MRI Angiography of Physiological and Pathological Pregnancy Placentas Ex-Vivo (MAPLE): protocol for a prospective pilot study. (Preprint)

2021 ◽  
Author(s):  
Matthieu Dap ◽  
Bailiang Chen ◽  
Claire Banasiak ◽  
Gabriella Hossu ◽  
Olivier Morel ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
Gestational Age ◽  
Ex Vivo ◽  
Texture Features ◽  
Primary Objective ◽  
Controlled Study ◽  
Histopathological Analysis ◽  
Vascular Architecture ◽  
Mri Angiography ◽  
Uterine Growth

BACKGROUND Preeclampsia (PE) and intra-uterine growth restriction (IUGR) are two major pregnancy complications due to abnormal placental vasculogenesis. Data on whole fetoplacental vasculature are still missing to better understand these pathologies. Ex-vivo magnetic resonance imaging (MRI) angiography has been developed to characterize the human placental vasculature by injecting contrast within the umbilical cord. OBJECTIVE The primary objective is to compare the vascular architecture of placenta between physiological and pathological pregnancies. Secondary objectives are (i) to analyse vascularization indices and texture features according to the group and within comparable gestational age (ii) to compare de vascularization indices to histological analysis. METHODS This is a prospective controlled study. We expect to include 100 placentas: 40 from normal pregnancies and 60 from pathological pregnancies with 30 for IUGR and 30 for PE. Ex-vivo MRI acquisition will be performed shortly after delivery and with preparation by injection within the umbilical cord. The vascular architecture will be quantitatively described by vascularization indices measured from ex-vivo MRI angiography data. Comparisons of vascularization indices and texture features according to the group and within comparable gestational age will be also performed. After MR acquisition, placental histopathological analysis will be performed. RESULTS The enrolment of women began in November 2019. In view of the recruitment capacity of our institution and the availability of the MRI, the recruitment should be completed by March 2022. As of November 2021, we enrolled 70% of the population. CONCLUSIONS This study protocol aims to provide information about the fetal side of placental vascular architecture in normal and pathological placenta with MRI. CLINICALTRIAL NCT 04389099 (Clinical Trial)

scholarly journals Evaluation of umbilical cord complication and its relation with foetal outcome

2018 ◽  
Vol 7 (10) ◽  
pp. 4214
Author(s):  
Aarti Jeenwal ◽  
Hemlata Jharbade
Keyword(s):  
Umbilical Cord ◽  
Umbilical Artery ◽  
Primary Objective ◽  
Medical College ◽  
Nuchal Cord ◽  
Uterine Growth ◽  
Intra Uterine Growth Restriction ◽  
Cord Prolapse ◽  
Foetal Outcome ◽  
Artery Flow

Background: There are numerous umbilical cord abnormalities ranging from false knots, which have no clinical significance, to vasa previa, which could cause foetal loss. With availability of more sophisticated prenatal ultrasound techniques, many can be detected early in utero, however many of these are not apparent till delivery. In this study primary objective was to study correlation of umbilical cord complications and foetal outcome. Authors also outlined available courses of action to avert their morbidity and mortality.Methods: Prospective case control study was conducted in Department of Obstetrics and Gynaecology of M.G.M. Medical College and M. Y. Hospitals, Indore. Antenatal women with more than 28 weeks gestation were included. 500 cases with cord abnormalities were followed till delivery and were compared to the 500 controls with normal cord findings. Data was recorded in predesigned coded case report forms and statistical analysis was performed.Results: Of all the cord complications studied nuchal cord was the commonest i.e. 66.2% followed by abnormal cord length 12.4%. Incidence of cord prolapse was 7.2%. Single umbilical artery, cord knot and abnormal umbilical artery flow were found in 4%, 1.38% and 0.68% respectively.Conclusions: The presence of nuchal cord per se is not found to be an indication of operative delivery. However, these cases require close intrapartum monitoring. Gross cord abnormality was associated with still birth, intra uterine growth restriction and intrapartum or immediate post-natal complication.

A Review of Evaluating Hematopoietic Stem Cells Derived from Umbilical Cord Blood's Expansion and Homing

2020 ◽  
Vol 15 (3) ◽  
pp. 250-262
Author(s):  
Maryam Islami ◽  
Fatemeh Soleimanifar
Keyword(s):  
Stem Cells ◽  
Hematopoietic Stem Cells ◽  
Umbilical Cord ◽  
Stromal Cells ◽  
Ex Vivo ◽  
Hematologic Malignancies ◽  
Future Directions ◽  
Hematopoietic Stem ◽  
Efficient Procedure ◽  
Hematopoietic Recovery

Transplantation of hematopoietic stem cells (HSCs) derived from umbilical cord blood (UCB) has been taken into account as a therapeutic approach in patients with hematologic malignancies. Unfortunately, there are limitations concerning HSC transplantation (HSCT), including (a) low contents of UCB-HSCs in a single unit of UCB and (b) defects in UCB-HSC homing to their niche. Therefore, delays are observed in hematopoietic and immunologic recovery and homing. Among numerous strategies proposed, ex vivo expansion of UCB-HSCs to enhance UCB-HSC dose without any differentiation into mature cells is known as an efficient procedure that is able to alter clinical treatments through adjusting transplantation-related results and making them available. Accordingly, culture type, cytokine combinations, O2 level, co-culture with mesenchymal stromal cells (MSCs), as well as gene manipulation of UCB-HSCs can have effects on their expansion and growth. Besides, defects in homing can be resolved by exposing UCB-HSCs to compounds aimed at improving homing. Fucosylation of HSCs before expansion, CXCR4-SDF-1 axis partnership and homing gene involvement are among strategies that all depend on efficiency, reasonable costs, and confirmation of clinical trials. In general, the present study reviewed factors improving the expansion and homing of UCB-HSCs aimed at advancing hematopoietic recovery and expansion in clinical applications and future directions.

Gestational Age Dependency of Umbilical Cord Serum IL-6 Levels for Detecting Fetal Inflammation

2020 ◽  
Author(s):  
Sota Iwatani ◽  
Takao Kobayashi ◽  
Sachiko Matsui ◽  
Akihiro Hirata ◽  
Miwa Yamamoto ◽  
...  
Keyword(s):  
Umbilical Cord ◽  
Gestational Age ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Significant Negative Correlation ◽  
Cord Serum ◽  
Very Preterm ◽  
Key Points ◽  
Extremely Preterm ◽  
Preterm Newborns

Objective The fetal inflammatory response syndrome (FIRS) is characterized by elevated concentrations of inflammatory cytokines in fetal blood, with preterm delivery and morbidity. Umbilical cord serum interleukin-6 (UC-s-IL-6) is an ideal marker for detecting FIRS. However, the effect of gestational age (GA) on UC-s-IL-6 levels has not been reported. This study aimed to determine the relationship between GA and UC-s-IL-6 levels, and GA-dependent cutoff values of UC-s-IL-6 levels for detecting fetal inflammation. Study Design UC-s-IL-6 concentrations were measured in 194 newborns (44 extremely preterm newborns (EPNs) at 22–27 weeks' GA, 68 very preterm newborns (VPNs) at 28–31 weeks' GA, and 82 preterm newborns (PNs) at 32–34 weeks' GA). Linear regression analyses were used to correlate GA and UC-s-IL-6 levels. Receiver operating characteristic (ROC) curves analyses were performed for detecting the presence of funisitis, as the histopathological counterpart of FIRS. Results A significant negative correlation between GA and UC-s-IL-6 levels was found in newborns with severe funisitis (r s =  − 0.427, p = 0.004) and those with mild funisitis (r s =  − 0.396, p = 0.025). ROC curve analyses revealed the area under the curve for detecting funisitis were 0.856, 0.837, and 0.622 in EPNs, VPNs, and PNs, respectively. The UC-s-IL-6 cutoff value in EPNs (28.1 pg/mL) exceeded those in VPNs and PNs (3.7 and 3.0 pg/mL, respectively). Conclusion UC-s-IL-6 levels were inversely correlated with GA especially in newborns with funisitis. Such GA dependency of UC-s-IL-6 should be considered for detecting fetal inflammation. Key Points

Neonatal Outcomes at Extreme Prematurity by Gestational Age Versus Birth Weight in a Contemporary Cohort

2021 ◽  
Author(s):  
Elizabeth B. Ausbeck ◽  
Phillip Hunter Allman ◽  
Jeff M. Szychowski ◽  
Akila Subramaniam ◽  
Anup Katheria
Keyword(s):  
Birth Weight ◽  
Umbilical Cord ◽  
Gestational Age ◽  
Predictive Value ◽  
Neonatal Death ◽  
Controlled Trial ◽  
Neonatal Morbidity ◽  
Mortality And Morbidity ◽  
Severe Morbidity ◽  
Multicenter Randomized Controlled Trial

Objective The aim of the study is to describe the rates of neonatal death and severe neonatal morbidity in a contemporary cohort, as well as to evaluate the predictive value of birth gestational age (GA) and birth weight, independently and combined, for neonatal mortality and morbidity in the same contemporary cohort. Study Design We performed a secondary analysis of an international, multicenter randomized controlled trial of delayed umbilical cord clamping versus umbilical cord milking in preterm infants born at 23 0/7 to 31 6/7 weeks of gestation. The current analysis was restricted to infants delivered <28 weeks. The primary outcomes of this analysis were neonatal death and a composite of severe neonatal morbidity. Incidence of outcomes was compared by weeks of GA, with planned subanalysis comparing small for gestational age (SGA) versus non-SGA neonates. Multivariable logistic regression was then used to model these outcomes based on birth GA, birth weight, or a combination of both as primary independent predictors to determine which had superior ability to predict outcomes. Results Of 474 neonates in the original trial, 180 (38%) were included in this analysis. Overall, death occurred in 27 (15%) and severe morbidity in 139 (77%) neonates. Rates of mortality and morbidity declined with increasing GA (mortality 54% at 23 vs. 9% at 27 weeks). SGA infants (n = 25) had significantly higher mortality compared with non-SGA infants across all GAs (p < 0.01). There was no difference in the predictive value for neonatal death or severe morbidity between the three prediction options (GA, birth weight, or GA and birth weight). Conclusion Death and severe neonatal morbidity declined with advancing GA, with higher rates of death in SGA infants. Birth GA and birth weight were both good predictors of outcomes; however, combining the two was not more predictive, even in SGA infants. Key Points

Inflammatory Markers in Umbilical Cord Blood from Small-For-Gestational-Age Newborns

2014 ◽  
Vol 33 (2) ◽  
pp. 114-118 ◽  
Author(s):  
Ulrik Lausten-Thomsen ◽  
Marianne Olsen ◽  
Gorm Greisen ◽  
Kjeld Schmiegelow
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Inflammatory Markers

EX-VIVO FINE NEEDLE ASPIRATION IN THE DIAGNOSIS OF RENAL MASSES: A PROSPECTIVE CONTROLLED STUDY

2009 ◽  
Vol 181 (4S) ◽  
pp. 213-213
Author(s):  
Brian T Kadow ◽  
Alex Gorbonos ◽  
Güliz A Barkan ◽  
Eva M Wojcik ◽  
Marcus L Quek
Keyword(s):  
Fine Needle Aspiration ◽  
Ex Vivo ◽  
Needle Aspiration ◽  
Controlled Study ◽  
Renal Masses ◽  
Fine Needle ◽  
Prospective Controlled Study

scholarly journals Gestational Age-Dependent Increase of Survival Motor Neuron Protein in Umbilical Cord-Derived Mesenchymal Stem Cells

2017 ◽  
Vol 5 ◽  
Author(s):  
Sota Iwatani ◽  
Nur Imma Fatimah Harahap ◽  
Dian Kesumapramudya Nurputra ◽  
Shinya Tairaku ◽  
Akemi Shono ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Motor Neuron ◽  
Umbilical Cord ◽  
Gestational Age ◽  
Survival Motor Neuron ◽  
Survival Motor Neuron Protein ◽  
Age Dependent ◽  
Motor Neuron Protein

Augmentation of umbilical cord blood (UCB) transplantation with ex vivo–expanded UCB cells: results of a phase 1 trial using the AastromReplicell System

Blood ◽  
2003 ◽  
Vol 101 (12) ◽  
pp. 5061-5067 ◽  
Author(s):  
Jennifer Jaroscak ◽  
Kristin Goltry ◽  
Alan Smith ◽  
Barbara Waters-Pick ◽  
Paul L. Martin ◽  
...  
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Ex Vivo ◽  
Phase 1 ◽  
Horse Serum ◽  
Perfusion Culture ◽  
Ex Vivo Expansion ◽  
Hematopoietic Stem ◽  
Phase 1 Trial

AbstractAllogeneic stem cell transplantation with umbilical cord blood (UCB) cells is limited by the cell dose a single unit provides recipients. Ex vivo expansion is one strategy to increase the number of cells available for transplantation. Aastrom Biosciences developed an automated continuous perfusion culture device for expansion of hematopoietic stem cells (HSCs). Cells are expanded in media supplemented with fetal bovine serum, horse serum, PIXY321, flt-3 ligand, and erythropoietin. We performed a phase 1 trial augmenting conventional UCB transplants with ex vivo–expanded cells. The 28 patients were enrolled on the trial between October 8, 1997 and September 30, 1998. UCB cells were expanded in the device, then administered as a boost to the conventional graft on posttransplantation day 12. While expansion of total cells and colony-forming units (CFUs) occurred in all cases, the magnitude of expansion varied considerably. The median fold increase was 2.4 (range, 1.0-8.5) in nucleated cells, 82 (range, 4.6-266.4) in CFU granulocyte-macrophages, and 0.5 (range, 0.09-2.45) in CD34+ lineage negative (lin–) cells. CD3+ cells did not expand under these conditions. Clinical-scale ex vivo expansion of UCB is feasible, and the administration of ex vivo–expanded cells is well tolerated. Augmentation of UCB transplants with ex vivo–expanded cells did not alter the time to myeloid, erythroid, or platelet engraftment in 21 evaluable patients. Recipients of ex vivo–expanded cells continue to have durable engraftment with a median follow-up of 47 months (range, 41-51 months). A randomized phase 2 study will determine whether augmenting UCB transplants with ex vivo–expanded UCB cells is beneficial.

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