| 1. |
- Akoka, S, et al.
(författare)
-
Cerebral MRI on fetuses submitted to repeated cocaine administration during the gestation: an ovine model
- 1999
-
Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - 0301-2115. ; 85:2, s. 185-190
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to determine the role of Magnetic Resonance Imaging (MRI) in investigating fetal cerebral lesions induced by long term exposure to cocaine during sheep pregnancy. Cerebral Magnetic Resonance Imaging was performed on two groups of fetuses at 125 days of gestation (normal gestation: 145 days). The control group consisted of eight fetuses of four pregnant ewes. The study group consisted of eight fetuses of four pregnant ewes receiving daily 140 mg/kg injection of cocaine from day 60 until delivery. The following MR sequences were applied: T1-weighted FLASH, and T2-weighted Fast-Spin-Echo. Cerebral images were evaluated semi quantitatively using the following criteria: Heterogenicity, contrast between grey and white matter, contours irregularity, hyposignal, lateral ventricle sizes. The brightness distribution and homogenicity of the images were analysed by means of edge pair distributions using a new computerized method originally designed for ultrasound images analysis developed by Ultrasight inc (USA). (1) Flash T1: Heterogenic areas and irregular contours were more frequent in cocaine exposed fetuses. The contrast between grey and white matter was more important in the cocaine group. Hyposignal was found only in the cocaine group. Enlarged lateral ventricle occurred more frequently in the cocaine group. (2) Spin echo T2: The contrast between grey and white matter was higher and the contours of the brain more irregular in the cocaine group. Heterogenicity and hyposignal were also more frequent in this group but the difference with the control group was not significant. The computerized analysis of the contrast density on the cerebral images showed that 88% of the areas exceeding the reference level concerned the cocaine group, while only 14% of the areas exceeding the reference level concerned the control group. Long term exposure to cocaine induces cerebral tissue modifications, in favor of an advanced maturation and the development of hypoxic lesions. The histology of the brains confirmed in the cocaine group, the existence of hypoxic lesions with gliosis, perivascular edema and hemorrhages, and neuronal death.
|
|
| 2. |
- Ayres-de-Campos, D, et al.
(författare)
-
Can the reproducibility of fetal heart rate baseline estimation be improved?
- 2004
-
Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - 0301-2115. ; 112:1, s. 49-54
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate the reproducibility of fetal heart rate (FHR) baseline estimation according to an objective and detailed definition presented in this article, by comparison with the FIGO guidelines' definition. Study design: Three hundred consecutively acquired FHR tracings, 150 from antepartum high-risk pregnancies and 150 from unselected intrapartum cases, were presented to nine experienced clinicians included in three different groups, for an estimation of the FHR baseline. The first group consisted of clinicians using the proposed definition, without previous training in its use. The second group consisted of clinicians using the proposed definition, where a previous training session was promoted. The third group consisted of clinicians using the FIGO guidelines' definition. Agreement in baseline estimation was evaluated using the kappa statistic, the proportions of agreement and the intra-class correlation coefficient. Results: Using the baseline definition proposed in this article, agreement was significantly higher in the group with prior training in its use. This group also showed a trend towards a higher agreement than the one using the FIGO guidelines. Conclusion: The FHR baseline definition proposed in this article provides an extremely reproducible estimation when associated with prior training in its use.
|
|
| 3. |
- Dubiel, Mariusz, et al.
(författare)
-
Blood velocity in the fetal vein of Galen and the outcome of high-risk pregnancy
- 2001
-
Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - 0301-2115. ; 99:1, s. 14-18
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Pulsation in the flow velocity waveform in the umbilical vein is related to perinatal mortality but the flow velocity waveform in the fetal vein of Galen is normally even and without fluctuation. OBJECTIVES: To establish whether blood flow velocity pulsations in the vein of Galen in high-risk pregnancies are related to outcome. STUDY DESIGN: The vein of Galen was located by colour Doppler ultrasound in 102 pregnancies complicated by severe pregnancy-induced hypertension. The blood velocity waveform was recorded by pulsed Doppler within 2 days of delivery and the presence pulsations related to pregnancy outcome, including emergency operative intervention and neonatal distress. Umbilical artery and vein and uterine artery blood flow velocity waveform were also recorded at the same time. The clinicians managing the women were unaware of the venous flow results. RESULTS: Pulsation were present in the vein of Galen in 68 cases and in the umbilical vein in 21. Both were significantly related to adverse outcome. Pulsations in the vein of Galen were seen in all seven perinatal deaths. CONCLUSIONS: Since umbilical venous pulsation are a late sign of fetal compromise, and pulsations in the vein of Galen seem to appear earlier, thus being an intermediate sign of fetal compromise that might be of great value for fetal surveillance.
|
|
| 4. |
- Hellsten, Charlotte, et al.
(författare)
-
Vaginal breech delivery: is it still an option?
- 2003
-
Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - 0301-2115. ; 111:2, s. 122-128
-
Tidskriftsartikel (refereegranskat)
|
|
| 5. |
|
|
| 6. |
- Hjelm, AM, et al.
(författare)
-
Changes of the uterine proteoglycan distribution at term pregnancy and during labour
- 2002
-
Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - 0301-2115. ; 100:2, s. 146-151
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To characterise uterine proteoglycans and changes therein during pregnancy and labour. Study Design: Uterine samples were collected from 6 non-pregnant, 10 term-pregnant and from 10 women in active tabour. The proteoglycans were extracted by 4 M guanidine hydrochloride and precipitated with Alcian Blue. They were separated by electrophoresis and identified by Western blotting. Results: Decorin was the dominating proteoalycan and smaller amounts of biglycan was found. A considerable amount of heparan sulphate proteoglycans wag also detected. Decorin and biglycan decreased by 40% until term. The amount of heparan sulphate proteoglycans increased by 46% during active labour. Conclusion: Our data indicate that a considerable remodelling of the uterine connective tissue occurs during pregnancy and labour. The decrease of decorin and biglycan and the increase of heparan sulphate proteoglycans may be important for normal myometrial contractions during tabour. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.
|
|
| 7. |
- Krebs, L, et al.
(författare)
-
Long-term outcome in term breech infants with low Apgar score--a population-based follow-up
- 2001
-
Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - 0301-2115. ; 100:1, s. 5-8
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the relation between low Apgar score in breech infants and handicap in childhood. STUDY DESIGN: A case-control study. A questionnaire to mothers of 323 non-malformed, singleton infants delivered in breech presentation at term, 105 cases with Apgar score below 7 at 5 min and 218 controls. RESULTS: Four cases (4.6%) and one control (0.5%) had cerebral palsy. In infants without cerebral palsy, speech/language problems were more frequent than controls (10.6 versus 3.2%) (P=0.02). There were no differences in rates of deficits in attention, motor control and perception (DAMP), epilepsy, cognitive developmental delay or learning disabilities. Absence of any handicap or disability was reported in 65 cases (75%) compared to 172 controls (92%) (OR: 3.9; 95% CI: 1.9-7.9). CONCLUSION: Even though low Apgar score indicates an increased risk of neurological sequelae, most (75%) breech infants with low Apgar score are without a handicap/disability at follow-up.
|
|
| 8. |
- Medda, Emanuela, et al.
(författare)
-
Genetic amniocentesis:a risk factor for preterm delivery?
- 2003
-
Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - 0301-2115. ; 110:2, s. 153-158
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine whether genetic amniocentesis performed in the second trimester of pregnancy is associated with the risk of preterm delivery. Study design: Case–control study performed in several departments of obstetrics and gynaecology of nine European countries. Three thousand and ninety-one preterm births and 5298 controls randomly selected from singleton births born at term during 1994–1997 were analysed. Logistic regression models were used to compare preterm births altogether and, separately, spontaneous preterm delivery and induced preterm delivery. Results: An increased risk of preterm delivery was found in women having second trimester genetic amniocentesis after taking account of other risk factors and confounding variables (odds ratios (OR)=1.59, 95% confidence intervals (95% CI): 1.31–1.92). The association was statistically significant and similar for spontaneous preterm delivery and induced preterm delivery. Conclusion: The study shows an association between preterm delivery and genetic amniocentesis. In view of the wide use of amniocentesis, further research on the etiologic role of this prenatal diagnostic technique is needed.
|
|
| 9. |
|
|
| 10. |
- Olofsson, Per
(författare)
-
Current status of intrapartum fetal monitoring: cardiotocography versus cardiotocography + ST analysis of the fetal ECG.
- 2003
-
Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - 0301-2115. ; 110 Suppl:Suppl. 1, s. 113-118
-
Tidskriftsartikel (refereegranskat)abstract
- Two randomized controlled trials (RCT) on intrapartum fetal monitoring with cardiotocography (CTG) only versus CTG combined with automatic ST segment waveform analysis of the fetal ECG have been performed. In altogether 6826 randomized cases, the odds ratio for operative delivery for fetal distress (ODFD) was 0.65 (95% confidence interval 0.53-0.78) and for metabolic acidosis at birth 0.39 (0.21-0.72). in favor of the CTG + ST method. CTG combined with ST analysis increases the ability of obstetricians to identify fetal hypoxia and to intervene more appropriately, resulting in an improved perinatal outcome. (C) 2003 Elsevier Ireland Ltd. All rights reserved.
|
|
