First trimester tricuspid regurgitation and fetal abnormalities

2015 ◽  
Vol 43 (5) ◽  
Author(s):  
Marcin Wiechec ◽  
Agnieszka Nocun ◽  
Ewa Wiercinska ◽  
Jill Beithon ◽  
Anna Knafel
Keyword(s):  
Tricuspid Regurgitation ◽  
Screening Tool ◽  
Ultrasound Examination ◽  
First Trimester ◽  
Study Group ◽  
Fetal Life ◽  
Inclusion Criteria ◽  
Positive Group ◽  
Congenital Cardiac Defects ◽  
Chromosomal Status

AbstractTricuspid regurgitation (TR) is a common sonographic finding during the fetal life. It has been reported in 7% of normal fetuses. It may be associated with aneuploidy and with both cardiac and extracardiac defects.In this study, we have looked at the characteristics of fetuses with and without TR at 11The study group included women, who underwent an ultrasound examination at 11–13Some 1075 patients met our inclusion criteria including 979 fetuses without TR and 96 with TR. There were 72 cases of aneuploidy diagnosed (6.7%). Isolated TR was found in 53 euploid fetuses (5.2%). All of the TR(+) aneuploid fetuses (n=40) had additional ultrasound markers present. Extracardiac anatomy showed a higher prevalence of abnormalities in the group of TR positives (12.5%) vs. TR negatives (1.6%). Abnormal cardiac findings were more frequent in the TR-positive group independently of chromosomal status and were found in 18.8% of fetuses with TR and in 1.9% with a normal tricuspid flow.TR in combination with other markers is the strongest predictor for aneuploidy. TR, as an isolated parameter, is a poor screening tool both for all and for each individual chromosomal abnormality and congenital cardiac defects.

First trimester severe ductus venosus flow abnormalities in isolation or combination with other markers of aneuploidy and fetal anomalies

2016 ◽  
Vol 44 (2) ◽  
Author(s):  
Marcin Wiechec ◽  
Agnieszka Nocun ◽  
Anna Matyszkiewicz ◽  
Ewa Wiercinska ◽  
Emilia Latała
Keyword(s):  
Screening Tool ◽  
Heart Defects ◽  
First Trimester ◽  
Nuchal Translucency ◽  
Ductus Venosus ◽  
Inclusion Criteria ◽  
Crown Rump Length ◽  
High Incidence ◽  
Singleton Pregnancies ◽  
Increased Nuchal Translucency

AbstractAltered flow in ductus venosus (DV) may be caused by the changes in preload or afterload. Its association with aneuploidy and congenital heart defects (CHDs) was widely described.The aim of this study was to examine the incidence of a reversed a-wave in DV flow (revDV) and the absence of DV (noDV), their coincidences with other markers of aneuploidy or fetal abnormalities in a mixed-risk population.The study group covered women who underwent an ultrasound scan between 11+0 and 13+6 weeks’ gestation.Singleton pregnancies with known pregnancy outcome and a crown-rump length of 45–84 mm.A total of 5811 cases, including 137 aneuploidies, met the inclusion criteria: 35 subjects of noDV, 189 of revDV and 5587 of normal DV flow. The incidence of noDV in euploidy was 0.47%, and in aneuploidy 5.8%. The incidence of revDV in euploidy was 2.46%, and in aneuploidy 35.7%. Among aneuploidy, the highest prevalence of noDV was found in monosomy 45X. revDV showed the highest prevalence in trisomy 18. Isolated noDV was only found in euploidy. Isolated revDV subjects were only observed in euploidy and trisomy 21. Any combination of revDV with additional markers showed high incidence in major trisomies. Extracardiac anatomy and abnormal cardiac findings showed a higher prevalence in noDV and revDV cases.The presence of noDV might be useful in suspicion of monosomy X among cases with increased nuchal translucency, as well as in differentiating them from other aneuploidies. The combinations of aneuploidy markers with revDV are strong indicators of aneuploidy. revDV alone is a poor screening tool for aneuploidy and euploidy with CHD.

Screening for fetal spina bifida by ultrasound examination in the first trimester of pregnancy using fetal biparietal diameter

2012 ◽  
Vol 207 (4) ◽  
pp. 306.e1-306.e5 ◽  
Author(s):  
Jean-Pierre Bernard ◽  
Howard S. Cuckle ◽  
Julien J. Stirnemann ◽  
Laurent J. Salomon ◽  
Yves Ville
Keyword(s):  
Spina Bifida ◽  
Ultrasound Examination ◽  
First Trimester ◽  
Biparietal Diameter ◽  
First Trimester Of Pregnancy

Three-Dimensional Sonographic Evaluation of the Position of the Fetal Conus Medullaris at First Trimester

2021 ◽  
pp. 1-8
Author(s):  
Ruben Ramirez Zegarra ◽  
Nicola Volpe ◽  
Evelina Bertelli ◽  
Greta Michela Amorelli ◽  
Luigi Ferraro ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Umbilical Cord ◽  
Interobserver Agreement ◽  
Interobserver Variability ◽  
First Trimester ◽  
3D Ultrasound ◽  
Conus Medullaris ◽  
Consecutive Series ◽  
Fetal Life ◽  
Umbilical Cord Insertion

<b><i>Objective:</i></b> The objective of this study was to assess the position of the conus medullaris (CM) at the first trimester 3D ultrasound in a cohort of structurally normal fetuses. <b><i>Methods:</i></b> This was a multicenter prospective study involving a consecutive series of structurally normal fetuses between 11 and 13 weeks of gestation (CRL between 45 and 84 mm). All fetuses were submitted to 3D transvaginal ultrasound using a sagittal view of the spine as the starting plane of acquisition. At offline analysis, the position of the CM was evaluated by 2 independent operators with a quantitative and a qualitative method: (1) the distance between the most caudal part of the CM and the distal end of the coccyx (CMCd) was measured; (2) a line perpendicular to the fetal spine joining the tip of the CM to the anterior abdominal wall was traced to determine the level of this line in relation to the umbilical cord insertion (conus to abdomen line, CAL). Interobserver agreement for the CCMd was evaluated. Linear regression analysis was used to determine the association between the CMCd and CRL, and a normal range was computed based on the best-fit model. The absence of congenital anomalies was confirmed in all cases after birth. <b><i>Results:</i></b> In the study period between December 2019 and March 2020, 143 fetuses were recruited. In 130 fetuses (90.9%), the visualization of the CM was feasible. The mean value of the CMCd was 1.09 ± 0.16 cm. The 95% limits of agreement for the interobserver variability in measurement of the CMCd were 0.24 and 0.26 cm. The interobserver variability based on the intra-class correlation coefficient (ICC) for the CCMd was good (ICC = 0.81). We found a positive linear relationship between the CCMd and CRL. In all these fetuses, the CAL encountered the abdominal wall at or above the level of the cord insertion. <b><i>Conclusion:</i></b> In normal fetuses, the assessment of the CM position is feasible at the first trimester 3D ultrasound with a good interobserver agreement. The CM level was never found below the fetal umbilical cord insertion, while the CMCd was noted to increase according to the gestational age, confirming the “ascension” of the CM during fetal life.

scholarly journals Pro- and Anti-Inflammatory Cytokines in the First Trimester—Comparison of Missed Miscarriage and Normal Pregnancy

2021 ◽  
Vol 18 (16) ◽  
pp. 8538
Author(s):  
Maciej Kwiatek ◽  
Tomasz Gęca ◽  
Anna Kwaśniewska
Keyword(s):  
Immune Response ◽  
Inflammatory Cytokines ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Control Group ◽  
Study Group ◽  
Tnf Α ◽  
Cytokine Levels ◽  
Anti Inflammatory ◽  
Tgf Β1

The advantage in response of Th2 over Th1 is observed in normal pregnancy in peripheral blood. A disturbance of this balance can lead to symptoms of miscarriage and pregnancy loss. The aim of this study was to evaluate the pro- and anti-inflammatory cytokines in sera of women who were diagnosed with missed miscarriage in the first trimester and to compare this systemic immune response to the response in women with normal pregnancy. The study group consisted of 61 patients diagnosed with missed miscarriage. In total, 19 healthy women with uncomplicated first trimester created the control group. Cytokines were determined in the maternal serum by ELISA. The analysis included INF-γ, TNF-α, Il-1β, Il-4, Il-5, Il-6, Il-9, Il-10, Il-13 and TGF-β1. Th1 cytokine levels in the study group reached slightly higher values for INF-γ, Il-1β and slightly lower for IL-6 and TNF-α. In turn, Th2 cytokine levels in the study group were slightly higher (Il-9, Il-13), significantly higher (Il4, p = 0.015; Il-5, p = 0.0003) or showed no differences with the control group (Il-10). Slightly lower concentration involved only TGF-β1. Analysis of the correlation between levels of pro- and anti-inflammatory cytokines resulted in some discrepancies, without showing predominance of a specific immune response. The results did not confirm that women with missed miscarriage had an advantage in any type of immune response in comparison to women with normal pregnancy.

THE HEART DAMAGE AND ITS STRUCTURAL STATE FEATURES IN MEN UNDER 60 YEARS OLD WITH MYOCARDIAL INFARCTION, COMPLICATED WITH ACUTE KIDNEY INJURY

2021 ◽  
pp. 36-44
Author(s):  
Gordienko A.V. ◽  
Golikov A.V. ◽  
Tassybayev B.B. ◽  
Reiza V.A.
Keyword(s):  
Myocardial Infarction ◽  
Acute Kidney Injury ◽  
Tricuspid Regurgitation ◽  
Interventricular Septum ◽  
Kidney Injury ◽  
Risk Groups ◽  
Control Group ◽  
Study Group ◽  
Type I ◽  
Acute Kidney Injury Development

Relevance. The role of hemodynamic changes in myocardial infarction complicated by acute kidney injury is interpreted in different ways. Aim. To evaluate the heart chambers and structures peculiarities in men under 60 years old with myocardial infarction complicated by acute kidney injury to improve prevention and outcomes. Material and methods. The study included men 19-60 years old with type I myocardial infarction. The patients were divided into two age-comparable groups: I - study group, with acute kidney injury - 25 patients; II - control, without it - 366 patients. A comparative assessment of the heart chambers and structures parameters in the first 48 hours (1) and at the end of the third week of the disease (2), their dynamics, also acute kidney injury development risk analysis (ANOVA) were performed. Results. The study group differed from the control group in smaller sizes of the left atrium2 (38.1±6.0 and 42.0±5.4 (mm), respectively; p=0.01), a higher frequency of the middle anterior (100 and 15.6%; p=0.02) and antero-septal (100 and 17.7; p=0.04) segments akinesia and the absence (0 and 81.5%; p=0.04) of tricuspid regurgitation. In the study group, there was a smaller increase in the ventricles size than in the control group (left: 0.6 and 1.7%, respectively; right: 15.3 and 33.6%) and a greater decrease in the atria size, compared in the control group (left: -1.8 and -25.3%; right: -25.3 and -0.1%) (p<0.0001). The risk markers of the acute kidney injury developing were the dimensions of the left atrium1˂34 mm, interventricular septum≥12.0 mm, end systolic1≥4.23 and diastolic1≥5.3 of the left ventricle, right ventricle1˂2.6; of the right atrium1≥4.7 (cm), the mass of the left ventricle1≥328.8 g. Conclusions. Men under 60 years old with acute kidney injury in myocardial infarction are characterized by lesions of the middle anterior and antero-septal segments, the absence of tricuspid regurgitation, and a smaller left atrium in the subacute period of the disease. The above of the heart chambers dimensions values should be used in the high-risk groups for the acute kidney injury development formation, as well as for prognostic modeling.

scholarly journals Interrater reliability of the Saint-Anne Dargassies Scale in assessing the neurological patterns of healthy preterm newborns

2018 ◽  
Vol 18 (1) ◽  
pp. 103-112
Author(s):  
Carla Ismirna Santos Alves ◽  
João Gonçalves de Medeiros ◽  
Luciana Arruda Carriço ◽  
Nívia Maria Arraes ◽  
Roselene Ferreira de Alencar ◽  
...  
Keyword(s):  
Gold Standard ◽  
Interrater Reliability ◽  
Ultrasound Examination ◽  
High Reliability ◽  
Interrater Agreement ◽  
Neurological Deficits ◽  
Cranial Ultrasound ◽  
Inclusion Criteria ◽  
Group I ◽  
Preterm Newborns

Abstract Objectives: to assess the interrater reliability of the Saint-Anne Dargassies Scale in assessing neurological patterns of healthy preterm newborns. Methods: twenty preterm newborns met the inclusion criteria for participation in this prospective study. The neurologic examination was performed using the Saint-Anne Dargassies Scale, showing normal serial cranial ultrasound examination. In order to test the reliability, the study was structured as follows: group I (rater 1/physiotherapist; rater 2/neonatologist); group II (rater 3/physiotherapist; rater 4/child neurologist) and the gold standard (expert and professor in pediatric neurology). Results: high interrater agreement was observed between groups I - II compared with the gold standard in assessing postural pattern (p<0.01). Regarding the assessment ofprimitive reflexes, greater agreement was observed in the evaluation of palmar grasp reflex and Moro reflex (p< 0.01) for group I compared with the gold standard. An analysis of tone demonstrated heterogeneous agreement, without compromising the reliability of the scale. The probability of equality between measurements of head circumference in the two groups, compared with the gold standard, was observed. Conclusions: the Saint-Anne Dargassies Scale demonstrated high reliability and homogeneity with significant power of reproducibility and may be capable to identify preterm newborns suspected of having neurological deficits.

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