Elevated maternal plasma homocysteine concentrations have been associated with adverse pregnancy outcomes, including birth defects, low birth weight, preeclampsia, spontaneous abortion, placental abruption, and other maternal or fetal complications. The purpose of this study was to assess the maternal plasma homocysteine level during pregnancy and to investigate the relationship between the plasma homocysteine concentrations and pregnancy outcomes. Venous blood samples were drawn from 82 pregnant women who were grouped with gestational age, 1st trimester (n = 26), 2nd trimester (n = 27) and 3rd trimester (n = 29). The concentration of plasma homocysteine was analyzed by HPLC, and pregnancy outcomes including gestational length, maternal weight gain, infant birth weight, and Apgar score were collected with the medical records of the pregnant women. The levels of plasma homocysteine of the pregnant women at the 1st, 2nd, and 3rd trimester were 5.7 $$\pm$ 3.7\mu㏖/L,\;5.6 \pm4.1\mu㏖/L\; and\; 7.0\pm 4.5\mu㏖/L$, respectively, which had not showed any significant difference. The result of this study showed that in case of the pregnant women at the 1st trimester, the maternal plasma homocysteine level of the pregnant women whose gestational length was less than 38 weeks was significantly high (p < 0.01) compared to that of the pregnants whose gestational length was more than 38 weeks. And also, the level of homocysteine of the pregnant women at the 2nd trimester was significantly low when the maternal weight gain was high (p < 0.05). These findings suggest that maternal plasma homocysteine level at early stage of gestation will be a predicter of gestational length and maternal weight gain.
Serial ultrasonographic examinations were performed on 9 Miniature Schnauzer bitches from day 15 of gestation until parturition to determine the ultrasonographic measurement of gestational structures. Ovulation was designated the day that plasma progesterone concentration exceeded 4.0 ng/ml (day 0). Extra-fetal structures were measured from day 17 or 18 to 60. Outer uterine diameter (OUD) increased from $6.50{\pm}1.06mm$ ($Mean{\pm}SD$) to $50.89{\pm}5.62mm$, inner chorionic cavity diameter (ICCD) increased from $2.10{\pm}0.15mm$ to $37.15{\pm}4.36mm$, and length of placenta (PL) increased from $7.50 {\pm}1.41mm$ to $40.62{\pm}3.27mm$. OUD and ICCD were significantly and linearly relative to gestational age especially through day 37, whereas PL was not significantly relative to gestational age. Of the extra-fetal structures, ICCD was the most accurate for estimation of gestational age before day 38 of gestation. Fetal structures increased at a linear rate to parturition. Fetal crown-rump length (CRL) increased from $2.55{\pm}0.07mm$ on day 22 to $85.25{\pm}9.89mm$ on day 48. Fetal head diameter (HD) increased from $3.43{\pm}0.64mm$ on day 27 to $25.06{\pm}0.41mm$ on day 63. Fetal body diameter (BD) increased from $ 5.96{\pm}0.84mm$ on day 30 to $43.76{\pm}3.36mm$ on day 63. Of the fetal structures, HD was the most accurate for estimation of gestational age after day 38 to parturition.
Serial ultrasonographic examination was daily performed on 12 pregnant Shih-tzu bitches from day 15 until parturition to determine the size of gestational structures. Gestational age was timed from the day of ovulation (day 0), which was estimated to occur when plasma progesterone concentration was first increased above 4.0 ng/ml. Extra-fetal structures were measurable from days 17 to 46. Outer uterine diameter increased from $9.9{\pm}0.4$ mm (Mean${\pm}$SD) at day 20 to $44.3{\pm}0.8$ mm at day 46 and inner chorionic cavity diameter increased from $7.2{\pm}0.2$ mm at day 17 to $36.9{\pm}1.5$mm at day 41. Length of chorionic cavity or zonary placenta increased from $6.6{\pm}0.4$ mm at day 21 to $46.4{\pm}0.9$ mm at day 44. Of the extra-fetal structures, inner chorionic cavity diameter was the most accurate for estimation of gestational age until day 38. Fetal structures were measurable from days 23 to 60. Crown-rump length increased from $3.9{\pm}0.3$ mm at day 23 to $55.2{\pm}3.3$ mm at day 41, fetal body diameter increased from $7.9{\pm}0.6$ mm at day 32 to $47.8{\pm}2$ mm at day 60, and fetal head diameter increased from $6.3{\pm}1.1$ mm at day 29 to $25.6{\pm}0.2$ mm at day 60. Of the fetal structures, fetal head diameter was the most accurate for estimation of gestational age from day 38 until day 60.
The correlation between maternal lipid nutritional status during pregnancy and gestational length was investigated. Subjects consisted of 30 full-term delivery mothers, 30 preterm delivery mothers, and babies of both groups. Dietary fat intake during pregnancy and serum lipid levels in mother and umbilical serum were measured. The mean daily intake levels of fatty acid during pregnancy were lower than the recommended dietary allowances, while $\omega$6/$\omega$3 ratios of dietary fatty acids were acceptable. For preterm delivery mothers, fatty acid intake levels to be lower than those in full-term delivery mothers, especially DHA intake of these two groups was significantly different. During gestation, hyperlipidemia was apparent in the pregnant women. The serum lipid contents of preterm delivery mothers tended to be lower than those of full-term delivery mothers, and umbilical cord serum lipid contents of the preterm delivery group tended to be higher than those of the full-term delivery group. Total cholesterol levels in the umbilical cord serum of preterm babies were significantly higher than those of full-term delivery group. On the other hand, total cholesterol and HDL-cholesterol levels between umbilical cord serum and maternal serum were positively correlated in the preterm delivery group. Concerning, energy and fatty acid intakes were more closely associated with umbilical cord serum lipid levels in full-term babies, but negatively associated in preterm babies. It was concluded that gestational length was related to the dietary intake of fatty acids such as DHA in pregnant women. For better understanding, the ralationship between placental lipid transport mechanisms and gestational length needs to be explored.
Serial ultrasonographic examinations were daily performed on 12 Shih-tzu bitches from 15 days after ovulation until parturition to determine the time of first detection and ultrasonographic appearance of the fetal and extra-fetal structures and to determine the size of gestational structures. Gestational age was timed from the day of ovulation (day 0), which was estimated to occur when plasma progesterone concentration was first increased above 4.0 ng/ml. The gestational length in 12 Shih-tzu bitches was 62.1 (range:60-64) days. The initial detection of the fetal and extra-fetal structures were: gestational sac at days 19.2 (16-21); zonary placenta in the uterine wall at days 25.9 (24-28); yolk sac membrane at days 24.1 (22-26); amniotic membrane at days 26.6 (24-28); embryo initial detection at days 22.3 (21-24); heartbeat at days 23.8 (23-25); limb buds at days 29.3 (27-31); fetal movement at days 32.3 (31-34); stomach at days 32.6 (29-34); urinary bladder at days 33.1 (29-35); skeleton at days 35.9 (34-38) and kidney at days 45.8 (45-48).
Serial ultrasonographic examinations were performed on 9 pregnant Korea Jin-do dog from days 15 to 60 to determine the size of gestational structures throughout pregnancy. Gestational age was timed from the day of ovulation (Day 0), which was estimated to occur when plasma progesterone concentration was first increased above 4.0 ng/ml. Extra-fetal structures were measureable from days 17 to 49. Outer uterine diameter increased from $7.0{\pm}0.7$ ($mean{\pm}SD$)mm at day 17 to $54.0{\pm}2.2mm$ at day 49 and inner chorionic cavity diameter increased from $3.0{\pm}0.7mm$ at day 17 to $37.5{\pm}0.6mm$ at day 49. Uterine wall thickness increased from $2.8{\pm}0.4mm$ at day 17 to $8.3{\pm}0.5mm$ at day 49, placental thickness increased from $1.0{\pm}0.1mm$ at day 22 to $5.7{\pm}0.2mm$ at day 49 and length of chorionic cavity or zonary placenta increased from $5.5{\pm}1.3mm$ at day 20 to $52.3{\pm}2.2mm$ at day 49. Inner chorionic cavity diameter, outer uterine diameter and placental length each increased at a linear rate through day 37, after which time, each had a marked plateau in growth. Of the extra-fetal structures, inner chorionic cavity diameter was the most accurate for estimation of gestational age until day 37. Fetal structures were measureable from days l7 to 60. Crown-rump length, increased from $3.0{\pm}0.7mm$ at day 22 to $118.7{\pm}3.1mm$ at day 49, fetal body diameter increased from $4.0{\pm}0.7mm$ at day 25 to $55.8{\pm}1.7mm$ at day 60 and fetal head diameter increased from $4.3{\pm}0.6mm$ at day 26 to $29.8{\pm}0.8mm$ at day 60. Of the fetal structures, fetal head diameter was the most accurate for estimation of gestational age from day 37 until day 60.
Depending on the definition used, between 3% and 10% of live neonates are small for gestational age (SGA). The definition of SGA requires the following: (1) accurate knowledge of gestational age; (2) accurate measurements at birth of weight, length, and head circumference; (3) a cutoff, which has been variably set at the 10th percentile, 3rd percentile, or at less than 2 standard deviation from the mean, and (4) race and ethnicity-specific growth curve. Consensus statements are needed on the management of growth hormone therapy in SGA children, as well as treatment and long-term health outcomes such as impaired cognitive function, increased risk of adult cardiovascular disease, and type 2 diabetes.
Serial ultrasonographic examinations were daily performed on 11 bitches (5 Maltese and 3 Yorkshire terrier) from day 15 until parturition to determine the time of Sift detection and ultrasonographic appearance of the fetal and extra-fetal structures. Gestational age was timed from the day of ovulation (day 0), which was estimated to occur when p18sma progesterone concentration was first increased above 4.0 ng/ml. The gestational length in 8 bitches was 61.5 (range: 60-64) days. The initial detection time of fetal and extra-fetal structures were: gestational sac at days 20.5 (18-23); zonary placenta in the uterine wall at days 25.4 (24-30); yolk sac membrane at days 25,5 (23-37); amniotic mombrane at days 28.7 (25-32); embryo initial detection at days 23.3 (20-26); fetal heartbeat at days 23.9 (21-27); fetal movement at days 31.3 (26-34); limb buds at days 32.1 (29-35); rotomarh at days 35.3 (32-40); urinary bladder at days 35.6 (33-39); skeleton at days 37.8 (37- 40) and kidney at days 45.3 (41-49), respectively.
Aum, Ji A;Jung, Hee Jin;Huh, Jae Won;Son, Sang Hee
Clinical and Experimental Pediatrics
/
v.50
no.6
/
pp.543-548
/
2007
Purpose : The anthropometric data of newborns published by Lubchenco et al in the 1960's have been most commonly used in Korea as a standard of newborn growth. We hypothesized that Lubchenco's data have limitations for Korean premature infants born in the 2000's. We analyzed and compared the data of birth weight, length, and head circumference. Methods : The medical records of 1,159 premature infants of 26 to 35 weeks of gestational age born at Il-Sin Christian Hospital of Busan from January 2,000 to August 2,006 were reviewed. The anthropometric data from total 1,010 premature infants were analyzed after excluding the data from infants whose gestational age were estimated by other than ultrasonogram, and infants with major congenital anomalies or chromosomal anomaly, born from foreign parent, and extreme outliers. Results : In the birth weights by gestational age, our 90 percentile values were lower than Lubchenco's 90 percentile values for all gestational age studied, particularly for less than 30 weeks the 90 percentile curve was drawn at the area as that of Lubchenco' 75 percentile. And our 10 percentile values were higher than Lubchenco's 10 percentile values for all gestational age studied. In the birth length and head circumference by gestational age, our 90 percentile values were lower than Lubchenco's 90 percentile values for all gestational age studied, and the 90 percentile curve was drawn at the area as that of Lubchenco's 75 percentile. And our 10 percentile values were higher than Lubchenco's 10 percentile values for all gestational age studied. Conclusion : It is unreasonable to apply Lubchenco's data published before 4th decades to present Korean premature infants and have a risk to underestimate intrauterine growth retardation or small for gestational age and large for gestational age. Considering for the possibility of increasing the mortality and morbidity of premature infants due to delayed diagnosis and treatment by these underestimating, our anthropometric data of premature infant is expected to contribute to lower the mortality and morbidity of premature infants.
The present study was undertaken to evaluate the accuracy of ultrasonography in early pregnancy diagnosis in goats. Ultrasonographic scanning with real time B-mode ultrasound machine having 5 MHz linear array transducer was performed on gravid uterus (n=24) obtained from slaughterhouse (Group I). Crown rump length (CRL) measured by ultrasound was found significantly different (p<0.05) with actual CRL measured after dissection in early pregnancy. However, age predicted by ultrasound through the measurement of CRL was found highly correlated (r=0.92) with age measured after dissection through CRL and the weight of fetus. Ages predicted by ultrasound through the measurement of trunk diameter (TD) and uterine diameter (UD) and ages measured after dissection were found highly and equally correlated (r=0.98) and did not differ significantly. Data from six does synchronized (Group II) with PGF2$\alpha$ (Estrumate) at 11 days apart were collected through ultrasound from 17 to 42 days post breding. The correlation between CRL and gestational age was high (r=0.97) in day 30 to 42 post breeding. A high coefficient of correlation (r=0.98) was also observed between predicated age by ultrasound and actual age calculated after kidding. The correlation between CRL and gestational age by the formula Y=(a+bX) i.e. Y=24.42+0.39 X where Y=gestational age and X=CRL, was recorded very high (r=0.99). Accuracy of ultrasonography was lowest on day 17 to 19 (66%) and reached 100% on day 34. Data from 30 does (group III) randomly subjected to only one time ultrasounds scanning to assess the accuracy of pregnancy diagnosis were also obtained. Ages predicted by TD and UD measurements were observed to be non-significantly different with actual age obtained after kidding and correlation between ages predicted by TD and UD measurement with actual age after kidding was found equally and highly correlated (r=0.98). The operator's accuracy in the whole experiment including all three groups was found to be 92%. The sensitivity was 93% and specificity was 86%. From the present study, it was observed that CRL was the most reliable parameter to find out gestational age in early pregnancy and the new formula derived was found very accurate to find out gestational age. TD and UD were also found to be equally reliable parameter to find out gestational age in mid and late stage of pregnancy through ultrasonography. It was concluded that ultrasonography by real time B mode with 5 MHz transrectal transducer was found to be reliable, safe and accurate and practicable means in diagnosing early pregnancy diagnosis as early as 25 days post breeding.
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