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Biomedical subjects

C Romanini

Publications and source records attributed to C Romanini.

At least 91 records · Page 5Linked to original sources
PubMed1995

Morpho-functional modifications of human syncytiotrophoblast plasma membrane during pregnancy induced hypertension.

A decrease of Na+/K(+)-ATPase activity has been reported in syncytiotrophoblast plasma membrane (SPM) obtained from pregnancy induced hypertensive (PIH) women. The aim of the present work was to verify if the reported modifications in activity are due to a decreased number of enzymatic molecules or to a conformational change of the enzyme itself. Morphological studies were performed in order to better understand the relations between the enzymatic protein and the lipid bilayer. Kinetic studies were also performed. SPM obtained from PIH showed: i) an increased affinity of Na+/K(+)-ATPase for ouabain binding, ii) a significant change in the maximum velocity of the enzyme, iii) a higher distribution factor (DF) of intramembrane particles (IMPs) in the exoplasmic face of the membrane, iv) a decreased mean diameter of IMPs both in the protoplasmic and exoplasmic faces, v) a decreased number of IMPs in the exoplasmic face. In conclusion, a conformational modification seems to be at the basis of the decreased Na+/K(+)-ATPase activity during PIH as suggested by binding, ultrastructural and kinetic data herein reported.

Adult↗
PubMed1995

Fetal behaviour in normal and compromised fetuses. An overview.

Fetal intrauterine behaviour is not a stable situation but a continuous alternation of states characterized by significant changes in fetal motility, heart rate, hemodynamics, metabolism and response to stimulation. Associations between fetal heart rate patterns and movements occur from 26-28 weeks of gestation onwards. As fetuses grow older these variables become gradually more related temporally and clustered in behavioural states similar to those present in newborns. This article describes the technique of recording and analyzing fetal behaviour, its development in normal pregnancy and its influence on different physiological parameters that are assessed in clinical practice. Furthermore the deviations from the norm occurring in compromised fetuses are described.

Behavior↗
PubMed1995

Blood levels of vasoactive intestinal polypeptide in normal and growth retarded fetuses: relationship with acid-base and haemodynamic status.

The objectives of this study were (1) to detect vasoactive intestinal polypeptide in fetal blood obtained by cordocentesis (2) to examine possible changes in growth retarded fetuses and to establish relationships between its levels and fetal blood acid-base status as well as fetal haemodynamics as assessed by Doppler ultrasonography. Vasoactive intestinal polypeptide was measured in umbilical vein blood obtained at cordocentesis in 12 growth retarded fetuses and in 13 control fetuses. Umbilical vein pH and PO2 values were determined in all the cases. Before the procedure, Doppler indices were calculated from umbilical artery, middle cerebral artery, renal artery, cardiac outflow tracts and inferior vena cava. Simple and multiple stepwise regression analysis were performed to examine the relationships between Doppler indices, acid-base status and vasoactive intestinal polypeptide levels. In control fetuses, vasoactive intestinal polypeptide was always detectable in cord blood and its levels did not change with gestational age. In growth retarded fetuses, vasoactive intestinal polypeptide levels were higher and significantly related to umbilical vein PO2 levels, Pulsatility Index in umbilical artery, middle cerebral artery and renal artery, while no relationship was found with umbilical vein pH, cardiac and venous Doppler indices. Stepwise multiple regression demonstrated middle cerebral artery Pulsatility Index to be the best explanatory variable for vasoactive intestinal polypeptide levels. In conclusion, vasoactive intestinal polypeptide blood levels are increased in growth retarded fetuses and this increase is inversely related to the Doppler measured impedance to flow in middle cerebral artery.

Acid-Base Equilibrium↗
PubMed1995

Normal fetal growth in women with antiphospholipid syndrome treated with high-dose intravenous immunoglobulin (IVIG).

Antiphospholipid antibodies are associated with fetal distress and fetal death. Although different therapeutic regimens have been used, the incidence of fetal growth retardation varies between 30 and 60 per cent of reported cases. We report the evolution of fetal growth in patients with antiphospholipid antibody syndrome treated with high-dose intravenous immunoglobulins (IVIG). Fourteen patients with a history of recurrent spontaneous abortion and immunological diagnosis of antiphospholipid syndrome were followed longitudinally. Intravenous immunoglobulin at a dose of 0.5 g/kg body weight for two consecutive days was started from the fifth week of pregnancy and repeated every 4 weeks until the 33rd week of gestation. Fetal biometry was evaluated longitudinally from the appearance of the gestational sac at 4 weekly intervals. In the period between 26 and 34 weeks, the frequency of evaluation was increased to every 14 days. Data obtained were compared with a control group of 70 fetuses with uneventful pregnancies matched for gestational age. Neonatal weight is shown in relation to the centiles for the normal population. One patient out of 14 (7.1 per cent) developed gestational hypertension and abruptio placentae. No other pregnancy complications were seen. No proteinuria was found. The mean maternal age was 31.2 +/- 3.8 years. Median birth weight was 3433 g +/- 287. The median centile of the birth weight was 65.3 +/- 18.6. Mean gestational age at delivery was 1.3 weeks. No fetal or neonatal growth retardation was seen.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Habitual↗
PubMed1995

Cardiac flow after fetal blood sampling in normally grown and growth-retarded fetuses.

The objective of this study was to evaluate the effect of fetal blood sampling on cardiac flow velocity waveforms. Flow velocity waveforms were measured from the ascending aorta and pulmonary artery immediately before and after fetal blood sampling in 29 normally grown and 12 growth-retarded fetuses. The latter group was characterized by abnormal Doppler indices in the umbilical artery and middle cerebral artery suggestive of uteroplacental insufficiency as the causative factor of the impaired growth. The flow velocity parameters studied were the peak velocity, the time to peak velocity, and the left and right cardiac output and their ratio. In normally grown fetuses, the peak velocity and right and left cardiac output values increased significantly after fetal blood sampling, while no significant changes were observed in the other indices considered. The gestational age at the time of the procedure was positively related to the amplitude of these changes. In growth-retarded fetuses, fetal blood sampling did not induce any significant increase in cardiac output or peak velocities, while in more than 50 per cent of the fetuses these Doppler indices decreased. The amplitude of the decrease was significantly related to the severity of acidosis in the umbilical vein. In conclusion, the cardiac haemodynamic response to fetal blood sampling differs between normally grown and growth-retarded fetuses. This difference may explain the higher rate of complications occurring in the latter group of fetuses after blood sampling.

Blood Flow Velocity↗
PubMed1995

MIB 1 immunostaining in stage I squamous cervical carcinoma: relationship with natural killer cell activity.

The aim of the study was to investigate the prognostic significance of estimating tumor cell proliferation in stage I cervical squamous carcinoma by analyzing MIB 1 immunostaining with respect to the lesion size, lymphatic spread, and clinical outcome. A possible relationship between MIB 1 index and natural killer activity was also discussed. The medical records of 34 patients with stage I squamous cervical carcinoma who had undergone primary radical surgery at the Institute of Gynecologic and Obstetrics, Ancona University, between 1988 and 1993, were recruited from our series of 57 consecutive cases and reviewed. Thirty-one patients were considered eligible for the study and evaluated for age, demographic characteristics, tumor histologic grade, tumor size, lymphatic spread, and adjuvant radiotherapy. The expression of primary tumor proliferation related to Ki67 antigen was immunohistochemically evaluated by monoclonal MIB 1 antibody (Immunotech, Marseille Cedex, France) on microwave oven-processed formalin-fixed paraffin-embedded tissue. The basal natural killer cell activity of peripheral blood lymphocytes was evaluated against K562 cell line and expressed in lytic units for each patient. The MIB 1 immunostaining was significantly related with tumor size (P = 0.001) and lymphatic spread (P = 0.009); in contrast, there was no relationship between grade of histologic differentiation and MIB 1 immunostaining. The Cox proportional hazards analysis showed a significant independent relationship between MIB 1 immunostaining and disease-free survival (P = 0.004). The analysis of natural cytotoxicity defined a significant inverse relationship between peripheral blood lymphocyte's natural killer activity and tumor MIB 1 immunostaining (r = -0.07, with P = 0.03). Our data defined the prognostic significance of tumor cell proliferation immunostaining, an interesting parameter correlated with the disease-free survival in locally advanced cervical carcinoma. The relationship between MIB 1 index and natural killer activity is interesting; natural cytotoxicity seems to be altered in the host with respect to the cervical carcinoma characteristics.

Adult↗
PubMed1995

Cardiac and venous blood flow in fetuses of insulin-dependent diabetic mothers: evidence of abnormal hemodynamics in early gestation.

OBJECTIVE: Our purpose was to determine whether in early gestation cardiac and venous blood flow patterns of fetuses of insulin-dependent diabetic mothers differ from those of normal fetuses. STUDY DESIGN: Serial recordings were obtained at 12, 16, and 20 weeks of gestation in 11 normal fetuses, 16 fetuses of insulin-dependent diabetic mothers with first-trimester glycosylated hemoglobin levels < or = 8.5% (group 1), and 11 fetuses of insulin-dependent diabetic mothers with first-trimester glycosylated hemoglobin levels > 8.5% (group 2). Velocity waveforms at the level of atrioventricular valves, inferior vena cava, and umbilical vein were recorded by means of color and pulsed Doppler equipment by either transvaginal or transabdominal approaches. The following variables were measured: ratio between the peak velocities during early passive ventricular filling and active atrial filling at the level of atrioventricular valves, percent reverse flow during atrial contraction in inferior vena cava, and pulsations in umbilical vein. RESULTS: In all the fetuses the ratios between early and active ventricular filling increased linearly with advancing gestation, whereas the percent reverse flow in the inferior vena cava decreased linearly. However, fetuses of diabetic mothers showed significant differences in the slope of the functions describing the development with gestation of these index values, resulting in lower values of the ratios between early and active ventricular filling at the level of both ventricular valves and higher values of percent reverse flow in inferior vena cava. These differences were more evident in group 2 fetuses of diabetic mothers, and statistically significant differences were found in the slope values compared with group 1 fetuses. In normal fetuses umbilical vein pulsations were present only in two fetuses at 12 weeks of gestation (18.18%) and were never evidenced later in gestation. A significantly higher incidence of pulsations was found at 12 weeks in fetuses of diabetic mothers (group 1, 56.25%; group 2, 81.81%) and pulsations were present until 16 weeks (group 1, 37.5%; group 2, 45.47%). CONCLUSIONS: An impaired development of cardiac and venous blood flow patterns occurs in fetuses in insulin-dependent diabetic mothers. These abnormalities are more evident in pregnancies with poorer glycemic control but still occur in the presence of stricter metabolic control.

Adult↗
PubMed1995

Modulation of expression of p53 and cell proliferation in locally advanced cervical carcinoma after neoadjuvant combination chemotherapy.

OBJECTIVE: In the present study, we investigated changes of p53 expression and the cell proliferation index detected with MIB 1 in tumors before and after neoadjuvant combination chemotherapy with respect to the outcome of the disease. Our aim was to define more appropriately the significance of chemotherapy in locally advanced cervical carcinoma. MATERIALS AND METHODS: Our study included 17 women with locally advanced squamous cervical carcinoma who had been admitted to the Institute of Gynecology and Obstetrics Ancona University, between January 1990 and December 1994. The patients received neoadjuvant combination chemotherapy consisting of three cycles of cisplatin (80 mg/m2) and bleomycin (30 mg/m2). After chemotherapy, radical surgery was performed. Bioptic specimens were obtained from cervical tumors before and after chemotherapy and processed for immunohistochemical staining with a monoclonal antibody against p53 and with the monoclonal antibody MIB 1. RESULTS: Thirteen patients (76.5%) showed a clinical response (4 complete and 9 partial), while of the remaining 4 cases (23.5%) 3 had no change and 1 showed progression after neoadjuvant combination chemotherapy. A significant relationship was observed between the overexpression of p53 and the sensitivity to chemotherapy; responder patients showed a higher frequency of p53 positive cells than non-responders (P = 0.03). No significant relationship with MIB 1 index was observed. Both expression of p53 protein (P < 0.001) and reaction with MIB 1 (P = 0.003) significantly decreased after chemotherapy. The decrease in expression of p53 protein and staining with antibody MIB 1 was particularly evident in patients who responded to chemotherapy. DISCUSSION: In tumors, p53 protein and index of proliferating cells as determined with MIB 1 showed a significant modulation after treatment, suggesting an association with sensitivity to chemotherapy. However, the limited number of our series of patients does not permit a statement on the clinical implication of expression of p53 and cell proliferation in patients undergoing neoadjuvant combination chemotherapy for locally advanced cervical carcinoma.

Adult↗
PubMed1995

The effects of fetal blood sampling on ductus venosus blood flow velocity waveforms.

The objective of this study was to evaluate the effect of fetal blood sampling on ductus venosus hemodynamics. A secondary objective was to establish the relationship between the amplitude of these changes, if any, and different variables related either to the procedure of sampling or to fetal characteristics. The ratio was assessed between the systolic and atrial velocities from the ductus venosus that were measured immediately before and immediately after fetal blood sampling in 32 appropriately grown fetuses and in 12 growth-retarded fetuses. The latter group was characterized by abnormal Doppler indices in the umbilical artery and the middle cerebral artery, suggestive of uteroplacental insufficiency as the causative factor of the impaired growth. The systolic/atrial ratio fell significantly after fetal blood sampling, but this decrease was less evident in growth-retarded fetuses. Neither the site of needling (placental cord insertion or intrahepatic vein) nor transplacental puncture during the procedure affected this decline. Similarly, fetal smallness, the volume of fetal blood aspirated and baseline values in Doppler indices from the ductus venosus and middle cerebral artery were unrelated to the observed changes. Stepwise regression analysis indicated that the variables that most significantly and independently affect the decline of the Doppler index were gestational age at the time of the procedure and pO2 values in the umbilical vein. In conclusion, modifications in ductus hemodynamics are induced by fetal blood sampling. These changes are less evident in hypoxemic growth-retarded fetuses and this reduced hemodynamic response may explain the higher rate of complications occurring in such fetuses after blood sampling.

Blood Flow Velocity↗
PubMed1995

Ventricular ejection force in growth-retarded fetuses.

The objective of this study was to determine whether in growth-retarded fetuses secondary to uteroplacental insufficiency the cardiac ventricles exert a force different from that of appropriately grown fetuses. Doppler echocardiographic studies were performed in 156 appropriately grown fetuses (gestational age 18-38 weeks) and in 72 growth-retarded fetuses (gestational age 24-36 weeks) free from structural and chromosomal abnormalities and characterized by Doppler changes in the umbilical artery and middle cerebral artery suggesting uteroplacental insufficiency as the most likely etiology of the growth defect. Right and left ventricular ejection force values were calculated from velocity waveforms recorded at the level of aortic and pulmonary valves, according to Newton's second law of motion. In appropriately grown fetuses, left and right ventricular ejection force values significantly increased with advancing gestation and the two ventricles exerted similar force. In growth-retarded fetuses, the ventricular ejection force was significantly and symmetrically decreased in both ventricles. Among growth-retarded fetuses, a poorer perinatal outcome was observed in those fetuses in which the ejection force of both ventricles was below the 5th centile of the normal limits for gestation. In 12 growth-retarded fetuses followed longitudinally during the last week preceding intrauterine death or Cesarean section due to antepartum heart-rate late decelerations, a significant decrease of ejection force was found in both ventricles. Finally, a significant relationship was found between the severity of acidosis and right and left ventricular ejection force values in 22 fetuses in which Doppler recordings were performed immediately before cordocentesis.(ABSTRACT TRUNCATED AT 250 WORDS)

Case-Control Studies↗
PubMed1995

Effects of thyrotropin releasing hormone on cardiac and extracardiac flows of appropriately grown and growth-retarded fetuses.

The objective of this study was to establish the effect of thyrotropin releasing hormone on the fetal circulation of appropriately grown and growth-retarded fetuses. Doppler recordings were performed immediately before and 15 min after maternal administration of 400 micrograms of thyrotropin releasing hormone in 14 women with appropriately grown and 19 with growth-retarded fetuses. Furthermore, in six women with growth-retarded fetuses, serial recordings were performed at 2-hourly intervals for 8 h until a second thyrotropin releasing hormone dose was administered. Velocity waveforms were recorded from the outflow tracts, inferior vena cava, umbilical artery, middle cerebral artery and descending aorta, and different Doppler indices calculated. In appropriately grown fetuses, thyrotropin releasing hormone induced a significant increase of peak systolic velocity values in the aorta and pulmonary artery and an increase of Doppler-estimated cardiac output. In growth-retarded fetuses, these changes were more evident and associated with a significant decrease in reverse flow in the inferior vena cava during atrial contraction. No changes were observed in fetal heart rate or in the other fetal vessels investigated. In the growth-retarded fetuses followed longitudinally, these changes were evident for the following 8 h and were potentiated by the second thyrotropin releasing hormone administration. In conclusion, thyrotropin releasing hormone induces significant hemodynamic effects on the fetal heart that may temporarily improve the impaired cardiac function of growth-retarded fetuses.

Adult↗
PubMed1995

Prenatal diagnosis of gastroesophageal reflux by color and pulsed Doppler ultrasonography in a case of congenital pyloric atresia.

A case of pyloric atresia diagnosed in the third trimester is described. Real-time ultrasonographic examination revealed polyhydramnios, enlarged stomach, evident gastric peristalsis and esophageal dilatation. Color and pulsed Doppler studies of the gastroesophageal junction revealed the presence of a biphasic flow pattern that was consistent with gastroesophageal reflux.

Adult↗
PubMed1995

Endometrial evaluation in postmenopausal breast cancer patients receiving tamoxifen: an ultrasound, color flow Doppler, hysteroscopic and histological study.

The purpose of this study was to evaluate the effect of tamoxifen therapy on the endometrium by transvaginal color Doppler sonography, hysteroscopy and endometrial sampling. The study group (tamoxifen group) was composed of 38 asymptomatic postmenopausal women. All had been treated with tamoxifen (20-30 mg/day) for breast cancer for at least 1 year. The patients of the tamoxifen group underwent transvaginal color Doppler sonography, hysteroscopy and, if necessary, endometrial biopsy. Thirty asymptomatic postmenopausal women (control group) and 25 asymptomatic postmenopausal breast cancer patients not on tamoxifen therapy (no-tamoxifen group) served as the control groups. The endometrium was scanned by transvaginal ultrasound to evaluate thickness, echotexture, border and intraluminal fluid. Color and pulsed Doppler were used to evaluate the pulsatility (PI) and resistance (RI) indices of the uterine and endometrial arteries when possible. The patients receiving tamoxifen had a significantly thicker endometrium compared to the control groups. Endometrial pathology was observed in 61% (23/38) of cases and an endometrial thickness of "> or =" 10 mm was always associated with an endometrial lesion. Nineteen benign endometrial polyps were found, most of them having a typical sonographic endometrial pattern with regular borders and small hypoechoic cystic areas which we define as polypoid. Four endometrial hyperplasias, one of these atypical were observed. There were no endometrial cancers. The mean PI and RI of the uterine arteries in the tamoxifen group were 2.04 +/- 0.77 and 0.82 +/- 0.1, respectively and were significantly lower than those of the control group (2.93 +/- 0.9 and 0.93 +/- 0.06) and the no-tamoxifen group (2.53 +/- 0.7 and 0.89 +/- 0.1). The blood velocity changes were very similar to those described in postmenopausal women receiving estrogen replacement therapy. A correlation between the time of beginning tamoxifen therapy after menopause and development of endometrial pathology was observed: in patients who started therapy many years after the onset of menopause, the risk of developing endometrial pathology was higher than in those who began therapy a few years after the onset of menopause. Patients receiving tamoxifen, particularly those who start therapy many years after the onset of menopause, should be closely monitored by transvaginal ultrasound and color Doppler imaging to detect endometrial lesions.

Aged↗
PubMed1995

Site and menstrual cycle-dependent expression of proteins of the tumour necrosis factor (TNF) receptor family, and BCL-2 oncoprotein and phase-specific production of TNF alpha in human endometrium.

Apoptosis in human endometrial epithelium progressively increases from early to late secretory/menstrual phases and remains consistently more prominent in the basalis. It has been suggested that tumour necrosis factor (TNF) alpha secreted during the secretory/menstrual phases plays a role in induction of programmed cell death in these cells. In the present study, we characterized expression of receptors of TNF alpha, Fas antigen and BCL-2 in endometrial cells to gain insight as to whether this type of cell death in endometrium may be related to differential or preferential expression of these proteins at specific phases of the menstrual cycle. In addition, to relate production of TNF alpha to the development of apoptosis, the amount of TNF alpha released by human endometrium was measured. Immunostaining demonstrated that the TNF receptor (TNFr; p55/60)-I, TNFr-II (p75/80) as well as Fas protein were expressed in endometrial epithelium throughout the entire menstrual cycle. This expression was progressively diminished from the basalis towards the upper functionalis. In the proliferative phase, the expression of BCL-2 was prominent in the endometrial glands particularly in those residing in the basalis. This expression became weak as early as the third post-ovulatory day and remained low during the remaining phases of the menstrual cycle. The amount of TNF alpha released by endometrial fragments obtained from various phases of the menstrual cycle was determined. The amount of TNF alpha released into the culture medium by the endometrium was low in the proliferative phase. However, the amount of released TNF alpha progressively increased in the secretory phase and peaked in the menstrual phase. TNFr-I, TNFr-II, Fas, BCL-2 and TNF alpha could be identified by Western blot analysis of proteins extracted from endometrium. Therefore, endometrial epithelium by virtue of expression of receptors of TNF alpha as well as Fas protein is properly poised to respond to ligand signals that regulate apoptosis. Induction of apoptosis in endometrial epithelium and menstrual shedding may be related to loss of the protective effect of BCL-2 as well as to the amount of TNF alpha.

Antigens, Surface↗
PubMed1995

Menstruation is associated with disordered expression of desmoplakin I/II and cadherin/catenins and conversion of F- to G-actin in endometrial epithelium.

Endometrium is unique since it is the only tissue that undergoes regular cyclic bleedings. Menstrual shedding is associated with the breakdown of endometrium, including the fragmentation of endometrial glands. To gain insight into the underlying basis of fragmentation of the endometrial epithelium during the menstrual phase, we examined the expression of proteins implicated in epithelial cell-cell binding in human endometria throughout the entire menstrual cycle. Western blotting failed to reveal differences in the relative amount of E-cadherin, alpha- or beta-catenin or actin in the menstrual endometria compared with those in the proliferative or secretory phases. However, specific changes in the expression pattern of these proteins as well as desmoplakin I/II were detected by immunohistochemical staining in epithelial cells of menstrual endometria. Desmoplakin I/II, E-cadherin, alpha- and beta-catenins and beta-actin were localized to intercellular borders as well as the luminal and basal regions of glandular epithelium during the proliferative and secretory phases. Immunoreactivity of E-cadherin and alpha-catenin was confined to epithelial cells, whereas beta-catenin and beta-actin were present in epithelial cells, as well as in stroma and endothelial cells. Binding of F-actin to fluorescein isothiocyanate-labelled phalloidin localized this form of actin to the intercellular borders, and the basal and luminal cytoplasm of epithelial cells in proliferative and secretory endometria. Menstrual shedding was associated with disorganization of the site-specific distribution of desmoplakin I/II, E-cadherin and alpha- and beta-catenins.(ABSTRACT TRUNCATED AT 250 WORDS)

Actins↗
PubMed1995

The value of fetal arterial, cardiac and venous flows in predicting pH and blood gases measured in umbilical blood at cordocentesis in growth retarded fetuses.

OBJECTIVE: To assess the value of Doppler indices, calculated from fetal arterial peripheral vessels, cardiac outflow tracts and venous vessels, in the identification of acidaemia, hypercapnia and hypoxaemia as determined by pH and gas analysis of fetal blood obtained by cordocentesis in growth retarded fetuses. DESIGN: Doppler measurements were taken from umbilical artery, thoracic descending aorta, renal artery, middle cerebral artery, cardiac outflow tracts, inferior vena cava and ductus venosus immediately before cordocentesis. Logistic regression and receiver-operator characteristic curve analysis were performed to examine the relation between Doppler indices and acid-base status. SETTING: Tertiary centre for fetal medicine. SUBJECTS: Forty-eight growth retarded fetuses fulfilling these criteria for inclusion: 1. absence of chromosomal and structural anomalies; 2. an abdominal circumference or ultrasonographic estimated fetal weight less than the 5th centile; 3. presence of abnormal velocity waveforms in umbilical artery; and 4. postnatal confirmation of a birthweight below the 5th centile and absence of structural anomalies. RESULTS: The percentage of reverse flow in inferior vena cava was a more closely related variable for acidaemia (chi 2 = 29.69; P < or = 0.001) and hypercapnia (chi 2 = 12.86; P < or = 0.001) than the other Doppler indices. Hypoxaemia was better predicted by the pulsatility index from middle cerebral artery (chi 2 = 15.31; P < or = 0.001). CONCLUSION: The analysis of velocity waveforms from inferior vena cava and middle cerebral artery can be used to predict acid-base status in growth retarded fetuses secondary to placental insufficiency. This may lead to a more accurate antepartum monitoring of such fetuses.

Acidosis↗
PubMed1995

Umbilical vein pulsations and acid-base status at cordocentesis in growth-retarded fetuses with absent end-diastolic velocity in umbilical artery.

The objective of this study was to examine the acid-base status in blood obtained at cordocentesis in growth-retarded fetuses with absent end-diastolic velocity in the umbilical artery and divided according to the presence or absence of pulsations in the umbilical vein. Twenty-six growth-retarded fetuses free from structural and chromosomal abnormalities were considered for this study. All the fetuses had absent end-diastolic velocity in the umbilical artery associated in 11 cases (42.3%) with pulsations in the umbilical vein. Gas analysis of fetal blood obtained by cordocentesis was performed immediately after the Doppler recordings. Hypoxemia, acidemia and hypercapnia were defined respectively as the presence of pH or pO2 values 2 standard deviations below the normal mean for gestation and of pCO2 values 2 standard deviations above the normal mean for gestation. Fetuses with umbilical vein pulsations had lower values of pH (p < or = 0.001) and pO2 (p < or = 0.05) and higher values of pCO2 (p < or = 0.001) when compared to those without pulsations. All fetuses with pulsations were hypoxemic and hypercapnic and the incidence of acidemia was 90.9%. Fetuses with continuous blood flow in the umbilical vein, although frequently hypoxemic (80%), have pCO2 and pH values within the normal range in 40 and 52.3% of the cases, respectively. In conclusion, in fetuses with absent end-diastolic velocity in the umbilical artery the presence of umbilical vein pulsations identifies a subgroup of fetuses with a more severe compromise of acid-base status. This may be useful in the selection of the timing of delivery of such fetuses.

Blood Flow Velocity↗