The Experts below are selected from a list of 291 Experts worldwide ranked by ideXlab platform
Giancarlo Mari - One of the best experts on this subject based on the ideXlab platform.
-
biophysical profile in the treatment of intrauterine growth restricted Fetuses who weigh 1000 g
American Journal of Obstetrics and Gynecology, 2008Co-Authors: Satinder Kaur, Jason Picconi, Rati Chadha, Michael Kruger, Giancarlo MariAbstract:Objective The aim of this study was to determine the biophysical profile (BPP) usefulness in the prediction of cord pH, base excess, and guidance regarding the timing of delivery in preterm intrauterine growth-restricted (IUGR) Fetuses. Study Design A BPP was performed daily in 48 IUGR Fetuses and was considered abnormal when it was 2/10 on 1 single occasion or 4/10 on 2 consecutive occasions 2 hours apart. Results The median gestational age and fetal weight for the total population was 27.6 weeks and 632 g, respectively. In 13 Fetuses with a BPP of 6, there were 3 deaths, and 7 Fetuses were acidemic. In 27 Fetuses with a BPP of 8, there were 3 deaths, and 12 Fetuses were acidemic. Conclusion BPP alone is not a reliable test in the treatment of preterm IUGR Fetuses, because of high false-positive and -negative results. The common notion of a good BPP providing reassurance for at least 24 hours is not applicable in severely preterm IUGR Fetuses who weigh
-
variables that affect the middle cerebral artery peak systolic velocity in Fetuses with anemia and intrauterine growth restriction
American Journal of Perinatology, 2007Co-Authors: Farhan Hanif, K Drennan, Giancarlo MariAbstract:We have previously reported that the fetal middle cerebral artery (MCA) peak systolic velocity (PSV) increases in anemic Fetuses and in Fetuses with intrauterine growth restriction (IUGR). We hypothesized that the pathophysiology for the increased MCA PSV is different in anemic and IUGR Fetuses. Thus the aim of this study was to determine the factor(s) among fetal umbilical vein blood pH, P O2, P CO2, and hemoglobin that might affect the MCA PSV in Fetuses with anemia and IUGR. This study included two groups of Fetuses. The first group included Fetuses at risk for anemia because of red cell alloimmunization, whereas the second group included IUGR Fetuses. For both groups of Fetuses, we determined hemoglobin, umbilical vein blood gases-at cordocentesis in anemic Fetuses and immediately after cesarean delivery in IUGR Fetuses-and MCA PSV before cordocentesis, or before delivery. The relationship between MCA PSV and the hemoglobin, P O2, P CO2, and pH values for the anemic and the IUGR Fetuses were assessed by regression analysis using multiples of the mean. There were 14 Fetuses in the first group and 22 Fetuses in the second group. In the first group, the only parameter that was related to MCA PSV was the fetal hemoglobin ( R2 = 0.34; P < 0.05); in Fetuses with IUGR, the P CO2 ( R2 = 0.36; P < 0.01) and the P O2 ( R2 = 0.30; P < 0.01) correlated well with the MCA PSV, whereas no relationship was found between the MCA PSV and the hemoglobin. The data indicate that the mechanism of high MCA PSV is different in anemic and nonanemic IUGR Fetuses, and suggest that the process of cerebral autoregulation is present in the preterm IUGR fetus.
-
Single umbilical artery: does it matter which artery is missing?
American Journal of Obstetrics and Gynecology, 1995Co-Authors: Alfred Abuhamad, John C. Hobbins, Wendy Shaffer, Giancarlo Mari, Joshua A. Copel, Arthur T. EvansAbstract:Abstract OBJECTIVE: Our purpose was to determine whether the presence of congenital anomalies in Fetuses with a single umbilical artery is related to the side of the missing artery. STUDY DESIGN: During an 18-month prospective study, the side of the missing artery was identified in all pregnancies with a single umbilical artery ( n = 77). Targeted sonograms and perinatal follow-up were obtained. RESULTS: The left umbilical artery was absent in 56 of 77 (73%) Fetuses, compared with 21 of 77 (27%) for the right artery, p p = 0.561. Complex congenital anomalies occurred in 9 of 20 (45%) Fetuses. All complex anomalies had absence of the left artery, p = 0.103. Cytogenetic abnormalities were noted in 6 Fetuses, all with absence of the left artery, p = 0.181. In Fetuses with a single umbilical artery as an isolated finding, small-for-gestational-age Fetuses occurred in 4 of 50 (8%) pregnancies. CONCLUSION: In Fetuses with a single umbilical artery the left artery is more commonly absent than the right artery. In our series cytogenetic and complex fetal anomalies occurred exclusively in Fetuses with absence of the left artery. In contrast to previous reports, the incidence of small-for-gestational-age Fetuses does not appear to be increased in cases of an isolated single umbilical artery.
L Shenker - One of the best experts on this subject based on the ideXlab platform.
-
Doppler flow velocities in single umbilical arteries.
American journal of obstetrics and gynecology, 1991Co-Authors: N B Duerbeck, M Pietrantoni, K L Reed, C F Anderson, L ShenkerAbstract:Fetal compromise has been associated with an umbilical artery waveform pattern of low or absent diastolic velocity relative to systolic velocity. Fetuses with single umbilical arteries have an increased risk of major malformations, mortality, retarded fetal growth, and prematurity. In this study Doppler flow velocities were obtained in 13 Fetuses (four twin Fetuses and nine singletons) with a single umbilical artery. Five (38%) Fetuses, consisting of four singletons and one twin, had anomalies. Six (46%) Fetuses were small for gestational age, including two twin Fetuses and three singleton Fetuses with anomalies. Three (23%) of the 13 systolic-to-diastolic velocity ratios were abnormally high. Whereas this is a higher rate of abnormal ratios than the reported 2% to 3% in control populations, it is interesting to note that 77% of Fetuses with single umbilical arteries had normal systolic-to-diastolic ratios.
Arthur T. Evans - One of the best experts on this subject based on the ideXlab platform.
-
Single umbilical artery: does it matter which artery is missing?
American Journal of Obstetrics and Gynecology, 1995Co-Authors: Alfred Abuhamad, John C. Hobbins, Wendy Shaffer, Giancarlo Mari, Joshua A. Copel, Arthur T. EvansAbstract:Abstract OBJECTIVE: Our purpose was to determine whether the presence of congenital anomalies in Fetuses with a single umbilical artery is related to the side of the missing artery. STUDY DESIGN: During an 18-month prospective study, the side of the missing artery was identified in all pregnancies with a single umbilical artery ( n = 77). Targeted sonograms and perinatal follow-up were obtained. RESULTS: The left umbilical artery was absent in 56 of 77 (73%) Fetuses, compared with 21 of 77 (27%) for the right artery, p p = 0.561. Complex congenital anomalies occurred in 9 of 20 (45%) Fetuses. All complex anomalies had absence of the left artery, p = 0.103. Cytogenetic abnormalities were noted in 6 Fetuses, all with absence of the left artery, p = 0.181. In Fetuses with a single umbilical artery as an isolated finding, small-for-gestational-age Fetuses occurred in 4 of 50 (8%) pregnancies. CONCLUSION: In Fetuses with a single umbilical artery the left artery is more commonly absent than the right artery. In our series cytogenetic and complex fetal anomalies occurred exclusively in Fetuses with absence of the left artery. In contrast to previous reports, the incidence of small-for-gestational-age Fetuses does not appear to be increased in cases of an isolated single umbilical artery.
N B Duerbeck - One of the best experts on this subject based on the ideXlab platform.
-
Doppler flow velocities in single umbilical arteries.
American journal of obstetrics and gynecology, 1991Co-Authors: N B Duerbeck, M Pietrantoni, K L Reed, C F Anderson, L ShenkerAbstract:Fetal compromise has been associated with an umbilical artery waveform pattern of low or absent diastolic velocity relative to systolic velocity. Fetuses with single umbilical arteries have an increased risk of major malformations, mortality, retarded fetal growth, and prematurity. In this study Doppler flow velocities were obtained in 13 Fetuses (four twin Fetuses and nine singletons) with a single umbilical artery. Five (38%) Fetuses, consisting of four singletons and one twin, had anomalies. Six (46%) Fetuses were small for gestational age, including two twin Fetuses and three singleton Fetuses with anomalies. Three (23%) of the 13 systolic-to-diastolic velocity ratios were abnormally high. Whereas this is a higher rate of abnormal ratios than the reported 2% to 3% in control populations, it is interesting to note that 77% of Fetuses with single umbilical arteries had normal systolic-to-diastolic ratios.
Alfred Abuhamad - One of the best experts on this subject based on the ideXlab platform.
-
Single umbilical artery: does it matter which artery is missing?
American Journal of Obstetrics and Gynecology, 1995Co-Authors: Alfred Abuhamad, John C. Hobbins, Wendy Shaffer, Giancarlo Mari, Joshua A. Copel, Arthur T. EvansAbstract:Abstract OBJECTIVE: Our purpose was to determine whether the presence of congenital anomalies in Fetuses with a single umbilical artery is related to the side of the missing artery. STUDY DESIGN: During an 18-month prospective study, the side of the missing artery was identified in all pregnancies with a single umbilical artery ( n = 77). Targeted sonograms and perinatal follow-up were obtained. RESULTS: The left umbilical artery was absent in 56 of 77 (73%) Fetuses, compared with 21 of 77 (27%) for the right artery, p p = 0.561. Complex congenital anomalies occurred in 9 of 20 (45%) Fetuses. All complex anomalies had absence of the left artery, p = 0.103. Cytogenetic abnormalities were noted in 6 Fetuses, all with absence of the left artery, p = 0.181. In Fetuses with a single umbilical artery as an isolated finding, small-for-gestational-age Fetuses occurred in 4 of 50 (8%) pregnancies. CONCLUSION: In Fetuses with a single umbilical artery the left artery is more commonly absent than the right artery. In our series cytogenetic and complex fetal anomalies occurred exclusively in Fetuses with absence of the left artery. In contrast to previous reports, the incidence of small-for-gestational-age Fetuses does not appear to be increased in cases of an isolated single umbilical artery.