fetal development

胎儿发育
  • 文章类型: Journal Article
    目的:探讨妊娠期糖尿病(GDM)对胎儿额叶发育的影响。
    方法:这项研究是在2023年5月至2023年8月之间在安卡拉市医院围生学诊所进行的。产妇年龄,孕妇体重指数(BMI),孕周(GW),双顶直径(BPD),头围(HC),腹围(AC),股骨长度(FL),估计胎儿体重(EFW),额前前后径(FAPD),枕骨前端直径(OFD),FAPD/OFD比,和FAPD/HC比,比较GDM(n=40)和低风险对照(n=56)。
    结果:GDM组的平均产妇年龄高于对照组(p=0.002)。GDM组产妇BMI显著高于对照组(p=0.01)。与对照组相比,GDM组的腹围(AC)明显更高(p=0.04)。与对照组相比,GDM组的EFW明显更高(p=0.04)。发现GDM组的FAPD/OFD比率高于对照组(p=0.001)。在GDM患者中,在接受胰岛素治疗的组和未接受胰岛素治疗的组之间,超声测量结果无统计学差异.根据相关性分析结果,积极的,FAPD/OFD与GDM之间存在统计学上显著的相关性。在围产期结局中,GDM组的新生儿重症监护病房入院率明显较高.
    结论:胎儿额叶发育似乎受到GDM的影响。
    OBJECTIVE: To determine the effects of gestational diabetes mellitus (GDM) on fetal frontal lobe development.
    METHODS: This study was conducted prospectively between May 2023 and August 2023 in Ankara City Hospital perinatology clinic. Maternal age, maternal body mass index (BMI), gestational week (GW), biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL), estimated fetal weight (EFW), frontal antero-posterior diameter (FAPD), occipito-frontal diameter (OFD), FAPD/OFD ratio, and FAPD/HC ratio, were compared between GDM (n = 40) and low risk controls (n = 56).
    RESULTS: The mean maternal age was found higher in the GDM group compared to control group (p = 0.002). Maternal BMI was significantly higher in the GDM group than the control group (p = 0.01). Abdominal circumference (AC) was significantly higher in the GDM group compared to control group (p = 0.04). EFW was significantly higher in the GDM group compared to control group (p = 0.04). FAPD/OFD ratio was found to be higher in the GDM group than in the control group (p = 0.001). Among GDM patients, no statistically significant difference was found in the ultrasound measurements between the groups receiving insulin treatment and those without treatment. According to the correlation analysis results a moderate, positive, and statistically significant correlation was present between FAPD/OFD and GDM. In perinatal outcomes, the rate of neonatal intensive care unit admission was significantly higher in the GDM group.
    CONCLUSIONS: Fetal frontal lobe development seems to be affected by GDM.
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  • 文章类型: Journal Article
    目的:探讨肥胖对胎儿皮质发育的影响。
    方法:这项前瞻性横断面研究对91名孕妇进行。在妊娠晚期进行胎儿神经超声扫描,根据体重指数(BMI)值,将患者分为两组:肥胖(BMI≥30kg/m2)和正常体重(BMI<30kg/m2).在神经超声检查期间,胎儿岛礁深度和Sylvian裂隙,顶枕骨和扣带裂隙深度,额叶长度,使用经阴道方法测量call体和透明隔腔的大小。胎儿皮质发育和Sylvian裂手术分级。
    结果:与体重正常组相比,肥胖组孕妇中胎儿皮质发育2级的患者数量明显高于正常组(n=17,41.5%,n=8,16.0%,分别为;p=0.007)。在肥胖组中,4级及以下胎儿Sylvian裂手术的孕妇人数明显更高(n=13,31.7%),9级或以上操作的数量显着减少(n=1,2.5%)(p=0.003)。胎岛深度,额叶前后直径,扣带裂隙深度,肥胖组call体厚度较低,尽管没有显著差异。与对照组[10.5(7.2)mm]相比,肥胖组[6.8(6)mm]的枕骨深度显着降低(p=0.008)。发现两组之间的胎儿Sylvian裂比率和透明腔间隔比率相似。
    结论:这项研究获得的数据表明,肥胖导致孕妇的胎儿皮质改变。
    OBJECTIVE: To investigate the effect of obesity on fetal cortical development.
    METHODS: This prospective cross-sectional study was conducted with 91 pregnant women. Fetal neurosonography scans were performed in the third trimester, and according to body mass index (BMI) values, the patients were evaluated in two groups: obese (BMI ≥ 30 kg/m2) and normal weight (BMI < 30 kg/m2). During neurosonography, fetal insular depth and Sylvian fissures, parieo-occipital and cingulate fissure depth, frontal lobe length, and the sizes of the corpus callosum and cavum septum pellucidum were measured using a transvaginal approach. Fetal cortical development and Sylvian fissure operculization were graded.
    RESULTS: The number of patients with grade 2 fetal cortical development was significantly higher among the pregnant women in the obese group compared to the normal weight group (n = 17, 41.5% and n = 8, 16.0%, respectively; p = 0.007). In the obese group, the number of pregnant women with grade 4 or below fetal Sylvian fissure operculization was significantly higher (n = 13, 31.7%), and the number of those with grade 9 or above operculization was significantly lower (n = 1, 2.5%) (p = 0.003). The fetal insular depth, frontal lobe anterior-posterior diameter, cingulate fissure depth, and corpus callosum thickness were lower in the obese group, albeit with no significant difference. Parieto-occipital depth significantly decreased in the obese group [6.8 (6) mm)] compared to the control group [10.5 (7.2) mm)] (p = 0.008). The fetal Sylvian fissure ratio and the cavum septum pellucidum ratio were found to be similar between the groups.
    CONCLUSIONS: The data obtained from this study showed that obesity caused fetal cortical changes in pregnant women.
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  • 文章类型: Case Reports
    无性腺(AFA)是一种罕见的,良性先天性异常。值得注意的是,它的特征是上下眼睑的睫状边缘粘附在小梁线上。AFA通常是偶发性的孤立畸形;然而,它可以与其他先天性疾病一起发生。在这里,我们报告一例唇裂伴AFA。一名患者转诊至我院眼科。眼科诊断为双眼AFA。观察到左眼在中心有纤维粘连,她接受了手术用剪刀切除组织的纤维粘连。观察到右眼在外眼角有纤维粘连,并在嘴唇成形术期间切除。手术后,她的眼睛能够完全睁开,没有其他明显的疾病被诊断出来。AFA被认为是由外胚层衍生的发育异常引起的。值得注意的是,唇裂的AFA病例很少见。应及时进行诊断和手术,以最大程度地减少弱视的风险,并及早发现先天性疾病。包括青光眼.
    Ankyloblepharon filiforme adnatum (AFA) is a rare, benign congenital anomaly. Notably, it is characterized by the adhesion of the ciliary edges of the upper and lower eyelids at the trabecular line. AFA is usually a solitary malformation of sporadic occurrence; however, it can occur in conjunction with other congenital diseases. Herein, we report a case of cleft lip with AFA. A patient was referred to the ophthalmology department of our hospital. The ophthalmic diagnosis was AFA in both the eyes. The left eye was observed to have a fibrous adhesion in the center, and she underwent surgery to excise the fibrous adhesion of tissue with scissors. The right eye was observed to have a fibrous adhesion in the external canthus and was excised during lip plasty. After surgery, her eyes were able to fully open, and no other apparent disease was diagnosed. AFA is thought to be caused by an ectodermal-derived developmental abnormality. Notably, cases of AFA with a cleft lip are rare. Diagnosis and surgery should be performed promptly to minimize any risk of amblyopia and for the early detection of congenital diseases, including glaucoma.
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  • 文章类型: Journal Article
    目的:根据感染时机,使用神经超声检查评估患有严重急性呼吸道综合症冠状病毒2(SARS-CoV-2)的妊娠胎儿的大脑生长和胎儿皮质发育。
    方法:前瞻性研究了妊娠早期和中期SARS-CoV-2的妊娠,并与未受影响的对照组进行了匹配。封闭妇女在妊娠30-34周时接受了神经超声检查,并测量了call体(CC)和小脑(CV)的长度。进一步的西尔维安裂缝(SF),岛。枕骨裂(POF),并获得钙质沟裂缝(CSF)深度。所考虑的超声检查变量用胎头大小归一化。
    结果:考虑了一百七十四例经历SARSCOV2感染的连续怀孕(14周前81例,93周后)和131例未受影响的怀孕。三组妇女的一般特征和妊娠特征相似。组间CC和CV长度没有显著差异。同样,脑岛,SF,POF和CSF深度未导致受影响母亲的胎儿发生变化。
    结论:SARS-CoV-2感染与轻度症状孕妇的胎儿皮质发育或大脑发育差异无关。这些信息可能有助于让受感染的母亲放心胎儿的健康。
    OBJECTIVE: To assess cerebral growth and the development of fetal cortex using neurosonography in fetuses from pregnancies experiencing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) according to infection timing.
    METHODS: Pregnancies with by SARS-CoV-2 during first and second trimesters were prospectively studied and matched with unaffected controls. Enclosed women underwent neurosonography at 30-34 weeks of gestation and corpus callosum (CC) and cerebellar vermis (CV) lengths measured. Further Sylvian fissure (SF), insula. Parieto-occipital fissure (POF), and calcarine sulci fissures (CSF) depths were obtained. The ultrasonographic variables considered were normalized with fetal head size.
    RESULTS: One hundred and seventy four consecutive pregnancies experiencing SARS COV 2 infection (81 before 14 weeks and 93 later) and 131 not affected pregnancies were considered. General and pregnancy characteristics were similar between the three groups of women. No significant differences existed in CC and CV lengths across groups. Similarly, insula, SF, POF And CSF depth did not result changed in fetuses of affected mothers.
    CONCLUSIONS: SARS-CoV-2 infection does nor resulted associate with differential fetal cortical development or brain growth in mildly symptomatic pregnant women. This information may be useful to reassure infected mothers on the health of their fetuses.
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  • 文章类型: Case Reports
    我们报告了一例因21-羟化酶缺乏症而产前诊断为经典先天性肾上腺增生(CAH)的胎儿。虽然CAH通常在出生后进行评估,该胎儿病例有多个产前临床评估,跨学科CAH中心认为可行.该方法促进了对胎儿的全面和早期护理的发展和交付,和生活在这个建筑群中的家庭,先天性疾病,围生学,内分泌学,遗传咨询,心理学,和泌尿科的参与。同样,在标准超声中增加胎儿MRI显示双顶直径明显不足,枕额直径,和胎儿CAH脑的总颅内体积。大脑中的这些早期异常表明,在年龄较大的儿童和患有CAH的成年人中观察到的神经系统合并症应该早在产前进行研究。在超声检查中增加胎儿MRI可能有助于识别和理解CAH的产前异常。
    We report a case of a fetus with a prenatal diagnosis of classical congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency. Although CAH is typically assessed postnatally, this fetal case had multiple prenatal clinical assessments made feasible by an interdisciplinary CAH center. The approach facilitated the development and delivery of comprehensive and earlier care for the fetus, and the family living with this complex, congenital condition, with perinatology, endocrinology, genetic counseling, psychology, and urology involvement. As well, the addition of fetal MRI to standard ultrasound revealed significant deficits in the biparietal diameter, occipitofrontal diameter, and total intracranial volume of the fetal CAH brain. These early anomalies in the brain suggest that neurological comorbidities observed in older children and adults with CAH should be studied as early as prenatally, with the addition of fetal MRI to ultrasound potentially being useful for identifying and understanding prenatal anomalies in CAH.
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  • 文章类型: Case Reports
    The use of sugammadex for reversal of rocuronium-induced neuromuscular blockade after caesarean section is nowadays common practice, but concerns exist about its use in pregnant women undergoing non-obstetric surgery. We report six cases of pregnant women submitted to general anesthesia for non-obstetric surgery in which neuromuscular blockade was reversed with sugammadex. We followed the outcome of both mother and baby during and after delivery. Sugammadex seemed to be a safe option for both mother and baby but more reports are necessary to fill the evidence gap and increase the global knowledge about its safety in this special group of patients.
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  • 文章类型: Journal Article
    Globally, 292,982 women die due to the complications of pregnancy and childbirth per year, out of those deaths 85% occurs in Sub Saharan Africa. In Ethiopia, pre-eclampsia accounts for 11% of direct maternal deaths.
    To determine maternal and foetal outcomes of pregnancy-induced hypertension among women who gave birth at health facilities in Hossana town administration.
    Institutional based unmatched case-control study was conducted among women, who gave birth at health facilities from May 20 to October 30, 2018. By using Epi-Info version 7; 207 sample size was estimated, for each case two controls were selected. Two health facilities were selected using a simple random sampling method. Sample sizes for each facility were allocated proportionally. All cleaned & coded data were entered into Epi-info version 3.5.1 and analysis was carried out using SPSS version 20. Multivariate analysis was performed to determine predictors of pregnancy-induced hypertension at a p-value of <0.05.
    Women between 18 to 41 years old had participated in the study with the mean age of 26.00(SD ±4.42), and 25.87(SD ±5.02) for cases and controls respectively. Out of participants 21(30.4%) among cases and 21(15.2%) among controls had developed at least one complication following delivery. 12 (17.4%) and 8 (5.7%) foetal deaths were found in cases and controls groups respectively whereas 15.6% from cases and 3.6% from controls groups women gave birth to the foetus with intra-uterine growth retardation. Women gravidity AOR = 0.32 [95% CI (0.12 0.86)], Previous history of pregnancy-induced hypertension AOR = 22.50 [95% CI (14.95 16.52)] and educational status AOR = 0.32[95% CI (0.12, 0.85)] were identified as predictor of pregnancy-induced hypertension.
    Women with a previous history of pregnancy-induced hypertension had increased risk of developing pregnancy-induced hypertension, whilst ≥ 3 previous pregnancies and informal educational status decrease odds of developing pregnancy-induced hypertension.
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  • 文章类型: Journal Article
    In general terms, fetal growth restriction (FGR) is considered the impossibility of achieving the genetically determined potential size. In the vast majority of cases, it is related to uteroplacental insufficiency. Although its origin remains unknown and causes are only known in 30% of cases, it is believed to be related to an interaction of environmental and genetic factors with either a fetal or maternal origin. One hypothesis is that alterations in the gastrointestinal microbiota composition, and thus alteration in the immune response, could play a role in FGR development. We performed an observational, prospective study in a subpopulation affected with FGR to elucidate the implications of this microbiota on the FGR condition.A total of 63 fetuses with FGR diagnosed in the third trimester as defined by the Delphi consensus, and 63 fetuses with fetal growth appropriate for gestational age will be recruited. Obstetric and nutritional information will be registered by means of specific questionnaires. We will collect maternal fecal samples between 30 to 36 weeks, intrapartum samples (maternal feces, maternal and cord blood) and postpartum samples (meconium and new-born feces at 6 weeks of life). Samples will be analyzed in the Department of Biochemistry and Molecular Biology II, Nutrition and Food Technology Institute of the University of Granada (UGR), for the determination of the gastrointestinal microbiota composition and its relationship with inflammatory biomarkers.This study will contribute to a better understanding of the influence of gastrointestinal microbiota and related inflammatory biomarkers in the development of FGR.Trial registration: NCT04047966. Registered August 7, 2019, during the recruitment stage. Retrospectively registered. Ongoing research.
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  • 文章类型: Case Reports
    Ankyloglossia superior syndrome is an extremely rare entity in which centrally located glossopalatine ankylosis is a principal feature. Some cases are accompanied by cleft palate, micrognathia, or tongue hypoplasia, and affected patients need careful nutritional and respiratory support. We describe a newborn girl in whom ankyloglossia superior syndrome comprised complex craniofacial malformations, including cleft palate, micrognathia, microglossia, and natal teeth as well as limb anomalies. Surgical treatment entailed release of synechiae, and glossopexy was performed successfully to prevent postsurgical airway complications and to ensure adequate nutrition by nipple feeding during infancy.
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  • 文章类型: Journal Article
    This study determined risk factors, obstetric comorbidities, and fetal conditions among HIV-positive mothers to improve their maternal care.
    This retrospective case-control study included HIV-positive pregnant women 18 years of age or older and age-, parity-, and delivery method-matched HIV-negative controls between 2011 and 2018. Those who had stillbirth were excluded. Baseline demographics, labor process, CD4 count, plasma HIV viral load, and antiretroviral therapy (ART) regimen were recorded. Fetal conditions were recorded as well.
    Forty HIV-positive women (45 parities; 22 via NSD, 23 via C/S) were included, with 45 HIV-negative parities as controls. Twenty-nine (72.5%) HIV-positive women had illicit drug use. In the HIV-positive group, 17% received ART prior to first perinatal visit, and 75.6% reached viral suppression pre-delivery. Zidovudine and ritonavir-boosted lopinavir were the majorly prescribed ART. Mild perineal lacerations via NSD were observed in HIV-positive women. Fetal body weight was lower in HIV- and ART-exposed fetuses (2665 vs 3010 g, p < 0.001). Preterm delivery PTB (28.9% vs 8.9%, p= 0.015) and small-for gestational age SGA (28.9% vs 8.8%, p = 0.003) rates were higher in the HIV-positive group. There was no vertical transmission of HIV.
    HIV-positive women tend to deliver fetuses with low body weight and have higher SGA and PTB rates. Given that most women received zidovudine and protease inhibitors, benefits of newer agents for HIV-positive pregnancies should be studied.
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