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fetal Dopplers

Brun Jean-Frédéric, Boulot Pierre, Varlet-Marie Emmanuelle
Physiological studies on fetal blood in narrow glass tubes have suggested that fetal optimal hematocrit (hct) might be as high as 60%. A theoretical 'ideal' hct can also be predicted with a theoretical curve of hematocrit/viscosity (h/η) ratio vs hct constructed with Quemada's model. We used the database of one of our previous papers on fetal hemorheology to reinterpret its results with this concept. A series of 28 intrauterine cord punctures (between 19 and 33 weeks gestation) with doppler measurements of resistance in umbilical arteries was studied...
October 18, 2016: Clinical Hemorheology and Microcirculation
Myoung Seok Lee, Jeong Yeon Cho, Sang Youn Kim, Seung Hyup Kim, Joong Shin Park, Jong Kwan Jun
Purpose: The purpose of this study was to evaluate the feasibility and usefulness of sagittal color Doppler ultrasonography (CDUS) for the diagnosis of fetal cleft lip (CL) and cleft palate (CP). Methods: We performed targeted ultrasonography on 25 fetuses with CL and CP, taking coronal and axial images of the upper lip and maxillary alveolar arch in each case. The existence of defects in and malalignment of the alveolus on the axial image, hard palate defects on the midsagittal image, and flow-through defects on CDUS taken during fetal breathing or swallowing were assessed...
August 6, 2016: Ultrasonography
Oluwagbemiga Oluwole Ayoola, Peter Bulus, Olabisi Morebisi Loto, Bukunmi Michael Idowu
AIM: To determine the Doppler indices of the umbilical arteries in normal singleton pregnancy with a view to generating local reference ranges. METHODS: In this prospective, cross-sectional study, 400 pregnant women at 15-39 weeks' gestational age, with estimated fetal weight within the 10th and 90th percentile, no fetal malformation(s), and without any history of maternal medical disease, were recruited. Umbilical arteries were assessed on ultrasound, with the subjects in the supine position...
October 20, 2016: Journal of Obstetrics and Gynaecology Research
Sarah Schalekamp-Timmermans, Jerome Cornette, Albert Hofman, Willem A Helbing, Vincent W V Jaddoe, Eric A P Steegers, Bero O Verburg
BACKGROUND: There are sex differences in the risk of development of cardiovascular disease (CVD). According to the developmental origins of health and disease paradigm (DOHaD), CVD originates in fetal life. This study examines fetal sex differences in cardiovascular development in utero. METHODS: In 1028 pregnant women, we assessed fetal circulation using pulsed wave Doppler examinations between 28 and 34 weeks gestation. To test associations between fetal sex and fetal circulation measurements, linear regression models were used adjusting for fetal size, gestational age, and fetal heart rate...
2016: Biology of Sex Differences
Dawn S Hughes, Everett F Magann
The evaluation of amniotic fluid volume (AFV) is an established part of the antenatal surveillance of pregnancies at risk for an adverse pregnancy outcome. The two most commonly used ultrasound techniques to estimate AFV are the amniotic fluid index (AFI) and the single deepest pocket (SDP). Four studies have defined normal AFVs, and although their normal volumes have similarities, there are also differences primarily due to the statistical methodology used in each study. Dye-determined AFV correlates with ultrasound estimates for normal fluid volumes but correlates poorly for oligohydramnios and polyhydramnios...
September 16, 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
Rosemary Townsend, Asma Khalil
PURPOSE OF REVIEW: Selective intrauterine growth restriction (sIUGR) in twin pregnancies presents a complex management problem for the fetal medicine specialist. This review summarizes what is currently known about sIUGR pathophysiology, particularly in monochorionic pregnancies and looks at the results of early trials of fetal intervention in high-risk sIUGR pregnancies. RECENT FINDINGS: sIUGR in monochorionic pregnancies is due to unequal placental sharing, but the clinical outcome is determined by the characteristics of the placental vascular anastomoses...
October 15, 2016: Current Opinion in Obstetrics & Gynecology
Seneesh Kumar Vikraman, Vipin Chandra, Bijoy Balakrishnan, Sunil Jaiman, Meenu Batra, Gopinathan Kannoly
The anatomic causes for fetal right atrial dilatation with tricuspid regurgitation include Ebstein anomaly, tricuspid dysplasia, unguarded tricuspid orifice, and Uhl anomaly. Unguarded tricuspid orifice is characterized by complete or partial agenesis of the tricuspid valvular and subvalvular structures. It is commonly associated with pulmonary atresia. Its prenatal diagnosis is usually associated with unfavorable prognosis. We present a prenatally diagnosed case of fetal unguarded tricuspid orifice with description of its diagnostic workup, along with a review of literature, to enhance the understanding of this rarely reported entity...
October 18, 2016: Journal of Clinical Ultrasound: JCU
Sven Cnattingius, Anna-Karin Wikström, Olof Stephansson, Kari Johansson
BACKGROUND: Results from uterine artery Doppler investigations suggest that the aetiology of late preeclampsia with fetal growth restriction may be more similar to the aetiology of early preeclampsia than with late preeclampsia without fetal growth restriction. We hypothesised that a small-for-gestational-age (SGA) birth in a late preeclamptic pregnancy may be associated with increased subsequent risk of early preeclampsia. We also studied effects of maternal factors on risks of preeclampsia recurrence...
October 17, 2016: Paediatric and Perinatal Epidemiology
Moshe Bronshtein, Zeev Blumenfeld, Asaad Choury, Ayala Gover
OBJECTIVES: To assess the natural history and outcome of fetal pulmonary stenosis [PS] detected at 14 to 16 weeks gestation. METHODS: This is a retrospective study, in the years 2004-2015, with serial follow up during pregnancy. Patients referred for complete early fetal ultrasound including all fetal systems and a fetal echocardiogram. Ninety seven percent of the women were low risk, and 3% had risk factors such as maternal type 1 diabetes mellitus, exposure to teratogenic drugs or anomalies in previous pregnancies or in other family members...
October 14, 2016: Ultrasound in Obstetrics & Gynecology
You Li, Dongwoon Hyun, Lotfi Abou-Elkacem, Juergen Willmann, Jeremy Dahl
Power Doppler (PD) imaging is a widely used technique for flow detection. Despite the wide use of Doppler ultrasound, limitations exist in the ability of Doppler ultrasound to assess slow flow in small-diameter vasculature, such as the maternal spiral arteries and fetal villous arteries of the placenta and focal liver lesions. The sensitivity of PD in small vessel detection is limited by the low signal produced by slow flow and the noise associated with small vessels. The noise sources include electronic noise, stationary or slowly moving tissue clutter, reverberation clutter, and off-axis scattering from tissue, among others...
October 10, 2016: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
Emilio A Herrera, Francisca Cifuentes-Zúñiga, Esteban Figueroa, Cristian Villanueva, Cherie Hernández, René Alegría, Viviana Arroyo, Estefania Peñaloza, Marcelo Farías, Ricardo Uauy, Paola Casanello, Bernardo J Krause
In humans, intrauterine growth restriction (IUGR) is associated with vascular dysfunction, oxidative stress and signs of endothelial programming in umbilical vessels. We aimed to determine the effects of maternal antioxidant treatment with N-acetyl cysteine (NAC) on fetal endothelial function and eNOS programming in IUGR guinea pigs. IUGR was induced by implanting ameroid constrictors on uterine arteries of pregnant guinea pigs at mid gestation, receiving half of the sows NAC in the drinking water (from day 34 until term)...
October 14, 2016: Journal of Physiology
Charlotte Iacobaeus, Ellika Andolf, Malin Thorsell, Katarina Bremme, Gun JÖrneskog, Eva Östlund, Thomas Kahan
OBJECTIVE: To examine alterations in maternal vascular structure and function during normal pregnancy. METHODS: We assessed brachial and central blood pressure, pulse wave velocity and augmentation index (by pulse wave analysis and applanation tonometry), common carotid artery structure (by ultrasonography), and endothelial function in the brachial artery (by post-ischemic hyperemia induced flow mediated vasodilation and glyceryl nitrate) and in the forearm skin microcirculation (by laser Doppler perfusion imaging during iontophoretic administration of acetylcholine and sodium nitroprusside) in 52 healthy primiparous women at 14, 24 and 34 weeks of gestation, and nine months post partum...
October 12, 2016: Ultrasound in Obstetrics & Gynecology
Asma Khalil, Basky Thilaganathan
Identification of the fetus at risk of adverse outcome at term is a challenge to both clinicians and researchers alike. Despite the fact that fetal growth restriction (FGR) is a known risk factor for stillbirth, at least two thirds of the stillbirth cases at term are not small for gestational age (SGA) - a commonly used proxy for FGR. However, the majority of SGA fetuses are constitutionally small babies and do not suffer from adverse perinatal outcome. The cerebroplacental ratio (CPR) is emerging as a marker of failure to reach growth potential at term...
September 23, 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
Owen J Arthurs, A Rega, F Guimiot, N Belarbi, J Rosenblatt, V Biran, M Elmaleh, G Sebag, M Alison
OBJECTIVES: Diffusion weighted magnetic resonance imaging (DWI) is a sensitive method to assess brain maturation or detect brain lesions, providing Apparent Diffusion Coefficient (ADC) values as a measure of water diffusion. Abnormal ADC values are seen in ischemic brain lesions, such as acute or chronic hypoxia. The aim of this study was to assess whether ADC values in the fetal brain were different in a group of fetuses exposed to severe vascular intrauterine growth restriction, compared to normal controls...
October 5, 2016: Ultrasound in Obstetrics & Gynecology
Wei-Hsiu Chiu, Shy-Ming Lee, Tao-Hsin Tung, Xiao-Mei Tang, Ren-Shyan Liu, Ran-Chou Chen
Antenatal diagnosis of congenital heart disease (CHD) is still low even though screening was first introduced over 25 years ago. The purpose of our study was to determine the efficacy of a second-trimester prenatal ultrasonographic method of screening for CHD.From September 2012 to September 2013, the length and width of the fetal ductus venosus were measured sonographically in 1006 singleton fetuses, and the ratio of length to width was calculated. The accuracy of each fetal measurement and Doppler ultrasonography were determined...
September 2016: Medicine (Baltimore)
Serena Simeone, Marianna Pina Rambaldi, Caterina Serena, Serena Ottanelli, Federico Mecacci
INTRODUCTION: MCA and uterine artery Doppler PI are commonly used in the evaluation of IUGR. Targets: This retrospective pilot study aims to investigate whether MCA/UtA ratio may identify adverse outcome in late onset IUGRs. A cohort of 69 pregnancies affected with late IUGR which underwent labor induction according to local protocols was retrospectively revised on the relationship between MCA/UtA ratio at first observation and the following adverse outcomes: cesarean section for nonreassuring fetal status, birthweight (expressed as percentile and continuous values, umbilical artery pH, NICU admission and Apgar score < 7 after 1 and 5 min...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
D Lo Presti, G Gagliardi, G M Tiralongo, I Pisani, B Vasapollo, G P Novelli, H Valensise
OBJECTIVE: The objective of this study was to test the efficacy of bed rest in reducing total vascular resistance (TVR) in normotensive patients with TVR in the upper limits, evaluating the effect on fetal growth. METHODS: Thirty women patients were enrolled between 27 and 29 weeks gestation. All the patients met the following criteria: normal blood pressure values before and during pregnancy, TVR between 1300 and 1400 dyne sec_1 cm_5, normal fetal Doppler parameters at enrollment, abdominal circumference between the 10th and 25th centile...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
Ying Chang, Xu Chen, Hong-Yan Cui, Xing Li, Ya-Ling Xu
The aim of the present study was to determine a predictive model for early-onset preeclampsia with fetal growth restriction (FGR) to be used at 11(+0) to 13(+6) gestational weeks, by combining the maternal serum level of pregnancy-associated plasma protein-A (PAPP-A), placental growth factor (PLGF), placental protein 13 (PP13), soluble endoglin (sEng), mean arterial pressure (MAP), and uterine artery Doppler. This was a retrospective cohort study of 4453 pregnant women. Uterine artery Doppler examination was conducted in the first trimester...
September 27, 2016: Reproductive Sciences
Hyeon Kyeong Yeon, Mi-Young Lee, Sun-Young Yoon, Hee Jung Jung, Ji Eun Park, Jae-Yoon Shim, Hye-Sung Won, Pil-Ryang Lee, Ahm Kim
We describe a case of absent aortic and pulmonary valves, diagnosed at 16.4 weeks of gestation. Fetal echocardiography showed cardiomegaly with dilated both ventricles. No valve leaflets were observed in the aorta and pulmonary artery, and a typical to-and-fro flow pattern was noted in both great arteries on color Doppler imaging. Fetal hydrops was also detected. Follow-up ultrasonographic evaluation at 19 weeks demonstrated intrauterine fetal death. Postmortem autopsy revealed the absence of both aortic and pulmonary valve leaflets...
September 2016: Obstetrics & Gynecology Science
Sevan A Vahanian, Anthony M Vintzileos
PURPOSE OF REVIEW: Placental implantation abnormalities (PIAs) comprise a large group of disorders associated with significant maternal, fetal, and neonatal morbidity. RECENT FINDINGS: Risk factors include prior uterine surgery/myometrial scarring and the presence of placenta previa with or without prior cesarean delivery. Newly identified risk factors include previous prelabor cesarean delivery and previous postpartum hemorrhage. PIAs contribute substantially to preterm birth with prematurity rates ranging from 38 to 82%...
September 21, 2016: Current Opinion in Obstetrics & Gynecology
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