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P05.05: Fetal selective termination
Arigita, M.; Hernandez, A. S.; Borrell, A. ...
Ultrasound in obstetrics & gynecology,
September 2006, 2006-09-00, 20060901, Volume:
28, Issue:
4
Journal Article
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Impact of aspirin on trophoblastic invasion in women with abnormal uterine artery Doppler at 11-14weeks: a randomized controlled study
Scazzocchio, E; Oros, D; Diaz, D ...
Ultrasound in obstetrics & gynecology,
04/2017, Volume:
49, Issue:
4
Journal Article
Objective Defective trophoblastic invasion is a key feature in many cases of pre-eclampsia (PE). Uterine artery (UtA) Doppler is a validated non-invasive proxy for trophoblastic invasion. The aim of ...
this study was to explore whether low-dose aspirin, administered from the first trimester, improves trophoblastic invasion, evaluated by UtA Doppler during the second and third trimesters in women defined as high risk by abnormal first-trimester UtA Doppler. Methods This randomized Phase-II study had a triple-blind, parallel-arm, controlled design. Singleton pregnancies with abnormal mean UtA Doppler at 11-14weeks and absence of other major risk factors for PE received 150mg extended-release aspirin or identical-appearing placebo tablets from study inclusion to 28weeks. Main outcome measure was UtA pulsatility index (PI) at 28weeks' gestation. Secondary outcomes included frequency of development of PE and growth restriction/small-for-gestational age (SGA). Results A total of 155 women completed the follow-up and were analyzed. No difference in mean UtA-PI was found between women in the aspirin and placebo groups at 28weeks (mean UtA-PI Z-score (mean±SD), 0.99±1.48 vs 0.85±1.25; P=0.52). Seven women developed PE: four (5%) in the aspirin group and three (4%) in the placebo group. There was a trend toward lower incidence of SGA in the aspirin group (8.8% vs 17.3%; P=0.11). Conclusion In women with defective trophoblastic invasion, as reflected by abnormal UtA Doppler, low-dose aspirin started in the first trimester does not have a significant effect on UtA impedance as pregnancy progresses; however, the study was underpowered to detect potential small effects . Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. Linked Comment: Ultrasound Obstet Gynecol 2017; 49: 433-433
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Impact of laser coagulation in severe twin–twin transfusion syndrome on fetal Doppler indices and venous blood flow volume
Gratacós, E.; Van Schoubroeck, D.; Carreras, E. ...
Ultrasound in obstetrics & gynecology,
1 August 2002, Volume:
20, Issue:
2
Journal Article
Objective
To evaluate the impact of fetoscopic laser coagulation of placental anastomoses in severe twin–twin transfusion syndrome on fetal Doppler indices and umbilical vein blood flow volume as ...
calculated with Doppler and two‐dimensional ultrasound.
Methods
Thirty‐two cases of second‐trimester severe twin–twin transfusion undergoing laser therapy were examined with serial ultrasound before and 1, 3 and 5 days after therapy. Pulsatility indices in the umbilical artery and ductus venosus were measured. Blood volume flow at the level of the intra‐abdominal umbilical vein was calculated by means of Doppler and two‐dimensional ultrasound. The development of hydropic signs in donors was recorded. Perinatal outcome in terms of neonatal survival was recorded for all cases.
Results
In recipients, ductus venosus pulsatility index decreased progressively after therapy and, by day 5, median pulsatility index was significantly lower than that before therapy (0.97 vs. 0.82, P < 0.0001). Umbilical vein blood flow volume in recipient twins showed no significant variations before and after laser. In donors, umbilical artery pulsatility index decreased significantly by the first day following therapy (2.1 vs. 1.6, P < 0.0001). Previously absent or reverse umbilical end‐diastolic flow reappeared after therapy in 46% (7/15) of donors. Ductus venosus pulsatility index in donors increased significantly by day 1 after therapy (0.99 vs. 1.35, P < 0.0001) but, over days 3 and 5, it returned towards preoperative values. Umbilical vein flow volume measurements (mL/min/kg) in the donor increased by approximately 50% the day after treatment (151 vs. 232, P < 0.0001) and remained elevated. Umbilical vein flow volume before laser therapy was significantly lower in donors compared to recipients (151 vs. 260, P < 0.0001), but the difference was non‐significant after treatment (240 vs. 267). One or more hydropic signs developed in eight (25%) donors during the 5 days' observation after therapy.
Conclusions
Laser therapy induced important changes in fetal hemodynamic parameters, resulting in a reversion of the disturbances associated with severe twin–twin transfusion syndrome. The recipient twin showed a progressive improvement of previous signs of right cardiac overload. The donor experienced a substantial increase in umbilical vein blood volume flow accompanied by a transitory state of relative right overload, which may explain the development of transient hydropic signs in a proportion of donors. Copyright © 2000 International Society of Ultrasound in Obstetrics and Gynecology
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498.
TrkB and TrkC Are Differentially Regulated by Excitotoxicity during Development of the Basal Ganglia
Checa, Núria; Canals, Josep M.; Gratacòs, Elena ...
Experimental neurology,
12/2001, Volume:
172, Issue:
2
Journal Article
During development neurons are protected against various insults by intrinsic properties. Here we evaluate trkB (both full-length and truncated forms) and trkC expression in the striatum, cortex, and ...
substantia nigra after intrastriatal injection of quinolinic acid (QUIN) at different stages of postnatal (P) development, by RNase protection assay and in situ hybridization. During normal development, a region-specific regulation of trkB and trkC was observed, showing the maximal mRNA levels at P5. Excitotoxic lesion did not modify striatal trkB mRNA levels at any age examined. However, trkC decreased after QUIN injection at P5 in the striatum (52 ± 2% of control levels). On the other hand, regulation of trkB and trkC expression was observed in cortex and substantia nigra after striatal excitotoxic lesion. Both full-length and truncated receptor isoforms of trkB were enhanced in the cortex when striatal injury was produced at P21 (268 ± 38 and 206 ± 35%) or P30 (174 ± 35 and 157 ± 13%). In situ hybridization studies localized this increase in trkB expression in layers II/III and V along the cerebral cortex. Within the substantia nigra, striatal excitotoxicity at P5 selectively decreased the truncated form of trkB (70 ± 7%), whereas the full-length form was up-regulated at P30 (130 ± 2%). A biphasic increase in trkC mRNA levels was observed at P5 (151 ± 3%) and P21 (168 ± 4%). These changes were localized in the substantia nigra pars compacta. Triple-labeling studies disclosed that all these changes were mainly located in neurons. These results demonstrate that the endogenous response to excitotoxicity includes transneuronal regulation of neurotrophin receptors, which is specific for each nucleus and depends on the developmental stage.
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