Estudio de la madurez fetal canina al final del embarazo: aplicabilidad de diagnóstico / Study of canine fetal maturity, emphasizing final stage of gestation, and diagnostic applicability / Estudo da maturidade fetal canina em fase final de gestação: aplicabilidade diagnóstica

En la medicina, las técnicas para la evaluación de la madurez esquelética, pulmón, riñón y corazón ya se usan de forma rutinaria en obstetricia, a diferencia de veterinaria que estas evaluaciones están siendo estudiados recientemente. La evaluación de los fluidos fetales se convierte en obstetricia humana para un parámetro para la determinación de la madurez fetal, embarazo de alto riesgo, muerte fetal, infección fetal y el sexo. Mientras que para los pequeños animales es necesario desarrollar técnicas aplicables para determinar la maduración fetal ción de los fetos, el presente trabajo tiene como objetivo revisar o describir la aplicación de estos métodos y la evaluación de la madurez fetal en animales pequeños.(AU)

In medicine, techniques for assessing skeletal maturity, lung, kidney and heart are already routinely used in obstetrics, unlike veterinary that these assessments are being studied recently. The assessment of fetal fluids becomes for obstetrics human a parameter for determining fetal maturity, high-risk pregnancy, fetal death, fetal infection and sex. Whereas for small animals it is necessary to develop techniques applicable to determine the fetal maturation of fetuses, this paper aims to review or describe the application of these methods and assessment of fetal maturity in small animals.(AU)

Em medicina, técnicas para avaliar maturidade óssea, pulmonar, renal e cardíaca são rotineiramente utilizadas em obstetrícia, diferentemente da veterinária em que essas avaliações estão sendo recentemente estudadas. A avaliação dos fluidos fetais torna-se para a obstetrícia humana um parâmetro de determinação da maturidade fetal, gestação de alto risco, morte fetal, infecção e sexo fetais. Considerando que para pequenos animais faz-se necessário o desenvolvimento de técnicas para determinação da maturação fetal dos conceptos, a presente revisão tem como objetivo descrever a aplicação de métodos diagnósticos para avaliação da maturidade fetal em pequenos animais.(AU)

Estudio de la madurez fetal canina al final del embarazo: aplicabilidad de diagnóstico / Study of canine fetal maturity, emphasizing final stage of gestation, and diagnostic applicability / Estudo da maturidade fetal canina em fase final de gestação: aplicabilidade diagnóstica

En la medicina, las técnicas para la evaluación de la madurez esquelética, pulmón, riñón y corazón ya se usan de forma rutinaria en obstetricia, a diferencia de veterinaria que estas evaluaciones están siendo estudiados recientemente. La evaluación de los fluidos fetales se convierte en obstetricia humana para un parámetro para la determinación de la madurez fetal, embarazo de alto riesgo, muerte fetal, infección fetal y el sexo. Mientras que para los pequeños animales es necesario desarrollar técnicas aplicables para determinar la maduración fetal ción de los fetos, el presente trabajo tiene como objetivo revisar o describir la aplicación de estos métodos y la evaluación de la madurez fetal en animales pequeños.

In medicine, techniques for assessing skeletal maturity, lung, kidney and heart are already routinely used in obstetrics, unlike veterinary that these assessments are being studied recently. The assessment of fetal fluids becomes for obstetrics human a parameter for determining fetal maturity, high-risk pregnancy, fetal death, fetal infection and sex. Whereas for small animals it is necessary to develop techniques applicable to determine the fetal maturation of fetuses, this paper aims to review or describe the application of these methods and assessment of fetal maturity in small animals.

Em medicina, técnicas para avaliar maturidade óssea, pulmonar, renal e cardíaca são rotineiramente utilizadas em obstetrícia, diferentemente da veterinária em que essas avaliações estão sendo recentemente estudadas. A avaliação dos fluidos fetais torna-se para a obstetrícia humana um parâmetro de determinação da maturidade fetal, gestação de alto risco, morte fetal, infecção e sexo fetais. Considerando que para pequenos animais faz-se necessário o desenvolvimento de técnicas para determinação da maturação fetal dos conceptos, a presente revisão tem como objetivo descrever a aplicação de métodos diagnósticos para avaliação da maturidade fetal em pequenos animais.

Conceitos atuais sobre avaliação da maturidade pulmonar fetal / Current concepts on the assessment of fetal lung maturity

A Síndrome do Desconforto Respiratório (SDR), também conhecida como Doença da Membrana Hialina, é uma das principais causas de morbidade e mortalidade neonatal. O principal fator associado à SDR é a produção insuficiente de surfactante pulmonar, o que geralmente está associada à prematuridade. Alguns protocolos internacionais recomendam que a confirmação da maturidade pulmonar fetal seja realizada em partos eletivos antes de 39 semanas de gestação. Diversos são os métodos capazes de avaliar a maturidade pulmonar fetal, como a Relação Lecitina/Esfingomielina,a Pesquisa de Corpos Lamelares, a Relação Surfactante/Albumina, o percentual deFosfatidilglicerol, o Índice de Estabilidade da Espuma e o Shake Test ou Teste de Clements. Este estudo visa apresentar os principais métodos disponíveis e as recomendações atuais sobre quando realizar a avaliação da maturidade pulmonar fetal.(AU)

The Respiratory Distress Syndrome (RDS), also known as hyaline membrane disease, is a major cause of neonatal morbidity and mortality. The main factor associated with RDS is the insufficient production of pulmonary surfactant, which is usually associated with prematurity. Some international guidelines recommend that the confirmation of fetal lung maturity is performed in elective deliveries before 39 weeks of gestation. There are several methods to assess fetal lung maturity, such as the Lecithin/Sphingomyelin ratio, the Lamellar Body Count, the Surfactant/Albumin ratio, the percentage of phosphatidylglycerol, the Foam Stability Index and the Shake Test or Clements test. This study aims to present the main available methods and current recommendations on when to conduct the evaluation of fetal lung maturity.(AU)

Testicular migration chronology: do the right and the left testes migrate at the same time? Analysis of 164 human fetuses.

OBJECTIVE: To determine if the right and the left testes migrate at the same time during the human fetal period. SUBJECTS AND METHODS: We studied 164 human fetuses (328 testes) ranging in age from 12 to 35 weeks post-conception. The fetuses were carefully dissected with the aid of a stereoscopic lens at ×16/25. The abdomen and pelvis were opened to identify and expose the urogenital organs. Testicular position was classified as: (a) Abdominal, when the testis was proximal to the internal ring; (b) Inguinal, when it was found between the internal and external inguinal rings); and (c) Scrotal, when it was inside the scrotum. RESULTS: The testes were abdominal in 71% of the cases, inguinal in 9.41%, and scrotal in 19.81%. There was asymmetry in testicular migration in nine cases (5.5%). In three of these nine cases, one testis was situated in the abdomen and the other in the inguinal canal; in another three one testis was situated in the abdomen and the other in the scrotum, and in the remaining three, one testis was in the inguinal canal and the other in the scrotum. In five of the nine cases of asymmetry, the right testis completed the migration first, but this was not statistically significant. CONCLUSION: Asymmetry in testicular migration is a rare event, accounting for <6% of the cases. The right testis seems to complete migration first.

Intraluminal tracheal occlusion using a modified 8-mm Z-stent in a sheep model of left-sided congenital diaphragmatic hernia.

OBJECTIVE: To evaluate pulmonary growth and development after fetoscopic intraluminal tracheal occlusion (FITO) using a modified 8-mm Z-stent in an ovine model of congenital left-sided diaphragmatic hernia (CDH). METHODS: Thirty-three time-dated ewes were studied: Group I: healthy controls; Group II: CDH controls (untreated); Group III: CDH treated with FITO. CDH was created in Groups II and III at 70-80 days' gestation. FITO was performed at 100-110 days. Left lung histological, morphometric, immunohistochemical and biochemical studies were conducted after delivery and euthanasia at 138 days. RESULTS: Fifteen (45%) animals (Group I: 3; Group II: 5; Group III: 7) were available for analysis. The left lung parenchymal volume to fetal weight ratios were similar between Groups I and III (p = 0.24), and higher than Group II (p < 0.05III (79 versus 75%, p = 0.26), compared to 41% in Group II (p < 0.05). Pulmonary hypoplasia occurred in 1/7 (16%) in the FITO group, compared to 100% in Group II and 0% in Group I (p = .003). DNA and protein were significantly increased in Group III (p < 0.001). The concentration of type II pneumocytes was similar between healthy controls and the FITO group, and was paradoxically increased in untreated hernia fetuses. There was no histological evidence of tracheal injury. CONCLUSION: FITO with a modified 8-mm Z-stent is associated with lung growth and maturation similar to controls without obvious deleterious effects. A phase I clinical trial of FITO with the modified 8-mm Z-stent in severe CDH patients seems warranted.

In utero iron status and auditory neural maturation in premature infants as evaluated by auditory brainstem response.

OBJECTIVE: To determine whether cord ferritin (CF) concentration, an index of in utero iron status, is associated with auditory neural maturation in premature infants. STUDY DESIGN: A prospective cohort study was performed to compare auditory neural maturation in infants with latent iron deficiency (CF 11-75 ng/mL) and infants with normal iron status (CF > 75 ng/mL) at birth. Our inclusion criteria were infants of 27-33 weeks gestational age who were admitted to the neonatal intensive care unit between July 2007 and November 2008 within 12 hours after birth and had cord blood collected. Infants with TORCH infections (toxoplasmosis, other infections, rubella, cytomegalovirus infection, and herpes simplex), chromosomal disorders, craniofacial anomalies, culture-proven sepsis, and/or unstable conditions were excluded. CF level was measured using a chemiluminescence immunoassay method. Bilateral monaural auditory brainstem evoked response (ABR) was assessed using 80-dB nHL click stimuli at a repetition rate of 29.9/seconds within 48 hours after birth. RESULTS: Of the 80 infants studied, 35 had latent iron deficiency. After controlling for confounders, the infants with latent iron deficiency had significantly prolonged absolute wave latencies I, III, and V and decreased frequency of mature ABR waveforms compared with the infants with normal iron status. CONCLUSION: Premature infants with in utero latent iron deficiency have abnormal auditory neural maturation compared with infants with normal in utero iron status.

Delayed lung maturation of foetus of diabetic mother rats develop with a diminish, but without changes in the proportion of type I and II pneumocytes, and decreased expression of protein D-associated surfactant factor.

Newborn children of diabetic mothers have an increased morbidity and mortality because of respiratory distress syndrome. We study lung histogenesis during intrauterine development of offspring of diabetic Sprague-Dawley rats at 18, 19 and 21 days of gestation (DG). Pregnant rats were grouped into diabetic (streptozotocin-induced), citrate, and control groups; five female and five male offspring were selected randomly from each group at 18, 19 and 21 DG, and a biopsy of the lung was taken and processed in paraffin for histological examination. The biopsy for the transmission electron microscopy (TEM) analysis was taken at 21 days. A delay in alveolization of the offspring at 18, 19 and 21 days of the diabetic group was observed, which was confirmed at TEM level, and also less quantity of protein D associated to surfactant in diabetic group was detected (P < 0.001). The foetuses of the diabetic group presented a delay in lung histogenesis and in differentiation of the type II pneumocytes cells, but conserved the proportion with a decrease in 50% of pneumocytes, accompanied by a diminish of protein D associated to surfactant factor.

Comparison of the two-dimensional and multiplanar methods and establishment of a new constant for the measurement of fetal lung volume.

OBJECTIVES: To compare the two-dimensional (2D) and multiplanar methods in the measurement of lung volume in normal fetuses, to obtain a new constant to be incorporated into the 2D equation, and to apply the new equation in fetuses with pulmonary hypoplasia (PH) confirmed postnatally. METHODS: A cross-sectional study was performed on 51 pregnant women at between 20 and 35 weeks of gestation. The ellipsoid formula (x x y x z x 0.52) was used to calculate lung volume by the 2D method. A sequence of multiple planes with 2.0-mm intervals was used with the multiplanar method. In order to compare the techniques, the intra-class correlation coefficient (ICC) and the Student's t-test (p) were used. First-order linear regressions were used to establish a new constant, with three-dimensional (3D) lung volume as dependent variable and gestational age and 2D volume as independent variables. In order to validate it, the new equation was applied to 11 fetuses with confirmed lethal PH. RESULTS: The mean volumes obtained by the 2D method were overestimated when compared to the multiplanar method (right lung: 23.87 vs. 18.26 mL, respectively, p < 0.001 and left lung: 16.18 vs. 14.33 mL, respectively, p = 0.008). Using a first-order polynomial regression, new constants were obtained for the right lung (0.152) and for the left lung (0.167). When compared to the traditional formula, the new equation presented higher sensitivity (18.1%) in predicting lethal PH. CONCLUSION: The recalculated 2D equation can be a promising alternative to 3D ultrasonography in the prediction of PH.

Effects of sildenafil on the fetal growth of guinea pigs and their ability to survive induced intrapartum asphyxia.

OBJECTIVE: Our goal was to determine whether sildenafil increased fetal weight and favored fetal tolerance to induced asphyxia at birth in guinea pigs. STUDY DESIGN: Twenty guinea pigs were randomly allocated to placebo (n = 10) or sildenafil 50 microg/kg (n = 5) or 500 microg/kg (n = 5), starting from day 35 of gestation to delivery. Fetuses were delivered by cesarean section. Fetal asphyxia was induced by clamping the umbilical cord at birth for 5 minutes. RESULTS: Sildenafil protected the pups against induced asphyxia at birth in a dose-dependent manner (eg, partial pressure (tension) of carbon dioxide levels were 75.9 +/- 19.3, 66.9 +/- 18.8, and 54.8 +/- 13.0 in the control and low- and high-dose sildenafil groups, respectively). The high-dose sildenafil group of piglets gained 1.5 times more body weight. CONCLUSION: In guinea pigs, low doses of sildenafil administered from day 35 to the end of gestation favored fetal tolerability to induced intrapartum asphyxia. High doses of sildenafil increased fetal weight.

Aminiotic fluid and intrauterine growth restriction in a gastroschisis fetal rat model.

UNLABELLED: Fetuses with digestive anomalies such as gastroschisis may present intrauterine growth restriction (IUGR) and shortened intestines. OBJECTIVE: The aim of this study was to assess the influence caused by amniotic fluid (AF) in intestinal length and somatic growth in an experimental gastroschisis fetal model at two distinct gestational ages. MATERIAL AND METHOD: Fetal rats were operated according to Correia-Pinto on 2 different days of gestation: day 18.5 (group I) and day 19.5 (group II). Each group was divided into three sub-groups: fetuses with gastroschisis (G), control (C) and sham(S). Body measurements and histological analysis were done. RESULT: Body measurement analysis showed: average body weight (g) in group I was G = 5.32, C = 5.68, S = 5.86; group II was G = 5.32, C = 5.80, S = 5.66. Average intestine weight (g) in group I was G = 0.283, C = 0.238, S = 0.231; group II was G = 0.272, C = 0.231, S = 0.233. Average intestine length (mm) in group I was G = 125, C = 216, S = 209; group II was G = 148, C = 226, S = 226. Histological analysis showed a decrease in the number and size of the intestinal microvillae and a light edema of serosa. CONCLUSION: Gastroschisis had a direct correlation with IUGR and the time of exposure of the fetuses to AF had no influence on body weight in gastroschisis fetuses but did interfere with intestinal length.

[Leptin and its influence on the main gynecoobstetric diseases]. / Leptina y su influencia en los principales padecimientos ginecoobstétricos.

Leptin is a protein hormone synthesized and secreted by adipose tissue and also probably in other organs and systems in human body. It has multiple functions such as to regulate feed intake and energy balance, gonadal regulation, action in the hypothalamo-pituitary-gonadal axis, regulates the metabolism of the fetal-placental unit in the pregnancy, fertility and reproductive systems, actions in the endometrium, mammary gland with corresponding influences on important physiologic processes such as menstruation, pregnancy and lactation. In the gynecologic surgery the serum leptin concentration is also modified. The knowledge of serum leptin concentration in the oncological diseases is going-up. Leptin is modified in the choriocarcinoma, Meigs' syndrome and other tumors. A better understanding of regulatory mechanisms will have direct clinical significance, as leptin has been proposed to impact on those causes of human perinatal morbidity and mortality that are associated with abnormalities of fetal maturity and development, general concept growth, trophoblast endocrinology, and placental sufficiency. Further investigations in this area will be necessary to improve new knowledge and a better understanding of the actions about this hormone.