scholarly journals Estimation of the Functional Condition of a Fetus of Pregnancy in Chronic Pyelonephritis

2013 ◽  
Vol 68 (12) ◽  
pp. 80-82 ◽  
Author(s):  
Sh.G. Kadimova
Keyword(s):  
Blood Flow ◽  
Pregnant Women ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Umbilical Artery ◽  
Chronic Pyelonephritis ◽  
Performance Ratio ◽  
Control Group ◽  
Placental Blood ◽  
Placental Blood Flow

Aim of this study was to investigate the condition of the fetus and feto placental system in chronic pyelonephritis by identifying features in the feto- placental blood flow and middle cerebral artery system. Patients and methods.  We examined 68 pregnant women with chronic pyelonephritis and 50 healthy pregnant women as a control group . The study conducted a qualitative assessment of fetus and placental blood flow and blood flow in the middle cerebral artery of the fetus . The data on the condition of  feto- placental blood flow and blood flow in the middle cerebral artery in the examined pregnant and control group show a higher incidence of elevated systolic and diastolic performance ratio in the umbilical artery in patients with chronic pyelonephritis than somatically healthy women. Results. Studies have shown that the most accurate and informative indicator of violations feto- placental circulation is an increase in the umbilical artery  whose value ( 2.9 and above) reflects the high degree of suffering of the fetus on a background of chronic pyelonephritis. Conclusions. Diagnostically significant is the indicator of the middle cerebral artery blood flow, which reflects the mechanism of enhancement of cerebral circulation in chronic hypoxia due to violation of feto- placental circulation in patients with renal disease.Key words: placentary insufficiency, nephritic pathology, pregnancy.

scholarly journals Doppler ultrasound in pregnancy – quality requirements of DEGUM and clinical application (part 2)

2021 ◽  
Author(s):  
Renaldo Faber ◽  
Kai-Sven Heling ◽  
Horst Steiner ◽  
Ulrich Gembruch
Keyword(s):  
Blood Flow ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Umbilical Artery ◽  
Prophylactic Treatment ◽  
Doppler Sonography ◽  
First Trimester ◽  
Ductus Venosus ◽  
Fetal Diagnosis

AbstractThis second part on Doppler sonography in prenatal medicine and obstetrics reviews its clinical applications. While this has not become the initially anticipated screening tool, it is used for the diagnosis and surveillance of a variety of fetal pathologies. For example, the sonography-based determination of uterine artery blood flow indices is an important parameter for the first trimester multimodal preeclampsia risk assessment, increasing accuracy and providing indication for the prophylactic treatment with aspirin. It also has significant implications for the diagnosis and surveillance of growth-restricted fetuses in the second and third trimesters through Doppler-sonographic analysis of umbilical artery, middle cerebral artery and ductus venosus. Here, especially the hemodynamics of the ductus venosus provides a critical criterium for birth management of severe, early-onset FGR before 34 + 0 weeks of gestation. Further, determination of maximum blood flow velocity of the middle cerebral artery is a central parameter in fetal diagnosis of anemia which has been significantly improved by this analysis. However, it is important to note that the mentioned improvements can only be achieved through highest methodological quality. Importantly, all these analyses are also applied to twins and higher order multiples. Here, for the differential diagnosis of specific complications such as TTTS, TAPS and TRAP, the application of Doppler sonography has become indispensable. To conclude, the successful application of Doppler sonography requires both exact methodology and precise pathophysiological interpretation of the data.

Fetal sheep endocrine responses to sustained hypoxemic stress after chronic fetal placental embolization

1997 ◽  
Vol 272 (5) ◽  
pp. E817-E823 ◽  
Author(s):  
R. Gagnon ◽  
J. Murotsuki ◽  
J. R. Challis ◽  
L. Fraher ◽  
B. S. Richardson
Keyword(s):  
Blood Flow ◽  
Oxygen Content ◽  
Regional Distribution ◽  
Arterial Oxygen ◽  
Control Group ◽  
Fetal Sheep ◽  
Arterial Oxygen Content ◽  
Placental Blood ◽  
Chronic Hypoxemia ◽  
Placental Blood Flow

The purpose of this study was to determine the endocrine and circulatory responses of the ovine fetus, near term, to sustained hypoxemic stress superimposed on chronic hypoxemia. Fetal sheep were chronically embolized (n = 7) for 10 days between 0.84 and 0.91 of gestation via the descending aorta until arterial oxygen content was decreased by approximately 30%. Control animals (n = 8) received saline only. On experimental day 10, both groups were embolized over a 6-h period until fetal arterial pH decreased to approximately 7.00. Regional distribution of lower body blood flows was measured on day 10, before and at the end of acute embolization. On day 10, the chronically embolized group had lower arterial oxygen content (P < 0.05), Po2 (P < 0.01), and placental blood flow (P < 0.05) than controls and higher prostaglandin E2 (PGE2) and norepinephrine plasma concentrations (both P < 0.05). In response to a superimposed sustained hypoxemic stress, there was a twofold greater increase in PGE2 in the chronically embolized group than in the control group (P < 0.05). However, the increase in fetal plasma cortisol in response to superimposed hypoxemic stress was similar in both groups, despite significantly lower adrenocorticotropic hormone and adrenal cortex blood flow responses in the chronically hypoxemic group (both P < 0.05). We conclude that PGE2 response to a sustained superimposed reduction in placental blood flow, leading to metabolic acidosis, is enhanced under conditions of chronic hypoxemia and may play an important role for the maintenance of the fetal cortisol response to an episode of superimposed acute stress.

Association Between Fetal Thymus Size and Intrauterine Growth Restriction

2021 ◽  
pp. 875647932110547
Author(s):  
Elham Keshavarz ◽  
Marjan Rustazade Sheikhyusefi ◽  
Ensi Khalili Pouya ◽  
Masoumeh Mirzamoradi ◽  
Mehdi Khazaei ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Intrauterine Growth Restriction ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Control Group ◽  
Fetal Thymus ◽  
Intrauterine Growth ◽  
The Mean ◽  
Thymus Size

Objective: The objective of this study was to evaluate the association between reduced fetal thymus size and intrauterine growth restriction (IUGR). This study was devised to determine the association between thymus size and any abnormal Doppler indices within the fetal umbilical artery (UA), as well as the middle cerebral artery (MCA). Materials and Methods: Forty-six pregnancies between 20 and 38 weeks of gestation with IUGR and 46 normal pregnancies within similar gestational age (GA) range were included. The transverse diameter of fetal thymus was measured. In the IUGR group, the fetal umbilical artery (UA) and middle cerebral artery (MCA) Doppler flow velocities were recorded. Results: The mean GA of fetuses with IUGR (33.5 weeks) was higher than control group (30.3 weeks). To adjust for the effect of GA, analysis of covariance (ANCOVA) was performed. The adjusted mean thymus diameters were 19.02 mm in IUGR and 21.25 within the control group (mean difference = 2.23 mm; P = .02). The mean (±SD) thymus size in 16 fetuses, with abnormal Doppler findings, was significantly lower than in the group with normal Doppler findings, 17.45 (±2.50) vs 22.02 (±5.39) mm; P < .001. Conclusion: IUGR may be associated with reduced fetal thymus size, especially when coupled with abnormal Doppler findings. The thymus size in a group of IUGR fetuses, with abnormal Doppler findings, was smaller than IUGR fetuses, with normal Doppler findings.

Cerebral blood flow of children with vasovagal syncope

2014 ◽  
Vol 25 (2) ◽  
pp. 267-273 ◽  
Author(s):  
Barsan Tugba ◽  
Kilic Zubeyir ◽  
Uzuner Nevzat ◽  
Yildirim Ali ◽  
Ucar Birsen ◽  
...  
Keyword(s):  
Blood Flow ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Flow Rate ◽  
Vasovagal Syncope ◽  
Blood Flow Rate ◽  
Tilt Test ◽  
Control Group ◽  
Group 2 ◽  
Group 1

AbstractIntroduction: We aimed to evaluate changes in the cerebral blood supply in children during vasovagal syncope and to clarify the diagnostic value of transcranial Doppler for vasovagal syncope. Materials and methods: Patients were divided into three groups. Group 1 consisted of 31 patients who were symptomatic and whose head-up tilt test was positive. Group 2 comprised 21 patients who were symptomatic but whose tilt test was negative. Group 3 included 22 healthy children. For the diagnosis of vasovagal syncope, the tilt test was applied. For the subjects of the patient and control groups, the tilt test was repeated. The flow rates of bilateral middle cerebral arteries were continuously and simultaneously recorded with temporal window transcranial Doppler. Results: There were no statistically significant differences between the three groups with respect to age and gender distribution (p>0.05). When the bed was at an upright position, the maximum blood flow rate of the right middle cerebral artery was lower in Group 1 than in Group 2, although the decrease was more significant in comparison to the healthy control group (p<0.05). The minimum blood flow rate of the right middle cerebral artery was lower in Group 1 than the Group 2, although the decrease was more significant in comparison with the healthy control group (p<0.05). The maximum blood flow rate of the left middle cerebral artery was significantly lower in Group 1 than in the control group (p<0.05). Conclusion: Minimum and maximum blood flow rates are significantly decreased in patients tilt test (+) patients with vasovagal syncope during orthostatic stress.

scholarly journals Endothelial dysfunction and its role in the prevention, treatment and complications of critical conditions in obstetrics

2020 ◽  
pp. 120-122
Author(s):  
Kim Jong-Din
Keyword(s):  
Growth Rate ◽  
Endothelial Cells ◽  
Blood Flow ◽  
Endothelial Dysfunction ◽  
Pregnant Women ◽  
Standard Therapy ◽  
Morbidity And Mortality ◽  
Group I ◽  
Placental Blood ◽  
Placental Blood Flow

Background. Preeclampsia (PE) remains the leading cause of maternal and perinatal morbidity and mortality. As of today, there is no treatment for PE, and the childbirth is the only way to completely eliminate this condition. However, early childbirth is associated with a high risk of fetal morbidity and mortality. Objective. To describe the role of endothelial dysfunction (ED) in the development of PE and the possibility of its correction; to evaluate the effectiveness of Tivortin (“Yuria-Pharm”) in the correction of uterine-fetal-placental dysfunction. Materials and methods. Analysis of literature sources on this topic; own PLACENTA study. The study involved 535 women with mild PE at 26-29 weeks of gestation. Group I received standard therapy, group II – standard therapy in combination with Tivortin (4.2 g per day for 7-10 days). Results and discussion. Until the fetus reaches viability, PE treatment is aimed at correcting hypertension, however, antihypertensive therapy does not have a beneficial effect on the condition of the kidneys and placental blood flow. Decreased blood flow in placenta leads to the syndrome of limited fetal development (SLFD) and multisystem ED. The development of PE is inextricably linked with the systemic damage to maternal endothelial cells and a further decrease in endothelium-dependent vasodilators, which promotes vasospasm and activates the coagulation cascade. PE is accompanied by the imbalance in the systems of prostacyclin and nitric oxide (NO), as well as thromboxane and endothelin. Superficial placentation with insufficient remodeling of the spiral arteries and impaired response to changes in blood flow is one of the main causes of PE. ED is the most studied pathogenetic mechanism of PE. NO has a potent vasodilating effect and is involved in inhibiting thromboxane formation, platelet aggregation and stimulating prostacyclin formation. NO-synthase of endothelial cells, the substrate of which is L-arginine, is the main enzyme of NO production. Disorders of vasodilation in pregnant women with PE can be eliminated by prescribing L-arginine. Literature data show that L-arginine is successfully used in the need to continue pregnancy, as well as to eliminate hypertension and correct SLFD. Canadian guidelines for the treatment of hypertensive complications of pregnancy state that L-arginine is able to improve uteroplacental blood flow. According to a study by J. Chen (2016), the inclusion of L-arginine contributes to both maternal and perinatal outcomes of pregnancy. The effect of L-arginine on fetal growth is mediated by promoting the production of creatine, skeletal muscle protein and growth hormone. L-arginine also promotes the synthesis of polyamines, which can stimulate the growth and development of placenta. Own studies have shown that the use of L-arginine (Tivortin, “Yuria-Pharm”) in the combined PE therapy had improved the growth rate of the fetus and its functional condition, which allowed to prolong pregnancy to the optimal term of childbirth, as well as improve the consequences of childbirth and adaptation of newborns in the early neonatal period. PE is not the only field of application of Tivortin: its intravenous administration in community-acquired pneumonia and pyelonephritis of pregnant women helps to quickly eliminate the pathological process. The results of the PLACENTA study found that Tivortin helped to improve uterine-fetal-placental blood flow and reduce the centralization of blood circulation. In the Tivortin group there was a smaller number of cesarean sections, a tendency to lower blood loss (by 19.5 %), a higher average score of newborns on the Apgar scale. Comparison of clinical and morphological changes showed that the administration of Tivortin in the late second and early third trimester of pregnancy reduces the likelihood of premature placental maturation by 2.1 %, halves the likelihood of placental necrosis, 10 times reduces the signs of hypoxia. Conclusions. 1. ED, caused by a decrease in NO, is the main link in the PE pathogenesis. 2. In the human body NO is produced from L-arginine. 3. The use of L-arginine (Tivortin) improves uterine-fetal-placental blood flow, growth rate and functional status of the fetus, reduces fetal distress and allows to prolong pregnancy to the optimal term of childbirth.

Features of hemodynamics of the mother–placenta–fetus system in the first half of pregnancy after the assisted reproductive technologies application

2018 ◽  
pp. 62-66
Author(s):  
L.M. Vygivska ◽  
◽  
I.V. Maidannyk ◽  
O.O. Chorna ◽  
V.F. Oleshko ◽  
...  
Keyword(s):  
Blood Flow ◽  
Pregnant Women ◽  
Doppler Ultrasound ◽  
Uterine Artery ◽  
Umbilical Artery ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Control Group ◽  
Uterine Arteries ◽  
The Right

Doppler study is one of the main methods for assessing the condition of placental blood circulation and fetal hemodynamics. Doppler blood flow in the uterine arteries demonstrates the broad capabilities of the method for predicting pregnancy complications such as gestosis, fetal development delay, preterm birth, as well as for diagnosing adverse perinatal consequences. However, there is still no clear opinion about the feasibility of using Doppler as a screening test, as well as about the optimal pregnancy period for this type of study. The objective: is to study the hemodynamic features in pregnant women after assisted reproductive technologies (ART) application in the dynamics of the first part of pregnancy. Materials and methods. 299 pregnant women were examined – the main group included 249 women whose pregnancy occurred as a result of ART application. The control group consisted of 50 pregnant women with spontaneous pregnancy and its physiological course. I group – 94 women with tubal-peritoneal factor of infertility, II group – 87 women with endocrine factor of infertility, III group - 68 women whose infertility was caused by the male factor. Doppler ultrasound examination of the uterine arteries, arteries of the umbilical cord and middle cerebral arteries of the fetus were conducted. Results. It was found that the highest intensity of hemodynamics in the uterine artery basin at 11–12 weeks of gestation was recorded in a group of patients with a physiological course of pregnancy. The systolic-diastolic ratio in the right and left uterine arteries in these patients was 1.9 (1.8–2.7) and 2.1 (1.9–2.6), respectively. In contrast to women in the control group, pregnant women after ART application analyzed indicators were higher (1.6–1.9 times; p<0.0001). The systolic-diastolic ratio in the right uterine artery in III group was 3.0 (2.4–3.5), I group – 3.3 (3.1–3.4). Similar data were obtained analyzing the curves of blood flow rates in the left uterine artery – 2.9 (2.1–3.5) and 3.0 (2.7–3.6), respectively. The highest peripheral resistance, both in the right (3.6 (3.4–3.7) and left (3.5 (3.2–3.8) uterine arteries, was naturally registered in pregnant women of II group. In 36 (72%) patients with uncomplicated course and successful gestation at 11–12 weeks of pregnancy, blood flow was not recorded in the intervellon space. In the vast majority – 50 (73.5%) pregnant women of I group, two types of blood flow were registered in the intervellar space: pulsating arterial and continuous venous. Only in 18 (26.5%) patients of this group the blood flow in intervellon space was not determined. As a result of the obtained data analysis, it was found that at 16-17 weeks of gestation, the highest intensity of blood flow in the uterine artery pool was recorded in the control group. Thus, the systolic-diastolic ratio of the right and left uterine arteries in these subjects was 1.6 (1.5–1.8) and 1.8 (1.6–2.0). In pregnant women of the main group, the indicators were significantly higher (1.2-2.0 times; p<0.0001). The systolic-diastolic ratio in the uterine arteries in group III was 2,1 (1,9–2,6); 2,2 (1,9–2,5), in the II group – 3,1 (2,5–3,3); 2,2 (1,9–2,5), in the I group – 2,6 (2,5–3,2); 2,7 (2,5–2,9). In contrast to the control group, in which the systolic-diastolic ratio in the fetal umbilical artery was 3.4 (3.3–3.5), in III group patients, there was a significantly higher intensity of umbilical blood flow (S/D – 3.3 (3.5–3.6), p=0.03). At the same time, feto-placental hemodynamics in II and I groups patients was characterized by a significant increase in the numerical values of blood flow in the umbilical arteries (S/D – 4.5 (4.4–4.7), p=0.0001 and 3.5 (3.5–3.6), p=0.03, respectively). In patients of the control group, the systolic-diastolic ratio of the middle cerebral artery of the fetus at 16–17 weeks of gestation was 3.4 (3.4–3.5), almost completely coinciding with the same indicator in the umbilical artery (S/D – 3.4 (3.3–3.5). Patients of group III had a higher blood flow intensity, as evidenced by significantly lower (S/D 3.2 (3.1–3.3), compared with the control group (S/D 3.4 (3.4–3.5) absolute values of the systolic-diastolic ratio. An increase in the intensity of blood flow in the fetal medial artery (against the background of increased vascular resistance in the umbilical artery) was also recorded in the group of subjects of group II (S/D – 2.8 (2.7–2.9). High absolute values of systolic-diastolic ratio in the indicated vessel (4.4 (4.3–4.5) were found in the fetuses of the examined group and group, which characterize a significant decrease in the intensity of cerebral blood flow, compared with all the analyzed groups. Conclusions. Thus, the results of the study allow us to attribute Doppler ultrasound to highly informative research methods that make it possible to predict hemodynamic changes in the mother-placenta-fetus system, depending on the type of infertility, take preventive measures and start correction in time. Keywords: pregnancy, assisted reproductive technologies, Doppler ultrasound, uterine arteries, systolic-diastolic ratio.

scholarly journals Placental Transfer of Lactate, Glucose and 2-deoxyglucose in Control and Diabetic Wistar Rats

2001 ◽  
Vol 2 (2) ◽  
pp. 113-120 ◽  
Author(s):  
Chris R. Thomas ◽  
Beryl B. Oon ◽  
Clara Lowy
Keyword(s):  
Blood Flow ◽  
Wistar Rats ◽  
Placental Transfer ◽  
Maternal Plasma ◽  
Diabetic Group ◽  
Control Group ◽  
Placental Blood ◽  
Lactate Levels ◽  
Placental Blood Flow

Placental transfer of lactate, glucose and 2-deoxyglucose was examined employing thein situperfused placenta. Control and streptozotocin induced diabetic Wistar rats were infused with U-14C]-glucose and [3H]-2-deoxyglucose (2DG). The fetal side of the placenta was perfuseci with a cell free medium and glucose uptake was calculated in the adjacent fetuses. Despite the 5-fold higher maternal plasma glucose concentration in the diabetic dams the calculated fetal glucose metabolic index was not significantly different between the 2 groups. Placental blood flow was reduced in the diabetic animals compared with controls but reduction of transfer of [U-14C]-glucose and [3H]-2-deoxyglucose and endogenously derived [14C]-Lactate to the fetal compartment, could not be accounted for by reduced placental blood flow alone. There was no significant net production or uptake of lactate into the perfusion medium that had perfused the fetal side of the placenta in either group. The plasma lactate levels in the fetuses adjacent to the perfused placenta were found to be higher than in the maternal plasma and significantly higher in the fetuses of the diabetic group compared with control group. In this model thein situperfused placenta does not secrete significant quantities of lactate into the fetal compartment in either the control or diabetic group.

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