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1
Cohen, Doron. "Human fetal phonocardiography and the detection of fetal activity." Thesis, University of Cambridge, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.235812.
Повний текст джерелаАнотація:
Antepartum detection of the fetus at risk of death or damage in-utero remains a major challenge in modern obstetrics. Ultrasonic monitoring of individual fetal biophysical activities (such as fetal heart rate, fetal breathing or fetal body movements) has become widely applied as a method for evaluating fetal well-being. The combined assessment of these fetal activities and the relations between them, however, may well be more useful both in predicting imminent fetal death and in preventing it. The results of ultrasound studies, however, are hampered (e.g. from a safety viewpoint) by the natural periodicity of fetal activities. Fetal phonocardiographic techniques, on the other hand, can be easily used over long time periods and there can be no doubt of their safety. Furthermore, the fetal phonocardiogram may contain more information that fetal heart rate alone. This thesis describes the design and development of a new high-fidelity fetal phono-sensor, based on a piezo-electric PVDF transducer, which offers a completely non-invasive and reliable method of assessing the fetus over the long term. This sensor has been optimised to record faithfully the acoustic output of the fetus and to maximise the signal energy transfer across the maternal abdominal wall, where hitherto this has not been achieved. This is done by matching the compliance of the sensor to that of the maternal abdominal wall. Using a purpose built measuring device, abdominal wall compliance was measured clinically as 3.5 mm/N (averaged over 76 patients). Theoretical and experimental techniques were used to adjust the sensor's compliance to match that of the maternal abdominal wall [to within 4:1], as well as to minimise noise and maximise signal capture. The sensor's force and displacement senstivities were measured as 2183 V/N and 2480 mm/N (much greater than for any present or past phono-sensors). Using a new experimental rig developed to simulate the transmission of the fetal phono-signals through the maternal abdominal wall, the dynamic performance and frequency response of the sensor were also optimised. Clinical studies on 18 patients from 28-41 weeks gestation, showed that the fetal phonocardiogram contains not only fetal heart rate information, but also information about fetal breathing movements (FBM) and fetal body movements (FM), as well as detailed beat-to-beat heart sound interval information. By comparison with real-time ultrasound, various phono-signal patterns were shown to be caused by the fetal activities: regular and cyclic for FBM; and intermittent and noise-like for FM. By using new computerised signal processing techniques in the time domain (such as template-matching and zero-crossing functions), these recorded fetal activities were detected automatically (in over 80% of the time) and their timing periodicities analysed. Frequency domain analysis (using techniques such as the Hilbert transform and cepstral analysis) of the timing periodicities of the fetal heart sounds, showed that diastolic and beat-to-beat time intervals (as wll as their variabilities) are significantly increased during FBM. Fetal heart rate is also decreased [from 147 to 141 bpm] during FBM episodes. Fetal body movements, on the other hand, are associated with significant decreases in systolic, diastolic and beat-to-beat time intervals, whilst their variabilities are increased. Fetal heart rate, in this case, is found to increase [from 144 to 157 bpm]. Although these techniques do not run in real-time at present, they would be capable of doing so if transferred onto fast computers (or transputers). As a result of this work, one is now perhaps in a better position to envisage an automatic real-time fetal phono-based monitoring system for the routine clinical assessment of fetal well-being.
2
冼世源 and Sai-yuen Sin. "Fetal cardiac function predicting fetal compromise: a prospective study." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1999. http://hub.hku.hk/bib/B31969823.
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3
Sin, Sai-yuen. "Fetal cardiac function predicting fetal compromise : a prospective study /." Hong Kong : University of Hong Kong, 1999. http://sunzi.lib.hku.hk/hkuto/record.jsp?B21903566.
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4
Jaishankar, Gayatri. "Fetal Alcohol Syndrome." Digital Commons @ East Tennessee State University, 1995. https://dc.etsu.edu/etsu-works/8867.
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5
Barreira, Ana Raquel Matos Alves. "Hidrópsia fetal imune." Master's thesis, Faculdade de Medicina da Universidade do Porto, 2010. http://hdl.handle.net/10216/61128.
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6
Proniaiev, D. V. "Fetal uterus anatomy." Thesis, БДМУ, 2022. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/19329.
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7
Barreira, Ana Raquel Matos Alves. "Hidrópsia fetal imune." Dissertação, Faculdade de Medicina da Universidade do Porto, 2010. http://hdl.handle.net/10216/61128.
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8
Damodaram, Mellisa. "Brain development in fetal growth restriction : a volumetric approach using fetal MRI." Thesis, Imperial College London, 2012. http://hdl.handle.net/10044/1/9853.
Повний текст джерелаАнотація:
Fetal growth restriction is the failure of a fetus to achieve its full growth potential, resulting in a neonate that is small for its gestational age. The aetiology of fetal growth restriction is varied and fetal growth restriction secondary to placental insufficiency is attributed to a failure of trophoblast invasion leading to under perfusion of the uteroplacental bed. In response to the adverse conditions in-utero, fetuses tend to compensate by increasing blood flow to the essential organs such as the brain, heart, and adrenals, at the expense of other organs (cerebral redistribution). As a consequence, growth tends to be asymmetric, with maintenance of the head growth velocity while the other growth parameters tail off; an effect which is also known as the ‘brain sparing effect’. Despite this apparent brain sparing effect, children who were growth restricted in utero are at increased risk of developmental delay and behavioural problems. 30 growth restricted and 48 normally grown fetuses were recruited into this study and were imaged using both conventional ultrasound with Doppler assessment, as well as fetal MRI with ssFSE sequences through the feto-placental unit and fetal brain. A dynamic approach was taken when imaging the fetal brain to compensate for the presence of fetal motion. MR imaging of the feto-placental unit detected significant differences in placental appearance, significantly smaller volumes of intra-abdominal and intra-thoracic organs, and significantly smaller regional brain growth among growth restricted fetuses. MR studies of the placenta in fetal growth restriction demonstrated a placental phenotype in growth restricted pregnancies that is characterised by smaller placental volumes, a significant increase in the placental volume affected by apparent pathology on MRI and a thickened, globular placenta. Although placental volume increased with gestation in both groups, the placental volume remained significantly smaller in the growth restricted fetuses (p = 0.003). There was also a significant correlation between the percentage of placental volume affected by abnormal heterogeneity and the severity of fetal growth restriction (r = 0.82, p < 0.001), and an increase in the maximal placental thickness to placental volume ratio above the 95th centile for gestational age was associated with fetal and early neonatal mortality (relative risk = 7, 95%CI = 2.96 – 16.55, p < 0.001) (figure 3.6) MR studies of fetal intra-thoracic and intra-abdominal volumes showed that although the volume of the intra-thoracic and intra-abdonimal organs (heart, lungs, thymus, liver and kidney) increased as gestation increased in both groups, the volumes of all three structures remained smaller in growth restricted fetuses (p < 0.01) (Figures 4.7 - 4.9) compared with normally grown fetuses. MR studies of the fetal brain demonstrated smaller intracranial volume, total brain volume and cerebellar volume in growth restricted fetuses. In addition, growth restricted fetuses with early onset fetal growth restriction demonstrated smaller vermis height and a corresponding increase in the tegmento-vermian angle. Growth restricted fetuses also demonstrated a disproportionate decrease in extra- and intra-cerebral fluid. This thesis showed evidence of changes in regional and global organ growth in growth restricted fetuses using high resolution fetal MRI. It is hoped that future imaging studies could offer useful insights into the origins and clinical significance of these findings and its consequences for later neurodevelopment.
9
Price, Robin Owen. "Maternal health and fetal brain development : altered fetal neurogenesis following maternal inflammation /." May be available electronically:, 2009. http://proquest.umi.com/login?COPT=REJTPTU1MTUmSU5UPTAmVkVSPTI=&clientId=12498.
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10
Beckett, Cynthia Diane. "Navajo children and families living with fetal alcohol syndrome/fetal alcohol effects." Diss., The University of Arizona, 2002. http://hdl.handle.net/10150/280150.
Повний текст джерелаАнотація:
The aim of the study was to develop a culturally sensitive Grounded Theory of Navajo parenting for families who are living with Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE). The research question was: What are the social and cultural factors and processes that Navajo families use to mange care for a child with FAS/FAE? The philosophical perspectives that guided the study were: the Navajo philosophy, or view of life; resilience (middle range theory); the Family Stress Theory; and the Resiliency Mode of Family Stress, Adjustment, and Adaptation. Resilience was used as the over arching conceptual perspective for the study. A Grounded Theory of Navajo Parenting emerged from the data. Key categories to support the emerging theory were identified. The core category was Versatility through Transcendence. The supporting categories were: Strategies for Managing Challenges; Transcendence in Parenting; Intergenerational Alcohol Abuse, Violence and Suffering; and Knowledge/Acquisition of Needs. The families described their stories of transcendence through substance abuse, suffering, and violence to be able to parent their children who were living with the primary and secondary challenges of prenatal alcohol exposures. Further research is needed to test and expand this emerging theory of Navajo parenting of children with FAS/FAE. The challenges that were related to FAS/FAE were more easily managed with patterns of resilience within the families. Factors that influenced family's abilities to parent will be disseminated to assist other families who are managing the problems associated with FAS/FAE.
11
East, Christine Elizabeth. "Fetal intrapartum pulse oximetry /." [St. Lucia, Qld.], 2006. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe19387.pdf.
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Joffe, Tracey Helene. "Fetal and infant encephalisation." Thesis, University College London (University of London), 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.398119.
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13
McGinley, Susan. "Fetal Programming in Diabetes." College of Agriculture and Life Sciences, University of Arizona (Tucson, AZ), 2010. http://hdl.handle.net/10150/622072.
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14
Carneiro, Bruno Correia. "Sexagem Fetal por Ecografia." Master's thesis, Instituto de Ciências Biomédicas Abel Salazar, 2011. http://hdl.handle.net/10216/63715.
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Carneiro, Bruno Correia. "Sexagem Fetal por Ecografia." Dissertação, Instituto de Ciências Biomédicas Abel Salazar, 2011. http://hdl.handle.net/10216/63715.
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16
O'Connor, David. "The role of the fetal microenvironment in abnormal fetal haematopoiesis in Down syndrome." Thesis, Imperial College London, 2014. http://hdl.handle.net/10044/1/29169.
Повний текст джерелаАнотація:
Children with Down syndrome (DS; trisomy 21, T21) have a 500-fold risk of developing acute megakaryoblastic leukaemia (AMKL) in early childhood compared to children without DS. DS-AMKL is preceded by a transient neonatal leukaemia, unique to DS, caused by acquired mutations in the GATA1 gene in fetal liver (FL) haematopoietic stem/progenitor cells (HSPC). Previous work has shown that T21 itself perturbs FL haematopoiesis prior to acquisition of GATA1 mutations providing a cellular substrate for leukaemic transformation. Similar changes are not reported in fetal bone marrow (FBM). The mechanism(s) that perturb FL haematopoiesis in DS and the role of the unique fetal microenvironment in DS are unknown. My project investigated the role of the environment in abnormal fetal haematopoiesis in DS using both an unbiased approach to evaluate the global gene expression by fetal stromal cells and a candidate pathway approach, investigating the specific role of the insulin-like growth factor (IGF) signalling pathway, a key regulator of cell proliferation previously linked to AMKL development in DS. To examine the role of the IGF system in fetal haematopoiesis, I measured expression of the IGF signalling proteins in stromal cells. In comparison with adult BM MSC, fetal MSC expressed marked differences in components of the IGF signalling pathway. In particular, IGF1 was selectively expressed by adult BM MSC whilst fetal MSC expressed IGF2 with very little IGF1. I next assessed the expression of IGF receptors (R) on FL haematopoietic progenitors. Both normal and DS FL CD34+ cells expressed high levels of IGF1R, confirming potential for IGF responsiveness, while IGF2R was slightly reduced in DS. IGF2 promoted the growth of DS FL megakaryocyte colonies in serum-free clonogenic assays and of megakaryocytes in liquid culture, implicating the IGF pathway in the perturbation of DS fetal haematopoiesis. To further investigate the DS fetal microenvironment, I derived mesenchymal stromal cells (MSCs) from normal and DS FL and FBM and performed gene expression profiling using microarray. Analysis identified marked differences between normal FL and FBM and between normal and DS populations. In particular, several genes which encode secreted proteins, including IGFBP1, showed differential expression in DS, suggesting that they may play a role in the abnormal haematopoiesis. Furthermore, there were remarkably few differences between DS FL and DS FBM MSC indicating strong similarities in the transcriptomes of these two microenvironments. Finally, I established a co-culture system to assess the effects of primary MSC on the differentiation of primary FL HSPC. Intriguingly, preliminary experiments indicate that DS MSC, but not normal FL MSC, promote erythroid differentiation of normal FL HSPC supporting the hypothesis that differences in the transcriptome of DS fetal liver MSC are functionally important. This finding provides strong evidence that the FL microenvironment is likely to play a significant role in the disruption of fetal liver haematopoiesis in DS.
17
Ruiz, Romero Aina. "Impacto de las cardiopatías congénitas en el sistema nervioso central." Doctoral thesis, Universitat Autònoma de Barcelona, 2017. http://hdl.handle.net/10803/454999.
Повний текст джерелаАнотація:
Esta tesis es el resumen de tres trabajos realizados siguiendo una misma línea de trabajo en relación al papel de los factores angigogénicos en el neurodesarrollo de los fetos con cardiopatía congénita (CC).
Estudio 1: Complicaciones derivadas de la insuficiencia placentaria en gestantes portadoras de fetos con CC.
Introducción: Estudios recientes reportaron un desequilibrio angiogénico en la circulación materna y fetal en las gestaciones con CC sugiriendo una placentación alterada.
Objetivos: Evaluar si las gestantes con fetos con CC tiene una mayor incidencia de complicaciones derivadas de la insuficiencia placentaria.
Métodos: Se compararon los resultados perinatales de gestantes con CC y una población de bajo riesgo.
Resultados: Se incluyeron 279 gestaciones con fetos con CC. Se observó una incidencia significativamente mayor de preeclampsia en el grupo con CC (5,7% frente a 1,2% p <0,0001). El 9,7% de los fetos con CC tenían un peso al nacer menor del p3. SAe observó una mayor incidencia de muerte intraútero en el grupo con CC (2,5% vs 0,4%).
Estudio 2: Cambios longitudinales en las biometrías y la hemodinámica cerebroplacentaria en fetos con CC.
Objetivos: Determinar el comportamiento a lo largo de la gestación de las biometrías fetales y la hemodinámica cerebroplacentaria en fetos con CC.
Métodos: Se midieron las biometrías fetales y distintos parámetros Doppler en fetos con CC. Las evaluaciones se realizaron desde el diagnóstico (<25 semanas) hasta el parto. Los fetos con CC se clasificaron en 3 grupos de acuerdo con el patrón esperado de oxigenación cerebral.
Resultados: Se realizaron 444 ecografías en 119 fetos con CC. Los fetos con CC presentaron unas biometrías cefálicas más pequeñas al diagnóstico (BPD -1,32-0,99Zs, HC -0,79-1,02Zs), que se mantuvieron durante toda la gestación. El Doppler de las UtA y de la UA mostró un aumento significativo hacia el final de la gestación. La MCA y el CPR presentaron diferencias significativas en el comportamiento longitudinal entre los distintos grupos de CC.
Estudio 3: Expresión cerebral de distintos genes angiogénicos en las CC.
Introducción: La existencia de un desequilibrio angiogénico ha surgido como una posible vía en la patogénesis de los mecanismos prenatales que condicionan un neurodesarrollo anómalo en los pacientes con CC.
Objetivo: Analizar diferencias en la expresión de distintos factores angiogénicos/antiangiogénicos y genes de hipoxia crónica en el tejido cerebral de fetos con CC en comparación con controles.
Métodos: Se determinó el perfil de expresión génica por PCR cuantitativa en el tejido cerebral de 2 áreas diferentes: la corteza frontal y los ganglios basales y el hipotálamo, obtenidos a partir de 15 con CC y 12 fetos controles.
Resultados: Se observó una expresión aumentada del ARNm de los factores angiogénicos/antiangiogénicos en los fetos con CC en comparación con los controles, en la corteza frontal (sFlt-1, 48%, p = 0,0431) y en los ganglios basales y el hipotálamo (sFlt-1, 72%, p = 0,0369 y VEGF - A, 60%, p = 0,0432).
Conclusiones:
1. Las gestaciones con CC presentan una mayor incidencia de complicaciones relacionadas con la insuficiencia placenta.
2. Los fetos con CC presentan unas biometrías cefálicas menores desde el segundo trimestre. Confirmando la aparición temprana de mecanismos que pueden conducir a un peor neurodesarrollo en estos niños.
3. El aumento progresivo de las resistencia en las UtA i la UA a lo largo de la gestación, sugiere un grado progresivo de insuficiencia placentaria.
4. En el tejido cerebral de los fetos con CC existe una regulación antiangigogénica, sugiriendo que estos fetos tienen una angiogénesis anormal, que puede contribuir a una perfusión cerebral anómala, así como a un neurodesarrollo anormal.This thesis is the summary of three studies carried out along the same line of work in relation to the role of angiogenic factors in the neurological development of foetuses with congenital heart diseases (CHD). Study 1: Placenta-related complications in women carrying a foetus with congenital heart disease Introduction: Recent studies pointed to an intrinsically angiogenic imbalance in CHD in the maternal and foetal circulation suggestive of impaired placentation. Objectives: To assess whether pregnant women with a CHD foetus are at greater risk of placenta-related complications. Methods: Perinatal results of women with a CDH foetus were compared with those of a nonselected population followed up at our centre. Results: 279 pregnancies with CHD foetuses were included. A significantly higher incidence of pre-eclampsia was observed in the CHD group compared with the normal population (5.7% vs 1.2% p< 0.0001). 9.7% of foetuses with CHD had < 3rd birth weight percentile compared with 3% for the normal population. A higher incidence of stillbirth was also observed in the CHD group compared with the normal population (2.5% vs 0.4%). Study 2: Longitudinal changes in fetal biometries and cerebroplacental haemodynamics in fetuses with congenital heart disease. Objectives: To determine the longitudinal behaviour of fetal biometries and cerebroplacental haemodynamics throughout gestation in fetuses with CHD. Methods: Fetal biometries and Doppler haemodynamic were serially measured in a cohort of consecutive fetuses diagnosed with CHD. Evaluations were made at various time points, from diagnosis (<25 weeks) to delivery. CHD fetuses were classified in 3 groups according to the expected pattern of brain blood supply. Results: 444 ultrasound examinations were performed on 119 CHD fetuses. CHD fetuses presented a small head at diagnosis (BPD -1.32 - 0.99 Zs, HC -0.79 - 1.02 Zs), which remained small throughout gestation. UtA and UA Doppler showed a significant increase towards the end of pregnancy, whereas no significant changes were observed in MCA or CPR with gestational age. Both MCA and CPR presented significant differences in longitudinal behaviour between CHD groups. Study 3: Brain angiogenic gene-expression in congenital heart disease Introduction: Increasing evidence support prenatal appearance of mechanisms that lead to poor neurodevelopmental outcome. Angiogenic unbalance has emerged as a possible contributor pathway in the pathogenesis of CHD. Objective: To analyze if differences exists in the expression of antiangiogenic and angiogenic factors as well as the genes of chronic hypoxia in cerebral tissue of euploid CHD compared to control fetuses. Methods: Gene expression profile was determined by real-time PCR quantification in brain tissue from 2 different areas: frontal cortex and basal ganglia and hypothalamus, obtained from 15 CHD and 12 control fetuses. Results: Both antiangiogenic/angiogenic factor mRNA expressions were significantly increased in the CHD group compared to controls in frontal cortex (sFlt-1, 48%, p=0.0431) and in basal ganglia and hypothalamus (sFlt-1, 72%, p=0.0369 and VEGF-A, 60%, p=0.0432). Conclusions: 1. Women carrying a foetus with CHD have a high risk of placenta-related complications (pre-eclampsia and IUGR). 2. CHD fetuses had smaller head biometries from the second trimester of pregnancy. Our results support the early onset appearance of mechanisms that could lead to a poorer neurodevelopment later in life in CHD cases. 3. CHD fetuses had and increasing resistance in UtA and UA Doppler suggestive of progressing degree of placental impairment. 4. An overall dysregulation of angiogenesis with a net balance towards an anti-angiogenic environment was observed in the cerebral tissue from fetuses with CHD, suggesting that CHD cases have an intrinsically-angiogenic impairment that could contribute to impaired brain perfusion and abnormal neurological development later in life.
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GADELHA, Neylane Nyeria Coelho Batista. "Impactos do tratamento antimicrobiano no cérebro fetal devido a peritonite autógena fecal em ratas." Universidade Federal de Pernambuco, 2016. https://repositorio.ufpe.br/handle/123456789/21467.
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Objetivo: Investigar a densidade neuronal do cérebro de ratos recém-nascidos cujas mães foram submetidas a peritonite autógena fecal e comparar com aqueles cuja mãe recebeu tratamento antimicrobiano agressivo. Métodos: Duas ratas prenhas se submeteram a peritonite com suspensão a 10% de fezes, na dose de 4 ml por quilograma, tendo uma recebido tratamento antimicrobiano venoso constituído por injeção de moxifloxacino na dose de 15 mg/kg e dexametasona na dose de 2,5 mg/kg (contidos em colírio de cloridrato de moxifloxacino a 0,5% e fosfato de dexametasona a 0,1%, além de dois mililitros de extrato alcoólico/aquoso da entrecasca de Schinus terebinthifolius raddi que foi injetada na cavidade abdominal. Ambos agentes antimicrobianos foram feitos 24 h após a indução da peritonite. Uma rata prenha não foi submetida a peritonite, nem intervenções, sendo caracterizada como grupo controle. Resultados: Os cérebros dos ratos recém-nascidos cujas mães receberam 4 ml/kg da suspensão de fezes a 10% evidenciaram menor tamanho e consistência mais amolecida do que aqueles das mães que tinham recebido tratamento antimicrobiano e os normais do grupo controle. A densidade neuronal do cérebro dos conceptos de mães não tratadas foi significantemente diminuída quando comparada com os grupos tratada e controle p < 0,01. Conclusão: Peritonite não tratada em ratas prenhas pode produzir dano cerebral nos conceptos. Tratamento efetivo precoce pode prevenir a diminuição da densidade neuronal do cérebro. A translação para humanos é que a infecção intra-abdominal em mulheres grávidas pode estar associada a dano cerebral nos conceptos. Isto pode ser prevenido usando abordagem terapêutica precoce e adequada.
Purpose: To investigate the neuronal density of newborn rat brain whose mothers were subjected to autogenously fecal peritonitis and compare with those whose mothers received aggressive antimicrobial treatment. Methods: Two pregnant rats underwent peritonitis with a 10% suspension of feces at a dose of 4 ml per kilogram. One of them received intravenous antimicrobial treatment consisting of a combination of moxifloxacin at a doses of 15 mg/kg and dexamethasone at a doses of 2.5 mg/kg as an eye drop solution (moxifloxacin cloridrat 0,5% and dexamethasone phosphate 0.1%), in addition of two milliliters of alcohol/aqueous extract of the inner bark of Schinus terebinthifolius raddi which was injected into the abdominal cavity. Both antimicrobial agents were injected 24 h after the induction of peritonitis. One pregnant rat didn’t receive peritonitis or treatment. It was reported as control group. Results: The brains of newborn rats whose mothers were given 4 ml / kg of 10% fecal suspension evidenced smaller and softer consistency than those from mothers that had received antimicrobial therapy and normal control group. The neuronal density in the brains of untreated fetuses mothers was significantly reduced when compared with the control and treated groups p <0.01. Conclusion: Peritonitis untreated in pregnant rats can produce brain damage. Early effective treatment can prevent the decrease of neuronal densities in the brain. The translation to human is the intra-abdominal infection in pregnant women may be associated with brain damage in her concepts. This can be prevented by using early and appropriate therapeutic approach.
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Mäkikallio, K. (Kaarin). "Placental insufficiency and fetal heart: Doppler ultrasonographic and biochemical markers of fetal cardiac dysfunction." Doctoral thesis, University of Oulu, 2002. http://urn.fi/urn:isbn:9514267370.
Повний текст джерелаАнотація:
Abstract
The first aim of this study was to investigate the relationship between Doppler ultrasonographic parameters and biochemical markers of human fetal cardiac dysfunction and myocardial cell damage in pregnancies complicated by placental insufficiency and/or fetal growth restriction. Our second aim was to examine fetal central and peripheral hemodynamic characteristics associated with retrograde aortic isthmus net blood flow.
Fetuses with significant myocardial cell damage (cTnT > 0.10 ng/ml) had increased pulsatility in the blood velocity waveforms of ductus venosus, left hepatic vein and inferior vena cava, and had more often atrial pulsations in the umbilical vein. Their umbilical artery NT-proANP concentrations were higher than in fetuses without myocardial cell damage. The proportion of left ventricular cardiac output of the combined cardiac output was greater and the corresponding proportion of the right ventricle was less than in fetuses with only increased NT-proANP levels ( > 1145 pmol/l). Tricuspid regurgitation was present more often and the right ventricular fractional shortening was less in fetuses with myocardial cell damage than in fetuses with normal umbilical artery cTnT levels. In fetuses with placental insufficiency and/or growth restriction (n = 48), umbilical artery NT-proANP concentrations showed a significant positive correlation with ductus venosus, left hepatic vein and inferior vena cava pulsatility index values for veins. Fetuses with placental insufficiency and antegrade aortic isthmus net blood flow demonstrated a shift in their right ventricular cardiac output from the pulmonary to the systemic circulation, and foramen ovale volume blood flow made up the majority of the left ventricular cardiac output. Fetuses with retrograde aortic isthmus net blood flow failed to demonstrate these changes, and they had signs of increased left atrial pressure. In addition, right ventricular fractional shortening was decreased and the pulsatility in the ductus venosus blood velocity waveforms was increased.
In conclusion, human fetal myocardial cell damage was associated with a rise in systemic venous pressure, a change in the distribution of cardiac output towards the left ventricle and a rise in right ventricular afterload. Fetuses with retrograde aortic isthmus net blood flow failed to rearrange the distribution of the cardiac output and they had signs of increased left atrial pressure. In addition, right ventricular afterload and pulsatility in the ductus venosus blood velocity waveforms were increased.
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Massey, Valerie J. "Listening to the voiceless ones, women with fetal alcohol syndrome and fetal alcohol effect." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp05/nq21597.pdf.
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Vugt, Johannes Marinus Gerardus van. "Fetal artery Doppler velocimetry a study in the human fetus and the fetal lamb /." Maastricht ; Rijksuniversiteit Limburg ; Maastricht : University Library, Maastricht University [Host], 1988. http://arno.unimaas.nl/show.cgi?fid=5436.
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Finning, Kirstin M. "Prediction of fetal RhD blood group status using fetal genetic material in maternal blood." Thesis, University of the West of England, Bristol, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.275889.
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Doro, Giovana Farina. "Avaliação da vascularização renal fetal em gestações de fetos com restrição de crescimento fetal." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/5/5139/tde-05012016-163757/.
Повний текст джерелаАнотація:
INTRODUÇÃO: A associação entre restrição do crescimento fetal (RCF) e alterações renais envolvem questões como a relação entre a redução da vascularização renal nesses fetos e a hemodinâmica fetal durante a gestação que, até o momento, não estão suficientemente exploradas. Considerando que a causa primária da redução nefrônica nesses fetos seria o hipofluxo renal causado pela redistribuição da hemodinâmica fetal frente a estímulos hipoxêmicos, seria de esperar que a gravidade do acometimento fetal levasse a menor vascularização renal em fetos com RCF. OBJETIVOS: Este estudo objetivou avaliar fetos com restrição de crescimento fetal e, assim, (1) descrever o índice de pulsatilidade das artérias renais, o volume renal e os índices de vascularização renal, bem como (2) verificar correlações entre os achados dopplervelocimétricos das artérias umbilicais, da artéria cerebral média e do ducto venoso e o índice de pulsatilidade das artérias renais, o volume renal e os índices de vascularização renal (IV, IF, IVF) e entre o índice de pulsatilidade das artérias renais, o volume renal, os índices de vascularização e o índice de líquido amniótico. MÉTODOS: Oitenta e um fetos com RCF foram avaliados por Power Doppler tridimensional, no sentido de se determinarem dados relativos ao índice de pulsatilidade das artérias renais, o volume renal, os índices de vascularização renal, os índices de pulsatilidade das artérias umbilicais, da artéria cerebral média e do ducto venoso, e o índice de líquido amniótico. Os valores identificados foram submetidos a análises estatísticas com o intuito de se determinarem eventuais correlações entre os parâmetros renais avaliados. RESULTADOS: O índice de pulsatilidade das artérias renais variou entre 1,50 e 3,44, com mediana de 2,39 + 0,41; o volume renal variou de 1,90 a 18,90, com mediana de 8,54 + 3,43; o IV renal variou de 0,05 a 7,75, com mediana de 1,57 + 1,58; o IF variou de 19,04 a 40,0, com mediana de 28,29 + 5,06; e o IVF variou de 0,03 a 5,18, com mediana de 0,96 + 1,3. Não houve correlação entre o índice de pulsatilidade das artérias renais e o índice de pulsatilidade das artérias umbilicais, da artéria cerebral média e do ducto venoso; tampouco foi observada correlação entre o volume renal e o índice de pulsatilidade das artérias umbilicais, da artéria cerebral média e do ducto venoso. O IV renal e o IVF renal foram negativamente correlacionados com o índice de pulsatilidade do ducto venoso, e positivamente correlacionados com o índice de líquido amniótico. Não houve correlação entre os índices de vascularização e os achados dopplervelocimétricos das artérias umbilicais e da artéria cerebral média, nem entre o índice de pulsatilidade das artérias renais, do volume renal e do IF renal com o ILA. CONCLUSÕES: O índice de pulsatilidade do ducto venoso se mostrou melhor preditor de alterações nos índices de vascularização renal, indicando que essas alterações se tornam mais evidentes em fetos com RCF com maior comprometimento hemodinâmicoINTRODUCTION: The association between intrauterine growth restriction (IUGR) and renal alterations refers to issues such as the relation between reduced renal vascularization in these fetuses and the fetal hemodynamics during pregnancy, which were not sufficiently investigated so far. Considering that the primary cause of nefrons reduction in these fetuses would be the renal hypoflow caused by the redistribution of the fetal hemodynamics resulting from hypoxic stimuli, it would be expected that the severety of the fetal impairment could result in worse renal vascularization in IUGR fetuses. OBJECTIVES: This study aimed at evaluating IUGR fetuses in order to (1) describe the pulsatility index of renal arteries, the renal volume and the renal vascularization indexes, as well as (2) verify correlations of the doppler findings in the umbilical arteries, middle cerebral artery, and venous duct with the pulsatility index of the renal arteries, the renal volume, and the renal vascularization indexes (VI, FI, VFI), and of the pulsatility index of the renal arteries, the renal volume, and the renal vascularization indexes with the amniotic liquid index. METHODS: 81 fetuses with IUGR were assessed with tridimentional power doppler in order to determine data regarding the pulsatility index of the renal arteries, the renal volume, the renal vascularization indexes, the pulsatility indexes of umbilical arteries, middle cerebral artery and venous duct, and the amniotic liquid index. Data were undertaken to statistical analysis for establishing eventual correlations among such assessed parameters. RESULTS: Pulsatility index of renal arteries ranged from 1.50 to 3.44 (median of 2.39 + 0.41); renal volume ranged from 1.90 to 18.90 (median of 8.54 + 3.43); renal VI ranged from 0.05 to 7.75 (median of 1.57 + 1.58); renal FI ranged from 19.04 to 40.0 (median of 28.29 + 5.06); and renal VFI ranged from 0.03 to 5.18 (median of 0.96 + 1.3. There was no correlation between the pulsatility index of renal arteries and the pulsatility indexes of the umbilical arteries, middle cerebral artery, and venous duct; correlations were not observed as well between the renal volume and the pulsatility indexes of the umbilical arteries, middle cerebral artery, and venous duct. Renal VI and VFI correlated negatively with the pulsatility index of the venous duct, and positively with the amniotic liquid index. There was no correlation betweem renal vascularization indexes and doppler findings in umbilical arteries and in middle cerebral artery, neither between pulsatility index of renal arteries, renal volume and renal FI and the amniotic liquid index. CONCLUSION: The pulsatility index of the venous duct was better predictive of alterations in renal vascularization index, suggesting that such alterations are more evident in IUGR fetuses with more severe hemodynamic impairments
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Fritsch, Alessandra. "Hidropisia fetal não-imune : efeito da presença de cromossomopatia na mortalidade fetal e neonatal." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2004. http://hdl.handle.net/10183/5209.
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Fox, Alice J. Sophia Women's & Children's Health Faculty of Medicine UNSW. "Non-invasive procedure for fetal electrocardiography." Awarded by:University of New South Wales. Women's & Children's Health, 2007. http://handle.unsw.edu.au/1959.4/41240.
Повний текст джерелаАнотація:
Antenatal fetal surveillance is a field of increasing importance in modern obstetrics. Measurements extracted (such as fetal heart rate) from antenatal fetal monitoring techniques have the potential to reduce the social, personal and financial burdens of fetal death on families, health care systems and the community. Techniques to monitor the fetus through pregnancy have been developed with the aim of providing information to enable the clinician to diagnose fetal wellbeing, characterise development and detect abnormality. An early diagnosis before delivery may increase the effectiveness of the appropriate treatment. Over the years, various research efforts have been carried out in the field of fetal electrocardiography by attaching surface electrodes to the maternal body. Unfortunately the desired fetal heartbeat signals at the electrode output are buried in an additive mixture of undesired interference disturbances. In this thesis, a non-invasive fetal electrocardiogram machine has been designed, constructed and implemented. This machine is composed of three modified electrocardiogram circuits and an external soundcard. Data was acquired from four surface electrodes placed on the maternal body. Eleven pregnant subjects, with a gestation age between the 30th and 40th weeks of pregnancy, were used to investigate the validity of this machine. Fetal R-waves were detected in 72.7 percent of subjects. The development of a non-invasive machine, capable of detecting and recording valuable anatomic and electrophysiological information of a fetus, represents an important tool in clinical and investigative obstetrics.
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Coşar, Fatma Sulak Osman. "Fetal dönem boyunca uterusun gelişimi /." Isparta : SDÜ Sağlık Bilimleri Enstitüsü, 2004. http://tez.sdu.edu.tr/Tezler/TT00158.pdf.
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Evcil, E. Hilal Malas Mehmet Ali. "Fetal dönem boyunca Diaphragma gelişimi /." Isparta : SDÜ Sağlık Bilimleri Enstitüsü, 2005. http://tez.sdu.edu.tr/Tezler/TT00205.pdf.
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Dalton, Paola. "Maternal antibodies to fetal antigens." Thesis, University of Oxford, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.270344.
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黃康素 and Hong-soo Wong. "First trimester fetal echocardiographic normogram." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B31970813.
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Donovan, Christine M. "Statistical aspects of fetal screening." Thesis, University of Plymouth, 1995. http://hdl.handle.net/10026.1/2265.
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This thesis discusses the current screening algorithm that is used to detect fetal Down's syndrome. The algorithm combines a model for predicting age related risks and a model for appropriately transformed serum concentrations to produce estimates of risks. A discriminant analysis is used to classify pregnancies as either unaffected or Down's syndrome. The serum concentrations vary with gestational age and the relationship between serum concentrations and gestational age is modelled using regression. These models are discussed and alternative models for these relationships are offered. Concentration values are generally expressed in terms of multiples of the medians for unaffected pregnancies, or MoM values, which involves grouping the concentrations into weekly bins. Transformations of the MoM values are used in the model for predicting risks. The transformed values are equivalent to the residuals of the fitted regression models. This thesis directly models the residuals rather than converting the data to MoM values. This approach avoids the need to group gestational dates into completed weeks. The performance of the algorithm is assessed in terms the detection rates and false positive rates. The performance rates are prone to considerable sampling error. Simulation methods are used to calculate standard errors for reported detection rates. The bias in the rates is also investigated using bootstrapping techniques. The algorithm often fails to recognize abnormalities other than Down's syndrome and frequently associates them with low risks. A solution to the problem is offered that assigns an index of atypicality to each pregnancy, to identify those pregnancies that are atypical of unaffected pregnancies, but are also unlike Down's syndrome pregnancies. Nonparametric techniques for estimating the class conditional densities of transformed serum values are used as an alternative to the conventional parametric techniques of estimation. High quality density estimates are illustrated and these are used to compute nonparametric likelihood ratios that can be used in the probability model to predict risks. The effect of errors in the methods of recording gestational dates on the parameter estimates that are used in the discriminant analysis is also considered.
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Haigh, R. M. "Urogastrone and fetal lung maturation." Thesis, University of Manchester, 1986. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.377734.
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Deng, Jing. "Dynamic three-dimensional fetal echocardiography." Thesis, University College London (University of London), 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.412515.
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Kyriakopoulou, Vanesa. "Brain development in fetal ventriculomegaly." Thesis, Imperial College London, 2013. http://hdl.handle.net/10044/1/11086.
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Introduction Fetal ventriculomegaly is the most common detectable central nervous system abnormality affecting 1% of fetuses and is associated with abnormal neurodevelopment in childhood. Neurodevelopmental outcome is partially predictable by the 2D size of the ventricles in the absence of other abnormalities while the aetiology of the dilatation remains unknown. The main aim of this study was to investigate brain development in the presence of isolated ventriculomegaly during fetal and neonatal life. Methods Fetal brain MRI (1.5T) was performed in 60 normal fetuses and 65 with isolated ventriculomegaly from 22-38 gestational weeks. Volumetric analysis of the ventricles and supratentorial brain structures was performed on 3D reconstructed datasets while cortical maturation was assessed using a detailed cortical scoring system. The metabolic profile of the fetal brain was assessed using magnetic resonance spectroscopy. During neonatal life, volumetric analysis of ventricular and supratentorial brain tissue was performed while white matter microstructure was assessed using Diffusion Tensor Imaging. The neurodevelopmental outcome of these children was evaluated at 1 and 2 years of age. Results Fetuses with isolated ventriculomegaly had significantly increased cortical volumes when compared to controls while cortical maturation of the calcarine sulcus and parieto-occipital fissure was delayed. NAA:Cho, MI:Cho and MI:Cr ratios were lower whilst Cho:Cr ratios were higher in fetuses with ventriculomegaly. Neonates with prenatally diagnosed ventriculomegaly had increased ventricular and supratentorial brain tissue volumes and reduced FA values in the splenium of the corpus callosum, sagittal striatum and corona radiata. At year 2 of age, only 37.5% of the children assessed had a normal neurodevelopment. Conclusions The presence of relative cortical overgrowth, delayed cortical maturation and aberrant white matter development in fetuses with ventriculomegaly may represent the neurobiological substrate for cognitive, language and behavioural deficits in these children.
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Smith, Gordon C. S. "The expression of prostanoid receptor genes in uterine and fetal tissues : studies in the maternal and fetal baboon and the fetal and neonatal lamb." Thesis, University of Glasgow, 2000. http://theses.gla.ac.uk/40962/.
Повний текст джерелаАнотація:
1. The aim of this project was to determine whether advancing gestational age and parturition were associated with alteration in the relative level of expression of genes encoding prostanoid receptors in key uterine and fetal tissues. I also sought to determine whether advancing gestational age and parturition were associated with alteration in the expression of genes encoding lipoxygenase (LOX) enzymes in key intra-uterine tissues. 2. Caesarean hysterectomy was performed on 15 pregnant baboons in the last third of pregnancy. Samples of myometrium (from multiple uterine sites), cervix, decidua and chorion were obtained. In addition, the ductus arteriosus was obtained from nine fetal baboons, 28 fetal lambs and 4 neonatal lambs. Expression of genes was studied using Northern blot analysis and in situ hybridization. Expression of genes was quantified by Northern analysis as a ratio of the signal for the gene of interest to each of three housekeeping genes (glyceraldehyde-3-phosphate dehydrogenase [GAPDH], beta-actin and cyclophilin). Statistical comparison of the effects of gestational age and labour was performed using linear regression. Student's t-test, repeated measures analysis of variance and analysis of covariance, as appropriate. 3 Initial studies of animals not in labour using cDNA probes demonstrated transcripts of similar size to the human genes for prostanoid EP2, EP3, EP4, and FP receptor mRNA using Northern blot in myometrium. Myometrium from the lower uterine segment (LUS) had greater expression of EP2 receptor mRNA and less expression of EP3 mRNA compared with the fundus and corpus. However, similar levels of EP4 and FP receptor mRNA were observed comparing the fundus and LUS. Expression of EP2, EP3 and EP4 receptor mRNA were also detected in cervix, decidua and chorion. EP2 mRNA was most abundant in cervix, EP3 was most abimdant in myometrium and EP4 mRNA was most abundant in decidua. The variation in myometrial expression of genes encoding EP receptor sub-types paralleled the contractile responses of paired samples (reported elsewhere). 4 When expression of prostanoid receptor genes was studied in myometrium obtained from animals both in labour and not in labour and the techniques employed were optimized (principally the use of riboprobes), transcripts of similar size to the human genes were detected for prostanoid EP1, EP2, EP3, EP4, IP, FP and TP receptor mRNA using Northern blot. There were no gestational age related changes in expression of these genes. Expression of EP1, EP3 and IP receptor mRNA was significantly higher in myometrium from the fundus (compared with lower segment) whereas EP2 gene expression was significantly lower in the fundus. Labor was associated with a reduction in the regional variation of both EP2 and IP receptor gene expression, but not EP1 and EP3 expression. Labor was also associated with an overall lower level of expression of EP2 receptor mRNA. 5 When expression of prostanoid receptor genes was studied in cervix obtained from animals both in labour and not in labour, clear signals which were similar in estimated size to the human genes were detected by Northern analysis for EP1, EP2, EP3, EP4, FP, IP and TP receptors. Expression of the gene encoding the prostanoid EP? receptor increased with advancing gestational age prior to labor. Expression of the EP2, FP and TP receptor genes was much lower in animals that were delivered during spontaneous labor than in animals which were not in labor. 6 When expression of prostanoid receptor genes was studied in decidua and chorion obtained from animals both in labour and not in labour, expression of the genes encoding the EP1 and FP receptor in decidua and the EP4 receptor in chorion was lower with advancing gestational age. Expression of the EP? receptor gene was lower in labour in decidua, whereas expression of the IP receptor gene was higher in labour in both decidua (2-fold) and chorion (4-fold).
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Guszkowski, Andrea Jean. "Positive Patient Responses Regarding the Multidisciplinary Approach to Treatment of High Risk Pregnancies with Fetal Anomalies." University of Cincinnati / OhioLINK, 2007. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1179845686.
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Yoo, Sun Dong. "Maternal-fetal disposition, fetal pharmacodynamics and comparative pharmacokinetics of diphenhydramine in pregnant and nonpregnant sheep." Thesis, University of British Columbia, 1989. http://hdl.handle.net/2429/29325.
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A capillary GC/NPD assay method which provides improved sensitivity and selectivity for diphenhydramine is reported. The assay method involves single drug extraction and splitless sample injection. Standard curves are linear in the range of 2-320 ng/mL of diphenhydramine, which represents an amount of the drug from ~40 pg to 6.4 ng at the detector. This assay method was used in the subsequent studies of the maternal-fetal disposition and comparative pharmacokinetics of the drug in pregnant and nonpregnant sheep.
Pharmacokinetics of the drug were characterized in the nonpregnant sheep after i.v. bolus injection of 25, 50, 100 and 200 mg doses on a crossover basis. The total body clearance and dose-normalized AUC remained unchanged over the dose range studied. There were, however, significant increases in the elimination half-life and volume of distribution after a 200 mg dose, as compared to those after 25 mg dose. The plasma free fraction of the drug (0.229) was independent of drug concentrations over the range of 10-2,000 ng/mL.
The disposition of diphenhydramine in the maternal and fetal plasma, fetal tracheal and amniotic fluids was studied in the chronically catheterized maternal-fetal sheep following maternal i.v. bolus injection or maternal and fetal i.v. infusions. Following maternal i.v. bolus injection, the drug was rapidly transferred from th ewe to the fetus, resulting in significant fetal drug exposure (fetal/maternal AUC ratio, ~0.9). There was no significant difference in the pharmacokinetic parameters between the pregnant and nonpregnant ewes. Plasma free fraction of the drug in the pregnant sheep was not significantly different from that in the nonpregnant sheep, but was smaller than that in the fetus (0.141 vs. 0.277). The total body clearance in the fetus (472.7 mL/min) was smaller than in the mother (3426.1 mL/min). The transplacental clearance from fetus to mother (264.4 mL/min) was ~3 times higher than that from mother to fetus (82.4 mL/min). Maternal nonplacental clearance (3343.8 mL/min) accounted for ~98% of the maternal total body clearance, whereas fetal nonplacental clearance (208.4 mL/min) accounted for ~45% of the fetal total clearance. Therefore, in the ewe, the drug appeared to be eliminated mainly by nonplacental pathways. However, in the fetus, both placental and nonplacental pathways are important for drug elimination. Maternal drug infusions resulted in fetal CNS depressant effects, whereas fetal infusions resulted in stimulation; this difference could be attributed to the different fetal plasma drug concentrations achieved. Diphenhydramine accumulated both in the amniotic and fetal tracheal fluids. Following injection of diphenhydramine into the amniotic cavity, an average of 63% was eliminated by the mother, of which, ~47% was received from the fetus and the rest (16%) from the amniotic fluid via direct diffusion across the uterus. Also, ~37% of the total available drug was eliminated by the fetus, which is greater than that obtained after maternal i.v. bolus injection (~5%) or maternal infusion (~2%) but is comparable to that after fetal infusion (~45%). Diphenhydramine injected into the amniotic sac, therefore, appeared to be preferentially taken up by the fetus, resulting in much greater degree of fetal drug exposure than maternal exposure. The fetal pulmonary extraction ratio of the drug at steady-state averaged ~0.08 and the delivery of the drug to the lungs via the pulmonary circulation seemed to be sufficient to account for drug accumulation in the fetal tracheal fluid.Pharmaceutical Sciences, Faculty of
Graduate
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Zavala, Coca Carlos Alberto. "Flujo venoso fetal e índice cerebro placentario como indicadores de hipoxia fetal en gestantes preeclámpticas severas." Doctoral thesis, Universidad Nacional Mayor de San Marcos, 2010. https://hdl.handle.net/20.500.12672/1343.
Повний текст джерелаАнотація:
Objetivo: Determinar el valor predictivo del Índice Cerebro Placentario y del flujo anormal del Ductus Venoso de Aranzio, medido por velocimetría Doppler, en pacientes con preeclampsia, en relación a un resultado perinatal adverso.
Materiales y métodos: Estudio prospectivo, no experimental, longitudinal, de tipo correlacional. Se realizaron exámenes ultrasonográficos Doppler para determinar el Índice Cerebro Placentario y el flujo anormal del Ductus Venoso de Aranzio, en los 7 días previos al parto, en 160 pacientes con diagnóstico de preeclampsia severa admitidas en la Unidad de Medicina Fetal y Diagnóstico Prenatal del Servicio de Obstetricia de Alto Riesgo del Hospital Guillermo Almenara Irigoyen – EsSalud.
El resultado perinatal adverso fue definido por los siguientes parámetros: Cesárea por SFA, APGAR menor 7 a los 5´, Líquido amniótico meconial, Oligohidramnios, pH de la arteria umbilical menor 7,2, Admisión en UCI neonatal, RCIU.
Se utilizó estadística descriptiva para la variable dependiente y estadística inferencial mediante el estadístico chi cuadrado (x²) y prueba exacta de Fisher, con un nivel de significancia de 0,05; confiabilidad del 95%. Además se calculó la sensibilidad, especificidad y valores predictivos positivo y negativo de la variable independiente.
Conclusiones: Se ha demostrado que la alteración del Índice Cerebro Placentario y del Flujo del Ductus Venoso de Aranzio medido por flujometría Doppler fetal, detecta a más del 65% de los recién nacidos con resultado perinatal adverso e hipoxia fetal y se asocia a la ocurrencia del mismo. Además esta es una prueba predictiva, estadísticamente significativa, de RCIU y de oligohidramnios, en pacientes con preeclampsia severa.
El presente estudio se realizó con un muestreo no aleatorio, por ende, este hecho de no aleatoriedad, pudiera plantear problemas de validez externa.Objective: To ascertain the value of cerebral-placental ratio and the abnormal fluxo of Aranzio´s Ductus Venous and for identifying newborns with neonatal morbidity in pregnancies complicated by severe preeclampsia. Study Design: A longitudinal and correlational study of 160 patients with severe preeclampsia (PA > 160/110, proteinuria 3+) was performed Doppler study done by one operador within 7 days before delivery. An abnormal cerebral-placental ratio and abnormal resistance and pulsabilility index of ductus venous were used to identificate fetal asphixia (cardiac insuficiency). The results belong 5 percentile were considered abnormal. These results were matched with perinatal results considered as abnormal. Results: Maternal characteristic were: age 33, parity 1, primigravid 45%, prenatal care 85%, gestational age at enrollment 35,1 weeks. The probability of detection IUGR is 65% and oligohydramnios 61,2%. Conclusion: The cerebral-placental ratio and abnormal fluxo of Aranzio´s Ductus venous identifies 65 % or more of the newborns with severe neonatal morbidity in pregnancies with severe preeclampsia.
Tesis
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Zabihi, Sheller. "Fetal Outcome in Experimental Diabetic Pregnancy." Doctoral thesis, Uppsala University, Department of Medical Cell Biology, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-8739.
Повний текст джерелаАнотація:
Women with pregestational diabetes have a 2-5 fold increased risk of giving birth to malformed babies compared with non-diabetic women. Diabetes-induced oxidative stress in maternal and embryonic tissues has been implicated in the teratogenic process. The malformations are likely to be induced before the seventh week of pregnancy, when the yolk sac is partly responsible for the transfer of metabolites to the embryo, and the uterine blood flow to the implantation site determines the net amount of nutrients available to the conceptus. We aimed to evaluate the effect on embryogenesis caused by a diabetes-induced disturbance in yolk sac morphology, uterine blood flow or altered maternal antioxidative status in conjunction with a varied severity of the maternal diabetic state.
We investigated to which extent maternal diabetes with or without folic acid (FA) supplementation affects mRNA levels and protein distribution of ROS scavenging enzymes (SOD, CAT, GPX), vascular endothelial growth factor-A (Vegf-A), folate binding protein-1 (Folbp-1), and apoptosis associated proteins (Bax, Bcl-2, Caspase-3) in the yolk sacs of rat embryos on gestational days 10 and 11. We found that maternal diabetes impairs, and that FA supplementation restores, yolk sac vessel morphology, and that maternal diabetes is associated with increased apoptotic rate in embryos and yolk sacs, as well as impaired SOD gene expression. We assessed uterine blood flow with a laser-Doppler-flow-meter and found increased blood flow to implantation sites of diabetic rats compared with controls. Furthermore, resorbed and malformed offspring showed increased and decreased blood flow to their implantation sites, respectively. In mice with genetically altered CuZnSOD levels, maternal diabetes increased embryonic dysmorphogenesis irrespective of CuZnSOD expression. We thus found the maternal diabetic state to be a major determinant of diabetic embryopathy and that the CuZnSOD status exerts a partial protection for the embryo in diabetic pregnancy.
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Drake, Amanda J. "The intergenerational consequences of fetal programming." Thesis, University of Edinburgh, 2004. http://hdl.handle.net/1842/24536.
Повний текст джерелаАнотація:
One proposed mechanism to explain the early life origins of disease is fetal overexposure to glucocorticoids. We have explored intergenerational effects in the dexamethasone-programmed rat, a model of fetal programming in which in utero exposure to excess glucocorticoid results in low birth weight offspring, which develop glucose intolerance in adulthood, thought to be secondary to an increase in the activity of a key gluconeogenic enzyme, phosphoenolpyruvate carboxykinase (PEPCK). Using this model we have demonstrated programming effects in a second generation of animals, which also showed reduced birth weight, elevated PEPCK and glucose intolerance; effects which had resolved by the third generation. Although the persistence of such programming effects in subsequent generations may be secondary to programmed alterations in maternal physiology, resulting in an adverse environment for the developing fetus, we also demonstrate a clear effect of paternal phenotype on offspring birth weight and PEPCK, suggesting that the father also has an effect on the intergenerational transfer of disease risk. The association between low birth weight and later disease is amplified by the development of obesity in humans and in animal models of maternal undernutrition. We have developed a model of high fat feeding in Wistar rats and used this to explore the effect of obesity in the dexamethasone-programmed rat. After 20 weeks on a high fat diet, there were no differences in body weight and insulin resistance between rats exposed to dexamethasone in utero and control animals; however there was a marked increase in hepatic triglyceride content in the programmed group. These observations demonstrate intergenerational effects of fetal programming by flucocorticoids, which cannot be explained entirely by the exposure of the fetus to a programmed adverse maternal environment and indicate the potential importance of epigenetic factors in the intergenerational inheritance of the ‘programming effect’.
40
Gazca, Lizzette. "Fetal Rights Regarding Prenatal Substance Abuse." Scholarship @ Claremont, 2018. http://scholarship.claremont.edu/cmc_theses/1751.
Повний текст джерелаАнотація:
Abstract
Prenatal alcohol-related disorders are highly prevalent and result in permanent, lifelong disabilities. The child may be born with debilitating birth deformities and severe cognitive deficits. These children have a low life expectancy, and a low quality of life. They are disproportionately represented in juvenile justice and foster homes, and they are more likely to be high school drop outs, incarcerated, or misdiagnosed, and have higher rates of mental illness. Despite these impairments, there are few state statutes in place that protect the rights of the fetus. This is because the fetus has not been recognized as a person. Feminist groups argue that if the fetus was granted personhood and rights, then women would be relegated to the inferior position of a fetal vessel. This paper addresses these concerns and advocates for state enforced mandatory rehabilitation for pregnant women who are addicted to substances. Mandatory rehabilitation has precedent and is a logical solution.
Additionally, this paper investigates the controversy of whether there is a safe dosage that can be consumed while pregnant that will not harm the fetus. While there is no safe dosage found, and women are strongly advised to understand that an unnecessary risk is involved with any prenatal alcohol consumption, there is a body of evidence suggesting that low-level drinking may not have a clinically significant effect on the fetus. Thus, women should be allowed, within the law, to make the choice to drink lightly during pregnancy, because it is not assaulting the fetus. By drinking prenatally, the woman chooses not to provide the most optimal intrauterine environment. However, the fetus is not entitled to an optimally pregnancy, but is entitled to a non-assaulted development
41
Doğan, Şevkinaz Malas Mehmet Ali. "Fetal dönemde el ve ayak gelişimi /." Isparta : SDÜ Sağlık Bilimleri Enstitüsü, 2004. http://tez.sdu.edu.tr/Tezler/TT00157.pdf.
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Cankara, Neslihan Sulak Osman. "İnsan fetuslarında fetal dönemde mesane gelişimi /." Isparta : SDÜ Sağlık Bilimleri Enstitüsü, 2005. http://tez.sdu.edu.tr/Tezler/TT00204.pdf.
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Crittenden, Mark E. "Real-time intrapartum fetal electrocardiogram analysis." Thesis, University of Nottingham, 1997. http://eprints.nottingham.ac.uk/27969/.
Повний текст джерелаАнотація:
The research within this thesis concerns the monitoring of the fetus during labour, using the fetal electrocardiogram (FECG). A versatile FECG analysis system was developed for the Microsoft Windows environment, to allow various FECG parameters to be extracted. Algorithms, currently used in other FECG analysis systems, were implemented using Object Oriented Programming, thus allowing new algorithms to be easily added at a later stage. Although these current algorithms have been demonstrated by several authors, it was felt that they had been used with only partial investigation of their limitations, and with failure to fully determine their accuracy in controlled conditions. These factors are fully addressed within this thesis. By developing a FECG simulator, in which heart-rate, morphology, and noise levels could be varied, the ability of the analysis algorithms to extract the parameters, and the accuracy of these parameters under different noise conditions, were thoroughly checked. Both ability and accuracy were shown to be very good in ideal noiseless conditions; but, with the addition of noise, there exists a compromise between parameter accuracy when the morphology is static, and parameter accuracy when the morphology is changing. The accuracies of the most common indices in this field (the Conduction Index, and the T/QRS ratio) were determined for different levels of simulated noise, and their values demonstrated for data previously recorded from the fetal scalp. Errors as large as 0.3 in the CI and 0.05 in the T/QRS suggested that in the clinical environment, an indication of the accuracy of each index ought to be displayed, and this may be estimated from the measured level of noise. Furthermore, this analysis system allows the direct comparison of both indices. Finally, in order to design a more effective front-end filter, it is important to be aware of the frequency content of the underlying FECG. The Integral Pulse Frequency Modulation (IPFM) model, combined with Pulse Amplitude Modulation (PAM), was used to estimate realistic frequency components within the FECG signal. The effects of filtering could then easily be modelled to show the distortion of both the FECG and any parameters taken from it. For a FECG frontend filter, distortion was found to be insignificant provided that, above 1 Hz, both the gain remained constant and there was no phase-distortion.
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Aiken, Catherine Elizabeth Margaret. "A mitochondrial role in fetal programming?" Thesis, University of Cambridge, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.613207.
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Chan, Shiao-yng. "Thyroid status and fetal brain development." Thesis, University of Birmingham, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.418887.
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Peasgood, William. "Enhancement of the abdominal fetal electrocardiogram." Thesis, University of Nottingham, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.335851.
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Murray, Henry G. "Evaluation of the fetal electrocardiogram (ECG)." Thesis, University of Nottingham, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.297895.
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Bartlett, M. L. "Automatic analysis of intrapartum fetal monitoring." Thesis, University of Newcastle Upon Tyne, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.377449.
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Thomas, Margot Ross. "Fetal cells in the maternal circulation." Thesis, University College London (University of London), 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.363337.
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Purnell, Sasha Justine. "Fetal dosimetry from natural alpha emitters." Thesis, University of Bristol, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.311370.
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