Hyperthermia—a prospective evaluation of a possibleteratogenic agent in man

Clarren, Sterling K.; Smith, Dale E.; Harvey, Mary Ann Sedgwick; Ward, R. H. T.; Myrianthopoulos, Ntinos C.

doi:10.1016/s0022-3476(79)80092-x

Cited by 73 publications

(26 citation statements)

References 8 publications

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“…In one large retrospective study, 2,300 infants with neural tube defects were examined and they found no evidence of a significant correlation between maternal illness and congenital defects (Kleinbrecht et al, 1979). A smaller study using medical records on 165 pregnancies reported that a febrile illness where the fevers exceeded 38.91C during the first trimester, the incidence of neurological defects, intelligence, or growth patterns did not differ from children in a control group (Clarren et al, 1979). Similarly, a cohort of 51 women who experienced a fever of 1011F or greater during the first trimester delivered infants that were not different from the control group .…”

Section: Clinical Observationsmentioning

confidence: 99%

Hyperthermia: malformations to chaperones

Bennett

2010

Birth Defects Research Pt B

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Hyperthermia has been known to induce malformations in numerous animal models as well being associated with human abnormalities. This was apparent particularly when the hyperthermia exposure was during the early stages of neural development. Although it was recognized relatively early that these exposures induced cell death, the specific molecular mechanism of how a brief heat exposure was translated in to specific cellular functions remains largely unknown. While our understanding of the events that govern how cells react to heat, or stresses in general, has increased, there is much that remains undiscovered. In this brief review, animal and clinical observations are outlined as are some of the scientific explorations that were undertaken to characterize, define, and better understand the morphological, biochemical, and molecular effects of hyperthermia on the developing embryo.

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Section: Clinical Observationsmentioning

confidence: 99%

Hyperthermia: malformations to chaperones

Bennett

2010

Birth Defects Research Pt B

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“…Elevated maternal temperature in early gestation, secondary to viral infection, for instance, has been associated with a higher than expected incidence of congenital anomalies [15]. Edwards and others have demonstrated that hyperthermia is teratogenic for many animal species (such as guinea pigs, rats, monkeys, and more), including the human [14,16]. Major anomalies observed included microcephaly, encephalocele, microphthalmia, skeletal anomalies as well as growth delay.…”

Section: Thermal Effectsmentioning

confidence: 99%

Ultrasound in the First Trimester and Earlier: How to Keep It Safe

Abramowicz

2016

First-Trimester Ultrasound

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1"Ultrasound is safe. Ultrasound is not X-rays. Our machines are FDA-approved." These are the statements most commonly made when initiating a conversation on safety of ultrasound. This is one of the reasons cited for its becoming an essential tool in medicine (together with its relatively low cost and immediate results availability). Diagnostic ultrasound (DUS) has been in use for over half a century in obstetrics and gynecology [1] and the benefits of this technology are multiple [2]. Most pregnant women have 2-3 ultrasound examinations (and many more in certain countries) during their pregnancies. In early pregnancy and before (i.e., in Artificial Reproductive Technologies [(ART]), these include serial scans of the developing follicles during ovulation induction [3] and in the earliest stages of gestation [4], first-trimester ultrasound for viability and/or aneuploidy screening (nuchal translucency, NT) and, more and more, early anatomy survey [5]. Such is the widespread enthusiasm and the generally accepted notion of safety that its use has spilled into the commercial world with mall stores offering non-medical ultrasound or "souvenir" scans. The record of safety of DUS is excellent: there are no epidemiological studies demonstrating harmful effects in human fetuses [6]. Most human epidemiological studies, however, published so far are based on information obtained with pre-1991/1992 machines. Around that time, the US Federal Drug Administration (FDA) allowed the acoustic output of ultrasound machines for fetal use to be increased from 94 to 720 mW/cm 2 , a factor of almost 8 [7,8]. Is there enough evidence to validate the use of ultrasound imaging in general and Doppler in particular in the first trimester [9] and could ultrasound have detrimental effects on the fetus in the first trimester, a time of maximal susceptibility to external factors? If there are clinical indications to perform these scans (and if there were none, there would be no raison-d'être for this book) safety must be guaranteed by educating the end-users on ways to limit the possible hazards of exposure of the follicles/ova and the fetus at early stages of gestation [2].

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“…Halperin and Wilroy (1978), in addition to Miller et al (1978) found an association between high maternal temperature and higher risk for NTD. Clarren et al (1979) showed a wide spectrum of CAs associated with hyperthermia depending on the time of febrile illness, if it occurred between 21st and 28th postconceptional days, NTD was found in approximately 10% of offspring. Layde et al (1980) studied the possible association between maternal fever and NTD and found a significant increase in fever among mothers who delivered infants with spina bifida cystica.…”

Section: High Fever Related Maternal Diseases During Pregnancy 437mentioning

confidence: 99%