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Fetal doppler

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https://www.readbyqxmd.com/read/27896244/adaptive-responses-of-cardiac-function-to-fetal-postural-change-as-gestational-age-increases
#1
Woo Jin Kim, Hye Jin Choi, Sun Young Yang, Boo Hae Koo, Ki Hoon Ahn, Geum Joon Cho, Soon Cheol Hong, Min-Jeong Oh, Hai-Joong Kim
OBJECTIVE: The cardiovascular system maintains homeostasis through a series of adaptive responses to physiological requirements. However, little is known about the adaptation of fetal cardiac function to gravity, according to gestational age. In the present study, we aimed to evaluate the adaptive responses of cardiac function to postural changes, using Tei index measurements. METHODS: Fetal echocardiography and Doppler examination were performed on 114 women with vertex singleton pregnancies at 19 to 40 weeks' gestation...
November 2016: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/27894704/antenatal-fetal-surveillance-in-multiple-pregnancies
#2
REVIEW
Dick Oepkes, Marieke Sueters
Multiple pregnancies occur either spontaneously or because of assisted reproduction techniques in 1-3% of pregnancies. The presence of more than one fetus in the womb is associated with a range of possible complications, both for the mother and fetuses. Early detection of these complications followed by timely and appropriate management will reduce the risk of adverse outcomes. The techniques, skills, and experience for timely detection of complications and managing them appropriately require sufficient training and exposure...
September 29, 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/27888318/toward-improving-the-fetal-diagnosis-of-coarctation-of-the-aorta
#3
Meaghan Beattie, Shabnam Peyvandi, Suguna Ganesan, Anita Moon-Grady
Coarctation of the aorta (CoA) is the most common ductal-dependent lesion missed on neonatal exam screening. Prenatal diagnosis of CoA improves outcomes through early initiation of prostaglandin. Fetal echocardiographic parameters including 2D and Doppler findings have been studied as predictive measures for fetal diagnosis of CoA, but diagnosis rates remain variable. A comprehensive set of predictor variables was applied to fetuses suspected of CoA to analyze which parameters were associated with postnatal CoA...
November 25, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27883332/effect-of-signal-acquisition-method-on-the-fetal-heart-rate-analysis-with-phase-rectified-signal-averaging
#4
J A M van Scheepen, M P H Koster, B Vasak, C Redman, A Franx, A Georgieva
Phase rectified signal averaging (PRSA) is increasingly used for fetal heart rate (FHR) monitoring, both with traces acquired with external Doppler cardiotocography (D-FHR), and with transabdominal fetal electrocardiography (ta-FHR). However, it is unclear to what extend the acquisition method influences the PRSA analysis, whether results from using one acquisition method are comparable to those based on FHR acquired by the other method, and if not, which should be the preferred method. To address these questions, we applied PRSA analysis to 28 antepartum synchronous recordings of the FHR using simultaneously D-FHR and ta-FHR...
November 24, 2016: Physiological Measurement
https://www.readbyqxmd.com/read/27874184/antenatal-ultrasound-features-in-fetuses-with-gastroschisis-and-its-prediction-in-neonatal-outcome
#5
Jessica A Robertson, Roy M Kimble, Kellie Stockton, Renuka Sekar
BACKGROUND: Gastroschisis is the most common major congenital anomaly managed by paediatric surgeons. The significance of certain associated antenatal ultrasound features in determining fetal outcome is under discussion. AIM: The study aims to define if associated antenatal ultrasound features of gastroschisis are useful prognostic markers for fetal outcome. By establishing the significance of features, including extra- and intra-abdominal bowel dilatation, stomach herniation, stomach dilatation, bowel matting, growth restriction, abnormal umbilical artery (UA) Doppler ultrasounds, and abnormal amniotic fluid volume, it is hoped clinicians will have enhanced ability to counsel parents about the likely outcomes for their infant...
November 22, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/27873373/cardiac-output-and-blood-flow-redistribution-in-the-fetus-with-d-loop-transposition-of-the-great-arteries-and-intact-ventricular-septum-insights-into-the-pathophysiology
#6
Max E Godfrey, Kevin G Friedman, Monika Drogosz, Abraham M Rudolph, Wayne Tworetzky
OBJECTIVES: Although the postnatal physiology of D-loop transposition of the great arteries with intact ventricular septum (DTGA-IVS) is well established, little is known about fetal DTGA-IVS. In the normal fetus, the pulmonary valve (PV) is larger than the aortic valve (AoV), there is exclusive right to left flow at the foramen ovale (FO) and ductus arteriosus (DA), and the left ventricle (LV) ejects 40% of combined ventricular output (CVO) through the aorta, primarily to the brain. In DTGA-IVS, the LV ejects O2 -rich blood to the pulmonary artery, theoretically leading to pulmonary vasodilation, increased branch pulmonary arterial flow and reduced DA flow...
November 22, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27872421/risk-of-adverse-outcomes-in-euploid-pregnancies-with-isolated-short-fetal-femur-and-humerus-on-second-trimester-sonography
#7
Marja Kaijomaa, Veli-Matti Ulander, Markku Ryynanen, Vedran Stefanovic
OBJECTIVES: The purpose of this study was to evaluate pregnancies with isolated short fetal femur and humerus on second-trimester sonography. Short fetal long bones are known to be associated with aneuploidy and structural anomalies. In this study, we wanted to show the risk of adverse pregnancy outcomes in euploid and nonanomalous pregnancies. METHODS: Singleton pregnancies with short femur and humerus were included. Pregnancies with normal fetal bone lengths and age-matched mothers were selected as controls...
December 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27862084/intra-and-inter-observer-reproducibility-and-generalizability-of-first-trimester-uterine-artery-pulsatility-index-by-transabdominal-and-transvaginal-ultrasound
#8
Laura Marchi, Eva Zwertbroek, Judith Snelder, Maaike Kloosterman, Caterina Maddalena Bilardo
OBJECTIVES: The primary aim of the study was to assess intra-observer and inter-observer reproducibility and generalizability (general reliability) of first trimester Doppler measurements of uterine arteries (UtA) performed both transabdominally (TA) and transvaginally (TV). Secondary aims were to investigate whether maternal BMI and acquisition modality (transabdominal or transvaginal) affect feasibility and reliability of UtA Doppler evaluation. METHODS: Singleton pregnancies between 11(+0) and 13(+6) weeks underwent TA and TV Doppler measurements of UtA prospectively, blindly and independently by Fetal Medicine Foundation-accredited operators...
November 16, 2016: Prenatal Diagnosis
https://www.readbyqxmd.com/read/27859836/outcome-in-monochorionic-twin-pregnancies-with-selective-intrauterine-growth-restriction-according-to-the-umbilical-artery-doppler-pattern-of-the-smaller-twin-a-systematic-review-and-meta-analysis
#9
REVIEW
Danilo Buca, Giorgio Pagani, Giuseppe Rizzo, Alessandra Familiari, Maria Elena Flacco, Lamberto Manzoli, Marco Liberati, Francesco Fanfani, Giovanni Scambia, Francesco D'Antonio
OBJECTIVE: To explore the outcome of monochorionic (MC) twin pregnancies affected by selective intra-uterine growth restriction (sIUGR) according to the umbilical artery Doppler pattern of the smaller twin. METHODS: Medline, Embase, Cinhal and ClinicalTrials.gov databases (2000-2016) were searched. sIUGR was defined as the presence of one twin with estimated fetal weight and/or abdominal circumference less than 10(th) or 5(th) percentile and classified according to the umbilical artery Doppler flow pattern of the smaller twin (type I: persistently positive, type II: persistently absent/reversed, type III: intermittently absent/reversed)...
November 18, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27858967/placental-pulsatility-index-a-new-more-sensitive-parameter-for-predicting-adverse-outcome-in-pregnancies-suspected-of-fetal-growth-restriction
#10
Saemundur Gudmundsson, Kari Flo, Gisela Ghosh, Tom Wilsgaard, Ganesh Acharya
INTRODUCTION: The pulsatility indices (PI) of the umbilical (UA) and uterine (UtA) arteries are used as the surrogate measures of utero-placental perfusion. Combining the two might simplify the evaluation of total placental vascular impedance, possibly improve prediction of adverse outcomes and help to identify pregnancies with suspected fetal growth restriction that need more intense surveillance. MATERIAL AND METHODS: UA and UtA blood flow velocities were recorded using pulsed-wave Doppler in a longitudinal study of 53 low-risk pregnancies (248 observations) during 20-40 weeks of gestation...
November 17, 2016: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/27858228/prenatal-diagnosis-of-abnormal-umbilical-cord-insertion-a-rare-case-of-furcate-insertion
#11
Yasuyuki Fujita, Yasuo Yumoto, Kiyoko Kato
Furcate insertion (FI) is an extremely rare abnormality of umbilical cord insertion. One of the complications associated with FI is hemorrhage from the umbilical vein at the site of FI of the umbilical cord, which can cause sudden intrauterine fetal death. Because of its rarity, no prenatal diagnosis of FI has been reported. A 31-year-old woman at 34 weeks' gestation was referred to us for suspected abnormal cord insertion. Ultrasonography showed normal fetal growth and amniotic fluid volume, with no fetal anomalies...
November 17, 2016: Journal of Medical Ultrasonics
https://www.readbyqxmd.com/read/27854395/prediction-of-stillbirth-from-placental-growth-factor-at-19-24-weeks
#12
J E Aupont, R Akolekar, A Illian, S Neonakis, K H Nicolaides
OBJECTIVES: To investigate whether the addition of maternal serum placental growth factor (PlGF) measured at 19-24 weeks' gestation improves the performance of screening for stillbirth that is achieved by a combination of maternal factors, fetal biometry and uterine artery pulsatility index (UtA-PI) and to evaluate the performance of screening with this model for all stillbirths and those due to impaired placentation and unexplained or other causes. METHODS: This was a prospective screening study of 70 003 singleton pregnancies including 268 stillbirths, carried out in two phases...
November 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27854387/prediction-of-stillbirth-from-maternal-factors-fetal-biometry-and-uterine-artery-doppler-at-19-24-weeks
#13
R Akolekar, M Tokunaka, N Ortega, A Syngelaki, K H Nicolaides
OBJECTIVES: To evaluate the performance of screening for all stillbirths and those due to impaired placentation and unexplained or other causes using a combination of maternal factors, fetal biometry and uterine artery pulsatility index (UtA-PI) at 19-24 weeks' gestation and to compare this performance with that of screening by UtA-PI alone. METHODS: This was a prospective screening study of 70 003 singleton pregnancies including 69 735 live births and 268 (0.38%) antepartum stillbirths; 159 (59%) were secondary to impaired placentation and 109 (41%) were due to other or unexplained causes...
November 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27854384/short-term-outcome-of-periviable-small-for-gestational-age-babies-is-our-counseling-up-to-date
#14
A R Lawin-O'Brien, A Dall'Asta, C Knight, S Sankaran, C Scala, A Khalil, A Bhide, S Heggarty, A Rakow, D Pasupathy, A T Papageorghiou, C C Lees
OBJECTIVE: There are limited data for counseling on and management of periviable small-for-gestational-age (SGA) fetuses. We therefore aimed to investigate the short-term outcome of periviable SGA fetuses in relation to the likely underlying cause. METHODS: This was a retrospective study of data from three London tertiary fetal medicine centers obtained between 2000 and 2015. We included viable singleton pregnancies with a severely small fetus, defined as those with an abdominal circumference ≤ 3(rd) percentile, identified between 22 + 0 and 25 + 6 weeks' gestation...
November 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27845691/non-invasive-evaluation-of-placental-blood-flow-lessons-from-animal-models
#15
Eve Mourier, Anne Tarrade, Jie Duan, Christophe Richard, Charline Bertholdt, Marine Beaumont, Olivier Morel, Pascale Chavatte-Palmer
In human obstetrics, placental vascularisation impairment is frequent as well as linked to severe pathological events (preeclampsia and intra-uterine growth restriction) and there is a need for reliable methods allowing non-invasive evaluation of placental blood flow. Uteroplacental vascularisation is complex and animal models are essential for the technical development and safety assessment of these imaging tools for human clinical use but these techniques can also be applied in the veterinary context. This paper reviews how ultrasound based imaging methods such as 2D and 3D Doppler can provide valuable insight for the exploration of placental blood flow both in humans and animals and how new approaches such as the use of ultrasound contrast agents or ultrafast Doppler may allow to discriminate between maternal (non-pulsatile) and fetal (pulsatile) blood flow in the placenta...
November 14, 2016: Reproduction: the Official Journal of the Society for the Study of Fertility
https://www.readbyqxmd.com/read/27832863/endothelial-progenitor-cells-from-human-fetal-aorta-cure-diabetic-foot-in-a-rat-model
#16
Wan-Ni Zhao, Shi-Qing Xu, Jian-Feng Liang, Liang Peng, Hong-Lin Liu, Zai Wang, Qing Fang, Meng Wang, Wei-Qin Yin, Wen-Jian Zhang, Jin-Ning Lou
OBJECTIVE: Recent evidence has suggested that circulating endothelial progenitor cells (EPCs) can repair the arterial endothelium during vascular injury. However, a reliable source of human EPCs is needed for therapeutic applications. In this study, we isolated human fetal aorta (HFA)-derived EPCs and analyzed the capacity of EPCs to differentiate into endothelial cells. In addition, because microvascular dysfunction is considered to be the major cause of diabetic foot (DF), we investigated whether transplantation of HFA-derived EPCs could treat DF in a rat model...
December 2016: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/27831924/transient-fetal-blood-redistribution-associated-with-maternal-supine-position
#17
Karina P Silva, Tatiana Emy N K Hamamoto, Roseli M Y Nomura
OBJECTIVE: To investigate whether fetal blood circulation is influenced by the maternal supine position. METHODS: The inclusion criteria were good health, a singleton pregnancy, maternal age between 18 and 40 years, gestational age between 36 and 40 weeks, and an agreement to participate in the study. Each participant (n=20) was initially asked to adopt the left lateral position for 5 min, while fetal Doppler measurements were taken of the fetal middle cerebral artery (MCA), umbilical artery (UA), and umbilical vein (UV)...
November 10, 2016: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/27825311/criteria-based-audit-to-improve-quality-of-care-of-foetal-distress-standardising-obstetric-care-at-a-national-referral-hospital-in-a-low-resource-setting-tanzania
#18
Andrew H Mgaya, Helena Litorp, Hussein L Kidanto, Lennarth Nyström, Birgitta Essén
BACKGROUND: In Tanzania, substandard intrapartum management of foetal distress contributes to a third of perinatal deaths, and the majority are term deliveries. We conducted a criteria-based audit with feedback to determine whether standards of diagnosis and management of foetal distress would be improved in a low-resource setting. METHODS: During 2013-2015, a criteria-based audit was performed at the national referral hospital in Dar es Salaam. Case files of deliveries with a diagnosis of foetal distress were identified and audited...
November 8, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27824565/visualization-of-small-diameter-vessels-by-reduction-of-incoherent-reverberation-with-coherent-flow-power-doppler
#19
You Leo Li, Dongwoon Hyun, Lotfi Abou-Elkacem, Juergen Karl Willmann, Jeremy J Dahl
Power Doppler (PD) imaging is a widely used technique for flow detection. Despite the wide use of Doppler ultrasound, limitations exist in the ability of Doppler ultrasound to assess slow flow in the small-diameter vasculature, such as the maternal spiral arteries and fetal villous arteries of the placenta and focal liver lesions. The sensitivity of PD in small vessel detection is limited by the low signal produced by slow flow and the noise associated with small vessels. The noise sources include electronic noise, stationary or slowly moving tissue clutter, reverberation clutter, and off-axis scattering from tissue, among others...
November 2016: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
https://www.readbyqxmd.com/read/27822432/standard-external-doppler-fetal-heart-tracings-versus-external-fetal-electrocardiogram-in-very-preterm-gestation-a-pilot-study
#20
Gary Fruhman, Jeffrey A Gavard, Kristina McCormick, Judy Wilson-Griffin, Erol Amon, Gilad A Gross
Introduction Very preterm babies can be difficult to monitor using standard external Doppler fetal heart tracings (eFHR). External fetal electrocardiogram (fECG) is a potential alternative. Methods This was a prospective observational pilot study of hospitalized patients at 24 to 28 weeks' gestation. A total of 30 women were traced for up to 2 hours using eFHR followed by up to 2 hours using fECG. The percentage of time the fetal heart rate was traced during the 2-hour window for each modality was calculated...
October 2016: American Journal of Perinatology Reports
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