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https://www.readbyqxmd.com/read/29229321/the-role-of-aspirin-heparin-and-other-interventions-in-the-prevention-and-treatment-of-fetal-growth-restriction
#1
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/29209071/inhaled-nicotine-equivalent-to-cigarette-smoking-disrupts-systemic-and-uterine-hemodynamics-and-induces-cardiac-arrhythmia-in-pregnant-rats
#2
Xuesi M Shao, Héctor E López-Valdés, Jing Liang, Jack L Feldman
Maternal smoking with obligatory nicotine inhalation is associated with preterm delivery, low birth weight, fetal growth retardation and developmental defects. We tested the hypothesis that cigarette smoking-relevant nicotine inhalation during pregnancy impairs cardiovascular function and uterine hemodynamics with consequential fetal ischemia. Pregnant rats exposed to episodic inhaled nicotine via a novel lung alveolar region-targeted aerosol method produced nicotine pharmacokinetics resembling cigarette smoking in humans...
December 5, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29208663/haemodynamic-effects-of-umbilical-cord-milking-in-premature-sheep-during-the-neonatal-transition
#3
Douglas A Blank, Graeme R Polglase, Martin Kluckow, Andrew William Gill, Kelly J Crossley, Alison Moxham, Karyn Rodgers, Valerie Zahra, Ishmael Inocencio, Fiona Stenning, Domeic A LaRosa, Peter G Davis, Stuart B Hooper
OBJECTIVE: Umbilical cord milking (UCM) at birth may benefit preterm infants, but the physiological effects of UCM are unknown. We compared the physiological effects of two UCM strategies with immediate umbilical cord clamping (UCC) and physiological-based cord clamping (PBCC) in preterm lambs. METHODS: At 126 days' gestational age, fetal lambs were exteriorised, intubated and instrumented to measure umbilical, pulmonary and cerebral blood flows and arterial pressures...
December 5, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29193660/preterm-birth-with-placental-evidence-of-malperfusion-is-associated-with-cardiovascular-risk-factors-after-pregnancy-a-prospective-cohort-study
#4
Janet M Catov, Matthew F Muldoon, Steven E Reis, Roberta B Ness, Lananh N Nguyen, Jose-Miguel Yamal, Hyunsoo Hwang, W Tony Parks
OBJECTIVE: Preterm birth (PTB) is associated with excess maternal cardiovascular disease risk. We considered that women with PTB and placental evidence of maternal malperfusion would be particularly affected. DESIGN: Pregnancy cohort study. SETTING: Pittsburgh Pennsylvania, US. POPULATION: Women with PTB (n=115) and term births (n=210) evaluated 4-12 years after pregnancy. METHODS: Cardiometabolic risk markers were compared in women with prior PTB vs...
November 28, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29191812/physiologically-based-cord-clamping-stabilises-cardiac-output-and-reduces-cerebrovascular-injury-in-asphyxiated-near-term-lambs
#5
Graeme R Polglase, Douglas A Blank, Samantha K Barton, Suzanne L Miller, Vanesa Stojanovska, Martin Kluckow, Andrew W Gill, Domenic LaRosa, Arjan B Te Pas, Stuart B Hooper
BACKGROUND: Physiologically based cord clamping (PBCC) has advantages over immediate cord clamping (ICC) during preterm delivery, but its efficacy in asphyxiated infants is not known. We investigated the physiology of PBCC following perinatal asphyxia in near-term lambs. METHODS: Near-term sheep fetuses (139±2 (SD) days' gestation) were instrumented to measure umbilical, carotid, pulmonary and femoral arterial flows and pressures. Systemic and cerebral oxygenation was recorded using pulse oximetry and near-infrared spectroscopy, respectively...
November 30, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29186314/reproducibility-of-retinal-microvascular-traits-decoded-by-the-singapore-i-vessel-assessment-software-across-the-human-age-range
#6
Qi-Fang Huang, Fang-Fei Wei, Zhen-Yu Zhang, Anke Raaijmakers, Kei Asayama, Lutgarde Thijs, Wen-Yi Yang, Blerim Mujaj, Karel Allegaert, Peter Verhamme, Harry A J Struijker-Boudier, Yan Li, Jan A Staessen
BACKGROUND: Retinal microvascular traits predict adverse health outcomes. The Singapore I Vessel Assessment (SIVA) software improved automated post-processing of retinal photographs. In addition to microvessel caliber, it generates measures of arteriolar and venular geometry. Few studies addressed the reproducibility of SIVA measurements across a wide age range. METHODS: In the current study, two blinded graders read images obtained by nonmydriatic retinal photography twice in twenty 11-year old children, born prematurely (n = 10) or at term (n = 10) and in sixty adults (age range, 18...
November 24, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/29181841/epidural-therapy-for-the-treatment-of-severe-pre-eclampsia-in-non-labouring-women
#7
REVIEW
Amita Ray, Sujoy Ray
BACKGROUND: Pre-eclampsia is a pregnancy-specific multi-organ disorder, which is characterised by hypertension and multisystem organ involvement and which has significant maternal and fetal morbidity and mortality. Failure of the placental vascular remodelling and reduced uteroplacental flow form the etiopathological basis of pre-eclampsia. There are several established therapies for pre-eclampsia including antihypertensives and anticonvulsants. Most of these therapies aim at controlling the blood pressure or preventing complications of elevated blood pressure, or both...
November 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29175171/early-warning-system-hypertension-thresholds-to-predict-adverse-outcomes-in-pre-eclampsia-a-prospective-cohort-study
#8
Hannah L Nathan, Paul T Seed, Natasha L Hezelgrave, Annemarie De Greeff, Elodie Lawley, John Anthony, David R Hall, Wilhelm Steyn, Lucy C Chappell, Andrew H Shennan
OBJECTIVES: To evaluate the association between blood pressure (BP) measurements and adverse outcomes in women with pre-eclampsia. STUDY DESIGN: A prospective cohort study of women with pre-eclampsia admitted to three South African tertiary facilities. BP was measured using the CRADLE Vital Signs Alert (VSA), incorporated with a traffic light early warning system; green: systolic BP <140 mmHg and diastolic BP <90 mmHg, yellow: systolic BP 140-159 and/or diastolic BP 90-109 mmHg (but neither is above the upper threshold), red: systolic BP ≥160 mmHg and/or diastolic BP ≥110 mmHg...
November 21, 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29175170/first-trimester-mean-arterial-blood-pressure-and-the-risk-of-preeclampsia-the-great-obstetrical-syndromes-gos-study
#9
Cédric Gasse, Amélie Boutin, Maxime Coté, Nils Chaillet, Emmanuel Bujold, Suzanne Demers
OBJECTIVE: To estimate the predictive value of first-trimester mean arterial pressure (MAP) for the hypertensive disorders of pregnancy (HDP). STUDY METHODS: We performed a prospective cohort study of nulliparous women recruited at 110/7-136/7 weeks. MAP was calculated from blood pressure measured on both arms simultaneously using an automated device taking a series of recordings until blood pressure stability was reached. MAP was reported as multiples of the median adjusted for gestational age...
November 21, 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29161235/influence-of-ductus-arteriosus-on-peripheral-muscle-oxygenation-and-perfusion-in-neonates
#10
Lukas Peter Mileder, Tessa Mueller, Nariae Baik-Schneditz, Jasmin Pansy, Bernhard Schwaberger, Corinna Binder-Heschl, Berndt Urlesberger, Gerhard Pichler
In neonates, a patent ductus arteriosus (DA) may be associated with severe complications. We used near-infrared spectroscopy (NIRS) with venous occlusion to investigate the influence of an open DA on peripheral muscle oxygenation/perfusion in preterm neonates. Approach: We analyzed secondary outcome parameters collected as part of prospective observational studies. NIRS measurements were performed between the first and third day of life. Arterial oxygen saturation (SaO2) and heart rate (HR) were monitored by pulse oximetry on the ipsilateral foot...
November 21, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/29153686/progression-of-gestational-hypertension-to-pre-eclampsia-a-cohort-study-of-20-103-pregnancies
#11
Kuo-Hu Chen, Kok-Min Seow, Li-Ru Chen
OBJECTIVE: To investigate previously un-identified risk factors for the progression of gestational hypertension (GH) to pre-eclampsia (PE) by considering Grade III preterm placental calcification (PPC) and excessive weight gain (≧10kgw) at 28weeks gestation. METHODS: At a tertiary teaching hospital, obstetric ultrasonography was performed at 28weeks gestation to establish a diagnosis of grade III PPC. Weight gain during pregnancy was recorded at the same time...
October 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29141932/umbilical-artery-perforation-a-potentially-life-threatening-complication-of-umbilical-artery-catheterisation
#12
Daniel Molanus, Machteld van Scherpenzeel, Joep Derikx, Frank van den Dungen
Umbilical artery catheterisation is frequently performed in preterm or critically ill newborn infants for invasive monitoring of blood pressure and blood sampling for laboratory tests. It is associated with well-known complications like catheter-related infections, thromboembolic events and aneurysmal formation of the aorta. In this report, we present another major complication of umbilical artery catheterisation: umbilical artery perforation. This complication occurred in a prematurely born infant and resulted in severe haemorrhagic shock, subsequent renal failure and severe periventricular leukomalacia...
November 14, 2017: BMJ Case Reports
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/29128160/prone-sleeping-position-in-infancy-implications-for-cardiovascular-and-cerebrovascular-function
#14
REVIEW
Kelsee L Shepherd, Stephanie R Yiallourou, Rosemary S C Horne, Flora Y Wong
Advances in neonatal care have improved the survival rates of preterm infants, however, the likelihood of brain injury and neurodevelopmental disability remains a significant problem. Whilst the etiology of preterm brain injury is complex, impairments in the cardio- and cerebro-vascular function have been implicated. During infancy, sleep is vital for brain development. However, instabilities in cardio- and cerebro-vascular function are most marked during sleep. Sleeping position is an important part of a safe sleeping environment...
October 13, 2017: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/29120452/vascular-aging-and-cardiac-maladaptation-in-growth-restricted-preterm-infants
#15
A Sehgal, B J Allison, S M Gwini, S Menahem, S L Miller, G R Polglase
OBJECTIVE: To assess arterial morphology and mechanics in preterm infants with fetal growth restriction (FGR) compared with those appropriate for gestational age (AGA) in the early neonatal period. STUDY DESIGN: This observational study involved 20 preterm FGR infants (28 to 32 weeks) of gestational age (GA) and birth weight (BW) <10th centile and 20 preterm AGA infants. Vascular ultrasound was performed to measure aortic properties. RESULTS: GA and BW of FGR and AGA infants were 29...
November 9, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29096631/prediction-of-uncomplicated-pregnancies-in-obese-women-a-prospective-multicentre-study
#16
Matias C Vieira, Sara L White, Nashita Patel, Paul T Seed, Annette L Briley, Jane Sandall, Paul Welsh, Naveed Sattar, Scott M Nelson, Debbie A Lawlor, Lucilla Poston, Dharmintra Pasupathy
BACKGROUND: All obese pregnant women are considered at equal high risk with respect to complications in pregnancy and birth, and are commonly managed through resource-intensive care pathways. However, the identification of maternal characteristics associated with normal pregnancy outcomes could assist in the management of these pregnancies. The present study aims to identify the factors associated with uncomplicated pregnancy and birth in obese women, and to assess their predictive performance...
November 3, 2017: BMC Medicine
https://www.readbyqxmd.com/read/29091282/correlation-between-maternal-anxiety-reactivity-of-fetal-cerebral-circulation-to-auditory-stimulation-and-birth-outcome-in-normotensive-and-gestational-hypertensive-women
#17
Marina Vujović, Mirjana Sovilj, Ljiljana Jeličić, Miodrag Stokić, Darko Plećaš, Snežana Plešinac, Nadežda Nedeljković
This study investigated the correlation between maternal anxiety and blood flow changes through the fetal middle cerebral artery (MCA) after defined acoustic stimulation in 43 normotensive (C) and 40 gestational hypertensive (GH) subjects. Neonatal outcomes (gestational age at birth, Apgar score, birth weight) in the C and GH groups were analyzed. State (STAI-S) and trait (STAI-T) anxiety was assessed using Spielberger's questionnaire. The MCA blood flow was assessed once between 28 and 41 weeks of gestation using color Doppler ultrasound before and after application of defined acoustic stimulus...
November 1, 2017: Developmental Psychobiology
https://www.readbyqxmd.com/read/29074472/external-validation-study-of-first-trimester-obstetric-prediction-models-expect-study-i-research-protocol-and-population-characteristics
#18
Linda Jacqueline Elisabeth Meertens, Hubertina Cj Scheepers, Raymond G De Vries, Carmen D Dirksen, Irene Korstjens, Antonius Lm Mulder, Marianne J Nieuwenhuijze, Jan G Nijhuis, Marc Ea Spaanderman, Luc Jm Smits
BACKGROUND: A number of first-trimester prediction models addressing important obstetric outcomes have been published. However, most models have not been externally validated. External validation is essential before implementing a prediction model in clinical practice. OBJECTIVE: The objective of this paper is to describe the design of a study to externally validate existing first trimester obstetric prediction models, based upon maternal characteristics and standard measurements (eg, blood pressure), for the risk of pre-eclampsia (PE), gestational diabetes mellitus (GDM), spontaneous preterm birth (PTB), small-for-gestational-age (SGA) infants, and large-for-gestational-age (LGA) infants among Dutch pregnant women (Expect Study I)...
October 26, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/29072344/the-effect-of-sex-and-prematurity-on-the-cardiovascular-baroreflex-response-in-sheep
#19
Beth J Allison, Vivian Nguyen, Stephanie R Yiallourou, Ilias Nitsos, Mary Jane Black, Graeme R Polglase
Very preterm infants have an increased risk of cardiovascular disease, however the effects of a late preterm birth on future cardiovascular function are not known. We hypothesized that well describes impairments in heart rate variability and baroreflex sensitivity would persist into adulthood following a late preterm birth. To test this hypothesis sheep born preterm (0.9 gestation: 9M, 7F) or term (11M, 6F) underwent surgery at 14 months of age for insertion of femoral arterial and venous catheters and femoral flow probe...
October 26, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/29063594/late-7-days-systemic-postnatal-corticosteroids-for-prevention-of-bronchopulmonary-dysplasia-in-preterm-infants
#20
REVIEW
Lex W Doyle, Jeanie L Cheong, Richard A Ehrenkranz, Henry L Halliday
BACKGROUND: Many preterm infants who survive go on to develop bronchopulmonary dysplasia, probably as the result of persistent inflammation in the lungs. Corticosteroids have powerful anti-inflammatory effects and have been used to treat individuals with established bronchopulmonary dysplasia. However, it is unclear whether any beneficial effects outweigh the adverse effects of these drugs. OBJECTIVES: To examine the relative benefits and adverse effects of late systemic postnatal corticosteroid treatment (> 7 days) for preterm infants with evolving or established bronchopulmonary dysplasia...
October 24, 2017: Cochrane Database of Systematic Reviews
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