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https://www.readbyqxmd.com/read/28921728/undifferentiated-connective-tissue-diseases-and-adverse-pregnancy-outcomes-an-undervalued-association
#1
REVIEW
Arsenio Spinillo, Fausta Beneventi, Roberto Caporali, Veronique Ramoni, Carlomaurizio Montecucco
Undifferentiated connective tissue diseases (UCTDs) are a heterogeneous group of disorders characterized by symptoms and signs suggestive of systemic autoimmune rheumatic disease (ARD), but which do not fulfill all the established criteria for definite diagnosis of a condition. Although a third of UCTDs can progress to a definite ARD within months or years, most UCTDs can remain stable for years with minimal disease activity. The annual incidence of UCTD in the general population ranges from 14 to 140 per 100 000 people...
September 16, 2017: American Journal of Reproductive Immunology: AJRI
https://www.readbyqxmd.com/read/28915426/intravenous-dexamethasone-as-an-adjunct-to-improve-labor-analgesia-a-randomized-double-blinded-placebo-controlled-clinical-trial
#2
Pratibha Dube, Sukanya Mitra, Jasveer Singh, Richa Saroa, Reeti Mehra
OBJECTIVE: To study the role of intravenous (i.v.) dexamethasone as an analgesic adjunct in labor analgesia. DESIGN: Double-blinded randomized controlled trial. SETTING: Labor analgesia in a tertiary-care teaching hospital. PATIENTS: Eighty consenting ASA I-II parturients, age>18year, nulliparous, single gestation, cephalic presentation at ≥36 wk. of gestation, in early spontaneous labor (cervical dilatation≤5cm) requesting epidural analgesia...
September 12, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28913590/challenges-of-anticoagulation-therapy-in-pregnancy
#3
REVIEW
Annemarie E Fogerty
Thrombotic complications in pregnancy represent a major cause of morbidity and mortality. Pregnancy is a primary hypercoagulable state due to enhanced production of clotting factors, a decrease in protein S activity, and inhibition of fibrinolysis. These physiologic changes will yield a collective rate of venous thromboembolism (VTE) of about 1-2 in 1000 pregnancies for the general obstetric population, which represents a five- to tenfold increased risk in pregnancy compared to age-matched non-pregnant peers...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28912727/a-hybrid-emd-kurtosis-method-for-estimating-fetal-heart-rate-from-continuous-doppler-signals
#4
Haitham M Al-Angari, Yoshitaka Kimura, Leontios J Hadjileontiadis, Ahsan H Khandoker
Monitoring of fetal heart rate (FHR) is an important measure of fetal wellbeing during the months of pregnancy. Previous works on estimating FHR variability from Doppler ultrasound (DUS) signal mainly through autocorrelation analysis showed low accuracy when compared with heart rate variability (HRV) computed from fetal electrocardiography (fECG). In this work, we proposed a method based on empirical mode decomposition (EMD) and the kurtosis statistics to estimate FHR and its variability from DUS. Comparison between estimated beat-to-beat intervals using the proposed method and the autocorrelation function (AF) with respect to RR intervals computed from fECG as the ground truth was done on DUS signals from 44 pregnant mothers in the early (20 cases) and late (24 cases) gestational weeks...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28912192/mechanical-cervical-ripening-for-women-with-prolongedpregnancies-magpop-protocol-for-a-randomised-controlled-trial-of-a-silicone-double-balloon-catheter-versus-the-propess-system-for-the-slow-release-of-dinoprostone-for-cervical-ripening-of-prolonged-pregnancies
#5
Caroline Diguisto, Amélie Le Gouge, Bruno Giraudeau, Franck Perrotin
INTRODUCTION: Induction of labour for prolonged pregnancies (PP) when the cervix is unfavourable is a challenging situation. Cervical ripening by pharmacological or mechanical techniques before oxytocin administration is used to increase the likelihood of vaginal delivery. Both techniques are equally effective in achieving vaginal delivery but excessive uterine activity, which induces fetal heart rate (FHR) anomalies, is more frequent after the pharmacological intervention. We hypothesised that mechanical cervical ripening could reduce the caesarean rate for non-reassuring FHR especially in PP where fetuses are already susceptible to this...
September 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/28910276/igf2-stimulates-fetal-growth-in-a-sex-and-organ-dependent-manner
#6
Veronica White, Alicia Jawerbaum, Maria Belen Mazzucco, Martin Gauster, Gernot Desoye, Ursula Hiden
BACKGROUND: IGF2 is a key determinant of fetal growth, and altered expression of IGF2 is implicated in fetal growth disorders and maternal metabolic derangements including gestational diabetes. Here we studied how increased levels of IGF2 in late pregnancy affect fetal growth. METHODS: We employed a rat model of repeated intra-fetal IGF2 administration in late pregnancy, i.e. during GD19-GD21, and measured the consequences on fetal organ weight and expression of insulin/IGF-axis components...
September 14, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28904928/prenatal-sonographic-diagnosis-of-hypoplastic-left-heart-syndrome
#7
Raghu Teja Sadineni, B Santh Kumar, N B Chander, Durga Mahita Boppana
Hypoplastic left heart syndrome (HLHS) represents a variety of cardiac malformations that may result from errors in the early stages of cardiac development. HLHS includes a wide spectrum of cardiac malformations including hypoplasia of the left ventricle, ascending aorta, hypoplasia, or atresia of the aortic and mitral valves. Over the recent years, the improved resolution of advanced equipment with awareness and increased performance of second-trimester ultrasound examinations for the assessment of fetal anomalies have helped in understanding the spectrum and have expanded our knowledge of HLHS...
July 2017: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/28903760/feasibility-of-detecting-myocardial-infarction-in-the-sheep-fetus-using-late-gadolinium-enhancement-cmr-imaging
#8
An Qi Duan, Mitchell C Lock, Sunthara Rajan Perumal, Jack R Darby, Jia Yin Soo, Joseph B Selvanayagam, Christopher K Macgowan, Mike Seed, Janna L Morrison
BACKGROUND: Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) imaging has enabled the accurate assessment of myocardial infarction (MI). However, LGE CMR has not been performed successfully in the fetus, where it could be useful for animal studies of interventions to promote cardiac regeneration. We believe that LGE imaging could allow us to document the presence, extent and effect of MI in utero and would thereby expand our capacity for conducting fetal sheep MI research...
September 13, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/28902389/women-s-experiences-of-continuous-fetal-monitoring-a-mixed-methods-systematic-review
#9
Alexandra Crawford, Dexter Hayes, Edward D Johnstone, Alexander E P Heazell
INTRODUCTION: Antepartum stillbirth is often preceded by detectable signs of fetal compromise, including changes in fetal heart rate and movement. It is hypothesised that continuous fetal monitoring could detect these signs more accurately and objectively than current forms of fetal monitoring and allow for timely intervention. This systematic review aimed to explore available evidence on women's experiences of continuous fetal monitoring to investigate its acceptability prior to clinical implementation and to inform clinical studies...
September 13, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28901007/pharmacological-and-mechanical-interventions-for-labour-induction-in-outpatient-settings
#10
REVIEW
Joshua P Vogel, Alfred O Osoti, Anthony J Kelly, Stefania Livio, Jane E Norman, Zarko Alfirevic
BACKGROUND: Induction of labour is carried out for a variety of indications and using a range of methods. For women at low risk of pregnancy complications, some methods of induction of labour or cervical ripening may be suitable for use in outpatient settings. OBJECTIVES: To examine pharmacological and mechanical interventions to induce labour or ripen the cervix in outpatient settings in terms of effectiveness, maternal satisfaction, healthcare costs and, where information is available, safety...
September 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28899735/a-randomised-comparison-of-bolus-phenylephrine-and-ephedrine-for-the-management-of-spinal-hypotension-in-patients-with-severe-preeclampsia-and-fetal-compromise
#11
R A Dyer, A Emmanuel, S C Adams, C J Lombard, M J Arcache, A Vorster, C A Wong, N Higgins, A R Reed, M F James, Y Joolay, S Schulein, D van Dyk
BACKGROUND: Studies in healthy patients undergoing elective caesarean delivery show that, compared with phenylephrine, ephedrine used to treat spinal hypotension is associated with increased fetal acidosis. This has not been investigated prospectively in women with severe preeclampsia. METHODS: Patients with preeclampsia requiring caesarean delivery for a non-reassuring fetal heart tracing were randomised to receive either bolus ephedrine (7.5-15mg) or phenylephrine (50-100µg), to treat spinal hypotension...
August 11, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28899642/evaluation-of-myocardial-function-according-to-early-diastolic-intraventricular-pressure-difference-in-fetuses
#12
Yuka Yamamoto, Ken Takahashi, Yo Takemoto, Maki Kobayashi, Keiichi Itatani, Toshiaki Shimizu, Atsuo Itakura, Satoru Takeda
BACKGROUND: Intraventricular pressure difference (IVPD), the diastolic suction during early diastole, is known as a useful marker of myocardial diastolic function in adults with different heart diseases, but there are no studies of fetal IVPD. The aim of this study was to determine whether IVPD exists and changes prenatally and whether IVPD correlates with preexisting parameters to evaluate fetal cardiac diastolic function and ventricular dominance. METHODS: Cross-sectional study data (stroke volume, fetal cardiac output, E/A ratio, and myocardial performance index) from 117 healthy fetuses at 17 to 36 weeks of gestation were retrospectively evaluated...
September 9, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28899619/first-do-the-experiment-do-computerised-interpretation-of-cardiotocography-and-other-widely-used-interventions-improve-newborn-outcomes
#13
REVIEW
Philip Steer
The introduction of continuous electronic fetal heart rate monitoring (EFM) in labour has coincided with a steady and remarkable fall in perinatal mortality. Whether this is cause or coincidence remains unclear because randomised trials have been underpowered. Attempts to improve the sensitivity and specificity of fetal compromise detection using fetal blood sampling and pH measurement, pulse oximetry, and fetal electrocardiogram analysis have failed to provide evidence of additional value in randomised trials...
September 9, 2017: Early Human Development
https://www.readbyqxmd.com/read/28891400/glycosylated-cell-surface-markers-for-the-isolation-of-human-cardiac-progenitors
#14
Asja T Moerkamp, Hau Wan Leung, Noortje A M Bax, Stephanie Holst, Kirsten Lodder, Thijs Berends, Calinda K E Dingenouts, Andre Boon Hwa Choo, Anke M Smits, Marie-Jose Goumans
The aim of stem cell therapy after cardiac injury is to replace damaged cardiac tissue. Human cardiac progenitor cells (CPCs) represent an interesting cell population for clinical strategies to treat cardiac disease and human CPC-specific antibodies would aid in the clinical implementation of cardiac progenitor based cell therapy. However, the field of CPC biology suffers from the lack of human CPC-specific markers. Therefore, we raised a panel of monoclonal antibodies (mAb) against CPCs Of this panel of antibodies, we show that mAb C1096 recognizes a progenitor-like population in the fetal and adult human heart and partially co-localize with reported CPC populations in vitro...
September 11, 2017: Stem Cells and Development
https://www.readbyqxmd.com/read/28889037/gender-specific-evolution-of-fetal-heart-rate-variability-throughout-gestation-a-study-of-8823-cases
#15
Hernâni Gonçalves, Célia Amorim-Costa, Diogo Ayres-de-Campos, João Bernardes
BACKGROUND: Fetal heart rate (FHR) variability throughout gestation reflects aspects of fetal development, and its analysis has been used for the assessment of fetal well-being. AIM: The objective of this study was to provide a gender-specific analysis of the evolution of FHR variability indices throughout gestation, using linear time-domain, spectral and nonlinear FHR indices. STUDY DESIGN: A large retrospective study was carried out using antepartum FHR recordings obtained from 4713 male and 4110 female fetuses, with normal pregnancy outcome, between 2004 and 2013, with gestational ages ranging between 25 and 40weeks...
September 7, 2017: Early Human Development
https://www.readbyqxmd.com/read/28888054/maternal-salivary-testosterone-in-pregnancy-and-fetal-neuromaturation
#16
Kristin M Voegtline, Kathleen A Costigan, Janet A DiPietro
Testosterone exposure during pregnancy has been hypothesized as a mechanism for sex differences in brain and behavioral development observed in the postnatal period. The current study documents the natural history of maternal salivary testosterone from 18 weeks gestation of pregnancy to 6 months postpartum, and investigates associations with fetal heart rate, motor activity, and their integration. Findings indicate maternal salivary testosterone increases with advancing gestation though no differences by fetal sex were detected...
September 9, 2017: Developmental Psychobiology
https://www.readbyqxmd.com/read/28888041/supplementation-with-the-methyl-donor-betaine-prevents-congenital-defects-induced-by-prenatal-alcohol-exposure
#17
Ganga Karunamuni, Megan M Sheehan, Yong Qiu Doughman, Shi Gu, Jiayang Sun, Youjun Li, James P Strainic, Andrew M Rollins, Michael W Jenkins, Michiko Watanabe
BACKGROUND: Despite decades of public education about dire consequences of prenatal alcohol exposure, drinking alcohol during pregnancy remains prevalent. As high as 40% of live-born infants exposed to alcohol during gestation and diagnosed with Fetal Alcohol Syndrome have congenital heart defects that can be life-threatening. In animal models, the methyl donor betaine, found in foods such as wheat bran, quinoa, beets and spinach, ameliorated neurobehavioral deficits associated with prenatal alcohol exposure (PAE) but effects on heart development are unknown...
September 9, 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/28887130/gender-specific-impairment-of-in-vitro-sinoatrial-node-chronotropic-responses-and-of-myocardial-ischemia-tolerance-in-rats-exposed-prenatally-to-betamethasone
#18
L R A Kiguti, C S Borges, A Mueller, K P Silva, C M Polo, J L Rosa, P V Silva, G Missassi, L Valencise, W G Kempinas, A S Pupo
Excessive fetal glucocorticoid exposure has been linked to increased susceptibility to hypertension and cardiac diseases in the adult life, a process called fetal programming. The cardiac contribution to the hypertensive phenotype of glucocorticoid-programmed progeny is less known, therefore, we investigated in vitro cardiac functional parameters from rats exposed in utero to betamethasone. Pregnant Wistar rats received vehicle (VEH) or betamethasone (BET, 0.1mg/kg, i.m.) at gestational days 12, 13, 18 and 19...
September 5, 2017: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/28880700/anti-ro52-antibody-level-is-an-important-marker-of-fetal-congenital-heart-block-risk-in-anti-ro-ssa-antibody-positive-pregnancy
#19
Mai Miyasato-Isoda, Masako Waguri, Yuko Yamada, Akira Miyano, Yoshinao Wada
OBJECTIVE: The aims of this study are to determine the incidence of CHB in the Japanese population and to identify maternal factors predicting fetal congenital heart block (CHB) in anti-Ro/SSA antibody positive pregnancy. METHODS: A retrospective study was performed using 52,147 clinical records of pregnancies followed in a single center. For 183 anti-Ro/SSA antibody-positive women, anti-Ro52 and Ro60 antibodies were measured, and the odds of CHB in relation to maternal clinical features were calculated by multivariate analysis...
September 7, 2017: Modern Rheumatology
https://www.readbyqxmd.com/read/28879597/prenatal-congenital-vertical-talus-rocker-bottom-foot-a-marker-for-multisystem-anomalies
#20
Eva I Rubio, Nimisha Mehta, Anna R Blask, Dorothy I Bulas
BACKGROUND: Congenital vertical talus is a rare foot anomaly characterized by a prominent calcaneus and rigid forefoot dorsiflexion. While congenital vertical talus has been associated with anomalies such as trisomy 18, myelomeningocele and arthrogryposis, postnatal series have reported cases of isolated congenital vertical talus. OBJECTIVE: The purpose of our study was to determine the incidence of isolated congenital vertical talus prenatally and identify the most common anomalies associated with this finding...
September 6, 2017: Pediatric Radiology
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