Navegando por Palavras-chave "fetal growth restriction"
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- ItemSomente MetadadadosAvaliação do índice de performance miocárdica em fetos com restrição do crescimento(Universidade Federal de São Paulo (UNIFESP), 2015-12-31) Silva, Carolina Pacheco [UNIFESP]; Nardozza, Luciano Marcondes Machado Nardozza [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: This study aims to evaluate the Myocardial Performance Index in fetuses with growth restriction (IUGR) compared with healthy fetuses. To assess the intra and interobserver repeatability of the method. Method: We conducted a prospective cross-sectional study in pregnant women between 24 and 34 weeks, with singleton pregnancies, divided in three groups (controls, restricted fetuses below the 3rd percentile and restricted between percentiles 3 and10). For the estimation of fetal weight (EPF), we used the formula of Hadlock 4. The fetal modified Myocardial Performance Index was assessed in all fetuses. Assessed restricted fetuses umbilical artery Doppler normal. Regarding the repeatability of the method used the intraclass correlation coefficient (ICC) and Bland-Altman. Results: There was no statistically significant difference between the values found in the IPM-mod among fetuses with growth restriction below the 3rd percentile (0.36 SD ± 0.06), fetuses between percentiles 3:10 (0.35 ± 0.05) and normal fetuses (0.32 ± 0.05). Regarding the repeatability, the intraclass correlation coefficient (ICC) was 0.726 intra and interobserver 0.76. Conclusion: The mod-IPM is an important tool for assessment of fetal cardiac function and the values found for fetuses with FGR with normal umbilical artery Doppler and healthy fetuses were not statistically significant, suggesting that at this stage of RCF these fetuses still present normal cardiac function. This valuation method proved reproducible, but requires a substantial number of measurements for non-experienced examiner to achieve competence
- ItemSomente MetadadadosAvaliação do padrão hemodinâmico da artéria oftálmica em gestantes portadoras de fetos com restrição do crescimento(Universidade Federal de São Paulo (UNIFESP), 2015-07-31) Melo, Nayana Alves de Brito [UNIFESP]; Nardozza, Luciano Marcondes Machado Nardozza [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: To assess the Doppler parameters of the ophthalmic artery of pregnant women carrying fetuses with growth restriction (FGR) comparing with normal fetuses. Compare AO Doppler and uterine artery Doppler in FGR group. Methods: A prospective case-control cross-sectional study was conducted on 120 pregnant women between 32 and 40 weeks of gestation; 60 women were carrying FGR and 60 were carrying normal fetuses. FGR diagnosis was based on an estimated fetal weight below the 10th percentile of the Hadlock curve. Ophthalmic artery Doppler images were obtained with a linear transducer, with color Doppler examination of the region medial to the optic nerve. The following indices were obtained: pulsatility index (PI), resistance index (RI), peak systolic velocity (PSV), second peak velocity (P2), end diastolic velocity (EDV), and P2 / PSV ratio (RPV). The Mann?Whitney and Student?s t-tests were used to compare the groups with regard to quantitative variables, and the chi-square test was used for categorical variables. In FGR group, 17 showed uterine artery Doppler abnormal and 43 was normal. Results: PI and RI were significantly lower in pregnant women with FGR than in those with normal fetuses, with p <0.001 in both indices. P2 and EDV were significantly higher in pregnant women with FGR than in those with normal fetuses (p=0.002 and p=0.004, respectively). RPV was significantly higher in the FGR group than in the control group (p<0.001). In FGR subgroups, with and without uterine artery abnormality, no significant change was observed in AO Doppler between the groups. Conclusion: In the third trimester of pregnancy, we observed significant differences in the ophthalmic artery Doppler parameters of pregnant women with FGR compared with those with normal fetuses.
- ItemSomente MetadadadosAvaliação do volume de estruturas cranianas por meio da ultrassonografia tridimensional em fetos com restrição do crescimento(Universidade Federal de São Paulo (UNIFESP), 2015-04-30) Caetano, Ana Carolina Rabachini [UNIFESP]; Nardozza, Luciano Marcondes Machado Nardozza [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: To assess the Doppler parameters of the ophthalmic artery of pregnant women carrying fetuses with growth restriction (FGR) comparing with normal fetuses. Compare AO Doppler and uterine artery Doppler in FGR group. Methods: A prospective case-control cross-sectional study was conducted on 120 pregnant women between 32 and 40 weeks of gestation; 60 women were carrying FGR and 60 were carrying normal fetuses. FGR diagnosis was based on an estimated fetal weight below the 10th percentile of the Hadlock curve. Ophthalmic artery Doppler images were obtained with a linear transducer, with color Doppler examination of the region medial to the optic nerve. The following indices were obtained: pulsatility index (PI), resistance index (RI), peak systolic velocity (PSV), second peak velocity (P2), end diastolic velocity (EDV), and P2 / PSV ratio (RPV). The Mann?Whitney and Student?s t-tests were used to compare the groups with regard to quantitative variables, and the chi-square test was used for categorical variables. In FGR group, 17 showed uterine artery Doppler abnormal and 43 was normal. Results: PI and RI were significantly lower in pregnant women with FGR than in those with normal fetuses, with p <0.001 in both indices. P2 and EDV were significantly higher in pregnant women with FGR than in those with normal fetuses (p=0.002 and p=0.004, respectively). RPV was significantly higher in the FGR group than in the control group (p<0.001). In FGR subgroups, with and without uterine artery abnormality, no significant change was observed in AO Doppler between the groups. Conclusion: In the third trimester of pregnancy, we observed significant differences in the ophthalmic artery Doppler parameters of pregnant women with FGR compared with those with normal fetuses.
- ItemSomente MetadadadosCongenital heart disease and adverse perinatal outcome in fetuses with confirmed isolated single functioning umbilical artery(Informa Healthcare, 2015-01-01) Araujo Junior, E. [UNIFESP]; Palma-Dias, R.; Martins, W. P.; Reidy, K.; Costa, F. da Silva; Royal Womens Hosp; Univ Melbourne; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)To examine the association between isolated single umbilical artery (SUA) and congenital heart disease/adverse perinatal outcome in an Australian tertiary centre. the study population was comprised of fetuses diagnosed with SUA at the mid-trimester scan between May 2003 and March 2009 during detailed ultrasound examination at the Royal Women's Hospital Melbourne, Australia. Colour Doppler was used to visualise the umbilical arteries adjacent to the fetal bladder and in a section of a free loop of cord. the diagnosis of SUA was confirmed on histopathology examination of the placenta and umbilical cord. Monochorionic twins, fetuses with chromosomal abnormalities or concurrent extracardiac anomalies were excluded from the study. A total of 261 fetuses with SUA were identified in the study period and 146 (59%) cases were isolated; no chromosomal or extracardiac abnormalities were present. Complete data were available in 104/146 pregnancies (71.2%). the mean gestational age at diagnosis was 21 weeks. A cardiac anomaly was detected in 19 of these fetuses (13.0%): six hypoplastic left heart syndromes; three coarctations of the aorta; two tetralogies of Fallot; two hypoplastic right heart syndromes; two pulmonary atresia/stenosis; one absent ductus venosus with cardiomegaly; one left isomerism; one right isomerism and one transposition of the great arteries. Fetal growth restriction was present in 9.8% (10) and preterm delivery before 34 weeks occurred in nine cases (8.7%). Our study has shown that isolated SUA is associated with cardiac anomalies, but is not associated with increased frequency of FGR and preterm delivery before 34 weeks.
- ItemSomente MetadadadosMarcadores de angiogênese e dopplervelocimetria útero placentária em pacientes com restrição do crescimento fetal(Universidade Federal de São Paulo (UNIFESP), 2014-07-30) Zamarian, Ana Cristina Perez [UNIFESP]; Nardozza, Luciano Marcondes Machado Nardozza [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: Assessing the levels of sFlt-1, sEng, adiponectin, ADAM-12, PAPP-A, ANGI-2, VEGF, TGF-? and PP13 in pregnant women with fetal growth restriction (FGR) and controls. Methods: This case?control study included 66 patients with FGR and 64 healthy controls at 24-41 weeks´ gestation. Maternal serum levels of sFlt-1, sEng, adiponectin, ADAM-12, PAPP-A, ANGI-2, VEGF, PP13 and TGF-? were determined by ELISA method and uterine artery Doppler studies were performed. Results: Concentrations of sFlt-1, sEng, PAPP-A were significantly higher in FGR patients than controls (p<0.0001, p=0.02 and p=0.03, respectively). Concentration of ADAM-12, ANGI-2 (p=0.05 and p<0.0001) were significantly lower in FGR than controls. Increased sEng concentrations were correlated with abnormal uterine Doppler in FGR. Adiponectin and TGF-? were not associated with any analyzed parameters. Conclusion: Patients with FGR showed increased serum levels of sFlt-1, sEng and PAPP-A and decreased levels of ADAM-12 and ANGI-2. Moreover, we observed a positive association between elevated concentrations of sEng and changing impedance uterine artery Dopplervelocimetry.