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Kenna Degner, Ronald R Magness, Dinesh M Shah
The uterine vasculature undergoes marked changes during pregnancy in order to provide the necessary increase in blood flow to support growth and nutrition of the uterus, placenta, and developing fetus. Pregnancy-associated uterine vascular transformations are orchestrated by a complex array of endocrine and cellular mechanisms to bring about structural modifications at the maternal-fetal interface, which collectively lead to development of the uteroplacental circulation. Understanding intrinsic uterine vascular remodeling in pregnancy is essential for understanding the physiologic and pathophysiologic regulation of maternal uterine blood flow...
October 12, 2016: Reproductive Sciences
Derek S Boeldt, Ian M Bird
Maternal vascular adaptation to pregnancy is critically important in order to expand the capacity for blood flow through the uteroplacental unit to meet the needs of the developing fetus. Failure of the maternal vasculature to properly adapt can result in hypertensive disorders of pregnancy such as preeclampsia (PE). Herein, we review the endocrinology of maternal adaptation to pregnancy and contrast this with that of PE. Our focus is specifically on those hormones with directly impact endothelial cell function and dysfunction, as endothelial cell dysfunction is a hallmark of PE...
October 11, 2016: Journal of Endocrinology
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
Terry K Morgan, Alexander G Beristain
No abstract text is available yet for this article.
October 2016: Journal of Leukocyte Biology
Sung Hye Byun, So Young Lee, Seong Yeon Hong, Taeha Ryu, Baek Jin Kim, Jin Yong Jung
INTRODUCTION: In fetuses who are predicted to be at risk of catastrophic airway obstruction at delivery, the ex utero intrapartum treatment (EXIT) procedure is useful for securing the fetal airway while maintaining fetal oxygenation via placental circulation. Factors, including poor posture of the fetus and physician, narrow visual field, and issues of contamination in the aseptic surgical field, make fetal intubation during the EXIT procedure difficult. Herein, we report our experience of the usefulness of the GlideScope video laryngoscope (GVL) for intubation during the EXIT procedure...
September 2016: Medicine (Baltimore)
Khrystyna Levytska, Mary Higgins, Sarah Keating, Nir Melamed, Melissa Walker, Neil J Sebire, John C P Kingdom
Objectives Current guidelines for diagnosis and management of early-onset intrauterine growth restriction (IUGR) rely on umbilical artery Doppler (UAD), without including uterine artery Doppler (UtAD). We hypothesized that IUGR cases with abnormal UAD but normal UtAD has a different spectrum of placental pathology compared with those with abnormal UtAD. Study Design Retrospective review of pregnancies with sonographic evidence of IUGR and abnormal UAD prior to delivery. Cases with ≥ 1 UtAD record(s) after 18(+0) weeks' gestation and placental pathology were included...
September 20, 2016: American Journal of Perinatology
A Chabot-Lecoanet, J Duan, E Perdriolle-Galet, O Morel
No abstract text is available yet for this article.
September 2016: Ultrasound in Obstetrics & Gynecology
Qian Meng, Li Shao, Xiucui Luo, Yingping Mu, Wen Xu, Li Gao, Haoqin Xu, Yugui Cui
BACKGROUND: Gestational diabetes mellitus (GDM) is one of the most common medical complications of pregnancy, and has important health implications for mother and child. Changes in the fetoplacental vessels may predict those in the vasculature of the developing fetus, as these have been implicated in the pathogenesis of human GDM. This study aimed to determine the differences in the localization and expression level of VEGFA and VEGFR2 between placentas of women with GDM and placentas of normal pregnancies, which is the first step in elucidating the possible roles of VEGFA and VEGFR2 in the altered uteroplacental function resulting from maternal hyperglycaemia and ultimately in the manifestation of GDM...
2016: Reproductive Biology and Endocrinology: RB&E
Ramanathan K Kasimanickam
The objective was to elucidate gene expression differences in uterus, caruncle, and cotyledon of ewes with subclinical pregnancy toxemia (SCPT) and healthy ewes, and to identify associated biological functions and pathways involved in pregnancy toxemia. On Day 136 (±1 day) post-breeding, ewes (n = 18) had body condition score (BCS; 1-5; 1, emaciated; 5, obese) assessed, and blood samples were collected for plasma glucose and β-hydroxybutyrate (BHBA) analyses. The ewes were euthanized, and tissue samples were collected from the gravid uterus and placentomes...
2016: Frontiers in Veterinary Science
E Latif, S Adam, B Rungruang, A Al-Hendy, M P Diamond, E Rotem, J Cannell, P C Browne
Uterine artery embolization (UAE) is typically not indicated in the pre-operative management of pregnancies with a live fetus, because risk of fetal death from reduced uteroplacental blood flow. However, pre-operative UAE in pregnancies with a fetal demise poses no fetal risk, and may offer maternal benefits. Patients with placental abruption resulting in fetal demise are at high-risk for developing disseminated intravascular coagulation (DIC), which could have devastating complications such as peri-operative hemorrhage and death...
September 16, 2016: Journal of Neonatal-perinatal Medicine
Alessandra Familiari, Carolina Scala, Maddalena Morlando, Amar Bhide, Asma Khalil, Basky Thilaganathan
INTRODUCTION: To evaluate the relative value of mid trimester fetal growth, uterine artery (UtA) Doppler indices and maternal demographics in prediction of stillbirth. MATERIAL AND METHODS: Retrospective cohort study; 23,894 singleton pregnancies routinely scanned between 19 and 24 weeks' gestation. Maternal characteristics included age, body mass index, ethnicity and medical history. Fetal biometry indices, birthweight and UtA pulsatility index (PI) values were converted to percentiles and multivariable logistic regression analysis was performed...
September 2, 2016: Acta Obstetricia et Gynecologica Scandinavica
Yukiko Chinen, Tadatsugu Kinjo, Hayase Nitta, Yui Kinjo, Hitoshi Masamoto, Yoichi Aoki
It was demonstrated that second- and third-trimester therapeutic termination of pregnancy (TOP) is feasible in cases with placenta previa. We report a 34-year-old woman with complex fetal malformations associated with placenta previa. An ultrasound examination at 21 weeks of gestation revealed fetal growth restriction (FGR) and complex fetal malformations associated with a placenta previa. After extensive information, the parents opted for careful observation. Thereafter, FGR gradually progressed and we observed arrest of end-diastolic velocity of the umbilical artery...
2016: Case Reports in Obstetrics and Gynecology
Amanda J Cain, Caleb O Lemley, F Kevin Walters, David L Christiansen, E Heath King, Richard M Hopper
The objective of the present study was to evaluate the effects of beef heifer development practices and the influence of season on uterine artery hemodynamics during mid to late gestation. Metrics of uterine artery blood flow (BF) of fall calving and spring calving crossbred beef heifers (n = 27) developed on either a low-input (LOW|FALL n = 6; LOW|SPRING n = 6) or a conventional (CON|FALL n = 9; CON|SPRING n = 6) heifer development scheme were evaluated. Heifer body weight (BW) was measured every 30 days, and uterine BF, arterial diameter (AD), pulsatility index (PI), and resistance index were measured for uterine arteries ipsilateral and contralateral to the conceptus on days 180, 210, and 240 of gestation...
August 5, 2016: Theriogenology
Jean N Cheong, James Sm Cuffe, Andrew J Jefferies, Kristina Anevska, Karen M Moritz, Mary E Wlodek
Low birth weight increases adult metabolic disease risk in both the first (F1) and second (F2) generation. Physiological stress during pregnancy in F1 females that were born small induces F2 fetal growth restriction, but the long-term metabolic health of these F2 offspring is unknown. Uteroplacental insufficiency (Restricted) or sham (Control) surgery was performed in F0 rats. F1 females (Control, Restricted) were allocated to Unstressed or Stressed pregnancies. F2 offspring exposed to maternal stress in utero had reduced birth weight...
August 29, 2016: Endocrinology
Rana Choudhary, Kavita Desai, Hetal Parekh, Kedar Ganla
Fetal growth restriction (FGR) and preeclampsia are the major causes of neonatal morbidity and mortality, which affect up to 8% of all pregnancies. The pathogenesis in FGR is an abnormal trophoblastic invasion leading to compromised uteroplacental circulation. However, in spite of this understanding and identification of high-risk patients, the management options are limited. There are some new studies which have demonstrated the role of sildenafil citrate in improving vasodilatation of small myometrial vessels and therefore improvement in amniotic fluid index, fetal weight, and even uterine and umbilical artery Doppler patterns...
2016: International Journal of Women's Health
Michaela Golic, Nadine Haase, Florian Herse, Anika Wehner, Lisbeth Vercruysse, Robert Pijnenborg, Andras Balogh, Per Christian Saether, Erik Dissen, Friedrich C Luft, Lukasz Przybyl, Joon-Keun Park, Patji Alnaes-Katjavivi, Anne Cathrine Staff, Stefan Verlohren, Wolfgang Henrich, Dominik N Muller, Ralf Dechend
Uterine natural killer cells are important for uteroplacental development and pregnancy maintenance. Their role in pregnancy disorders, such as preeclampsia, is unknown. We reduced the number of natural killer cells by administering rabbit anti-asialo GM1 antiserum in an established rat preeclamptic model (female human angiotensinogen×male human renin) and evaluated the effects at the end of pregnancy (day 21), compared with preeclamptic control rats receiving normal rabbit serum. In 100% of the antiserum-treated, preeclamptic rats (7/7), we observed highly degenerated vessel cross sections in the mesometrial triangle at the end of pregnancy...
October 2016: Hypertension
Joanna Sue Yee Chan, Debra Heller, Rebecca Baergen
Decidual vasculopathy (DV) is a general term for a number of lesions involving uteroplacental vessels. It is often seen in preeclamptic placentas and indicates a disorder of uteroplacental malperfusion and is associated with placental ischemia and infarction. Although some have advocated submitting special sections in order to better document DV, it is unclear which placental sections have the highest yield in demonstrating these abnormal vessels. 76 consecutive cases of decidual vasculopathy were identified and evaluated for location of DV, as well as presence of other lesions of ischemic change, infarcts and retroplacental hematomas...
August 11, 2016: Pediatric and Developmental Pathology
Luana Azevedo de Freitas, Gustavo Lobato Mota, Herlon Victor Rodrigues Silva, Cibele Figueira Carvalho, Lúcia Daniel Machado da Silva
The goals of this study were to report embryonic and fetal ultrasound changes and compare blood flow of uteroplacental and umbilical arteries of normal and abnormal conceptus. Accordingly, from the day of mating or artificial insemination, all fetuses in 60 pregnancies were evaluated weekly. According to the ultrasound findings, the gestational age was determined and the conceptuses were divided into normal or abnormal (embryonic and fetal abnormalities). The two-dimensional ultrasound assessment consists of measuring and evaluating the echogenicity of conceptus and extra-fetal structures...
September 2016: Animal Reproduction Science
H Small, R Nosalski, H Morgan, E Beattie, T Guzik, D Graham, C Delles
OBJECTIVE: Impaired vascular remodelling has been extensively studied in pre-eclampsia but little is known about adaptation of the cardiovascular (CV) system to pregnancy in women with chronic hypertension. We have previously characterised the stroke prone spontaneously hypertensive rat (SHRSP) as a model of deficient uterine artery remodelling and identified an increase in pro-inflammatory TNF α relative to the normotensive WKY strain during pregnancy. DESIGN AND METHOD: SHRSP were treated with etanercept (0...
September 2016: Journal of Hypertension
Ane M Holme, Marie C P Roland, Tore Henriksen, Trond M Michelsen
BACKGROUND: Preeclampsia is characterized by maternal endothelial dysfunction, which underlies a highly diverse clinical presentation. The pathophysiologic condition remains to be unraveled fully, but interplay between factors that are released from the placenta and maternal vascular vulnerability is likely. An imbalance in circulating angiogenic factors is a prominent feature of preeclampsia; placental growth factor and soluble Fms-like tyrosine kinase 1 have been implemented as biomarkers of placental function and preeclampsia...
August 5, 2016: American Journal of Obstetrics and Gynecology
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