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fetal heart

Sabina Martí Gamboa, Olga Redrado Giménez, Jara Pascual Mancho, María Lapresta Moros, Julia Ruiz Sada, Sergio Castan Mateo
Objective The objective of this study was to determine ability to detect neonatal acidemia and interobserver agreement with the FIGO 3-tier and 5-tier fetal heart rate (FHR) classification systems. Design This was a case-control study. Setting This study was set at the University Medical Center. Population A total of 202 FHR tracings of 102 women who delivered an acidemic fetus (umbilical arterial cord gas pH ≤ 7.10 and BE < - 8) and 100 who delivered a nonacidemic fetus (umbilical arterial cord gas pH > 7...
October 25, 2016: American Journal of Perinatology
Michelle T Nguyen, Laurence B McCullough, Frank A Chervenak
In obstetric practice, each pregnant woman presents with a composite of maternal and fetal characteristics that can alter the risk of significant harm without cesarean intervention. The hospital's availability of resources and the obstetrician's training, experience, and skill level can also alter the risk of significant harm without cesarean intervention. This paper proposes a clinical ethical framework that takes these clinical and organizational factors into account, to promote a deliberative rather than simplistic approach to decision-making and counseling about cesarean delivery...
October 25, 2016: Journal of Perinatal Medicine
Eng Loon Tng
Subclinical hypothyroidism (SCH) represents a mild or compensated form of primary hypothyroidism. The diagnosis of SCH is controversial, as its symptoms are non-specific and its biochemical diagnosis is arbitrary. The treatment of SCH was examined among non-pregnant adults, pregnant adults and children. In non-pregnant adults, treatment of SCH may prevent its progression to overt hypothyroidism, reduce the occurrence of coronary heart disease, and improve neuropsychiatric and musculoskeletal symptoms associated with hypothyroidism...
October 2016: Singapore Medical Journal
Takeshi Nishimura, Keisuke Kohama, Takaaki Osako, Taihei Yamada, Hiroyuki Tanaka, Atsunori Nakao, Joji Kotani
Advances in critical care medicine have made it possible to sustain vital organ systems in brain-dead patients. One clinical scenario besides donor organ retrieval in which a benefit may be gained from continuing life support is pregnancy. A pregnant woman in her late 30's at 23 weeks gestation exhibiting worsening depression was referred to the Department of Psychiatry. One day after admission she attempted suicide by hanging and suffered a cardiopulmonary arrest. A fetal heart beat and fetal motion was confirmed immediately after resuscitation...
October 2016: Acta Medica Okayama
T Schmitz
OBJECTIVE: To evaluate short- and long-term benefits and risks associated with antenatal administration of a single course of corticosteroids and the related strategies: multiple and rescue courses. METHODS: The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. RESULTS: Antenatal administration of a single course of corticosteroids before 34 weeks of gestation is associated in the neonatal period with a significant reduction of respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC) and death (LE1), and in possibly childhood with a reduction of cerebral palsy and increased psychomotor development index and intact survival (LE3)...
October 21, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Karl T Weber
Current dogma suggests patients with advanced systolic heart failure have an irreversible depression in myocardial contractility. Recent experience with improved ventricular function during continuous flow ventricular assist devices used as destination therapy would suggest otherwise. Herein, cellular and molecular signaling involved in reversing depressed myocardial contractility would be addressed. This includes cardiomyocyte thyroid hormone signaling responsible for the reexpression of fetal gene program that preserves cell efficiency (work and energy consumed) and the rescue of an endogenous population of atrophic myocytes bordering on microdomains of fibrosis to improve contractile mass...
October 2016: American Journal of the Medical Sciences
Hadis Biglari, Reza Sameni
Fetal motility is a widely accepted indicator of the well-being of a fetus. In previous research, it has be shown that fetal motion (FM) is coherent with fetal heart rate accelerations and an indicator for active/rest cycles of the fetus. The most common approach for FM and fetal heart rate (FHR) assessment is by Doppler ultrasound (DUS). While DUS is the most common approach for studying the mechanical activities of the heart, noninvasive fetal electrocardiogram (ECG) and magnetocardiogram (MCG) recording and processing techniques have been considered as a possible competitor (or complement) for the DUS...
October 24, 2016: Physiological Measurement
Amanda M Casabella, Timur M Urakov, Gregory Basil, Jacques J Morcos
Foramen magnum meningiomas are very rare and challenging lesions. Their presentation in female patients during pregnancy tremendously complicates the course of gestation. Conservative management is always the first choice but in cases of a deteriorating clinical picture there are currently no clear guidelines on best management. We looked closely at a case of foramen magnum meningioma presenting at 30 weeks of gestation. Successful surgical resection was performed with intraoperative fetal heart monitoring and ¾ prone position of the patient...
October 20, 2016: World Neurosurgery
Rafaianne Queiroz Moraes-Souza, Thaigra Sousa Soares, Nágilla Orleanne Lima Carmo, Débora Cristina Damasceno, Kleber Eduardo Campos, Gustavo Tadeu Volpato
ETHNOPHARMACOLOGICAL RELEVANCE: Several women often use plant extracts during pregnancy without any concern about its possible toxic effects. The plant effects have been experimentally confirmed in animals and humans, while others require additional investigations. AIM OF STUDY: To evaluated the effect of aqueous extract of Croton urucurana latex on the maternal-fetal repercussions in rats. METHODS: Pregnant rats were randomly distributed into four experimental groups: Control=treated with water (vehicle); Treated 200=treated with a dose 200mg/kg; Treated 400= dose 400mg/kg and; and Treated 800= dose 800mg/kg...
October 20, 2016: Journal of Ethnopharmacology
Mieke L G Ten Eikelder, Kelly Mast, Annemarie van der Velden, Kitty W M Bloemenkamp, Ben W Mol
Importance: Induction of labor is a widely used obstetric intervention, occurring in one in four pregnancies. When the cervix is unfavorable, still many different induction methods are used. Objective: We compared Foley catheter alone to different misoprostol dosages and administration routes, and the combination of Foley catheter with misoprostol. Evidence acquisition: We reviewed the literature on the best induction method regarding their safety and effectiveness, using the outcome measures hyperstimulation, fetal distress, neonatal morbidity and mortality as well as cesarean delivery, vaginal instrumental delivery, and maternal morbidity...
October 2016: Obstetrical & Gynecological Survey
Carmela Nardelli, Ilaria Granata, Laura Iaffaldano, Valeria D'Argenio, Valentina Del Monaco, Giuseppe Maria Maruotti, Daniela Omodei, Luigi Del Vecchio, Pasquale Martinelli, Francesco Salvatore, Mario Rosario Guarracino, Lucia Sacchetti, Lucio Pastore
Clinical findings and data obtained in animal models indicate that nutrient uptake and exposure to environmental agents during pregnancy may affect fetal/newborn gestational programming thereby resulting in obesity and/or obesity-related disorders in offspring. Human amniotic mesenchymal stem cells (hA-MSCs) differentiate into adipocytes, and are thus a suitable model to investigate adipocyte functions in obesity. The aim of this study was to elucidate the miRNome of hA-MSCs and its contribution to obesity in pregnancy...
October 20, 2016: Stem Cells and Development
Hanna Gustafsson, Colleen Doyle, Michelle Gilchrist, Elizabeth Werner, Catherine Monk
The consequences of childhood maltreatment are profound and long lasting. Not only does the victim of abuse suffer as a child, but there is mounting evidence that a history of maltreatment places the next generation at risk for significant psychopathology. Research identifies postnatal factors as affecting this intergenerational transmission of trauma. However, emerging evidence suggests that part of this risk may be transmitted before birth, passed on via abuse-related alterations in the in utero environment that are as yet largely unidentified...
October 20, 2016: Development and Psychopathology
Jimena Giudice, Zheng Xia, Wei Li, Thomas A Cooper
The RNA binding protein Celf1 regulates alternative splicing in the nucleus and mRNA stability and translation in the cytoplasm. Celf1 is strongly down-regulated during mouse postnatal heart development. Its re-induction in adults induced severe heart failure and reversion to fetal splicing and gene expression patterns. However, the impact of Celf1 depletion on cardiac transcriptional and posttranscriptional dynamics in neonates has not been addressed. We found that homozygous Celf1 knock-out neonates exhibited cardiac dysfunction not observed in older homozygous animals, although homozygous mice are smaller than wild type littermates throughout development...
October 19, 2016: Scientific Reports
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
Kathryn J Sharma, Tania F Esakoff, Alyson Guillet, Richard M Burwick, Aaron B Caughey
OBJECTIVE: To determine whether adverse outcomes were more common in late preterm pregnancies complicated by preeclampsia and growth restriction compared to those affected by preeclampsia alone. METHODS: This was a retrospective cohort study of 8,927 singleton pregnancies with preeclampsia. Pregnancies with small for gestational age (SGA) neonates (birthweight <10(th) percentile) were compared to those appropriate for gestational age (AGA) neonates. Maternal outcomes included cesarean delivery (CD) rate, CD for fetal heart rate (FHR) abnormalities, abruption, postpartum hemorrhage (PPH), maternal transfusion, acute renal failure, and peripartum cardiomyopathy...
October 19, 2016: Journal of Maternal-fetal & Neonatal Medicine
Kim M J Verdurmen, Alexandra D J Hulsenboom, Judith O E H van Laar, S Guid Oei
INTRODUCTION: Tocolytics may cause changes in fetal heart rate pattern, while fetal heart rate variability is an important marker of fetal wellbeing. We aim to systematically review the literature on how tocolytic drugs affect fetal heart rate variability. MATERIAL AND METHODS: We searched CENTRAL, PubMed, and EMBASE up to June 2016. Studies published in English, using computerized or visual analysis to describe the effect of tocolytics on heart rate variability in human fetuses were included...
October 19, 2016: Journal of Maternal-fetal & Neonatal Medicine
Toshifumi Yamauchi, Masaki Mogi, Hirotomo Nakaoka, Kana Tsukuda, Masanori Kukida, Akinori Higaki, Hui-Yu Bai, Bao-Shuai Shan, Li-Juan Min, Jun Iwanami, Masatugu Horiuchi
OBJECTIVE: Fetal growth restriction (FGR) is one of the risks of cardiovascular problems in adulthood. We previously reported that the vascular injury enhanced vascular remodeling in FGR mice, but the mechanisms are still unclear. Angiotensin II type 2 receptor (AT2R) is relatively highly expressed in fetal mice but not in adult mice. Therefore, we investigated the effects of AT2R in FGR mice, using AT2R knockout (AT2KO) mice. DESIGN AND METHOD: Dams (C57BL/6J strain (WT) mice and AT2KO mice) were fed an isocaloric diet containing 20% protein (normal protein; NP) or 8% protein (low protein; LP) from 10 weeks of age until delivery...
September 2016: Journal of Hypertension
Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
Patricio Lopez-Jaramillo
Cardiovascular diseases (CVD) are major causes of death and illness worldwide. In recent decades an increased prevalence of CVD mortality has been reported in low-medium income countries, which has been associated with changes in life styles, deficiencies in health systems and the persistence of social inequities.The metabolic syndrome comprises a cluster of cardiometabolic risk factors, with insulin resistance and increased adiposity as its central features. Identifying individuals with metabolic syndrome is important due to its association with an increased risk of coronary heart disease and type 2 diabetes mellitus (DM2)...
September 2016: Journal of Hypertension
Steven L Clark, Emily Hamilton, Thomas J Garite, Audra Timmins, Philip A Warrick, Samuel Smith
BACKGROUND: Despite intensive efforts directed at initial training in fetal heart rate interpretation, continuing medical education, board certification/recertification, team training and the development of specific protocols for the management of abnormal fetal heart rate patterns, the goals of consistently preventing hypoxia-induced fetal metabolic acidemia and neurologic injury remain elusive. OBJECTIVE: To validate a recently published algorithm for the management of category II fetal heart rate tracings , examine reasons for the birth of infants with significant metabolic acidemia despite the use of electronic fetal heart rate monitoring and critically examine the limits of EFHRM in the prevention of neonatal metabolic acidemia...
October 14, 2016: American Journal of Obstetrics and Gynecology
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