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Javier U Ortiz, Ximena Torres, Elisenda Eixarch, Mar Bennasar, Monica Cruz-Lemini, Olga Gómez, Silvia M Lobmaier, Josep M Martínez, Eduard Gratacós, Fatima Crispi
OBJECTIVE: To evaluate left myocardial performance index (MPI) and time intervals in fetuses with twin-to-twin transfusion syndrome (TTTS) before and after laser surgery. METHODS: Fifty-one fetal pairs with TTTS and 47 uncomplicated monochorionic twin pairs were included. Left ventricular isovolumetric contraction time (ICT), ejection time (ET), and isovolumetric relaxation time (IRT) were measured using conventional Doppler. RESULTS: Recipients showed prolonged ICT (46 ± 12 vs...
January 19, 2018: Fetal Diagnosis and Therapy
Edgar Hernandez-Andrade, Manasi Patwardhan, Mónica Cruz-Lemini, Suchaya Luewan
Evaluation of the fetal heart at 11-13 + 6 weeks of gestation is indicated for women with a family history of congenital heart defects (CHD), a previous child with CDH, or an ultrasound finding associated with cardiac anomalies. The accuracy for early detection of CHD is highly related to the experience of the operator. The 4-chamber view and outflow tracts are the most important planes for identification of an abnormal heart, and can be obtained in the majority of fetuses from 11 weeks of gestation onward...
2017: Fetal Diagnosis and Therapy
Francesc Figueras, Eduard Gratacos, Marta Rial, Ilan Gull, Ladislav Krofta, Marek Lubusky, Rogelio Cruz-Martinez, Mónica Cruz-Lemini, Miguel Martinez-Rodriguez, Pamela Socias, Cristina Aleuanlli, Mauro C Parra Cordero
INTRODUCTION: Fetal growth restriction (FGR) affects 5%-10% of all pregnancies, contributing to 30%-50% of stillbirths. Unfortunately, growth restriction often is not detected antenatally. The last weeks of pregnancy are critical for preventing stillbirth among babies with FGR because there is a pronounced increase in stillbirths among growth-restricted fetuses after 37 weeks of pregnancy. Here we present a protocol (V.1, 23 May 2016) for the RATIO37 trial, which evaluates an integrated strategy for accurately selecting at-risk fetuses for delivery at term...
June 15, 2017: BMJ Open
Brenda Valenzuela-Alcaraz, Mónica Cruz-Lemini, Mérida Rodríguez-López, Ana Goncé, Laura García-Otero, Helena Ayuso, Marta Sitges, Bart Bijnens, Juan Balasch, Eduard Gratacós, Fátima Crispi
BACKGROUND: Recent data suggest that singleton fetuses conceived by assisted reproductive technologies (ART) present cardiovascular remodeling that may persist postnatally. Twin pregnancies are more frequent in the ART population, and are associated with increased adverse perinatal outcomes like hypertensive disorders, gestational diabetes and preterm birth. However, it is unknown whether cardiac remodeling is also present in twin pregnancies conceived by ART. Our aim was to assess the presence of fetal cardiac remodeling and dysfunction in twin pregnancies conceived by ART, as compared to spontaneously conceived (SC) ones...
May 15, 2017: Ultrasound in Obstetrics & Gynecology
M Rodríguez-López, M Cruz-Lemini, B Valenzuela-Alcaraz, L Garcia-Otero, M Sitges, B Bijnens, E Gratacós, F Crispi
OBJECTIVE: To identify different cardiac phenotypes among cases of fetal growth restriction (FGR). METHODS: Echocardiography was performed in 126 cases with FGR (birth weight < 10(th) centile) and 64 appropriate-for-gestational-age (AGA) fetuses. Principal component and cluster analyses were performed to identify different cardiac phenotypes among FGR cases. RESULTS: Three different cardiac phenotypes were identified among the FGR group: globular in 54% of cases, elongated in 29% of cases and hypertrophic in 17% of cases...
August 2017: Ultrasound in Obstetrics & Gynecology
Rui V Simões, Emma Muñoz-Moreno, Mónica Cruz-Lemini, Elisenda Eixarch, Núria Bargalló, Magdalena Sanz-Cortés, Eduard Gratacós
BACKGROUND: Intrauterine growth restriction and premature birth represent 2 independent problems that may occur simultaneously and contribute to impaired neurodevelopment. OBJECTIVE: The objective of the study was to assess changes in the frontal lobe metabolic profiles of 1 year old intrauterine growth restriction infants born prematurely and adequate-for-gestational-age controls, both premature and term adequate for gestational age and their association with brain structural and biophysical parameters and neurodevelopmental outcome at 2 years...
January 2017: American Journal of Obstetrics and Gynecology
R Cruz-Martinez, A Mendez, M Cruz-Lemini, M Martinez-Rodriguez, B Nieto-Castro, A K Gámez-Varela, C Rebolledo-Fernández
No abstract text is available yet for this article.
September 2016: Ultrasound in Obstetrics & Gynecology
M Rodriguez-Lopez, M Cruz-Lemini, B Valenzuela-Alcaraz, L Garcia-Otero, M Sitges, B Bijnens, E Gratacós, F Crispi
No abstract text is available yet for this article.
September 2016: Ultrasound in Obstetrics & Gynecology
B Valenzuela-Alcaraz, F Crispi, M Cruz-Lemini, B Bijnens, L García-Otero, M Sitges, J Balasch, E Gratacós
OBJECTIVE: Fetuses conceived by assisted reproductive technology (ART) and those that are small-for-gestational age (SGA) show cardiovascular remodeling in utero; however, these two conditions are often associated. We aimed to evaluate the differential effect of ART and SGA on fetal cardiac remodeling. METHODS: This was a prospective cohort study of term singleton pregnancies seen at our department between April 2011 and September 2013. The cohort was divided according to fetal growth and mode of conception into the following four groups: 102 appropriate-for-gestational-age (AGA) fetuses conceived spontaneously (controls), 72 AGA fetuses conceived by ART (ART-AGA), 31 SGA fetuses conceived by ART (ART-SGA) and 28 SGA fetuses conceived naturally (Spont-SGA)...
July 2017: Ultrasound in Obstetrics & Gynecology
Eva Stein, Monica Cruz-Lemini, Jose Altamirano, Nambi Ndugga, David Couper, Juan G Abraldes, Ramon Bataller
BACKGROUND & AIMS: Studies assessing alcohol as a population-level risk factor for cirrhosis, typically focus on per capita consumption. However, clinical studies indicate that daily intake is a strong predictor of alcoholic cirrhosis. We aimed to identify the determinants of alcohol's contribution to the global cirrhosis burden and to evaluate the influence of daily drinking on a population level. METHODS: We performed a comprehensive analysis of the WHO 2014 Global Status Report on Alcohol and Health...
July 5, 2016: Journal of Hepatology
A Ruiz, M Cruz-Lemini, N Masoller, M Sanz-Cortés, Q Ferrer, I Ribera, J M Martínez, F Crispi, S Arévalo, O Gómez, S Pérez-Hoyos, E Carreras, E Gratacós, E Llurba
OBJECTIVES: To determine the longitudinal behavior of fetal biometric measures and cerebroplacental hemodynamics throughout gestation in fetuses with congenital heart disease (CHD). METHODS: Fetal biometry and Doppler hemodynamics (uterine artery (UtA), umbilical artery (UA) and fetal middle cerebral artery (MCA)) were measured serially in a cohort of consecutive fetuses diagnosed with CHD. Evaluations were made at various time points, from diagnosis (20-25 weeks) to delivery, with at least two measurements per fetus that were at least 2 weeks apart...
March 2017: Ultrasound in Obstetrics & Gynecology
Patricia Garcia-Canadilla, Fatima Crispi, Monica Cruz-Lemini, Brenda Valenzuela-Alcaraz, Paula A Rudenick, Eduard Gratacos, Bart H Bijnens
OBJECTIVE: The aortic isthmus (AoI) blood flow has a characteristic shape with a small end-systolic notch observed during the third trimester of pregnancy. However, what causes the appearance of this notch is not fully understood. We used a lumped model of the fetal circulation to study the possible factors causing the end-systolic notch and the changes of AoI flow through gestation. METHODS: A validation of the model was performed by fitting patient-specific data from two normal fetuses...
2017: Fetal Diagnosis and Therapy
Brenda Valenzuela-Alcaraz, Fátima Crispi, Dolors Manau, Mónica Cruz-Lemini, Aina Borras, Juan Balasch, Eduard Gratacós
Objectives To examine perinatal outcomes in pregnancies conceived by different methods: fertile women with spontaneous pregnancies, infertile women who achieved pregnancy without treatment, pregnancies achieved by ovulation induction (OI) and in vitro fertilization or intra-cytoplasmic sperm injection (IVF/ICSI). Methods Retrospective single-center cohort study including 200 fertile and 748 infertile women stratified according to infertility treatment. The outcome measurements were preterm delivery (PTD), small-for-gestational-age (SGA), gestational diabetes, placenta previa or preeclampsia...
December 2016: Journal of Maternal-fetal & Neonatal Medicine
Rogelio Cruz-Martínez, Monica Cruz-Lemini, Antonio Mendez, Miriam Illa, Víctor García-Baeza, Josep Maria Martinez, Eduard Gratacós
OBJECTIVE: To assess the learning curve for intrapulmonary artery Doppler in fetuses with congenital diaphragmatic hernia (CDH). METHODS: Three fetal medicine fellows with the theoretic knowledge, but without prior experience, in the evaluation of intrapulmonary artery Doppler in CDH fetuses were selected. Each trainee and 1 experienced explorer assessed the intrapulmonary artery in the contralateral lung to the side of the hernia for calculation of 2 Doppler parameters - pulsatility index (PI) and peak early diastolic reversed flow (PEDRF) - in a cohort of 90 consecutive CDH fetuses...
2016: Fetal Diagnosis and Therapy
Mónica Cruz-Lemini, Brenda Valenzuela-Alcaraz, Francesc Figueras, Marta Sitges, Olga Gómez, Josep María Martínez, Bart Bijnens, Eduard Gratacós, Fátima Crispi
INTRODUCTION: Recent studies have reported variations of up to 30% between different ultrasound machines for tissue Doppler imaging (TDI), a problem that can significantly impact clinical diagnosis, patient management and research studies. The objective of this study was to assess repeatability and agreement between fetal myocardial peak velocities evaluated by TDI with two different ultrasound systems. MATERIALS AND METHODS: Systolic (S'), early (E') and late (A') diastolic myocardial peak velocities at mitral and tricuspid annuli as well as at the basal septum were evaluated by spectral TDI in 150 fetuses using two different ultrasound systems: Siemens Antares (Siemens Medical Systems, Malvern, Pa...
2016: Fetal Diagnosis and Therapy
M Cruz-Lemini, F Crispi, B Valenzuela-Alcaraz, F Figueras, M Sitges, B Bijnens, E Gratacós
OBJECTIVES: Intrauterine growth restriction is associated with increased cardiovascular risk later in life but the link between fetal disease and postnatal risk is not well-documented. We evaluated longitudinally the association between cardiovascular remodeling in small-for-gestational-age (SGA) fetuses and at 6 months of age. METHODS: A cohort of 80 SGA fetuses (defined by estimated fetal and birth weights < 10(th) centile) delivered > 34 weeks' gestation was compared with 80 normally grown age-matched control fetuses, with follow-up at 6 months of corrected age (i...
September 2016: Ultrasound in Obstetrics & Gynecology
Merida Rodriguez-Lopez, Lyda Osorio, Ruthy Acosta-Rojas, Josep Figueras, Monica Cruz-Lemini, Francesc Figueras, Bart Bijnens, Eduard Gratacós, Fatima Crispi
BACKGROUND: Our aim was to determine the influence of breastfeeding and postnatal nutrition on cardiovascular remodeling induced by fetal growth restriction (FGR). METHODS: A cohort study including 81 children with birthweight <10th centile (FGR) and 121 with adequate fetal growth for gestational age (AGA) was conducted. Cardiovascular endpoints were left ventricular sphericity index (LVSI), carotid intima-media thickness (cIMT), and blood pressure (BP) at 4-5 y of age...
January 2016: Pediatric Research
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