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[PMID]:28453379
[Au] Autor:Han M; Afshar Y; Chon AH; Scibetta E; Rao R; Chmait RH
[Ad] Endereço:a Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology , University of California , Los Angeles, Los Angeles , California , USA.
[Ti] Título:Pseudoamniotic Band Syndrome Post Fetal Thoracoamniotic Shunting for Bilateral Hydrothorax.
[So] Source:Fetal Pediatr Pathol;36(4):311-318, 2017 Aug.
[Is] ISSN:1551-3823
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Pseudoamniotic band syndrome (PABS) occurs iatrogenically after fetal surgery or amniocentesis due to chorioamniotic membrane separation. Separation of the amnion from the chorion can expand to form fibrous amniotic bands that can envelope fetal limbs or the umbilical cord, with consequences ranging from limb constriction to fetal demise. CASE REPORT: We report a case of bilateral fetal pleural effusions at 27 weeks' gestation treated by bilateral thoracoamniotic shunts. Following shunt placement, the hydrothorax resolved. However, chorioamniotic membrane separation developed resulting in PABS with subsequent umbilical cord strangulation and fetal demise at 32 weeks' gestation. CONCLUSION: PABS has been previously described in the literature following various fetal interventions. This is the first reported case of pseudoamniotic band syndrome after placement of fetal thoracoamniotic shunts. A high index of suspicion is required to diagnose PABS via postoperative ultrasound. Post intervention chorioamniotic membrane separation warrants close surveillance for sonographic evidence of PABS.
[Mh] Termos MeSH primário: Síndrome de Bandas Amnióticas/etiologia
Quilotórax/congênito
Terapias Fetais/efeitos adversos
Hidropisia Fetal/cirurgia
[Mh] Termos MeSH secundário: Quilotórax/cirurgia
Feminino
Morte Fetal
Feto
Seres Humanos
Derrame Pleural/cirurgia
Gravidez
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1080/15513815.2017.1313915


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[PMID]:28455451
[Au] Autor:Okamura H; Emrich F; Trojan J; Chiu P; Dalal AR; Arakawa M; Sato T; Penov K; Koyano T; Pedroza A; Connolly AJ; Rabinovitch M; Alvira C; Fischbein MP
[Ad] Endereço:Department of Cardiothoracic Surgery, Stanford University, Stanford, California.
[Ti] Título:Long-term miR-29b suppression reduces aneurysm formation in a Marfan mouse model.
[So] Source:Physiol Rep;5(8), 2017 Apr.
[Is] ISSN:2051-817X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Aortic root aneurysm formation and subsequent dissection and/or rupture remain the leading cause of death in patients with Marfan syndrome. Our laboratory has reported that miR-29b participates in aortic root/ascending aorta extracellular matrix remodeling during early aneurysm formation in Marfan mice. Herein, we sought to determine whether miR-29b suppression can reduce aneurysm formation long-term. Marfan mice were treated with retro-orbital LNA-anti-miR-29b inhibitor or scrambled-control-miR before aneurysms develop either (1) a single dose prenatally (pregnant mice at 14.5 days post-coitum) ( = 8-10, each group) or (2) postnatally every other week, from 2 to 22 weeks of age, and sacrificed at 24 weeks ( = 8-10, each group). To determine if miR-29b blockade was beneficial even after aneurysms develop, a third group of animals were treated every other week, starting at 8 weeks of age, until sacrificed ( = 4-6, each group). miR-29b inhibition resulted in aneurysm reduction, increased elastogenesis, decreased matrix metalloproteinase activity and decreased elastin breakdown. Prenatal LNA-anti-miR-29b inhibitor treatment decreased aneurysm formation up to age 32 weeks, whereas postnatal treatment was effective up to 16 weeks. miR-29b blockade did not slow aortic growth once aneurysms already developed. Systemic miR-29b inhibition significantly reduces aneurysm development long-term in a Marfan mouse model. Drug administration during aortic wall embryologic development appears fundamental. miR-29b suppression could be a potential therapeutic target for reducing aneurysm formation in Marfan syndrome patients.
[Mh] Termos MeSH primário: Aneurisma Aórtico/prevenção & controle
Terapia Genética/métodos
Síndrome de Marfan/terapia
MicroRNAs/antagonistas & inibidores
[Mh] Termos MeSH secundário: Animais
Aneurisma Aórtico/diagnóstico por imagem
Aneurisma Aórtico/etiologia
Aneurisma Aórtico/patologia
Modelos Animais de Doenças
Progressão da Doença
Ecocardiografia
Elastina/metabolismo
Matriz Extracelular/fisiologia
Feminino
Terapias Fetais/métodos
Masculino
Síndrome de Marfan/complicações
Síndrome de Marfan/genética
Metaloproteinases da Matriz/fisiologia
Camundongos Endogâmicos C57BL
Camundongos Mutantes
Terapia de Alvo Molecular/métodos
Cuidado Pré-Natal/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (MIRN29 microRNA, mouse); 0 (MicroRNAs); 9007-58-3 (Elastin); EC 3.4.24.- (Matrix Metalloproteinases)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE


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[PMID]:29229117
[Au] Autor:Mon RA; Treadwell MC; Berman DR; Day L; Kreutzman J; Mychaliska GB; Perrone EE
[Ad] Endereço:Section of Pediatric Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, Michigan; University of Michigan Health System, Fetal Diagnosis and Treatment Center, Ann Arbor, Michigan.
[Ti] Título:Outcomes of fetuses with primary hydrothorax that undergo prenatal intervention (prenatal intervention for hydrothorax).
[So] Source:J Surg Res;221:121-127, 2018 Jan.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Primary hydrothorax is a congenital anomaly affecting 1 in 10,000-15,000 pregnancies. The natural history of this condition is variable with some fetuses having spontaneous resolution and others showing progression. The associated pulmonary hypoplasia leads to increased perinatal morbidity and mortality. Optimal prenatal intervention remains controversial. METHODS: After obtaining the Institutional Review Board approval, a retrospective review of all patients evaluated for a fetal pleural effusion in the Fetal Diagnosis and Treatment Center at The University of Michigan, between 2006 and 2016 was performed. Cases with secondary etiologies for an effusion or when families decided to pursue elective termination were excluded. RESULTS: Pleural effusions were identified in 175 patients. Primary hydrothorax was diagnosed in 15 patients (8%). The effusions were bilateral in 13/15 cases (86%) and 10/15 (66%) had hydrops at presentation. All 15 patients with primary hydrothorax underwent prenatal intervention. Thoracentesis was performed in 14/15 cases (93%). Shunt placement was performed in 10/15 cases (66%). Shunt migration was seen in four patients (40%) and all of these underwent prenatal shunt replacement. Overall survival was 76%. The rates of prematurity and preterm premature rupture of membranes were 69% and 35%, respectively. CONCLUSIONS: Fetal intervention for the treatment of primary hydrothorax is effective, and it appears to confer a survival advantage. Both the fetuses and the mothers tolerated the procedures well. Preterm labor and preterm premature rupture of membranes remain an unsolved problem. Further studies are needed to understand the mechanisms behind the development of fetal hydrothorax.
[Mh] Termos MeSH primário: Quilotórax/congênito
Terapias Fetais
Toracentese
[Mh] Termos MeSH secundário: Quilotórax/terapia
Feminino
Seres Humanos
Gravidez
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171220
[Lr] Data última revisão:
171220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171213
[St] Status:MEDLINE


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[PMID]:29189693
[Au] Autor:Committee on Practice Bulletins-Obstetrics
[Ti] Título:Practice Bulletin No. 187: Neural Tube Defects.
[So] Source:Obstet Gynecol;130(6):e279-e290, 2017 12.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Neural tube defects (NTDs) are congenital structural abnormalities of the central nervous system and vertebral column. Neural tube defects may occur as an isolated malformation, in combination with other malformations, as part of a genetic syndrome, or as a result of teratogenic exposure (1). Neural tube defects are the second-most-common major congenital anomaly (2) after cardiac malformations, and their prevalence varies by geographic region, race, and environmental factors (3). Outcomes and disabilities depend on level and extent of lesion; for instance, anencephaly is incompatible with life but most infants with spina bifida will survive after surgical repair (4). Importantly, and in contrast to many other congenital abnormalities, primary prevention of NTDs is possible with folic acid. In addition, prenatal screening and diagnosis are widely available, and fetal surgery has improved outcomes for some newborns. The purpose of this document is to provide information about NTDs and make management recommendations for the pregnancy complicated by a fetal NTD.
[Mh] Termos MeSH primário: Parto Obstétrico/métodos
Terapias Fetais/métodos
Ácido Fólico/uso terapêutico
Testes para Triagem do Soro Materno/métodos
Defeitos do Tubo Neural
Complicações na Gravidez
Ultrassonografia Pré-Natal/métodos
[Mh] Termos MeSH secundário: Sistema Nervoso Central/anormalidades
Sistema Nervoso Central/diagnóstico por imagem
Feminino
Seres Humanos
Recém-Nascido
Masculino
Defeitos do Tubo Neural/diagnóstico
Defeitos do Tubo Neural/terapia
Gravidez
Complicações na Gravidez/diagnóstico
Complicações na Gravidez/terapia
Coluna Vertebral/anormalidades
Coluna Vertebral/diagnóstico por imagem
Estados Unidos
Complexo Vitamínico B/uso terapêutico
alfa-Fetoproteínas/análise
[Pt] Tipo de publicação:JOURNAL ARTICLE; PRACTICE GUIDELINE
[Nm] Nome de substância:
0 (alpha-Fetoproteins); 12001-76-2 (Vitamin B Complex); 935E97BOY8 (Folic Acid)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171206
[Lr] Data última revisão:
171206
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002412


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[PMID]:28736420
[Au] Autor:Wasserman D
[Ti] Título:Better Parenting through Biomedical Modification: A Case for Pluralism, Deference, and Charity.
[So] Source:Kennedy Inst Ethics J;27(2):217-247, 2017.
[Is] ISSN:1054-6863
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In this paper, I will argue that the moral assessment of the prenatal selection and postnatal modification biotechnologies requires a nuanced approach, which pays close attention to the variety of sometimes conflicting parental roles and reasons involved in decisions for and against their use. I will focus on several related but distinct reasons that parents have, or give, for modifying existing children or selecting future children. Many of these reasons are expressed in terms of more effective parenting. Because there is a plurality of legitimate parental goals, I will conclude that assessing parental interventions requires us to adjudicate conflicts or tradeoffs among those goals.
[Mh] Termos MeSH primário: Comportamento de Escolha/ética
Anormalidades Congênitas/prevenção & controle
Terapias Fetais/ética
Melhoramento Genético/ética
Princípios Morais
Poder Familiar/psicologia
[Mh] Termos MeSH secundário: Bioética
Feminino
Seres Humanos
Masculino
Ética Baseada em Princípios
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170912
[Lr] Data última revisão:
170912
[Sb] Subgrupo de revista:E; IM
[Da] Data de entrada para processamento:170725
[St] Status:MEDLINE
[do] DOI:10.1353/ken.2017.0016


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[PMID]:28385862
[Au] Autor:Pham A; Melchior M
[Ad] Endereço:Department of Obstetrics and Gynecology, St. Joseph's Health Centre, Toronto, Ont. alice.pham@mail.utoronto.ca.
[Ti] Título:Screening for fetal congenital heart disease.
[So] Source:CMAJ;189(12):E468, 2017 03 27.
[Is] ISSN:1488-2329
[Cp] País de publicação:Canada
[La] Idioma:eng
[Mh] Termos MeSH primário: Ecocardiografia/métodos
Cardiopatias Congênitas/diagnóstico por imagem
Ultrassonografia Pré-Natal/métodos
[Mh] Termos MeSH secundário: Feminino
Terapias Fetais
Cardiopatias Congênitas/terapia
Seres Humanos
Medição da Translucência Nucal
Gravidez
Diagnóstico Pré-Natal
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170408
[St] Status:MEDLINE
[do] DOI:10.1503/cmaj.160700


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[PMID]:28277805
[Au] Autor:Zwiers C; van Kamp I; Oepkes D; Lopriore E
[Ad] Endereço:a Department of Obstetrics , Leiden University Medical Center , Leiden , the Netherlands.
[Ti] Título:Intrauterine transfusion and non-invasive treatment options for hemolytic disease of the fetus and newborn - review on current management and outcome.
[So] Source:Expert Rev Hematol;10(4):337-344, 2017 Apr.
[Is] ISSN:1747-4094
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Hemolytic disease of the fetus and newborn (HDFN) remains a serious pregnancy complication which can lead to severe fetal anemia, hydrops and perinatal death. Areas covered: This review focusses on the current prenatal management, treatment with intrauterine transfusion (IUT) and promising non-invasive treatment options for HDFN. Expert commentary: IUTs are the cornerstone in prenatal management of HDFN and have significantly improved perinatal outcome in the past decades. IUT is now a relatively safe procedure, however the risk of complications is still high when performed early in the second trimester. Non-invasive management using intravenous immunoglobulin may be a safe alternative and requires further investigation.
[Mh] Termos MeSH primário: Anemia Hemolítica/terapia
Transfusão de Sangue Intrauterina
Terapia Combinada
Doenças Fetais/terapia
Terapias Fetais
Hemólise
Doenças do Recém-Nascido/terapia
[Mh] Termos MeSH secundário: Anemia Hemolítica/diagnóstico
Anemia Hemolítica/etiologia
Transfusão de Sangue Intrauterina/efeitos adversos
Transfusão de Sangue Intrauterina/métodos
Terapia Combinada/efeitos adversos
Terapia Combinada/métodos
Gerenciamento Clínico
Feminino
Doenças Fetais/diagnóstico
Doenças Fetais/etiologia
Terapias Fetais/efeitos adversos
Terapias Fetais/métodos
Seres Humanos
Recém-Nascido
Doenças do Recém-Nascido/diagnóstico
Doenças do Recém-Nascido/etiologia
Gravidez
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170518
[Lr] Data última revisão:
170518
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170310
[St] Status:MEDLINE
[do] DOI:10.1080/17474086.2017.1305265


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[PMID]:28182812
[Au] Autor:Thong XY; Lee LY; Chia DA; Wong YC; Biswas A
[Ad] Endereço:Department of Paediatrics, Yong Loo Lin School of Medicine, National University Singapore, Singapore.
[Ti] Título:Management and Outcomes of Fetal Hydrops in a Tertiary Care Centre in Singapore.
[So] Source:Ann Acad Med Singapore;46(1):4-10, 2017 Jan.
[Is] ISSN:0304-4602
[Cp] País de publicação:Singapore
[La] Idioma:eng
[Ab] Resumo:: Fetal hydrops is a serious condition which can be caused by immune and non-immune aetiologies. We aimed to review the management of fetal hydrops at our hospital. : A retrospective review of all cases of fetal hydrops diagnosed in our institution from 2006 to 2013 was carried out. : Out of the 30 cases of fetal hydrops diagnosed antenatally, 17 were cases of Bart's hydrops which were all terminated in-utero. Of the remaining 13 cases, 11 cases consisted of non-immune causes of hydrops. Planned antenatal interventions including in-utero blood transfusions (n = 4) and thoracentesis (n = 5) as well as planned caesarean deliveries (n = 11) were performed in the majority of cases. Postnatal neonatal intensive care with interventions including chest drainage and transfusions were also performed. A majority, 92%, of the cases survived the perinatal period following a variable length of hospital stay ranging from a week to 3 months. : Management of fetal hydrops is complex. Close coordination between the obstetric and neonatal teams was the key to good short-term survival of neonates with antenatally diagnosed hydrops, as it allows timely antenatal intervention and anticipation of potential perinatal complications.
[Mh] Termos MeSH primário: Transfusão de Sangue
Cesárea
Terapias Fetais
Hidropisia Fetal/terapia
Toracentese
[Mh] Termos MeSH secundário: Aborto Induzido
Gerenciamento Clínico
Drenagem
Feminino
Hemoglobinas Anormais
Seres Humanos
Hidropisia Fetal/sangue
Hidropisia Fetal/etiologia
Recém-Nascido
Unidades de Terapia Intensiva Neonatal
Gravidez
Diagnóstico Pré-Natal
Estudos Retrospectivos
Singapura
Taxa de Sobrevida
Centros de Atenção Terciária
Talassemia alfa/sangue
Talassemia alfa/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hemoglobins, Abnormal); 9056-09-1 (hemoglobin Bart's)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170221
[Lr] Data última revisão:
170221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170210
[St] Status:MEDLINE


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[PMID]:28160543
[Au] Autor:D'Addario V
[Ti] Título:Fetal diagnosis and therapy: a continously evolving discipline.
[So] Source:J Perinat Med;45(2):147-148, 2017 Feb 01.
[Is] ISSN:1619-3997
[Cp] País de publicação:Germany
[La] Idioma:eng
[Mh] Termos MeSH primário: Terapias Fetais/tendências
Diagnóstico Pré-Natal/tendências
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Gravidez
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170205
[St] Status:MEDLINE


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[PMID]:28120066
[Au] Autor:Mattogno PP; Massimi L; Tamburrini G; Frassanito P; Di Rocco C; Caldarelli M
[Ad] Endereço:Pediatric Neurosurgery - A. Gemelli Hospital, Catholic University Medical School, Largo A. Gemelli, Rome, Italy. pierpaolo.mattogno@gmail.com.
[Ti] Título:Myelomeningocele Repair: Surgical Management Based on a 30-Year Experience.
[So] Source:Acta Neurochir Suppl;124:143-148, 2017.
[Is] ISSN:0065-1419
[Cp] País de publicação:Austria
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Myelomeningocele (MMC) is a rare but severe spinal defect resulting from a failed neurulation process. Surgical repair is a delicate procedure that needs accurate neuroanatomical knowledge and adequate surgical planning. MATERIALS AND METHODS: The authors report on the main problems of the surgical management of this type of dysraphism. The technique used for reconstruction, and the management strategies, are analyzed according to the authors' experience with more than 600 cases, in comparison with the relevant literature. RESULTS: Tip and tricks of more than 30 years of MMC surgical management are reported, with special mention of the timing of surgery, the management of early hydrocephalus, and the principles of the repair, from the dissection to the closure of five separate layers (arachnoid, dura, muscular fascia, subcutaneous layer, skin). CONCLUSIONS: Accuracy and attention to the reconstruction are crucial for achieving good results and avoiding perioperative complications.
[Mh] Termos MeSH primário: Terapias Fetais/métodos
Hidrocefalia/cirurgia
Meningomielocele/cirurgia
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Hidrocefalia/diagnóstico por imagem
Hidrocefalia/etiologia
Recém-Nascido
Meningomielocele/complicações
Meningomielocele/diagnóstico por imagem
Procedimentos Neurocirúrgicos
Gravidez
Procedimentos Cirúrgicos Reconstrutivos
Fatores de Tempo
Ultrassonografia Pré-Natal
Derivação Ventriculoperitoneal
[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:170126
[St] Status:MEDLINE
[do] DOI:10.1007/978-3-319-39546-3_22



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