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Biomedical subjects

D Arduini

Publications and source records attributed to D Arduini.

At least 127 records · Page 7Linked to original sources

[Materno-fetal complications in pregnancies with multiple myomas].

46 pregnant women with multiple myomas underwent serial ultrasound examination until delivery. The effect of myomas on the course of pregnancy, fetal well-being and the type of delivery were studied, also in relationship to the number of myomas present. The authors stress the need for ultrasound monitoring when pregnancy is complicated by multiple myomas, along with intensive prenatal care in order to reduce risks for both the pregnancy itself and the fetus.

Abortion, Threatened↗

Modulation of echocardiographic parameters by fetal behaviour.

In order to verify if fetal behavioural states could affect cardiac parameters, thirty-one healthy fetuses were studied near term. We evaluated systolic time intervals (pre-ejection period and ventricular ejection time), M-mode parameters (fractional shortening and mean circumferential shortening) and Doppler flow velocities (mean peak velocity of aortic and pulmonary arteries) of left and right ventricles. Both fetal breathing movements and fetal heart rate patterns seem to modify these parameters with an increase of cardiac contractility during active phases of fetal behaviour.

Blood Flow Velocity↗

Fetal behaviour in growth retardation: its relationship to fetal blood flow.

The fetal behaviour of asymmetrical growth retarded fetuses was compared with that of a control group of healthy fetuses. Fetuses underwent simultaneous cardiotocographic and echographic examinations for two consecutive hours at 36-38 weeks of gestation. The distribution of gross fetal body movements, fetal breathing movements and fetal eye movements was analysed during the different fetal heart rate patterns. Furthermore, the incidence and organization of fetal behavioural states was investigated. The degree of vascular peripheral resistance was also evaluated by means of pulsed doppler ultrasonic equipment. Growth retarded fetuses were divided into two groups on the basis of the presence or absence of end diastolic flow in the fetal thoracic descending aorta. Growth retarded fetuses showed a delay in the integration of behavioural patterns and a lower coincidence of behavioural states. These findings are particularly evident in the fetuses with a severe increase of peripheral vascular resistance (absence of end diastolic flow in descending aorta). Thus, we suggest that a delay in central nervous system development is present in asymmetrical growth retarded fetuses and that there is a possible relationship of this delay to the degree of peripheral vascular resistance.

Blood Circulation↗

Longitudinal assessment of blood flow velocity waveforms in the healthy human fetus.

A longitudinal study was carried out on 30 healthy fetuses in order to assess the modifications of fetal blood flow throughout pregnancy. The pulsatility index was evaluated at two-week intervals by means of pulsed Doppler equipment. In the umbilical artery measurements were performed from 20 weeks onwards, whereas in the descending aorta and internal carotid artery analysis started from 26 weeks onwards. A decrease of the pulsatility index in umbilical artery and in the ratio between the pulsatility indexes in umbilical artery and internal carotid artery was found over the second half of pregnancy.

Aorta, Thoracic↗

Effect of naloxone on fetal behavior near term.

Fetal behavior was studied after intravenous administration of either 0.4 mg of naloxone or an equal volume of saline solution in 54 healthy pregnant women near term. The number, duration, and amplitude of fetal heart rate accelerations increased after naloxone injection. The incidence of both gross fetal body movements and fetal breathing movements increased, especially in the first hour after naloxone administration. The distribution of fetal behavioral states was modified with a prevalence of active sleep and active awake states compared to the quiet sleep state. These data suggest that endorphins could be involved in the modulation of fetal behavior.

Adult↗

Utero-placental blood flow velocity waveforms as predictors of pregnancy-induced hypertension.

Sixty high-risk pregnancies were studied in order to define the validity of the analysis of utero-placental blood flow velocity waveforms in early screening for developing hypertensive diseases. Recordings were obtained at 18-20 weeks gestation, in normotensive patients, using a pulsed duplex Doppler system at the level of uterine vessels. The patients (n = 22) who developed hypertension showed a higher resistance index value (p less than 0.001) than normotensive patients (n = 38). The validity of uteroplacental waveform analysis was as follows: specificity = 84.2%; sensitivity = 63.6%; positive predictive value = 70%; negative predictive value = 80%; accuracy = 76.6%. The high specificity attained suggests that this test can adequately identify, among a high-risk population, patients destined to remain normotensive during pregnancy.

Arteries↗

Abnormal fetal cerebral blood flow velocity waveforms as a sign of an aneurysm of the vein of Galen.

A cerebral midline cystic lesion was detected by real-time ultrasound in utero in the absence of other congenital abnormalities. Pulsed Doppler ultrasound assessment of fetal circulation demonstrated normal peripheral and intracardiac hemodynamics associated with decreased cerebral vascular resistance. Furthermore, a markedly turbulent flow pattern was evidenced within the cerebral lesion. The presence of a cerebral arteriovenous malformation with an aneurysm of the vein of Galen was suggested and the provisional diagnosis was later confirmed by computed tomography and carotid angiography performed after birth.

Adult↗

Development of behavioral states in hydrocephalic fetuses.

Behavioral states observations were carried out in 12 hydrocephalic fetuses by means of a computerized system. Recordings of behavioral parameters, including fetal heart rate, gross body movements, breathing movements and eye movements, were performed at 2-week intervals from 30 weeks of gestation onwards. The hydrocephalic fetuses showed quantitative and qualitative differences in their motor behavior in comparison to healthy fetuses of equivalent gestational age. Similarly the appearance of behavioral states was delayed in hydrocephalic fetuses. Furthermore, an increased discordance between the behavioral parameters was evidenced. The degree of discordance seems to be related to the severity of neonatal outcome suggesting a possible estimation of CNS dysfunction by means of behavioral state analysis.

Brain↗

Effects of nifedipine on umbilical artery velocity waveforms in healthy human fetuses.

The purpose of this investigation was to analyze the changes in umbilical artery (UA) velocity waveforms after administration of nifedipine in 30 healthy pregnant women. The effects on fetal and maternal heart rates and maternal arterial pressure were also analyzed. The patients included in this double blind study received sublingually either 10 mg of nifedipine or a placebo. A transient fall of the UA resistance (as expressed by the pulsatility index) occurred 15 min after nifedipine administration, but resistance returned to control values after 90 min. Maternal heart rate increased after nifedipine administration and returned toward the control value by 45 min. Fetal heart rate and maternal mean arterial pressure did not change significantly. These data suggest a possible use of nifedipine to normalize the UA velocity waveform in pregnancies complicated by hypertension and fetal growth retardation.

Blood Flow Velocity↗

Loss of circadian rhythms of fetal behaviour in a totally adrenalectomized pregnant woman.

Fetal heart rate and fetal movements were recorded over a 24-hour interval in a totally adrenalectomized pregnant woman at term. Cortisol, ACTH, unconjugated estriol and 17 beta-estradiol were contemporaneously measured every 2 h in the maternal peripheral plasma. Owing to the substitution therapy the patient showed a loss of circadian variations of all the hormones investigated. Moreover, the circadian rhythms of fetal heart rate and fetal movements, usually present at term, were no longer evident. We can thus suggest that the circadian variations of plasma maternal cortisol could affect the alternations of fetal behaviour.

Adrenalectomy↗

Fetal blood flow velocity waveforms as predictors of growth retardation.

Seventy-five high-risk pregnancies were studied in order to define the clinical value of the analysis of fetal blood flow velocity waveforms in early screening for growth retardation. Recordings were obtained at 26-28 weeks' gestation, in the absence of ultrasonographic signs of growth retardation, using a pulsed duplex Doppler system. The pulsatility index was evaluated at the level of the umbilical artery, descending aorta, and internal carotid artery. Fetuses (N = 23) who developed growth retardation showed higher values of pulsatility index in the umbilical artery (P less than .001) and descending aorta (P less than .05) than fetuses of normal growth. In the internal carotid artery, the pulsatility index was lower (P less than .001) in the fetuses who developed growth retardation than in those with normal growth. The ratio between the pulsatility indexes of the umbilical and internal carotid arteries proved an accurate predictor of growth retardation (specificity 92.3%; sensitivity 78.2%; positive predictive value 81.8%; negative predictive value 90.5%; accuracy 88%).

Blood Flow Velocity↗

Effects of free fatty acids and L-carnitine on the spontaneous motility of rat isolated uterine horn.

In the present investigation the effects of free fatty acids (FFA) and L-carnitine were investigated on the rat isolated uterine horn. The cumulative addition of FFA and L-carnitine to the isolated organ bath produced a significant increase of isometric developed tension and functional activity, especially evident at 5 mM carnitine concentration. No variations in the frequency of contractions were found. These data suggest a possible role of FFA as energy source in the rat uterus.

Animals↗

A new method for the measurement of pre-ejection period in the human fetus.

The pre-ejection period (PEP) of the cardiac cycle was measured in the human fetus using pulse Doppler in association with transabdominal ECG. The technique permitted the exact localization of the aortic valve, a good recording of its opening and the exact measurement of PEP. Between 32 and 42 weeks of pregnancy there is a strong correlation between PEP and gestational age. This new method seems to be an easy and reliable tool for measuring the PEP during intrauterine life.

Aortic Valve↗

[Sinusoidal fetal heart rhythm (author's transl)].

The authors describe 6 cases of pregnancy, four of the patients presenting fetomaternal Rhesus incompatibility, and two showing no abnormality. Fetal heart rhythm (FHR) recordings in all patients demonstrated the presence of a sinusoidal rhythm, either alone or associated with deceleration. The physiopathology of the rhythm, according to a very critical analysis of reports in the published literature (very severe fetal anemia, hypoxia), was not typical in three of the cases. The authors conclude that the observation of this sinusoidal rhythm for a period of up to 60 min, but not repeated, does not constitute a danger for the fetus. If the period is longer, however, or if there is a fetomaternal pathological condition, decelerations, or reduced amplitude of FHR oscillations, there is a very severe risk to the fetus and the need for urgent delivery has to be seriously considered.

Adult↗

Umbilical artery velocity waveforms in early pregnancy: a transvaginal color Doppler study.

In a cross-sectional study, umbilical artery velocity waveforms were recorded in 214 low-risk pregnancies at 7 weeks to 16 weeks, menstrual age, by means of transvaginal color and pulsed Doppler ultrasonography. In all the cases studied, end diastolic velocities were absent until the 10th week. From this age onward end diastolic velocities were present in a percentage of pregnancies, progressively increasing with gestation and reaching 100% at 15 weeks. Similarly, the percentage of cardiac cycles in which end diastolic velocities were absent progressively decreased with advancing menstrual age. The normal range for the pulsatility index was constructed and a quadratic function was found to optimally fit its fall during gestation. No differences in pulsatility index values were found at these menstrual ages in 12 pregnancies that later developed intrauterine growth retardation and/or pregnancy-induced hypertension, suggesting that placental alterations causing abnormalities in umbilical velocity waveforms occur later in gestation.

Blood Flow Velocity↗