Average Duration Of Pregnancy Research Articles

The impact of cerclage placement on gestational length in women with premature cervical shortening.

Cervical insufficiency (CI) is a condition consistent with painless cervical dilatation that can lead to preterm delivery. Cervical cerclage is a procedure in which cervical suture is performed for preventing preterm labor in several indications. Late emergency cerclage is technically more challenging compared to elective cerclage, performed earlier during pregnancy, prior to cervical changes. Pregnancy outcomes with emergency cerclage were found to be improved in previous reports, but there is still inconclusive data. To assess the effectiveness and safety of emergency cerclage vs. conservative management with progesterone and/or bed resting, in preventing preterm birth and improving neonatal outcomes in women with clinically evident cervical insufficiency. This is a retrospective cohort study conducted on all women diagnosed with cervical insufficiency between the 16th and 24th gestational week who met the inclusion criteria, from January 2012 to December 2018. Obstetric and neonatal outcomes: time from diagnosis to delivery, duration of pregnancy, birth weight and Apgar score, were compared between women who underwent cerclage and those who treated conservatively. Twenty eight women underwent emergency cerclage (cerclage group) and 194 managed with a conservative therapy, progesterone and/or bed rest (control group). Time from diagnosis to delivery 13 weeks vs. 8weeks and birth weight 2,418 g vs. 1914 g were significantly higher in the first cohort. Average pregnancy duration was three weeks longer in the cerclage group, but that was not significant. No complications occurred in the cerclage group and no difference in mode of delivery were found. Emergency cerclage is an effective and safe procedure in preventing preterm birth and prolongation of pregnancy, in women with cervical insufficiency in the late second trimester.

Hypoxic ischemic encephalopathy and perinatal asphyxia

Background: There is considerable variation in the clinical manifestations of neonatal encephalopathy. It has been associated to early-onset neurological abnormalities and preterm or late delivery (before or after 35 weeks of gestation, respectively). Convulsions, coma, respiratory distress, slowed or halted breathing, slowed or halted reflexes, and depressed tone are all possible outcomes. The goal of this study was to assess the prevalence of hypoxic ischemic encephalopathy (HIE) among tertiary care hospital patients with a diagnosis of perinatal asphyxia. Contents and techniques: In Sawabi, Pakistan, researchers from the GKMC/BKMC Hospital surveyed the local population. Investigators gathered data from July 1, 2021, through December 31, 2021. The study comprised 80 babies diagnosed with perinatal hypoxia. Each newborn was evaluated using established screening criteria for hypoxic ischemic encephalopathy. The average age was 2.5371.28 days for the participants in this research, which ranged in age from 1 to 10 days. The average duration of pregnancy was 37.6811.24 weeks, and the mean birth weight was 3.2750.35 kg. Seventy-five percent of all births were accomplished by vaginal delivery, while the remaining twenty-five percent were accomplished through caesarean section. Eight persons were diagnosed with hypoxic ischemic encephalopathy.

Perinatal Delivery in Women with Retrochorial Hematomas in the First Trimester

The objective: an analysis of the peculiarities of childbirth and the condition of newborns in women with retrochorial hematoma (RCH) in the I trimester of pregnancy. Materials and methods. At the beginning of the study, 100 pregnant women 18–44 years old (mean age 28.08±3.5 years) were examined – 70 women included in the main group and 30 – control one. In 10 cases out of 70, the pregnancy was interrupted in the I trimester on the background of RCH. Sixty patients of the main group, in whom the pregnancy progressed, were divided into two subgroups: subgroup A (n=39) – primigravida pregnant women with the threat of abortion due to RCH; subgroup B (n=21) – multigravida women with complicated obstetrical and gynecological history and RCH. The control group (n=30) included primi- and multigravida women with physiological course of the current and previous pregnancies. All women had a complete clinical and laboratory examination. The patients with a risk of abortion and RCH received pathogenetical therapy for pregnancy preservation (sedative, anti stress therapy, spasmolytics, hormonal support (progestogens), fibrinolysis inhibitors, anticoagulants and antiplatelet agents, tocolytics). The condition of newborns in the first minutes of life was assessed by the Apgar scale, if necessary, rehabilitation measures were applied. Results. The majority of patients in all groups had complicated obstetrical and gynecological history: 22.5% of patients in subgroup A, 30% – subgroup B, 16.6% – control group, and half of them were diagnosed two or more somatic diseases. Every third patient of the main group (7 (17.9%) women in subgroup A and 5 (23.8%) in subgroup B) delivered by cesarean section, in the control group – 5 (16.6%) persons. Spontaneous vaginal childbirth in the main group had 71.7% of the women, in the control group – 80%, premature birth – 2 (5.1%) women in subgroup A, 4 (19%) – subgroup B and 1 (3,3%) case – control group. The average duration of pregnancy in the main group was 37.3±2.4 weeks, in the control group – 39.4±0.3 weeks. In the main group 54 (90%) full-term newborns were born, in the control group – 29 (96.7%); premature infants – 2 (5.1%) in subgroup A, 4 (19%) – subgroup B, 1 (3.3%) – control group. In the main group the frequency of infants birth with hypoxia, who needed resuscitation and intensive care, was more than 2 times higher compared to the control group (5 (8.3%) and 2 (6.7%) infants, respectively). Newborns of subgroups A and B, due to intrauterine hypoxia, had pathological conditions such as morphological and functional immaturity, neurological disorders, signs of intrauterine infection, but not a single child needed to be transferred to a specialized department for the second stage of care. Conclusions. Preservation of pregnancy in the patients with a risk of abortion and RCH in the I trimester is possible in 85.7% of cases. Pregnant women with complicated obstetrical and gynecological history are at risk for preterm birth. The infants born in women with the threat of abortion and the formation of RCH in the I trimester belong to the risk group of intrauterine hypoxia and infectious complications. Comprehensive pathogenetical therapy helps to prolong pregnancy, reduce the incidence of early reproductive losses, improve perinatal outcomes and reduce the incidence of perinatal morbidity.

Delivery management of a complete hydatidiform mole and co-existing viable fetus: A meta-analysis and systematic review

ObjectiveA twin pregnancy with a complete hydatidiform mole and co-existing viable fetus (CHMCF) is an exceedingly rare obstetric complication with few data related to perinatal treatment. This study determined the optimal timing of pregnancy termination and mode of delivery in women with CHMCF and a viable fetus. MethodsThe articles published involving CHMCF and a viable fetus from 1967 to 31 December 2020 in the PubMed and EMBASE databases were systematically reviewed. Observational cohort studies with three or more cases identified and data on delivery management were selected. The articles were analyzed independently for full text and the data were integrated. The timing of pregnancy termination and mode of delivery were calculated using Review Manager 5.4.1. ResultsThere were 192 reports involving CHMCF; 209 cases had a viable fetus. According to the inclusion criteria, there were 6 case series, including 72 cases that were eligible for the analysis. The average rate of live births was 34.4%. The average duration of pregnancy was 34 weeks, ranging from 25 to 41 weeks. From 2000–2017 the live birth rate was increased year-after-year. Specifically, the live birth rate was16.7% in 2000, 33.3% in 2012, and 50% in 2017. Fifty-two cases (72.2%) had cesarean sections and 20 cases (27.8%) had vaginal deliveries. The incidence of gestational trophoblastic neoplasia was not significantly different between the two modes of delivery. ConclusionsIdeally, a twin pregnancy with a complete hydatidiform mole co-existing with a viable fetus is managed by an obstetrician, pediatrician, and oncologist. Appropriate timing of pregnancy termination and mode of delivery are related to the pregnancy outcome.

PRETERM BIRTH AND LOW BIRTH WEIGHT IN SINGLETON PREGNANCIES AFTER IN VITRO FERTILIZATION- INFLUENCE OF INFERTILITY AND METHOD OF FERTILIZATION

The aim of our study was to determine the effect of infertility and the method of fertilization on the frequency of preterm birth and low birth weight in singleton pregnancies achieved by in vitro fertilization (IVF). The study was conducted in the period 01.2013 - 12.2017 and included 286 patients with births from singleton IVF pregnancies. Classical IVF received 107 patients (group A1) and ICSI fertilization - 148 (group A2). Cases with tubal infertility were 81 (group B1), and 85 were with male infertility (group B2). In group A1, birth prior to 37 weeks of gestation (w.g.) was found in 33 (30.8%) cases, compared to 26 (17.6%) in group A2 (p=0.029).In group A1, birth weight <2500 g was observed in 27 (25.3%) of cases, and in group A2 - in 17 (11.5%) of cases (p=0.015). In group B1, birth prior to 37 w.g. was established in 26 (32.1%) of the cases, compared to 9 (10.6%) in group B2 (p=0.003). In group B1 there was birth weight <2500 g in 19 (23.5%) of patients, compared to 6 (7.1%) in group B2 (p = 0.009). The average weight of the newborn and average duration of pregnancy was lower in groups with IVF fertilization and tubal infertility compared to ICSI fertilization and male infertility. Tubal infertility and classical IVF fertilization are independent risk factors that increase the frequency of preterm birth and low birth weight in IVF singleton pregnancies.

FREKUENSI PEMERIKSAAN ANC BERHUBUNGAN DENGAN PREEKLAMPSIA

The gestation period starts from conception until the birth of the fetus. The normal duration of pregnancy is 280 days (40 weeks or 9 months and 7 days) counting from the first day of the last menstruation. Pregnancy is divided into 3, the first trimester starts from conception until 3 months, the second trimester starts from the fourth month to 6 months, the third trimester is from the seventh month to 9 months. Preeclampsia is a disease characterized by hypertension, proteinuria and edema that occurs during pregnancy. or up to 48 hours postpartum. This study aims to determine the frequency of ANC examinations with preeclamptic. The research method used was analytic survey research design with a cross sectional approach. Data collection techniques. Data collection in this study used a questionnaire sheet. The technique used in this study was purposive sampling. The data analysis used was univariate and bivariate analysis and the statistical test used was Chi Square. The significance of the relationship between the two variables is p = 0.000, p = 0.002 <α 0.05, this means that Ha is accepted and Ho is rejected, so there is a relationship between the frequency of ANC examinations and preeclamptic

Potential pregnancy days lost: an innovative measure of gestational age.

ABSTRACTIn Brazil, the excess of interventions that anticipate childbirth, such as cesarean sections and labor inductions, has resulted in the shortening of pregnancy, with negative consequences on maternal-infant outcomes. This commentary presents a novel way to measure gestational age: the continuous variable “Potential pregnancy days lost.” Using data from the Live Birth Information System (SINASC), we counted the missing days between the period until childbirth and the average duration of pregnancy (280 days), or the lost weeks. This measure can be used as an outcome variable (socioeconomic-demographic characteristics of the mother, type of childbirth, financing, etc.) or exposure variable (for neonatal, infant, and maternal outcomes). The indicator can be used in municipal and national cohorts and intervention studies to analyze hospitals and regions. We discuss the limits and scope of gestational age measures and, given their inaccuracies, the importance of studying their trends.

Serum Decorin, Biglycan, and Extracellular Matrix Component Expression in Preterm Birth

Preterm birth is a leading cause of infant morbidity and mortality. Decorin and biglycan are proteoglycans that play key roles in maintaining the connective tissue matrix and tensile strength of human fetal membranes and have been previously linked to PPROM. Extracellular matrix proteins, such as matrix metalloproteinase 2 (MMP-2), matrix metalloproteinase 9 (MMP-9), TIMP metallopeptidase inhibitor 1 (TIMP-1), TIMP metallopeptidase inhibitor 2 (TIMP-2), and collagen VI (COL-6), have also been linked to PPROM and may have utility in a serum-based screening model for this condition. To define the natural course of serum decorin and biglycan expression throughout the duration of healthy pregnancy, to explore patterns of serum decorin and biglycan expression in serum of asymptomatic women who go on to develop spontaneous preterm labor, and to investigate the potential role for matrix metalloproteinases, their inhibitors, and collagen VI in a serum-based screening model to predict PPROM. Serum decorin level decreases less than 1% per week, and serum biglycan decreases by 2.9% per week over the duration of healthy pregnancy. Serum decorin and biglycan concentrations do not differ in spontaneous preterm labor cases compared with those in controls. Mean concentrations of MMP-2, MMP-9, TIMP-1, TIMP-2, and COL-6 do not differ in PPROM cases compared with those in controls. We have demonstrated that serum decorin and biglycan concentrations remain stable throughout the duration of normal pregnancy and are not early indicators of preterm labor, while common MMPs, TIMPs, and collagen VI are not early indicators of PPROM.

The Incidence of Adolescent Pregnancy at Clinic of Gynecology and Obstetrics of Clinical Center Kragujevac

Abstract Adolescent pregnancy belongs to a group of high-risk pregnancies with high maternal and fetal mortality and morbidity rate with high prevalence globally (11%). The aim of this observational study is to show the incidence of adolescent deliveries in relation to the total number of births in the twelve-year period from 2007 to 2019 at the Department of Gynecology and Obstetrics of Clinical Center in Kragujevac from medical protocols and patients’ medical records. By evaluating the data of our research, we noticed a continuing decrease in the percentage of adolescents that give births each year. The total number of births in our clinic in this twelve-year period was 26544, and the number of teenage deliveries was 390 (1.74%), which is in accordance with the results of a similar research which was conducted in our clinic in the period from 2002 to 2007 (16.1%). However, despite the increase in the number of caesarean sections, Apgar score of newborn babies was similar to the results of previous tests - 8.31 which proves that the increase in caesarean sections is not correlated with growth of Apgar score. The average pregnancy duration of adolescents is similar as in the previous five-year period (37.5 w.g.), while in the general population of pregnant women it is 39.2 w.g which represents a statistically significant difference. The main causes of poor outcomes of adolescent pregnancies are biological immaturity of mothers, poor health care, that comes from poor socio-demographic conditions, as well as emotional stress. It is necessary to change the attitude of society towards these young people, give them support in the environment they live and provide them with better health care and social treatment.

Insights and expectations for Tdap vaccination of pregnant women in Italy

Background Pertussis is a widespread vaccine-preventable disease, associated with an increasing trend to hospitalization among newborns. Pertussis in newborns can be fatal, and the most effective way to prevent it is maternal immunization (MI) with a reduced antigen content tetanus, diphtheria, and acellular pertussis vaccine (Tdap). In Italy, the National Immunization Plan (NIP) 2017–2019 introduced de novo Tdap vaccination during each pregnancy at no cost for the recipient. Despite this, vaccination coverage is suboptimal. This survey of pregnant women across Italy was conducted to investigate their knowledge and expectations of Tdap. Methods A cross-sectional survey was conducted. Pregnant women up to 28th gestational weeks were interviewed by Telephone using a questionnaire with 16 questions. Statistics were descriptive. Results The final sample recruited 600 respondents evenly distributed across Italy. The average duration of pregnancy at the time of the interview was 20.8 weeks (standard deviation [SD] 6.0). Most women (60.7%) were between 30 and 40 years of age. About half were aware of the risks of pertussis for newborns (54.5%) and the increased risk of hospitalization (59.8%); 47.2% were aware that Tdap MI was offered free of charge under the NIP. Safety information regarding the mother and newborn was considered the most important information in deciding whether to be vaccinated (47.4%), followed by safety information related only to the newborn (29.5%). About half (52.2%) stated that they would “certainly” accept MI, and 25.3% would like to receive more information. Gynecologists were the preferred healthcare providers (HCPs) for the provision of MI information (34.3%), followed by pediatricians (25.5%). Two-thirds of the respondents would prefer to be informed about MI before getting pregnant (66.0%). Vaccines investigated specifically for use in pregnancy were preferred by respondents. Overall, no relevant differences were observed between women pregnant for the first time and those with more than one pregnancy, nor between geographical regions. Conclusions The results show room for improving the awareness and understanding of the risks of pertussis for infants and the protective role of MI. The pregnant women preferred to receive advice on MI from an HCP, primarily their gynecologist. They were most interested in information on the safety profile of Tdap during pregnancy, on the mother, fetus, and newborn. The potential impact of this study to support clinical practice of Healthcare Providers is highlighted in the Focus on the Patient section.

Contribution of Fractalkine to Incorrect Angiogenesis in Preeclamptic Placentas

Disregarding the multiple research in the field of preeclampsia, the exact pathology remains unclear. The shallow invasion of extravillous trophoblast (EVT) in spiral arteries leads to the development of pregnancy‐induced hypertension, nevertheless the etiological factor is unknown. Disturbed differentiation of EVT and incorrect placental angiogenesis seem to be one of the most important starting points for pathogenetic and etiological concepts in preeclampsia. As fractalkine (chemokine CX3CL1) by the activation of its only receptor CX3CR1 stimulates angiogenesis and integrin‐dependent cell migration, the authors ask the question about the possible role of CX3CL1 in placental angiogenesis in preeclampsia. A total number of 58 pregnant patients were included into the study, preeclampsia was diagnosed in 29 patients, and 29 patients were healthy, normotensive term pregnancies. In all women between 30 and 32 week of pregnancy CX3CL1 level was assessed in plasma using ELISA and the expression of CX3CR1 and angiogenesis score (V/EVTI: vascular/extravascular tissular index) were assessed in placental tissues obtained after delivery. Quantitative immunohistochemistry was applied for assessment of both CX3CR1 expression and V/EVTI in placental sections. For this second purpose, morphometric measurements of the placental microvasculature were performed after immunohistochemistry of endothelial cells with CD‐34 antibody. The average duration of pregnancy in preeclamptic group was shorter by 5,3 weeks than in normotensive pregnancies. CXC3CL1 plasma concentration was significantly lower in preeclamptic patients (mean 279 pg/ml ± 243 vs mean 846 pg/ml ± 418), whereas CX3CR1 expression was significantly (p < 0.05) higher in preeclamptic group. A negative correlation between CX3CL1 level and CX3CR1 expression was observed. Moreover, the V/EVTI value was lowered in preeclampsia (p < 0.05). In conclusion, disturbed placental angiogenesis in preeclampsia may be associated with low plasma fractalkine level.Support or Funding InformationWUM grant: 2M2‐W1‐18This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Abstract P261: Dietary Sodium, Potassium, and Blood Pressure in Normotensive Pregnant Women: The National Health and Nutrition Examination Survey

Dietary sodium, potassium, and the sodium-to-potassium ratio are linearly associated with blood pressure in non-pregnant adults in a dose-response manner. Earlier investigations suggested null or inverse associations of sodium and blood pressure during normotensive pregnancy, but this finding has not been confirmed in a large, racially diverse group while accounting for counteractive effects of dietary potassium. Our purpose was to determine associations of blood pressure with sodium, potassium and the sodium-to-potassium ratio in normotensive pregnant women. We used cross-sectional blood pressure measurements and dietary data from 984 normotensive pregnant women in multiple cycles of the National Health and Nutrition Examination Survey (mean age=27.6 ± 0.2 years). We used Kruskal-Wallis tests to determine differences in blood pressure across quartiles of sodium intake and linear regression to test for associations of sodium, potassium, and the sodium-to-potassium ratio with systolic and diastolic blood pressure. Adjustment variables included: age, race, education, marital status, body mass index, smoking, and month of pregnancy. Average duration of pregnancy was 5.6 ± 0.1 months with no difference between quartiles of sodium intake. There was no difference in unadjusted systolic or diastolic blood pressures across quartiles of sodium intake; Quartile 1: 106/56; Quartile 2: 106/55; Quartile 3: 107/57; Quartile 4: 107/56, p>0.60 for all, and no difference in age and race-adjusted systolic or diastolic blood pressures across quartiles of dietary intake, Figure 1. In adjusted regression analyses, sodium ( b =0.16, 95%CI: -0.20, 0.52) and potassium ( b =0.18, 95%CI: -0.24, 0.60) intake and the sodium-to-potassium ratio ( b = -0.54, 95%CI: -1.55, 0.47) were not associated with systolic or diastolic blood pressure in normotensive pregnant women. Results were similar in analyses stratified by race/ethnicity. Blood pressure may be insensitive to sodium and potassium intake during normotensive pregnancy.

The Role of Pro- and Antioxidant Systems in the Development of Placental Dysfunction in Human Pregnancy

The pro-and antioxidant systems of the human placenta have been studied in its central and peripheral areas in the state of dysfunction. It has been shown that the intensity of free-radical oxidation (FRO) is 24% higher (p < 0.05) in mitochondria isolated from peripheral placental areas in the case of preterm termination of pregnancy than in placental mitochondria of women with normal pregnancy ending in delivery on due dates. The values of total antioxidant activity in mitochondria isolated from the central and peripheral areas of placentae of women with preterm labor exceeded 1.5-and 1.8-fold the respective values for the placental mitochondria of women with the normal duration of pregnancy. The rate of glutathione peroxidase activity in placental mitochondria of women with preterm labor was lower than in patients with normal duration of pregnancy terminated on due dates. Higher values of intensity of both the FRO processes and the active components of thiobarbituric acid (TBA) were recorded (higher by 42% and 62%, respectively) in the postmitochondrial fraction in the peripheral area of placentae of women with spontaneous termination of pregnancy, compared with the placentae of women with uncomplicated duration of pregnancy with labor on due date. No differences have been observed in the intensity of oxidative modification of placental proteins in both the periphery and the center in the placentae of women from the studied groups. The rate of glutathione peroxidase activity in the placenta of women with spontaneous termination of pregnancy was more than twice as high as the activity of this enzyme during the first trimester of normal pregnancy and remained high during the second and third trimesters. The activity of the enzyme did not depend on its localization (center or periphery) in placentae of women participating in the study. The values of glutathione transferase activity in the placentae increased in the course of normal pregnancy but remained at the level of the first trimester in the central and peripheral areas in the case of a miscarriage at different gestational terms. Our findings allow us to suggest that oxidative stress developing in placenta from its center to periphery plays a key role in the pathogenesis of placental dysfunction, mainly, due to the glutathione-dependent component of the placental antioxidant defense.

Heart Tumors in 33 Fetuses - Review of Twenty-Two Years of the Single-Centre Experience

Abstract INTRODUCTION: Cardiac tumors (CT) have been diagnosed since the eighties of the last century. The three most commonly diagnosed types of CT are rhabdomyomas, teratomas and fibromas. Severe fetal disturbances, such as arrythmias, fetal hydrops, ventricular obstructions, may be associated with the heart tumor. AIM OF THE STUDY: To present the key role of the echocardiographic examination in the perinatal care and to present some demographic changes in this population of the youngest patients. MATERIAL AND METHODS: From the Filemaker database of the Department for Diagnosis and Prevention of Congenital Malformations, Polish Mother’s Memorial Hospital &amp; Medical University of Lodz, all cases with prenatal diagnoses of cardiac tumor in singleton pregnancy were compiled over a 22-year period (1993–2015). 33 cases of heart tumors in fetuses had 72 fetal echo examinations. The average number of cases per year was 1,5 (range 1 – 5). The retrospective analysis of the material was performed using the Statistica package. The analysis included the assessment of the cardiovascular condition defined by Cardiovascular Profile Score, location and number of tumors; age, past obstetric history, place of residence of the mother, type of delivery and neonatal follow-up. RESULTS: The number of fetuses with cardiac tumor cases did not increase during this period. The maternal age was 28,1 years (± 5,2 years) and was decreasing over time. The primigravidae constituted 60% of examined population. The history of past miscarriages was observed in 26% of women. The majority of tumors were detected and diagnosed in the third trimester – at mean 29,6 hbd, but the diagnosis was made earlier in the past decades (regression analysis, p=0,042). The average duration of pregnancy was 36,6 hbd (range: 27-42 hbd). There was no statistical difference between decades in term on pregnancy duration. The cardiac tumors were more frequent in the female fetuses (71,4% to 28,6%; X2 test; p=0,006). The proportions between the groups of single and multiple tumors changed in last five years – currently the multiple tumors are more frequent (87,5%). The mortality in the group of single tumors was twice as high as in the group of multiple tumors. The percentage of cesarean sections between 1993 and 2005 was 67% and between 2006 and 2015 was 75% (p=0,63). The mortality of neonates with cardiac tumors declined over the period taken into account. CONCLUSIONS: The perinatal care of the fetuses with cardiac tumors improved over last 20 years. The characteristics of analyzed population had shown that fetal CTs affected healthy, young mothers, more often primigravidae, more often female fetuses. The prevalence of CTs did not increase over time. The gestational age at the time of the diagnosis decreased, thus the period of fetal echo monitoring increased. However, the rate of cesarean sections also increased, which requires further studies and explanations.

The clinical signs and risk factors of non-ambulatory children with cerebral palsy

The aim of the study was to analyze the risk factors and clinical picture of cerebral palsy in non-ambulatory children. The study included 133 children (77 boys and 56 girls) with cerebral palsy aged 6– 17 years. The patients remained under the care of the Outpatient Clinic and Department of Pediatric Rehabilitation of the Medical University of Bialystok. Ninety-eight of the studied patients had spastic tetraplegia, 14 diplegia and 21 hemiplegia. The average duration of pregnancy was 35.21 ± 1.32 weeks, the mean Apgar score was 4.31 ± 3.60 and the mean birth weight was 2448.3 ± 384.7 g. The patients exhibited the following types of motor dysfunctions: spasticity was found in 91 (68.9%) of the patients, hypotonia in 24 (18.2%), extrapyramidal symptoms in 13 (9.8%) and ataxia in 4 (3.0%) cases. More than3/4 (79%) of the children were classified as level V on the Gross Motor Functional Classification System (GMFCS) scale, and 21% as level IV. All the children had mental retardation: 10 (7.5%) mild, 45 (33.3%) moderate and 78 (58.6%) severe. Most children (69.2%) with cerebral palsy did not speak, although 41 (30.8%) managed to utter single words and sentences. More than half (64.6%) required assistance in order to eat, whereas 47 (35.4%) had to be fed. Nearly half (44%) of the patients suffered from epilepsy. Periventricular leukomalacia and atrophy of the cerebral cortex were the most frequent findings on magnetic resonance imaging. Low birth weight, a low Apgar score, and preterm birth were factors that had a negative impact on the ability of children with cerebral palsy to ambulate independently. Spasticity of the lower limbs, mental retardation, lack of speech development and inability to eat without assistance, as well as changes observed on magnetic resonance imaging were also factors determining lack of independent walking.

Characterization of fetal growth by repeated ultrasound measurements in the wild guinea pig (Cavia aperea)

Fetal growth during pregnancy has previously been studied in the domesticated guinea pig (Cavia aperea f. porcellus) after dissecting pregnant females, but there are no studies describing the fetal growth in their wild progenitor, the wild guinea pig (C aperea). In this study, 50 pregnancies of wild guinea pig sows were investigated using modern ultrasound technique. The two most common fetal growth parameters (biparietal diameter [BPD] and crown-rump-length [CRL]) and uterine position were measured. Data revealed similar fetal growth patterns in the wild guinea pig and domesticated guinea pig in the investigated gestation period, although they differ in reproductive milestones such as gestation length (average duration of pregnancy 68 days), average birth weight, and litter mass. In this study, pregnancy lasted on average 60.2 days with a variance of less than a day (0.96 days). The measured fetal growth parameters are strongly correlated with each (R = 0.91; P < 0.001) other and with gestational age (BPD regression equation y = 0.04x − 0.29; P < 0.001 and CRL regression equation y = 0.17x − 2.21; P < 0.01). Furthermore, fetuses in the most frequent uterine positions did not differ in their growth parameters and were not influenced by the mother ID. Our results imply that ultrasound measurement of a single fetal growth parameter is sufficient to reliably estimate gestational age in the wild guinea pig.

Analysis of infants based on data from the German Perinatal Survey of the years 1994-2011 in Mecklenburg-Pomerania, Germany: new percentile values for anthropometric measures of infants.

This communication presents precise percentile values for birth weight, birth length and cranial circumference of infants in Mecklenburg-Pomerania, Germany. Based on data from the German Perinatal Survey of the years 1994-2011 in Mecklenburg-Pomerania, the 3rd, 10th, 25th, 50th, 75th, 90th and 97th percentile values for birth weight, birth length and head circumference are specified. The measurements of a total of 174,084 infants from non-multiple births are shown. The statistically calculated percentile values are presented in tabular and graph forms. The mean birth weight of the infants was 3,437.8 g. The average age of the mothers was 27.9 years. The average duration of pregnancy was 39.4 complete weeks. The insights gained from many years of data collection are presented as standardised, regional percentile values and curves for Mecklenburg-Pomerania for the first time. The differentiated presentation for the federal state opens the possibility for individually tailored consultations in clinical practice and may provide support for recognised national curves for these values.

A Novel Translational Model of Percutaneous Fetoscopic Endoluminal Tracheal Occlusion - Baboons (Papio spp.)

Introduction: Percutaneous fetoscopic endoluminal reversible tracheal occlusion (FETO) was developed to prevent the pulmonary complications of fetal congenital diaphragmatic herniation. There is an urgent need to establish the closest to human translational model of FETO in order to improve fetal outcomes and to determine new clinical approaches and applications. Material and Methods: Seven non-human primates underwent two subsequent surgeries: the first, the FETO in the experimental group (n = 3) or sham operation in the control animals (S-FETO, n = 4) at 132-142 days of gestation (dGA); the second, the reversal of occlusion or sham operation at 162 ± 5 dGA. Maternal stress axis, complete blood count, and biochemical parameters were evaluated and newborn tracheal radiography was performed. Results: The average pregnancy duration and neonatal weights in the FETO group did not differ from the animals in the S-FETO group. There was no bleeding or premature fetal membrane rupture during the procedures in any of the baboons. The maximal tracheal width was 7.02 ± 0.6 mm in the FETO versus 5.46 ± 0.6 mm in S-FETO group. Discussion: This is the very first report of a successful FETO model in non-human primates. Similarities to human tracheomegaly were for the first time documented in any model studied.

Reproductive performance of Arab mares in the Kingdom of Saudi Arabia

The aim of this study was to evaluate the reproductive performance of the Arab mares in the Kingdom of Saudi Arabia (KSA). Managers of 26 studfarms containing 1014 Arab mares at five districts were asked to complete a questionnaire on the reproductive efficiency of their mares. The mean age at first mating was 3.06 ± 0.5 years. Mares were mated equally in winter and all over the year. Natural mating was mostly used (76.9%). The means of estrus duration and estrus interval were 6.58 ± 1 days and 19.57 ± 1.8 days, respectively. The means of first service and over- all pregnancy rates and the number of cycles/pregnancy were 52.71 ± 20.2%, 83.72 ± 15.0%, and 1.46 ± 0.3, respectively, with no effect of the postpartum interval, district, or season. The average pregnancy duration was 335.5 ± 10.2 days. It was shorter in mares mated by day 9 postpartum than in those mated later (p < 0.05). The ratio of stallion/mares ranged from 1:4 to 1:24, with no correlation with the pregnancy rates or the number of cycles/pregnancy. Photoperiodic regulation and changes in the hypothalamic-hypophyseal axis of mares are usually associated with the seaso- nal reproductive activity of mares in the temperate but not in subtropical areas. Short duration of gestation for mares mated by day 9 after foaling may be related to the nutritional status of dams. The obtained data represent the first record of the reproductive performance of Arab mares in the KSA, which could be used to anticipate their performance under different managements. The Arab mares in the KSA are not seasonal and can reproduce efficiently all over the year. District and season did not influence the fertility.

The Expression of Surfactant Proteins A and D in the Intestines and Pancreas of Murine Fetuses

Purpose: Surfactant proteins exist in the digestive tract and may play an important role in the host defense. However, the expression of surfactant proteins in the premature digestive system remains unclear. The aim of this study was to investigate the expression of surfactant proteins in the intes-tines and pancreas of murine fetuses. Methods: Immunostaining for SP-A and SP-D was assessed in the small intestine and pancreas of ICR murine fetuses on days 15, 16, 17 and 18 of gestation (normal duration of pregnancy: 19 - 21 days). RT-PCR was performed to detect the expression of spa and spd mRNA in the small intestine and pancreas on day 16, 17 and 18 of gestation. Results: Immunoreactivity for SP-A and SP-D in the acinar cells of pancreas and intestinal mucosal surface were positive on day 16 of gestation onward. RT-PCR revealed that the expression of spa and spd mRNA was significant in the pancreas but weak in the small intestine. Conclusions: Our data revealed that surfactant proteins are present in the fetal intestines and pancreas and that a significant expression of spa and spd mRNA is detected in the fetal pancreas. Pancreas may be a possible organ involved in the synthesis and secretion of surfactant proteins into the intestinal lumen.