the amount of the opacifiers used in this study had a significant effect on the translucency of the experimental UDMA-based dental composite resins. The most effective opacifier was TiO 2 , followed by ZrO 2 and Al 2 O 3 in decreasing order, respectively. Copyright © 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  16. Software package to automate the design and production of translucent building structures made of pvc

    Directory of Open Access Journals (Sweden)

    Petrova Irina Yur’evna

    2016-08-01

    Full Text Available The article describes the features of the design and production of translucent building structures made of PVC. The analysis of the automation systems of this process currently existing on the market is carried out, their advantages and disadvantages are identified. Basing on this analysis, a set of requirements for automation systems for the design and production of translucent building structures made of PVC is formulated; the basic entities are involved in those business processes. The necessary functions for the main application and for dealers’ application are specified. The main application is based on technological platform 1C: Enterprise 8.2. The dealers’ module is .NET application and is developed with the use of Microsoft Visual Studio and Microsoft SQL Server because these software products have client versions free for end users (.NET Framework 4.0 Client Profile and Microsoft SQL Server 2008 Express. The features of the developed software complex implementation are described; the relevant charts are given. The scheme of system deployment and protocols of data exchange between 1C server, 1C client and dealer is presented. Also the functions supported by 1C module and .NET module are described. The article describes the content of class library developed for .NET module. The specification of integration of the two applications in a single software package is given. The features of the GUI organization are described; the corresponding screenshots are given. The possible ways of further development of the described software complex are presented and a conclusion about its competitiveness and expediency of new researches is made.

  17. Platelet Count in First Trimester of Pregnancy as a Predictor of Perinatal Outcome

    Directory of Open Access Journals (Sweden)

    Santiago Garcia-Tizon Larroca

    2017-02-01

    CONCLUSIONS: Maternal and pregnancy factors can poorly predict relevant changes in PLT at the first trimester of gestation. PLT at first trimester of pregnancy might predict adverse perinatal outcome in combination with other markers.

  18. Second trimester cardiac diagnosis : screening standards and outcomes

    NARCIS (Netherlands)

    Clur, Sally-Ann B.; Bilardo, Caterina M.

    2014-01-01

    Second trimester screening for congenital heart defects occurs during the routine 18-20 weeks' anomaly scan in many countries. Most congenital heart defects can be prenatally detected by experts in foetal echocardiography working in tertiary centres with high-risk pregnancies. Many studies, however,

  19. Second trimester cardiac diagnosis: screening standards and outcomes

    NARCIS (Netherlands)

    Clur, Sally-Ann B.; Bilardo, Caterina M.

    2014-01-01

    Second trimester screening for congenital heart defects occurs during the routine 18-20 weeks' anomaly scan in many countries. Most congenital heart defects can be prenatally detected by experts in foetal echocardiography working in tertiary centres with high-risk pregnancies. Many studies, however,

  20. Co-variables in first trimester maternal serum screening

    NARCIS (Netherlands)

    de Graaf, I. M.; Cuckle, H. S.; Pajkrt, E.; Leschot, N. J.; Bleker, O. P.; van Lith, J. M.

    2000-01-01

    The objective of this study was to determined the influence of maternal weight, maternal smoking habits, gravidity, parity and fetal gender on the level of maternal serum marker used in first trimester screening for Down syndrome. A total of 2449 singleton unaffected pregnancies from two centres

  1. Taste preferences of west African dwarf ewes at different trimester ...

    African Journals Online (AJOL)

    Taste preferences of pregnant West African dwarf (WAD) ewes were studied at different trimester periods using the multiple choice preference test method. A total of twelve WAD ewes of average body weight of 15.96 ± 4.17 kg, divided into two groups (A and B) were used for the study. Six pregnant ewes (in group A) served ...

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

    Directory of Open Access Journals (Sweden)

    Pei-Ying Ling

    2006-09-01

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

  3. First trimester biochemistry in pregnancies conceived using assisted reproduction techniques

    DEFF Research Database (Denmark)

    Tabor, Ann; Ekelund, Charlotte; Nørgaard, Pernille

    Objective: To examine the effects of method of conception on first trimester PAPP-A and free beta-hCG and the dependency of gestational age at the time of sampling on these effects Methods: Data on more than 100 000 spontaneously conceived and on 6 859 pregnancies conceived by assisted reproducti...

  4. Electrolytes concentration patterns in the three trimesters of pregnancy

    African Journals Online (AJOL)

    The physiologic adaptations of the pregnant woman involve the renal, cardiovascular and other systems of the body. This study aimed at evaluating electrolyte concentrations in the three trimesters of pregnancy. Blood samples were collected by aseptic techniques and the concentrations of electrolytes were determined ...

  5. Maternal weight gain in second and third trimesters and their ...

    African Journals Online (AJOL)

    A prospective study was carried out to determine the relationship between weight gain in the second and third trimesters with the corresponding birth weights in Morogoro, Tanzania. A total of 270 pregnant women who gave birth to singleton deliveries and their consecutive newborns were randomly selected from among ...

  6. A highly conspicuous mineralized composite photonic architecture in the translucent shell of the blue-rayed limpet

    OpenAIRE

    Li, Ling; Kolle, Stefan; Weaver, James C.; Ortiz, Christine; Aizenberg, Joanna; Kolle, Mathias

    2015-01-01

    Many species rely on diverse selections of entirely organic photonic structures for the manipulation of light and the display of striking colours. Here we report the discovery of a mineralized hierarchical photonic architecture embedded within the translucent shell of the blue-rayed limpet Patella pellucida. The bright colour of the limpet’s stripes originates from light interference in a periodically layered zig-zag architecture of crystallographically co-oriented calcite lamellae. Beneath t...

  7. Highly-translucent, strong and aging-resistant 3Y-TZP ceramics for dental restoration by grain boundary segregation.

    Science.gov (United States)

    Zhang, Fei; Vanmeensel, Kim; Batuk, Maria; Hadermann, Joke; Inokoshi, Masanao; Van Meerbeek, Bart; Naert, Ignace; Vleugels, Jef

    2015-04-01

    Latest trends in dental restorative ceramics involve the development of full-contour 3Y-TZP ceramics which can avoid chipping of veneering porcelains. Among the challenges are the low translucency and the hydrothermal stability of 3Y-TZP ceramics. In this work, different trivalent oxides (Al2O3, Sc2O3, Nd2O3 and La2O3) were selected to dope 3Y-TZP ceramics. Results show that dopant segregation was a key factor to design hydrothermally stable and high-translucent 3Y-TZP ceramics and the cation dopant radius could be used as a controlling parameter. A large trivalent dopant, oversized as compared to Zr(4+), exhibiting strong segregation at the ZrO2 grain boundary was preferred. The introduction of 0.2 mol% La2O3 in conventional 0.1-0.25 wt.% Al2O3-doped 3Y-TZP resulted in an excellent combination of high translucency and superior hydrothermal stability, while retaining excellent mechanical properties. Copyright © 2015 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  8. Simulation of DNAPL migration in heterogeneous translucent porous media based on estimation of representative elementary volume

    Science.gov (United States)

    Wu, Ming; Wu, Jianfeng; Wu, Jichun

    2017-10-01

    When the dense nonaqueous phase liquid (DNAPL) comes into the subsurface environment, its migration behavior is crucially affected by the permeability and entry pressure of subsurface porous media. A prerequisite for accurately simulating DNAPL migration in aquifers is then the determination of the permeability, entry pressure and corresponding representative elementary volumes (REV) of porous media. However, the permeability, entry pressure and corresponding representative elementary volumes (REV) are hard to determine clearly. This study utilizes the light transmission micro-tomography (LTM) method to determine the permeability and entry pressure of two dimensional (2D) translucent porous media and integrates the LTM with a criterion of relative gradient error to quantify the corresponding REV of porous media. As a result, the DNAPL migration in porous media might be accurately simulated by discretizing the model at the REV dimension. To validate the quantification methods, an experiment of perchloroethylene (PCE) migration is conducted in a two-dimensional heterogeneous bench-scale aquifer cell. Based on the quantifications of permeability, entry pressure and REV scales of 2D porous media determined by the LTM and relative gradient error, different models with different sizes of discretization grid are used to simulate the PCE migration. It is shown that the model based on REV size agrees well with the experimental results over the entire migration period including calibration, verification and validation processes. This helps to better understand the microstructures of porous media and achieve accurately simulating DNAPL migration in aquifers based on the REV estimation.

  9. Determination of the solar transmittance for the translucent shutter with PCM in liquid and solid state

    Science.gov (United States)

    Komerska, Anna; Ksionek, Dariusz; Rosiński, Marian

    2017-11-01

    This article presents results of the energy performance of an external translucent shading component integrated with a phase change material. A proposed technology is able to accumulate considerable amounts of energy in the latent heat by absorbing solar energy. Due to selective optical properties, much of the visible light is still transmitted through the facade. Experimental measurements were carried out in a laboratory set-up - testing thermal chamber, located in the Faculty of Building Services, Hydro and Environmental Engineering at Warsaw University of Technology. The main result of the experimental study was the evaluation of the average solar transmittance in the whole measured spectrum, as well as in the infrared and visible light. Since the shift in optical properties was observed when the material was undergoing a phase transition, the average spectral transmittances were measured for different states of matter of the PCM material. The tested shutter showed abilities to reduce and modulate daylight and solar heat gains in the indoor environment, which could contribute to considerable energy savings.

  10. Determination of the solar transmittance for the translucent shutter with PCM in liquid and solid state

    Directory of Open Access Journals (Sweden)

    Komerska Anna

    2017-01-01

    Full Text Available This article presents results of the energy performance of an external translucent shading component integrated with a phase change material. A proposed technology is able to accumulate considerable amounts of energy in the latent heat by absorbing solar energy. Due to selective optical properties, much of the visible light is still transmitted through the facade. Experimental measurements were carried out in a laboratory set–up – testing thermal chamber, located in the Faculty of Building Services, Hydro and Environmental Engineering at Warsaw University of Technology. The main result of the experimental study was the evaluation of the average solar transmittance in the whole measured spectrum, as well as in the infrared and visible light. Since the shift in optical properties was observed when the material was undergoing a phase transition, the average spectral transmittances were measured for different states of matter of the PCM material. The tested shutter showed abilities to reduce and modulate daylight and solar heat gains in the indoor environment, which could contribute to considerable energy savings.

  11. Averaged subtracted polarization imaging for endoscopic diagnostics of surface microstructures on translucent mucosae

    Science.gov (United States)

    Kanamori, Katsuhiro

    2016-07-01

    An endoscopic image processing technique for enhancing the appearance of microstructures on translucent mucosae is described. This technique employs two pairs of co- and cross-polarization images under two different linearly polarized lights, from which the averaged subtracted polarization image (AVSPI) is calculated. Experiments were then conducted using an acrylic phantom and excised porcine stomach tissue using a manual experimental setup with ring-type lighting, two rotating polarizers, and a color camera; better results were achieved with the proposed method than with conventional color intensity image processing. An objective evaluation method that uses texture analysis was developed and used to evaluate the enhanced microstructure images. This paper introduces two types of online, rigid-type, polarimetric endoscopic implementations using a polarized ring-shaped LED and a polarimetric camera. The first type uses a beam-splitter-type color polarimetric camera, and the second uses a single-chip monochrome polarimetric camera. Microstructures on the mucosa surface were enhanced robustly with these online endoscopes regardless of the difference in the extinction ratio of each device. These results show that polarimetric endoscopy using AVSPI is both effective and practical for hardware implementation.

  12. Effect of translucence of engineering ceramics on heat transfer in diesel engines. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Wahiduzzaman, S.; Morel, T. [Integral Technologies, Inc., Westmont, IL (United States)

    1992-04-01

    This report describes the experimental portion of a broader study undertaken to assess the effects of translucence of ceramic materials used as thermal barrier coatings in diesel engines. In an earlier analytical work a parametric study was performed, varying several radiative properties over ranges typical of engineering ceramics, thereby identifying the most important radiative properties and their impact on in-cylinder heat transfer. In the current study these properties were experimentally determined for several specific zirconia coatings considered for thermal barrier applications in diesel engines. The methodology of this study involved formulation of a model capable of describing radiative transfer through a semitransparent medium as a function of three independent model parameters, ie, absorption coefficient, scattering coefficient and refractive index. For the zirconia-based ceramics investigated in this study, it was concluded that for usual coating thicknesses (1.5--2.5 mm) these ceramics are optically thick and hence, are effective as radiative heat transfer barriers. These ceramics possess high scattering coefficients and low absorption coefficients causing them to be highly reflective (60-80%) in the spectral region where thermal radiation is important. The performance of the investigated ceramics and the mechanism of heat transfer were found to depend on surface condition, specifically on soot deposition. Thus, to insure the optimum thermal barrier operation for either clean or heavily sooted surfaces, a ceramic material with high scattering coefficient provides the best choice.

  13. Effect of translucence of engineering ceramics on heat transfer in diesel engines

    Energy Technology Data Exchange (ETDEWEB)

    Wahiduzzaman, S.; Morel, T. (Integral Technologies, Inc., Westmont, IL (United States))

    1992-04-01

    This report describes the experimental portion of a broader study undertaken to assess the effects of translucence of ceramic materials used as thermal barrier coatings in diesel engines. In an earlier analytical work a parametric study was performed, varying several radiative properties over ranges typical of engineering ceramics, thereby identifying the most important radiative properties and their impact on in-cylinder heat transfer. In the current study these properties were experimentally determined for several specific zirconia coatings considered for thermal barrier applications in diesel engines. The methodology of this study involved formulation of a model capable of describing radiative transfer through a semitransparent medium as a function of three independent model parameters, ie, absorption coefficient, scattering coefficient and refractive index. For the zirconia-based ceramics investigated in this study, it was concluded that for usual coating thicknesses (1.5--2.5 mm) these ceramics are optically thick and hence, are effective as radiative heat transfer barriers. These ceramics possess high scattering coefficients and low absorption coefficients causing them to be highly reflective (60-80%) in the spectral region where thermal radiation is important. The performance of the investigated ceramics and the mechanism of heat transfer were found to depend on surface condition, specifically on soot deposition. Thus, to insure the optimum thermal barrier operation for either clean or heavily sooted surfaces, a ceramic material with high scattering coefficient provides the best choice.

  14. Validation of second trimester miscarriages and spontaneous deliveries

    DEFF Research Database (Denmark)

    Sundtoft, Iben Blaabjerg; Sneider, Kirstine; Christiansen, Ole Bjarne

    2015-01-01

    OBJECTIVE: To validate the diagnosis of second trimester miscarriages/deliveries (16+0 weeks to 27+6 weeks of gestation) recorded as miscarriages in the Danish National Patient Registry or spontaneous deliveries in the Danish Medical Birth Registry, and asses the validity of risk factors, pregnancy...... information and calculated positive predictive values of the registry diagnoses stratified by type of registry, as well as sensitivity, specificity, positive predictive value, and kappa coefficients of risk factors, pregnancy complications, and cerclage. RESULTS: Miscarriage/spontaneous delivery in the second......-based information on pregnancy complications need to be improved. We recommend that all pregnancies ending spontaneously beyond the first trimester are included in the national birth registry and described by appropriate variables....

  15. Medical management of first trimester miscarriage according to ultrasonographic findings

    DEFF Research Database (Denmark)

    Vejborg, Thomas; Nilas, Lisbeth; Rørbye, Christina

    2007-01-01

    BACKGROUND: The efficacy of medical treatment of first trimester miscarriages may depend on the regimen used, the definition of success, clinical symptoms, and, possibly, on the ultrasonographic findings. Our primary aim was to assess if a single dose of misoprostol could reduce the number of sur...... of pregnancy failure, time of assessment, and the criteria for success.......BACKGROUND: The efficacy of medical treatment of first trimester miscarriages may depend on the regimen used, the definition of success, clinical symptoms, and, possibly, on the ultrasonographic findings. Our primary aim was to assess if a single dose of misoprostol could reduce the number...... ultrasonography after either 1, 2 or 3 days. Treatment was successful if a complete abortion was diagnosed at follow-up. The women were divided into 4 ultrasonographically-defined groups: missed abortion with a crown rump length (CRL)>or=6 mm (Group A1) or CRL

  16. Conjoined twins detected in the first trimester: A review

    Directory of Open Access Journals (Sweden)

    Chih-Ping Chen

    2011-12-01

    Full Text Available Conjoined twinning occurs in 1 in 100 sets of monozygotic twins, 1 in 50,000 gestations or 1 in 250,000 live births. With the advent of ultrasound technology, prenatal diagnosis of conjoined twins is possible. This article provides a comprehensive review of conjoined twins detected in the first trimester including fetal gender, maternal age, parity, types of fusion, related ultrasound abnormalities, perinatal outcome and association with assisted reproduction.

  17. HELLP kan ses i andet trimester ved antifosfolipidsyndrom

    DEFF Research Database (Denmark)

    Madsen, Bjørn Stæhr; Havelund, Troels

    2011-01-01

    The syndrome of haemolysis, elevated liver enzymes and low platelets (HELLP) is estimated to occur in 0.01-0.2% of pregnancies and is considered a severe form of preeclampsia. It is associated with considerable risk of maternal and foetal mortality. HELLP syndrome associated with antiphospholipid...... syndrome is known to occur early in the pregnancy. We report a case of severe HELLP syndrome complicated by multiple hepatic infarctions and portal vein thrombosis in the second trimester in a patient with antiphospholipid syndrome....

  18. Pregnancy outcomes after first-trimester vaginitis drug therapy.

    Science.gov (United States)

    Rosa, F W; Baum, C; Shaw, M

    1987-05-01

    Prescription frequencies in the first trimester were compared for miconazole, clotrimazole, nystatin, candicidin, aminacrine compounds, and metronidazole before deliveries involving congenital anomalies versus those not linked to congenital anomalies. Prescriptions before spontaneous abortions were compared with those in the first trimester of deliveries and with those before legal abortions. No statistically significant association was observed with any of these agents for the overall frequency of birth defects or for specific birth defects analyzed (cardiovascular defects, oral clefts, and spina bifida). Two hundred fifty miconazole exposures among 4264 spontaneous abortions, compared with 2236 in the first trimester of 55,736 deliveries, provided an estimated relative risk of 1.4 (95% confidence limits 1.2-1.5). One hundred twelve treatments with clotrimazole among the spontaneous abortions, compared with 1086 among the deliveries, provided a relative risk of 1.4 (95% confidence limits 1.1-1.6). In contrast, large numbers of exposures to nystatin and aminacrine compounds did not show this association, suggesting that spontaneous abortions are caused by the imidazole agents miconazole and clotrimazole rather than the condition being treated. Because many associations were examined without previous hypotheses, and because the data were inadequate to show an elevated risk for clotrimazole when comparing spontaneous with legal abortion exposures, these findings are considered to be a signal for further studies rather than definitive in themselves.

  19. Relative translucency of six all-ceramic systems. Part I: core materials.

    Science.gov (United States)

    Heffernan, Michael J; Aquilino, Steven A; Diaz-Arnold, Ana M; Haselton, Debra R; Stanford, Clark M; Vargas, Marcos A

    2002-07-01

    All-ceramic restorations have been advocated for superior esthetics. Various materials have been used to improve ceramic core strength, but it is unclear whether they affect the opacity of all-ceramic systems. This study compared the translucency of 6 all-ceramic system core materials at clinically appropriate thicknesses. Disc specimens 13 mm in diameter and 0.49 +/- 0.01 mm in thickness were fabricated from the following materials (n = 5 per group): IPS Empress dentin, IPS Empress 2 dentin, In-Ceram Alumina core, In-Ceram Spinell core, In-Ceram Zirconia core, and Procera AllCeram core. Empress and Empress 2 dentin specimens also were fabricated and tested at a thickness of 0.77 +/- 0.02 mm (the manufacturer's recommended core thickness is 0.8 mm). A high-noble metal-ceramic alloy (Porc. 52 SF) served as the control, and Vitadur Alpha opaque dentin was used as a standard. Sample reflectance (ratio of the intensity of reflected light to that of the incident light) was measured with an integrating sphere attached to a spectrophotometer across the visible spectrum (380 to 700 nm); 0-degree illumination and diffuse viewing geometry were used. Contrast ratios were calculated from the luminous reflectance (Y) of the specimens with a black (Yb) and a white (Yw) backing to give Yb/Yw with CIE illuminant D65 and a 2-degree observer function (0.0 = transparent, 1.0 = opaque). One-way analysis of variance and Tukey's multiple-comparison test were used to analyze the data (P In-Ceram Spinell > Empress, Procera, Empress 2 > In-Ceram Alumina > In-Ceram Zirconia, 52 SF alloy.

  20. Radiative Transfer in a Translucent Cloud Illuminated by an Extended Background Source

    Science.gov (United States)

    Biganzoli, Davide; Potenza, Marco A. C.; Robberto, Massimo

    2017-05-01

    We discuss the radiative transfer theory for translucent clouds illuminated by an extended background source. First, we derive a rigorous solution based on the assumption that multiple scatterings produce an isotropic flux. Then we derive a more manageable analytic approximation showing that it nicely matches the results of the rigorous approach. To validate our model, we compare our predictions with accurate laboratory measurements for various types of well-characterized grains, including purely dielectric and strongly absorbing materials representative of astronomical icy and metallic grains, respectively, finding excellent agreement without the need to add free parameters. We use our model to explore the behavior of an astrophysical cloud illuminated by a diffuse source with dust grains having parameters typical of the classic ISM grains of Draine & Lee and protoplanetary disks, with an application to the dark silhouette disk 114-426 in Orion Nebula. We find that the scattering term modifies the transmitted radiation, both in terms of intensity (extinction) and shape (reddening) of the spectral distribution. In particular, for small optical thickness, our results show that scattering makes reddening almost negligible at visible wavelengths. Once the optical thickness increases enough and the probability of scattering events becomes close to or larger than 1, reddening becomes present but is appreciably modified with respect to the standard expression for line-of-sight absorption. Moreover, variations of the grain refractive index, in particular the amount of absorption, also play an important role in changing the shape of the spectral transmission curve, with dielectric grains showing the minimum amount of reddening.

  1. Radiative Transfer in a Translucent Cloud Illuminated by an Extended Background Source

    Energy Technology Data Exchange (ETDEWEB)

    Biganzoli, Davide [Università degli Studi dell’Insubria Dept. of Science and High Technology Via Valleggio, 11, I-22100 Como (Italy); Potenza, Marco A. C. [Universitá degli Studi di Milano Dept. of Physics Via Celoria 16, I-20133 Milano (Italy); Robberto, Massimo, E-mail: robberto@stsci.edu [Space Telescope Science Institute Baltimore, MD 21218 (United States)

    2017-05-01

    We discuss the radiative transfer theory for translucent clouds illuminated by an extended background source. First, we derive a rigorous solution based on the assumption that multiple scatterings produce an isotropic flux. Then we derive a more manageable analytic approximation showing that it nicely matches the results of the rigorous approach. To validate our model, we compare our predictions with accurate laboratory measurements for various types of well-characterized grains, including purely dielectric and strongly absorbing materials representative of astronomical icy and metallic grains, respectively, finding excellent agreement without the need to add free parameters. We use our model to explore the behavior of an astrophysical cloud illuminated by a diffuse source with dust grains having parameters typical of the classic ISM grains of Draine and Lee and protoplanetary disks, with an application to the dark silhouette disk 114–426 in Orion Nebula. We find that the scattering term modifies the transmitted radiation, both in terms of intensity (extinction) and shape (reddening) of the spectral distribution. In particular, for small optical thickness, our results show that scattering makes reddening almost negligible at visible wavelengths. Once the optical thickness increases enough and the probability of scattering events becomes close to or larger than 1, reddening becomes present but is appreciably modified with respect to the standard expression for line-of-sight absorption. Moreover, variations of the grain refractive index, in particular the amount of absorption, also play an important role in changing the shape of the spectral transmission curve, with dielectric grains showing the minimum amount of reddening.

  2. WATER ABSORPTION IN GALACTIC TRANSLUCENT CLOUDS: CONDITIONS AND HISTORY OF THE GAS DERIVED FROM HERSCHEL /HIFI PRISMAS OBSERVATIONS

    Energy Technology Data Exchange (ETDEWEB)

    Flagey, N.; Goldsmith, P. F. [Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, CA 91109 (United States); Lis, D. C.; Monje, R.; Phillips, T. G. [California Institute of Technology, 1200 East California Boulevard, Pasadena, CA 91125 (United States); Gerin, M.; De Luca, M.; Godard, B. [LERMA, UMR 8112 du CNRS, Observatoire de Paris, Ecole Normale Superieure, UPMC and UCP (France); Neufeld, D. [Department of Physics and Astronomy, Johns Hopkins Univ. 3400 N. Charles St., Baltimore, MD 21218 (United States); Sonnentrucker, P. [Space Telescope Science Institute, 3700 San Martin Drive, Baltimore, MD 21218 (United States); Goicoechea, J. R., E-mail: nflagey@jpl.nasa.gov [Centro de Astrobiologia (CSIC-INTA), E-28850 Torrejon de Ardoz, Madrid (Spain)

    2013-01-01

    We present Herschel/HIFI observations of the three ground state transitions of H{sub 2}O (556, 1669, and 1113 GHz) and H{sub 2}{sup 18}O (547, 1655, and 1101 GHz)-as well as the first few excited transitions of H{sub 2}O (987, 752, and 1661 GHz)-toward six high-mass star-forming regions, obtained as part of the PRISMAS (PRobing InterStellar Molecules with Absorption line Studies) Guaranteed Time Key Program. Water vapor associated with the translucent clouds in Galactic arms is detected in absorption along every line of sight in all the ground state transitions. The continuum sources all exhibit broad water features in emission in the excited and ground state transitions. Strong absorption features associated with the source are also observed at all frequencies except 752 GHz. We model the background continuum and line emission to infer the optical depth of each translucent cloud along the lines of sight. We derive the column density of H{sub 2}O or H{sub 2}{sup 18}O for the lower energy level of each transition observed. The total column density of water in translucent clouds is usually about a few 10{sup 13} cm{sup -2}. We find that the abundance of water relative to hydrogen nuclei is 1 Multiplication-Sign 10{sup -8} in agreement with models for oxygen chemistry in which high cosmic ray ionization rates are assumed. Relative to molecular hydrogen, the abundance of water is remarkably constant through the Galactic plane with X(H{sub 2}O) =5 Multiplication-Sign 10{sup -8}, which makes water a good traced of H{sub 2} in translucent clouds. Observations of the excited transitions of H{sub 2}O enable us to constrain the abundance of water in excited levels to be at most 15%, implying that the excitation temperature, T {sub ex}, in the ground state transitions is below 10 K. Further analysis of the column densities derived from the two ortho ground state transitions indicates that T {sub ex} {approx_equal} 5 K and that the density n(H{sub 2}) in the translucent clouds

  3. Molybdenum cofactor deficiency causes translucent integument, male-biased lethality, and flaccid paralysis in the silkworm Bombyx mori.

    Science.gov (United States)

    Fujii, Tsuguru; Yamamoto, Kimiko; Banno, Yutaka

    2016-06-01

    Uric acid accumulates in the epidermis of Bombyx mori larvae and renders the larval integument opaque and white. Yamamoto translucent (oya) is a novel spontaneous mutant with a translucent larval integument and unique phenotypic characteristics, such as male-biased lethality and flaccid larval paralysis. Xanthine dehydrogenase (XDH) that requires a molybdenum cofactor (MoCo) for its activity is a key enzyme for uric acid synthesis. It has been observed that injection of a bovine xanthine oxidase, which corresponds functionally to XDH and contains its own MoCo activity, changes the integuments of oya mutants from translucent to opaque and white. This finding suggests that XDH/MoCo activity might be defective in oya mutants. Our linkage analysis identified an association between the oya locus and chromosome 23. Because XDH is not linked to chromosome 23 in B. mori, MoCo appears to be defective in oya mutants. In eukaryotes, MoCo is synthesized by a conserved biosynthesis pathway governed by four loci (MOCS1, MOCS2, MOCS3, and GEPH). Through a candidate gene approach followed by sequence analysis, a 6-bp deletion was detected in an exon of the B. mori molybdenum cofactor synthesis-step 1 gene (BmMOCS1) in the oya strain. Moreover, recombination was not observed between the oya and BmMOCS1 loci. These results indicate that the BmMOCS1 locus is responsible for the oya locus. Finally, we discuss the potential cause of male-biased lethality and flaccid paralysis observed in the oya mutants. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Thickness dependence of light transmittance, translucency and opalescence of a ceria-stabilized zirconia/alumina nanocomposite for dental applications.

    Science.gov (United States)

    Shiraishi, Takanobu; Watanabe, Ikuya

    2016-05-01

    This study was conducted to investigate thickness dependence of light transmittance, translucency and opalescence of a commercially available fully-sintered ceria-stabilized zirconia/alumina nanocomposite for dental all-ceramic restorations. Three disk samples of 16 mm in diameter and thickness ranging from 0.2 to 0.6 mm with 0.1 mm increment each were cut from a fully-sintered rod-shaped Ce-TZP/alumina nanocomposite (NANOZR, Panasonic Healthcare, Japan) and polished flat by using diamond slurry. Spectral light transmittance data under the CIE standard illuminant D65 were recorded at 10nm intervals from 360 to 740 nm using a computer-controlled spectrophotometer. Average transmittance, translucency and opalescence parameters were determined as a function of sample thickness. Optical properties of a fully-sintered yttria-stabilized tetragonal zirconia polycrystals (Cercon(®) base, DeguDent GmbH, Germany) were also investigated as a reference. Two-way ANOVA was performed to determine the significant differences in various optical parameters among types of ceramic and thicknesses at α=0.05. Results of the two-way ANOVA showed that the average transmittance, translucency and opalescence parameters of both ceramic materials were significantly influenced by the type of ceramic and thickness (popalescence parameters exceeding 20 CIE units when the sample thickness was nearly 0.3 mm. The prominent characteristics of high opalescence and low transmittance of light in the NANOZR was considered to be caused by its specific very fine interpenetrated intragranular microstructure and by a large difference of refractive indices of Ce-TZP and alumina components. High opalescence and low transmittance of light of the ceria-stabilized zirconia/alumina nanocomposite (NANOZR) are attractive properties for use as a substructure in fabricating porcelain-veneering-type esthetic all-ceramic restorations. Copyright © 2016 Academy of Dental Materials. Published by Elsevier Ltd. All

  5. Use of complementary and alternative medicines during the third trimester.

    Science.gov (United States)

    Pallivalapila, Abdul Rouf; Stewart, Derek; Shetty, Ashalatha; Pande, Binita; Singh, Rajvir; McLay, James S

    2015-01-01

    To estimate the prevalence, indications, and associated factors for complementary and alternative medicine use during the last trimester of pregnancy. A questionnaire survey was conducted of women with a live birth (N=700) admitted to the postnatal unit at the Royal Aberdeen Maternity Hospital, northeast Scotland. Outcome measures included: complementary and alternative medicine used; vitamins and minerals used; reasons for complementary and alternative medicine use; independent associated factors for use; views; and experiences. Descriptive and inferential statistical analysis was performed. The response rate was 79.6% of eligible women. Two thirds of respondents (61.4%) reported using complementary and alternative medicine, excluding vitamins and minerals, during the third trimester. Respondents reported using a total of 30 different complementary and alternative medicine modalities, of which oral herbal products were the most common (38% of respondents, 40 different products). The independent associated factors for complementary and alternative medicine use identified were: complementary and alternative medicine use before pregnancy (odds ratio [OR] 4.36, 95% confidence interval [CI] 2.39-7.95, Palternative medicine use by family or friends (OR 2.36, 95% CI 1.61-3.47, Palternative medicines were safer than prescribed medicines (P=.006), less likely to be associated with side effects (P≤.001), and could interfere with conventional medicines (P≤.001). Despite the majority of respondents, and notably users, being uncertain about their safety and effectiveness, complementary and alternative medicine modalities and complementary and alternative medicine products are widely used during the third trimester of pregnancy in this study population. Although prior use was the most significant independent associated factor, the role of family and friends, rather than health professionals, in the decision to use complementary and alternative medicine may be of concern

  6. ACR Appropriateness Criteria® First Trimester Vaginal Bleeding.

    Science.gov (United States)

    Brown, Douglas L; Packard, Ann; Maturen, Katherine E; Deshmukh, Sandeep Prakash; Dudiak, Kika M; Henrichsen, Tara L; Meyer, Benjamin J; Poder, Liina; Sadowski, Elizabeth A; Shipp, Thomas D; Simpson, Lynn; Weber, Therese M; Zelop, Carolyn M; Glanc, Phyllis

    2018-05-01

    Vaginal bleeding is not uncommon in the first trimester of pregnancy. The majority of such patients will have a normal intrauterine pregnancy (IUP), a nonviable IUP, or an ectopic pregnancy. Ultrasound (US) is the primary imaging modality in evaluation of these patients. US, along with clinical observations and serum human chorionic gonadotropin levels, can usually distinguish these causes. Although it is important to diagnose ectopic pregnancies and nonviable IUPs, one should also guard against injury to normal pregnancies due to inappropriate treatment with methotrexate or surgical intervention. Less common causes of first trimester vaginal bleeding include gestational trophoblastic disease and arteriovenous malformations. Pulsed methods of Doppler US should generally be avoided in the first trimester when there is a normal, or a potentially normal, IUP. Once a normal IUP has been excluded, Doppler US may be useful when other diagnoses such as retained products of conception or arteriovenous malformations are suspected. MRI may occasionally be helpful as a problem-solving tool. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  7. The importance of scintimetry in the differential diagnosis of roentgenological areas of increased 'translucence' in the skeleton of children

    International Nuclear Information System (INIS)

    Georgi, P.; Benz, G.

    1979-01-01

    A random selection of lesions representing osteolytic bone processes was evaluated with the 'region-of-interest' technique in order to determine whether scintimetry can be helpful in the differential diagnosis of such processes in children. Bone tumours with structural densification, as well as osteomyelitides, were reviewed for comparative purposes. It was found that scintigraphy of the skeleton, while supplying additional and clinically quite interesting information, does not make any substantial contribution to the differential diagnostic clarification of roentgenological translucence in the skeleton of children. (orig.) [de

  8. Effects of surface-finishing protocols on the roughness, color change, and translucency of different ceramic systems.

    Science.gov (United States)

    Akar, Gülcan Coşkun; Pekkan, Gürel; Çal, Ebru; Eskitaşçıoğlu, Gürcan; Özcan, Mutlu

    2014-08-01

    Surface-finishing protocols have a mechanical impact on ceramic surfaces that could eventually affect surface topography and light scattering. An optimum protocol is needed to avoid damaging the optical properties of ceramics. The purpose of this study was to determine the effects of different surface-finishing protocols on the surface roughness, color change, and translucency of ceramic and metal ceramic restorations. Standardized disk-shaped specimens (1.5 × 10 mm, n=128) were fabricated from 3 different ceramic core materials (aluminum oxide [Al2O3]-AL, zirconium oxide [ZrO2]-ZR, lithium disilicate [Li2Si2O5]-LIT), veneered (V) with dentin ceramics (n=32 per group), and placed in the following groups: ALV, ZRV, and LITV. The metal ceramic group acted as the control (n=32). Four different surface-finishing methods were tested. Airborne-particle abrasion with 50 μm Al2O3, polishing with adjustment kit, polishing with adjustment kit plus diamond polishing paste, and autoglazing (n=8 subgroup) were applied on the veneering ceramics. The specimens were analyzed with a profilometer for surface roughness, and color change and translucency were measured with a clinical spectrophotometer. Statistical analyses were performed with 1-way ANOVA and the Tukey honest significant difference tests (α=.05). Specimens treated with the airborne particle abrasion method showed significantly higher mean profilometer for surface roughness values in all groups (P.05). With the diamond polishing paste method, lower surface roughness values were achieved in the ZRV and metal ceramic groups acted as the control groups. Different surface-finishing methods affected the color change of the ceramic systems, except for ZRV. Surface-finishing protocols significantly affected the translucency values of the ALV, LITV, and metal ceramic groups (Pceramics tested. The airborne-particle abrasion protocol created rougher surfaces and decreased translucency, and color change in zirconia was not

  9. Sexual function of pregnant women in the third trimester

    Directory of Open Access Journals (Sweden)

    Nülüfer Erbil

    2018-06-01

    Full Text Available Introduction: Physical, hormonal and psychological changes during pregnancy can affect a woman’s sexuality as well as a couple’s sexual relationship. The aim of this study was to examine sexual function of pregnant women in the third trimester of pregnancy. Methods: The data of descriptive and cross-sectional study was collected via a questionnaire form and Female Sexual Function Index. A score ≤ 26.55 is classified as female sexual dysfunction. A total of 125 volunteer healthy and married pregnant women in third trimester of pregnancy who admitted to the antenatal policlinics were included in this study. Results: The determined that 92% of participants had sexual dysfunction. The Female Sexual Function Index and domains scores in the 28th-31st, 32nd-35th and 36th and higher gestational weeks of pregnancy were as follows: sexual desire scores, 2.50, 2.77 and 2.40; sexual arousal scores, 2.26, 2.72 and 1.69; lubrication scores, 2.61, 3.42 and 1.97; orgasm scores, 2.51, 2.85 and 1.78; sexual satisfaction scores, 3.17, 3.77 and 2.66; pain scores, 2.44, 2.72 and 1.66, and total Female Sexual Function Index scores were 15.51, 18.29, 12.26, respectively. Sexual arousal (p = 0.008, lubrication (p = 0.001, orgasm (p = 0.031, sexual satisfaction (p = 0.005, pain (p = 0.049 and total Female Sexual Function Index score (p = 0.004 were the lowest in 36th and higher gestational weeks, and only sexual desire did not differ (p = 0.191. Conclusions: Sexual function of pregnant women in the third trimester were negatively effected. Health professionals should be trained to evaluate sexual difficulties in pregnant women and to recommend possible solutions. Keywords: Pregnancy, Sexuality, Third trimester, Female sexual function index

  10. Pancytopenia in the first trimester: An indicator of hidden hyperthyroidism.

    Science.gov (United States)

    Imai, Ken; Ohkuchi, Akihide; Nagayama, Shiho; Saito, Shinsuke; Matsubara, Shigeki; Suzuki, Mitsuaki

    2015-12-01

    Pancytopenia in the first trimester is very rare. A 33-year-old multiparous woman presented with nausea, loss of appetite, and bodyweight loss of 7.4 kg at 9(1/7) weeks of gestation due to hyperemesis gravidarum. Her laboratory data demonstrated pancytopenia involving white blood cell count of 3500/μL, a hemoglobin level of 9.8 g/dL, and a platelet count of 10.5 × 10(4)/μL. An extensive investigation into the causes of the pancytopenia detected true hyperthyroidism: thyroid-stimulating hormone, hyperthyroidism. © 2015 Japan Society of Obstetrics and Gynecology.

  11. First Trimester Down's syndrome screening - pregnant women's knowledge

    DEFF Research Database (Denmark)

    Dahl, Katja; Hvidman, Lone; Jørgensen, Finn Stener

    2011-01-01

    OBJECTIVES: The primary aim of this study was to assess pregnant women's knowledge of first trimester combined Down's syndrome screening in a setting of required informed consent. Secondary, we wanted to identify relevant differences in knowledge level among subgroups of pregnant women, including...... of adverse findings other than Down's syndrome. Knowledge level was positively associated with length of education (adjusted ORs 1.0 (0.8-1.4) to 3.9 (2.4-6.4)) and participation in the screening programme (adjusted OR 0.9 (0.6-1.3) to 5.9 (3.9-8.8)). Participation in an individual information session...

  12. First trimester Down's syndrome screening - pregnant women's knowledge

    DEFF Research Database (Denmark)

    Dahl, Katja; Hvidman, Lone; Jørgensen, Finn Stener

    2011-01-01

    OBJECTIVES: The primary aim of this study was to assess pregnant women's knowledge of first trimester combined Down's syndrome screening in a setting of required informed consent. Secondary, we wanted to identify relevant differences in knowledge level among subgroups of pregnant women, including...... of adverse findings other than Down's syndrome. Knowledge level was positively associated with length of education (adjusted ORs 1.0 (0.8-1.4) to 3.9 (2.4-6.4)) and participation in the screening programme (adjusted OR 0.9 (0.6-1.3) to 5.9 (3.9-8.8)). Participation in an individual information session...

  13. Relationships among Constitution, Stress, and Discomfort in the First Trimester

    Directory of Open Access Journals (Sweden)

    Hsiao-Ling Wang

    2012-01-01

    trimester of pregnancy. We adopted a descriptive and correlational research design and collected data from 261 pregnant women during their first trimester in southern Taiwan using structured questionnaires. Results showed that (1 stress was significantly and positively correlated with Yang-Xu, Yin-Xu, and Tan-Shi-Yu-Zhi constitutions, respectively; (2 Yin-Xu and Tan-Shi-Yu-Zhi constitutions had significant correlations with all symptoms of discomfort, while Yang-Xu had significant correlations with all symptoms of discomfort except for “running nose”; (3 Tan-Shi-Yu-Zhi constitution and stress were two indicators for “fatigue”; Tan-Shi-Yu-Zhi was the indicator for “nausea”; Yang-Xu and Yin-Xu were indicators for “frequent urination.” Our findings also indicate that stress level affects constitutional changes and that stress and constitutional change affect the incidence of discomfort. This research can help healthcare professionals observe these discomforts and provide individualized care for pregnant women, to nurture pregnant women into neutral-type constitution, minimize their levels of discomfort, and promote the health of the fetus and the mother.

  14. First trimester phthalate exposure and anogenital distance in newborns

    Science.gov (United States)

    Swan, S.H.; Sathyanarayana, S.; Barrett, E.S.; Janssen, S.; Liu, F.; Nguyen, R.H.N.; Redmon, J.B.; Liu, Fan; Scher, Erica; Stasenko, Marina; Ayash, Erin; Schirmer, Melissa; Farrell, Jason; Thiet, Mari-Paule; Baskin, Laurence; Gray Chelsea Georgesen, Heather L.; Rody, Brooke J.; Terrell, Carrie A.; Kaur, Kapilmeet; Brantley, Erin; Fiore, Heather; Kochman, Lynda; Parlett, Lauren; Marino, Jessica; Hulbert, William; Mevorach, Robert; Pressman, Eva; Ivicek, Kristy; Salveson, Bobbie; Alcedo, Garry

    2015-01-01

    STUDY QUESTION Is first trimester phthalate exposure associated with anogenital distance (AGD), a biomarker of prenatal androgen exposure, in newborns? SUMMARY ANSWER Concentrations of diethylhexyl phthalate (DEHP) metabolites in first trimester maternal urine samples are inversely associated with AGD in male, but not female, newborns. WHAT IS KNOWN ALREADY AGD is a sexually dimorphic measure reflecting prenatal androgen exposure. Prenatal phthalate exposure has been associated with shorter male AGD in multiple animal studies. Prior human studies, which have been limited by small sample size and imprecise timing of exposure and/or outcome, have reported conflicting results. STUDY DESIGN, SIZE, DURATION The Infant Development and the Environment Study (TIDES) is a prospective cohort study of pregnant women recruited in prenatal clinics in San Francisco, CA, Minneapolis, MN, Rochester, NY and Seattle, WA in 2010–2012. Participants delivered 787 infants; 753 with complete data are included in this analysis. PARTICIPANTS/MATERIALS, SETTING, METHODS Any woman over 18 years old who was able to read and write English (or Spanish in CA), who was <13 weeks pregnant, whose pregnancy was not medically threatened and who planned to deliver in a study hospital was eligible to participate. Analyses include all infants whose mothers provided a first trimester urine sample and who were examined at or shortly after birth. Specific gravity (SpG) adjusted concentrations of phthalate metabolites in first trimester urine samples were examined in relation to genital measurements. In boys (N = 366), we obtained two measures of anogenital distance (AGD) (anoscrotal distance, or AGDAS and anopenile distance, AGDAP) as well as penile width (PW). In girls (N = 373), we measured anofourchette distance (AGDAF) and anoclitoral distance (AGDAC). We used multivariable regression models that adjusted for the infant's age at exam, gestational age, weight-for-length Z-score, time of day of urine

  15. Effects of Fibers on Color and Translucency Changes of Bulk-Fill and Anterior Composites after Accelerated Aging

    Directory of Open Access Journals (Sweden)

    Ali Riza Tuncdemir

    2018-01-01

    Full Text Available The aim of this study was to determine the effects of glass and polyethylene fibers on the color and translucency change of bulk-fill and anterior composites before and after artificial accelerated aging (AAA. Two types of teflon molds were used to fabricate samples which were 13 mm in diameter and, respectively, 2 mm and 4 mm in height. Polyethylene fiber (PF and glass fiber (GF were incorporated in the middle of the composite samples. Color and translucency changes of each composite were evaluated before and after AAA with spectrophotometer. ANOVA and Tukey’s HSD post hoc statistical analysis were used at a significance level of 0.05. Before AAA (for anterior composites, there were no significant differences in L* and b* parameters among the three groups (p>0.05; there were no significant differences in L* parameter between PF and GF groups or in TP between GF and control groups (p>0.05 (for bulk-fill composites. After AAA, there were no significant differences in L* parameter between GF and control groups, in a* parameter between PF and control groups, in b* parameter among all groups, or in TP parameter between GF and control groups (p>0.05. Fiber reinforcement led to color and TP change in both anterior and bulk-fill resin composites.

  16. Topical Non-Iontophoretic Application of Acetylcholine and Nitroglycerin via a Translucent Patch: A New Means for Assessing Microvascular Reactivity

    Science.gov (United States)

    Schonberger, Robert B.; Worden, William S.; Shahmohammadi, Kaveh; Menn, Kirsten; Silverman, Tyler J.; Stout, Robert G.; Shelley, Kirk H.; Silverman, David G.

    2007-01-01

    Objective: Assessments of endothelial cell function with acetylcholine have typically used systemic, regional intra-arterial, or iontophoretic delivery of drug. Each of these techniques induces systemic and/or local changes that compromise their safety or effectiveness. Using translucent drug preparations applied under laser Doppler flowmetry (LDF) probes, we tested whether local vasodilation can be induced with non-iontophoretic transdermal delivery of acetylcholine and how such dilation would compare to the dilation achieved with topical nitroglycerin in healthy volunteers. Methods: Ten subjects without known vascular disease were recruited for LDF monitoring at sites of drug application for this preliminary investigation. Topical acetylcholine chloride, nitroglycerin, and placebo were applied via translucent patches to the forehead directly below LDF probes. Results: LDF readings increased by 406 percent (245 percent to 566 percent) and 36 percent (26 percent to 46 percent), respectively, at the acetylcholine and placebo sites (p = .005 by Wilcoxon Signed Rank Test (WSRT) for acetylcholine vs. placebo); and they increased by 365 percent (179 percent to 550 percent) at the nitroglycerin site (p = .005 by WSRT for nitroglycerin vs. placebo; p = .6 vs. acetylcholine). Conclusion: Transdermal delivery of acetylcholine can induce significant local vasodilatory responses comparable to those achieved with nitroglycerin without requiring iontophoresis. The means of transdermal delivery and monitoring described herein may constitute a new minimally invasive way to interrogate the microvasculature and thereby assess the microcirculatory changes induced by various disorders and therapeutic interventions. PMID:17876370

  17. Effects of aging and HEMA content on the translucency, fluorescence, and opalescence properties of experimental HEMA-added glass ionomers.

    Science.gov (United States)

    Lee, Yong-Keun; Yu, Bin; Zhao, Guang-Feng; Lim, Jin Ik

    2010-01-01

    Changes in the translucency, fluorescence, and opalescence of experimental 10-50% 2-hydroxyethyl methacrylate (HEMA)-added glass ionomers (HAGIs) after 5,000 cycles of thermocycling were determined and compared with those of commercial resin-modified glass ionomers (RMGIs). Changes in the translucency (TP), fluorescence (FL), and opalescence (OP) parameters were in the range of -3.5 to 0.2, -2.3 to 0.3 and -2.6 to 9.1 units respectively for HAGIs; and -0.9 to 0.3, -0.7 to 0.6, and 1.1 to 2.3 units respectively for RMGIs. Changes in the TP, FL, and OP of HAGIs were influenced by the HEMA content and powder shade, and were generally larger than those of RMGIs. Since the changes in TP, FL, and OP of experimental HAGIs were influenced by the HEMA content, there arises a need to determine the optimal HEMA ratio to attain high stability for these optical properties. In addition, results of this study showed that apart from optimal HEMA ratio, future studies should include other aspects and factors that contribute to age-dependent changes in optical properties.

  18. The impact of translucent fabric shades and control strategies on energy savings and visual quality

    Science.gov (United States)

    Wankanapon, Pimonmart

    Translucent fabric shades provide opportunities for building occupants to control sunlight penetration for heat reduction, thermal comfort, and visual quality. Regulating shades affects building energy and can potentially reduce the size of mechanical cooling systems. Shades are not normally included in energy model studies during the design process, even though shades potential impact energy use. This is because the occupants normally leave shades closed a large fraction of the time, but models are generally performed with no shades. Automatic shade control is now available, so it is necessary to understand the impact of shades on visual quality and their energy saving potential in order to optimize their overall performance. There are very limited studies that have address shades and their integrated performance on energy consumption and visual quality. Most of these do not reflected modern shade types and their application. The goals of this study are: First, to determine the impact of shades on total, heating, cooling and lighting energy savings with different design and operation parameters. Second, to study and develop different automatic shade control strategies to promote and optimize energy savings and visual quality. A simulation-based approach using EnergyPlus in a parametric study provide better understanding energy savings under different shade conditions. The parametric runs addressed various building parameters such as geometry, orientation, site climate, glazing/shade properties, and shade control strategies with integrated lighting control. The impact of shades was determined for total building and space heating, cooling and lighting energy savings. The effect of shades on visual quality was studied using EnergyPlus, AGI32 and DAYSIM for several indices such as daylight glare index (DGI), work plane illuminance, luminance ratios and view. Different shade control strategies and integrated lighting control were considered with two translucent fabric

  19. Maternal anemia in various trimesters and its effect on newborn weight and maturity: An observational study

    Directory of Open Access Journals (Sweden)

    K Jagadish Kumar

    2013-01-01

    Conclusions: The incidence of low birth weight babies was significantly more in mothers who were anemic in their third trimester. Preterm deliveries occurred more frequently in mothers who were anemic in their second and third trimesters. Higher hemoglobin did not show any effect on either birth weight or gestation in our study.

  20. Decreased IGF-1 concentration during the first trimester of pregnancy in women with normal somatotroph function.

    Science.gov (United States)

    Persechini, Marie-Laure; Gennero, Isabelle; Grunenwald, Solange; Vezzosi, Delphine; Bennet, Antoine; Caron, Philippe

    2015-08-01

    A decrease of insulin-like growth factor-I levels (IGF-I) has been reported during the first trimester of pregnancy in women with acromegaly before the secretion of placental growth hormone (GH) progressively increases IGF-1 concentration. To evaluate variations of concentrations of IGF-1, insulin-like growth factor (IGF)-binding protein-3 (IGF-BP3) and GH during the first trimester of pregnancy in women with normal somatotroph function. Sixteen women (median age 31 years) with as who were followed for benign thyroid disorders (n = 15) or prolactin-secreting microadenoma (n = 1) were evaluated before and in the first trimester of pregnancy. Serum concentrations of GH, IGF-1, IGF-BP3, TSH and estradiol (E2) were measured before and in the first trimester (5.4 ± 2.2 weeks of gestation). Before pregnancy, somatotroph and thyroid functions (median TSH 1.2 mU/L) were normal in all women. At the first trimester IGF-1 levels decreased significantly (before = 210 ng/mL, first trimester = 145 ng/mL, p function, IGF-1 levels decrease in the first trimester of pregnancy without changes in GH or IGF-BP3 levels. These results confirm liver resistance to GH as a consequence of the physiological increase of estrogens during the first trimester.

  1. 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.

  2. First trimester screening for intra-uterine growth restriction and early-onset pre-eclampsia

    NARCIS (Netherlands)

    Vandenberghe, G.; Mensink, I.; Twisk, J. W. R.; Blankenstein, M. A.; Heijboer, A. C.; van Vugt, J. M. G.

    2011-01-01

    To assess first trimester placental growth factor (PlGF) and pregnancy-associated plasma protein-A (PAPP-A) as screening markers for early-onset pre-eclampsia (PE) and intra-uterine growth restriction (IUGR). PlGF concentration was retrospectively measured in first trimester serum specimens of 23

  3. First trimester screening for intra-uterine growth restriction and early-onset pre-eclampsia

    NARCIS (Netherlands)

    Vandenberghe, G.; Mensink, I.; Twisk, J.W.; Blankenstein, M.A.; Heijboer, A.C.; van Vugt, J.M.

    2011-01-01

    Objective: To assess first trimester placental growth factor (PlGF) and pregnancy-associated plasma protein-A (PAPP-A) as screening markers for early-onset pre-eclampsia (PE) and intra-uterine growth restriction (IUGR). Methods: PlGF concentration was retrospectively measured in first trimester

  4. ADAM 12 as a second-trimester maternal serum marker in screening for Down syndrome

    DEFF Research Database (Denmark)

    Christiansen, Michael; Spencer, Kevin; Laigaard, Jennie

    2007-01-01

    ADAM 12 is a placenta-derived glycoprotein that is involved in growth and differentiation. The maternal serum concentration of ADAM 12 is a potential first-trimester maternal serum marker of Down syndrome (DS). Here we examine the potential of ADAM 12 as a second-trimester maternal serum marker...

  5. Fetal first trimester growth is not associated with kidney outcomes in childhood

    NARCIS (Netherlands)

    H. Bakker (Hanneke); R. Gaillard (Romy); A. Hofman (Albert); I.K.M. Reiss (Irwin); E.A.P. Steegers (Eric); V.W.V. Jaddoe (Vincent)

    2017-01-01

    textabstractBackground: Impaired fetal growth is associated with increased risks of kidney diseases in later life. Because human development rates are highest during the first trimester, this trimester may be a particularly critical period for kidney outcomes. We have therefore examined the

  6. Pregnancy Outcome after Varenicline Exposure in the First Trimester

    Directory of Open Access Journals (Sweden)

    Yusuf Cem Kaplan

    2014-01-01

    Full Text Available To the best of our knowledge this is the first case report describing exposure to varenicline, an α4β2 nicotinic acetylcholine partial receptor agonist used for smoking cessation therapy in pregnancy. A 29-year-old multiparous woman with an unplanned pregnancy has used varenicline 2 mg/day unintentionally yet regularly 4 weeks from her last menstrual period. Fetal ultrasound performed at each trimester, detailed anomaly scan, and fetal echocardiography which were performed at the 22nd gestational week showed normal fetal growth with no malformations. The patient delivered a healthy baby at the 38th week of gestation with normal Apgar score and physical examination findings. Age-appropriate physical and neurological development of the child has been observed for 6 months. Although it is not possible to draw definitive conclusions, this case report may contribute to the current available limited data regarding the safety of varenicline use in pregnancy.

  7. First trimester nicotine exposure and the risk of infantile colic

    DEFF Research Database (Denmark)

    Milidou, Ioanna; Henriksen, Tine Brink; Jensen, Morten Søndergaard

    Background: Although prenatal exposure to maternal smoking has been associated with infantile colic (IC), to date no published studies have reported on the relationship between the prenatal use of nicotine replacement therapy (NRT) and IC. Aim: We aimed to assess the relationship between fetal...... exposure to nicotine, coming from both cigarette smoking and use of NRT early in pregnancy, and IC. Methods: The study population consisted of 63,883 pregnancies that resulted in live born singletons enrolled in the Danish National Birth Cohort between 1997 and 2002. Mother’s smoking habits and use of NRT......: The results indicate that prenatal exposure to nicotine from any source during the first trimester of the pregnancy increases the risk of infantile colic....

  8. Induced first-trimester abortion and risk of mental disorder

    DEFF Research Database (Denmark)

    Munk-Olsen, Trine; Laursen, Thomas Munk; Pedersen, Carsten B

    2011-01-01

    Background Concern has been expressed about potential harm to women's mental health in association with having an induced abortion, but it remains unclear whether induced abortion is associated with an increased risk of subsequent psychiatric problems. Methods We conducted a population-based cohort......-trimester induced abortion or a first childbirth during that period. We estimated the rates of first-time psychiatric contact (an inpatient admission or outpatient visit) for any type of mental disorder within the 12 months after the abortion or childbirth as compared with the 9-month period preceding the event....... Results The incidence rates of first psychiatric contact per 1000 person-years among girls and women who had a first abortion were 14.6 (95% confidence interval [CI], 13.7 to 15.6) before abortion and 15.2 (95% CI, 14.4 to 16.1) after abortion. The corresponding rates among girls and women who had a first...

  9. A Fetus with Iniencephaly Delivered at the Third Trimester

    Directory of Open Access Journals (Sweden)

    Esra Cinar Tanriverdi

    2015-01-01

    Full Text Available Iniencephaly is an uncommon neural tube defect, having retroflexion of the head without a neck and severe distortion of the spine. Iniencephaly is classified into two groups, iniencephaly apertus (with encephalocele and iniencephaly clausus (without encephalocele. Incidence ranges from 0.1 to 10 in 10.000 pregnancies and it is seen more frequently in girls. Most of the fetuses with this defect die before birth or soon after birth, while those with the milder forms may live through childhood. Recurrence risk is around 1–5%. Family should be offered termination to reduce maternal risks and counseled for folic acid supplementation before the next planned pregnancy. Here we present a rare case of iniencephaly clausus which was diagnosed at 18th week of gestation by ultrasonography and delivered in the third trimester of pregnancy due to rejection of termination.

  10. Induced first-trimester abortion and risk of mental disorder.

    Science.gov (United States)

    Munk-Olsen, Trine; Laursen, Thomas Munk; Pedersen, Carsten B; Lidegaard, Øjvind; Mortensen, Preben Bo

    2011-01-27

    Concern has been expressed about potential harm to women's mental health in association with having an induced abortion, but it remains unclear whether induced abortion is associated with an increased risk of subsequent psychiatric problems. We conducted a population-based cohort study that involved linking information from the Danish Civil Registration system to the Danish Psychiatric Central Register and the Danish National Register of Patients. The information consisted of data for girls and women with no record of mental disorders during the 1995-2007 period who had a first-trimester induced abortion or a first childbirth during that period. We estimated the rates of first-time psychiatric contact (an inpatient admission or outpatient visit) for any type of mental disorder within the 12 months after the abortion or childbirth as compared with the 9-month period preceding the event. The incidence rates of first psychiatric contact per 1000 person-years among girls and women who had a first abortion were 14.6 (95% confidence interval [CI], 13.7 to 15.6) before abortion and 15.2 (95% CI, 14.4 to 16.1) after abortion. The corresponding rates among girls and women who had a first childbirth were 3.9 (95% CI, 3.7 to 4.2) before delivery and 6.7 (95% CI, 6.4 to 7.0) post partum. The relative risk of a psychiatric contact did not differ significantly after abortion as compared with before abortion (P = 0.19) but did increase after childbirth as compared with before childbirth (P abortion does not support the hypothesis that there is an increased risk of mental disorders after a first-trimester induced abortion.

  11. First and second trimester screening for fetal structural anomalies.

    Science.gov (United States)

    Edwards, Lindsay; Hui, Lisa

    2018-04-01

    Fetal structural anomalies are found in up to 3% of all pregnancies and ultrasound-based screening has been an integral part of routine prenatal care for decades. The prenatal detection of fetal anomalies allows for optimal perinatal management, providing expectant parents with opportunities for additional imaging, genetic testing, and the provision of information regarding prognosis and management options. Approximately one-half of all major structural anomalies can now be detected in the first trimester, including acrania/anencephaly, abdominal wall defects, holoprosencephaly and cystic hygromata. Due to the ongoing development of some organ systems however, some anomalies will not be evident until later in the pregnancy. To this extent, the second trimester anatomy is recommended by professional societies as the standard investigation for the detection of fetal structural anomalies. The reported detection rates of structural anomalies vary according to the organ system being examined, and are also dependent upon factors such as the equipment settings and sonographer experience. Technological advances over the past two decades continue to support the role of ultrasound as the primary imaging modality in pregnancy, and the safety of ultrasound for the developing fetus is well established. With increasing capabilities and experience, detailed examination of the central nervous system and cardiovascular system is possible, with dedicated examinations such as the fetal neurosonogram and the fetal echocardiogram now widely performed in tertiary centers. Magnetic resonance imaging (MRI) is well recognized for its role in the assessment of fetal brain anomalies; other potential indications for fetal MRI include lung volume measurement (in cases of congenital diaphragmatic hernia), and pre-surgical planning prior to fetal spina bifida repair. When a major structural abnormality is detected prenatally, genetic testing with chromosomal microarray is recommended over

  12. Flexural strength and translucent characteristics of lithium disilicate glass-ceramics with different P2O5 content

    International Nuclear Information System (INIS)

    Wang, Fu; Gao, Jing; Wang, Hui; Chen, Ji-hua

    2010-01-01

    Lithium disilicate glass-ceramics derived from the SiO 2 -Li 2 O-K 2 O-Al 2 O 3 -ZrO 2 -P 2 O 5 system with different P 2 O 5 content (from 0.5 mol.% to 2.0 mol.% at a step of 0.5 mol.%) were prepared for dental restorative application. Flexural strength of final glass-ceramics and translucent characteristics expressed in term of contrast ratio (CR) were measured. The interrelations between P 2 O 5 content, microstructure and properties were discussed. Glass-ceramic with a P 2 O 5 content of 1.0 mol.%, in which elongated rod-like Li 2 Si 2 O 5 crystals formed an interlocking microstructure, showed the highest flexural strength and suitable contrast ratio for dental restorative application.

  13. Factors associated with second trimester abortion in rural Maharashtra and Rajasthan, India.

    Science.gov (United States)

    Zavier, A J Francis; Jejeebhoy, Shireen; Kalyanwala, Shveta

    2012-01-01

    Many married women in India experience abortion in their second trimester of pregnancy. While there is an impression that second trimester abortions are now overwhelmingly used for sex selection, little is known about the extent to which second trimester abortions are indeed associated with son preference and sex selection motives, relative to other factors. Using data from a community-based study in rural Maharashtra and Rajasthan, research highlights the role of limited access in explaining second trimester abortion. While women with a single child who was a daughter were indeed more likely than other women to have terminated a pregnancy carrying a female foetus in the second trimester, more strikingly, exclusion from abortion-related decision-making, unsuccessful prior attempts to terminate the pregnancy, and distance from the facility in which their abortion was performed, were significantly associated with second trimester abortion, even after controlling for confounding factors. The study calls for greater efficiency in implementing the PCPNDT Act and addressing deep-rooted son preference. At the same time, findings that poverty and limited access to facilities are as, if not more, important drivers of second trimester abortion, highlight the need to meet commitments to ensure accessible abortion facilities for poor rural women.

  14. Kinematic Analysis of Gait in the Second and Third Trimesters of Pregnancy

    Directory of Open Access Journals (Sweden)

    Marco Branco

    2013-01-01

    Full Text Available The kinematic analysis of gait during pregnancy provides more information about the anatomical changes and contributes to exercise and rehabilitation prescription. The purposes were to quantify the lower limb kinematics of gait and to compare it between the second and third trimesters of pregnancy and with a control group. A three-dimensional analysis was performed in twenty-two pregnant women and twelve nonpregnant. Repeated Measures and Manova tests were performed for comparisons between trimesters and between pregnant and controls. The walking speed, stride width, right-/left-step time, cycle time and time of support, and flight phases remain unchanged between trimesters and between pregnant and controls. Stride and right-/left-step lengths decreased between trimesters. Double limb support time increased between trimesters, and it increased when compared with controls. Joint kinematics showed a significant decrease of right-hip extension and adduction during stance phase between trimesters and when compared with controls. Also, an increase in left-knee flexion and a decrease in right-ankle plantarflexion were found between trimesters. The results suggested that pregnant women need to maintain greater stability of body and to become more efficient in locomotion. Further data from the beginning of pregnancy anthropometric data may contribute to the analysis.

  15. Fetal first trimester growth is not associated with kidney outcomes in childhood.

    Science.gov (United States)

    Bakker, Hanneke; Gaillard, Romy; Hofman, Albert; Reiss, Irwin K; Steegers, Eric A P; Jaddoe, Vincent W V

    2017-04-01

    Impaired fetal growth is associated with increased risks of kidney diseases in later life. Because human development rates are highest during the first trimester, this trimester may be a particularly critical period for kidney outcomes. We have therefore examined the association of fetal first trimester growth with kidney outcomes in childhood. This study was embedded in a prospective population-based cohort study among 1176 pregnant women and their children. We used fetal first trimester crown-length as the growth measure among mothers with a regular menstrual cycle and a known first day of the last menstrual period. At the childhood age of 6 (median 5.7-6.8) years, we measured combined kidney volume, microalbuminuria and estimated glomerular filtration rate (eGFR) based on serum creatinine and cystatin C concentrations. No consistent associations of fetal first trimester crown-rump length with childhood combined kidney volume, eGFR and microalbuminuria were observed. Compared to children with a fetal first trimester crown-rump length in the highest quintile, those in the lowest quintile had a larger childhood combined kidney volume (difference 5.32 cm 3 , 95 % confidence interval 1.06 to 9.57), but no differences in kidney function. Our results do not support the hypothesis that fetal first trimester growth restriction affects kidney size and function in childhood. Further studies are needed to focus on critical periods in early life for kidney function and disease in later life.

  16. [Evaluation of alumina effects on the mechanical property and translucency of nano-zirconia all-ceramics].

    Science.gov (United States)

    Jiang, Li; Zhao, Yong-qi; Zhang, Jing-chao; Liao, Yun-mao; Li, Wei

    2010-06-01

    To study the effects of alumina content on sintered density, mechanical property and translucency of zirconia nanocomposite all-ceramics. Specimens of zirconia nanocomposite all-ceramics were divided into five groups based on their alumina content which are 0% (control group), 2.5%, 5.0%, 7.5% and 10.0% respectively. The sintered densities were measured using Archimedes' method. Specimens' bending strengths were measured with three-point bending test (ISO 6872). The visible light transmittances were measured with spectrophotometric arrangements and the fractured surfaces were observed using scanning electron microscope (SEM). The control group of pure zirconia could be sintered to the theoretical density under pressure-less sintering condition. The bending strength was (1100.27 ± 54.82) MPa, the fracture toughness was (4.96 ± 0.35) MPa×m(1/2) and the transmittance could reach 17.03%. The sintered density and transmittance decreased as alumina content increased from 2.5% to 10%. However, the fracture toughness only increased slightly. In all four alumina groups, the additions of alumina had no significant effect on samples' bending strengths (P > 0.05). When the content of alumina was 10%, fracture toughness of specimens reached (6.13 ± 0.44) MPa×m(1/2) while samples' transmittance declined to 6.21%. SEM results showed that alumina particles had no significant effect on the grain size and distribution of tetragonal zirconia polycrystals. Additions of alumina to yttria-tetragonal zirconia polycrystals could influence its mechanical property and translucency. Additions of the other phase to zirconia ceramics should meet the clinical demands of strength and esthetics.

  17. The effect of variations in translucency and background on color differences in CAD/CAM lithium disilicate glass ceramics.

    Science.gov (United States)

    Al Ben Ali, Abdulaziz; Kang, Kiho; Finkelman, Matthew D; Zandparsa, Roya; Hirayama, Hiroshi

    2014-04-01

    The purpose of this study was to compare the effect of variations in translucency and background on color differences (ΔE) for different shades of computer-aided design and computer-aided manufacturing (CAD/CAM) lithium disilicate glass ceramics. A pilot study suggested n = 10 as an appropriate sample size for the number of lithium disilicate glass ceramic cylinders per group. High-transparency (HT) and low-transparency (LT) cylinders (diameter, 12 mm; length, 13 mm) were fabricated in three ceramic shades (BL1, A2, C3) using CAD/CAM technology and were cut into specimen disks (thickness, 1.2 mm; diameter, 12 mm) for placement on Natural Die (ND1 and ND4) backgrounds. Four combinations of translucency and background color were evaluated in terms of color differences for the three ceramic shades: group 1 (HT ND1, reference), group 2 (HT ND4), group 3 (LT ND1), and group 4 (LT ND4). A spectrophotometer was used to measure the color differences. Nonparametric tests (Kruskal-Wallis tests) were used to evaluate the color differences among the tested groups, and Mann-Whitney U tests with Bonferroni correction were used as post hoc tests. Furthermore, for each ceramic shade, the HT groups were compared to the LT groups using the Mann-Whitney U test. Significant differences were present among the tested groups of the same ceramic shade (p glass ceramic color among the BL1, A2, and C3 ceramic shades. Changing the underlying color from a lighter background to a darker background resulted in increased color differences. © 2013 by the American College of Prosthodontists.

  18. Trimester- and Assay-Specific Thyroid Reference Intervals for Pregnant Women in China

    Directory of Open Access Journals (Sweden)

    Jinfang Xing

    2016-01-01

    Full Text Available Objective. The guidelines of the American Thyroid Association (ATA recommend an upper limit reference interval (RI of thyroid stimulating hormone (TSH of 2.5 mIU/L in the first trimester of pregnancy and 3.0 mIU/L in subsequent trimesters, but some reported ranges in China are significantly higher. Our study aimed to establish trimester- and assay-specific RIs for thyroid hormones in normal pregnant Chinese women. Methods. In this cross-sectional study, 2540 women with normal pregnancies (first trimester, n=398; second trimester, n=797; third trimester, n=1345 and 237 healthy nonpregnant control subjects were recruited. Serum TSH, free thyroxin (FT4, thyroid peroxidase antibody (TPOAb, and thyroglobulin antibody (TgAb levels were determined by automated chemiluminescence with an Immulite 2000 system (Siemens, Erlangen, Germany. After outliers were excluded, the 2.5–97.5th percentiles were used to define the RIs. Results. The RIs of thyroid function in the first, second, and third trimesters of pregnancy and in nonpregnant controls were 0.07–3.96, 0.27–4.53, 0.48–5.40, and 0.69–5.78 mIU/L for TSH and 9.16–18.12, 8.67–16.21, 7.80–13.90, and 8.24–16.61 pmol/L for FT4, respectively. Conclusion. The trimester- and assay-specific RIs of thyroid function during pregnancy differed between trimesters, which suggests that it is advisable to detect and avoid misclassification of thyroid dysfunction during pregnancy for women in Henan, China.

  19. Therapeutic termination of second trimester pregnancies with low dose misoprostol

    International Nuclear Information System (INIS)

    Liaquat, N.F.; Javed, I.; Shuja, S.; Shoaib, T.; Bano, K.; Waheed, S.; Ansar, A.

    2006-01-01

    To determine the effectiveness of 50 micro g misoprostol for midtrimester termination of pregnancies. The study subjects were 54 pregnant women admitted during the 2nd trimester (14-26 weeks) of gestation, willing or requiring termination of pregnancy. Those patients were included in the study who were admitted with closed cervical os, either had intrauterine death, fetal anomaly, medical disorder (hypertension or diabetes) or history of previous ceasrean section. Cases of placenta previa, acute asthma, glaucoma, cardiac diseases and allergy to prostaglandins were excluded. Each patient received 50 micro g misoprostol intravaginally. Maximum 4 doses were given at 4 hours interval and state of cervical os was assessed by vaginal examination before insertion of next dose or at the onset of uterine contractions. After 4 doses of misoprostol, patients were kept under observation and watched for uterine contractions to start or for expulsion of products. Syntocinon infusion was started to augment labour where products of conception failed to expel out inspite of open os. Outcome measures include success rate of termination within 12, 24, 36 and 48 hours, mean induction - abortion time interval and maternal side effects. Results: The success rate of termination within 12, 24, 36 and 48 hours were 27.7%, 83.3%, 94.4% and 96.3% respectively. Mean induction to abortion time interval, in case of abortion within 48 hours, was found to be 18.9 +- 11.58 (range 4-48 hours). Dead fetuses were aborted earlier than alive fetuses. The mean induction abortion time interval was 17.01+-8.7 hours in dead and 23.4 +- 15.9 hours in alive fetuses (t -value:1.9, p: 0.05). Two patients failed to deliver within 48 hours of induction. Two patients suffered from febrile illness. Vaginal administration of 50 micro g misoprostol every 4 hourly is an effective and safe agent for ripening of cervix and convenient way of inducing abortion during 2nd trimester of pregnancy in a women either with

  20. Intravenous amino acids in third trimester isolated oligohydramnios

    International Nuclear Information System (INIS)

    Qureshi, F.U.

    2011-01-01

    To determine the efficacy of maternal administration of intravenous amino acid solution in improving amniotic fluid volume in cases of isolated oligohydramnios and to observe its impact on mode of delivery and neonatal outcome. Study Design: A prospective case series. Methodology: Forty two women with singleton pregnancy, well established gestational age and clinically and sonographically proven isolated oligohydramnios in the third trimester before 36 weeks were administered amino acid solution intravenously after excluding cases of premature rupture of membranes, congenital anomaly of fetus, maternal pulmonary, cardiovascular and hypertensive disorders, and severe placental insufficiency (raised S/D ratio). Pre-infusion and postinfusion Amniotic fluid Index (AFI) was measured and repeated weekly. Women were followed till delivery. Results: According to repeated measurement analysis of variance, mean pre-infusion AFI was 4.7 cm, mean one week postinfusion AFI was 5.8 cm, mean two week post-infusion AFI was 6.2 cm and mean three week AFI was 6.3 cm (p-value 0.029, significant). Cesarean section became a predominant mode of delivery in this group without a firm evidence of associated fetal compromise. Conclusion: Amino acid infusion is an effective therapy for raising AFI in isolated oligohydramnios in this case series. Liberal use of cesarean section in this selected group should be carefully re-evaluated. (author)

  1. Subclinical hypothyroidism in the first trimester of pregnancy in North India

    Directory of Open Access Journals (Sweden)

    Jubbin Jagan Jacob

    2013-01-01

    Full Text Available Subclinical hypothyroidism based on population and trimester specific cut-offs is reported to complicate 1-2% of all pregnancies. Using the recent Endocrine Society guidelines of 2.5 mIU/L of Thyroid Stimulating Hormone as the upper level of normal in the first trimester the reported prevalence of subclinical hypothyroidism is much higher. Recent publications have also emphasized that there is considerable racial variation in the prevalence of thyroid disorders in pregnancy. Among published literature North Indian women appear to have the highest rates of subclinical hypothyroidism in the first trimester of pregnancy. More widespread use of universal screening and trimester specific ranges in pregnancy for thyroid hormonal assays will lead to a large number of North Indian women requiring treatment for thyroid disorders in pregnancy.

  2. First trimester diagnosis of sirenomelia: a case report and review of the literature.

    Science.gov (United States)

    Akbayir, Ozgur; Gungorduk, Kemal; Sudolmus, Sinem; Gulkilik, Ahmet; Ark, Cemal

    2008-12-01

    Sirenomelia sequence is a rare lethal pattern of congenital anomalies characterized by a number of hallmark skeletal anomalies, including fusion of the lower extremities or a single lower limb, bilateral renal agenesis or dysgenesis with absent or hypoplastic renal arteries, oligohydramnios, and the presence of aberrant vasculature. The etiology is still controversial. Prognosis is very poor, with the babies being stillborn or succumbing soon after birth. In the second trimester, oligohydramnios due to renal agenesis makes the diagnosis of sirenomelia difficult. Conversely, in the first trimester, the amniotic fluid volume is usually normal, unrelated to the fetal urine production. Therefore, a first-trimester or early second trimester anatomic survey of the fetus is proposed as preferable and more accurate for the diagnosis of this rare anomaly. In this article, we report a case of sirenomelia detected by two- and three-dimensional ultrasound in the 11th week of gestation and the associated literature is discussed.

  3. Value of first trimester epidemiologic and sonographic markers as chromosome-diseases risk indicators

    International Nuclear Information System (INIS)

    Llanusa Ruiz, Celia; Nodarse Rodriguez, Alfredo; Vazquez, Yovany Enrique; Carrillo Bermudez, Lourdes; Sanchez Lombana, Rita

    2009-01-01

    Prenatal screening of chromosomal anomalies using epidemiological and sonographic markers during the first trimester, allow identifying pregnant with high risk of chromosome disease; we offer the cytogenetics prenatal diagnosis as option

  4. First-Trimester Working Conditions and Birthweight: A Prospective Cohort Study

    NARCIS (Netherlands)

    Vrijkotte, Tanja G. M.; van der Wal, Marcel F.; van Eijsden, Manon; Bonsel, Gouke J.

    2009-01-01

    Objectives. We investigated the relationship between women's first-trimester working conditions and infant birthweight. Methods. Pregnant women (N=8266) participating in the Amsterdam Born Children and Their Development study completed a questionnaire gathering information on employment and working

  5. Normative Trimester-Specific Thyroid Function Data from India: The State of the Nation

    OpenAIRE

    Subramanian Kannan; Sanjay Kalra

    2018-01-01

    Background: International guidelines recommend using local trimester-specific normative data for TSH (thyroid stimulating hormone). However, there are no unified Indian data for the same. Material and Methods: This review collates recently published data from various Indian centres and discusses the state of trimester-specific TSH ranges in the country. Results: The authors describe the strengths and limitations of available data, and support the need for pan-India data. Conclusion: To ensure...

  6. COMPARISON OF MISOPROSTOL AND MISOPROSTOL WITH ISOSORBIDE MONONITRATE IN SECOND TRIMESTER TERMINATION OF PREGNANCY

    OpenAIRE

    Shanthi Sivakumar; Nalina. S; Rukkayal Fathima; Rekha Radha

    2016-01-01

    BACKGROUND To compare the efficacy and side effect profile of vaginal misoprostol versus misoprostol and isosorbide mononitrate in enhancing cervical ripening in second trimester pregnancy termination. METHODS It is a random clinical trial done in 100 patients for mid trimester termination of pregnancy (between 12 and 24 weeks of gestational age). They were divided into two groups: Group A Combination of 400 mcg of misoprostol and 40 mg of ISMN placed intravaginally. Repe...

  7. Prevalence and risk factors for urinary incontinence in pregnant women during late third trimester

    OpenAIRE

    Aruna Nigam; Ayesha Ahmad; Diksha Gaur; Arifa A. Elahi; Swaraj Batra

    2016-01-01

    Background: Urinary incontinence (UI) is defined as any involuntary urinary leakage by the International continence society (ICS). The objective of this study was to analyze the prevalence and risk factors of urinary incontinence in pregnant women in late third trimester. Methods: A questionnaire based survey done on 400 pregnant women in third trimester beyond 34 weeks of gestation. A pretested, semi structured questionnaire was used to enquire about demographic and personal information r...

  8. Is a third-trimester antibody screen in Rh+ women necessary?

    Science.gov (United States)

    Rothenberg, J M; Weirermiller, B; Dirig, K; Hurd, W W; Schilder, J; Golichowski, A

    1999-09-01

    To determine the need for routine third-trimester antibody screening in Rh+ women. An analytic case-control study. We identified Rh+ pregnant women who had received prenatal care and retrospectively analyzed their laboratory data. Patients were grouped into those with a positive third-trimester antibody screen (cases) and those with a negative third-trimester screen (controls). Because entry into a group was decided by the investigators, it could not be randomized. We reviewed the maternal medical records for antibody identification and final pregnancy outcome. We also reviewed the neonatal medical records for evidence of direct Coombs-positive cord blood, anemia, need for transfusion or phototherapy, other medical complications, and death. Using a computerized laboratory database from 2 teaching hospitals, we identified 10,581 obstetric patients who underwent routine first- and third-trimester antibody screening between 1988 and 1997. Of these, 1233 patients were Rh- and 9348 were Rh+. Among the Rh+ patients, 178 (1.9%) had 1 or more atypical antibodies at the first-trimester screen, and 53 (0.6%) had a positive third-trimester antibody screen despite a negative first-trimester screen. Although 6 of these 53 patients (0.06% of the study population) had clinically relevant antibodies for hemolytic disease of the new-born, no significant neonatal sequelae occurred among these 6 patients. Based on the patient and hospital records studied, a repeat third-trimester antibody screen for Rh+ patients is clinically and economically unjustified. Eliminating this laboratory test from clinical practice will not adversely affect pregnancy outcomes and will decrease the costs of prenatal care.

  9. Hubungan Pengetahuan Ibu Hamil Trimester III Tentang Gizi Seimbang Selama Hamil Dengan Kejadian Bblr

    OpenAIRE

    Woro Tri Utami, Woro Tri Utami; Waqidil Hidayah, Waqidil Hidayah; Ika Junita, Ika Junita

    2013-01-01

    Knowledge of mothers on nutrition is crucial to the future of children and families. The purpose of the study to analyze the relationship of knowledge maternal 3rd trimester about balanced diet for pregnant with BBLR incident . Survey design used analytic approaches Prospective ( Cohort ) , sampling techniques using simple random sampling . Independent Variable knowledge maternal 3rd trimester about balanced nutrition and dependent variable BBLR incident . Instrument research questionnaires a...

  10. Medical treatment of second-trimester fetal miscarriage; A retrospective analysis

    OpenAIRE

    Niinimaki, Maarit; Mentula, Maarit; Jahangiri, Reetta; Mannisto, Jaana; Haverinen, Annina; Heikinheimo, Oskari

    2017-01-01

    Abstract Objectives: Research on the treatment of second-trimester miscarriages is scarce. We studied the outcomes, and the factors associated with adverse events and need for hospital resources in the medical treatment of second-trimester miscarriage. Materials and methods: In these retrospective analyses we studied women treated for spontaneous fetal miscarriage with misoprostol-only (n = 24) or mifepristone and misoprostol (n = 177) in duration of gestation 12+1–21+6. Primary outcome...

  11. 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...

  12. Accompaniment of second-trimester abortions: the model of the feminist Socorrista network of Argentina.

    Science.gov (United States)

    Zurbriggen, Ruth; Keefe-Oates, Brianna; Gerdts, Caitlin

    2018-02-01

    Legal restrictions on abortion access impact the safety and timing of abortion. Women affected by these laws face barriers to safe care that often result in abortion being delayed. Second-trimester abortion affects vulnerable groups of women disproportionately and is often more difficult to access. In Argentina, where abortion is legally restricted except in cases of rape or threat to the health of the woman, the Socorristas en Red, a feminist network, offers a model of accompaniment wherein they provide information and support to women seeking second-trimester abortions. This qualitative analysis aimed to understand Socorristas' experiences supporting women who have second-trimester medication abortion outside the formal health care system. We conducted 2 focus groups with 16 Socorristas in total to understand experiences accompanying women having second-trimester medication abortion who were at 14-24 weeks' gestational age. We performed a thematic analysis of the data and present key themes in this article. The Socorristas strived to ensure that women had the power of choice in every step of their abortion. These cases required more attention and logistical, legal and medical risks than first-trimester care. The Socorristas learned how to help women manage the possibility of these risks and were comfortable providing this support. They understood their work as activism through which they aim to destigmatize abortion and advocate against patriarchal systems denying the right to abortion. Socorrista groups have shown that they can provide supportive, women-centered accompaniment during second-trimester medication abortions outside the formal health care system in a setting where abortion access is legally restricted. Second-trimester self-use of medication abortion outside of the formal health system supported by feminist activist groups could provide an alternative model for second-trimester care worldwide. More research is needed to document the safety and

  13. Ankle Proprioception Pattern in Women Across Various Trimesters of Pregnancy and Postpartum

    Directory of Open Access Journals (Sweden)

    Ramachandra P

    2016-01-01

    Full Text Available Background and Objectives: Ankle foot complex is the part of the body which is in contact with the ground and it is important to have an intact proprioceptive system in order to maintain postural control. Previous study has established that there is significant difference between ankle proprioception in pregnant women in their third trimester and non-pregnant women. There is lack of literature regarding when the ankle does the ankle proprioception gets affected during pregnancy and whether this change reverts back during postpartum and hence this study. Method: A cohort of 70 primiparous women were included in the study and the women were followed through 12th week, 24th week, 32nd week , immediate postpartum and 6 weeks postpartum. The ankle repositioning error was measured using photography method and was analyzed using UTHSCSA Image tool software. Repeated measures ANOVA was used to measure the differences across various time periods. Results: It was found that there was a significant differences (p<0.001 in ankle repositioning error in pregnant women across the trimesters and in the postpartum period and the value did not reach the first trimester value even after six weeks postpartum. Conclusion: Ankle proprioception was significantly affected across the various trimesters of pregnancy with the peak variability observed in the third trimester and the value did not reach back to the first trimester value even after 6 weeks postpartum.

  14. An analysis of posture and back pain in the first and third trimesters of pregnancy.

    Science.gov (United States)

    Franklin, M E; Conner-Kerr, T

    1998-09-01

    While the incidence of back pain during pregnancy has been shown to be high, few studies have investigated postural changes that occur during pregnancy and their relationship to back pain. The purpose of this study was to determine if posture and back pain changed from the first to the third trimester of pregnancy and whether there was a relationship between the two. Twelve healthy women who were having uncomplicated pregnancies participated in the study. During the first and third trimesters, each subject had their standing posture and back pain assessed by a Metrecom Skeletal Analysis System and a 0- to 10-cm line pain scale, respectively. Repeated measures analysis of variance and Pearson correlation coefficients were calculated on or between back pain and nine posture variables and revealed significant increases in third trimester back pain and postures compared with first trimester back pain (p postures for lumbar angle (p change in posture and back pain. These results suggest that in the standing position the lumbar lordosis and sagittal pelvic tilt increased and head position become more posterior as women progressed from the first trimester to the last trimester of pregnancy. These postural changes, however, were not related to back pain. This suggests that many of the posture-correcting clinical exercise regimens given to pregnant women need to be investigated.

  15. Prenatal cytogenetic diagnosis in Spain: analysis and evaluation of the results obtained from amniotic fluid samples during the last decade.

    Science.gov (United States)

    Mademont-Soler, Irene; Morales, Carme; Clusellas, Núria; Soler, Anna; Sánchez, Aurora

    2011-08-01

    Chromosome abnormalities are one of the main causes of congenital defects, and establishing their frequency according to the different clinical indications for invasive procedure during pregnancy is especially important for genetic counselling. We analyzed the results of 29,883 amniotic fluid samples referred to our laboratory for cytogenetic studies from 1998 to 2009, which constitutes the largest series of cytogenetic analysis performed on amniotic fluid samples in Spain. The number of samples received tended to increase from 1998 to 2005, but after 2005 it decreased substantially. Cytogenetic results were obtained in 99.5% of the samples, and the detected incidence of chromosome abnormalities was 2.9%. Of these, 48.1% consisted of classical autosomal aneuploidies, trisomy 21 being the most frequent one. The main clinical indications for amniocentesis were positive prenatal screening and advanced maternal age, but referral reasons with highest positive predictive values were, excluding parental chromosome rearrangement, increased nuchal translucency (9.2%) and ultrasound abnormalities (6.6%). In conclusion, performing the karyotype on amniotic fluid samples is a good method for the detection of chromosome abnormalities during pregnancy. The number of cytogenetic studies on amniotic fluid has now decreased, however, due to the implementation of first trimester prenatal screening for the detection of Down syndrome, which allows karyotyping on chorionic villus samples. Our results also show that both ultrasound abnormalities and increased nuchal translucency are excellent clinical indicators for fetal chromosome abnormality. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  16. Bm-muted, orthologous to mouse muted and encoding a subunit of the BLOC-1 complex, is responsible for the otm translucent mutation of the silkworm Bombyx mori.

    Science.gov (United States)

    Zhang, Haokun; Kiuchi, Takashi; Wang, Lingyan; Kawamoto, Munetaka; Suzuki, Yutaka; Sugano, Sumio; Banno, Yutaka; Katsuma, Susumu; Shimada, Toru

    2017-09-20

    "Tanaka's mottled translucent" (otm) is a mutation of the silkworm Bombyx mori that exhibits translucent skin during larval stages. We performed positional cloning of the gene responsible for otm and mapped it to a 364-kb region on chromosome 5 that contains 22 hypothetical protein-coding genes. We performed RNA-seq analysis of the epidermis and fat body of otm larvae and determined that the gene BGIBMGA002619 may be responsible for the otm mutation. BGIBMGA002619 encodes the biosynthesis of lysosome-related organelles complex 1 (BLOC-1) subunit 5, whose ortholog is responsible for the Muted mutant in mouse. Accordingly, we named this gene Bm-muted. We discovered that the expression of Bm-muted in the epidermis and fat body of otm mutants was dramatically suppressed compared with the wild type. We determined the nucleotide sequences of the full-length cDNA and genomic region corresponding to Bm-muted and found that a 538-bp long DNA sequence similar to B. mori transposon Organdy was inserted into the 3' end of the first intron of Bm-muted in two otm strains. The Bm-muted cDNA of otm mutants lacked exon 2, and accordingly generated a premature stop codon in exon 3. In addition, short interfering RNA (siRNA)-mediated knockdown of this gene caused localized partial translucency of larval skin. These data indicate that the mutation in Bm-muted caused the otm-mutant phenotype. We propose that the insertion of Organdy caused a splicing disorder in Bm-muted in the otm mutant, resulting in a null mutation of Bm-muted. This mutation is likely to cause deficiencies in urate granule formation in epidermal cells that result in translucent larval skin. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. The effects of additives (MgO, La2O3 and Y2O3) in the translucency of alumina

    International Nuclear Information System (INIS)

    Genova, L.A.; Bressiani, A.H.A.; Bressiani, J.C.

    1993-01-01

    The effect of the addition of small amounts of Mg O, La 2 O 3 and Y 2 O 3 in the optical characteristics of the high purity alumina has been studied. Specimens with high transmittance in the visible region has been obtained. High purity alumina powders have also been obtained through the crystallization of ammonium alum. Translucent samples have been produced from these powders. (author). 6 refs, 5 figs, 4 tabs

  18. Model-based analysis of nonstationary thermal mode in premises with an insolation passive heating system with a three-layer translucent shield

    International Nuclear Information System (INIS)

    Avezova, N.R.; Avezov, R.R.; Rashidov, Y.K. et al.

    2014-01-01

    The results of the model-based study of nonstationary thermal mode in premises with an insolation passive heating system with a three-layer translucent shield are presented. The article is aimed at determining daily variations in the air temperature of the heated premise on typical heating season days and analyzing the optimization of the thermal capacity of the short-term (daily) thermal battery of the heating system on this basis. (author)

  19. Psychological responses of women after first-trimester abortion.

    Science.gov (United States)

    Major, B; Cozzarelli, C; Cooper, M L; Zubek, J; Richards, C; Wilhite, M; Gramzow, R H

    2000-08-01

    Controversy exists over psychological risks associated with abortion. The objectives of this study were to examine women's emotions, evaluations, and mental health after an abortion, as well as changes over time in these responses and their predictors. Women arriving at 1 of 3 sites for an abortion of a first-trimester unintended pregnancy were randomly approached to participate in a longitudinal study with 4 assessments-1 hour before the abortion, and 1 hour, 1 month, and 2 years after the abortion. Eight hundred eighty-two (85%) of 1043 eligible women approached agreed; 442 (50%) of 882 were followed for 2 years. Preabortion and postabortion depression and self-esteem, postabortion emotions, decision satisfaction, perceived harm and benefit, and posttraumatic stress disorder were assessed. Demographic variables and prior mental health were examined as predictors of postabortion psychological responses. Two years postabortion, 301 (72%) of 418 women were satisfied with their decision; 306 (69%) of 441 said they would have the abortion again; 315 (72%) of 440 reported more benefit than harm from their abortion; and 308 (80%) of 386 were not depressed. Six (1%) of 442 reported posttraumatic stress disorder. Depression decreased and self-esteem increased from preabortion to postabortion, but negative emotions increased and decision satisfaction decreased over time. Prepregnancy history of depression was a risk factor for depression, lower self-esteem, and more negative abortion-specific outcomes 2 years postabortion. Younger age and having more children preabortion also predicted more negative abortion evaluations. Most women do not experience psychological problems or regret their abortion 2 years postabortion, but some do. Those who do tend to be women with a prior history of depression.

  20. Screening for fetal chromosome abnormalities during the second trimester

    International Nuclear Information System (INIS)

    Dong Hui; Li Ming; Li Ping

    2005-01-01

    Objective: To develop a pre -natal screening program for fetal chromosome abnormalities based on risk values calculated from maternal serum markers levels during the second trimester. Methods: Serum levels of AFP, β-HCG, uE 3 were determined with CLIA in 1048 pregnant women during 14-21w gestation period and the results were analyzed with a specific software (screening program for Down' s syndrome developed by Beckman) for the risk rate. In those women defined as being of high risk rate, cells from amniotic fluid or umbilical cord blood were studied for karyotype analysis. Results: Of these 1048 women, 77 were designated as being of high risk rate for several chromosome abnormalities i.e. Down's syndrome, open spina bifida and trisomy -18 syndrome (overall positive rate 7.3%). Further fetal chromosome study in 31 of them revealed three proven cases of abnormality. Another cord blood study was performed in a calculated low risk rate case but with abnormal sonographic finding at 31 w gestation and proved to be abnormal (software study false negative). The remaining 46 high risk rate cases either refused future study (n=35) or were lost for follow-up (n=11). Fortunately, all the 35 women refused further study gave birth to normal babies without any chromosome abnormalities discovered on peripheral blood study. Besides, in a trial study, five high risk rate women were again evaluated a few weeks later but with tremendous difference between the results. Conclusion: The present program proves to be clinically useful but needs further study and revision. Many factors may influence the result of the analysis and the duration of gestation period in weeks should be as accurate as possible. At present, in order to avoid getting false negatives, we don't advise a second check in 'high risk' cases. (authors)

  1. The Effect of Ramadan Fasting On Neonatal Weight In Different Trimesters Of Pregnancy

    Directory of Open Access Journals (Sweden)

    nahid sarafraz

    2015-09-01

    Full Text Available Background and Objectives: several investigations have been done to evaluate the effect of Ramadan fasting on fetal and maternal health, which have all led to controversial results. The role of Ramadan fasting time in birth weight is still unclear. This study evaluated the effect of fasting at different periods of pregnancy on birth weight. Methods: 250 pregnant women fasting at least one day during Ramadan participated in this retrospective cohort study. Subjects were categorized into 3 groups, namely first trimester (n=112, second trimester (n=68 and third trimester (n=70 of pregnancy. Demographic and anthropometric data, obstetric history and history of Ramadan fasting were recorded. After delivery, neonatal birth weight was measured. The mean of weight and frequency of low birth weight in each group were calculated. Probable related factors of low birth weight of neonates with fasting mothers were evaluated. Results: The mean of birth weight in different groups of Ramadan fasting time in first, second and third trimester of pregnancy were 3411.52±529.88, 3214.57±463.56 and 3336.86±444.89 gr respectively, which had a statistically significant difference (p=0.03. Frequencies of low birth weight in different groups of Ramadan fasting time in first trimester was 8.9%, in second trimester 8.8% and in third trimester it was 7.1%, which had no statistically significant difference (p=0.9. Among all evaluated factors, only neonatal sex was related to low birth weight. Conclusion: Time of Ramadan fasting during pregnancy does not affect birth weight.

  2. A Systematic Review on Normative Values of Trimester-specific Thyroid Function Tests in Indian Women.

    Science.gov (United States)

    Kannan, Subramanian; Mahadevan, Shriraam; Sigamani, Alben

    2018-01-01

    Small cross-sectional studies are published on the trimester-specific normal ranges of thyrotropin and thyroxine levels in Indian women from various parts of the country. We sought to review the published literature on thyroid function tests in normal pregnant Indian women to see if the pooled data from various studies can define normative data and hypothyroidism in pregnancy. We retrieved 56 studies from online databases with detailed search using multiple search terms. Unanimously eight studies were finalized. Data of 2703 pregnant women (age 16-45 years; 966 were in the first trimester, 1072 in their second trimester, and 1037 women in their third trimester) were analyzed. All eight studies included singleton pregnancies from the northern and eastern part of India with seven studies being cross-sectional in nature. The exclusion criteria in all studies included those with historical/clinical evidence of thyroid dysfunction, those with family history of thyroid dysfunction, infertility and those with history of recurrent miscarriages (usually >3). Ultrasound evidence of thyroid disease, urinary iodine assessment, and thyroid antibodies were included as additional exclusion criteria in two, three, and four studies, respectively. None of the studies included the outcome of pregnancy as part of follow-up. As part of the pooled data analysis, the 5 th -95 th centile values of normal TSH extended from 0.09 to 6.65 IU/mL in the first trimester, 0.39-6.61 IU/mL in the second trimester, and 0.70-5.18 IU/mL in the third trimester. The FT4 levels (5 th -95 th centile values) extended from 8.24 to 25.74 pmol/L in the first trimester, 6.82-26.0 pmol/L, and 5.18-25.61 pmol/L in the third trimester. With due limitations imposed by the quality of the available studies, the current review suggests that upper normal limit of TSH values can extend up to 5-6 IU/mL in pregnancy.

  3. Magnitude and determinants of inadequate third-trimester weight gain in rural Bangladesh.

    Science.gov (United States)

    Hasan, S M Tafsir; Rahman, Sabuktagin; Locks, Lindsey Mina; Rahman, Mizanur; Hore, Samar Kumar; Saqeeb, Kazi Nazmus; Khan, Md Alfazal; Ahmed, Tahmeed

    2018-01-01

    The objective of this study was to estimate the magnitude and determinants of inadequate weight gain in the third-trimester among rural women in Matlab, Bangladesh. The study analyzed data on weight gain in the third trimester in 1,883 pregnant women in Matlab, Bangladesh. All these women were admitted to Matlab hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) for childbirth during 2012-2014, and they had singleton live births at term. Data were retrieved from the electronic databases of Matlab Health and Demographic Surveillance System and Matlab hospital. A multivariable logistic regression for inadequate weight gain in the third trimester (≤4 kg) was built with sociodemographic, environmental and maternal factors as predictors. One thousand and twenty-six (54%) pregnant women had inadequate weight gain in the third trimester. In the multivariable model, short stature turned out to be the most robust risk factor for inadequate weight gain in the third trimester (OR = 2.5; 95% CI 1.8, 3.5 for short compared to tall women). Pre-third-trimester BMI was inversely associated with insufficient weight gain (OR = 0.96; 95% CI 0.93, 0.99 for 1 unit increase in BMI). Other risk factors for inadequate weight gain in the third trimester were advanced age (OR = 1.9; 95% CI 1.2, 3.1 for ≥35 years compared to ≤19 years), parity (OR = 1.5; 95% CI 1.2, 1.9 for multipara compared to nulliparous women), low socioeconomic status (OR = 1.7; 95% CI 1.2, 2.3 for women in the lowest compared to women in the highest wealth quintile), low level of education (OR = 1.6; 95% CI 1.2, 2.1 for ≤5 years compared to ≥10 years of education), belonging to the Hindu religious community (OR = 1.8; 95% CI 1.3, 2.5), consuming arsenic-contaminated water (OR = 1.4; 95% CI 1.1, 1.9), and conceiving during monsoon or dry season compared to summer (OR = 1.4; 95% CI 1.1, 1.8). Among rural Bangladeshi women in Matlab, third-trimester weight gain was in

  4. No. 360-Induced Abortion: Surgical Abortion and Second Trimester Medical Methods.

    Science.gov (United States)

    Costescu, Dustin; Guilbert, Édith

    2018-06-01

    This guideline reviews evidence relating to the provision of surgical induced abortion (IA) and second trimester medical abortion, including pre- and post-procedural care. Gynaecologists, family physicians, nurses, midwives, residents, and other health care providers who currently or intend to provide and/or teach IAs. Women with an unintended or abnormal first or second trimester pregnancy. PubMed, Medline, and the Cochrane Database were searched using the key words: first-trimester surgical abortion, second-trimester surgical abortion, second-trimester medical abortion, dilation and evacuation, induction abortion, feticide, cervical preparation, cervical dilation, abortion complications. Results were restricted to English or French systematic reviews, randomized controlled trials, clinical trials, and observational studies published from 1979 to July 2017. National and international clinical practice guidelines were consulted for review. Grey literature was not searched. The quality of evidence in this document was rated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology framework. The summary of findings is available upon request. IA is safe and effective. The benefits of IA outweigh the potential harms or costs. No new direct harms or costs identified with these guidelines. Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada. All rights reserved.

  5. Risk and uncertainty: shifting decision making for aneuploidy screening to the first trimester of pregnancy.

    Science.gov (United States)

    Farrell, Ruth M; Dolgin, Natasha; Flocke, Susan A; Winbush, Victoria; Mercer, Mary Beth; Simon, Christian

    2011-05-01

    The clinical introduction of first trimester aneuploidy screening uniquely challenges the informed consent process for both patients and providers. This study investigated key aspects of the decision-making process for this new form of prenatal genetic screening. Qualitative data were collected by nine focus groups that comprised women of different reproductive histories (N = 46 participants). Discussions explored themes regarding patient decision making for first trimester aneuploidy screening. Sessions were audio recorded, transcribed, coded, and analyzed to identify themes. Multiple levels of uncertainty characterize the decision-making process for first trimester aneuploidy screening. Baseline levels of uncertainty existed for participants in the context of an early pregnancy and the debate about the benefit of fetal genetic testing in general. Additional sources of uncertainty during the decision-making process were generated from weighing the advantages and disadvantages of initiating screening in the first trimester as opposed to waiting until the second. Questions of the quality and quantity of information and the perceived benefit of earlier access to fetal information were leading themes. Barriers to access prenatal care in early pregnancy presented participants with additional concerns about the ability to make informed decisions about prenatal genetic testing. The option of the first trimester aneuploidy screening test in early pregnancy generates decision-making uncertainty that can interfere with the informed consent process. Mechanisms must be developed to facilitate informed decision making for this new form of prenatal genetic screening.

  6. First Trimester Influenza Vaccination and Risks for Major Structural Birth Defects in Offspring.

    Science.gov (United States)

    Kharbanda, Elyse Olshen; Vazquez-Benitez, Gabriela; Romitti, Paul A; Naleway, Allison L; Cheetham, T Craig; Lipkind, Heather S; Klein, Nicola P; Lee, Grace; Jackson, Michael L; Hambidge, Simon J; McCarthy, Natalie; DeStefano, Frank; Nordin, James D

    2017-08-01

    To examine risks for major structural birth defects in infants after first trimester inactivated influenza vaccine (IIV) exposures. In this observational study, we used electronic health data from 7 Vaccine Safety Datalink sites to examine risks for selected major structural defects in infants after maternal IIV exposure. Vaccine exposures for women with continuous insurance enrollment through pregnancy who delivered singleton live births between 2004 and 2013 were identified from standardized files. Infants with continuous insurance enrollment were followed to 1 year of age. We excluded mother-infant pairs with other exposures that potentially increased their background risk for birth defects. Selected cardiac, orofacial or respiratory, neurologic, ophthalmologic or otologic, gastrointestinal, genitourinary and muscular or limb defects were identified from diagnostic codes in infant medical records using validated algorithms. Propensity score adjusted generalized estimating equations were used to estimate prevalence ratios (PRs). We identified 52 856 infants with maternal first trimester IIV exposure and 373 088 infants whose mothers were unexposed to IIV during first trimester. Prevalence (per 100 live births) for selected major structural birth defects was 1.6 among first trimester IIV exposed versus 1.5 among unexposed mothers. The adjusted PR was 1.02 (95% CI 0.94-1.10). Organ system-specific PRs were similar to the overall PR. First trimester maternal IIV exposure was not associated with an increased risk for selected major structural birth defects in this large cohort of singleton live births. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. First-Trimester Pregnancy Exposure to Venlafaxine or Duloxetine and Risk of Major Congenital Malformations

    DEFF Research Database (Denmark)

    Lassen, Dorte; Ennis, Zandra Nymand; Damkier, Per

    2016-01-01

    and noradrenaline reuptake inhibitors, SNRIs, significantly less data are available. Following the PRISMA guideline for systematic reviews, we performed a systematic search on the risk of major congenital malformations after first trimester in utero exposure to venlafaxine or duloxetine. We identified eight cohort...... studies reporting on the outcome upon in utero exposure to venlafaxine or duloxetine during the first trimester. The cumulated data for venlafaxine were 3186 exposed infants and 107 major malformations, resulting in a relative risk estimate and 95% confidence interval of 1.12 (0.......92-1.35). The corresponding data for duloxetine were 668 infants and 16 major malformations, resulting in a relative risk estimate and 95% confidence interval of 0.80 (0.46-1.29). First-trimester in utero exposure to venlafaxine is not associated with an increased risk of major congenital malformations. The amount of data...

  8. An experience of second-trimester anhydramnios salvaged by single amnioinfusion.

    Science.gov (United States)

    Io, Shingo; Kondoh, Eiji; Chigusa, Yoshitsugu; Tani, Hirohiko; Hamanishi, Junzo; Konishi, Ikuo

    2017-11-20

    Second-trimester anhydramnios, which is primarily caused by ruptured membranes, placental dysfunction, or congenital renal malformations, is associated with high perinatal morbidity and mortality. Although amnioinfusion temporarily increases amniotic fluid volume, it does not generally provide a fundamental solution. We describe a case of second-trimester anhydramnios with an umbilical cord factor, wherein single amnioinfusion may have successfully broken a vicious circle involving non-reassuring fetal status. A 34-year-old primigravid woman was referred to our hospital because of anhydramnios at 22 weeks' gestation. Single amnioinfusion improved the fetal circulatory failure, and the patient delivered a healthy full-term newborn. Single amnioinfusion may be a therapeutic approach to improve the prognosis of pregnancy when second-trimester anhydramnios results from umbilical cord factors.

  9. Predisposing Factors to Abnormal First Trimester Placentation and the Impact on Fetal Outcomes

    Science.gov (United States)

    Kroener, Lindsay; Wang, Erica T.; Pisarska, Margareta D.

    2016-01-01

    Normal placentation during the first trimester sets the stage for the rest of pregnancy and involves a finely orchestrated cellular and molecular interplay of maternal and fetal tissues. The resulting intrauterine environment plays an important role in fetal programming and the future health of the fetus, and is impacted by multiple genetic and epigenetic factors. Abnormalities in placentation and spiral artery invasion can lead to ischemia, placental disease and adverse obstetrical outcomes including preeclampsia, intrauterine growth restriction, and placental abruption. Although first trimester placentation is affected my multiple factors, preconception environmental influences such as mode of conception, including assisted reproductive technologies which result in fertilization in vitro and intrauterine influences due to sex differences are emerging as potential significant factors impacting first trimester placentation. PMID:26696276

  10. Dating of Pregnancy in First versus Second Trimester in Relation to Post-Term Birth Rate

    DEFF Research Database (Denmark)

    Thagaard, Ida Näslund; Krebs, Lone; Lausten-Thomsen, Ulrik

    2016-01-01

    OBJECTIVES: To evaluate in a national standardised setting whether the performance of ultrasound dating during the first rather than the second trimester of pregnancy had consequences regarding the definition of pre- and post-term birth rates. METHODS: A cohort study of 8,551 singleton pregnancies...... with spontaneous delivery was performed from 2006 to 2012 at Copenhagen University Hospital, Holbæk, Denmark. We determined the duration of pregnancy calculated by last menstrual period, crown rump length (CRL), biparietal diameter (1st trimester), BPD (2nd trimester), and head circumference and compared mean...... and median durations, the mean differences, the systematic discrepancies, and the percentages of pre-term and post-term pregnancies in relation to each method. The primary outcomes were post-term and pre-term birth rates defined by different dating methods. RESULTS: The change from use of second to first...

  11. Prenatal diagnosis of sirenomelia in the first trimester: A case report.

    Science.gov (United States)

    Ceylan, Yasin; Doğan, Yasemin; Özkan Özdemir, Sebiha; Yücesoy, Gülseren

    2016-03-01

    Sirenomelia or "mermaid syndrome" is a rare congenital syndrome characterized by the anomalous development of the caudal region of the body. We present a case of sirenomelia diagnosed in the first trimester using two-dimensional and three-dimensional ultrasonographic examination. A nulliparous woman aged thirty years was referred to our perinatology unit for evaluation because of oligohydramnios at 12 weeks of gestation. Her medical history was unremarkable. There was no family history of genetic abnormalities. We identified a single lower extremity and severe oligohydramnios, which are characteristics of sirenomelia. Sirenomelia, a developmental defect involving the caudal region of the body, is associated with several internal visceral anomalies. Sirenomelia is fatal in most cases due to the characteristic pulmonary hypoplasia and renal agenesia. Prenatal diagnosis of sirenomelia may be difficult in the second or third trimester because of the severe oligohydramnios; it should be easier to diagnose sirenomelia in the first trimester.

  12. Serum chemerin level during the first trimester of pregnancy and the risk of gestational diabetes mellitus.

    Science.gov (United States)

    Yang, Xuezhou; Quan, Xiaozhen; Lan, Yanli; Ye, Jinhai; Wei, Qipeng; Yin, Xiaofang; Fan, Fangfang; Xing, Hui

    2017-10-01

    To investigate the association between chemerin level in the first trimester of pregnancy and the risk of gestational diabetes mellitus. The blood samples of 212 women at 8-12 weeks of gestation were collected. After screening for gestational diabetes mellitus (GDM), 19 women with GDM and 20 women randomly selected from 144 women with normal glucose tolerance (NGT) were included in the study. Blood samples were collected from these women. Triglycerides, glucose, total cholesterol, and HDL cholesterol, LDL cholesterol, insulin and chemerin were measured. Gestational weight gain and body mass index was assessed. Serum levels of chemerin were significantly elevated during late gestation, and the risk of GDM was positively associated with maternal serum chemerin in the first trimester. Serum chemerin level during the first trimester of pregnancy has the potential to predict risk of GDM.

  13. Trimester specific reference intervals for thyroid function tests in normal Indian pregnant women.

    Science.gov (United States)

    Sekhri, Tarun; Juhi, Juhi Agarwal; Wilfred, Reena; Kanwar, Ratnesh S; Sethi, Jyoti; Bhadra, Kuntal; Nair, Sirimavo; Singh, Satveer

    2016-01-01

    Accurate assessment of thyroid function during pregnancy is critical, for initiation of thyroid hormone therapy, as well as for adjustment of thyroid hormone dose in hypothyroid cases. We evaluated pregnant women who had no past history of thyroid disorders and studied their thyroid function in each trimester. 86 normal pregnant women in the first trimester of pregnancy were selected for setting reference intervals. All were healthy, euthyroid and negative for thyroid peroxidase antibody (TPOAb). These women were serially followed throughout pregnancy. 124 normal nonpregnant subjects were selected for comparison. Thyrotropin (TSH), free thyroxine (FT4), free triiodothyronine (FT3) and anti-TPO were measured using Roche Elecsys 1010 analyzer. Urinary iodine content was determined by simple microplate method. The 2.5th and 97.5th percentiles were calculated as the reference intervals for thyroid hormone levels during each trimester. SPSS (version 14.0, SPSS Inc., Chicago, IL, USA) was used for data processing and analysis. The reference intervals for the first, second and third trimesters for the following parameters: TSH 0.09-6.65, 0.51-6.66, 0.91-4.86 µIU/mL, FT4 9.81-18.53, 8.52-19.43, 7.39-18.28 pM/L and FT3 3.1-6.35, 2.39-5.12, 2.57-5.68 pM/L respectively. Thyroid hormone concentrations significantly differed during pregnancy at different stages of gestation. The pregnant women in the study had median urinary iodine concentration of 150-200 µg/l during each trimester. The trimester-specific reference intervals for thyroid tests during pregnancy have been established for pregnant Indian women serially followed during pregnancy using 2.5th and 97.5th percentiles.

  14. Neonatal congenital lung tumors - the importance of mid-second-trimester ultrasound as a diagnostic clue

    International Nuclear Information System (INIS)

    Waelti, Stephan L.; Garel, Laurent; Rypens, Francoise; Dubois, Josee; Dal Soglio, Dorothee; Messerli, Michael

    2017-01-01

    The differential diagnosis for primary lung masses in neonates includes a variety of developmental abnormalities; it also consists of the much rarer congenital primary lung tumors: cystic pleuropulmonary blastoma (cystic PPB), fetal lung interstitial tumor (FLIT), congenital peribronchial myofibroblastic tumor (CPMT), and congenital fibrosarcoma. Radiologic differentiation between malformations and tumors is often very challenging. The objective was to establish distinctive features between developmental pulmonary abnormalities and primary lung tumors. We conducted a retrospective study of 135 congenital lung lesions at a university mother and child center over a period of 10 years (2005-2015). During this time, we noted four tumors (two cystic PPBs and two FLITs) and 131 malformations. We recorded the following parameters: timing of conspicuity in utero (mid-second trimester, third trimester, or not seen prenatally), presence of symptoms at birth, prenatal and perinatal radiologic findings, and either histological diagnoses by pathology or follow-up imaging in non-operated cases. All lesions except the four tumors were detected during mid-second-trimester ultrasound. In none of the tumors was any pulmonary abnormality found on the mid-second-trimester sonogram, contrary to the developmental pulmonary abnormalities. The timing of conspicuity in utero appears to be a key feature for the differentiation between malformations and tumors. Lesions that were not visible at the mid-second-trimester ultrasound should be considered as tumor. A cystic lung lesion in the context of a normal mid-second-trimester ultrasound is highly suggestive of a cystic PPB. Differentiating the types of solid congenital lung tumors based upon imaging features is not yet feasible. (orig.)

  15. Maternal age during pregnancy is associated with third trimester blood pressure level: the generation R study.

    Science.gov (United States)

    Gaillard, Romy; Bakker, Rachel; Steegers, Eric A P; Hofman, Albert; Jaddoe, Vincent W V

    2011-09-01

    We hypothesized that hemodynamic adaptations related to pregnancy and ageing might be associated with differences in blood pressure levels during pregnancy between younger and older women. This might partly explain the increased risk of gestational hypertensive disorders with advanced maternal age. We examined the associations of maternal age with systolic and diastolic blood pressure in each trimester of pregnancy and the risks of gestational hypertensive disorders. The study was conducted among 8,623 women participating in a population-based prospective cohort study from early pregnancy onwards. Age was assessed at enrolment. Blood pressure was measured in each trimester. Information about gestational hypertensive disorders was available from medical records. In second and third trimester, older maternal age was associated with lower systolic blood pressure (-0.9 mm Hg (95% confidence interval: -1.4, -0.3) and -0.6 mm Hg (95% confidence interval: -1.1, -0.02) per additional 10 maternal years, respectively). Older maternal age was associated with higher third trimester diastolic blood pressure (0.5 mm Hg (95% confidence interval: 0.04, 0.9) per additional 10 maternal years). Maternal age was associated with pregnancy-induced hypertension among overweight and obese women. Older maternal age is associated with lower second and third trimester systolic blood pressure, but higher third trimester diastolic blood pressure. These blood pressure differences seem to be small and within the physiological range. Maternal age is not consistently associated with the risks of gestational hypertensive disorders. Maternal body mass index might influence the association between maternal age and the risk of pregnancy-induced hypertension.

  16. Neonatal congenital lung tumors - the importance of mid-second-trimester ultrasound as a diagnostic clue

    Energy Technology Data Exchange (ETDEWEB)

    Waelti, Stephan L.; Garel, Laurent; Rypens, Francoise; Dubois, Josee [University of Montreal, Department of Medical Imaging, Sainte-Justine Hospital, Quebec (Canada); Dal Soglio, Dorothee [University of Montreal, Department of Pathology, Sainte-Justine Hospital, Quebec (Canada); Messerli, Michael [University Hospital Zurich, University of Zurich, Department of Nuclear Medicine, Zurich (Switzerland)

    2017-12-15

    The differential diagnosis for primary lung masses in neonates includes a variety of developmental abnormalities; it also consists of the much rarer congenital primary lung tumors: cystic pleuropulmonary blastoma (cystic PPB), fetal lung interstitial tumor (FLIT), congenital peribronchial myofibroblastic tumor (CPMT), and congenital fibrosarcoma. Radiologic differentiation between malformations and tumors is often very challenging. The objective was to establish distinctive features between developmental pulmonary abnormalities and primary lung tumors. We conducted a retrospective study of 135 congenital lung lesions at a university mother and child center over a period of 10 years (2005-2015). During this time, we noted four tumors (two cystic PPBs and two FLITs) and 131 malformations. We recorded the following parameters: timing of conspicuity in utero (mid-second trimester, third trimester, or not seen prenatally), presence of symptoms at birth, prenatal and perinatal radiologic findings, and either histological diagnoses by pathology or follow-up imaging in non-operated cases. All lesions except the four tumors were detected during mid-second-trimester ultrasound. In none of the tumors was any pulmonary abnormality found on the mid-second-trimester sonogram, contrary to the developmental pulmonary abnormalities. The timing of conspicuity in utero appears to be a key feature for the differentiation between malformations and tumors. Lesions that were not visible at the mid-second-trimester ultrasound should be considered as tumor. A cystic lung lesion in the context of a normal mid-second-trimester ultrasound is highly suggestive of a cystic PPB. Differentiating the types of solid congenital lung tumors based upon imaging features is not yet feasible. (orig.)

  17. Regulating irrigation during pre-harvest to avoid the incidence of translucent flesh disorder and gamboge disorder of mangosteen fruits

    Directory of Open Access Journals (Sweden)

    Rawee Chiarawipa

    2005-09-01

    Full Text Available In humid tropical areas, excess water during pre-harvest usually causes the occurrence of translucent flesh disorder (TFD and gamboge disorder (GD in mangosteen. To evaluate options for avoiding these incidences, an experiment was conducted with different water management regimes during pre-harvest. Twelve 14-year-old trees were grown under transparent plastic cover with three irrigation regimes: 1 Control (rainfed condition, 2 7-d interval watering, 3 4-d interval watering and 4 daily watering. A further four trees were arranged as the control (rainfed treatment, but these were grown without the plastic roof cover. The treatments were started at 9 weeks after bloom. The results showed that diurnal changes of leaf water potential and stomatal conductance were lowest in the control, because intermittent drying occurred during the study period. The highest fruit diameter, fruit weight, flesh firmness and flesh and rind water contents were found in the daily watering treatment. However, all of these values were lowest in the control trees. The amount of TFD was also lowest in the control (3.7%, and it was significantly different from the treatment where trees were watered at 4-d intervals (18.0% and where trees were watered daily (28.9%. There was no significant difference of TFD between the control and the 7-d interval watering treatments. In contrast, GD was not significantly different among the treatments. It is suggested that the risk of TFD and GD incidence could be avoided by maintaining mild soil water deficit around -70 kPa during pre-harvest.

  18. Evaluation of shear bond strength and shear stress on zirconia reinforced lithium silicate and high translucency zirconia.

    Directory of Open Access Journals (Sweden)

    Amanda Maria de Oliveira Dal Piva

    2018-01-01

    Full Text Available This study evaluated the shear stress distribution on the adhesive interface and the bond strength between resin cement and two ceramics. For finite element analysis (FEA, a tridimensional model was made using computer-aided design software. This model consisted of a ceramic slice (10x10x2mm partially embedded on acrylic resin with a resin cement cylinder (Ø=3.4 mm and h=3mm cemented on the external surface. Results of maximum principal stress and maximum principal shear were obtained to evaluate the stress generated on the ceramic and the cylinder surfaces. In order to reproduce the in vitro test, similar samples to the computational model were manufactured according to ceramic material (Zirconia reinforced lithium silicate - ZLS and high translucency Zirconia - YZHT, (N=48, n=12. Half of the specimens were submitted to shear bond test after 24h using a universal testing machine (0.5 mm/min, 50kgf until fracture. The other half was stored (a (180 days, water, 37ºC prior to the test. Bond strength was calculated in MPa and submitted to analysis of variance. The results showed that ceramic material influenced bond strength mean values (p=0.002, while aging did not: YZHT (19.80±6.44a, YZHTa (17.95±7.21a, ZLS (11.88±5.40b, ZLSa (11.76±3.32b. FEA results showed tensile and shear stress on ceramic and cylinder surfaces with more intensity on their periphery. Although the stress distribution was similar for both conditions, YZHT showed higher bond strength values; however, both materials seemed to promote durable bond strength.

  19. Adiponectin and leptin as first trimester markers for gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Thagaard, Ida Näslund; Krebs, Lone; Holm, Jens Christian

    2017-01-01

    Background: Gestational diabetes mellitus (GDM) is increasing partly due to the obesity epidemic. Adipocytokines have thus been suggested as first trimester screening markers for GDM. In this study we explore the associations between body mass index (BMI) and serum concentrations of adiponectin......, leptin, and the adiponectin/leptin ratio. Furthermore, we investigate whether these markers can improve the ability to screen for GDM in the first trimester. Methods: A cohort study in which serum adiponectin and leptin were measured between gestational weeks 6+0 and 14+0 in 2590 pregnant women...

  20. Program of complex rehabilitation of pregnant with alimentary-constitutional obesity in the third trimester.

    Directory of Open Access Journals (Sweden)

    Kovalenko T.N.

    2011-03-01

    Full Text Available In the article is presented the complex rehabilitation program for pregnant with alimentary-constitutional obesity in the third trimester. The program is directed on the decline of bodyweight, with the purpose of increase of scray-protective reactions of organism of pregnant and to the decline of obstetric traumatism in births. In an experiment took part 90 pregnant of the third trimester with obesity of I-III degree, middle genesial age. The developed and inculcated program foresaw the use of physical, psychological and medical rehabilitation.

  1. Low PAPP-A in the first trimester is associated with reduced fetal growth rate prior to gestational week 20

    DEFF Research Database (Denmark)

    Salvig, J D; Kirkegaard, I; Winding, Trine Nøhr

    2010-01-01

    To evaluate the association between maternal pregnancy-associated plasma protein-A (PAPP-A) and fetal growth from the first to the second trimester.......To evaluate the association between maternal pregnancy-associated plasma protein-A (PAPP-A) and fetal growth from the first to the second trimester....

  2. Effects of small-grit grinding and glazing on mechanical behaviors and ageing resistance of a super-translucent dental zirconia.

    Science.gov (United States)

    Lai, Xuan; Si, Wenjie; Jiang, Danyu; Sun, Ting; Shao, Longquan; Deng, Bin

    2017-11-01

    The purpose of this study is to elucidate the effects of small-grit grinding on the mechanical behaviors and ageing resistance of a super-translucent dental zirconia and to investigate the necessity of glazing for the small-grit ground zirconia. Small-grit grinding was performed using two kinds of silicon carbide abrasive papers. The control group received no grinding. The unground surfaces and the ground surfaces were glazed by an experienced dental technician. Finally, the zirconia materials were thermally aged in water at 134°C for 5h. After aforementioned treatments, we observed the surface topography and the microstructures, and measured the extent of monoclinic phase, the nano-hardness and nano-modulus of the possible transformed zone and the flexural strength. Small-grit grinding changed the surface topography. The zirconia microstructure did not change obviously after surface treatments and thermal ageing; however, the glaze in contact with zirconia showed cracks after thermal ageing. Small-grit grinding did not induce a phase transformation but improved the flexural strength and ageing resistance. Glazing prevented zirconia from thermal ageing but severely diminished the flexural strength. The nano-hardness and nano-modulus of the surface layer were increased by ultrafine grinding. The results suggest that small-grit grinding is beneficial to the strength and ageing resistance of the super-translucent dental zirconia; however, glazing is not necessary and even impairs the strength for the super-translucent dental zirconia. This study is helpful to the researches about dental grinding tools and maybe useful for dentists to choose reasonable zirconia surface treatments. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Prevalence of oral lesions and measurement of salivary pH in the different trimesters of pregnancy.

    Science.gov (United States)

    Jain, Kanu; Kaur, Harshaminder

    2015-01-01

    Oral changes observed during pregnancy have been studied for many years, but their magnitude and frequency have not been stressed upon. This study was undertaken to assess the prevalence of oral lesions during different trimesters of pregnancy and their correlation with salivary pH change. The gingival, simplified oral hygiene, community periodontal and decayed-missing-filled teeth indices were used to assess a total of 120 pregnant women (40 in each trimester group) and 40 nonpregnant women (control group). Salivary pH was measured using a digital pH meter. Presence of any oral lesions was determined via oral examination. Scores for all indices increased while salivary pH decreased from the control group to the first trimester group, through to the third. Oral lesions were seen in 44.2% of pregnant women. Lesions were seen in 27.5%, 52.5% and 52.5% of women in the first, second and third trimesters, respectively. The percentage of pregnant women with one oral lesion was highest in the second trimester (47.5%), whereas the third trimester had the highest prevalence (17.5%) of two concurrent oral lesions. The incidence of fissured tongue was highest in the first trimester group, and that of gingival enlargement was highest in the third trimester group. In the second trimester group, there was an almost equal incidence of fissured tongue and gingival/mucosal enlargement. Most changes in oral tissues during pregnancy can be avoided with good oral hygiene. Salivary pH could be used to assess the prevalence of oral lesions in the different trimesters of pregnancy.

  4. Medical First-Trimester Termination of Pregnancy with Massive Fibroid Uterus

    Directory of Open Access Journals (Sweden)

    Michael Saad-Naguib

    2017-01-01

    Full Text Available First-trimester termination of pregnancy by medical or surgical route is highly effective with a low complication rate. Uterine abnormalities can complicate a procedure due to distortion of normal anatomy. In this case presentation, medical termination of pregnancy is performed using fetal intracardiac potassium chloride injection and intramuscular methotrexate.

  5. Pelaksanaan Antenatal Care Berhubungan dengan Anemia pada Kehamilan Trimester III di Puskesmas Sedayu I Yogyakarta

    Directory of Open Access Journals (Sweden)

    Fatimah Fatimah

    2015-11-01

    Full Text Available Anemia is one of the problems in Indonesia that important to examine, especially for pregnant women. This research used quantitative with explanatory design. Population were 44 pregnant women in 3 trimester selected by the total sampling technique. The independent variable were implementation of the antenatal care by midwives and dependent variable is anemia in 3 trimester of pregnancy at Puskesmas Sedayu I Yogyakarta. Data was collected using questionnaire. The analysis used was chi-square. The results of study showed that there was 33 (75% of antenatal care in good category, with no anemia were 32 (72.7% respondents, and there was a significant relationship between antenatal care and anemia in the third trimester of pregnancy with p-value=0.004. In conclusion, there was a significant relationship between antenatal care and anemia in the third trimester of pregnancy. Suggestions were needed to maintain and improve the care of midwives in antenatal care to improve the health of pregnant women, especially anemia in pregnancy.

  6. ORIGIN OF RAISED MATERNAL SERUM ALPHA-FETOPROTEIN LEVELS IN 2ND-TRIMESTER OLIGOHYDRAMNIOS

    NARCIS (Netherlands)

    LOS, FJ; BEEKHUIS, [No Value; MARRINK, J; HAGENAARS, AM; REUSS, A; SACHS, ES; JAHODA, MGJ; WLADIMIROFF, JW

    Concanavalin A (Con A) subtyping of alpha-fetoprotein (AFP) revealed higher concentrations of AFP non-reactive with Con A in sera of 12 pregnant women with second-trimester oligohydramnios and raised total serum AFP levels than in sera of 42 pregnant women with raised total serum AFP levels and a

  7. FIRST-TRIMESTER MATERNAL SERUM ALPHA-FETOPROTEIN AS A MARKER FOR FETAL CHROMOSOMAL DISORDERS

    NARCIS (Netherlands)

    VANLITH, JMM

    1994-01-01

    We evaluated first-trimester maternal serum alpha-fetoprotein (MS-AFP) as a marker for fetal chromosomal disorders. The multicentre study was performed under the auspices of the Dutch Working Party on Prenatal Diagnosis. MS-AFP was measured in 2404 normal pregnancies and 72 chromosomally abnormal

  8. 1ST-TRIMESTER SCREENING FOR FETAL CHROMOSOMAL-ABNORMALITIES - PRELIMINARY-RESULTS

    NARCIS (Netherlands)

    VANLITH, JMM

    We have started a multicentre trial to study the possibilities of first-trimester maternal serum screening for fetal chromosomal abnormalities. Maternal blood samples were obtained before 13 weeks of gestation. We present the preliminary results of the first 950 patients on alpha-fetoprotein (AFP).

  9. Pengetahuan Ibu Hamil Trimester III Tentang KB Pasca Persalinan di Puskesmas Jetis Kota, Yogyakarta

    Directory of Open Access Journals (Sweden)

    Nining Kurnia

    2015-03-01

    Full Text Available The population of Indonesia increased every year. The goverment makes family planning post delivery to press off Indonesian growth. In Yogyakarta family planning post delivery were used by 527 people, at Puskesmas Jetis were 167 women from 363 total target of pregnant women. A succession of this program influenced by knowledge and education. The purpose of this study was to know the knowledge level of pregnant women in trimester III about family planning post delivery at Puskesmas Jetis Yogyakarta. The methode of this study was descriptive quantitative with cross sectional design. The sample obtained by saturated sampling technique which consisted of 45 pregnant women trimester III. The data used univariate analysys. The results showed that most of pregnants women in trimester III was aged 20-35 years (77.7%, high school education (37.8%, and there was 51.1% of pregnant women in fair knowledge level. Most of pregnant women decides to used family planning injection post delivery (44.4%. In conclusion, the knowledge level of pregnant women in trimester III about family planning post delivery was mostly in fair knowledge level.

  10. Alcohol reduction in the first trimester is unrelated to smoking, patient or pregnancy characteristics

    Directory of Open Access Journals (Sweden)

    Kristen A. Schmidt

    2017-06-01

    Conclusions: Women reported reducing their alcohol consumption during pregnancy, including those screening positive for pre-pregnancy problem drinking. First trimester alcohol reduction cannot be accounted for by smoking, patient or pregnancy characteristics; public health initiatives, psychological factors and hormonal mechanisms may be implicated.

  11. Application of First Trimester Screening in the Prognostication of Small for Gestational Age

    Directory of Open Access Journals (Sweden)

    Reza Saeidi

    2018-05-01

    Full Text Available Background: Fetal growth restriction is defined as the failure of the fetus to achieve its full growth potential. The present study aimed to investigate the application of first trimester screening in the prediction of small for gestational age (SGA.Methods: This cohort study was conducted on the consecutive and unselected women with singleton pregnancies undergoing routine first-trimester examinations in a health center affiliated to Neyshabur University of Medical Sciences in Razavi Khorasan Iran during February 2014-March 2016. Subjects received a first-trimester visit by a physician, which included the entry of basic maternal characteristics, medical history, measurement of maternal weight and height, ultrasound examination for fetal anatomy, and measurement of crown-rump length to assess gestational age.Results: SGA was significantly correlated with maternal age, parity, and body mass index. Furthermore, a significant association was observed between SGA and smoking habits in the mothers.Conclusion: According to the results, first trimester screening was a useful method for the prediction of SGA.

  12. Fetal nasal bone length in the second trimester: comparison between population groups from different ethnic origins.

    Science.gov (United States)

    Papasozomenou, Panayiota; Athanasiadis, Apostolos P; Zafrakas, Menelaos; Panteris, Eleftherios; Loufopoulos, Aristoteles; Assimakopoulos, Efstratios; Tarlatzis, Basil C

    2016-03-01

    To compare normal ranges of ultrasonographically measured fetal nasal bone length in the second trimester between different ethnic groups. A prospective, non-interventional study in order to establish normal ranges of fetal nasal bone length in the second trimester in a Greek population was conducted in 1220 singleton fetuses between 18 completed weeks and 23 weeks and 6 days of gestation. A literature search followed in order to identify similar studies in different population groups. Fetal nasal bone length mean values and percentiles from different population groups were compared. Analysis of measurements in the Greek population showed a linear association, i.e., increasing nasal bone length with increasing gestational age from 5.73 mm at 18 weeks to 7.63 mm at 23 weeks. Eleven studies establishing normal ranges of fetal nasal bone length in the second trimester were identified. Comparison of fetal nasal bone length mean values between the 12 population groups showed statistically significant differences (Pdifferent ethnic groups. Hence, distinct ethnic nomograms of fetal nasal bone length in the second trimester should be used in a given population rather than an international model.

  13. Assessment of Cardiac Function in Fetuses of Gestational Diabetic Mothers During the Second Trimester.

    Science.gov (United States)

    Atiq, Mehnaz; Ikram, Anum; Hussain, Batool M; Saleem, Bakhtawar

    2017-06-01

    Fetuses of diabetic mothers may have structural or functional cardiac abnormalities which increase morbidity and mortality. Isolated functional abnormalities have been identified in the third trimester. The aim of the present study was to assess fetal cardiac function (systolic, diastolic, and global myocardial performance) in the second trimester in mothers with gestational diabetes, and also to relate cardiac function with glycemic control. Mothers with gestational diabetes mellitus referred for fetal cardiac evaluation in the second trimester (between 19 and 24 weeks) from March 2015 to February 2016 were enrolled as case subjects in this study. Non-diabetic mothers who had a fetal echocardiogram done between 19 and 24 weeks for other indications were enrolled as controls. Functional cardiac variables showed a statistically significant difference in isovolumetric relaxation and contraction times and the myocardial performance index and mitral E/A ratios in the gestational diabetic group (p = 0.003). Mitral annular plane systolic excursion was significantly less in the diabetic group (p = 0.01). The only functional cardiac variable found abnormal in mothers with poor glycemic control was the prolonged isovolumetric relaxation time. Functional cardiac abnormalities can be detected in the second trimester in fetuses of gestational diabetic mothers and timely intervention can improve postnatal outcomes.

  14. Facial profile markers in second- and third-trimester fetuses with trisomy 18

    NARCIS (Netherlands)

    Vos, F. I.; De Jong-Pleij, E. A P; Bakker, M.; Tromp, E.; Manten, G. T R; Bilardo, C. M.

    2015-01-01

    Objectives To evaluate nasal bone length (NBL), maxilla-nasion-mandible (MNM) angle, fetal profile (FP) line, prenasal thickness (PT), prenasal thickness to nasal bone length (PT:NBL) ratio and prefrontal space ratio (PFSR) as markers of trisomy 18 in the second and third trimesters of pregnancy.

  15. Placenta percreta causing acute abdomen in the second trimester of pregnancy

    International Nuclear Information System (INIS)

    Hussain, M.; Bhutta, S. Z.; Sarwar, S.

    2004-01-01

    Two cases of acute abdomen due to haemoperitoneum caused by placenta percreta in the second trimester are presented. Both had a history of previous lower segment caesarean section, a factor well-known to predispose the condition. How- ever, the rarity of the condition, presenting in mid pregnancy makes diagnosis and management difficult. Optimum ways of management are discussed. (author)

  16. Maternal serum laeverin (aminopeptidase Q) measured in the first trimester of pregnancy does not predict preeclampsia

    DEFF Research Database (Denmark)

    Pihl, Kasper; Sørensen, Steen; Nystad, Mona

    2018-01-01

    OBJECTIVE: The aim of this study was to compare the laeverin level in maternal serum from first trimester (11-14 weeks) of pregnancy between normal pregnancies and pregnancies that later developed preeclampsia (PE). MATERIAL AND METHODS: This was a case-cohort study. The laeverin concentration wa...

  17. Malaria and fetal growth alterations in the 3(rd) trimester of pregnancy

    DEFF Research Database (Denmark)

    Schmiegelow, Christentze; Minja, Daniel Thomas; Oesterholt, Mayke

    2013-01-01

    Pregnancy associated malaria is associated with decreased birth weight, but in-utero evaluation of fetal growth alterations is rarely performed. The objective of this study was to investigate malaria induced changes in fetal growth during the 3(rd) trimester using trans-abdominal ultrasound....

  18. Maternal leptin and body composition in the first trimester of pregnancy.

    LENUS (Irish Health Repository)

    Fattah, Chro

    2012-02-01

    BACKGROUND: Leptin is produced mainly by adipocytes. Levels are increased in women with obesity and during pregnancy. Increased levels are also associated with pregnancy complications such as, pre-eclampsia and gestational diabetes mellitus. OBJECTIVE: We studied what component of body composition correlated best with maternal leptin in the first trimester of pregnancy and, whether maternal leptin correlated better with visceral fat rather than fat distributed elsewhere. SUBJECTS AND METHODS: Women were recruited in the first trimester. Maternal adiposity was measured using body mass index and advanced bioelectrical impedance analysis. Maternal leptin was measured using an enzyme-linked immunosorbent assay technique. RESULTS: Of the 100 subjects studied, the mean leptin concentration was 37.7 ng\\/ml (range: 2.1-132.8). Leptin levels did not correlate with gestational age in the first trimester, maternal age, parity or birth weight. Serum leptin correlated positively with maternal weight and body mass index, and with the different parameters of body composition. On multiple regression analysis, serum leptin correlated with visceral fat but not fat distributed elsewhere. CONCLUSIONS: Visceral fat is the main determinant of circulating maternal leptin in the first trimester of pregnancy. This raises the possibility that maternal leptin in early pregnancy may be a marker for the development of metabolic syndrome, including diabetes mellitus.

  19. Cross-trimester repeated measures testing for Down's syndrome screening: an assessment.

    LENUS (Irish Health Repository)

    Wright, D

    2010-07-01

    To provide estimates and confidence intervals for the performance (detection and false-positive rates) of screening for Down\\'s syndrome using repeated measures of biochemical markers from first and second trimester maternal serum samples taken from the same woman.

  20. Maternal weight and body composition in the first trimester of pregnancy.

    LENUS (Irish Health Repository)

    Fattah, Chro

    2012-02-01

    OBJECTIVE: Previous studies on weight gain in pregnancy suggested that maternal weight on average increased by 0.5-2.0 kg in the first trimester of pregnancy. This study examined whether mean maternal weight or body composition changes in the first trimester of pregnancy. DESIGN: Prospective observational study. POPULATION: We studied 1,000 Caucasian women booking for antenatal care in the first trimester of pregnancy. SETTING: Large university teaching hospital. METHODS: Maternal height and weight were measured digitally in a standardized way and Body Mass Index (BMI) was calculated. Maternal body composition was measured using segmental multifrequency Bioelectrical Impedance Analysis (BIA). Sonographic examination confirmed the gestational age and a normal ongoing singleton pregnancy in all subjects. MAIN OUTCOME MEASURES: Maternal weight, maternal body composition. RESULTS: The mean BMI was 25.7 kg\\/m(2) and 19.0% of the women were in the obese category (> or =30.0 kg\\/m(2)). Cross-sectional analysis by gestational age showed that there was no change in mean maternal weight, BMI, total body water, fat mass, fat-free mass or bone mass before 14 weeks gestation. CONCLUSIONS: Contrary to previous reports, mean maternal weight and mean body composition values remain unchanged in the first trimester of pregnancy. This has implications for guidelines on maternal weight gain during pregnancy. We also recommend that calculation of BMI in pregnancy and gestational weight gain should be based on accurate early pregnancy measurements, and not on self-reported or prepregnancy measurements.

  1. MULTISCAN--a Scandinavian multicenter second trimester obstetric ultrasound and serum screening study

    DEFF Research Database (Denmark)

    Jørgensen, F S; Valentin, L; Salvesen, K A

    1999-01-01

    AIM: To study the detection rates of second trimester ultrasound screening for neural tube defects (NTD), abdominal wall defects (AWD) and Down's syndrome (DS) in low risk populations at tertiary centers, and to compare the ultrasound screening detection rates with those that were obtainable by b...

  2. Actualization regarding genetic sonographic markers in the 1 trimester of pregnancy

    International Nuclear Information System (INIS)

    Trull Martinez, Felicia Amaralis; Pimentel Benitez, Hector; Garcia Borrego, Aniorland; Medina Ali, Frank Ernesto

    2010-01-01

    The topic of sonographic markers in the first trimester of pregnancy is reviewed, in order to provide an update. The predictive markers on the most frequent congenital anomalies are emphasized. It was concluded with important aspects that should be considered for a correct interpretation of these findings

  3. Comparison of two dose regimens of misoprostol for second-trimester pregnancy termination

    NARCIS (Netherlands)

    Brouns, Joseph Franciscus Gertrudis Maria; van Wely, Madelon; Burger, Mattheus Petrus Maria; van Wijngaarden, Willem Jacobus

    2010-01-01

    Objective: The study was conducted to compare the efficacy of two different dose regimens of misoprostol administered vaginally in combination with mifepristone for second trimester termination of viable and non-viable pregnancies. Design: Double-blind randomized controlled trial conducted at the

  4. First trimester screening for Down syndrome and assisted reproduction: no basis for concern

    DEFF Research Database (Denmark)

    Wøjdemann, K R; Larsen, S O; Shalmi, A

    2001-01-01

    In pregnancies obtained after assisted reproduction the false-positive rate of second trimester Down syndrome (DS) screening is increased by 1.5-3-fold. This may cause an increase in the number of amniocenteses and the fetal loss rate. The present study for the first time examined whether assiste...

  5. Down syndroom kansbepaling met de eerste trimester combinatietest 2002-2004

    NARCIS (Netherlands)

    Schielen PCJI; Leeuwen M van; Elvers LH; Loeber JG; LIS

    2007-01-01

    Here, the first evaluation is presented of the first-trimester combined test screening carried out in the Netherlands among pregnant women to determine the chance of the baby being born with Down's syndrome. The screening, commissioned by the Health Care Inspectorate of the Dutch Ministry of Health,

  6. Outcome of infants presenting with echogenic bowel in the second trimester of pregnancy

    NARCIS (Netherlands)

    Buiter, Hannah D.; Scholtenhuis, Marloes A. G. Holswilder-Olde; Bouman, Katelijne; van Baren, Robertine; Bilardo, Caterina M.; Bos, Arend F.

    Objective Fetal echogenic bowel (FEB) is a soft marker found on second trimester sonography. Our main aim was to determine the outcome of infants who presented with FEB and secondarily to identify additional sonographic findings that might have clinical relevance for the prognosis. Design We

  7. Maternal first-trimester diet and childhood bone mass: The Generation R Study

    NARCIS (Netherlands)

    D.H.M. Heppe (Denise); M.C. Medina-Gomez (Carolina); A. Hofman (Albert); O.H. Franco (Oscar); F. Rivadeneira Ramirez (Fernando); V.W.V. Jaddoe (Vincent)

    2013-01-01

    textabstractBackground: Maternal diet during pregnancy has been suggested to influence bone health in later life. Objective: We assessed the association of maternal first-trimester dietary intake during pregnancy with childhood bone mass. Design: In a prospective cohort study in 2819 mothers and

  8. Second-trimester cervical length as risk indicator for Cesarean delivery in women with twin pregnancy

    NARCIS (Netherlands)

    Van de Mheen, L.; Schuit, E.; Liem, S. M. S.; Lim, A. C.; Bekedam, D. J.; Goossens, S. M. T. A.; Franssen, M. T. M.; Porath, M. M.; Oudijk, M. A.; Bloemenkamp, K. W. M.; Duvekot, J. J.; Woiski, M. D.; De Graaf, I.; Sikkema, J. M.; Scheepers, H. C. J.; Van Eijk, J.; De Groot, C. J. M.; Van Pampus, M. G.; Mol, B. W. J.

    2015-01-01

    Objective To determine whether second-trimester cervical length (CL) in women with a twin pregnancy is associated with the risk of emergency Cesarean section. Methods This was a secondary analysis of two randomized trials conducted in 57 hospitals in The Netherlands. We assessed the univariable

  9. Third Trimester Brain Growth in Preterm Infants Compared With In Utero Healthy Fetuses.

    Science.gov (United States)

    Bouyssi-Kobar, Marine; du Plessis, Adré J; McCarter, Robert; Brossard-Racine, Marie; Murnick, Jonathan; Tinkleman, Laura; Robertson, Richard L; Limperopoulos, Catherine

    2016-11-01

    Compared with term infants, preterm infants have impaired brain development at term-equivalent age, even in the absence of structural brain injury. However, details regarding the onset and progression of impaired preterm brain development over the third trimester are unknown. Our primary objective was to compare third-trimester brain volumes and brain growth trajectories in ex utero preterm infants without structural brain injury and in healthy in utero fetuses. As a secondary objective, we examined risk factors associated with brain volumes in preterm infants over the third-trimester postconception. Preterm infants born before 32 weeks of gestational age (GA) and weighing <1500 g with no evidence of structural brain injury on conventional MRI and healthy pregnant women were prospectively recruited. Anatomic T2-weighted brain images of preterm infants and healthy fetuses were parcellated into the following regions: cerebrum, cerebellum, brainstem, and intracranial cavity. We studied 205 participants (75 preterm infants and 130 healthy control fetuses) between 27 and 39 weeks' GA. Third-trimester brain volumes were reduced and brain growth trajectories were slower in the ex utero preterm group compared with the in utero healthy fetuses in the cerebrum, cerebellum, brainstem, and intracranial cavity. Clinical risk factors associated with reduced brain volumes included dexamethasone treatment, the presence of extra-axial blood on brain MRI, confirmed sepsis, and duration of oxygen support. These preterm infants exhibited impaired third-trimester global and regional brain growth in the absence of cerebral/cerebellar parenchymal injury detected by using conventional MRI. Copyright © 2016 by the American Academy of Pediatrics.

  10. Lupus anticoagulant, disease activity and low complement in the first trimester are predictive of pregnancy loss.

    Science.gov (United States)

    Mankee, Anil; Petri, Michelle; Magder, Laurence S

    2015-01-01

    Multiple factors, including proteinuria, antiphospholipid syndrome, thrombocytopenia and hypertension, are predictive of pregnancy loss in systemic lupus erythematosus (SLE). In the PROMISSE study of predictors of pregnancy loss, only a battery of lupus anticoagulant tests was predictive of a composite of adverse pregnancy outcomes. We examined the predictive value of one baseline lupus anticoagulant test (dilute Russell viper venom time) with pregnancy loss in women with SLE. From the Hopkins Lupus Cohort, there were 202 pregnancies from 175 different women after excluding twin pregnancies and pregnancies for which we did not have a first trimester assessment of lupus anticoagulant. We determined the percentage of women who had a pregnancy loss in groups defined by potential risk factors. The lupus anticoagulant was determined by dilute Russell viper venom time with appropriate mixing and confirmatory testing. Generalised estimating equations were used to calculate p values, accounting for repeated pregnancies in the same woman. The age at pregnancy was 40 (3%). 55% were Caucasian and 34% African-American. Among those with lupus anticoagulant during the first trimester, 6/16 (38%) experienced a pregnancy loss compared with only 16/186 (9%) of other pregnancies (p=0.003). In addition, those with low complement or higher disease activity had a higher rate of pregnancy loss than those without (p=0.049 and 0.005, respectively). In contrast, there was no association between elevated anticardiolipin in the first trimester and pregnancy loss. The strongest predictor of pregnancy loss in SLE in the first trimester is the lupus anticoagulant. In addition, moderate disease activity by the physician global assessment and low complement measured in the first trimester were predictive of pregnancy loss. These data suggest that treatment of the lupus anticoagulant could be considered, even in the absence of history of pregnancy loss.

  11. [Bacterial flora in the genital tract the last trimester of pregnancy].

    Science.gov (United States)

    Balaka, B; Agbèrè, A D; Baeta, S; Kessie, K; Assimadi, K

    2003-10-01

    Very widespread in our clinical setting, early-onset sepsis is due to organisms that commonly colonize or infect the maternal genital tract; identifying such organisms would help improve prevention and treatment. To determine the bacterial ecology and the pathological status of the genital organs during the last trimester of pregnancy, in order to evaluate the risk of materno-fetal infections and to improve the present prophylactic measures based on monitoring bacterial carriage during the first trimester. Vaginal and endocervical samples, usually taken during the first trimester of pregnancy were delayed and taken during the last trimester of pregnancy, in patients with no signs of sepsis and not taking antibiotics. A macroscopic examination described the aspect of the vagina, the cervix uteri, leukorrhea and possible inflammatory lesions or ulcerations. A microscopic examination searched for parasites, epithelial cells, Clue cells and leukocytes. The appropriate bacteriological cultures were performed after reading the Gram stain and scoring the vaginal flora. The clinical and cytobacteriological aspects were used to identify the bacterial ecology and the pathological genital states. Genital samples were collected from 306 pregnant women. Among them 118 were at 29-32 weeks of gestation, 104 at 33-36 and 84 at 37-40. The most frequent germs were C. albicans (33.3%), Enterobacteriaceae (20.3%) including E. coli (10.9%), S. aureus (15.4%), Gardnerella (13.6%), and Trichomonas (10.6%), in monomicrobian (79.2%) or polymicrobian carriage (20.8%). Lower genital tract pathological states such as vaginitis (29.4%), bacterial vaginosis (21.5%) or cervicitis (10.4%) and asymptomatic bacterial carriage (23.5%) and normal genital flora (15%) were identified. This is the first report of genital bacterial carriage in African women during the last trimester of pregnancy. Larger studies are required to evaluate the risk of maternofetal infections and to improve current

  12. First and second trimester maternal serum inhibin A levels in twins with pre-eclampsia.

    Science.gov (United States)

    Svirsky, Ran; Maymon, Ron; Melcer, Yaakov; Klog, Esther; Cuckle, Howard

    2016-11-01

    To investigate maternal serum inhibin as a marker of pre-eclampsia (PE) in twins. One hundred forty-three twins and 109 unaffected singleton pregnancies were recruited in the first trimester from the same institution. Blood samples were stored at recruitment and in the second trimester, retrospectively tested for inhibin and values expressed in multiples of the gestation-specific median (MoMs) in singletons, adjusted for maternal weight, as appropriate. The median inhibin level in unaffected twins was 2.04 MoM compared with 1.00 MoM in singletons (P < 0.0001, Wilcoxon Rank Sum Test, one-tailed). Excluding early fetal losses the median in 22 samples from 12 twins with PE was 2.65 MoM compared with 1.99 MoM in 201 samples from 120 unaffected twins (P < 0.02, Wilcoxon Rank Sum Test). This effect was restricted to second trimester samples with medians in cases and controls of 2.86 and 1.91 MoM respectively. Logistic regression of inhibin A together with established PE marker placental growth factor and placental associated plasma protein showed that in the second trimester, it improved screening performance although not reaching statistical significance (P = 0.08). Inhibin A is a potential second trimester marker of PE in twins. It may improve on existing twin screening protocols but more data are required. © 2016 John Wiley & Sons, Ltd. © 2016 John Wiley & Sons, Ltd.

  13. Routine Iron Supplementation and Anaemia by Third Trimester in a Nigerian Hospital.

    Science.gov (United States)

    Adanikin, Abiodun I; Awoleke, Jacob O; Olofinbiyi, Babatunde A; Adanikin, Pipeloluwa O; Ogundare, Omobolanle R

    2015-10-01

    Anaemia in pregnancy is associated with adverse maternal and fetal outcome. Unfortunately, in developing countries its prevalence has continued to rise. To improve the situation, iron supplement is routinely prescribed during pregnancy. We therefore examine the impact of the intervention as being currently practised in our clinical setting. In total, 255 prenatal clinic attendees who had more than 8 weeks of prescribed iron supplements were sampled. Data was obtained on their socio-demographic features, haemoglobin concentration at booking, compliance with iron supplements and third trimester haemoglobin value. Observed iron supplementation compliance rate was 184(72.2%). There was a significant drop in mean haemoglobin (Hb) concentration between the two time points (booking Hb: 32.56±2.99; third trimester Hb: 31.67±3.01; mean diff: 0.89±3.04; t = 4.673; 95% CI= 0.52-1.27; p= Anaemia increased from 132(51.8%) to 150(58.8%) by the third trimester. Increase in anaemia occurred in both iron-compliant and non-compliant groups. Non-compliance however had higher odds of predicting anaemia by the third trimester (OR: 1.83; 95% CI: 1.03-3.26; p: 0.04). Although iron supplementation is still a good intervention in developing countries, it is not sufficient to reduce overall prevalence of anaemia by the third trimester. There is a need to look beyond the approach and reinforce the importance of better feeding practices, food fortification and reduced frequency of pregnancies.

  14. Maternal first-trimester dietary intake and childhood blood pressure: the Generation R Study.

    Science.gov (United States)

    van den Hil, Leontine C L; Rob Taal, H; de Jonge, Layla L; Heppe, Denise H M; Steegers, Eric A P; Hofman, Albert; van der Heijden, Albert J; Jaddoe, Vincent W V

    2013-10-01

    Suboptimal maternal dietary intake during pregnancy might lead to fetal cardiovascular adaptations and higher blood pressure in the offspring. The aim of the present study was to investigate the associations of maternal first-trimester dietary intake with blood pressure in children at the age of 6 years. We assessed first-trimester maternal daily dietary intake by a FFQ and measured folate, homocysteine and vitamin B₁₂ concentrations in the blood, in a population-based prospective cohort study among 2863 mothers and children. Childhood systolic and diastolic blood pressure was measured using a validated automatic sphygmomanometer. First-trimester maternal daily intake of energy, fat, protein and carbohydrate was not associated with childhood blood pressure. Furthermore, maternal intake of micronutrients was not associated with childhood blood pressure. Also, higher maternal vitamin B₁₂ concentrations were associated with a higher diastolic blood pressure (0·31 mmHg per standard deviation increase in vitamin B₁₂ (95% CI 0·06, 0·56)). After taking into account multiple testing, none of the associations was statistically significant. Maternal first-trimester folate and homocysteine concentrations were not associated with childhood blood pressure. The results from the present study suggest that maternal Fe intake and vitamin B₁₂ concentrations during the first trimester of pregnancy might affect childhood blood pressure, although the effect estimates were small and were not significant after correction for multiple testing. Further studies are needed to replicate these findings, to elucidate the underlying mechanisms and to assess whether these differences in blood pressure persist in later life.

  15. Effect of zircon-based tricolor pigments on the color, microstructure, flexural strength and translucency of a novel dental lithium disilicate glass-ceramic.

    Science.gov (United States)

    Yuan, Kun; Wang, Fu; Gao, Jing; Sun, Xiang; Deng, Zai-Xi; Wang, Hui; Jin, Lei; Chen, Ji-Hua

    2014-01-01

    The purpose of this study was to investigate the effect of zircon-based tricolor pigments (praseodymium zircon yellow, ferrum zircon red, and vanadium zircon blue) on the color, thermal property, crystalline phase composition, microstructure, flexural strength, and translucency of a novel dental lithium disilicate glass-ceramic. The pigments were added to the glass frit, milled, pressed, and sintered. Ninety monochrome samples were prepared and the colors were analyzed. The effect of the pigments on thermal property, crystalline phase composition, and microstructure were determined by differential scanning calorimetry (DSC), X-ray diffraction (XRD), and scanning electron microscopy (SEM), respectively. Addition of the pigments resulted in the acquisition of subtractive primary colors as well as tooth-like colors, and did not demonstrate significant effects on the thermal property, crystalline phase composition, microstructure, and flexural strength of the experimental glass-ceramic. Although significant differences (p ceramics, the translucencies of the latter were sufficient to fabricate dental restorations. These results indicate that the zircon-based tricolor pigments can be used with dental lithium disilicate glass-ceramic to produce abundant and predictable tooth-like colors without significant adverse effects, if mixed in the right proportions. Copyright © 2013 Wiley Periodicals, Inc.

  16. Magnitude and determinants of inadequate third-trimester weight gain in rural Bangladesh

    Science.gov (United States)

    Hasan, S. M. Tafsir; Rahman, Sabuktagin; Locks, Lindsey Mina; Rahman, Mizanur; Hore, Samar Kumar; Saqeeb, Kazi Nazmus; Khan, Md. Alfazal

    2018-01-01

    Objectives The objective of this study was to estimate the magnitude and determinants of inadequate weight gain in the third-trimester among rural women in Matlab, Bangladesh. Methods The study analyzed data on weight gain in the third trimester in 1,883 pregnant women in Matlab, Bangladesh. All these women were admitted to Matlab hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) for childbirth during 2012–2014, and they had singleton live births at term. Data were retrieved from the electronic databases of Matlab Health and Demographic Surveillance System and Matlab hospital. A multivariable logistic regression for inadequate weight gain in the third trimester (≤4 kg) was built with sociodemographic, environmental and maternal factors as predictors. Results One thousand and twenty-six (54%) pregnant women had inadequate weight gain in the third trimester. In the multivariable model, short stature turned out to be the most robust risk factor for inadequate weight gain in the third trimester (OR = 2.5; 95% CI 1.8, 3.5 for short compared to tall women). Pre-third-trimester BMI was inversely associated with insufficient weight gain (OR = 0.96; 95% CI 0.93, 0.99 for 1 unit increase in BMI). Other risk factors for inadequate weight gain in the third trimester were advanced age (OR = 1.9; 95% CI 1.2, 3.1 for ≥35 years compared to ≤19 years), parity (OR = 1.5; 95% CI 1.2, 1.9 for multipara compared to nulliparous women), low socioeconomic status (OR = 1.7; 95% CI 1.2, 2.3 for women in the lowest compared to women in the highest wealth quintile), low level of education (OR = 1.6; 95% CI 1.2, 2.1 for ≤5 years compared to ≥10 years of education), belonging to the Hindu religious community (OR = 1.8; 95% CI 1.3, 2.5), consuming arsenic-contaminated water (OR = 1.4; 95% CI 1.1, 1.9), and conceiving during monsoon or dry season compared to summer (OR = 1.4; 95% CI 1.1, 1.8). Conclusions Among rural Bangladeshi women in Matlab

  17. 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.

  18. First-trimester multimarker prediction of gestational diabetes mellitus using targeted mass spectrometry

    DEFF Research Database (Denmark)

    Ravnsborg, Tina; Andersen, Lise Lotte T; Trabjerg, Natacha D.

    2016-01-01

    –control study was performed on first-trimester serum samples from 199 GDM cases and 208 controls, each divided into an obese group (BMI ≥27 kg/m2) and a non-obese group (BMI 2). Based on their biological relevance to GDM or type 2 diabetes mellitus or on their previously reported potential as biomarkers......Aims/hypothesis: Gestational diabetes mellitus (GDM) is associated with an increased risk of pre-eclampsia, macrosomia and the future development of type 2 diabetes mellitus in both mother and child. Although an early and accurate prediction of GDM is needed to allow intervention and improve...... perinatal outcome, no single protein biomarker has yet proven useful for this purpose. In the present study, we hypothesised that multimarker panels of serum proteins can improve first-trimester prediction of GDM among obese and non-obese women compared with single markers. Methods: A nested case...

  19. Assessment of global DNA methylation in the first trimester fetal tissues exposed to maternal cigarette smoking

    DEFF Research Database (Denmark)

    Fa, Svetlana; Larsen, Trine Vilsbøll; Bilde, Katrine

    2016-01-01

    to exposures with an epigenetic impact. We have assessed the influence of maternal cigarette smoking during the first trimester for fetal global DNA methylation. METHODS AND RESULTS: We analyzed the human fetal intestines and livers as well as the placentas from the first trimester pregnancies. Global DNA......AIMS: Maternal cigarette smoking during pregnancy increases the risk of negative health consequences for the exposed child. Epigenetic mechanisms constitute a likely link between the prenatal exposure to maternal cigarette smoking and the increased risk in later life for diverse pathologies....... Maternal smoking induces gene-specific DNA methylation alterations as well as global DNA hypermethylation in the term placentas and hypomethylation in the cord blood. Early pregnancy represents a developmental time where the fetal epigenome is remodeled and accordingly can be expected to be highly prone...

  20. Selective serotonin reuptake inhibitor antidepressant use in first trimester pregnancy and risk of congenital anomalies

    DEFF Research Database (Denmark)

    Wemakor, A.; Casson, K.; Garne, E.

    2015-01-01

    Objective / Background The Selective Serotonin Reuptake Inhibitor (SSRI) antidepressants are widely prescribed in pregnancy, but there is evidence that they may cause congenital anomalies, particularly congenital heart defects (CHD). Objective: To determine the specificity of association between...... first trimester pregnancy exposure to individual SSRI and specific congenital anomalies (CAs). Methods Population-based case-malformed control study covering 3.3 million births from 12 EUROCAT registries 1995-2009. CAs included non-syndromic live births, fetal deaths and terminations of pregnancy......% confidence intervals (CI) were calculated adjusted for registry. Results SSRI use in first trimester pregnancy was associated with CHD overall (OR 1.38, 95 % CI 1.05-1.82, n=109); and with severe CHDs (OR 1.56, 95 % CI 1.03-2.38, n=29). Specific associations between SSRI and Tetralogy of Fallot (OR 3.36, 95...

  1. Characteristics of first-trimester screening of non-responders in a high-uptake population

    DEFF Research Database (Denmark)

    Wolf, Hanne Trap; Wulff, Camilla Bernt; Ekelund, Charlotte

    2016-01-01

    INTRODUCTION: Our aim was to compare demographic, social and reproductive health-related medical factors between women who did and women who did not undergo combined first-trimester screening (cFTS) and to examine their reasons for declining a screening offer, especially whether non-participation......INTRODUCTION: Our aim was to compare demographic, social and reproductive health-related medical factors between women who did and women who did not undergo combined first-trimester screening (cFTS) and to examine their reasons for declining a screening offer, especially whether non...... with the following factors: country of origin other than Denmark (p ... of a conscious choice based on ethical considerations, rather than being the result of a lack of information. However, a low response rate decreases the strength of our conclusions. FUNDING: none. TRIAL REGISTRATION: not relevant....

  2. Including ethical considerations in models for first-trimester screening for pre-eclampsia

    DEFF Research Database (Denmark)

    Jørgensen, Jennifer Maureen; Hedley, Paula L.; Gjerris, Mickey

    2014-01-01

    Recent efforts to develop reliable and efficient early pregnancy screening programmes for pre-eclampsia have focused on com-bining clinical, biochemical and biophysical markers. The same model has been used for first-trimester screening for fetal aneuploidies i.e. prenatal diagnosis (PD), which...... is routinely offered to all pregnant women in many developed countries. Some studies suggest combining PD and pre-eclampsia screening, so women can be offered testing for a number of conditions at the same clinical visit. A combination of these tests may be practical in terms of saving time and resources......; however, the combination raises ethical issues. First-trimester PD and pre-eclampsia screening entail qualitative differences which alter the requirements for disclosure, non-directedness and consent with regard to the informed consent process. This article explores the differences related to the ethical...

  3. Amniotic fluid gamma-glutamyl transpeptidase activity during the second trimester.

    Science.gov (United States)

    Legge, M; Potter, H C

    1986-03-12

    Gamma glutamyl transpeptidase (GGTP) activity was determined in second trimester amniotic fluid taken from normal fetuses and those with fetal abnormalities. GGTP activity decreased with advancing gestation. Increasing meconium contamination correlated with an increase in GGTP activity as did increasing fetal blood contamination. Maternal blood did not affect GGTP activity. Anencephaly did not significantly alter the GGTP activity, however, fetuses with spina bifida had significantly lower activity. Klinefelters and Turners syndromes both had GGTP activity close to the 50th percentile, and two trisomy 21 fetuses had GGTP activity below the 40th percentile. Two trisomy 18 fetuses and two translocation Downs syndromes (46 XY, t (14;21) had GGTP activities considerably lower than the 20th percentile as did a fetus with gastroschisis. Second trimester amniotic fluid GGTP activity may provide an easy preliminary test to screen amniotic fluids for the possibility of certain fetal chromosome abnormalities.

  4. Plasma cross-gestational sphingolipidomic analyses reveal potential first trimester biomarkers of preeclampsia.

    Directory of Open Access Journals (Sweden)

    Aneta Dobierzewska

    Full Text Available Preeclampsia (PE is a gestational disorder, manifested in the second half of pregnancy by maternal hypertension, proteinuria and generalized edema. PE is a major cause of maternal and fetal morbidity and mortality, accounting for nearly 40% of all premature births worldwide. Bioactive sphingolipids are emerging as key molecules involved in etiopathogenesis of PE, characterized by maternal angiogenic imbalance and symptoms of metabolic syndrome. The aim of this study was to compare the cross-gestational profile of circulating bioactive sphingolipids in maternal plasma from preeclamptic (PE versus normotensive control (CTL subjects with the goal of identifying sphingolipids as candidate first trimester biomarkers of PE for early prediction of the disease.A prospective cohort of patients was sampled at the first, second and third trimester of pregnancy for each patient (11-14, 22-24, and 32-36 weeks´ gestation. A retrospective stratified study design was used to quantify different classes of sphingolipids in maternal plasma. We used a reverse-phase high-performance liquid chromatography-tandem mass spectrometry (HPLC-ESI-MS/MS approach for determining different sphingolipid molecular species (sphingosine-1-phosphate (S1P, dihydro-sphingosine-1-phosphate (DH-S1P, sphingomyelins (SM and ceramides (Cer in cross-gestational samples of human plasma from PE (n = 7, 21 plasma samples across pregnancy and CTL (n = 7, 21 plasma samples across pregnancy patients.Plasma levels of angiogenic S1P did not change significantly in control and in preeclamptic patients´ group across gestation. DH-S1P was significantly decreased in second trimester plasma of PE patients in comparison to their first trimester, which could contribute to reduced endothelial barrier observed in PE. The major ceramide species (Cer 16:0 and Cer 24:0 tended to be up-regulated in plasma of control and PE subjects across gestation. The levels of a less abundant plasma ceramide species (Cer

  5. An Unusual Case of Fulminant Type 1 Diabetes during the Second Trimester of Pregnancy

    Directory of Open Access Journals (Sweden)

    Tomohiro Okuda

    2014-01-01

    Full Text Available Fulminant type 1 diabetes is a new subtype of rapid-onset type 1 diabetes, with pancreatic exocrine dysfunction, that usually develops during the third trimester of pregnancy. We describe a patient with fulminant type 1 diabetes onset during her second trimester, resulting in premature delivery. The 34-year-old woman, without any known risk factors for diabetes mellitus, experienced a sudden stillbirth at 24-weeks gestation. Her blood glucose level was 950 mg/dL and she was positive for urine ketone bodies. The condition met all the diagnostic criteria for fulminant type 1 diabetes, and was diagnosed as such. Although this disease is rare, its progression is rapid, and its clinical course is severe and occasionally leads to death; therefore, a full knowledge of the disease is important to facilitate an accurate diagnosis.

  6. Using knowledge management to improve learning experience of first-trimester students

    Directory of Open Access Journals (Sweden)

    Nelson K. Y. Leung

    2015-06-01

    Full Text Available To address the lack of insights into the engagement of tertiary students to manage knowledge at a course level, a knowledge management approach is proposed to allow students to interact with lecturers inside and outside a large lecture hall to create, disseminate, use and evaluate knowledge. The proposed approach was applied to an undergraduate business computing related course conducted at the offshore campus of an Australian university in the third trimester of 2012. The proposed KM approach was evaluated using quantitative analysis. The findings show that the majority of the students agreed that the computerized tool (Facebook could enhance their learning experience by allowing students to ask for, share, discuss, and extend knowledge. In particular, the KM approach provided additional channels and platforms for the first-trimester students who were passive and preferred not to seek help from lecturers directly for cultural reasons.

  7. A Rare Case of Second Trimester Uterine Rupture in Unscarred Uterus

    Directory of Open Access Journals (Sweden)

    Poonam Kashyap

    2017-11-01

    Full Text Available Second trimester uterine rupture is rare and presents with life threatening emergency. Few cases have been reported in literature. Most of the cases which have been reported are with the use of labor-induction agents in late termination of pregnancy. Others are involving any surgical procedures in placenta percreta or scarred uterus. The main contributory factors were scarred uterus and abnormal placentation. In this study, uterine rupture had occurred in unscarred uterus in non-laboring women in second trimester without any intervention which is very rare to found. The lack of index of high suspicion diverts attention to search for other non-gynecological causes. Our aim is to create awareness through this case study to avoid delay in diagnosis and timely management of such cases.

  8. Total and Trimester-Specific Gestational Weight Gain and Offspring Birth and Early Childhood Weight

    DEFF Research Database (Denmark)

    Scheers Andersson, Elina; Silventoinen, Karri; Tynelius, Per

    2016-01-01

    Gestational weight gain (GWG) has in numerous studies been associated with offspring birth weight (BW) and childhood weight. However, these associations might be explained by genetic confounding as offspring inherit their mother's genetic potential to gain weight. Furthermore, little is known about...... whether particular periods of pregnancy could influence offspring body weight differently. We therefore aimed to explore total and trimester-specific effects of GWG in monozygotic (MZ) twin mother-pairs on their offspring's BW, weight at 1 year and body mass index (BMI) at 5 and 10 years. MZ twin mothers...... statistically weak, suggested no associations between GWG and offspring weight or BMI during infancy or childhood. Our study suggests that total, and possibly also second and third trimester, GWG are associated with offspring BW when taking shared genetic and environmental factors within twin pairs into account...

  9. First Trimester Prenatal Care Initiation Among Hispanic Women Along the U.S.-Mexico Border

    OpenAIRE

    Selchau, Katherine; Babuca, Maricela; Bower, Kara; Castro, Yara; Coakley, Eugenie; Flores, Araceli; Garcia, Jonah O.; Reyes, Maria Lourdes F.; Rojas, Yvonne; Rubin, Jason; Samuels, Deanne; Shattuck, Laura

    2017-01-01

    Background First trimester prenatal care (FTPNC) is associated with improved birth outcomes. U.S.-Mexico border Hispanic women have lower FTPNC than non-border or non-Hispanic women. This study aimed to identify (1) what demographic, knowledge and care-seeking factors influence FTPNC among Hispanic women in border counties served by five Healthy Start sites, and (2) what FTPNC barriers may be unique to this target population. Healthy Starts work to eliminate disparities in perinatal health in...

  10. Ultrasound Assessment of Umbilical Cord Morphology in the First Trimester: A Feasibility Study

    DEFF Research Database (Denmark)

    Narayan, Rajit; Saaid, Rahmah; Pedersen, Lars Henning

    2015-01-01

    Objective: The aim of this study was to determine whether morphology and measurement of the umbilical cord could be accurately assessed at the time of the 11- to 13+6-week scan. Methods: We conducted a prospective study of 100 consecutive women with singleton pregnancies at 11-13+6 weeks' gestation...... be consistently studied in the first trimester. A subjective method of evaluation of the morphology may be a more reproducible technique until measurement strategies are refined and operator experience developed....

  11. Indication of prenatal diagnosis in pregnancies complicated by undetectable second-trimester maternal serum estriol levels.

    Science.gov (United States)

    Minsart, Anne-Frédérique; Van Onderbergen, Anne; Jacques, Francotte; Kurt, Crener; Gillerot, Yves

    2008-07-01

    Undetectable maternal serum unconjugated estriol levels in the second-trimester screening test have been associated with congenital pathology and an adverse pregnancy outcome. We reviewed outcomes of pregnancies with undetectable levels of estriol (threatened fetal abortion, one case of multiple congenital anomalies and one case of isolated adrenocorticotropin hormone deficiency. There were 6 women remaining with unexplained undetectable estriol. Undetectable maternal estriol values may indicate a severe fetal pathology and should lead to further investigations.

  12. Maternal serum proteome changes between the first and third trimester of pregnancy in rural southern Nepal.

    Science.gov (United States)

    Scholl, P F; Cole, R N; Ruczinski, I; Gucek, M; Diez, R; Rennie, A; Nathasingh, C; Schulze, K; Christian, P; Yager, J D; Groopman, J D; West, K P

    2012-05-01

    Characterization of normal changes in the serum proteome during pregnancy may enhance understanding of maternal physiology and lead to the development of new gestational biomarkers. In 23 Nepalese pregnant women who delivered at term, two-dimensional difference in-gel electrophoresis (DIGE) was used to assess changes in relative protein abundance between paired serum samples collected in the first and third trimesters. One-hundred and forty-five of over 700 protein spots in DIGE gels (pI 4.2-6.8) exhibited nominally significant (p < 0.05) differences in abundance across trimesters. Additional filtering using a Bonferroni correction reduced the number of significant (p < 0.00019) spots to 61. Mass spectrometric analysis detected 38 proteins associated with gestational age, cytoskeletal remodeling, blood pressure regulation, lipid and nutrient transport, and inflammation. One new protein, pregnancy-specific β-glycoprotein 4 was detected. A follow-up isotope tagging for relative and absolute quantitation (iTRAQ) experiment of six mothers from the DIGE study revealed 111 proteins, of which 11 exhibited significant (p < 0.05) differences between trimesters. Four of these proteins: gelsolin, complement C1r subcomponent, α-1-acid glycoprotein, and α-1B-glycoprotein also changed in the DIGE analysis. Although not previously associated with normal pregnancy, gelsolin decreased in abundance by the third trimester (p < 0.01) in DIGE, iTRAQ and Western analyses. Changes in abundance of proteins in serum that are associated with syncytiotrophoblasts (gelsolin, pregnancy-specific β-1 glycoprotein 1 and β-2-glycoprotein I) probably reflect dynamics of a placental proteome shed into maternal circulation during pregnancy. Measurement of changes in the maternal serum proteome, when linked with birth outcomes, may yield biomarkers for tracking reproductive health in resource poor settings in future studies. Published by Elsevier Ltd.

  13. Sirenomelia apus after trimethoprim exposure: first-trimester ultrasound diagnosis-a case report.

    Science.gov (United States)

    Dosedla, Erik; Kalafusová, Michaela; Calda, Pavel

    2012-01-01

    We report the early prenatal ultrasound diagnosis of sirenomelia apus at 12+4 weeks in a patient with trimethoprim exposure in the vulnerable period. First-trimester scan revealed a malformed fetus with one femur, one small tibia, no feet, intraabdominal unilocular cystic structure, and two-vessel umbilical cord with allantoic cyst. Ultrasound visualization with two/three/four-dimensions was helpful in the process of parental counseling. Copyright © 2012 Wiley Periodicals, Inc.

  14. Prenatal diagnosis of sirenomelia in the first trimester: A case report

    OpenAIRE

    Ceylan, Yasin; Do?an, Yasemin; ?zkan ?zdemir, Sebiha; Y?cesoy, G?lseren

    2016-01-01

    Sirenomelia or ?mermaid syndrome? is a rare congenital syndrome characterized by the anomalous development of the caudal region of the body. We present a case of sirenomelia diagnosed in the first trimester using two-dimensional and three-dimensional ultrasonographic examination. A nulliparous woman aged thirty years was referred to our perinatology unit for evaluation because of oligohydramnios at 12 weeks of gestation. Her medical history was unremarkable. There was no family history of gen...

  15. Haemorheological profiles in different trimesters among pregnant women in South West Nigeria

    International Nuclear Information System (INIS)

    Oke, O.T.; Oyedeji, S.O.; Awofadeju, S.O.

    2011-01-01

    Normal pregnancy is characterised by a reduction in peripheral resistance in order to increase blood flow and facilitate the supply of oxygen and nutrients to the peripheral tissues. The aim of this study was to see the effect of pregnancy on haemorheological profiles based on trimesters. Methods: This study was carried out at Haematology Department of Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria. Sixty pregnant and twenty non-pregnant women were included. Estimation of packed cell volume, erythrocyte sedimentation rate, relative plasma viscosity, relative whole blood viscosity, and fibrinogen concentration were carried out based on trimesters using standard approved methods. Results: The mean of packed cell volume (PCV), erythrocyte sedimentation rate (ESR), and relative plasma viscosity (RPV) were 0.33L/L, 26.10 mm/1 Hr, and 1.70 mPa.s, while that of relative whole blood viscosity (RWBV) and fibrinogen concentration (FIBC) were 3.88 mPa.s and 4.38g/L. In the second trimester, the mean PCV was 0.32L/L, mean ESR was 43.20 mm/1 Hr, RPV was 1.72 mPa.s, WBV 3.50 mPa.s and FIBC 4.86 g/L. For the third trimester, the means were: PCV 0.29 L/L, ESR 86.65 mm/1 Hr, RPV 1.77 mPa.s, and RWB 3.88 mPa.s while FIBC was 5.04 g. Conclusion: Normal pregnancy exerts positive influence on haemorheological profiles and this could explain the reduced risk of cardiovascular disease in pregnancy. Haemorheological profiles can be used to monitor the development of cardiovascular disease during pregnancy. (author)

  16. Comparison of gemeprost and vaginal misoprostol in first trimester mifepristone-induced abortion

    DEFF Research Database (Denmark)

    Svendsen, Pernille Fog; Rørbye, Christina; Vejborg, Thomas

    2005-01-01

    Abstract Background The aim of this study was to compare efficacy and side effects of gemeprost and vaginal misoprostol in mifepristone-induced abortions in women up to 63 days of gestation. Methods A retrospective study of 833 consecutive patients admitted for medical termination of first......, gemeprost and vaginal misoprostol are equally effective for termination of first trimester abortion, but may be associated with varying intensity of side effects....

  17. Maternal first-trimester diet and childhood bone mass: the Generation R Study.

    Science.gov (United States)

    Heppe, Denise H M; Medina-Gomez, Carolina; Hofman, Albert; Franco, Oscar H; Rivadeneira, Fernando; Jaddoe, Vincent W V

    2013-07-01

    Maternal diet during pregnancy has been suggested to influence bone health in later life. We assessed the association of maternal first-trimester dietary intake during pregnancy with childhood bone mass. In a prospective cohort study in 2819 mothers and their children, we measured first-trimester daily energy, protein, fat, carbohydrate, calcium, phosphorus, and magnesium intakes by using a food-frequency questionnaire and homocysteine, folate, and vitamin B-12 concentrations in venous blood. We measured childhood total body bone mass by using dual-energy X-ray absorptiometry at the median age of 6.0 y. Higher first-trimester maternal protein, calcium, and phosphorus intakes and vitamin B-12 concentrations were associated with higher childhood bone mass, whereas carbohydrate intake and homocysteine concentrations were associated with lower childhood bone mass (all P-trend childhood bone mass. In the fully adjusted regression model that included all dietary factors significantly associated with childhood bone mass, maternal phosphorus intake and homocysteine concentrations most-strongly predicted childhood bone mineral content (BMC) [β = 2.8 (95% CI: 1.1, 4.5) and β = -1.8 (95% CI: -3.6, 0.1) g per SD increase, respectively], whereas maternal protein intake and vitamin B-12 concentrations most strongly predicted BMC adjusted for bone area [β = 2.1 (95% CI: 0.7, 3.5) and β = 1.8 (95% CI: 0.4, 3.2) g per SD increase, respectively]. Maternal first-trimester dietary factors are associated with childhood bone mass, suggesting that fetal nutritional exposures may permanently influence bone development.

  18. Frequency Of Illicit Drug Consumption In The First Trimester Of Pregnancy (Tehran - 2001

    Directory of Open Access Journals (Sweden)

    Ramezanzadeh f

    2003-11-01

    Full Text Available Illicit drug abuse is a major area of interest for clinicians, as well as for public health and social authorities, but one of the major concerns is the illicit drug abuse during the periconceptional period and throughout pregnancy, because of its potential effects on the embryo and fetus. In this study we investigated the prevalence of illicit drug abuse in the first trimester of pregnancy in women who referred to Iran, Tehran and Shahid Beheshti universities of medical sciences, for prenatal care."nMaterials and Methods: In this descriptive cross sectional study, a non-randomized sample of 2000 pregnant women that were in their second and third trimester of their pregnancy, were interviewed about drug abuse in their first trimester. Collected data were analyzed by SPSS software."nResults: The prevalence of illicit drug abuse in the first trimester was 2.5% which the majority of these drugs were in group B. The prevalence of drug abuse was 0.9% and alcohol usage and alcohol abuse was 0.2%, cigarette smoking was the most common drug abusing phenomena. Variables such as husband education, infertility and satisfaction with pregnancy have significant relation with drug abuse."nConclusion: The results of this study support the need for continued education and this education must end in by itself to make dramatic changes in behavior. So results of this study showed that, improving education and knowledge of mothers and consultation with them in regard to risks and complications of drug abuse during pregnancy, would make dramatic changes in their behavior."n"n"n"n"n"n"n"n 

  19. Fetal gender determination through Y-STR analysis of maternal plasma during the third trimester of pregnancy

    Directory of Open Access Journals (Sweden)

    Hanaa M.H. Aal-Hamdan

    2015-01-01

    Conclusion: It is recommended to use Y-STR profiling as an alternative technique for fetal gender determination during the third trimester of pregnancy, in addition to its significance in forensic casework.

  20. First trimester serum levels of the soluble transcobalamin receptor, holo-transcobalamin, and total transcobalamin in relation to preeclampsia risk

    DEFF Research Database (Denmark)

    Abuyaman, Omar; Torring, Niels; Obeid, Rima

    2016-01-01

    transcobalamin (TC) with the risk of subsequent preeclampsia using serum samples from asymptomatic first trimester pregnant women. Moreover, we aimed to establish reference intervals of the aforementioned biomarkers for first trimester pregnant women who remained healthy throughout pregnancy. STUDY DESIGN...... preeclampsia while the controls remained normotensive throughout pregnancy. We measured the serum concentration of sCD320, holoTC, and total TC by using in-house ELISA methods. RESULTS: First trimester median concentrations of sCD320, holoTC and total TC were not significantly different between cases...... and controls. The odd ratio for developing preeclampsia based on exposure to low or high levels of sCD320, holoTC or total TC at first trimester was not significant. The reference intervals (2.5-97.5% percentiles (median)) derived from the controls were 50-170 (90) pmol\\L for sCD320, 20-140 (70) pmol...

  1. [Group counselling for the second trimester ultrasound: can group counselling be an alternative for individual counselling?].

    Science.gov (United States)

    de Lau, Hinke; Depmann, Martine; Laeven, Yvo J M; Stoutenbeek, Philip H; Pistorius, Lou R; van Beek, Erik; Schuitemaker, Nico W E

    2013-01-01

    To compare group counselling to individual counselling with respect to the second trimester ultrasound. A prospective cohort study at two hospitals. At one hospital, 100 pregnant women were counselled on the risks and benefits of the second trimester ultrasound in groups of up to 15 patients. Shortly before the ultrasound they were asked to fill out a questionnaire. Results were compared to 100 women who were counselled individually at another hospital. The primary outcome was the level of informed choice whether or not to undergo the ultrasound, defined as sufficient knowledge and a value-consistent decision. The secondary outcome measures were level of understanding of the second trimester ultrasound and the degree of satisfaction with the counselling. The resulting level of informed choice was 87.0% after group counselling compared to 79.4% after individual counselling (p = 0.47). The mean knowledge score was 8.8 for the women who attended group counselling; women who were individually counselled had a mean score of 7.4 (p counselling was 7.0 for group counselling and 6.2 for individual counselling (p group counselling was associated with higher post-counselling knowledge and satisfaction scores. Group counselling should therefore be considered as an alternative counselling method.

  2. The reverse boomerang sign: a marker for first-trimester transposition of great arteries.

    Science.gov (United States)

    Bravo-Valenzuela, Nathalie Jeanne; Peixoto, Alberto Borges; Araujo Júnior, Edward; Da Silva Costa, Fabricio; Meagher, Simon

    2017-10-12

    To describe a new sonographic marker of transposition of great arteries (TGA) during the first-trimester screening. We reviewed six cases of TGA from 2013 to 2016 in which an antenatal diagnosis of TGA at first-trimester screening (11-13 + 6 weeks of gestation) was confirmed postnatally. We specifically assessed images obtained by scanning the fetal heart in three vessels (3V) and three-vessel with trachea (3VT) views using color Doppler. The "reverse boomerang" sign was defined as a reverse curvature of right ventricle outflow tract (RVOT) at level of the 3VT view. We described six cases of confirmed TGA, five singletons and one twin pregnancy, among which only two vessels and the reverse curvature of RVOT (reverse boomerang sign) was demonstrated in the first-trimester screening at level of 3VT view. Ventricular septal defects were observed in three cases, and double outlet right ventricle in one case. No other cardiac or extracardiac anomalies were identified. Termination of pregnancy was not performed in any case. Our series case suggests that the reverse boomerang sign may improve the early prenatal screening for TGA.

  3. The use of misoprostol in termination of second-trimester pregnancy

    Directory of Open Access Journals (Sweden)

    Chen-Ju Lin

    2011-09-01

    Full Text Available Misoprostol, a synthetic prostaglandin E1 analog, is initially used to prevent peptic ulcer. The initial US Food and Drug Administration-approved indication in the product labeling is the treatment and prevention of intestinal ulcer disease resulting from nonsteroidal anti-inflammatory drugs use. In recent two decades, misoprostol has approved to be an effective agent for termination of pregnancy in various gestation, cervical ripening, labor induction in term pregnancy, and possible management of postpartum hemorrhage. For the termination of second-trimester pregnancy using the combination of mifepristone and misoprostol seems to have the highest efficacy and the shortest time interval of abortion. When mifepristone is not available, misoprostol alone is a good alternative. Misoprostol, 400 μg given vaginally every 3–6 hours, is probably the optimal regimen for second-trimester abortion. More than 800 μg of misoprostol is likely to have more side effects, especially diarrhea. Although misoprostol can be used in women with scarred uterus for termination of second-trimester pregnancy, it is recommended that women with a scarred uterus should receive lower doses and do not double the dose if there is no initial response. It is also important for us to recognize the associated teratogenic effects of misoprostol and thorough consultation before prescribing this medication to patients regarding these risks, especially when failure of abortion occurs, is needed.

  4. Peripheral blood cell microRNA quantification during the first trimester predicts preeclampsia: Proof of concept.

    Directory of Open Access Journals (Sweden)

    Edward E Winger

    Full Text Available We investigated the capacity of microRNAs isolated from peripheral blood buffy coat collected late during the first trimester to predict preeclampsia.The cohort study comprised 48 pregnant women with the following pregnancy outcomes: 8 preeclampsia and 40 with normal delivery outcomes. Quantitative rtPCR was performed on a panel of 30 microRNAs from buffy coat samples drawn at a mean of 12.7±0.5 weeks gestation. MicroRNA Risk Scores were calculated and AUC-ROC calculations derived.The AUC-ROC for preeclampsia risk was 0.91 (p<0.0001. When women with normal delivery and high-risk background (those with SLE/APS, chronic hypertension and/or Type 2 Diabetes were compared to women who developed preeclampsia but with a normal risk background (without these mentioned risk factors, preeclampsia was still predicted with an AUC-ROC of 0.92 (p<0.0001.MicroRNA quantification of peripheral immune cell microRNA provides sensitive and specific prediction of preeclampsia in the first trimester of pregnant women. With this study, we extend the range during which disorders of the placental bed may be predicted from early to the end of the first trimester. This study confirms that buffy coat may be used as a sample preparation.

  5. Assessment of iodine nutrition in pregnant north Indian subjects in three trimesters

    Directory of Open Access Journals (Sweden)

    Emmy Grewal

    2013-01-01

    Full Text Available Objective: The cross-sectional study was carried out to assess the iodine status of pregnant women, using median urinary iodine concentration (MUI as the measure of outcome, to document the impact of advancing gestation on the MUI in normal pregnancy. Materials and Methods: The present study assessed the MUI in casual urine samples from 50 pregnant subjects of each trimester and 50 age-matched non-pregnant controls. Results: The median (range of urinary iodine concentration (UIC in pregnant women was 304 (102-859 μg/L and only 2% of the subjects had prevalence of values under 150 μg/L (iodine insufficiency. With regard to the study cohort, median (range UIC in the first, second, and third trimesters was 285 (102-457, 318 (102-805, and 304 (172-859 μg/L, respectively. Differences between the first, second, and third trimesters were not statistically significant. The MUI in the controls (305 μg/L was not statistically different from the study cohort. Conclusion: The pregnant women had no iodine deficiency, rather had high median urinary iodine concentrations indicating more than adequate iodine intake. Larger community-based studies are required in iodine-sufficient populations, to establish gestation-appropriate reference ranges for UIC in pregnancy.

  6. Nursing care for patients with placenta previa undergoing interventional therapy in the second trimester of pregnancy

    International Nuclear Information System (INIS)

    Pan Suzhao; Lu Aijin; Wang Xuezhen

    2009-01-01

    Objective: To discuss the nursing care for patients with placenta previa,who receive uterine arterial catheterization and embolization in the second trimester of pregnancy. Methods: By using superselective catheterization with Seldinger technique, bilateral uterine artery angiography and embolization were performed in 16 patients with placenta previa in the second trimester of pregnancy. Two to four hours after the procedure, rivanol intra-amniotic injection was employed to induce the abortion. Close perioperative observation and careful nursing were carried out. Results: The fetus with its subsidiary tissue was delivered in a mean time of 4.5 hours after the operation in 15 cases. No postpartum hemorrhage occurred. Induced abortion failed in one case with 26 weeks pregnancy because of a scar uterus and cervical dystocia. Hysterotomy was performed 6 days later, blood loss during the operation was about 100 ml. No nursing care related complications occurred in all 16 patients. Conclusion: Uterine arterial embolization is very helpful in making the induced abortion for the treatment of bleeding placenta previa in the second trimester of pregnancy. Strengthening of perioperative care can improve successful rate of interventional therapy and prevent the occurrence of complication. (authors)

  7. Construction of modern Australian first trimester ultrasound dating and growth charts

    International Nuclear Information System (INIS)

    McLennan, A. C.; Schluter, P. J.; and the University of Queensland, Brisbane, Queensland Australia

    2008-01-01

    Full text: Accurate pregnancy dating is vital to obstetric management. However, first trimester fetal charts commonly used in Australia rely on data reported more than three decades ago. This study reports first trimester dating and growth charts for crown-rump length between 5 and 14 weeks of gestation and biparietal diameter between 9 and 14 weeks of gestation on an Australia population using modern real-time ultrasound equipment. All consenting eligible women attending a large Sydney clinic for first trimester ultrasound between March 2005 and December 2006 were recruited. Measurements were carried out to Australasian Society for Ultrasound in Medicine standard protocols. Statistical analyses were undertaken using polynomial regression models and thorough diagnostic checks made. Overall 396 eligible women consented to the study, with 268 between 9 and 14 weeks of gestation. The average participant age was 34 years (range 22-45 years), 371 and all yielded valid biometry measurements. Equations, means and 90% reference intervals for crown-rump length measurements and biparietal diameter measurements were derived using polynomial regression models. Thorough residual and diagnostic checks were made. Once validated by others, we believe they will warrant consideration for use by Australasian Society for Ultrasound in Medicine.

  8. Potential Value of Coagulation Parameters for Suggesting Preeclampsia During the Third Trimester of Pregnancy.

    Science.gov (United States)

    Chen, Ying; Lin, Li

    2017-07-01

    Preeclampsia is a relatively common complication of pregnancy and considered to be associated with different degrees of coagulation dysfunction. This study was developed to evaluate the potential value of coagulation parameters for suggesting preeclampsia during the third trimester of pregnancy. Data from 188 healthy pregnant women, 125 patients with preeclampsia in the third trimester and 120 age-matched nonpregnant women were analyzed. Prothrombin time, prothrombin activity, activated partial thromboplastin time, fibrinogen (Fg), antithrombin, platelet count, mean platelet volume, platelet distribution width and plateletcrit were tested. All parameters, excluding prothrombin time, platelet distribution width and plateletcrit, differed significantly between healthy pregnant women and those with preeclampsia. Platelet count, antithrombin and Fg were significantly lower and mean platelet volume and prothrombin activity were significantly higher in patients with preeclampsia (P preeclampsia was 0.872 for Fg with an optimal cutoff value of ≤2.87g/L (sensitivity = 0.68 and specificity = 0.98). For severe preeclampsia, the area under the curve for Fg reached up to 0.922 with the same optimal cutoff value (sensitivity = 0.84, specificity = 0.98, positive predictive value = 0.96 and negative predictive value = 0.93). Fg is a biomarker suggestive of preeclampsia in the third trimester of pregnancy, and our data provide a potential cutoff value of Fg ≤ 2.87g/L for screening preeclampsia, especially severe preeclampsia. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  9. [Behaviour and attitudes towards the sexuality of the pregnant woman during the last trimester. Phenomenological study].

    Science.gov (United States)

    Panea Pizarro, Isabel; Domínguez Martin, Ana Teresa; Barragán Prieto, Vanessa; Martos Sánchez, Almudena; López Espuela, Fidel

    2018-04-13

    To explore the life experiences on sexual relationships in the third trimester of pregnancy in primiparous women. Phenomenological qualitative study, SITE: Cáceres (Extremadura). Primiparous women in the third trimester of their pregnancy. We use theoretical sampling, was conducted on pregnant primiparous. The study included 15 participants. The data was collected using in-depth interviews, that were voiced recorded and later transcribed. The analysis was made using Giorgi's proposal. The results show three main points. Fear of doing damage, mediated by the obstetric history and the desire to have the long-awaited child. Exploring new routes: forms of sexual expression are modified by the physical changes, the fears, and the mobility. Highlighting the importance of other displays of affection and love (kisses and caresses). The Sex Taboo: lack of information against sexuality during pregnancy is still common. Women in the third trimester of their pregnancy put aside their sexual appetite and that of their partners, and concentrate in the wellbeing of their new born baby. It highlights the role of the mother before the couple. The more desired and difficult the pregnancy has been, the more the sexual life is reduced. The Health Professionals must advise and inform the couples with an open-minded attitude. Copyright © 2018 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. 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.

  11. Regionally-specified second trimester fetal neural stem cells reveals differential neurogenic programming.

    Directory of Open Access Journals (Sweden)

    Yiping Fan

    Full Text Available Neural stem/progenitor cells (NSC have the potential for treatment of a wide range of neurological diseases such as Parkinson Disease and multiple sclerosis. Currently, NSC have been isolated only from hippocampus and subventricular zone (SVZ of the adult brain. It is not known whether NSC can be found in all parts of the developing mid-trimester central nervous system (CNS when the brain undergoes massive transformation and growth. Multipotent NSC from the mid-trimester cerebra, thalamus, SVZ, hippocampus, thalamus, cerebellum, brain stem and spinal cord can be derived and propagated as clonal neurospheres with increasing frequencies with increasing gestations. These NSC can undergo multi-lineage differentiation both in vitro and in vivo, and engraft in a developmental murine model. Regionally-derived NSC are phenotypically distinct, with hippocampal NSC having a significantly higher neurogenic potential (53.6% over other sources (range of 0%-27.5%, p<0.004. Whole genome expression analysis showed differential gene expression between these regionally-derived NSC, which involved the Notch, epidermal growth factor as well as interleukin pathways. We have shown the presence of phenotypically-distinct regionally-derived NSC from the mid-trimester CNS, which may reflect the ontological differences occurring within the CNS. Aside from informing on the role of such cells during fetal growth, they may be useful for different cellular therapy applications.

  12. The role of histopathological examination of the products of conception following first-trimester miscarriage in Erbil Maternity Hospital

    OpenAIRE

    Payman Anwar Rashid

    2017-01-01

    Background and objective: Miscarriage represents a common problem that occurs in the first trimester of pregnancy. There is no general agreement on the value of submitting tissues from uterine evacuation in cases of miscarriage for histopathological examination. This study aimed to evaluate the role of histopathological examination in cases of first-trimester miscarriage. Methods: This is a descriptive study was carried out over a period of 14 months, from January 2015 to March 2016, at E...

  13. Sequential combined test, second trimester maternal serum markers, and circulating fetal cells to select women for invasive prenatal diagnosis.

    Directory of Open Access Journals (Sweden)

    Paolo Guanciali Franchi

    Full Text Available From January 1st 2013 to August 31st 2016, 24408 pregnant women received the first trimester Combined test and contingently offered second trimester maternal serum screening to identify those women who would most benefit from invasive prenatal diagnosis (IPD. The screening was based on first trimester cut-offs of ≥1:30 (IPD indicated, 1:31 to 1:899 (second trimester screening indicated and ≤1:900 (no further action, and a second trimester cut-off of ≥1:250. From January 2014, analysis of fetal cells from peripheral maternal blood was also offered to women with positive screening results. For fetal Down syndrome, the overall detection rate was 96.8% for a false-positive rate of 2.8% resulting in an odds of being affected given a positive result (OAPR of 1:11, equivalent to a positive predictive value (PPV of 8.1%. Additional chromosome abnormalities were also identified resulting in an OAPR for any chromosome abnormality of 1:6.6 (PPV 11.9%. For a sub-set of cases with positive contingent test results, FISH analysis of circulating fetal cells in maternal circulation identified 7 abnormal and 39 as normal cases with 100% specificity and 100% sensitivity. We conclude that contingent screening using conventional Combined and second trimester screening tests is effective but can potentially be considerably enhanced through the addition of fetal cell analysis.

  14. Hydrothermal degradation of a 3Y-TZP translucent dental ceramic: A comparison of numerical predictions with experimental data after 2 years of aging.

    Science.gov (United States)

    Cattani-Lorente, Maria; Durual, Stéphane; Amez-Droz, Michel; Wiskott, H W Anselm; Scherrer, Susanne S

    2016-03-01

    The purpose of the study was to assess the hydrothermal resistance of a translucent zirconia with two clinical relevant surface textures by means of accelerated tests (LTD) and to compare predicted monoclinic fractions with experimental values measured after two years aging at 37°C. Polished (P) and ground (G) specimens were subjected to hydrothermal degradation by exposure to water steam at different temperatures and pressures. The t-m phase transformation was quantified by grazing incidence X-ray diffraction (GIXDR). The elastic modulus and hardness before- and after LTD were determined by nanoindentation. G specimens presented a better resistance to hydrothermal degradation than P samples. Activation energies of 89 and 98kJ/mol and b coefficients of 2.0×10(-5) and 1.8×10(-6) were calculated for P and G samples respectively. The coefficients were subsequently used to predict transformed monoclinic fractions at 37°C. A good correlation was found between the predicted values and the experimental data obtained after aging at 37°C during 2 years. Hydrothermal degradation led to a significant decrease of the elastic moduli and hardness in both groups. The dependency of the t-m phase transformation rate on temperature must be determined to accurately predict the hydrothermal behavior of the zirconia ceramics at oral temperatures. The current prevailing assumption, that 5h aging at 134°C corresponds to 15-20 years at 37°C, will underestimate the transformed fraction of the translucent ceramic at 37°C. In this case, the mechanical surface treatment influences the ceramic's transformability. While mild grinding could potentially retard the hydrothermal transformation, polishing after occlusal adjustment is recommended to prevent wear of the antagonist teeth and maintain structural strength. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  15. The maternal age-related first trimester risks for trisomy 21, 18 and 13 based on Danish first trimester data from 2005 to 2014

    DEFF Research Database (Denmark)

    Hartwig, Tanja Schlaikjær; Sørensen, Steen; Jørgensen, Finn Stener

    2016-01-01

    OBJECTIVES: Most currently used age-related risks of T21, T18 and T13 are based on estimates of the live-birth prevalence, and describe an exponential increase of risk by increased maternal age. We investigated the first trimester prevalence of T21, T18 and T13 in a large population of Danish women......) / slope)) was found to best describe the age-related risk of T21, T18 and T13. CONCLUSION: We found that the age-related risks are better described by sigmoidal functions, contrary to the widely assumed exponential functions. Our results indicate a lower age-related a priori risk of T21, T18 and T13...

  16. Interaction between the SLC19A1 gene and maternal first trimester fever on offspring neural tube defects.

    Science.gov (United States)

    Pei, Lijun; Zhu, Huiping; Ye, Rongwei; Wu, Jilei; Liu, Jianmeng; Ren, Aiguo; Li, Zhiwen; Zheng, Xiaoying

    2015-01-01

    Many studies have indicated that the reduced folate carrier gene (SLC19A1) is associated with an increased risk of neural tube defects (NTDs). However, the interaction between the SLC19A1 gene variant and maternal fever exposure and NTD risk remains unknown. The aim of this study was to investigate whether the risk for NTDs was influenced by the interactions between the SLC19A1 (rs1051266) variant and maternal first trimester fever. We investigated the potential interaction between maternal first trimester fever and maternal or offspring SLC19A1 polymorphism through a population-based case-control study. One hundred and four nuclear families with NTDs and 100 control families with nonmal newborns were included in the study. SLC19A1 polymorphism was determined using polymerase chain reaction-restricted fragment length polymorphism. Mothers who had the GG/GA genotype and first trimester fever had an elevated risk of NTDs (adjusted odds ratio, 11.73; 95% confidence interval, 3.02-45.58) as compared to absence of maternal first trimester fever and AA genotype after adjusting for maternal education, paternal education, and age, and had a significant interactive coefficient (γ = 3.17) between maternal GG/GA genotype and first trimester fever. However, there was no interaction between offspring's GG/GA genotype and maternal first trimester fever (the interactive coefficient γ = 0.97) after adjusting for confounding factors. Our findings suggested that the risk of NTDs was potentially influenced by a gene-environment interaction between maternal SLC19A1 rs1051266 GG/GA genotype and first trimester fever. Maternal GG/GA genotype may strengthen the effect of maternal fever exposure on NTD risk in this Chinese population. © 2014 Wiley Periodicals, Inc.

  17. Dating of Pregnancy in First versus Second Trimester in Relation to Post-Term Birth Rate: A Cohort Study.

    Directory of Open Access Journals (Sweden)

    Ida Näslund Thagaard

    Full Text Available To evaluate in a national standardised setting whether the performance of ultrasound dating during the first rather than the second trimester of pregnancy had consequences regarding the definition of pre- and post-term birth rates.A cohort study of 8,551 singleton pregnancies with spontaneous delivery was performed from 2006 to 2012 at Copenhagen University Hospital, Holbæk, Denmark. We determined the duration of pregnancy calculated by last menstrual period, crown rump length (CRL, biparietal diameter (1st trimester, BPD (2nd trimester, and head circumference and compared mean and median durations, the mean differences, the systematic discrepancies, and the percentages of pre-term and post-term pregnancies in relation to each method. The primary outcomes were post-term and pre-term birth rates defined by different dating methods.The change from use of second to first trimester measurements for dating was associated with a significant increase in the rate of post-term deliveries from 2.1-2.9% and a significant decrease in the rate of pre-term deliveries from 5.4-4.6% caused by systematic discrepancies. Thereby 25.1% would pass 41 weeks when GA is defined by CRL and 17.3% when BPD (2nd trimester is used. Calibration for these discrepancies resulted in a lower post-term birth rate, from 3.1-1.4%, when first compared to second trimester dating was used.Systematic discrepancies were identified when biometric formulas were used to determine duration of pregnancy. This should be corrected in clinical practice to avoid an overestimation of post-term birth and unnecessary inductions when first trimester formulas are used.

  18. Dating of Pregnancy in First versus Second Trimester in Relation to Post-Term Birth Rate: A Cohort Study.

    Science.gov (United States)

    Näslund Thagaard, Ida; Krebs, Lone; Lausten-Thomsen, Ulrik; Olesen Larsen, Severin; Holm, Jens-Christian; Christiansen, Michael; Larsen, Torben

    2016-01-01

    To evaluate in a national standardised setting whether the performance of ultrasound dating during the first rather than the second trimester of pregnancy had consequences regarding the definition of pre- and post-term birth rates. A cohort study of 8,551 singleton pregnancies with spontaneous delivery was performed from 2006 to 2012 at Copenhagen University Hospital, Holbæk, Denmark. We determined the duration of pregnancy calculated by last menstrual period, crown rump length (CRL), biparietal diameter (1st trimester), BPD (2nd trimester), and head circumference and compared mean and median durations, the mean differences, the systematic discrepancies, and the percentages of pre-term and post-term pregnancies in relation to each method. The primary outcomes were post-term and pre-term birth rates defined by different dating methods. The change from use of second to first trimester measurements for dating was associated with a significant increase in the rate of post-term deliveries from 2.1-2.9% and a significant decrease in the rate of pre-term deliveries from 5.4-4.6% caused by systematic discrepancies. Thereby 25.1% would pass 41 weeks when GA is defined by CRL and 17.3% when BPD (2nd trimester) is used. Calibration for these discrepancies resulted in a lower post-term birth rate, from 3.1-1.4%, when first compared to second trimester dating was used. Systematic discrepancies were identified when biometric formulas were used to determine duration of pregnancy. This should be corrected in clinical practice to avoid an overestimation of post-term birth and unnecessary inductions when first trimester formulas are used.

  19. Trimester-specific reference intervals for haemoglobin A(1c) (HbA(1c)) in pregnancy.

    LENUS (Irish Health Repository)

    O'Connor, Catherine

    2011-11-26

    Abstract Background: Diabetes in pregnancy imposes additional risks to both mother and infant. These increased risks are considered to be primarily related to glycaemic control which is monitored by means of glycated haemoglobin (HbA(1c)). The correlation of HbA(1c) with clinical outcomes emphasises the need to measure HbA(1c) accurately, precisely and for correct interpretation, comparison to appropriately defined reference intervals. Since July 2010, the HbA(1c) assay in Irish laboratories is fully metrologically traceable to the IFCC standard. The objective was to establish trimester-specific reference intervals in pregnancy for IFCC standardised HbA(1c) in non-diabetic Caucasian women. Methods: The authors recruited 311 non-diabetic Caucasian pregnant (n=246) and non-pregnant women (n=65). A selective screening based on risk factors for gestational diabetes was employed. All subjects had a random plasma glucose <7.7 mmol\\/L and normal haemoglobin level. Pregnancy trimester was defined as trimester 1 (T1, n=40) up to 12 weeks +6 days, trimester 2 (T2, n=106) 13-27 weeks +6 days, trimester 3 (T3, n=100) >28 weeks to term. Results: The normal HbA(1c) reference interval for Caucasian non-pregnant women was 29-37 mmol\\/mol (Diabetes Control and Complications Trial; DCCT: 4.8%-5.5%), T1: 24-36 mmol\\/mol (DCCT: 4.3%-5.4%), T2: 25-35 mmol\\/mol (DCCT: 4.4%-5.4%) and T3: 28-39 mmol\\/mol (DCCT: 4.7%-5.7%). HbA(1c) was significantly decreased in trimesters 1 and 2 compared to non-pregnant women. Conclusions: HbA(1c) trimester-specific reference intervals are required to better inform the management of pregnancies complicated by diabetes.

  20. Simulation analysis of 9033 cases of second trimester maternal serum screening for Down’s syndrome

    Directory of Open Access Journals (Sweden)

    Shu-fang JIANG

    2017-06-01

    Full Text Available Objective To reduce the screening positive rate (SPR and improve clinical efficiency of maternal serum screening for Down's syndrome. Methods Nine thousand and thirty-three cases of second trimester maternal serum screening for Down's syndrome were included from Apr. 2013 to Apr. 2014 in the present study. The screening results, all basic data and equation curves were analyzed retrospectively. Based on the data from the authors' laboratory, the important adjustment parameters were simulated. Combined with postnatal follow-up results, the quality and clinical performance of second trimester serum screening for Down's syndrome were evaluated. Results The SPR of second trimester serum screening for Down's syndrome was 6.69%(604/9033, the detection rate (DR was 75%(3/4, and FPR was 6.65%(601/9033. The median multiple of median (MOM of alpha-fetoprotein (AFP was low and SPR was high, and MOM of free human chorionic gonadotropin β subunit (free hCGβ were high and SPR was high, while MOM of unconjugated estriol (uE3 were a little bit low, and SPR was slightly high. Considering these three factors, it is believed that the screening positive rate is high. By the simulation adjustments of MOM value equations (AFP and free hCGβ and weight correction equation, the SPR reduced to 4.11%(371/9033 after recalculating the risk, FPR declined to 4.07%(368/9033, and no more Down's syndrome fetus were missed compared with postnatal follow-up results. Conclusion Based on a localized setting depending on the local laboratory data, we suggest that the MOM value distributions(AFP, free hCGβ and uE3 and maternal weight should be regularly adjusted since it is a useful way to reduce the false-positive rate and improve clinical efficiency of maternal serum screening for Down's syndrome. DOI: 10.11855/j.issn.0577-7402.2017.04.13

  1. Comparison of oral and vaginal misoprostol for cervical ripening before evacuation of first trimester missed miscarriage

    International Nuclear Information System (INIS)

    Jabir, Maysoon M.; Smeet, Rania I.

    2009-01-01

    Objective was to assess the effectiveness of misoprostol in cervical ripening before evacuation of conception in the first trimester missed miscarriages and to compare between oral and vaginal routes of administration. A randomized control study was carried out in Baghdad Teaching Hospital, Baghdad, Iraq in 2006. One hundred and twenty women with first fist trimester missed miscarriages were divided into 2 study groups, randomized for oral and vaginal (400 mcg) misoprostol priming of cervix and 2 control groups randomized for oral and vaginal placebo, before undergoing surgical evacuation of conception after 3 hours. Measured outcomes were: post medication cervical dilatation, time needed to dilate the cervix surgically, blood loss and developments of the side effects of misoprostol. Post medication cervical dilation was higher in the misoprostol group (7.07+-1.36 mm for oral misoprostol, 7.77+-1.22 mm for vaginal misoprostol), versus the control groups (2.43+-0.5 mm). Post medication cervical dilatation was significantly higher in the vaginal misoprostol group, compared to the oral group (p=0.04). The time required to dilate the cervix in the misoprostol group was shorter, compared with placebo. There were no significant differences in the amount of blood loss between oral (p=0.074) and vaginal misoprostol groups (p=0.62) and gastrointestinal side effects were significantly more in the oral misoprostol group (p=0.014). Misoprostol is an effective cervical priming agent when administered either orally or vaginally before evacuation of conception in the termination of the first trimester missed miscarriage. (author)

  2. Proteomic Analysis of Early Mid-Trimester Amniotic Fluid Does Not Predict Spontaneous Preterm Delivery

    Science.gov (United States)

    Lenco, Juraj; Vajrychova, Marie; Link, Marek; Tambor, Vojtech; Liman, Victor; Bullarbo, Maria; Nilsson, Staffan; Tsiartas, Panagiotis; Cobo, Teresa; Kacerovsky, Marian; Jacobsson, Bo

    2016-01-01

    Objective The aim of this study was to identify early proteomic biomarkers of spontaneous preterm delivery (PTD) in mid-trimester amniotic fluid from asymptomatic women. Methods This is a case-cohort study. Amniotic fluid from mid-trimester genetic amniocentesis (14–19 weeks of gestation) was collected from 2008 to 2011. The analysis was conducted in 24 healthy women with subsequent spontaneous PTD (cases) and 40 randomly selected healthy women delivering at term (controls). An exploratory phase with proteomics analysis of pooled samples was followed by a verification phase with ELISA of individual case and control samples. Results The median (interquartile range (IQR: 25th; 75th percentiles) gestational age at delivery was 35+5 (33+6–36+6) weeks in women with spontaneous PTD and 40+0 (39+1–40+5) weeks in women who delivered at term. In the exploratory phase, the most pronounced differences were found in C-reactive protein (CRP) levels, that were approximately two-fold higher in the pooled case samples than in the pooled control samples. However, we could not verify these differences with ELISA. The median (25th; 75th IQR) CRP level was 95.2 ng/mL (64.3; 163.5) in women with spontaneous PTD and 86.0 ng/mL (51.2; 145.8) in women delivering at term (p = 0.37; t-test). Conclusions Proteomic analysis with mass spectrometry of mid-trimester amniotic fluid suggests CRP as a potential marker of spontaneous preterm delivery, but this prognostic potential was not verified with ELISA. PMID:27214132

  3. COMPARISON OF MISOPROSTOL AND MISOPROSTOL WITH ISOSORBIDE MONONITRATE IN SECOND TRIMESTER TERMINATION OF PREGNANCY

    Directory of Open Access Journals (Sweden)

    Shanthi Sivakumar

    2016-08-01

    Full Text Available BACKGROUND To compare the efficacy and side effect profile of vaginal misoprostol versus misoprostol and isosorbide mononitrate in enhancing cervical ripening in second trimester pregnancy termination. METHODS It is a random clinical trial done in 100 patients for mid trimester termination of pregnancy (between 12 and 24 weeks of gestational age. They were divided into two groups: Group A Combination of 400 mcg of misoprostol and 40 mg of ISMN placed intravaginally. Repeat doses included combination of 400 mcg of misoprostol and 20 mg of ISMN every 4 hours for maximum 4 doses. Group B 400 mcg of misoprostol placed intravaginally every 4 hours for maximum 4 doses for termination. In both the above-mentioned groups, T. mifepristone 600 mg was given orally 36-48 hrs. prior to termination. RESULTS The mean induction abortion interval was significantly less (7 hrs. 36 mins in Group A compared with group B (9 hrs. 55 min. There was no statistical significant difference in the amount of mean dose used in both groups. The complete abortion rate within 48 hrs. in Group A was 94%, which shows no statistical significance when compared with Group B complete abortion rates (80%. However, it is interpreted that on adding ISMN, the number of complete abortion rates are higher. There was no failure of abortion in both the groups. The side effects such as pain abdomen and fever were less in Group A (38% when compared to Group B (78%. CONCLUSION Vaginally administered ISMN seems to be safe and effective method in second trimester pregnancy termination. There is a reduction in hospital stay, manpower, economy spent on patient, and a sense of wellbeing from the patient also.

  4. [Motor behavior of human fetuses during the second trimester of gestation: a longitudinal ultrasound study].

    Science.gov (United States)

    Reynoso, C; Crespo-Eguílaz, N; Alcázar, J L; Narbona, J

    2015-03-01

    The aim of this research is to contribute to knowledge of the normal spontaneous motor behavior of the human fetus during the second trimester of pregnancy. This study focuses on five patterns of spontaneous fetal movement: startle (S), axo-rhizomelic rhythmia (ARR), axial stretching (AS), general movement (GM), and diaphragmatic contraction (DC). A cohort of 13 subjects was followed up using 2D obstetrical ultrasound images at 12, 16, 20, and 24 weeks of gestation. As inclusion criteria, neonatal neurological examination and general movements after eutocic delivery at term were normal in all of the subjects, and their neuromotor and cognitive development until the end of pre-school age were also normal. All these five motor patterns are present at the beginning of the 2(nd) gestational trimester, but their quantitative and qualitative traits are diverse according to gestational ages. The phasic, isolated or rhythmically repeated movements, S and ARR, are prominent at 12 and 16 weeks of gestation, and then their presence gradually diminishes. By contrast, tonic and complex AS and GM movements increase their presence and quality at 20 and 24 weeks. RAR constitute a particular periodic motor pattern not described in previous literature. Moreover, the incidence of DC is progressive throughout the trimester, in clusters of 2-6 arrhythmic and irregular beats. Fetal heart rate increases during fetal motor active periods. All five normal behavioral patterns observed in the ultrasounds reflect the progressive tuning of motor generators in human nervous system during mid-pregnancy. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  5. Woman's body symmetry and oxidative stress in the first trimester of pregnancy.

    Science.gov (United States)

    Żelaźniewicz, Agnieszka; Nowak, Judyta; Pawłowski, Bogusław

    2015-01-01

    High level of oxidative stress (OS) during the first weeks of pregnancy is related to many serious pregnancy complications. Previous studies showed that body fluctuating asymmetry (FA) is related to OS level in men, suggesting that FA is a marker of oxidative balance in an individual. The aim of this study was to analyze if body FA was related to the level of biomarkers of OS in the first trimester of pregnancy. The sample included 34 women in the first trimester of pregnancy, not smoking, and not exposed to toxins in their work environment. The composite FA and levels of two biomarkers of OS, 8-iso-ProstaglandinF2α (an indicator of oxidative damage to lipids) and 8-OH-dG (an indicator of oxidative damage to DNA) were measured. Factors that may affect the level of OS (vitamin supplementation, age, smoking, alcohol drinking, physical activity, and health condition) were controlled. The levels of OS markers in the first trimester of pregnancy correlated positively with women's FA (r = 0.52, P = 0.002 for 8-OH-dG; r = 0.50; P = 0.003 for 8-iso-PGF2α level) and positively with body height (r = 0.37, P = 0.03 for 8-OH-dG level). The level of OS is likely to be a substantial and important fitness trait, and FA may convey information on the level of OS in women. The result confirms that FA is an indicator of biological condition, as suggested by an evolutionary approach to morphological human traits perceived as attractive. © 2015 Wiley Periodicals, Inc.

  6. Comparison of manual vacuum aspiration and sharp curettage in the treatment of first trimester abortions

    International Nuclear Information System (INIS)

    Iftikhar, G.; Tanveer, S.; Gilani, T.A.; Gilani, S.T.A.

    2014-01-01

    To compare the safety and efficacy of manual vacuum aspiration and sharp curettage in the treatment of first trimester abortions. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Gynecology, Social Security Hospital Shahdra Lahore in collaboration with Family Health Hospital Johar Town Lahore, from May 2007 to May 2012. Patients and Methods: Six hundred women admitted with the diagnosis of first trimester less than or equal to 12 weeks abortions were randomly assigned, 300 to manual vacuum aspiration (MVA) and 300 to traditional sharp curettage. Diagnosis of abortion was confirmed by last menstrual period, physical examination and ultrasonography. Results: In total of 600 patients, 300 randomly assigned to MVA and another 300 patients assigned to sharp curettage management were having mean age of 31.8 and 33 yrs respectively. Mean parity was in both groups, mean gestational age 8.9 and 8.2 weeks, mean duration of procedure was 6.4 and 5.8 minutes, duration of hospital stay was 4 and 40 hrs, missed abortion in 47% and 43% patients, incomplete abortion in 53% and 57% patients, cervical dilatation was needed in 1% against 53%, 10% against 8 % experienced mild pain in both groups, no patient of incomplete evacuation against 0.6%, uterine perforation in none against 0.3 %, excessive bleeding was experienced by 0.3% against 0.6% patients in both groups, and patient satisfaction rate was 99% against 99.4% in the two groups respectively. Conclusion: In the management of first trimester pregnancy loss, MVA offers a quick solution to the problem with reduced hospital stay and lower rate of complications. (author)

  7. Plantar pressure and foot pain in the last trimester of pregnancy.

    Science.gov (United States)

    Karadag-Saygi, Evrim; Unlu-Ozkan, Feyza; Basgul, Alin

    2010-02-01

    Back and foot pain are common complaints during pregnancy. Progression of symptoms is seen especially in the third trimester as the center of gravity (COP) is altered due to weight gain. The aim of the study was to evaluate plantar pressure changes and postural balance differences of pregnant women. Thirty-five last trimester pregnant women with complaints of foot pain were included. The control group consisted of 35 non-pregnant women who were age and body mass index (BMI) matched volunteers. All selected cases were overweight. Foot pain in pregnancy was measured by Visual analogue scale (VAS). Percentages of pressure on forefoot and hindfoot were measured using static pedobarography and peak pressures at forefoot, midfoot and hindfoot were measured using dynamic pedobarography. As a measurement of balance, COP sway length and width were also analyzed. Compared to overweight individuals, pregnant patients had higher forefoot pressure on the right side with standing and walking. Also, significant increases in contact times under the forefoot and longer floor contact times were found. VAS scores were correlated with forefoot contact times during walking. Although the sway length from COP was higher than controls, no significant correlation was found in sway length and weight gain. These data suggest that forefoot pressures increase in the last trimester of pregnancy during standing and walking. There is prominent increased postural sway in anterior-posterior direction in this period. We believe that based on the observed pressure changes, foot pain in pregnancy due to changes in body mass and distribution may be relieved by exercise and shoewear modifications.

  8. A COMPARATIVE STUDY OF MIFEPRISTONE AND MISOPROSTOL VERSUS MISOPROSTOL ALONE IN MID TRIMESTER TERMINATION OF PREGNANCY

    Directory of Open Access Journals (Sweden)

    Surendra Nath Soren

    2018-01-01

    Full Text Available BACKGROUND Termination of pregnancy in second trimester continues to be a challenge in developing countries especially in rural areas. There is an exponential rise in complications of abortion along with advancing gestational age. The search is on for an ideal method of abortion, which is reliable, safe and cheap. This study was conducted in M.K.C.G. Medical College and Hospital, Berhampur, from November 2015 to October 2017 with the aim of finding an effective method to induce second trimester abortion within reasonable time with fewer complications. MATERIALS AND METHODS A total of 80 patients were studied to compare combination of mifepristone and misoprostol (30 patients with single drug misoprostol alone (50 patients for second trimester abortion. The Induction Abortion Interval (IAI, success rate, misoprostol dose requirement and side effects with demographic characteristics were compared between the two groups. RESULTS There was a significant difference in the IAI in both the groups. The mean IAI was 562.218 minutes in study group, whereas in control group, IAI was 922.698 minutes. The success rate (complete abortion was 92.5% in study group and 68.4% in control group, and this was statistically significant. Misoprostol dose requirement (average in study group was 1081.48 μg and in control group was 1675.67 μg. More side effects were observed in the control group. CONCLUSION Mifepristone followed by misoprostol was more effective than misoprostol alone as it had a shorter IAI, better success rate, less requirement of misoprostol and fewer side effects.

  9. Impact on obstetric outcome of third-trimester screening for small-for-gestational-age fetuses.

    Science.gov (United States)

    Callec, R; Lamy, C; Perdriolle-Galet, E; Patte, C; Heude, B; Morel, O

    2015-08-01

    To evaluate the performance of screening for small-for-gestational-age (SGA) fetuses by ultrasound biometry at 30-35 weeks' gestation, and to determine the impact of screening on obstetric and neonatal outcomes. For this prospective cohort study, pregnant women were recruited from two French university maternity centers between 2003 and 2006. Performance measures of third-trimester biometry for the prediction of SGA, defined as estimated fetal weight third-trimester ultrasound had a sensitivity of 29.0% (95% CI, 22.5-36.6%) and specificity of 94.2% (95% CI, 93.0-95.2%). Positive and negative predictive values were 30.8% (95% CI, 23.9-38.7%) and 93.7% (95% CI, 92.5-94.8%), respectively. One hundred and ten SGA neonates went undiagnosed at ultrasound. Compared to the TN neonates considered as of normal weight at ultrasound, planned preterm delivery (before 37 weeks) and elective Cesarean section for a fetal growth indication were 2.4 (P = 0.01) and 2.85 (P = 0.003) times more likely to occur, respectively, in the FP group of non-SGA neonates, diagnosed incorrectly as SGA during the antenatal period. There was no statistically significant difference in 5-min Apgar score third-trimester ultrasound screening for SGA seems poor, as it misses the diagnosis of a large number of SGA neonates. The consequences of routine screening for SGA in a low-risk population may lead to unnecessary planned preterm deliveries and elective Cesarean sections in FP pregnancies, without improved neonatal outcome in the FN pregnancies. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.

  10. Adiposity and hyperleptinemia during the first trimester among pregnant women with preeclampsia

    Directory of Open Access Journals (Sweden)

    Yeboah FA

    2017-06-01

    Full Text Available Francis Agyemang Yeboah,1 Robert Amadu Ngala,1 Ahmed Tijani Bawah,2 Henry Asare-Anane,3 Huseini Alidu,2 Abdul-Wahab Mawuko Hamid,2 Joshua Dokurugu Kwame Wumbee4 1Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, 2Department of Medical Laboratory Science, University of Health and Allied Sciences, Ho, 3Department of Chemical Pathology, School of Biomedical and Allied Health Sciences, University of Ghana, Accra, 4Internal Quality Control Unit, Quality Control Directorate, Kumasi Technical University, Kumasi, Ghana Background: Leptin levels start increasing from the early stages of pregnancy, irrespective of the maternal body mass index. Leptin levels are increased in pregnant women with preeclampsia (PE and may precede the clinical onset of the disease, with peaks occurring around 28 weeks of gestation. This study was aimed at determining whether serum leptin concentration and body fat percentage are significantly altered during the first trimester in pregnancies that subsequently develop PE and whether such changes are useful in predicting the disease.Materials and methods: This was a prospective longitudinal study conducted among pregnant women in Ho municipality. A cohort of 314 pregnant women was monitored from the first antenatal visit to delivery period at the Volta Regional Hospital, Ho, Ghana. Maternal serum leptin and lipid profile were analyzed and body fat percentage determined during first trimester. Body mass index was also calculated.Results: First trimester serum leptin level (P<0.0001 and body fat percentage (P<0.0001 were significantly higher in those who developed PE than those who did not; while triglycerides (P=0.8600, total cholesterol (P=0.5620, high-density lipoprotein (P=0.5880, low-density lipoprotein (P=0.4870 and very low-density lipoprotein (P=0.6540 did not show any significant difference between those with PE and those without PE.Conclusion: Leptin levels are increased

  11. Non-postural serial changes in renal function during the third trimester of normal human pregnancy.

    Science.gov (United States)

    Ezimokhai, M; Davison, J M; Philips, P R; Dunlop, W

    1981-05-01

    Seventeen healthy women were investigated near the beginning and again near the end of the third trimester of their normal pregnancies. Infusion studies were performed in the left lateral position. There was a highly significant decrease in effective renal plasma flow but not in glomerular filtration rate, measured as inulin clearance. Plasma creatinine concentration increased significantly, but the renal handling of creatinine was unchanged; simultaneous 24-hour creatinine clearance showed a tendency to decrease. Serum urate concentration also increased significantly, apparently due to an increase in net tubular reabsorption of urate.

  12. [Genital bacterial carriage during the last trimester of pregnancy and early-onset neonatal sepsis].

    Science.gov (United States)

    Balaka, B; Agbèrè, A; Dagnra, A; Baeta, S; Kessie, K; Assimadi, K

    2005-05-01

    Bacterial infections remain a major cause of morbidity and mortality in newborn infants. To determine the bacterial ecology and pathological status of the genital organs during the last trimester of pregnancy and the germs of the following early-onset neonatal sepsis, in order to evaluate the risk of materno-foetal infections and to find out a drug prophylaxis. Vaginal and endocervical samples, usually taken during the first trimester of pregnancy were delayed and taken during the last trimester of pregnancy. A macroscopic examination described the aspect of the vagina, the cervix uteri, leukorrhea and of possible inflammatory lesions or ulcerations. A microscopic examination searched for parasites, epithelial cells, clue cells and leukocytes. The appropriate bacteriological cultures were performed after reading the Gram stain and scoring the vaginal flora. The clinical and cytobacteriological aspects were used to identify the bacterial ecology and the pathological genital states. An exploration was carried out in every newborn suspected of infection. Genital samples were collected from 306 pregnant women. Among them, 118 were at 29-32 weeks of gestation, 104 at 33-36, and 84 at 37-40. The most frequent germs were C. albicans (33,5%), Enterbacteriaceae (20.3%) including E. coli (10.9%), S. aureus (15.4%), Gardnerella (13.6%), and Trichomonas (10.6%), in monomicrobian (79.2%) and polymicrobian carriage (20.8%). Lower genital tract pathological states such as vaginitis (29.4%), bacterial vaginosis (21.5%) or endocervicitis (10.4%), asymptomatic bacterial carriage (23.5%) and normal genital flora (15%) were identified. These pregnancies led to 334 live births with 27 cases of early-onset neonatal sepsis to which endocervicitis (25%) and vaginosis (19,7%) were most often linked. Genital samples at the last trimester of pregnancy could evaluate the risk of maternofoetal infections and allow to adapt a drug prophylaxis of Enterobacteriaceae, the most frequent germ of

  13. Diagnosis of Pentalogy of Cantrell in the First Trimester Using Transvaginal Sonography and Color Doppler

    Directory of Open Access Journals (Sweden)

    Ayşe Figen Türkçapar

    2015-01-01

    Full Text Available We report the prenatal diagnosis of Cantrell syndrome in the first trimester. During a routine transabdominal ultrasonographic examination, a midline supraumbilical abdominal wall defect including herniated liver and ectopia cordis with a large omphalocele containing the intestines and cystic hygroma was incidentally identified at the 12th week of gestation. A transvaginal sonography examination revealed a severe lumbosacral scoliosis in addition to the inability to visualize the abdominal aorta which was indicative of a severe intracardiac defect. The parents opted for pregnancy to be terminated. In this case report, we discuss the complementary role of transvaginal sonography and Doppler imaging in the diagnosis of Cantrell syndrome in early pregnancy.

  14. Towards Early Biochemical screening for Fetal Aneupliody in the First Trimester

    DEFF Research Database (Denmark)

    Tørring, Niels

    2011-01-01

    Objectives At Aarhus University Hospital, Denmark, the first trimester screening has been performed with the blood sample taken as early as gestational week 7 since 2003. We hereby present the status for the screening program. Methods: The study includes singleton pregnancies with complete first......: Screening for fetal aneuploidy can be performed with good results with the blood sample taken as early as the 7th week of gestation. Taking the blood sample before the 10th gestational week showed a high detection rate of fetal trisomy 21, with no difference in the detection of fetal trisomy 18, 13...

  15. Parvovirus B19 Infection in the First Trimester of Pregnancy and Risk of Fetal Loss

    DEFF Research Database (Denmark)

    Lassen, Jonathan; Jensen, Anne K V; Bager, Peter

    2012-01-01

    in 3 regions in Denmark from 1992 to 1994. Cases of women with fetal loss were identified in the National Patient Register (n = 2,918), and control women with live-born children were identified in the Medical Birth Register (n = 8,429) by matching on age and sampling week. First-trimester serum samples......Because parvovirus B19 infection during pregnancy has been associated with increased risk of fetal loss in small or selected study populations, the authors evaluated the risk in a population-based study. A nested case-control study was conducted by using a population-based screening for syphilis...

  16. Prenatal cytogenetic diagnosis after transabdominal chorionic villus sampling in the first trimester

    DEFF Research Database (Denmark)

    Therkelsen, A J; Jensen, P K; Hertz, Jens Michael

    1988-01-01

    First trimester prenatal cytogenetic diagnosis was attempted in 350 pregnancies after transabdominal chorionic villus sampling. The cytogenetic investigation was performed using both a short-term method (24 h incubation) and cell culture. Adequate samples were obtained in 99.1 per cent and in all...... of 181 cases where the 24 h incubation revealed a male karyotype. Studies of culture morphology showed that colonies of convoluted cells may serve as a marker for contamination with maternal cells in culture. For the present, we recommend using a short-term method as well as cell culture for cytogenetic...

  17. First-trimester maternal protein intake and childhood kidney outcomes: the Generation R Study.

    Science.gov (United States)

    Miliku, Kozeta; Voortman, Trudy; van den Hooven, Edith H; Hofman, Albert; Franco, Oscar H; Jaddoe, Vincent W V

    2015-07-01

    Nutritional exposures during in utero development may have long-lasting consequences for postnatal renal health. Animal studies suggest that specifically maternal dietary protein intake during pregnancy influences childhood kidney function. We examined the associations of total, animal, and vegetable maternal protein intake during pregnancy with kidney volume and function in school-aged children. This study was conducted in 3650 pregnant women and their children who were participating in a population-based cohort study from early life onward. First-trimester energy-adjusted maternal protein intake was assessed with a food-frequency questionnaire. At the child's age of 6 y, we assessed kidney volume, estimated glomerular filtration rate (eGFR) using serum creatinine and cystatin C concentrations, and microalbuminuria using urine albumin:creatinine ratios. First-trimester maternal total protein intake was associated with a higher childhood creatinine-based eGFR (difference: 0.06 mL × min(-1) × 1.73 m(-2); 95% CI: 0.01, 0.12 mL · min(-1) · 1.73 m(-2) per gram of protein intake). This association was mainly driven by vegetable protein intake (0.22 mL × min(-1) × 1.73 m(-2); 95% CI: 0.10, 0.35 mL · min(-1) · 1.73 m(-2) per gram of vegetable protein intake). These associations were not explained by protein intake in early childhood. First-trimester maternal protein intake was not significantly associated with childhood kidney volume, cystatin C-based eGFR, or the risk of microalbuminuria. Our findings suggest that higher total and vegetable, but not animal, maternal protein intake during the first trimester of pregnancy is associated with a higher eGFR in childhood. Further follow-up studies are needed to investigate whether maternal protein intake in early pregnancy also affects the risk of kidney diseases in later life. © 2015 American Society for Nutrition.

  18. Spontaneous first trimester miscarriage rates per woman among parous women with 1 or more pregnancies of 24 weeks or more.

    Science.gov (United States)

    Cohain, Judy Slome; Buxbaum, Rina E; Mankuta, David

    2017-12-22

    The purpose of this study was to quantify spontaneous first trimester miscarriage rates per woman among parous women. A vast amount of data has accumulated regarding miscarriage rates per recognized pregnancy as well as about recurrent miscarriage. This is the second study of miscarriage rates per woman in a parous population and the first study of recurrent and non-recurrent, spontaneous first trimester miscarriage rates per woman in a large parous population. Extraction of the following variables from all delivery room admissions from both Hadassah Medical Centers in Jerusalem Israel, 2004-2014: # of first trimester spontaneous miscarriages, # live births; # living children; age on admission, pre-pregnancy height and weight, any smoking this pregnancy, any alcohol or drug abuse this pregnancy, blood type, history of ectopic pregnancy, history of cesarean surgery (CS) and use of any fertility treatment(s). Among 53,479 different women admitted to labor and delivery ward, 43% of women reported having had 1 or more first trimester spontaneous miscarriages; 27% reported having had one, 10% two, 4% three, 1.3% four, 0.6% five and 0.05% reported having 6-16 spontaneous first trimester miscarriages. 18.5% had one or more first trimester miscarriages before their first live birth. Eighty-one percent of women with 11 or more living children experienced one or more first trimester miscarriages. First trimester miscarriage rates rose with increasing age, increasing parity, after previous ectopic pregnancy, after previous cesarean surgery, with any smoking during pregnancy and pre-pregnancy BMI ≥30. Miscarriages are common among parous women; 43% of parous women report having experienced one or more first trimester spontaneous miscarriages, rising to 81% among women with 11 or more living children. One in every 17 parous women have three or more miscarriages. Depending on her health, nutrition and lifestyle choices, even a 39 year old parous woman with a history of 3 or

  19. Urinary tract infection in pregnant population, which empirical antimicrobial agent should be specified in each of the three trimesters?

    Science.gov (United States)

    Unlu, Bekir Serdar; Yildiz, Yunus; Keles, Ibrahim; Kaba, Metin; Kara, Halil; Tasin, Cuma; Erkilinc, Selcuk; Yildirim, Gulcin

    2014-05-01

    We aimed to investigate the bacterial profile and the adequacy of antimicrobial treatment in pregnant women with urinary tract infection. This retrospective observational study was conducted with 753 pregnant women who needed hospitalization because of UTI in each of the three trimesters. Midstream urine culture and antimicrobial susceptibility tests were evaluated. E. Coli was the most frequently isolated bacterial agent (82.2%), followed by Klebsiella spp. (11.2%). In each of the three trimesters, E. Coli remained the most frequently isolated bacterium (86%, 82.2%, 79.5%, respectively), followed by Klebsiella spp. (9%, 11.6%, 12.2%, respectively). Enterococcus spp. were isolated as a third microbial agent, with 43 patients (5.7%) in the three trimesters. The bacteria were found to be highly sensitive to fosfomycin, with 98-99% sensitivity for E.Coli and 88-89% for Klebsiella spp. and for Enterococcus spp. 93-100% nitrofurantoin sensitivity for each of the three trimesters. We demonstrated that E. Coli and Klebsiella spp. are the most common bacterial agents isolated from urine culture of pregnant women with UTI in each of the three trimesters. We consider fosfomycin to be the most adequate first-line treatment regimen due to high sensitivity to the drug, ease of use and safety for use in pregnancy

  20. Changes of intraocular pressure in different trimesters of pregnancy among Syrian refugees in Turkey: A cross-sectional study.

    Science.gov (United States)

    Tolunay, Harun Egemen; Özcan, Sait Coşkun; Şükür, Yavuz Emre; Özarslan Özcan, Deniz; Adıbelli, Fatih Mehmet; Hilali, Neşe Gül

    2016-06-01

    To evaluate the physiologic changes in intraocular pressure associated with pregnancy in healthy Syrian refugee women in Turkey. In this cross-sectional study, intraocular pressures were measured using a Goldmann tonometer in 235 patients in the first, second, and third trimester of pregnancy and puerperium among Syrian refugees in Turkey. Mean intraocular pressures values of the right eye were 15.5±2.5 mmHg, 14.4±1.4 mmHg, 13.9±1.6 and 14.7±1.9 mmHg in the three trimesters and puerperium, respectively. Mean intraocular pressures values of the left eye were 15.3±1.6 mmHg, 14.3±1.4 mmHg, 13.9±1.6 and 15.3±2.2 mmHg in the three trimesters and puerperium, respectively. The mean intraocular pressures values measured from both eyes were significantly higher in first trimester and puerperal period than in the third trimester (p<0.001). Changes in the intraocular pressure in pregnancy are common and temporary. This study shows the baseline changes in the intraocular pressure during pregnancy in healthy women. Therefore, we cannot extrapolate the results to the whole eye. A decrease in intraocular pressures was shown in healthy pregnant women.

  1. T CD3+CD8+ Lymphocytes Are More Susceptible for Apoptosis in the First Trimester of Normal Human Pregnancy

    Directory of Open Access Journals (Sweden)

    Dorota Darmochwal-Kolarz

    2014-01-01

    Full Text Available Aims. Normal human pregnancy is a complex process of many immunoregulatory mechanisms which protect fetus from the activation of the maternal immune system. The aim of the study was to investigate the apoptosis of lymphocytes in peripheral blood of normal pregnant patients and healthy nonpregnant women. Methods. Sixty pregnant women and 17 nonpregnant women were included in the study. Lymphocytes were isolated and labeled with anti-CD3, anti-CD4, and anti-CD8 monoclonal antibodies. Apoptosis was detected by CMXRos staining and analyzed using the flow cytometric method. Results. We found significantly higher apoptosis of total lymphocytes in peripheral blood of pregnant patients when compared to healthy nonpregnant women. The percentage of apoptotic T CD3+CD8+ cells in the first trimester was significantly higher when compared to the third trimester of normal pregnancy. The ratio of T CD3+CD4+ : T CD3+CD8+ apoptotic lymphocytes was significantly lower in the first trimester when compared to other trimesters of pregnancy and to both of the phases of the menstrual cycle. Conclusions. The higher apoptosis of T CD3+CD8+ lymphocytes and the lower ratio of T CD3+CD4+ : T CD3+CD8+ apoptotic cells in the first trimester of normal pregnancy may suggest a higher susceptibility of T CD3+CD8+ cells for apoptosis as a protective mechanism at the early stage of pregnancy.

  2. The triple test as a screening technique for Down syndrome: reliability and relevance

    Directory of Open Access Journals (Sweden)

    Tim Reynolds

    2010-05-01

    Full Text Available Tim ReynoldsClinical Chemistry Department, Queen’s Hospital, Burton-on-Trent, Staffordshire, UKAbstract: The triple test is a second trimester screening test used to identify those pregnant women who should be offered a diagnostic test to identify whether their fetus has an aneuploidy. It was first described in 1988, but has largely been superseded by newer tests either conducted earlier in the first trimester (ie, the combined test, using ultrasound measurement of nuchal translucency,pregnancy-associated plasma protein A, and human chorionic gonadotrophin [hCG] or in the second trimester (ie, the quadruple test, using α-fetoprotein, hCG, uE3, and inhibin. These newer tests have been introduced because they offer greater detection and lower screen positive results thereby enhancing diagnosis rates, while decreasing the risk of iatrogenic harm caused by the invasive testing required when collecting suitable sample tissue. Noninvasive alternatives to the triple test have been identified, but these have not been adopted despite 13 years of development. It is likely, therefore, that the triple test (or variants thereof will continue to be used in routine antenatal care for the foreseeable future.Keywords: pregnancy, screening test, antenatal, Down syndrome

  3. Combined First-Trimester Screening in Northern Finland: Experiences of the First Ten Years

    Directory of Open Access Journals (Sweden)

    Merilainen Anna

    2014-01-01

    Full Text Available Objective To evaluate the efficacy of first trimester combined screening for Down's syndrome in Northern Finland during the first 10 years of practice. Methods During 1 January 2002 to 31 December 2011, 47,896 women participated voluntarily in combined screening during first trimester. The risk cutoff was 1:250. The study period was divided into two time periods; 2002-2006 and 2007-2011. Results During the first half of the study period, the detection rate (DR was 77.3% with a 4.9% false-positive rate (FPR. During the latter half, the DR was 77.1% with a 2.8% FPR. Conclusions An important issue is the number of invasive procedures needed to detect one case of Down's syndrome. The screening performance improved markedly in the latter five years period since the FPR lowered from 4.9% to 2.8% and the number of invasive procedures needed to detect one case of Down's syndrome lowered from 15 to 11.

  4. Synthetic Receptors Induce Anti Angiogenic and Stress Signaling on Human First Trimester Cytotrophoblast Cells

    Directory of Open Access Journals (Sweden)

    Ahmed F. Pantho

    2017-05-01

    Full Text Available The cytotrophoblast (CTB cells of the human placenta have membrane receptors that bind certain cardiotonic steroids (CTS found in blood plasma. One of these, marinobufagenin, is a key factor in the etiology of preeclampsia. Herein, we used synthetic receptors (SR to study their effectiveness on the angiogenic profile of human first trimester CTB cells. The humanextravillous CTB cells (Sw.71 used in this study were derived from first trimester chorionic villus tissue. Culture media of CTB cells treated with ≥1 nM SR level revealed sFlt-1 (Soluble fms-like tyrosine kinase-1 was significantly increased while VEGF (vascular endothelial growth factor was significantly decreased in the culture media (* p < 0.05 for each The AT2 receptor (Angiotensin II receptor type 2 expression was significantly upregulated in ≥1 nM SR-treated CTB cells as compared to basal; however, the AT1 (Angiotensin II receptor, type 1 and VEGFR-1 (vascular endothelial growth factor receptor 1 receptor expression was significantly downregulated (* p < 0.05 for each. Our results show that the anti-proliferative and anti-angiogenic effects of SR on CTB cells are similar to the effects of CTS. The observed anti angiogenic activity of SR on CTB cells demonstrates that the functionalized-urea/thiourea molecules may be useful as potent inhibitors to prevent CTS-induced impairment of CTB cells.

  5. First-trimester visualization of the fourth ventricle in fetuses with and without spina bifida.

    Science.gov (United States)

    Solt, Ido; Acuna, Joann G; Adeniji, Beni A; Mirocha, James; Kim, Matthew J; Rotmensch, Siegfried

    2011-12-01

    The purpose of this study was to examine the efficacy of nonvisualization of the fourth ventricle for first-trimester detection of spina bifida. A total of 250 digitally stored sonographic examinations at gestational ages of 11 weeks to 13 weeks 6 days (245 normal and 5 randomly interspersed spina bifida cases) were retrospectively analyzed by 4 blinded reviewers for the presence or absence of the fourth ventricle followed by an anteroposterior ventricular dimension measurement. The ventricle size was related to the crown-rump length and gestational age by linear regression analysis and Pearson correlation. The fourth ventricle was identified in 971 of 1000 image readings (97.1%). False-negative and false-positive readings occurred in 11 of 20 (55.0%) and 20 of 980 (2.0%) cases, respectively (sensitivity, 0.45; specificity, 0.98.). False-negative and false-positive readings were evenly distributed throughout the gestational age range. When the ventricular size was measurable, its mean dimensions increased linearly with gestational age and were below the fifth percentile in 10 of 245 (4.0%) normal and 0 of 4 spina bifida cases, respectively. Intraclass correlation coefficient estimates were calculated based on the 2-way analysis of variance model and found to be 0.30 for a single rater and 0.64 for the mean of 4 raters. Nonvisualization of the first-trimester fourth ventricle is a less robust screening parameter for spina bifida than previously published.

  6. Determinants of Antenatal Healthcare Utilisation by Pregnant Women in Third Trimester in Peri-Urban Ghana

    Directory of Open Access Journals (Sweden)

    Jones Asafo Akowuah

    2018-01-01

    Full Text Available Access to quality healthcare still remains a major challenge in the efforts at reversing maternal morbidity and mortality. Despite the availability of established maternal health interventions, the health of the expectant mother and the unborn child remains poor due to low utilisation of interventions. The study examined the socioeconomic determinants of antenatal care utilisation in peri-urban Ghana using pregnant women who are in their third trimester. Two-stage sampling technique was used to sample 200 pregnant women who were in their third trimester from the District Health Information Management System software. Well-structured questionnaire was the instrument used to collect data from respondents. Descriptive statistics and inferential statistics including binary logit regression model were used to analyse the data with the help of SPSS and STATA software. The results showed varying utilisation levels of ANC. From the regression result, age, household size, and occupational status were identified as the important socioeconomic determinants of antenatal care utilisation among the respondents. The important system factors which influence antenatal care utilisation by the respondents are distance to ANC, quality of service, and service satisfaction. The study concludes that socioeconomic and health system factors are important determinants of antenatal care utilisation. Stepping up of interventions aimed at improving the socioeconomic status and addressing health system and proximity challenges could be helpful in improving antenatal care utilisation by pregnant women in Ghana.

  7. First-trimester antihistamine exposure and risk of spontaneous abortion or preterm birth.

    Science.gov (United States)

    Aldridge, Tiara D; Hartmann, Katherine E; Michels, Kara A; Velez Edwards, Digna R

    2014-10-01

    We tested whether antihistamine exposure during early pregnancy is associated with spontaneous abortion (SAB) or preterm birth (PTB). Women were enrolled in Right from the Start (2004-2010), a prospective pregnancy cohort. Data about first-trimester antihistamine use were obtained from screening and first-trimester interviews. Self-reported outcomes included SAB and PTB and were verified by medical records. Cox proportional hazards models were used to test for an association between antihistamine use and each outcome, both performed adjusting for confounders. Among the 2685 pregnancies analyzed, 14% (n = 377) reported use of antihistamines. Among antihistamine users, 12% (n = 44) experienced SABs, and 6% (n = 21) had PTBs. Antihistamine exposure was not associated with SAB (adjusted hazard ratio [aHR] = 0.88, 95% confidence interval [CI] 0.64, 1.21) or PTB, which was modified by maternal race (aHR = 1.03, 95%CI 0.61, 1.72 among White women and aHR = 0.43, 95%CI 0.14, 1.34 among Black women). Despite the biologic plausibility that antihistamine use may influence pregnancy outcomes, we did not detect evidence of an association with SAB or PTB. These data demonstrate the utility of large prospective cohorts for evaluating drug safety in pregnancy when concerns are raised from animal models. Copyright © 2014 John Wiley & Sons, Ltd.

  8. A Case of Idiopathic Acute Pancreatitis in the First Trimester of Pregnancy

    Directory of Open Access Journals (Sweden)

    Tomomi Hara

    2015-01-01

    Full Text Available Acute pancreatitis is rare in pregnancy, with an estimated incidence of approximately 1 in 1000 to 1 in 10,000 pregnancies. Acute pancreatitis in pregnancy usually occurs in the third trimester. Here, we report a case of acute pancreatitis in the first trimester. A 36-year-old primigravida at 11 weeks of gestation complained of severe lower abdominal pain. The pain gradually worsened and migrated toward the epigastric region. She had no history of chronic alcoholism. Blood investigations showed elevated level of C-reactive protein (9.58 mg/dL, pancreatic amylase (170 IU/L, and lipase (332 IU/L. There was no gallstone and no abnormality in the pancreatic and biliary ducts on ultrasonography. Antinuclear antibody and IgG4 were negative and no evidence of hyperlipidemia or diabetes was found. There was also no evidence of viral infection. On the third day of hospitalization, she was diagnosed with severe acute pancreatitis on magnetic resonance imaging. Medical interventions were initiated with nafamostat mesilate and ulinastatin, and parenteral nutrition was administered through a central venous catheter. On the eighth day of hospitalization, her condition gradually improved with a decreased level of pancreatic amylase and the pain subsided. After conservative management, she did not have any recurrence during her pregnancy.

  9. Sildenafil Prevents Apoptosis of Human First-Trimester Trophoblast Cells Exposed to Oxidative Stress

    Science.gov (United States)

    Bolnick, Jay M.; Kilburn, Brian A.; Bolnick, Alan D.; Diamond, Michael P.; Singh, Manvinder; Hertz, Michael; Dai, Jing

    2015-01-01

    Human first-trimester trophoblast cells proliferate at low O2, but survival is compromised by oxidative stress, leading to uteroplacental insufficiency. The vasoactive drug, sildenafil citrate (Viagra, Sigma, St Louis, Missouri), has proven useful in reducing adverse pregnancy outcomes. An important biological function of this pharmaceutical is its action as an inhibitor of cyclic guanosine monophosphate (cGMP) phosphodiesterase type 5 activity, which suggests that it could have beneficial effects on trophoblast survival. To investigate whether sildenafil can prevent trophoblast cell death, human first-trimester villous explants and the HTR-8/SVneo cytotrophoblast cell line were exposed to hypoxia and reoxygenation (H/R) to generate oxidative stress, which induces apoptosis. Apoptosis was optimally inhibited during H/R by 350 ng/mL sildenafil. Sildenafil-mediated survival was reversed by l-NG-nitro-l-arginine methyl ester hydrochloride or cGMP antagonist, indicating a dependence on both nitric oxide (NO) and cGMP. Indeed, either a cGMP agonist or an NO generator was cytoprotective independent of sildenafil. These findings suggest a novel intervention route for patients with recurrent pregnancy loss or obstetrical placental disorders. PMID:25431453

  10. Regional apparent diffusion coefficient values in 3rd trimester fetal brain

    International Nuclear Information System (INIS)

    Hoffmann, Chen; Weisz, Boaz; Lipitz, Shlomo; Katorza, Eldad; Yaniv, Gal; Bergman, Dafi; Biegon, Anat

    2014-01-01

    Apparent diffusion coefficient (ADC) values in the developing fetus can be used in the diagnosis and prognosis of prenatal brain pathologies. To this end, we measured regional ADC in a relatively large cohort of normal fetal brains in utero. Diffusion-weighted imaging (DWI) was performed in 48 non-sedated 3rd trimester fetuses with normal structural MR imaging results. ADC was measured in white matter (frontal, parietal, temporal, and occipital lobes), basal ganglia, thalamus, pons, and cerebellum. Regional ADC values were compared by one-way ANOVA with gestational age as covariate. Regression analysis was used to examine gestational age-related changes in regional ADC. Four other cases of CMV infection were also examined. Median gestational age was 32 weeks (range, 26-33 weeks). There was a highly significant effect of region on ADC, whereby ADC values were highest in white matter, with significantly lower values in basal ganglia and cerebellum and the lowest values in thalamus and pons. ADC did not significantly change with gestational age in any of the regions tested. In the four cases with fetal CMV infection, ADC value was associated with a global decrease. ADC values in normal fetal brain are relatively stable during the third trimester, show consistent regional variation, and can make an important contribution to the early diagnosis and possibly prognosis of fetal brain pathologies. (orig.)

  11. Regional apparent diffusion coefficient values in 3rd trimester fetal brain

    Energy Technology Data Exchange (ETDEWEB)

    Hoffmann, Chen [Tel Aviv University, Department of Radiology, Sheba Medical Center, Tel Hashomer (affiliated to the Sackler School of Medicine), Tel Aviv (Israel); Sheba Medical Center, Diagnostic Imaging, 52621, Tel Hashomer (Israel); Weisz, Boaz; Lipitz, Shlomo; Katorza, Eldad [Tel Aviv University, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer (affiliated to the Sackler School of Medicine), Tel Aviv (Israel); Yaniv, Gal; Bergman, Dafi [Tel Aviv University, Department of Radiology, Sheba Medical Center, Tel Hashomer (affiliated to the Sackler School of Medicine), Tel Aviv (Israel); Biegon, Anat [Stony Brook University School of Medicine, Department of Neurology, Stony Brook, NY (United States)

    2014-07-15

    Apparent diffusion coefficient (ADC) values in the developing fetus can be used in the diagnosis and prognosis of prenatal brain pathologies. To this end, we measured regional ADC in a relatively large cohort of normal fetal brains in utero. Diffusion-weighted imaging (DWI) was performed in 48 non-sedated 3rd trimester fetuses with normal structural MR imaging results. ADC was measured in white matter (frontal, parietal, temporal, and occipital lobes), basal ganglia, thalamus, pons, and cerebellum. Regional ADC values were compared by one-way ANOVA with gestational age as covariate. Regression analysis was used to examine gestational age-related changes in regional ADC. Four other cases of CMV infection were also examined. Median gestational age was 32 weeks (range, 26-33 weeks). There was a highly significant effect of region on ADC, whereby ADC values were highest in white matter, with significantly lower values in basal ganglia and cerebellum and the lowest values in thalamus and pons. ADC did not significantly change with gestational age in any of the regions tested. In the four cases with fetal CMV infection, ADC value was associated with a global decrease. ADC values in normal fetal brain are relatively stable during the third trimester, show consistent regional variation, and can make an important contribution to the early diagnosis and possibly prognosis of fetal brain pathologies. (orig.)

  12. Iodine nutritional status of women in their first trimester of pregnancy in Catalonia.

    Science.gov (United States)

    Torres, Maria Teresa; Francés, Lidia; Vila, Lluis; Manresa, Josep María; Falguera, Gemma; Prieto, Gemma; Casamitjana, Roser; Toran, Pere

    2017-07-26

    Sufficient iodine intake is needed during pregnancy to ensure proper fetal development. The iodine levels of women in their first trimester of pregnancy in Catalonia are currently unknown. This data would help to determine whether our public health services should establish recommendations or interventions in this line. The aim of this study was to investigate the iodine nutritional status, prevalence of urinary iodine pregnancy in our setting. Cross-sectional study. Data were collected during 2008-2009 from women in their first trimester at the primary care centers of the province of Barcelona (Spain). Pregnant women included in the study completed a questionnaire on eating habits and underwent urinary iodine concentration (UIC) assessment. Nine hundred forty five women completed the dietary questionnaire and urinary iodine testing. Median UIC was 172 μg/L, with 407 participants (43.1%) showing levels 2 glasses, OR = 0.593 95% CI (0.37-0.95); iodized salt consumption, OR = 0.678 95% CI (0.51-0. 90); and use of iodine supplementation, OR = 0.410 95% CI (0.31-0.54), protected against the risk of UIC nutritional status according to the criteria established by the WHO and ICCIDD. The risk of urinary iodine <150 μg/L decreased with simultaneous consumption of milk and iodized salt, similar to the decrease seen with iodine supplementation.

  13. Investigation of serum leptin levels in pregnant women during various trimesters and their neonates

    International Nuclear Information System (INIS)

    Gao Juxing; Zhang Jiyun

    2003-01-01

    Objective: To investigate the variations of serum leptin levels in pregnant women of various trimesters and their neonates as well as the correlativity in-between. Methods: Serum leptin levels in 300 women at pregestation during the three trimesters and the umbilical blood leptin levels in their neonates were measured with RIA. Results: Serum leptin levels in pregnant women rose significantly only from midgestation with a peak at partum (p < 0.05 or p < 0.01 vs pregestation). The leptin levels in neonates were almost the same as those of women of pregestation. The maternal leptin levels were positively correlated to body weight, body weight-index, abdominal perimeter, height of fundus of uterus, diastolic and systolic pressure. The leptin levels in neonates were positively correlated to the birth weight, but not correlated to maternal leptin levels. Conclusion: Leptin in neonates comes from neonates themselves, and its concentrations are determined by the degree of accumulation of body adipose tissue. Measurement of blood leptin concentrations in pregnant women during pregnancy has little meaning for accessing the body weight of fetus, but it can show the degree of maternal weight-gaining and may have some value for clinical observation of the syndrome of pregnant hypertension

  14. What is my Baby Like? Representations Concerning the Baby in the Third Trimester of Pregnancy

    Directory of Open Access Journals (Sweden)

    Marta Pedreira

    2015-11-01

    Full Text Available AimTo investigate if during the third trimester of pregnancy fantasies emerge in the baby representations based on the information that pregnant women have on their real babies through ultrasound techniques.MethodA qualitative, descriptive and exploratory research based on a sample of 30 pregnant Portuguese women, whose average age is 32 years old, was developed. A socio-demographic questionnaire and a semi-directive interview entitled "Interview of Maternal Representations During Pregnancy – Revised Version" (IRMAG-R, Ammaniti & Tambelli, 2010 were employed.ResultsBaby representations are immersed in a fantasy dimension, which means that the imaginary baby is quite present in this phase of pregnancy. Pregnant women mainly attribute psychological characteristics to the babies, rather than physical characteristics. Regardless of the type of characteristics analysed, the preference for these characteristics emerges based on their wishes. Secondly, characteristics of the parents may also emerge. Fetal movements and information from ultrasound have no significant influence on the characterization of the baby.ConclusionDespite the development of ultrasound techniques, the imaginary baby defines parents representations about the baby on the third trimester of pregnancy. Consequently, a new understanding of how pregnant women experience the transition to the postnatal phase has to be considered.

  15. Intrauterine hematomas in the second and third trimesters associated with adverse pregnancy outcomes: a retrospective study.

    Science.gov (United States)

    Ji, Wanqing; Li, Weidong; Mei, Shanshan; He, Ping

    2017-09-01

    To carry out a retrospective study of the clinical features of patients with intrauterine hematoma in the second and third trimesters, and discuss the risk factors for poor pregnancy outcomes. A total of 398 patients who underwent routine examination in our hospital from January 2011 to December 2015 were classified into normal pregnancy (NP) group (N = 265) and adverse pregnancy (AP) group (N = 133), according to their pregnancy outcomes. Maternal clinical demographics, gestational age, location of hematoma, volume of hematoma, and accompanying contraction and vaginal bleeding were recorded. The average age of pregnant women in the NP and AP groups was 28.25 ± 4.06 and 29.5 ± 5.06 years, respectively (p = 0.007). Gestational age at first detection of hematoma was 15.11 ± 5.13 weeks in the NP group compared with 21.22 ± 8.25 weeks in the AP group (p hematoma (54.1%) and palpable contractions (62.8%) was significantly higher than in the NP group (25.7% and 12.1%, respectively; p hematoma and incidence of vaginal bleeding were found. Intrauterine hematoma in the second and third trimesters is a sign of pathological pregnancy, resulting in adverse outcomes. Maternal age, gestational age at first diagnosis, location of hematoma and accompanying contraction are risk factors for poor pregnancy outcomes.

  16. Prevalence of Group B Streptococcus Vaginal Colonization in The Third Trimester of Pregnancy.

    Directory of Open Access Journals (Sweden)

    MR Nazer

    2011-03-01

    Full Text Available Introduction: Group B Strepococcus(GBS is one of the most important causes of neonatal infections including septicemia and meningitis. It also plays an important role in maternal infections such as chorioamnionitis, pyelonephritis, metritis and post partum infection. The present study was carried out to find the prevalence of GBS in pregnant women with 28 to 38 weeks gestational age. Methods: In this study, 100 pregnant women referring to the obstetrical clinic of Asalian Hospital in Khorramabad city in the third trimester of pregnancy (after explaining the study, getting informed consent and demographic informations were tested for GBS by taking a vaginal sample. The sample was taken by sterile cotton swab. The swabs were placed in transport media, transported to the central Lab, and were inoculated in blood agar. Then all samples were analyzed for the presence of GBS. Results: In this study, the prevalence of positive vaginal GBS culture in pregnant women was 14% (CI: 7.2-20.8%. No significant correlation were found between this positive culture and maternal age, gestational age, abortion status, diabetes mellitus and pregnancy induced hypertension, while a significant correlation was found between positive cultures and parity. Conclusion: As the colonization rate of GBS in pregnant women of Khorramabad is high, routine culture-based screening is recommended for all pregnant women in third trimester of pregnancy.

  17. Placenta Percreta in First Trimester after Multiple Rounds of Failed Medical Management for a Missed Abortion

    Directory of Open Access Journals (Sweden)

    Jaimin Shah

    2017-01-01

    Full Text Available Background. The detection of a morbidly adherent placenta (MAP in the first trimester is rare. Risk factors such as multiparity, advanced maternal age, prior cesarean delivery, prior myomectomy, placenta previa, or previous uterine evacuation place patients at a higher risk for having abnormal placental implantation. If these patients have a first trimester missed abortion and fail medical management, it is important that providers have a heightened suspicion for a MAP. Case. A 24-year-old G4P3003 with 3 prior cesarean deliveries underwent multiple rounds of failed medical management for a missed abortion. She had a dilation and curettage that was complicated by a significant hemorrhage and ultimately required an urgent hysterectomy. Conclusion. When patients fail medical management for a missed abortion, providers need to assess the patient’s risk factors for a MAP. If risk factors are present, a series of specific evaluations should be triggered to rule out a MAP and help further guide management. Early diagnosis of a MAP allows providers to coordinate a multidisciplinary treatment approach and thoroughly counsel patients. Ensuring adequate resources and personnel at a tertiary hospital is essential to provide the highest quality of care and improve outcomes.

  18. Adverse Pregnancy Outcomes of Patients with History of First-Trimester Recurrent Spontaneous Abortion

    Directory of Open Access Journals (Sweden)

    Jing Yang

    2017-01-01

    Full Text Available Although a history of first-trimester recurrent spontaneous abortion (FRSA is regarded as a risk factor in antenatal care, the characteristic of subsequent pregnancy outcome is not clearly elucidated. Here, a retrospective analysis was performed on the clinical data of 492 singleton pregnant women. 164 of them with the history of FRSA were enrolled in study group, compared to 328 deliveries without the history of FRSA. For maternal outcomes, patients in the study group delivered earlier with mean gestational age and the incidences of cesarean section and postpartum hemorrhage were higher compared to the control group. For placental outcomes, the incidence of placenta-mediated pregnancy complications (PMPC in the study group increased in terms of late-onset preeclampsia, oligohydramnios, early-onset fetal growth restriction, and second-trimester abortion. Patients in the study group were more likely to suffer from placenta accreta, placenta increta, and placenta percreta. For perinatal outcomes, the proportion of birth defects of newborns in the study group was greater. At last, logistic regression analyses showed that the history of FRSA was an independent risk factor for cesarean section and pregnancy complications. In conclusion, women with the history of FRSA are often exposed to an elevated incidence of maternal-placental-perinatal adverse pregnancy outcomes.

  19. [Prescribed and dispensed in the third trimester of pregnancy drugs: What practices and risks?].

    Science.gov (United States)

    Parent, G; Mottet, N; Mairot, P; Baudier, F; Carel, D; Goguey, M; Riethmuller, D; Limat, S

    2016-09-01

    The aim of the study was to describe the prescribing of drugs to pregnant women during the third trimester of pregnancy. The retrospective analysis is interested by pregnant women from August 2009 to April 2011, living in Franche-Comté. The used data are recorded in the database of the French Health Insurance Service. Drugs prescribing were analyzed and classified according to three categories: drugs that are contraindicated, not recommended drugs and drugs that are used. This classification is based on two databases: the Summaries of Product Characteristics of Vidal 2010 and data from the National Security Agency of Medicines. The potential exposure of patients was pointed out. On 15,027 patients, 80% had a prescription. Six percent of prescriptions containing drugs not recommended and 1% drugs that contraindicated. Therapeutic classes identified are analgesics, anti-infective drugs and medicines supplementing with vitamins and minerals. Contraindicated drugs (10%) are NSAIDs, rubella vaccine, cyclins and ACE inhibitors and ARBs. Approximately 2.7% of women were potentially exposed to these drugs. Despite the recommendations of the ANSM, some drugs that are contraindicated are prescribed for pregnant women in their third trimester of pregnancy. In the absence of studies, the decision must be made on a case by case basis by assessing the risk-benefit ratio. Particular care is to bring about the drugs taken in self-medication. Information and advice are key steps to avoid incidents. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  20. ANALYSIS OF SERUM URIC ACID LEVELS IN EARLY SECOND TRIMESTER AS AN EARLY PREDICTOR FOR PREECLAMPSIA

    Directory of Open Access Journals (Sweden)

    Ratna Bulusu

    2017-01-01

    Full Text Available BACKGROUND Hypertensive disorders complicate 5-10% of all pregnancies. Screening for these factors in the second trimester of pregnancy will help in early detection of hypertensive disorders of pregnancy, thus enabling. 1. Early identification of patients at risk of developing preeclampsia and eclampsia. 2. Prophylactic medication to prevent hypertension or to reduce its severity. 3. Proper antenatal care. The aim of the study is to study the accuracy of serum uric acid levels in early second trimester (14-20 weeks as early predictor of preeclampsia. MATERIALS AND METHODS 100 pregnant normotensive women between 14-20 weeks gestation with singleton pregnancy irrespective of parity were selected randomly and serum levels of uric acid was estimated. Regular follow up of the cases was done till delivery. Number of cases developing preeclampsia was noted. Results were analysed statistically. RESULTS Out of the 100 patients enrolled in the study, 11 developed preeclampsia while rest 89 remained normotensive. Mean value of uric acid in preeclampsia cases was 6.28±0.86 mg/dL while that in normotensive cases was 3.42±0.94 mg/dL. This result was statistically significant. CONCLUSION Serum uric acid level at 14-20 weeks of gestation was significantly raised in the cases who developed preeclampsia as compared to those who remained normotensive. Hence, serum uric acid estimation at 14-20 weeks of gestation could be used as an effective parameter for predicting preeclampsia.

  1. Predictive role of prenasal thickness and nasal bone for Down syndrome in the second trimester.

    Science.gov (United States)

    Ozcan, Tulin; Özlü, Tülay; Allen, Julie; Peterson, Jeanne; Pressman, Eva K

    2013-12-01

    To assess the efficacy of prenasal thickness (PNT) and nasal bone (NB) for prediction of Down syndrome (DS) fetuses in the second trimester ultrasound examination. PNT was measured from stored two-dimensional fetal profile images taken at 15-23 weeks in 242 fetuses with normal karyotype (Group 1) and 24 fetuses with DS (Group 2). It was measured as the shortest distance from the anterior edge of the lowest part of the frontal bone to the skin. The efficacy of PNT, NB, PNT/NB and biparietal diameter (BPD)/NB was evaluated for prediction of DS. PNT values increased with gestational age in normal fetuses. PNT measurement was ≥95th percentile in 54.2% (13/24) of the DS cases and 2.9% of the normal cases. Receiver operator curve analysis showed that PNT/NB ratio had the best area under the curve with a detection rate of 80% for a false positive rate of 5% at a cut-off value of 0.76. PNT is increased in fetuses with DS as compared to normal fetuses. PNT/NB≥0.76 in the second trimester is a better predictor of DS than the use of PNT or NB alone. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  2. Factors affecting delays in first trimester pregnancy termination services in New Zealand.

    Science.gov (United States)

    Silva, Martha; McNeill, Rob; Ashton, Toni

    2011-04-01

    To identify the factors affecting the timeliness of services in first trimester abortion service in New Zealand. Primary data were collected from all patients attending nine abortion clinics between February and May 2009. The outcome measured was delay between the first visit with a referring doctor and the date of the abortion procedure. Patient records (n=2,950) were audited to determine the timeline between the first point of entry to the health system and the date of abortion. Women were also invited to fill out a questionnaire identifying personal factors affecting access to services (n=1,086, response rate = 36.8%). Women who went to private clinic had a significantly shorter delay compared to public clinics. Controlling for clinic type, women who went to clinics that offered medical abortions or clinics that offered single day services experienced less delay. Also, women who had more than one visit with their referring doctor experienced a greater delay than those who had a single visit. The earlier in pregnancy women sought services the longer the delay. Women's decision-making did not have a significant effect on delay. Several clinic level and systemic factors are significantly associated with delay in first trimester abortion services. In order to ensure the best physical and emotional outcomes, timeliness of services must improve. © 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.

  3. Noninvasive Recording of True-to-Form Fetal ECG during the Third Trimester of Pregnancy

    Directory of Open Access Journals (Sweden)

    Istvan Peterfi

    2014-01-01

    Full Text Available Objective. The aim of the study was to develop a complex electrophysiological measurement system (hardware and software which uses the methods of electrophysiology and provides significant information about the intrauterine status of the fetus, intending to obtain true-to-form, morphologically evaluated fetal ECG from transabdominal maternal lead. Results. The present method contains many novel ideas that allow creating true-to-form noninvasive fetal ECG in the third trimester of the pregnancy in 80% of the cases. Such ideas are the telemetric data collection, the “cleanse” of the real time recording from the maternal ECG, and the use of the cardiotocograph (CTG that allows identifying the fetal heart events. The advantage of this developed system is that it does not require any qualified staff, because both the extraction of the information from the abdominal recording and the processing of the data are automatic. Discussion. Although the idea of a noninvasive fetal electrocardiography is more than 100 years old still there is no simple, effective, and cheap method available that would enable an extensive use. This developed system can be used in the third trimester of the pregnancy efficiently. It can produce true-to-form fetal ECGs with amplitude less than 10 µV.

  4. Impact of Second Trimester Maternal Dietary Intake on Gestational Weight Gain and Neonatal Birth Weight

    Directory of Open Access Journals (Sweden)

    Malshani L. Pathirathna

    2017-06-01

    Full Text Available Poor maternal nutrition is a major contributor to the high incidence of low birth weight deliveries in developing countries. This study aimed to assess the impact of second trimester maternal dietary intake on gestational weight gain and neonatal birth weight. A longitudinal study was conducted in a tertiary care hospital in Sri Lanka. Participants were 141 pregnant women at 18–24 weeks gestation who were followed up until delivery. Maternal dietary intake was assessed using a validated Food Frequency Questionnaire at 21.1 ± 1.8 gestational weeks. Gestational weight gain was examined at the end of 28 weeks gestation and at the end of pregnancy. Energy and nutrient intakes were calculated using NutriSurvey 2007 (EBISpro, Willstaett, Germany nutrient analysis software, modified for Sri Lankan foods. The mean total gestational weight gain of women with low carbohydrate intake (229–429 g/day was 2.2 kg less than that of women with moderate carbohydrate intake (430–629 g/day (95% confidence interval (CI 0.428–4.083 kg; p = 0.016. Similarly, babies of women with low carbohydrate intake were 312 g lighter compared with those of women with a moderate carbohydrate intake (95% CI 91–534 g; p = 0.006. Our results suggest that second trimester maternal carbohydrate intake has significant impacts on total gestational weight gain and neonatal birth weight.

  5. Role of Oxidative Stress on Vaginal Bleeding during The First Trimester of Pregnant Women

    Directory of Open Access Journals (Sweden)

    Rüya Deveer

    2014-01-01

    Full Text Available Background: Reactive oxygen species (ROS are produced in many metabolic and physiologic processes. Antioxidative mechanisms remove these harmful species. Our aim was to assess whether serum total antioxidant capacity and total oxidant status altered during first trimester pregnancies with vaginal bleeding. Materials and Methods: In this cross-sectional study, A group of pregnant women at less than 10 weeks of gestation with vaginal bleeding (n=25 and a control group of healthy pregnancies with similar characteristics (n=25 were included. All of the patients in the two groups were matched for age, gestational age and body mass index. Serum total antioxidant capacity and total oxidant status levels were determined using a Hitachi 912 analyzer and compared between the two groups. Results: Characteristics, including maternal age, parity, and gestational age were similar between the two groups. Serum total antioxidant capacity levels were significantly lower in the women with vaginal bleeding than in control women (1.16 ± 0.20 vs. 1.77 ± 0.08 mmol Trolox Equiv./L; p=0.001, whereas higher total oxidant status measurements were found in women with vaginal bleeding compared to the control group (4.01 ± 0.20 vs. 2.57 ± 0.65 μmol H2O2 Equiv./L; p=0.001. Conclusion: Increased total oxidant status might be involved in the pathophysiology of vaginal bleeding during early first trimester pregnancies.

  6. Lower dietary vitamin E intake during the second trimester is associated with insulin resistance and hyperglycemia later in pregnancy.

    Science.gov (United States)

    Ley, S H; Hanley, A J; Sermer, M; Zinman, B; O'Connor, D L

    2013-11-01

    Beneficial effects of vitamin E on insulin sensitivity have been reported in observational and short-term intervention studies in non-pregnant populations. We aimed to investigate whether dietary vitamin E intake during the second trimester would be associated with glucose metabolism later in pregnancy and whether this association would be influenced by an insulin-sensitizing hormone adiponectin. Women with singleton pregnancies (n=205) underwent a 3-h oral glucose tolerance test at 30 weeks gestation and were asked to recall second trimester dietary intake. Higher dietary vitamin E intake was associated with lower fasting glucose, lower HOMA insulin resistance, and higher Matsuda insulin sensitivity index after covariate adjustment including serum adiponectin among women consuming daily multivitamin supplements (all P≤0.03). Lower dietary vitamin E intake during the second trimester is associated with hyperglycemia and insulin resistance later in pregnancy among women consuming daily multivitamin supplementations. Further, these associations are not influenced by adiponectin.

  7. [Anaesthetic management of patients in the third trimester of pregnancy undergoing urgent laparoscopic surgery. Experience in a general hospital].

    Science.gov (United States)

    López-Collada Estrada, María; Olvera Martínez, Rosalba

    2016-01-01

    Laparoscopic surgery is well accepted as a safe technique when performed on a third trimester pregnant woman. The aim is to describe the anaesthetic management of a group of patients undergoing this type of surgery. An analysis was made of records of 6 patients in their third trimester of pregnancy and who underwent urgent laparoscopic surgery from 2011 to 2013. The study included 6 patients, with a diagnosis of acute cholecystitis in 4 of them. The other 2 patients had acute appendicitis, both of who presented threatened preterm labour. The most frequent indications for laparoscopic surgery during the last trimester of birth were found to be acute cholecystitis and acute appendicitis. Acute appendicitis is related to an elevated risk of presenting threatened preterm labour. Copyright © 2015 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  8. Comparison of placental three-dimensional power Doppler indices and volume in the first and second trimesters of pregnancy complicated by gestational diabetes mellitus.

    Science.gov (United States)

    Wong, Chian-Huey; Chen, Chie-Pein; Sun, Fang-Ju; Chen, Chen-Yu

    2018-05-01

    To compare the changes of placental three-dimensional power Doppler indices and volume in the first and second trimesters of pregnancy with gestational diabetes mellitus (GDM). This was a prospective case-control study of singleton pregnancies with risk factors for GDM. Data on placental vascular indices including vascularization index (VI), flow index (FI), and vascularization flow index (VFI), as well as placental volume were obtained and analyzed during the first and second trimesters between pregnant women with and without GDM. Of the 155 pregnant women enrolled, 31 developed GDM and 124 did not. VI and VFI were significantly lower in the GDM group during the first and second trimesters (VI: p = 0.023, and VFI: p = 0.014 in the first trimester; VI: p = 0.049, and VFI: p = 0.031 in the second trimester). However, the placental volume was similar in both groups during the first trimester, while it was significantly increased in the GDM group during the second trimester (p = 0.022). There were no significant differences in FI and uterine artery pulsatility index between the two groups. After adjustments in multivariate logistic regression analysis, significant differences were observed in the first trimester VFI (adjusted odds ratio (OR) 0.76, 95% confidence interval (CI) 0.61-0.93), second trimester VFI (adjusted or 0.83, 95% CI 0.71-0.96), and second trimester placental volume (adjusted or 1.03, 95% CI 1.01-1.05). Placental vascular indices can provide an insight into placental vascularization in GDM during early pregnancy. VFI rather than placental volume may be a sensitive sonographic marker in the first trimester of GDM placentas.

  9. Determinants of first and second trimester induced abortion - results from a cross-sectional study taken place 7 years after abortion law revisions in Ethiopia.

    Science.gov (United States)

    Bonnen, Kristine Ivalu; Tuijje, Dereje Negussie; Rasch, Vibeke

    2014-12-19

    In 2005 Ethiopia took the important step to protect women's reproductive health by liberalizing the abortion law. As a result women were given access to safe pregnancy termination in first and second trimester. This study aims to describe socio-economic characteristics and contraceptive experience among women seeking abortion in Jimma, Ethiopia and to describe determinants of second trimester abortion. A cross-sectional study conducted October 2011 - April 2012 in Jimma Town, Ethiopia among women having safely induced abortion and women having unsafely induced abortion. In all 808 safe abortion cases and 21 unsafe abortion cases were included in the study. Of the 829 abortions, 729 were first trimester and 100 were second trimester abortions. Bivariate and multivariate logistic regressions were used to determine risk factors associated with second trimester abortion. The associations are presented as odds ratios (OR) with 95% confidential intervals. Age stratified analyses of contraceptive experience among women with first and second trimester abortions are also presented. Socio-economic characteristics associated with increased ORs of second trimester abortion were: age abortion where only 15% and 19% stated they had ever used contraception. Young age, poor education and the prospect of single parenthood were associated with second trimester abortion. Young girls and young women were using contraception comparatively less often than older women. To ensure women full right to control their fertility in the setting studied, modern contraception should be made available, accessible and affordable for all women, regardless of age.

  10. Changes in circulating level of IGF-I and IGF-binding protein-1 from the first to second trimester as predictors of preeclampsia

    DEFF Research Database (Denmark)

    Vatten, Lars J; Nilsen, Tom I L; Juul, Anders

    2008-01-01

    To assess whether circulating IGF-I and IGF-binding protein-1 (IGFBP-1) in the first and second trimester are associated with subsequent risk of preterm and term preeclampsia.......To assess whether circulating IGF-I and IGF-binding protein-1 (IGFBP-1) in the first and second trimester are associated with subsequent risk of preterm and term preeclampsia....

  11. Exposure to candesartan during the first trimester of pregnancy in type 1 diabetes: experience from the placebo-controlled diabetic retinopathy candesartan trials

    DEFF Research Database (Denmark)

    Porta, M; Hainer, J W; Jansson, S-O

    2011-01-01

    AIMS/HYPOTHESIS: The teratogenic consequences of angiotensin-converting enzyme inhibitors angiotensin receptor blockers (ARBs) during the second and third trimesters of pregnancy are well described. However, the consequences of exposure during the first trimester are unclear, especially in diabet...

  12. Foveal and parafoveal retinal thickness in healthy pregnant women in their last trimester

    Directory of Open Access Journals (Sweden)

    Demir M

    2011-09-01

    Full Text Available Mehmet Demir, Ersin Oba, Efe Can, Mahmut Odabasi, Semra Tiryaki, Erhan Ozdal, Hakan SensozEye Clinic, Sisli Etfal Training and Research Hospital, Istanbul, TurkeyPurpose: The inspection of foveal and parafoveal thickness in healthy pregnant women in the last trimester.Materials and methods: This study included 40 healthy pregnant women in their last trimester (study group: 40 women, 80 eyes and 37 nonpregnant women (control group: 37 women, 74 eyes. Visual acuity, intraocular pressure, slit lamp examination of anterior and posterior segments, and visual field examination with automated perimetry were performed in both groups. Foveal and parafoveal thickness in the four quadrants (upper, nasal, temporal, and inferior parafoveal and peripapillary retinal nerve fiber layer were measured by optical coherence tomography. There were no systemic or ocular problems in either group. Findings were analyzed with statistical software. A P value <0.05 was considered statistically significant.Results: Mean foveal and parafoveal thicknesses in the study group were: foveal 236.12 ± 27.28 µm, upper quadrant 321.31 ± 12.28 µm, temporal quadrant 307.0 ± 12.05 µm, inferior quadrant 317.0 ± 10.58 µm, and nasal quadrant 313.62 ± 14.51 µm. Mean foveal and parafoveal thicknesses in the control group were: foveal 224.62 ± 21.19 µm, upper quadrant 311.62 ± 12.71 µm, temporal quadrant 296.87 ± 13.78 µm, inferior quadrant 305.43 ± 13.25 µm, and nasal quadrant 304.93 ± 13.44 µm. Mean retinal nerve fiber layer thicknesses in the study and control group were 110 ± 12.4 µm and 108 ± 13.1 µm, respectively.Conclusion: Mean retinal thickness in pregnant women was higher than control group in all measurements. Statistically significant difference in thickness was only found in upper, temporal, and inferior parafoveal areas.Keywords: pregnancy, last trimester, foveal and parafoveal thickness, optical coherence tomography

  13. An economic evaluation of second-trimester genetic ultrasonography for prenatal detection of down syndrome.

    Science.gov (United States)

    Vintzileos, A M; Ananth, C V; Fisher, A J; Smulian, J C; Day-Salvatore, D; Beazoglou, T; Knuppel, R A

    1998-11-01

    The objective of this study was to perform an economic evaluation of second-trimester genetic ultrasonography for prenatal detection of Down syndrome. More specifically, we sought to determine the following: (1) the diagnostic accuracy requirements (from the cost-benefit point of view) of genetic ultrasonography versus genetic amniocentesis for women at increased risk for fetal Down syndrome and (2) the possible economic impact of second-trimester genetic ultrasonography for the US population on the basis of the ultrasonographic accuracies reported in previously published studies. A cost-benefit equation was developed from the hypothesis that the cost of universal genetic amniocentesis of patients at increased risk for carrying a fetus with Down syndrome should be at least equal to the cost of universal genetic ultrasonography with amniocentesis used only for those with abnormal ultrasonographic results. The main components of the equation included the diagnostic accuracy of genetic ultrasonography (sensitivity and specificity for detecting Down syndrome), the costs of the amniocentesis package and genetic ultrasonography, and the lifetime cost of Down syndrome cases not detected by the genetic ultrasonography. After appropriate manipulation of the equation a graph was constructed, representing the balance between sensitivity and false-positive rate of genetic ultrasonography; this was used to examine the accuracy of previously published studies from the cost-benefit point of view. Sensitivity analyses included individual risks for Down syndrome ranging from 1:261 (risk of a 35-year-old at 18 weeks' gestation) to 1:44 (risk of a 44-year-old at 18 weeks' gestation). This economic evaluation was conducted from the societal perspective. Genetic ultrasonography was found to be economically beneficial only if the overall sensitivity for detecting Down syndrome was >74%. Even then, the cost-benefit ratio depended on the corresponding false-positive rate. Of the 7

  14. Transvaginal ultrasonography in first trimester of pregnancy and its comparison with transabdominal ultrasonography

    Directory of Open Access Journals (Sweden)

    Aneet Kaur

    2011-01-01

    Full Text Available Objectives : Examination of pregnant women in the first trimester with transvaginal ultrasonography with the aim to study various fetal development markers, e.g., gestation sac, yolk sac, fetal heart motion, CRL length, and fetal anatomy in both normal and abnormal pregnancies. Comparative evaluation of transvaginal ultrasonography vis-ΰ-vis transabdominal scanning in the study of first trimester of pregnancy and its complications. To assess the relative merits and demerits of transvaginal ultrasonography in comparison with the transabdominal technique. Materials and Methods : The study will be conducted on 50 females patients during the first trimester of pregnancy. The study population will consist of both normal and abnormal pregnancies. These patients will be included on the basis of suspicion of or proven pregnancy of duration up to 12 weeks from LMP. The evaluation of the patients will include the following: Record of patients obstetrical history and clinical examination, record of pregnancy test and relevant investigations, ultrasonic examination of pregnancy. (a Transabdominal ultrasound scanning will be done with moderately distended bladder by using real time scanners with low frequency probe (3/3.5 MHz; (b transvaginal sonography will be done with the real-time sector scanner using high-frequency endovaginal probe (5/7.5 MHz, after the patient voids urine. Relevant images will be taken by using the multiformat automatic camera. Results and Conclusions : In the study of 46 normal intrauterine pregnancies, TVS showed additional information in 36 patients (78.3% as compared to TAS, in detection of gestation sac, yolk sac, double bleb sign, or better visualization of embryonic anatomy. In the abnormal pregnancy (n=17, TVS provided more information in 11 cases (64.9%, which included detection of embryonic demise, yolk sac, double bleb sign, or subchorionic hemorrhage. Regarding ectopic gestations (n=7, TVS gave additional information in 5

  15. Elevated second-trimester serum homocyst(e)ine levels and subsequent risk of preeclampsia.

    Science.gov (United States)

    Sorensen, T K; Malinow, M R; Williams, M A; King, I B; Luthy, D A

    1999-01-01

    Elevated plasma homocyst(e)ine is a risk factor for endothelial dysfunction and vascular disease. In late gestation, levels of homocyst(e)ine are higher in preeclamptics, as compared with normotensive pregnant women. Our objective was to determine whether homocyst(e)ine elevations precede the development of preeclampsia. We used a prospective nested case-control study design to compare second trimester maternal serum homocyst(e)ine concentrations in 52 patients who developed preeclampsia (pregnancy-induced hypertension with proteinuria) compared with 56 women who remained normotensive throughout pregnancy. Study subjects were selected from a base population of 3, 042 women who provided blood samples at an average gestational age of 16 weeks and later delivered at our center. Serum homocyst(e)ine was measured by high-performance liquid chromatography and electrochemical detection. Approximately 29% of preeclamptics, as compared to 13% of controls had homocyst(e)ine levels >/=5.5 micromol/l (upper decile of distribution of control values). Adjusted for maternal age, parity, and body mass-index, a second trimester elevation of homocyst(e)ine was associated with a 3. 2-fold increased risk of preeclampsia (adjusted OR = 3.2; 95% CI 1. 1-9.2; p = 0.030). There was evidence of a interaction between maternal adiposity (as indicated by her prepregnancy body mass index) and parity with second trimester elevations in serum homocyst(e)ine. Nulliparous women with elevated homocyst(e)ine levels experienced a 9.7-fold increased risk of preeclampsia as compared with multiparous women without homocyst(e)ine elevations (95% CI 2.1-14.1; p = 0.003). Women with a higher prepregnancy body mass index (>/=21.4 kg/m(2), or upper 50th percentile) and who also had elevated homocyst(e)ine levels, as compared with leaner women without homocyst(e)ine elevations were 6.9 times more likely to later develop preeclampsia (95% CI 1.4-32.1; p = 0.016). Our findings are consistent with other

  16. Determinants of first and second trimester induced abortion - results from a cross-sectional study taken place 7 years after abortion law revisions in Ethiopia

    DEFF Research Database (Denmark)

    Bonnen, Kristine Ivalu; Tuijje, Dereje Negussie; Rasch, Vibeke

    2014-01-01

    BACKGROUND: In 2005 Ethiopia took the important step to protect women's reproductive health by liberalizing the abortion law. As a result women were given access to safe pregnancy termination in first and second trimester. This study aims to describe socio-economic characteristics and contraceptive...... experience among women seeking abortion in Jimma, Ethiopia and to describe determinants of second trimester abortion. METHODS: A cross-sectional study conducted October 2011 - April 2012 in Jimma Town, Ethiopia among women having safely induced abortion and women having unsafely induced abortion. In all 808...... safe abortion cases and 21 unsafe abortion cases were included in the study. Of the 829 abortions, 729 were first trimester and 100 were second trimester abortions. Bivariate and multivariate logistic regressions were used to determine risk factors associated with second trimester abortion...

  17. 1st and 2nd Trimester Headsize in Fetuses with Congenital Heart Disease: A Cohort Study

    DEFF Research Database (Denmark)

    Lauridsen, Mette Høj; Petersen, Olav Bjørn; Vestergaard, Else Marie

    2014-01-01

    and screening for fetal malformations is carried out. Our cohort includes all fetuses in Western Denmark (2.9 million inhabitants) screened in between January 1st 2012 and December 31st 2013, diagnosed with any structural, non-syndromic congenital heart disease either during pregnancy or up to 6 months after......Background: Congenital heart disease (CHD) is associated with neuro-developmental disorders. The influence of CHD on the brain may be present in the fetus. We hypothesize that fetal cerebral growth is impaired as early as 2nd trimester. Aim: To investigate if fetal cerebral growth is associated...... birth. Results 276 fetuses with CHD were identified. 114 (41%) were genetically screened primarily by chromosomal microarray analysis (n=82). Fetuses with identified chromosomal abnormalities were excluded as were multiple gestation fetuses and fetuses with major extra cardiac malformations. Data from...

  18. A prospective self-controlled study of fertility after second-trimester prostaglandin-induced abortion.

    Science.gov (United States)

    MacKenzie, I Z; Fry, A

    1988-05-01

    One hundred forty women whose pregnancies were terminated in the second trimester with prostaglandins because of suspected fetal disease have been prospectively followed to assess their subsequent fertility. In six instances difficulties had been experienced in conceiving the pregnancy that was terminated. Since abortion 104 women have conceived, 97% within 24 months of abortion but in five instances after some delay. Only one woman had not succeeded in conceiving a wished-for pregnancy. There were no apparent differences in abortion management between those women readily conceiving and those in whom there was some delay, although termination because of chromosomal reasons or anatomic abnormalities was less commonly followed by another pregnancy as compared with those terminated for rubella or other viral infections. Reduced fertility after a late prostaglandin-induced abortion thus appears to be very infrequent.

  19. Gastroschisis, destructive brain lesions, and placental infarction in the second trimester suggest a vascular pathogenesis.

    Science.gov (United States)

    Folkerth, Rebecca D; Habbe, Donald M; Boyd, Theonia K; McMillan, Kristin; Gromer, Jessica; Sens, Mary Ann; Elliott, Amy J

    2013-01-01

    The cause and pathogenesis of gastroschisis are uncertain. We report the autopsy and placental pathology of a stillbirth at 20 gestational weeks, in which gastroschisis was accompanied by destructive lesions in the cerebral cortex and brainstem, as well as cardiac calcification, consistent with ischemic injury during the 2nd trimester. An important potential underlying mechanism explaining the fetal abnormalities is the presence of infarcts in the placenta, indicative at this gestational age of maternal vascular underperfusion. The association of gastroschisis with ischemic lesions in the brain, heart, and placenta in this case supports the concept that gastroschisis, at least in some instances, may result from vascular event(s) causing disruption of the fetal abdominal wall and resulting in the extrusion of the abdominal organs, as well as hypoxic-ischemic brain and cardiac injury.

  20. Correlation between prenatal diagnosis by ultrasound and fetal autopsy findings in second-trimester abortions

    DEFF Research Database (Denmark)

    Hauerberg, Laura; Skibsted, Lillian; Graem, Niels

    2012-01-01

    We evaluated the correlation between prenatal diagnosis by ultrasound and autopsy findings, based on 52 second-trimester pregnancies terminated due to fetal malformations or chromosome aberrations diagnosed at a gestational age of 12-25 weeks. In 24 pregnancies, there was full agreement between...... ultrasound and autopsy. In 23 fetuses, the main diagnosis was confirmed and additional or more specific findings were observed on autopsy. In five fetuses, there were considerable differences. Discrepancies between ultrasound and autopsy findings were mainly anomalies undetectable by ultrasound and thus...... expected; however, about one-third of the discrepancies were not expected, representing findings that were 'missed' at ultrasound. The main ultrasound diagnoses were confirmed in the majority of the pregnancies, but the additional information obtained at autopsy in more than half of the fetuses clearly...

  1. Intrauterine adhesions as a risk factor for failed first-trimester pregnancy termination.

    Science.gov (United States)

    Luk, Janelle; Allen, Rebecca H; Schantz-Dunn, Julianna; Goldberg, Alisa B

    2007-10-01

    Risk factors for failed first-trimester surgical abortion include endometrial distortion caused by leiomyomas, uterine anomalies and malposition and cervical stenosis. This report introduces intrauterine adhesions as an additional risk factor. A multiparous woman presented for pregnancy termination at 6 weeks' gestation. Three suction-curettage attempts failed to remove what appeared to be an intrauterine pregnancy. Rising beta-hCG levels and concern for an interstitial ectopic pregnancy prompted a diagnostic laparoscopy and exploratory laparotomy without the identification of an ectopic pregnancy. After methotrexate treatment failed, the patient underwent ultrasound-guided hysteroscopy and suction curettage using a cannula with a whistle-cut aperture for the successful removal of a pregnancy implanted behind intrauterine adhesions. Intrauterine adhesions are a cause of failed surgical abortion. Ultrasound-guided hysteroscopy may be required for diagnosis.

  2. FACTORS LEAD TO DEPRESION DURING ANTENATAL CARE EVERY TRIMESTER OF PREGNANT MOTHER

    Directory of Open Access Journals (Sweden)

    Eddy Surya Kurniawan

    2013-03-01

    Full Text Available The most important factor in reducing maternal and infant mortality rates began during pregnancy. In 2000, one in twenty children die before reaching the age of five years and a mother died of childbirth out of every 325 live births. The death rate in research mainly indicated comparable levels of depression due to stress in pregnant women. The occurrence of symptoms of depression during the perinatal period can be easily recognized. Depression during pregnancy is a common mood disorder such as depression that occurs in the laity in general, where the incidence of depression will occur chemical changes in the brain. Each trimester of pregnancy are at risk of psychological disorders respectively. Antenatal care plays a very important for the safety of the mother and fetus, minimizing the risks of pregnancy, and reduce the number of neonatal deaths. Nursing antenatal care should have run in accordance with minimum standards for pregnant women to obtain a safe childbirth and satisfying.

  3. Idiopathic massive fetomaternal hemorrhage in the third trimester of pregnancy causing neonatal death.

    Science.gov (United States)

    Peng, X; Liu, C; Peng, B

    2016-01-01

    Fetomaternal hemorrhage (FMH), which can occur throughout pregnancy, is still a poorly understood clinical condition. It is very difficult to be timely diagnosed and often results in poor pregnancy outcomes. Here the authors reported two rare cases of silent massive FMH of unknown cause in the third trimester of pregnancy, which presented with non-reactive fetal heart rhythm or decreased fetal movement at the very beginning, and resulted in severe fetal anemia and neonatal deaths. A pregnant woman at late pregnancy with a com- plain of unspecific signs such as decreased fetal movement should arouse a high index of clinical suspicion of idiopathic FMH, and an urgent ultrasound or lab tests detecting FMH could be suggested. Considering emergent delivery versus expectantly management will de- pend upon acute or chronic FMH, gestational age, results of fetal testing, availability of experienced personnel, and procedural difficulty.

  4. The transverse technique; a complementary approach to the measurement of first-trimester uterine artery Doppler.

    Science.gov (United States)

    Drouin, Olivier; Johnson, Jo-Ann; Chaemsaithong, Piya; Metcalfe, Amy; Huber, Janie; Schwarzenberger, Jill; Winters, Erin; Stavness, Lesley; Tse, Ada W T; Lu, Jing; Lim, Wan Teng; Leung, Tak Yeung; Bujold, Emmanuel; Sahota, Daljit; Poon, Liona C

    2017-10-04

    The objectives of this study were to 1) define the protocol for the first-trimester assessment of the uterine artery pulsatility index (UtA-PI) using the new transverse technique, 2) evaluate UtA-PI measured by the transverse approach versus that obtained by the conventional sagittal approach, and 3) determine if accelerated onsite training (both methods) of inexperienced sonographers can achieve reproducible UtA-PI measurements compared to that measured by an experienced sonographer. The study consists of 2 parts conducted in 2 centers (Part 1, Calgary, Canada and Part 2, Hong Kong). Part 1 Prospective observational study of women with singleton pregnancies between 11-13+6 weeks' gestation. UtA-PI measurements were performed using the 2 techniques (4 sonographers trained in both methods, 10 cases each) and measurement indices (PI), time required and subjective difficulty to obtain satisfactory measurements were compared. One sample t-test and Wilcoxon rank sign test was used when appropriate. Bland-Altman difference plots were used to assess measurement agreement, and intra-class correlation (ICC) was used to evaluate measurement reliability. A target plot was used to assess measures of central tendency and dispersion. Part 2 One experienced and three inexperienced sonographers prospectively measured the UtA-PI at 11-13+6 weeks' gestation in two groups of women (42 and 35, respectively), with singleton pregnancies using both approaches. Inexperienced sonographers underwent accelerated on-site training by the experienced sonographer. Measurement approach and sonographer order were on a random basis. ICC, Bland-Altman and Passing-Bablok analyses were performed to assess measurement agreement, reliability and effect of accelerated training. Part 1 We observed no difference in the mean time to acquire the measurements (Sagittal: 118 seconds vs Transverse: 106 seconds, p=0.38). The 4 sonographers reported the transverse technique was subjectively easier to perform (p=0

  5. Uterine fibroids at routine second-trimester ultrasound survey and risk of sonographic short cervix.

    Science.gov (United States)

    Blitz, Matthew J; Rochelson, Burton; Augustine, Stephanie; Greenberg, Meir; Sison, Cristina P; Vohra, Nidhi

    2016-11-01

    To determine whether women with sonographically identified uterine fibroids are at higher risk for a short cervix. This retrospective cohort study evaluated all women with singleton gestations who had a routine second-trimester ultrasound at 17-23 weeks gestational age from 2010 to 2013. When fibroids were noted, their presence, number, location and size were recorded. Exclusion criteria included a history of cervical conization or loop electrosurgical excision procedure (LEEP), uterine anomalies, maternal age greater than 40 years, and a previously placed cerclage. The primary variable of interest was short cervix (cervix was increased in women with fibroids (OR 2.29, 95% CI: 1.40, 3.74). The number of fibroids did not affect the frequency of short cervix. Fibroids were significantly associated with preterm delivery (cervix. Fibroids are also associated with several adverse obstetric and neonatal outcomes.

  6. Representing and intervening: 'doing' good care in first trimester prenatal knowledge production and decision-making

    DEFF Research Database (Denmark)

    Schwennesen, Nete; Koch, Lene

    2012-01-01

    This article investigates processes of knowledge production and decision-making in the practice of the first trimester prenatal risk assessment (FTPRA) at an ultrasound clinic in Denmark. On the basis of ethnographic material and interviews with professionals facilitating FTPRAs in Denmark, we draw...... attention to the active engagement of health professionals in this process. Current professional and policy debate over the use of prenatal testing emphasises the need for informed choice making and for services that provide prospective parents with what is referred to as 'non-directive counselling...... of reducing emotional suffering and supporting a pregnant woman's ability to make meaningful choices on the basis of uncertain knowledge. As such, these practices can be seen as representing another (caring) solution to the problem of paternalism and authoritarian power. In opposition to an ethics aiming...

  7. Central pontine myelinolysis presenting as isolated sixth nerve palsy in third trimester of pregnancy

    Directory of Open Access Journals (Sweden)

    Tushar Divakar Gosavi

    2015-01-01

    Full Text Available A 30-year-old primigravida presented with isolated left sixth nerve palsy at 38 weeks gestation. Her MRI showed a lesion consistent with central pontine myelinolysis (CPM. Extensive investigations did not reveal any secondary cause for the CPM. She recovered spontaneously in 2 weeks with complete resolution of her MRI changes. To our knowledge, this is the first report of CPM occurring in third trimester in the absence of identifiable secondary causes and of CPM presenting as an isolated sixth nerve palsy. We discuss the reported causes of CPM in pregnancy, possible pathophysiologic mechanisms involved and the anatomic basis of the unique clinical presentation of sixth nerve palsy in our case.

  8. The HELLP syndrome : Its association with unexplained elevation of MSAFP and MShCG in the second trimester

    NARCIS (Netherlands)

    Morssink, LP; Heringa, MP; Beekhuis, [No Value; DeWolf, BTHM; Mantingh, A

    In this study, we examined the relationship between concentrations of maternal serum alpha-fetoprotein (MSAFP) and maternal serum human chorionic gonadotropin (MShCG) in the second trimester and the 'haemolysis, elevated liver enzymes, low platelet count' (HELLP) syndrome. The concentrations of both

  9. CONCANAVALIN-A VARIANTS OF ALPHA-FETOPROTEIN IN FIRST TRIMESTER FETUSES WITH TRISOMY-21 AND WITH NORMAL KARYOTYPES

    NARCIS (Netherlands)

    LOS, FJ; JANSE, HC; BRANDENBURG, H; DEVRIJ, RW; DEBRUIJN, HWA

    1995-01-01

    Total alpha-fetoprotein (AFP) concentrations and proportions of AFP non-reactive with the lectin concanavalin A (Con A) were studied in extracellular fluid of 22 first-trimester fetuses. Total AFP concentrations were significantly lower in fetuses with Down's syndrome than in those with

  10. MATERNAL SERUM ALPHA-FETOPROTEIN LEVELS AND FETAL-OUTCOME IN EARLY 2ND-TRIMESTER OLIGOHYDRAMNIOS

    NARCIS (Netherlands)

    LOS, FJ; HAGENAARS, AM; MARRINK, J; COHENOVERBEEK, TE; GAILLARD, JLJ; BRANDENBURG, H

    Early second-trimester oligohydramnios was associated with normal maternal serum alpha-fetoprotein (MSAFP) levels in nine out of 26 cases (35 per cent). Congenital malformations of the fetal urinary tract resulting in fetal anuria were present in nine cases; in seven of them, normal MSAFP levels

  11. [Assessment of the sonographer's knowledge on the second trimester ultrasound recommendations of the National Technical Committee of Ultrasound].

    Science.gov (United States)

    Matar, M; Picone, O; Dalmon, C; Ayoubi, J-M

    2013-09-01

    To evaluate the sonographers' knowledge of the National Technical Committee of Ultrasound's recommendations concerning second trimester ultrasound. Anonymous questionnaire was sent by e-mails containing 25 questions about demographic elements, the practice of second trimester ultrasound and the recommendations of the National Technical Committee of Ultrasound about second trimester ultrasound. Six hundred and eighty-four responses were obtained. Six hundred and fifty-three upon 684 (95%) of respondents practice second trimester ultrasound and 635 upon 653 (97%) know about the existence of the report of the National Technical Committee of Ultrasound. The rates of correct answers concerning recommended biometrical images vary between 97% for the biparietal diameter and head circumference, 98% for abdominal circumference and 100% for the femur length. While for morphological images, rates vary between 52% and 100%. A subgroup analysis (whether the respondents have already read the recommendations or not) showed that those who had read the recommendations have significantly better results than those who did not. Those who have already read the recommendations have better knowledge and global knowledge can be improved. National recommendations serve to promote a policy of quality assurance of ultrasound and may be used in medicolegal issues. The societies that make recommendations should more diffuse their work and practitioners should make effort to pursue the continuing medical education and to implement the recommendations. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  12. Real life is different: a qualitative study of why women delay abortion until the second trimester in Vietnam.

    Science.gov (United States)

    Gallo, Maria F; Nghia, Nguyen C

    2007-05-01

    Although legal and safe-induced abortion services are available on request in Vietnam, second-trimester abortion still occurs. Given the increased risks and higher costs associated with later-term abortions, we conducted a qualitative study to understand the determinants of delaying abortion until the second trimester. We used purposive sampling to conduct semi-structured face-to-face interviews with 60 women aged 14-47 receiving an abortion at 13-24 weeks of gestation in 5 health facilities in 3 provinces in Vietnam. We also interviewed 6 providers from the study facilities. Three broad categories for factors influencing delays in obtaining abortions emerged: most women failed to recognize their pregnancy during the first trimester; women described structural barriers to accessing services earlier; and some women either needed time to make a decision or only decided to abort after other events had transpired. A richer understanding of the factors that prevent women from obtaining an abortion during the first trimester could be useful for informing interventions that support women in receiving care earlier during their pregnancies.

  13. First-trimester maternal serum human thyroid-stimulating hormone in chromosomally normal and Down syndrome pregnancies

    NARCIS (Netherlands)

    Pratt, JJ; de Wolf, BTHM; Mantingh, A

    Maternal serum human thyroid-stimulating hormone (TSH) levels were investigated in chromosomally normal and Down syndrome pregnancies to determine whether TSH can be used as a marker for Down syndrome in the first trimester. Measurements were conducted on stored serum samples collected from 23 Down

  14. Intra- and inter-observer reproducibility and generalizability of first trimester uterine artery pulsatility index by transabdominal and transvaginal ultrasound

    NARCIS (Netherlands)

    Marchi, Laura; Zwertbroek, Eva; Snelder, Judith; Kloosterman, Maaike; Bilardo, Caterina Maddalena

    2016-01-01

    Objectives The primary aim of the study was to assess intra-observer and inter-observer reproducibility and generalizability (general reliability) of first trimester Doppler measurements of uterine arteries (UtA) performed both transabdominally (TA) and transvaginally (TV). Secondary aims were to

  15. Third trimester screening for alloimmunisation in Rhc-negative pregnant women : evaluation of the Dutch national screening programme

    NARCIS (Netherlands)

    Slootweg, Y. M.; Koelewijn, J. M.; van Kamp, I. L.; van der Bom, J. G.; Oepkes, D.; de Haas, M.

    ObjectiveTo evaluate the effect of red blood cell (RBC) antibody screening in the 27th week of pregnancy in Rhc-negative women, on detection of alloimmunisation, undetected at first trimester screening (late' alloimmunisation), and subsequent haemolytic disease of the fetus and newborn (HDFN), to

  16. Lokal østrogen-fobehandling reducerer aborttiden ven prostaglandin E1 analog-induceret abort i 2. trimester

    DEFF Research Database (Denmark)

    Petersen, Lone Kjeld; Uldbjerg, N; Allen, J G

    1991-01-01

    Twenty-eight patients (median gestational age 17 weeks) referred for induction of second trimester abortion, were randomized to intracervical preliminary treatment by either 50 mg 17 beta-oestradiol or placebo. Abortion was then induced by 1 mg prostaglandin E1 vagitories. The preliminary treatme...

  17. Maternal Serum Resistin Is Reduced in First Trimester Preeclampsia Pregnancies and Is a Marker of Clinical Severity

    DEFF Research Database (Denmark)

    Christiansen, Michael; Hedley, Paula L; Placing, Sophie

    2015-01-01

    OBJECTIVE: To examine whether resistin levels in first trimester maternal serum are associated with insulin resistance or preeclampsia (PE). METHODS: A case-control study of maternal serum resistin concentration conducted using 285 normal pregnancies and 123 PE pregnancies matched for gestational...

  18. ADAM 12 may be used to reduce the false positive rate of first trimester combined screening for Down syndrome

    DEFF Research Database (Denmark)

    Christiansen, Michael; Pihl, Kasper; Hedley, Paula L.

    2010-01-01

    BACKGROUND: ADAM12 has been shown to be an efficient maternal serum marker for Down syndrome (DS) in the first trimester; but recent studies, using a second generation assay, have not confirmed these findings. We examined the efficiency of a second generation assay for ADAM12. MATERIALS AND METHODS...

  19. Risk of Fetal Loss Associated With Invasive Testing Following Combined First-Trimester Screening for Down Syndrome

    DEFF Research Database (Denmark)

    Wulff, C. B.; Gerds, T. A.; Rode, L.

    2016-01-01

    from being based on maternal age to combined first-trimester screening (cFTS) for trisomy 21. The aim of the study was to assess prospectively the risk of fetal loss associated with CVS and AC after cFTS for Down syndrome. A nationwide population-based study (Danish Fetal Medicine Database, 2008...

  20. Vasculogenesis and Angiogenesis in the First Trimester Human Placenta: An Innovative 3D Study Using an Immersive Virtual Reality System

    NARCIS (Netherlands)

    van Oppenraaij, R. H. F.; Koning, A. H. J.; Lisman, B. A.; Boer, K.; van den Hoff, M. J. B.; van der Spek, P. J.; Steegers, E. A. P.; Exalto, N.

    2009-01-01

    First trimester human villous vascularization is mainly Studied by conventional two-dimensional (213) microscopy. With this (2D) technique it is not possible to observe the spatial arrangement of the haemangioblastic cords and vessels, transition of cords into vessels and the transition of

  1. The experience of amnioinfusion for oligohydramnios during the early second trimester.

    Science.gov (United States)

    Hsu, Tian-Lun; Hsu, Te-Yao; Tsai, Ching-Chang; Ou, Chia-Yu

    2007-12-01

    In the past, oligohydramnios occurring early during the secondary trimester was the reason to terminate the pregnancy because of poor prognosis. Even though amnioinfusion has been reported for improving the prognosis of the infant, it is still not frequently used because of unfavorable results. We present our experience with amnioinfusion for oligohydramnios with or without preterm premature rupture of membranes. A retrospective study was performed from July 2005 to December 2006 in our hospital. Amnioinfusions were performed in pregnant women found with oligohydramnios during their second trimesters. Chromosomal studies were recommended and performed under informed consent. Level II sonography was performed after each amnioinfusion. Magnetic resonance imaging was arranged for those with suggested urinary tract malformations. Seventeen cases were included in our study. No mother was exposed to drugs that have been associated with oligohydramnios. The women received one to six procedures of amnioinfusion separately with a total of 28 procedures. Only one procedure failed. No chromosomal anomalies were found. Fetal anomalies were found after amnioinfusion in five cases. One woman had preterm delivery within 1 week after amnioinfusion. In the four cases of oligohydramnios with rupture of membranes, one case had a healthy full-term baby delivered. In the 13 cases of oligohydramnios without rupture of membranes, there were two preterm infants delivered before 34 weeks of gestation, including pulmonary hypoplasia in one neonate, and three healthy babies delivered after 35 weeks of gestation. Amnioinfusion performed the first time might provide some benefits for those with early-onset oligohydramnios, such as to provide confirmation of rupture of membranes, detailed sonography examination and further counseling. We would recommend that this procedure be considered once for these cases.

  2. Elevated CRP levels during first trimester of pregnancy and subsequent preeclampsia: a prospective study

    Directory of Open Access Journals (Sweden)

    Beigi A

    2008-06-01

    Full Text Available Background: Whatever its etiology, the inflammatory reactions of preeclampsia lead to the activation of endothelium and result in vascular damage. CRP is considered a sensitive index of systemic inflammation, so it is used as predictive factor for disease. This study was carried out to test the screening and predictive abilities of the CRP test in order to detect and diagnose pregnant women prone to preeclampsia prior to the onset of symptoms.Methods: In this prospective cohort study, conducted in Arash Hospital between 2005 and 2006, we determined the CRP levels of 201 pregnant women at 10-16 weeks of pregnancy. Based on exclusion criteria and illness, 31 patients were excluded and 170 patients were followed until the end of their pregnancies.Results: In this study, the mean serum CRP values of those who had preeclamptic and those who had normal pregnancies were compared and the statistical differences were significant: 6.18 mg/L for preeclamptic patients compared with 4.12 mg/L for normal patients (p=0.003. Using a chi-square test, we found that patients whose CRP level was ≥4 were six times more likely to have preeclampsia than those with CRP levels <4 (k=9.4; p=0.002; OR=6.15; 95% CI=0.69-22.28.Conclusion: This study confirms the results of previous reports indicating a significant relationship between rising serum CRP in the first trimester of pregnancy and preeclampsia at third trimester. More studies consisting of other inflammation factors are necessary to find an acceptable and reasonable screening test to diagnose pregnant women who are prone to preeclampsia.

  3. [Could we perform quality second trimester ultrasound among obese pregnant women?].

    Science.gov (United States)

    Fuchs, F; Voulgaropoulos, A; Houllier, M; Senat, M-V

    2013-05-01

    To compare the quality of second trimester ultrasound images and their anatomical quality scores among obese women and those with a normal body mass index (BMI). This prospective study, which took place from 2009 to 2011, included every obese pregnant woman (prepregnancy BMI greater than 30 kg/m(2)) who had an ultrasound examination at 20 to 24 weeks in our hospital and a control group with a normal BMI (20-24.9kg/m(2)) who had the same examination. A single operator evaluated the quality of all images, reviewing the standardized ultrasound planes - three biometric and six anatomical - required by French guidelines and scoring the quality of the six anatomical images. Each image was assessed according to 4-6 criteria, each worth one point. We sought excellent quality, defined as the frequency of maximum points for a given image. The obese group included 223 women and the control group 60. The completion rate for each image was at least 95 % in the control group and 90 % in the obese group, except for diaphragm and right outflow tract images. Overall, the excellence rate varied from 35 % to 92 % in the normal BMI group and 18 % to 58 % in the obese group and was significantly lower in the latter for all images except abdominal circumference (P=0.26) and the spine (P=0.06). Anatomical quality scores were also significantly lower in the obese group (22.3 vs. 27.2 ; P=0.001). Image quality and global anatomical scores in second trimester ultrasound scans were significantly lower among obese than normal-weight women. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  4. First-trimester plasma tocopherols are associated with risk of miscarriage in rural Bangladesh.

    Science.gov (United States)

    Shamim, Abu Ahmed; Schulze, Kerry; Merrill, Rebecca D; Kabir, Alamgir; Christian, Parul; Shaikh, Saijuddin; Wu, Lee; Ali, Hasmot; Labrique, Alain B; Mehra, Sucheta; Klemm, Rolf D W; Rashid, Mahbubur; Sungpuag, Pongtorn; Udomkesmalee, Emorn; West, Keith P

    2015-02-01

    Tocopherols were discovered for their role in animal reproduction, but little is known about the contribution of deficiencies of vitamin E to human pregnancy loss. We sought to determine whether higher first-trimester concentrations of α-tocopherol and γ-tocopherol were associated with reduced odds of miscarriage (pregnancy losses tocopherol (tocopherol (tocopherol distribution in women who did not miscarry). In all women, plasma α- and γ-tocopherol concentrations were low [median (IQR): 10.04 μmol/L (8.07-12.35 μmol/L) and 0.66 μmol/L (0.50-0.95 μmol/L), respectively]. In a logistic regression analysis that was adjusted for cholesterol and the other tocopherol, low α-tocopherol was associated with an OR of 1.83 (95% CI: 1.04, 3.20), whereas a low γ-tocopherol concentration was associated with an OR of 0.62 (95% CI: 0.41, 0.93) for miscarriage. Subgroup analyses revealed that opposing ORs were evident only in women with BMI (in kg/m(2)) ≥18.5 and serum ferritin concentration ≤150 μg/L, although low BMI and elevated ferritin conferred stronger risk of miscarriage. In pregnant women in rural Bangladesh, low plasma α-tocopherol was associated with increased risk of miscarriage, and low γ-tocopherol was associated with decreased risk of miscarriage. Maternal vitamin E status in the first trimester may influence risk of early pregnancy loss. The JiVitA-1 study, from which data for this report were derived, was registered at clinicaltrials.gov as NCT00198822. © 2015 American Society for Nutrition.

  5. OUTCOME OF PREGNANCIES COMPLICATED BY THREATENED ABORTION IN THE SECOND TRIMESTER OF PREGNANCY - PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Rajeswary

    2015-11-01

    Full Text Available AIM: To compare the outcome of pregnancies complicated by bleeding per vaginum between 14- 20 weeks with those not complicated by bleeding per vaginum before 20 weeks. To evaluate the potential determinants of outcome such as gestational age at bleeding, number of bleeding episodes, extent of placental separation or sub chorionic bleed, incidence of complications as placenta previa, abruptio placenta, development of gestational hypertension and pre eclampsia, intra uterine growth restriction, and neonatal outcomes as birth weight, mode of delivery, neonatal ICU admission, and congenital anomalies. SETTINGS AND DESIGN: This was a prospective, comparative study, for a duration of one year. STUDY POPULATION: Cases- 100 women admitted in IMCH with first episode of bleeding per vaginum between 14- 20 weeks and continuing their pregnancy after 20 weeks. CONTROLS: 200 uncomplicated pregnancies attending antenatal outpatient clinic which were followed up till delivery. EXCLUSION CRITERIA: 1. Women with history of threatened abortion in first trimester were not included in the study. 2. Subjects age more than 35 years. 3. Previous history of abortion. 4. Any significant medical, surgical or gynecological history. RESULTS: When patients who presented with bleeding pv after completion of 1st trimester were analyzed by USS, a significant number of them had evidence of sub chorionic bleed, heavier the bleed, more the likelihood of presence of sub placental hematoma. There was no significant difference in prevalence of development of hypertensive disorders of pregnancy in both study groups. There was no significant rise in ante partum hemorrhage between cases and controls. Incidence of IUGR, PPROM, PRE TERM LABOR was significantly increased in study group. LSCS rate was not significantly different in both groups. In this study, there was no significant difference in incidence of congenital anomalies in both groups. STUDY AREA: Tertiary health center

  6. Prospective Fathers: Psychosocial Adaptation and Involvement in the Last Trimester of Pregnancy.

    Science.gov (United States)

    Kuljanić, Karin; Dorčić, Tamara Martinac; Bistrović, Ivana Ljubičić; Brnčić-Fischer, Alemka

    2016-12-01

    Paternal involvement in pregnancy has been recognized to have an impact on new-born's outcomes and only recently got under the spot light of mental health perspective. The aim of this study was to test differences in paternal involvement in pregnancy, perceived stress and relationship quality regarding complications in pregnancy and pregnancy duration (gestational weeks) in the last trimester of pregnancy. The role of personality traits (neuroticism and extroversion), relationship quality satisfaction and perceived stress in prospective father's perception of pregnancy involvement were examined. One-hundred forty-three primiparus couples in the last trimester of their pregnancy participated in the study. Prospective fathers completed a booklet with questionnaires including The Quality of Marriage Index, The Perceived Stress Scale, Eysenck Personality Questionnaire and Partner's Involvement in Pregnancy Scale. Prospective mothers completed only Eysenck Personality Questionnaire and questions on pregnancy complications and demographics. The prospective fathers showed high involvement in their partner's pregnancies, elevated levels of perceived stress and high relationship quality. There were found no differences in the above named variables regarding complications in pregnancy and pregnancy duration. Higher involvement of prospective fathers was related with older age, lower male neuroticism and higher female extroversion, better relationship quality and lower perceived stress. The findings demonstrate that prospective father's involvement in pregnancy is supported with psychological factors, namely personality traits, quality of relationship and perceived stress. These results should lead to target interventions that can modify and improve fathers' involvement perspective and promoting a couples mental health during pregnancy: thus clinically important for promotion of healthy prenatal behaviour and decrease in mothers' emotional distress.

  7. Experiences, feelings and thoughts of women undergoing second trimester medical termination of pregnancy.

    Science.gov (United States)

    Andersson, Inga-Maj; Christensson, Kyllike; Gemzell-Danielsson, Kristina

    2014-01-01

    The objective of this study was to explore women's expectations and experiences of undergoing second trimester abortion. This is a cross-sectional study using a screening questionnaire and semi-structured interviews for data collection. Thirty-one women filled out the questionnaire and 23 of them were later interviewed. The questionnaires were analyzed by descriptive statistics. The interviews were recorded, transcribed verbatim and analyzed with qualitative content analysis. Indications for the abortion were fetal malformation or unintended pregnancy. The women expressed similar feelings and these were irrespective for the reason for having an abortion. Both physical and mental pain was experienced during the abortion process and described by the women. Taking the mifepristone-pill was experienced as especially emotionally difficult for many participants. Professional support from the staff together with support from the partner, a friend or relative helped in transforming the worries related to something unknown to feelings of coping with a new and hard experience. Prior to the abortion most women stated that they did not want to view the fetus but women who chose to view the fetus described this as a way of confronting the reality and an opportunity to say farewell to the pregnancy/fetus. The analysis of the interview transcripts revealed five themes mirroring the women's experiences, thoughts and feelings related to the abortion. The decision to undergo second trimester abortion sometimes exposes women to strong and conflicting emotions which are irrespective for the reason for having an abortion. Despite this women do not regret their decision to terminate the pregnancy. This analysis shows that their rational thinking outweighs their emotionally difficult feelings. It is important for the attending staff to be responsive to the needs of each individual woman whatever the indication is for the abortion.

  8. CLASSICAL MUSIC DECREASE STRESS LEVEL AND BLOOD PRESSURE PRIMIGRAVIDA IN THE THIRD TRIMESTER

    Directory of Open Access Journals (Sweden)

    Ni Ketut Alit Armini

    2017-07-01

    Full Text Available Introduction: Many changes in psychology and biology increase primigravida’s stress in the third trimester. The stress response makes blood pressure being unstable, it causes bad effect for pregnancy. Classical music can be used as one of relaxation facilities that can reduce stress. The aimed of this study were to analyze the effect of classical music on stress level and blood pressure. Method: This study was used a quasy experimental purposive sampling design. The sample in this study were 14 pregnancy women in the third trimester in RSIA Cempaka Putih Permata Surabaya. The independent variable in this study was classical music and the dependent variable were stress level and blood pressure. Data were analyzed by Wilcoxon Signed Rank Test, Mann Withney U Test, Paired t Test and Independent t Test with significance level α≤0.05. Result: The result showed that the stress level in controlled group with p=0.567 and intervention group with p=0.025. The result of blood pressure in controlled group with p=0.522 in systolic blood pressure, p=0.35 in diastolic blood pressure and intervention group showed p=0.103 in systolic blood pressure and p=1.00 in diastolic blood pressure. Discussion: It can be concluded that listening classical music can reduce stress level, stabilize blood pressure, although blood pressure hasn’t significant result but mean of blood pressure show that it was stable. Further studies should be considered to used cortisol to identify stress biology response spesifically.

  9. Experiences, feelings and thoughts of women undergoing second trimester medical termination of pregnancy.

    Directory of Open Access Journals (Sweden)

    Inga-Maj Andersson

    Full Text Available MAIN OBJECTIVE: The objective of this study was to explore women's expectations and experiences of undergoing second trimester abortion. METHODS: This is a cross-sectional study using a screening questionnaire and semi-structured interviews for data collection. Thirty-one women filled out the questionnaire and 23 of them were later interviewed. The questionnaires were analyzed by descriptive statistics. The interviews were recorded, transcribed verbatim and analyzed with qualitative content analysis. MOST IMPORTANT FINDINGS: Indications for the abortion were fetal malformation or unintended pregnancy. The women expressed similar feelings and these were irrespective for the reason for having an abortion. Both physical and mental pain was experienced during the abortion process and described by the women. Taking the mifepristone-pill was experienced as especially emotionally difficult for many participants. Professional support from the staff together with support from the partner, a friend or relative helped in transforming the worries related to something unknown to feelings of coping with a new and hard experience. Prior to the abortion most women stated that they did not want to view the fetus but women who chose to view the fetus described this as a way of confronting the reality and an opportunity to say farewell to the pregnancy/fetus. The analysis of the interview transcripts revealed five themes mirroring the women's experiences, thoughts and feelings related to the abortion. CONCLUSIONS: The decision to undergo second trimester abortion sometimes exposes women to strong and conflicting emotions which are irrespective for the reason for having an abortion. Despite this women do not regret their decision to terminate the pregnancy. This analysis shows that their rational thinking outweighs their emotionally difficult feelings. It is important for the attending staff to be responsive to the needs of each individual woman whatever the

  10. Relationships of the First Trimester Maternal BMI with New-born Anthropometric Characteristics and Visfatin Levels throughout Pregnancy

    Directory of Open Access Journals (Sweden)

    Tahergorabi Zoya

    2017-08-01

    Full Text Available Background: Birth weight has been shown to be influenced by numerous factors including, maternal characteristics such as maternal BMI. In pregnancy, there is increased adipose tissue which can cause to maternal obesity and insulin resistance. There is visfatin expression increase specific to pregnancy. Aim: We planned this study to assess relationships of the first trimester maternal BMI with new-born anthropometric characteristics and visfatin levels throughout pregnancy. Methods and Material: This longitudinal, observational study on 100 nulliparous pregnant women carried out in Birjand, Iran, over three trimesters in 2016. The researcher asked the participants to fill out the Researcher-made questionnaire including demographic and anthropometric characteristics including first trimester BMI and then referred them to laboratory to serum sample taking from mothers and visfatin levels measurement in the three trimesters. Neonate’s anthropometric measures (weight, height, head circumference and sex of new-borns were obtained from hospital reports. Results: Pearson correlation test indicated significant correlation between birth weight and the first trimester maternal BMI (r= 0.27, P=0.02. Also, Spearman’s correlation test showed a weak negative correlation between head circumference with mean visfatin level (r= -0.23, P=0.04. Linear regression showed that birth weight predicts 28% of variation of BMI. Also, there was significant difference between the maternal level of education and the mean of birth weight (P=0.027. Conclusions: Results of the present study showed that the mean of birth weight was comparable with capital cities in Iran, it is necessary to strengthen the existing mother and child health care program and to develop new approaches.

  11. Serum alpha-fetoprotein in the three trimesters of pregnancy: effects of maternal characteristics and medical history.

    Science.gov (United States)

    Bredaki, F E; Sciorio, C; Wright, A; Wright, D; Nicolaides, K H

    2015-07-01

    To define the contribution of maternal variables which influence the measured level of maternal serum alpha-fetoprotein (AFP) in screening for pregnancy complications. Maternal characteristics and medical history were recorded and serum AFP was measured in women with a singleton pregnancy attending for three routine hospital visits at 11 + 0 to 13 + 6, 19 + 0 to 24 + 6 and 30 + 0 to 34 + 6 weeks' gestation. For pregnancies delivering phenotypically normal live births or stillbirths ≥ 24 weeks' gestation, variables from maternal demographic characteristics and medical history that are important in the prediction of AFP were determined from a linear mixed-effects multiple regression. Serum AFP was measured in 17 071 cases in the first trimester, 8583 in the second trimester and 8607 in the third trimester. Significant independent contributions to serum AFP were provided by gestational age, maternal weight, racial origin, gestational age at delivery and birth-weight Z-score of the neonate of the previous pregnancy and interpregnancy interval. Cigarette smoking was found to significantly affect serum AFP in the first trimester only. The machine used to measure serum AFP was also found to have a significant effect. Random-effects multiple regression analysis was used to define the contribution of maternal variables that influence the measured level of serum AFP and express the values as multiples of the median (MoMs). The model was shown to provide an adequate fit of MoM values for all covariates, both in pregnancies that developed pre-eclampsia and in those without this pregnancy complication. A model was fitted to express measured serum AFP across the three trimesters of pregnancy as MoMs, after adjusting for variables from maternal characteristics and medical history that affect this measurement. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

  12. Severe hemolytic disease of fetus and newborn caused by red blood cell antibodies undetected at first-trimester screening (CME).

    Science.gov (United States)

    Dajak, Slavica; Stefanović, Vedran; Capkun, Vesna

    2011-07-01

    The objective was to determine clinical consequences of anti-D and non-D antibodies undetected at first-trimester screening for infant or fetus. This retrospective cohort study included all pregnant women with red blood cell (RBC) antibodies who were tested between 1993 and 2008. Data were obtained from the forms for tracking immunization at the transfusion department. Each form was analyzed for three data sets: the order of screening at which the antibodies were detected (initial or repeated screening), the order of pregnancy (first pregnancy or higher), and whether the antibodies caused severe hemolytic disease of fetus and newborn (HDFN). In D- women, anti-D was detected in 1.3% of cases. The anti-D was undetected in 72 (37%) cases on the first-trimester screening, of which eight cases were complicated by severe HDFN. In this group, three patients were primigravidae. An overall non-D incidence of 0.2% was observed. In 16 cases, non-D were undetected on the first-trimester screening (10 anti-c, two anti-E, two anti-C, one anti-S, and one case of anti-Rh17). Non-D antibodies undetected on initial screening caused 11 cases of severe HDFN (27% of all severe non-D HDFN). Ten of them were in multiparous women. Seven of 11 cases with severe HDFN that were missed were caused by anti-c. The third-trimester screening may detect RBC antibodies that were not present or detected on the first-trimester screening. Such screening may be especially relevant in D+ multiparous women due to the risk of HDFN. © 2010 American Association of Blood Banks.

  13. Comparison of two immunoassay systems for hCGβ and PAPP-A in prenatal screening for trisomy 21, 18, and 13 in the first trimester

    DEFF Research Database (Denmark)

    Engell, Anna Elise; Carlsson, Elin Rebecka; Jørgensen, Finn Stener

    2017-01-01

    OBJECTIVES: The biochemical serum markers free β-human chorionic gonadotropin (hCGβ) and pregnancy associated plasma protein A (PAPP-A), used in screening for trisomy 21 (T21), trisomy 18 (T18), and trisomy 13 (T13) during the first trimester, can be measured on different laboratory instruments e.......g. Kryptor (Brahms) and Cobas (Roche). We compared the performance of these two analytical instruments when used for first trimester combined testing. DESIGN AND METHODS: Serum samples from 944 singleton pregnant women attending for first trimester combined testing were routinely assayed for hCGβ and PAPP...

  14. Recurrence of second trimester miscarriage and extreme preterm delivery at 16 to 27 weeks of gestation with a focus on cervical insufficiency and prophylactic cerclage

    DEFF Research Database (Denmark)

    Sneider, Kirstine; Christiansen, Ole Bjarne; Sundtoft, Iben Blaabjerg

    2016-01-01

    INTRODUCTION: The objective of this study was to describe recurrence rates of second trimester miscarriage and extreme preterm delivery by phenotype and use of prophylactic cerclage in a register-based cohort. MATERIAL AND METHODS: We included women with a first second trimester miscarriage......, multiple gestation, uterine anomaly, placental insufficiency, antepartum bleeding, cervical insufficiency, preterm premature rupture of membranes, and intrauterine fetal death. Recurrence rate after a second trimester miscarriage/spontaneous delivery in the period was calculated based on the register data....... In cervical insufficiency outcome was stratified by prophylactic cerclage applied Overall recurrence rate was 7.3% (n = 452), a rate that differed by phenotype from

  15. Prognostic value of repeated serum CA 125 measurements in first trimester pregnancy.

    Science.gov (United States)

    Schmidt, T; Rein, D T; Foth, D; Eibach, H W; Kurbacher, C M; Mallmann, P; Römer, T

    2001-08-01

    To assess the diagnostic value of maternal CA 125 in patients with symptomatic first trimester pregnancy and to evaluate the prognostic significance of CA 125 versus beta-hCG in early pregnancies with intact fetal heartbeat, complicated by vaginal bleeding. Two prospective open-label studies with longitudinal follow-up in the second trial. Academic Department of Obstetrics and Gynecology, University of Cologne. Study 1: 168 patients presenting between gestational weeks 6 and 12 with: extrauterine pregnancy, 29; missed abortion, 50; incomplete spontaneous abortion, 38; imminent abortion, 33; and normal pregnancy (no history of endometriosis or ovarian mass), 18. Study 2: Fifty consecutive patients with vaginal bleeding during gestational weeks 6-12 all of whom having demostrable fetal heartbeat. Eighteen patients finally aborted whereas the remainder had normally continuing pregnancy until term. Study 1: Single serum determinations of CA 125 and beta-hCG were correlated with the different disorders observed. Study 2: Two sequential measurements of serum CA 125 and beta-hCG performed within a 5-7 days interval were related to the outcome of pregnancy as indicated by changes of the ultrasound presentation, miscarriage, future hospitalization, or delivery. Study 1: Patients with vaginal bleeding generally had higher median CA 125 values (38 IU/ml; range 1.3-540) compared to non-bleeding patients (17.8 IU/ml; range 1.0-157). No statistically significant differences in regard to median serum CA 125 levels between symptomatic and normal pregnancies occurred: normal pregnancy, 25.5 IU/ml (range 3.2-97); ectopic pregnancy, 26 IU/ml (range 1.3-157); missed abortion, 19.1IU/ml (range 1-242); threatened abortion, 48 IU/ml (range 5.2-540); spontaneous abortion, 40 IU/ml (range 5.4-442). Study 2: Initial CA 125 levels did not differ significantly between both groups of patients with 27/32 non-aborters and 13/18 aborters showing concentrations below 65 IU/ml. After 5-7 days, CA

  16. Performance of third-trimester combined screening model for prediction of adverse perinatal outcome.

    Science.gov (United States)

    Miranda, J; Triunfo, S; Rodriguez-Lopez, M; Sairanen, M; Kouru, H; Parra-Saavedra, M; Crovetto, F; Figueras, F; Crispi, F; Gratacós, E

    2017-09-01

    To explore the potential value of third-trimester combined screening for the prediction of adverse perinatal outcome (APO) in the general population and among small-for-gestational-age (SGA) fetuses. This was a nested case-control study within a prospective cohort of 1590 singleton gestations undergoing third-trimester evaluation (32 + 0 to 36 + 6 weeks' gestation). Maternal baseline characteristics, mean arterial blood pressure, fetoplacental ultrasound and circulating biochemical markers (placental growth factor (PlGF), lipocalin-2, unconjugated estriol and inhibin A) were assessed in all women who subsequently had an APO (n = 148) and in a control group without perinatal complications (n = 902). APO was defined as the occurrence of stillbirth, umbilical artery cord blood pH < 7.15, 5-min Apgar score < 7 or emergency operative delivery for fetal distress. Logistic regression models were developed for the prediction of APO in the general population and among SGA cases (defined as customized birth weight < 10 th centile). The prevalence of APO was 9.3% in the general population and 27.4% among SGA cases. In the general population, a combined screening model including a-priori risk (maternal characteristics), estimated fetal weight (EFW) centile, umbilical artery pulsatility index (UA-PI), estriol and PlGF achieved a detection rate for APO of 26% (area under receiver-operating characteristics curve (AUC), 0.59 (95% CI, 0.54-0.65)), at a 10% false-positive rate (FPR). Among SGA cases, a model including a-priori risk, EFW centile, UA-PI, cerebroplacental ratio, estriol and PlGF predicted 62% of APO (AUC, 0.86 (95% CI, 0.80-0.92)) at a FPR of 10%. The use of fetal ultrasound and maternal biochemical markers at 32-36 weeks provides a poor prediction of APO in the general population. Although it remains limited, the performance of the screening model is improved when applied to fetuses with suboptimal fetal growth. Copyright © 2016 ISUOG. Published by John Wiley & Sons

  17. Thick corpus callosum in the second trimester can be transient and is of uncertain significance.

    Science.gov (United States)

    Shinar, S; Har-Toov, J; Lerman-Sagie, T; Malinger, G

    2016-10-01

    Depiction of a thick corpus callosum (CC) in utero is rare, and is generally associated with severe brain anomalies. Our aim was to describe a group of fetuses diagnosed during second-trimester ultrasound examination as having an apparently isolated thick CC, which normalized subsequently in the cases followed to term. Among 59 fetuses referred to the Ob-Gyn Ultrasound Division of Lis Maternity Hospital with suspected callosal anomalies between January 2013 and June 2014, we identified nine cases with an apparently isolated thick CC for inclusion in this retrospective cohort study. Length and body thickness of the CC were compared with previously published nomograms. Fetuses with a suspected isolated thick CC were identified and followed until delivery or termination of pregnancy (TOP). Evaluation consisted of chromosomal analysis, at least one magnetic resonance imaging (MRI) examination and repeat ultrasound examinations. Postnatal evaluation included brain ultrasound examination, MRI when indicated and neurodevelopmental assessment through validated pediatric questionnaires. The nine fetuses were diagnosed with an apparently isolated thick CC at a mean gestational age of 23 + 5 (range, 21-29) weeks. Eight exhibited a CC body thickness ≥ 2SD above the mean for gestational age and one exhibited only a thickened genu. Six also exhibited a relatively short CC. Two patients opted for TOP but declined autopsy. In five of the seven remaining fetuses, the CC thickness normalized during follow-up. In the remaining two, the increased CC thickness was a variant of the cingulate sulcus. The CC length remained ≤ 2SD in five of the six fetuses with a short CC. Fetal MRI was performed and confirmed the diagnosis in six fetuses. The karyotype was normal in all fetuses. Short-term neurodevelopmental outcome was reported as normal in all six children with complete follow-up. Although the number of fetuses in our study is relatively small, it seems that an apparently

  18. Noise exposure during the first trimester and the risk of gestational diabetes mellitus

    Science.gov (United States)

    Min, Kyoung-Bok; Min, Jin-Young

    2017-07-01

    Gestational diabetes mellitus (GDM) is a form of diabetes that affects pregnant women. GDM tends to resolve after delivery, but has an impact on the health of the mother and her offspring. Considering the potential association between noise and diabetes and the susceptibility of the pregnant state to diabetogenesis, noise pollution may be associated with the risk of GDM; however, there is no evidence of the effect of noise pollution on GDM. In this study, we investigated the association between residential exposure to noise during the first trimester and incidence of GDM using the National Health Insurance Service-National Sample Cohort (NHIS-NSC), a representative sample of South Koreans. We analyzed the National Health Insurance Service-National Sample Cohort (2002-2013), a population-wide health insurance claim data. Study population was a total of 18 165 pregnant women. GDM was defined as ICD-10 code O244, and noise exposure levels were categorized as daytime (07:00-19:00) and nighttime (23:00-7:00). Other known risk factors for GDM were age, income, residential area, physical activity, smoking, drinking, blood sugar levels, and body mass index before getting pregnant. The study population included 18 165 pregnant women, of which 8.8% developed gestational diabetes. After adjustment, the adjusted OR (95% CI) for GDM associated with 1 dB increase in nighttime noise was 1.07 (95% CI: 1.05-1.10). Compared with the reference group (Quartile 1), the adjusted ORs for GDM in those exposed to the highest quartile of noise exposure (Quartile 4) was 1.61 (95% CI: 1.38-1.87) at nighttime noise. However, no significant association was observed between daytime noise exposure (07:00-19:00) and the incidence of GDM. We observed that the odds of gestational diabetes during the first trimester was 1.6 times higher for pregnant women exposed to elevated nighttime noise compared to similar women exposed to normal baseline noise levels in South Korea. Although this finding

  19. Effect of counseling quality on anxiety, grief, and coping after second-trimester abortion for pregnancy complications.

    Science.gov (United States)

    Kerns, Jennifer L; Mengesha, Biftu; McNamara, Blair C; Cassidy, Arianna; Pearlson, Geffan; Kuppermann, Miriam

    2018-06-01

    We sought to explore the relationship between counseling quality, measured by shared decision making and decision satisfaction, and psychological outcomes (anxiety, grief, and posttraumatic stress) after second-trimester abortion for pregnancy complications. We conducted a cross-sectional study of women who underwent second-trimester abortion for complications. We recruited participants from Facebook and online support groups and surveyed them about counseling experiences and psychosocial issues. We used multivariate linear regression to evaluate relationships between counseling quality and psychological outcomes. We analyzed data from 145 respondents. Shared decision making and decision satisfaction scores were positively and strongly correlated in bivariate analysis (r=0.7, pCounseling quality may be especially important in this setting given the sensitive nature of decisions regarding pregnancy termination for complications. These results highlight the importance of patient-centered counseling for women seeking pregnancy termination. Copyright © 2018. Published by Elsevier Inc.

  20. Inflammatory Markers in the Second Trimester Prior to Clinical Onset of Preeclampsia, Intrauterine Growth Restriction, and Spontaneous Preterm Birth

    DEFF Research Database (Denmark)

    Haedersdal, Sofie; Salvig, Jannie Dalby; Aabye, Martine

    2013-01-01

    Low-grade inflammation has been associated with pregnancy complications including preeclampsia (PE), intrauterine growth restriction (IUGR), and spontaneous preterm birth (SPB). In an unmatched, nested case-control study, we assessed the possible predictive association of maternal C-reactive prot......Low-grade inflammation has been associated with pregnancy complications including preeclampsia (PE), intrauterine growth restriction (IUGR), and spontaneous preterm birth (SPB). In an unmatched, nested case-control study, we assessed the possible predictive association of maternal C...... to normotensive healthy pregnant controls (n = 127). We found no statistically significant difference in CRP, IP-10, or suPAR in second trimester plasma samples from pregnant women with later PE, IUGR, and SPB when compared to normotensive healthy controls. Second trimester plasma samples of CRP, IP-10, and su...

  1. First trimester prenatal screening among women pregnant after IVF/ICSI

    DEFF Research Database (Denmark)

    Anne Cathrine, Gjerris; Tabor, Ann; Loft, Anne

    2012-01-01

    BACKGROUND Prenatal screening and diagnosis of chromosomal abnormalities especially Down's syndrome in IVF pregnancies are complicated by higher maternal age, a high multiple pregnancy rate, a high risk of a vanishing twin and an increased risk of chromosomal abnormalities, particularly in pregna......BACKGROUND Prenatal screening and diagnosis of chromosomal abnormalities especially Down's syndrome in IVF pregnancies are complicated by higher maternal age, a high multiple pregnancy rate, a high risk of a vanishing twin and an increased risk of chromosomal abnormalities, particularly...... in pregnancies after ICSI. The aim of the present systematic review was to evaluate the findings of first trimester screening for chromosomal abnormalities in IVF/ICSI singleton and twin pregnancies. METHODS A systematic MESH-term search in MEDLINE using PubMed and the Cochrane Library was performed until May...... 2011, with no earlier date limit. RESULTS The electronic search retrieved 562 citations, 96 of which were evaluated in detail and 57 were then excluded for not meeting the selection criteria. A total of 61 articles were finally selected for review. Our analysis of the data shows that, for IVF...

  2. The first trimester human placenta is a site for terminal maturation of primitive erythroid cells.

    Science.gov (United States)

    Van Handel, Ben; Prashad, Sacha L; Hassanzadeh-Kiabi, Nargess; Huang, Andy; Magnusson, Mattias; Atanassova, Boriana; Chen, Angela; Hamalainen, Eija I; Mikkola, Hanna K A

    2010-10-28

    Embryonic hematopoiesis starts via the generation of primitive red blood cells (RBCs) that satisfy the embryo's immediate oxygen needs. Although primitive RBCs were thought to retain their nuclei, recent studies have shown that primitive RBCs in mice enucleate in the fetal liver. It has been unknown whether human primitive RBCs enucleate, and what hematopoietic site might support this process. Our data indicate that the terminal maturation and enucleation of human primitive RBCs occurs in first trimester placental villi. Extravascular ζ-globin(+) primitive erythroid cells were found in placental villi between 5-7 weeks of development, at which time the frequency of enucleated RBCs was higher in the villous stroma than in circulation. RBC enucleation was further evidenced by the presence of primitive reticulocytes and pyrenocytes (ejected RBC nuclei) in the placenta. Extravascular RBCs were found to associate with placental macrophages, which contained ingested nuclei. Clonogenic macrophage progenitors of fetal origin were present in the chorionic plate of the placenta before the onset of fetoplacental circulation, after which macrophages had migrated to the villi. These findings indicate that placental macrophages may assist the enucleation process of primitive RBCs in placental villi, implying an unexpectedly broad role for the placenta in embryonic hematopoiesis.

  3. Accelerated tibial fracture union in the third trimester of pregnancy: a case report

    Directory of Open Access Journals (Sweden)

    Ahmad Mudussar A

    2008-02-01

    Full Text Available Abstract Introduction We present a case of accelerated tibial fracture union in the third trimester of pregnancy. This is of particular relevance to orthopaedic surgeons, who must be made aware of the potentially accelerated healing response in pregnancy and the requirement for prompt treatment. Case presentation A 40 year old woman at 34 weeks gestational age sustained a displaced fracture of the tibial shaft. This was initially treated conservatively in plaster with view to intra-medullary nailing postpartum. Following an emergency caesarean section, the patient was able to fully weight bear without pain 4 weeks post injury, indicating clinical union. Radiographs demonstrated radiological union with good alignment and abundant callus formation. Fracture union occurred within 4 weeks, less than half the time expected for a conservatively treated tibial shaft fracture. Conclusion Long bone fractures in pregnancy require clear and precise management plans as fracture healing is potentially accelerated. Non-operative treatment is advisable provided satisfactory alignment of the fracture is achieved.

  4. Permissive cytomegalovirus infection of primary villous term and first trimester trophoblasts.

    Science.gov (United States)

    Hemmings, D G; Kilani, R; Nykiforuk, C; Preiksaitis, J; Guilbert, L J

    1998-06-01

    Forty percent of women with primary cytomegalovirus (CMV) infections during pregnancy infect their fetuses with complications for the baby varying from mild to severe. How CMV crosses the syncytiotrophoblast, the barrier between maternal blood and fetal tissue in the villous placenta, is unknown. Virus may cross by infection of maternal cells that pass through physical breaches in the syncytiotrophoblast or by direct infection of the syncytiotrophoblast, with subsequent transmission to underlying fetal placental cells. In this study, we show that pure (>99.99%), long-term and healthy (>3 weeks) cultures of syncytiotrophoblasts are permissively infected with CMV. Greater than 99% of infectious progeny virus remained cell associated throughout culture periods up to 3 weeks. Infection of term trophoblasts required a higher virus inoculum, was less efficient, and progressed more slowly than parallel infections of placental and human embryonic lung fibroblasts. Three laboratory strains (AD169, Towne, and Davis) and a clinical isolate from a congenitally infected infant all permissively infected trophoblasts, although infection efficiencies varied. The infection of first trimester syncytiotrophoblasts with strain AD169 occurred at higher frequency and progressed more rapidly than infection of term cells but less efficiently and rapidly than infection of fibroblasts. These results show that villous syncytiotrophoblasts can be permissively infected by CMV but that the infection requires high virus titers and proceeds slowly and that progeny virus remains predominantly cell associated.

  5. Sleep Hygiene and Sleep Quality of Third-Trimester Pregnant Women.

    Science.gov (United States)

    Tsai, Shao-Yu; Lee, Chien-Nan; Wu, Wei-Wen; Landis, Carol A

    2016-02-01

    The purpose of this descriptive study was to examine the associations of sleep hygiene and actigraphy measures of sleep with self-reported sleep quality in 197 pregnant women in northern Taiwan. Third-trimester pregnant women completed the Sleep Hygiene Practice Scale (SHPS) and the Pittsburgh Sleep Quality Index (PSQI) as well as the Center for Epidemiologic Studies-Depression Scale (CES-D), and wore an actigraph for 7 consecutive days. Student's t-test was used to compare the SHPS scores and means as well as variability of actigraphy sleep variables between poor sleepers (i.e., PSQI global score >5) and good sleepers (i.e., PSQI global score ≤5). Compared to good sleepers, poor sleepers reported significantly worse sleep hygiene, with higher SHPS scores and higher sleep schedule, arousal-related behavior, and sleep environment subscale scores. Poor sleepers had significantly greater intra-individual variability of sleep onset latency, total nighttime sleep, and wake after sleep onset than good sleepers. In stepwise linear regression, older maternal age (p = .01), fewer employment hours per week (p = .01), higher CES-D total score (p hygiene intervention in women during pregnancy. © 2015 Wiley Periodicals, Inc.

  6. Third trimester ultrasound for fetal macrosomia: optimal timing and institutional specific accuracy.

    Science.gov (United States)

    Parikh, Laura I; Iqbal, Sara N; Jelin, Angie C; Overcash, Rachael T; Tefera, Eshetu; Fries, Melissa H

    2017-11-28

    To determine the performance of third trimester ultrasound in women with suspected fetal macrosomia. We performed a retrospective cohort study of fetal ultrasounds from January 2004 to December 2014 with estimated fetal weight (EFW) between 4000 and 5000 g. We determined accuracy of birth weight prediction for ultrasound performed at less than and greater than 38 weeks, accounting for diabetic status and time between ultrasound and delivery. There were 405 ultrasounds evaluated. One hundred and twelve (27.7%) were performed at less than 38 weeks, 293 (72.3%) at greater than 38 weeks, and 91 (22.5%) were performed in diabetics. Sonographic identification of EFW over 4000 g at less than 38 weeks was associated with higher correlation between EFW and birth weight than ultrasound performed after 38 weeks (71.5 versus 259.4 g, p < .024). EFW to birth weight correlation was within 1.7% of birth weight for ultrasound performed less than 38 weeks and within 6.5% of birth weight for ultrasound performed at greater than 38 weeks. Identification of EFW with ultrasound performed less than 38 weeks has greater reliability of predicting fetal macrosomia at birth than measurements performed later in gestation. EFW to birth weight correlation was more accurate than previous reports.

  7. [Detection of small for gestational age fetuses during third trimester ultrasound. A monocentric observational study].

    Science.gov (United States)

    Peyronnet, V; Kayem, G; Mandelbrot, L; Sibiude, J

    2016-09-01

    Fetus small for gestational age (SGA) screening rate is evaluated around 21,7 % in France. Recommendations were developed to improve the efficiency of ultrasound conducted in the third trimester (T3), because neonatal consequences can be significant. This study aims to evaluate screening of SGA during T3 ultrasound and to describe causes for failure and differences with the recommendations of CNGOF. All children born between 2011 and 2012 with a birth weight below the 3rd percentile were included in this observational, retrospective, monocentric study. We noted that the diagnosis of SGA was placed on file. Then, as recommended by the CNGOF, we calculated estimated fetal weight (EFW) with Hadlock 3 and Hadlock 4, and the corresponding percentiles, using the biometrics from the ultrasound report. We thus could evaluate a new screening rate with SGA fetus identified through this technique. A total of 142 patients were included. By calculating correctly all EFW and checking abdominal circumference percentiles, the screening rate of SGA fetuses with T3 ultrasound increased from 40 % to 50 % and the overall screening rate (clinical and ultrasound) from 54 % to 66 %. By following the recommendations we found a real improvement in fetal SGA screening rates to T3 ultrasound with a potential benefit for their care. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  8. Acute HIV Infection in Pregnancy: The Case for Third Trimester Rescreening

    Directory of Open Access Journals (Sweden)

    Jocelyn Wertz

    2011-01-01

    Full Text Available Combination testing with anti-HIV Elisa and Western blot is both sensitive and specific for diagnosis of established HIV-1 infection but could not detect acute HIV infection (AHI. AHI is a time of extremely high viral load, which may correlate to increased risk of horizontal or vertical transmission. Thus, early identification of AHI could allow for interventions to decrease transmission. However, recognition of AHI can be challenging as symptoms could be absent or nonspecific, therefore, AHI is often not detected, particularly in pregnancy. We present a case report of AHI in a pregnant woman who presented with headache and fever. She tested negative for HIV in the first trimester and at time of AHI at 26 3/7 weeks by anti-HIV Elisa, but was diagnosed with AHI based on an HIV RNA viral load of 434,000 copies/mL. This report presents a case for improved awareness of AHI in pregnancy, and the need for repeat HIV testing in late pregnancy, and highlighted that early detection of AHI might be possible with adding HIV RNA testing at time of standard anti-HIV Elisa screening test in pregnancy. Novel laboratory approaches including pooling of sera for HIV RNA could reduce the cost of HIV RNA testing.

  9. First-Trimester Serum Acylcarnitine Levels to Predict Preeclampsia: A Metabolomics Approach

    Directory of Open Access Journals (Sweden)

    Maria P. H. Koster

    2015-01-01

    Full Text Available Objective. To expand the search for preeclampsia (PE metabolomics biomarkers through the analysis of acylcarnitines in first-trimester maternal serum. Methods. This was a nested case-control study using serum from pregnant women, drawn between 8 and 14 weeks of gestational age. Metabolites were measured using an UPLC-MS/MS based method. Concentrations were compared between controls (n=500 and early-onset- (EO- PE (n=68 or late-onset- (LO- PE (n=99 women. Metabolites with a false discovery rate <10% for both EO-PE and LO-PE were selected and added to prediction models based on maternal characteristics (MC, mean arterial pressure (MAP, and previously established biomarkers (PAPPA, PLGF, and taurine. Results. Twelve metabolites were significantly different between EO-PE women and controls, with effect levels between −18% and 29%. For LO-PE, 11 metabolites were significantly different with effect sizes between −8% and 24%. Nine metabolites were significantly different for both comparisons. The best prediction model for EO-PE consisted of MC, MAP, PAPPA, PLGF, taurine, and stearoylcarnitine (AUC = 0.784. The best prediction model for LO-PE consisted of MC, MAP, PAPPA, PLGF, and stearoylcarnitine (AUC = 0.700. Conclusion. This study identified stearoylcarnitine as a novel metabolomics biomarker for EO-PE and LO-PE. Nevertheless, metabolomics-based assays for predicting PE are not yet suitable for clinical implementation.

  10. Changes in heart rate variability and QT variability during the first trimester of pregnancy.

    Science.gov (United States)

    Carpenter, R E; D'Silva, L A; Emery, S J; Uzun, O; Rassi, D; Lewis, M J

    2015-03-01

    The risk of new-onset arrhythmia during pregnancy is high, presumably relating to changes in both haemodynamic and cardiac autonomic function. The ability to non-invasively assess an individual's risk of developing arrhythmia during pregnancy would therefore be clinically significant. We aimed to quantify electrocardiographic temporal characteristics during the first trimester of pregnancy and to compare these with non-pregnant controls. Ninety-nine pregnant women and sixty-three non-pregnant women underwent non-invasive cardiovascular and haemodynamic assessment during a protocol consisting of various physiological states (postural manoeurvres, light exercise and metronomic breathing). Variables measured included stroke volume, cardiac output, heart rate, heart rate variability, QT and QT variability and QTVI (a measure of the variability of QT relative to that of RR). Heart rate (p pregnancy only during the supine position (p pregnancy in all physiological states (p pregnancy in all states (p pregnancy is associated with substantial changes in heart rate variability, reflecting a reduction in parasympathetic tone and an increase in sympathetic activity. QTVI shifted to a less favourable value, reflecting a greater than normal amount of QT variability. QTVI appears to be a useful method for quantifying changes in QT variability relative to RR (or heart rate) variability, being sensitive not only to physiological state but also to gestational age. We support the use of non-invasive markers of cardiac electrical variability to evaluate the risk of arrhythmic events in pregnancy, and we recommend the use of multiple physiological states during the assessment protocol.

  11. Echogenic intracardiac focus on second trimester ultrasound: prevalence and significance in a Middle Eastern population.

    Science.gov (United States)

    Mirza, Fadi G; Ghulmiyyah, Labib; Tamim, Hani; Bou Hamdan, Farah; Breidy, Juliana; Geagea, Sandra; Usta, Ihab; Adra, Abdallah; Nassar, Anwar H

    2016-01-01

    The association between echogenic intracardiac focus (EIF) and trisomy 21 is well established, with a recognized ethnic variation. Our study aimed to determine the prevalence of EIF in a Middle Eastern population and to examine its association with trisomy 21 and other adverse pregnancy outcomes. Retrospective case-control study of second-trimester obstetric sonograms (16-28 weeks) performed at a tertiary care center over a 5-year period. Cases with EIF were retrieved, and a matched control group with no EIF was identified. The incidence of trisomy 21 and other adverse pregnancy outcomes was compared. A total of 9270 obstetric sonograms were examined, with an EIF prevalence of 2.5% (95% CI: 2.2-2.8%). Of patients with available outcome data, EIF was not associated with trisomy 21 (0/163 versus 1/163; p value = 1.00). Additionally, EIF was not associated with trisomy 18, trisomy 13, small for gestational age, preterm birth, fetal demise, cesarean delivery, operative vaginal delivery, or admission to the neonatal intensive care unit. In a contemporary Middle Eastern population, EIF is a rare occurrence. As an isolated finding, it is not associated with aneuploidy or other adverse pregnancy outcomes. EIF appears to be incidental with no impact on clinical practice.

  12. Factors related to elevated vaginal pH in the first trimester of pregnancy.

    Science.gov (United States)

    Zodzika, Jana; Rezeberga, Dace; Jermakova, Irina; Vasina, Olga; Vedmedovska, Natalija; Donders, Gilbert

    2011-01-01

    To assess different bacterial and epidemiological factors associations with increased vaginal pH in the pregnant women population during the first trimester. A cross-sectional, observational study. Three outpatient clinics in Riga. From July 2009 until January 2010, 139 unselected consecutive pregnant women at the first prenatal visit. Pregnant women were submitted to an interview, vaginal examination and vaginal specimen collection for pH measurement and native microscopy. Vaginal pH ≥4.5 was considered as elevated. Abnormal bacterial microflora was classified according to Donders. Elevated vaginal pH was significantly associated with bacterial vaginosis (p aerobic vaginitis (p aerobic vaginitis and bacterial vaginosis flora (p vaginal flora. Normal lactobacillary morphotypes were more often found in the pH ≤4.4 group (p vaginal pH is associated with different types of abnormal vaginal flora and the presence of sperm cells. © 2010 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2010 Nordic Federation of Societies of Obstetrics and Gynecology.

  13. Association of third-trimester abdominal circumference with provider-initiated preterm delivery

    Science.gov (United States)

    Hawkins, Leah K.; Schnettler, William T.; Modest, Anna M.; Hacker, Michele R.; Rodriguez, Diana

    2016-01-01

    Objective Evaluate the association of a small third-trimester abdominal circumference (AC < 10th percentile) in the setting of a normal estimated fetal weight (EFW ≥ 10th percentile) with gestational age at delivery, indication for delivery and neonatal outcomes. Methods Retrospective cohort study at an academic hospital of women with singleton pregnancy seen for ultrasound from 28+0-33+6 weeks of gestation during 2009-2011. Outcomes were compared between two groups: normal AC (AC and EFW ≥ 10th percentile) and small AC (AC < 10th percentile and EFW ≥ 10th percentile). Results Among 592 pregnancies, fetuses in the small AC group (n = 55) experienced a higher incidence of overall preterm delivery (RR: 2.2, 95% Cl: 1.3–3.7) and provider-initiated preterm delivery (RR: 3.7, Cl: 1.8–7.5) compared to those in the normal AC group (n = 537). Neonates in the small AC group had a lower median birth weight whether delivered at term (p < 0.001) or preterm (p = 0.04), but were not more likely to experience intensive care unit admission or respiratory distress syndrome (all p ≥ 0.35). Conclusions Small AC, even in the setting of an EFW ≥ 10th percentile, was associated with a higher incidence of overall and provider-initiated preterm delivery despite similar neonatal outcomes. Further investigation is warranted to determine whether these preterm deliveries could be prevented. PMID:24102316

  14. Ovarian Torsion in the Third Trimester of Pregnancy Leading to Iatrogenic Preterm Delivery

    Directory of Open Access Journals (Sweden)

    Evangelia Vlachodimitropoulou Koumoutsea

    2016-01-01

    Full Text Available Ovarian torsion in the third trimester of pregnancy leading to a midline laparotomy and caesarean section for the delivery of a preterm baby is an uncommon event. As the woman is likely to present with nonspecific symptoms of lower abdominal pain, nausea, and vomiting, ovarian torsion can often be misdiagnosed as appendicitis or preterm labour. Treatment and the opportunity to preserve the tube and ovary may consequently be delayed. We report the case of a multiparous woman who had undergone two previous caesarean sections at term, presenting at 35 weeks of gestation with a presumptive diagnosis of acute appendicitis. Ultrasonography described a cystic lesion 6 × 3 cm in the right adnexa, potentially a degenerating fibroid or a torted right ovary. MRI of the pelvis was unable to provide further clarity. The patient was managed by midline laparotomy and simultaneous detorsion of the ovarian pedicle and ovarian cystectomy together with caesarean section of a preterm infant. This report describes that prompt recognition and ensuring intraoperative access can achieve a successful maternal and fetal outcome in this rare and difficult scenario. Furthermore, we would like to emphasise that the risk for a pregnant woman and her newborn could be reduced by earlier diagnosis and management of ovarian masses (Krishnan et al., 2011.

  15. 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.

  16. [Microbiological screening and postoperative course in patients undergoing first trimester abortion].

    Science.gov (United States)

    La Rosa, R; Ricci, M G; Oliveti, C; Giovani, M; Lapucci, T; Morgante, G; Danero, S; Alegente, G

    1985-01-01

    Pelvic infections are a serious and widespread gynecological disease, often leading to sterility. Procedures like evacuation of the products of conception by vacuum suction are known to facilitate their appearance. 300 patients were examined the same day of the abortion (first trimester); before the hysterosuction a vaginal tampon was taken from the cervix and from the posterior fornix. The patients were invited to come back for an exam in two weeks and to refer to the clinic for any problem before then. A wet mount, aerobic and anaerobic cultures in several media and Gram stains were used to identify the pathogens. 40.3% of the tampons were positive for pathogens, mostly staphilococci (52%), but also Candida, alfa and beta hemolytic Streptococci, Proteus, E. Coli, Trichomonas. 5 patients had serious complications that required hospital admission. Only 128 patients showed up for the postoperative control; of these, 14 presented with symptoms of pelvic infection. Since pelvic infections are the most frequent complication after induced abortion, and considering the larege number of women who carry vaginal pathogens, the Authors strongly recommend a guided antibiotic profilaxis before the hysterosuction operation.

  17. 4D ultrasound study of fetal facial expressions in the third trimester of pregnancy.

    Science.gov (United States)

    AboEllail, Mohamed Ahmed Mostafa; Kanenishi, Kenji; Mori, Nobuhiro; Mohamed, Osman Abdel Kareem; Hata, Toshiyuki

    2018-07-01

    To evaluate the frequencies of fetal facial expressions in the third trimester of pregnancy, when fetal brain maturation and development are progressing in normal healthy fetuses. Four-dimensional (4 D) ultrasound was used to examine the facial expressions of 111 healthy fetuses between 30 and 40 weeks of gestation. The frequencies of seven facial expressions (mouthing, yawning, smiling, tongue expulsion, scowling, sucking, and blinking) during 15-minute recordings were assessed. The fetuses were further divided into three gestational age groups (25 fetuses at 30-31 weeks, 43 at 32-35 weeks, and 43 at ≥36 weeks). Comparison of facial expressions among the three gestational age groups was performed to determine their changes with advancing gestation. Mouthing was the most frequent facial expression at 30-40 weeks of gestation, followed by blinking. Both facial expressions were significantly more frequent than the other expressions (p facial expressions did not change between 30 and 40 weeks. The frequency of yawning at 30-31 weeks was significantly higher than that at 36-40 weeks (p facial expressions among the three gestational age groups. Our results suggest that 4D ultrasound assessment of fetal facial expressions may be a useful modality for evaluating fetal brain maturation and development. The decreasing frequency of fetal yawning after 30 weeks of gestation may explain the emergence of distinct states of arousal.

  18. Insulin resistance in first-trimester pregnant women with pre-pregnant glucose tolerance and history of recurrent spontaneous abortion.

    Science.gov (United States)

    Hong, Y; Xie, Q X; Chen, C Y; Yang, C; Li, Y Z; Chen, D M; Xie, M Q

    2013-01-01

    Insulin resistance (IR) has been reported to play an important role in recurrent spontaneous abortion (RSA) among patients with polycystic ovary syndrome (PCOS). However, scanted materials exist regarding the independent effect of IR on RSA. The aim of this study is to investigate the status of IR in first trimester pregnant patients with normal pre-pregnant glucose tolerance and history of RSA. This two-center case-control study enrolled totally 626 first trimester pregnant women including 161 patients with a history of recurrent spontaneous abortion, who were pre-pregnantly glucose-tolerant according to oral glucose tolerance test (OGTT), and 465 women with no history of abnormal pregnancies of any kind. Clinical, biochemical and hormonal parameters were simultaneously measured in all participants. Serum beta-HCG, estradiol, progesterone, fasting plasma glucose and fasting plasma insulin levels, as well, the calculated homeostasis model assessment of insulin resistance index (HOMA-IR), fasting plasma glucose/insulin ratio(G/I) and pregnancy outcome were analyzed and compared. Serum beta-HCG and progesterone were found to be significantly lower in RSA group compared to controls. Subjects in RSA group were found to have higher HOMA-IR and lower G/I ratio than those in control group. Serum beta-HCG and progesterone were negatively correlated with HOMA-IR, and positively with G/I ratio even after adjustment for BMI. The spontaneous abortion rate within first trimester pregnancy of RSA patients was significantly higher than that in controls. In conclusion, woman with recurrent spontaneous abortion and normal pre-pregnant glucose metabolism tends to be more insulin resistant during first trimester pregnancy than healthy controls, no matter whether she has PCOS or not. Insulin resistance might be one of the direct causes that lead to recurrent abortion.

  19. Immediate vs. delayed insertion of intrauterine contraception after second trimester abortion: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Soon Judith A

    2011-06-01

    Full Text Available Abstract Background We describe the rationale and protocol for a randomized controlled trial (RCT to assess whether intrauterine contraception placed immediately after a second trimester abortion will result in fewer pregnancies than current recommended practice of intended placement at 4 weeks post-abortion. Decision analysis suggests the novel strategy could substantially reduce subsequent unintended pregnancies and abortions. This paper highlights considerations of design, implementation and evaluation of a trial expected to provide rigorous evidence for appropriate insertion timing and health economics of intrauterine contraception after second trimester abortion. Methods/Design Consenting women choosing to use intrauterine contraception after abortion for a pregnancy of 12 to 24 weeks will be randomized to insertion timing groups either immediately (experimental intervention or four weeks (recommended care post abortion. Primary outcome measure is pregnancy rate at one year. Secondary outcomes include: cumulative pregnancy rates over five year follow-up period, comprehensive health economic analyses comparing immediate and delayed insertion groups, and device retention rates, complication rates (infection, expulsion and, contraceptive method satisfaction. Web-based Contraception Satisfaction Questionnaires, clinical records and British Columbia linked health databases will be used to assess primary and secondary outcomes. Enrolment at all clinics in the province performing second trimester abortions began in May 2010 and is expected to complete in late 2011. Data on one year outcomes will be available for analysis in 2014. Discussion The RCT design combined with access to clinical records at all provincial abortion clinics, and to information in provincial single-payer linked administrative health databases, birth registry and hospital records, offers a unique opportunity to evaluate such an approach by determining pregnancy rate at one

  20. Early childhood development when second-trimester ultrasound dating disagrees with last menstrual period: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Grewal Jagteshwar

    2012-04-01

    Full Text Available Abstract Background When an ultrasound-based estimate of gestational age (GA is less (greater than an estimate based on a definite last menstrual period, the fetus may grow slower (faster than average. While the association between these discrepancies in GA estimates and adverse perinatal outcomes has been examined extensively, there is scant evidence about long-term effects, such as child neurodevelopment. Methods Using data from a prospective cohort study titled, NICHD Study of Successive Small-for-Gestational Age Births, we examined if GA discrepancies in early second trimester of pregnancy (17 weeks’ gestation are associated with: (1 impaired motor and mental function at 13 months (measured using Bayley Scales of Infant Development (Bayley, and (2 impaired cognitive development at five years (assessed by Wechsler Preschool and Primary Scale of Intelligence – Revised Intelligence Quotient (WPPSI-R in the infant. The study population consisted of 572 (30% of the overall sample of 1,945 women who presented for prenatal care in Norway and Sweden between 1986 and 1988. Results Our results showed that GA discrepancies in early second trimester are significantly associated with birthweight. We found no significant relationship, however, with the Bayley development scores at 13 months and with the WPPSI-R IQ measures at five years. Conclusions GA discrepancies at 17 weeks’ gestation are not associated child neurodevelopment. These discrepancies do, however, relate to birthweights, providing a basis for detecting fetal growth patterns early in the second trimester of pregnancy. Our study, however, was unable to evaluate the impact of first-trimester discrepancies on impaired neurodevelopment in the infant.