Repositório Institucional - Unifesp :: Navegando por Palavras-chave "Fetus"

Navegando por Palavras-chave "Fetus"

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Acesso aberto (Open Access)
Abnormalities of digestive tract innervation in rat fetus treated with ethylenethiourea
(Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2012-03-01) Lemos, Sidney Pereira Pinto [UNIFESP]; Martins, Jose Luiz [UNIFESP]; Lemos, Patrícia Veruska Ribeiro Barbosa; Silva, Silvio Romero Gonçalves e [UNIFESP]; Santos, Fernando Leandro dos; Silva Júnior, Valdemiro Amaro da; UNIVASF; Universidade Federal de São Paulo (UNIFESP); Federal Rural University Department of Veterinary Medicine; Federal Rural University Department of Animal Morphology and Physiology
PURPOSE: The pathophysiology of abnormalities associated with myenteric plexus lesions remains imperfectly understood. Such abnormalities have been correlated with subocclusive intestinal conditions in children with Hirschsprung's disease, cases of chronic constipation and, postoperatively, in cases of anorectal anomalies. This study evaluated abnormalities of the myenteric plexus in fetus from female rats that received ethylenethiourea. METHODS: Female rats were exposed to ethylenethiourea on the 11th day of pregnancy (experimental group) or to 0.9% physiological solution (control group). Abnormalities were only found in the experimental group. The digestive tract muscle layer was analyzed morphometrically and changes to the frequencies of nerve plexus cells and interstitial cells of Cajal were evaluated, using hematoxylin-eosin, S-100 protein, neuron-specific enolase and C-Kit, respectively. RESULTS: Muscle and skeletal abnormalities were observed in 100%, anorectal anomalies in 86%, absent tail in 71%, short tail in 29%, duodenal atresia in 5%, esophageal atresia in 5% and persistent omphalomesenteric duct in 5%. Histopathological analysis showed a thinner muscle layer associated with lower frequencies of ganglion cells and interstitial cells of Cajal, in all gastrointestinal tract. CONCLUSION: Severe nerve plexus abnormalities associated with muscle layer atrophy were observed throughout the gastrointestinal tract in newborn rats exposed to ethylenethiourea.
Acesso aberto (Open Access)
Aplicações da ultra-sonografia tridimensional na avaliação do cerebelo fetal
(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2007-06-01) Araujo Júnior, Edward [UNIFESP]; Guimarães Filho, Hélio Antonio [UNIFESP]; Pires, Claudio Rodrigues [UNIFESP]; Nardozza, Luciano Marcondes Machado [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
For the last years three-dimensional ultrasonography has become an imaging diagnosis method of great importance in obstetrics. One of its advantages would be the higher sensitivity compared with two-dimensional ultrasound in the diagnosis of some fetal malformations. The potential applications of this new method would be an improved accuracy in the measurement of fetal organs, the possibility of reviewing volumes in the absence of the patient, and using different planes to assess specific anatomical structures, as well as the capacity to transfer data files to remote reference centers. Ultrasonographic evaluation of fetal cerebellum is particularly important, since developmental alterations are correlated with the fetal growth alterations and congenital anomalies. The objective of this updating is to demonstrate the VOCAL and 3D XI methods in the evaluation of the fetal cerebellum, their potential benefits, and the latest information in the literature about this subject.
Somente Metadadados
Assessment of cerebral circulation in normal fetuses by three-dimensional power Doppler ultrasonography
(Elsevier B.V., 2012-03-01) Figuinha Milani, Herbene Jose [UNIFESP]; Sa Barreto, Enoch Quindere de [UNIFESP]; Araujo Junior, Edward [UNIFESP]; Haratz, Karina Krajden [UNIFESP]; Rolo, Liliam Cristine [UNIFESP]; Machado Nardozza, Luciano Marcondes [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Objective: To assess the three-dimensional power Doppler ultrasonography (3D power Doppler) vascular indices in the middle cerebral artery (MCA), anterior cerebral artery (ACA) and posterior cerebral artery (PCA) territories. Methods: A cross-sectional study was carried out on 111 normal pregnancies between 26 and 34 weeks. the MCA, ACA and PCA territories closest to the transducer were scanned and volumes were calculated by using the VOCAL (Virtual Organ Computer-aided Analysis) program. the 3D power Doppler indices - vascularization index (VI), flow index (FI) and vascularization-flow index (VFI) were calculated. Scatter graphs, Pearson correlation coefficients (r) and linear regression models were used. Results: Only the FI-MCA (r = 0.38 and p < 0.001), VFI-MCA (r = 0.23 and p = 0.016) and FI-PCA (r = 0.191 and p = 0.040) had a low correlation with gestational age. the other 3D power Doppler indices VI-MCA (r = 0.153 and p = 0.150), VI-ACA (r = 0.105 and p = 0.271), FI-ACA (r = 0.154 and p = 0.106), VFI-ACA (r = 0.134 and p = 0.161), VI-PCA (r = 0.105 and p = 0.270) and VFI-PCA (r = 0.126 and p = 0.180) showed no statistically significant correlation with gestational. Conclusion: It was observed a low correlation between gestational age and the FI-MCA, VFI-MCA and FI-PCA. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
Somente Metadadados
Assessment of fetal lung maturity by ultrasound: objective study using gray-scale histogram
(Informa Healthcare, 2015-04-01) Avritscher Beck, Ana Paula [UNIFESP]; Araujo Junior, Edward [UNIFESP]; Figueiredo Stochero Leslie, Ana Teresa [UNIFESP]; Camano, Luiz [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Objective: To evaluate lung maturity using ultrasound (US), comparing the subjective and gray-scale histogram (GSH) techniques.Methods: A total of 77 single pregnancies were evaluated and divided into the following two groups: 11 women of gestational age 28 to 35 + 6 weeks and 66 women >= 36 weeks. the women underwent to emergency or planned cesarean section, according to fetal-maternal indications. the US was performed on the mean sagittal plane of the fetal torso, in order to observe the lung and hepatic areas. Fetal lung maturity was evaluated subjectively and through GSH. After delivery, the incidence of respiratory distress in the newborn was evaluated. the analyses were considered to be correct or incorrect, and comparisons were made using the McNemar test. in order to compare lung/hepatic echogenicity using GSH in groups with and without respiratory distress, the Student's t-test was used.Results: the subjective evaluation identified 41 cases (53.2%) correctly and 36 (46.8%) incorrectly, while GSH found 58 (75.3%) correctly and 19 (24.7%) incorrectly (p = 0.006). There was a significant difference in mean lung/hepatic echogenicity between the groups with and without respiratory distress (1.05 versus 1.26; p = 0.002). in the group of 28 to 35 + 6 weeks, GSH presented sensitivity, specificity and accuracy in predicting respiratory distress of 61.9%, 89.1% and 81.6%, respectively.Conclusion: the evaluation of fetal lung maturity through GSH was more effective than the subjective method in predicting respiratory distress among newborns.
Acesso aberto (Open Access)
Avaliação da vitamina D nas gestantes com fetos de peso abaixo do percentil 10
(Universidade Federal de São Paulo (UNIFESP), 2019-11-28) Marcal, Vivian Macedo Gomes [UNIFESP]; Nardozza, Luciano Marcondes Machado [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Objective: To evaluate the vitamin D dosage in pregnant women with small fetuses for gestational age (SGA) and with fetal growth restriction (FGR). Methods: This was a cross-sectional prospective case-control study in which pregnant women with gestational age between 26 and 36 weeks were selected, with fetuses that had adequate weight for gestational age (AGA), small for gestational age (SGA) and fetal growth restriction (FGR), diagnosed by ultrasound. We performed the dosage of Vitamin D, which was evaluated by the chemiluminescence method. In addition, for the numerical variables, the variance analysis model with a fixed factor and Tukey's multiple comparisons method were adjusted; To compare the groups for categorical variables, Fisher's exact test was used. Results: Peripheral blood was collected from 100 pregnant women, and thirteen cases were excluded. No statistical differences were observed between the groups (p=0.672); however, we observed a higher concentration of vitamin D in pregnant women with fetuses affected by FGR compared to the other groups (FGR: 24.80 ng/mL vs. SGA: 23.61). ng/mL vs. AGA: 22.47ng/mL). Conclusion: No statistical difference was found in Vitamin D dosage between fetuses with weight below the 10th percentile.
Acesso aberto (Open Access)
Avaliação do comprimento e área do corpo caloso fetal por meio da ultrassonografia tridimensional
(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2010-12-01) Visentainer, Milena [UNIFESP]; Araujo Júnior, Edward [UNIFESP]; Rolo, Liliam Cristine [UNIFESP]; Nardozza, Luciano Marcondes Machado [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
PURPOSE: to establish reference values for the length and area of the fetal corpus callosum between the 20th and 33rd weeks of gestation using three-dimensional ultrasound (3DUS). METHODS: this cross-sectional study involved 70 normal pregnancies with gestational age between 20 and 33 weeks. An Accuvix XQ instrument with a convex volumetric transducer (3 to 5 MHz) was used. To assess the corpus callosum, a transfrontal plane was obtained using the metopic suture as an acoustic window. Length was obtained by measuring the distance between the proximal and distal extremities of the corpus callosum. Area was obtained by manual tracing of the external corpus callosum surface. The means, medians, standard deviations, and maximum and minimum values were calculated for the corpus callosum length and area. Scatter graphs were created to analyze the correlation between corpus callosum length and area and gestational age and biparietal diameter, the quality adjustments was verified according to the determination coefficient (R²). The intraclass correlation coefficient (ICC) was used to assess the intraobserver variability. RESULTS: mean corpus callosum length increased from 21.7 (18.6 - 25.2 mm) to 38.7 mm (32.6 - 43.3 mm) between 20 and 33 weeks of pregnancy, respectively. Mean corpus callosum area increased from 55.2 (41.0 - 80.0 mm²) to 142.2 mm² (114.0 - 160.0 mm²), between 20 to 33 weeks of pregnancy, respectively. There was a strong correlation between corpus callosum length and area and gestational age (R² = 0.7 and 0.7, respectively) and biparietal diameter (R² = 0.7 and 0.6, respectively). Intraobserver variability was appropriate, with an ICC of 0.9 and 0.9 for length and area, respectively. CONCLUSIONS: reference values for corpus callosum length and area were established for fetuses between 20 and 33 weeks gestation. Intraobserver variability was appropriate.
Acesso aberto (Open Access)
Avaliação do desfecho dos conceptos com risco aumentado de ocorrência de anomalias cromossômicas calculado pela medida da translucência nucal
(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2005-03-01) Camano, Luiz [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Nardozza, Luciano Marcondes Machado [UNIFESP]; Pares, David Baptista da Silva [UNIFESP]; Chinen, Paulo Alexandre [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
PURPOSE: to evaluate the outcome of fetuses with risk of chromosomal anomalies over 1:300, based on the nuchal translucency measurement, according to the Fetal Medicine Program. METHODS: in the pregnancies with risk of chromosomal anomalies over 1:300, variables like fetal karyotype, spontaneous or induced abortion, prematurity, stillbirth, neonatal death, malformations, and healthy newborn were considered. We used Fisher's exact test to compare differences in proportions between groups. RESULTS: we selected 193 (3.6%) single pregnancies with risk of chromosomal anomalies over 1:300. Only 165 cases fulfilled the inclusion criteria. Of these only 32.1% underwent fetal karyotyping and of which 8.5% had chromosomal anomalies (85.7% had trisomy 21). Regarding pregnancy outcomes, 4.2% were spontaneous miscarriages, 4.2% induced abortions, 4.8% were premature, 1.8% had neonatal death, 1.8% were stillborn, and 4.2% had structural malformation (85.7% congenital heart diseases). Almost 85.0% were healthy newborns. Patients with abnormal karyotyping had more induced abortions (p<0.001) and more structural malformations (p<0.001) than patients with normal karyotyping. None of the genetic diseases or miscarriages was associated with invasive procedures. Sixty-six percent of the pregnancies with prenatal diagnosis of abnormal karyotype were interrupted. CONCLUSION: nuchal translucency is an important screening tool for chromosomal diseases especially for low-risk pregnancies. However, counseling pregnancies with high risk of chromosomal anomalies should consider that, although these fetuses have a worse prognosis, most of the outcomes are favorable.
Somente Metadadados
Comparison between 2D ultrasonography and magnetic resonance imaging for assessing brain and spine parameters in fetuses with spina bifida
(Springer, 2013-05-01) Araujo Junior, Edward [UNIFESP]; Nakano, Mayra Lemos [UNIFESP]; Machado Nardozza, Luciano Marcondes [UNIFESP]; Haratz, Karina Krajden [UNIFESP]; Oliveira, Patricia Soares [UNIFESP]; Martins, Wellington P.; Ajzen, Sergio Aron [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
To compare two-dimensional ultrasonography (2DUS) and magnetic resonance imaging (MRI) for assessing brain and spine parameters in fetuses with spina bifida.A cross-sectional study was conducted on 15 fetuses with spina bifida (one with encephalocele, four with rachischisis and 10 with myelomeningocele). the size of the atrium of the lateral ventricle, percentage shortening of the cerebellum, degree of compromising of the first vertebra and total number of vertebras affected by herniation were assessed. the MRI examination was performed not more than 7 days after the 2DUS. To compare and correlate the parameters from the two techniques, the paired Student's t test and intraclass correlation coefficient (ICC) were used. To assess the correlations of atrium measurements from 2DUS and MRI with other parameters, Pearson's correlation coefficient (r) was used.No significant difference was observed in any of the means of the parameters assessed using the two techniques (p > 0.05). Both 2DUS and MRI seemed to present satisfactory reliability in measurements on the size of the atrium of the lateral ventricle and the first vertebra affected (ICC = 0.88 and 0.75, respectively). Measurements on the atrium of the lateral ventricle from 2DUS correlated better with the other parameters than did measurements from MRI.In fetuses with spina bifida, 2DUS and MRI present similar results, but measurements on the atrium of the lateral ventricle from 2DUS correlated better with the other parameters.
Acesso aberto (Open Access)
Comparison between multiplanar and rendering modes in the assessment of fetal atrioventricular valve areas by 3D/4D ultrasonography
(Sociedade Brasileira de Cirurgia Cardiovascular, 2012-09-01) Araujo Júnior, Edward [UNIFESP]; Rolo, Liliam Cristine [UNIFESP]; Simioni, Christiane [UNIFESP]; Nardozza, Luciano Marcondes Machado [UNIFESP]; Rocha, Luciane Alves da [UNIFESP]; Martins, Wellington P.; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); University of São Paulo Faculty of Medicine of Ribeirão Preto Department of Obstetrics and Gynecology; School of Ultrasound and Medicine of Ribeirão Preto Recycling; National Institute of Science and Technology (INCT) of Hormones and Women's Health
OBJECTIVE: To compare the agreement of multiplanar and rendering modes in the assessment fetal atrioventricular valves (mitral and tricuspid) areas by three-dimensional (3D) ultrasonography using the software spatio-temporal image correlation (STIC). METHODS: We conducted a prospective cross-sectional study with normal pregnant women, with single fetuses, between 18-33 weeks. To measure the areas, we used the plan of four-chamber view. In the case of multiplanar, the plane was rotated on the axis Z form the heart to position at 9h. For rendering, the green line (region of interest - ROI) was placed from the atria of the heart perpendicular to the crux. The agreement was assessed by a Bland-Altman (limits of agreement) using the relative difference between the measures: ((rendering mode) - (multiplanar mode)) / (average). RESULTS: 328 fetuses were evaluated. We have not identified the occurrence of systematic error between methods: the average relative difference was 1.62% (-2.07% to 5.32%, confidence interval 95%) in the mitral and 1.77% (- 1.08% to 4.62%) in the tricuspid valve. The limits of agreement between methods were -65.26% to 68.51% for the mitral and -49.91% to 53.45% for the tricuspid. CONCLUSIONS: There was no systematic error between modes and thus the observed values for the area of fetal atrioventricular valves can be used for comparisons needs to be corrected. However, relatively large variations may be observed when repeating the measurement area by different modes.
Somente Metadadados
Correlation of the fetal cerebellar volume with other fetal growth indices by three-dimensional ultrasound
(Taylor & Francis Ltd, 2007-08-01) Araujo Junior, Edward [UNIFESP]; Pires, Claudio Rodrigues [UNIFESP]; Nardozza, Luciano Marcondes Machado [UNIFESP]; Guimarães Filho, Hélio Antonio [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Objective. To verify the correlation of fetal cerebellar volume by three- dimensional ultrasound ( 3D US) with other indices of fetal growth in normal fetuses.Methods. This was a longitudinal prospective study involving 52 normal pregnant women between 20 and 32 weeks of gestation. the assessments of the fetal cerebellar volume were carried out at intervals of two weeks, and the method used was VOCAL ( virtual organ computer- aided analysis) with a 308 rotation angle. At each assessment, the following biometric indices were evaluated using the two- dimensional method: biparietal diameter, head circumference, transverse cerebellar diameter, femur length, and estimated fetal weight. We used Pearson's correlation coefficient to evaluate the correlation between fetal cerebellar volume and these indices; we also used polynomial regression analysis with fetal cerebellar volume as the dependent variable and the other indices as the independent variable.Results. the fetal cerebellar volume was highly correlated with gestational age ( r 0.94; p < 0.001) and with all other fetal growth indices ( p < 0.001).Conclusions. the assessment of the fetal cerebellar volume by 3D US is an important tool to evaluate fetal growth.
Embargo
Curva de referência do volume do braço e coxa fetal por meio da ultrassonografia tridimensional usando o método XI VOCAL
(Universidade Federal de São Paulo (UNIFESP), 2011-03-30) Cavalcante, Rafael de Oliveira [UNIFESP]; Araujo Júnior, Edward [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Objective: To determine reference ranges for fetal upper arm and thigh volumes by three-dimensional (3D) ultrasonography using and the eXtended Imaging Virtual Organ Computer-aided AnaLysis method (XI VOCAL) method. Methods: This cross-sectional study enrolled 425 healthy pregnant women between 20 and 40 weeks of gestation. For volumetric calculation, XI VOCAL method was performed in 10 sequential areas along the axial cross-section, having proximal and distal epiphyses as references. In order to evaluate the correlation between fetal limb volume and gestational age (GA) second degree polynomial regression models were created determining the 5th, 10th, 25th, 50th, 75th, 90th and 95th percentiles. Intraclass correlation coefficient (ICC) was used to evaluate intra and interobserver reproducibility. Results: Mean fetal upper arm volume varied from 4.59 ± 1.18 (3.10 – 7.40 cm3) to 53.87 ± 10.72 cm3 (40.30 – 76.60 cm3) and thigh volume from 8.00 ± 1.86 (3.90 – 11.90 cm3) to 122.14 ± 14.90 cm3 (105.0 – 153.50 cm3). Fetal limb volumes were highly associated with GA: upper arm volume = 34.26 – 3.62xGA + 0.11xGA2 (R2= 0.913) and thigh volume = 68.70 – 7.63xGA + 0.23xGA2 (R2= 0.946). Intra and interobserver reproducibility were excellent with an ICC= 0.997 and 0.996, for fetal upper arm and thigh volumes, respectively. Conclusions: The reference ranges of fetal upper arm and thigh volumes were determined by 3D-ultrasound imaging using the XI VOCAL method and were found to be highly reproducible.
Acesso aberto (Open Access)
Desenvolvimento das fissuras cerebrais fetais: avaliação com ultrassonografia tridimensional
(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2011-03-01) Alves, Cynthia Maria Soares [UNIFESP]; Araujo Júnior, Edward [UNIFESP]; Nardozza, Luciano Marcondes Machado [UNIFESP]; Oliveira, Patrícia Soares de [UNIFESP]; Goldman, Suzan Menasce [UNIFESP]; Ajzen, Sergio Aron [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
PURPOSE: to assess the distance of the fetal cerebral fissures from the inner edge of the skull by three-dimensional ultrasonography (3DUS). METHODS: this cross-sectional study included 80 women with normal pregnancies between 21st and 34th weeks. The distances between the Sylvian, parieto-occiptal, hippocampus and calcarine fissures and the internal surface of the fetal skull were measured. For the evaluation of the distance of the first three fissures, an axial three-dimensional scan was obtained (at the level of the lateral ventricles). To obtain the calcarine fissure measurement, a coronal scan was used (at the level of the occipital lobes). First degree regressions were performed to assess the correlation between fissure measurements and gestational age, using the determination coefficient (R²) for adjustment. The 5th, 50th and 95th percentiles were calculated for each fissure measurement. Pearson's correlation coefficient (r) was used to assess the correlation between fissure measurements and the biparietal diameter (BPD) and head circumference (HC). RESULTS: all fissure measurements were linearly correlated with gestational age (Sylvian: R²=0.5; parieto-occiptal: R²= 0.7; hippocampus: R²= 0.3 and calcarine: R²= 0.3). Mean fissure measurement ranged from 7.0 to 14.0 mm, 15.9 to 28.7 mm, 15.4 to 25.4 mm and 15.7 to 24.8 mm for the Sylvian, parieto-occiptal, hippocampus and calcarine fissures, respectively. The Sylvian and parieto-occiptal fissure measurements had the highest correlations with the BPD (r=0.8 and 0.7, respectively) and HC (r=0.7 and 0.8, respectively). CONCLUSION: the distance from the fetal cerebral fissures to the inner edge of the skull measured by 3DUS was positively correlated with gestational age.
Somente Metadadados
Development of fetal brain sulci and gyri: assessment through two and three-dimensional ultrasound and magnetic resonance imaging
(Springer, 2011-02-01) Rolo, Liliam Cristine [UNIFESP]; Araujo, Edward [UNIFESP]; Machado Nardozza, Luciano Marcondes [UNIFESP]; Oliveira, Patricia Soares de [UNIFESP]; Ajzen, Sergio Aron [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Cerebral malformations may lead to permanent postnatal sequels. the antenatal detection of anomalous or absent fetal sulci and gyri may indicate abnormal brain development and future neurological and psychomotor problems in that infant. the prenatal diagnosis of these conditions allows genetic counseling, psychological support of the parents and optimization of obstetric management. Diagnosis is usually based on two-dimensional obstetric ultrasound (2DUS) and eventually fetal magnetic resonance imaging (MRI), to confirm findings. Fetal three-dimensional ultrasound (3DUS) using the rendering mode has been recently introduced but has not yet been extensively tested in clinical practice.This study reviewed and compared three imaging modalities, 2DUS, 3DUS, and MRI, in the analysis of the development of the main sulci and gyri of central nervous system of normal fetuses between 20 and 32 weeks' gestation.
Embargo
Efeito do tratamento materno com dexametasona em fígado fetal de ratos: o papel de macrófagos no metabolismo do ferro e maturação de eritroblastos
(Universidade Federal de São Paulo (UNIFESP), 2010-11-24) Neves, Flavia Macedo de Oliveira [UNIFESP]; Miraglia, Sandra Maria [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Macrophages (MƒÖs) have important roles during development as a phagocytosis of apoptotic cells, secretion of growth factors and cytokines as well as angiogenesis induction. In the fetal liver (FL), erythroblasts at various stages of differentiation associate with central MƒÖs to form erythroblastic islands (EI). During erythropoiesis, central MƒÖs regulate the proliferation and differentiation of erythroblasts by supplying of growth factors and nutrients as iron to heme synthesis. In addition, central MƒÖs have been shown to produce erythropoietin, the principal factor in the regulation of erythropoiesis. In addition, these cells recognize and uptake extruded erythroblast nuclei. Macrophage differentiation and erythropoiesis can be affected by glucocorticoids (GCs). During the pregnancy, GCs are frequently used to accelerate fetal lung maturation and other organs in the preterm delivery. Thus, in these work we examined changes in the central MƒÖs and erythroblasts of EI after maternal treatment with synthetic GCs. To investigate this, female Wistar rats were mated and treated between 13 to 16 dpc with dexamethasone 21-phosphate (100 ƒÝg/Kg BW/day) or vehicle (control - 0.9% NaCl). At 17 dpc, pregnant rats were euthanized and fetuses were collected to liver isolation. Fetal livers (FL) were processed to light and transmission electron microscopy. Sections (2 £gm) of FL embedded in glycol methacrylate were stained with PAS to determine the erythroid cell (proerythroblasts, basophilic, polychromatophilic and orthochromatic erythroblasts) frequencies. Total cell number from each EI was significant reduced in treated animals. To iron detection, tissue was embedded in paraffin, cut at 5 £gm and stained by Perls+DAB method. Iron accumulation was more evident in MƒÖs from FL of treated fetuses. To confirm this, areas staining positive for iron were converted to pixels and analyzed by software. Ultrastructural observations also showed electron dense granular material similar at iron deposits in cells from IE from treated fetuses. The same was not observed in the control. Iron deposits in central MƒÖs and erythroblasts were confirmed by staining sections with bismuth subnitrate. To test if GCs may induce changes in the cellular iron storage we used rat peritoneal macrophages treated with dexamethasone (10 nM) for 24 h. These cells were incubated with FeCl3 (100 £gM) for 4 h and stained by Prussian blue method. Dexamethasone treated-MƒÖs exhibited greatest amount of intracellular iron than untreated cells confirmed by blue granules quantification. Taken together, these results suggest that dexamethasone can interfere in iron uptake and/or release by macrophages and in the proliferation of erythroblasts affecting the fetal erythropoiesis in rats.
Acesso aberto (Open Access)
Intervalos de referência do pico de velocidade sistólica da artéria cerebral média fetal na população brasileira
(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2008-12-01) Nardozza, Luciano Marcondes Machado [UNIFESP]; Araujo Júnior, Edward [UNIFESP]; Simioni, Christiane [UNIFESP]; Camano, Luiz [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
OBJECTIVE: To determine a reference curve for the peak systolic velocity of fetal middle cerebral artery. MATERIALS AND METHODS: The authors developed a cross-sectional study with 143 healthy pregnant women between the 23rd and 35th gestational weeks. A bidimensional axial scan of the fetal skull was performed, including the thalami and pellucid septum. Subsequently, the middle cerebral artery was visualized with the color Doppler mode. The pulsed-wave Doppler transducer was positioned over the origin of this vessel, at < 20° insonation angle. The correlation between the peak systolic velocity of the middle cerebral artery and gestational age was evaluated by means of the Pearson's correlation coefficient (r). Regression models were utilized in the construction of a table with multiples of the medians of the middle cerebral artery peak systolic velocity for each gestational age. Additionally, reference values for this variable were determined. RESULTS: A strong correlation was observed between the middle cerebral artery peak systolic velocity and gestational age (r = 0.70; p < 0.001). Values of middle cerebral artery peak systolic velocity were calculated for the following multiples of the medians: 1.0, 1.29, 1.5, 1.55. The 2.5th and 97.5th percentiles were determined for the middle cerebral artery peak systolic velocity ranging between 24.33 cm²/s and 78.36 cm²/s. CONCLUSION: A nomogram for the fetal middle cerebral artery peak systolic velocity during the second half of pregnancy was generated.
Acesso aberto (Open Access)
Intervalos de referência para o volume da cisterna magna fetal por meio do método bidimensional usando o modo multiplanar da ultrassonografia tridimensional
(Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2014-07-01) Nardozza, Luciano Marcondes Machado [UNIFESP]; Passos, Ana Paula; Araujo Júnior, Edward [UNIFESP]; Bruns, Rafael Frederico; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Clínica Fetalmed; Universidade Federal do Paraná Departamento de Ginecologia e Obstetrícia
Objective: To establish reference intervals for the fetal cisterna magna volume by means of two-dimensional (2D) method using the multiplanar mode of three-dimensional ultrasonography. Materials and Methods: Cross-sectional study with 224 healthy pregnant women between the 17th and 29th gestational weeks. The volume was automatically obtained by multiplying the three major axes in axial and sagittal planes by the constant 0.52. Polynomial regression was utilized to establish the correlation between fetal cisterna magna volume and gestational age, with adjustments by coefficient of determination (R2). Reliability and agreement were obtained by intraclass correlation coefficient (ICC) and limits of agreement, respectively. Results: Mean fetal cisterna volume with the 2D method ranged from 0.71 ± 0.19 cm3 to 4.18 ± 0.75 cm3 at the 17th and 29th weeks, respectively. The authors observed a good correlation between fetal cisterna magna volume and gestational age (R2 = 0.67), excellent intraobserver reliability and agreement with ICC = 0.89 and limits of agreement 95% (-52.0; 51.8), respectively, and low interobserver reliability and agreement with ICC = 0.64 and limits of agreement 95% (-110.1; 84.6), respectively. Conclusion: Reference intervals for fetal cisterna magna volume by means of 2D method using the multiplanar mode of three-dimensional ultrasonography were established and presented excellent intraobserver reliability and agreement.
Somente Metadadados
Nomogram of fetal middle cerebral artery peak systolic velocity at 23-35 weeks of gestation in a Brazilian population: Pilot study
(Taylor & Francis Ltd, 2008-01-01) Machado Nardozza, Luciano Marcondes [UNIFESP]; Simioni, Christiane [UNIFESP]; Garbato, Gabriel [UNIFESP]; Araujo Junior, Edward [UNIFESP]; Guimaraes Filho, Helio Antonio [UNIFESP]; Torloni, Maria Regina [UNIFESP]; Camano, Luiz [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Objective. To establish normative data for the peak systolic velocity of the middle cerebral artery (MCA-PSV) of fetuses in the second half of pregnancy using multiples of the median and percentile reference range. Methods. A cross-sectional study was performed in 90 healthy fetuses at between 23 and 35 weeks of gestation. A bi-dimensional axial scan of the brain, including the thalami and cavitas septi pellucidi was obtained. the circle of Willis was visualized using color flow mapping. Pulsed-wave Doppler velocimetry of the MCA was performed close to the artery's origin, with a beam-vessel angle below 20. A table with the multiples of the median (MoM) of the MCA-PSV for each gestational age was generated and Pearson's correlation coefficient (r) was calculated. Regression modeling across gestational age was performed to obtain the reference values. Results. There was a strong correlation between the MCA-PVS and gestational age (r=0.70; p0.001). Values for the MCA-PSV for the following MoM were calculated: 1.0, 1.29, 1.50, and 1.55. the MCA-PSV 2.5th and 97.5th centiles ranged from 24.33cm2/s to 78.36cm2/s, respectively, between weeks 23 and 35. Conclusions. A nomogram for the fetal MCA-PSV during the second half of pregnancy was generated.
Acesso aberto (Open Access)
Predição de peso ao nascimento pela ultra-sonografia tridimensional usando o volume do braço fetal: resultados preliminares
(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2008-04-01) Vieira, Márcio Fragoso [UNIFESP]; Nardozza, Luciano Marcondes Machado [UNIFESP]; Araujo Júnior, Edward [UNIFESP]; Guimarães Filho, Hélio Antonio [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
PURPOSE: to evaluate the accuracy of fetal upper arm volume, using three-dimensional ultrasound (3DUS), in the prediction of birth weight. METHODS: this prospective cross-sectional study involved 25 pregnancies without structural or chromosomal anomalies. Bidimensional parameters (biparietal diameter, abdominal circumference and femur length) and the 3DUS fetal upper arm volume were obtained in the last 48 hours before delivery. The multiplanar method, using multiple sequential planes with 5.0-mm intervals, was used to calculate fetal upper arm volume. Polynomial regressions were used to determine the best equation in the prediction of fetal weight. The accuracy of this new formula was compared with Shepard's and Hadlock's formulas. RESULTS: fetal upper arm volume was strongly correlated to birth weight (r=0.83; p<0.005). Linear regression was the best equation [birth weight=681.59 + 43.23 x fetal upper arm volume]. The fetal upper arm volume mean error (0 g), mean absolute error (196.6 g) and mean percent absolute error (6.5%) were lower than using Shepard's formula; however, the difference did not reach significance (p>0.05). Birth weight predicted by fetal upper arm volume had a mean error lower than Hadlock's formula, but this difference was not statistically significant (p>0.05). CONCLUSIONS: the accuracy of fetal upper arm volume obtained through 3DUS is similar to the accuracy of bidimensional ultrasound in the prediction of birth weight. These findings need to be confirmed by larger studies.
Somente Metadadados
Reference Range of Fetal Renal Volume by Three-Dimensional Ultrasonography Using the Vocal Method
(Karger, 2009-01-01) Tedesco, Giselle Darahem; Silva Bussamra, Luiz Claudio de [UNIFESP]; Araujo Junior, Edward [UNIFESP]; Werneck Britto, Ingrid Schwach; Machado Nardozza, Luciano Marcondes [UNIFESP]; Moron, Antonio Fernandes [UNIFESP]; Aoki, Tsutomu; Universidade Federal de São Paulo (UNIFESP); Med Sci Coll Santa Casa São Paulo FCMSCSP
Objective: To establish reference values for fetal renal volume by three-dimensional sonography using the VOCAL Virtual Organ Computer-Aided Analysis) method. Methods: This prospective longitudinal study involved 57 healthy pregnant women who were examined between 24 and 34 weeks of pregnancy. Each fetal kidney was evaluated separately using the VOCAL method with a 30 rotation angle. for each gestational age, the following measures were obtained for the right and left kidneys: mean, standard deviation, minimum and maximum values, and the 5th, 10th, 25th, 50th, 75th and 90th percentiles. Polynomial regression models were constructed to assess the relationship between renal volume and gestational age, adjusted by the determination coefficient (R(2)). the Wilcoxon test was used to evaluate the concordance between the right and left renal volumes. Bland-Altman graphs were used to assess intra- and inter-observer variability. Results: the right renal volume increased from 4.5 +/- 1.3 cm(3) at 24 weeks to 12.1 +/- 1.5 cm(3) at 34 weeks. the left renal volume increased from 4.6 +/- 0.8 cm(3) at 24 weeks to 11.9 +/- 1.1 cm(3) at 34 weeks. There was a strong correlation between both the right and left renal volumes and gestational age (R(2) = 0.975 and 0.970, respectively). There were no significant differences between the right and left renal volumes. the mean difference between repeated measures by the same examiner was -0.07 cm(3) (-0.88 to 0.75) for the right kidney and -0.21 cm(3) (-0.95 to 0.75) for the left kidney. the mean difference between repeated measures obtained by two different examiners was -0.07 cm(3) (-1.25 to 1.12) for the right kidney and 0 cm(3) (-1.53 to 1.53) for the left kidney. Conclusion: Reference values were generated for fetal renal volume assessed by three-dimensional ultrasonography using the VOCAL method. Copyright (C) 2009 S. Karger AG, Basel
Somente Metadadados
ROLE of 3-D ULTRASOUND in CLINICAL OBSTETRIC PRACTICE: EVOLUTION OVER 20 YEARS
(Elsevier B.V., 2015-05-01) Tonni, Gabriele [UNIFESP]; Martins, Wellington P.; Guimaraes Filho, Helio; Araujo Junior, Edward [UNIFESP]; Guastalla Civil Hosp; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); CETRIM Ctr Imaginol Training
The use of 3-D ultrasound in obstetrics has undergone dramatic development over the past 20 years. Since the first publications on this application in clinical practice, several 3-D ultrasound techniques and rendering modes have been proposed and applied to the study of fetal brain, face and cardiac anatomy. in addition, 3-D ultrasound has improved calculations of the volume of fetal organs and limbs and estimations of fetal birth weight. and furthermore, angiographic patterns of fetal organs and the placenta have been assessed using 3-D power Doppler ultrasound quantification. in this review, we aim to summarize current evidence on the clinical relevance of these methodologies and their application in obstetric practice. (C) 2015 World Federation for Ultrasound in Medicine & Biology.

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