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Journal articles on the topic 'ECG foetal'

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Author: Grafiati

Published: 20 July 2024

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1

Djungha Okitadiowo, John P., Aimé Lay-Ekuakille, Tommaso Isernia, Vikrant Bhateja, and Satya Prakash Singh. "Beamforming-based algorithms for recovering information from fetal electrocardiographic sensors." Acta IMEKO 12, no. 2 (June 26, 2023): 1–8. http://dx.doi.org/10.21014/actaimeko.v12i2.1470.

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We deal with the extraction of the fetal electrocardiography (ECG) signal from the raw ECG signals of the mother by the beamforming- based algorithms. The foetal ECG sensors bring out signals containing information from the pregnant mother and the infant. Detailed and separate signals are already provided by the foetal ECG instruments; but for some specific studies related to the infant conditions, it is necessary to improve the quality of the signal with a dedicated processing. In this paper, four techniques, with some enhancements, are proposed to perform the processing; we have applied the following techniques: Least Mean Square (LMS) with adaptive noise cancellation technique, Discrete Wavelet Transform (DWT)-based technique, Empirical Wavelet Transform (EWT) technique, and Multiple Signal Classification (MUSIC). The LMS and the MUSIC pertain to beamforming approach. The techniques were used to decompose and identify the different elements constituting the source signal (mother's signal) and noise cancellation by Multivariate Empirical Mode Decomposition (MEMD) technique. The signal was adaptively decomposed by LMS, DWT and MUSIC according to optimised parameters to extract some hidden components of the source signal, such as the foetal features, QRS, heartbeat etc. The results have showed that LMS, with enhancements, is more effective in identifying and removing useless noise. The techniques were applied to the ECG signal of a 30-year-old healthy pregnant woman, which allowed to verify their applicability. The present research leads to the below main contributions among others: separation of the ECG signal of the foetus from the mother, highlighting the functional state of the foetal heart rhythm (heart rate and heartbeat,) and this can show us if the foetal ECG has malfunctions.

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2

Sivaraman, Himani. "Application of SVM Algorithm for Fetal ECG Extraction from a Single Maternal Abdominal Record." Turkish Journal of Computer and Mathematics Education (TURCOMAT) 10, no. 1 (April 10, 2019): 638–44. http://dx.doi.org/10.17762/turcomat.v10i1.13560.

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The electrical activity of the foetal cardiac muscles is known as foetal ECG (FECG), and it can provide crucial details on the health of the fetus's heart. A pregnant woman's belly can be used to non-invasively capture this signal during pregnancy. However, since additional sources of noise, including the maternal ECG generally overpower the FECG recording, it would be ineffective. However, a clean FECG may be retrieved from the abdominal recording if it is correctly processed, and FECG can be used to evaluate the functioning of the foetal heart. In order to extract foetal electrocardiogram (ECG) from a single abdomen record, a unique two-tier approach is presented in this work. The abdominal signal is processed through a smoothing filter in the first layer of the proposed approach in order to determine the maternal ECG's estimated value. Findings on synthetic and actual abdominal ECG data demonstrate that the intended technique can extract foetal ECG with signal quality equivalent or superior to that retrieved by multichannel based mechanisms. The anticipated maternal ECG is then nonlinearly matched with the abdominal signal through polynomial networks.

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3

Wei, Zheng, Li Xiaolong, Wei Xueyun, and Liu Hongxing. "Foetal ECG extraction by support vector regression." Electronics Letters 52, no. 7 (April 2016): 506–7. http://dx.doi.org/10.1049/el.2016.0171.

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4

Lee, J., K. L. Park, and K. J. Lee. "Temporally constrained ICA-based foetal ECG separation." Electronics Letters 41, no. 21 (2005): 1158. http://dx.doi.org/10.1049/el:20052235.

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5

Parameshwari, R., C. Emlyn Gloria Ponrani, and S. Shenbaga Devi. "Foetal ECG extraction using BPN and UWT." International Journal of Biomedical Engineering and Technology 22, no. 1 (2016): 1. http://dx.doi.org/10.1504/ijbet.2016.078980.

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6

Curnow, J. S. H., L. B. Barron, J. Westgate, and K. G. Greene. "Four channel foetal ECG data collection system." Medical Engineering & Physics 17, no. 2 (March 1995): 122–25. http://dx.doi.org/10.1016/1350-4533(95)91883-i.

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7

Camps-Valls, Gustavo, Marcelino Martı́nez-Sober, Emilio Soria-Olivas, Rafael Magdalena-Benedito, Javier Calpe-Maravilla, and Juan Guerrero-Martı́nez. "Foetal ECG recovery using dynamic neural networks." Artificial Intelligence in Medicine 31, no. 3 (July 2004): 197–209. http://dx.doi.org/10.1016/j.artmed.2004.03.005.

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8

Amer-Wåhlin, I., B. Yli, and S. Arulkumaran. "Foetal ECG and STAN technology—a review." European Clinics in Obstetrics and Gynaecology 1, no. 2 (June 17, 2005): 61–73. http://dx.doi.org/10.1007/s11296-005-0017-2.

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9

John, Rolant Gini, and K. I. Ramachandran. "Extraction of foetal ECG from abdominal ECG by nonlinear transformation and estimations." Computer Methods and Programs in Biomedicine 175 (July 2019): 193–204. http://dx.doi.org/10.1016/j.cmpb.2019.04.022.

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10

Xueyun, Wei, and Zheng Wei. "Application of kernel PCA for foetal ECG estimation." Electronics Letters 54, no. 6 (March 2018): 340–42. http://dx.doi.org/10.1049/el.2018.0071.

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11

Behar, Joachim, Fernando Andreotti, Sebastian Zaunseder, Qiao Li, Julien Oster, and Gari D. Clifford. "An ECG simulator for generating maternal-foetal activity mixtures on abdominal ECG recordings." Physiological Measurement 35, no. 8 (July 29, 2014): 1537–50. http://dx.doi.org/10.1088/0967-3334/35/8/1537.

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12

Ali, Mahmoud Ahmed Suliman. "Continuously Monitoring Foetal ECG using Mobile Telemedicine Sensor Network." Engineering 05, no. 05 (2013): 63–66. http://dx.doi.org/10.4236/eng.2013.55b013.

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13

Adam, D., and D. Shavit. "Complete foetal ECG morphology recording by synchronised adaptive filtration." Medical & Biological Engineering & Computing 28, no. 4 (July 1990): 287–92. http://dx.doi.org/10.1007/bf02446144.

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14

ZARZOSO, V., A. K. NANDI, and E. BACHARAKIS. "Maternal and foetal ECG separation using blind source separation methods." Mathematical Medicine and Biology 14, no. 3 (September 1, 1997): 207–25. http://dx.doi.org/10.1093/imammb/14.3.207.

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15

Uçmak, Melih, Özge Turna, Zeynep Günay Uçmak, and Asuman Erzengin. "Evaluation of serum anti-Müllerian hormone (AMH) and equine chorionic gonadotrophin (eCG) concentrations in pregnant mares in relation to foetal sex." Acta Veterinaria Brno 92, no. 1 (2023): 31–38. http://dx.doi.org/10.2754/avb202392010031.

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The aim of this study was to investigate the foetal sex related difference and progression in maternal serum anti-Müllerian hormone (AMH) and equine chorionic gonadotrophin (eCG) concentrations during different points of time in pregnant Arabian mares. The study groups formed by 12 healthy male offspring- and 12 healthy female offspring-foaling mares, designated as group MFM and group FFM, respectively. Peripheral blood samples were collected on the day of natural mating and then monthly until the 6th month (mo) of gestation. Serum AMH was measured in all serum samples; eCG was measured in samples collected from 2 to 5 months Of gestation. Serum AMH concentrations of group FFM at mo 4 and mo 5 (3.89 ± 0.49 ng/ml; 2.89 ± 0.32 ng/ml), were significantly higher than in group MFM (2.11 ± 0.46 ng/ml; 1.87 ± 0.32 ng/ml), (P < 0.05). The mo of gestation (mo 1–6) had no effect on serum AMH concentrations of either group MMF or FFM (P > 0.05). Serum eCG concentrations of group FFM at mo 2 (359.73 ± 41.51 mIU/ml), were significantly higher than in group MFM (255 ± 21.18 mIU/ml) (P < 0.05). Group-time interaction for eCG concentrations at mo 2–4 was non-significant (P > 0.05). Concentrations of serum AMH showed no relationship with corresponding eCG levels at mo 2–4 (P > 0.05). Individual variations in AMH and eCG concentrations and the inability to determine a cut-off point for determination of foetal sex make these hormones unlikely candidates for determining foetal sex in the mare.

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16

Reinhard, J., and F. Louwen. "Non-invasive Foetal ECG - a Comparable Alternative to the Doppler CTG?" Geburtshilfe und Frauenheilkunde 72, no. 03 (March 2012): 211–14. http://dx.doi.org/10.1055/s-0031-1298329.

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17

Muceli, S., D. Pani, and L. Raffo. "Real-time foetal ECG extraction with JADE on floating point DSP." Electronics Letters 43, no. 18 (2007): 963. http://dx.doi.org/10.1049/el:20071331.

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18

Oostendorp, T. F., A. van Oosterom, and H. W. Jongsma. "Electrical properties of tissues involved in the conduction of foetal ECG." Medical and Biological Engineering and Computing 27, no. 3 (May 1989): 322–24. http://dx.doi.org/10.1007/bf02441492.

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19

Conley, Alan J., and Barry A. Ball. "Steroids in the establishment and maintenance of pregnancy and at parturition in the mare." Reproduction 158, no. 6 (December 2019): R197—R208. http://dx.doi.org/10.1530/rep-19-0179.

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Historically, studies on the endocrinology of pregnancy and parturition in horses have made major contributions of relevance to mammals in general. Recent use of liquid chromatography mass spectrometry, measuring multiple steroid hormones simultaneously in blood, foetal and placental tissues throughout normal gestation, and in mares with experimentally induced placentitis, has advanced our current understanding of many of the unusual strategies seen during gestation and at foaling. This includes the stimulation of luteal steroidogeneisis by equine chorionic gonadotropin (eCG) from the endometrial cups, resulting in additional androgen and oestrogen secretion. Progesterone declines as the endometrial cups and eCG disappears, replaced by 5α-dihydroprogesterone (DHP), a potent equine progesterone receptor (PR) agonist, as the chorioallantoic placenta develops. Placental steroidogenesis thereafter is influenced by foetal pregnenolone and dehydroepiandrosterone secretion, providing substrate for 5α-pregnane and oestrogen synthesis, an unusual example of a ‘foeto-placental unit’. Foetal gonadal dehydroepiandrosterone fuels placental oestrone sulphate secretion, peaking at higher concentrations in mares than any other species known, declining steadily thereafter to term. Additional 5α-reduced (DHP) metabolites increase from mid-gestation to peak concentrations 3–5 days before foaling, declining prepartum, most likely as a result of selective loss of placental SRD5A1 (5α-reductase) expression and activity. Similar changes occur in mares with experimentally induced placentitis, which is also associated with a decreased ratio of equine PR-B:PR-A in myometrium, suggesting that progestin withdrawal is both systemic (pregnanes) and local (receptor-dependent) in mares. In addition, some steroids detected during equine pregnancy by immuno-assay are not detected by mass spectrometry, further illustrating the immense value of this technology.

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20

Swarnalatha, R., and D. V. Prasad. "Foetal ECG extraction using combination of wavelets and hybrid-algorithm-based ANFIS." International Journal of Healthcare Technology and Management 11, no. 3 (2010): 133. http://dx.doi.org/10.1504/ijhtm.2010.034085.

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21

Sänger, N., B. Hayes-Gill, S. Schiermeier, W. Hatzmann, J. Yuan, E. Herrmann, F. Louwen, and J. Reinhard. "Prenatal Foetal Non-invasive ECG instead of Doppler CTG - A Better Alternative?" Geburtshilfe und Frauenheilkunde 72, no. 07 (July 2012): 630–33. http://dx.doi.org/10.1055/s-0032-1315012.

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22

Andreotti, Fernando, Joachim Behar, Sebastian Zaunseder, Julien Oster, and Gari D. Clifford. "An open-source framework for stress-testing non-invasive foetal ECG extraction algorithms." Physiological Measurement 37, no. 5 (April 12, 2016): 627–48. http://dx.doi.org/10.1088/0967-3334/37/5/627.

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23

Ma, Yaping, Yegui Xiao, Guo Wei, and Jinwei Sun. "Foetal ECG extraction using non‐linear adaptive noise canceller with multiple primary channels." IET Signal Processing 12, no. 2 (April 2018): 219–27. http://dx.doi.org/10.1049/iet-spr.2016.0605.

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24

Hutchon, David J. R. "Neonatal heart rate monitoring at birth with hands-free foetal doppler." Proceedings of the International Conference on Condition Monitoring and Asset Management 2023, no. 1 (January 1, 2023): 1–5. http://dx.doi.org/10.1784/cm2023.2d2.

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There is a need for improved measurement and documentation of the neonatal heart rate immediately after birth, which currently relies on auscultation with a stethoscope. Measurement of the heart rate is a medical requirement within the first minute after birth in all babies. Heart rate at birth is the only reliable indicator of the health of the neonate which does not establish breathing immediately. In sick neonates pulse oximetry is usually available but does not provide an output for the first minute even in healthy neonates. Although the ECG is considered the gold standard, it may provide a false measurement due to pulseless electrical activity of the myocardium. Neonatal ECG technology is not routinely available at birth, however prior to birth the fetal heart rate is routinely obtained and documented by a low cost doppler ultrasound. Recently the fetal doppler has been shown to be effective immediately after birth on the neonatal chest (Hutchon 2022) but requires constant attention by the carer, and may interfere with measures to provide positive pressure ventilation or other resuscitation measures. A fetal doppler ultrasound device has been extended to provide a hands free sensor which is secured on the neonatal chest by the surface tension of the transducer gel. The system also works well through polythene and provides a safe and effective neonatal heart rate monitor inside a sterile polythene bag for use at caesarean birth. The design features are presented and preliminary data showing the precordial doppler provides a heart rate closely equivalent to the heart rate from the gold standard ECG.

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25

Zhang, Yanmin, Xiaomin Li, Ying Yang, Jie Wang, Xinru Gao, and Mengyun Fan. "The combined novel KCNQ1 frameshift I145Sfs*92 and nonsense W392X variants caused Jervell and Lange-Nielsen syndrome in a Chinese infant presenting with sustained foetal bradycardia." EP Europace 22, no. 12 (August 23, 2020): 1880–84. http://dx.doi.org/10.1093/europace/euaa154.

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Abstract Aims We report clinical and molecular analysis of an infant presenting with foetal bradycardia and clinical outcome of Jervell and Lange-Nielsen syndrome (JLNS). Methods and results Clinical, electrocardiogram (ECG), and echocardiographic data were collected from members in a three-generation family. Whole exomes were amplified and sequenced for proband. The identified variants were verified in the remaining members. The pathogenicity of candidate variants was predicted using multiple software programmes. A 28-year-old non-consanguineous Chinese woman at 23 weeks’ gestation presenting with sustained foetal bradycardia of 100 b.p.m. Immunological disorders and infection were excluded. The infant was delivered at 37 weeks’ gestation with 2700-g birthweight. QTc was prolonged in both ECG and Holter recording. Hearing tests confirmed bilateral sensorineural hearing loss. Genetic testing demonstrated that the infant carried a novel frameshift c.431delC (p.I145Sfs*92) and a novel nonsense c.1175G>A (p.W392X) compound variants of KCNQ1 inherited from mother and father, respectively, in autosomal recessive inheritance. Only relative II-5 carrying heterozygous KCNQ1-I145Sfs*92 variant had prolonged QTc, while the other carriers did not have prolonged QT, suggesting an autosomal dominant inheritance of LQT1 phenotype with incomplete penetrance in the family. Conclusion We report the novel frameshift KCNQ1-I145Sfs*92 and nonsense KCNQ1-W392X compound variants in autosomal recessive inheritance that caused JLNS presenting as sustained foetal bradycardia for the first time. Meanwhile, KCNQ1-I145Sfs*92 heterozygous variant demonstrated LQT1 phenotype in autosomal dominant inheritance with incomplete penetrance.

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26

Zhang, Miao, and Guo Wei. "An Instantaneous Correlation Coefficient and Simplified Coherent Averaging Method for Single-Channel Foetal ECG Extraction." Applied Sciences 10, no. 16 (August 14, 2020): 5634. http://dx.doi.org/10.3390/app10165634.

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In this paper, an instantaneous correlation coefficient and simplified coherent averaging method for single-channel foetal ECG (FECG) extraction is proposed. The instantaneous correlation coefficient is used to determine the position of the R peak of the measured ECG signal, and the simplified coherent averaging method is used to extract the main information of the ECG signal. The loss of the nonlinear and nonstationary characteristics by coherent averaging is recovered by threshold processing of the residual signal. The FECG signal extraction is performed in three steps. In the first step, the main information of the maternal electrocardiogram (MECG) is extracted from the abdomen electrocardiogram (AECG) signal by means of the instantaneous correlation coefficient and simplified coherent averaging method, and then the noisy FECG is obtained by subtracting the MECG obtained by simplified coherent averaging from the AECG. The second step is to extract the main information of the FECG by applying the instantaneous correlation coefficient and simplified coherent averaging method to the noisy FECG. The remaining signal is obtained by subtracting the simplified coherent averaging FECG from the noisy FECG. Thirdly, the threshold method is utilised to remove MECG residual noise and random gross value noise from the remaining signal to extract the nonlinear and nonstationary information, and the final FECG extraction is obtained by adding the nonlinear and nonstationary information to the simplified coherent averaging FECG. The validity of the proposed method is verified by experiments using synthetic data and real database data. FECG extracted by the method has the advantages of clear QRS complex wave, reasonable enhancement of P wave and T wave morphology, and no loss of nonlinear and nonstationary characteristics.

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27

Dewan, Lillie, and Prabhjot Kaur. "LabVIEW-based cardiac risk assessment of foetal ECG signal extracted from maternal abdominal signal." International Journal of Computer Applications in Technology 66, no. 2 (2021): 115. http://dx.doi.org/10.1504/ijcat.2021.10043450.

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28

Kaur, Prabhjot, and Lillie Dewan. "LabVIEW-based cardiac risk assessment of foetal ECG signal extracted from maternal abdominal signal." International Journal of Computer Applications in Technology 66, no. 2 (2021): 115. http://dx.doi.org/10.1504/ijcat.2021.119761.

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29

Behar, Joachim, Julien Oster, and Gari D. Clifford. "Combining and benchmarking methods of foetal ECG extraction without maternal or scalp electrode data." Physiological Measurement 35, no. 8 (July 29, 2014): 1569–89. http://dx.doi.org/10.1088/0967-3334/35/8/1569.

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30

Al-Zaben, A., and A. Al-Smadi. "Extraction of foetal ECG by combination of singular value decomposition and neuro-fuzzy inference system." Physics in Medicine and Biology 51, no. 1 (December 15, 2005): 137–43. http://dx.doi.org/10.1088/0031-9155/51/1/010.

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31

Hutchon, David. "The Use of Foetal Doppler Ultrasound to Determine the Neonatal Heart Rate Immediately after Birth: A Systematic Review." Children 9, no. 5 (May 13, 2022): 717. http://dx.doi.org/10.3390/children9050717.

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Determining the neonatal heart rate immediately after birth is unsatisfactory. Auscultation is inaccurate and provides no documented results. The use of foetal Doppler ultrasound has been recognised as a possible method of determining the neonatal heart rate after birth over the last nine years. This review includes all published studies of this approach, looking at accuracy, speed of results, and practical application of the approach. Precordial Doppler ultrasound has been shown to be as accurate as ECG and more accurate than oximetry for the neonatal heart rate, and provides quicker results than either ECG or oximetry. There is the potential for a much improved determination and documentation of the neonatal heart rate using this approach.

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32

Sutha, P., and V. E. Jayanthi. "Implementation of a Biopotential Amplifier with a Conventional and Current-Balancing Approach for Foetal ECG Monitoring." Circuits, Systems, and Signal Processing 39, no. 6 (November 20, 2019): 2860–79. http://dx.doi.org/10.1007/s00034-019-01311-x.

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33

Martinek, R., M. Kelnar, P. Koudelka, J. Vanus, P. Bilik, P. Janku, H. Nazeran, and J. Zidek. "Enhanced processing and analysis of multi‐channel non‐invasive abdominal foetal ECG signals during labor and delivery." Electronics Letters 51, no. 22 (October 2015): 1744–46. http://dx.doi.org/10.1049/el.2015.2222.

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34

Scurtu, Iuliu, Cosmin Pestean, Radu Lacatus, Meda Lascu, Mircea Mircean, Razvan Codea, Cristian Popovici, Robert Purdoiu, and Gabril Giurgiu. "REVERSE PDA – LESS COMMON TYPE OF PATENT DUCTUS ARTERIOSUS -CASE REPORT." Bulletin of University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca. Veterinary Medicine 73, no. 2 (November 30, 2016): 351. http://dx.doi.org/10.15835/buasvmcn-vm:12225.

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Introduction: PDA represents one of the most frequently diagnosed type of congenital heart disease. Ductus arteriosus is a normal structure in foetal life, which permits shunting of oxygenated blood from the pulmonary artery into the aorta. Failure of sealing after birth is an abnormal condition and is called patent ductus arteriosus. In normal PDA, due to fact that systemic pressure is fivefold higher than pulmonary circulation, blood is shunted from the aorta into the pulmonary artery. In reverse PDA, pulmonary artery pressure does not drop after birth, and blood will be shunted form right to left. Aims: We want to evaluate clinical, haematological, ECG and echocardiographic changes in case of reverse PDA. Materials and Methods: Two-year old female Bichon Frise was referred to our clinic with signs of effort intolerance and dyspnoea for more than a year. ECG was performed in the right lateral recumbency using a digital device and echocardiography was done with Esaote MyLab40 Vet with a phased array transducer matched with the size of the dog (7.5 MHz). Results: We identified a dog with a good body score, quite alert and without any sign of illness. Haematological investigation underlined polycythaemia and very high PCV. The ECG revealed a normal sinus rhythm with a deep S wave, changes consistent with right ventricle enlargement. Right atrial dilation and right ventricle hypertrophy were found on cardiac ultrasonography. The right ventricle free wall was hypertrophied and interventricular septum was flattened, changes consistent with increased pressure on the right side of the heart. The left heart was small. Positive diagnosis was done, performing “bubble study” and identification of contrast bubble within the abdominal aorta. Conclusion: Reverse PDA is a rarely diagnosed congenital heart disease. Polycythaemia in young dogs could raise the suspicion of reverse PDA. For positive diagnosis, echocardiography and bubble study are required. ECG is not a sensitive tool for diagnosis.

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35

Mertes, Gert, Yuan Long, Zhangdaihong Liu, Yuhui Li, Yang Yang, and David A. Clifton. "A Deep Learning Approach for the Assessment of Signal Quality of Non-Invasive Foetal Electrocardiography." Sensors 22, no. 9 (April 26, 2022): 3303. http://dx.doi.org/10.3390/s22093303.

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Non-invasive foetal electrocardiography (NI-FECG) has become an important prenatal monitoring method in the hospital. However, due to its susceptibility to non-stationary noise sources and lack of robust extraction methods, the capture of high-quality NI-FECG remains a challenge. Recording waveforms of sufficient quality for clinical use typically requires human visual inspection of each recording. A Signal Quality Index (SQI) can help to automate this task but, contrary to adult ECG, work on SQIs for NI-FECG is sparse. In this paper, a multi-channel signal quality classifier for NI-FECG waveforms is presented. The model can be used during the capture of NI-FECG to assist technicians to record high-quality waveforms, which is currently a labour-intensive task. A Convolutional Neural Network (CNN) is trained to distinguish between NI-FECG segments of high and low quality. NI-FECG recordings with one maternal channel and three abdominal channels were collected from 100 subjects during a routine hospital screening (102.6 min of data). The model achieves an average 10-fold cross-validated AUC of 0.95 ± 0.02. The results show that the model can reliably assess the FECG signal quality on our dataset. The proposed model can improve the automated capture and analysis of NI-FECG as well as reduce technician labour time.

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36

Grigioni, M., A. Carotti, C. Daniele, G. D'avenio, U. Morbiducci, E. Iannace, S. B. Albanese, et al. "Extracorporeal Circulation in Ewe's Foetus: Towards a Reliable Foetal Cardiac Surgery Protocol a Comparison of two Cases." International Journal of Artificial Organs 23, no. 3 (March 2000): 189–98. http://dx.doi.org/10.1177/039139880002300308.

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Foetal cardiac surgery is the ultimate goal in the treatment of congenital cardiac malformations. The aim of our research is to elucidate some of the features of the necessarily invasive experimental protocol to be used in an animal model of foetal cardiac surgery. In particular, we assessed the foetal placentar reactivity to prolonged cardiac bypass in steady-flow conditions. Methods Two cases were selected to show the outcome of prolonged (> 30 minutes) extracorporeal circulation (ECC) instituted without oxygenator under steady-flow assistance. Following the instrumentation of the animal (placement of pressure, flow and myocardial fiber length transducers) and the baseline recordings, a 60-minute bypass period was established with an axial turbopump (Hemopump 14 Fr), after systemic heparinisation and artero-venous cannulation. At the end of the circulatory assistance, the cannulae were removed and a 90 minute observation period followed. The cardiac function was assessed by means of indirectly obtained P-V loops. Results Case A showed a marked reduction in the end-systolic pressure-volume relationship (ESPVR) during ECC, corresponding to a rightward shift of the P-V loop, with a gradual recovery after the assisted circulation. On the contrary, case B was subjected to progressive placental dysfunction, as evidenced by haemogasanalytical data. Consequently, the haemodynamic data also outlined a negative outcome, with high ESPVR values after bypass. Conclusions The present study, while confirming the possibility of cardiac intervention in the foetus, underlines the critical role of minimally invasive protocol to limit both foetal stress and placental dysfunction.

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37

Kohen, Dora. "Psychotropic medication in pregnancy." Advances in Psychiatric Treatment 10, no. 1 (January 2004): 59–66. http://dx.doi.org/10.1192/apt.10.1.59.

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The risks and benefits of psychopharmacological treatment in pregnancy need careful consideration. Conventional antipsychotics and tricyclic antidepressants are relatively safe for the foetus. Selective serotonin reuptake inhibitors appear to be safe, but mood stabilisers such as lithium, sodium valproate and carbamazepine are associated with increased foetal malformations. Benzodiazepines in the first trimester are teratogenic, and in high dosage can also cause withdrawal symptoms, hypotonia and agitation in the newborn. Women taking atypical antipsychotics should be switched to conventional antipsychotics before they conceive. In women with long-term mental illness necessitating psychotropic medication, effort should be made to stop polypharmacy and non-essential medication (e.g. benzodiazepines) and to decrease the dose of essential drugs, after full assessment. There is rarely a valid reason to stop essential drug treatment during pregnancy.

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38

Sotiriadis, Alexandros, Makarios Eleftheriades, Fotios Chatzinikolaou, Demetrios Hassiakos, George P. Chrousos, and Panagiota Pervanidou. "National curves of foetal growth in singleton foetuses of Greek origin." European Journal of Clinical Investigation 46, no. 5 (March 22, 2016): 425–33. http://dx.doi.org/10.1111/eci.12611.

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Cleal, J. K., S. Bagby, M. A. Hanson, H. M. Gardiner, and L. R. Green. "The effect of late gestation foetal hypoglycaemia on cardiovascular and endocrine function in sheep." Journal of Developmental Origins of Health and Disease 1, no. 1 (December 10, 2009): 42–49. http://dx.doi.org/10.1017/s204017440999016x.

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An appropriate foetal cardiovascular (CV) response to reduced substrate supply (e.g. oxygen or other nutrients) is vital for growth and development, and may impact on CV control. The prevailing nutritional environment and associated CV changes may influence subsequent CV responses to challenges during late gestation, for example, umbilical cord occlusion (UCO). We investigated the effect of low-circulating glucose on foetal CV control mechanisms and response to UCO. Under general anaesthesia, late gestation foetal sheep (n = 7, 119 days gestational age (dGA), term ∼147 days) were implanted with vascular catheters, a bladder catheter, electrocardiogram electrodes and an umbilical cord occluder. Mean arterial pressure (MAP), heart rate (HR) and kidney function were monitored during maternal saline (MSAL, 125dGA) and insulin (MINS, 126dGA) infusion, and foetal CV responses were assessed during incremental doses of angiotensin II, a 90-s total UCO, and administration of phenylephrine to assess baroreflex function. During MINS infusion, the decrease in maternal and foetal blood glucose was associated with a small but significant decrease in foetal HR and reduced foetal baroreflex sensitivity (P < 0.05). The increase in foetal MAP during a 90-s UCO was greater during hypoglycaemia (P < 0.05). The MAP response to angiotensin II was not affected by hypoglycaemia. Decreased foetal HR and baroreflex sensitivity and increased CV responsiveness to UCO during hypoglycaemia indicates altered CV homoestatic mechanisms. The combination of altered nutrition and a CV challenge, such as UCO, during late gestation may have a cumulative effect on foetal CV function.

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Maugeri, Andrea, Martina Barchitta, and Antonella Agodi. "How Wearable Sensors Can Support the Research on Foetal and Pregnancy Outcomes: A Scoping Review." Journal of Personalized Medicine 13, no. 2 (January 26, 2023): 218. http://dx.doi.org/10.3390/jpm13020218.

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The application of innovative technologies, and in particular of wearable devices, can potentially transform the field of antenatal care with the aim of improving maternal and new-born health through a personalized approach. The present study undertakes a scoping review to systematically map the literature about the use wearable sensors in the research of foetal and pregnancy outcomes. Online databases were used to identify papers published between 2000–2022, from which we selected 30 studies: 9 on foetal outcomes and 21 on maternal outcomes. Included studies focused primarily on the use of wearable devices for monitoring foetal vital signs (e.g., foetal heart rate and movements) and maternal activity during pregnancy (e.g., sleep patterns and physical activity levels). There were many studies that focused on development and/or validation of wearable devices, even if often they included a limited number of pregnant women without pregnancy complications. Although their findings support the potential adoption of wearable devices for both antenatal care and research, there is still insufficient evidence to design effective interventions. Therefore, high quality research is needed to determine which and how wearable devices could support antenatal care.

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Veeramachaneni, D. N. Rao, and Gary R. Klinefelter. "Phthalate-induced pathology in the foetal testis involves more than decreased testosterone production." REPRODUCTION 147, no. 4 (April 2014): 435–42. http://dx.doi.org/10.1530/rep-13-0441.

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Foetal exposure to phthalates is known to adversely impact male reproductive development and function. Developmental anomalies of reproductive tract have been attributed to impaired testosterone synthesis. However, species differences in the ability to produce testosterone have been noted; e.g., following foetal exposure, abnormal clustering of Leydig cells or decreased production of testosterone that is manifested in rats does not occur in mice or humans. Nonetheless, other facets of testicular dysgenesis occur in both rats and mice as well as in some other species tested. We recently published a comprehensive evaluation of the foetal rat testis proteome, following in utero exposure to diethylhexyl phthalate (DEHP), which revealed changes in individual proteins that are known to be factors in cellular differentiation and migration or related to the capacity of the foetal Leydig cell to produce testosterone and fit a pathway network in which each is regulated directly or indirectly by oestradiol. Plasma oestradiol indeed was found to be elevated approximately twofold in 19-day-old DEHP-exposed foetal male rats. In this brief review, we discuss our new findings vis-à-vis ‘oestrogen hypothesis’ as a cause for testicular dysgenesis syndrome.

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Caruso, Martina, Giuseppina Dell’Aversano Orabona, Marco Di Serafino, Francesca Iacobellis, Francesco Verde, Dario Grimaldi, Vittorio Sabatino, Chiara Rinaldo, Maria Laura Schillirò, and Luigia Romano. "Role of Ultrasound in the Assessment and Differential Diagnosis of Pelvic Pain in Pregnancy." Diagnostics 12, no. 3 (March 5, 2022): 640. http://dx.doi.org/10.3390/diagnostics12030640.

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Pelvic pain (PP) is common in pregnant women and can be caused by several diseases, including obstetrics, gynaecological, gastrointestinal, genitourinary, and vascular disorders. Timely and accurate diagnosis as well as prompt treatment are crucial for the well-being of the mother and foetus. However, these are very challenging. It should be considered that the physiological changes occurring during pregnancy may confuse the diagnosis. In this setting, ultrasound (US) represents the first-line imaging technique since it is readily and widely available and does not use ionizing radiations. In some cases, US may be conclusive for the diagnosis (e.g., if it detects no foetal cardiac activity in suspected spontaneous abortion; if it shows an extrauterine gestational sac in suspected ectopic pregnancy; or if it reveals a dilated, aperistaltic, and blind-ending tubular structure arising from the cecum in suspicious of acute appendicitis). Magnetic resonance imaging (MRI), overcoming some limits of US, represents the second-line imaging technique when an US is negative or inconclusive, to detect the cause of bowel obstruction, or to characterize adnexal masses.

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Mendes, Sara, Filipa Timóteo-Ferreira, Henrique Almeida, and Elisabete Silva. "New Insights into the Process of Placentation and the Role of Oxidative Uterine Microenvironment." Oxidative Medicine and Cellular Longevity 2019 (June 25, 2019): 1–18. http://dx.doi.org/10.1155/2019/9174521.

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For a successful pregnancy to occur, a predecidualized receptive endometrium must be invaded by placental differentiated cells (extravillous trophoblast cells (EVTs)) and, at the same time, continue decidualization. EVT invasion is aimed at anchoring the placenta to the maternal uterus and ensuring local blood supply increase necessary to provide normal placental and foetal development. The first is achieved by migrating through the maternal endometrium and deeper into the myometrium, while the second by transforming uterine spiral arteries into large vessels. This process is a tightly regulated battle comprising interests of both the mother and the foetus. Invading EVTs are required to perform a scope of functions: move, adhere, proliferate, differentiate, interact, and digest the extracellular matrix (ECM); tolerate hypoxia; transform the maternal spiral arteries; and die by apoptosis. All these functions are modulated by their surrounding microenvironment: oxygen, soluble factors (e.g., cytokines, growth factors, and hormones), ECM proteins, and reactive oxygen species. A deeper comprehension of oxidative uterine microenvironment contribution to trophoblast function will be addressed in this review.

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Schor, S. L., A. M. Schor, G. Rushton, and L. Smith. "Adult, foetal and transformed fibroblasts display different migratory phenotypes on collagen gels: evidence for an isoformic transition during foetal development." Journal of Cell Science 73, no. 1 (February 1, 1985): 221–34. http://dx.doi.org/10.1242/jcs.73.1.221.

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Data are presented indicating that the migration of fibroblasts into three-dimensional collagen gels is affected by cell density. We have defined a ‘cell density migration index’ (CDMI) to express this behavioural response in quantitative terms. The results of a survey of 77 different cell types indicate that the CDMI values expressed by normal adult skin fibroblasts and transformed cell lines fall into two distinct, non-overlapping groups. Measurement of the CDMI therefore provides an additional means of distinguishing between normal and transformed cells and may be used in conjunction with other commonly recognized criteria (e.g. anchorage-independent growth) to assess expression of a transformed phenotype in vitro. It is of interest to note that the CDMI values expressed by foetal cells define a group lying intermediate between normal and transformed cells. Both uncloned and cloned foetal cells have been observed to undergo a stable transition to expression of CDMI values characteristic of adult cells when followed throughout the duration of their in vitro lifespan. In addition to providing a novel means of distinguishing between normal adult and foetal cells, our results suggest that foetal fibroblasts undergo an ‘isoformic’ transition at some point in their developmental history, which is manifest in vitro by the expression of an adult CDMI.

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Tjon, Jill K., Maria B. Tan-Sindhunata, Marianna Bugiani, Melinda M. E. H. Witbreuk, Johannes A. van der Sluijs, Marjan M. Weiss, Mirjam M. van Weissenbruch, et al. "Care Pathway for Foetal Joint Contractures, Foetal Akinesia Deformation Sequence, and Arthrogryposis Multiplex Congenita." Fetal Diagnosis and Therapy 48, no. 11-12 (2021): 829–39. http://dx.doi.org/10.1159/000520869.

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<b><i>Introduction:</i></b> The majority of arthrogryposis multiplex congenita (AMC) and lethal forms of AMC such as foetal akinesia deformation sequence (FADS) cases are missed prenatally. We have demonstrated the additional value of foetal motor assessment and evaluation in a multidisciplinary team for the period 2007–2016. An applied care pathway was developed for foetuses presenting with joint contracture(s) in one anatomic region (e.g., talipes equinovarus [TEV]), more than one body part with non-progressive contractures and motility (AMC) and with deterioration over time (FADS). <b><i>Methods:</i></b> The multidisciplinary team of Amsterdam University Medical Centre Expertise Centre FADS and AMC developed the care pathway. Additional tools are provided including a motor assessment by ultrasound examination and a post-mortem assessment form. <b><i>Results:</i></b> An eight-step care pathway is presented with a proposed timing for prenatal sonographic examination, genetic examinations, multidisciplinary meetings, prenatal and postnatal counselling of the parents by a specialist also treating after birth, and the follow-up of prenatal and postnatal findings with counselling for future pregnancies. <b><i>Discussion/Conclusion:</i></b> The scheduled serial structural and motor sonograpahic assessment together with follow-up examinations and genetic analysis should be tailored per prenatal centre per available resources. The multidisciplinary care pathway may pave the way to increase the detection rate and diagnosis of isolated contracture(s), TEV with underlying genetic causes, and the rare phenotypes AMC/FADS and prompt treatment after birth within expertise teams.

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Martinek, R., M. Kelnar, P. Vojcinak, P. Koudelka, J. Vanus, P. Bilik, P. Janku, H. Nazeran, and J. Zidek. "Virtual simulator for the generation of patho‐physiological foetal ECGs during the prenatal period." Electronics Letters 51, no. 22 (October 2015): 1738–40. http://dx.doi.org/10.1049/el.2015.2291.

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Hans-Joachim, Trappe. "Cardiac Arrhythmias in the Pregnant Woman and the Foetus." European Cardiology Review 4, no. 2 (2008): 67. http://dx.doi.org/10.15420/ecr.2008.4.2.67.

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Schor, S. L., A. M. Schor, P. Durning, and G. Rushton. "Skin fibroblasts obtained from cancer patients display foetal-like migratory behaviour on collagen gels." Journal of Cell Science 73, no. 1 (February 1, 1985): 235–44. http://dx.doi.org/10.1242/jcs.73.1.235.

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When plated on the surface of collagen gel substrata, all types of fibroblasts rapidly begin to migrate down into the three-dimensional collagen matrix. We have previously demonstrated that normal (adult and foreskin), foetal and transformed fibroblasts may be distinguished from each other by virtue of their differential migratory response to changes in cell density. The effects of cell density on fibroblast migration into the gel may be expressed by a single numerical value, the ‘cell density migration index’ (CDMI). We now present evidence that ostensibly normal skin fibroblasts obtained from the majority of patients we examined with carcinoma of the breast, malignant melanoma, familial polyposis coli, retinoblastoma and Wilms' tumours display aberrant CDMI values falling within the foetal range. Skin fibroblasts obtained from the majority of patients examined with genetic or chronic diseases (e.g. rheumatoid arthritis, Duchenne muscular dystrophy) displayed CDMI values falling within the normal range.

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Maeyama, H., T. Hirasawa, Y. Tahara, C. Obata, H. Kasai, K. Moriishi, K. Mochizuki, and T. Kubota. "Maternal restraint stress during pregnancy in mice induces 11β-HSD1-associated metabolic changes in the livers of the offspring." Journal of Developmental Origins of Health and Disease 6, no. 2 (February 24, 2015): 105–14. http://dx.doi.org/10.1017/s2040174415000100.

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In rats, maternal exposure to restraint stress during pregnancy can induce abnormalities in the cardiovascular and central nervous systems of the offspring. These effects are mediated by long-lasting hyperactivation of the hypothalamic–pituitary–adrenal axis. However, little is known about the potential effects of stress during pregnancy on metabolic systems. We examined the effect of restraint stress in pregnant mice on the liver function of their offspring. The offspring of stressed mothers showed significantly higher lipid accumulation in the liver after weaning than did the controls; this accumulation was associated with increased expression of lipid metabolism-related proteins such as alanine aminotransferase 2 diglyceride acyltransferase 1, peroxisome proliferator-activated receptor gamma and glucocorticoid receptor. Additionally, we observed increased levels of 11β-hydroxysteroid dehydrogenase type 1, an intercellular mediator that converts glucocorticoid from the inactive to the active form, in the foetal and postnatal periods. These results indicate that restraint stress in pregnancy in mice induces metabolic abnormalities via 11β-hydroxysteroid dehydrogenase type 1-related pathways in the foetal liver. It is therefore possible that exposure to stress in pregnant women may be a risk factor for metabolic syndromes (e.g. fatty liver) in children.

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Pahlitzsch, Tamara Margit Jutta, Laura Hanne, Wolfgang Henrich, and Alexander Weichert. "Influence of Foetal Macrosomia on the Neonatal and Maternal Birth Outcome." Geburtshilfe und Frauenheilkunde 79, no. 11 (November 2019): 1191–98. http://dx.doi.org/10.1055/a-0880-6182.

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Abstract Introduction Foetal macrosomia is associated with various obstetrical complications and is a common reason for inductions and primary or secondary Caesarean sections. The objective of this study is the generation of descriptive data on the mode of delivery and on maternal and foetal complications in the case of foetal macrosomia. The causes and consequences of foetal macrosomia as well as the rate of shoulder dystocia are examined in relation to the severity of the macrosomia. Patients The study investigated all singleton births ≥ 37 + 0 weeks of pregnancy with a birth weight ≥ 4000 g at the Charité University Medicine Berlin (Campus Mitte 2001 – 2017, Campus Virchow Klinikum 2014 – 2017). Results 2277 consecutive newborns (birth weight 4000 – 4499 g [88%], 4500 – 4999 g [11%], ≥ 5000 g [1%]) were included. Maternal obesity and gestational diabetes were more common in the case of newborns weighing ≥ 4500 g than newborns weighing 4000 – 4499 g (p = 0.001 and p < 0.001). Women with newborns ≥ 5000 g were more often ≥ 40 years of age (p = 0.020) and multipara (p = 0.025). The mode of delivery was spontaneous in 60% of cases, vaginal-surgical in 9%, per primary section in 14% and per secondary section in 17%. With a birth weight ≥ 4500 g, a vaginal delivery was more rare (p < 0.001) and the rate of secondary sections was increased (p = 0.011). Women with newborns ≥ 4500 g suffered increased blood loss more frequently (p = 0.029). There was no significant difference with regard to the rate of episiotomies or serious birth injuries. Shoulder dystocia occurred more frequently at a birth weight of ≥ 4500 g (5 vs. 0.9%, p = 0.000). Perinatal acidosis occurred in 2% of newborns without significant differences between the groups. Newborns ≥ 4500 g were transferred to neonatology more frequently (p < 0.001). Conclusion An increased birth weight is associated with an increased maternal risk and an increased rate of primary and secondary sections as well as shoulder dystocia; no differences in the perinatal outcome between newborns with a birth weight of 4000 – 4499 g and ≥ 4500 g were seen. In our collective, a comparably low incidence of shoulder dystocia was seen. In the literature, the frequency is indicated with a large range (1.9 – 10% at 4000 – 4499 g, 2.5 – 20% at 4500 – 5000 g and 10 – 20% at ≥ 5000 g). One possible cause for the low rate could be the equally low prevalence of gestational diabetes in our collective. A risk stratification of the pregnant women (e.g. avoidance of vacuum extraction, taking gestational diabetes into account during delivery planning) is crucial. If macrosomia is presumed, it is recommended that delivery take place at a perinatal centre in the presence of a specialist physician, due to the increased incidence of foetal and maternal complications.

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