Congenital Malformations In Children Research Articles

P–788 Health outcomes at birth, 12 and 24 months of 747 children conceived after Preimplantation Genetic Testing: a single centre experience

Abstract Study question Does conception by Preimplantation Genetic Testing (PGT-M, PGT-SR) adversely affect health outcomes in children born through this assisted reproductive technique? Summary answer No significant difference was noted in the rate of congenital malformations in children born after PGT-M and PGT-SR compared with IVF-ICSI children. What is known already It is already known that the risk of congenital anomalies in IVF-ICSI pregnancies is higher when compared with pregnancies conceived naturally. Study design, size, duration This is a prospective study on 747 children born between December 1999 and July 2016 after a cycle of PGT-M or PGT-SR (IVF +/- ICSI + embryo biopsy) performed at a single London reproductive centre. PGT-A is not performed in the Centre, so pregnancy outcomes in this group are not relevant. The children were examined at birth, at 12 and 24 months of age and the data collected in three questionnaires. Participants/materials, setting, methods 747 PGT-M and PGT-SR children were enrolled in the study. 742/747 were examined at birth, 444/747 at 12 months and 168/747 at 24 months. The assessment consisted of three separate questionnaires completed at birth, 12 months and two years of age. The first questionnaire focused on the detection of congenital anomalies in newborn babies. The questionnaire at follow up recorded growth data and examination of the baby’s health and development. Main results and the role of chance We found no evidence that PGT-M and PGT-SR increased the risk of an adverse perinatal outcome when compared with children born after IVF-ICSI. The overall malformation rate in our group of live born after PGT-M and PGT-SR was 3.9% and of major malformations was 2%. These values are comparable with literature data on malformation risk in children born after IVF-ICSI. In terms of misdiagnosis, we had one misdiagnosis of SMA type 1 in 658 pregnancies obtained. This was very early on in the centre’s experience of offering PGT-M. Follow-up visits in our cohort allowed us to evaluate their development. Unfortunately, the low participation rate at 24 months (23%) significantly reduced the size of our cohort. We observed a cumulative value of 10% at 24 months of babies with developmental delay which is comparable with the value of 10% given by the WHO, but is twice the incidence Global Research on Developmental Disabilities Collaborators described in the UK in 2016 (4.6%). To our knowledge, no large studies have assessed the risk of developmental delay in children born after PGT. We cannot draw conclusions on this from our small cohort at 24 months and recommend further studies. Limitations, reasons for caution Although our sample is one of the largest reported, it is too small to generalise results due to the heterogeneity of the conditions for which PGT was being offered and the rarity of these conditions. There were multiple confounding factors including couple’s fertility background, varying fertility treatments and embryological techniques. Wider implications of the findings: Our results support published literature highlighting the safety of PGT-M and PGT-SR techniques. We followed up at birth, 12 months and 24 months a large cohort of children, in one of the largest datasets published so far. Trial registration number Not applicable

Antiseizure medications use during pregnancy and congenital malformations: A retrospective study in Saudi Arabia

AimTo evaluate the incidence of congenital malformations in children exposed prenatally to antiseizure medications (ASMs), to assess other perinatal and fetal complications, and to determine the potential predictors for these complications. MethodA retrospective review of pregnancy outcomes of women with epilepsy. Patients were followed up at the King Faisal Specialist Hospital and Research Centre, Riyadh and Jeddah, Saudi Arabia, between Dec 1993 and Oct 2020. ResultsOf 162 pregnancies included, 10 (6.17%) congenital malformations were observed, 6.82% in ASM-exposed babies versus 3.33% in babies of epilepsy-untreated mothers (P = 0.69). The overall incidence of perinatal and fetal complications was 53%; most frequent were low birth weight (24%), preterm birth (19%), transfer to neonatal intensive care unit (18%) and abortion (8%). These complications were higher in the untreated group (66.67%) than in the ASM group (50%). The use of other non-antiseizure medications during pregnancy was the only factor that significantly increased the risk of complications. ConclusionPrenatal exposure to ASMs was associated with increased risk of congenital malformations. However, overall perinatal and fetal complications were higher in the untreated group than in the ASM group, which could be explained by maternal seizures. Therefore, taking ASMs to control epilepsy and prevent perinatal complications may outweigh the risks of teratogenicity.

The degree of anthropogenic load, gene polymorphism of the xenobiotic biotransformation system and congenital malformations as links in the same chain

Introduction. According to epidemiological observations, the level of congenital malformations in children is associated with the degree of chemical pollution of the environment and certain forms of genes of the I and II phases of the xenobiotic biotransformation system. The study aimed to determine and compare the index of anthropogenic load with the probability of occurrence of congenital malformations of the fetus in combination with gene polymorphisms of I and II phases of the xenobiotic biotransformation system in women living in different administrative territories in the South of Kuzbass. Material and methods. The level of air pollution in the cities of the South of the Kemerovo region (Kuzbass) was established. Prenatal screening of 1,426 pregnant women at the term of 15-18 weeks in the cities of the South of Kuzbass was carried out. The Real Time-PCR method was used to determine the gene polymorphism of the xenobiotic biotransformation system (CYP1A2, GSTM1) in 53 women of Novokuznetsk who gave birth to newborns with congenital malformations. Results. In the cities of the South of Kuzbass, with a critical and high degree of pollution of atmospheric air and waterways, many women are at risk of congenital malformations in offsprings. The A/A CYP1A2*1F genotype in combination with the deletion polymorphism of the GSTM1 gene in the mother is reliably associated with the occurrence of congenital malformations in offsprings (χ2 - 4.72; р - 0.030; OR - 5.56; CI - 1.05-29.32), and the C/ACYP1A2*1F genotype in combination with the normal functioning GSTM1 “+” gene is associated with resistance to the development of congenital malformations (χ2 - 12.53; p - <0.001; OR - 0.11; CI - 0.03-0.4 ). Conclusion. Against the background of an increasingly unfavourable ecological situation in Kuzbass and raising the number of newborns with congenital malformations, it is essential to include in the algorithm for early prenatal diagnosis the determination of the forms of genes of different phases of the xenobiotic metabolism system to elaborate an algorithm for reducing the xenobiotic load on the body of pregnant women during critical periods of fetal organogenesis.

Effectiveness of analgesia with hydromorphone hydrochloride for postoperative pain following surgical repair of structural congenital malformations in children: a randomized controlled trial

BackgroundEffective postoperative analgesia is needed to prevent the negative effects of postoperative pain on patient outcomes. To compare the effectiveness of hydromorphone hydrochloride and sufentanil, combined with flurbiprofen axetil, for postoperative analgesia in pediatric patients.MethodsThis prospective randomized controlled trial included 222 pediatric patients scheduled for repair of a structural congenital malformation under general anesthesia. Patients were randomized into 3 groups: hydromorphone hydrochloride 0.1 mg/kg (H1), hydromorphone hydrochloride 0.2 mg/kg; (H2) or sufentanil 1.5 µg/kg (S). Analgesics were diluted in 0.9% saline to 100 ml and infused continuously at a basic flow rate of 2 mL per h. The primary outcome measure was the Face, Legs, Activity, Cry, and Consolability (FLACC) pain score. Secondary outcomes included heart rate (HR), respiration rate (RR), SpO2, Ramsay sedation scores, scores on the Paediatric Anaesthesia Emergence Delirium (PAED) scale, adverse reactions, parent satisfaction with analgesia.ResultsThe FLACC score was significantly lower in H1 and H2 groups compared to S. The Ramsay sedation score was significantly higher in H1 and H2 groups compared to S. Recovery time was shorter in H1 group compared to patients H2 group or S group. There were no significant differences in the PAED scale, HR, RR, SpO2, adverse reactions, satisfaction of parents with analgesia, or length and cost of hospital stay.ConclusionsHydromorphone hydrochloride is a more effective analgesic than sufentanil for postoperative pain in pediatric patients following surgical repair of a structural congenital malformation, however, hydromorphone hydrochloride and sufentanil had similar safety profiles in this patient population.Trial registrationChinese Clinical Trial Register ChiCTR-INR-17013935). Clinical trial registry URL: Date of registration: December 14, 2017.

Prenatal exposure to antipsychotic agents and the risk of congenital malformations in children: A systematic review and meta-analysis.

To evaluate the association between antipsychotic use in pregnancy and the risk of congenital malformations in children. Searches of PubMed, EMBASE, PsycINFO and Cochrane Library were conducted from inception to 06 January 2020 using keywords: antipsychotics, pregnancy, pregnancy complication and congenital abnormalities. Of 38 reports initially identified as being of potential interest, 13 studies met our inclusion criteria: English observational studies that examined the association between gestational antipsychotic use and congenital malformations in children. Data were extracted independently by 2 investigators including the publication year, study site, study period, data source, study design, sample size, medication exposure, exposure period and pregnancy definition, exposure as well as outcome ascertainment, selection of study and comparison group, confounding adjustment, statistical analysis, and method of linkage between mother and children. Risk estimates were pooled using a random-effect model and the I2 statistic was used to evaluate the degree of heterogeneity. Thirteen studies met our systematic review inclusion criteria. Six studies with a total of 2 515 272 pregnancy episodes were included in our meta-analysis, which provided a pooled adjusted risk ratio of 1.23, 95% confidence interval: 0.96-1.58. The I2 result showed moderate heterogeneity between studies (I2 = 35.2%, P= .173). We did not find strong evidence of an association between prenatal exposure to antipsychotic medications and the risk of congenital malformations in children. We recommend further studies investigate this association, focusing on specific medication classes and dose responses, which would help clinicians decide whether to prescribe certain antipsychotics during pregnancy.

STATE OF SYSTEMIC HEMODYNAMICS FOR CHILDREN WITH CONGENITAL SURGICAL PATHOLOGY IN DIFFERENT COMBINED ANESTHESIA TYPES

General anesthesia for a surgical correction of congenital malformations in children is accompanied, in particular, by the disorders of systemic hemodynamics. In order to assess the impact of different types of combined anesthesia on the state of systemic hemodynamics in surgical correction of congenital malformations, a retrospective study of the treatment of 150 newborns and infants was conducted. These were children with various congenital malformations, but the most common were intestinal obstruction and abdominal tumors. Three groups of patients were formed depending on the type of combined anesthesia during surgical correction of abnormalities: I − inhalation (sevorane) + regional anesthesia; II − inhalation (sevorane) + intravenous anesthesia (fentanyl); III − total intravenous anesthesia with two drugs: analgesic (fentanyl) and drug sleep on the background of intravenous injection of hypnotics (20 % sodium oxybutyrate). There were preformed the surgeries: thoracic, urological, abdominal. The study was retrospectively evaluated in five stages. The analysis of systemic hemodynamics showed a tendency to reduce diastolic blood pressure in children treated with anesthesia with two intravenous drugs (hypnotic and fentanyl), during all observation stages and a significant decrease in this index at the most painful and traumatic period. At the time of induction of anesthesia in children there was a decrease in heart rate. According to the research results, it is concluded that when using the pre−hypnotics as part of combined anesthesia in children with congenital malformations during surgery there is a risk of complications from central hemodynamics in the form of vasodilation, which leads to a drop in blood pressure and increases compensatively the heart contractions. Key words: infants, congenital malformations, anesthesia, hemodynamics.

Assessing Antiepileptic Drugs in Women with Epilepsy during Pregnancy in Srinagarind Hospital, Khon Kaen University, Thailand

Background: Epilepsy in pregnant women was related with many complications by itself. Antiepileptic drugs were prescribed for decreasing the frequent and severity of seizure, they causes malformation in the fetus. Objective: To assessing antiepileptic drugs in women with epilepsy during pregnancy in Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand. The second objective was to review abnormal congenital malformation effect of antiepileptic drugs, specialty in type of drug used in the hospital. Materials and Methods: A retrospective study was conducted in all pregnant women who using antiepileptic drugs during 2015 to 2019. Review the literature were searched from online publishing report. Results: The preliminary data from the hospital showed 7 AEDs used in pregnant period. The AEDs which highly used including phenobarbital, levetiracetam, and valproic acid, respectively. Co-medication was folic acid, ranitidine, and multivitamin. The review literation data showed valproic acid or valproate was the high risk drug inducing of congenital malformation in children who received AEDs during grown in uterus. The major congenital malformation composed of orofacial clefts, neural tube defects, and limb deficiencies, and usually found in older AEDs than new drug group. Conclusion: AEDs or epilepsy causes increases the risk of many complications in both maternal and child. It is challenging to obstetricians, neurologist, and pediatric doctors for well co-operation to management of WWE who intake AEDs during pregnant for good outcomes of maternal and her child at post-partum period. Keywords: Women with epilepsy (WWE), Pregnancy, Antiepileptic drugs, Epilepsy clinic Srinagarind hospital

PREDICTION MODEL OF PROBABILITY ESTIMATE OF FATAL CASES IN INFANTS WITH CONGENITAL MALFORMATIONS IN SURGICAL INTERVENTIONS

Aim: To evaluate different types of combined anesthesia in surgical correction of congenital malformations in infants and to develop a prediction model of the association of risk factors and fatal cases in chosen methods of anesthesia care. Material and methods: The retrospective study included newborns and infants with congenital malformations, who received and continued phased surgical treatment. Determination of risk factors was performed by the method of simple logistic regression with the calculation of the odds ratio (OR), 95% confidence interval (95% CI). Results: A total of 150 children were included in the study. The risk factors for deaths in the surgical correction of congenital malformations in children have been established, a prognostic model has been created. Conclusions: To prevent fatal cases in various types of surgery and options for anesthesia care of newborns and infants with CM, it is advisable to more closely monitor the cerebral, peripheral oximetry at all stages of treatment and timely correct the impaired condition of the child.

Determination the concentration of heavy elements and gross alpha, beta, and gamma activities in soil samples from Tworeach district at Karbala governorate

In this study, the radiological efficacy of selected samples of a hole produced by a rocket dropped during military operations in the second Gulf battle was measured. Since the fall of the rocket in 1991 on district of Tuwayrej, Karbala at central Iraq until this moment, there have been many miscarriages in women as well as cases of congenital malformation in children. For these reasons and in response to the appeals of the residents of the region, we conducted this study. Twelve different samples of soil were collected for the study area from different distances (0, 25, 50 and 100 m) and with different directions (North, South, East and West) from the edge of the hole. chemical method to calculate the percentage elements (Na, Cr, Ni, Ca, Fe, K, and Mg), in this samples, and using physical method to calculate the concentration of the natural radioactivity in the same samples the instrumentations used to count the gross alpha, beta, activities was alpha/beta proportional counter and High purity Germanium detector to calculate the gross gamma activity to count the radiation from these samples. The obtained results show that the gross alpha, beta and gamma activities ranged from (2.15 to 36.23Bq/Kg), (37.37 to 217.17Bq/Kg) and (2.26 to 50.92 Bq/Kg) respectively. In comparing the practical results with the global calculated results, the radiation levels of the studied models were found to be within permissible limits.

Cardiac Congenital Pathologies More Frequent in Children in a Hospital of Guayaquil (Ecuador)

Congenital heart diseases (CHD) are structural malformations of the heart or large vessels, which cause a functional impairment, present at birth, being discovered at that time or during the course of the life of the carrier. CHD are a group of complex diseases that cause a serious public health problem. the objective of the work was, to identify the most frequent congenital heart malformations in children under 1 year of age in the general hospital of the north IESS Los Ceibos of the city of Guayaquil (Ecuador) in the period July 2017- January 2018. The data of this investigation were taken from pediatric patients by reviewing medical records. In the study period, 35,105 pediatric care visits were made to children under 1 year of age. Around 1.025 (2.92%) cases of congenital malformations were detected, of which 108 corresponded to congenital heart malformations (CHD), that is, 10.53% of the malformations observed were of the CHD type. The most frequent cardiac congenital malformations in children under 1 year old are non-cyanotic congenital cardiac malformations (NC) with a total of 102 cases (94%) and 6 cases (6%). they correspond to congenital cardiac malformations (C), being these less frequent.

Программное обеспечение раннего пренатального скрининга врожденных пороков развития у детей

Разработан программный комплекс «Пренатальный скрининг» для раннего пренатального скрининга врожденных пороков развития у детей в Краснодарском крае. The software package «Prenatal Screening» has been developed for early prenatal screening of congenital malformations in children in Krasnodar region.

Neonatal outcome of children born after ICSI with epididymal or testicular sperm: A 10-year study in China

Some studies show that children born after ICSI with non-ejaculated sperm are at increased risk of birth defects, other studies hold the opposite view. Does neonatal outcome including congenital malformations in children born after ICSI with percutaneous epididymal sperm aspiration (PESA) and testicular sperm aspiration (TESA) differ from neonatal outcome in children born after ICSI with ejaculated sperm? In this study, we examined the data from our IVF center from 2006 to 2016, to compare neonatal outcomes and rates of congenital malformations in children born after ICSI with different sperm origin. The results showed the clinical pregnancy rate and implantation rate of non-ejaculated sperm group were significantly higher (P < 0.001) than ejaculated sperm group. There were 775 clinical pregnancies from non-ejaculated sperm group and 2,486 clinical pregnancies from ejaculated sperm group. Most of the clinical pregnancy outcomes were comparable between non-ejaculated sperm group and ejaculated sperm group (p > 0.05): the miscarriage rate per transfer, ectopic pregnancy rate per clinical pregnancy, induced abortion rate per clinical pregnancy and fetal deaths per clinical pregnancy. However, the live delivery rate per transfer of non-ejaculated sperm group was significantly higher than that of ejaculated sperm group (45.4% vs 36.7%, P < 0.001). Moreover, the comparison between the epididymal sperm, testicular sperm and ejaculated sperm groups showed there were no difference in the incidence of congenital malformations of babies live birth. Among singleton gestation live births, there were more girls than boys in both non-ejaculated sperm and ejaculated sperm group. In conclusion, the present study clearly showed no statistical increased risk in neonatal outcomes of newborns were found in the ICSI treatment with epididymal or testicular sperm. It may provide information for consultation for ICSI treatment in PESA or TESA patients.

Congenital Malformations in Children With Cerebral Palsy: Is Prematurity Protective?

BackgroundCongenital malformations are more common in children who are born prematurely, and prematurity is the leading risk factor for cerebral palsy. The primary objective of this study was to describe the profile of congenital malformations in a Canadian cohort of children with cerebral palsy. The secondary objectives were to compare the profiles of children with cerebral palsy with and without a congenital malformation and explore the possible role of prematurity. MethodsThis retrospective cohort study utilized data from the Canadian Cerebral Palsy Registry, a population based registry of children with a confirmed diagnosis of cerebral palsy. Differences between groups were compared using Pearson’s chi-square and Student t test as appropriate. Odds ratios and 95% confidence intervals were calculated ResultsCongenital malformations were present in 23% participants. In term-born children, brain malformations were the most common, whereas heart and gastrointestinal malformations were more common in children born prematurely. Children with a malformation had higher odds of being born at term (odds ratio 1.57, 95% confidence interval 1.20 to 2.04); having hypotonic, ataxic, or dyskinetic cerebral palsy (odds ratio 1.92, 95% confidence interval 1.35 to 2.72; being nonambulatory (odds ratio 1.70, 95% confidence interval 1.29 to 2.25); and having cerebral palsy-associated comorbidities. ConclusionsOne in four children with cerebral palsy have an associated congenital malformation. Their profile of term birth, higher Apgar scores, and lower frequency of perinatal seizures suggests a distinct causal pathway.

The regurgitation during anesthesia with the 2-ndLMA for Endovascular Correction of Congenital Malformations in Children

The regurgitation during anesthesia with the 2-ndLMA for Endovascular Correction of Congenital Malformations in Children

Immunosuppression and Reproductive Health After Kidney Transplantation.

Following successful kidney transplantation, recipients usually regain fertility. Post-engraftment pregnancies should be planned and the teratogenic mycophenolic acid should be replaced with azathioprine before conception. To avoid unintentional pregnancies, pre-conception counseling is mandatory in women of reproductive age who are scheduled for a kidney transplant. Counseling should be repeated after transplantation. Female recipients should receive advice to use long-acting reversible contraception and avoid pregnancy for a minimum of 1 year following transplantation. Conception should be deferred even longer in female recipients with moderate to severe proteinuria, uncontrolled hypertension or reduced graft function and be very carefully discussed in highly HLA-sensitized patients. The recipient wishes, values and acceptance of pregnancy-related risk should receive attention. Assisted fertilization increases the risk of pre-eclampsia, but still result in live births. Pregnancy management in kidney transplant recipients should be provided by a multidisciplinary team consisting of a nephrologist, a midwife and an obstetrician with expertise in high-risk pregnancies. Until measurement of unbound fraction of calcineurin inhibitors becomes clinically available, we recommend to adjust calcineurin inhibitor dose according to whole blood trough level, even though it overestimates the effective drug concentration during pregnancy. If nephrotoxicity is suspected, the calcineurin inhibitor dose should be reduced. Breastfeeding should be accepted after kidney transplantation since infant immunosuppressive drug exposure via breastmilk is extremely low. The prevalence of congenital malformations in children fathered by male recipients, including patients on mycophenolic acid therapy at the time of conception, is at level with the general population.

Fetal Congenital Heart Disease Echocardiogram Screening Based on DGACNN: Adversarial One-Class Classification Combined with Video Transfer Learning.

Fetal congenital heart disease (FHD) is a common and serious congenital malformation in children. In Asia, FHD birth defect rates have reached as high as 9.3%. For the early detection of birth defects and mortality, echocardiography remains the most effective method for screening fetal heart malformations. However, standard echocardiograms of the fetal heart, especially four-chamber view images, are difficult to obtain. In addition, the pathophysiological changes in fetal hearts during different pregnancy periods lead to ever-changing two-dimensional fetal heart structures and hemodynamics, and it requires extensive professional knowledge to recognize and judge disease development. Thus, research on the automatic screening for FHD is necessary. In this paper, we proposed a new model named DGACNN that shows the best performance in recognizing FHD, achieving a rate of 85%. The motivation for this network is to deal with the problem that there are insufficient training datasets to train a robust model. There are many unlabeled video slices, but they are tough and time-consuming to annotate. Thus, how to use these un-annotated video slices to improve the DGACNN capability for recognizing FHD, in terms of both recognition accuracy and robustness, is very meaningful for FHD screening. The architecture of DGACNN comprises two parts, that is, DANomaly and GACNN (Wgan-GP and CNN). DANomaly, similar to the ALOCC network, but incorporates cycle adversarial learning to train an end-to-end one-class classification (OCC) network that is more robust and has a higher accuracy than ALOCC in screening video slices. For the GACNN architecture, we use FCH (four chamber heart) video slices at around the end-systole, as screened by DANomaly, to train a WGAN-GP for the purpose of obtaining ideal low-level features that can robustly improve the FHD recognition accuracy. A few annotated video slices, as screened by DANomaly, can also be used for data augmentation so as to improve the FHD recognition further. The experiments show that the DGACNN outperforms other state-of-the-art networks by 1%-20% in recognizing FHD. A comparison experiment shows that the proposed network already outperforms the performance of expert cardiologists in recognizing FHD, reaching 84% in a test. Thus, the proposed architecture has high potential for helping cardiologists complete early FHD screenings.

P2575Excess and deficiency of serotonin in embryogenesis affects the contractility of the right ventricle myocardium

Abstract Background Congenital heart disease (CHD) is one of the most common pathologies among congenital malformations in children. The incidence of CHD is currently more than 30% of all malformations. The most frequent and severe complication of CHD is pulmonary hypertension (PH). PH worsens the CHD prognosis, affects the survival rate of children, and increases the risk of disability and mortality. Experimental studies demonstrate a high correlation between the PH degree, concentrations of serotonin and its metabolites in the blood. The purpose of our study was to investigate the effect of excess and lack of serotonin in the embryonic period on the functioning of the heart in early postnatal ontogenesis. Methods Study was conducted according to “Principles of laboratory animal care”. The study was carried out on pregnant female Wistar rats and their offspring at the age of 14 days. Myocardial contractility in vitro was studied on myocardial strips of right ventricle. The amplitude-time characteristics of the contraction were calculated by the method of S. Laer 1998. The following series of experiments were conducted: 1. Pregnant females, starting from the 11th day of pregnancy for 10 days were injected intraperitoneally: group 1 - serotonin synthesis inhibitor (p-chlorophenylalanine) at a dose of 100 mg/kg; group 2 - selective serotonin reuptake inhibitor (fluoxetine) at a dose of 50 mg/kg; group 3 - (control group) - saline solution. Inotropic myocardial function was studied in the offsprings of each group at the age of 14 days. The reactions of the contraction of myocardial stripes of rat pups were evaluated in 2 batches: first on epinephrine and then on the calcium channel inhibitor (verapamil) at concentrations of 2.5 μM and in the reverse order. Results Our experiment demonstrates that the reaction of inotropic function of the right ventricle on epinephrine in 2 weeks of age rats is not affected by changes in serotonin metabolism in the embryonic period of development. Against the background of a pronounced positive effect from the use of epinephrine, verapamil was used to inhibit calcium channels. We observed a significant reduction in the force of contraction by 83.41±3.14% in the control group, by 71.42±2.95% in the group with an excess of serotonin and by 63.97±7.93% in group with serotonin deficiency. In the next series of experiments, verapamil was first applied, resulting the decrease of contraction strength by 78.58±1.71% in the control group, by 80.81±7.33% in the myocardium of rats with an excess of serotonin and by 67.70±4, 66% in the group with serotonin deficiency. Subsequent exposure of epinephrine led to an increase in myocardial contractility equally in all groups at 132–135%. Conclusion Violation of serotonin metabolism during embryogenesis affects the regulation of contractility (force of contraction) of the right ventricle. Acknowledgement/Funding This work was supported by the Ministry of Science and Education of Republic of Kazakhstan [grant number AP05136034]

Neonatal outcomes and congenital malformations in children born after dydrogesterone application in progestin-primed ovarian stimulation protocol for IVF: a retrospective cohort study.

PurposeDydrogesterone (DYG) has been demonstrated to be an alternative progestin in the progestin-primed ovarian stimulation (PPOS) protocol with comparable oocyte retrieval and pregnancy outcomes. However, its safety regarding neonatal outcomes and congenital malformations is still unclear.Patients and methodsThis retrospective cohort study included 3556 live-born infants after in vitro fertilization and vitrified embryo transfer cycles using the DYG + human menopausal gonadotropin (hMG) protocol (n=1429) or gonadotropin-releasing hormone (GnRH)-agonist short protocol (n=2127) from January 2014 to December 2017. Newborn information was gathered from standardized follow-up questionnaires and/or access to medical records within 7 days after birth. Associations between ovarian stimulation protocols and outcome measures were analyzed by binary logistic regression after adjusting for confounding factors.ResultsIn both singletons and twins, birth characteristics regarding mode of delivery, newborn gender, gestational age, birthweight, length at birth and Z-scores were comparable between the two protocols. For adverse neonatal outcomes, the two protocols showed no significant differences on the rates of low birthweight, very low birthweight, preterm birth, very preterm birth, small-for-gestational age, large-for-gestational age and early neonatal death after adjustment. Furthermore, the incidence of major congenital malformations in the DYG + hMG protocol (1.12%) was similar to that in the GnRH-agonist short protocol (1.08%), with the adjusted odds ratio of 0.98 (95% confidence interval [CI]: 0.40–2.39) and 0.90 (95% CI: 0.33–2.41) in singletons and twins, respectively.ConclusionOur data suggested that compared with the conventional GnRH-agonist short protocol, application of DYG in the PPOS protocol was a safe option for the newborn population without compromising neonatal outcomes or increasing congenital malformation risks.

Etoposide. Documentation of proposed values of occupational exposure limits (OELs)

Etoposide. Documentation of proposed values of occupational exposure limits (OELs)

How does levetiracetam compare with other anti-epileptic drugs in terms of congenital malformations in children?

How does levetiracetam compare with other anti-epileptic drugs in terms of congenital malformations in children?