Teses / dissertações sobre o tema "Fetus Growth"
Crie uma referência precisa em APA, MLA, Chicago, Harvard, e outros estilos
Veja os 50 melhores trabalhos (teses / dissertações) para estudos sobre o assunto "Fetus Growth".
Ao lado de cada fonte na lista de referências, há um botão "Adicionar à bibliografia". Clique e geraremos automaticamente a citação bibliográfica do trabalho escolhido no estilo de citação de que você precisa: APA, MLA, Harvard, Chicago, Vancouver, etc.
Você também pode baixar o texto completo da publicação científica em formato .pdf e ler o resumo do trabalho online se estiver presente nos metadados.
Veja as teses / dissertações das mais diversas áreas científicas e compile uma bibliografia correta.
Koch, Jill Marie. "Periconceptional treatment with growth hormone alters fetal growth and development in sheep". Morgantown, W. Va. : [West Virginia University Libraries], 2008. https://eidr.wvu.edu/etd/documentdata.eTD?documentid=5713.
Texto completo da fonteTitle from document title page. Document formatted into pages; contains ix, 128 p. : ill. (some col.). Includes abstract. Includes bibliographical references.
Carr, Jillian M. "Insulin-like growth factor binding proteins (IGFBPs) in growth and development of the ovine fetus". Adelaide Thesis (Ph.D.) -- University of Adelaide, Department of Biochemistry, 1994. http://hdl.handle.net/2440/21607.
Texto completo da fonteLunshof, Maria Simone. "Circadian rhythms in the normal and growth-retarded fetus and infant". [S.l. : Amsterdam : s.n.] ; Universiteit van Amsterdam [Host], 2000. http://dare.uva.nl/document/81110.
Texto completo da fonteHoelle, Katharina. "The role of System A amino acid transport in fetal growth and development". Thesis, University of Cambridge, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.609768.
Texto completo da fonteZablith, Nadine. "The association between amniotic fluid albumin, prealbumin or transferrin and the fetal growth /". Thesis, McGill University, 2005. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=98526.
Texto completo da fonteDe, Blasio Miles Jonathon. "Placental restriction and endocrine control of postnatal growth". Title page, table of contents and abstract only, 2004. http://web4.library.adelaide.edu.au/theses/09PH/09phd2869.pdf.
Texto completo da fonteSibley, Colin. "The nutrient exchange phenotype of the placenta in fetal growth restriction : characterization, adaptation and regulation". Thesis, University of Manchester, 2013. https://www.research.manchester.ac.uk/portal/en/theses/the-nutrient-exchange-phenotype-of-the-placenta-in-fetalgrowth-restriction-characterization-adaptation-and-regulation(35a27da9-ad7c-4e7e-8e91-8742304a5c9c).html.
Texto completo da fonteLassala, Arantzatzu Leticia. "Arginine and fetal growth in ovine models of intrauterine growth restriction". [College Station, Tex. : Texas A&M University, 2008. http://hdl.handle.net/1969.1/ETD-TAMU-3238.
Texto completo da fonteBurrage, Deborah. "The impact of reduced nutrition on growth and cardiovascular control in the fetus". Thesis, University of Southampton, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.430705.
Texto completo da fonteCarr, D. "Evaluation of prenatal adenoviral vascular endothelial growth factor gene therapy in the growth-restricted sheep fetus and neonate". Thesis, University College London (University of London), 2013. http://discovery.ucl.ac.uk/1401185/.
Texto completo da fonteYunusova, Roza. "Effects of Maternal Nutrition, Intrauterine Growth Restriction (IUGR), and Estrogen (E2) Supplementation on Placental and Fetal Intestinal Growth and Development in Sheep". Thesis, North Dakota State University, 2012. https://hdl.handle.net/10365/26539.
Texto completo da fonteТурова, Людмила Олександрівна, Людмила Александровна Турова, Liudmyla Oleksandrivna Turova e A. M. Waal. "Cobalt exchange in the system "Mother-placenta-fetus" in case of intrauterine growth retardation". Thesis, Видавництво СумДУ, 2012. http://essuir.sumdu.edu.ua/handle/123456789/27538.
Texto completo da fonteO'Regan, Shaun. "A critical evaluation of the accuracy of foetal age estimation by sonographic biometry at Ipswich Hospital". Thesis, Queensland University of Technology, 1991. https://eprints.qut.edu.au/35980/1/35980_O%27Regan_1991.pdf.
Texto completo da fonteIlla, Armengol Míriam. "Brain effects of fetal growth restriction and their prevention in an animal model". Doctoral thesis, Universitat de Barcelona, 2017. http://hdl.handle.net/10803/565667.
Texto completo da fonteElian, Kelly Marie. "The relation between amniotic fluid constituents and human fetal growth". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0019/MQ55051.pdf.
Texto completo da fonteLavranos, Tina Christine. "Maternal-embryo interactions at the time of implantation in early pregnancy /". Adelaide : Thesis (Ph.D.) -- University of Adelaide, Department of Obstetrics and Gynaecology, 1993. http://web4.library.adelaide.edu.au/theses/09PH/09phl414.pdf.
Texto completo da fonteLavranos, Tina C. "Maternal-embryo interactions at the time of implantation in early pregnancy / by Tina Christine Lavranos". Adelaide Thesis (Ph.D.) -- University of Adelaide, Department of Obstetrics and Gynaecology, 1993. http://hdl.handle.net/2440/21664.
Texto completo da fonteTitle page, contents and abstract only. The complete thesis in print form is available from the University Library.
Thesis (Ph.D.)--University of Adelaide, Dept. of Obstetrics and Gynaecology, 1993
Lavranos, Tina C. "Maternal-embryo interactions at the time of implantation in early pregnancy / by Tina Christine Lavranos". Thesis, Adelaide Thesis (Ph.D.) -- University of Adelaide, Department of Obstetrics and Gynaecology, 1993. http://hdl.handle.net/2440/21664.
Texto completo da fonteSterle, Jodi A. "Effect of recombinant porcine somatotropin (rpST) on placental and fetal growth in gilts /". free to MU campus, to others for purchase, 1998. http://wwwlib.umi.com/cr/mo/fullcit?p9901288.
Texto completo da fonteLouey, Samantha 1977. "The effects of intrauterine growth restriction on postnatal growth, arterial pressure and the vasculature". Monash University, Dept. of Physiology, 2003. http://arrow.monash.edu.au/hdl/1959.1/7939.
Texto completo da fonteHowe, David Thomson. "The influence of maternal haemoglobin and ferritin on the growth of the placenta and fetus". Thesis, University of Southampton, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.295714.
Texto completo da fonteGurekian, Christine N. "Amniotic fluid amino acids as biological indicators of fetal growth in human and rat models". Thesis, McGill University, 2005. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=98718.
Texto completo da fonteLam, Shih-en, e 林詩恩. "A pilot study on potential involvement of epigenetic regulations secondary to perturbed intrauterine environment". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2008. http://hub.hku.hk/bib/B41509018.
Texto completo da fonteRenshall, Lewis. "Antenatal sildenafil citrate treatment in a mouse model of fetal growth restriction : effects on fetus and offspring". Thesis, University of Manchester, 2015. https://www.research.manchester.ac.uk/portal/en/theses/antenatal-sildenafil-citrate-treatment-in-a-mouse-model-of-fetal-growth-restriction-effects-on-fetus-and-offspring(c7512bee-9109-404d-a977-7eb9f3c50172).html.
Texto completo da fonteRubino, Maria. "Second trimester amniotic fluid insulin and glucose as predictors of macrosomia". Thesis, McGill University, 2008. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=111582.
Texto completo da fonteSantos, Victor José Correia. "Ultrassonografia modo b e dopplerfluxometria materno fetal na avaliação gestacional de ovelhas /". Jaboticabal, 2017. http://hdl.handle.net/11449/152361.
Texto completo da fonteCoorientador: Maria Emilia Franco Oliveira
Coorientador: Marcus Antônio Rossi Feliciano
Banca: Luciana Cristina Padilha Nakaghi
Banca: Felipe Farias Pereira da Câmara Barros
Banca: Erika da Silva Carvalho Morani
Banca: Eliandra Antonia Pires Buttler
Resumo: O entendimento acerca da fisiologia do processo gestacional e desenvolvimento embrionário/fetal oferece conhecimento para que se tome decisões acertadas em relação ao manejo da fêmea gestante, além destes animais serem utilizados como modelo experimental para a medicina humana, o que reforça a importância do estudo da gestação em ovinos. Nesse contexto, a ultrassonografia se apresenta como melhor opção para avaliar o desenvolvimento da gestação. É uma tecnologia segura que permite que se façam avaliações repetidas durante todo o processo gestacional. Objetivou-se estudar o desenvolvimento fisiológico embrionário/fetal durante a gestação de ovelhas por meio da ultrassonografia a fim de se obter parâmetros de normalidade que possam ser utilizados como referência para o diagnóstico de possíveis alterações do desenvolvimento embrionário/fetal e desenvolver fórmulas para predição de idade gestacional. Foram utilizadas 30 ovelhas Santa Inês pesando 45,4±4,3 kg, entre 2 e 5 anos e realizados exames ultrassonográficos semanais desde a 3ª, até a 21ª semana gestacional. Para a análise estatística, realizou-se teste de "Shapiro" para normalidade, com medidas reais ou transformadas correlacionadas com as semanas gestacionais pelo teste de "Spearman". Quando significativo, foram testados os ajustes dos parâmetros e semanas gestacionais à modelos de regressão. Foi utilizado nível de significância de 5% e os resultados apresentados como média±DP (desvio padrão). Foram avaliados os diâmetros... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: The understanding about the physiology of the gestational process and embryonic/fetal development offers tools to make wise decisions regarding the management of the pregnant female, besides, these animals are used as experimental models, which reinforces the importance of the study of gestation in sheep. In this context, ultrasonography is the best option for the evaluation of gestation. It is safe and allows repeated evaluations to be made throughout the gestational process. The objective of this study was to assess the embryonic/fetal physiological development during pregnancy of sheep by means of ultrasonography in order to obtain normality parameters that can be used as a reference for the diagnosis of embryonic/fetal development alterations and to develop formulas for estimate gestational age. Thirty Santa Ines sheep weighing 45.4±4.3kg, between 2 and 5 years old were used. Ultrasound examinations were performed weekly from the 3rd to the 21st gestational week. For the statistical analysis Shapiro test was performed for normality with real or transformed measurements correlated with the gestational weeks by the Spearman test. When significant, parameter adjustments and gestational weeks were tested for regression models. A significance level of 5% was used and the results presented as mean ± SD (standard deviation). The gestational vesicle (GV), abdominal (AD), thoracic (TD), biparietal (BPD), ocular orbit (OO) and placentonium (PL) diameters were evaluated, as well as ... (Complete abstract click electronic access below)
Doutor
Chidzanja, Stivelia. "Restricted implantation and undernutrition alter development and growth of the ovine placenta". Title page, abstract and contents only, 1994. http://hdl.handle.net/2440/18519.
Texto completo da fonte[xxvi], 199, [151] leaves, [7] leaves of plates : ill. (some col.) ; 30 cm.
Title page, contents and abstract only. The complete thesis in print form is available from the University Library.
Characterises the normal otogeny of the cellular composition and structure of placentomes in sheep, their relationship to the macroscopic parameters of placentome size and morphology, and the effect of experimental and natural restriction of implantation on the growth and development of placentomes between mid and late gestation.
Thesis (Ph.D.)--University of Adelaide, Dept. of Obstetrics and Gynaecology, 1995
Boland, Rochelle Elizabeth 1974. "Factors affecting structural development of the lung in fetal sheep". Monash University, Dept. of Physiology, 2002. http://arrow.monash.edu.au/hdl/1959.1/8135.
Texto completo da fonteXu, Wei. "The impact of rhizoma chuanxiong in fetal bone development". HKBU Institutional Repository, 2016. https://repository.hkbu.edu.hk/etd_oa/253.
Texto completo da fonteLam, Shih-en. "A pilot study on potential involvement of epigenetic regulations secondary to perturbed intrauterine environment". Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B41509018.
Texto completo da fonteComas, Rovira Montserrat. "Cardiac dysfunction by tissue doppler in earty-and late-onset fetal growth restriction". Doctoral thesis, Universitat de Barcelona, 2011. http://hdl.handle.net/10803/51517.
Texto completo da fonteKakar, Muhammad Azam. "Effect of peri-conceptional feed intake on early embryo development and fetal growth in the Merino ewe /". Title page, table of contents and abstract only, 2003. http://web4.library.adelaide.edu.au/theses/09ANP/09anpk138.pdf.
Texto completo da fonteMoore, Vivienne M. "Fetal growth and cardiovascular risk factors in an Australian cohort /". Title page, contents and abstract only, 1997. http://web4.library.adelaide.edu.au/theses/09PH/09phm824.pdf.
Texto completo da fonteEl-Halabi, Dima. "Oxidative and nitrative stress biomarkers in amniotic fluid and their association with fetal growth and pregnancy outcomes". Thesis, McGill University, 2007. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=101119.
Texto completo da fonteLok, Fong. "Role of IGF-I in ovine fetal and placental growth and development /". Title page, contents and abstract only, 1998. http://web4.library.adelaide.edu.au/theses/09PH/09phl836.pdf.
Texto completo da fonteVaughn, Mathew Alan. "Characterization of intra-litter variation on myogenic development and myogenic progenitor cell response to growth promoting stimuli". Diss., Kansas State University, 2016. http://hdl.handle.net/2097/34595.
Texto completo da fonteDepartment of Animal Sciences and Industry
John M. Gonzalez
This series of studies focuses on the impact of intra-litter variation on fetal myogenesis, and the ability of porcine progenitor cells to respond to growth promoting stimuli. In study 1, the smallest (SM), median (ME), and largest (LG) male fetuses from each litter were selected for muscle morphometric analysis from gilts at d-60 ± 2 and 95 ± 2 of gestation. On d-60 and 95 of gestation LG fetuses had greater whole muscle cross-sectional area (CSA) than ME and SM fetuses, and ME fetuses had greater whole muscle CSA than SM fetuses. Indicating that SM and ME fetuses are on a delayed trajectory for myogenesis compared to LG fetuses. At d-60 the advanced trajectory of LG compared to ME fetuses was due to increased development of secondary muscle fibers; whereas, the advanced myogenic development of LG and ME fetuses compared to SM fetuses was due to the presence of fewer primary and secondary muscle fibers. At d-95 of gestation the advanced myogenic development of LG and ME was due to increased hypertrophy of secondary muscle fibers. For study 2, porcine fetal myoblasts (PFM) were isolated from SM, ME, and LG fetuses from d-60 ± 2 of gestation fetuses and for study 3, porcine satellite cells (PSC) were isolated from the piglet nearest the average body weight of the litter. Both myogenic cell types were utilized to evaluate effects of porcine plasma on proliferation, differentiation, and indications of protein synthesis. For the proliferation assay, cells were exposed to one of three treatments: high serum which consisted high-glucose Dulbecco's Modified Eagle Medium supplemented with 10% (vol/vol) fetal bovine serum, 2% (vol/vol) porcine serum, 100 U penicillan/mL, 100 µg of strepmycin/mL, and 20 µg of gentamicin/mL (HS), low serum which consisted of HS without 10% FBS (LS), and LS supplemented with 10% (wt/vol) porcine plasma (PP). Treatments for the differentiation and protein synthesis assays consisted of either HS or LS media that either contained porcine plasma at 10% (wt/vol; PPP) or 0% (wt/vol; PPN). The HS-PFM had a greater proliferation rate compared to the LS and PP-PFM, and PP-PFM had a greater proliferation rate compared to LS-PFM. The LG fetuses’ PFM had a reduced proliferation rate compared to SM and ME fetuses’ PFM, which were similar. The PPP-PFM had a decreased myotube diameter compared to PPN-PFM. Small fetuses’ PFM had a greater myotube diameter compared to ME and LG fetuses’ PFM, and ME fetuses’ PFM had a greater myotube diameter compared to LG fetuses’ PFM. The proliferation rate of PP-PSC was decreased compared to the HS- and LS-PSC, and HS-PSC had a greater proliferation rate compared to LS-PSC. The PPP-PSC had greater differentiation capacity and myotube diameter than PPN-PSC. In conjunction these results indicate divergent myogenic development among different fetal sizes within a litter and suggest that porcine plasma supplementation stimulates myogenic progenitor cell activity in an age specific manner.
Li, Yuhong, e n/a. "Effect of alcohol exposure in early gestation on brain development". University of Otago. Department of Anatomy & Structural Biology, 2007. http://adt.otago.ac.nz./public/adt-NZDU20070502.100319.
Texto completo da fonteEnros, Erin. "Amniotic fluid fatty acids and cholesterol and their association with pregnancy outcomes". Thesis, McGill University, 2006. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=99341.
Texto completo da fonteCrang-Svalenius, Elizabeth. "The use of routine ultrasound in pregnancy with special reference to normal and abnormal foetal growth, information and informed choice and the womens' experiences of the prenatal diagnostic aspects /". Lund : Lund University, Dept. of Obstetrics and Gynaecology, University Hospital, 1997. http://catalog.hathitrust.org/api/volumes/oclc/39072830.html.
Texto completo da fonteDi, Giovanni Jessica Louise. "Early second trimester amniotic fluid erythropoietin and pregnancy outcomes". Thesis, McGill University, 2008. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=112615.
Texto completo da fonteJohnsen, Suzanne Louise 1960. "Early embryos of dams of heat stress". Thesis, The University of Arizona, 1989. http://hdl.handle.net/10150/277034.
Texto completo da fonteHebert, Jessica Faith. "Maternal Angiotensinogen Genotype and Fetal Sex Impact Uteroplacental Function and the Developmental Origins of Stress-Induced Hypertension". PDXScholar, 2018. https://pdxscholar.library.pdx.edu/open_access_etds/4405.
Texto completo da fonteMuscati, Siham K. (Siham Khalili). "Balance between fetal growth and maternal weight retention : effects of maternal diet, weight and smoking behaviour". Thesis, McGill University, 1996. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=40405.
Texto completo da fonteAkyol, Asli. "The effects of cafeteria diet feeding on maternal adaptation to pregnancy, growth and development of fetus and glucose homeostasis later in life". Thesis, University of Nottingham, 2011. http://eprints.nottingham.ac.uk/28539/.
Texto completo da fonteGoddard, Kalanithi Lucy Emily. "Placental Localization and Perinatal Outcome". Yale University, 2008. http://ymtdl.med.yale.edu/theses/available/etd-08132007-124118/.
Texto completo da fonteMohamed, Amenah Mahmoud Mustafa. "How safely can we follow up post-term pregnancy with uncertain gestation using amniotic fluid index measurement". Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/85722.
Texto completo da fonteENGLISH ABSTRACT: Background: Studies about management of prolonged pregnancy dealt with pregnancy with certain gestational age, confirmed with early ultrasound scans. Objective: The primary aim for the study is to review the current management of uncertain gestational age (GA) post term pregnancy in Tygerberg Academic Hospital (TBH). Women at 42 weeks with an uncertain GA and an amniotic fluid index (AFI) of ≥ 10 cm as well as reassuring cardiotocographs (CTG) would be assessed to determine whether follow up over one week or two weeks are required. Method: A retrospective descriptive study included all patients with an uncertain gestation of 42 weeks referred to TBH. Results: A total of 135 pregnant women were studied. Booking fundal height (BFH) was used to determine GA in 99% and last menstrual period (LMP) in 1% of patients. The time interval between first evaluation at 42 weeks and delivery varies between 0 to 46 days (median 10 days); 104 women delivered vaginally (71% spontaneously, 6% after induction of labour (IOL)); 31 women (23%) by caesarean section; 1 elective, 4 due to cephalopelvic proportion (CPD), 5 had failed IOL, 3 poor progress and 18 fetal distress. Out of the total 11 (8%) women with AFI ≥ 10 had caesarean sections for fetal distress within 2 weeks of the visit at 42 weeks. No neonatal morbidity or mortality was noted in this study. Conclusion: Weekly monitoring with AFI and CTG for women at 42 weeks with unsure gestation is safe. A follow-up following 2 weeks cannot be recommended as 8% of women required caesarean sections within less than 2 weeks due to fetal distress.
AFRIKAANSE OPSOMMING: Agtergrond: Studies oor verlengde swangerskap handel oor swangerskappe met seker swangerskapsduurte, bevestig met vroeë ultraklank skandering. Doelwit: Die primêre doelwit van die studie is om die huidige hantering van verlengde swangerskap met onseker swangerskapsduurte by Tygerberg Hospitaal (TBH) te beoordeel. Vroue wat volgens onseker swangerskapsduurte 42 weke swanger is met ‘n amnionvogindeks (AVI) van >10 en gerusstellende kardiotokogramme (KTG) sal nagegaan word om te bepaal of opvolg oor een of twee weke nodig is. Metode: ‘n Retrospektiewe studie wat alle pasiënte insluit wat na Tygerberg Akademiese Hospitaal verwys word wat ‘n onseker swangerskapsduurte van 42 weke het. Resultate: ‘n Totaal van 135 vroue is bestudeer. Die fundale hoogte is gebruik om swangerskapsduurte te bepaal in 99% van gevalle en die laaste menstruasie in 1%. Die tydsinterval tussen die eerste evaluasie op 42 weke en verlossing wissel tussen 0 en 46 dae (mediaan 10 dae); 104 vroue het ‘n vaginale verlossing gehad (71% met spontane aanvang van kraam, 6% na induksie van kraam); 31 (23%) is met keisersnitte verlos; 1 elektief, 4 as gevolg van skedelbekken disproporsie, 5 gefaalde induksies, 3 swak vordering en 18 met fetal nood. Uit die totaal was daar 11 (8%) vroue met ‘n AVI ≥ 10 wat keisersnitte vir fetale nood binne 2 weke van die besoek op 42 weke gehad het. Geen neonatale morbititeit of mortaliteit het in die studie voorgekom nie. Gevolgtrekking: Weeklikse monitering met AVI en KTG vir vroue wat 42 weke swanger is met onseker swangerskapsduurte, is veilig. Opvolg na 2 weke kan nie aanbeveel word nie want 8% het keisersnitte vir fetale nood gehad na minder as 2 weke.
Joyce, Belinda Jane. "Elastin synthesis in the fetal sheep lung in vivo : effects of physical, metabolic and endocrine factors". Monash University, Dept. of Physiology, 2004. http://arrow.monash.edu.au/hdl/1959.1/5263.
Texto completo da fonteLaing, David. "A semiquantitative and qualitative histopathologic assessment of the effect of type II intrauterine growth retardation on the structure of the carotid bodies in fetuses and neonates". Master's thesis, University of Cape Town, 1996. http://hdl.handle.net/11427/25811.
Texto completo da fonteGilfillan, Marlene. "Characteristics of black South African adult and adolescent women who gave premature birth to growth-restricted infants at Kalafong hospital, Gauteng". Thesis, Stellenbosch : University of Stellenbosch, 2006. http://hdl.handle.net/10019.1/2740.
Texto completo da fonteINTRODUCTION: The objective of the study was to determine the prevalence of certain known risk factors for intra-uterine growth restriction (IUGR) in women who gave premature birth to growth-restricted infants at a large regional hospital (Kalafong) in the Gauteng province of South Africa and to investigate the possible associations between the presence of various risk factors and the severity of growth restriction found in these infants. METHOD: The study was designed as cross-sectional, descriptive and observational. The subjects included singleton growth-restricted premature infants (n=80), without congenital abnormalities and their mothers (n=80). Anthropometric data [weight, height, mid-upper arm circumference (MUAC) and triceps skinfold thickness (TSF)] were collected from these mothers three to four days post-partum. Infant birth weights were recorded at birth, while the lengths and head circumferences were recorded within 2 days post-partum. Additional information, such as birth spacing, maternal age, smoking habits and alcohol use, was collected by personal interview and blood pressure data and HIV status was obtained from medical records. Data capturing and descriptive statistics were done using Microsoft Excel and comparative analytical statistics were performed with the Statistical Package for the Social Sciences (SPSS), version 12.0. RESULTS: The study demonstrated a high prevalence (69%) of infants born with a birth weight <3rd percentile. In the sample, 81% of the mothers were aged 17-34 years and most (93%) had their children 18 months or longer apart. Malnutrition prevalence was moderate. In 58% of the mothers the BMI was normal (18.5-24.9 kg/m2) and in 47% the upper arm muscle area (UAMA) was between the 10th-85th percentile. Grade III overweight occurred in 3% and TSF ≤5th percentile occurred in 35% of the mothers. About half (51%) of the mothers in the sample population had hypertension during the second trimester of pregnancy. Smoking and alcohol use during pregnancy was rare (1% and 6% respectively) and the prevalence of HIV infection in the mothers was 26%. The prevalence (16%) of Grade II overweight among the mothers of symmetric growth-restricted (SGR) infants was higher than among the mothers of asymmetric growth-restricted (AGR) infants (7%). Of the hypertensive mothers, 55% had infants with SGR compared to 45% with AGR (p=0.47). Although rare, smoking occurred only in mothers with AGR infants (3%). No significant differences were found between the smoking and non-smoking group (p=0.21). Although the use of alcohol was more prevalent at 6% in mothers with SGA infants and 7% in mothers with AGR infants, no significant associations were found (p=0.95). Although not significant (p=0.76), there was a higher prevalence of HIV infection in mothers with SGR infants at 29%, compared to 23% of mothers of AGR infants. CONCLUSION: Although further studies are needed before intervention strategies can be planned and implemented, the findings of this study suggest that apart from the usual factors (maternal age and nutritional status, smoking and alcohol use during pregnancy and birth spacing) that may influence intra-uterine growth, hypertension may contribute greatly to IUGR in this study population.
Isaacs, Ferial. "An evaluation of fetal growth in human immunodeficiency virus infected women at Khayelitsha and Gugulethu midwifery obstetric units in the Western Cape". Thesis, Cape Peninsula University of Technology, 2006. http://hdl.handle.net/20.500.11838/1547.
Texto completo da fonteA prospective cohort study was done on Human Immunodeficiency Virus (HIV) infected and uninfected women attending Khayelitsha Midwifery Obstetric Unit (MOU) and Gugulethu MOU from June 2003 to December 2004, primarily to establish whether there is an association between HIV infection and Intra-uterine growth restriction (lUGR). B-Mode real time ultrasound imaging was used to monitor fetal growth from ±22 weeks to 36 weeks gestational age. Birth weight, gestational age at delivery, gender, placental weight, and maternal complications were also included. Maternal factors considered included age, weight parity, singleton versus multiple pregnancy, previous IUGR or preterm delivery, previous fetal abnormality, social habits viz. cigarette smoking, alcohol and drug use, and vascular disease viz. Diabetes, hypertension, renal disease, cardiac disease and collagen disease. A secondary objective was to establish whether the CD4 T-lymphocyte count possibly modulated the presence of IUGR. All HIV infected women were given antiretroviral therapy according to the standard Protocol of the Provincial Government of Western Cape (2002). The research questions were: • Does maternal HIV infection increase the risk of intrauterine growth restriction and associated preterm delivery? • Does the immune status of (CD4 T-lymphocyte count) of HIV infected pregnant women modulate fetal growth? The primary objective of this study was to establish whether there is an association between HIV infection and IUGR, and hence that HIV infection leads to an adverse perinatal outcome. Ultrasound was used as a diagnostic tool to establish normal or abnormal fetal growth patterns. Anecdotal reports from health workers in the obstetric field suggested that IUGR and preterm delivery may be associated with low birth weight infants in HIV infected pregnant women. However, preterm delivery is associated with various other factors including low socio-economic status (poor nutrition), cigarette smoking, drug and alcohol abuse, previous history of preterm delivery, over distention of the uterus (hydramnios, multiple gestation), premature rupture of membranes, cervical incompetence, vaginal infections (bacterial vaginosis) and maternal disease e.g. hypertension, heart disease (Lizzi, 1993: Symmonds, 1992; Odendaal et aI, 2002). HIV is now thought to be an added factor. Afier doing a systematic review and meta-analysis of 31 studies, Brocklehurst and French (1998) reported that there is an association (although not strong) between HIV infection and adverse perinatal outcome in developed countries; but in developing countries, there is an increased risk of infant death. By excluding or controlling for confounding variables that could affect fetal growth, this study aimed to determine whether there is a significant association between HIV and fetal growth by comparing fetal growth in HIV infected and uninfected women from midsecond trimester to the time of delivery. A secondary objective was to establish whether there is an association between the immune status (CD4 T-lymphocyte count) of the mother and IUGR. The immune status of the mother is probably one of the most important factors affecting the fetus and perinatal outcome. As the mother's viral load increases, her immune system is increasingly compromised, resulting in the occurrence of HIV-related diseases, and a concurrent increase in fetal complications. In this study a CD4 T-lymphocyte count was used to assess the level of immunodeficiency of all the HIV infected participants. Ideally the test should have been done each time the participant was scanned so that the CD4 T-lymphoc)1e count could be monitored simultaneously with the fetal growth parameters, however due to financial constraints and ethical considerations, one test was done on each HIV infected women. This study was based at two MOU's where different antiretroviral therapy (ARVT) regimens were used. The one MOU offered Zidovudine (ZDV) to mothers from 34 weeks gestation to the onset of labour, and the other MOU offered Nevirapine (NVP) as a single dose to the mother at the onset of labour and to the neonate within 72 hours of birth (Provincial Government Western Cape, 2002). This presented an opportunity to compare two groups of HIV infected women on different regimes. The intention was to establish whether ZDV had an adverse effect on fetal growth and resulted in low birth weight. However, 6 months after the study started a revised Prevention of Mother to Child Transmission (PMTCT) Protocol was implemented where women at both MOU's received the same ARVT i.e. ZDV and NVP. This objective was therefore abandoned due to a change in the PMTCT Protocol in the Western Cape. The study was based at two Midwife Obstetric Units (MOU) in the Western Cape where the prevalence of HIV in pregnant women is relatively high i.e. 20 - 24 % (Mother-to-child transmission Monitoring Team, 2001), viz. Gugulethu MOU and Khayelitsha MOU. A prospective cohort study was done with the intention of recruiting a sample of 400 pregnant women, 200 HIV infected and 200 uninfected. The actual sample size was 415. The study group was 194 HIV infected women and the control group was 221 uninfected women. Confounding variables such as cigarette smoking, alcohol and drug abuse. multiple gestation. grand multipara pregnancy, history of IUGR or preterm delivery. fetal abnormality detected at the time of the first scan in the current pregnancy, and maternal vascular disease - were excluded. Confounding variables such as maternal age, maternal weight and gestational age were controlled. Ultrasound imaging was used as a diagnostic tool to establish normal and abnormal fetal growth patterns. A B-mode real time ultrasound unit was used to confirm the gestation age and rule out any obvious fetal abnormalities at 20-24 weeks gestation. Fetal growth scans were done at 28 weeks, 32 weeks and 36 weeks gestation to compare fetal growth patterns in the study and control groups. Fetal biometry used to monitor fetal growth included biparietal diameter (BPD), head circumference (HC), femur length (FL), abdominal circumference (AC) and estimated fetal weight (EFW). Amniotic fluid index (AFI), placental thickness & placental grading were also included. The following variables were analyzed post delivery: • Gestation age at delivery: Normal term delivery is considered to be at 37 - 42 weeks and premature delivery is considered to be less than 37 weeks gestation. The HIV infected and uninfected groups were compared to assess if there \vas a significant difference in the number of preterm deliveries. • Birth weight: The HIV infected and uninfected groups were compared to assess if there was a significant difference in the number of infants with low birth weight. • Perinatal complications: The HIV infected and uninfected groups were compared to assess if there was a significant difference in the number of perinatal complications and to assess if there was an association between the immune status (CD4 T-lymphocyte count) of HIV infected women and perinatal complications. Appropriate ethical principles in medical research were applied. The participant's autonomy, rights and best interests were always considered a priority. Informed consent was obtained from all the participants. Strict confidentiality was adhered to regarding any data collected throughout the study. The Research Ethics Committees at Cape Peninsula University of Technology and University of Cape Town granted ethics approval for the study. Statistical analysis was performed using the statistical package SPSS 12.0.