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Biomedical subjects

C Romanini

Publications and source records attributed to C Romanini.

At least 199 records · Page 11Linked to original sources
PubMed1989

Umbilical cord blood rheology in relation to maternal disease and fetal hypoxia.

Erythrocyte aggregation was studied in 60 samples of cord blood taken at delivery from neonates whose mothers suffered from hypertension or diabetes in pregnancy or from neonates who showed hypoxia during labor. Erythrocyte aggregation significantly increased in the cord blood of neonates who suffered from hypoxia during labor, and in neonates from hypertensive and diabetic mothers. The effects of maternal disease or intrapartum hypoxia may therefore stimulate fetal erythropoiesis and cause major changes in cord blood rheology.

Erythrocyte Aggregation↗
PubMed1989

Tryptophan availability and fetal behavioral states.

Behavioral state instability in growth-retarded fetuses might be related to a decrease in serotonine production. Tryptophan maternal and cord blood values after elective cesarean section have been investigated by means of high performance liquid chromatography in 20 growth-retarded fetuses due to pregnancy-induced hypertension (PIH) and 20 normal pregnancies as control group. The feto-maternal ratio of tryptophan is significantly higher in normal fetuses than in PIH growth-retarded fetuses (p less than 0.001). Behavioral states have been determined 1 week and just before cesarean section. Values of 1F, 2F, 3F and 4F differ in the 2 groups (p less than 0.001). A higher percentage of non-coincidences (p less than 0.001) and state interruptions (p less than 0.001) is found in PIH fetuses. A significant correlation is demonstrated between the increase of non-coincidences and decrease in the feto-maternal Trp ratio (p less than 0.001).

Female↗
PubMed1989

Morphological development of the human placenta in normal and complicated gestation: a quantitative and ultrastructural study.

In order to evaluate the structural potentialities of the placenta, we analyzed placentas in the following conditions: normal full term gestation, hypertensive status, twin pregnancy and abortion at 8-12 weeks of gestation, comparing cell structures, surface organization and tissue reaction. We quantitatively evaluated (1) the arborization of the placental villous tree, and (2) the microvillous density per unit of surface area, paralleling these data with ultrastructural and immunohistochemical features. In early gestation (8-12 weeks of pregnancy) the limited degree of branching of placental villi parallels a reduced number of clefts per unit of surface area (0.7/1,000 microns2), if compared with controls (2.7/1,000 microns2). In the full term twin placenta, the number of furrows is 2.26/1,000 microns2: this value reflects a low arborization potentiality, testifying to a low placental maturity. On the contrary, a high branching of the placental villous tree is present at term in hypertension. In this gestational condition, the number of sulci of 3.1/1,000 microns2 reveals a compensatory attitude of the placenta, aiming to sustain the impaired fetal-maternal metabolic interchange. In all these cases, syncytiotrophoblastic microvilli are reduced in number in comparison with the normal placenta, and this is likely to be an expression of a low trophoblastic maturation degree. The placenta is a barrier with a highly specialized function that conditions fetal outgrowth, and microenvironmental modifications are promptly faced by this structure through morphofunctional modulations.

Female↗
PubMed1989

Are blood flow velocity waveforms related to umbilical cord acid-base status in the human fetus?

Doppler blood flow velocity waveforms from fetal umbilical artery, descending aorta, internal carotid artery and maternal uterine arteries were recorded in 50 fetuses near term undergoing cesarean section before the onset of labor in order to evidence eventual relationships with the fetal acid-base status. The primary indications for cesarean section were in 16 cases an elective repeated cesarean section and in the remaining cases maternal hypertension often associated with fetal growth retardation and/or fetal distress. The technique of anesthesia was strictly standardized and fetal blood gas levels and acid-base status were analyzed in umbilical artery and vein immediately after birth. A significant correlation was found between the pulsatility index from internal carotid artery and the pO2 levels in umbilical vein (r = 0.87; p less than or equal to 0.001). Similar relationships were found between the pulsatility index from descending aorta and the pCO2 (r = 0.78; p less than or equal to 0.001), base excess (r = 0.72; p less than or equal to 0.001) and pH (r = 0.80; p less than or equal to 0.001) levels in umbilical artery. It is suggested that Doppler ultrasound could be useful in the diagnosis of fetal hypoxia and acidosis.

Acid-Base Equilibrium↗
PubMed1989

Hemodynamic changes in growth retarded fetuses during maternal oxygen administration as predictors of fetal outcome.

The changes in fetal hemodynamics during maternal administration of 60% humidified oxygen were assessed by Doppler ultrasonography in 15 growth retarded fetuses characterized by abnormal blood flow velocity waveforms. During oxygen treatment, nine fetuses exhibited temporary hemodynamic modifications as expressed by a recovery toward the normal range of vascular impedance in the descending aorta and internal carotid artery, whereas no changes were found in the remaining six fetuses. In this latter group, a rapid deterioration of fetal condition occurred and all the fetuses were delivered by emergency cesarean section within 9 days from the Doppler examination. The absence of recovery of vascular resistance during acute maternal oxygen administration seems therefore to be a useful marker of imminent acute distress in fetuses with growth retardation secondary to chronic hypoxia.

Blood Flow Velocity↗
PubMed1989

Prenatal cerebral Doppler ultrasonography and neonatal neurologic outcome.

The significance of fetal cerebral blood flow analysis in the prediction of neonatal neurologic outcome was investigated on 87 fetuses at risk for chronic hypoxia. Blood flow velocity waveforms were recorded from the fetal internal carotid artery immediately before cesarean section; newborns underwent neurologic follow-up until discharged from the neonatal division. Neonatal outcome was considered abnormal in presence of a postasphyxial encephalopathy. Receiver operating characteristic curves were used to demonstrate the efficacy of fetal cerebral blood flow velocity waveform analysis as a predictor of neonatal outcome. A value of the pulsatility index from the internal carotid artery below the second standard deviation of our range of normality was found to be a powerful indicator of the development of neonatal neurologic abnormalities (Cohen's Kappa index = .58). These results were particularly evident in fetuses with a birthweight above 2500 g in which a specificity of 93.7%, a sensitivity of 75%, and an accuracy of 89.7% were achieved.

Central Nervous System Diseases↗
PubMed1989

[Hypertension and syncytiotrophoblast: morpho-structural aspects].

Hypertension is a pathological condition that involves maternal fetal relationship. In hypertension placenta displays a syncytiotrophoblast plasmalemma with aspects of anomalous behaviour concerning Intramembranous Particles (IMP) and actin content of microvilli cytoskeleton. Decrease of syncytiotrophoblast microvilli IMP and microvilli actin further sustain the tendency of hypertensive placenta to show some features of immaturity that might deeply influence fetal-maternal exchanges during pregnancy associated with pathological status.

Calcium↗
PubMed1989

Molecular alterations induced by hypertension in pregnancy on syncythiotrophoblast plasma membranes from human placenta.

To evaluate the possible functional relationships between hypertensive status and syncythiotrophoblast plasma membrane behaviour we have carried out a freeze-fracturing and biochemical investigation to assess: 1) ultrastructurally, relations between number and diameter of Intramembrane Particles (IMP) and hypertensive conditions; 2) biochemically, actin content of microvilli in this pathological status. Our data in vitro show a decrease of IMP in hypertension before and after Ca++ addition and a decrease of actin in microvilli of hypertensive placenta. These observations seem to be in agreement with the hypothesis of a possible structural immaturity in hypertensive placenta and may represent morphological signs of placental insufficiency.

Actins↗
PubMed1988

Computer-assisted analysis of fetal behavioural states.

A computerized system which simultaneously acquires and quantifies several ultrasonically detected fetal activities, including gross body movements, breathing movements, and eye movements, was developed in order to obtain additional quantitative data on fetal behaviour. Movements were automatically related to fetal heart rate allowing computation of their mean incidence, duration, lag time and percentage time spent moving during different heart rate patterns. The incidence of various behavioural states was also calculated. The study of 15 healthy fetuses near term revealed the existence of statistically significant differences in these parameters between low and high variability patterns of fetal heart rate suggesting a quantitative modulation of fetal movements by behavioural states.

Computer Graphics↗
PubMed1988

Short-term effects of maternal oxygen administration on blood flow velocity waveforms in healthy and growth-retarded fetuses.

To determine whether maternal oxygen administration affects fetal hemodynamics, we investigated 10 healthy fetuses and 10 growth-retarded fetuses near term by means of Doppler ultrasonography. The growth-retarded fetuses were characterized by abnormal blood flow velocity waveforms. Velocity waveforms were simultaneously recorded at 5-minute intervals from the fetal descending aorta and internal carotid artery before, during, and after maternal oxygen administered through a face mask that delivered 60% oxygen. The pulsatility index was calculated. During oxygen treatment growth-retarded fetuses showed significant temporary hemodynamic modifications as expressed by changes of pulsatility index values that increased in the internal carotid artery and decreased at the level of the descending aorta. On the other side no changes were found in healthy fetuses. These findings suggest that maternal oxygen administration can modify fetal hemodynamics in cases of growth retardation associated with abnormal blood flow velocity waveforms.

Analysis of Variance↗
PubMed1988

Abnormal membrane cation transport in pregnancy-induced hypertension.

An abnormality of sodium handling has been suggested as one of the mechanisms responsible for the development of pregnancy-induced hypertension. We analysed the plasma and urinary concentrations, and the intraerythrocyte activities of Na and K, and the RBC membrane Na+/K+-ATPase activity of 77 hypertensive and 133 normal pregnant women. Umbilical cord blood of infants from 21 hypertensive and 28 control women was studied. The Na+/K+-ATPase activity was determined by measuring the inorganic phosphate released by incubation in a reaction medium in the presence and absence of K ions or ouabain. The intra-erythrocyte sodium and potassium activities were measured by ion-selective electrode analysis of the haemolysates, after washing the RBCs in 110 mmol/l MgCl2. We found a significant increase in intracellular sodium and a reduction in Na+/K+-ATPase activity in the hypertensive women in comparison with the control subjects during pregnancy. No difference was observed in early puerperium. Cord blood from infants of pregnancy-induced hypertensive women showed an increase in intracellular Na+ activity and a decrease in the erythrocyte membrane Na+/K+-ATPase activity in comparison with cord blood samples from control subjects. The observed abnormalities in the plasma membrane sodium transport may play a major role in the pathophysiology of pregnancy-induced hypertension.

Biological Transport↗
PubMed1988

Doppler echocardiographic assessment of atrioventricular velocity waveforms in normal and small-for-gestational-age fetuses.

A prospective longitudinal study determined the physiological patterns of blood flow velocity waveforms in normal and in small-for-gestational-age (SGA) fetuses. Using a Pulsed Doppler Duplex system, 125 normally grown fetuses and 35 SGA fetuses were studied longitudinally at between 27 and 42 weeks gestation. In normal fetuses the ratio between the E velocity (early passive ventricular filling) and the A velocity (active ventricular filling during atrial contraction) increased progressively during pregnancy in both transmitral and transtricuspid waveforms, approaching 1 at term. In SGA fetuses, the E/A ratios did not increase during pregnancy and the values obtained were significantly lower than in normal fetuses. The ratio between the transtricuspid and transmitral mean temporal velocities remained almost constant throughout pregnancy in the normal fetuses with transtricuspid velocity slightly exceeding the transmitral velocity. On the other hand, in SGA fetuses the ratio between the mean temporal velocities was inversed with the transmitral velocity progressively greater than the transtricuspid velocity suggesting the existence of intracardiac haemodynamic changes in these fetuses.

Blood Flow Velocity↗
PubMed1988

Computerized analysis of behavioural states in asymmetrical growth retarded fetuses.

The fetal behaviour of 15 asymmetrical intrauterine growth retarded (IUGR) fetuses was compared to that of a control group of healthy fetuses. Fetuses underwent simultaneous cardiotocographic and ultrasonographic examinations for 2 consecutive hours at 36-38 weeks' gestation. Behavioural states analysis was carried out by means of a computerized system (Digital PDP 11) that allowed the recording of several fetal variables including heart rate (FHR), gross body movements (FM), eye movements (FEM) and breathing movements (FBM). FHR was classified in four different patterns (FHRP) according to Nijhuis et al.; fetal movements were automatically synchronized with FHR and grouped for each FHRP. Several quantitative parameters (i.e. incidence, mean duration, lag time, % time spent moving) were then computed for each movement. There were no statistical differences in the distribution of FHRP between healthy and IUGR fetuses. On the other hand quantitative differences were found when the movements investigated were related to FHRP. In IUGR fetuses FEM were mainly represented by low frequency movements (IEM) during both low (FHRP A) and high variability (FHRP B) FHRP, whereas healthy fetuses exhibited mostly rapid eye movements (REM) during FHRP B and absent type of FEM during FHRP A. Moreover IUGR fetuses showed a reduction of state 1F (quiet sleep) and an increase of periods of no coincidence between behavioural state variable when compared to the control group fetuses. These findings, therefore suggest the existence of quantitative differences in fetal behaviour in asymmetrical IUGR fetuses when compared to healthy fetuses.

Cardiotocography↗
PubMed1988

Sodium/potassium-adenosine triphosphatase on erythrocyte ghosts from pregnant women and its relationship to pregnancy-induced hypertension.

The regulation of electrolytes has been proposed as a possible determinant in hypertensive conditions, including pregnancy-induced hypertension. We report a study of sodium/potassium-adenosine triphosphatase in erythrocyte membranes of 59 patients with pregnancy-induced hypertension and 48 normotensive pregnant controls. The kinetics of the enzyme were also investigated, and the enzyme activity related to different degrees of pathology. A marked reduction of the enzyme activity was found in hypertensive patients, compared with controls. This reduction was greater when hypertension was associated with worse prognostic signs, such as proteinuria. These features are in agreement with the increased sodium content and the increased vascular reactivity found in pregnancy-induced hypertension. The enzyme activity appears to be decreased by means of a conformational modification of the enzyme sites, a phenomenon related to the hypertensive condition.

Edema↗
PubMed1988

Effect of general anesthesia on syncytiotrophoblast plasma membranes from human placenta.

This investigation shows that a general anesthetic produces similar effects in vivo and in vitro. Anesthesia with a barbituric drug, Thiopental, induces an increase in membrane fluidity and a decrease in the activity of acetylcholinesterase in syncytiotrophoblast plasma membranes (SPM) obtained from placentas after caesarean section. The same effects can be reproduced in vitro after anesthetic addition to the isolated plasma membranes. Morphological and freeze-fracturing studies also suggest that membrane protein components are affected by anesthetics.

Acetylcholinesterase↗