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1.
Eur. j. anat ; 22(6): 483-488, nov. 2018. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-182115

RESUMO

Studies have described the placental morphology and its changes in a pathological scenario. But the role of a twisting pattern of umbilical vessels in determining the placental morphology of uncomplicated pregnancy has not been discussed. The objective of the study was to determine the clinical significance of umbilical cord twist in determining the umbilical cord coiling index, the diameter of hyrtl's anastomosis, branching pattern of the placental vasculature, placental weight, Eccentricity index and Cord centrality index. The proportion of umbilical cords with left and right twist were 246 (78.6%) and 67 (21.4%) respectively. The right twisted cords had significant higher umbilical artery diameter, higher umbilical cord coiling index and preferential magistral pattern of blood vessels. This proves that twisting of the cord might play a minor role in altering the blood flow and determining the vasculature pattern but not sufficient enough to influence the placental weight, the shape of the placenta and umbilical cord insertion


No disponible


Assuntos
Humanos , Feminino , Gravidez , Artérias Umbilicais/fisiopatologia , Cordão Umbilical/anatomia & histologia , Anormalidade Torcional , Placenta/anatomia & histologia , Cordão Nucal/complicações , Placenta/fisiopatologia , Circulação Placentária/fisiologia , Veias Umbilicais/anatomia & histologia , Estudos Prospectivos
2.
Eur. j. anat ; 22(6): 489-495, nov. 2018. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-182116

RESUMO

The normal growth and development of the fetus depends on the proper growth and functioning of the placenta. The macroscopic morphology of the placenta is highly affected by pre-eclampsia. This study was carried out to assess macroscopic morphological variation of the human placenta among normotensive and pre-eclamptic pregnant mothers in Northwest Ethiopia. A cross-sectional study was conducted on 200 term placentas. One hundred fifty placentas from normotensive mothers and 50 placentas from pre-eclamptic mothers were included in the study. Placental parameters such as shape, weight, diameter, thickness and number of cotyledons were examined. Fetal weight was also detected. The data were analyzed by using independent two-sample t-test and chi-square test. According to this study, the majority (68%) of placentas in normotensive participants were discoid-shaped and 18% oval. While 54% of placenta in pre-eclamptic mothers were oval-shaped and 24% were irregular. Mean placental weight, diameter and number of cotyledon in pregnant mothers with pre-eclampsia were significantly reduced as compared to normotensive mothers. The mean birth weight in pre-eclamptic pregnancies was significantly (p = 0.0001) lower than the mean birth weight in normotensive pregnancies. As a conclusion, mean fetal weight, placental weight, diameter, thickness and numbers of cotyledon in pre-eclamptic mothers were significantly lower than in normotensive mothers (p-value < 0.05). Placenta shape difference between normotensive and pre-eclamptic mothers was detected (p-value < 0.001)


No disponible


Assuntos
Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Placenta/anatomia & histologia , Pré-Eclâmpsia/fisiopatologia , Desenvolvimento Fetal/fisiologia , Pressão Arterial/fisiologia , Placenta/fisiopatologia , Etiópia , Peso Fetal , Estudos Transversais
3.
Rev. esp. ped. (Ed. impr.) ; 74(1): 5-7, oct. 2018. ilus
Artigo em Espanhol | IBECS | ID: ibc-179176

RESUMO

Introducción: La vasa previa (VP) es una rara condición obstétrica en la cual los vasos sanguíneos fetales, libres de tejido placentario y no protegidos por gelatina de Wharton, pasan a nivel del segmento uterino inferior entre la presentación fetal y el cérvix, recubiertos solo por membranas amnióticas. Esta condición conlleva un elevado riesgo de mortalidad perinatal (2,4-56,4%), debido al riesgo de la-ceración de los vasos fetales durante el parto o la ruptura de membranas amnióticas, y consecuentemente la exanguinación fetal. Casos clínicos: Presentamos dos casos clínicos de gestaciones con VP sin diagnóstico prenatal, que presentaron hemorragia fetal durante el parto, requiriendo maniobras de reanimación avanzada y transfusión urgente de concentrado de hematíes, con una adecuada evolución. Conclusión: Resaltar la importancia del diagnóstico prenatal de VP, mediante estudio ecográfico según protocolo, que puede mejorar significativamente los resultados perinatales


Introduction. The vasa previa (VP) is a rare obstetric condition in which the fetal blood vessels, free of placental tissue and not protected by Wharton's gelatin, pass at the level of the lower uterine segment between the fetal presentation and the cervix, coated only by amniotic membranes. This condition carries a high risk of perinatal mortality (2.4-56.4%), due to the risk of laceration of the fetal vessels during delivery or the rupture of amniotic membranes, and consequently fetal exanguination. Cases report: We present two clinical cases of pregnancies with VP without prenatal diagnosis, which presented fetal hemorrhage during labor, requiring advanced resuscitation maneuvers and urgent transfusion of packed red blood cells, with an adequate evolution. Conclusion: Highlight the importance of prenatal diag-nosis of VP, by means of an echographic study according to protocol, which can significantly improve perinatal results


Assuntos
Humanos , Feminino , Recém-Nascido , Vasa Previa/diagnóstico por imagem , Ultrassonografia Pré-Natal/métodos , Placenta/ultraestrutura , Sofrimento Fetal/diagnóstico por imagem , Morte Fetal/prevenção & controle , Doenças Fetais/prevenção & controle , Hemorragia Uterina/etiologia
4.
Prog. obstet. ginecol. (Ed. impr.) ; 61(2): 154-158, mar.-abr. 2018. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-173666

RESUMO

Objetivo: comparar la vascularización placentaria en preeclámpticas severas con embarazadas normotensas. Material y métodos: se realizó un estudio de casos y controles en el Hospital Central Dr. Urquinaona, Maracaibo, Venezuela, de 97 preeclámpticas severas (grupo A) y 97 embarazadas normotensas (grupo B), todas nulíparas y con embarazos simples de más de 30 semanas. La evaluación tridimensional y de doppler se realizó en la placenta para calcular los índices de vascularización, de flujo y de vascularización-flujo. Resultados: no se encontraron diferencias estadísticamente significativas en la edad materna y la edad gestacional (p = ns). Se encontraron diferencias estadísticamente significativas en los valores promedio de presión arterial sistólica y presión arterial diastólica y proteinuria entre el grupo de preeclámpticas severas y las embarazadas controles normotensas (p = 0,0001). Las pacientes del grupo A presentaron valores menores de los índices de vascularización, flujo y vascularización-flujo placentario comparadas con las pacientes del grupo B (p < 0,0001). La disminución del índice de vascularización, índice de flujo e índice de vascularización-flujo entre las preeclámpticas severas y los controles fue superior al 28%, 12% y 42%, respectivamente. No se encontró correlaciones significativas entre los índices de vascularización placentaria y los valores de presión arterial en ninguno de los dos grupos (p = ns). Conclusión: la vascularización placentaria es significativamente menor en las preeclámpticas severas comparado con las embarazadas Normotensas


Objective: To compare placental vascularization in severe preeclamptic patients with normotensive pregnant women. Material and methods: A case-control study was done at Hospital Central "Dr. Urquinaona", Maracaibo, Venezuela, with 97 severe preeclamptic patients (group A) and 97 normotensive pregnant women (group B), all nulliparous and with gestational age over 30 weeks. Tridimensional and power Doppler evaluation was performed to calculate vascular indexes: vascularization index, flow index and vascularization - flow index of placenta. Results: There were not found significant differences in maternal age and gestational age (p = ns). There were found significant differences in mean values of systolic and diastolic blood pressure and proteinuria between severe preeclamptic patients and normotensive pregnant women (p < 0.0001). Patients in group A presented significant lower placental values of vascularization index, flow index and vascularization - flow index compared with patients of group B (p < 0.0001). Decrease of vascularization index, flow index and vascularization - flow index between severe preeclamptic patients and controls were above 28%, 12% and 42%, respectively. There were not found significant correlation between placental vascular indexes and blood pressure values in none of both groups Conclusion: Placental vascularization is significantly lower in severe preeclamptic patients compared with normotensive pregnant Women


Assuntos
Humanos , Feminino , Gravidez , Adulto Jovem , Pré-Eclâmpsia/diagnóstico por imagem , Pré-Eclâmpsia/fisiopatologia , Hipertensão Induzida pela Gravidez/fisiopatologia , Placenta/diagnóstico por imagem , Pressão Arterial , Placentação , Pressão Sanguínea , Estudos de Casos e Controles , Idade Materna , Idade Gestacional , Imageamento Tridimensional/métodos , Placenta/fisiopatologia , Ultrassonografia Pré-Natal/métodos , Neovascularização Fisiológica
5.
Matronas prof ; 19(4): e67-e71, 2018. ilus, graf, tab
Artigo em Espanhol | IBECS | ID: ibc-182407

RESUMO

La displasia mesenquimal placentaria (DMP) es una anomalía cada vez más reconocible, que cursa con diversos signos, como placentomegalia, vasos tortuosos y vesículas quísticas en la placenta. Su repercusión sobre la madre y el recién nacido requiere una precisa valoración placentaria por parte de la matrona para el seguimiento de ambos. En el presente artículo se expone un caso clínico en el que la revisión pormenorizada de la placenta puso en marcha el correcto seguimiento de una madre y su recién nacido a partir del diagnóstico de DMP. La DMP es una entidad cuyo diagnóstico, aunque poco frecuente, no debe infraestimarse, dadas las repercusiones que pudiera tener tanto en la madre como en el desarrollo de su hijo. La revisión placentaria es una herramienta fundamental en el trabajo diario de la matrona. Esta práctica permite evitar sangrados e infecciones en el puerperio precoz e inmediato


Placental mesenchymal dysplasia (PMD) is an increasingly recognizable anomaly, with data such as placentomegaly, tortuous vessels and cystic vesicles in the placenta. Its repercussion on the mother and newborn makes the accurate placental assessment on the part of the matron is a necessary tool for the follow-up of both. This article presents a clinical case in which the detailed review of the placenta initiated the correct follow-up of a mother and her newborn due to the diagnosis of PMD. PMD is an entity that, although infrequent, should not be underestimated when it comes to diagnosing it, due to the repercussions it may have on both the mother and the development of her child. The placental revision is a fundamental tool in the daily work of the midwife. This practice allows bleeding and infection to be prevented in the early and immediate postpartum period


Assuntos
Humanos , Feminino , Gravidez , Adulto , Placenta/patologia , Doenças Placentárias/patologia , Cordão Umbilical/patologia , Complicações na Gravidez/etiologia , Complicações na Gravidez/patologia , Tocologia/instrumentação , Período Pós-Parto , Hemorragia Uterina/prevenção & controle
6.
Rev. esp. patol ; 50(4): 229-233, oct.-dic. 2017. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-166038

RESUMO

Recientemente se ha descrito un tumor placentario que se ha denominado corangiocarcinoma. Consiste en una proliferación vascular, con células estromales, rodeadas por una neoplasia trofoblástica atípica. La proliferación vascular y estromal se pone de manifiesto con CD-34 y vimentina. Las células trofoblásticas atípicas, pleomórficas con frecuentes mitosis son positivas para CK 8-18, panCK y BHCG. Es difícil distinguir de un tumor de colisión del tipo corangioma-coriocarcinoma. Hasta el momento actual se han descrito menos de diez casos de esta entidad en la literatura. Tras el seguimiento realizado en cada caso no se han observado metástasis en las progenitoras ni en los descendientes (AU)


Chorangiocarcinoma is a recently described placental tumour showing a vascular proliferation with stromal cells surrounded by an atypical trophoblastic neoplasia. The stromal and vascular proliferation is demonstrated with CD-34 and Vimentin. Atypical pleomorphic trophoblastic cells with frequent mitosis are positive for CK-8-18, pan CK and BCHG. It is difficult to differentiate this carcinoma from a collision tumour of the corangioma-choriocarcinoma type. To date, less than ten cases of this tumour have been reported but follow ups did not reveal any metastases in either mother or child in any case (AU)


Assuntos
Humanos , Feminino , Adulto , Doença Trofoblástica Gestacional/patologia , Células Estromais/patologia , Tumores do Estroma Endometrial/patologia , Coriocarcinoma/patologia , Placenta/patologia , Hemorragia Uterina/complicações , Hemorragia Uterina/patologia , Programas de Rastreamento/métodos , Mitose
7.
Rev. iberoam. fertil. reprod. hum ; 33(4): 20-27, oct.-dic. 2016. tab, graf, ilus
Artigo em Espanhol | IBECS | ID: ibc-160435

RESUMO

Objetivo: Comprobar si hay diferente vascularización placentaria en gestaciones espontáneas comparadas con las conseguidas tras técnicas de reproducción asistida (TRA). Métodos: Se realizó un estudio observacional de casos y controles retrospectivo, de embarazos únicos en semana 20, mediante ecografía transvaginal con Tridimensión y power Doppler. Los volúmenes adquiridos fueron analizados utilizando el programa de imagen VOCAL (Virtual Organ Computer Aided Analysis), para evaluar el Índice de Vascularización (IV), el Índice de Flujo (IF) y el Índice de Vascularización de Flujo (IVF). Resultados: De 130 gestantes incluidas en el estudio, 55 de ellas se habían sometido a tratamientos de esterilidad y 75 eran gestaciones espontáneas. En un análisis comparativo, la vascularización placentaria en el grupo de TRA mostró diferencias estadísticamente significativas, siendo menores, tanto para el IF (p=0,033) como para el IVF (p=0,038), acercándose a la significación estadística el IV (p=0,076). Conclusiones: El estudio de la vascularización placentaria, podría ser de utilidad para comprender algunas diferencias entre gestaciones espontáneas y tras TRA que explicarían algunos resultados perinatales adversos en este tipo de gestaciones (AU)


Aim: Check for different placental vascularization in spontaneous pregnancies compared with those obtained after assisted reproduction techniques (ART). Methods: An observational retrospective study of cases and controls, on singleton pregnancies at week 20, performed by tridimensional transvaginal sonographer and Power Doppler. The volumes acquired were analyzed using the program image VOCAL (Virtual Organ Computer Aided Analysis), to assess the vascularization index (VI), the flow index (FI) and vascularization index Flow (VIF). Outcome: Of 130 pregnant women included in the study, 55 of them had undergone a fertility treatment and 75 were spontaneous pregnancies. In a comparative analysis, placental vascularization in the ART group showed statistically significant differences, being lower for both the FI (p = 0.033) and for VIF (p = 0.038), approaching the VI statistical significance (p = 0.076). Conclusions: The study of placental vascularization could be useful to understand some differences between spontaneous and after ART pregnancies, to explain some adverse perinatal outcomes in those pregnancies (AU)


Assuntos
Humanos , Placenta/irrigação sanguínea , Ecocardiografia Doppler/métodos , Fertilização In Vitro , Placenta , Técnicas Reprodutivas , Implantação do Embrião/fisiologia , Imageamento Tridimensional , Estudos de Casos e Controles
8.
Prog. obstet. ginecol. (Ed. impr.) ; 59(5): 310-313, sept.-oct. 2016. ilus
Artigo em Espanhol | IBECS | ID: ibc-163921

RESUMO

El corioangioma es la tumoración benigna placentaria no trofoblástica más frecuente, aunque su incidencia es menor del 1%. En algunos casos raros superan los 4 cm, denominándose corioangiomas gigantes, y se relacionan con malos resultados perinatales debido al compromiso de flujo fetoplacentario. El diagnóstico de sospecha se realiza mediante ecografía-Doppler, siendo de utilidad la resonancia magnética nuclear. El diagnóstico definitivo es anatomopatológico. Es necesaria una vigilancia estrecha del bienestar fetal y puede precisar técnicas invasivas como la cordocentesis o la fetoscopia. Presentamos el caso de un corioangioma placentario gigante de 11 cm que fue diagnosticado a las 21 semanas de gestación (AU)


Chorioangioma is the most common non-trophoblastic placental benign tumour, although its incidence is less than 1%. Some rare tumours are larger than 4 cm, called giant choriangiomas, and are related to adverse perinatal outcomes because of the arrest of placental blood flow. Initial diagnosis is conducted with ultrasound Doppler, and magnetic resonance imaging can sometimes be useful. The definitive diagnosis is histological. Early suspicion allows more effective vigilance of foetal wellbeing and the possibility of diagnostic-therapeutic tools such as cordocentesis or foetoscopy. We present a case of a giant placental chorioangioma of 11 cm, diagnosed at 21 weeks of pregnancy (AU)


Assuntos
Humanos , Feminino , Gravidez , Adulto , Hemangioma/cirurgia , Hemangioma , Cordocentese/métodos , Cardiomegalia , Derrame Pericárdico , Ecocardiografia Doppler , Doenças Fetais , Doenças Fetais/diagnóstico , Placenta/patologia , Placenta , Células-Tronco Mesenquimais/patologia
9.
Rev. clín. esp. (Ed. impr.) ; 216(3): 135-145, abr. 2016. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-150041

RESUMO

El síndrome antifosfolipídico obstétrico es una alteración autoinmune adquirida que asocia diversas complicaciones obstétricas, en ausencia de historia trombótica previa, junto con la existencia de anticuerpos antifosfolipídicos dirigidos contra fosfolípidos, proteínas denominadas cofactores o contra complejos fosfolípidos-cofactor. Aunque las complicaciones obstétricas se han relacionado con sus propiedades procoagulantes, estudios anatomopatológicos en placentas humanas han demostrado su capacidad proinflamatoria vía sistema del complemento-citocinas proinflamatorias. No hay acuerdo general sobre cuál es el perfil de anticuerpos antifosfolipídicos (categoría de laboratorio) que confiere más riesgo obstétrico, aunque las denominadas categorías I y IIa son las mejores candidatas. El tratamiento combinado con dosis bajas de aspirina y heparina consigue buenos resultados obstétricos y maternos. Se revisan también las posibilidades terapéuticas en los casos refractarios. La evolución a otras enfermedades autoinmunes es baja. Se comenta brevemente el denominado síndrome antifosfolipídico obstétrico incompleto, también conocido como síndrome de morbilidad obstétrica asociada a anticuerpos antifosfolipídicos (AU)


Obstetric antiphospholipid syndrome is an acquired autoimmune disorder that is associated with various obstetric complications and, in the absence of prior history of thrombosis, with the presence of antiphospholipid antibodies directed against other phospholipids, proteins called cofactors or PL-cofactor complexes. Although the obstetric complications have been related to the procoagulant properties of antiphospholipid antibodies, pathological studies of human placenta have shown the proinflammatory capacity of antiphospholipid antibodies via the complement system and proinflammatory cytokines. There is no general agreement on which antiphospholipid antibodies profile (laboratory) confers the greatest obstetric risk, but the best candidates are categories I and IIa. Combined treatment with low doses of aspirin and heparin achieves good obstetric and maternal outcomes. In this study, we also review the therapeutic possibilities in refractory cases, although the likelihood of progressing to other autoimmune diseases is low. We briefly comment on incomplete obstetric antiphospholipid syndrome, also known as antiphospholipid antibody-mediated pregnancy morbidity syndrome (AU)


Assuntos
Humanos , Feminino , Síndrome Antifosfolipídica/complicações , Síndrome Antifosfolipídica/imunologia , Síndrome Antifosfolipídica/terapia , Anticorpos Antifosfolipídeos/uso terapêutico , Aborto , Pré-Eclâmpsia/diagnóstico , Pré-Eclâmpsia/terapia , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/imunologia , Placenta/anatomia & histologia , Placenta/imunologia , Inquéritos de Morbidade , Monócitos/imunologia , Monócitos/patologia , Síndrome Antifosfolipídica/epidemiologia , Síndrome Antifosfolipídica/prevenção & controle , Indicadores de Morbimortalidade , Período Pós-Parto/imunologia
10.
Prog. obstet. ginecol. (Ed. impr.) ; 59(1): 17-20, ene.-feb. 2016. ilus
Artigo em Espanhol | IBECS | ID: ibc-163814

RESUMO

La listeriosis es una infección poco frecuente causada por el bacilo Listeria monocytogenes. Cuando la infección se produce durante el embarazo suele afectar a la placenta y provoca villitis aguda y microabscesos, y, con menos frecuencia, macroabscesos. Generalmente se debe al consumo de alimentos contaminados. La sintomatología suele ser inespecífica o estar ausente, lo cual dificulta su diagnóstico. En la mujer embarazada puede producir aborto, parto prematuro e incluso muerte neoanatal. Presentamos un caso de infección por L. monocytogenes en una mujer embarazada que afecta a la placenta y provoca macroabscesos, y con resultado perinatal favorable (AU)


Listeriosis is an uncommon infection caused by the Listeria monocytogenes bacillus. Infection during pregnancy usually affects the placenta and causes acute villositis and microabscesses and, less frequently, macroabscesses. Listeriosis is usually due to consumption of contaminated food. Symptoms and signs are usually non-specific, or absent, making the infection difficult to diagnose. In pregnant women, listeriosis can cause miscarriage, preterm birth, and neonatal death. We present a case of L. monocytogenes infection in a pregnant woman that affected the placenta, provoking macroabscesses. The perinatal outcome was favourable (AU)


Assuntos
Humanos , Feminino , Gravidez , Adulto , Abscesso/complicações , Placenta/patologia , Listeria monocytogenes/isolamento & purificação , Listeriose/tratamento farmacológico , Acetaminofen/uso terapêutico , Ampicilina/uso terapêutico , Listeria monocytogenes , Listeria monocytogenes/patogenicidade , Placenta , Listeriose/complicações , Cesárea , Corioamnionite/tratamento farmacológico , Ultrassonografia , Miomectomia Uterina
11.
Rev. toxicol ; 33(2): 88-92, 2016. tab
Artigo em Espanhol | IBECS | ID: ibc-159107

RESUMO

En el estudio transversal relacional se estimó la relación cuantitativa entre la concentración de plomo en la placenta y el peso de la misma; a su vez la relación entre el peso de la placenta con la edad gestacional, peso, longitud y concentración de hemoglobina de recién nacidos en una región metalúrgica de Perú. Se evaluaron 40 productos del parto colectados en un periodo de tres meses, cuando la fundición funcionaba con normalidad, pues actualmente ha suspendido su actividad. El muestreo biológico siguió protocolos ya establecidos, y el plomo se cuantificó por absorción atómica con horno de grafito en el Instituto Peruano de Energía Nuclear. Se realizaron análisis bivariados de regresión y correlación lineal de Pearson. Los promedios y desviación estándar de la edad gestacional, contenido de plomo en la placenta, peso de la placenta y el peso, longitud y hemoglobia de los neonatos fueron: 39,20+1,18 semanas; 319+215,86 ng/g; 504,25+83,53 g; 3191,75+310,61 g; 49,72+1,26 cm y 16,76+1,88 g/dL, respectivamente. El modelo de regresión lineal fue el que se ajustó mejor a las variables estudiadas. Los niveles altos de plomo en la placenta se correlacionaron negativamente con su propio peso; a su vez, los mayores pesos de la placenta se correlacionaron positivamente con el peso, longitud y contenido de hemoglobina de los recién nacidos (AU)


This cross-sectional and correlational study has estimated the quantitative relationship between placental weight and the concentration of lead in the placenta; has also estimated the association between placental weight with gestational age, weight, length and concentration of hemoglobin in newborns in a metallurgical region of Peru, when the Oroya smelter was working normally, because at present it has ceased its activity. Forty birth products, collected over a period of three months in II Hospital EsSalud La Oroya were valued. Biological sampling responded to preset protocols. Lead quantified by atomic absorption spectrometry with graphite furnace in the Peruvian Institute of Nuclear Energy. Bivariate regression analysis and Pearson linear correlation were performed to establish associations between assessed variables. The averages and standard deviation of gestational age, lead content in the placenta, placental weight; birth weight, length and hemoglobin level of neonates were 39.20+1.18 weeks, 319+215.86 ng/g, 504.25+83.53 g, 3191.75+310.61 g; 49.72+1.26 cm and 16.76+1.88 g/dL, respectively. The regression model best adapted to the assessed variables was the linear model. Higher levels of lead in the placenta were negatively correlated with the placental weight. The greatest placental weight was positively correlated to birth weight, length and hemoglobin concentrations of newborns (AU)


Assuntos
Humanos , Feminino , Gravidez , Adulto , Intoxicação por Chumbo/complicações , Hemoglobinas/análise , Hemoglobinas/toxicidade , Placenta/fisiologia , Idade Gestacional , Estudos Transversais/tendências , Estudos Transversais/instrumentação , Estudos Transversais/métodos , Modelos Lineares , Peso ao Nascer/fisiologia , Mineração/métodos , Sangue Fetal/fisiologia , Monitoramento Ambiental/métodos
12.
Rev. osteoporos. metab. miner. (Internet) ; 7(1): 27-32, ene.-mar. 2015. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-137643

RESUMO

El embarazo constituye un modelo donde se produce el desarrollo del esqueleto fetal en un corto lapso de tiempo. Este logro se lleva a cabo bajo la tutela del propio feto, que gobierna este proceso a través de las señales generadas en la denominada unidad feto-placentaria. El organismo materno sufre un proceso de adaptación donde se produce un drástico reajuste en mecanismos implicados en el recambio óseo. Entre los cambios más evidentes detectables en sangre materna están los incrementos con la edad gestacional de los niveles de calcitriol, de la hormona de crecimiento de origen placentario, del factor de crecimiento similar a la insulina tipo I (IGF-1), de estrógenos, y de prolactina. También aumentan la osteoprotegerina y el ligando activador del receptor del factor nuclear kappa-B (RANKL). El fenómeno conduce a estados transitorios de deterioro óseo, que se alargan hasta que la lactancia concluye. El proceso en su conjunto está todavía insuficientemente explorado. Presentamos una actualización de los cambios que afectan a la madre y de los que tienen su origen en la placenta (AU)


Pregnancy defines a model where the development of the fetal skeleton occurs in a short lapse of time. This achievement is accomplished under the control of the own fetus, who regulates the process through the signals generated in the so-called feto-placental unit. The maternal organism undergoes an adaptation process in which a drastic readjustment of mechanisms involved in the bone turnover takes place. Among the most obvious changes detected in maternal blood there are the increases in calcitriol, placental growth hormone, insulin-like growth factor -1 (IGF-1), estrogens and prolactin. There are also increases in osteoprotegerin and in the ligand of the receptor activator of nuclear factor kappa (RANKL). The phenomenon leads to transitory states of bone deterioration, which extends up to the end of lactation. The whole process is still insufficiently explored. We present an update of the changes affecting the mother and of those that arise in the placenta (AU)


Assuntos
Humanos , Osso e Ossos/fisiologia , Calcitriol/sangue , Gravidez/fisiologia , Placenta/fisiologia , Testes de Função Placentária , Desenvolvimento Ósseo , Osteoporose/fisiopatologia , Esqueleto , Densidade Óssea/fisiologia
13.
Diagn. prenat. (Internet) ; 25(2): 35-42, jul.-dic. 2014.
Artigo em Inglês | IBECS | ID: ibc-129906

RESUMO

Careful placenta examination and injection studies are crucial to understand the differences between the various complications in monochorionic (MC) pregnancies. In this review, we will first describe an accurate and simple method of placental injection and then discuss the placental characteristics of normal MC, twin-twin transfusion syndrome (TTTS), twin anemia-polycythemia sequence (TAPS), selective intrauterine growth restriction (sIUGR), monoamniotic (MA) and other special cases (AU)


El examen cuidadoso de la placenta y los estudios de inyección son cruciales para comprender las diferencias existentes entre las diversas complicaciones de los embarazos MC. En esta revisión, vamos a describir primero un método preciso y simple de inyección placentaria y, posteriormente, abordaremos las características de una placenta normal en MC, el síndrome de transfusión fetal-fetal (STFF), la secuencia anemia-policitemia (SAP), la restricción del crecimiento intrauterino selectivo (CIRs), la placenta monoamniótica (MA) y otros casos especiales (AU)


Assuntos
Humanos , Feminino , Placenta/fisiopatologia , Anastomose Arteriovenosa/fisiopatologia , Retardo do Crescimento Fetal/fisiopatologia , Diagnóstico Pré-Natal/métodos , Diagnóstico Pré-Natal/tendências , Diagnóstico Pré-Natal , Âmnio/fisiopatologia , Transfusão Feto-Fetal/fisiopatologia , Gravidez de Gêmeos/fisiologia
14.
Eur. j. anat ; 18(3): 153-158, jul. 2014. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-125132

RESUMO

In this paper, we report the results of histological and histochemical studies to differentiate between normal-term and growth-retarded placentas. Histology was based on Gordon and Sweet, while histochemistry was carried out by localizing G-6-PDH and LDH in the placentas. Thirty (30) placentas, 15 normal-term and 15 growth-retarded placentas, were collected from female patients recruited from the Antenatal Clinic of Dolu Specialist Hospital, Mafoluku-Oshodi, Lagos, Nigeria. Normal-term placentas were collected at the point of delivery by a consultant obstetrician in the presence of other co-researchers, after the consent of the patient had been sought. 1 cm thick portion of both normal and growth-retarded tissues for histological study were cut and processed for Gordon and Sweet staining to demonstrate reticulin fibres, while tissues for histochemical studies (G-6-PDH and LDH) were homogenized in cold 0.5 M sucrose solution. Data were comparatively analyzed using ANOVA statistics, with p<0.005. The result revealed that some places on the syncytial layer were discontinuous. Micro-vessels lying within the core of loose connective tissue were closely opposed to the syncytial trophoblast in IUGR case. Areas of collagen and fibrin deposition reflect ongoing repair of breaches of tissue border and epithelial integrity. The levels of G-6-PDH and LDH activities were lower in the growth- retarded placentas when compared with the normal term placentas. This difference was statistically significant at p<0.005. It is surmised that the placentas in IUGR indicate abnormalities of the maternal spiral arterioles, deregulated villous vasculogenesis, and abundant fibrin deposition is characteristics in IUGR. This shows that there is a link between enzymes of glucose metabolism in the terminal stage of the antenatal period in placental tissues with consequences for foetal growth and development


No disponible


Assuntos
Humanos , Feminino , Gravidez , Placenta/ultraestrutura , Piruvato Desidrogenase (Lipoamida)-Fosfatase/análise , Glucose Desidrogenase/análise , Lactato Desidrogenases/análise , Placenta/crescimento & desenvolvimento , Histocitoquímica/métodos , Desenvolvimento Fetal
15.
Eur. j. anat ; 18(3): 165-169, jul. 2014. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-125134

RESUMO

The present study aimed to assess the morphological and histological changes of placentas associated with maternal anaemia (mothers with Hb level <11 g/dl). The study was conducted in Bankura Sammilani Medical College, West Bengal, India for a period of six months. Placentas collected from cases of maternal anaemia (Hb < 11 g/dl) were forty (40) and those collected from control mothers were thirty (30). All the deliveries were at full term (37-42 weeks) and in the antenatal periods were without any complications or diseases. Macroscopic and microscopic analyses of the placentas were done and these findings were compared. Statistical analysis was performed by using t-test for comparing the mean values of fetal weights, placental weights, placental indices and placental volumes of the maternal anaemia group with those of control group. It was observed that the mean fetal weight of pregnancy with anaemia group was less than those of the control group. The mean placental weight and mean placental volume in pregnancy with the anaemia group were more than the control group. Also, the mean placental index of the maternal anaemia group was higher than that of the control group. Light microscopy revealed increased fibrin deposition, increased syncytial knotting, more avascular villi with incomplete trophoblastic lining, stromal fibrosis, intervillous haemorrhage and cytotrophoblastic cell proliferation in placentas of anaemic mothers as compared to those of the controls. We concluded that maternal anaemia resulted into bigger, heavier placentas and smaller fetuses, whereas placental morphological changes showed signs of chronic hypoxia and placental insufficiency


No disponible


Assuntos
Humanos , Placenta/anatomia & histologia , Anemia/epidemiologia , Insuficiência Placentária/fisiopatologia , Complicações na Gravidez/epidemiologia , Tamanho do Órgão , Hipóxia/complicações , Desenvolvimento Fetal
16.
Diagn. prenat. (Internet) ; 24(3): 99-107, jul.-sept. 2013.
Artigo em Espanhol | IBECS | ID: ibc-115217

RESUMO

Introducción. El estudio de vellosidades coriales comprende realizar 2 cultivos celulares que pueden no tener resultados coincidentes. Estas discrepancias pueden ser debidas a mosaicos citogenéticos de origen in vivo o in vitro. En este trabajo nos planteamos analizar los cariotipos en mosaicos, ligado con los rendimientos de los cultivos celulares y los resultados citogenéticos. Material y métodos. Se han analizado 2.360 muestras prenatales y 510 de vellosidades de abortos. Con las muestras prenatales se efectúan rutinariamente 2 cultivos celulares, cultivo corto y cultivo largo, y para los abortos además se han estudiado muestras de restos fetales. Resultados. El porcentaje de muestras con resultado citogenético para el grupo prenatal fue del 99,9% y para el grupo de abortos del 87,1%. El porcentaje de anomalías cromosómicas en el grupo prenatal fue del 10,6% siendo las aneuploidías comunes (trisomías 13, 18, y 21) las más frecuentes, y para el grupo de abortos fue del 55,1% siendo las aneuploidías no-comunes las más frecuentes. El porcentaje de cariotipos en mosaico para el grupo prenatal fue del 3,1% y para el grupo de abortos del 6,8%. El mosaico confinado a la placenta tipo ii fue el más frecuente. Conclusiones. Para el estudio de los mosaicos en vellosidades coriales la mejor estrategia es realizar los 2 cultivos paralelos en muestras prenatales y los 3 cultivos en muestras de abortos. Teniendo en cuenta el riesgo que asume la pareja ante una prueba invasiva, es nuestro deber dar el resultado citogenético más completo posible(AU)


Introduction. The study of chorionic villus samples comprises performing two cell cultures that may not have matching results. These discrepancies may be due to cytogenetic mosaics of in vivo or in vitro origin. This study included analysing the karyotypes in mosaics, associated with the cell culture and cytogenetic results. Material and methods. Prospective study based on the analysis of 2,360 chorionic villus samples and 510 spontaneous abortion samples. Two cultures were routinely performed on the prenatal samples (short and long), as well as on the abortion samples. Results. The success rate was 99.9% in the prenatal group, and 87.1% in the abortion group. The percentage of chromosomal anomalies in the prenatal group was 10.6%, with the common aneuploidies (trisomy 13, 18, and 21) being the most frequent. In the abortions group there 55.1% anomalies, with uncommon aneuploidy the most frequent. The percentage of mosaicism in the prenatal group was 3.1%, and it was 6.8% in the abortion group. The confined placental mosaicism type ii was the most frequent. Conclusions. For the study of the mosaicism in chorionic villi samples the best strategy is to perform 2 prenatal samples cultures in parallel, and 3 abortion samples cultures. Given the risk to the mother and child using this invasive test, it is our duty to give the most comprehensive cytogenetic results achievable(AU)


Assuntos
Humanos , Masculino , Feminino , Vilosidades Coriônicas/anormalidades , Mosaicismo/estatística & dados numéricos , Citogenética/instrumentação , Citogenética/métodos , Análise Citogenética/métodos , Aneuploidia , Mosaicismo/embriologia , Placenta/anatomia & histologia , Doenças Placentárias/diagnóstico , Trissomia/diagnóstico , Síndrome de Down/diagnóstico
17.
Prog. obstet. ginecol. (Ed. impr.) ; 56(2): 94-100, feb. 2013. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-109178

RESUMO

El corioangioma es el tumor benigno placentario más frecuente. Se presenta en aproximadamente un 1% de las gestaciones. El diagnoótico del corioangioma se realiza fundamentalmente en el segundo o tercer trimestre y se basa en el estudio ecográfico. Se presenta el caso de un corioangioma gigante de 8,5 cm que finaliza en una gestación a término(AU)


Chorioangioma is the most frequent benign placental tumor, with a reported incidence of 1%. Diagnosis is made by ultrasound during the second or third trimester of pregnancy. We report a case of a giant chorioangioma (8.5 cm) in a woman who carried the pregnancy to term(AU)


Assuntos
Humanos , Feminino , Gravidez , Adulto , Diagnóstico Pré-Natal/instrumentação , Diagnóstico Pré-Natal/métodos , Diagnóstico Pré-Natal , Hemangioma/complicações , Hemangioma/diagnóstico , Complicações na Gravidez/patologia , Placenta/patologia , Placenta , Tumor Trofoblástico de Localização Placentária
18.
Rev. esp. patol ; 45(2): 109-112, abr.-jun. 2012. ilus
Artigo em Espanhol | IBECS | ID: ibc-99811

RESUMO

La displasia mesenquimática placentaria es una patología caracterizada por placentomegalia, alteraciones vasculares y vellosidades edematizadas. Frecuentemente se confunde con la mola hidatiforme, pero a diferencia de esta última no tiene potencial de malignización y permite, salvo algunas complicaciones, el desarrollo normal de la gestación. En este artículo informamos un nuevo caso, diagnosticado después del parto, asociado a retardo en el crecimiento intrauterino. Discutimos también la fisiopatología, la utilidad de p57 y el diagnóstico diferencial de esta entidad(AU)


Placental mesenchymal dysplasia (PMD) is characterized by placentomegaly, vascular alterations and oedematous villi and is often confused with hydatidiform mole; however, unlike the latter, it has no malignant potential and normal gestation is possible although complications may occur. We report a case of PMD, diagnosed after delivery, which was associated with intrauterine growth restriction. The pathophysiology, usefulness of p57 and differential diagnosis of PMD is discussed(AU)


Assuntos
Humanos , Feminino , Adulto , Retardo do Crescimento Fetal/diagnóstico , Retardo do Crescimento Fetal/patologia , Diagnóstico Pré-Natal/métodos , Inibidor de Quinase Dependente de Ciclina p57 , Imuno-Histoquímica/métodos , Diagnóstico Diferencial , Placenta/anatomia & histologia , Placenta/patologia , Placenta/ultraestrutura , Doenças Placentárias/patologia
19.
Endocrinol. nutr. (Ed. impr.) ; 59(5): 326-330, mayo 2012. tab
Artigo em Espanhol | IBECS | ID: ibc-105165

RESUMO

Introducción El yodo es un micronutriente esencial en la alimentación de la embarazada que transfiere al embrión-feto a través del transporte placentario. Existen antecedentes de su importancia para el desarrollo neurológico, pero no ha sido estudiada la relación entre ingesta de yodo y peso placentario ni su repercusión en el neonato (RN).Materiales y métodos Se analizó ingesta de yodo en 77 embarazadas, mediante eliminación urinaria de yodo (EUI) con la técnica modificada por Pino (normal ≥150μg/l). Se midió el peso placentario (PP: normal ≥500g). En el recién nacido se evaluó peso, talla y perímetro cefálico (PC). Se obtuvo el índice placentario (IP: peso placentario/ peso recién nacido) considerando normal ≥0,15.ResultadosLa EUI fue normal en 50 embarazadas (media±DE, 279μg/l±70,22μg/l) y disminuida en 27 (94μg/l ±31,49μg/l). Los RN de madres con EUI baja tenían un peso (3.357g±416,30g; n: 27) no diferente a las madres con yodurias normales (3.489g±560,59g; n: 50). Pero las madres con EUI bajo tenían un 44% de placentas con PP<500g y el análisis de los PC en los RN con bajo PP mostró que eran estadísticamente menores (PP3500g: 36,05cm±0,55cm, n: 54; PP<500g: 33,93cm±15cm, n: 23, p<0,019). El estudio con los IP fue similar aunque no alcanzó la significación estadística 0,17±0,04 (p: 0,066). Los demás parámetros no mostraron diferencias significativas. Conclusión El estudio evidencia una relación entre el PP y PC. Este hallazgo puede ser relacionado con la ingesta de yodo durante el embarazo (AU)


Introduction Iodine is considered to be an essential micronutrient in pregnant women. Iodine placental transport to the embryo–fetus is essential for hormone synthesis and is crucial for nervous system development. However, the relationship between iodine intake and placental weight and its potential implications for the newborn have not been studied. Material and methods Iodine intake was analyzed in 77 pregnant women based on urinary iodine excretion (UIE) levels, measured using Pino's modified method (normal value, ≥150μg/L). Placental weight was measured (PW: normal, ≥500g). In the newborn, weight, height, and head perimeter (HP) were also measured. Placental index (PI: placental weight/newborn weight) was calculated, and was considered normal if ≥0.15.ResultsUIE was normal in 50 pregnant women (mean±SD, 279±70.22μg/L) and decreased in 27 (94±31.49μg/L). Newborns of mothers with low UIE had a similar weight (3357±416.30g; n: 27) to those of mothers with normal UIE (3489±560.59g; n: 50). Forty-four percent of mothers with low UIE had PW <500g, and statistically lower HPs were found in newborns of mothers with low PW (PW3 500g: 36.05±0.55cm, n: 54; PW<500g: 33.93±15cm, n: 23, p<0.019). Similar results were found with PI, but they did not reach statistical significance (0.17±0.04; p=0.066). No differences were seen in all other parameters. Conclusion The study suggests the existence of a relationship between PW and HP. This finding may be related to iodine intake during pregnancy (AU)


Assuntos
Humanos , Feminino , Gravidez , Adolescente , Adulto Jovem , Adulto , Iodo/deficiência , Nutrição Materna , Placenta/anormalidades , Cefalometria , Iodo/urina , Transtornos Nutricionais/epidemiologia , Transtornos da Nutrição Fetal/epidemiologia
20.
Prog. obstet. ginecol. (Ed. impr.) ; 55(3): 137-140, mar. 2012.
Artigo em Espanhol | IBECS | ID: ibc-97804

RESUMO

La vasa previa es una situación que se produce cuando vasos fetales intramembranosos aberrantes, procedentes de la placenta o del cordón umbilical, atraviesan el orificio cervical interno y se sitúan por delante de la presentación fetal. Su incidencia es de 1/2.000-1/3.000 embarazos, y la mortalidad perinatal asociada es del 52-66%, aproximadamente. La reducción de esta elevada mortalidad se basa en su diagnóstico prenatal. Exponemos a continuación el caso clínico de una gestante, con controles obstétricos correctos, que acude a urgencias a las 34,5 semanas por rotura prematura de membranas, objetivándose un líquido amniótico hemático y bradicardia fetal severa, por lo que se realiza una cesárea urgente, naciendo una niña con anemia severa, que ingresa en la unidad de neonatología, presentando buena evolución posterior. Presentamos también una revisión de la literatura de los años 1980 al 2008, a través de Medline, usando las palabras «vasa previa» (AU)


Vasa previa is a condition in which the intramembranous fetal blood vessels within the placenta or umbilical cord cross the internal os and become trapped between the fetus and the opening of the birth canal. The incidence of this entity varies from 1/2000 to 1/3000 pregnancies and the associated perinatal mortality rate has been reported to be as high as 52-66%. Reduction of this high perinatal mortality depends on prenatal diagnosis. We report the case of a pregnant woman with no abnormalities in antenatal visits who presented to the emergency service at 34.5 weeks of pregnancy due to premature rupture of membranes, at which time blood-stained amniotic fluid and severe fetal bradycardia were noted. An emergency cesarean section was performed. A female neonate was delivered with severe anemia. The neonate was admitted into the neonatology unit and subsequent outcome was favorable. We also provide a review of the literature published between 1980 and 2008 using Medline, with the key words "vasa previa" (AU)


Assuntos
Humanos , Feminino , Gravidez , Adulto , Vasa Previa/diagnóstico , Vasa Previa/terapia , Cordão Umbilical/lesões , Cordão Umbilical/fisiopatologia , Cardiotocografia/tendências , Cardiotocografia , Vasa Previa , Mortalidade Perinatal/tendências , Diagnóstico Pré-Natal/métodos , Diagnóstico Pré-Natal/tendências , Placenta/patologia , Placenta/ultraestrutura
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