Fetal Medicine

The case of prenatally diagnosed isolated complete atrioventricular block  presented. There were no complications of the cardiovascular system during an observation throughout the prenatal period and after birth and therefore the tretment of this type of arrhythmia may be inexpedience. This is also consistent with  literature  review.

Aim of the study: Is to evaluate factors most correlated to homeostatic model analysis (HOMA-IR) and to construct a formula which can predict HOMA from the cheaper biochemical, biophysical and hormonal risk factors. Study design; case control Methods: A total of 34 patients with polycystic ovarian syndrome were recruited from infertility clinic in Al-Yarmuok teaching hospital. From the epidemiological characteristics the following were recorded: BMI, waist to hip ratio, menstrual cycle, hirsutism which was scored by modified Ferriman Gallwey system and the mean ovarian volume from measuring both ovaries while from the hormonal and biochemical variables, luteinizing hormone and follicle stimulating hormone, total testosterone and lipid profile were measured for each patient. For each group of variables stepwise regression followed by best subset regression were implemented to isolate the factors most correlated with HOMA. Coefficient of Mallows (Cp) was used to sort out the single mo...

This chapter introduces the concept of fetal palaeopathology in archaeological material, highlighting the limitations and potential of such research to inform us about the lives of mothers and their babies in the past. Problems with terminology, ageing methods, preservation and recognising lesions in skeletal remains are discussed, before potential new sources of research are highlighted.

Abstract Idiopathic arterial calcification of infancy is a rare autosomal recessive disease, characterized by deposition of calcium along the internal elastic membrane of arteries, accompanied by fibrous thickening of the intima which causes luminal narrowing. We hereby report a series of 20 cases seen over a period of 10 years. Nineteen cases were reported as idiopathic arterial calcification and one was reported as arterial calcification in a twin reversed arterial perfusion sequence. The sites of calcification were mainly aortic valve and root of aorta which was involved in 100% of cases followed by pulmonary artery up to its branches in 18 (90%) cases. There was recurrence in the subsequent pregnancies in three of the cases. Genetic association with ENPP1 was proved in one case. There was no survival in all the cases. Thus, the prognosis of idiopathic arterial calcification is very poor with very few long-term survivors.

MRI has been increasingly used for detailed visualization of the fetus in utero as well as pregnancy structures. Yet, the familiarity of radiologists and clinicians with fetal MRI is still limited. This article provides a practical approach to fetal MR imaging. Fetal MRI is an interactive scanning of the moving fetus owed to the use of fast sequences. Single-shot fast spin-echo (SSFSE) T2-weighted imaging is a standard sequence. T1-weighted sequences are primarily used to demonstrate fat, calcification and hemorrhage. Balanced steady-state free-precession (SSFP), are beneficial in demonstrating fetal structures as the heart and vessels. Diffusion weighted imaging (DWI), MR spectroscopy (MRS), and diffusion tensor imaging (DTI) have potential applications in fetal imaging. Knowing the developing fetal MR anatomy is essential to detect abnormalities. MR evaluation of the developing fetal brain should include recognition of the multilayered-appearance of the cerebral parenchyma, knowledge of the timing of sulci appearance, myelination and changes in ventricular size. With advanced gestation, fetal organs as lungs and kidneys show significant changes in volume and T2-signal. Through a systematic approach, the normal anatomy of the developing fetus is shown to contrast with a wide spectrum of fetal disorders. The abnormalities displayed are graded in severity from simple common lesions to more complex rare cases. Complete fetal MRI is fulfilled by careful evaluation of the placenta, umbilical cord and amniotic cavity. Accurate interpretation of fetal MRI can provide valuable information that helps prenatal counseling, facilitate management decisions, guide therapy, and support research studies. ª 2013 Production and hosting by Elsevier B.V. on behalf of Cairo University. Sahar N. Saleem studied medicine at Cairo University-Egypt where she earned her Master degree and Medical Doctorate in Radiology. She did Fellowships in Neuroradiology as well as in Education and Research at the University of Western Ontario-Canada. She currently works as a Professor of Radiology at Cairo University-Egypt. Saleem is specialized in advanced imaging technology. She is a pioneer in fetal Magnetic Resonance Imaging (MRI). Her achievements include proposal of the first protocol of MRI of the fetal heart, screening of fetal brain anomalies, and describing several new syndromes. Saleem has also publications in neuro-imaging, education, and studies of the mummies.

J Babol Univ Med Sci; 20(5); May 2018; PP: 38-47 Received: Aug 4 2017, Revised: Nov 29 2017, Accepted: Dec 24 2017. ABSTRACT BACKGROUND AND OBJECTIVE: Health promoting lifestyle is any kind of action that is taken to maintain the health of the individual. Healthy lifestyle plays an important role in improving the maternal-fetal outcomes. The aim of this study is to determine the effect of training pregnant women and their husbands on health promoting lifestyle. METHODS: This clinical trial was conducted among 189 pregnant women in the city of Bukan, Iran. Participants were categorized into three groups: the recipients of the training along with their husbands (the first intervention group), the recipients of the training without their husbands (the second group of intervention) and the routine care recipients (control group). Four sessions of group training were held for mothers of both interventional groups and one group training session was held for the mothers of the first interv...

The intravascular volume load that an anemic fetus can tolerate was studied retrospectively in 124 consecutive intravascular transfusions in 35 erythroblastotic fetuses. The tolerated volume load correlated well to the estimated fetal weight. Transfusion volume loads above 20 ml/kg of the estimated fetal weight resulted in a lower fetal survival. We recommend an upper transfusion limit at 20 ml/kg corresponding to approximately 20% of the feto-placental blood volume.

ObjectivesFollowing perinatal death, organ weights at autopsy may provide evidence of growth restriction and pulmonary hypoplasia. Whilst postmortem magnetic resonance imaging (MRI) may provide comparable information to autopsy about structural abnormalities, its ability to provide reproducible data about organ size has yet to be determined. We examined the feasibility of using postmortem MRI to provide estimates of organ size and weight.Following perinatal death, organ weights at autopsy may provide evidence of growth restriction and pulmonary hypoplasia. Whilst postmortem magnetic resonance imaging (MRI) may provide comparable information to autopsy about structural abnormalities, its ability to provide reproducible data about organ size has yet to be determined. We examined the feasibility of using postmortem MRI to provide estimates of organ size and weight.MethodsTwenty-five fetuses of gestational age from 16 to 40 weeks underwent postmortem MRI prior to autopsy. Fetal lung, brain and liver volume estimations were performed by two observers using the stereology technique on postmortem MRI slices. Fetal lung, brain and liver weights were recorded at autopsy. Organ volume estimates and autopsy organ weights were compared using regression analysis, and estimates of fetal organ densities made. Interobserver variability was assessed using a Bland–Altman plot. Receiver–operating characteristics curve (ROC) analysis compared MRI brain : liver volume ratios to autopsy brain : liver weight ratios.Twenty-five fetuses of gestational age from 16 to 40 weeks underwent postmortem MRI prior to autopsy. Fetal lung, brain and liver volume estimations were performed by two observers using the stereology technique on postmortem MRI slices. Fetal lung, brain and liver weights were recorded at autopsy. Organ volume estimates and autopsy organ weights were compared using regression analysis, and estimates of fetal organ densities made. Interobserver variability was assessed using a Bland–Altman plot. Receiver–operating characteristics curve (ROC) analysis compared MRI brain : liver volume ratios to autopsy brain : liver weight ratios.ResultsA linear relationship between organ volume estimates and organ weight was observed. Estimated densities for the fetal brain, liver and lung were 1.08 g/cm3, 1.15 g/cm3 and 1.15 g/cm3, respectively. Interobserver 5th and 95th percentile limits of agreement for fetal brain, liver and lung were − 5.4% to + 7.9%, − 11.8% to + 8.3% and − 14.3% to + 8.7%, respectively. For MRI organ volumes to detect a brain weight : liver weight ratio ≥ 4, ROC analysis demonstrated an area under the curve of 0.61, with an optimal cut-off of 4.1.A linear relationship between organ volume estimates and organ weight was observed. Estimated densities for the fetal brain, liver and lung were 1.08 g/cm3, 1.15 g/cm3 and 1.15 g/cm3, respectively. Interobserver 5th and 95th percentile limits of agreement for fetal brain, liver and lung were − 5.4% to + 7.9%, − 11.8% to + 8.3% and − 14.3% to + 8.7%, respectively. For MRI organ volumes to detect a brain weight : liver weight ratio ≥ 4, ROC analysis demonstrated an area under the curve of 0.61, with an optimal cut-off of 4.1.ConclusionPostmortem MRI organ volumetry can be used to estimate weights of major fetal organs. This may increase the information obtained from a minimally-invasive perinatal autopsy, particularly in the context of pulmonary hypoplasia and intrauterine growth restriction, where differential organ growth plays a major part in assessment of the underlying pathology. Copyright © 2007 ISUOG. Published by John Wiley & Sons, Ltd.Postmortem MRI organ volumetry can be used to estimate weights of major fetal organs. This may increase the information obtained from a minimally-invasive perinatal autopsy, particularly in the context of pulmonary hypoplasia and intrauterine growth restriction, where differential organ growth plays a major part in assessment of the underlying pathology. Copyright © 2007 ISUOG. Published by John Wiley & Sons, Ltd.