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Fetal lung maturity

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https://www.readbyqxmd.com/read/29460323/clinical-guidelines-for-prevention-and-management-of-preterm-birth-a-systematic-review
#1
Nancy Medley, Borna Poljak, Silvia Mammarella, Zarko Alfirevic
BACKGROUND: Clinical practice guidelines (CPG) endorse multiple strategies to prevent or manage preterm birth (PTB). OBJECTIVES: To summarise CPG recommendations for PTB and identify areas of international consensus. SEARCH STRATEGY: In June 2017 we searched for all CPG relavant to PTB without language restrictions. SELECTION CRITERIA: CPG were eligible if the following criteria were met. i.The guideline was published or current from June 2013...
February 20, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29436664/knockout-of-microrna%C3%A2-26a-promotes-lung-development-and-pulmonary-surfactant-synthesis
#2
Yi-Fan Sun, Qing Kan, Yang Yang, Ying-Hui Zhang, Jin-Xin Shen, Cun Zhang, Xiao-Yu Zhou
Normal formation and function of the lungs are essential for the transition of the fetus to an air‑breathing environment at birth. The synthesis of pulmonary surfactant (PS), which is produced by type II alveolar epithelial cells (AECIIs), is required for proper lung development. Previous in vitro studies have suggested that PS synthesis is regulated by microRNA (miR)‑26a in fetal rat AECIIs. The present study explored the potential role of miR‑26a in lung development and PS synthesis by using a miR‑26a‑1/miR‑26a‑2 double knockout mouse model...
February 13, 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29408744/the-use-of-antenatal-fetal-magnetic-resonance-imaging-in-the-assessment-of-patients-at-high-risk-of-preterm-birth
#3
REVIEW
L Story, J Hutter, T Zhang, A H Shennan, M Rutherford
Preterm birth, defined as birth occurring prior to 37 weeks gestation is a common obstetric complication affecting 8% of pregnancies and is associated with significant morbidity and mortality. Infection/inflammation has been implicated in both the aetiology of preterm birth itself and associated neonatal pulmonary and neurological morbidity. Treatment options are currently limited to prolongation of the pregnancy using cervical cerclage, pessaries or progesterone or administration of drugs including steroids to promote lung maturity and neuroprotective agents such as magnesium sulphate, the timing of which are highly critical...
March 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29367581/pre-eclampsia-and-eclampsia-an-update-on-the-pharmacological-treatment-applied-in-portugal
#4
REVIEW
Gonçalo Miguel Peres, Melissa Mariana, Elisa Cairrão
Pre-eclampsia and eclampsia are two hypertensive disorders of pregnancy, considered major causes of maternal and perinatal death worldwide. Pre-eclampsia is a multisystemic disease characterized by the development of hypertension after 20 weeks of gestation, with the presence of proteinuria or, in its absence, of signs or symptoms indicative of target organ injury. Eclampsia represents the consequence of brain injuries caused by pre-eclampsia. The correct diagnosis and classification of the disease are essential, since the therapies for the mild and severe forms of pre-eclampsia are different...
January 17, 2018: Journal of Cardiovascular Development and Disease
https://www.readbyqxmd.com/read/29348396/a-case-of-umbilical-artery-thrombosis-in-the-third-trimester-of-pregnancy
#5
Fouad Lutfallah, Nina Oufkir, Georges A Markou, Delphine Frimigacci, Christophe Poncelet
BACKGROUND Umbilical artery thrombosis is an extremely rare complication during pregnancy. Umbilical artery thrombosis has a poor prognosis and is associated with increased rates of perinatal morbidity, including intrauterine growth restriction (IUGR), and fetal mortality. CASE REPORT We report a rare case of umbilical artery thrombosis, diagnosed by ultrasound, at 33 weeks gestation in a 30-year-old woman who had previously had an uneventful pregnancy. CONCLUSIONS Umbilical artery thrombosis is a rare complication of pregnancy that is associated with high fetal mortality...
January 19, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29281153/microvascular-perfusion-of-the-placenta-developing-fetal-liver-and-lungs-assessed-with-intravoxel-incoherent-motion-imaging
#6
András Jakab, Ruth L Tuura, Raimund Kottke, Nicole Ochsenbein-Kölble, Giancarlo Natalucci, Thi Dao Nguyen, Christian Kellenberger, Ianina Scheer
BACKGROUND: In utero intravoxel incoherent motion magnetic resonance imaging (IVIM-MRI) provides a novel method for examining microvascular perfusion fraction and diffusion in the developing human fetus. PURPOSE: To characterize gestational changes in the microvascular perfusion fraction of the placenta, fetal liver, and lungs using IVIM-MRI. STUDY TYPE: Retrospective, cross-sectional study. SUBJECTS: Fifty-five datasets from 33 singleton pregnancies were acquired (17-36 gestational weeks)...
December 27, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/29275510/bisphenol-a-induces-dsb-atm-p53-signaling-leading-to-cell-cycle-arrest-senescence-autophagy-stress-response-and-estrogen-release-in-human-fetal-lung-fibroblasts
#7
Laziyan Mahemuti, Qixuan Chen, Melanie C Coughlan, Cunye Qiao, Nikolai L Chepelev, Maria Florian, Dillon Dong, Robert G Woodworth, Jin Yan, Xu-Liang Cao, Kylie A Scoggan, Xiaolei Jin, William G Willmore
Experimental and/or epidemiological studies suggest that prenatal exposure to bisphenol A (BPA) may delay fetal lung development and maturation and increase the susceptibility to childhood respiratory disease. However, the underlying mechanisms remain to be elucidated. In our previous study with cultured human fetal lung fibroblasts (HFLF), we demonstrated that 24-h exposure to 1 and 100 µM BPA increased GPR30 protein in the nuclear fraction. Exposure to 100 μM BPA had no effects on cell viability, but increased cytoplasmic expression of ERβ and release of GDF-15, as well as decreased release of IL-6, ET-1, and IP-10 through suppression of NFκB phosphorylation...
December 23, 2017: Archives of Toxicology
https://www.readbyqxmd.com/read/29274832/extremely-preterm-fetal-sheep-lung-responses-to-antenatal-steroids-and-inflammation
#8
Kevin Visconti, Paranthaman Senthamaraikannan, Matthew W Kemp, Masatoshi Saito, Boris W Kramer, John P Newnham, Alan H Jobe, Suhas G Kallapur
BACKGROUND: The efficacy of antenatal steroids for fetal lung maturation in the periviable period is not fully understood. OBJECTIVE: We sought to determine the lung maturational effects of antenatal steroids and inflammation in early gestation sheep fetuses, similar to the periviable period in human beings. STUDY DESIGN: Date-mated ewes with singleton fetuses were randomly assigned to 1 of 4 treatment groups (n = 8/group): (1) maternal intramuscular injection of betamethasone; (2) intraamniotic lipopolysaccharide; (3) betamethasone + lipopolysaccharide; and (4) intraamniotic + intramuscular saline (controls)...
December 21, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29229321/the-role-of-aspirin-heparin-and-other-interventions-in-the-prevention-and-treatment-of-fetal-growth-restriction
#9
REVIEW
Katie M Groom, Anna L David
Fetal growth restriction and related placental pathologies such as preeclampsia, stillbirth, and placental abruption are believed to arise in early pregnancy when inadequate remodeling of the maternal spiral arteries leads to persistent high-resistance and low-flow uteroplacental circulation. The consequent placental ischaemia, reperfusion injury, and oxidative stress are associated with an imbalance in angiogenic/antiangiogenic factors. Many interventions have centered on the prevention and/or treatment of preeclampsia with results pertaining to fetal growth restriction and small-for-gestational-age pregnancy often included as secondary outcomes because of the common pathophysiology...
December 8, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29191292/long-term-childhood-outcomes-after-interventions-for-prevention-and-management-of-preterm-birth
#10
REVIEW
Sarah R Murray, Sarah J Stock, Jane E Norman
Globally, preterm birth rates are rising and have a significant impact on neonatal morbidity and mortality. Preterm birth remains difficult to prevent and a number of strategies for preterm birth prevention (progesterone, cervical pessaries, cervical cerclage, tocolytics, and antibiotics) have been identified. While some of these show more promise, there is a paucity of evidence regarding the long-term effects of these strategies on childhood outcomes. Strategies used to improve the health of babies if born preterm, such as antenatal magnesium sulfate for fetal neuroprotection and antenatal corticosteroids for fetal lung maturation, show evidence of short-term benefit but lack large-scale follow-up data of long-term childhood outcomes...
December 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/29187357/iap-antagonists-enhance-cytokine-production-from-mouse-and-human-inkt-cells
#11
Eleanor Clancy-Thompson, Lestat Ali, Patrick T Bruck, Mark A Exley, Richard S Blumberg, Glenn Dranoff, Michael Dougan, Stephanie K Dougan
Inhibitor of apoptosis protein (IAP) antagonists are in clinical trials for a variety of cancers, and mouse models show synergism between IAP antagonists and anti-PD-1 immunotherapy. Although IAP antagonists affect the intrinsic signaling of tumor cells, their most pronounced effects are on immune cells and the generation of antitumor immunity. Here we examined the effects of IAP antagonism on T-cell development using mouse fetal thymic organ culture and observed a selective loss of iNKT cells, an effector cell type of potential importance for cancer immunotherapy...
November 29, 2017: Cancer Immunology Research
https://www.readbyqxmd.com/read/29173937/relationship-between-ultrasonic-marker-of-fetal-lung-maturity-and-lamellar-body-count
#12
Khadije Rezaie Keikhaie, Kolsoum Rezaie Kahkhaie, Nooshin Mohammadi, Nooshin Amjadi, Aliye Ahmadi Forg, Abbas Ali Ramazani
BACKGROUND: The aim of this study was prediction the fetal lung maturity by ultrasonic markers and comparison by lamellar body count and fetal outcome. METHODS: A prospective Longitudinal study Department of perinatology of performed Emam Khomeini hospital and Mirza Kochak Khan Hospital in Tehran, Iran from March 2013 to January 2014. 100 pregnant women (37-40 weeks of gestation) who were admitted for elective cesarean section and referred for an obstetric ultrasound scan at the same day of their elective cesarean section were included...
January 2017: Journal of the National Medical Association
https://www.readbyqxmd.com/read/29138038/low-dose-betamethasone-acetate-for-fetal-lung-maturation-in-preterm-sheep
#13
Augusto F Schmidt, Matthew W Kemp, Judith Rittenschober-Böhm, Paranthaman S Kannan, Haruo Usuda, Masatoshi Saito, Lucy Furfaro, Shimpei Watanabe, Sarah Stock, Boris W Kramer, John P Newnham, Suhas G Kallapur, Alan H Jobe
BACKGROUND: Antenatal steroids (ANS) are standard of care for women at risk of preterm delivery; however ANS dosing and formulation have not been adequately evaluated. The standard clinical 2-dose treatment with betamethasone-acetate+betamethasone-phosphate (Beta-P+Beta-Ac) is more effective than 2 doses of Beta-P for inducing lung maturation in preterm fetal sheep. We hypothesized that the slowly-released Beta-Ac component induces similar lung maturation to Beta-P+Beta-Ac with decreased dose and fetal exposure...
November 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29138031/mortality-and-pulmonary-outcomes-of-extremely-preterm-infants-exposed-to-antenatal-corticosteroids
#14
Colm P Travers, Waldemar A Carlo, Scott A Mcdonald, Abhik Das, Edward F Bell, Namasivayam Ambalavanan, Alan H Jobe, Ronald N Goldberg, Carl T D'Angio, Barbara J Stoll, Seetha Shankaran, Abbot R Laptook, Barbara Schmidt, Michele C Walsh, Pablo J Sanchez, M Bethany Ball, Ellen C Hale, Nancy S Newman, Rosemary D Higgins
BACKGROUND: Antenatal corticosteroids are given primarily to induce fetal lung maturation but results from meta-analyses of randomized controlled trials have not shown mortality or pulmonary benefits for extremely preterm infants although these are the infants most at risk of mortality and pulmonary disease. OBJECTIVE: To determine if exposure to antenatal corticosteroids is associated with a lower rate of death and pulmonary morbidities by 36 weeks' postmenstrual age...
November 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29126797/the-cytokine-tgf-%C3%AE-promotes-the-development-and-homeostasis-of-alveolar-macrophages
#15
Xueyang Yu, Anne Buttgereit, Iva Lelios, Sebastian G Utz, Dilay Cansever, Burkhard Becher, Melanie Greter
Alveolar macrophages (AMs) derive from fetal liver monocytes, which colonize the lung during embryonic development and give rise to fully mature AMs perinatally. AM differentiation requires granulocyte macrophage colony-stimulating factor (GM-CSF), but whether additional factors are involved in AM regulation is not known. Here we report that AMs, in contrast to most other tissue macrophages, were also dependent on transforming growth factor-β receptor (TGF-βR) signaling. Conditional deletion of TGF-βR in mice at different time points halted the development and differentiation of AMs...
November 21, 2017: Immunity
https://www.readbyqxmd.com/read/29104474/association-of-surfactant-protein-with-expression-of-hoxa5-and-hoxb5-in-rabbit-fetal-lung
#16
Sung-Hoon Chung, Chong-Woo Bae
Hox genes regulate organ formation and identity of the embryo, and expressed in specific temporo-spatial patterns in the developing embryo. We compared the expression levels of the Hoxa5, Hoxb5, surfactant protein (SP)-A, and SP-B genes in immature and mature rabbit fetal lung tissues, and to uncover roles for Hoxa5, Hoxb5, SP-A, and SP-B. Cesarean sections were performed after rabbits were divided into two groups of 30-31 days of gestation (term group, n = 24) and 26-27 days of gestation (preterm group, n = 24)...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/29079144/society-for-maternal-fetal-medicine-smfm-consult-series-44-management-of-bleeding-in%C3%A2-the-late-preterm-period
#17
Cynthia Gyamfi-Bannerman
Third-trimester bleeding is a common complication arising from a variety of etiologies, some of which may initially present in the late preterm period. Previous management recommendations have not been specific to this gestational age window, which carries a potentially lower threshold for delivery. The purpose of this document is to provide guidance on management of late preterm (34 0/7-36 6/7 weeks of gestation) vaginal bleeding. The following are Society for Maternal-Fetal Medicine recommendations: (1) we recommend delivery at 36-37 6/7 weeks of gestation for stable women with placenta previa without bleeding or other obstetric complications, such as preeclampsia or fetal growth restriction (Grade 1B); (2) we do not recommend routine cervical length screening for women with placenta previa in the late preterm period because of a lack of data on an appropriate management strategy (Grade 2C); (3) we recommend a planned delivery between 34 and 37 weeks of gestation for stable women with placenta accreta (Grade 1C); (4) we recommend delivery between 34 and 37 weeks of gestation for stable women with vasa previa (Grade 1C); (5) we recommend that in women with active hemorrhage in the late preterm period, delivery should not be delayed for the purpose of administering antenatal corticosteroids (Grade 1B); (6) we recommend that fetal lung maturity testing should not be used to guide management in the late preterm period when an indication for delivery is present (Grade 1B); and (7) we recommend that antenatal corticosteroids should be administered to women who are eligible and are managed expectantly if delivery is likely within 7 days, the gestational age is between 34 0/7 and 36 6/7 weeks of gestation, and antenatal corticosteroids has not previously been administered (Grade 1A)...
October 25, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29028158/effects-of-intratracheal-budesonide-during-early-postnatal-life-on-lung-maturity-of-premature-fetal-rabbits
#18
Ling Li, Chen Yang, Xiuliang Feng, Yongping Du, Zhihong Zhang, Yueping Zhang
AIM: This study aimed to study the effects of intratracheal instillation of budesonide on lung maturity of premature fetal rabbits. The developmental pattern of pulmonary alveoli in rabbits is similar to that in humans. METHOD: Fetal rabbits were taken out from female rabbits on the 28th day of pregnancy (full term = 31 days) by cesarean section (c-section). The fetal rabbits were divided into four groups: control (normal saline, NS), budesonide (budesonide, BUD), calf pulmonary surfactant for injection (pulmonary surfactant, PS), and calf pulmonary surfactant + budesonide for injection (pulmonary surfactant + budesonide, PS + BUD)...
October 13, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29022513/discrepancies-in-animal-models-of-preterm-birth
#19
Clarence R Manuel, Charles R Ashby, Sandra E Reznik
BACKGROUND: Preterm birth (PTB) is a multifactorial syndrome occurring before the 37th week of full-term pregnancy [1]. Babies delivered preterm experience short-term and long-term complications affecting multiple organ systems, and serious maternal complications include hemorrhage and infection. Each year, an estimated 15 million babies are born preterm, and complications from prematurity are the leading cause of death among children up to 5 years of age [2]. With another increase in PTB rates over the last several years, the United States continues to have the highest incidence of any industrialized country [3]...
October 12, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29018962/the-fetal-lung-to-liver-signal-intensity-ratio-on-magnetic-resonance-imaging-as-a-predictor-of-outcomes-from-isolated-congenital-diaphragmatic-hernia
#20
Masaya Yamoto, Teruo Iwazaki, Kasumi Takeuchi, Kyouhei Sano, Koji Fukumoto, Toshiaki Takahashi, Akiyoshi Nomura, Kei Ooyama, Akinori Sekioka, Yutaka Yamada, Naoto Urushihara
PURPOSE: We investigated the developmental changes in the unaffected contralateral lungs of patients with isolated left-sided congenital diaphragmatic hernia (CDH) using signal intensity ratios on prenatal magnetic resonance imaging (MRI) and determined whether these changes correlated with clinical outcomes. METHODS: We performed 47 fetal MRI screens on 30 patients with isolated left-sided CDH. A cohort of 88 fetuses was selected as the control. We calculated the lung-to-liver signal intensity ratio (LLSIR) using region of interest analysis and compared LLSIR between the groups and between those in the CDH group with good and poor prognoses...
October 10, 2017: Pediatric Surgery International
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