Background
Meconium peritonitis (MP) is a rare fetal disease that needs to be urgently identified for surgical intervention. We report a series of 35 patients diagnosed prenatally with MP by magnetic resonance imaging (MRI), illustrate the imaging findings and investigate the predictive value of these findings for postpartum management.
Method
A consecutive cohort of patients diagnosed with MP who were born at our institution from 2013 to 2018 was enrolled retrospectively. The prenatal ultrasound and MRI findings were analyzed. Fisher’s exact probability test was used to evaluate the predictive value of MRI for surgical intervention between the operative group and the nonoperative group.
Results
Ascites (30/35) and distended bowel loops (27/35) were two of the most common prenatal MP-related findings on fetal MRI. Of the 35 infants, 26 received surgical intervention. All fetuses with MRI scans showing bowel dilatation (14/26, p = 0.048) and micro-colorectum (13/26, p = 0.013) required surgery. There were no significant differences in the number of fetuses with meconium pseudocysts and peritoneal calcifications between the two groups.
Conclusion
Fetuses with bowel dilatation and micro-colorectum on MRI may need postpartum surgical intervention. Infants with only a small amount of ascites and slight bowel distention were likely to receive conservative treatment.
To investigate the biocompatibility of polylactic acid-glycolic acid copolymer (PLGA) and PLGA/gelatin scaffolds and their suitability for tubular urethral replacement in a canine model. PLGA and PLGA/gelatin scaffolds was constructed by electrospinning. Microstructural differences between the scaffolds was examined by Scanning electron microscopy (SEM) followed by mechanical properties testing. Biocompatibility of the material was evaluated using SEM 4, 8, 12 and 72 h after PLGA and PLGA/gelatin scaffolds co-culture with urothelial cells. And confocal analysis was also used to showed the cell adhesive and growth at 12 h. Approximately 2 cm of the anterior urethra of twelve dogs were removed and replaced with a scaffold. After the surgery for 1 month performed urethrography and for 3 month perform hematoxylin–eosin (H&E) and Masson. The results indicated that PLGA and PLGA/gelatin scaffolds had a void microfilament structure, similar to that of normal acellular matrix tissue. And the tensile strength was decreased whereas the tensile deformation and suture retention strength was increased in PLGA/gelatin scaffolds compared to that in PLGA scaffolds Urothelial cells grew well on both scaffolds. Postoperatively, animals recovered well and urinated spontaneously. However, urethrography showed varying degrees of urethral strictures in the reconstructed urethras. H&E and Masson showed that multilayer urothelial cells were formed in both the proximal and distal segments of the reconstructed urethras but without continuity. There was a small amount of smooth muscle and blood vessels under the epithelium, but regenerative urothelial cells at the midpoint of the reconstructed segment did not continue. Lots of lymphocyte infiltration was observed under the epithelium, some collagen tissue was deposited under the neo-urethral epithelium were observed. In conclusion, PLGA and PLGA/gelatin scaffolds are not suitable for tubularized urethral replacement in the canine model.
Objective The aim of this study was to investigate placental blood perfusion in middle and late pregnancy and explore its predictive value for fetal growth restriction (FGR).
Methods All pregnant women included in the study were examined using placental intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI). Three IVIM parameters (D, f, D*) were obtained for each pregnant woman and analyzed using Image J software. Perfusion fraction f is a radiological marker of placental perfusion. The pulsatility index (PI) of the uterine artery is used to indirectly evaluate placental function.
Results f-values were significantly lower in the late-onset FGR group compared to the normal late pregnancy group (19.07 vs. 27.78%). In addition, uterine artery PI values were markedly increased in the late-onset FGR group compared to the normal late pregnancy group (1.96 vs. 1.03), and neonatal weight was significantly lower in the late-onset FGR group (2.75 vs. 3.18 kg). There was a significant positive correlation between f-value, uterine artery PI and neonatal weight (r = 0.968, p < 0.01; r = 0.959, p < 0.01). There was a significant negative correlation between f-value and age of gestation (r = − 0.534, p < 0.01).
Conclusion Perfusion fraction f was strongly correlated with uterine artery blood flow resistance as measured by color Doppler and had a certain predictive value for late-onset FGR.
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