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[PMID]:27777190
[Au] Autor:Deng XJ; Chen CH; Qiu YW; Xiao SF; Liao SX; Zhong M; Yang F
[Ad] Endereço:Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. E-mail: dengxujie@126.com.
[Ti] Título:[Correlation analysis of fetal middle cerebral artery peak systolic velocity, cardiothoracic ratio and crown-rump length in early pregnancy].
[So] Source:Nan Fang Yi Ke Da Xue Xue Bao;36(10):1312-1315, 2016 Oct 20.
[Is] ISSN:1673-4254
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:OBJECTIVE: To explore the pattern of variations in middle cerebral artery peak systolic velocity (MCA PSV) and cardiothoracic ratio (CTR) during early pregnancy, establish their reference ranges and explore their correlation with the crown-rump length (CRL). METHODS: A total of 522 pregnant women with normal findings in antenatal examinations underwent routine color Doppler ultrasound examination to collect the data of MCA PSV, CTR and CRL. The reference ranges of MCA PSV and CTR for different CRL levels were established, and the correlation of MCA PSV and CTR with CRL was analyzed. RESULTS: During the first trimester, MCA PSV and CRL showed a moderate positive correlation with a correlation coefficient of 0.426 (P<0.001), while CTR and CRL showed no significant correlation (0.168, P<0.001). The reference range of MCA PSV was 14.35 (14.08-14.62) cm/s and that of CTR was 0.34 (0.33-0.34) during early pregnancy. CONCLUSION: Color Doppler ultrasound is a safe and feasible modality to assess fetal MCA PSV and CTR for detecting fetal growth abnormalities in early pregnancy. The established reference ranges of MCA PSV and CTR offer a clinical theoretical basis for detecting α-thalassemia in early pregnancy.
[Mh] Termos MeSH primário: Velocidade do Fluxo Sanguíneo
Estatura Cabeça-Cóccix
Artéria Cerebral Média/fisiologia
Ultrassonografia Pré-Natal
[Mh] Termos MeSH secundário: Feminino
Doenças Fetais/diagnóstico por imagem
Seres Humanos
Gravidez
Primeiro Trimestre da Gravidez
Valores de Referência
Sístole
Ultrassonografia Doppler em Cores
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


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[PMID]:28732073
[Au] Autor:Rashid H; Ma E; Ferdous F; Ekström EC; Wagatsuma Y
[Ad] Endereço:International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
[Ti] Título:First-trimester fetal growth restriction and the occurrence of miscarriage in rural Bangladesh: A prospective cohort study.
[So] Source:PLoS One;12(7):e0181967, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Fetal growth restriction in early pregnancy increases the risk of adverse pregnancy outcome, which has a significant social and psychological impact on women. There is limited information related to community-based study to evaluate early indicators related to miscarriage. The aim of this study is to examine the relationship between fetal growth restriction, measured by ultrasound crown-rump length (CRL), and subsequent occurrence of miscarriage in pregnant women in rural Bangladesh. The study was conducted within the Maternal and Infant Nutrition Interventions Trial in Matlab (MINIMat study), Bangladesh. A total of 4436 pregnant women were enrolled in the study when they were at less than 14 gestational weeks. The expected CRL was determined based on an established growth curve of gestational age and CRL, and deviation from this curve of CRL was expressed as a z-score. After identifying related covariates, the multiple Poisson regression model was used to determine the independent contribution from the CRL to miscarriage. A total of 3058 singleton pregnant women were included in analyses, with 92 miscarriages and 2966 continued pregnancies. The occurrence of miscarriages was significantly higher in the smaller categories of CRL z-score after adjustments for maternal age, parity, early pregnancy BMI, gestational age at CRL measurement and socioeconomic status (adjusted relative risk [95% confidence interval]: 1.03 [1.02-1.05] for less than -2 z-score). In a rural Bangladesh population, smaller than expected CRL for the gestational age was related to subsequent miscarriage. Ultrasound biometry information together with careful clinical assessment should provide much needed attention and care for pregnant women.
[Mh] Termos MeSH primário: Aborto Espontâneo/etiologia
Retardo do Crescimento Fetal/fisiopatologia
Primeiro Trimestre da Gravidez/fisiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Bangladesh
Estatura Cabeça-Cóccix
Feminino
Idade Gestacional
Seres Humanos
Idade Materna
Paridade/fisiologia
Gravidez
Estudos Prospectivos
População Rural
Ultrassonografia Pré-Natal/métodos
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170722
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0181967


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[PMID]:28622784
[Au] Autor:Bardin R; Oron G; Levy Y; Sapir O; Meizner I; Fisch B; Wiznitzer A; Hadar E
[Ad] Endereço:Helen Schneider's Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
[Ti] Título:First-trimester inter- and intrafetal size discrepancies in bichorionic twins conceived by in vitro fertilization: can it predict pregnancy outcome?
[So] Source:Fertil Steril;108(2):296-301, 2017 Aug.
[Is] ISSN:1556-5653
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the association between first-trimester inter- and intrafetal size discrepancies and pregnancy outcome, among bichorionic-biamniotic twins conceived by IVF. DESIGN: A retrospective study design was used. SETTING: Tertiary university-affiliated medical center. PATIENT(S): All women with a viable first-trimester bichorionic-biamniotic twin gestation, who conceived after IVF in 2007-2015. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): The association between fetal size differences and pregnancy outcome was analyzed. Intrafetal size discordance was defined as a difference between the actual gestational age calculated by ovum pickup (OPU) date and the evaluated gestational age by crown-rump length (CRL), for each twin. Intertwin size discrepancy was defined as a difference in CRL between the twins. The primary outcome was the number of live-born fetuses; the secondary outcome measures were gestational age at birth, birth weight percentile, and birth weight discordancy. RESULT(S): A total of 277 women met the study criteria and were divided into three groups by outcome: 218 (78.7%) live-born twins, 41 (14.8%) live-born singleton, and 19 (6.5%) non-live-born pregnancy. Among the smaller than expected twin, the association of CRL-OPU differences with the primary outcome was significant for twin live-born delivery (-1.43 day), singleton live-born delivery (-4.12 days), and non-live-born pregnancy (-6.72 days). For the relatively larger twin, the association was significant for non-live-born pregnancy (-4.33 days) compared with any live-born delivery, either singleton (-0.95 days) or twin (-0.21 days). CONCLUSION(S): Among IVF conceived twin gestations, a CRL-OPU gap was associated with an increased risk of a negative pregnancy outcome.
[Mh] Termos MeSH primário: Estatura Cabeça-Cóccix
Fertilização In Vitro/estatística & dados numéricos
Infertilidade/epidemiologia
Infertilidade/terapia
Resultado da Gravidez/epidemiologia
Primeiro Trimestre da Gravidez
Gravidez de Gêmeos/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Biomarcadores
Feminino
Idade Gestacional
Seres Humanos
Infertilidade/diagnóstico
Israel/epidemiologia
Gravidez
Prevalência
Estudos Retrospectivos
Resultado do Tratamento
Gêmeos Dizigóticos/estatística & dados numéricos
Ultrassonografia Pré-Natal/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE; TWIN STUDY
[Nm] Nome de substância:
0 (Biomarkers)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170825
[Lr] Data última revisão:
170825
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170618
[St] Status:MEDLINE


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[PMID]:28604823
[Au] Autor:D'ippolito S; Di Simone N; Orteschi D; Pomponi MG; Genuardi M; Sisti LG; Castellani R; Rossi ED; Scambia G; Zollino M
[Ad] Endereço:Department of Obstetrics and Gynecology, Università Cattolica Del Sacro Cuore, Fondazione Policlinico A. Gemelli, Rome, Italy.
[Ti] Título:The chromosome analysis of the miscarriage tissue. Miscarried embryo/fetal crown rump length (CRL) measurement: A practical use.
[So] Source:PLoS One;12(6):e0178113, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To investigate whether miscarried embryo/fetal crown rump length (CRL) measurement may yield a practical application for predicting a conclusive result at the cytogenetic analysis of miscarriage tissue. Our study might help in improving the cytogenetic method, the results of which may be affected by maternal cell contamination (MCC). In particular, we aimed at establishing whether the miscarried embryo/fetal CRL measurement shows accuracy in predicting the possibility of MCC and the scan cut-off value useful to this purpose and, as a result, suggest a multi-step procedure for the genetic ascertainment. METHODS: Women experiencing at least two miscarriages of less than 20 weeks size at the Pregnancy Loss Unit at Fondazione Policlinico A. Gemelli underwent a scan before surgery. The CRL value was recorded. After the dilatation and courettage (D&C) procedure, miscarriage tissue was processed through the proposed multi-step procedure before performing oligo-nucleotide-based and SNP (single nucleotide polymorphisms)-based comparative genomic hybridization (CGH+SNP) microarray analysis. RESULTS: 63 women and 63 miscarriages met the criteria. By using the Receiving Operator Characteristic (ROC) curves, CRL showed an AUC of 0.816 (95%CI:0.703-0.928,p<0.001). A CRL≥24.5 mm cut-off value showed a higher positive likelihood ratio (5.27) but, conversely, a higher negative likelihood ratio (0.64) in predicting the possibility of MCC. Microarray analysis was successful in the totality of cases in which the embryo/fetal origin of miscarriage tissues was proven. CONCLUSIONS: The 24.5 mm CRL value emerges as the most suitable cut-off enabling the identification of cases in which the embryo-fetal component can be isolated in the absence of MCC and the chromosomal array provide informative results.
[Mh] Termos MeSH primário: Feto Abortado
Aborto Espontâneo/genética
Estatura Cabeça-Cóccix
Análise Citogenética
Feto/anatomia & histologia
[Mh] Termos MeSH secundário: Adulto
Aberrações Cromossômicas
Feminino
Aconselhamento Genético
Seres Humanos
Repetições de Microssatélites
Meia-Idade
Gravidez
Curva ROC
Ultrassonografia Pré-Natal
[Pt] Tipo de publicação:JOURNAL ARTICLE
[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:170613
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0178113


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[PMID]:28164322
[Au] Autor:Meengeonthong D; Luewan S; Sirichotiyakul S; Tongsong T
[Ad] Endereço:Department of Obstetrics and Gynecology, Faculty of Medicine Chiang Mai University, Thailand.
[Ti] Título:Reference ranges of placental volume measured by virtual organ computer-aided analysis between 10 and 14 weeks of gestation.
[So] Source:J Clin Ultrasound;45(4):185-191, 2017 May.
[Is] ISSN:1097-0096
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To establish the reference ranges of the placental volume between 10 and 14 weeks of gestation of Thai fetuses. METHODS: The placental volumes were acquired in normal pregnancies between 10 and 14 weeks of gestation using transabdominal three-dimensional ultrasound. The placental volume was then analyzed using VOCAL (virtual organ computer-aided analysis) technique with a rotation angle of 30°. The measured values were regressed to identify the best-fit model. RESULTS: A total of 236 volume datasets met the inclusion criteria and were used for offline analysis. Placental volume significantly increased with increasing crown-rump length (CRL). The best-fit regression models for predicted mean and SD as a function of CRL, available for z score calculation and construction of the percentile chart, are as follows: [Formula: see text] CONCLUSION: Reference ranges of placental volume have been constructed. This normative data may be a useful tool in the evaluation of various conditions affecting placental size, eg, fetal hemoglobin Bart's disease. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:185-191, 2017.
[Mh] Termos MeSH primário: Imagem Tridimensional/métodos
Placenta/anatomia & histologia
Ultrassonografia Pré-Natal/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Estatura Cabeça-Cóccix
Feminino
Seres Humanos
Tamanho do Órgão
Placenta/diagnóstico por imagem
Gravidez
Estudos Prospectivos
Valores de Referência
Tailândia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170207
[St] Status:MEDLINE
[do] DOI:10.1002/jcu.22441


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[PMID]:28069173
[Au] Autor:Parisi F; Rousian M; Koning AH; Willemsen SP; Cetin I; Steegers EA; Steegers-Theunissen RP
[Ad] Endereço:Department of Obstetrics and Gynecology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands.
[Ti] Título:Periconceptional maternal biomarkers of one-carbon metabolism and embryonic growth trajectories: the Rotterdam Periconceptional Cohort (Predict Study).
[So] Source:Fertil Steril;107(3):691-698.e1, 2017 Mar.
[Is] ISSN:1556-5653
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To study the associations between the periconceptional maternal biomarkers of one-carbon metabolism and embryonic growth. DESIGN: Prospective, periconceptional hospital-based birth cohort. SETTING: Tertiary medical care center. PATIENT(S): Between 2010 and 2014, 236 women with early singleton ongoing pregnancies that resulted in 139 strictly dated spontaneous pregnancies and 97 pregnancies conceived after assisted reproductive technology. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Maternal serum vitamin B and plasma total homocysteine (tHcy) assessed at enrollment, and longitudinal first-trimester crown-rump length (CRL), embryonic volume (EV), and absolute growth rates obtained via three-dimensional ultrasound (3D-US) and virtual reality. RESULT(S): In early pregnancy, we performed a median of five 3D-US scans (range: 1-7). Vitamin B concentrations were positively associated with CRL and EV measurements in the total population (CRL: ß 5ˆ10 (1ˆ10 to 9ˆ10 ) √mm; EV: ß 2ˆ10 (0ˆ10 to 4ˆ10 ) √cm ) and in the strictly dated spontaneous pregnancy subgroup. The tHcy concentration was negatively associated with embryonic growth in all study groups. High tHcy concentrations (+2 standard deviation [SD], 10.3 µmol/L) were associated with a 1.7 mm smaller CRL (-13.4%) at 7 weeks and a 3.6-mm smaller CRL (-7.1%) at 11 weeks compared with -2 SD tHcy (-3.0 µmol/L). A high tHcy concentration was also associated with a 0.10 cm smaller EV (-33.3%) at 7 weeks and a 1.65 cm smaller EV (-16.1%) at 11 weeks. The embryonic growth rate was positively associated with vitamin B and negatively associated with tHcy. CONCLUSION(S): Minor variations in periconceptional maternal concentrations of one-carbon metabolism biomarkers are associated with human embryonic growth.
[Mh] Termos MeSH primário: Carbono/metabolismo
Desenvolvimento Embrionário
Infertilidade/metabolismo
[Mh] Termos MeSH secundário: Adulto
Biomarcadores/sangue
Estatura Cabeça-Cóccix
Feminino
Fertilidade
Homocisteína/sangue
Seres Humanos
Imagem Tridimensional
Infertilidade/diagnóstico
Infertilidade/fisiopatologia
Infertilidade/terapia
Países Baixos
Valor Preditivo dos Testes
Gravidez
Primeiro Trimestre da Gravidez
Prognóstico
Estudos Prospectivos
Técnicas de Reprodução Assistida
Centros de Atenção Terciária
Ultrassonografia Pré-Natal/métodos
Vitamina B 12/sangue
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Biomarkers); 0LVT1QZ0BA (Homocysteine); 7440-44-0 (Carbon); P6YC3EG204 (Vitamin B 12)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170605
[Lr] Data última revisão:
170605
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170111
[St] Status:MEDLINE


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[PMID]:28062907
[Au] Autor:Gabbay-Benziv R; Dolev A; Bardin R; Meizner I; Fisch B; Ben-Haroush A
[Ad] Endereço:IVF and Infertility Unit and Obstetrics and Gynecology Ultrasound Unit, Helen Schneider Hospital for Women, Rabin Medical Center, Beilinson Hospital, 4941492, Petach Tikva, Israel.
[Ti] Título:Prediction of fetal loss by first-trimester crown-rump length in IVF pregnancies.
[So] Source:Arch Gynecol Obstet;295(3):771-775, 2017 Mar.
[Is] ISSN:1432-0711
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the association between small crown-rump length (CRL) and fetal loss ≤22 weeks in IVF pregnancies. METHODS: A retrospective analysis of prospectively collected data at a university-affiliated medical center. All singleton IVF pregnancies within a 5-year period, with a live embryo on first-trimester ultrasound and verified pregnancy outcome were included. Rates of fetal loss ≤22 weeks were compared between pregnancies with a CRL ≤tenth percentile and above the tenth percentile of our population. RESULTS: Overall, 397 pregnancies met inclusion criteria. Ninety-five percent of CRL measurements were performed at 40-80 gestational days. All live-embryo's CRL measurements, from 40 to 80 mm, were plotted against expected gestational age (in 5-day clusters), with calculation of the tenth percentile for every gestational age. Total of 64 pregnancies had CRL ≤tenth percentile for gestational age. The rate of fetal loss in this group was significantly higher than in pregnancies with CRL >tenth percentile (17.2 vs. 6.6%, p = 0.005, OR = 2.93, 95% CI 1.2-6.7). In both groups, the majority of fetal losses occurred ≤10 weeks of gestation. CONCLUSION: In IVF pregnancies with a live embryo, a small CRL at 40-80 days' gestation may predict fetal loss. Repeated ultrasound should be considered after 1-2 weeks.
[Mh] Termos MeSH primário: Aborto Espontâneo/etiologia
Estatura Cabeça-Cóccix
Fertilização In Vitro
[Mh] Termos MeSH secundário: Adulto
Feminino
Idade Gestacional
Seres Humanos
Gravidez
Primeiro Trimestre da Gravidez
Estudos Retrospectivos
[Pt] Tipo de publicação: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:170108
[St] Status:MEDLINE
[do] DOI:10.1007/s00404-016-4266-8


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[PMID]:28046002
[Au] Autor:Lopez-Tello J; Arias-Alvarez M; Jimenez-Martinez MA; Garcia-Garcia RM; Rodriguez M; Lorenzo Gonzalez PL; Bermejo-Poza R; Gonzalez-Bulnes A; Garcia Rebollar P
[Ad] Endereço:Department of Animal Production, Veterinary Faculty, Complutense University of Madrid, Ciudad Universitaria, Madrid, Spain.
[Ti] Título:Competition for Materno-Fetal Resource Partitioning in a Rabbit Model of Undernourished Pregnancy.
[So] Source:PLoS One;12(1):e0169194, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The major goal of animal production is to obtain abundant and healthy meat for consumers. Maternal food restriction (MFR) is often applied in farms to reduce production costs. However, the suitability of MFR in livestock animals is questionable, as this management may compromise maternal fitness due to a severe negative energetic balance and can induce Intrauterine Growth Restriction (IUGR) and prenatal programming in the offspring. Here, we sought to determine, using pregnant rabbits, the consequences of MFR on maternal endocrine and metabolic status and conceptus development. Pregnant dams were distributed into three groups: CONTROL (ad libitum feeding throughout the entire pregnancy; mean pregnancy length being around 31 days), UNDERFED (50% MFR during the entire pregnancy) and EARLY-UNDERFED (50% MFR only during the preimplantation period, Days 0-7). Maternal leptin concentrations and glycemic and lipid profiles were determined throughout pregnancy, whilst conceptus development was assessed ex-vivo at Day 28. Placental parameters were determined by macroscopic and histological evaluations and apoptotic assessments (TUNEL and Caspase-3). The main results of the study showed that, despite MFR altered maternal plasma lipid concentration (P<0.05), there were no effects on maternal bodyweight, plasma leptin concentration or glycemic profile. Fetal crown-rump lengths were reduced in both undernourished groups (P<0.001), but a significant reduction in fetal weight was only observed in the UNDERFED group (P<0.001). Growth in both undernourished groups was asymmetrical, with reduced liver weight (P<0.001) and significantly increased brain: fetal weight-ratio (P<0.001) and brain: liver weight-ratio (P<0.001) when compared to the CONTROL group. A significant reduction in placental weight was only observed in the UNDERFED group (P<0.001), despite both undernourished groups showing higher apoptotic rates at decidua and labyrinth zone (P<0.05) than the CONTROL group. Thus, these groups evidenced signs of placental degeneration, necrosis and stromal collapse. In summary, MFR may encourage the mother to make strategic decisions to safeguard her metabolic status and fitness at the expense of growth reduction in the litter, resulting in enhanced apoptotic and pathological processes at placental level and IUGR.
[Mh] Termos MeSH primário: Retardo do Crescimento Fetal/metabolismo
Feto/metabolismo
Desnutrição/complicações
Placenta/metabolismo
[Mh] Termos MeSH secundário: Animais
Apoptose
Blastocisto
Glicemia
Peso Corporal
Estatura Cabeça-Cóccix
Modelos Animais de Doenças
Feminino
Peso Fetal
Leptina/sangue
Metabolismo dos Lipídeos
Gravidez
Complicações na Gravidez
Prenhez
Coelhos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Blood Glucose); 0 (Leptin)
[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:170104
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0169194


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[PMID]:28006080
[Au] Autor:Sabria J; Guirado L; Miró I; Gómez-Roig MD; Borrell A
[Ad] Endereço:BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Sant Joan de Déu and Hospital Clínic), University of Barcelona, Barcelona, Spain.
[Ti] Título:Crown-rump length audit plots with the use of operator-specific PAPP-A and ß-hCG median MoM.
[So] Source:Prenat Diagn;37(3):229-234, 2017 Mar.
[Is] ISSN:1097-0223
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Audit the crown-rump length (CRL) measurements taken at 11 to 13 weeks scan, using operator-specific median multiples of the median (MoM) for pregnancy-associated plasma protein-A (PAPP-A) and free ß-human chorionic gonadotropin (ß-hCG) plots, to identify deviations potentially related to a systematic CRL bias. METHODS: Study population included consecutive singleton pregnancies undergoing first trimester combined screening, scanned by sonologists with at least 100 scans, during the 2011 to 2012 period. Previously described plots for PAPP-A and ß-hCG median MoM points, with their 95% confidence intervals circles, in relation with the expected deviation line were used. These plots have been modified to adjust the deviation line to the sonologist-specific expected MoM variation for each CRL millimetre bias according to each sonologist-specific median gestational ages at both blood sampling and ultrasound. RESULTS: Twenty-eight sonologists performing 9472 scans were included, accounting for 36% of the 77 sonologists and 70% of the 13 643 scans initially considered. Mean gestational age was 10 + 2 weeks at blood sampling and 12 + 4 weeks at ultrasound. Fifteen sonologists (53%) did not demonstrate any CRL bias, 10 (36%) present with a significant CRL underestimation, being above 2 mm in 6 (21%), and in 3 (11%) the observed deviation could not be explained by a systematic CRL bias. CONCLUSIONS: In sonologists with more than 100 NT measurements, operator-specific PAPP-A and ß-hCG median MoM plots are able to identify deviations potentially related to a systematic CRL bias. Systematic underestimation above 2 mm was observed in 1/5 of them. © 2016 John Wiley & Sons, Ltd.
[Mh] Termos MeSH primário: Biomarcadores/sangue
Gonadotropina Coriônica Humana Subunidade beta/sangue
Estatura Cabeça-Cóccix
Gráficos de Crescimento
Proteína Plasmática A Associada à Gravidez/análise
[Mh] Termos MeSH secundário: Adulto
Auditoria Clínica
Feminino
Idade Gestacional
Seres Humanos
Gravidez
Primeiro Trimestre da Gravidez/sangue
Diagnóstico Pré-Natal/métodos
Diagnóstico Pré-Natal/normas
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (Chorionic Gonadotropin, beta Subunit, Human); EC 3.4.24.- (Pregnancy-Associated Plasma Protein-A)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161223
[St] Status:MEDLINE
[do] DOI:10.1002/pd.4996


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Texto completo
[PMID]:27894704
[Au] Autor:Oepkes D; Sueters M
[Ad] Endereço:Department of Obstetrics, Leiden University Medical Centre, Leiden, The Netherlands. Electronic address: d.oepkes@lumc.nl.
[Ti] Título:Antenatal fetal surveillance in multiple pregnancies.
[So] Source:Best Pract Res Clin Obstet Gynaecol;38:59-70, 2017 Jan.
[Is] ISSN:1532-1932
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Multiple pregnancies occur either spontaneously or because of assisted reproduction techniques in 1-3% of pregnancies. The presence of more than one fetus in the womb is associated with a range of possible complications, both for the mother and fetuses. Early detection of these complications followed by timely and appropriate management will reduce the risk of adverse outcomes. The techniques, skills, and experience for timely detection of complications and managing them appropriately require sufficient training and exposure. Therefore, referral of women pregnant with more than one fetus to specialized clinics is preferable. One of the most essential elements of appropriate management of multiple pregnancies is early determination of chorionicity. Monochorionic and monoamniotic multiple pregnancies require additional surveillance for a whole range of specific complications that are unique to this group. Ultrasound and Doppler are the most important tools in the management of multiple pregnancies. This chapter will summarize the current best practice, in particular the use of ultrasound and Doppler, in the antenatal management of multiple pregnancies.
[Mh] Termos MeSH primário: Retardo do Crescimento Fetal/diagnóstico por imagem
Transfusão Feto-Fetal/diagnóstico por imagem
Complicações na Gravidez/diagnóstico
Gravidez Múltipla
[Mh] Termos MeSH secundário: Âmnio/diagnóstico por imagem
Cesárea
Córion/diagnóstico por imagem
Estatura Cabeça-Cóccix
Diagnóstico Precoce
Intervenção Médica Precoce
Feminino
Retardo do Crescimento Fetal/terapia
Transfusão Feto-Fetal/terapia
Idade Gestacional
Seres Humanos
Gravidez
Primeiro Trimestre da Gravidez
Encaminhamento e Consulta
Gêmeos Monozigóticos
Ultrassonografia Pré-Natal
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170314
[Lr] Data última revisão:
170314
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161130
[St] Status:MEDLINE



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