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1.
Int Urogynecol J ; 35(5): 1051-1060, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38635039

RESUMO

INTRODUCTION AND HYPOTHESIS: The obturator artery (ObA) is described as a branch of the anterior division of the internal iliac artery. It arises close to the origin of the umbilical artery, where it is crossed by the ureter. The main goal of the present study was to create an anatomical map of the ObA demonstrating the most frequent locations of the vessel's origin and course. METHODS: In May 2022, an evaluation of the findings from 75 consecutive patients who underwent computed tomography angiography studies of the abdomen and pelvis was performed. RESULTS: The presented results are based on a total of 138 arteries. Mostly, ObA originated from the anterior trunk of the internal iliac artery (79 out of 138; 57.2%). The median ObA diameter at its origin was found to be 3.34 mm (lower quartile [LQ] = 3.00; upper quartile [UQ] = 3.87). The median cross-sectional area of the ObA at its origin was found to be 6.31 mm2 (LQ = 5.43; UQ = 7.32). CONCLUSIONS: Our study developed a unique arterial anatomical map of the ObA, showcasing its origin and course. Moreover, we have provided more data for straightforward intraoperative identification of the corona mortis through simple anatomical landmarks, including the pubic symphysis. Interestingly, a statistically significant difference (p < 0.05) between the morphometric properties of the aberrant ObAs and the "normal" ObAs originating from the internal iliac artery was found. It is hoped that our study may aid in reducing the risk of serious hemorrhagic complications during various surgical procedures in the pelvic region.


Assuntos
Angiografia por Tomografia Computadorizada , Artéria Ilíaca , Humanos , Feminino , Artéria Ilíaca/anatomia & histologia , Artéria Ilíaca/diagnóstico por imagem , Pessoa de Meia-Idade , Idoso , Adulto , Pelve/irrigação sanguínea , Pelve/diagnóstico por imagem , Pelve/anatomia & histologia , Artérias Umbilicais/diagnóstico por imagem , Artérias Umbilicais/anatomia & histologia
2.
Women Health ; 59(7): 718-729, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30786837

RESUMO

The aim of this study was to determine the reference values of the placental thickness in 400 normal pregnant women during weeks 16-41 of gestation who were referred to the Mahdiyeh hospital during January 2014-February 2015. The placental thickness at the junction of the umbilical artery was measured using ultrasonography. Multivariable linear regression was used to model the mean placental thickness and assess associations with measured covariates, including gestational age (GA). Centiles for placental thickness distribution were estimated according to the modulus exponential-normal model. The mean and standard deviation of the age of the participants was 31.4 ± 5.7 years. The Pearson correlation coefficient indicated a very strong positive linear correlation between GA and placental thickness (p <.001; r = 0.93). A nonlinear increase of placental thickness with estimated fetal weights was observed. GA-specific placental thicknesses for the 2.5th, 5th, 10th, 25th, 50th, 75th, 90th, 95th, and 97.5th percentiles of placental thickness were calculated. By making use of the provided nomogram in this study, neonatal outcomes associated with the placental thickness, such as Hemoglobin Bart's disease, can be diagnosed early to improve maternal and newborn health.


Assuntos
Placenta/anatomia & histologia , Gravidez/fisiologia , Artérias Umbilicais/anatomia & histologia , Adolescente , Adulto , Feminino , Retardo do Crescimento Fetal/diagnóstico por imagem , Idade Gestacional , Humanos , Pessoa de Meia-Idade , Placenta/irrigação sanguínea , Placenta/diagnóstico por imagem , Segundo Trimestre da Gravidez , Valores de Referência , Ultrassonografia , Ultrassonografia Pré-Natal , Artérias Umbilicais/diagnóstico por imagem , Adulto Jovem
3.
Surg Radiol Anat ; 40(7): 729-734, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29589145

RESUMO

OBJECTIVE: In radical cystectomy, the surgeon generally ligates the umbilical artery at its origin. This artery may give rise to several arteries that supply the sexual organs. Our aim was to evaluate pelvic and perineal devascularisation in women after total cystectomy. PATIENTS AND METHODS: We carried out a prospective anatomical and radiological study. We performed bilateral pelvic dissections of fresh adult female cadavers to identify the dividing branches of the umbilical artery. In parallel, we examined and compared the pre- and postoperative imaging investigations [magnetic resonance imaging (MRI) angiography] in patients undergoing cystectomy for benign disease to quantify the loss of pelvic vascularisation on the postoperative images by identifying the occluded arteries. RESULTS: The anatomical study together with the radiological study visualised 35 umbilical arteries (n = 70) with their branching patterns and collateral arteries. The uterine artery originated from the umbilical artery in more than 75% of cases (n = 54) of the internal pudendal artery in 34% (n = 24) and the vaginal artery in 43% (n = 30). The postoperative MRI angiograms showed pelvic devascularisation in four patients. Devascularisation was dependent on the level of surgical ligation. In the four patients with loss of pelvic vascular supply, the umbilical artery had been ligated at its origin. CONCLUSION: The umbilical artery gives rise to various branches that supply the pelvis and perineum. If the surgeon ligates the umbilical artery at its origin during total cystectomy, there is a significant risk of pelvic and perineal devascularisation.


Assuntos
Cistectomia , Angiografia por Ressonância Magnética , Artérias Umbilicais/anatomia & histologia , Artérias Umbilicais/cirurgia , Artéria Uterina/anatomia & histologia , Cadáver , Circulação Colateral , Meios de Contraste , Feminino , Humanos , Ligadura , Pessoa de Meia-Idade , Compostos Organometálicos , Pelve/irrigação sanguínea , Períneo/irrigação sanguínea , Estudos Prospectivos
4.
Surg Radiol Anat ; 39(9): 961-965, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28229186

RESUMO

PURPOSE: The aim of our study was to clarify the origin of the inferior vesical artery and determine its existence in women. METHODS: This descriptive study is based on 25 dissections (6 male and 19 female cadavers). We dissected the internal iliac artery and its branches from the iliac bifurcation, bilaterally and comparatively. Each arterial branch supplying the bladder was identified and dissected as far as the bladder. RESULTS: In total, 50 topographies of the bladder vascularization were visualised. The inferior vesical artery was observed in 92% of the male subjects and in 47.4% of the female subjects. In the male cadavers, it arose from the internal iliac artery in 72.7% of cases and from the umbilical artery in 27.3% of cases. In the female cadavers, it arose from a common trunk with the umbilical artery and the uterine artery in 33.3% of cases and directly from the umbilical artery in 33.3% with one terminal branch supplying the upper part of the vagina. In two female subjects, the inferior vesical artery arose from the first segment of the uterine artery (22.2%), and in one subject from the obturator artery (11.1%). CONCLUSIONS: The inferior vesical artery is not specific to the male sex. The contradictions found in the literature of this artery are due to the variations observed in pelvic vascularization and to the close connections between vaginal and bladder vascularisation in women. However, surgeons should consider these variations, to prevent bladder devascularization by non-selective ligation.


Assuntos
Artéria Ilíaca/anatomia & histologia , Artérias Umbilicais/anatomia & histologia , Bexiga Urinária/irrigação sanguínea , Artéria Uterina/anatomia & histologia , Adulto , Variação Anatômica , Cadáver , Dissecação , Feminino , Humanos , Masculino , Caracteres Sexuais
5.
Prenat Diagn ; 35(5): 500-5, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25641521

RESUMO

OBJECTIVES: The objectives of this study were to establish gestational age-specific reference ranges for cross-sectional area of the umbilical cord, and its components, in twin pregnancies and to compare them with previously reported singleton reference ranges. METHODS: This was a prospective longitudinal study involving uncomplicated dichorionic twin pregnancies. Sonographic measurements of the cross-sectional area of the umbilical cord, umbilical vein and arteries and Wharton's jelly were obtained in a plane adjacent to the fetal abdomen, every 3 weeks, between 18 and 32 weeks of gestations. Multilevel regression analysis was used to determine gestational age-specific reference ranges for each parameter, and these were plotted against singleton pregnancy references. RESULTS: Three hundred and thirty four ultrasound scans were performed in 44 twin pregnancies, between 18 and 32.9 weeks (mean: 3.8 ± 0.7 scans/pregnancy and mean interval between scans: 3.3 ± 0.9 weeks). All umbilical cord cross-sectional areas (total, vein, artery and Wharton's jelly) showed a significant increase with gestational age. Compared with singleton pregnancy ranges, mean values were considerably lower in twin pregnancies and resemble the lower limits observed in singletons. CONCLUSION: In twin pregnancies, cross-sectional area of the umbilical cord, and its components, increases between 18 and 32 weeks, and mean values are substantially lower compared with singleton pregnancies.


Assuntos
Idade Gestacional , Gravidez de Gêmeos , Artérias Umbilicais/diagnóstico por imagem , Veias Umbilicais/diagnóstico por imagem , Geleia de Wharton/diagnóstico por imagem , Estudos de Coortes , Feminino , Humanos , Estudos Longitudinais , Análise Multinível , Tamanho do Órgão , Gravidez , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Estudos Prospectivos , Valores de Referência , Análise de Regressão , Ultrassonografia Pré-Natal , Artérias Umbilicais/anatomia & histologia , Cordão Umbilical/anatomia & histologia , Cordão Umbilical/diagnóstico por imagem , Veias Umbilicais/anatomia & histologia , Geleia de Wharton/anatomia & histologia
6.
Zhonghua Fu Chan Ke Za Zhi ; 49(12): 899-902, 2014 Dec.
Artigo em Zh | MEDLINE | ID: mdl-25608989

RESUMO

OBJECTIVE: To investigate the reconstruction of digital three-dimensional (3D) model of normal human placental vascular network based on MRI data in vitro. METHODS: Six full term placentas were collected, casted with modified self-curing denture base resin and scanned by T1 e-THRIVE high resolution magnetic resonance imaging. MRI images were imported into Mimics 14.0 software for 3D reconstruction, and the 3D model was compared with placental vascular casting model. RESULTS: (1) The placental vascular network could be obtained on MR 2D images. The 3D model were reconstructed successfully, which showed clear, realistic images. The 3D model could be zoomed and revolved from any direction to observe the branches of arteries and veins. (2) The umbilical vein and 2 umbilical arteries could be seen in the 3D model. In the root of the umbilical cord, the umbilical vein divided into 5-7 branches. While the 2 umbilical arteries anatomoses to form blood sinus and then devided into sub-branches. All the peripheral vessels ended in chorionic plate with abundant sub-branches. (3) When compared with the casting of placental arterial-venous vascular network, the morphology, structure, angle and trend of vessels in 3D model was consistent with the casting network. CONCLUSIONS: Reconstruction of digital 3D model of normal human placental vascular network based on MRI in vitro is a new and promising method for the study of placental vasculature. It has better vascular exposure, free rotation, radiation-free. It provides a promising base for the study of placental vasculature in vivo in the future.


Assuntos
Imageamento por Ressonância Magnética , Modelos Anatômicos , Placenta/irrigação sanguínea , Artérias Umbilicais/anatomia & histologia , Cordão Umbilical/irrigação sanguínea , Córion , Feminino , Humanos , Imageamento Tridimensional , Técnicas In Vitro , Microcirculação/fisiologia , Placenta/anatomia & histologia , Gravidez , Artérias Umbilicais/fisiologia , Cordão Umbilical/anatomia & histologia
7.
Prenat Diagn ; 33(8): 764-9, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23553794

RESUMO

OBJECTIVES: The aim of this study was to clarify the effects of umbilical cord coiling on the umbilical blood flow at 11-13 weeks of gestation. METHODS: A cross-sectional study was conducted among consecutive pregnant females at 11-13 weeks of gestation. Transabdominal ultrasound examinations were performed to obtain the umbilical coiling index (CI), the maximum umbilical arterial peak velocity at the free loop, the venous velocities at the free loop and the umbilical ring, and the umbilical arterial and venous flow volumes. After every measurement was standardized according to the crown-rump length (CRL), correlations between the CI and these measurements were analyzed. RESULTS: A total of 364 subjects were enrolled. The CI significantly decreased in association with advancing gestation. There were significant correlations between the CRLs and the umbilical arterial peak velocities, the venous velocities at the free loop and the umbilical ring, and the umbilical arterial and venous flow volumes. The z-scores of the umbilical arterial and venous velocimetries exhibited no significant correlations with the CI. The umbilical arterial and venous flow volumes were also not found to correlate with the CI. CONCLUSIONS: The CI does not affect either the umbilical arterial or venous blood flow at 11-13 weeks of gestation.


Assuntos
Indicadores Básicos de Saúde , Primeiro Trimestre da Gravidez , Cordão Umbilical/anatomia & histologia , Cordão Umbilical/irrigação sanguínea , Adulto , Velocidade do Fluxo Sanguíneo/fisiologia , Volume Sanguíneo/fisiologia , Estudos Transversais , Estatura Cabeça-Cóccix , Feminino , Sangue Fetal/diagnóstico por imagem , Idade Gestacional , Humanos , Gravidez , Primeiro Trimestre da Gravidez/fisiologia , Ultrassonografia Pré-Natal , Artérias Umbilicais/anatomia & histologia , Artérias Umbilicais/diagnóstico por imagem , Cordão Umbilical/diagnóstico por imagem
8.
J Obstet Gynaecol ; 32(3): 230-6, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22369394

RESUMO

The objective was to determine the cross-sectional area of the umbilical cord, its diameter and the diameter of its vessels to establish a reference curve for these parameters during pregnancy, through a prospective cross-sectional study, including 2,310 low-risk pregnancies between 12 and 40 weeks' gestation. Means and standard deviations (SDs), plus the 10th, 50th and 90th percentiles for each measurement were calculated using polynomial regression analysis. Mann-Whitney, Kruskal-Wallis and Wilcoxon tests were used for statistical analysis. These parameters increased significantly with gestational age. The area of the cord also varied significantly with parity. Their new reference curves for low risk pregnancies were calculated using polynomial regression, and an almost linear increase in values was found up to 32 weeks of pregnancy, tending to stabilise from then onwards. The regression equation of the umbilical cord area according to gestational age (GA) was: -1.417 + 0.3026*GA-0.008*GA(2) + 0.000007*GA(3) and the degree of adjustment (R(2)) was 0.89.


Assuntos
Ultrassonografia Pré-Natal/normas , Cordão Umbilical/diagnóstico por imagem , Adulto , Brasil , Estudos Transversais , Feminino , Idade Gestacional , Humanos , Gravidez , Estudos Prospectivos , Padrões de Referência , Valores de Referência , Análise de Regressão , Artérias Umbilicais/anatomia & histologia , Artérias Umbilicais/diagnóstico por imagem , Cordão Umbilical/anatomia & histologia , Cordão Umbilical/irrigação sanguínea , Veias Umbilicais/anatomia & histologia , Veias Umbilicais/diagnóstico por imagem
9.
Am Surg ; 86(2): 146-151, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-32106908

RESUMO

We aim to observe and dissect the essential anatomical landmarks in totally extraperitoneal (TEP) procedures. Forty-six TEP procedures in 30 patients were prospectively performed in our department. During the dissection of the preperitoneal space, the following distances between landmarks were measured. D1: the distance from pubic symphysis to the arcuate line in the midline; D2: the distance from the inferior epigastric artery to the lateral border of the arcuate line (before sharp incision was performed); D3: as in D2 (but after sharp incision was performed); D4: the distance from the inferior epigastric artery to the crossing site of vas deferens and obliterated umbilical artery. Furthermore, the morphology of the posterior rectus sheath was documented. The corresponding distance between the anatomical landmarks varied greatly in each individual. D1: 8 ± 1.6 cm (range 4-10 cm). D2: 4.9 ± 0.8 cm (3.5-7 cm). D3: 6.8 ± 0.9 cm (5-9 cm). D4: 6.1 ± 1 cm (4.8-8.5 cm). Complete rectus sheath was found in 30.4 per cent (14/46) of the hernias. Anatomical variations were common in preperitoneal space. The crossing site of vas deferens and obliterated umbilical artery can serve as a landmark for dissection. Complete rectus was present in one-third of hernias, which necessitates a sharp incision for entering the correct lateral preperitoneal space.


Assuntos
Pontos de Referência Anatômicos/anatomia & histologia , Endoscopia/métodos , Hérnia Inguinal/cirurgia , Herniorrafia/métodos , Músculos Abdominais/anatomia & histologia , Dissecação/métodos , Artérias Epigástricas/anatomia & histologia , Humanos , Masculino , Estudos Prospectivos , Sínfise Pubiana/anatomia & histologia , Telas Cirúrgicas , Artérias Umbilicais/anatomia & histologia , Ducto Deferente/anatomia & histologia
10.
J Physiol ; 587(3): 693-708, 2009 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-19074967

RESUMO

Fetal growth is decreased at high altitude (> 2700 m). We hypothesized that variation in fetal O(2) delivery might account for both the altitude effect and the relative preservation of fetal growth in multigenerational natives to high altitude. Participants were 168 women of European or Andean ancestry living at 3600 m or 400 m. Ancestry was genetically confirmed. Umbilical vein blood flow was measured using ultrasound and Doppler. Cord blood samples permitted calculation of fetal O(2) delivery and consumption. Andean fetuses had greater blood flow and oxygen delivery than Europeans and weighed more at birth, regardless of altitude (+208 g, P < 0.0001). Fetal blood flow was decreased at 3600 m (P < 0.0001); the decrement was similar in both ancestry groups. Altitude-associated decrease in birth weight was greater in Europeans (-417 g) than Andeans (-228 g, P < 0.005). Birth weight at 3600 m was > 200 g lower for Europeans at any given level of blood flow or O(2) delivery. Fetal haemoglobin concentration was increased, decreased, and the fetal / curve was left-shifted at 3600 m. Fetuses receiving less O(2) extracted more (r(2) = 0.35, P < 0.0001). These adaptations resulted in similar fetal O(2) delivery and consumption across all four groups. Increased umbilical venous O(2) delivery correlated with increased fetal O(2) consumption per kg weight (r(2) = 0.50, P < 0.0001). Blood flow (r(2) = 0.16, P < 0.001) and O(2) delivery (r(2) = 0.17, P < 0.001) correlated with birth weight at 3600 m, but not at 400 m (r(2) = 0.04, and 0.03, respectively). We concluded that the most pronounced difference at high altitude is reduced fetal blood flow, but fetal haematological adaptation and fetal capacity to increase O(2) extraction indicates that deficit in fetal oxygen delivery is unlikely to be causally associated with the altitude- and ancestry-related differences in fetal growth.


Assuntos
Aclimatação , Altitude , Sangue Fetal , Desenvolvimento Fetal/fisiologia , Oxigênio , Velocidade do Fluxo Sanguíneo , Gasometria , Feminino , Hemoglobina Fetal/análise , Humanos , Indígenas Sul-Americanos , Recém-Nascido , Oxigênio/sangue , Gravidez , Fluxo Sanguíneo Regional/fisiologia , Artérias Umbilicais/anatomia & histologia , Artérias Umbilicais/fisiologia , Veias Umbilicais/anatomia & histologia , Veias Umbilicais/fisiologia , Resistência Vascular , População Branca
11.
Eur J Obstet Gynecol Reprod Biol ; 235: 66-70, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30798083

RESUMO

OBJECTIVES: Radical hysterectomy is performed for invasive cervical cancer. In this surgery, separation of the anterior leaf and posterior leaves of the vesicouterine ligament (VUL) is important. We studied the local anatomy of the anterior leaf of the VUL, especially the branches of the umbilical artery from the view point of surgery and cadaver dissection. STUDY DESIGN: We observed the cervicovesical blood vessels and the connective tissue layer continued from umbilical artery and searched for the origin of the cervicovesical blood vessels in radical hysterectomy. We also dissected a formalin-fixed female cadaver, and observed the same points. RESULTS: After separation of the connective tissue of urinary bladder from the cervical fascia, we could discern the outline of the distal ureter near the ureterovesical junction. We separate the connective tissue of the so-called anterior leaf of the VUL enwrapping the ureter gently, and then the ureter with the connective tissue is completely rolled out laterally. We identified a cervicovesical vessel crossing over the ureter. We looked for the central side of the cervicovesical vessel and found that cervicovesical vessel was a branch of the superior vesical artery. And, during cadaver dissection, we found that the connective tissue and the branches of the superior vesical artery were similarly observed. CONCLUSIONS: We found the precise anatomy of the connective tissue layer from umbilical artery to urinary bladder and the superior vesical artery. Our procedure based on the precise anatomy obtained in this study is reasonable anatomically as a method for separation of the vesicouterine ligament during radical hysterectomy.


Assuntos
Histerectomia/métodos , Ligamentos/anatomia & histologia , Ureter/anatomia & histologia , Neoplasias do Colo do Útero/cirurgia , Útero/anatomia & histologia , Feminino , Humanos , Ligamentos/cirurgia , Artérias Umbilicais/anatomia & histologia , Artérias Umbilicais/cirurgia , Ureter/cirurgia , Útero/cirurgia
12.
Early Hum Dev ; 83(9): 571-4, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17276632

RESUMO

OBJECTIVE: To determine if presence of the Roach muscle, a small muscle bundle lying just beside the umbilical artery, contributes to umbilical cord coiling. METHODS: 251 umbilical cords were examined. The umbilical coiling index (UCI) was calculated as the number of coils divided by the cord length in cm. Cords were classified as hypocoiled (UCIp90). On microscopic examination of a cross section of the cord, absence or presence of a Roach muscle was determined. The t-test for independent samples and logistic regression were used for statistical analysis. RESULTS: A Roach muscle was observed in 101 cords. The mean UCI was higher in cords with the muscle bundle (0.23 coils/cm) than in cords without a muscle (0.18 coils/cm). Difference in mean: 0.05 coils/cm (95% C.I. 0.01-0.09). OR for hypercoiling in presence of the muscle was 2.98 (95% C.I. 1.57-5.64). OR for hypocoiling in the presence of the muscle was 1.49 (95% C.I. 0.79-2.81). CONCLUSIONS: Our results suggest that presence of a Roach muscle bundle contributes to umbilical cord coiling. Given the divergence in umbilical cord coiling within subgroups with or without this muscle, other factors must play a more dominant role.


Assuntos
Músculo Liso Vascular/anatomia & histologia , Artérias Umbilicais/anatomia & histologia , Cordão Umbilical/anormalidades , Cordão Umbilical/irrigação sanguínea , Estudos de Casos e Controles , Humanos , Recém-Nascido
13.
Int J Gynaecol Obstet ; 96(3): 156-61, 2007 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-17280668

RESUMO

OBJECTIVE: To determine the normal cross-sectional areas of the umbilical vein, umbilical artery, and Wharton jelly in healthy pregnancies, and correlate the obtained values with fetal anthropometric parameters. METHODS: A cross-sectional study was performed with 312 women between the 24th and 39th weeks of a normal pregnancy. The cross-sectional areas of umbilical cord vessels were measured at the junction of the cord and fetal abdomen, and the values were subtracted from the total cord cross-sectional area to assess the cross-sectional area of the Wharton jelly. The anthropometric parameters analyzed were biparietal diameter, head circumference, femur length, and estimated fetal weight, and the Spearman correlation was used to assess the correlation between the cross-sectional areas of umbilical cord components and fetal anthropometric parameters. A polynomial regression analysis was performed to identify the curves that best adjusted to mean and standard deviation according to gestational age. RESULTS: A statistically significant correlation was observed between the cross-sectional areas of cord components and fetal anthropometric parameters (P<0.001) as well as gestational age (P<0.001). CONCLUSIONS: Reference measurements of the cross-sectional areas of umbilical cord components are important tools in the assessment of fetal growth.


Assuntos
Artérias Umbilicais/anatomia & histologia , Veias Umbilicais/anatomia & histologia , Adolescente , Adulto , Anatomia Transversal , Cefalometria , Estudos Transversais , Feminino , Fêmur/embriologia , Peso Fetal , Feto/anatomia & histologia , Idade Gestacional , Humanos , Gravidez , Análise de Regressão , Ultrassonografia Pré-Natal , Artérias Umbilicais/diagnóstico por imagem , Veias Umbilicais/diagnóstico por imagem
14.
J Chir (Paris) ; 144 Spec No 4: 5S5-10, 2007.
Artigo em Francês | MEDLINE | ID: mdl-18065911

RESUMO

Knowledge of the groin's anatomy is indispensable to understanding the pathological anatomy of hernias and their surgical treatment. Although classical anatomy provides an understanding of the techniques of open surgery, learning celioscopic techniques requires a new mental representation and specific training. The objective of this focus was to describe the anatomic approaches to inguinal hernias and compare them to those described during the celioscopic approach.


Assuntos
Endoscopia , Virilha/anatomia & histologia , Canal Inguinal/anatomia & histologia , Humanos , Masculino , Músculo Esquelético/anatomia & histologia , Cordão Espermático/anatomia & histologia , Artérias Umbilicais/anatomia & histologia
15.
J Ark Med Soc ; 103(7): 181-3, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17253010

RESUMO

Umbilical artery catheters are valuable tools for physicians who provide intensive care to newborns. The successful cannulation of the umbilical arteries can be a challenging and sometimes frustrating experience. Despite this fact, recognizing a few pitfalls and implementing some simple solutions can make this procedure more likely to be successful.


Assuntos
Cateterismo , Artérias Umbilicais , Cateterismo/métodos , Cateterismo/normas , Humanos , Recém-Nascido , Guias de Prática Clínica como Assunto , Artérias Umbilicais/anatomia & histologia
16.
Int. j. morphol ; 40(6): 1530-1535, dic. 2022. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1421801

RESUMO

La anastomosis de Hyrtl's (AH), vaso único con amplia variabilidad anatómica, comunica las arterias umbilicales cerca de la inserción del cordón umbilical en las placentas humanas. El objetivo del presente trabajo fue determinar si existe relación entre las características morfométricas de la placenta y la presencia de anastomosis y analizar si esta tiene influencia en la eficiencia placentaria. Estudio descriptivo. Se analizaron 60 placentas provenientes de madres que aceptaron participar en la investigación, embarazo único, a término (entre 37,0 y 41,6 semanas), con edades entre 18 y 37 años, con al menos cuatro visitas a control prenatal, sin comorbilidades. Las características placentarias de peso, diámetros y grosor se tomaron en fresco. Una vez fijadas con formaldehido al 10 %, mediante disección se ubicó, clasificó y fotografió la anastomosis. El peso de la placenta fue 494,4 ± 87,1 gramos, el grosor central correspondió a 1,7 ± 0,4 cm, DM 19,9 ± 2,0 cm y Dm 18,4 ± 1,7 cm. La inserción de cordón predominante fue excéntrica (65 %) y la forma discoidea u ovalada (60 %). En 51 placentas se ubicó la presencia de anastomosis (85 %). En el grupo de placentas con presencia AH se encontró un peso placentario más bajo al compararlo con el grupo que no presentó AH, el resto de las características morfométricas de la placenta, incluido el tipo de inserción de cordón umbilical no presentaron relación con la anastomosis. La eficiencia placentaria expresada con la relación entre peso neonato/peso placenta presentó diferencias significativas en el grupo con presencia de anastomosis, con mayores valores comparados con el grupo sin anastomosis. La presencia de AH contribuye positivamente a la eficiencia placentaria. Sin embargo, el incremento del peso placentario puede ser un efecto compensador de la placenta y no siempre indica una mayor eficiencia funcional del órgano.


SUMMARY: Hyrtl's anastomosis (HA), a single vessel, with wide anatomical variability, communicates the umbilical arteries, near the insertion of the umbilical cord in human placentas. The objective of this study was to determine if there is a relationship between the morphometric characteristics of the placenta and the presence of the anastomosis and to analyze if this influences the placental efficiency. Descriptive study. We analyzed 60 placentas from mothers who agreed to participate in the study, single pregnancy, term (between 37.0 and 41.6 weeks), aged between 18 and 37 years with at least four visits to prenatal control, without comorbidities. The placental characteristics of weight, diameters and thickness were taken fresh. Once fixed with 10 % formaldehyde, the anastomosis was located, classified, and photographed by dissection. The weight of the placenta was 494.4 ± 87.1 g, the central thickness corresponded to 1.7 ± 0.4 cm, the MD 19.9 ± 2.0 cm and Dm 18.4 ± 1.7 cm: The predominant cord insertion was eccentric, with 65 % and the discoid or oval shape with 60 %. In 51 placentas the presence of anastomosis was found (85 %). In the group of placentas with AH presence, a lower placental weight was found when compared to the group that did not present AH, the rest of the morphometric characteristics of the placenta, including the type of umbilical cord insertion, were not related to the anastomosis. Placental efficiency expressed as the neonatal weight/placental weight ratio showed significant differences in the group with presence of anastomosis, with higher values compared to the group without anastomosis. The presence of HA contributes positively to placental efficiency. However, the increase in placental weight may be a compensatory effect of the placenta and does not always indicate a greater functional efficiency of the organ.


Assuntos
Humanos , Feminino , Adolescente , Adulto , Adulto Jovem , Placenta/anatomia & histologia , Artérias Umbilicais/anatomia & histologia , Tamanho do Órgão , Placenta/irrigação sanguínea , Peso ao Nascer
17.
J Dev Orig Health Dis ; 8(3): 349-356, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28260559

RESUMO

Prematurity is a risk factor for hypertension, vascular stiffness, nephron deficit and adult onset cardiorenal disease. The vascular tree and kidneys share morphogenic drivers that promote maturation in utero before 36 weeks of gestation. Vascular elastin accrual terminates after birth leaving collagen to promote vascular stiffness. Our objective was to determine if the histomorphometry of the umbilical artery, an extension of the aorta, parallels nephron mass across gestational age groups. From a cohort of 54 newborns, 32 umbilical cord specimens were adequate for evaluation. The umbilical cord was sectioned, stained with trichrome, and digitalized. Muscular and collagenous areas of the umbilical artery were measured in pixels using the Image J 1.48q software. Total kidney volume was measured by ultrasound and factored by body surface area (TKV/BSA). The umbilical artery total area was significantly greater in term v. preterm infants (9.3±1.3 v. 7.0±2.0 mm2; P<0.05) and increased with gestational age; while the percent muscular and collagen areas were independent of gestational age (R 2=0.04; P=ns). Percent muscular area correlated positively with TKV/BSA (r=0.53; P=0.002); while an increase in collagen correlated inversely with kidney mass (r=-0.53; P=0.002). In conclusion, an enhanced % muscular area and presumed vascular elasticity was associated with increased renal mass in all infants. Umbilical artery histomorphometry provides a link between the intrauterine environment, vascular and kidney development.


Assuntos
Rim/anatomia & histologia , Rim/embriologia , Artérias Umbilicais/anatomia & histologia , Artérias Umbilicais/embriologia , Adulto , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro/crescimento & desenvolvimento , Rim/crescimento & desenvolvimento , Masculino , Gravidez , Artérias Umbilicais/crescimento & desenvolvimento , Cordão Umbilical/anatomia & histologia , Cordão Umbilical/irrigação sanguínea , Cordão Umbilical/embriologia , Adulto Jovem
18.
Anat Histol Embryol ; 46(6): 533-538, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28884482

RESUMO

The histomorphometric features of umbilical cord constituents in seven foetuses of alpaca (Vicugna pacos) from Cerro de Pasco, Department, Peru, were determined. Sections of 2-5 cm of umbilical cord were fixed in 10% neutral buffered formalin and processed for light microscopy. Standard histological slides stained with haematoxylin and eosin, Masson's trichrome and Van Gieson's trichrome were obtained. Histologically, common features of umbilical artery and vein were observed as well as mucous connective tissue, some cell features that compound this tissue constituted by cells presented features of myofibroblasts. Among most important findings that were observed, the lumen of umbilical vein was obliterated into star-shaped form with the thinner umbilical artery wall; the smooth muscles and fibroblast were comparatively more in number in umbilical artery than that of umbilical vein, and the tunica media was larger in dimension than the tunica adventitia in umbilical vein. Conclusively, this histological study features an observation of the umbilical cord of alpaca foetuses and shows the similarity between them and those of other mammal species, including dromedaries and South American camelids.


Assuntos
Camelídeos Americanos/anatomia & histologia , Cordão Umbilical/anatomia & histologia , Túnica Adventícia/anatomia & histologia , Alantoide/anatomia & histologia , Animais , Compostos Azo , Camelídeos Americanos/embriologia , Corantes , Tecido Elástico/anatomia & histologia , Amarelo de Eosina-(YS) , Feminino , Fibroblastos/citologia , Hematoxilina , Verde de Metila , Músculo Liso/anatomia & histologia , Gravidez , Túnica Média/anatomia & histologia , Artérias Umbilicais/anatomia & histologia , Cordão Umbilical/irrigação sanguínea , Veias Umbilicais/anatomia & histologia
20.
Anat Histol Embryol ; 45(3): 189-96, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26183610

RESUMO

The aim of this study was to analyse and describe the variability of the umbilical artery. Two hundred and thirty-two pelvic halves from 116 adult dogs were examined. To study the permeability of the umbilical artery, ten adult dogs, nine newborns and thirteen foetuses between 35 and 50 days of gestation were also used. In relation to the origin of the umbilical artery, six anatomical variations were found. From which five involved a cranial (n = 4) or caudal (n = 1) relocation of its origin, and in one case (n = 1), the umbilical artery arose from the median sacral artery. In eight cases, the umbilical artery gave off the prostatic (n = 1) or vaginal (n = 7) arteries. The permeability of the umbilical artery was the most significant anatomical variation: permeability was detected in 45% (106 of 232 pelvic halves) of all cases, from which 36 were males and 70 females. Interestingly, an equal vascular permeability in both hemipelvises was found for 82% of the dogs, thus additional data related to such feature of the umbilical artery was also recorded. In accordance with the statistical study, the main anatomical variations described showed significant values for gender, side of the body, size and profile variables.


Assuntos
Variação Anatômica/fisiologia , Permeabilidade Capilar/fisiologia , Dissecação/veterinária , Cães/anatomia & histologia , Artéria Ilíaca/anatomia & histologia , Pelve/irrigação sanguínea , Artérias Umbilicais/anatomia & histologia , Animais , Feminino , Masculino , Gravidez
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