The Impact of Oral Intake of Dydrogesterone on Fetal Heart Development During Early Pregnancy

2015 ◽  
Vol 36 (7) ◽  
pp. 1483-1488 ◽  
Author(s):  
Mahmoud Zaqout ◽  
Emad Aslem ◽  
Mazen Abuqamar ◽  
Osama Abughazza ◽  
Joseph Panzer ◽  
...  
Keyword(s):  
Early Pregnancy ◽  
Heart Development ◽  
Fetal Heart ◽  
Oral Intake ◽  
The Impact

scholarly journals Bayes Theorem and Protopathic Bias: Methodological Concerns When Addressing the Impact of Fetal Heart Rate Patterns on the Cesarean Section Rate

2020 ◽  
Vol 10 (03) ◽  
pp. e342-e345
Author(s):  
Jacques Balayla ◽  
Ariane Lasry ◽  
Yaron Gil ◽  
Alexander Volodarsky-Perel
Keyword(s):  
Heart Rate ◽  
Caesarean Section ◽  
Fetal Heart Rate ◽  
Predictive Power ◽  
Fetal Heart ◽  
Caesarean Section Rate ◽  
Bayes Theorem ◽  
The Poor ◽  
Clinical Scenarios ◽  
The Impact

AbstractOver the last 30 years, the caesarean section rate has reached global epidemic proportions. This trend is driven by multiple factors, an important one of which is the use and inconsistent interpretation of the electronic fetal monitoring (EFM) system. Despite its introduction in the 1960s, the EFM has not definitively improved neonatal outcomes, yet it has since significantly contributed to a seven-fold increase in the caesarean section rate. As we attempt to reduce the caesarean rates in the developed world, we should consider focusing on areas that have garnered little attention in the literature, such as physician sensitization to the poor predictive power of the EFM and the research method biases that are involved in studying the abnormal heart rate patterns—umbilical cord pH relationship. Herein, we apply Bayes theorem to different clinical scenarios to illustrate the poor predictive power of the EFM, as well as shed light on the principle of protopathic bias, which affects the classification of research outcomes among studies addressing the effects of the EFM on caesarean rates. We propose and discuss potential solutions to the aforementioned considerations, which include the re-examination of guidelines with which we interpret fetal heart rate patterns and the development of noninvasive technologies that evaluate fetal pH in real time.

scholarly journals Dysphagia in Perry Syndrome: Pharyngeal Pressure in Two Cases

2017 ◽  
Vol 9 (2) ◽  
pp. 161-167 ◽  
Author(s):  
George Umemoto ◽  
Yoshio Tsuboi ◽  
Hirokazu Furuya ◽  
Takayasu Mishima ◽  
Shinsuke Fujioka ◽  
...  
Keyword(s):  
Tube Feeding ◽  
Oral Intake ◽  
Normal Diet ◽  
Oral Feeding ◽  
Tongue Pressure ◽  
Normal Range ◽  
Swallowing Function ◽  
Pharyngeal Pressure ◽  
Swallowing Dysfunction ◽  
The Impact

Background: To investigate the impact of dysphagia in Perry syndrome (PS), an autosomal dominant parkinsonism caused by mutation of DCTN1, which is associated with hypoventilation, depression, and weight loss. Case Presentation: We used tongue pressure measurements and manofluorography to investigate swallowing function in 2 patients with PS. Case 1, a 60-year-old male showing parkinsonism, and case 2, a 49-year-old male admitted with pneumonia, were diagnosed as having PS based on the DCTN1 gene analysis. Case 1 showed a pharyngeal retention of the bolus on videofluorography (VF) and a few swallows were required for its passage into the esophagus. However, tongue pressure and manometry were within the normal range. This patient could eat a normal diet under supervision. Case 2 required artificial ventilation and tube feeding on admission. The VF image showed a slow transfer of the bolus, delayed swallow reflex, and pharyngeal retention of the bolus that required several swallows for its passage into the esophagus. The tongue pressure was within the normal range, but manometry showed a significant decrease in pressure at the hypopharynx and upper esophageal sphincter. The oral intake of the patients was limited to 2 cups of jelly per day. Conclusions: The investigation of swallowing dysfunction of 2 cases of PS showed that maintaining pharyngeal pressure within the normal range was very important for oral feeding success and prognosis.

Characterizing the effects of in utero exposure to valproic acid on murine fetal heart development

2019 ◽  
Vol 111 (19) ◽  
pp. 1551-1560
Author(s):  
Nicola A. Philbrook ◽  
Ana Nikolovska ◽  
Rebecca D. Maciver ◽  
Christine L. Belanger ◽  
Louise M. Winn
Keyword(s):  
Valproic Acid ◽  
Heart Development ◽  
Fetal Heart ◽  
In Utero ◽  
In Utero Exposure

scholarly journals The effect of a pharmacist consultation on pregnant women’s quality of life with a special focus on nausea and vomiting: an intervention study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Maria Bich-Thuy Truong ◽  
Elin Ngo ◽  
Hilde Ariansen ◽  
Ross T. Tsuyuki ◽  
Hedvig Nordeng
Keyword(s):  
Quality Of Life ◽  
Early Pregnancy ◽  
Standard Care ◽  
Intervention Study ◽  
Intervention Group ◽  
Nausea And Vomiting ◽  
Quality Of Life Scale ◽  
The Impact ◽  
In Pregnancy

Abstract Background Maternal wellbeing and quality of life (QOL) are increasingly being recognized as important for healthy pregnancies. The aim of this study was to investigate the impact of a pharmacist consultation on pregnant women’s QOL focusing on nausea and vomiting in pregnancy (NVP), and patient satisfaction. Methods For this intervention study in 14 community pharmacies, women in early pregnancy were recruited and assigned to a pharmacist consultation (intervention) or standard care (control). The consultation aimed to address each woman’s concerns regarding medications and pregnancy-related ailments. Data were collected through online questionnaires at baseline (Q1) and during the second trimester (Q2). The intervention group completed an additional satisfaction questionnaire after the consultation was completed. The primary outcome was the impact of the intervention on the Quality of Life Scale (QOLS) scores between the first and second trimesters. The impact of the intervention was assessed by linear regression, and secondary analyses were performed to assess effect modification by NVP. Results Of the 340 women enrolled in the study, we analyzed data for 245. Half (170/340) of the original participants were allocated to the intervention group, of whom 131 received the pharmacist consultation. Most women (75%, 78/96) reported that the consultation was useful to a large/very large extent. The consultation had no overall impact on QOLS scores between the first and the second trimesters compared with standard care (adjusted β: 0.7, 95% CI: -2.1, 3.4). The impact of the intervention on QOLS was greater amongst women with moderate/severe NVP (adjusted β: 3.6, 95% CI: -0.6, 7.7) compared to those with no/mild NVP (adjusted β: -1.4, 95% CI: -5.1, 2.2) (interaction term study group*NVP severity, p = 0.048). Conclusions The pregnant women highly appreciated the pharmacist consultation, but the intervention did not affect their QOL scores compared with standard care. Future studies should further explore the effect of a pharmacist consultation specifically for NVP and on other outcomes such as use of health care services and medication use in pregnancy. Trial registration Retrospectively registered in ClinicalTrials.gov (identifier: NCT04182750, registration date: December 2, 2019).

Restriction of placental function alters heart development in the sheep fetus

2007 ◽  
Vol 293 (1) ◽  
pp. R306-R313 ◽  
Author(s):  
J. L. Morrison ◽  
K. J. Botting ◽  
J. L. Dyer ◽  
S. J. Williams ◽  
K. L. Thornburg ◽  
...  
Keyword(s):  
Heart Development ◽  
Relative Proportion ◽  
Relative Size ◽  
Neonatal Morbidity ◽  
Growth Restriction ◽  
Heart Weight ◽  
Postnatal Life ◽  
Fetal Sheep ◽  
The Impact

Placental insufficiency, resulting in restriction of fetal substrate supply, is a major cause of intrauterine growth restriction (IUGR) and increased neonatal morbidity. Fetal adaptations to placental restriction maintain the growth of key organs, including the heart, but the impact of these adaptations on individual cardiomyocytes is unknown. Placental and hence fetal growth restriction was induced in fetal sheep by removing the majority of caruncles in the ewe before mating (placental restriction, PR). Vascular surgery was performed on 13 control and 11 PR fetuses at 110–125 days of gestation (term: 150 ± 3 days). PR fetuses with a mean gestational Po2 < 17 mmHg were defined as hypoxic. At postmortem (<135 or >135 days), fetal hearts were collected, and cardiomyocytes were isolated and fixed. Proliferating cardiomyocytes were counted by immunohistochemistry of Ki67 protein. Cardiomyocytes were stained with methylene blue to visualize the nuclei, and the proportion of mononucleated cells and length and width of cardiomyocytes were measured. PR resulted in chronic fetal hypoxia, IUGR, and elevated plasma cortisol concentrations. Although there was no difference in relative heart weights between control and PR fetuses, there was an increase in the proportion of mononucleated cardiomyocytes in PR fetuses. Whereas mononucleated and binucleated cardiomyocytes were smaller, the relative size of cardiomyocytes when expressed relative to heart weight was larger in PR compared with control fetuses. The increase in the relative proportion of mononucleated cardiomyocytes and the relative sparing of the growth of individual cardiomyocytes in the growth-restricted fetus are adaptations that may have long-term consequences for heart development in postnatal life.

scholarly journals A before and after study of the impact on obstetric and perinatal outcomes following the introduction of an educational package of fetal heart rate monitoring education coupled with umbilical artery lactate sampling in a low resource setting labor ward in South Africa

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Emma R. Allanson ◽  
Robert C. Pattinson ◽  
Elizabeth A. Nathan ◽  
Jan E. Dickinson
Keyword(s):  
Heart Rate ◽  
Cesarean Section ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Perinatal Outcomes ◽  
Heart Rate Monitoring ◽  
Post Intervention ◽  
Fetal Heart Rate Monitoring ◽  
Resource Setting ◽  
The Impact

Abstract Introduction Rates of cesarean section (CS) are increasing and abnormal fetal heart rate tracing and concern about consequent acidosis remain one of the most common indications for primary CS. Umbilical artery (UA) lactate sampling provides clinicians with point of care feedback on CTG interpretation and intrapartum care and may result in altered future practice. Materials and methods From 3rd March - 12th November 2014 we undertook a before and after study in Pretoria, South Africa, to determine the impact of introducing a clinical package of fetal heart rate monitoring education and prompt feedback with UA cord lactate sampling, using a hand-held meter, on maternal and perinatal outcomes. Results Nine hundred thirty-six consecutive samples were analyzed (pre n = 374 and post n = 562). There was no difference in mean lactate (4.6 mmol/L [95%CI 4.4–4.8] compared with 4.9 mmol/L [95%CI 4.7–5.1], p = 0.089). Suspected fetal compromise was reduced in the post-intervention period: 30·2% vs 22·1%, aOR 0·71, 95% CI 0·52–0·96, p = 0·027. Cesarean section rates were significantly reduced in the univariate analysis: pre- 40·3% vs post-intervention 31·6% (p = 0·007). This reduction remained significant when adjusted for previous cesarean section, primiparity, maternal HIV infection and preterm birth (aOR 0·72, 95%CI 0·54–0·98, p = 0·035). Neonatal outcomes did not differ between the two groups. Conclusion The introduction of a clinical practice package of fetal heart rate monitoring education combined with routine UA cord lactate sampling has the potential to reduce the cesarean section rate without increasing adverse neonatal outcomes in a low-resource setting.

scholarly journals Association between oral intake of dydrogesterone during early pregnancy and congenital heart disease: a case-control study

The Lancet ◽  
2017 ◽  
Vol 390 ◽  
pp. S8 ◽  
Author(s):  
Mahmoud Zaqout ◽  
Emad Aslem ◽  
Mazen Abuqamar ◽  
Osama Abughazza ◽  
Joseph Panzer ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Early Pregnancy ◽  
Congenital Heart ◽  
Case Control Study ◽  
Oral Intake ◽  
Case Control ◽  
Control Study

scholarly journals Adenylyl Cyclase Signaling in the Developing Chick Heart: The Deranging Effect of Antiarrhythmic Drugs

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Lucie Hejnova ◽  
Klara Hahnova ◽  
Radka Kockova ◽  
Jarmila Svatunkova ◽  
David Sedmera ◽  
...  
Keyword(s):  
Chick Embryo ◽  
Adenylyl Cyclase ◽  
System Application ◽  
Heart Development ◽  
Antiarrhythmic Drugs ◽  
Cardiac Contractility ◽  
Signaling System ◽  
Blocking Agents ◽  
Chick Heart ◽  
The Impact

The adenylyl cyclase (AC) signaling system plays a crucial role in the regulation of cardiac contractility. Here we analyzed the key components of myocardial AC signaling in the developing chick embryo and assessed the impact of selectedβ-blocking agents on this system. Application of metoprolol and carvedilol, two commonly usedβ-blockers, at embryonic day (ED) 8 significantly downregulated (by about 40%) expression levels of AC5, the dominant cardiac AC isoform, and the amount of Gsαprotein at ED9. Activity of AC stimulated by forskolin was also significantly reduced under these conditions. Interestingly, when administered at ED4, these drugs did not produce such profound changes in the myocardial AC signaling system, except for markedly increased expression of Giαprotein. These data indicate thatβ-blocking agents can strongly derange AC signaling during the first half of embryonic heart development.

Sign in / Sign up

Export Citation Format

Share Document