Evaluation of the relationship between vitamin D level during pregnancy and the rate of fetal heart problems: a cross-sectional study.

BACKGROUND & AIMS: One of the most important things that change during pregnancy is the serum vitamin D level, which is essential for both the mother's and the fetus's health. Vitamin D deficiency can increase the possibility of fetal abnormalities, including heart abnormalities in the fetus. METHODS: This descriptive cross-sectional study was carried out on 81 pregnant women who were referred to Bandar Abbas Children's Hospital in 2019 to examine the fetal heart. Individuals were classified into three groups (average reduction - mild/moderate reduction - severe reduction) considering serum vitamin D levels measured by high-performance liquid chromatography methods. Also, in terms of the echocardiographic status of the heart, examined at 18-28 weeks of gestation, they were divided into three groups: regular, heart failure, and anatomical heart abnormality (defect). Finally, the relationship between these two indicators, namely the serum vitamin D level of the pregnant woman and fetal heart status, was investigated. RESULTS: There was a statistically significant relationship between maternal serum vitamin D level and fetal heart status based on the Chi-square test (P = 0.007). Heart problems increased in fetuses of mothers with lower serum vitamin D levels. No abnormality was also observed in the fetal heart of mothers with normal vitamin D levels. CONCLUSIONS: There is a significant relationship between serum vitamin D levels during pregnancy and the rate of fetal heart problems; therefore, vitamin D replacement therapy can cause reducing the cases of functional and structural abnormalities of the heart in the fetus and improve the final prognosis of pregnancy. Vitamin D deficiency in the mother can also be considered an indication of fetal echocardiography.

The Predictive Value of Pulse Oximeters for Pulse Improvement after Angiography in Infants and Children.

BACKGROUND: Information from pulse oximeter waves confirms the presence of a pulse and helps obtain waves from tissue when the supplying artery is not readily accessible. OBJECTIVES: This study determined the predictive value of pulse oximeters for detecting improved arterial pulses after angiography. PATIENTS AND METHODS: This cross-sectional, multi-center study included 467 4-day-old to 12-year-old patients and was conducted from January 2012 to January 2016. Angiographies were performed on 12-year-old or younger children for various medical reasons using venous, arterial, or both types of paths. The posterior malleolar or dorsalis pedis were palpated in punctured lower extremities. In the absence of a pulse, pulse oximetry was performed to identify pulse curves at 1 hour, 6 hours, and 12 hours after each angiography. RESULTS: Pulse oximetry displayed the pulses of 319 patients immediately following each angiography. Of these, 262 patients had palpable pulses at 6 hours after angiography (P < 0.0001), while 57 patients had no palpable pulse. Of these 57 patients, 15 had no palpable pulse at 12 hours after angiography (P < 0.0001). The odds of pulse improvement in children 6 hours after catheter angiography were 76% for the arterial path, 90% for the venous path, and 83.2% for both paths. At 12 hours after catheter angiography, these values increased to 91.6% for the arterial path, 100% for the venous path, and 95.9% for both paths. CONCLUSIONS: The pulse oximeter can display the pulse curve immediately (1 hour) after angiography and indicate pulse improvement at 12 hours maximally following an angiography. In this case, heparin alone may be used instead of thrombolytic agents.