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Find video protocols related to scientific articles indexed in Pubmed.
First trimester screening for early and late preeclampsia based on maternal characteristics, biophysical parameters, and angiogenic factors.
Prenat. Diagn.
PUBLISHED: 07-22-2014
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The aim of this article is to develop the best first-trimester screening model for preeclampsia (PE) based on maternal characteristics, biophysical parameters, and angiogenic factors in a low-risk population.
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Postsystolic shortening by myocardial deformation imaging as a sign of cardiac adaptation to pressure overload in fetal growth restriction.
Circ Cardiovasc Imaging
PUBLISHED: 06-13-2014
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Fetal growth restriction (FGR) is associated with global adverse cardiac remodeling in utero and increased cardiovascular mortality in adulthood. Prenatal myocardial deformation has not been evaluated in FGR to date. We aimed to evaluate prenatal cardiac remodeling comprehensively in FGR including myocardial deformation imaging.
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A computational model of the fetal circulation to quantify blood redistribution in intrauterine growth restriction.
PLoS Comput. Biol.
PUBLISHED: 06-01-2014
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Intrauterine growth restriction (IUGR) due to placental insufficiency is associated with blood flow redistribution in order to maintain delivery of oxygenated blood to the brain. Given that, in the fetus the aortic isthmus (AoI) is a key arterial connection between the cerebral and placental circulations, quantifying AoI blood flow has been proposed to assess this brain sparing effect in clinical practice. While numerous clinical studies have studied this parameter, fundamental understanding of its determinant factors and its quantitative relation with other aspects of haemodynamic remodeling has been limited. Computational models of the cardiovascular circulation have been proposed for exactly this purpose since they allow both for studying the contributions from isolated parameters as well as estimating properties that cannot be directly assessed from clinical measurements. Therefore, a computational model of the fetal circulation was developed, including the key elements related to fetal blood redistribution and using measured cardiac outflow profiles to allow personalization. The model was first calibrated using patient-specific Doppler data from a healthy fetus. Next, in order to understand the contributions of the main parameters determining blood redistribution, AoI and middle cerebral artery (MCA) flow changes were studied by variation of cerebral and peripheral-placental resistances. Finally, to study how this affects an individual fetus, the model was fitted to three IUGR cases with different degrees of severity. In conclusion, the proposed computational model provides a good approximation to assess blood flow changes in the fetal circulation. The results support that while MCA flow is mainly determined by a fall in brain resistance, the AoI is influenced by a balance between increased peripheral-placental and decreased cerebral resistances. Personalizing the model allows for quantifying the balance between cerebral and peripheral-placental remodeling, thus providing potentially novel information to aid clinical follow up.
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Usefulness of circulating microRNAs for the prediction of early preeclampsia at first-trimester of pregnancy.
Sci Rep
PUBLISHED: 04-10-2014
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To assess the usefulness of circulating microRNAs (miRNAs) as non-invasive molecular biomarkers for early prediction of preeclampsia, a differential miRNA profiling analysis was performed in first-trimester pooled sera from 31 early preeclampsia patients, requiring delivery before 34 weeks of gestation, and 44 uncomplicated pregnancies using microfluidic arrays. Among a total of 754 miRNAs analyzed, the presence of 63 miRNAs (8%) was consistently documented in the sera from preeclampsia and control samples. Nevertheless, only 15 amplified miRNAs (2%) seemed to be differentially, although modestly, represented (fold change range: 0.4-1.4). After stem loop RT-qPCR from individual samples, the statistical analysis confirmed that none of the most consistent and differentially represented miRNAs (3 overrepresented and 4 underrepresented) were differentially abundant in serum from preeclamptic pregnancies compared with serum from normal pregnancies. Therefore, maternal serum miRNA assessment at first-trimester of pregnancy does not appear to have any predictive value for early preeclampsia.
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Added value of angiogenic factors for the prediction of early and late preeclampsia in the first trimester of pregnancy.
Fetal. Diagn. Ther.
PUBLISHED: 04-05-2014
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To explore the predictive role of angiogenic factors for the prediction of early and late preeclampsia (PE) in the first trimester.
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Further insights on diastolic dysfunction in first trimester trisomy 21 fetuses.
Ultrasound Obstet Gynecol
PUBLISHED: 02-20-2014
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The aim of this study was to assess fetal cardiac function in first trimester trisomy 21 fetuses as compared with fetuses with other aneuploidies, euploid fetuses with cardiac defects or isolated increased nuchal translucency and controls.
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The utility of circulating LHCGR as a predictor of Down's syndrome in early pregnancy.
BMC Pregnancy Childbirth
PUBLISHED: 02-09-2014
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Previous studies showed that soluble LHCGR/hCG-sLHCGR concentrations in serum or plasma combined with PAPP-A and free ?hCG significantly increased the sensitivity of Down's syndrome screen at early pregnancy without altering the false positive rate. The goal of the present study was to further examine the role of sLHCGR forms as combinatorial markers and to investigate whether sLHCGR could serve as an independent biomarker for Down's syndrome in first trimester pregnancy screens.
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Automated cardiac sarcomere analysis from second harmonic generation images.
J Biomed Opt
PUBLISHED: 01-29-2014
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Automatic quantification of cardiac muscle properties in tissue sections might provide important information related to different types of diseases. Second harmonic generation (SHG) imaging provides a stain-free microscopy approach to image cardiac fibers that, combined with our methodology of the automated measurement of the ultrastructure of muscle fibers, computes a reliable set of quantitative image features (sarcomere length, A-band length, thick-thin interaction length, and fiber orientation). We evaluated the performance of our methodology in computer-generated muscle fibers modeling some artifacts that are present during the image acquisition. Then, we also evaluated it by comparing it to manual measurements in SHG images from cardiac tissue of fetal and adult rabbits. The results showed a good performance of our methodology at high signal-to-noise ratio of 20 dB. We conclude that our automated measurements enable reliable characterization of cardiac fiber tissues to systematically study cardiac tissue in a wide range of conditions.
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Levels of maternal serum angiogenic factors in third-trimester normal pregnancies: reference ranges, influence of maternal and pregnancy factors and fetoplacental Doppler indices.
Fetal. Diagn. Ther.
PUBLISHED: 01-23-2014
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To establish normal ranges of maternal placental growth factor (PlGF), soluble fms-like tyrosine kinase-1 (sFlt-1) and sFlt-1/PlGF ratio at 32-41 weeks' gestation and to evaluate the influence of maternal characteristics, and of fetoplacental Doppler.
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Cardiac dysfunction is associated with altered sarcomere ultrastructure in intrauterine growth restriction.
Am. J. Obstet. Gynecol.
PUBLISHED: 01-15-2014
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The purpose of this study was to assess whether abnormal cardiac function in human fetuses with intrauterine growth restriction (IUGR) is associated with ultrastructural differences in the cardiomyocyte sarcomere.
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Permanent cardiac sarcomere changes in a rabbit model of intrauterine growth restriction.
PLoS ONE
PUBLISHED: 01-01-2014
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Intrauterine growth restriction (IUGR) induces fetal cardiac remodelling and dysfunction, which persists postnatally and may explain the link between low birth weight and increased cardiovascular mortality in adulthood. However, the cellular and molecular bases for these changes are still not well understood. We tested the hypothesis that IUGR is associated with structural and functional gene expression changes in the fetal sarcomere cytoarchitecture, which remain present in adulthood.
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Intrauterine growth restriction is associated with cardiac ultrastructural and gene expression changes related to the energetic metabolism in a rabbit model.
Am. J. Physiol. Heart Circ. Physiol.
PUBLISHED: 10-04-2013
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Intrauterine growth restriction (IUGR) affects 7-10% of pregnancies and is associated with cardiovascular remodeling and dysfunction, which persists into adulthood. The underlying subcellular remodeling and cardiovascular programming events are still poorly documented. Cardiac muscle is central in the fetal adaptive mechanism to IUGR given its high energetic demands. The energetic homeostasis depends on the correct interaction of several molecular pathways and the adequate arrangement of intracellular energetic units (ICEUs), where mitochondria interact with the contractile machinery and the main cardiac ATPases to enable a quick and efficient energy transfer. We studied subcellular cardiac adaptations to IUGR in an experimental rabbit model. We evaluated the ultrastructure of ICEUs with transmission electron microscopy and observed an altered spatial arrangement in IUGR, with significant increases in cytosolic space between mitochondria and myofilaments. A global decrease of mitochondrial density was also observed. In addition, we conducted a global gene expression profile by advanced bioinformatics tools to assess the expression of genes involved in the cardiomyocyte energetic metabolism and identified four gene modules with a coordinated over-representation in IUGR: oxygen homeostasis (GO: 0032364), mitochondrial respiratory chain complex I (GO:0005747), oxidative phosphorylation (GO: 0006119), and NADH dehydrogenase activity (GO:0003954). These findings might contribute to changes in energetic homeostasis in IUGR. The potential persistence and role of these changes in long-term cardiovascular programming deserves further investigation.
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A fetal cardiovascular score to predict infant hypertension and arterial remodeling in intrauterine growth restriction.
Am. J. Obstet. Gynecol.
PUBLISHED: 09-09-2013
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Intrauterine growth restricted (IUGR) fetuses suffer cardiovascular remodeling which persists into infancy and has been related to cardiovascular outcomes in adulthood. Hypertension in infancy has been demonstrated to be a strong risk factor for later cardiovascular disease. Close monitoring together with dietary interventions have shown to improve cardiovascular health in hypertensive children; however, not all IUGR show increased blood pressure. We evaluated the potential of fetal echocardiography for predicting hypertension and arterial remodeling in 6 month old IUGR infants.
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Assisted reproductive technologies are associated with cardiovascular remodeling in utero that persists postnatally.
Circulation
PUBLISHED: 08-28-2013
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Assisted reproductive technologies (ARTs) have been shown to be associated with general vascular dysfunction in late childhood. However, it is unknown whether cardiac remodeling is also present and if these changes already manifest in prenatal life. Our aim was to assess fetal and infant (6 months of age) cardiovascular function in ART pregnancies.
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Prognostic Role of Maternal Neutrophil Gelatinase-Associated Lipocalin in Women with Severe Early-Onset Preeclampsia.
Fetal. Diagn. Ther.
PUBLISHED: 07-30-2013
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Introduction: The association between maternal plasma levels of neutrophil gelatinase-associated lipocalin (NGAL) and maternal complications in women admitted with severe early-onset preeclampsia was evaluated. Material and Methods: Plasma levels of NGAL were measured at admission in patients with severe early-onset (presenting before 34 weeks) preeclampsia. The maternal outcome of women with elevated plasma levels was compared with those with normal levels. Maternal complications included eclampsia, HELLP syndrome, acute renal failure, subcapsular hepatic hematoma, pulmonary edema and disseminated intravascular disease. Results: Sixty-seven patients were included. The median NGAL plasma levels in the group of women who subsequently had a complication were significantly higher than in those uncomplicated cases (114.8 vs. 84.2 ng/ml; Mann-Whitney U test p = 0.03). Maternal complications were more common in the elevated (>100 ng/ml) NGAL group (58.3 vs. 25.6%; ?(2) test p = 0.008), with an OR of 4.1 (95% CI 1.4-11.8). After adjustment by gestational age at onset, the association between elevated NGAL plasma levels and maternal complications remained significant (OR 4.2; 95% CI 1.4-12.4). Discussion: Women with severe early-onset preeclampsia are at higher risk of maternal complications if plasma levels of NGAL are elevated. © 2013 S. Karger AG, Basel.
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Dysregulation of hydrogen sulfide producing enzyme cystathionine ?-lyase contributes to maternal hypertension and placental abnormalities in preeclampsia.
Circulation
PUBLISHED: 05-23-2013
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The exact etiology of preeclampsia is unknown, but there is growing evidence of an imbalance in angiogenic growth factors and abnormal placentation. Hydrogen sulfide (H2S), a gaseous messenger produced mainly by cystathionine ?-lyase (CSE), is a proangiogenic vasodilator. We hypothesized that a reduction in CSE activity may alter the angiogenic balance in pregnancy and induce abnormal placentation and maternal hypertension.
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Long-Term Follow-Up of Intrauterine Growth Restriction: Cardiovascular Disorders.
Fetal. Diagn. Ther.
PUBLISHED: 05-15-2013
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In the modern world, cardiovascular disorders are the leading cause of mortality in developed countries, which in most cases undergo a long subclinical phase that can last decades before the first clinical symptoms appear. Aside from the well-known risk factors related to lifestyle and genetics, there is growing evidence that in a proportion of cases, the predisposition to cardiovascular disease lies in prenatal life. Moreover, numerous historical cohort studies and animal models have shown a clear association between low birth weight and increased cardiovascular mortality in adulthood, including increased risk of hypertension, diabetes, dyslipidemia and coagulation disorders in children and adults. Besides premature birth, low birth weight in the majority of the cases is caused by intrauterine growth restriction (IUGR), which affects up to 10% of all births. Several clinical and experimental studies showed that IUGR fetuses present signs of cardiac dysfunction in utero that persist postnatally and may condition higher cardiovascular risk later in life. The present review discusses the importance of the long-term cardiovascular follow-up of the patients who suffered early or late IUGR in utero, particularly with regard to the long-term epidemiological studies in adults, prospective studies in children and the possible mechanisms that trigger IUGR and cardiovascular programming. Considering the high prevalence of IUGR and the progressing availability of intervention strategies, it is of the highest clinical relevance to detect cardiovascular risks as early as possible, to introduce timely preventive interventions and to adapt the lifestyle, in order to improve the long-term cardiovascular health outcome of IUGR cases.
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Patterns of maternal vascular remodeling and responsiveness in early- versus late-onset preeclampsia.
Am. J. Obstet. Gynecol.
PUBLISHED: 04-22-2013
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We sought to assess vascular structure and function in early- and late-onset preeclampsia (PE) at the time of diagnosis.
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Metabolomic Profile of Umbilical Cord Blood Plasma from Early and Late Intrauterine Growth Restricted (IUGR) Neonates with and without Signs of Brain Vasodilation.
PLoS ONE
PUBLISHED: 01-01-2013
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To characterize via NMR spectroscopy the full spectrum of metabolic changes in umbilical vein blood plasma of newborns diagnosed with different clinical forms of intrauterine growth restriction (IUGR).
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Loss of Akt activity increases circulating soluble endoglin release in preeclampsia: identification of inter-dependency between Akt-1 and heme oxygenase-1.
Eur. Heart J.
PUBLISHED: 03-16-2011
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Endothelial dysfunction is a hallmark of preeclampsia. Desensitization of the phosphoinositide 3-kinase (PI3K)/Akt pathway underlies endothelial dysfunction and haeme oxygenase-1 (HO-1) is decreased in preeclampsia. To identify therapeutic targets, we sought to assess whether these two regulators act to suppress soluble endoglin (sEng), an antagonist of transforming growth factor-? (TGF-?) signalling, which is known to be elevated in preeclampsia.
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Changes in central and peripheral circulation in intrauterine growth-restricted fetuses at different stages of umbilical artery flow deterioration: new fetal cardiac and brain parameters.
Gynecol. Obstet. Invest.
PUBLISHED: 02-24-2011
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To evaluate changes in central and peripheral circulation, including new and standard parameters of the fetal brain and heart in fetuses with intrauterine growth restriction (IUGR) in relation to progressive deterioration of the umbilical artery (UA).
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Tissue Doppler echocardiographic markers of cardiac dysfunction in small-for-gestational age fetuses.
Am. J. Obstet. Gynecol.
PUBLISHED: 02-01-2011
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The objective of the study was to evaluate echocardiographic markers of cardiac dysfunction in small-for-gestational age (SGA) fetuses with normal umbilical artery Doppler.
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Differential effects of intrauterine growth restriction on brain structure and development in preterm infants: a magnetic resonance imaging study.
Brain Res.
PUBLISHED: 01-10-2011
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Previous evidence suggests that preterm newborns with intrauterine growth restriction (IUGR) have specific neurostructural and neurodevelopmental anomalies, but it is unknown whether these effects persist in early childhood. We studied a sample of 18 preterm IUGR, 15 preterm AGA - born between 26 and 34 weeks of gestational age (GA) - and 15 healthy born-term infants. Infants were scanned at 12 months corrected age (CA), in a 3T scanner, without sedation. Analyses were made by automated lobar volumetry and voxel-based morphometry (VBM). The neurodevelopmental outcome was assessed in all subjects at 18 months CA with the Bayley Scale for Infant and Toddler Development, third edition. IUGR infants had reduced relative volumes for the insular and temporal lobes. According to VBM, IUGR infants had bilateral reduced gray matter (GM) in the temporal, parietal, frontal, and insular regions compared with the other groups. IUGR infants had increased white matter (WM) in temporal regions compared to the AGA group and in frontal, parietal, occipital, and insular regions compared to the term group. They also showed decreased WM in the cerebellum and a non-significant trend in the hippocampus compared to term infants. IUGR infants had reduced neurodevelopmental scores, which were positively correlated with GM in various regions. These data suggest that the IUGR induces a distinct brain pattern of structural changes that persist at 1 year of life and are associated with specific developmental difficulties.
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Selective intrauterine growth restriction in monochorionic twins: pathophysiology, diagnostic approach and management dilemmas.
Semin Fetal Neonatal Med
PUBLISHED: 08-03-2010
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Selective intrauterine growth restriction (sIUGR) in monochorionic twins is associated with a substantial increase in perinatal mortality and morbidity for both twins. Clinical evolution depends on the combination of the effects of placental insufficiency in the IUGR twin with inter-twin blood transfer through placental anastomoses. Classification of sIUGR into types according to the characteristics of umbilical artery diastolic flow in the IUGR twin permits the differentiation of clinical and prognostic groups. sIUGR type I has normal diastolic flow and relatively good outcome. Type II is defined by persistently absent/reverse end-diastolic flow and is associated with a high risk of intrauterine demise of the IUGR twin and/or very preterm delivery. Type III is defined by the presence of intermittent absent/reverse end-diastolic flow (iAREDF), and is associated with 10-20% risk of unexpected fetal demise of the smaller twin and 10-20% risk of neurological injury in the larger twin. The management strategy for sIUGR with abnormal umbilical artery Doppler (types II and III) remains a challenge, and may include elective fetal therapy or close surveillance with fetal therapy or elective delivery in the presence of severe fetal deterioration. Small clinical series reporting the use of cord occlusion or laser therapy in severe cases suggest that the outcome of the larger twin might be improved. There is probably no single optimal strategy, since decisions will ultimately be influenced by the severity of IUGR, gestational age, parents wishes and technical issues.
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Fetal growth restriction results in remodeled and less efficient hearts in children.
Circulation
PUBLISHED: 05-24-2010
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Fetal growth restriction (FGR) affects 5% to 10% of newborns and is associated with increased cardiovascular mortality in adulthood. The most commonly accepted hypothesis is that fetal metabolic programming leads secondarily to diseases associated with cardiovascular disease, such as obesity, diabetes mellitus, and hypertension. Our main objective was to evaluate the alternative hypothesis that FGR induces primary cardiac changes that persist into childhood.
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Clinical and biochemical predictors of very preterm birth in twin-to-twin transfusion syndrome treated by fetoscopy.
Am. J. Obstet. Gynecol.
PUBLISHED: 04-16-2010
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To evaluate pre- and postoperative predictors of preterm birth in twin-to-twin transfusion syndrome treated with fetoscopic placental laser coagulation.
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Usefulness of myocardial tissue Doppler vs conventional echocardiography in the evaluation of cardiac dysfunction in early-onset intrauterine growth restriction.
Am. J. Obstet. Gynecol.
PUBLISHED: 02-16-2010
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To evaluate cardiac function by tissue Doppler imaging vs conventional echocardiography in intrauterine growth restriction.
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The prognostic role of uterine artery Doppler investigation in patients with severe early-onset preeclampsia.
Am. J. Obstet. Gynecol.
PUBLISHED: 01-19-2010
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The purpose of this study was to evaluate the prediction capacity of uterine artery Doppler investigation for maternal and neonatal complications in women who are admitted with severe early-onset preeclampsia.
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Prognostic role of uterine artery Doppler in patients with preeclampsia.
Fetal. Diagn. Ther.
PUBLISHED: 06-29-2009
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To evaluate the predictive capacity of umbilical, cerebral and uterine artery Doppler in women admitted for preeclampsia (PE).
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Hypoxia induces dilated cardiomyopathy in the chick embryo: mechanism, intervention, and long-term consequences.
PLoS ONE
PUBLISHED: 01-27-2009
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Intrauterine growth restriction is associated with an increased future risk for developing cardiovascular diseases. Hypoxia in utero is a common clinical cause of fetal growth restriction. We have previously shown that chronic hypoxia alters cardiovascular development in chick embryos. The aim of this study was to further characterize cardiac disease in hypoxic chick embryos.
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Performance of a first-trimester screening of preeclampsia in a routine care low-risk setting.
Am. J. Obstet. Gynecol.
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We sought to evaluate the effectiveness of an integrated first-trimester screening test to predict preeclampsia (PE).
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Risk of perinatal death in early-onset intrauterine growth restriction according to gestational age and cardiovascular Doppler indices: a multicenter study.
Fetal. Diagn. Ther.
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To assess the value of gestational age and cardiovascular Doppler indices in predicting perinatal mortality in a multicenter cohort of early-onset intrauterine growth-restricted (IUGR) fetuses.
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Feasibility and reproducibility of a standard protocol for 2D speckle tracking and tissue Doppler-based strain and strain rate analysis of the fetal heart.
Fetal. Diagn. Ther.
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Assessment of cardiac function in the fetal heart is challenging because of its small size and high heart rate, restricted physical access to the fetus, and impossibility of fetal ECG recording. We aimed to standardize the acquisition and postprocessing of fetal echocardiography for deformation analysis and to assess its feasibility, reproducibility, and correlation for longitudinal strain and strain rate measurements by tissue Doppler imaging (TDI) and 2D speckle tracking (2D-strain) during pregnancy.
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Cardiovascular programming in children born small for gestational age and relationship with prenatal signs of severity.
Am. J. Obstet. Gynecol.
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The objective of the study was to evaluate cardiovascular function in children who were small-for-gestational-age (SGA) fetuses.
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Assessment of fetal cardiac function using tissue Doppler techniques.
Fetal. Diagn. Ther.
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Tissue Doppler echocardiography is being increasingly used in fetal medicine as a clinical and research tool. The objective of this study was to review the current status of tissue Doppler imaging (TDI) techniques applied to the fetus.
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Fetal cardiac function: technical considerations and potential research and clinical applications.
Fetal. Diagn. Ther.
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Fetal echocardiography was initially used to detect structural anomalies but has more recently also been proposed to assess fetal cardiac function. This review summarizes technical issues and limitations in fetal cardiac function evaluation, as well as its potential research and clinical applications. Functional echocardiography has been demonstrated to select high-risk populations and to be associated with outcome in several fetal conditions including intrauterine growth restriction, twin-to-twin transfusion syndrome, maternal diabetes, and congenital diaphragmatic hernia. Fetal heart evaluation is challenging due to the smallness and high heart rate of the fetus and restricted access to the fetus far from the transducer. Due to these limitations and differences in cardiac function which are related to fetal maturation, cardiovascular parameters should be validated in the fetus and used with caution. Despite these precautions, in expert hands and with appropriate ultrasound equipment, evaluation of cardiac function is feasible in most fetuses. Functional fetal echocardiography is a promising tool that may soon be incorporated into clinical practice. Research is warranted to further refine the contribution of fetal cardiac assessment to the diagnosis, monitoring, or prediction of outcomes in various fetal conditions.
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JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

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In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.