scholarly journals Trophoblastic volumetric bloodflow evaluation in women with trombophylia on 7–10th week of pregnancy

2021 ◽  
Vol 25 (3) ◽  
pp. 131-139
Author(s):  
M. A. Asriyants ◽  
O. V. Astafieva
Keyword(s):  
Blood Flow ◽  
Pregnant Women ◽  
Blood Supply ◽  
Three Dimensional ◽  
First Trimester ◽  
Successful Outcome ◽  
Basal Surface ◽  
Volumetric Reconstruction ◽  
High Degree

Spontaneous abortion occur in 15–20% of all detected pregnancies, and 45–70% of all spontaneous miscarriages take place up to 10 weeks. Thrombophilia is one of the main causes of miscarriage and its effect on the course of pregnancy remains poorly understood. In this regard, there is great interest in the problem of diagnosing thrombophilia and further prevention of thrombosis in obstetric practice.Purpose. Compare the parameters of volumetric blood flow in the chorion with different types of trophoblastic blood flow disturbance in pregnant women with thrombophilia in the first trimester for their quantitative verification.Materials and methods. The study included 129 pregnant women at the 7th to 10th week of gestation with a diagnosis of thrombophilia and a control group - pregnant women with a normal course of this pregnancy and a successful outcome of past pregnancies.The patients were divided into III clinical groups:I. Pregnant women with a normal course of this pregnancy and a successful outcome of past pregnancies (n = 33) – comparison group;II. Pregnant women with thrombophilia, in whom current pregnancy occurred on anticoagulant therapy (n = 28);III. Pregnant women with thrombophilia without taking anticoagulant drugs before registration of pregnancy (n = 68).Ultrasound was performed on Voluson E8 and S8 machines. All pregnant women underwent transabdominal and transvaginal ultrasound in B-mode, in color-doppler (CD) mode, and volumetric reconstruction of chorion was performed using the VOCAL program. In B-mode, the state of the embryo and extraembryonic structures were examined. The identification of trophoblastic vessels was carried out using the CD – region of interest was placed in the trophoblast area detected in B-mode, size and shape was adapted for a particular section.Using three-dimensional echography, the chorion volume was performed. The degree of blood supply in chorionic volume were calculated; vascularization index (VI), flow index (FI) and perfusion index (VFI) were displayed on a histogram with quantitative indicators.ResultsIn the CD mode, the types of trophoblastic blood flow were identified in the chorionic vessels:1) continuous type – blood flow loci are continuously identified over the entire area of the basal surface of the trophoblast;2) intermittent type – blood flow loci are unevenly identified along the basal surface of the trophoblast;3) single loci – single blood flow loci are identified along the basal surface of the trophoblast;4) lack of blood flow – blood flow loci are not determined along the basal surface of the trophoblast.Assessment of the quantitative parameters of the volumetric blood flow was used in the corresponding type of blood flow to verify the classification of types of trophoblastic blood flow in the CD mode.Statistical analysis of the volumetric blood flow indices using three-dimensional chorionic reconstruction showed a high degree of reliability (p < 0.0001) in the VI and VFI values between all corresponding types of blood flow.Discussion. High incidence of spontaneous abortion and the significant role of thrombophilia in this pathology leads to necessity of expanding the research in this area. There has been a lot of research done over the past decade. The quantitative threshold values of the resistance indices in the chorionic vessels were calculated using pulse-wave Doppler, the chorionic blood supply indices were determined using volumetric reconstruction for various pathologies.However, we have not previously met the classification of chorionic blood supply in the CD mode. This technique is very simple to perform and is a highly informative for predicting miscarriage in the first trimester. For the first time, we proposed the above classification of trophoblastic blood flow; for the first time, we proved the reliability of the classification developed by us using the method of volumetric reconstruction of the chorion with an assessment of trophoblastic blood flow, which allows us to recommend its use when writing a protocol for ultrasound of the fetus in the first trimester in pregnant women with thrombophilia.Conclusion. The classification of trophoblastic blood flow was verified by three-dimensional echography with quantitative indicators of the volumetric blood flow of the trophoblast vessels, with a high degree of reliability (p < 0.001) which to indicates the reliability of this classification. It can be recommended to conduct a multicenter study for investigating fetal ultrasound with the additional use of the CD in the first trimester in pregnant women with a diagnosis of thrombophilia.

Further insights into unusual acrania-exencephaly-anencephaly sequence caused by amniotic band – first trimester fetoscopic correlation with two- and three-dimensional ultrasound

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Jan Weichert ◽  
Waldo Sepulveda ◽  
Michael Gembicki
Keyword(s):  
Neural Tube Defect ◽  
Three Dimensional ◽  
First Trimester ◽  
Cystic Degeneration ◽  
Amniotic Band ◽  
Case Presentation ◽  
Constriction Ring ◽  
Antenatal Detection ◽  
Unusual Type

Abstract Objectives Antenatal detection of acrania-exencephaly-anencephaly (AEA) sequence beyond 10 completed weeks of gestation is usually straight-forward. An earlier detection and classification of the causative conditions prior to disaggregation of exposed dysplastic brain tissue remains challenging. Case presentation We present two- and three-dimensional ultrasound correlated with fetoscopic findings of an unusual type of neural tube defect at 11 gestational weeks caused by an amniotic constriction ring resulting in cystic degeneration of the developing skull. Conclusions By giving further illustrative insights into early defective brain development, this report confirms recent findings of an unusual subtype of acrania-exencephaly-anencephaly sequence suggesting early disruption of the developing brain, following an amniotic entrapment of the skull.

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

2020 ◽  
Author(s):  
N.A. Venchikova, À.À. Ershova-Pavlova, I.V. Novikova et all
Keyword(s):  
Pregnant Women ◽  
Three Dimensional ◽  
First Trimester ◽  
Population Based ◽  
Control Group ◽  
Axial Section ◽  
Mother And Child ◽  
Trimester Screening ◽  
2D Ultrasound ◽  
3D Sonography

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.

Intraplacental blood flow in third trimester of placental insufficiency pregnancy

2014 ◽  
Vol 63 (5) ◽  
pp. 51-57
Author(s):  
Anna N Zakurina ◽  
Natalia G Pavlova
Keyword(s):  
Blood Flow ◽  
Pregnant Women ◽  
Blood Circulation ◽  
Power Doppler ◽  
Three Dimensional ◽  
Functional System ◽  
Placental Insufficiency ◽  
Delivery Time ◽  
Third Trimester ◽  
Additional Criterion

Background. Serious perinatal, most of all, neurological consequences of placental insufficiency condition necessity further search it’s markers for optimal delivery time. Methods. At third term of pregnancy we examined 16 singleton physiological pregnant women (first group) and 27 placental insufficiency patients (second group). We standard obstetrical examined, ultrasound fetometry, basic arteries of functional system mother-placenta-fetus Doppler and three-dimensional power Doppler in central, two paracentral and two periphery placenta areas. We processing images by VOCAL and analyzed vascularisation (VI), flow (FI) and vascularisation-flow indexes (VFI). Results. In placentae correlated groups FI differ in size reliable in central (t=4,03; p<0,001 и U=240,00; p<0,001) and paracentral (t=2,61; p<0,05 и U=348,00; p<0,05) areas. Patients second group indexes were relative on 17% and 8% less than patients first group indexes. Patients second group VFI was on 35% less than patients first group VFI (t=2,08; p<0,05 и U=337,00; p<0,05). We described results of comparison three-dimensional power Doppler intraplacental blood flow indexes from patients second group with different degree hemodynamic disorder. Conclusion. In placental insufficiency presence reduction blood circulation, particular in central placenta area, conditioned by reduction blood flow in initial vessels number. Central placenta area FI may be regarded new additional criterion of placental insufficiency at third term of pregnancy.

RELATIONSHIP OF INTERLEUKIN-6 AND BLOOD FLOW IN THE UMBILICAL ARTERY DURING EXCERVATION OF MONO- AND MIXT-CYTOMEGALOVIRAL INFECTION IN THE SECOND TRIMESTER OF PREGNANCY

2020 ◽  
Author(s):  
Irina Andrievskaya ◽  
A Milovanov ◽  
Igor Gorikov ◽  
Inna Dovzhikova ◽  
Nataliya Ishutina
Keyword(s):  
Blood Flow ◽  
Pregnant Women ◽  
Blood Supply ◽  
Interleukin 6 ◽  
Cytomegalovirus Infection ◽  
Umbilical Artery ◽  
Second Trimester ◽  
Relationship Of ◽  
The Relationship

In order to determine the role of a cytokine in the regulation of blood supply to the placenta, the relationship between interleukin-6 (IL-6) in serum and blood flow in the umbilical artery in healthy pregnant women and during pregnancy complicated by exacerbation of mono- and mixed cytomegalovirus infection in the second trimester was studied

Formational features of the vascular component of the chorion in miscarriage in the first trimester of gestation

2016 ◽  
pp. 72-74
Author(s):  
E.V. Kravchenko ◽  
Keyword(s):  
Pregnant Women ◽  
Vascular System ◽  
Three Dimensional ◽  
Local Therapy ◽  
First Trimester ◽  
Study Groups ◽  
Flow Index ◽  
Control Group ◽  
Symptomatic Therapy ◽  
Micronized Progesterone

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.

scholarly journals Estimation of Cutoff Values of Cotinine in Urine and Saliva for Pregnant Women in Poland

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
Joanna Stragierowicz ◽  
Karolina Mikołajewska ◽  
Marta Zawadzka-Stolarz ◽  
Kinga Polańska ◽  
Danuta Ligocka
Keyword(s):  
Pregnant Women ◽  
Analytical Method ◽  
Smoking Status ◽  
First Trimester ◽  
Third Trimester ◽  
Roc Curve Analysis ◽  
Cutoff Values ◽  
Highly Sensitive ◽  
Salivary Cotinine

Setting appropriate cutoff values and the use of a highly sensitive analytical method allow for correct classification of the smoking status. Urine-saliva pairs samples of pregnant women in the second and third trimester, and saliva only in the first trimester were collected. Offline SPE and LC-ESI-MS/MS method was developed in the broad concentration range (saliva 0.4–1000 ng/mL, urine 0.8–4000 ng/mL). The mean recoveries were3.7±7.6% for urine and99.1±2.6% for saliva. LOD for saliva was 0.12 ng/mL and for urine 0.05 ng/mL; LOQ was 0.4 ng/mL and 0.8 ng/mL, respectively. Intraday and interday precision equaled, respectively, 1.2% and 3.4% for urine, and 2.3% and 6.4% for saliva. There was a strong correlation between salivary cotinine and the uncorrected cotinine concentration in urine in the second and third trimesters of pregnancy. The cutoff values were established for saliva 12.9 ng/mL and urine 42.3 ng/mL or 53.1 μg/g creatinine with the ROC curve analysis. The developed analytical method was successfully applied to quantify cotinine, and a significant correlation between the urinary and salivary cotinine levels was found. The presented cut-off values for salivary and urinary cotinine ensure a categorization of the smoking status among pregnant women that is more accurate than self-reporting.

scholarly journals Digital Methods to Optimize Pregnant Women’s Participation in Longitudinal Research (Preprint)

2019 ◽  
Author(s):  
Beth McGee ◽  
Marie Leonte ◽  
Kevin Wildenhaus ◽  
Martha Wilcox ◽  
Jenna Reps ◽  
...  
Keyword(s):  
Mental Health ◽  
Pregnant Women ◽  
Repeated Measures ◽  
Longitudinal Research ◽  
Well Being ◽  
First Trimester ◽  
Target Audience ◽  
Data Set ◽  
Digital Methods ◽  
High Degree

BACKGROUND The scientific and medical communities require advanced study of maternal health and well-being to develop improved outcomes for mothers and their babies but can be challenged measuring mental health during pregnancy and into postpartum due to accessibility and cooperation issues. OBJECTIVE This work employs digital methods to describe mental health and maternal experience from the first trimester of pregnancy through 3 months postpartum among a cohort similar to the general population of pregnant women in the US. The objective was to collect a data set of longitudinal measures for epidemiologists to develop predictive modeling to determine early in pregnancy which women will develop perinatal depression with a high degree of accuracy. METHODS The authors recruited 1,179 pregnant women from BabyCenter.com and followed them with repeated measures using custom, mobile optimized, questionnaires administered online. The authors employed a combination of typical and novel digital strategies to minimize attrition and build trust among participants. In all stages of recruitment, data collection, and participant engagement, the authors adapted their strategies to meet the target audience and leveraged digital means to achieve the final goal. RESULTS Active participants completed 7,757 assessments. These assessments contribute to a robust data set that is enabling predictive models that can identify with a high degree of accuracy women at risk of developing mood disorders before symptoms onset. CONCLUSIONS The study’s success at retaining pregnant women through the postpartum period was based on leveraging a platform with an already established reach and trust among the target audience (BabyCenter), and adapting engagement methodologies tailored to the needs of this target audience.

scholarly journals THREE-DIMENSIONAL ECHOGRAPHIC EVALUATION OF CHORION VASCULARIZATION IN 1st TRIMESTER OF GESTATION IN WOMEN WITN THROMBOFILIA

2018 ◽  
Vol 25 (6) ◽  
pp. 19-25
Author(s):  
M. A. Asriyants ◽  
O. V. Astafieva ◽  
V. G. Shcherbina
Keyword(s):  
Pregnant Women ◽  
Anticoagulant Therapy ◽  
High Reliability ◽  
Three Dimensional ◽  
High Specificity ◽  
First Trimester ◽  
Flow Index ◽  
Control Group ◽  
Quantitative Indices ◽  
Before And After

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. 

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