Fetal

The analysis of genetic and environmental contributions to preterm birth is not straightforward in family studies, as etiology could involve both maternal and fetal genes. Markov Chain Monte Carlo (MCMC) methods are presented as a flexible approach for defining user-specified covariance structures to handle multiple random effects and hierarchical dependencies inherent in children of twin (COT) studies of pregnancy outcomes. The proposed method is easily modified to allow for the study of gestational age as a continuous trait and as a binary outcome reflecting the presence or absence of preterm birth. Estimation of fetal and maternal genetic factors and the effect of the environment are demonstrated using MCMC methods implemented in WinBUGS and maximum likelihood methods in a Virginia COT sample comprising 7,061 births. In summary, although the contribution of maternal and fetal genetic factors was supported using both outcomes, additional births and/or extended relationships are re...

The effects of chronic maternal salicylism on fetal growth were studied in chronically catheterized pregnant rabbits. Graded intravenous infusions of sodium salicylate were given continuously between days 22 and 29 of gestation. Maternal plasma salicylate concentrations (mean +/- SD) of 12.0 +/- 1.6 mg/dl (low-dose group) or 24.1 +/- 5.3 mg/dl (high-dose group) were achieved. Control rabbits were infused with saline solution. Pups were delivered by hysterotomy on day 29. Fetal/maternal salicylate concentration ratios were near unity for both infusion groups. There were significant dose-related reductions (mean +/- SD) in fetal weight (control, 39.7 +/- 6.7 gm; low-dose group, 34.4 +/- 6.4 gm; high-dose group, 22.2 +/- 7.1 gm; p less than 0.001) and in crown-rump length (control, 9.7 +/- 0.45 cm; low-dose group, 9.1 +/- 0.68 cm; high-dose group, 7.7 +/- 0.86 cm; p less than 0.001). There was a significant reduction in fetal brain weight only in the high-dose group, and brain weight/f...

Fetal programming refers to abnormal somatic and functional development of target tissues in response to over nutrition or to adverse stimulus with a deficient supply of nutrients and oxygen through the placenta that is experienced during crucial periods of fetal growth. These early responses may have an impact on metabolic processes and hormonal homeostasis resulting in functional aberrations and metabolic diseases during childhood tracking into adulthood. The greater propensity to obesity is characterized by central and visceral adipose tissue deposit, lack of skeletal muscle development and insulin resistance related cardio metabolic risk factors. Nutritional programming during early infancy is influenced by accelerated postnatal growth induced by hypercaloric over nutrition that seems to be independent of birth weight. Although controversies may exist, breastfeeding must be encouraged since multiple advantages including obesity prevention have been described. The recognition tha...

Objective: To analyse the pregnant women with heart disease and to assess its influence on the fetomaternal outcome. Materials and methods: This observational study was carried out during the period from Jan 2006 to Sept 2007. Fifty pregnant women with cardiac diseases who were admitted in the Fetomaternal Medicine unit of the department of Obstetrics & Gynaecology in Bangabandhu Sheikh Mujib Medical University (BSMMU) were included in the study. Results: Rheumatic heart disease (n-37, 74%) with isolated mitral stenosis (28%) was the predominant cardiac problem among the study subjects while atrial septal defect (16%) was the most common form of congenital heart disease (n-13, 26%). Based on New York Heart Association (NYHA) functional classification, 40(80%) women were in class-I, 7(14%) were in class-II and 3(6%) were in class-III heart disease on presentation. The mean (±SD) gestational age at delivery was 37.50(±2.50) weeks and pregnancy duration was shortened in more advanced c...

Absent pulmonary valve with ventricular septal defect is associated with ductal agenesis and markedly dilated main and branch pulmonary arteries. The less common variant with intact ventricular septum generally exhibits a patent ductus and smaller branch pulmonary arteries, and may be associated with tricuspid atresia. We identified 7 patients with the prenatal diagnosis of absent pulmonary valve, 5 with ventricular septal defect (Group 1) and 2 with an intact ventricular septum (Group 2). Imaging, color Doppler, and pulsed-Doppler recordings were analyzed. The branch and main pulmonary arteries were measured and expressed as a ratio with the descending aorta. Pulmonary regurgitation time (PRT) and diastolic acceleration time (DAT) were derived, and DAT/PRT was calculated to characterize diastolic pulmonary flow. Group 1 patients all had a large ventricular septal defect, normal biventricular size and function, and dilated main and branch pulmonary arteries. Group 2 patients had dilated main but smaller branch pulmonary arteries, moderate right ventricular dilation with severe dysfunction, and limited or absent tricuspid inflow. Group 1 demonstrated shorter acceleration time and earlier peak velocity, resulting in a smaller DAT/RT ratio. We speculate that free communication between the fetal aorta and the ventricles may limit atrial inflow and elevate diastolic pressure, affecting cardiac output, ventricular function, and atrioventricular valve development. With an intact ventricular septum, these physiologic and anatomic repercussions are limited to the right ventricle, but with a ventricular septal defect, both ventricles would experience similar consequences and cardiac performance could be critically impaired.