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1.
Rev. bras. ginecol. obstet ; 42(9): 529-534, Sept. 2020. tab, graf
Article in English | LILACS | ID: biblio-1137878

ABSTRACT

Abstract Objective The purpose of the present study was to analyze the influence of chorionicity in the biometric parameters crown-rump length (CRL), birthweight (BW), crown-rump length discordancy (CRLD) and birthweight discordancy (BWD), determine the correlation between these latter two in cases of intertwin discordancy, and to analyze the influence of chronicity in the presence of these discordancies with clinical relevance (> 10% and > 15%, respectively). Methods The present study was a retrospective study based on the twin pregnancy database of the Centro Hospitalar S. João (2010-2015), including 486 fetuses among 66 monochorionic (MC) and 177 dichorionic gestations (DC). The inclusion criteria were multiple pregnancies with 2 fetuses and healthy twin gestations. The exclusion criteria were trichorionic gestations and pregnancies with inconclusive chorionicity, multiple pregnancy with ≥ 3 fetuses and pathological twin gestations. Results No statistically significant difference was found in BW (p = 0.09) and in its discordancy (p = 0.06) nor in CRL (p = 0.48) and its discordancy (p = 0.74) between MCs and DCs. Crown-rump length discordancy and birthweight discordancy were correlated by the regression line "BWD = 0.8864 x CRLD + 0.0743," with r2 = 0.1599. Crown-rump length discordancy > 10% was found in 7.58% of monochorionic and in 13.56% of dichorionic twins. Birthweight discordancy > 15% was detected in 16.67% of monochorionic and in 31.64% of dichorionic twins. Conclusion No statistically significant influence of chorionicity was identified in both birthweight and birthweight discordancy, as in crown-rump length and crown-rump length discordancy. Birthweight discordancy was correlated to crown-rump length discordancy in 20% of cases.


Resumo Objetivo O objetivo do presente estudo foi analisar a influência da corionicidade nos parâmetros biométricos comprimento craniocaudal, peso ao nascimento, discordância de comprimento craniocaudal e discordância de peso ao nascimento, determinar a correlação entre estes dois últimos caso haja discordância intergemelar e analisar a influência da corionicidade na presença destas discordâncias com relevância clínica (> 10% e > 15%, respectivamente). Métodos O presente estudo foi um estudo retrospectivo baseado na base de dados de gestações gemelares do Centro Hospitalar S. João (2010-2015), incluindo 486 fetos de 66 gestações monocoriônicas e 177 dicoriônicas. Os critérios de inclusão foram gestações múltiplas de 2 fetos e gestações gemelares saudáveis. Os critérios de exclusão foram gestações tricoriônicas ou de corionicidade inconclusiva, gestações múltiplas com ≥ 3 fetos e gestações gemelares patológicas. Resultados Não se encontrou diferença estatisticamente significativa no peso ao nascimento (p =0,09) e sua discordância (p = 0,06) nem no comprimento craniocaudal (p = 0,48) e sua discordância (p = 0,74) entre gestações monocoriônicas e dicoriônicas. Considerando todas as gestações, as discordâncias de comprimento craniocaudal e peso ao nascimento foram correlacionadas pela reta de regressão "discordância de peso ao nascimento = 0.8864 x discordância de comprimento craniocaudal + 0.0743," com r2 = 0,1599. A discordância de comprimento craniocaudal > 10% descobriu-se em 7.58% das gestações monocoriônicas e em 13.56% das dicoriônicas. A discordância de peso ao nascimento > 15% detectou-se em 16.67% das gestações monocoriônicas e em 31.64% das dicoriônicas. Conclusão Não se identificou influência estatisticamente significativa no peso ao nascimento e sua discordância, bem como no comprimento craniocaudal e sua discordância. A discordância de peso ao nascimento correlacionou-se com a discordância de comprimento craniocaudal em 20% dos casos.


Subject(s)
Birth Weight/physiology , Chorion/physiology , Chorion/physiopathology , Crown-Rump Length , Pregnancy, Twin , Pregnancy Complications/physiopathology , Retrospective Studies
2.
Int. j. morphol ; 38(4): 1018-1025, Aug. 2020. graf
Article in English | LILACS | ID: biblio-1124891

ABSTRACT

The equine placenta is a simple apposition of fetal and maternal tissues, becoming more complex with the formation of microcotyledons around days 75 and 100 of gestation. The present study aimed to describe the gross and microscopic morphology of early equine placenta. Embryonic/fetal membranes from thirty-seven mares were submitted to macroscopic description, light, scanning and transmission microscopy. Overall the gross characteristics of membranes were similar with already described for older stages. However, transmission electron microscopy evidenced high metabolic rate in chorion and allantois, and high secretion profile in amnion and even higher in yolk sac. Gene ontologies enrichment, using published data, pointed several common ontologies in allantoic and amniotic fluids, related to oxygen and iron transport, extracellular space and high-density lipoprotein receptor binding. Overall, the morphological and ontology enrichment could indicate allantois and amnion crosstalk.


La placenta equina es una simple aposición de tejidos fetales y maternos, que se vuelve más compleja con la formación de microcotiledones alrededor de los días 75 y 100 de gestación. El presente estudio tuvo como objetivo describir la morfología macroscópica y microscópica de la placenta equina temprana. Las membranas embrionarias / fetales de treinta y siete yeguas fueron sometidas a descripción macroscópica, luz, escaneo y microscopía de transmisión. En general, las características generales de las membranas fueron similares a las ya descritas para las etapas más antiguas. Sin embargo, la microscopía electrónica de transmisión mostró una alta tasa metabólica en corion y alantoides, y un alto perfil de secreción en amnios e incluso mayor en el saco vitelino. El enriquecimiento de ontologías génicas, utilizando datos publicados, señaló varias ontologías comunes en fluidos alantoideos y amnióticos, relacionados con el transporte de oxígeno y hierro, espacio extracelular y unión a receptores de lipoproteínas de alta densidad. En general, el enriquecimiento morfológico y ontológico podría indicar alantoides y diafonía de amnios.


Subject(s)
Animals , Female , Pregnancy , Placenta/anatomy & histology , Horses , Placenta/ultrastructure , Pregnancy Trimester, First , Chorion , Allantois , Amnion , Microscopy/methods
3.
Article in English | WPRIM | ID: wpr-766114

ABSTRACT

PURPOSE: The aim of this study was to evaluate the use of dehydrated human amnion/chorion membrane (dHACM) to repair perforated sinus membranes in rabbits. METHODS: Bilateral surgical windows (7.5-mm diameter) were prepared on the nasal bones of 14 rabbits. Standardized circular perforations (5-mm diameter) were made in the sinus membrane by manipulating implant twist drills. The perforated sinus membranes were repaired using dHACM or a resorbable collagen membrane (CM). The negative control (NC) group did not undergo perforated sinus membrane repair, while the positive control (PC) group underwent sinus augmentation without perforations. The same amount of deproteinized porcine bone mineral was grafted in all 4 groups. After 6 weeks, micro-computed tomography (micro-CT) and histomorphometric evaluations were conducted. RESULTS: The micro-CT analysis revealed that the total augmented volume was not significantly different among the groups. In the dHACM group, newly formed bone filled the augmented area with remaining biomaterials; however, non-ciliated flat epithelium and inflammatory cells were observed on the healed sinus membrane. Histometric analysis showed that the percentage of newly formed bone area in the dHACM group did not differ significantly from that in the CM group. The dHACM group showed a significantly higher percentage of newly formed bone area than the NC group, but there was no significant difference between the dHACM and PC groups. CONCLUSIONS: dHACM could be a feasible solution for repairing sinus membrane perforations that occur during sinus floor augmentation.


Subject(s)
Amnion , Biocompatible Materials , Chorion , Collagen , Epithelium , Humans , Membranes , Miners , Nasal Bone , Rabbits , Sinus Floor Augmentation , Transplants
4.
Article in English | WPRIM | ID: wpr-764970

ABSTRACT

BACKGROUND: Under certain situations, women with twin pregnancies may be counseled to undergo invasive prenatal diagnostic testing. Chorionic villus sampling and amniocentesis are the two generally performed invasive prenatal diagnostic tests. Studies comparing procedure-related fetal loss between first-trimester chorionic villus sampling and second-trimester amniocentesis in twin pregnancies are limited. This study aimed to evaluate the procedure-related fetal loss and the obstetrical outcomes of these two procedures, chorionic villus sampling and amniocentesis in twin pregnancies. METHODS: The data from dichorionic-diamniotic twin pregnancies on which first-trimester chorionic villus sampling (n = 54) or second-trimester amniocentesis (n = 170) was performed between December 2006 and January 2017 in a single center were retrospectively analyzed. The procedure-related fetal loss was classified as loss of one or all fetuses within 4 weeks of procedure, and overall fetal loss was classified as loss of one or all fetuses during the gestation. The groups were compared with respect to the procedure-related and obstetrical outcomes. RESULTS: The difference in proportion of procedure-related fetal loss rate (1.9% for chorionic villus sampling vs. 1.8% for amniocentesis; P = 1.000) and the overall fetal loss rate (7.4% for chorionic villus sampling vs. 4.7% for amniocentesis; P = 0.489) between the two groups was not significant. The mean gestational ages at delivery were not statistically significant. CONCLUSION: Both the overall fetal loss rate and the procedure-related fetal loss rate of chorionic villus sampling and amniocentesis in dichorionic twin pregnancies had no statistical significance. Both procedures can be safely used individually.


Subject(s)
Amniocentesis , Chorion , Chorionic Villi Sampling , Chorionic Villi , Diagnostic Tests, Routine , Female , Fetus , Gestational Age , Humans , Pregnancy , Pregnancy, Twin , Retrospective Studies , Twins
5.
Rev. chil. obstet. ginecol. (En línea) ; 83(1): 99-103, feb. 2018. graf, ilus
Article in Spanish | LILACS | ID: biblio-899977

ABSTRACT

RESUMEN La protuberancia coriónica (del inglés chorionic bump) es una condición que involucra al saco gestacional y que puede ser visualizada en la ecografía de primer trimestre. Ha sido descrita como una convexidad irregular que protruye hacia el saco gestacional y que probablemente corresponda a la formación de un hematoma en la superficie coriodecidual. Nosotros reportamos los hallazgos y el seguimiento ecográfico de un caso, junto con una revisión de la literatura.


SUMMARY Chorionic bump is a condition that involves the gestational sac and can be viewed during the first-trimester ultrasound scan. It has been described as an irregular convexity protruding into the gestational sac and probably corresponds to the formation of a hematoma within the choriodecidual surface. We reported both the sonographic findings and follow-up of a case, along with a review of the literature.


Subject(s)
Humans , Female , Pregnancy , Adult , Pregnancy Trimester, First , Pregnancy Outcome , Ultrasonography, Prenatal , Gestational Sac/diagnostic imaging , Chorion/diagnostic imaging , Ultrasonography, Doppler
6.
Article in English | WPRIM | ID: wpr-716901

ABSTRACT

OBJECTIVE: In frozen and thawed embryos, the zona pellucida (ZP) can be damaged due to hardening. Laser-assisted hatching (LAH) of embryos can increase the pregnancy rate. This study compared thinning and drilling of the ZP before frozen embryo transfer (FET). METHODS: Patients were randomly allocated into two groups for LAH using thinning or drilling on day 2 after thawing. Twenty-five percent of the ZP circumference and 50% of the ZP thickness was removed in the thinning group, and a hole 40 µm in diameter was made in the drilling group. RESULTS: A total of 171 in vitro fertilization/intracytoplasmic sperm injection FET cycles, including 85 cycles with drilling LAH and 86 cycles with thinning LAH, were carried out. The thinning group had a similar β-human chorionic gonadotropin-positive rate (38.4% vs. 29.4%), implantation rate (16.5% vs. 14.4%), clinical pregnancy rate (36.0% vs. 25.9%), miscarriage rate (5.8% vs. 2.4%), ongoing pregnancy rate (30.2% vs. 23.5%), and multiple pregnancy rate (7.0% vs. 10.6%) to the drilling LAH group. There were no significant differences in pregnancy outcomes between subgroups defined based on age (older or younger than 35 years) or ZP thickness (greater or less than 17 µm) according to the LAH method. CONCLUSION: The present study demonstrated that partial ZP thinning or drilling resulted in similar outcomes in implantation and pregnancy rates using thawed embryos, irrespective of women's age or ZP thickness.


Subject(s)
Abortion, Spontaneous , Chorion , Embryo Transfer , Embryonic Structures , Female , Humans , In Vitro Techniques , Methods , Pregnancy , Pregnancy Outcome , Pregnancy Rate , Pregnancy, Multiple , Reproductive Techniques, Assisted , Spermatozoa , Zona Pellucida
7.
Frontiers of Medicine ; (4): 542-549, 2018.
Article in English | WPRIM | ID: wpr-772718

ABSTRACT

Preeclampsia (PE) is a pregnancy-specific, multi-system disorder and the leading cause of maternal and perinatal morbidity and mortality in obstetrics worldwide. Excessive vasoconstriction and dysregulated coagulation function are closely associated with PE. Heat shock protein 20 (HSP20) is ubiquitously expressed under normal physiological conditions and has important roles in vascular dilatation and suppression of platelet aggregation. However, the role of HSP20 in the pathogenesis of PE remains unclear. In this study, we collected chorionic plate resistance arteries (CPAs) and serum from 118 healthy pregnant women and 80 women with PE and detected the levels of HSP20 and its phosphorylated form. Both HSP20 and phosphorylated HSP20 were downregulated in CPAs from women with PE. Comparison of the vasodilative ability of CPAs from the two groups showed impaired relaxation responses to acetyl choline in preeclamptic vessels. In addition to the reduced HSP20 in serum from women with PE, the platelet distribution width and mean platelet volume were also decreased, and the activated partial thromboplastin time and thromboplastin time were elevated.With regard to the vital roles of HSP20 in mediating vasorelaxation and coagulation function, the decreased HSP20 might contribute to the pathogenesis of PE.


Subject(s)
Adult , Case-Control Studies , Chorion , Female , HSP20 Heat-Shock Proteins , Metabolism , Humans , Phosphorylation , Placenta , Platelet Function Tests , Pre-Eclampsia , Metabolism , Pregnancy , Vasoconstriction , Vasodilation
8.
Article in English | WPRIM | ID: wpr-713116

ABSTRACT

OBJECTIVE: To compare human chorionic gonadotropin (HCG)-administered natural cycle with spontaneous ovulatory cycle in patients undergoing frozen-thawed embryo transfer (FTET) in natural cycles. METHODS: In this retrospective cohort study, we analyzed the clinical outcome of a total of 166 consecutive FTET cycles that were performed in either natural cycle controlled by HCG for ovulation triggering (HCG group, n=110) or natural cycle with spontaneous ovulation (control group, n=56) in 166 infertile patients between January 2009 and November 2013. RESULTS: There were no differences in patients' characteristics between the 2 groups. The numbers of oocytes retrieved, mature oocytes, fertilized oocytes, grade I or II embryos and frozen embryos in the previous in vitro fertilization (IVF) cycle in which embryos were frozen were comparable between the HCG and control groups. Significant differences were not also observed between the 2 groups in clinical pregnancy rate (CPR), embryo implantation rate, miscarriage rate, live birth rate and multiple CPR. However, the number of hospital visits for follicular monitoring was significantly fewer in the HCG group than in the control group (P < 0.001). CONCLUSION: Our results demonstrated that HCG administration for ovulation triggering in natural cycle reduces the number of hospital visits for follicular monitoring without any detrimental effect on FTET outcome when compared with spontaneous ovulatory cycles in infertile patients undergoing FTET in natural ovulatory cycles.


Subject(s)
Abortion, Spontaneous , Cardiopulmonary Resuscitation , Chorion , Chorionic Gonadotropin , Cohort Studies , Embryo Implantation , Embryo Transfer , Embryonic Structures , Female , Fertilization in Vitro , Humans , Live Birth , Oocytes , Ovulation , Pregnancy , Pregnancy Rate , Retrospective Studies , Zygote
9.
Clinics ; 72(5): 265-271, May 2017. tab, graf
Article in English | LILACS | ID: biblio-840074

ABSTRACT

OBJECTIVE: The aim of the present study was to compare the placental weight and birth weight/placental weight ratio for intrauterine growth-restricted and non-intrauterine growth-restricted monochorionic and dichorionic twins. METHODS: This was a retrospective analysis of placentas from twin pregnancies. Placental weight and the birth weight/placental weight ratio were compared in intrauterine growth-restricted and non-intrauterine growth-restricted monochorionic and dichorionic twins. The association between cord insertion type and placental lesions in intrauterine growth-restricted and non-intrauterine growth-restricted monochorionic and dichorionic twins was also investigated. RESULTS: A total of 105 monochorionic (intrauterine growth restriction=40; non-intrauterine growth restriction=65) and 219 dichorionic (intrauterine growth restriction=57; non-intrauterine growth restriction=162) placentas were analyzed. A significantly lower placental weight was observed in intrauterine growth-restricted monochorionic (p=0.022) and dichorionic (p<0.001) twins compared to non-intrauterine growth-restricted twins. There was no difference in the birth weight/placental weight ratio between the intrauterine growth restriction and non-intrauterine growth restriction groups for either monochorionic (p=0.36) or dichorionic (p=0.68) twins. Placental weight and the birth weight/placental weight ratio were not associated with cord insertion type or with placental lesions. CONCLUSION: Low placental weight, and consequently reduced functional mass, appears to be involved in fetal growth restriction in monochorionic and dichorionic twins. The mechanism by which low placental weight influences the birth weight/placental weight ratio in intrauterine growth-restricted monochorionic and dichorionic twins needs to be determined in larger prospective studies.


Subject(s)
Humans , Female , Pregnancy , Adult , Young Adult , Birth Weight/physiology , Chorion/physiology , Fetal Development/physiology , Fetal Growth Retardation/physiopathology , Placenta/anatomy & histology , Pregnancy, Twin/physiology , Gestational Age , Organ Size , Placenta/pathology , Placenta/physiopathology , Reference Values , Retrospective Studies , Statistics, Nonparametric , Time Factors , Twins, Dizygotic , Twins, Monozygotic
10.
Article in English | WPRIM | ID: wpr-649863

ABSTRACT

Mesenchymal stem cells (MSCs) can be obtained from a variety of human tissues. Placenta has become an attractive stem cell source for potential applications in regenerative medicine and tissue engineering. The aim of this study was to localize and characterize MSCs within human chorionic membranes (hCMSCs). For this purpose, immunofluorescence labeling with CD105 and CD90 were used to determine the distribution of MSCs in chorionic membranes tissue. A medium supplemented with a synthetic serum and various concentrations of neurotrophic factors and cytokines was used to induce hCMSCs to neural cells. The results showed that the CD90 positive cells were scattered in the chorionic membranes tissue, and the CD105 positive cells were mostly located around the small blood vessels. hCMSCs expressed typical mesenchymal markers (CD73, CD90, CD105, CD44 and CD166) but not hematopoietic markers (CD45, CD34) and HLA-DR. hCMSCs differentiated into adipocytes, osteocytes, chondrocytes, and neuronal cells, as revealed by morphological changes, cell staining, immunofluorescence analyses, and RT-PCR showing the tissue-specific gene presence for differentiated cell lineages after the treatment with induce medium. Human chorionic membranes may be the source of MSCs for treatment of nervous system injury.


Subject(s)
Adipocytes , Blood Vessels , Cell Lineage , Chondrocytes , Chorion , Cytokines , Fluorescent Antibody Technique , HLA-DR Antigens , Humans , Membranes , Mesenchymal Stem Cells , Nerve Growth Factors , Neurons , Osteocytes , Placenta , Regenerative Medicine , Stem Cells , Tissue Engineering , Trauma, Nervous System
11.
Article in English | WPRIM | ID: wpr-110374

ABSTRACT

BACKGROUND: Meconium aspiration syndrome (MAS) is defined by respiratory distress requiring supplemental oxygen in a meconium-stained neonate. MAS is clinically subclassified as mild, moderate, and severe according to the oxygen requirement. The aims of this study were to compare the histological findings in the placentas of MAS neonates with those of meconium-stained but non-MAS neonates and to analyze the correlation between the severity of MAS and the grade of its histological parameters. METHODS: We collected 160 singleton term placentas from neonates with meconium staining at birth from a tertiary medical center, Seoul, Republic of Korea. We reviewed hematoxylin and eosin sections of tissue samples (full-thickness placental disc, chorioamniotic membranes, and umbilical cord). RESULTS: Funisitis was present more frequently in MAS than in non-MAS (p < .01), of which the stage was correlated with the severity of MAS (p < .001). The histological findings consistent with maternal underperfusion and chronic deciduitis were more frequent in MAS than in non-MAS (p < .05). There was a correlation between the degree of chorionic vascular muscle necrosis and the severity of MAS (p < .05). CONCLUSIONS: Our results suggest that fetal inflammatory response evidenced by funisitis occurs prenatally in MAS and that the stage of funisitis and of chorionic vascular muscle necrosis may be a predictive marker of the severity of MAS.


Subject(s)
Chorioamnionitis , Chorion , Eosine Yellowish-(YS) , Female , Hematoxylin , Humans , Infant, Newborn , Meconium Aspiration Syndrome , Meconium , Membranes , Necrosis , Oxygen , Parturition , Placenta , Pregnancy , Republic of Korea , Seoul
12.
Medisan ; 20(12)dic. 2016. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-829194

ABSTRACT

Se realizó un estudio descriptivo, prospectivo y longitudinal de todos los nacimientos pretérminos cuya causa fue la corioamnionitis, asistidos en el Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba, durante el trienio 2013-2015, con la finalidad de determinar su incidencia e impacto en la prematuridad. La edad materna promedio de las pacientes que presentaron corioamnionitis fue de 28,6 años, mientras que la edad gestacional media fue de 32,3 semanas; en tanto, la infección genital resultó el factor de riesgo predominante (74,0 %), seguida de la anemia (70,1 %) y la rotura prematura de membranas (55,8 %), y el peso promedio al nacer fue 1 753 gramos. Pudo concluirse que la prematuridad continúa siendo uno de los principales problemas de salud, y que existe una tendencia a disminuir la incidencia de corioamnionitis y la mortalidad por esta causa


A descriptive, prospective and longitudinal study of all preterm births whose cause was the chorioamnionitis, assisted in "Dr. Juan Bruno Zayas Alfonso" Teaching General Hospital in Santiago de Cuba was carried out, during 2013-2015, with the purpose of determining its incidence and impact in prematurity. The average maternal age of women that presented chorioamnionitis was 28.6 years, while the mean gestational age was 32.3 weeks; as long as, the genital infection was the predominant risk factor (74.0 %), followed by anemia (70.1 %) and the premature rupture of membranes (55.8 %), and the average birth weight was 1 753 grams. It was concluded that prematurity continues being one of the main health problems, and that there is a tendency to diminish chorioamnionitis incidence and mortality due to this cause


Subject(s)
Reproductive Tract Infections , Obstetric Labor, Premature , Infant, Premature , Chorion , Amnion
13.
Article in English | WPRIM | ID: wpr-50891

ABSTRACT

OBJECTIVE: To validate quantitative fluorescent polymerase chain reaction (QF-PCR) via chorionic villus sampling (CVS) for the diagnosis of fetal aneuploidies. METHODS: We retrospectively reviewed the medical records of consecutive pregnant women who had undergone CVS at Cheil General Hospital between December 2009 and June 2014. Only cases with reported QF-PCR before long-term culture (LTC) for conventional cytogenetic analysis were included, and the results of these two methods were compared. RESULTS: A total of 383 pregnant women underwent QF-PCR and LTC via CVS during the study period and 403 CVS specimens were collected. The indications of CVS were as follows: abnormal first-trimester ultrasonographic findings, including increased fetal nuchal translucency (85.1%), advanced maternal age (6.8%), previous history of fetal anomalies (4.2%), and positive dual test results for trisomy 21 (3.9%). The results of QF-PCR via CVS were as follows: 76 (18.9%) cases were identified as trisomy 21 (36 cases), 18 (33 cases), or 13 (seven cases), and 4 (1.0%) cases were suspected to be mosaicism. All results of common autosomal trisomies by QF-PCR were consistent with those of LTC and there were no false-positive findings. Four cases suspected as mosaicism in QF-PCR were confirmed as non-mosaic trisomies of trisomy 21 (one case) or trisomy 18 (three cases) in LTC. CONCLUSION: QF-PCR via CVS has the advantage of rapid prenatal screening at an earlier stage of pregnancy for common chromosomal trisomies and thus can reduce the anxiety of parents. In particular, it can be helpful for pregnant women with increased fetal nuchal translucency or abnormal first-trimester ultrasonographic findings.


Subject(s)
Aneuploidy , Anxiety , Chorion , Chorionic Villi Sampling , Chorionic Villi , Cytogenetic Analysis , Diagnosis , Down Syndrome , Female , Fluorescence , Hospitals, General , Humans , Maternal Age , Medical Records , Mosaicism , Nuchal Translucency Measurement , Parents , Polymerase Chain Reaction , Pregnancy , Pregnant Women , Prenatal Diagnosis , Retrospective Studies , Trisomy
14.
Article in English | WPRIM | ID: wpr-56127

ABSTRACT

OBJECTIVE: The purpose of this study was to identify useful clinical factors for the identification of patients with polycystic ovary syndrome (PCOS) who would benefit from in vitro maturation (IVM) treatment without exhibiting compromised pregnancy outcomes. METHODS: A retrospective cohort study was performed of 186 consecutive patients with PCOS who underwent human chorionic gonadotropin-primed IVM treatment between March 2010 and March 2014. Only the first IVM cycle of each patient was included in this study. A retrospective case-control study was subsequently conducted to compare pregnancy outcomes between IVM and conventional in vitro fertilization (IVF) cycles. RESULTS: Through logistic regression analyses, we arrived at the novel finding that serum anti-Müllerian hormone (AMH) levels and the number of fertilized oocytes in IVM were independent predictive factors for live birth with unstandardized coefficients of 0.078 (95% confidence interval [CI], 1.005-1.164; p=0.037) and 0.113 (95% CI, 1.038-1.208; p=0.003), respectively. Furthermore, these two parameters were able to discriminate patients who experienced live births from non-pregnant IVM patients using cut-off levels of 8.5 ng/mL and five fertilized oocytes, respectively. A subsequent retrospective case-control study of patients with PCOS who had serum AMH levels ≥8.5 ng/mL showed that IVM had pregnancy outcomes comparable to conventional IVF, and that no cases of ovarian hyperstimulation syndrome were observed. CONCLUSION: Serum AMH levels are a useful factor for predicting pregnancy outcomes in PCOS patients before the beginning of an IVM cycle. IVM may be an alternative to conventional IVF for PCOS patients if the patients are properly selected according to predictive factors such as serum AMH levels.


Subject(s)
Case-Control Studies , Chorion , Cohort Studies , Female , Fertilization in Vitro , Humans , In Vitro Oocyte Maturation Techniques , In Vitro Techniques , Live Birth , Logistic Models , Oocytes , Ovarian Hyperstimulation Syndrome , Polycystic Ovary Syndrome , Pregnancy , Pregnancy Outcome , Pregnancy Rate , Retrospective Studies
15.
Article in English | WPRIM | ID: wpr-180149

ABSTRACT

OBJECTIVE: To investigate the neonatal outcome according to the gestational age at delivery and to determine the optimal timing for delivery in uncomplicated monochorionic and dichorionic twin pregnancies. METHODS: This is a retrospective cohort study of women with uncomplicated twin pregnancies delivered at or beyond 35 weeks of gestation from 1995 to 2013. The primary outcome was neonatal composite morbidity, which was defined as when either one or both twins have one or more of the followings: fetal death after 35 weeks gestation, admission to neonatal intensive care unit, mechanical ventilator requirement, respiratory distress syndrome and neonatal death. To determine the optimal gestational age for delivery according to chorionicity, we compared the neonatal composite morbidity rate between women who delivered and women who remained undelivered at each gestational week in both monochorionic and dichorionic twin pregnancies. RESULTS: A total of 697 twin pregnancies were included (171 monochorionic and 526 dichorionic twins). The neonatal composite morbidity rate significantly decreased with advancing gestational age at delivery and its nadir was observed at 38 and > or =39 weeks of gestation in monochorionic and dichorionic twins, respectively. However, the composite morbidity rate did not differ between women who delivered and women who remained undelivered > or =36 and > or =37 weeks in monochorionic and dichorionic twins, respectively. CONCLUSION: Our data suggest that the optimal gestational age for delivery was at > or =36 and > or =37 weeks in uncomplicated monochorionic and dichorionic twin pregnancies, respectively.


Subject(s)
Chorion , Cohort Studies , Female , Fetal Death , Gestational Age , Humans , Infant, Newborn , Intensive Care, Neonatal , Pregnancy , Pregnancy, Twin , Retrospective Studies , Twins , Ventilators, Mechanical
16.
Article in English | WPRIM | ID: wpr-123081

ABSTRACT

Placental chorioangioma is a benign non-trophoblastic tumor of the placenta that can have various adverse effects on the mother and fetus depending on its size. Chorioamniotic membrane separation is rare condition of detachment between the amniotic membrane and chorionic membrane. Chorioamniotic membrane separation after the second trimester of pregnancy is usually occurs after invasive procedures or may occur spontaneously; it is mostly associated with fetal abnormalities. Here, we report a case of chorioamniotic membrane separation that might be occurred caused by the seromucinous secretion from a placental chorioangioma.


Subject(s)
Amnion , Chorion , Female , Fetus , Hemangioma , Humans , Membranes , Mothers , Placenta , Pregnancy , Pregnancy Trimester, Second
17.
Article in English | WPRIM | ID: wpr-110498

ABSTRACT

Ovarian stimulation with commercial preparations of equine chorionic gonadotropin (eCG) produces extremely variable responses in domestic animals, ranging from excessive stimulation to practically no stimulation, when applied on the basis of their declared unitage. This study was conducted to analyze four commercial preparations from different manufacturers via reversed-phase HPLC (RP-HPLC) in comparison with a reference preparation and an official International Standard from the World Health Organization. The peaks obtained by this qualitative and quantitative physical–chemical analysis were compared using an in vivo bioassay based on the ovarian weight gain of prepubertal female rats. The RP-HPLC data showed one or two peaks close to a main peak (t(R) = 27.9 min), which were related to the in vivo bioactivity. Commercial preparations that have this altered peak showed very little or no in vivo activity, as demonstrated by rat ovarian weight and in peripubertal gilts induced to ovulate. Overall, these findings indicate that RP-HPLC can be a rapid and reliable tool to reveal changes in the physicochemical profile of commercial eCG that is apparently related to decreased biological activity of this hormone.


Subject(s)
Animals , Animals, Domestic , Biological Assay , Chorion , Chorionic Gonadotropin , Chromatography, High Pressure Liquid , Electrocardiography , Female , Humans , Ovulation Induction , Rats , Weight Gain , World Health Organization
18.
Article in Korean | WPRIM | ID: wpr-65274

ABSTRACT

Two trials of external quality assessment were performed in 2015, with 13 test items grouped into four test categories. The first trial materials were sent on May 19, 2015 and the second trial was performed on November 9, 2015 with 13 items including tumor markers, thyroid hormones, cardiac marker troponin (troponin T or troponin I), and procalcitonin (PCT) as biomarkers by immunoassay methods. The bone marker, carboxy-terminal collagen crosslinks (CTX) was replaced by procalcitonin since 2014, because a limited number of institutions performed assays with CTX. External quality surveys of 13 immunoassay test items with 16 control materials were conducted, as scheduled. In total, 13 control materials were used, which consisted of six tumor markers, namely alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), carcinoma antigen (CA) 125, carbohydrate antigen (CA) 19-9, human chorionic gonadotrophin (HCG), and prostate specific antigen (PSA). In addition to tumor markers, 5 thyroid markers, namely thyroid hormone (T)3, T4, thyroid stimulating hormone (TSH), free T4, and thyroglobulin (TG) were included. Furthermore, troponin, as a cardiac marker, and procalcitonin, as a new biomarker, have been adopted since 2014. Five home-made pooled sera and 3 commercial control sera were used as survey materials. MAS Tri-point Liquimmune level 3 (Medical Analysis Systems Inc., USA) was used for thyroid hormones. Procalcitonin and troponin control materials were from Elecsys Precis Control Varia and Elecsys Precis Control Troponin (Roche, Germany), respectively. The number of laboratories participating in the external quality assessment for Immunoassay Subcommittee was 719 institutions in the first trial survey (response rate 98.7%) and 730 institutions in the second survey (94.9%). The test items most frequently used in immunoassays were TSH (93.2%, 93.1%), free T4 (90.3%, 90.2%), and AFP (89.4%, 89.0%), whereas recently adopted biomarkers were less frequently used: troponin I (36.6%, 37.1%), procalcitonin (24.1%, 26.7%), and thyroglobulin (10.3%, 10.7%). The quality of the laboratories participating in the survey seems to be continuously improving, according to their peer group results.


Subject(s)
alpha-Fetoproteins , Biomarkers , Biomarkers, Tumor , Carcinoembryonic Antigen , Chorion , Collagen , Humans , Immunoassay , Korea , Peer Group , Prostate-Specific Antigen , Thyroglobulin , Thyroid Gland , Thyroid Hormones , Thyrotropin , Troponin , Troponin I
19.
Article in English | WPRIM | ID: wpr-100491

ABSTRACT

The incidence of uterine arteriovenous malformation (AVM) is rare. However, it is clinically significant in that it can cause life-threatening vaginal bleeding. We report a case of a large uterine AVM with positive serum beta-human chorionic gonadotropin. A presumptive diagnosis was made; a uterine AVM accompanied by, early pregnancy or retained product of conception. Because this uterine AVM was extensive, transcatheter arterial embolization of both uterine arteries and extra-uterine feeding arteries was performed. Three months after undergoing transcatheter arterial embolization, complete resolution of the uterine AVM was confirmed without major complication.


Subject(s)
Arteries , Arteriovenous Malformations , Chorion , Chorionic Gonadotropin , Diagnosis , Fertilization , Incidence , Pregnancy , Uterine Artery , Uterine Hemorrhage
20.
Int. j. morphol ; 33(1): 178-186, Mar. 2015. ilus
Article in Spanish | LILACS | ID: lil-743783

ABSTRACT

La ecografía es uno de los métodos de diagnóstico gestacional más utilizados, que permite confirmar una gestación temprana y realizar seguimientos del desarrollo embrio-fetal. En este estudio se emplearon 10 gatas gestantes, entre 10 meses a 6 años de edad, con fecha de cruza conocida. Se realizaron exámenes ecográficos seriados en los días 15 (estadio 1), 18 (estadio 2), 21 (estadio 3), 38 (estadio 4), y 45 (estadio 5) de gestación para medir parámetros biométricos. Vesícula coriónica: diámetro transversal (DTVC), diámetro longitudinal (DLVC); Placenta: grosor (GP); Feto: longitud céfalo-caudal (LCC), diámetro toraco-abdominal (DTA), diámetro cefálico (DC), tomándose un registro fotográfico de cada estadio. En el estadio 1, no se logró visualizar el embrión. En el estadio 2, el embrión se observó cercano a la pared midiendo en promedio 4,7 milímetros de LCC, el tubo endocárdico se observó funcional. En el estadio 3, se observó el cordón umbilical, pero resultó difícil distinguir los diferentes órganos, excepto el corazón, debido al movimiento causado por sus latidos. En el estadio 4, el feto adquiere movimientos, se observó órganos como el encéfalo, pulmones, el tabicamiento del corazón, diafragma, hígado, estómago, asas intestinales, vejiga y la osificación de huesos. Se observó la flexión de los miembros. En los miembros anteriores se visualizaron los dedos separados, con garras y cojinetes plantares. En el estadio 5, además de las características observadas en el estadio anterior, los riñones muestran la corteza y médula, las cámaras del corazón se visualizaron claramente. Se realizó una correlación lineal entre los parámetros biométricos estudiados y los resultados dieron valor significativo (p<0,0001) para la mayoría de éstos. Se logró caracterizar los estadios gestacionales estudiados. Siete de las diez gatas presentaron una gestación normal, mientras que una de ellas presentó en uno de sus fetos una malformación congénita y en las otras dos gatas se presentó muerte embrio-fetal.


Ultrasound is one of the most widely used methods for gestational diagnosis, allowing the detection of early pregnancy and evaluation of fetal growth and development. Ten pregnant cats (aged 10 months to-6 years) were used in this study, with known dates of mating. Serial ultrasound testings were performed on days 15th (stage 1), 18th (stage 2), 21st (stage 3), 38th (stage 4) and 45th (stage 5) of gestation, to measure biometric parameters (Chorionic vesicle: transverse diameter (DTVC), longitudinal diameter (DLVC); Placenta: thickness (GP); Fetus: cephalocaudal length (LCC), thoraco-abdominal diameter (DTA), cephalic diameter (DC). Photographic records were made at each stage. In stage 1, it was impossible to visualize the embryo. In stage 2, the embryo was observed near the wall measuring 4.7 mm on average LCC, and the endocardial tube was functioning. In stage 3, the umbilical cord was observed, but it was difficult to distinguish different organs, with the exception of the heart, which was detected by heartbeat movements. In stage 4, the fetus begins to move. Organs, such as the brain, lungs, heart septation, diaphragm, liver, stomach, bowel, bladder and bone ossification were observed. In the forelimbs, fingers apart with claws and footpads were visualized. In stage 5, in addition to the features observed in the previous stage, the kidneys show the cortex and medulla, and the heart chambers are clearly visualize. A linear correlation analysis among the biometric parameters was performed. Results were statistically significant for most parameters studied (p<0.0001). We characterized the gestational stages studied. Out of the ten cats studied, seven cats had a normal pregnancy. One cat showed one congenitally malformed fetus, and one fetal death occurred in the other two cats.


Subject(s)
Animals , Female , Cats/anatomy & histology , Chorion/diagnostic imaging , Gestational Age , Placenta/diagnostic imaging , Ultrasonography, Prenatal , Cats/embryology , Chorion/embryology , Embryonic and Fetal Development , Fetus/embryology , Placenta/embryology
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