Two- and three-dimensional sonography of anomalies of orofacial area in the first trimester of gestation

Author(s):  
N.A. Venchikova, À.À. Ershova-Pavlova, I.V. Novikova et all

As part of the population-based prenatal screening of 900 pregnant women, who underwent 1st trimester screening at the RPMC “Mother and Child” in 2018–2019, an ultrasound scan of the fetal palate was performed to evaluate the effectiveness of new ultrasound markers in detecting orofacial clefts (OFC). Fetal palatal defects were screened at a 2D assessment of bone markers of the palate – the image of the palatal line in the sagittal section, the retronasal triangle in the coronary section, the alveolar arch of the upper jaw in the axial section. If a palate abnormality was detected or suspected in the 2D study, the fetal palate was evaluated using the 3D mode. In 50 pregnant women of the control group, 3D sonography of the fetal palate was performed in the norm. In total, during the gestation period of 10+5–12+5 weeks, 10 cases of OFC were detected, of which 1 case was a median lip/palate cleft (LPC), 6 — bilateral LPC, 1 — left-sided LPC, 1 — unspecified LPC, 1 — PC. Visualization of 2D ultrasound markers was possible in 9 cases of palate anomalies, 3D assessment worked out in all 10 cases. In all identified OFC cases, cytogenetic and/or pathomorphological studies were performed.

2016 ◽  
pp. 72-74
Author(s):  
E.V. Kravchenko ◽  

In women with miscarriage in early pregnancy by ultrasound was studied the volume of the ovum, the volume of the cavity of the amnion and their relationship. Using special three-dimensional VOCAL program performed the calculation of the volume of the chorion, the evaluation of his vascular system based on the definition of the vascularization index (VI) and flow index (FI). The aim of the study: to study the stages of growth and vascularization of the chorion with the threat of miscarriage in the first trimester of gestation. Materials and methods. There were examined 50 pregnant women with threat of miscarriage at early terms of gestation: 30 - burdened obstetric history (BOH), receiving the drug micronized progesterone 50 mg 3-4 times per day (the main group) and 20 pregnant women, the history of which was not encumbered, who were on symptomatic therapy (control group). Results. Analysis of the frequency of occurrence of extragenital pathology in the study groups showed that in women with recurrent pregnancy loss and BOH somatic diseases were almost 2 times more often than in the control group (respectively 60% and 30%). The frequency of infectious complications in the first trimester of pregnancy in women with threatened abortion and BOH compared to the control group of patients, significantly more frequently noted violations of vaginal microbiocenosis, in the form of gardnerellosis (20% and 10%), Candida vaginitis (30% and 5.5%) and urogenital infections – chlamydia, ureaplasmosis, mycoplasmosis (15% and 0%). All pregnant women was carried out sanitation of the source of infection in the first trimester of gestation – local therapy, systemic treatment after completion of the processes of placentation. Conclusion. The study found that use of micronized progesterone in miscarriage in the first trimester of gestation contributes to the growth of the volume of the chorion, the intensity of the flow in the parenchyma and a complete restructuring of the spiral arteries resulting in inadequate formation of the placental-uterine blood flow, which certainly improves the prediction of the further course of pregnancy. Key words: miscarriage, the I trimester of gestation, the vessels of the chorion.


2018 ◽  
Vol 25 (6) ◽  
pp. 19-25
Author(s):  
M. A. Asriyants ◽  
O. V. Astafieva ◽  
V. G. Shcherbina

Aim.Determine the threshold values of quantitative indices of chorionic volume flow in pregnant women with thrombophilia in the first trimester of pregnancy for the prediction of miscarriage and evaluate the effectiveness of anticoagulant therapy.Materials and methods.Ultrasound examination of the embryo and extraembryonic structures with volume reconstruction of the chorion and determination of quantitative indices using VOCAL program − vascularization index (VI), flow index (FI), vascularization flow index (VFI) in women with thrombophilia from 7th to 10th of the week of gestation.Results.The analysis of the quantitative parameters VI, FI and VFI in pregnant women in the first trimester showed high reliability (p<0.001) in the value of VI and VFI in pregnant women with thrombophilia without treatment and in the pregnant control group, as well as in pregnant women with thrombophilia before and after anticoagulant therapy. Among the most informative parameters for assessing the chorion vascularization in predicting miscarriage VFI≤7,80 has highest value for negative outcome. Index VI due to the very high specificity (SP = 82.6%) better more informative for predicting a favorable outcome.Conclusion.The use of the proposed method allows us to identify a risk group for predicting miscarriage in the first trimester in pregnant women with thrombophilia and promptly prescribe anticoagulant therapy and evaluate its efficiency. 


2016 ◽  
pp. 160-164
Author(s):  
D.N. Maslo ◽  

The objective: frequency decrease perinatal pathologies at women after ART on the basis of studying clinical-ehografical, endocrinological, biochemical, dopplerometrical, cardiotokografical and morphological researches, and also improvement of algorithm of diagnostic and treatment-and-prophylactic actions. Patients and methods. The work basis is made spent by us from 2012 on 2015 by complex inspection of 300 pregnant women from which 250 were after ART and 50 – firstlabours which pragnency without ART, and also their newborns. For the decision of an object in view of research spent to two stages. At 1 stage spent prosperctive research which included 150 pregnant women: з them 100 women pregnancy at which has come out ART (1 group) and 50 healthy women (control group). At 2 stage spent prospective randomization in which result of patients after ART have divided on two equal groups by therapy principle: 2 basic group - 75 pregnant women after ART at which used the algorithm improved by us; 3 group of comparison - 75 pregnant women after ART which have been spent on the standard treatment-and-prophylactic actions. Results. The results suggest that women after using ART is a high frequency of reproductive losses in the first trimester (10.0%), 3.0% of spontaneous abortion from 16 to 22 weeks, and 3.0% "early" premature delivery (22 to 28 weeks of pregnancy). The frequency of violations of the functional state of placenta in women after using IVF is 63.0%, which is the main cause of high levels of perinatal losses (40.0 ‰), and delivery by cesarean section (96.0%). Placental dysfunction in women after using ART characterized by retrohorialnyh hematoma (21.0%); size mismatch fruit (30.0%) and hypertonicity of the uterus (73.0%) against changes in fruit-placental blood flow - increased resistance index in umbilical artery and increased vascular resistance in the uterine arteries. Endocrinological and biochemical changes in placental dysfunction in women after using IVF starting from 28 weeks of pregnancy and are in significant reduction in progesterone, placental b1-microglobulin, B2-microglobulin of fertility and trophic в-glycoprotein. Conclusion. The received results: use of the algorithm of diagnostic and treatment-and-prophylactic actions improved by us allows to lower frequency of spontaneous interruption of pregnancy till 22 weeks – from 13.0% to 5.7%; «early» premature birth – from 3.0% to 1.0%; placentary dysfunction from 63.0% to 40.6%; cesarean sections – from 96.0% to 56.5%, and also perinatal losses – from 40.0‰ to 16.2‰. Key words: pregnancy, childbirth, auxiliary reproductive technologies.


2015 ◽  
Vol 43 (2) ◽  
Author(s):  
Ritsuko Kimata Pooh ◽  
Asim Kurjak

AbstractRecent development of three-dimensional (3D) high definition (HD) ultrasound has resulted in remarkable progress in visualization of early embryos and fetuses in sonoembryology. The new technology of HDlive assesses both structural and functional developments in the first trimester with greater reliably than two-dimensional (2D) ultrasound. The ability to visualize not only fetal face, hands, fingers, feet, and toes, but also amniotic membranes, is better with volumetric ultrasound than 2D ultrasound. In this article, detailed and comprehensive structures of normal and abnormal fetuses depicted by 3D HDlive are presented, including various faces of Down’s syndrome and holoprosencephaly, as well as low-set ear and finger/toe abnormalities from the first trimester. Three-dimensional HDlive further “humanizes” the fetus, enables detailed observation of the fetal face in the first trimester as shown in this article, and reveals that a small fetus is not more a fetus but a “person” from the first trimester. There has been an immense acceleration in understanding of early human development. The anatomy and physiology of embryonic development is a field where medicine exerts greatest impact on early pregnancy at present, and it opens fascinating aspects of embryonic differentiation. Clinical assessment of those stages of growth relies heavily on 3D/four-dimensional (4D) HDlive, one of the most promising forms of noninvasive diagnostics and embryological phenomena, once matters for textbooks are now routinely recorded with outstanding clarity. New advances deserve the adjective “breathtaking”, including 4D parallel study of the structural and functional early human development.


2020 ◽  
Author(s):  
AYSE OZBAN

Abstract Objective: This study aims to determine whether it is possible to predict preeclampsia by comparing postpartum results and test results of the pregnant women diagnosed with preeclampsia, whose first and/or second trimester screening tests were accessible, and to demonstrate the predictability of severity and week of onset.Background: 204 patients underwent renal transplantation in our center and 84 of them were female. Five of our patients (one of them had two births) gave birth to a total of 6 pregnancies.Method: 135 patients were diagnosed with preeclampsia and their first and/or second trimester screening tests were accessible, and 366 control participants gave birth to a healthy baby between 37-41 weeks after standard follow-up period for pregnancy and their screening tests were also accessible.Results: The study results show that the first trimester maternal serum PAPP-A level is significantly low in preeclamptic pregnant women, and that the second trimester maternal serum AFP and hCG levels are significantly high and uE3 levels are significantly low The results also suggest that the first and second trimester Down syndrome biochemical markers can be used in preeclampsia screening.Conclusion: Among these markers, uE3 is the parameter which affects the possibility of preeclampsia the most. However, the first and second trimester Down syndrome biochemical markers are not effective in predicting the severity and onset week of preeclampsia.


Author(s):  
Ümit Görkem ◽  
Özgür Kan ◽  
Mehmet Ömer Bostancı ◽  
Deniz Taşkıran ◽  
Hasan Ali İnal

Objective: Spontaneous abortion is the most common complication of early pregnancy, affecting up to 20% of recognized pregnancies. Kisspeptin is predominantly released by placental syncytiotrophoblasts, and regulates their placental invasion into the uterine matrices. We aimed to establish an association of serum kisspeptin levels with pregnancy outcomes during the early gestational stage of the first trimester. Method: In this prospective study, 90 pregnant women in their 7 to 8 6/7 gestational weeks were classified into three groups: (i) The control group, consisting of healthy pregnant women (n=30), (ii) the threatened abortion group (n=30), and (iii) the spontaneous abortion group (n=30). The maternal serum samples were analyzed for complete blood count parameters and kisspeptin levels. Results: There was no statistical difference regarding body mass index (BMI) and gestational age (p=0.370). Regarding detailed obstetric notations, including gravida, parity, abortion, and living children, socioeconomic levels, and employment rates, all study groups were comparable (p>0.05, for all). No significant association was found regarding the biochemical parameters of complete blood count, including neutrophil, lymphocyte, and platelet concentrations, as well as neutrophil-to-lymphocyte ratios (NLR) and platelet-to-lymphocyte ratios (PLR) (p>0.05, for all). The median serum kisspeptin levels of the study groups did not differ between the groups (p=0.153). Correlation analysis revealed no significant relationship between serum kisspeptin levels and other study parameters in any study groups (p>0.05, for all) Conclusions: We found no statistically significant relationship between serum kisspeptin concentrations and pregnancy outcomes in the early gestational stage of the first trimester, and serum kisspeptin concentrations did not seem to be a reliable marker to distinguish abortion status from viable pregnancy


2021 ◽  
Vol 9 (A) ◽  
pp. 1019-1023
Author(s):  
Salma Salma ◽  
Veni Hadju ◽  
Jamaluddin Jompa ◽  
Stang Stang ◽  
Sundari Sundari ◽  
...  

BACKGROUND: The prevalence of anemic pregnant women is still reasonably high, especially in low-middleincome countries. AIM: This study was aimed to assess the effect of giving red seaweed (Kappaphycus alvarezii) biscuits on changes in hemoglobin (Hb) levels and body weight of pregnant women in the first trimester. METHODS: The study used a quasi-experiment pretest-posttest study design. The study was conducted from April to June 2021 involving pregnant women in the first trimester who living in the working area of the Wapunto Community Health Center, Muna Regency, Indonesia. A total of 45 pregnant women were selected purposively and assigned to three different groups. The first group was given two pieces of red seaweed biscuits per day. The second group was given two pieces of red seaweed biscuits plus Fe tablets (60 mg/day), and the last group was given Fe tablet only (60 mg/day). Chi-square, paired sample t-test, Wilcoxon, and Kruskal–Wallis tests were performed using SPSS. RESULTS: The intervention group of red seaweed biscuits plus Fe tablets had the highest increase in Hb levels after 8 weeks of intervention, followed by the red seaweed biscuit group and the control group (0.97, 0.78, and 0.60 g/dL, respectively, p-value < 0.05). The red seaweed biscuit intervention group had the highest changes for body weight compared to the red seaweed biscuit plus Fe tablet group and the control group (1.07, 0.43, and 0.04 kg, respectively). CONCLUSION: The provision of red seaweed biscuits could increase maternal Hb level and weight during the first trimester of their pregnancy.


2021 ◽  
Vol 86 (4) ◽  
pp. 228-235
Author(s):  
Elena Timokhina ◽  
◽  
Vadim Zinin ◽  
Irina Ignatko ◽  
Sapyat Ibragimova ◽  
...  

Summary: Introduction: Preeclampsia is a life-threatening condition for the mother and foetus. Globally, it is diagnosed in 10 mil. women every year, which accounts for 3% to 8% of all pregnancies. Currently there is no proven effective treatment for preeclampsia. The aforesaid text actualises the issue of predicting this complication. To determine the prognostic significance of matrix metalloproteinases-2 and -9 levels as early markers of preeclampsia, the present prospective study was conducted. Materials and methods: The levels of matrix metalloproteinases-2  and -9  were assessed in 72  patients. Thirty-four  of them subsequently developed preeclampsia during pregnancy (20 patients with moderate preeclampsia, 14 patients with severe preeclampsia), and constituted the basic group; 38 patients made up the control group. Results: In pregnant women with the subsequent development of preeclampsia, the level of matrix metalloproteinase-2 at 11–13 weeks of gestation was 155 ± 73.4 ng/mL and significantly exceeded its level in pregnant women without hypertensive disorders – 75.0 ± 32.8 ng/mL. The study conducted demonstrates a significantly lower concentration of matrix metalloproteinase-9 in pregnant women with preeclampsia compared to the control – 749 ± 296 ng/mL and 1,667 ± 552 ng/mL (P < 0.001). The performed research figures that in the first trimester, the cut-off value of matrix metalloproteinase-2 for predicting the development of preeclampsia is ≥ 102 ng/mL (sensitivity 88.24% and specificity 82.76%). For matrix metalloproteinase-9, a level of ≤ 980 ng/mL in the first trimester predicts the development of preeclampsia with a sensitivity of 85.29% and a specificity of 84.48%. Conclusion: The study established the cut-off values of matrix metalloproteinases-2 and -9 for predicting the development of preeclampsia in the first trimester.


Genes ◽  
2020 ◽  
Vol 11 (6) ◽  
pp. 590
Author(s):  
Vera Belova ◽  
Daria Plakhina ◽  
Sergey Evfratov ◽  
Kirill Tsukanov ◽  
Gennady Khvorykh ◽  
...  

Non-invasive prenatal testing (NIPT) for aneuploidy on Chromosomes 21 (T21), 18 (T18) and 13 (T13) is actively used in clinical practice around the world. One of the limitations of the wider implementation of this test is the high cost of the analysis itself, as high-throughput sequencing is still relatively expensive. At the same time, there is an increasing trend in the length of reads yielded by sequencers. Since extracellular DNA is short, in the order of 140–160 bp, it is not possible to effectively use long reads. The authors used high-performance sequencing of cell-free DNA (cfDNA) libraries that went through additional stages of enzymatic fragmentation and random ligation of the resulting products to create long chimeric reads. The authors used a controlled set of samples to analyze a set of cfDNA samples from pregnant women with a high risk of fetus aneuploidy according to the results of the first trimester screening and confirmed by invasive karyotyping of the fetus using laboratory and analytical approaches developed by the authors. They evaluated the sensitivity, specificity, PPV (positive predictive value), and NPV (negative predictive value) of the results. The authors developed a technique for constructing long chimeric reads from short cfDNA fragments and validated the test using a control set of extracellular DNA samples obtained from pregnant women. The obtained sensitivity and specificity parameters of the NIPT developed by the authors corresponded to the approaches proposed earlier (99.93% and 99.14% for T21; 100% and 98.34% for T18; 100% and 99.17% for T13, respectively).


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