Poster discussion hub abstracts in NICU, despite neonatal weight the behaviour was as child with restriction. Conclusions:The studies should be focussed on the more accurate interpretation of the fetal growth in maternal obesity and accelerate maternal weight growth. In obese women and in women with gestational diabetes -even in the well-controlled cases, interpretation of the fetal growth curves should be interpreted with caution in estimated fetal well-being. The present study is still ongoing, and hope to find an algorithm to asses more accurate the risks. P08.09The influence of cigarette smoking and dietary habits on first trimester growth rate and embryonic heart rate Objectives: The aim of this study was to evaluate the effects of cigarette smoking and commonly consumed foods/drinks on the first trimester growth and embryonic heart rate. Methods: A prospective study from Feb 2013 -June 2015. Women recruited in the first trimester underwent two ultrasound scans; both the Crown-rump length (CRL) and the embryonic heart rate (EHR) were recorded. Each woman answered a standardised questionnaire which recorded smoking history, consumption of coffee, hot chocolate, tea, soft drinks, sweets (chocolate, candy bars and toffee) and curry. Consumption of food was calculated by multiplying the consumption frequency by the portion size. Results: 700 first trimester women were approached and a total of 378 women were recruited: 244 non-smokers, 58 smokers, 50 ex-smokers or quit in early pregnancy and 26 passive smokers. Smoking habits did not influence the CRL growth. There was a significant correlation between coffee/hot chocolate consumption and the initial CRL value. A negative correlation was noted between the EHR and curry consumption (R=-0.133, p-value=0.009), coffee consumption (R=-0.11, p-value=0.02), hot chocolate intake (R=-0.22, p-value<0.0001), and sweets (R=-0.1, p-value=0.04). Tea intake was positively correlated with the EHR (R=0.16, P=0.002). The CRL growth rate was inversely correlated with coffee (R=-0.11) and hot chocolate (R=-0.14) consumption. Multivariate analysis showed that increasing consumption of coffee and hot chocolate was associated with lower EHR. Consumption of tea correlated with increased EHR (p-value<0.05). Increasing consumption of coffee and hot chocolate was associated with a lower CRL growth rate. Conclusions: Our findings suggest that first trimester CRL growth rates and the EHR may be influenced by a variety of commonly consumed foods and drinks. The influence of these on the developing fetus beyond the first trimester requires further studies. Cigarette smoking was associated with lower EHR but did not influence the CRL growth. Department of Obstetrics and Gynecology, Universidad de los Andes, Santiago, ChileObjectives: Intrinsic/idiopathic factors are considered to be responsible of fetal growth. This could be detected even in early pregnancy. Also, variation in CRL increase has been demonstrated in daily practice. The objective was to evaluate if first trimester growth variat...
Poster discussion hub abstracts in the CT-angiography. The application of this biological glue is a minimally invasive and a selective treatment which could avoid uterine embolisation and emergency hysterectomy. More research is needed to confirm the safety and feasibility of this procedure.
INTRODUCCIÓNEl síndrome de transfusión feto-materna (STFM), corresponde a la transferencia de sangre fetal directamente hacia la circulación materna durante el embarazo o durante el trabajo de parto. Es una patología poco frecuente; sin embargo, puede constituir una condición grave en cuyos casos más severos el feto puede sufrir anemia severa, encefalopatía hipóxico-isquémica o incluso la muerte [1][2][3][4] .Durante la gestación normal existe de manera fisiológica un grado mínimo de transfusión fetomaterna, sin llegar a constituir un evento clínicamente relevante. Esta transfusión ocurre en la mayoría de los casos sin factores de riesgo identificables, y en promedio no superaría los 15 ml de sangre, permaneciendo en su gran mayoría clínicamente asintomáticas 5,6 . Se estima que una transfusión fetomaterna sería significativa cuando supera los 30 ml de sangre. [7][8][9] . Se han propuesto niveles de 80 a 150 ml de sangre para sangrados feto maternos o transfusiones "masivas" 10 . Tomando este valor como punto de corte, se estima que la incidencia de transfusión masiva sería alrededor de 3 cada 1000 recién nacidos vivos 11,12 . Es importante destacar que las implicancias clínicas de la transfusión feto materna guardan estrecha relación con el volumen porcentual de volemia fetal transfundida. Una pérdida sanguínea fetal superior a 20 ml/Kg (25% de la volemia fetal estimada) se asocia a mayor incidencia de muerte fetal, parto prematuro, hospitalización en Unidad de Cuidados Intensivos Neonatal (UCIN) y necesidad de transfusión neonatal 11 .Dada la gravedad potencial del cuadro, es importante el diagnóstico precoz para establecer el tratamiento oportuno, el cual, dependiendo de la edad gestacional, incluye desde la transfusión fetal in útero hasta la interrupción inmediata del embarazo 5 . Una herramienta diagnóstica fundamental orientada a la detección de la anemia fetal como consecuencia de la transfusión feto-materna es la ultrasonografía doppler obstétrica, la cual permite obtener una estimación bastante precisa de la magnitud de las repercusiones fetales por la anemia secundaria. Ésta, en conjunto con otras técnicas de laboratorio, tanto cualitativas como cuantitativas, permiten verificar el diagnóstico y estimar la gravedad del cuadro. Caso Clínico 1Paciente primigesta de 30 años, RH (-) no sensibilizada, sin antecedentes mórbidos asociados. Cursando embarazo controlado de 35+3 semanas, consulta al servicio de urgencia por ausencia de movimientos fetales desde alrededor de 16 horas antes. Al interrogatorio dirigido no refiere pérdida de líquido, sangrado genital, dinámica uterina, fiebre ni otro síntoma asociado. Se realiza ecografía doppler obstétrica que muestra feto vivo, creciendo en percentil 5 para su edad gestacional según Alarcón-Pittaluga, y oligohidroamnios moderado. Doppler de arteria cerebral media no evaluado, doppler de arteria umbilical normal. Se realiza registro de la frecuencia cardíaca fetal (FCF) que resulta no reactivo, con frecuencia basal de 150 latidos por minuto,
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