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Fetal and surgery

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https://www.readbyqxmd.com/read/29031539/fetal-surgery-for-myelomeningocele-after-the-management-of-myelomeningocele-study-moms
#1
REVIEW
Julie S Moldenhauer, N Scott Adzick
Myelomeningocele (MMC) is the most frequently occurring congenital abnormality of the central nervous system and leads to significant physical disabilities. Historically treatment involved postnatal closure with management of the associated sequelae including ventricular shunting. The mechanism of neurologic damage that begins with abnormal neurulation followed by continued injury over the course of gestation made MMC a plausible candidate for in-utero surgical repair. Animal and early human studies demonstrated the feasibility of fetal closure...
October 11, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29026065/urethral-diverticulum-presenting-as-a-large-vaginal-mass-complicating-pregnancy-and-delivery
#2
Everett F Magann, Lisa S Newton, Susan A Barr
BACKGROUND A case report of urethral diverticulum complicating pregnancy is presented. The diagnosis and management are challenging because of the rare nature of this condition, the varied presentations and differential diagnoses, and the possibility of misdiagnosis. CASE REPORT A 25-year-old primigravida with scheduled induction of labor at 39 weeks gestation due to gestational diabetes mellitus presented for a routine antenatal appointment at 38 weeks and four days. On digital cervical examination, she was found to have a large semi-solid anterior vaginal mass, shown by trans-vaginal ultrasound to have a nearly solid appearance of a 5×7 cm mass with septation...
October 13, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29020780/-selective-feticide-in-monochorionic-twin-pregnancies-with%C3%A2-discordant-fetal-anomalies-management-and-outcome
#3
J Vojtěch, L Hašlík, R Pock, K Běhávková, K Macková, P Hanulíková, H Heřman, L Krofta
OBJECTIVE: To analyze results and outcome after selective feticide for discordant anomalies in monochorionic twins. DESIGN: Prospective cohort study. SETTING: Fetal medicine center, Institute for the Care of Mother and Child, Praha. METHODS: Analysis of outcome of monochorionic pregnancies after intrauterine surgery for structural abnormalities between January 2013 and June 2016. RESULTS: We performed 13 intrauterine operations in monochorionic twins with structural anomalies during the period...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/29018178/attitudes-of-paediatric-and-obstetric-specialists-towards-prenatal-surgery-for-lethal-and-non-lethal-conditions
#4
Ryan M Antiel, Farr A Curlin, John D Lantos, Christopher A Collura, Alan W Flake, Mark P Johnson, Natalie E Rintoul, Stephen D Brown, Chris Feudtner
BACKGROUND: While prenatal surgery historically was performed exclusively for lethal conditions, today intrauterine surgery is also performed to decrease postnatal disabilities for non-lethal conditions. We sought to describe physicians' attitudes about prenatal surgery for lethal and non-lethal conditions and to elucidate characteristics associated with these attitudes. METHODS: Survey of 1200 paediatric surgeons, neonatologists and maternal-fetal medicine specialists (MFMs)...
October 10, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29016414/prenatal-diagnosis-of-a-melanotic-neuroectodermal-tumor-of-infancy-mnti-a-case-report-with-a-favorable-outcome-after-chemotherapy-failure-and-incomplete-resection
#5
Audrey Moreau, Louise Galmiche, Kahina Belhous, Gerald Franchi, Vincent Couloigner, Jerome Nevoux, Pierre Antoine Aymard, Arnaud Picard, Veronique Minard-Colin, Natacha Kadlub
We present the case of a woman referred to our department at 34 weeks of pregnancy with a fetal ultrasonographic scan showing a mass that had developed within the right maxilla with invasion of the orbit. A retrospective examination showed that this tumor had been present since the 12th week of pregnancy. At 39+4 weeks of gestation, a boy was born. He presented a black firm aspect in the maxilla. A computed tomographic scan and magnetic resonance imaging revealed a soft tissue swelling over the right maxilla, extending into the orbit but without invasion of the globe...
October 9, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28988673/predictive-value-of-cortical-transit-time-on-mag3-for-surgery-in-antenatally-detected-unilateral-hydronephrosis-caused-by-ureteropelvic-junction-stenosis
#6
Jun Nyung Lee, Jun-Koo Kang, Shin Young Jeong, So Mi Lee, Min Hyun Cho, Yun-Sok Ha, Hyun Tae Kim, Tae-Hwan Kim, Eun Sang Yoo, Tae Gyun Kwon, Sung Kwang Chung
BACKGROUND: In children with antenatally detected hydronephrosis caused by ureteropelvic junction (UPJ) stenosis, the main challenge is preserving renal function by identifying children who require early surgical intervention from those for whom watchful waiting may be appropriate because of the potential for spontaneous resolution without a significant loss of renal function. OBJECTIVE: To assess the impact of initial cortical transit time (CTT) on technetium-99m mercaptoacetyltriglycerine (MAG3) diuretic renogram on the need for surgery in children with antenatally detected unilateral hydronephrosis caused by UPJ stenosis...
September 19, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28988434/maternal-and-obstetrical-outcome-in-35-cases-of-well-differentiated-thyroid-carcinoma-during-pregnancy
#7
Jan Boucek, Jorine de Haan, Michael J Halaska, Jan Plzak, Kristel Van Calsteren, Christianne J M de Groot, Karina Dahl Steffensen, Robert Fruscio, Elske T Massolt, Philipp Klaritsch, Paolo Zola, Frédéric Amant
OBJECTIVES/HYPOTHESIS: Thyroid cancer, with 6% to 10% of cancer diagnoses, is one of the most common malignancies during pregnancy. Its treatment poses a risk for the pregnancy, as the thyroid gland plays a crucial role in the evolution of pregnancy. The aim of this study is to evaluate treatment of primary well-differentiated thyroid carcinoma during pregnancy and fetal and maternal outcomes. STUDY DESIGN: This is an international cohort study. METHODS: Primary thyroid cancer patients were identified from the database of the International Network on Cancer, Infertility, and Pregnancy registration study...
October 8, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28986215/the-ethics-of-maternal-fetal-surgery
#8
REVIEW
Frank A Chervenak, Laurence B McCullough
Maternal-fetal surgery is performed on two patients, the pregnant patient and the fetal patient. Ethics is therefore an essential dimension of maternal-fetal surgery. From its beginnings in only a few centers, various procedures have become available in highly specialized centers in developed countries. Innovation and research have played an indispensable role in the development of maternal-fetal surgery and will continue to do so. In this article we present ethically justified criteria, based on the ethical concept of the fetus as a patient, for clinical innovation and research of maternal-fetal surgery and for the professionally responsible transition from innovation and research into clinical practice...
October 3, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28974162/antenatal-assessment-and-postnatal-outcome-of-fetal-echogenic-lung-lesions-a-decade-s-experience-at-a-tertiary-referral-hospital
#9
Stefan C Kane, Fabrício D A Silva Costa, Joseph A Crameri, Karen L Reidy, Helen Kaganov, Ricardo Palma-Dias
INTRODUCTION: Fetal echogenic lung lesions (ELL) are the commonest pulmonary pathology diagnosed on antenatal sonography, and include congenital pulmonary airway malformations (CPAMs) and bronchopulmonary sequestrations. This study aimed to evaluate the predictive utility of the CPAM volume ratio (CVR) at presentation in a series of fetuses with ELLs at a tertiary Australian referral hospital. MATERIAL AND METHODS: Retrospective cohort study of all pregnancies with a prenatal diagnosis of an isolated fetal echogenic lung lesion managed at the Royal Women's Hospital, Victoria, Australia, between 2005 and 2015...
October 3, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28969534/perioperative-management-of-female-hormone-medications
#10
Lynsey A Seim, Joan M Irizarry-Alvarado
BACKGROUND: No clear guideline exists for the management of female hormone therapy in the perioperative period. Besides oral contraceptives (OCPs), hormone medications have been prescribed to treat cancer, osteoporosis, and menopausal symptoms. Since the introduction of OCPs in the 1960s, the thromboembolic risk associated with these medications has been studied and alterations have been made in the hormone content. The continuation of hormone therapy in the perioperative period and its possible interactions with commonly used anesthetic agents are important information for all perioperative health care providers...
September 26, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28967088/uncommon-somatic-mutations-in-metastatic-nut-midline-carcinoma
#11
Stefano Cavalieri, Anastasios Stathis, Alessandra Fabbri, Angelica Sonzogni, Federica Perrone, Elena Tamborini, Giuseppe Pelosi, Filippo de Braud, Marco Platania
INTRODUCTION: NUT midline carcinoma (NMC) is a rare and aggressive epithelial cancer arising from median organs. It is driven by chromosomal translocation t(15;19) involving the rearrangement of NUT (nuclear protein in testis) and BRD4 (bromodomain 4) genes leading to fusion oncoprotein BRD4-NUT. CASE PRESENTATION: We report the case of a woman who was previously treated with induction chemotherapy, surgery, radiotherapy and adjuvant trastuzumab for HER-2 positive invasive ductal carcinoma of the breast...
September 25, 2017: Tumori
https://www.readbyqxmd.com/read/28967071/outcomes-of-cataract-surgery-in-children-with-persistent-hyperplastic-primary-vitreous
#12
Jitender Jinagal, Parul C Gupta, Jagat Ram, Manu Sharma, Simar R Singh, Sonam Yangzes, Jaspreet Sukhija, Ramandeep Singh
PURPOSE: To evaluate postoperative outcomes of cataract surgery in children with persistent hyperplastic primary vitreous (PHPV) and factors affecting outcomes. METHODS: We analyzed 29 eyes of 28 children with PHPV presenting at a tertiary care center in northern India. All eyes underwent phacoaspiration followed by primary posterior capsulotomy with or without cauterization of persistent fetal vasculature under general anesthesia. Hydrophobic intraocular lens was implanted in selective cases...
September 14, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28965437/midtrimester-isolated-oligohydramnios-in-monochorionic-diamniotic-multiple-gestations
#13
Andrew H Chon, Lisa M Korst, Ryan D Assaf, Arlyn Llanes, Joseph G Ouzounian, Ramen H Chmait
OBJECTIVE: To describe the natural history and perinatal outcomes of monochorionic diamniotic twins with midtrimester isolated oligohydramnios (iOligo). MATERIALS AND METHODS: We performed a retrospective study of iOligo patients who were initially referred for the management of evolving twin-twin transfusion syndrome (TTTS) or selective intrauterine growth restriction (sIUGR). iOligo was defined as a maximum vertical pocket of amniotic fluid of ≤ 2 cm in the iOligo twin's sac and normal fluid level (> 2 and < 8 cm) in the co-twin's sac...
October 1, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28962216/assessing-the-impact-of-total-extracorporeal-circulation-on-hemodynamics-in-an-ovine-fetal-model
#14
Fei Xiao, Jian Zhuang, Cheng-Bin Zhou, Ji-Mei Chen, Jian-Zheng Cen, Gang Xu, Shu-Sheng Wen
The present study aimed to evaluate the impact of total extracorporeal circulation on hemodynamics and placental function in an ovine fetal model. Mid-term ovine fetuses (n=6) underwent extracorporeal circulation (30 min), cardioplegic arrest (20 min) and monitoring (120 min). The ascending aorta and umbilical cords of the fetuses were occluded during the bypass and an extracorporeal membrane oxygenator was used as the oxygen source. Biventricular intracardiac pressures, echocardiographic data, blood gas levels and placental function variables were recorded, and statistical analysis was performed using the repeated-measure analysis of variance test...
September 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28960660/conservative-post-natal-management-of-antenatally-diagnosed-congenital-pulmonary-airway-malformations
#15
Allya V Makhijani, Flora Y Wong
AIM: Management of congenital pulmonary airway malformations (CPAM) is controversial, especially for asymptomatic patients. We aim to describe the clinical manifestations and management of CPAM at a tertiary paediatric hospital using a retrospective audit. METHODS: Infants with CPAM were identified on the Fetal Diagnostic Unit database from 2007 to 2014. Information on antenatal and post-natal management was collected from medical record. RESULTS: Thirty-five infants with antenatally diagnosed CPAM were included...
September 28, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28953615/on-opportunity-for-emergency-cesarean-hysterectomy-and-pregnancy-outcomes-of-patients-with-placenta-accreta
#16
Xiang Kong, Yan Kong, Jin Yan, Jin-Ju Hu, Fang-Fang Wang, Lei Zhang
Effective diagnosis and clinical management of placenta accreta (PA) in China are not clear. The purpose of the study was to analyze the risk factors and diagnosis of PA, maternal and neonatal outcomes in patients with PA. It was a retrospective study of cases with PA, confirmed by histologically and/or clinically suspected during 3 years in 2 tertiary referral hospitals. The incidence rate of patients with PA, who had history of artificial abortion, cesarean section (CS), and placenta previa (PP) was 94%, 70%, and 72%, respectively...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28948240/ultrasonic-needle-tracking-with-a-fibre-optic-ultrasound-transmitter-for-guidance-of-minimally-invasive-fetal-surgery
#17
Wenfeng Xia, Sacha Noimark, Sebastien Ourselin, Simeon J West, Malcolm C Finlay, Anna L David, Adrien E Desjardins
Ultrasound imaging is widely used for guiding minimally invasive procedures, including fetal surgery. Visualisation of medical devices such as medical needles is critically important and it remains challenging in many clinical contexts. During in-plane insertions, a needle can have poor visibility at steep insertion angles and at large insertion depths. During out-of-plane insertions, the needle tip can have a similar ultrasonic appearance to the needle shaft when it intersects with the ultrasound imaging plane...
September 2017: Medical Image Computing and Computer-assisted Intervention: MICCAI ..
https://www.readbyqxmd.com/read/28947264/surgical-techniques-influence-local-environment-of-injured-spinal-cord-and-cause-various-grafted-cell-survival-and-integration
#18
Shaoping Hou, Tatiana M Saltos, Idiata W Iredia, Veronica J Tom
BACKGROUND: Cellular transplantation to repair a complete spinal cord injury (SCI) is tremendously challenging due to the adverse local milieu for graft survival and growth. Results from cell transplantation studies yield great variability, which may possibly be due to the surgical techniques employed to induce an SCI. In order to delineate the influence of surgery on such inconsistency, we compared lesion morphology and graft survival as well as integration from different lesion methodologies of SCI...
September 22, 2017: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/28946860/severe-hydronephrosis-secondary-to-uterine-artery-pseudoaneurysm-in-the-early-second-trimester-of-pregnancy-a-case-report
#19
Tsukuru Amano, Shinsuke Tokoro, Shunichiro Tsuji, Takashi Inoue, Fuminori Kimura, Takashi Murakami
BACKGROUND: Uterine artery pseudoaneurysm (UAP) normally presents genital bleeding in the puerperal period, and severe hydronephrosis rarely presents during pregnancy. We report a rare case of severe ureteral obstruction accompanied by uterine artery pseudoaneurysm in the early second trimester of pregnancy, which was successfully treated by surgical intervention. CASE PRESENTATION: A 42-year-old nulligravid woman who had undergone myomectomy 3 years earlier was referred to our hospital for acute left abdominal pain at the 17th week of gestation...
September 25, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28946817/fetal-growth-restriction-induced-by-transient-uterine-ischemia-reperfusion-differential-responses-in-different-mouse-strains
#20
Larry G Thaete, Xiao-Wu Qu, Mark G Neerhof, Emmet Hirsch, Tamas Jilling
We characterized fetal and placental growth and uterine and placental inflammation in pregnant C3H/HeOuJ and C57BL/6J mice (strains with different sensitivities to metabolic and circulatory pathologies), using different uterine ischemia/reperfusion (I/R) protocols, to establish and refine a murine model of I/R-induced fetal growth restriction (FGR). Pregnant C3H/HeOuJ mice on gestation day 15 were subjected to unilateral uterine I/R by (1) total blood flow restriction (TFR) by occlusion of the right ovarian and uterine arteries for 30 minutes, (2) partial flow restriction (PFR) by occlusion of only the right ovarian artery for 30 minutes, or (3) sham surgery...
January 1, 2017: Reproductive Sciences
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