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[PMID]:28716993
[Au] Autor:Saleh L; Samantar R; Garrelds IM; van den Meiracker AH; Visser W; Danser AHJ
[Ad] Endereço:From the Division of Vascular Medicine and Pharmacology, Department of Internal Medicine (L.S., I.M.G., A.H.v.d.M., W.V., A.H.J.D.) and Division Obstetrics and Prenatal Medicine, Department of Obstetrics and Gynaecology (L.S., R.S., W.V.), Erasmus MC, Rotterdam, The Netherlands.
[Ti] Título:Low Soluble Fms-Like Tyrosine Kinase-1, Endoglin, and Endothelin-1 Levels in Women With Confirmed or Suspected Preeclampsia Using Proton Pump Inhibitors.
[So] Source:Hypertension;70(3):594-600, 2017 Sep.
[Is] ISSN:1524-4563
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Patients with preeclampsia display elevated placenta-derived sFlt-1 (soluble Fms-like tyrosine kinase-1) and endoglin levels and decreased placental growth factor levels. Proton pump inhibitors (PPIs) decrease trophoblast sFlt-1 and endoglin secretion in vitro. PPIs are used during pregnancy to combat reflux disease. Here, we investigated whether PPIs affect sFlt-1 in women with confirmed/suspected preeclampsia, making use of a prospective cohort study involving 430 women. Of these women, 40 took PPIs (6 esomeprazole, 32 omeprazole, and 2 pantoprazole) for 8 to 45 (median 29) days before sFlt-1 measurement. Measurements were only made once, at study entry between weeks 20 and 41 (median 33 weeks). PPI use was associated with lower sFlt-1 levels, with no change in placental growth factor levels, both when compared with all non-PPI users and with 80 gestational age-matched controls selected from the non-PPI users. No sFlt-1/placental growth factor alterations were observed in women using ferrous fumarate or macrogol while, as expected, women using antihypertensive medication displayed higher sFlt-1 levels and lower placental growth factor levels. The PPI use-associated decrease in sFlt-1 was independent of the application of antihypertensive drugs and also occurred when restricting our analysis to patients with hypertensive disease of pregnancy at study entry. PPI users displayed more cases with preexisting proteinuria, less gestational hypertension, and a lower number of neonatal sepsis cases. Finally, their plasma endoglin and endothelin-1 levels were lower while sFlt-1 levels correlated positively with both. In conclusion, PPI use associates with low sFlt-1, endoglin, and endothelin-1 levels, warranting prospective trials to investigate the therapeutic potential of PPIs in preeclampsia.
[Mh] Termos MeSH primário: Endoglina/metabolismo
Endotelina-1/metabolismo
Pré-Eclâmpsia
Inibidores da Bomba de Prótons
Receptor 1 de Fatores de Crescimento do Endotélio Vascular
[Mh] Termos MeSH secundário: Adulto
Determinação da Pressão Arterial/métodos
Estudos de Coortes
Feminino
Refluxo Gastroesofágico/prevenção & controle
Idade Gestacional
Seres Humanos
Países Baixos/epidemiologia
Testes de Função Placentária/métodos
Pré-Eclâmpsia/tratamento farmacológico
Pré-Eclâmpsia/epidemiologia
Pré-Eclâmpsia/metabolismo
Pré-Eclâmpsia/fisiopatologia
Gravidez
Estudos Prospectivos
Inibidores da Bomba de Prótons/administração & dosagem
Inibidores da Bomba de Prótons/efeitos adversos
Receptor 1 de Fatores de Crescimento do Endotélio Vascular/análise
Receptor 1 de Fatores de Crescimento do Endotélio Vascular/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Endoglin); 0 (Endothelin-1); 0 (Proton Pump Inhibitors); EC 2.7.10.1 (Vascular Endothelial Growth Factor Receptor-1)
[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:170719
[St] Status:MEDLINE
[do] DOI:10.1161/HYPERTENSIONAHA.117.09741


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[PMID]:26602956
[Au] Autor:Heazell AE; Whitworth M; Duley L; Thornton JG
[Ad] Endereço:Maternal and Fetal Health Research Centre, University of Manchester, 5th floor (Research), St Mary's Hospital, Oxford Road, Manchester, UK, M13 9WL.
[Ti] Título:Use of biochemical tests of placental function for improving pregnancy outcome.
[So] Source:Cochrane Database Syst Rev;(11):CD011202, 2015 Nov 25.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The placenta has an essential role in determining the outcome of pregnancy. Consequently, biochemical measurement of placentally-derived factors has been suggested as a means to improve fetal and maternal outcome of pregnancy. OBJECTIVES: To assess whether clinicians' knowledge of the results of biochemical tests of placental function is associated with improvement in fetal or maternal outcome of pregnancy. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 July 2015) and reference lists of retrieved studies. SELECTION CRITERIA: Randomised, cluster-randomised or quasi-randomised controlled trials assessing the merits of the use of biochemical tests of placental function to improve pregnancy outcome.Studies were eligible if they compared women who had placental function tests and the results were available to their clinicians with women who either did not have the tests, or the tests were done but the results were not available to the clinicians. The placental function tests were any biochemical test of placental function carried out using the woman's maternal biofluid, either alone or in combination with other placental function test/s. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trials for inclusion, extracted data and assessed trial quality. Authors of published trials were contacted for further information. MAIN RESULTS: Three trials were included, two quasi-randomised controlled trials and one randomised controlled trial. One trial was deemed to be at low risk of bias while the other two were at high risk of bias. Different biochemical analytes were measured - oestrogen was measured in one trial and the other two measured human placental lactogen (hPL). One trial did not contribute outcome data, therefore, the results of this review are based on two trials with 740 participants.There was no evidence of a difference in the incidence of death of a baby (risk ratio (RR) 0.88, 95% confidence interval (CI) 0.36 to 2.13, two trials, 740 participants (very low quality evidence)) or the frequency of a small-for-gestational-age infant (RR 0.44, 95% CI 0.16 to 1.19, one trial, 118 participants (low quality evidence)).In terms of this review's secondary outcomes, there was no evidence of a clear difference between women who had biochemical tests of placental function compared with standard antenatal care for the incidence of stillbirth (RR 0.56, 95% CI 0.16 to 1.88, two trials, 740 participants (very low quality evidence)) or neonatal death (RR 1.62, 95% CI 0.39 to 6.74, two trials, 740 participants, very low quality evidence)) although the directions of any potential effect were in opposing directions. There was no evidence of a difference between groups in elective delivery (RR 0.98, 95% CI 0.84 to 1.14, two trials, 740 participants (low quality evidence)), caesarean section (one trial, RR 0.48, 95% CI 0.15 to 1.52, one trial, 118 participants (low quality evidence)), change in anxiety score (mean difference -2.40, 95% CI -4.78 to -0.02, one trial, 118 participants), admissions to neonatal intensive care (RR 0.32, 95% CI 0.03 to 3.01, one trial, 118 participants), and preterm birth before 37 weeks' gestation (RR 2.90, 95% CI 0.12 to 69.81, one trial, 118 participants). One trial (118 participants) reported that there were no cases of serious neonatal morbidity. Maternal death was not reported.A number of this review's secondary outcomes relating to the baby were not reported in the included studies, namely: umbilical artery pH < 7.0, neonatal intensive care for more than seven days, very preterm birth (< 32 weeks' gestation), need for ventilation, organ failure, fetal abnormality, neurodevelopment in childhood (cerebral palsy, neurodevelopmental delay). Similarly, a number of this review's maternal secondary outcomes were not reported in the included studies (admission to intensive care, high dependency unit admission, hospital admission for > seven days, pre-eclampsia, eclampsia, and women's perception of care). AUTHORS' CONCLUSIONS: There is insufficient evidence to support the use of biochemical tests of placental function to reduce perinatal mortality or increase identification of small-for-gestational-age infants. However, we were only able to include data from two studies that measured oestrogens and hPL. The quality of the evidence was low or very low.Two of the trials were performed in the 1970s on women with a variety of antenatal complications and this evidence cannot be generalised to women at low-risk of complications or groups of women with specific pregnancy complications (e.g. fetal growth restriction). Furthermore, outcomes described in the 1970s may not reflect what would be expected at present. For example, neonatal mortality rates have fallen substantially, such that an infant delivered at 28 weeks would have a greater chance of survival were those studies repeated; this may affect the primary outcome of the meta-analysis.With data from just two studies (740 women), this review is underpowered to detect a difference in the incidence of death of a baby or the frequency of a small-for-gestational-age infant as these have a background incidence of approximately 0.75% and 10% of pregnancies respectively. Similarly, this review is underpowered to detect differences between serious and/or rare adverse events such as severe neonatal morbidity. Two of the three included studies were quasi-randomised, with significant risk of bias from group allocation. Additionally, there may be performance bias as in one of the two studies contributing data, participants receiving standard care did not have venepuncture, so clinicians treating participants could identify which arm of the study they were in. Future studies should consider more robust randomisation methods and concealment of group allocation and should be adequately powered to detect differences in rare adverse events.The studies identified in this review examined two different analytes: oestrogens and hPL. There are many other placental products that could be employed as surrogates of placental function, including: placental growth factor (PlGF), human chorionic gonadotrophin (hCG), plasma protein A (PAPP-A), placental protein 13 (PP-13), pregnancy-specific glycoproteins and progesterone metabolites and further studies should be encouraged to investigate these other placental products. Future randomised controlled trials should test analytes identified as having the best predictive reliability for placental dysfunction leading to small-for-gestational-age infants and perinatal mortality.
[Mh] Termos MeSH primário: Placenta/fisiologia
Testes de Função Placentária/métodos
Resultado da Gravidez
[Mh] Termos MeSH secundário: Biomarcadores/sangue
Feminino
Seres Humanos
Recém-Nascido
Recém-Nascido Pequeno para a Idade Gestacional
Morte Perinatal
Gravidez
Ensaios Clínicos Controlados Aleatórios como Assunto
Natimorto/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Biomarkers)
[Em] Mês de entrada:1603
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:151126
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD011202.pub2


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[PMID]:25581778
[Au] Autor:Sobrevia L; Salsoso R; Sáez T; Sanhueza C; Pardo F; Leiva A
[Ad] Endereço:Cellular and Molecular Physiology Laboratory (CMPL), Division of Obstetrics and Gynaecology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile; University of Queensland Centre for Clinical Research (UQCCR), Faculty of Medicine and Biomedical Sciences, University of Queensland, Herston, Queensland, Australia; Department of Physiology, Faculty of Pharmacy, Universidad de Sevilla, Seville, Spain.
[Ti] Título:Insulin therapy and fetoplacental vascular function in gestational diabetes mellitus.
[So] Source:Exp Physiol;100(3):231-8, 2015 Mar.
[Is] ISSN:1469-445X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:NEW FINDINGS: What is the topic of this review? This review focuses on the effects of insulin therapy on fetoplacental vasculature in gestational diabetes mellitus and the potentiating effects of adenosine on this therapy. What advances does it highlight? This review highlights recent studies exploring a potential functional link between insulin receptors and their dependence on adenosine receptor activation (insulin-adenosine axis) to restore placental endothelial function in gestational diabetes mellitus. Gestational diabetes mellitus (GDM) is a disease that occurs during pregnancy and is associated with maternal and fetal hyperglycaemia. Women with GDM are treated via diet to control their glycaemia; however, a proportion of these patients do not achieve the recommended values of glycaemia and are subjected to insulin therapy until delivery. Even if a diet-treated GDM pregnancy leads to normal maternal and newborn glucose levels, fetoplacental vascular dysfunction remains evident. Thus, control of glycaemia via diet does not prevent GDM-associated fetoplacental vascular and metabolic alterations. We review the available information regarding insulin therapy in the context of its potential consequences for fetoplacental vascular function in GDM. We propose the possibility that insulin therapy to produce normoglycaemia in the mother and newborn may require additional therapeutic measures to restore the normal metabolic condition of the vascular network in GDM. A role for A1 and A2A adenosine receptors and insulin receptors A and B as well as a potential functional link in the cell signalling associated with the activation of these receptors is proposed. This possibility could be helpful for the planning of strategies, including adenosine receptor-improved insulin therapy, for the treatment of GDM patients, thereby promoting the wellbeing of the growing fetus, newborn and mother.
[Mh] Termos MeSH primário: Diabetes Gestacional/tratamento farmacológico
Diabetes Gestacional/fisiopatologia
Insulina/uso terapêutico
Circulação Placentária/fisiologia
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Recém-Nascido
Testes de Função Placentária/métodos
Gravidez
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Insulin)
[Em] Mês de entrada:1511
[Cu] Atualização por classe:150227
[Lr] Data última revisão:
150227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150113
[St] Status:MEDLINE
[do] DOI:10.1113/expphysiol.2014.082743


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[PMID]:24712853
[Au] Autor:Bourjeily G; Butterfield K; Curran P; Lambert-Messerlian G
[Ad] Endereço:Warren Alpert Medical School of Brown University , Providence, RI , USA .
[Ti] Título:Obstructive sleep apnea is associated with alterations in markers of fetoplacental wellbeing.
[So] Source:J Matern Fetal Neonatal Med;28(3):262-6, 2015 Feb.
[Is] ISSN:1476-4954
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Obstructive sleep apnea (OSA) has been associated with adverse fetal outcomes in some studies. Second trimester Down syndrome screening markers reflect fetal and fetoplacental wellbeing. We aimed to compare markers of fetal and feto-placental wellbeing in women with OSA and low risk controls. METHODS: A retrospective case-control study of pregnant women with OSA and available second trimester markers was performed. Controls were screened for sleep disordered breathing (SDB) at the time of delivery using a questionnaire. Women at low risk for OSA were selected. Marker levels were adjusted for gestational age and race and reported as multiples of median and later adjusted for body mass index (BMI). RESULTS: Twenty-four OSA cases and 166 controls were identified. Women with OSA had a higher mean BMI when compared to controls (37.1 ± 12.7 versus 24.1 ± 5.1, p = 0.03). Estriol (uE3) multiples of the median (MoM) levels were lower in women with OSA compared to controls, even after adjusting for BMI, 0.74 (interquartile range (IQR) 0.45) versus 1.06 (IQR 0.38), respectively, p = 0.026. Once adjusted for BMI, alpha feto-protein (AFP) MoM levels were no longer significantly different in women with OSA compared to controls. CONCLUSION: OSA is associated with reduced serum uE3 levels, independently of BMI, possibly indicating fetal distress.
[Mh] Termos MeSH primário: Biomarcadores/sangue
Estriol/sangue
Complicações na Gravidez
Apneia Obstrutiva do Sono/sangue
alfa-Fetoproteínas/metabolismo
[Mh] Termos MeSH secundário: Adulto
Índice de Massa Corporal
Estudos de Casos e Controles
Feminino
Desenvolvimento Fetal/fisiologia
Idade Gestacional
Seres Humanos
Circulação Placentária
Testes de Função Placentária
Gravidez
Estudos Retrospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (alpha-Fetoproteins); FB33469R8E (Estriol)
[Em] Mês de entrada:1602
[Cu] Atualização por classe:150219
[Lr] Data última revisão:
150219
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:140410
[St] Status:MEDLINE
[do] DOI:10.3109/14767058.2014.913131


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[PMID]:24381148
[Au] Autor:Carubbi C; Masselli E; Gesi M; Galli D; Mirandola P; Vitale M; Gobbi G
[Ad] Endereço:Department of Biomedical, Biotechnological and Translational Sciences (S.Bi.Bi.T.), Anatomy and Histology Unit, University of Parma, Ospedale Maggiore, Parma, Italy.
[Ti] Título:Cytofluorimetric platelet analysis.
[So] Source:Semin Thromb Hemost;40(1):88-98, 2014 Feb.
[Is] ISSN:1098-9064
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Blood platelets are highly specialized cells that drive hemostatic events and tissue repair mechanisms at the site of vascular injury. Their peculiar morphology and certain functional characteristics can be analyzed by flow cytometry (FCM). Specifically, platelet activation, a hallmark of prothrombotic states and inflammatory conditions, is associated with changes in expression of both surface and intracellular antigens that are recognized by specific monoclonal antibodies. Assessment of platelet activation status as ex vivo or in vitro reactivity to specific agonists has become relevant in particular conditions (namely, cardiovascular diseases, hematological malignancies, monitoring of pharmacological antiaggregation). In addition, aberrant surface marker expression that characterizes inherited and acquired platelet function disorders is also detected by FCM. This review discusses the main applications of FCM in platelet analyses, which are relevant for both research and clinical settings.
[Mh] Termos MeSH primário: Plaquetas/metabolismo
Plaquetas/patologia
Citometria de Fluxo/métodos
[Mh] Termos MeSH secundário: Animais
Anticorpos Monoclonais/química
Antígenos de Plaquetas Humanas/biossíntese
Regulação da Expressão Gênica
Seres Humanos
Testes de Função Placentária/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Antibodies, Monoclonal); 0 (Antigens, Human Platelet)
[Em] Mês de entrada:1409
[Cu] Atualização por classe:140128
[Lr] Data última revisão:
140128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:140102
[St] Status:MEDLINE
[do] DOI:10.1055/s-0033-1363472


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[PMID]:23772778
[Au] Autor:Londero AP; Bertozzi S; Visentin S; Fruscalzo A; Driul L; Marchesoni D
[Ad] Endereço:Clinic of Obstetrics and Gynecology, AOU SM della Misericordia, Udine, Italy. ambrogio.londero@gmail.com
[Ti] Título:High placental index and poor pregnancy outcomes: a retrospective study of 18,386 pregnancies.
[So] Source:Gynecol Endocrinol;29(7):666-9, 2013 Jul.
[Is] ISSN:1473-0766
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Our aim was to state the correlation between placental index and pregnancy outcomes or in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) pregnancies. MATERIALS AND METHODS: We included in this retrospective study all singleton births in a third level clinic during the period 2001-2011 (n = 18,386). We divided placental index into quartiles and analyzed the differences between the groups in term of pregnancy outcomes. Then, we estimated crude and adjusted odds ratios (ORs) for placental index over the third centile of the distribution to correlate with pregnancy outcomes. We also analyzed the correlation between IVF/ICSI conceived pregnancies and placental index. RESULTS: Poor pregnancy outcomes were overrepresented in the highest quartile of placental index distribution. Thus, placental index was higher in pregnancies characterized by pregnancy-related hypertensive disorders (PRHDs), small for gestational age infants, newborn needing cardiopulmonary resuscitation or hospitalization in neonatal intensive care unit. These findings were independent of maternal age, length of gestation at delivery, IVF/ICSI conception and ethnicity. For IVF/ICSI pregnancies, the OR for being over the third quartile of placental index distribution was 2.01 (CI.95 1.40-2.90) after adjustment for maternal age, length of gestation, ethnicity, birth weight, parity, fetal sex, alteration of glucose metabolism in pregnancy and PRHDs. CONCLUSIONS: We found a high placental index among pregnancies characterized by poor outcomes and conceived by IVF/ICSI.
[Mh] Termos MeSH primário: Peso Fetal/fisiologia
Indicadores Básicos de Saúde
Placentação
Resultado da Gravidez/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Asfixia Neonatal/epidemiologia
Asfixia Neonatal/terapia
Reanimação Cardiopulmonar/estatística & dados numéricos
Estudos de Coortes
Feminino
Fertilização In Vitro/estatística & dados numéricos
Seres Humanos
Recém-Nascido
Masculino
Testes de Função Placentária
Gravidez
Complicações na Gravidez/epidemiologia
Complicações na Gravidez/etiologia
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1402
[Cu] Atualização por classe:151119
[Lr] Data última revisão:
151119
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:130619
[St] Status:MEDLINE
[do] DOI:10.3109/09513590.2013.798273


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[PMID]:23618930
[Au] Autor:Miller LA
[Ad] Endereço:Perinatal Risk Management and Education Services, Portland, Oregon, USA.
[Ti] Título:The placenta as expert witness.
[So] Source:J Perinat Neonatal Nurs;27(2):110-1, 2013 Apr-Jun.
[Is] ISSN:1550-5073
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Erros de Diagnóstico/prevenção & controle
Doenças Placentárias/diagnóstico
Placenta/patologia
Testes de Função Placentária
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Unidade Hospitalar de Ginecologia e Obstetrícia/normas
Testes de Função Placentária/métodos
Testes de Função Placentária/utilização
Guias de Prática Clínica como Assunto
Gravidez
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1404
[Cu] Atualização por classe:130426
[Lr] Data última revisão:
130426
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:130427
[St] Status:MEDLINE
[do] DOI:10.1097/JPN.0b013e31828f6a01


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[PMID]:23444746
[Au] Autor:Li WJ; Wei ZT; Yan RL; Zhang YL
[Ad] Endereço:Department of Fetal Medicine, the First Affiliated Hospital of Jinan University, Guangzhou China. mood0904@yahoo.com.cn
[Ti] Título:Detection of placenta elasticity modulus by quantitative real-time shear wave imaging.
[So] Source:Clin Exp Obstet Gynecol;39(4):470-3, 2012.
[Is] ISSN:0390-6663
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To explore the clinical values in detecting the placental elastic modulus using real-time quantitative shear wave elasticity imaging. METHODS: A total of 30 women in the late pregnancy stage without complications and having normal, single pregnancies, as well as normal fetal growth, amniotic fluid index, and anterior placenta were selected. A real-time elasticity imaging shear wave ultrasonic diagnostic apparatus was used to randomly select regions of interest at the central and edge of the placenta. The elastography imaging mode was launched to measure the elasticity of the elastic modulus of these placental parts. A total of 15 measured values were obtained at the placental center and edge for each pregnancy case. Umbilical artery and uterine artery pulsatility index (PI) values for 18 cases were also randomly measured. RESULTS: The average value of 30 placental edges of the elastic modulus (n = 15) was (7.60 +/- 1.71) kPa. The average value of the 30 placental central elastic modulus (n = 15 ) was (7.84 +/- 1.68) kPa. No significant difference was observed between placenta central and edge elastic modulus. The PI mean value of umbilical artery in 18 cases was 0.94, whereas the average PI values of the uterine artery was 0.83. No linear correlation was found among the elastic modulus, the placental uterine artery PI values, and the umbilical artery PI values (p > 0.05). CONCLUSION: No difference between the placental center of normal pregnancies and the edge of the elastic modulus was detected. The elastic modulus of the placenta could be obtained in the best position. The placenta varied greatly between elastic modulus. No correlation was found between the placental elastic modulus, the uterine artery, and umbilical artery PI values. Real-time shear wave elasticity imaging technology can provide morphological evidence of placental function, which may emerge as a new clinical assessment approach.
[Mh] Termos MeSH primário: Técnicas de Imagem por Elasticidade/métodos
Placenta/fisiopatologia
Testes de Função Placentária/métodos
Ultrassonografia Pré-Natal/métodos
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Gravidez
Fluxo Pulsátil
Artérias Umbilicais/diagnóstico por imagem
Artérias Umbilicais/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1303
[Cu] Atualização por classe:161125
[Lr] Data última revisão:
161125
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:130301
[St] Status:MEDLINE


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[PMID]:22895915
[Au] Autor:Neilson JP
[Ad] Endereço:Department of Women's and Children's Health, The University of Liverpool, First Floor, Liverpool, UK. jneilson@liverpool.ac.uk.
[Ti] Título:Biochemical tests of placental function for assessment in pregnancy.
[So] Source:Cochrane Database Syst Rev;(8):CD000108, 2012 Aug 15.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Biochemical tests of placental or feto-placental function were widely used in the 1960s and 1970s in high-risk pregnancies to try to predict, and thus try to avoid, adverse fetal outcome. OBJECTIVES: To assess the effects of performing biochemical tests of placental function in high-risk, low-risk, or unselected pregnancies. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (10 May 2012). SELECTION CRITERIA: Controlled trials (randomized or 'quasi-randomized') that compare the use of biochemical tests of placental function in pregnancy with non-use. DATA COLLECTION AND ANALYSIS: Trial quality was assessed and data were extracted by the review author. MAIN RESULTS: A single eligible trial of poor quality was identified. It involved 622 women with high-risk pregnancies who had had plasma (o)estriol estimations. Women were allocated to have their (o)estriol results revealed or concealed on the basis of hospital record number (with attendant risk of selection bias). There were no obvious differences in perinatal mortality (relative risk (RR) 0.88, 95% confidence interval (CI) 0.36 to 2.13) or planned delivery (RR 0.97, 95% CI 0.81 to 1.15) between the two groups. AUTHORS' CONCLUSIONS: The available trial data do not support the use of (o)estriol estimation in high-risk pregnancies. The single small trial available does not have the power to exclude a beneficial effect but this is probably of historical interest since biochemical testing has been superseded by biophysical testing in antepartum fetal assessment.
[Mh] Termos MeSH primário: Estriol/sangue
Doenças Fetais/diagnóstico
Gravidez de Alto Risco/sangue
[Mh] Termos MeSH secundário: Biomarcadores/sangue
Feminino
Seres Humanos
Testes de Função Placentária/métodos
Gravidez
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Biomarkers); FB33469R8E (Estriol)
[Em] Mês de entrada:1209
[Cu] Atualização por classe:160602
[Lr] Data última revisão:
160602
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:120817
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD000108.pub2


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[PMID]:22311629
[Au] Autor:Gerotziafas GT; Zarifis J; Bandi A; Mossialos L; Galea V; Tsinopoulos G; Chaari M; Baccouche H; Sassi M; Elalamy I
[Ad] Endereço:Service d'Hématologie Biologique, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Paris, France. grigoris.gerotziafas@tnn.aphp.fr
[Ti] Título:Description of response to aspirin and clopidogrel in outpatients with coronary artery disease using multiple electrode impedance aggregometry.
[So] Source:Clin Appl Thromb Hemost;18(4):356-63, 2012 Jul.
[Is] ISSN:1938-2723
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Identification of outpatients with high platelet reactivity (HPR) on antiplatelet treatment is an unmet need. The present study was conducted in healthy individuals (n = 50) and in outpatients with coronary artery disease (CAD) at a distance from the acute ischemic episode (aspirin group, n = 71; aspirin/clopidogrel group, n = 106). We studied the feasibility and the precision of whole blood multiple electrode aggregometry (MEA) after triggering platelet aggregation by arachidonic acid or adenosine diphospate (ADP). The MEA can be performed on whole blood within 2 hours after sample venipuncture. The threshold for the diagnosis of HPR is situated at 55 and 50 U for the arachidonic acid and ADP test, respectively. Frequency of HPR was 7% and 20% in aspirin and aspirin/clopidogrel groups, respectively. In 3.8% of patients in aspirin/clopidogrel group, combined HPR on aspirin and clopidogrel was found. In outpatients with CAD, use of MEA is feasible for the diagnosis of HPR.
[Mh] Termos MeSH primário: Aspirina/administração & dosagem
Doença da Artéria Coronariana/sangue
Doença da Artéria Coronariana/tratamento farmacológico
Inibidores da Agregação de Plaquetas/administração & dosagem
Agregação Plaquetária/efeitos dos fármacos
Ticlopidina/análogos & derivados
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Testes de Função Placentária/métodos
Ticlopidina/administração & dosagem
[Pt] Tipo de publicação:CLINICAL TRIAL; COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Platelet Aggregation Inhibitors); A74586SNO7 (clopidogrel); OM90ZUW7M1 (Ticlopidine); R16CO5Y76E (Aspirin)
[Em] Mês de entrada:1210
[Cu] Atualização por classe:131121
[Lr] Data última revisão:
131121
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:120208
[St] Status:MEDLINE
[do] DOI:10.1177/1076029611429122



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