Search PubMed⌕ Search

Biomedical subjects

E Ferrazzi

Publications and source records attributed to E Ferrazzi.

At least 73 records · Page 4Linked to original sources
PubMed1989

Spectral analysis of antepartum heart rate variability.

The present paper illustrates the basic methodological aspects of the power spectral analysis applied to fetal ECG starting from a gestational age around the 25th week of gestation until term. An abdominal ECG signal is recorded and fetal and maternal QRSs are recognised through selective digital filtering and averaging techniques. Power Spectral Density (PSD) of the discrete R-R series is then calculated through an autoregressive (AR) technique. In analogy with what happens in adult human subjects, fetuses manifest variability in correspondence to particular bands in the spectrum which are sensitive to the sympatho-vagal balance which controls many cardiovascular functions and respiration in different physiological conditions. Such a method is easily implemented on a personal computer and may be used to asses the development of the autonomic nervous system in fetuses as well as to show the physiopathological reasons which perturbate the relevant control mechanisms.

Cardiotocography↗
PubMed1989

Power spectral analysis of the heart rate of the human fetus at 26 and 36 weeks of gestation.

The fetal electrocardiogram (ECG) was recorded from the maternal abdomen together with sonographic detection of fetal states in four pregnant patients at 26 and 36 weeks of gestation. Computerised algorithms obtained a good recognition of maternal ECG and fetal ECG. The corresponding power spectral density (PSD) was estimated during epochs of quiet or breathing movements for 256 consecutive heart beats. At 36 weeks of gestation the PSD analysis showed heart rate variability components similar to an adult heart. A low frequency component was observed together with a high frequency component in the range of fetal breathing movements. This high frequency component (0.6 - 0.9 Hz) disappeared from the PSD analysis during epochs of apnea. To our knowledge this is the first demonstration of such a mechanism in the human fetus in utero. At 26 weeks no respiratory component was observed in the PSD analysis. The maturation of control mechanisms could be responsible for this difference.

Electrocardiography↗
PubMed1989

Prenatal diagnosis and management of congenital heart disease.

Thirty-two fetuses were diagnosed as having congenital heart disease (CHD). The major indications for level II echocardiography other than suspected cardiac abnormalities were fetal malformations, nonimmune hydrops and cardiac arrhythmia. Only three patients had a previous history of fetal CHD. No false-abnormal diagnosis of severe CHD was made. Aortic arch anomalies represented the major diagnostic problem among the six correct but incomplete diagnoses. Sixty-one percent of the fetuses were growth retarded, thus confirming the severity of their CHD. Chromosomal anomalies and extracardiac malformations were associated in 19% and 44% of the fetuses, respectively. Obstetric management and fetal prognosis in cases of extracardiac malformations were greatly influenced by the diagnosis of CHD. The poorest perinatal outcome was associated with heart failure. The only intrauterine deaths occurred in that group, and only one neonate survived. The outcome was more favorable in neonates without other malformations or heart failure. Four of ten (40%) of those neonates survived, while the overall perinatal survival rate was 24%.

Chromosome Aberrations↗
PubMed1988

The correlation of biochemical monitoring versus umbilical flow velocity measurements of the human fetus.

The pulsatility index of the fetal umbilical arteries was evaluated in 14 high-risk pregnant patients delivered by cesarean section between 30 and 35 weeks of gestation. Transabdominal cord sampling by ultrasonic guidance was performed on 10 of these patients. Umbilical arterial and venous blood was obtained in all patients from the doubly clamped cord at the time of cesarean section. The blood samples were analyzed for respiratory gases, acid-base balance, and lactate concentrations. A significant relationship was found between the pulsatility index and pH, PCO2, and lactate concentrations measured on umbilical venous blood sampled in utero. The pulsatility index also correlated with the same variables measured on venous and arterial blood sampled at cesarean section. Umbilical venous blood obtained transabdominally had a significantly higher oxygen content than blood obtained at cesarean section. No significant correlation was found between umbilical venous oxygen content obtained at transabdominal cord sampling and the pulsatility index. At a pulsatility index greater than 1.5, lactate concentrations in umbilical venous blood increased sharply. There would appear to be a curvilinear relationship between umbilical blood flow and these indices of fetal oxygenation, such that moderate increases in pulsatility index were not associated with a significant increase in fetal lactate concentrations.

Acid-Base Equilibrium↗
PubMed1988

The yolk sac in early pregnancy failure.

An attempt was made to visualize the yolk sac in 845 patients scheduled for chorionic villi sampling. The distribution of yolk sac diameters and the interpolating growth curve up to 11 weeks of development were analyzed in 239 pregnant women who were delivered of normal infants. The highest visualizing rate of the yolk sac in normal pregnancies was 97 at 7 weeks of gestation. A total of 130 miscarriages occurred before chorionic villi sampling. In these cases, the diameter of the yolk sac versus crown-rump length tended to be larger than found in normal pregnancies. The visualizing rate of the yolk sac in miscarriages after the embryo had been formed was significantly higher in those women who demonstrated fetal heart activity (82.1%) than in those who did not (54.5%). On the other hand, the yolk sac was observed in 44% of miscarriages without a visible embryo. These findings suggest different types of missed abortion. An abnormal karyotype was observed in 23 of 29 chromosomal analyses performed on aborted specimens. An abnormal karyotype was observed in all eight cases with only a yolk sac-like structure within the gestational sac.

Abortion, Spontaneous↗
PubMed1988

The relationship of maternal and fetal glucose concentrations in the human from midgestation until term.

The relationship between maternal and fetal glucose concentrations was investigated in pregnant women at different gestational ages. Maternal and fetal blood samples were obtained during 14 fetoscopies (17 to 21 weeks), four umbilical cord samples (32 to 36 weeks), nine elective cesarean sections with appropriate for gestational age (AGA) fetuses (35 to 39 weeks) and nine elective cesarean sections with small for gestational age (SGA) fetuses (34 to 37 weeks). A significant linear relationship between maternal and fetal glucose concentrations was demonstrated at midgestation (P less than .001) and at late gestation (P less than .001). At equal maternal concentrations there were no significant differences in fetal glucose concentration between the cord samples obtained in late gestation and those obtained at cesarean section. At midgestation fetal glucose concentration is independent of and may exceed maternal concentration at maternal glucose levels less than 4.44 mmol/L. Furthermore, the relationship between maternal and fetal concentrations at maternal glucose concentrations greater than 4.44 mmol/L is significantly different at midgestation from that at late gestation (P less than .01); at equal maternal concentrations there were higher glucose concentrations in the mid trimester fetus. In late gestation as the maternal glucose concentration increases there is an increase in the maternal arterial-umbilical arterial glucose concentration difference and the umbilical glucose/oxygen quotient (P less than .003) reflecting increased glucose utilization by the fetus. There were no significant differences between AGA and SGA babies with respect to these relationships.

Blood Glucose↗
PubMed1988

Ultrasonography in the differential diagnosis of "double" uteri.

A total of 43 infertile patients with hysterosalpingographic diagnosis of bifid uterus underwent sonography and subsequent laparoscopy/hysteroscopy to evaluate the capacity of ultrasound to demonstrate the peritoneal profile of the malformed uteri correctly. Sonographic visualization was adequate in 39 cases (90.7%) and the following were identified correctly: 1 of 2 didelphic uteri, all of 11 bicornuate uteri, all of 4 complete septate uteri, and all of 22 partial septate uteri. The sensitivity of ultrasound in detecting the presence of a perimetrial fundal notch was 92.3% and its specificity 100%. Thus, a precise differential diagnosis of "double" uteri was possible with this technique, which may in some clinical situations provide an alternative to laparoscopy.

Endoscopy↗
PubMed1987

Fitting growth curves to head and abdomen measurements of the fetus: a multicentric study.

Three different mathematical models were fitted to ultrasonic measurements of the biparietal diameter, head circumference, and abdomen circumference obtained from 1,426 healthy fetuses. The linear cubic function gives coefficients comparable with most previous studies, but it does not thoroughly explain fetal growth throughout pregnancy. Both the exponential-power function and the logistic-logarithmic function fit the raw data well and theoretically reflect the biological phenomena of human fetal growth. The characteristics of each model are discussed.

Abdomen↗
PubMed1987

Chorionic villus sampling: an analysis of the obstetric experience of 1,000 cases.

Chorionic villus sampling was performed between 7 and 12 weeks gestation in 1,000 patients, 935 of whom intended to continue after fetal diagnosis. Transcervical and Transabdominal aspiration techniques were used providing a sampling success rate of 99 per cent. Anatomical and clinical contraindications to transcervical aspiration were pointed out, and the complementary role of the transabdominal approach evaluated. In the 615 concluded pregnancies an overall abortion rate of 4.1 per cent was observed. A significant association between fetal loss and number of catheter insertions was demonstrated. Bacterial inoculation by catheter insertion and colonization of uterine cavity was suspected as the cause of chorionamnionitis diagnosed in two cases (0.2 per cent) after CVS. Bleeding was the most frequent early complication (12.0 per cent) following chorionic aspiration, but was not significantly related to pregnancy wastage. Late complications, i.e. premature rupture of membranes (0.8 per cent), preterm delivery (6.3 per cent), perinatal losses (1.2 per cent), placental disorders (1.6 per cent), and congenital defects (2.6 per cent) did not exceed the expected values. Normal intrauterine growth patterns were ultrasonically estimated by cross-sectional and longitudinal studies, while the weight at birth was normally distributed in the range of the general population.

Abortion, Missed↗
PubMed1987

Cord sampling for the evaluation of oxygenation and acid-base balance in growth-retarded human fetuses.

In 14 pregnancies complicated by intrauterine growth retardation, the umbilical cord was sampled before delivery under ultrasonic guidance for rapid fetal karyotyping. Fetal blood was analyzed for respiratory gases, acid-base balance, and lactate concentrations. Two patients were excluded from the study because cord samples were diluted with amniotic fluid. In six patients (group 1), the clinical assessment warranted continuation of pregnancy. Cesarean sections were performed in the remaining eight patients (group 2) within 8 hours of cord sampling. The data from the two groups were compared with those obtained from umbilical venous blood at the time of elective repeat cesarean section in term appropriate for gestational age infants (controls). No significant difference in PO2 was found between groups 1 and 2 and controls. In contrast, there were significant differences in oxygen saturation and acid-base balance between groups 1 and 2. Lactate concentration was inversely correlated with pH and was elevated in five of six fetuses requiring a prompt cesarean section: In two of these five fetuses, nonstress fetal heart rate tracings were reactive. The results suggest that fetal blood biochemistry, and particularly lactate concentration, may represent an additional indicator of fetal well-being in pregnancies complicated by intrauterine growth retardation.

Acid-Base Equilibrium↗
PubMed1987

Perinatal management of fetal hydronephrosis with normal bladder.

This report covers 30 cases of prenatal diagnosis of uni- or bilateral hydronephrosis not associated with an overdistended bladder. Oligohydramnios was observed only in four cases while polyhydramnios occurred in three affected fetuses. In no case was fetal urine aspirated or drained prenatally. Early delivery was performed in four cases with oligohydramnios. Sixteen newborns required surgical correction of the lesion as it was confirmed by urography, following at least two sonographic examinations which confirmed a moderate to severe hydronephrosis after birth. The most frequent lesion was pyelo-ureteric junction obstruction (12 cases). Thirteen cases were normal at follow-up, and in two of these the dilation cleared up during intrauterine life. One case of severe hydronephrosis proved to be a multicystic kidney. In this series isolated hydronephrosis, both uni- or bilateral did not result in fetuses being at high risk for survival (only one infant died after surgery) nor as regards to associated malformations and perinatal morbidity. Provided a properly timed surgical correction was performed, renal function resulted to be good at follow-up.

Cesarean Section↗
PubMed1987

Bis-substituted hydroxy-anthracenediones: DNA binding and biological activity.

Three new hydroxy-9,10-anthracenedione derivatives (compounds 1-3 in Figure 1), bearing two charged or polar side chains at positions 2 and 4/5 of the tricyclic system, have been investigated for their DNA binding, cytotoxic and genotoxic activity. The interaction mode with nucleic acids is intercalative for compounds 1 and 2, while external and intercalative binding probably coexist for compound 3. Complexation of the nucleic acid occurs in all cases in a cooperative manner, so that drug binding favours further binding to double helical DNA. The scale of the intrinsic binding constant is discussed in terms of the nature and position of the side chain. Cell growth and DNA synthesis inhibition data match quite well with DNA affinity. Alkaline elution experiments show a correlation between drug cytotoxicity and DNA damage. Our results indicate that the position and number of OH groups, as well as of charged side chains, play an important role in modulating drug affinity for DNA and the consequent biological effects.

Anthraquinones↗
PubMed1986

Routine obstetric ultrasound: effectiveness of cross-sectional screening for fetal growth retardation.

Sonographic detection of fetal growth retardation was evaluated on a sample of 778 patients routinely scanned over a 16-month period. From the 29th week to term, the sensitivity of abdominal circumference measurement progressively increased from 41% to 88% (P less than 0.01). Higher rates were achieved by using the biparietal diameter but false-positive diagnoses were twice as frequent as with the abdominal measurements. When the limitations in precision of abdominal circumference were considered, the screening rate of this parameter increased about 16%. Moreover, 50% of the false-negative diagnoses were made on fetuses weighing between the fifth and 10th centiles at birth. These diagnostic indices for biparietal diameter and abdominal circumference evaluated on a retrospective series proved to be lower than those reported for the prospective selected series. However, the results yielded by routine ultrasound were better than those obtained with clinical or traditional biochemical methods. These findings underline the importance of sonography not only in serial control of high-risk pregnancies but also in cross-sectional screening programs.

Diagnostic Errors↗
PubMed1986

The intraventricular conduction time of fetal heart in pregnancies with suspected fetal growth retardation.

Electrocardiographs from 68 fetuses with ultrasound evidence of growth retardation were recorded from the maternal abdomen; QRS duration was measured and compared to normal standards previously obtained in our Institute. Of these fetuses, 54 were small-for-gestational-age at birth and 44 exhibited QRS duration values below -2 SD for their gestational age. All but one of the 14 normal fetuses showed normal QRS values (positive predictive value = 98%; negative predictive value = 57%). Of 11 fetuses with QRS duration values below -4 SD, nine were particularly small, below the 2nd centile of weight for gestation. QRS duration measurements may represent a sensitive method for identifying fetal growth-retardation. The QRS duration also seems to provide a reliable prognosis of perinatal outcome. Normal values are a reassuring factor: abnormal cardiotocographic records were observed in only 2 out of 23 cases and no low Apgar scores or perinatal deaths occurred. QRS values below -4 SD proved to be associated with abnormal cardiotocographic records (7/13), low Apgar scores (5/15) and perinatal deaths (3/15).

Birth Weight↗
PubMed1986

Ultrasound contributions to the management of the severely isoimmunized fetus.

Twenty-four out of 81 fetuses affected by anti-D isoimmunization underwent ultrasonic guided intrauterine transfusions (2.8 I. U. T.s per fetus). The absolute value and trend of delta OD 450 micron value was correlated with the severity of fetal condition as evaluated by ultrasonography following simple semiquantitative grading of ascites (mild, moderate, severe) and diagnosis of hydrops. The evaluation of disease was monitored in this way during transfusion therapy. Transfusion procedures have been ultrasonically guided. When ascites was present a few milliliters of isolytic solution allowed the bubbling effect to be observed. In the case of no ascites we confirmed the needle positioning by a cineradiographic sequence lasting a few seconds. Fetal transfusions were repeated every 10 to 15 days and the amount of packed red cells to be injected was determined according to the week of gestation. Post-transfusion monitoring included ultrasonic reevaluation of fetal parameters and non-stress testing. All fetuses were delivered via cesarean section before the 35th week of gestation. In no case was treatment started after the 31st week. Seventeen fetuses were transfused before the 26th week (71%). In 13 fetuses transfusions were started before ascites had appeared. Only 5 fetuses worsened and the 3 which became hydropic eventually died. The delta OD-450 value of these 5 cases before therapy had already indicated that they were more severely affected. Survival rate in this group was 69%. Eleven fetuses showed different degrees of ascites or hydrops at the time of the first transfusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Transfusion, Intrauterine↗
PubMed1986

Accuracy of an average ultrasonic laboratory in measurements of fetal biparietal diameter, head circumference and abdominal circumference.

Twenty patients between 14 and 28 gestational weeks were scanned on three occasions during a single day by six operators with different ultrasonic experience (three use a compound scanner and three a real-time equipment). On each occasion every operator had to measure in a "blind" manner the fetal biparietal diameter (BPD), head circumference and abdominal circumference (HC and AC); a coded copy of head and abdominal circumference was subsequently measured by one of the members of the staff. Statistical analysis was carried out on the 1800 measurements, and it was concluded that the accuracy was not dissimilar from that reported by pilot studies. The reproducibility of the parameters studied did not change throughout pregnancy and real-time and compound scanner yielded homogeneous results.

Abdomen↗