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Interventions for Early and Late Twin-Twin Transfusion Syndrome 早期和晚期双胎输血综合征的干预措施
Fetal therapy Pub Date : 2019-10-31 DOI: 10.1017/9781108564434.034
T. Mieghem, D. Baud, G. Ryan
{"title":"Interventions for Early and Late Twin-Twin Transfusion Syndrome","authors":"T. Mieghem, D. Baud, G. Ryan","doi":"10.1017/9781108564434.034","DOIUrl":"https://doi.org/10.1017/9781108564434.034","url":null,"abstract":"","PeriodicalId":77713,"journal":{"name":"Fetal therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/9781108564434.034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45611621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Interventions in Pregnancy to Reduce Risk of Stillbirth 降低死产风险的妊娠干预措施
Fetal therapy Pub Date : 2019-01-01 DOI: 10.1017/9781108564434.006
A. Heazell, V. Flenady
{"title":"Interventions in Pregnancy to Reduce Risk of Stillbirth","authors":"A. Heazell, V. Flenady","doi":"10.1017/9781108564434.006","DOIUrl":"https://doi.org/10.1017/9781108564434.006","url":null,"abstract":"Stillbirth remains a global health challenge, with more than 2.6 million stillbirths per year [1]. Although only 2% of the global burden of stillbirths is in high-income countries (HICs), with virtually no improvement in rates for over two decades, action in HICs is urgently needed [2]. There is a six-fold difference between the highest and lowest rates (Ukraine 8.8 stillbirths per 1,000 births after 28 weeks vs. Iceland 1.3 stillbirths per 1,000 births). As well as variation between countries it is well established that there is variation within countries, with women from indigenous or minority ethnic groups, migrant populations or socioeconomically deprived groups as well as women at extremes of maternal age being at increased risk of stillbirth [2]. The disparity between and within countries suggests that more could be done in HICs to reduce stillbirth rates: this includes reducing the frequency of substandard care recurrently described in Confidential Enquiries into Stillbirth and implementing strategies to mitigate the increased risk of stillbirth in specific groups of women [3, 4].","PeriodicalId":77713,"journal":{"name":"Fetal therapy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/9781108564434.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56921458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Oligohydramnios and Polyhydramnios: Therapeutic Manipulation of Amniotic Fluid Volume 羊水过少和羊水过多:羊水容量的治疗性处理
Fetal therapy Pub Date : 2019-01-01 DOI: 10.1017/9781108564434.021
J. Gibson, J. Brennand
{"title":"Oligohydramnios and Polyhydramnios: Therapeutic Manipulation of Amniotic Fluid Volume","authors":"J. Gibson, J. Brennand","doi":"10.1017/9781108564434.021","DOIUrl":"https://doi.org/10.1017/9781108564434.021","url":null,"abstract":"","PeriodicalId":77713,"journal":{"name":"Fetal therapy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/9781108564434.021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56921021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
The Ethics of Consent for Fetal Therapy 同意胎儿治疗的伦理
Fetal therapy Pub Date : 2019-01-01 DOI: 10.1017/9781108564434.008
S. V. D. Hout, W. Dondorp, G. Wert
{"title":"The Ethics of Consent for Fetal Therapy","authors":"S. V. D. Hout, W. Dondorp, G. Wert","doi":"10.1017/9781108564434.008","DOIUrl":"https://doi.org/10.1017/9781108564434.008","url":null,"abstract":"In this chapter, we will discuss the ethics of consent for fetal therapy. The latter term refers to a very broad field, ranging from open surgery to pharmacotherapy, from experimental procedures to accepted treatment, and from interventions aimed at saving fetuses from in utero or perinatal death to treatments with a rationale of improving long-term health outcomes. Because the fetus can only be treated via the body of the pregnant woman, fetal therapy is always a form of ‘maternal-fetal medicine’ and cannot be performed without her informed consent (or that of her representative). However, what makes informed consent for fetal therapy special is that, unlike in other medical contexts, the consenting (or non-consenting) person not only decides for herself, but also for the fetus who may or may not survive and/or for the future child who may or may not benefit. As a consequence, consent for fetal therapy is inevitably asked and given in the context of ideas about the responsibility of the pregnant woman as an expectant mother, a responsibility that, rightly or wrongly, is either assumed by her from within or ascribed to her from without.","PeriodicalId":77713,"journal":{"name":"Fetal therapy","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1017/9781108564434.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56921202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Selective birth in a dyzygotic twin pregnancy with discordancy for Down's syndrome. 唐氏综合症不一致的同卵双胞胎妊娠的选择性分娩。
Fetal therapy Pub Date : 1989-01-01 DOI: 10.1159/000263391
L Pijpers, M G Jahoda, A Reuss, E S Sachs, F J Los, J W Wladimiroff
{"title":"Selective birth in a dyzygotic twin pregnancy with discordancy for Down's syndrome.","authors":"L Pijpers,&nbsp;M G Jahoda,&nbsp;A Reuss,&nbsp;E S Sachs,&nbsp;F J Los,&nbsp;J W Wladimiroff","doi":"10.1159/000263391","DOIUrl":"https://doi.org/10.1159/000263391","url":null,"abstract":"<p><p>The discovery of a twin pregnancy by ultrasound at the intake procedure for chorionic villus sampling or amniocentesis is not unusual because of the raised incidence of dizygotic twins at increased maternal age. Since the conception of dizygotic twins is genetically a separate and unrelated event, the risk of abnormalities in each twin is independent, but additive. In advanced maternal age, the risk of chromosomal aneuploidy in one of both fetuses varies between 2 and 6% [1]. This case report discusses the early prenatal diagnosis of twins discordant for Down's syndrome.</p>","PeriodicalId":77713,"journal":{"name":"Fetal therapy","volume":"4 1","pages":"58-60"},"PeriodicalIF":0.0,"publicationDate":"1989-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000263391","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13678725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Computer-assisted analysis of fetal behavior in fetal abnormalities. 胎儿畸形中胎儿行为的计算机辅助分析。
Fetal therapy Pub Date : 1989-01-01 DOI: 10.1159/000263431
N Shinozuka, H Masuda, T Okai, Y Kuwabara, M Mizuno
{"title":"Computer-assisted analysis of fetal behavior in fetal abnormalities.","authors":"N Shinozuka,&nbsp;H Masuda,&nbsp;T Okai,&nbsp;Y Kuwabara,&nbsp;M Mizuno","doi":"10.1159/000263431","DOIUrl":"https://doi.org/10.1159/000263431","url":null,"abstract":"<p><p>Fetal behavior was studied in 17 cases of fetal abnormalities including nonimmune hydrops fetalis and in 11 cases of intrauterine growth retardation (IUGR) in comparison to 30 healthy fetuses. Breathing movements, rapid eye movements and trunk movements were observed ultrasonically and analyzed using a computer-assisted system. The cases with central nervous system anomalies showed a markedly different behavioral pattern. In the fetal abnormalities without chromosomal anomalies, the cases without major behavioral disorders were cured by neonatal treatment. IUGR cases with decreased trunk, breathing and REM period were finally diagnosed as having fetal distress by fetal heart rate monitoring. The findings on fetal behavior hint at the possibility of diagnosing abnormalities in neural development as well as in well-being.</p>","PeriodicalId":77713,"journal":{"name":"Fetal therapy","volume":"4 2-3","pages":"97-109"},"PeriodicalIF":0.0,"publicationDate":"1989-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000263431","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13631532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
SDS-PAGE as an additional test to determine fetal kidney function prior to intrauterine diversion of urinary tract obstruction. SDS-PAGE作为一个额外的测试，以确定胎儿肾功能前宫内转移尿路梗阻。
Fetal therapy Pub Date : 1989-01-01 DOI: 10.1159/000263430
W Holzgreve, A Lison, M Bulla
{"title":"SDS-PAGE as an additional test to determine fetal kidney function prior to intrauterine diversion of urinary tract obstruction.","authors":"W Holzgreve,&nbsp;A Lison,&nbsp;M Bulla","doi":"10.1159/000263430","DOIUrl":"https://doi.org/10.1159/000263430","url":null,"abstract":"<p><p>The analysis of urine obtained from fetuses with hydronephrosis, seen on ultrasound, can give a misleading assessment of residual renal function. Additional parameters for assessment of fetal renal function would be helpful. We have used SDS-polyacrylamide gel electrophoresis to separate urinary proteins from a fetus with obstructive uropathy and severe oligohydramnios, already present at 18 weeks of gestation. The dilated urinary bladder of the fetus was successfully shunted in utero with a double pigtail catheter which worked for 17 weeks, and a boy without renal or pulmonary insufficiency was born at 36 weeks. In this case the prenatal protein analysis by electrophoresis was a better indicator of the ultimate good pregnancy outcome than the evaluation of urinary electrolytes and osmolarity alone. We therefore suggest the addition of this test to the profile of renal function studies performed on fetal urine.</p>","PeriodicalId":77713,"journal":{"name":"Fetal therapy","volume":"4 2-3","pages":"93-6"},"PeriodicalIF":0.0,"publicationDate":"1989-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000263430","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13631531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 7
Conservative management of urinary abnormalities detected in utero. 子宫内尿路异常的保守处理。
Fetal therapy Pub Date : 1989-01-01 DOI: 10.1159/000263389
R Chierici, G Riccipetitoni, L Tamisari, F Vesce, B Zanella, L Merlo, V Vigi
{"title":"Conservative management of urinary abnormalities detected in utero.","authors":"R Chierici,&nbsp;G Riccipetitoni,&nbsp;L Tamisari,&nbsp;F Vesce,&nbsp;B Zanella,&nbsp;L Merlo,&nbsp;V Vigi","doi":"10.1159/000263389","DOIUrl":"https://doi.org/10.1159/000263389","url":null,"abstract":"During a 5-year period, we observed 48 fetuses with urinary malformations diagnosed by antenatal sonography. Postnatal investigations confirmed the presence of a urinary tract anomaly in 44 of the 48 fetuses selected by prenatal ultrasound (91%). Accurate antenatal diagnosis was made in 35 of the 48 cases (73%). In 9 fetuses renal disease was detected, but its specific nature was not in accordance with the prenatal diagnosis. In our series the most common anomaly was hydronephrosis secondary to ureteropelvic junction obstruction. This condition was observed in 31 of the 44 patients (70.4%); 7 of the newborns who showed an obstructive pattern were submitted to early surgical repair, while the remaining 24 cases and 1 renal unit of the group undergoing early surgical repair were relegated to expectant observation, with periodic clinical and laboratory controls. A spontaneous recovery was observed in 12 cases; the dilatation remained unchanged in 10 cases, while 3 patients showed a progressive worsening of the condition which led to a surgical correction. Our findings agree with those in recent reports in providing little support for early, indiscriminate surgical repair. Moreover, our experience confirms the possibility of a spontaneous recovery in newborns with hydronephrosis and draws attention to the benefit of a conservative management in properly selected patients.","PeriodicalId":77713,"journal":{"name":"Fetal therapy","volume":"4 1","pages":"43-8"},"PeriodicalIF":0.0,"publicationDate":"1989-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000263389","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13631567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
In utero intravesicular pressure and the prune belly syndrome. 子宫内囊内压力和梅干肚综合征。
Fetal therapy Pub Date : 1989-01-01 DOI: 10.1159/000263426
M T Cullen, A P Athanassiadis, P Grannum, J J Green, J C Hobbins
{"title":"In utero intravesicular pressure and the prune belly syndrome.","authors":"M T Cullen,&nbsp;A P Athanassiadis,&nbsp;P Grannum,&nbsp;J J Green,&nbsp;J C Hobbins","doi":"10.1159/000263426","DOIUrl":"https://doi.org/10.1159/000263426","url":null,"abstract":"<p><p>The pathogenesis of the prune belly syndrome is unclear. The proposed etiologies include a distal obstructive uropathy or a mesodermal defect of the anterior abdominal wall and urinary tract. Detection of increased intravesicular pressure might identify those fetuses with an obstructive etiology who, therefore, would benefit from shunting.</p>","PeriodicalId":77713,"journal":{"name":"Fetal therapy","volume":"4 2-3","pages":"73-7"},"PeriodicalIF":0.0,"publicationDate":"1989-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000263426","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13632309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Significance of velocimetry as a monitor of fetal assessment and management. 速度计作为胎儿评估和管理监测的意义。
Fetal therapy Pub Date : 1989-01-01 DOI: 10.1159/000263450
N Echizenya, A Kagiya, T Tachizaki, Y Saito
{"title":"Significance of velocimetry as a monitor of fetal assessment and management.","authors":"N Echizenya,&nbsp;A Kagiya,&nbsp;T Tachizaki,&nbsp;Y Saito","doi":"10.1159/000263450","DOIUrl":"https://doi.org/10.1159/000263450","url":null,"abstract":"<p><p>Using pulsed Doppler ultrasound velocimetry, we set out to examine (a) the significance of velocimetry as a monitor of fetal management (including fetal therapy), and (b) the correlation between the occurrence of abnormal blood flow values and perinatal morbidity. We compared the incidence of abnormal values between a control group of normal pregnant women (59 cases) and an 'abnormal pregnancy' group (60 cases), composed of patients exhibiting maternal complications, IUGR, and fetal distress. The incidence of abnormal values was 23.7% in the control group and 71.7% in the abnormal group. Our results indicate clearly that velocimetry of the middle cerebral artery is the most reliable way to diagnose fetal distress. Also, when high or multiple abnormal values are detected by velocimetry, the incidence and degree of perinatal morbidity increases.</p>","PeriodicalId":77713,"journal":{"name":"Fetal therapy","volume":"4 4","pages":"188-94"},"PeriodicalIF":0.0,"publicationDate":"1989-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000263450","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13633332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
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