Fetal major cardiac defects and placental dysfunction at 11-13 weeks' gestation.

OBJECTIVE: To investigate the relationship between fetal major cardiac defects and markers of placental perfusion and function. METHODS: This was a prospective screening study in singleton pregnancies at 11-13 weeks' gestation. Uterine artery pulsatility index (UtA-PI), serum pregnancy-associated plasma protein-A (PAPP-A) and placental growth factor (PlGF) were measured and the values were converted into multiples of the normal median (MoM). Median MoM values in fetuses with isolated major cardiac defects were compared with those in fetuses without major defects. RESULTS: The 50 094 singleton pregnancies fulfilling the entry criteria included 49 898 pregnancies with normal cardiac anatomy and 196 (0.39%) with major congenital cardiac defects: 73 (37.2%) with conotruncal defects, 63 (32.1%) with left ventricular outflow tract defects and 60 (30.6%) with valvular defects. In the group with cardiac defects, compared with controls, there was lower median PAPP-A MoM (0.81 vs 1.00, P < 0.0001) and PlGF MoM (0.78 vs 1.00, P < 0.0001) but no significant difference in UtA-PI MoM (1.01 vs 1.00, P = 0.162). CONCLUSION: In pregnancies with isolated fetal major cardiac defects, there is evidence of placental dysfunction in the absence of impaired placental perfusion. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

The effect of surgical menopause on the intima-media thickness of the carotid and coronary arteries.

OBJECTIVE: To evaluate the effect of prior bilateral oophorectomy on the intima-media thickness (IMT) of coronary and carotid arteries. METHODS: A total of 25 Wistar albino rats, aged 8-10 weeks, were assigned to three groups: ovariectomized (n = 10), control (n = 10) and sham (n = 5). The rats in the sham group only underwent midline laparotomy, while the other rats' ovaries were removed by the same type of laparotomy. All rats were sacrificed to evaluate microscopically the impact of a prolonged 26-week surgical menopause (menopausal period) on the IMT of the carotid and coronary arterial structure. RESULTS: The mean IMTs of both the carotid and coronary arteries in the ovariectomized group were significantly thicker than those of the control and sham groups (carotid arteries: 268.69 ± 53.67, 195.61 ± 47.60 and 193.86 ± 75.01 µm, p = 0.014; coronary arteries: 182.40 ± 30.22, 136.00 ± 35.82 and 165.24 ± 40.68 µm, p = 0.022, respectively). CONCLUSION: According to the results of this study, surgical menopause results in a noteworthy increase in the IMT of the carotid and coronary arteries when compared with the controls. This interventional effect may have a significant role in accelerating the process of atherosclerosis.