B Porter, D Maulik, S Babbar, T Schrufer-Poland, J Allsworth, S Q Ye, D P Heruth, T Lei
OBJECTIVE: Fetal growth restriction constitutes a major complication of pregnancy. The efficacy of its prenatal identification remains challenging. Recently, placental expression of neuropilin-1 (NRP1) was discovered to be downregulated in fetal growth restriction (FGR) with abnormal umbilical artery (UA) Doppler. A member of the vascular endothelial growth factor receptor family, NRP1 has emerged as an important mediator of sprouting angiogenesis. Whereas NRP1 is proangiogenic, soluble NRP1 (sNRP1) is an antagonist to NRP1...
February 3, 2021: Ultrasound in Obstetrics & Gynecology
J Wen, J Tang, S Ran, H Ho
The systole/diastole (S/D) flow velocity ratios in umbilical arteries (UAs) have been used to assess the health status of the feto-placental circulation, yet its connection to the morphology of UAs, specifically its coiling pattern remains unclear. Spiral flow induces unbalanced wall shear stress (WSS) distribution in UAs, and may contribute to the uneven arterial wall thickness, and the chirality. In this paper, we use a 3D computational fluid dynamics (CFD) technique to quantify the wall shear stress (WSS) in UA models of two configurations, i...
October 2020: Medical Engineering & Physics
D Aggarwal, G S Bora, R S Mavuduru, K Jangra, A P Sharma, S Gupta, S K Devana, K Parmar, S Kumar, U K Mete, S K Singh
To evaluate the feasibility and outcomes of performing robot-assisted pelvic surgery at a reduced angle of Trendelenburg position. This was a prospective case-control study of 67 patients in 2:1 ratio. Controls were operated with steep Trendelenburg position of 30°, whereas cases were operated using a graduated method to achieve minimal optimal angle of operating table. Various body habitus parameters, console time, blood loss, rise in mean arterial pressure (MAP) and end-tidal carbon-dioxide (ET-CO2 ), duration of ileus, postoperative stay and complications were recorded...
August 17, 2020: Journal of Robotic Surgery
Tuangsit Wataganara, Nisarat Phithakwatchara, Julaporn Pooliam, Suparat Jaingam, Piyatida Thongkloung, Nadda Mongkolchat, Sommai Viboonchart, Katika Nawapun
BACKGROUND: Twin reversed arterial perfusion (TRAP) sequence consists of acardiac twin (A) paradoxically perfused by pump twin (P) through an umbilical artery (UA). We proposed characterization of acardiac twins with intrafetal vascular pattern (IVP), and assessed its correlation with morphology and UA Doppler indices. METHODS: We prospectively evaluated 21 cases of TRAP sequence. Morphology (acardia vs hemicardia) and IVP (simple vs complex) of acardiac twins were characterized with ultrasound and color Doppler...
July 2020: Prenatal Diagnosis
Michael Z Liao, Shannon K Flood Nichols, Mahmoud Ahmed, Shannon Clark, Gary D Hankins, Steve Caritis, Raman Venkataramanan, David Haas, Sara K Quinney, Laura S Haneline, Alan T Tita, Tracy Manuck, Joanne Wang, Kenneth E Thummel, Linda Morris Brown, Zhaoxia Ren, Thomas R Easterling, Mary F Hebert
This study's primary objective was to fully characterize the pharmacokinetics of metformin in pregnant women with GDM vs. non-pregnant controls. Steady-state oral metformin pharmacokinetics in pregnant women with GDM receiving either metformin mono-therapy (n=24) or in combination with glyburide (n=30) as well as in non-pregnant women with type 2 diabetes mellitus (T2DM, n=24) were determined utilizing non-compartmental analysis. Maternal and umbilical cord blood samples were collected at delivery from 38 women...
January 24, 2020: Drug Metabolism and Disposition: the Biological Fate of Chemicals
Nicola Fratelli, Serena Amighetti, Amar Bhide, Anna Fichera, Asma Khalil, Aris T Papageorghiou, Federico Prefumo, Basky Thilaganathan
INTRODUCTION: We aimed to assess if maximum velocities of the ductus venosus flow velocity waveform are associated with adverse outcomes in early-onset fetal growth restriction. MATERIAL AND METHODS: Retrospective cohort study from two tertiary referral units, including singleton fetuses with estimated birthweight or fetal abdominal circumference ≤10th centile and absent or reversed end-diastolic velocity in the umbilical artery delivered between 26+0 and 34+0  weeks of gestation...
May 2020: Acta Obstetricia et Gynecologica Scandinavica
Hyunjin Cho
OBJECTIVES: In placental insufficiency, alteration of left heart compliance occurs, with consequent increased placental vascular impedance. Pulmonary vein flow patterns could reflect altered left atrial pressure. Although the fetal pulmonary venous pulsatility index (PVPI) has been reported as an early marker to evaluate fetal cardiac dysfunction, no studies have been focused on its correlation with oligohydramnios. The aim of this study was to determine whether fetal pulmonary venous flow impedance was greater in women with placental insufficiency-related oligohydramnios than in women with adequate amounts of amniotic fluid during the third trimester...
November 9, 2019: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
A Houzé de l'Aulnoit, M Génin, S Boudet, R Demailly, C Ternynck, G Babykina, D Houzé de l'Aulnoit, R Beuscart
OBJECTIVE: To identify clinical parameters and intrapartum fetal heart rate parameters associated with a risk of umbilical cord acidosis at birth, using an automated analysis method based on empirical mode decomposition. METHODS: Our single-center study included 381 cases (arterial cord blood pH at birth pHa ≤7.15) and 1860 controls (pHa ≥7.25) extracted from a database comprising 8,383 full datasets for over-18 mothers after vaginal or caesarean non-twin, non-breech deliveries at term (>37 weeks of amenorrhea)...
December 2019: Computers in Biology and Medicine
Jinggui Zhang, Jun Li
Efficacy and safety of the combination of magnesium sulfate, phentolamine and nifedipine in the treatment of patients with hypertensive disorder complicating pregnancy (HDCP) and its effect on hemodynamics and urinary protein level were investigated. One hundred and six patients with HDCP diagnosed at the Affiliated Hospital of Beihua University from February 5, 2016 to May 9, 2017 were retrospectively analyzed. Patients were divided into the magnesium sulfate group and the combination group, according to the therapeutic schemes...
November 2019: Experimental and Therapeutic Medicine
D Chen, S Yuan, M Lao, Y Zhan, H Xu, L Liang, X Cai, X Wang, Z Zhan
OBJECTIVES: To investigate the fetal adverse pregnancy outcomes (APOs) and the predictive value of umbilical arterial Doppler ultrasonography in the third trimester in pregnant women with lupus nephritis (LN). METHODS: A retrospective cohort study enrolling 203 LN patients from 2007 to 2017 was performed. Ultrasonic parameters were recorded. RESULTS: Fetal APOs occurred in 103 patients (103/203, 50.7%). Sixty-six pregnancies (66/203, 32.5%) ended with preterm births...
October 2019: Lupus
Tarul Umarwal, Manisha Kumar
Objective: Construction of reference centile chart of middle cerebral (MCA) and umbilical artery (UA) Doppler along with cerebroplacental ratio from 24 to 40 weeks gestation in Indian population. Method: It was a cross-sectional observational study; antenatal women between 24 and 40 weeks gestation underwent the MCA and UA Doppler. The centile charts for MCA, UA and cerebroplacental ratio (CPR) were derived. Results: Total 300 antenatal women were included; the MCA PI, RI, S/D ratio values showed a parabolic curve with the peak at 33-35 weeks; the umbilical artery Doppler and cerebroplacental ratio showed a linear decrease with increasing gestational age...
August 2019: Journal of Obstetrics and Gynaecology of India
Dongying Chen, Minxi Lao, Xiaoyan Cai, Hao Li, Yanfeng Zhan, Xiaodong Wang, Zhongping Zhan
BACKGROUND: Hypertension disorders in pregnancy (HDP) were common complications in women with systemic lupus erythematosus (SLE). However, the impact of HDP and the measures to prevent HDP-related fetal adverse pregnancy outcomes (APOs) remained to be explored. METHODS: A multicenter retrospective study of 342 pregnant women with SLE was performed. Variables related to SLE and APOs were recorded. Fetal development was evaluated by umbilical artery Doppler ultrasonography...
August 3, 2019: Clinical Rheumatology
S Ruiz-Martinez, A T Papageorghiou, E Staines-Urias, J Villar, R Gonzalez de Agüero, D Oros
OBJECTIVE: To assess clinical variability in the management of fetal growth restriction according to published Doppler reference values for the umbilical artery (UA), middle cerebral artery (MCA) and cerebroplacental ratio (CPR). METHODS: We performed a systematic search of MEDLINE, EMBASE, CINAHL, and the Web of Science databases between the years 1954 and 2018, and selected studies with the sole aim of creating fetal Doppler reference values for the UA, MCA and CPR...
June 25, 2019: Ultrasound in Obstetrics & Gynecology
Ademola Joseph Adekanmi, Adebola Roberts, Janet Adetinuke Akinmoladun, Abiodun Oludotun Adeyinka
Background: Pre-eclampsia (PE) is an important public health menace in both developed and developing countries with high maternal and perinatal morbidity and mortality globally. A major goal towards improving antenatal management of PE is to develop accurate prediction models that identify women at high risk of this disease for appropriate interventions. Methodology: In a longitudinal cohort study, high-risk singleton pregnant women enroled between April 2015 and February 2016 had uterine and umbilical artery Doppler sonography at 22-24 weeks and 32-34 weeks gestation and had their delivery outcomes documented by the obstetrician and gynaecologist...
April 2019: Nigerian Postgraduate Medical Journal
Liping Wang, Zhankai Lu, Xuewu Zhou, Yong Ding, Lijie Guan
The effects of intrahepatic cholestasis of pregnancy (ICP) on hepatic function, changes of inflammatory cytokines and fetal outcomes were studied. In total, 663 pregnant women admitted to Daqing Longnan Hospital from July 2016 to December 2017 were selected. There were, 40 cases with ICP enrolled in the observation group, and 40 normal pregnant women were recruited in the normal group. They were also grouped according to hepatic function and inflammatory cytokines, with 40 cases in each group. Neonatal Apgar scores were recorded...
April 2019: Experimental and Therapeutic Medicine
Alexandra D J Hulsenboom, Kim M J Verdurmen, Rik Vullings, M Beatrijs van der Hout-van der Jagt, Anneke Kwee, Judith O E H van Laar, S Guid Oei
INTRODUCTION: The additional value of ST analysis during labour is uncertain. In ST analysis, a T/QRS baseline value is calculated from the fetal electrocardiogram and successive T/QRS ratios are compared to this baseline. However, variation in the orientation of the electrical heart axis between fetuses may yield different T/QRS baseline values. In case of a higher T/QRS baseline value more ST events are encountered, although not always related to perinatal outcome. We hypothesised that we can partly correct for this effect by analysing T/QRS rises as a percentage from baseline (relative ST analysis)...
2019: PloS One
Shalini Gainder, Monika Thakur, S C Saha, Mahesh Prakash
OBJECTIVE: To compare the efficacy of intravenous labetalol or oral nifedipine in treatment of acute maternal hypertension and study the fetal hemodynamic changes using color Doppler ultrasound that follows treatment. STUDY DESIGN: Thirty women with severe preeclampsia having acute hypertension (more than or equal to 160/105 mmHg) were randomized in 2 groups to receive intravenous labetalol or oral nifedipine until blood pressure was lowered to less than or equal to 140/90 mmHg...
January 2019: Pregnancy Hypertension
Rachel J Skow, Margie H Davenport, Michelle F Mottola, Gregory A Davies, Veronica J Poitras, Casey E Gray, Alejandra Jaramillo Garcia, Nick Barrowman, Victoria L Meah, Linda G Slater, Kristi B Adamo, Ruben Barakat, Stephanie-May Ruchat
OBJECTIVE: To perform a systematic review and meta-analysis examining the influence of acute and chronic prenatal exercise on fetal heart rate (FHR) and umbilical and uterine blood flow metrics. DESIGN: Systematic review with random-effects meta-analysis and meta-regression. DATA SOURCES: Online databases were searched up to 6 January 2017. STUDY ELIGIBILITY CRITERIA: Studies of all designs were included (except case studies) if published in English, Spanish or French, and contained information on the population (pregnant women without contraindication to exercise), intervention (subjective or objective measures of frequency, intensity, duration, volume or type of exercise, alone ["exercise-only"] or in combination with other intervention components [eg, dietary; "exercise + co-intervention"]), comparator (no exercise or different frequency, intensity, duration, volume and type of exercise) and outcomes (FHR, beats per minute (bpm); uterine and umbilical blood flow metrics (systolic:diastolic (S/D) ratio; Pulsatility Index (PI); Resistance Index (RI); blood flow, mL/min; and blood velocity, cm/s))...
January 2019: British Journal of Sports Medicine
Ivana Chandra, Lizhou Sun
OBJECTIVE: To analyze the similarities and differences in the clinical parameters, laboratory biomarkers, and pregnancy outcomes between preterm and term preeclampsia (PE). METHODS: Data on 185 women diagnosed with PE were collected from a Jiangsu Province Hospital from January 2017 to December 2017 and analyzed. 74 (40%) patients were diagnosed with preterm PE, of which 70 (94.6%) patients with PE with severe features (PEs) and the rest with PE. 111 (60%) patients were diagnosed with term PE, of which 54 (48...
November 2018: Postgraduate Medicine
D Oros, S Ruiz-Martinez, E Staines-Urias, A Conde-Agudelo, J Villar, E Fabre, A T Papageorghiou
OBJECTIVE: To assess studies reporting reference ranges for umbilical artery (UA) and fetal middle cerebral artery (MCA) Doppler indices and cerebroplacental ratio (CPR), using a set of predefined methodological quality criteria for study design, statistical analysis and reporting methods. METHODS: This was a systematic review of observational studies in which the primary aim was to create reference ranges for UA and MCA Doppler indices and CPR in fetuses of singleton gestations...
April 2019: Ultrasound in Obstetrics & Gynecology
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