Pub Date : 2011-05-01DOI: 10.1017/S0965539511000076
Z. Laksman, L. Harris, C. Silversides
Physiologic changes in maternal haemodynamics, hormones and autonomic properties contribute to arrhythmias in pregnancy. While arrhythmias most commonly occur in pregnant women with structural heart disease or those with a history of cardiac arrhythmias, they can also occur de novo in women with no documented cardiac disease.
{"title":"CARDIAC ARRHYTHMIAS DURING PREGNANCY: A CLINICAL APPROACH","authors":"Z. Laksman, L. Harris, C. Silversides","doi":"10.1017/S0965539511000076","DOIUrl":"https://doi.org/10.1017/S0965539511000076","url":null,"abstract":"Physiologic changes in maternal haemodynamics, hormones and autonomic properties contribute to arrhythmias in pregnancy. While arrhythmias most commonly occur in pregnant women with structural heart disease or those with a history of cardiac arrhythmias, they can also occur de novo in women with no documented cardiac disease.","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"22 1","pages":"123-143"},"PeriodicalIF":0.0,"publicationDate":"2011-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0965539511000076","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56977642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-05-01DOI: 10.1017/S0965539511000064
B. Myers, E. Truelove
Platelets are an essential component of the first step in the process of haemostasis, plugging defects in the endothelium and providing a surface for secondary haemostasis to occur, via the coagulation pathway. Platelet aggregation and activation cause granule release of von Willebrand factor, ADP and serotonin, which, in turn, results in recruitment of more platelets to form the platelet plug. This serves to stop the bleeding, and also to activate the coagulation pathway on the surface of the activated platelets, leading to a firm fibrin clot.
{"title":"DIAGNOSIS AND MANAGEMENT OF THROMBOCYTOPENIA IN PREGNANCY","authors":"B. Myers, E. Truelove","doi":"10.1017/S0965539511000064","DOIUrl":"https://doi.org/10.1017/S0965539511000064","url":null,"abstract":"Platelets are an essential component of the first step in the process of haemostasis, plugging defects in the endothelium and providing a surface for secondary haemostasis to occur, via the coagulation pathway. Platelet aggregation and activation cause granule release of von Willebrand factor, ADP and serotonin, which, in turn, results in recruitment of more platelets to form the platelet plug. This serves to stop the bleeding, and also to activate the coagulation pathway on the surface of the activated platelets, leading to a firm fibrin clot.","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"22 1","pages":"144-167"},"PeriodicalIF":0.0,"publicationDate":"2011-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0965539511000064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56977575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-02-01DOI: 10.1017/S0965539510000136
N. Jones, N. Raine-Fenning, G. Bugg
{"title":"3D POWER DOPPLER IN OBSTETRICS","authors":"N. Jones, N. Raine-Fenning, G. Bugg","doi":"10.1017/S0965539510000136","DOIUrl":"https://doi.org/10.1017/S0965539510000136","url":null,"abstract":"","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"22 1","pages":"1-24"},"PeriodicalIF":0.0,"publicationDate":"2011-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0965539510000136","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56977050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-02-01DOI: 10.1017/S0965539511000027
J. Unterscheider, F. Malone
Screening for Down syndrome is an important part of routine antenatal care and should be made available, if requested, after appropriate counselling including risks and benefits, to all pregnant women, regardless of maternal age. Prenatal screening for fetal Down syndrome and other aneuploidies has advanced significantly since its advent in the 1980s. Historically, women 35 years or older were offered prenatal genetic counselling and the option of a diagnostic test such as chorionic villus sampling or amniocentesis. With this screening approach only 20% to 30% of the fetal Down syndrome population are detected antenatally. Sonographic and maternal biochemical markers are now used in combination to screen for aneuploidies in the first and second trimesters. The most common screening method in the first trimester combines the maternal serum markers HCG and PAPP-A with the sonographic evaluation of fetal nuchal translucency thickness. Newer markers have been proposed to further refine the risk assessment for Down syndrome to maximise detection rates and minimise false positive rates. These newer first trimester markers include sonographic assessment of the fetal nasal bone (NB), the frontomaxillary facial (FMF) angle, ductus venosus (DV) Doppler and tricuspid valve regurgitation (TR).
{"title":"First and second trimester sonographic screening for fetal Down syndrome","authors":"J. Unterscheider, F. Malone","doi":"10.1017/S0965539511000027","DOIUrl":"https://doi.org/10.1017/S0965539511000027","url":null,"abstract":"Screening for Down syndrome is an important part of routine antenatal care and should be made available, if requested, after appropriate counselling including risks and benefits, to all pregnant women, regardless of maternal age. Prenatal screening for fetal Down syndrome and other aneuploidies has advanced significantly since its advent in the 1980s. Historically, women 35 years or older were offered prenatal genetic counselling and the option of a diagnostic test such as chorionic villus sampling or amniocentesis. With this screening approach only 20% to 30% of the fetal Down syndrome population are detected antenatally. Sonographic and maternal biochemical markers are now used in combination to screen for aneuploidies in the first and second trimesters. The most common screening method in the first trimester combines the maternal serum markers HCG and PAPP-A with the sonographic evaluation of fetal nuchal translucency thickness. Newer markers have been proposed to further refine the risk assessment for Down syndrome to maximise detection rates and minimise false positive rates. These newer first trimester markers include sonographic assessment of the fetal nasal bone (NB), the frontomaxillary facial (FMF) angle, ductus venosus (DV) Doppler and tricuspid valve regurgitation (TR).","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"22 1","pages":"45-66"},"PeriodicalIF":0.0,"publicationDate":"2011-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0965539511000027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56976883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2011-02-01DOI: 10.1017/S0965539511000039
R. Grayson, M. Hewison
At the end of 2007, Time magazine listed the “benefits of vitamin D” as one of its top 10 medical breakthroughs for that year. Since then there has been a remarkable upsurge of interest in vitamin D, with new research advances seemingly published on a weekly basis. In particular, there has been increasing awareness of the variability of vitamin D status in populations across the globe and, significantly, a growing debate about the need for revised parameters for vitamin D supplementation. Although sub-optimal vitamin D is likely to be a widespread problem for 21 st century societies, it is also clear that some groups are at much greater risk of low vitamin D status. Prominent amongst these are pregnant women and the aim of the following review article will be to discuss this problem in further detail with specific emphasis on its potential physiological and clinical impact.
{"title":"VITAMIN D AND HUMAN PREGNANCY","authors":"R. Grayson, M. Hewison","doi":"10.1017/S0965539511000039","DOIUrl":"https://doi.org/10.1017/S0965539511000039","url":null,"abstract":"At the end of 2007, Time magazine listed the “benefits of vitamin D” as one of its top 10 medical breakthroughs for that year. Since then there has been a remarkable upsurge of interest in vitamin D, with new research advances seemingly published on a weekly basis. In particular, there has been increasing awareness of the variability of vitamin D status in populations across the globe and, significantly, a growing debate about the need for revised parameters for vitamin D supplementation. Although sub-optimal vitamin D is likely to be a widespread problem for 21 st century societies, it is also clear that some groups are at much greater risk of low vitamin D status. Prominent amongst these are pregnant women and the aim of the following review article will be to discuss this problem in further detail with specific emphasis on its potential physiological and clinical impact.","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"22 1","pages":"67-90"},"PeriodicalIF":0.0,"publicationDate":"2011-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0965539511000039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56977428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-11-01DOI: 10.1017/S0965539510000112
L. Shaffer, D. Chitayat
Invasive prenatal testing, amniocentesis and chorionic villus sampling, has been used for over four decades to identify fetal genetic disorders. The most common test after obtaining fetal tissues is chromosome analysis, performed for a variety of medical indications including abnormal ultrasound findings, advanced maternal age and an abnormal screen for Down syndrome. About 2% of pregnancies in women over the age of 35 will show a chromosome abnormality, with trisomy 21 being the most common. In addition to Down syndrome, the most commonly observed trisomies are those of chromosomes 13 and 18. Numerical abnormalities of the sex chromosomes are also relatively common, as well as triploidy.
{"title":"CHROMOSOMAL MICROARRAYS: THE BENEFITS AND CHALLENGES OF INTRODUCTION INTO PRENATAL DIAGNOSIS","authors":"L. Shaffer, D. Chitayat","doi":"10.1017/S0965539510000112","DOIUrl":"https://doi.org/10.1017/S0965539510000112","url":null,"abstract":"Invasive prenatal testing, amniocentesis and chorionic villus sampling, has been used for over four decades to identify fetal genetic disorders. The most common test after obtaining fetal tissues is chromosome analysis, performed for a variety of medical indications including abnormal ultrasound findings, advanced maternal age and an abnormal screen for Down syndrome. About 2% of pregnancies in women over the age of 35 will show a chromosome abnormality, with trisomy 21 being the most common. In addition to Down syndrome, the most commonly observed trisomies are those of chromosomes 13 and 18. Numerical abnormalities of the sex chromosomes are also relatively common, as well as triploidy.","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"21 1","pages":"307-322"},"PeriodicalIF":0.0,"publicationDate":"2010-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0965539510000112","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56976946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-11-01DOI: 10.1017/S0965539510000094
B. Jones, J. Girling
Pregnancy is a physiological condition that affects all organs. Diseases unrelated to pregnancy may present coincidentally during pregnancy or may be exacerbated by pregnancy, and may increase maternal and/or fetal morbidity or mortality. Compared with many other systems, the changes within the biliary tree and pancreas are relatively minimal. However, pregnancy is associated with an increased likelihood of cholelithiasis, which can have significant implications for the parturient.
{"title":"BILIARY AND PANCREATIC DISEASE IN PREGNANCY","authors":"B. Jones, J. Girling","doi":"10.1017/S0965539510000094","DOIUrl":"https://doi.org/10.1017/S0965539510000094","url":null,"abstract":"Pregnancy is a physiological condition that affects all organs. Diseases unrelated to pregnancy may present coincidentally during pregnancy or may be exacerbated by pregnancy, and may increase maternal and/or fetal morbidity or mortality. Compared with many other systems, the changes within the biliary tree and pancreas are relatively minimal. However, pregnancy is associated with an increased likelihood of cholelithiasis, which can have significant implications for the parturient.","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"21 1","pages":"263-282"},"PeriodicalIF":0.0,"publicationDate":"2010-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0965539510000094","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56976375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-11-01DOI: 10.1017/S0965539510000100
N. Adab, Michael F. O’Donoghue
Wediscussstudiesbasedonanimalmodelsaswellasthosethathavefollowed-upchildrenexposed to AEDs in-utero. Careful longitudinal human research can document thecognitiveandbehaviouraleffects,butthelongtimescalesrequiredandinabilitytoruleout confounding variables, both genetic and environmental, are serious limitations.Animal studies are based on the assumption that many developmental processes areconserved between the animals used in the models (most often rodents) and humans.However, the hugely expanded cortex and cognitive and behavioural repertoire ofhumans implies that there are aspects that can not be well modelled. In addition,due to differences in how susceptible different species are to various teratogens,studies always need to be done in man as well. Nevertheless, an understanding of themolecular mechanisms of neuro-teratogenesis derived from animal models will helpus predict which anti-epileptic drugs are likely to cause fewer neuro-developmentalproblems in humans.In the first section we present a simplified account of how the developmentof the human CNS is regulated by evolutionary conserved genetic and signallingpathways. We emphasize these pathways because AEDs can potentially interferewith them. Because of the complexity and duration of brain development there isa wealth of critical periods during which AEDs have the potential to interfere with
{"title":"ANTI-EPILEPTIC DRUGS AND BRAIN AND BEHAVIOURAL DEVELOPMENT IN ANIMAL MODELS AND HUMANS","authors":"N. Adab, Michael F. O’Donoghue","doi":"10.1017/S0965539510000100","DOIUrl":"https://doi.org/10.1017/S0965539510000100","url":null,"abstract":"Wediscussstudiesbasedonanimalmodelsaswellasthosethathavefollowed-upchildrenexposed to AEDs in-utero. Careful longitudinal human research can document thecognitiveandbehaviouraleffects,butthelongtimescalesrequiredandinabilitytoruleout confounding variables, both genetic and environmental, are serious limitations.Animal studies are based on the assumption that many developmental processes areconserved between the animals used in the models (most often rodents) and humans.However, the hugely expanded cortex and cognitive and behavioural repertoire ofhumans implies that there are aspects that can not be well modelled. In addition,due to differences in how susceptible different species are to various teratogens,studies always need to be done in man as well. Nevertheless, an understanding of themolecular mechanisms of neuro-teratogenesis derived from animal models will helpus predict which anti-epileptic drugs are likely to cause fewer neuro-developmentalproblems in humans.In the first section we present a simplified account of how the developmentof the human CNS is regulated by evolutionary conserved genetic and signallingpathways. We emphasize these pathways because AEDs can potentially interferewith them. Because of the complexity and duration of brain development there isa wealth of critical periods during which AEDs have the potential to interfere with","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"21 1","pages":"283-306"},"PeriodicalIF":0.0,"publicationDate":"2010-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0965539510000100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56976896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-11-01DOI: 10.1017/S0965539510000124
R. Gundry, D. Siassakos, J. Crofts, T. Draycott
{"title":"Simulation training for obstetric procedures and emergencies","authors":"R. Gundry, D. Siassakos, J. Crofts, T. Draycott","doi":"10.1017/S0965539510000124","DOIUrl":"https://doi.org/10.1017/S0965539510000124","url":null,"abstract":"","PeriodicalId":89369,"journal":{"name":"Fetal and maternal medicine review","volume":"21 1","pages":"323-345"},"PeriodicalIF":0.0,"publicationDate":"2010-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/S0965539510000124","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56976986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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