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2.
Obstet Gynecol Clin North Am ; 48(4): 745-758, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34756294

RESUMO

The field of fetal medicine has evolved significantly over the past several decades. Our ability to identify and treat the unborn patient has been shaped by advancements in imaging technology, genetic diagnosis, an improved understanding of fetal physiology, and the development and optimization of in utero surgical techniques. The future of the field will be shaped by medical innovators pushing for the continued refinement of minimally invasive surgical technique, the application of pioneering technologies such as robotic surgery and in utero stem cell and gene therapies, and the development of innovative ex utero fetal support systems.


Assuntos
Doenças Fetais , Feminino , Doenças Fetais/diagnóstico , Doenças Fetais/cirurgia , Feto/cirurgia , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos , Gravidez , Cuidado Pré-Natal
3.
Clin Obstet Gynecol ; 64(4): 861-875, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34668889

RESUMO

In utero fetal therapy offers the opportunity to prevent and treat diseases with a cellular or genetic basis. Components of successful fetal treatment include isolation of a replacement cell population, in utero stem cell transplantation, cell engraftment with fetal immune tolerance, and ongoing cell function. Fetal gene therapy with CRISPR-Cas9 represents an exciting potential therapy for genetic diseases not amenable to gene supplementation via adenoviral vector transduction. These fetal therapies have unique ethical and safety considerations. Clinical trials for in utero cell therapy are underway, as additional discoveries in stem cell biology and gene therapy move closer to clinical translation.


Assuntos
Doenças Fetais , Terapias Fetais , Transplante de Células-Tronco Hematopoéticas , Sistemas CRISPR-Cas , Feminino , Doenças Fetais/genética , Doenças Fetais/terapia , Terapia Genética , Humanos , Gravidez
4.
Washington, D.C.; PAHO; 2021-10-29. (PAHO/NMH/MH/21-0027).
em Inglês | PAHO-IRIS | ID: phr-55084

RESUMO

This fact sheet summarizes the risks of alcohol consumption during pregnancy. It explains the term fetal alcohol spectrum disorders (FASDs), and lists the problems they can cause, for example, birth defects, brain abnormalities, and problems with behavior and learning. The fact sheet stresses the importance of preventing FASDs in both children and adults, and explains how to do so.


Assuntos
Doenças não Transmissíveis , Consumo de Bebidas Alcoólicas , Transtornos Relacionados ao Uso de Álcool , Gravidez , Transtornos do Espectro Alcoólico Fetal , Doenças Fetais
6.
Pan Afr Med J ; 39: 116, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34512852

RESUMO

Ballantyne syndrome or mirror syndrome was first described in 1892. It is a disorder affecting pregnant women describing the association of fetal anasarca complicated by more or less generalized maternal edema and albuminuria (and sometimes anemia). It is a rare clinical entity. Diagnosis is based on a triad consisting of fetal hydrops, generalized maternal edema and placentomegaly. It can be associated with fetal hydrops from any cause. Diagnostic should be suspected in patients with maternal edema syndrome associated with fetal anasarca. Guarded fetal prognosis can be associated with high maternal morbidity; hence the need for early diagnosis, resting on a clear determination of its cause, and aimed to implement antenatal treatment improving maternal and fetal prognosis. We here report a unique case of Ballantyne syndrome which has never been described in the literature. The study involved a 32-year-old female patient with fetal hydrops caused by fetal cardiac rhabdomyoma.


Assuntos
Doenças Fetais/diagnóstico , Neoplasias Cardíacas/diagnóstico , Complicações na Gravidez/diagnóstico , Rabdomioma/diagnóstico , Adulto , Edema/diagnóstico , Edema/patologia , Feminino , Doenças Fetais/fisiopatologia , Neoplasias Cardíacas/patologia , Humanos , Hidropisia Fetal/diagnóstico , Hidropisia Fetal/etiologia , Doenças Placentárias/diagnóstico , Doenças Placentárias/patologia , Gravidez , Complicações na Gravidez/fisiopatologia , Prognóstico , Rabdomioma/patologia , Síndrome
7.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi ; 38(9): 900-906, 2021 Sep 10.
Artigo em Chinês | MEDLINE | ID: mdl-34487541

RESUMO

OBJECTIVE: To investigate the application value of whole exome sequencing technology in fetuses with congenital structural abnormalities. METHODS: The chromosomal abnormalities of 1147 families were analyzed. According to the follow-up results, the data of fetuses with new phenotypes in late pregnancy or after birth were reanalyzed. Subgroups were divided according to the organs involved and whether single malformation or not. The gene regulatory network map was drawn by using string database and Cytoscape software. Fisher exact probability method was used to compare the difference of the diagnostic rate of pathogenic genes among the groups. RESULTS: A total of 160 fetal cases received positive molecular diagnosed, involving 178 variant sites of 125 pathogenic genes, including 8 cases (4.9%, 8/163) by data reanalysis, and the overall positive diagnosis rate was 13.9%. Diagnostic rate was highest in the group of skeletal malformation (31.5%, 39/124) and lowest in that with thoracic malformation (0, 0/32). The gene clusters of fetal edema and intrauterine growth restriction were independent, and were not associated with the major structural malformations. The probability of each parent carrying the same recessive gene variant was 0.03 (39/1146) and 0.08 (4/53) with positive family history. CONCLUSION: For fetuses with congenital structural abnormalities that are negative for conventional genetic tests, 13.9% of phenotypic associated pathogenic/likely pathogenic genetic variants can be detected by whole exome sequencing technology. Its application value for prenatal diagnosis varies in fetus with different organs involved. Reanalysis of sequencing data for cases with new phenotypes in late pregnancy or after birth can further improve the molecular diagnosis rate. Further investigations are needed to explore the related genetic mechanisms.


Assuntos
Doenças Fetais , Feto , Feminino , Feto/diagnóstico por imagem , Humanos , Gravidez , Diagnóstico Pré-Natal , Tecnologia , Ultrassonografia Pré-Natal , Sequenciamento Completo do Exoma
8.
Clin Perinatol ; 48(3): 485-511, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34353577

RESUMO

Maternal pathogens can be transmitted to the fetus resulting in congenital infection with sequelae ranging from asymptomatic infection to severe debilitating disease and still birth. The TORCH pneumonic (toxoplasmosis, rubella, cytomegalovirus, and herpes simplex virus) is used widely, but it provides a limited description of the expanding list of pathogens associated with congenital infection. This article focuses on the evaluation and management of infants with common congenital infections such as cytomegalovirus, and infections that warrant early diagnosis and treatment to prevent serious complications, such as toxoplasmosis, human immunodeficiency virus, and syphilis. Zika virus and Chagas disease remain uncommon.


Assuntos
Doenças Fetais , Herpes Simples , Complicações Infecciosas na Gravidez , Rubéola (Sarampo Alemão) , Sífilis , Toxoplasmose Congênita , Toxoplasmose , Infecção por Zika virus , Zika virus , Feminino , Herpes Simples/diagnóstico , Herpes Simples/tratamento farmacológico , Humanos , Recém-Nascido , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/tratamento farmacológico , Complicações Infecciosas na Gravidez/epidemiologia , Rubéola (Sarampo Alemão)/diagnóstico , Toxoplasmose Congênita/diagnóstico , Toxoplasmose Congênita/tratamento farmacológico , Toxoplasmose Congênita/epidemiologia , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/epidemiologia
9.
Biomed Res Int ; 2021: 2180883, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34423032

RESUMO

Introduction: Translational models of myelomeningocele (MMC) are needed to test novel in utero interventions. An ideal animal model for MMC has locomotor function at birth and is low cost enough to allow for high throughput. The rat MMC model is limited by immature locomotor function at birth. The ovine MMC model is a costly surgical model. Guinea pigs are uniquely suited for an MMC model being a small animal model with locomotor function at birth. We aimed to develop a retinoic acid (RA) model of MMC in the guinea pig and to evaluate if pregnant guinea pigs could tolerate uterine manipulation. Methods: Time-mated Dunkin Hartley guinea pig dams were dosed with 60 mg/kg of RA between gestation age (GA) 12 and 15 days in the development of an RA model. Fetuses were grossly evaluated for MMC lesions at Cesarean section after GA 31 days. Evaluation of the ability of pregnant guinea pig dams to tolerate uterine surgical intervention was performed by hysterotomy of a separated group of time-mated guinea pigs at GA 45, 50, and 55. Results: Forty-two pregnant guinea pigs were dosed with RA, with a total of 189 fetuses. The fetal demise rate was 38% (n = 71). A total of 118 fetuses were viable, 83% (n = 98) were normal fetuses, 8% (n = 10) had a neural tube defect, and 8% (n = 10) had a hematoma or other anomalies. No fetuses developed an MMC defect. None of the fetuses that underwent hysterotomy survived to term. Conclusion: RA dosed at 60 mg/kg in guinea pigs between GA 12 and 15 did not result in MMC. Dunkin Hartley guinea pigs did not tolerate a hysterotomy near term in our surgical model. Further work is needed to determine if MMC can be induced in guinea pigs with alternate RA dosing.


Assuntos
Doenças Fetais/patologia , Histerotomia/efeitos adversos , Meningomielocele/patologia , Tretinoína/toxicidade , Animais , Cesárea/efeitos adversos , Modelos Animais de Doenças , Feminino , Doenças Fetais/induzido quimicamente , Idade Gestacional , Cobaias , Humanos , Meningomielocele/induzido quimicamente , Gravidez
10.
Ann Clin Lab Sci ; 51(4): 570-572, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34452898

RESUMO

COVID-19 has affected patients of all ages and demographics, not excluding pregnant women. The effects of COVID-19 on pregnant women are still largely unknown. Several adverse perinatal outcomes have been reported in COVID-19-positive pregnant women, including pre-eclampsia, miscarriage, pre-term labor, and stillbirth. Histopathological examination of COVID-19 placentas can contribute significant data regarding maternal and fetal health and can elucidate more findings in this novel disease. A 23-year-old female with morbid obesity and scant antenatal care presented to the emergency department complaining of shortness of breath and fever; she was found to be positive for COVID-19. Grossly, her placenta showed no abnormalities. Histological examination of her placenta showed chronic lymphoplasmacytic deciduitis, villous fibrosis, loss of capillarization, extravasation of erythrocytes, chorangiosis, and thrombosis of upstream stem vessels, including large fetal vessels on the chorionic plate. These changes were deemed to be consistent with fetal thrombotic vasculopathy (FTV). In conclusion, this case of FTV in the placenta of a patient with COVID-19 is a significant finding, as it can be critical to clinicians in the management of prenatal care for expecting mothers during this pandemic.This case was presented at the annual meeting of the Association of Clinical Scientists (ACS) on May 13, 2021.


Assuntos
COVID-19/complicações , Doenças Fetais/patologia , Feto/patologia , Doenças Placentárias/patologia , Placenta/patologia , SARS-CoV-2/isolamento & purificação , Trombose/patologia , Adulto , COVID-19/transmissão , COVID-19/virologia , Feminino , Doenças Fetais/virologia , Feto/virologia , Humanos , Placenta/virologia , Doenças Placentárias/virologia , Gravidez , Prognóstico , Trombose/virologia , Adulto Jovem
11.
Nutrients ; 13(8)2021 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-34444709

RESUMO

Bovine colostrum (BC), the first milk produced from cows after parturition, is increasingly used as a nutritional supplement to promote gut function and health in other species, including humans. The high levels of whey and casein proteins, immunoglobulins (Igs), and other milk bioactives in BC are adapted to meet the needs of newborn calves. However, BC supplementation may improve health outcomes across other species, especially when immune and gut functions are immature in early life. We provide a review of BC composition and its effects in infants and children in health and selected diseases (diarrhea, infection, growth-failure, preterm birth, necrotizing enterocolitis (NEC), short-bowel syndrome, and mucositis). Human trials and animal studies (mainly in piglets) are reviewed to assess the scientific evidence of whether BC is a safe and effective antimicrobial and immunomodulatory nutritional supplement that reduces clinical complications related to preterm birth, infections, and gut disorders. Studies in infants and animals suggest that BC should be supplemented at an optimal age, time, and level to be both safe and effective. Exclusive BC feeding is not recommended for infants because of nutritional imbalances relative to human milk. On the other hand, adverse effects, including allergies and intolerance, appear unlikely when BC is provided as a supplement within normal nutrition guidelines for infants and children. Larger clinical trials in infant populations are needed to provide more evidence of health benefits when patients are supplemented with BC in addition to human milk or formula. Igs and other bioactive factors in BC may work in synergy, making it critical to preserve bioactivity with gentle processing and pasteurization methods. BC has the potential to become a safe and effective nutritional supplement for several pediatric subpopulations.


Assuntos
Fenômenos Fisiológicos da Nutrição Infantil , Colostro , Suplementos Nutricionais , Fenômenos Fisiológicos da Nutrição do Lactente , Animais , Infecções Bacterianas/terapia , Bovinos , Criança , Colostro/química , Colostro/imunologia , Doenças Fetais/terapia , Glicolipídeos/análise , Glicoproteínas/análise , Transtornos do Crescimento/terapia , Humanos , Imunoglobulinas/análise , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Enteropatias/terapia , Gotículas Lipídicas , Proteínas do Leite/análise , Oligossacarídeos/análise
14.
BMC Pregnancy Childbirth ; 21(1): 548, 2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34384376

RESUMO

BACKGROUND: Arterial tortuosity syndrome (ATS) is a rare autosomal recessive connective tissue disorder chiefly characterized by elongated and tortuosity of the large and medium sized arteries and anomalies of the vascular elastic fibers. Here we reported cases of brother about ATS from the same family on the prenatal ultrasound diagnosis. Reports of this case are rare in antenatally and we draw the vessel simulated diagram to display visually. CASE PRESENTATION: Prenatal ultrasound scanning at 29 weeks of gestation of the first fetus showed obvious tortuous and elongated of the aortic arch, ductus arteriosus, left and right pulmonary arteries, carotid and subclavian arteries. Three months after delivery, Contrast-enhanced computed tomography images (CTA) were performed to clearly display vascular abnormalities consistent with prenatal diagnosis of ultrasound. Whole exome sequencing (WES) was performed eight months after birth, two heterozygous variants of SLC2A10 gene was detected in newborn and their father and mother, respectively. Prenatal ultrasound scan at 22 weeks of gestation of the second fetus showed similar cardiovascular imaging. After birth the siblings have facial characteristic features gradually as aging. No surgical intervention was performed in the siblings follow up 19 months. CONCLUSIONS: The key points of prenatal ultrasound diagnosis of ATS are the elongation and tortuosity of the large and medium sized arteries. Genetic counseling is the process of providing individuals and families with information on the nature, inheritance, and implications of genetic disorders to help them make informed medical and personal decisions.


Assuntos
Artérias/anormalidades , Doenças Fetais/diagnóstico , Doenças Fetais/genética , Proteínas Facilitadoras de Transporte de Glucose/genética , Instabilidade Articular/diagnóstico , Instabilidade Articular/genética , Dermatopatias Genéticas/diagnóstico , Dermatopatias Genéticas/genética , Malformações Vasculares/diagnóstico , Malformações Vasculares/genética , Sequenciamento Completo do Exoma , Artérias/diagnóstico por imagem , Feminino , Doenças Fetais/diagnóstico por imagem , Humanos , Lactente , Recém-Nascido , Instabilidade Articular/diagnóstico por imagem , Masculino , Mutação , Pais , Gravidez , Diagnóstico Pré-Natal , Irmãos , Dermatopatias Genéticas/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Ultrassonografia Pré-Natal , Malformações Vasculares/diagnóstico por imagem
15.
Sci Rep ; 11(1): 13777, 2021 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-34215818

RESUMO

Necrotizing enterocolitis (NEC) and focal intestinal perforation (FIP) are two of the most common emergencies of the gastrointestinal tract in preterm infants with very low birth weight (VLBW, birth weight < 1500 g). Identification of risk factors among these children is crucial for earlier diagnosis and prompt intervention. In this study, we investigated a relationship between ABO blood groups and the risk for surgical NEC/FIP. We genotyped the ABO locus (rs8176746 and rs8176719) in VLBW infants enrolled in a prospective, population-based cohort study of the German Neonatal Network (GNN). Of the 10,257 VLBW infants, 441 (4.3%) had surgical NEC/FIP. In univariate analyses, the blood group AB was more prevalent in VLBW infants with surgical NEC/FIP compared to non-AB blood groups (OR 1.51, 95% CI 1.07-2.13, p = 0.017; absolute risk difference 2.01%, 95% CI 0.06-3.96%). The association between blood group AB and surgical NEC/FIP was observed in a multivariable logistic regression model (OR of 1.58, 95% CI 1.10-2.26, p = 0.013) as well. In summary, our study suggests that the risk of surgical NEC and FIP is higher in patients with blood group AB and lower in those having non-AB blood groups.


Assuntos
Sistema ABO de Grupos Sanguíneos/sangue , Enterocolite Necrosante/epidemiologia , Doenças do Recém-Nascido/epidemiologia , Doenças do Prematuro/epidemiologia , Perfuração Intestinal/epidemiologia , Pré-Escolar , Enterocolite Necrosante/sangue , Enterocolite Necrosante/patologia , Enterocolite Necrosante/cirurgia , Feminino , Doenças Fetais/sangue , Doenças Fetais/patologia , Doenças Fetais/cirurgia , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Doenças do Recém-Nascido/sangue , Doenças do Recém-Nascido/patologia , Doenças do Recém-Nascido/cirurgia , Recém-Nascido Prematuro/sangue , Doenças do Prematuro/patologia , Doenças do Prematuro/cirurgia , Recém-Nascido de muito Baixo Peso , Perfuração Intestinal/sangue , Perfuração Intestinal/patologia , Perfuração Intestinal/cirurgia , Masculino , Fatores de Risco
16.
Cells ; 10(6)2021 06 14.
Artigo em Inglês | MEDLINE | ID: mdl-34198576

RESUMO

Infants with congenital diaphragmatic hernia (CDH) are at high risk of postnatal mortality due to lung hypoplasia and arterial pulmonary hypertension. In severe cases, prenatal intervention by fetal endoscopic tracheal occlusion (FETO) can improve survival by accelerating lung growth. However, postnatal mortality remains in the range of about 50% despite fetal treatment, and there is currently no clear explanation for this different clinical response to FETO. We evaluated the concentration of extracellular vesicles (EVs) and associated microRNA expression in amniotic and tracheal fluids of fetuses with CDH undergoing FETO, and we examined the association between molecular findings and postnatal survival. We observed a higher count of EVs in the amniotic fluid of non-survivors and in the tracheal fluid sampled in utero at the time of reversal of tracheal occlusion, suggesting a pro-inflammatory lung reactivity that is already established in utero and that could be associated with a worse postnatal clinical course. In addition, we observed differential regulation of four EV-enclosed miRNAs (miR-379-5p, miR-889-3p; miR-223-3p; miR-503-5p) in relation to postnatal survival, with target genes possibly involved in altered lung development. Future research should investigate molecular therapeutic agents targeting differentially regulated miRNAs to normalize their expression and potentially improve clinical outcomes.


Assuntos
Líquido Amniótico/metabolismo , Vesículas Extracelulares/metabolismo , Doenças Fetais/metabolismo , Feto/metabolismo , Hérnias Diafragmáticas Congênitas/metabolismo , MicroRNAs/metabolismo , Traqueia/embriologia , Vesículas Extracelulares/patologia , Feminino , Doenças Fetais/cirurgia , Feto/cirurgia , Hérnias Diafragmáticas Congênitas/cirurgia , Humanos , Índice de Gravidade de Doença , Traqueia/cirurgia
17.
BMC Pregnancy Childbirth ; 21(1): 489, 2021 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-34229662

RESUMO

OBJECTIVE: To investigate the predictive value of pre-induction digital examination, sonographic measurements and parity for the prediction of non-reassuring fetal status and cord arterial pH < 7.2 prior to the induction of labor (IOL). METHOD: This was a prospective observational study, including 384 term pregnancies undergoing IOL. Before the IOL, the Bishop score (BS) by digital examination, sonographic Doppler parameters and the estimated fetal weight (EFW) was assessed. The fetal cord arterial was sampled to measure the pH at delivery. Multivariate logistic regression analysis was performed to identify independent predictors of non-reassuring fetal status and low cord arterial pH. RESULTS: Forty four cases (11.5%) had non-reassuring fetal status, and 76 cases (19.8%) had fetal cord arterial pH < 7.2. In the non-reassuring fetal status group, the incidence of cord arterial pH < 7.2 was significantly higher than that in the normal fetal heart rate group (χ2 = 6.401, p = 0.011). Multivariate analysis indicated that significant independent predictors of non-reassuring fetal status were nulliparity (adjusted odds ratio [AOR]: 3.746, p = 0.003), EFW < 10th percentile (AOR: 3.764, p = 0.003) and cerebroplacental ratio (CPR) < 10th centile (AOR:4.755, p < 0.001). In the prediction of non-reassuring fetal status, the performance of the combination of nulliparity and EFW < 10th percentile was improved by the addition of CPR < 10th percentile (AUC: 0.681, (95%CI: 0.636 to 0.742) vs 0.756, (95%CI:0.713 to 0.795)), but the difference was not significant (DeLong test: z = 1.039, p = 0.053).. None of the above variables were predictors of cord arterial pH < 7.2. CONCLUSION: The risk of fetal acidosis has increased in cases of non-reassuring fetal status. Nulliparity, small for gestational age and CPR < 10th centile are independent predictors for non-reassuring fetal status in term fetuses, though the addition of CPR < 10th centile could not significantly improve the screening accuracy.


Assuntos
Acidose/diagnóstico , Doenças Fetais/diagnóstico , Circulação Placentária , Diagnóstico Pré-Natal/métodos , Ultrassonografia Pré-Natal/métodos , Acidose/embriologia , Adulto , Feminino , Peso Fetal , Feto/irrigação sanguínea , Feto/diagnóstico por imagem , Feto/embriologia , Frequência Cardíaca Fetal , Humanos , Concentração de Íons de Hidrogênio , Recém-Nascido , Recém-Nascido Pequeno para a Idade Gestacional , Trabalho de Parto Induzido , Modelos Logísticos , Artéria Cerebral Média/diagnóstico por imagem , Artéria Cerebral Média/embriologia , Artéria Cerebral Média/metabolismo , Análise Multivariada , Razão de Chances , Paridade , Valor Preditivo dos Testes , Gravidez , Terceiro Trimestre da Gravidez/metabolismo , Estudos Prospectivos , Fluxo Pulsátil , Ultrassonografia Doppler , Artérias Umbilicais/diagnóstico por imagem , Artérias Umbilicais/embriologia , Artérias Umbilicais/metabolismo
19.
J Clin Ultrasound ; 49(8): 822-827, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34245032

RESUMO

PURPOSE: To determine the natural history of fetal ovarian cysts and to investigate whether the prognosis can be predicted by prenatal ultrasonography (US). METHODS: This retrospective study includes cases of fetal ovarian cysts diagnosed by prenatal US over a 6-year period. Cases were divided into four subgroups of cysts (small and simple, small and complex, large and simple, large and complex) according to their size and echotexture. US examinations were repeated every 2 weeks from the time of diagnosis to treatment. RESULTS: A total of 37 cases were included in the study. 32.4% of the cases regressed spontaneously in the prenatal period and 32.4% did so in the infantile period. Prenatal resolution occurred more frequently with small cysts than with large cysts (p = 0.03). Neonates with complex cysts required surgical treatment more often than neonates with simple cysts (p = 0.009). 27.0% of the cases underwent surgery due to ovarian torsion. The torsion rate of fetal ovarian cysts that progressed in the prenatal period was significantly higher than in the case of stable cysts (p = 0.001). CONCLUSION: The size of the fetal ovarian cysts, their US appearance and the progression of the cysts during follow-up are the main determinants of the neonatal outcome.


Assuntos
Doenças Fetais , Cistos Ovarianos , Feminino , Doenças Fetais/diagnóstico por imagem , Humanos , Recém-Nascido , Cistos Ovarianos/diagnóstico por imagem , Gravidez , Estudos Retrospectivos , Ultrassonografia Pré-Natal
20.
Biochemistry (Mosc) ; 86(6): 716-728, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34225594

RESUMO

The article presents current views on maternal hyperhomocysteinemia (HHcy) as an important factor causing prenatal stress and impaired nervous system development in fetuses and newborns in early ontogenesis, as well as complications in adulthood. Experimental data demonstrate that prenatal HHcy (PHHcy) affects the morphological maturation of the brain and activity of its neurotransmitter systems. Cognitive deficit observed in the offspring subjected to PHHcy in experimental studies can presumably cause the predisposition to various neurodegenerative diseases, as the role of maternal HHcy in the pathogenesis such diseases has been proven in clinical studies. The review also discusses molecular mechanisms of the HHcy neurotoxic action on the nervous system development in the prenatal and early postnatal periods, which include oxidative stress, apoptosis activation, changes in the DNA methylation patterns and microRNA levels, altered expression and processing of neurotrophins, and neuroinflammation induced by an increased production of pro-inflammatory cytokines. Special attention is given to the maternal HHcy impact on the placenta function and its possible contribution to the brain function impairments in the offspring. Published data suggest that some effects of PHHcy on the developing fetal brain can be due to the disturbances in the transport functions of the placenta resulting in an insufficient supply of nutrients necessary for the proper formation and functioning of brain structures.


Assuntos
Encéfalo/fisiopatologia , Disfunção Cognitiva/etiologia , Doenças Fetais/etiologia , Hiper-Homocisteinemia/complicações , Placenta/fisiopatologia , Animais , Feminino , Humanos , Gravidez , Complicações na Gravidez
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