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https://www.readbyqxmd.com/read/29437032/computerised-interpretation-of-the-fetal-heart-rate-during-labour-a-randomised-controlled-trial-infant
#1
Peter Brocklehurst, David Field, Keith Greene, Edmund Juszczak, Sara Kenyon, Louise Linsell, Chris Mabey, Mary Newburn, Rachel Plachcinski, Maria Quigley, Philip Steer, Liz Schroeder, Oliver Rivero-Arias
BACKGROUND: Continuous electronic fetal monitoring (EFM) in labour is widely used and computerised interpretation has the potential to increase its utility. OBJECTIVES: This trial aimed to find out whether or not the addition of decision support software to assist in the interpretation of the cardiotocograph (CTG) reduced the number of poor neonatal outcomes, and whether or not it was cost-effective. DESIGN: Two-arm individually randomised controlled trial...
February 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29303768/detection-of-autoantibodies-to-the-p200-epitope-of-ssa-ro52-antigen-a-comparison-of-two-laboratory-assays
#2
Elena Mattia, Ariela Hoxha, Marta Tonello, Maria Favaro, Teresa Del Ross, Antonia Calligaro, Anna Ghirardello, Amelia Ruffatti
BACKGROUND: Anti-p200 antibodies have been receiving growing interest in view of findings associating their presence to risk of fetal autoimmune congenital heart block (CHB). The study compares and evaluates the performance of two assays currently being used for their detection. METHODS: One hundred and sixteen pregnant women positive for anti-SSA/Ro52 antibodies were considered as the study population. Fifty women negative for anti-SSA/Ro52 antibodies were considered as the control population...
January 5, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29224680/pregnancy-in-systemic-lupus-erythematosus-and-antiphospholipid-syndrome
#3
REVIEW
Rebecca Fischer-Betz, Christof Specker
Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease with a high prevalence in females of childbearing age. Pregnancy in SLE nowadays has favorable outcomes for the majority of women. However, flares of disease activity, preeclampsia, fetal loss, and preterm birth are well-known risks in such pregnancies. Anti-SS-A(Ro)/SS-B(La) antibodies put fetuses at risk for congenital heart block and neonatal lupus. Several risk factors for adverse pregnancy outcomes have been identified. Women with antiphospholipid antibodies or antiphospholipid syndrome and lupus nephritis represent a group with high risk for obstetric complications...
June 2017: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/29186007/anatomically-realistic-ultrasound-phantoms-using-gel-wax-with-3d-printed-moulds
#4
Efthymios Maneas, Wenfeng Xia, Daniil I Nikitichev, Batol Daher, Maniragav Manimaran, Rui Yen J Wong, Chia-Wei Chang, Benyamin Rahmani, Claudio Capelli, Silvia Schievano, Gaetano Burriesci, Sebastien Ourselin, Anna L David, Malcolm C Finlay, Simeon J West, Tom Vercauteren, Adrien E Desjardins
Here we describe methods for creating tissue-mimicking ultrasound phantoms based on patient anatomy using a soft material called gel wax. To recreate acoustically realistic tissue properties, two additives to gel wax were considered: paraffin wax to increase acoustic attenuation, and solid glass spheres to increase backscattering. The frequency dependence of ultrasound attenuation was well described with a power law over the measured range of 3-10 MHz. With the addition of paraffin wax in concentrations of 0 to 8 w/w%, attenuation varied from 0...
January 5, 2018: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29176145/autoimmune-associated-congenital-heart-block-a-new-insight-in-fetal-life
#5
REVIEW
Kai-Yu Zhou, Yi-Min Hua
OBJECTIVE: Congenital heart block (CHB) is a rare but life-threatening disorder. More than half of CHB cases are associated with maternal autoimmune, which are termed as autoimmune-associated CHB. This review summarized the recent research findings in understanding autoimmune-associated CHB, discussed the current diagnostic approaches and management strategies, and summarized the problems and future directions for this disorder. DATA SOURCES: We retrieved the articles published in English from the PubMed database up to January 2017, using the keywords including "Autoimmune-associated", "Autoimmune-mediated", and "Congenital heart block"...
December 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/29141373/-a-concentration-response-observation-of-hydromorphone-combined-with-ropivacaine-in-labor-analgesia
#6
Y Y Lu, H Huang, W L Mao, R H Liu, M J Hu, L X Shao, M P Hu, J Li
Objective: To investigate the median effective dose (ED(50)) of hydromorphone and the appropriate concentration of ropivacaine combined with hydromorphone in epidural labor analgesia. Methods: One hundred and forty nulliparous women undergoing labor selected for delivery with epidural analgesia were enrolled in our hospital from January to June 2016. The first of top 50 women received 0.12% ropivacaine plus 20 μg/ml hydromorphone complex solution, then sequential women were used the modified sequential method to determine the ED(50) and ED(95) of hydromorphone...
November 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29128504/biophysical-comparison-of-sodium-currents-in-native-cardiac-myocytes-and-human-induced-pluripotent-stem-cell-derived-cardiomyocytes
#7
Robert J Goodrow, Suveer Desai, Jacqueline A Treat, Brian K Panama, Mayurika Desai, Vladislav V Nesterenko, Jonathan M Cordeiro
INTRODUCTION: Human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) are used for safety pharmacology and to investigate genetic diseases affecting cardiac ion channels. It is unclear whether adult myocytes or hiPSC-CMs are the better platform for cardiac safety pharmacology. We examined the biophysical and molecular properties of INa in adult myocytes and hiPSC-CMs. METHODS: hiPSC-CMs were plated at low density. Atrial and ventricular cells were obtained from dog hearts...
November 8, 2017: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/29116459/neonatal-systemic-lupus-erythematosus-syndrome-a-comprehensive-review
#8
REVIEW
Federica Vanoni, Sebastiano A G Lava, Emilio F Fossali, Riccardo Cavalli, Giacomo D Simonetti, Mario G Bianchetti, Marie-Ange Bozzini, Carlo Agostoni, Gregorio P Milani
Neonatal lupus erythematosus is an uncommon syndrome, which is caused by transplacental passage of maternal autoantibodies to Sjögren's syndrome A or B autoantigens. The clinical presentation includes distinctive cutaneous lesions resembling those seen in systemic lupus erythematosus, hepatobiliary disease, and cytopenias, which disappear with the clearance of maternal autoantibodies. The most severe presentation is a total atrioventricular heart block, which begins during the second trimester of gestation and is irreversible...
December 2017: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/29110745/an-unusual-course-of-anti-ro-antibody-mediated-fetal-complete-heart-block
#9
Claudia Renaud, Edgar Jaeggi, Varsha Thakur
Fetal hydrops is a serious complication of immune-mediated congenital complete atrioventricular block. We present the case of a fetus with severe hydrops and profound bradycardia and an unusual favourable outcome. This case enhances the importance of considering the contribution of ventricular ectopic beats to the cardiac output when counselling and predicting outcome of complete heart block.
November 7, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29100355/role-of-dna-methylation-in-perinatal-nicotine-induced-development-of-heart-ischemia-sensitive-phenotype-in-rat-offspring
#10
Jun Ke, Nianguo Dong, Lei Wang, Yong Li, Chiranjib Dasgupta, Lubo Zhang, Daliao Xiao
Background and purpose: Maternal cigarette smoking increases the risk of cardiovascular disease in offspring. Recently, we have demonstrated that perinatal nicotine exposure alters heart development and increases heart susceptibility to ischemia/reperfusion (I/R) injury in rat offspring. The present study tested the hypothesis that DNA methylation plays a key role in the nicotine-induced development of heart ischemia-sensitive phenotype in offspring. Experimental approach: Nicotine was administered to pregnant rats via subcutaneous osmotic minipumps from gestational day 4 until postnatal day 10...
September 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/29045069/association-of-natural-killer-cell-ligand-polymorphism-hla-c-asn80lys-with-the-development-of-anti-ssa-ro-associated-congenital-heart-block
#11
Hannah C Ainsworth, Miranda C Marion, Tiziana Bertero, Antonio Brucato, Rolando Cimaz, Nathalie Costedoat-Chalumeau, Micaela Fredi, Patrick Gaffney, Jennifer Kelly, Kateri Levesque, Alice Maltret, Nathalie Morel, Veronique Ramoni, Amelia Ruffatti, Carl D Langefeld, Jill P Buyon, Robert M Clancy
OBJECTIVE: Fetal exposure to maternal anti-SSA/Ro antibodies is necessary but not sufficient for the development of autoimmune congenital heart block (CHB), suggesting that other factors, such as fetal genetic predisposition, are important. Given the previously described association between major histocompatibility complex alleles and CHB risk, we undertook the present study to test the hypothesis that a variant form of HLA-C Asn80Lys, which binds with high affinity to an inhibitory killer cell immunoglobulin-like receptor (KIR) and thus renders natural killer (NK) cells incapable of restricting inflammation, contributes to the development of CHB...
November 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/29023736/an-investigation-of-fetal-behavioural-states-during-maternal-sleep-in-healthy-late-gestation-pregnancy-an-observational-study
#12
Peter R Stone, Wendy Burgess, Jordan McIntyre, Alistair J Gunn, Christopher A Lear, Laura Bennet, Edwin A Mitchell, John M D Thompson
KEY POINTS: Fetal behavioural state in healthy late gestation pregnancy is significantly affected by maternal position overnight. Maternal left lateral position is the one most frequently adopted at sleep onset. The maternal position at sleep onset is maintained the longest overnight. Fetal state 1F is more common in maternal supine positions overnight. Fetal state 4F is less common in maternal supine sleep positions. Fetal state and maternal sleep position are independently associated with fetal heart rate variability...
December 15, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/29021295/mitochondrial-cardiomyopathy-caused-by-elevated-reactive-oxygen-species-and-impaired-cardiomyocyte-proliferation
#13
Donghui Zhang, Yifei Li, Danielle A Heims-Waldron, Vassilios J Bezzerides, Silvia Guatimosim, Yuxuan Guo, Fei Gu, Pingzhu Zhou, Zhiqiang Lin, Qing Ma, Jianming Liu, Da-Zhi Wang, William T Pu
Rationale: Although mitochondrial diseases often cause abnormal myocardial development, the mechanisms by which mitochondria influence heart growth and function are poorly understood. Objective: To investigate these disease mechanisms, we studied a genetic model of mitochondrial dysfunction caused by inactivation of Tfam (Transcription Factor A, Mitochondrial), a nuclear-encoded gene that is essential for mitochondrial gene transcription and mitochondrial DNA replication. Methods and Results:Tfam inactivation by Nkx2...
October 11, 2017: Circulation Research
https://www.readbyqxmd.com/read/28957562/factors-influencing-fetal-cardiac-conduction-in-anti-ro-ssa-positive-pregnancies
#14
Sven-Erik Sonesson, Malin Hedlund, Aurélie Ambrosi, Marie Wahren-Herlenius
Objectives: Congenital heart block (CHB) develops in 1-2% of anti-Ro/SSA-positive pregnancies and has a recurrence rate of 12-20%, which indicates that factors other than maternal autoantibodies are crucial for CHB to occur. Here, we aimed to evaluate the influence of factors previously associated with CHB on the occurrence of milder forms of fetal cardiac conduction disturbances, shown to occur in up to 30% of anti-Ro/SSA-positive pregnancies, and on neonatal outcome in a large cohort of prospectively followed pregnancies...
October 1, 2017: Rheumatology
https://www.readbyqxmd.com/read/28928552/comparative-efficacy-of-minimal-concentration-of-racemic-bupivacaine-0-0625-with-fentanyl-and-ropivacaine-0-1-with-fentanyl-for-epidural-labor-analgesia
#15
T N Chethanananda, M R Shashank, N Madhu, J Achyutha, Karna Venkata Siva Kumar
BACKGROUND AND AIMS: This study aims to compare the minimum effective concentration of local anesthetic (LA) bupivacaine and ropivacaine with highly lipid soluble opioids fentanyl for providing optimal labor epidural analgesia. SETTINGS AND DESIGN: The objective of this study was to evaluate the efficacy of racemic bupivacaine 0.0625% and 0.1% of ropivacaine both mixed with 2 μg/ml of fentanyl for epidural labor analgesia in parturients with spontaneous labor and normal fetal heart rate tracing...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28921728/undifferentiated-connective-tissue-diseases-and-adverse-pregnancy-outcomes-an-undervalued-association
#16
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...
December 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
#17
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...
December 2017: Journal of Clinical Anesthesia
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
#18
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/28794892/the-use-of-non-invasive-fetal-electrocardiography-in-diagnosing-second-degree-fetal-atrioventricular-block
#19
Igor Lakhno, Joachim A Behar, Julien Oster, Vyacheslav Shulgin, Oleksii Ostras, Fernando Andreotti
BACKGROUND: Complete atrioventricular block in fetuses is known to be mostly associated with autoimmune disease and can be irreversible if no steroids treatment is provided. Conventional methods used in clinical practice for diagnosing fetal arrhythmia are limited since they do not reflect the primary electrophysiological conduction processes that take place in the myocardium. The non-invasive fetal electrocardiogram has the potential to better support fetal arrhythmias diagnosis through the continuous analysis of the beat to beat variation of the fetal heart rate and morphological analysis of the PQRST complex...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28727929/na-h-exchanger-and-proton-channel-in-heart-failure-associated-with-becker-and-duchenne-muscular-dystrophies
#20
Ghassan Bkaily, Danielle Jacques
Cardiomyopathy is found in patients with Duchenne (DMD) and Becker (BMD) muscular dystrophies, which are linked muscle diseases caused by mutations in the dystrophin gene. Dystrophin defects are not limited to DMD but are also present in mild BMD. The hereditary cardiomyopathic hamster of the UM-X7.1 strain is a particular experimental model of heart failure (HF) leading to early death in muscular dystrophy (dystrophin deficiency and sarcoglycan mutation) and heart disease (δ-sarcoglycan deficiency and dystrophin mutation) in human DMD...
October 2017: Canadian Journal of Physiology and Pharmacology
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