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JAYPEE JOURNALS
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List of All Articles
1.  Picture of the Month
Prenatal Diagnosis of Low-set Ears with Asymmetrical Microtia in the First Trimester
Ritsuko K Pooh
[Year:2016] [Month:April-June] [Volume:10 ] [Number:2] [Pages:91] [Pages No:111-112] [No of Hits : 700]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10009-1451 | PAID (Buy Now)

ABSTRACT

Initially, the external ears are in the lower neck region, but with the development of the mandible, they ascend to the side of the head at the level of the eyes. Low-set ear is one of the features often associated with genetic disorders, and external ear defects are significant because they are often associated with other malformations. The problem may occur as a symmetrical condition but an asymmetrical condition is not rare, in which one side of the face is maldeveloped. This defect varies in severity; however, it always includes maldevelopment of the ear and the mandible. Recent advanced 3D HDlive ultrasound enables us to demonstrate fetal external ear position and development even as early as in the first trimester. The picture of the month clearly demonstrated low-set ears with asymmetrical development of the ear and face at 12 weeks of gestation. Early detection of ear abnormality leads to further genetic and morphologic investigation as well as to proper management and counseling.

Keywords: Asymmetrical, Ear, Fetus, First trimester, Low-set, 3D ultrasound.a

How to cite this article: Pooh RK. Prenatal Diagnosis of Low-set Ears with Asymmetrical Microtia in the First Trimester. Donald School J Ultrasound Obstet Gynecol 2016;10(2):111-112.

Source of support: Nil

Conflict of interest: None

 
2.  Editorial
Facts and Doubts about the Beginning of the Human Life and Personality
Asim Kurjak, Lara Spalldi Barisic, Taib Delic, Selma Porovic, Milan Stanojevic
[Year:2016] [Month:July-September] [Volume:10 ] [Number:3] [Pages:160] [Pages No:205-213] [No of Hits : 631]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10009-1470 | FREE

ABSTRACT

Scientists have been negligent in failing to translate science into the terms that allow mankind to share their excitement of discovering life before birth. In spite of remarkable scientific development, man’s curiosity, and speculations dating back to Hippocrates, life before birth still remains a big secret. Various kinds of intellectuals were involved in trying to offer their contribution to solve the human life puzzle. Their leading idea is that each newborn child will reach its full potential if its development in uterus is not exposed to any adverse influence, providing the best possible environment for the embryo/fetus. Considering the embryo/fetus, we should always keep in mind the amazing aspect of human life where the mother and the embryo/fetus, although linked in the most intimate relationships, are at all times two separate people. Considering the embryo/fetus as the person opened a new set of questions about its personality and human rights. Today, scientific data and hypotheses, philosophical thought, and issues in the humanities have become a necessity in order to deal with ethical, juridical, and social problems arising from man’s interference in many aspects and stages of life.

Keywords: Fetal life, Personality, Ultrasound diagnosis.

How to cite this article: Kurjak A, Spalldi Barisic L, Delic T, Porovic S, Stanojevic M. Facts and Doubts about the Beginning of Human Life and Personality. Donald School J Ultrasound Obstet Gynecol 2016;10(3):205-213.

Source of support: Nil

Conflict of interest: None

 
3.  Review Article
Prenatal Detection of Critical Congenital Heart Disease
Lina W Irshaid, Najwa Elfky, Badreldeen Ahmed
[Year:2016] [Month:April-June] [Volume:10 ] [Number:2] [Pages:91] [Pages No:131-135] [No of Hits : 607]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10009-1455 | PAID (Buy Now)

ABSTRACT

Congenital heart disease (CHD) is a leading cause of infant mortality and 30% fetuses born with CHDs have other associated malformations and chromosomal abnormalities. Prenatal diagnosis also allows parents to opt for termination of the pregnancy.

Keywords: Critical congenital heart disease, Fetal echocardiography, Prenatal diagnosis.

How to cite this article: Irshaid LW, Elfky N, Ahmed B. Prenatal Detection of Critical Congenital Heart Disease. Donald School J Ultrasound Obstet Gynecol 2016;10(2):131-135.

Source of support: Nil

Conflict of interest: None

 
4.  Review Article
Maternal and Perinatal Mortality in the 21st Century
Aris Antsaklis
[Year:2016] [Month:April-June] [Volume:10 ] [Number:2] [Pages:91] [Pages No:143-146] [No of Hits : 593]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10009-1457 | PAID (Buy Now)

ABSTRACT

The maternal mortality ratio measures how safe it is to become pregnant and give birth in a geographic area or a population. The total number of maternal deaths observed annually fell from 526,000 in 1980 to 358,000 in 2008, a 34% decline over this period. Similarly, the global MMR declined from 422 in 1980 to 320 in 1990 and was 250 per 100,000 live births in 2008, a decline of 34% over the entire period and an average annual decline of 2.3%.

More specifically, in 1990 around 58% of maternal deaths worldwide occurred in Asia and 36% in sub-Saharan Africa. In contrast, in 2008, 57% of global maternal deaths occurred in sub-Saharan Africa and 39% in Asia. In Europe, the main causes of death from any known direct obstetric complication remains bleeding (13%), thromboembolic events (10.1%), complicationassociated birth, hypertensive disease of pregnancy (9.2%), and amniotic fluid embolism (10.6%).

Preterm birth is the most common cause of perinatal mortality (PNM) causing almost 30% of neonatal deaths, while birth defects cause about 21% of neonatal deaths. The PNM rate refers to the number of perinatal deaths per 1,000 total births. Perinatal mortality rate may be below 10 for certain developed countries and more than 10 times higher in developing countries. Perinatal health in Europe has improved dramatically in recent decades. In 1975, neonatal mortality ranged from 7 to 27 per 1,000 live births in the countries that now make up the EU. By 2005, it had declined to 8 per 1,000 live births.

We need to bring together data from civil registration, medical birth registers, hospital discharge systems in order to have European Surveys which present exciting research possibilities.

Keywords: Maternal mortality, Perinatal mortality, Pregnancy.

How to cite this article: Antsaklis A. Maternal and Perinatal Mortality in the 21st Century. Donald School J Ultrasound Obstet Gynecol 2016;10(2):143-146.

Source of support: Nil

Conflict of interest: None

 
5.  Review Article
Are We Ready to investigate Cognitive Function of Fetal Brain? The Role of Advanced Four-dimensional Sonography
Asim Kurjak, Lara S Barisic, Milan Stanojevic, Aida S Kadic, Selma Porovic
[Year:2016] [Month:April-June] [Volume:10 ] [Number:2] [Pages:91] [Pages No:116-124] [No of Hits : 573]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10009-1453 | PAID (Buy Now)

ABSTRACT

Human brain is fascinating organ in so many ways. Some of its cognitive functions, such as ability to learn, memorize, think, percept different sensations, such as pain, to have emotion, process audio-visual inputs, and to coordinate reaction and movements have been subjects of studies for many years. Yet, till recently, we could only make assumptions about prenatal activities, interactions and its construction of complex structures in the time frame of antenatal life. With the prenatal assessment (sonoembryology, neurosonoembryology, KANET test, etc.) by latest advanced HDlive, Silhouette and Flow 3D/4D imaging there is possibility to follow in continuity normal structural and functional development from the early beginnings of “life” and on the other hand consider what might be different (not necessarily abnormal) and deviate from normal development and behavior.

On this way, we are able to supplement knowledge of fundamental building blocks of development of fetal cognitive functions, to pay more attention and follow up fetuses at higher risk and finally find some of the possible origins of cognitive dysfunctions which may manifest in childhood or later in life.82 With the introduction of different 3D/4D ultrasound modes we have ability to observe all of this in vivo while emerging, and make “time-lapse” of fetal neurodevelopment and behavior in correlation to its cognitive functional development.

Keywords: Fetal awareness, Fetal behavior, Fetal facial expression, Fetal neurodevelopment, Four-dimensional ultrasound, Prenatal cognitive function.

How to cite this article: Kurjak A, Spalldi Barisic L, Stanojevic M, Salihagic Kadic A, Porovic S. Are We Ready to investigate Cognitive Function of Fetal Brain? The Role of Advanced Fourdimensional Sonography. Donald School J Ultrasound Obstet Gynecol 2016;10(2):116-124.

Source of support: Nil

Conflict of interest: None

 
6.  Review Article
Some Future Aspects within Perinatal Medicine considered by a Senior Fellow
Erich Saling
[Year:2016] [Month:April-June] [Volume:10 ] [Number:2] [Pages:91] [Pages No:113-115] [No of Hits : 563]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10009-1452 | PAID (Buy Now)

ABSTRACT

During the last six decades, a unique new field of applied medicine has been brought forward in the phase before the great biological event of birth, namely into the intrauterine space. On the basis of experiences collected during this time, a few selected thoughts about further aspects based on new but also on some old achievements are presented.

The first one concerns the hardly necessary too frequent use of antibiotics with its negative side effects, such as damage of intestinal flora. We found convincing results in a group of cases with premature rupture of membranes, using PVP-iodine solution for vaginal rinsing to practice in this way an efficient local antiseptic therapy until birth. Another example is amnioscopy, unfortunately replaced to a large extent. But its use remains appropriate because of the low expense and high safety of this method.

A current progress of great importance for the future is the field of perinatal programming. Malprogramming via epigenetic mechanisms results in a lifelong disposition for overweight, obesity, and diabetic metabolic disorders across generations. Important progress and reduction of risks in later life can be expected by suitable research.

A fascinating new field is fetal neurology. Fetal behavioral patterns diagnosed by four-dimensional (4D) ultrasound are directly reflecting developmental and maturational processes of the fetal central nervous system. Such information will hopefully be of great value for further elucidation of neurological problems, for instance, cerebral palsy.

And finally a field in which we have been involved in the 1980s concerns the compensatory intrauterine supply of malnourished fetuses.

Fortunately, there are some efforts to continue these studies to treat severe placental insufficiency with amino acid and glucose by intraumbilical supplementation via a port system.

Keywords: Amnioscopy, Fetal neurology, Perinatal programming, Supply of malnourished fetuses, Vaginal antiseptics.

How to cite this article: Saling E. Some Future Aspects within Perinatal Medicine considered by a Senior Fellow. Donald School J Ultrasound Obstet Gynecol 2016;10(2):113-115.

Source of support: Nil

Conflict of interest: None

 
7.  Review Article
Diagnosis and Counseling of Fetal Mild Ventriculomegaly
Vincenzo D’Addario, M Cialdella, G Volpe
[Year:2016] [Month:April-June] [Volume:10 ] [Number:2] [Pages:91] [Pages No:154-159] [No of Hits : 560]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10009-1459 | PAID (Buy Now)

ABSTRACT

Mild ventriculomegaly (MVM) is defined as a lateral ventricular diameter measured at the level of the atrium of ≥10 mm but < 15 mm. Prenatal evaluation includes targeted sonographic examination for central nervous system (CNS) and extra- CNS abnormalities (present in 41.4% of the cases), and diagnostic amniocentesis for chromosomal analysis (3% of chromosomopaties in isolated cases) and infectious disease studies (1.5% incidence). Individualized patient counseling is based on these test results. Optimal postnatal care involves appropriate pediatric neurologic and developmental specialists.

Learning objectives: After completion of this article, the reader will be able to define the normal appearance and size of the fetal cerebral ventricles, to list the conditions associated with MVM, and to counsel the parents properly.

Keywords: Fetus, Neurodevelopmental delay, Ultrasound, Ventriculomegaly

How to cite this article: D’Addario V, Cialdella M, Volpe G. Diagnosis and Counseling of Fetal Mild Ventriculomegaly. Donald School J Ultrasound Obstet Gynecol 2016;10(2):154-159.

Source of support: Nil

Conflict of interest: None

 
8.  Original Scientific Article
Recent Advances in 3D Ultrasound, Silhouette Ultrasound, and Sonoangiogram in Fetal Neurology
Ritsuko K Pooh
[Year:2016] [Month:April-June] [Volume:10 ] [Number:2] [Pages:91] [Pages No:193-200] [No of Hits : 553]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10009-1468 | PAID (Buy Now)

ABSTRACT

New fields of neurosonoembryology and fetal neurology have been established by the remarkable contribution of threedimensional/ four-dimensional (3D/4D) ultrasound technology. A recent evolution in prenatal imaging is HDlive silhouette/flow technology. By HDlive silhouette mode, an inner cystic structure with fluid collection can be depicted through the outer surface structure of the body, and it can be appropriately named “seethrough fashion.” HDlive flow mode adds more spatial resolution to conventional 3D ultrasound angiogram. We have utilized this technology in neuroimaging and investigated its clinical significance.

HDlive silhouette imaging demonstrated clear images of ventricular system with outer fetal surface structure in early pregnancy as well as in the middle gestation. Silhouette ultrasound demonstration of a thick slice of 3D volume dataset shows a more concrete inside structure of complicated morphology in specific cases. Silhouette ultrasound can also depict a bony structure; therefore, cranial bones and vertebrae of spina bifida can be detected using this technology. HDlive flow imaging can demonstrate the cerebral vascular structure of fine arteries and veins throughout gestation. By HDlive silhouette and flow imaging, inner cystic as well as noncystic structures can be demonstrated with outer surface. HDlive flow imaging can demonstrate fine peripheral brain vasculature.

The degree of gain, threshold, and silhouette or a combination of these makes it possible to create completely different images with different clinical information from a single-volume dataset. This fact expands the flexibility of imaging and demonstration, but at the same time it can create a virtual reality. Although any new technology is not always perfect, HDlive silhouette and flow imaging will greatly contribute to perinatal medicine.

Keywords: Fetus, Flow, HDlive, Neurology, Prenatal diagnosis, See-through fashion, Silhouette, Three-dimensional, Ultrasound.

How to cite this article: Pooh RK. Recent Advances in 3D Ultrasound, Silhouette Ultrasound, and Sonoangiogram in Fetal Neurology. Donald School J Ultrasound Obstet Gynecol 2016;10(2):193-200.

Source of support: Nil

Conflict of interest: None

 
9.  Review Article
Severe Congenital Diaphragmatic Hernia—Exemplary Management in Poland: Fetoscopic Endotracheal Occlusion
Miroslaw Wielgos, Przemyslaw Kosinski
[Year:2016] [Month:April-June] [Volume:10 ] [Number:2] [Pages:91] [Pages No:178-179] [No of Hits : 549]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10009-1464 | PAID (Buy Now)

ABSTRACT

Congenital diaphragmatic hernia (CDH) is a developmental closure defect resulting in discontinuity of the diaphragm. Abdominal viscera herniate into the chest leading to mediastinal shift and lung compression. Congenital diaphragmatic hernia occurs in approximately 1 in 4,000 live births. Vast majority of cases is on the left side of the diaphragm. Congenital diaphragmatic hernia is also associated with severe pulmonary hypoplasia and pulmonary arterial hypertension. Approximately 50 to 70% of cases of CDH are isolated, but may also be associated with rare and severe genetic syndromes. It is one of the most severe birth defects with extremely high neonatal mortality and morbidity. Prognosis is worse in cases of an abnormal chromosomal microarray, severe associated anomalies, right-sided defect, liver herniation, and lower fetal lung volume. In some countries, fetoscopic endotracheal occlusion (FETO) for severe CDH is offered to selected group of patients. Since 2014, this procedure is also available in Poland in the 1st Department of Obstetrics and Gynecology of Medical University of Warsaw. This article reviews management in diaphragmatic hernia and presents protocol implemented in our center.

Keywords: Congenital diaphragmatic hernia, Endotracheal occlusion, Fetoscopy, Tracheal occlusion.

How to cite this article: Wielgos M, Kosinski P. Severe Congenital Diaphragmatic Hernia–Exemplary Management in Poland: Fetoscopic Endotracheal Occlusion. Donald School J Ultrasound Obstet Gynecol 2016;10(2):178-179.

Source of support: Nil

Conflict of interest: None

 
10.  Review Article
Early Neonatal Morbidity after Term Delivery: How should We respond?
Milan Stanojevic, Lana Leko
[Year:2016] [Month:April-June] [Volume:10 ] [Number:2] [Pages:91] [Pages No:180-184] [No of Hits : 549]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10009-1465 | PAID (Buy Now)

ABSTRACT

Aim: The aim of this retrospective study was to investigate the influence of gestational age and mode of delivery at term on early neonatal morbidity and mortality in a tertiary maternity center in a 10-year period.

Materials and methods: The data were derived from the medical records between January 1, 2005, and December 31, 2014, from the University Hospital “Sveti Duh,” Zagreb, Croatia. There were 30,363 live born term infants included in the study. The data from the medical records have been used to analyze their mode of delivery, morbidity, and mortality.

Results: Term newborn infants delivered by cesarean section (CS) had increased prevalence of lower Apgar scores, resuscitation, neonatal convulsions, and neonatal encephalopathy, respiratory pathology (except for amniotic fluid aspiration), and mechanical ventilation. Early and late neonatal deaths were more prevalent in term infants delivered by CS. The prevalence of birth trauma (except for facial nerve palsy) and hyperbilirubinemia was significantly increased in vaginally born neonates. The prevalence of perinatal infections was equal in both groups of infants. Morbidity and mortality of term newborn infants presented as prevalence per 1,000 live born, regardless of the mode of a delivery week by week from 37 through 41 weeks of gestation, were also investigated. The highest prevalence for most of the observed parameters were at 37 to 41 weeks of gestation, while the lowest prevalence was observed at a gestational age between 39 and 40 weeks. This was not the case for the 1st and the 5th minute 4 to 7 Apgar scores, birth injuries, respiratory pathology, and late neonatal deaths.

Conclusion: Early-term delivery was connected with more morbidity and mortality in the early neonatal period. It seems that the best gestational age to be born is at 39 to 40 weeks of gestation. Mode of delivery at term counts as well, showing that vaginal delivery at term had the lowest risk of morbidity and mortality.

Keywords: Morbidity, Neonate, Term delivery

How to cite this article: Stanojevic M, Leko L. Early Neonatal Morbidity after Term Delivery: How should We respond? Donald School J Ultrasound Obstet Gynecol 2016;10(2):180-184.

Source of support: Nil

Conflict of interest: None

 
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