scholarly journals Cerebellum and Prematurity: A Complex Interplay Between Disruptive and Dysmaturational Events

2021 ◽  
Vol 15 ◽  
Author(s):  
Giulia Spoto ◽  
Greta Amore ◽  
Luigi Vetri ◽  
Giuseppe Quatrosi ◽  
Anna Cafeo ◽  
...  

The cerebellum plays a critical regulatory role in motor coordination, cognition, behavior, language, memory, and learning, hence overseeing a multiplicity of functions. Cerebellar development begins during early embryonic development, lasting until the first postnatal years. Particularly, the greatest increase of its volume occurs during the third trimester of pregnancy, which represents a critical period for cerebellar maturation. Preterm birth and all the related prenatal and perinatal contingencies may determine both dysmaturative and lesional events, potentially involving the developing cerebellum, and contributing to the constellation of the neuropsychiatric outcomes with several implications in setting-up clinical follow-up and early intervention.

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Alex Farr ◽  
Valentina Sustr ◽  
Herbert Kiss ◽  
Ingo Rosicky ◽  
Alexandra Graf ◽  
...  

AbstractThis study aimed to evaluate the potential of oral probiotics to eradicate vaginal GBS colonization during the third trimester of pregnancy. We screened 1058 women for GBS colonization at 33–37 gestational weeks using a combination of vaginal-to-rectal swab and culture-based methods. Women who tested GBS positive were randomized to either the verum group, receiving a dietary probiotic supplement of four viable strains of Lactobacillus twice-daily for 14 days, or to the placebo group. Women underwent follow-up smears, whereat GBS colonization upon follow-up was considered the primary endpoint. We found that 215 women (20.3%) were positive for GBS upon screening, of which 82 (38.1%) were eligible for study inclusion; 41 (50%) of these were randomized to the verum and placebo groups each. After treatment, 21/33 (63.6%) members of the verum group, and 21/27 (77.8%) of the placebo group were still GBS positive (p = 0.24). Four (9.8%) women in the verum group and one (2.4%) in the placebo group experienced preterm birth (p = 0.20); smokers showed significantly higher rates of preterm birth (p = 0.03). Hence, the findings did not support the hypothesis that oral probiotics can eradicate GBS during pregnancy, although we observed a trend toward reduced GBS persistence after probiotic intake.


2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
José Palla Garcia ◽  
Rita Sampaio ◽  
Carlos Peixoto

The urachus is a tubular structure that connects the bladder to the allantois in the embryonic development, involuting after the third trimester. The urachus carcinoma is an extremely rare tumor that accounts for <1% of all bladder cancers. We report a case of a 46-year-old woman, with no past medical history, complaining of hematuria with 6-month duration and a physical exam and an abdominal computed topographic scan revealing an exophytic mass of 6.8 cm longer axis that grew depending on the anterior bladder wall, invading the anterior abdominal wall. Cystoscopy detected mucosal erosion. The biopsy showed structures of adenocarcinoma of enteric type. The surgical specimen showed urachus adenocarcinoma of enteric type with stage IVA in the Sheldon system and stage III in the Mayo system. This case has a 3-year follow-up without disease recurrence.


Author(s):  
Jonathan Gaughran ◽  
Argha Datta ◽  
Judith Hamilton ◽  
Tom Holland ◽  
Ahmad Sayasneh

This case report describes the rare finding of a granulosa cell tumour in the third trimester of pregnancy. The presentation, investigation, management, histopathological findings and subsequent follow up are detailed. The difficulties associated with such diagnoses in pregnancy are explored.


2018 ◽  
Vol 69 (9) ◽  
pp. 1526-1532 ◽  
Author(s):  
Valentine Faure-Bardon ◽  
Jean-François Magny ◽  
Marine Parodi ◽  
Sophie Couderc ◽  
Patricia Garcia ◽  
...  

Abstract Background The known relationship between the gestational age at maternal primary infection an the outcome of congenital CMV is based on small, retrospective studies conducted between 1980 and 2011. They reported that 32% and 15% of cases had sequelae following a maternal primary infection in the first and second or the third trimester, respectively. We aimed to revisit this relationship prospectively between 2011 and 2017, using accurate virological tools. Methods We collected data on women with a primary infection and an infected child aged at least 1 year at the time of analysis. An accurate determination of the timing of the primary infection was based upon serial measurements of immunoglobulin (Ig) M and IgG and on IgG avidity in sera collected at each trimester. The case outcome was assessed according to a structured follow-up between birth and 48 months. Results We included 255 women and their 260 fetuses/neonates. The dating of the maternal infection was prospective in 86% of cases and retrospective in 14%. At a median follow-up of 24 months, the proportion of sensorineural hearing loss and/or neurologic sequelae were 32.4% (95% confidence interval [CI] 23.72–42.09) after a maternal primary infection in the first trimester, 0 (95% CI 0–6.49) after an infection in the second trimester, and 0 (95% CI 0–11.95) after an infection in the third trimester (P < .0001). Conclusions These results suggest that a cytomegalovirus infection can be severe only when the virus hits the fetus in the embryonic or early fetal period. Recent guidelines recommend auditory follow-ups for at least 5 years for all infected children. This raises parental anxiety and generates significant costs. We suggest that auditory and specialized neurologic follow-ups may be recommended only in cases of a maternal infection in the first trimester.


Author(s):  
Parul T. Shah ◽  
Sapana R. Shah ◽  
Sushma R. Shah ◽  
Pushpa A. Yadava ◽  
Babulal S. Patel ◽  
...  

Background: WHO has declared COVID-19 infection a health emergency of international concern on 11th March, 2020. It is not clear whether clinical characteristics of pregnant women with COVID-19 differ from those of nonpregnant women and whether it aggravates COVID-19 symptoms and whether antiviral therapy is necessary for COVID-19 infected pregnant women.Methods: This is prospective study of 125 cases based on the compiled clinical data for pregnant women with COVID-19 between 15th April 2020 and 10th June 2020. A laboratory confirmed positive case of COVID-19 infection in pregnant women were included.Results: The most common symptoms at presentation were cough in 61.6% (77/125) and fever in 46.4% (58/125). Other reported symptoms were sore throat in 13.6% (17/125), myalgia in 10.4% (13/125) while 38.4% (48/125) were asymptomatic. There were total 97 deliveries (including 2 twins’ deliveries) among which 3 cases had IUD. Present study reported 96 live births. The incidence of missed abortion was 2.4% (3/125). The incidence of preterm birth before 37 weeks was 8.2% (8/97). Ninety-six (96.9%) of neonates were tested for SARS-CoV-2 viral nucleic acid on nasopharyngeal and pharyngeal samples and 16.67% (16/96) were resulted positive.Conclusions: At present, there is no evidence regarding the greater risk of pregnant women to succumb to COVID-19 infection and experience severe pneumonia. The risks of spontaneous abortion and preterm birth are not increased as reported in this study but shows possibility of vertical transmission when it manifests during the third trimester of pregnancy.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ya Chen ◽  
Yun Fang Yan ◽  
Ying Zhang ◽  
Xianming Carroll ◽  
Hui Rong Li ◽  
...  

Abstract Background Spontaneous formation of urinoma is a rare condition, especially for pregnant women. We report a patient in the third trimester of pregnancy with a spontaneous renal rupture who then develops a urinoma from urine leaking into the perinephric space. Case presentation A 23-year-old primagravida was diagnosed with a spontaneous renal rupture and acute left loin pain accompanied by hematuria when she was 35 weeks pregnant. A sub-capsular perinephric cyst then developed to a size of 319 × 175 × 253 mm, and because of discomfort to the patient, we performed Cesarean section. After a healthy male newborn was delivered, fluid was suctioned from a large perirenal cyst that had an estimated size of 300 × 200 × 300 mm. A percutaneous nephrostomy tube was left in the cyst until CT showed no remaining fluid. In the six-month follow-up, the patient showed no perirenal extravasation according to an ultrasound scan, and the urine analysis and renal function tests were normal. Conclusion Close follow-up should be recommended for the patient who has renal rupture after conservative therapy, especially for pregnant woman. CT or MRI should be considered in addition to utilizing ultrasound in the management of pregnant women who present with urinomas. Percutaneous nephrostomy is suggested as an appropriate treatment for large urinomas.


Anemia ◽  
2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Bahredin Abdella ◽  
Mohammed Ibrahim ◽  
Iyasu Tadesse ◽  
Kalkidan Hassen ◽  
Mekonnin Tesfa

Background. Anemia in pregnancy is defined as a hemoglobin (Hb) concentration of less than 11 grams (gm)/deciliter (dl) in venous blood. Globally, it affects 1.62 billion people. In developing countries, anemia is a major cause of maternal and child morbidity and mortality. Globally, anemia contributes to 20% of all maternal deaths. Nearly 50% of the world’s population is estimated to be infected with Helicobacter pylori (HP). High prevalence of HP among pregnant women was also reported in developing countries than developed ones. The association between HP infection and occurrence of anemia is not well known in Ethiopia. Therefore, the aim of this study was to determine the association between anemia and Helicobacter pylori infection among pregnant women attending antenatal care follow-up in Kulito Health Center, Halaba Zone, South Ethiopia. Methods. Institution-based cross-sectional study was employed. Systematic random sampling procedure was employed to select 236 pregnant women who attended antenatal care at Kulito Health Center. An interviewer-administered questionnaire supplemented by laboratory tests was used to obtain the data. The collected data were analyzed by using SPSS version 20.0. Results. The prevalence of anemia among antenatal care attendant pregnant women of Kulito Health Center was 27.5% with 36 (15.2%) of mild, 29 (12.3%) of moderate, and no severe cases of anemia. The overall prevalence of HP infection among study participants was found to be 129 (54.7%) (95% CI: 47.9–61.4). Factors significantly associated with anemia were presence of HP infection (AOR = 3.064, 95% CI: 1.336 7.027), low interpregnancy gap (AOR = 2.863, 95% CI: 1.245–6.582), being on the third trimester (AOR = 6.457; 95% CI: 1.276–32.729), and mid-upper arm circumference (MUAC) level <21 cm (AOR = 2.595, 95% CI: 1.044–6.450). Conclusion. This study revealed that anemia and HP infection were highly prevalent among pregnant women attending the antenatal follow-up clinic in Kulito Health Center. HP infection, low interpregnancy gap, being on the third trimester, and MUAC less than 21 cm were the independent factors associated with anemia. Recommendation. Pregnant women should be aware that anemia is a problem that can be prevented by early prevention and treatment of HP infection and undernutrition, using family planning to widen the interpregnancy gap. Further experimental studies are warranted to determine the cause and effect of the association between anemia and HP infection.


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