Letter - Why do the fetal membranes rupture after fetoscopy? – Comments on proposed mechanisms and adding the fetus as a potential culprit

2021 ◽  
Author(s):  
Thomas Kohl
Keyword(s):  
Spina Bifida ◽  
Amniotic Membrane ◽  
Gestational Age ◽  
Fetal Membranes ◽  
Fetal Movements ◽  
Expectant Mothers ◽  
The Mean

It has never been taken into account that the fetus itself, by being trapped within the iatrogenic openings in the amniotic membrane from a previous intervention, can tear her home to pieces. As early rupture of membranes within hours or days after percutaneous fetoscopic surgery for spina bifida occurs in less than 10% of our cases, I would attribute most ruptures later in gestation to this effect. Fetal fingers and toes fit all too easily and – with advanced gestational age (the mean age of PROM after my approach to fetoscopic spina bifida surgery occurs around 30 weeks of gestation) – the fetus becomes certainly strong enough to achieve this mischievous feat. Supporting this notion of the (trapped) fetus as a potential culprit, many expectant mothers report a period of stronger fetal movements shortly prior to the occurrence of PROM.

scholarly journals Time of quickening is associated with the placental site and BMI in nulliparous women

2020 ◽  
Author(s):  
Negin Jaafar ◽  
Lars Henning Pedersen ◽  
Olav Bjørn Petersen ◽  
Lone Hvidman
Keyword(s):  
Pregnant Women ◽  
Gestational Age ◽  
Prospective Observational Study ◽  
Nuchal Translucency ◽  
Second Trimester ◽  
Nulliparous Women ◽  
Placental Site ◽  
Fetal Movements ◽  
The Mean ◽  
Important Milestone

AbstractIntroductionQuickening, the first sensation of fetal movements, is an important milestone for pregnant women. Information on the expected gestational age at quickening may reduce anxiety and prevent delayed detection of intrauterine demise but the available data are from the 1980s before the emergence of modern ultrasound techniques.Materials and methodsProspective observational study on nulliparous women blinded for placental location in two hospitals in Denmark. The pregnant women were enrolled at the time of nuchal translucency scan, placental location was determined at time of second trimester scanning.. The women were blinded to placenta location before time of quickening. Time of quickening were reported by 122 women, 65 with an anterior and 57 with a posterior placenta. Thirteen women had a BMI >30 (10.7%).ResultsThe mean gestational age for quickening was 19 + 0 weeks for nulliparous women. The timing depended on placental site; women with an anterior placenta experienced quickening 6.4 days later than the women with a posterior placenta. BMI > 30 was associated with a later time of quickening.ConclusionsAnterior placental location is associated with delay in experience of fetal movements of 6.4 days and this may further be delayed in women with a BMI>30.

Activity of 3β-hydroxysteroid dehydrogenase-5,4-en isomerase in chorioallantois and amnion from pregnant sheep

1983 ◽  
Vol 97 (3) ◽  
pp. 347-356 ◽  
Author(s):  
S. G. A. Power ◽  
J. R. G. Challis
Keyword(s):  
Gestational Age ◽  
Subcellular Distribution ◽  
Chorioallantoic Membrane ◽  
Hydroxysteroid Dehydrogenase ◽  
Fetal Membranes ◽  
Pregnant Sheep ◽  
Competitive Inhibitors ◽  
The Mean ◽  
Ovine Fetal

Activity of 3β-hydroxysteroid dehydrogenase-5,4-en isomerase (3β-HSD; pregnenolone to progesterone) was investigated in homogenates of chorioallantois and amnion obtained from sheep at three gestational ages (day 50, day 100 and term) using an isotope assay. Chorioallantois and, to a lesser extent, amnion possessed 3β-HSD at each gestational age studied. Activity in the chorioallantoic membrane was greater at term than at days 50 and 100, and was similar to that in the placenta at day 100 and term. Activity in the placenta was considerably greater at day 50 than at day 100 and term. The subcellular distribution of 3β-HSD in chorioallantoic membrane was particulate in nature. The mean Km values (± s.e.m.) were 56·8 ± 5·5 and 39·0 ± 8·7 nmol/l at day 50 and term respectively. The mean Vmax values were 14·1 ±3·1 and 62·7± 11·4 pmol/min per mg protein at day 50 and term respectively. Several steroids inhibited the conversion of pregnenolone to progesterone, particularly dehydroepiandrosterone (DHEA), oestrone and oestradiol. Oestrone and DHEA were competitive inhibitors. The Ki values were 19·6 ± 5·9 and 40·2± 14·7 nmol/l for oestrone and DHEA inhibition respectively. The results show that ovine fetal membranes have the capacity to convert pregnenolone to progesterone and demonstrate the possibility of inhibition by other steroids. Progesterone produced by the fetal membranes might influence the local intra-uterine steroid milieu during pregnancy and before parturition.

Sonographic Assessment of Amniotic Fluid Volume using Single Deepest Pocket (SDP) among Igbo Women with Uncomplicated Singleton Pregnancies.

2019 ◽  
Vol 2 (1) ◽  
pp. 1-18
Author(s):  
Chijioke Okeudo ◽  
B.U. Ezem
Keyword(s):  
Amniotic Fluid ◽  
Gestational Age ◽  
Cross Sectional Study ◽  
Fluid Volume ◽  
Singleton Pregnancy ◽  
Cross Sectional ◽  
South Eastern ◽  
Amniotic Fluid Volume ◽  
The Mean ◽  
Singleton Pregnancies

Background: The amniotic fluid is fundamental for proper fetal development and growth. Ultrasound visualization of the amniotic fluid permits both subjective and objective estimates of the amniotic fluid. Objective: The objective of this study was to determine the reference values of normal single deepest pocket (SDP) – upper and lower limits, mean SDP and variation of the SDP with gestational age among Igbo women of South-Eastern Nigeria extraction carrying uncomplicated singleton pregnancy. Methodology: This was a prospective cross sectional study involving 400 women carrying uncomplicated singleton pregnancies and who were sure of the date of the first day of their last menstrual period. The single deepest pocket / maximum vertical pool were determined once at presentation at the hospital.. The study was conducted from January 1st to December 31st 2015. The second author carried out all the scanning. The SDP was obtained. Results: The womens’ mean and median ages were the same at 28 years. The gestational age range of the pregnancies was 14-41 weeks. The mean SDP was 5.8cm, while the 5th and 95th percentiles were 3.3cm and 8.5cm respectively. There was no difference in the mean SDP in both term and preterm. There was irregular but continuous rise of mean SDP to a peak of 6.8cm at gestational age of 39 weeks. In conclusion, the participants had a mean SDP of 5.8cm. There was also a positive correlation between SDP and Gestational age. We therefore recommend a longitudinal study to assess perinatal outcome and abnormal amniotic fluid volume among Igbo women of South-Eastern Nigeria. Key words: Single Deepest Pocket, Uncomplicated Singleton Pregnancy, Igbo Women.

Association of Retained Fetal Membranes with Haematological Profile in Crossbred Cows

2017 ◽  
Vol 12 (3) ◽  
Author(s):  
K. Rokde ◽  
S. Kumar ◽  
A. Bhardwaz ◽  
S. S. Mahour ◽  
S. P. Nema ◽  
...  
Keyword(s):  
Eosinophil Count ◽  
Jugular Vein ◽  
Dairy Farm ◽  
Fetal Membranes ◽  
Monocyte Count ◽  
Blood Samples ◽  
Mean Values ◽  
Crossbred Cows ◽  
Haematological Profile ◽  
The Mean

This study was carried out on clinical cases of retained fetal membranes in crossbred cows presented at College Clinics and College dairy farm and from Villages in and around Mhow. The blood samples were collected from jugular vein just before 12 hr. postpartum and on 7th day postpartum. Haematological profile revealed that the mean values of haemoglobin, neutrophil and monocyte count after 12 hrs and 7th day postpartum were significantly lower and lymphocyte count was significantly higher in RFM cows (n=18) than normally calved cows (n=6). The differences in mean TLC, eosinophil and basophil counts were non-significant at 12 hrs postpartum, however on 7th day postpartum the TLC and eosinophil count were significantly higher and basophil count was non-significantly different in RFM cows than the normally calved cows.

Stillbirth Rate and Weight at Birth of Quintuplets in Japan

1989 ◽  
Vol 38 (1-2) ◽  
pp. 65-69 ◽  
Author(s):  
Yoko Imaizumi
Keyword(s):  
Sample Size ◽  
Birth Order ◽  
Gestational Age ◽  
Size Effects ◽  
Maternal Age ◽  
Small Sample Size ◽  
Small Sample ◽  
Stillbirth Rate ◽  
The Mean

AbstractNation-wide data in Japan on births and prenatal deaths of 16 sets of quintuplets during 1974-1985 were analysed. Among the 16 sets, 3 sets were liveborn, 8 were stillborn, and 5 were mixed, with a stillbirth rate of 0.64 (51/80). Effects of sex, maternal age and birth order on the stillbirth rate were not considered because of the small sample size. Effects of gestational age and birthweight on stillbirth rate were also examined. The mean weight of the 40 quintuplet individuals was 1,048 g.

Insulin Responses During Catch-up Growth of Infants Who Were Small for Gestational Age

PEDIATRICS ◽  
1976 ◽  
Vol 57 (3) ◽  
pp. 363-371
Author(s):  
Eleanor Colle ◽  
David Schiff ◽  
Gail Andrew ◽  
Charles B. Bauer ◽  
Pamela Fitzhardinge
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Growth Velocity ◽  
Insulin Response ◽  
Growth Characteristics ◽  
Term Infants ◽  
The Mean ◽  
Catch Up ◽  
Insulin Responses ◽  
Permissive Role

Growth characteristics of 15 full-term infants, selected because of weights more than 2 SD below the mean for gestational age, are described. The response to an intravenous injection of glucose was utilized to measure the insulin response of the infants at 6 months. Infants small for gestational age grow at a faster rate than appropriate-for-age infants during the first six months of life. There was a positive correlation between the growth velocity of the period and insulin release and a negative correlation between growth velocity and birth length. There was no correlation between these variables and increases in weight during the same period. Growth velocity during catch-up growth is related to the degree of preceding retardation but insulin may play a permissive role.

scholarly journals Single Dose of Methotrexate Therapy Followed By Suction Curettage for Management of Cesarean Scar Pregnancy

2019 ◽  
Vol 3 (1) ◽  
pp. 01-04
Author(s):  
Hend S Saleh ◽  
Hala E Sherif ◽  
Eman M Mahfouz
Keyword(s):  
Single Dose ◽  
Gestational Age ◽  
Wedge Resection ◽  
Rare Condition ◽  
Prospective Clinical Study ◽  
Maternal Complications ◽  
Cesarean Scar Pregnancy ◽  
Cesarean Scar ◽  
Suction Curettage ◽  
The Mean

Objective Implantation of the pregnancy in a cesarean scar is a rare condition named ; Cesarean scar pregnancy (CSP). Maternal complications can be prevented with the early diagnosis and an appropriate management .It is a Prospective clinical study to evaluate the efficacy and success rate of single dose use of methotrexate (MTX) followed by dilation and suction (D&S) regimen in management of women with cesarean scar pregnancy (CSP) . Methods 50mg of MTX in the form of a single dose Intramuscular injection then cervical dilatation and suction aspiration with a Karman cannula(D&S) under guidance of ultrasound after 48 preeceeded by vaginal misoprostol 2 tablet (200 mg) 4 hours ago. Results The mean gestational age at diagnosis was (8.5±1.6 ) and The mean level of serum b-human chorionic gonadotropin was (7424±2.560 ) and The mean gestational age of pregnancy was (8.5±1.6 ) .88.7% is the successive rate without complication need intervention, 2 (5.7%) patients needed intrauterine Foley's catheter for 24 hours as a mechanical hemostasis . 2 (5.7 %) had laparotomy with wedge resection of the gestational sac lesion and successful repair of the uterine defect and one (2.8 %)underwent subtotal hysterectomy. Conclusion: Systemic single dose MTX injection followed by D&S is an effective and harmless management for CSP. Nevertheless more studies are required to prove the efficiency, safety, and reproductive outcome of variant modalities in treatment of CSP.

scholarly journals Iodine and iodothyronine content in human neonate thyroid gland

2002 ◽  
Vol 54 (3-4) ◽  
pp. 69-74 ◽  
Author(s):  
Svetlana Savin-Zegarac ◽  
Dubravka Cvejic ◽  
Olgica Nedic ◽  
R. Radosavljevic ◽  
Ivana Petrovic
Keyword(s):  
Thyroid Gland ◽  
Gestational Age ◽  
Thyroid Tissue ◽  
Iodine Content ◽  
Postnatal Life ◽  
Total Iodine ◽  
Mean Values ◽  
Human Neonate ◽  
The Mean ◽  
Human Neonates

A few years after the iodine content of salt in Serbia was increased from 7 to 15 mg/kg NaCI, iodine, thyroxine (T4) and triiodothyronine (T3) concentrations were measured in thyroid tissue obtained at autopsy from 21 human neonates who died within 30 days after birth. The thyroidal iodine as well as T4 and T3 content per gland in?creased progressively with gestational age of human neonates (r = 0.73, 0.70 and 0.67 respectively, p < 0.001). In seven newborns (gestational age 36 to 41 weeks) the mean values for total iodine, T4 and T3 per gland were 109.1 ?g, 52.2 ?g and 4.4 ?g respectively. The results of iodine and iodothyroninc content found in neonatal thyroid gland, particularly at the end of gestation and a few days of postnatal life, indicates that the iodine supply was satisfactory.

scholarly journals Gambaran Kasus Spina Bifida di RSUD Arifin Achmad Provinsi Riau Periode 2015-2017

2021 ◽  
Vol 14 (1) ◽  
pp. 52
Author(s):  
Syntha Novianti Rahmad ◽  
Andrea Valentino ◽  
Huriatul Masdar
Keyword(s):  
Spina Bifida ◽  
Gestational Age ◽  
Congenital Abnormalities ◽  
Second Child ◽  
Spina Bifida Aperta

Spina bifida is a fault in the development of spine and the bones around until it leaves gap or defect in the spine. About 36 cases of spina bifida were involved in this research. The characteristis of spina bifida patients, mostly occurs at the patients at the age of > 28 days (83,3%). Most of them were male (52,8%). The most frequent spina bifida patients were the second child (44,4%) and location where spina bifida occurs were at the lumbosakral (72,2%). Classified into spina bifida aperta type (86,1%). The highest age of patients’ mother suffering from spina bifida was at the age of  20-40 (80,6%). In general, rupture didn’t occur on spina bifida patients (94.4%). The weight of spina bifida patients were between 2.500-4.000 gr (94,4%) and they didn’t have other congenital abnormalities (47,2%). The most gestational age of spina bifida patients’ mothers when giving birth were, is at 28-40 weeks (94.4%).

scholarly journals Short Term Outcomes of Neonates Born after Prolonged Premature Rupture of Membranes < 34 Weeks Gestation

2019 ◽  
Vol 4 (2) ◽  
pp. 83
Author(s):  
Isam Bsisu ◽  
Alaa Aldalaeen ◽  
Rawan Elrajabi ◽  
Ala AlZaatreh ◽  
Rama Jadallah ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Neonatal Intensive Care ◽  
Preterm Births ◽  
University Hospital ◽  
High Rate ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Gestational Week ◽  
The Mean

<p><strong><em>Background:</em></strong><em> Preterm premature rupture of membranes (PPROM) is responsible for one?third of all preterm births worldwide. This aim of this study was to investigate the outcome of neonates born after prolonged PPROM with gestational age below 34 weeks. </em></p><p><strong><em>Materials and methods:</em></strong><em> This retrospective study included 65 patients who were born to mothers with Prolonged PPROM &lt;34 weeks gestation between January 2011 and December 2015 and admitted to the neonatal intensive care unit (NICU) at Jordan University Hospital. </em></p><p><strong><em>Results: </em></strong><em>The mean gestational age of included patients was (31.9 ± 2.5 weeks), mean birth weight was (1840 ± 583 g) and 43 (66.2%) were males. The mortality rate in those infants was 12.3 %. Gestational age, birth weight, and Apgar score were significantly lower among mortality cases compared to surviving cases (P &lt; 0.05). </em></p><p><strong><em>Conclusion:</em></strong><em> Prolonged PPROM before the 34<sup>th</sup> gestational week is associated with high rate of morbidity and mortality, for which early identification of risk factors for developing PPROM can help in reducing the risk for preterm labors and subsequent burden on healthcare system.</em></p>

Sign in / Sign up

Export Citation Format

Share Document