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Pesquisa : C23.888.144.300 [Categoria DeCS]
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[PMID]:27776071
[Au] Autor:American College of Obstetricians and Gynecologists' Committee on Practice Bulletins­Obstetrics
[Ti] Título:Practice Bulletin No. 173: Fetal Macrosomia.
[So] Source:Obstet Gynecol;128(5):e195-e209, 2016 11.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Suspected fetal macrosomia is encountered commonly in obstetric practice. As birth weight increases, the likelihood of labor abnormalities, shoulder dystocia, birth trauma, and permanent injury to the neonate increases. The purpose of this document is to quantify those risks, address the accuracy and limitations of methods for estimating fetal weight, and suggest clinical management for a pregnancy with suspected fetal macrosomia.
[Mh] Termos MeSH primário: Macrossomia Fetal
[Mh] Termos MeSH secundário: Cesárea
Parto Obstétrico
Feminino
Macrossomia Fetal/diagnóstico
Macrossomia Fetal/etiologia
Macrossomia Fetal/terapia
Peso Fetal
Seres Humanos
Trabalho de Parto Induzido
Gravidez
Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:29175438
[Au] Autor:Ahmed RG; El-Gareib AW; Shaker HM
[Ad] Endereço:Division of Anatomy and Embryology, Zoology Department, Faculty of Science, Beni-Suef University, Beni-Suef, Egypt. Electronic address: r_g_a_ahmed@science.bsu.edu.eg.
[Ti] Título:Gestational 3,3',4,4',5-pentachlorobiphenyl (PCB 126) exposure disrupts fetoplacental unit: Fetal thyroid-cytokines dysfunction.
[So] Source:Life Sci;192:213-220, 2018 Jan 01.
[Is] ISSN:1879-0631
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Exposure to polychlorinated biphenyls (PCBs) is related to several endocrine disorders. This study examined the effect of maternal exposure of 3,3',4,4',5-pentachlorobiphenyl (PCB 126) on the fetoplacental unit and fetal thyroid-cytokine axis during the pregnancy. Pregnant albino rats received PCB 126 (20 or 40µg/kgb.wt.) by oral gavage from gestation day (GD) 1 to 20. Potential effects of PCB 126 were evaluated by following the histopathological changes in the placenta by Haematoxylin and Eosin (H&E) stain and measuring the maternofetal thyroid axis (ELIZA), maternofetal body weight, and fetal growth markers (ELIZA), and cytokines (ELIZA) at embryonic day (ED) 20. Placental tissues of both treated groups showed hyperemia, hemorrhage, degeneration and apoptosis in labyrinth layer and spiral artery at GD 20. Both administrations of PCB 126 elevated serum thyrotropin (TSH) concentration, and decreased free thyroxine (FT4) and free triiodothyronine (FT3) concentrations, resulting in a maternofetal hypothyroidism. The presence of hypothyroidism increased fetal serum concentration of transforming growth factor-ß (TGF-ß), leptin (LEP), tumor necrosis factor-α (TNF-α), interleukin-1ß (IL-1ß), and decreased the fetal serum insulin growth factor-I (IGF-I), IGF-II, insulin, adiponectin (ADP), and growth hormone (GH) in both treated groups at ED 20. However, the increase in resistin (RETN) and interferon-γ (IFN-γ) was non-significant in low-dose group and highly significant in high-dose group. Simultaneously, the reduction in body weight of the dams and fetuses was observed in both PCB 126 groups of examined day with respect to the control group. The maternal PCB 126 distorted the fetoplacental unit might disrupt the fetal thyroid-cytokines axis and prenatal development.
[Mh] Termos MeSH primário: Citocinas/metabolismo
Poluentes Ambientais/toxicidade
Feto/efeitos dos fármacos
Placenta/efeitos dos fármacos
Bifenilos Policlorados/toxicidade
Doenças da Glândula Tireoide/induzido quimicamente
[Mh] Termos MeSH secundário: Adiponectina/biossíntese
Animais
Peso Corporal/efeitos dos fármacos
Feminino
Peso Fetal/efeitos dos fármacos
Feto/metabolismo
Hormônio do Crescimento/biossíntese
Fator de Crescimento Insulin-Like I/biossíntese
Fator de Crescimento Insulin-Like II/biossíntese
Placenta/metabolismo
Placenta/patologia
Gravidez
Ratos
Ratos Wistar
Tireotropina/sangue
Tiroxina/sangue
Tri-Iodotironina/sangue
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Adiponectin); 0 (Cytokines); 0 (Environmental Pollutants); 0 (insulin-like growth factor II, rat); 0 (insulin-like growth factor-1, rat); 06LU7C9H1V (Triiodothyronine); 67763-96-6 (Insulin-Like Growth Factor I); 67763-97-7 (Insulin-Like Growth Factor II); 9002-71-5 (Thyrotropin); 9002-72-6 (Growth Hormone); DFC2HB4I0K (Polychlorinated Biphenyls); Q51BO43MG4 (Thyroxine); TSH69IA9XF (3,4,5,3',4'-pentachlorobiphenyl)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE


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[PMID]:28957383
[Au] Autor:Vargas VE; Gurung S; Grant B; Hyatt K; Singleton K; Myers SM; Saunders D; Njoku C; Towner R; Myers DA
[Ad] Endereço:Departments of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America.
[Ti] Título:Gestational hypoxia disrupts the neonatal leptin surge and programs hyperphagia and obesity in male offspring in the Sprague-Dawley rat.
[So] Source:PLoS One;12(9):e0185272, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The effect of gestational hypoxia on the neonatal leptin surge, development of hypothalamic arcuate nuclei (ARH) projections and appetite that could contribute to the programming of offspring obesity is lacking. We examined the effect of 12% O2 from gestational days 15-19 in the Sprague-Dawley rat on post-weaning appetite, fat deposition by MRI, adipose tissue cytokine expression, the neonatal leptin surge, ARH response to exogenous leptin, and αMSH projections to the paraventricular nucleus (PVN) in response to a high fat (HFD) or control diet (CD) in male offspring. Normoxia (NMX) and Hypoxia (HPX) offspring exhibited increased food intake when fed a HFD from 5-8 weeks post-birth; HPX offspring on the CD had increased food intake from weeks 5-7 vs. NMX offspring on a CD. HPX offspring on a HFD remained hyperphagic through 23 weeks. Body weight were the same between offspring from HPX vs. NMX dams from 4-12 weeks of age fed a CD or HFD. By 14-23 weeks of age, HPX offspring fed the CD or HFD as well as male NMX offspring fed the HFD were heavier vs. NMX offspring fed the CD. HPX offspring fed a CD exhibited increased abdominal adiposity (MRI) that was amplified by a HFD. HPX offspring fed a HFD exhibited the highest abdominal fat cytokine expression. HPX male offspring had higher plasma leptin from postnatal day (PN) 6 through 14 vs. NMX pups. HPX offspring exhibited increased basal c-Fos labeled cells in the ARH vs. NMX pups on PN16. Leptin increased c-Fos staining in the ARH in NMX but not HPX offspring at PN16. HPX offspring had fewer αMSH fibers in the PVN vs. NMX offspring on PN16. In conclusion, gestational hypoxia impacts the developing ARH resulting in hyperphagia contributing to adult obesity on a control diet and exacerbated by a HFD.
[Mh] Termos MeSH primário: Hiperfagia/sangue
Hiperfagia/complicações
Hipóxia/sangue
Hipóxia/complicações
Leptina/sangue
Obesidade/sangue
Obesidade/complicações
[Mh] Termos MeSH secundário: Tecido Adiposo/metabolismo
Animais
Animais Recém-Nascidos
Ansiedade/sangue
Ansiedade/complicações
Núcleo Arqueado do Hipotálamo/metabolismo
Comportamento Animal
Dieta
Medo
Comportamento Alimentar
Feminino
Peso Fetal
Interleucina-1beta/genética
Interleucina-1beta/metabolismo
Interleucina-6/genética
Interleucina-6/metabolismo
Imagem por Ressonância Magnética
Masculino
Fenômenos Fisiológicos da Nutrição Materna
Aprendizagem em Labirinto
Atividade Motora
Gravidez
Ratos Sprague-Dawley
Fator de Necrose Tumoral alfa/genética
Fator de Necrose Tumoral alfa/metabolismo
Água
Desmame
alfa-MSH/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Interleukin-1beta); 0 (Interleukin-6); 0 (Leptin); 0 (Tumor Necrosis Factor-alpha); 059QF0KO0R (Water); 581-05-5 (alpha-MSH)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171018
[Lr] Data última revisão:
171018
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170929
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0185272


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[PMID]:28727729
[Au] Autor:Moldéus K; Cheng YW; Wikström AK; Stephansson O
[Ad] Endereço:Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska University Hospital and Institutet, Stockholm, Sweden.
[Ti] Título:Induction of labor versus expectant management of large-for-gestational-age infants in nulliparous women.
[So] Source:PLoS One;12(7):e0180748, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: There is no apparent consensus on obstetric management, i.e., induction of labor or expectant management of women with suspected large-for-gestational-age (LGA)-fetuses. METHODS AND FINDINGS: To further examine the subject, a nationwide population-based cohort study from the Swedish Medical Birth Register in nulliparous non-diabetic women with singleton, vertex LGA (>90th centile) births, 1992-2013, was performed. Delivery of a live-born LGA infant induced at 38 completed weeks of gestation in non-preeclamptic pregnancies, was compared to those of expectant management, with delivery at 39, 40, 41, or 42 completed weeks of gestation and beyond, either by labor induction or via spontaneous labor. Primary outcome was mode of delivery. Secondary outcomes included obstetric anal sphincter injury, 5-minute Apgar<7 and birth injury. Multivariable logistic regression analysis was performed to control for potential confounding. We found that among the 722 women induced at week 38, there was a significantly increased risk of cesarean delivery (aOR = 1.44 95% CI:1.20-1.72), compared to those with expectant management (n = 44 081). There was no significant difference between the groups in regards to risk of instrumental vaginal delivery (aOR = 1.05, 95% CI:0.85-1.30), obstetric anal sphincter injury (aOR = 0.81, 95% CI:0.55-1.19), nor 5-minute Apgar<7 (aOR = 1.06, 95% CI:0.58-1.94) or birth injury (aOR = 0.82, 95% CI:0.49-1.38). Similar comparisons for induction of labor at 39, 40 or 41 weeks compared to expectant management with delivery at a later gestational age, showed increased rates of cesarean delivery for induced women. CONCLUSIONS: In women with LGA infants, induction of labor at 38 weeks gestation is associated with increased risk of cesarean delivery compared to expectant management, with no difference in neonatal morbidity.
[Mh] Termos MeSH primário: Parto Obstétrico/métodos
Peso Fetal/fisiologia
Trabalho de Parto Induzido/métodos
Conduta Expectante
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Recém-Nascido
Paridade
Gravidez
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170928
[Lr] Data última revisão:
170928
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0180748


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[PMID]:28704412
[Au] Autor:Di Simone N; Di Nicuolo F; Marana R; Castellani R; Ria F; Veglia M; Scambia G; Surbek D; Barnea E; Mueller M
[Ad] Endereço:Department of Obstetrics and Gynecology, Università Cattolica Del Sacro Cuore, A. Gemelli Universitary Hospital, Rome, Italy.
[Ti] Título:Synthetic PreImplantation Factor (PIF) prevents fetal loss by modulating LPS induced inflammatory response.
[So] Source:PLoS One;12(7):e0180642, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Maternal control of inflammation is essential during pregnancy and an exaggerated response is one of the underlying causes of fetal loss. Inflammatory response is mediated by multiple factors and Toll-like receptors (TLRs) are central. Activation of TLRs results in NALP-3 mediated assembly of apoptosis-associated speck-like protein containing a CARD (ASC) and caspase-1 into the inflammasome and production of pro-inflammatory cytokines IL-1ß and IL-18. Given that preventing measures are lacking, we investigated PreImplantation Factor (PIF) as therapeutic option as PIF modulates Inflammation in pregnancy. Additionally, synthetic PIF (PIF analog) protects against multiple immune disorders. We used a LPS induced murine model of fetal loss and synthetic PIF reduced this fetal loss and increased the embryo weight significantly. We detected increased PIF expression in the placentae after LPS insult. The LPS induced serum and placenta cytokines were abolished by synthetic PIF treatment and importantly synthetic PIF modulated key members of inflammasome complex NALP-3, ASC, and caspase-1 as well. In conclusion our results indicate that synthetic PIF protects against LPS induced fetal loss, likely through modulation of inflammatory response especially the inflammasome complex. Given that synthetic PIF is currently tested in autoimmune diseases of non-pregnant subjects (clinicaltrials.gov, NCT02239562), therapeutic approach during pregnancy can be envisioned.
[Mh] Termos MeSH primário: Aborto Espontâneo/tratamento farmacológico
Anti-Inflamatórios/uso terapêutico
Citocinas/sangue
Peptídeos/uso terapêutico
[Mh] Termos MeSH secundário: Aborto Espontâneo/etiologia
Aborto Espontâneo/prevenção & controle
Animais
Anti-Inflamatórios/farmacologia
Proteínas Reguladoras de Apoptose/genética
Proteínas Reguladoras de Apoptose/metabolismo
Proteínas Adaptadoras de Sinalização CARD
Caspase 1/genética
Caspase 1/metabolismo
Feminino
Peso Fetal/efeitos dos fármacos
Doenças do Sistema Imune/prevenção & controle
Inflamassomos/metabolismo
Inflamação/etiologia
Lipopolissacarídeos/toxicidade
Camundongos
Proteína 3 que Contém Domínio de Pirina da Família NLR/genética
Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo
Peptídeos/genética
Peptídeos/metabolismo
Peptídeos/farmacologia
Placenta/metabolismo
Gravidez
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents); 0 (Apoptosis Regulatory Proteins); 0 (CARD Signaling Adaptor Proteins); 0 (Cytokines); 0 (Inflammasomes); 0 (Lipopolysaccharides); 0 (NLR Family, Pyrin Domain-Containing 3 Protein); 0 (Nlrp3 protein, mouse); 0 (Peptides); 0 (Pycard protein, mouse); 0 (preimplantation factor, mouse); 0 (preimplantation factor, synthetic); EC 3.4.22.36 (Caspase 1)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170714
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0180642


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[PMID]:28700705
[Au] Autor:Vesterinen HM; Morello-Frosch R; Sen S; Zeise L; Woodruff TJ
[Ad] Endereço:Program on Reproductive Health and the Environment, University of California, San Francisco, United States of America.
[Ti] Título:Cumulative effects of prenatal-exposure to exogenous chemicals and psychosocial stress on fetal growth: Systematic-review of the human and animal evidence.
[So] Source:PLoS One;12(7):e0176331, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Adverse effects of prenatal stress or environmental chemical exposures on fetal growth are well described, yet their combined effect remains unclear. OBJECTIVES: To conduct a systematic review on the combined impact and interaction of prenatal exposure to stress and chemicals on developmental outcomes. METHODS: We used the first three steps of the Navigation Guide systematic review. We wrote a protocol, performed a robust literature search to identify relevant animal and human studies and extracted data on developmental outcomes. For the most common outcome (fetal growth), we evaluated risk of bias, calculated effect sizes for main effects of individual and combined exposures, and performed a random effects meta-analysis of those studies reporting on odds of low birthweight (LBW) by smoking and socioeconomic status (SES). RESULTS: We identified 17 human- and 22 animal-studies of combined chemical and stress exposures and fetal growth. Human studies tended to have a lower risk of bias across nine domains. Generally, we found stronger effects for chemicals than stress, and these exposures were associated with reduced fetal growth in the low-stress group and the association was often greater in high stress groups, with limited evidence of effect modification. We found smoking associated with significantly increased odds of LBW, with a greater effect for high stress (low SES; OR 4.75 (2.46-9.16)) compared to low stress (high SES; OR 1.95 (95% CI 1.53-2.48)). Animal studies generally had a high risk of bias with no significant combined effect or effect modification. CONCLUSIONS: We found that despite concern for the combined effects of environmental chemicals and stress, this is still an under-studied topic, though limited available human studies indicate chemical exposures exert stronger effects than stress, and this effect is generally larger in the presence of stress.
[Mh] Termos MeSH primário: Retardo do Crescimento Fetal/etiologia
Peso Fetal/efeitos dos fármacos
Exposição Materna/efeitos adversos
Estresse Psicológico/complicações
[Mh] Termos MeSH secundário: Poluição do Ar/efeitos adversos
Animais
Etanol/toxicidade
Feminino
Retardo do Crescimento Fetal/induzido quimicamente
Retardo do Crescimento Fetal/epidemiologia
Peso Fetal/fisiologia
Seres Humanos
Metais/toxicidade
Gravidez
Fatores Socioeconômicos
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS
[Nm] Nome de substância:
0 (Metals); 3K9958V90M (Ethanol)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170713
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0176331


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[PMID]:28683173
[Au] Autor:Simic M; Wikström AK; Stephansson O
[Ad] Endereço:Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska University Hospital and Institutet, Stockholm, Sweden.
[Ti] Título:Accelerated fetal growth in early pregnancy and risk of severe large-for-gestational-age and macrosomic infant: a cohort study in a low-risk population.
[So] Source:Acta Obstet Gynecol Scand;96(10):1261-1268, 2017 Oct.
[Is] ISSN:1600-0412
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Our objective was to examine the association between fetal growth in early pregnancy and risk of severe large-for-gestational-age (LGA) and macrosomia at birth in a low-risk population. MATERIAL AND METHODS: Cohort study that included 68 771 women with non-anomalous singleton pregnancies, without history of diabetes or hypertension, based on an electronic database on pregnancies and deliveries in Stockholm-Gotland Region, Sweden, 2008-2014. We performed multivariable logistic regression to estimate the association between accelerated fetal growth occurring in the first through early second trimester as measured by ultrasound and LGA and macrosomia at birth. Restricted analyses were performed in the groups without gestational diabetes and with normal body mass index (18.5-24.9 kg/m ). RESULTS: When adjusting for confounders, the odds of having a severely LGA or macrosomic infant were elevated in mothers with fetuses that were at least 7 days larger than expected as compared with mothers without age discrepancy at the second-trimester scan (adjusted odds ratio 1.80; 95% CI 1.23-2.64 and adjusted odds ratio 2.15; 95% CI 1.55-2.98, respectively). Additionally, mothers without gestational diabetes and mothers with normal weight had an elevated risk of having a severely LGA or macrosomic infant when the age discrepancy by second-trimester ultrasound was at least 7 days. CONCLUSIONS: In a low-risk population, ultrasound-estimated accelerated fetal growth in early pregnancy was associated with an increased risk of having a severely LGA or macrosomic infant.
[Mh] Termos MeSH primário: Desenvolvimento Fetal/fisiologia
Macrossomia Fetal
Peso Fetal
Primeiro Trimestre da Gravidez
[Mh] Termos MeSH secundário: Peso Corporal
Estudos de Coortes
Feminino
Seres Humanos
Recém-Nascido
Placentação
Gravidez
Segundo Trimestre da Gravidez
Medição de Risco
Suécia
Ultrassonografia Pré-Natal
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170707
[St] Status:MEDLINE
[do] DOI:10.1111/aogs.13189


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[PMID]:28651860
[Au] Autor:Simcox LE; Myers JE; Cole TJ; Johnstone ED
[Ad] Endereço:Maternal and Fetal Health Research Center, Institute of Human Development, University of Manchester, Manchester, United Kingdom; St Mary's Hospital, Central Manchester University Hospitals National Health Service Foundation Trust, Manchester Academic Health Science Center, Manchester, United Kingdom
[Ti] Título:Fractional fetal thigh volume in the prediction of normal and abnormal fetal growth during the third trimester of pregnancy.
[So] Source:Am J Obstet Gynecol;217(4):453.e1-453.e12, 2017 Oct.
[Is] ISSN:1097-6868
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Currently, 2-dimensional ultrasound estimation of fetal size rather than fetal growth is used to define fetal growth restriction, but single estimates in late pregnancy lack sensitivity and may identify small for gestational age rather than growth restriction. Single or longitudinal measures of 3-dimensional fractional thigh volume may address this problem. OBJECTIVE: We sought to derive normal values for 3-dimensional fractional thigh volume in the third trimester, determine if fractional thigh volume is superior to 2-dimensional ultrasound biometry alone for detecting fetal growth restriction, and determine whether individualized growth assessment parameters have the potential to identify fetal growth restriction remote from term delivery. STUDY DESIGN: This was a longitudinal prospective cohort study of 115 unselected pregnancies in a tertiary referral unit (St Mary's Hospital, Manchester, United Kingdom). Standard 2-dimensional ultrasound biometry measurements were obtained, along with fractional thigh volume measurements (based on 50% of the femoral diaphysis length). Measurements were used to calculate estimated fetal weight (Hadlock). Individualized growth assessment parameters and percentage deviations in longitudinally measured biometrics were determined using a Web-based system (iGAP; http://iGAP. RESEARCH: bcm.edu). Small for gestational age was defined <10th and fetal growth restriction <3rd customized birthweight centile. Logistic regression was used to compare estimated fetal weight (Hadlock), estimated fetal weight (biparietal diameter-abdominal circumference-fractional thigh volume), fractional thigh volume, and abdominal circumference for the prediction of small for gestational age or fetal growth restriction at birth. Screening performance was assessed using area under the receiver operating characteristic curve. RESULTS: There was a better correlation between fractional thigh volume and estimated fetal weight ((biparietal diameter-abdominal circumference-fractional thigh volume) obtained at 34-36 weeks with birthweight than between 2-dimensional biometry measures such as abdominal circumference and estimated fetal weight (Hadlock). There was also a modest improvement in the detection of both small for gestational age and fetal growth restriction using fractional thigh volume-derived measures compared to standard 2-dimensional measurements (area under receiver operating characteristic curve, 0.86; 95% confidence interval, 0.79-0.94, and area under receiver operating characteristic curve, 0.92; 95% confidence interval, 0.85-0.99, respectively). CONCLUSION: Fractional thigh volume measurements offer some improvement over 2-dimensional biometry for the detection of late-onset fetal growth restriction at 34-36 weeks.
[Mh] Termos MeSH primário: Diáfises/diagnóstico por imagem
Fêmur/diagnóstico por imagem
Retardo do Crescimento Fetal/diagnóstico
Imagem Tridimensional
Ultrassonografia Pré-Natal
[Mh] Termos MeSH secundário: Estudos de Coortes
Diáfises/crescimento & desenvolvimento
Feminino
Fêmur/crescimento & desenvolvimento
Peso Fetal
Idade Gestacional
Seres Humanos
Recém-Nascido
Recém-Nascido Pequeno para a Idade Gestacional
Modelos Logísticos
Estudos Longitudinais
Gravidez
Terceiro Trimestre da Gravidez
Circunferência da Cintura
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170628
[St] Status:MEDLINE


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[PMID]:28619691
[Au] Autor:Rahman A; Cahill LS; Zhou YQ; Hoggarth J; Rennie MY; Seed M; Macgowan CK; Kingdom JC; Adamson SL; Sled JG
[Ad] Endereço:Mouse Imaging Centre, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.
[Ti] Título:A mouse model of antepartum stillbirth.
[So] Source:Am J Obstet Gynecol;217(4):443.e1-443.e11, 2017 Oct.
[Is] ISSN:1097-6868
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Many stillbirths of normally formed fetuses in the third trimester could be prevented via delivery if reliable means to anticipate this outcome existed. However, because the etiology of these stillbirths is often unexplained and although the underlying mechanism is presumed to be hypoxia from placental insufficiency, the placentas often appear normal on histopathological examination. Gestational age is a risk factor for antepartum stillbirth, with a rapid rise in stillbirth rates after 40 weeks' gestation. We speculate that a common mechanism may explain antepartum stillbirth in both the late-term and postterm periods. Mice also show increasing rates of stillbirth when pregnancy is artificially prolonged. The model therefore affords an opportunity to characterize events that precede stillbirth. OBJECTIVE: The objective of the study was to prolong gestation in mice and monitor fetal and placental growth and cardiovascular changes. STUDY DESIGN: From embryonic day 15.5 to embryonic day 18.5, pregnant CD-1 mice received daily progesterone injections to prolong pregnancy by an additional 24 hour period (to embryonic day 19.5). To characterize fetal and placental development, experimental assays were performed throughout late gestation (embryonic day 15.5 to embryonic day 19.5), including postnatal day 1 pups as controls. In addition to collecting fetal and placental weights, we monitored fetal blood flow using Doppler ultrasound and examined the fetoplacental arterial vascular geometry using microcomputed tomography. Evidence of hypoxic organ injury in the fetus was assessed using magnetic resonance imaging and pimonidazole immunohistochemistry. RESULTS: At embryonic day 19.5, mean fetal weights were reduced by 14% compared with control postnatal day 1 pups. Ultrasound biomicroscopy showed that fetal heart rate and umbilical artery flow continued to increase at embryonic day 19.5. Despite this, the embryonic day 19.5 fetuses had significant pimonidazole staining in both brain and liver tissue, indicating fetal hypoxia. Placental weights at embryonic day 19.5 were 21% lower than at term (embryonic day 18.5). Microcomputed tomography showed no change in quantitative morphology of the fetoplacental arterial vasculature between embryonic day 18.5 and embryonic day 19.5. CONCLUSION: Prolongation of pregnancy renders the murine fetus vulnerable to significant growth restriction and hypoxia because of differential loss of placental mass rather than any compromise in fetoplacental blood flow. Our data are consistent with a hypoxic mechanism of antepartum fetal death in human term and postterm pregnancy and validates the inability of umbilical artery Doppler to safely monitor such fetuses. New tests of placental function are needed to identify the late-term fetus at risk of hypoxia to intervene by delivery to avoid antepartum stillbirth.
[Mh] Termos MeSH primário: Retardo do Crescimento Fetal/patologia
Hipóxia Fetal/patologia
Gravidez Prolongada
Natimorto
[Mh] Termos MeSH secundário: Animais
Velocidade do Fluxo Sanguíneo
Encéfalo/patologia
Feminino
Peso Fetal
Idade Gestacional
Frequência Cardíaca Fetal
Fígado/patologia
Pulmão/patologia
Camundongos
Modelos Animais
Tamanho do Órgão
Placenta/diagnóstico por imagem
Placenta/patologia
Gravidez
Artérias Umbilicais/diagnóstico por imagem
Microtomografia por Raio-X
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170617
[St] Status:MEDLINE


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Fotocópia
Alves, Joäo Guilherme B
Texto completo
[PMID]:28485827
[Au] Autor:Lopes KRM; Souza ASR; Figueiroa JN; Alves JGB
[Ad] Endereço:Fetal Cardiology Department, Fetal Medicine Unit, Instituto de Medicina Integral Prof. Fernando Figueira, Recife, Brazil.
[Ti] Título:Correlation between pre-pregnancy body mass index and maternal visceral adiposity with fetal biometry during the second trimester.
[So] Source:Int J Gynaecol Obstet;138(2):133-137, 2017 Aug.
[Is] ISSN:1879-3479
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To determine the correlation between pre-pregnancy body mass index (BMI) and maternal visceral adiposity with fetal biometry during the second trimester. METHODS: A cross-sectional observational study was conducted among pregnant women who received prenatal care at a center in Recife, Brazil, between October 3, 2011, and September 27, 2013. Pre-pregnancy BMI was determined at the first prenatal care visit. Maternal visceral adiposity and fetal biometry were measured at the same ultrasonography session. The associations between maternal and fetal variables were evaluated using the Pearson correlation coefficient (R). The Student t test was used to test the null hypothesis of adjusted correlation coefficients. RESULTS: Overall, 740 women were included. No correlation was found between pre-pregnancy BMI and any of the fetal biometric variables assessed. By contrast, maternal visceral adiposity positively correlated with fetal abdominal circumference (R=0.529), estimated fetal weight (R=0.524), head circumference (R=0.521), femur length (R=0.521), and biparietal diameter (R=0.524; P<0.001 for all fetal variables). These findings remained statistically significant after controlling for pregnancy length. CONCLUSION: Maternal visceral adiposity, but not pre-pregnancy BMI, positively correlated with fetal biometry during the second trimester.
[Mh] Termos MeSH primário: Índice de Massa Corporal
Feto/diagnóstico por imagem
Gordura Intra-Abdominal/diagnóstico por imagem
Segundo Trimestre da Gravidez/fisiologia
Gravidez/fisiologia
Ultrassonografia Pré-Natal
[Mh] Termos MeSH secundário: Adiposidade
Adulto
Biometria
Estudos Transversais
Feminino
Peso Fetal
Seres Humanos
Cuidado Pré-Natal
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170510
[St] Status:MEDLINE
[do] DOI:10.1002/ijgo.12202



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