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- Tiblad, E, et al.
(author)
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Procedure-related complications and perinatal outcome after intrauterine transfusions in red cell alloimmunization in Stockholm
- 2011
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In: Fetal diagnosis and therapy. - : S. Karger AG. - 1421-9964 .- 1015-3837. ; 30:4, s. 266-273
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Journal article (peer-reviewed)abstract
- <i>Introduction:</i> We present a review of all cases of intravascular transfusions in red cell alloimmunization over a time span of 20 years in Stockholm. The aim of the study is to compare our results with published results from larger centers and to identify areas that can be further improved. <i>Material and Methods:</i> A retrospective cohort study was conducted of all women treated with intrauterine transfusions due to erythrocyte immunization in our hospital between June 1990 and June 2010. Primary outcome variables were fetal and neonatal survival, procedure-related complications and gestational age at delivery. <i>Results:</i> A total of 284 intrauterine transfusions were performed in 84 pregnancies, with an overall survival rate of 91.8%. Procedure-related and fatal complications occurred in the present study in 4.9 and 1.4% of fetuses or neonates, respectively. Procedure-related complications were significantly more common in free-loop transfusions than in transfusions in the intrahepatic part of the umbilical vein (OR: 5.4, p = 0.025). There was no significant difference between the intrahepatic and the placental cord insertion route (p = 0.83). Gestational age at first transfusion was significantly associated with an increased risk of a procedure-related complication (OR: 0.8, p = 0.019). Of the live-born infants, 24% of the neonates were born before gestational week 34. <i>Discussion:</i> Our study confirms previous studies demonstrating favorable results with intravascular transfusions.
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- Albin, Anna-Karin, et al.
(author)
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Does growth hormone treatment influence pubertal development in short children?
- 2011
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In: Hormone Research in Paediatrics. - : S. Karger AG. - 1663-2826 .- 1663-2818. ; 76:4, s. 262-72
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Journal article (peer-reviewed)abstract
- AIM: To study the influence of growth hormone (GH) treatment on the initiation and progression of puberty in short children. METHODS: This prospective, randomized, controlled study included 124 short children (33 girls) who received GH treatment (Genotropin(R); Pfizer Inc.) from a mean age of 11 years until near adult height [intent-to-treat (ITT) population]. Children were randomized into three groups: controls (n = 33), GH 33 mug/kg/day (n = 34) or GH 67 mug/kg/day (n = 57). Prepubertal children at study start constituted the per-protocol (PP) population (n = 101). Auxological measurements were made and puberty was staged every 3 months. Serum sex-steroid concentrations were assessed every 6 months. RESULTS: No significant differences were found between the groups, of both PP and ITT populations, in time elapsed from start of treatment until either onset of puberty, age at start of puberty or age at final pubertal maturation in either sex. In the ITT population, pubertal duration was significantly longer in GH-treated girls, and maximum mean testicular volume was significantly greater in GH-treated boys than controls, but there were no differences in testosterone levels between the groups. CONCLUSION: GH treatment did not influence age at onset of puberty and did not accelerate pubertal development. In boys, GH treatment appeared to increase testicular volume.
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- Elmstedt, Nina, et al.
(author)
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Temporal frequency requirements for tissue velocity imaging of the fetal heart
- 2011
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In: Ultrasound in Obstetrics and Gynecology. - : Wiley. - 0960-7692 .- 1469-0705. ; 38:4, s. 413-417
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Journal article (peer-reviewed)abstract
- Objectives The high velocity and short duration of myocardial motion requires a high sampling rate to obtain adequate temporal resolution; this issue becomes even more important when taking into consideration the high fetal heart rate. In this study we have established optimal sampling requirements for assessing the duration of various cardiac cycle events and myocardial velocities of the fetal heart using color-coded tissue velocity imaging (TVI). Methods Recordings from 30 fetuses were acquired at an initial frame rate of 180-273 frames/s. All TVI recordings were performed from an apical four-chamber view and stored as cineloops of five to 10 consecutive cardiac cycles for subsequent offline analysis using software enabling a reduction in frame rate. Different components of the myocardial velocity curve, obtained from the basal part of the ventricular septum, were measured at the initial frame rate and compared with their equivalents at gradually decreased frame rates. Results As acquisition frame rate was reduced, there was a marked increase in deviation from the initial values, resulting in an underestimation of all systolic and diastolic velocities. For the measured durations, there was a clear tendency to underestimate isovolumetric contraction and relaxation, and a clear tendency to overestimate ventricular ejection and diastolic E-wave and A-wave. An acceptable <= 5% deviation from the value obtained at the highest frame rate corresponded to measurements obtained at above 150-200 frames/s. Conclusions A high sampling rate of at least 200 frames/s is necessary for adequate reconstruction of TVI data for the fetal heart. Frame rates that are too low result in considerable loss of temporal and velocity information.
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- Geirsson, RT, et al.
(author)
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A man of many talents remembered
- 2013
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In: ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA. - : Wiley. - 0001-6349. ; 92:1, s. 116-117
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Journal article (other academic/artistic)
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- Gotherstrom, Cecilia, et al.
(author)
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Pre- and Postnatal Transplantation of Fetal Mesenchymal Stem Cells in Osteogenesis Imperfecta : A Two-Center Experience
- 2014
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In: Stem Cells Transnational Medicine. - : Oxford University Press (OUP). - 2157-6564 .- 2157-6580. ; 3:2, s. 255-264
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Journal article (peer-reviewed)abstract
- Osteogenesis imperfecta (OI) can be recognized prenatally with ultrasound. Transplantation of mesenchymal stem cells (MSCs) has the potential to ameliorate skeletal damage. We report the clinical course of two patients with OI who received prenatal human fetal MSC (hfMSC) transplantation and postnatal boosting with same-donor MSCs. We have previously reported on prenatal transplantation for OI type III. This patient was retransplanted with 2.8 x 10(6) same-donor MSCs per kilogram at 8 years of age, resulting in low-level engraftment in bone and improved linear growth, mobility, and fracture incidence. An infant with an identical mutation who did not receive MSC therapy succumbed at 5 months despite postnatal bisphosphonate therapy. A second fetus with OI type IV was also transplanted with 30 x 10(6) hfMSCs per kilogram at 31 weeks of gestation and did not suffer any new fractures for the remainder of the pregnancy or during infancy. The patient followed her normal growth velocity until 13 months of age, at which time longitudinal length plateaued. A postnatal infusion of 10 x 10(6) MSCs per kilogram from the same donor was performed at 19 months of age, resulting in resumption of her growth trajectory. Neither patient demonstrated alloreactivity toward the donor hfMSCs or manifested any evidence of toxicities after transplantation. Our findings suggest that prenatal transplantation of allogeneic hfMSCs in OI appears safe and is of likely clinical benefit and that retransplantation with same-donor cells is feasible. However, the limited experience to date means that it is not possible to be conclusive and that further studies are required.
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- Marsal, K, et al.
(author)
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Fostrets utveckling och fysiologi.
- 2014
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In: Obstetrik / redaktörer: Henrik Hagberg, Karel Maršál, Magnus Westgren ; [illustrationer: Jeanette Engqvist] 2., [uppdaterade] uppl.. - LUND : Studentlitteratur. - 9789144095707
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Book chapter (other academic/artistic)
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- Westgren, M
(author)
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Fetal medicine and treatment
- 2011
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In: Handbook of experimental pharmacology. - Berlin, Heidelberg : Springer Berlin Heidelberg. - 0171-2004. ; 205, s. 271-83
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Journal article (peer-reviewed)
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