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Clinical Trial 2013; 34(8): 787-791 PubMed PMID: 24522017 Citation  Keywords:  Adult, Female, Fetus:blood supply, Heart Rate:drug effects, Heart Rate, Fetal:drug effects, Humans, Obstetric Labor, Premature:diagnostic imaging, Pregnancy, Regional Blood Flow:drug effects, Tocolytic Agents:administration & dosage, Ultrasonography, Pren.   

OBJECTIVES: The aims were to evaluate whether any changes in blood flow in fetal inferior vena cava (IVC) are observed during Atosiban tocolysis within the first 48 hours of therapy.

METHODS: Detailed Doppler evaluation of blood flow in fetal IVC was performed prior to Atosiban administration and after 24 and 48 hours respectively. Maternal and fetal heart rate was assessed. IVC Doppler indices, such as, S/D (systole/diastole), PVIV (peak velocity index for the vein) and PLI (preload index) were calculated. To determine changes over time in all study variables, analysis of variance (ANOVA) for repeated measurements was used and followed by Tukey-Kramer's post hoc test. The effects of additional clinical covariates were checked.

RESULTS: Maternal heart rate was not altered significantly during Atosiban administration. No significant changes in FHR (fetal heart rate) as well as following IVC Doppler parameters (S/D, PVIV) were recorded after 24/48 hours of tocolytic treatment. The fetal IVC PLI values were significantly reduced after 24 hours and 48 hours of treatment. The changes in PLI values when comparing 24 and 48 hours results were not statistically significant.

CONCLUSIONS: As the questions about drug safety appeared after the animal study had been published about possible myocyte injury, detailed Doppler evaluation of IVC blood flow was performed. It revealed the changes in preload conditions which could be a reflection of successful Atosiban tocolytic treatment. No hemodynamic changes in IVC were noted, suggesting the presence of fetal acidemia due to possible heart damage was observed....

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Clinical Trial 2013; 34(7): 681-686 PubMed PMID: 24464012 Citation  Keywords:  Adult, Female, Fetus:blood supply, Heart Rate:drug effects, Heart Rate, Fetal:drug effects, Hemodynamics:drug effects, Humans, Obstetric Labor, Premature:diagnostic imaging, Pilot Projects, Placenta:blood supply, Pregnancy, Regional Blood Flow:drug effect.   

OBJECTIVES: The aims were to investigate whether there are any changes in placental and fetal circulation during Atosiban tocolysis within the first 48 hours of therapy.

METHODS: Detailed Doppler evaluation of placental and fetal circulation was performed prior to Atosiban administration and thereafter at 24 and 48 hours. Maternal heart rate and the pulsatility index (PI) in both uterine arteries (R-UtA, L-UtA) were assessed. Fetal heart rate (FHR), the resistance (RI) and pulsatility index (PI) of umbilical (UA) and middle cerebral artery (MCA) were measured. Additionally cerebroplacental ratio was calculated. E-wave/A-wave ratio (E/A) for atrioventricular valves, the myocardial performance index (MPI) and shortening fraction (SF) for both ventricles were calculated for both ventricles independently. To determine changes over time in all study variables analysis of variance (ANOVA) for repeated measurements followed by Tukey-Kramer's post hoc test was used. The effects of additional clinical covariates were checked.

RESULTS: Maternal heart rate and blood flow in (R-UtA/L-UtA) were not altered significantly during Atosiban administration. No significant changes in FHR as well as Doppler parameters (RI, PI, PSV) in UA and MCA were recorded after 24/48 hours of tocolytic treatment. The mean values of cerebroplacental ratio (CPR) remained unaltered during treatment. Detailed evaluation of fetal cardiac function parameters (E/A, SF, MPI) calculated independently for both ventricles, revealed no significant changes over the time.

CONCLUSIONS: To our best knowledge this study has been first evaluation of placental and fetal circulation with assessment of cardiac hemodynamic function during 48-hours administration of Atosiban. This kind of tocolysis treatment seems not to alter uterine nor fetal arterial blood flow pattern seriously. Hemodynamic cardiac activity in fetuses has remained unaffected. We cannot conclude definitely that there are absolutely no changes in the fetal hemodynamic condition due to Atosiban. Further studies should be performed to verify its possible influence on fetal venous blood flow....

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Case Reports 2008; 29(1): 67-68 PubMed PMID: 18283251 Citation  Keywords:  Brain:blood supply, Creutzfeldt-Jakob Syndrome:diagnostic imaging, Diagnosis, Differential, Female, Fluorodeoxyglucose F18:metabolism, Humans, Middle Aged, Positron-Emission Tomography:methods, Radiopharmaceuticals:metabolism, Regional Blood Flow, Tomogra.   

: Creutzfeldt-Jakob disease (CJD) is a subacute spongiform encephalopathy. This fatal prion disease is characterized by rapidly progressive dementia with a variety of neurological disorders. Diagnostic methods provided by nuclear medicine might be helpful for evaluation of patients with probable CJD as additional diagnostic tools to MRI and cerebro-spinal fluid evaluation. The experience with FDG-PET and brain perfusion SPECT is presented....

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Journal Article 2007; 28(5): 713-716 PubMed PMID: 17984953 Citation  Keywords:  Blood Flow Velocity, Female, Fetal Heart:physiology, Fetus:blood supply, Gestational Age, Humans, Pregnancy, Reference Values, Regional Blood Flow, Ultrasonography, Doppler, Pulsed, Ultrasonography, Prenatal:methods, Umbilical Veins:diagnostic imaging, Ve.   

UNLABELLED: The ductus venosus is the very important part of fetal venous circulation. It plays a central role in return of venous blood from the placenta. This unique shunt carries well-oxygenated blood from the umbilical vein through the inferior atrial inlet on its way across the foramen ovale. Using Doppler ultrasound, it is possible to assess the blood flow in fetal vessels including ductus venosus. It is observed, in animal and human studies, that the typical waveform for blood flow in ductus venosus in early pregnancy can be different depending on numerous conditions e.g. fetal karyotype. This study is performed to assess the physiologic parameters of blood flow in ductus venosus in uncomplicated early pregnancy.

MATERIAL AND METHODS: 404 women were examined between 11+0 and 13+6 weeks (+ days) of gestation by ultrasound. Fetal crown-rump length (CRL) was measured to assess the gestational age. The assessment of risk of fetal abnormalities was based on nuchal translucency (NT) measurement. The ductus venosus blood flow with color and spectral Doppler was obtained in all patients. The following features were assessed: pulsatility index (PI), and direction of flow (positive/negative) during atrial contraction (wave A). All cases were followed up to 22 weeks of gestation when the control scan was performed.

RESULTS AND CONCLUSIONS: 30 cases were excluded from the uncomplicated group due to: high risk of fetal abnormalities, fetal loss, confirmed fetal abnormalities and utero-placental pathology. 374 women were considered as uncomplicated pregnancy. In both uncomplicated and complicated groups the mean values for pulsatility index (PI) were established. The mean PI value in uncomplicated pregnancies was: 0.91 (SD +/- 0.32). No significant differences between groups were noticed. In 370 cases of uncomplicated pregnancy the A wave direction was positive but in 1.1% of cases the reverse flow in atrial contraction was observed....

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Journal Article 2007; 28(4): 502-506 PubMed PMID: 17693967 Citation  Keywords:  Abortion, Habitual:blood, Adult, Arteries:diagnostic imaging, Blood Flow Velocity:physiology, Case-Control Studies, Female, Homocysteine:blood, Humans, Regional Blood Flow:physiology, Ultrasonography, Doppler, Color, Uterus:blood supply, Vascular Resistan.   

OBJECTIVES: To study the assessment of diagnostic value and clinical usefulness of the determination of homocysteine concentration in blood serum in cases of recurrent miscarriages and the relation between the concentration of homocysteine in blood serum and parameter values determining the Doppler blood flow in the uterine arteries.

METHODS: Homocysteine concentration in blood serum was determined in a group of 30 women with at least two subsequent miscarriages with no clear reason and in the control group consisted of 20 non-pregnant women without a medical history of obstetric failures, having at least one healthy child. In all cases Color Doppler sonography was performed to determine flow velocity waveforms of the uterine arteries in luteal phase of the menstrual cycle.

RESULTS: Both pulsatility (PI) and resistance indices (RI) were considerably higher (p<0.01, p<0.05) for the group of women with recurrent abortions. In the group of women with obstetrical failures high positive correlation (R=0.6903, p<0.001) and in the control group very high positive correlation (r=0.8163, p<0.001) was found, between average values of PI and average HC concentration. High positive correlation (R=0.6260, p<0.001) in the examined group and very high positive correlation (r=0.9201, p<0.001) in the control group was obtained between average values of RI, and average HC concentrations in blood serum .

CONCLUSIONS: The recurring miscarriages occur in connection with the elevated homocysteine concentration, in consequence they can point out the pathology within the uterine-fetal blood vessels....

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