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Fetal cardiac intervention

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https://www.readbyqxmd.com/read/29905020/persistent-fetal-cardiovascular-remodeling-in-art-children
#1
Medhat Alberry
Children conceived by ART have manifested cardiac and vascular remodeling. There is growing evidence that remodeling is present in fetal life and persists in postnatal life which suggest the presence of opportunities for early detection and potential intervention. The underlying mechanisms and the effect of potential confounders such as growth restriction or prematurity remain unclear. Scherrer U, et al, Eur Heart J. 2015 Jul 1;36(25):1583-9. This article is protected by copyright. All rights reserved.
June 15, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29886608/-prenatal-interventional-therapy-in-two-cases-with-critical-pulmonary-stenosis-or-pulmonary-atresia-with-intact-ventricular-septum
#2
C C Pang, W Pan, Z W Zhang, C B Zhou, Y F Li, X Zhang, F Z Han, Y X Sun, S Wang, J Zhuang
Objectives: Two cases who underwent fetal pulmonary valvuloplasty (FPV) for pulmonary atresia with intact ventricular septum (PA-IVS) or critical pulmonary stenosis with intact ventricular septum (CPS-IVS) successfully were reported. The aim of the report was to explore the criteria for case selection, the technical essentials of FPV, and the postpartum outcome of the fetus. Methods: One case with PA-IVS and the other with CPS-IVS were enrolled in September 2016 and February 2017 in Guangdong General Hospital, and both cases were diagnosed with severe right ventricular dysplasia and tricuspid regurgitation by fetal echocardiogram...
June 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29765784/use-of-the-tei-index-in-the-conservative-management-of-trap-sequence-pregnancies-diagnosed-during-the-periviable-period-a-case-series
#3
Kristina Martimucci, Theresa Kuhn, Robyn Bilinski, Jesus Alvarez-Perez
Twin Reverse Arterial Perfusion (TRAP) Sequence is a rare complication of monochorionic pregnancies. Without intervention, the viable pump twin in a case of TRAP Sequence may develop high output cardiac failure leading to an intrauterine fetal demise. We present 3 cases of TRAP Sequence pregnancy diagnosed during the second or third trimesters of pregnancy. There are minimal sonographic tools for the guidance of a fetal therapeutic interventional procedure during the second trimester or timing of delivery during the third trimester to reduce morbidity and mortality of a viable fetus...
2018: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29761681/milestones-in-the-development-of-fetal-cardiac-interventions
#4
REVIEW
Edward G Abinader
Cardiac patients of all ages were managed in the past by internists who specialized in cardiology. During the past 50 years, the medical field has witnessed great strides in the management of congenital heart disease, and thus pediatric cardiology has become a subspecialty in many countries. This review article focuses on the advances in fetal cardiac interventions (FCI) since its inception by our group in 1975. Three major modes of FCI have evolved during the past 42 years: pharmacologic, closed FCI, and open FCI...
May 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29716424/prenatal-therapy-for-fetal-cardiac-disorders
#5
Sailesh Kumar, Jade Lodge
Fetal cardiac abnormalities are some of the commonest congenital disorders seen in prenatal life. They can be anatomical or functional and can develop de novo or as a consequence of either maternal or fetal disease. Untreated, morbidity and mortality rates are high for hypoplastic left heart disorders and for some fetal tachy and bradyarrhythmias. Optimum management strategies are often not clear because of the lack of knowledge about the precise natural history of some of these conditions. Prenatal therapy ranges from invasive fetal cardiac intervention to maternal administration of drugs for transplacental transfer to the fetus...
May 1, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29703793/liraglutide-increases-ivf-pregnancy-rates-in-obese-pcos-women-with-poor-response-to-first-line-reproductive-treatments-a-pilot-randomized-study
#6
Vesna Salamun, Mojca Jensterle, Andrej Janez, Eda Vrtacnik Bokal
OBJECTIVE: Glucagon-like peptide-1 (GLP-1) has been investigated in regulation of reproductive system in animal models. The potential impact of short-term preconception intervention with liraglutide on fertility potential in PCOS has not been evaluated yet. DESIGN: A prospective randomized open-label study was conducted in 28 infertile obese PCOS patients (age 31.07±4.75 years, BMI 36.7±3.5 kg/m2, mean±SD). They were assigned to metformin (MET) 1000 mg BID or to MET 1000 mg BID combined with low-dose liraglutide 1...
April 27, 2018: European Journal of Endocrinology
https://www.readbyqxmd.com/read/29694994/predicting-the-future-delivery-room-planning-of-congenital-heart-disease-diagnosed-by-fetal-echocardiography
#7
Mary T Donofrio
Advances in prenatal imaging have improved the examination of the fetal cardiovascular system. Fetal echocardiography facilitates the prenatal diagnosis of congenital heart disease (CHD) and through sequential examination, allows assessment of fetal cardiac hemodynamics, predicting the evolution of anatomical and functional cardiovascular abnormalities in utero and during the transition to a postnatal circulation at delivery. This approach allows detailed diagnosis with prenatal counseling and enables planning to define perinatal management, selecting the fetuses at a risk of postnatal hemodynamic instability who are likely to require a specialized delivery plan...
May 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29684673/exercise-as-a-therapeutic-intervention-to-optimize-fetal-weight
#8
REVIEW
Laura M Reyes, Margie H Davenport
The Developmental Origins of Health and Disease suggest the in utero environment programs offspring obesity and cardiovascular disease. Therefore, there is a need to implement safe therapeutic interventions that do not involve the intake of medications or biological products during pregnancy that can improve maternal and fetal health. Prenatal exercise is established to promote maternal and fetal health. It is generally recommended that women accumulate at least 150 min per week of moderate-intensity exercise...
June 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29652283/mitral-valve-repair-in-infective-endocarditis-during-pregnancy
#9
Takahiro Tamura, Shuichi Yokota
Infective endocarditis (IE) during pregnancy and subsequent cardiac surgery are rare and associated with a high risk of mortality for the mother and fetus. It is difficult to determine the right time for cardiac intervention when IE is diagnosed early in pregnancy. A 33-year-old previously healthy woman in the 11th week of pregnancy was diagnosed with IE and underwent surgical intervention. The cardiopulmonary bypass settings and the anesthetic drugs were carefully chosen. Although she was in good health, while being discharged, the fetus did not survive...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29579059/cardiac-findings-in-infants-with-in-utero-exposure-to-zika-virus-a-cross-sectional-study
#10
Dulce H G Orofino, Sonia R L Passos, Raquel V C de Oliveira, Carla Verona B Farias, Maria de Fatima M P Leite, Sheila M Pone, Marcos V da S Pone, Helena A R Teixeira Mendes, Maria Elizabeth L Moreira, Karin Nielsen-Saines
BACKGROUND: Antenatal exposure to Zika virus (ZIKV) is related to severe neurological manifestations. A previous study in Brazil reported an increased incidence of non-severe congenital heart defects in infants with diagnosis of congenital Zika syndrome but without laboratory confirmation of ZIKV infection in the mother or infant. The objective of this study is to report echocardiographic (ECHO) findings in infants with laboratory confirmed antenatal exposure to ZIKV. METHODOLOGY: Cross sectional study of cardiologic assessments of infants born between November 2015 and January 2017 with confirmed vertical exposure to ZIKV in Rio de Janeiro, Brazil...
March 2018: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29577782/anatomically-corrected-malposition-of-the-great-arteries-a-challenging-fetal-diagnosis
#11
Nathalie Jeanne Bravo-Valenzuela, Milene Carvalho Carrilho, Alberto Borges Peixoto, Marilim Souza Bezerra, Edward Araujo Júnior
Anatomically corrected malposed great arteries are uncommon and benign entity. Basically, this occurs with ventriculoarterial concordance in which the great vessels arise parallel instead of a twisting fashion. In this manuscript, we described two cases in which the antenatal diagnosis of anatomically corrected malposition of great arteries was suspected and confirmed during the postnatal period. During the fetal life, this diagnosis remains a challenge and this condition is often misdiagnosed as the transposition of the great arteries (TGA)...
April 3, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29561649/magnesium-sulfate-and-sex-differences-in-cardiovascular-and-neural-adaptations-during-normoxia-and-asphyxia-in-preterm-fetal-sheep
#12
Robert Galinsky, Simerdeep K Dhillon, Christopher A Lear, Kyohei Yamaguchi, Guido Wassink, Alistair J Gunn, Laura Bennet
Magnesium sulfate (MgSO4 ) is recommended for preterm neuroprotection, preeclampsia and preterm labor prophylaxis. There is an important unmet need to carefully test clinical interventions in both sexes. Therefore, we aimed to investigate cardiovascular and neurophysiological adaptations to MgSO4 during normoxia and asphyxia in preterm male and female fetal sheep. Fetuses were instrumented at 98{plus minus}1 days of gestation (d; term=147 d). At 104 d, unanaesthetised fetuses were randomly assigned to intravenous MgSO4 (n=12 F, 10 M) or saline (n=13 F, 10 M)...
March 21, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/29409551/impact-of-prenatal-diagnosis-on-the-management-and-early-outcome-of-critical-duct-dependent-cardiac-lesions
#13
Varsha Thakur, Nathalie Dutil, Steven M Schwartz, Edgar Jaeggi
OBJECTIVE: The objective of this study was to compare the preoperative management and outcome of neonates with duct-dependent critical CHD with fetal versus postnatal diagnosis. METHODS: Patients referred with CHD to our centre from January 1, 2009 to December 31, 2010 were enrolled prospectively. Live births with a critical form of CHD, a gestational age ⩾36 weeks and a weight ⩾2 kg at birth, and the intention-to-treat were included in this sub-study. Excluded were neonates with lethal non-cardiac and/or genetic anomalies...
April 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29398177/percutaneous-fetal-atrial-balloon-septoplasty-for-simple-transposition-of-the-great-arteries-with-an-intact-atrial-septum
#14
Wadi Mawad, Rajiv R Chaturvedi, Greg Ryan, Edgar Jaeggi
We report the first ultrasonographically guided percutaneous balloon atrial septoplasty (BAS), to our knowledge, in a fetus with transposition of the great arteries and an intact ventricular and atrial septum (37 + 2 weeks). After vaginal delivery at 38 weeks, the infant had an elective septostomy (day 1) and an arterial switch procedure (day 7), with an uneventful postoperative course. For centres with experience in fetal cardiac interventions, fetal BAS is a superior management option compared with the alternatives for this high-risk physiology...
March 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29377175/the-effect-of-maternal-exposure-to-di-2-ethylhexyl-phthalate-on-fetal-cardiac-development-in-mice
#15
Changqing Tang, Yuxin Deng, Hongyu Duan, Yi Zhang, Yifei Li, Dajian Qiu, Kaiyu Zhou, Yimin Hua, Chuan Wang
Accumulating evidence has suggested a link between maternal di-(2-ethylhexyl)-phthalate (DEHP) exposure and various developmental abnormalities. However, the evidence regarding the effect of maternal DEHP exposure on fetal cardiac development is scarce. The present study aimed to determine the effect of maternal DEHP exposure on fetal cardiac development in mice and explore the possible involved mechanism preliminarily. The C57BL mice were randomly divided into four groups: the vehicle group (corn oil, n = 10), 250 mg kg-1 DEHP group (n = 15), 500 mg kg-1 DEHP group (n = 20) and 1 g kg-1 DEHP group (n = 20)...
June 2018: Journal of Applied Toxicology: JAT
https://www.readbyqxmd.com/read/29375148/comparison-of-four-methods-of-treating-ectopic-pregnancy-a-retrospective-cohort-study
#16
Zeynep Ozturk Inal, Hasan Ali Inal
Objective: To compare the results of expectant management, single and multidose methotrexate (MTX) and surgical management of ectopic pregnancy (EP). Materials and Methods: In this retrospective cohort study, the original files of 233 patients who were treated for EP between May 2009 and December 2016 were analyzed. The patients were assigned to the following groups based on the applied treatment methods: Group 1, expectant management (n = 24), Group 2, single-dose MTX (n = 144), Group 3, multiple-dose MTX (n = 25), and Group 4, surgical intervention (n = 40)...
January 2018: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/29372591/clinical-yield-of-fetal-echocardiography-for-suboptimal-cardiac-visualization-on-obstetric-ultrasound
#17
Rick D Vavolizza, Pe'er Dar, Barrie Suskin, Robert M Moore, Kenan W D Stern
OBJECTIVE: Suboptimal cardiac imaging on obstetric ultrasound is a frequent referral indication for fetal echocardiography, even in the absence of typical risk factors for fetal cardiac disease. The clinical profile of patients and findings of examinations performed for such an indication are not well defined. Given the increased cost, time and resource utilization of fetal echocardiography, we sought to determine the clinical findings of such referrals. STUDY DESIGN: We performed a single-center review of such referrals from January 2010 to June 2016...
January 25, 2018: Congenital Heart Disease
https://www.readbyqxmd.com/read/29317056/a-potentially-curative-fetal-intervention-for-hypoplastic-left-heart-syndrome
#18
Andrew T Hattam
Hypoplastic left heart syndrome (HLHS) encapsulates a spectrum of complex congenital cardiovascular malformations involving varying degrees of underdevelopment of the left-sided heart structures. However, despite improved survival rates since the introduction of staged surgical reconstruction, treatment options for HLHS remain palliative rather than curative. A major limiting factor in the development of definitive curative therapy for HLHS is an incomplete understanding of its pathogenesis. Currently, the aetiology HLHS is best conceptualised by the 'flow theory' of cardiogenesis, which states that normal cardiac development is reliant on the interrelationship of normal flow patterns of blood through the developing heart, and appropriate growth of the cardiac valves and myocardium...
January 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29287139/fetal-interventions-for-structural-heart-disease
#19
David N Schidlow, Lindsay Freud, Kevin Friedman, Wayne Tworetzky
Fetal cardiac intervention (FCI) offers the potential to alter in utero anatomy and physiology. For aortic stenosis with evolving hypoplastic left heart syndrome and pulmonary atresia with intact ventricular septum with evolving hypoplastic right heart syndrome, FCI may result in maintenance of a biventricular circulation, thus avoiding single-ventricle palliation and its attendant complications. In the case of hypoplastic left heart syndrome with intact atrial septum, FCI may ameliorate in utero pathophysiology and portend a more favorable postnatal prognosis...
December 2017: Echocardiography
https://www.readbyqxmd.com/read/29287133/cardiac-function-and-dysfunction-in-the-fetus
#20
Luke Eckersley, Lisa K Hornberger
Evaluation of fetal cardiac function is one of the most important components of fetal echocardiography. Fetal cardiac dysfunction is closely linked to risk of intrauterine fetal demise, in many, but not all cases is indicative of worse postnatal prognosis and may prompt the use of medications or interventions to optimize outcomes. There may be implications for termination versus continuation of pregnancy, an indication for early delivery, a change in location and even mode of delivery. In extreme cases, fetal cardiac dysfunction may prompt prenatal or early neonatal listing for cardiac transplantation...
December 2017: Echocardiography
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