DOCSLIB.ORG

Proteomic Biomarkers of Intra-Amniotic Inflammation

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Proteomic Biomarkers of Intra-Amniotic Inflammation 0031-3998/07/6103-0318 PEDIATRIC RESEARCH Vol. 61, No. 3, 2007 Copyright © 2007 International Pediatric Research Foundation, Inc. Printed in U.S.A. Proteomic Biomarkers of Intra-amniotic Inflammation: Relationship with Funisitis and Early-onset Sepsis in the Premature Neonate CATALIN S. BUHIMSCHI, IRINA A. BUHIMSCHI, SONYA ABDEL-RAZEQ, VICTOR A. ROSENBERG, STEPHEN F. THUNG, GUOMAO ZHAO, ERICA WANG, AND VINEET BHANDARI Department of Obstetrics, Gynecology and Reproductive Sciences [C.S.B., I.A.B., S.A.-R., V.A.R., S.F.T., G.Z., E.W.], and Department of Pediatrics [V.B.], Division of Perinatal Medicine, Yale University School of Medicine, New Haven, CT 06520 ABSTRACT: Our goal was to determine the relationship between 4 vein inflammatory cytokine levels, but not maternal serum val- amniotic fluid (AF) proteomic biomarkers (human neutrophil de- ues, correlate with the presence and severity of the placental fensins 2 and 1, calgranulins C and A) characteristic of intra-amniotic histologic inflammation and umbilical cord vasculitis (7). inflammation, and funisitis and early-onset sepsis in premature neo- Funisitis is characterized by perivascular infiltrates of in- nates. The mass restricted (MR) score was generated from AF flammatory cells and is considered one of the strongest hall- obtained from women in preterm labor (n ϭ 123). The MR score marks of microbial invasion of the amniotic cavity and fetal ranged from 0–4 (none to all biomarkers present). Funisitis was graded histologically and interpreted in relation to the MR scores. inflammatory syndrome (8,9). While there is some debate with Neonates (n ϭ 97) were evaluated for early-onset sepsis. There was regard to the origin of the amniotic fluid (AF) neutrophilic significant correlation between the severity of AF inflammation and response to infection (10), there is consensus that the fetal the presence (53/123) and grades of funisitis (p Ͻ 0.001). Funisitis inflammatory neutrophilic response originates initially from the occurred independently of the amniocentesis-to-delivery interval or umbilical vein and later from the arteries leading to umbilical status of the membranes and was best predicted by an MR score 3–4 cord vasculitis and funisitis (11). Funisitis is a well-recognized and an earlier gestational age (GA) at delivery. Neonates born to risk factor for early-onset sepsis in the premature neonate (12,13). women with an MR score 3–4 had an increased incidence of sus- We have previously shown that proteomic mapping of the pected/confirmed sepsis, even after adjusting for GA at birth. Cal- AF reveals a profile, designated as the Mass Restricted (MR) granulin C had the highest association with clinically significant score, that is highly characteristic of intra-amniotic inflamma- funisitis, while calgranulin A had the strongest association with tion (14). The presence of 4 protein biomarkers (neutrophil early-onset sepsis. To conclude, AF proteomic analysis shows that women with MR scores 3–4 are more likely to have histologic defensins 2 and 1, calgranulins C and A) were highly predic- funisitis, and deliver neonates with early-onset sepsis. (Pediatr Res tive of PTB, whether inflammation was secondary to infection 61: 318–324, 2007) or bleeding (15). We further found that the interpretation of the MR score is not binary (disease present or disease absent), but rather a gradient progressing from the absence of disease, espite extensive research and a variety of interventions, to minimal, and then severe inflammation. Therefore, grading D the rate of preterm birth (PTB) has actually increased the severity of umbilical cord inflammation with increasing over the past 20 y (1). More than 500,000 preterm infants were numerical values of the MR score was based on the number born in the United States in 2004 (1). Interventions to prevent (from 1 to 4) of protein biomarkers being identified in the AF. PTB and its consequences for the fetus should predominantly Thus far, the relationship between the MR score or the indi- be targeted at the prevention, early recognition and treatment vidual 4 proteomic biomarkers, and histologic funisitis has not of several risk factors including intra-amniotic inflammation/ been addressed. In the current study, we sought to determine infection (2). the relationship between presence in the AF of 4 proteomic Robust scientific evidence has confirmed that when intra- biomarkers characteristic of intra-amniotic inflammation, and amniotic inflammation secondary to, or independent of infec- the likelihood of histologic funisitis and early-onset sepsis in tion is superimposed upon prematurity, the consequences for premature neonates. the neonate can prove devastating (3,4). This association can be explained by an inflammatory cytokine cascade that seems METHODS to be, at least partially, of fetal origin (5,6). Indeed, fetal umbilical Patient population and study design. We conducted a prospective study that included 123 women recruited upon admission to the Labor and Birth unit or the antepartum units at Yale New Haven Hospital. For all participants, Received June 30, 2006; accepted October 6, 2006. following admission with symptoms of preterm labor (PTL), preterm prema- Correspondence: Vineet Bhandari, M.D., Yale University School of Medicine, Divi- sion of Perinatal Medicine, Department of Pediatrics, 333 Cedar Street, LCI 401B, New Haven, CT 06520; e-mail: [email protected] Supported by NICHD RO3 HD 50249-01 and K12 HD 047018-01 WRHR (C.S.B.); Abbreviations: AF, amniotic fluid; LDH, lactate dehydrogenase; MR score, NICHD RO1 HD 047321 (I.A.B.); and NHLBI K08 HL 074195 (V.B.). mass restricted score; PPROM, preterm premature rupture of membranes; DOI: 10.1203/01.pdr.0000252439.48564.37 PTB, pretem birth; PTL, preterm labor; WBC, white blood cells 318 AF PROTEOMIC PROFILE AND NEONATAL SEPSIS 319 ture rupture of membranes (PPROM), advanced cervical dilatation (Ն3 cm) Ciphergen Biosystems, Fremont, California). After1hofincubation the and/or uterine contractions refractory to tocolysis, AF was retrieved by arrays were read in the ProteinChip Reader (Model PBS IIC) (Ciphergen ultrasound-guided amniocentesis. Subjects were enrolled (May 2004–May Biosystems) using the ProteinChip Software 3.1.1. Peaks composing the MR 2006) based on the availability of one of the investigators (CSB), and all score were identified by their conspicuous aspect at or in proximity of their enrolled women were included in the final analysis. known respective masses: 3,377.0 and 3,448.1 Da (corresponding to neutro- The Human Investigation Committee of Yale University approved the phil defensins 2 and 1, respectively) and at 10,443.8 and 10,834.5 Da study and written informed consent was obtained from all participants. (corresponding to calgranulins C and A respectively) (14). The MR score Eligible subjects had: a singleton fetus, gestational age (GA) Ͻ37 wk with a provides qualitative information regarding the presence or absence of intra- clinically indicated amniocentesis to rule-out intra-amniotic infection. Exclu- amniotic inflammation (14). The MR score ranges from 0 to 4, depending sion criteria included: anhydramnios, human immunodeficiency virus or upon the presence or absence of each of the four protein biomarkers (14). A hepatitis infections, and the presence of fetal heart rate abnormalities at categorical value of 1 is assigned if a biomarker peak is present and 0 if enrollment (bradycardia, or prolonged variable decelerations). GA was estab- absent. For the purpose of data analysis, we stratified the study population lished based on an ultrasonographic examination before 20 wk in all in- based on the severity of inflammation (MR 0: no inflammation; MR 1–2: stances. PTL was defined as the presence of regular uterine contractions and minimal inflammation; MR 3–4: severe inflammation). One investigator documented cervical effacement and/or dilatation in patients Ͻ37 wk GA (IAB) performed all the protein chip assays and scored all the samples blindly, (16). The diagnosis of PPROM was confirmed by visualization of AF pooling being unaware of either clinical presentation or outcome. through the cervical os, nitrazine, ferning, or amniocentesis-dye positive tests. Histologic evaluation of umbilical cords and diagnosis of funisitis. At Management of the patients was left to the clinical team. In the absence of Yale-New Haven Hospital, placental pathologic study is a routine part of the clinical laboratory results suggestive of infection, or signs/symptoms of evaluation of a pregnancy complicated by PTL or PPROM. In all 123 cases, clinical chorioamnionitis (fever Ͼ100.4°F, abdominal tenderness, fetal tachy- hematoxylin- and eosin-stained sections of the umbilical cord were read by a cardia), and/or abnormalities of fetal heart rate (variable or late decelerations), perinatal pathologist unaware of the results of the proteomic profiling. Each and/or abruption, PPROM was managed expectantly. In PPROM patients, section was examined systematically for the presence or absence of inflam- digital exams were not permitted. Patients received corticosteroids for lung mation and funisitis was diagnosed when neutrophils infiltrated the umbilical maturity if Ͻ32 wk GA and antibiotic therapy (latency phase: ampicillin/ vessels walls or Wharton’s jelly. Funisitis results were expressed using the erythromycin or clindamycin; group B Streptococcus prophylaxis: penicillin, histologic grading system devised by Salafia et al. (22) as: Grade 0, no cefazolin, clindamycin, erythromycin or vancomycin, based on culture results neutrophils observed; Grade 1, neutrophils within the inner third of the and sensitivity). Eighty percent of women had their amniocentesis performed umbilical vein wall (umbilical phlebitis); Grade 2, neutrophils within the inner before initiation of antibiotic or steroid therapy. Women were monitored by third of at least two umbilical vessel walls; Grade 3, neutrophils in the cardiotocography at least twice daily for the presence of fetal heart abnor- perivascular Wharton’s jelly; or Grade 4, panvasculitis and funisitis extending malities and/or uterine contractions. deep into the Wharton’s jelly. Following amniocentesis, each woman was followed prospectively to Evaluation of early-onset neonatal sepsis.
Load more

Recommended publications
  • Pre-Term Pre-Labour Rupture of Membranes and the Role of Amniocentesis
    Fetal and Maternal Medicine Review 2010; 21:2 75–88 C Cambridge University Press 2010 doi:10.1017/S096553951000001X First published online 15 March 2010 PRE-TERM PRE-LABOUR RUPTURE OF MEMBRANES AND THE ROLE OF AMNIOCENTESIS 1,2 ANNA P KENYON, 1,2 KHALIL N ABI-NADER AND 2 PRANAV P PANDYA 1Elizabeth Garrett Anderson Institute for Women’s Health, University College London, 86-96 Chenies Mews, London WCIE 6NX. 2Fetal Medicine Unit, University College London Hospitals NHS Foundation Trust, 235 Euston Rd, London NWI 2BU. INTRODUCTION Pre-labour premature rupture of membranes (PPROM) is defined as rupture of membranes more than 1 hour prior to the onset of labour at <37 weeks gestation. PPROM occurs in approximately 3% of pregnancies and is responsible for a third of all preterm births.1 Once membranes are ruptured prolonging the pregnancy has no maternal physical advantage but fetal morbidity and mortality are improved daily at early gestations: 19% of those infants born <25 weeks develop cerebral palsy (CP) and 28% have severe motor disability.2 Those infants born extremely pre term (<28 weeks) cost the public sector £75835 (95% CI £27906–145508) per live birth3 not to mention the emotional cost to the family. To prolong gestation is therefore the suggested goal: however how and why might we delay birth in those at risk? PPROM is one scenario associated with preterm birth and here we discuss the causative mechanisms, sequelae, latency, strategies to prolong gestation (antibiotics) and consider the role of amniocentesis. We will also discuss novel therapies. PATHOPHYSIOLOGY OF MEMBRANE RUPTURE The membranes, which act to protect and isolate the fetus, are composed of two layers.
    [Show full text]
  • Characteristics of Heart Rate Tracings in Preterm Fetus
    medicina Review Characteristics of Heart Rate Tracings in Preterm Fetus Maria F. Hurtado-Sánchez 1, David Pérez-Melero 2, Andrea Pinto-Ibáñez 3 , Ernesto González-Mesa 4 , Juan Mozas-Moreno 1,5,6,7,* and Alberto Puertas-Prieto 1,7 1 Obstetrics and Gynecology Service, Virgen de las Nieves University Hospital, 18014 Granada, Spain; [email protected] (M.F.H.-S.); [email protected] (A.P.-P.) 2 Anesthesiology, Resuscitation and Pain Therapy Service, Virgen de las Nieves University Hospital, 18014 Granada, Spain; [email protected] 3 Obstetrics and Gynecology Service, Poniente Hospital, 04700 El Ejido (Almería), Spain; [email protected] 4 Obstetrics and Gynecology Service, Regional University Hospital of Malaga, 29011 Malaga, Spain; [email protected] 5 Department of Obstetrics and Gynecology, University of Granada, 18016 Granada, Spain 6 Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain 7 Biohealth Research Institute (Instituto de Investigación Biosanitaria Ibs.GRANADA), 18014 Granada, Spain * Correspondence: [email protected]; Tel.: +34-958242867 Abstract: Background and Objectives: Prematurity is currently a serious public health issue worldwide, because of its high associated morbidity and mortality. Optimizing the management of these preg- nancies is of high priority to improve perinatal outcomes. One tool frequently used to determine the degree of fetal wellbeing is cardiotocography (CTG). A review of the available literature on fetal heart rate (FHR) monitoring in preterm fetuses shows that studies are scarce, and the evidence thus far is unclear. The lack of reference standards for CTG patterns in preterm fetuses can lead to misinterpretation of the changes observed in electronic fetal monitoring (EFM).
    [Show full text]
  • G Eneral Introduction
    Follow-up studies in prenatal medicine Nagel, H.T.C. Citation Nagel, H. T. C. (2007, February 14). Follow-up studies in prenatal medicine. Retrieved from https://hdl.handle.net/1887/9762 Version: Corrected Publisher’s Version Licence agreement concerning inclusion of doctoral thesis in the License: Institutional Repository of the University of Leiden Downloaded from: https://hdl.handle.net/1887/9762 Note: To cite this publication please use the final published version (if applicable). Proefschrift H. Nagel 11-01-2007 13:34 Pagina 11 C H ! T " # $ * eneral introduction 11 Proefschrift H. Nagel 11-01-2007 13:34 Pagina 12 C H ! T " # $ The %etus in prenatal m edicine ccording to M edline de-initions' a conce.tus is an em ,ryo until a .ostconce.tional age o- 9 1 ee2s (or a gestational age o- $* 1 ee2s) and 1 ill then ,e a -etus until ,irth. =- ,orn via,le' the .erson then ,ecom es an in-ant. The -etus is a uni>ue .atient -or several reasons. 6irst' there is a uni>ue relationshi. ,et1 een the m other and her un,orn child. lthough the -etus has his o1 n rights' he or she can only ,e treated via the m other. There-ore the .ur.orted rights o- $ the -etus can never ta2e .recedence over that o- the m other. ;econd' des.ite advances in m edical care there is stri2ing little 2no1 ledge a,out -etal live. ? uestions such as does the -etus [email protected] .ain' does it have a m em ory' are still unans1 ered.
    [Show full text]
  • Prenatal and Preimplantation Genetic Diagnosis for Mps and Related Diseases
    PRENATAL AND PREIMPLANTATION GENETIC DIAGNOSIS FOR MPS AND RELATED DISEASES Donna Bernstein, MS Amy Fisher, MS Joyce Fox, MD Families who are concerned about passing on genetic conditions to their children have several options. Two of those options are using prenatal diagnosis and preimplantation genetic diagnosis. Prenatal diagnosis is a method of testing a pregnancy to learn if it is affected with a genetic condition. Preimplantation genetic diagnosis, also called PGD, is a newer technology used to test a fertilized embryo before a pregnancy is established, utilizing in vitro fertilization (IVF). Both methods provide additional reproductive options to parents who are concerned about having a child with a genetic condition. There are two types of prenatal diagnosis; one is called amniocentesis, and the other is called CVS (chorionic villus sampling). Amniocentesis is usually performed between the fifteenth and eighteenth weeks of pregnancy. Amniocentesis involves inserting a fine needle into the uterus through the mother's abdomen and extracting a few tablespoons of amniotic fluid. Skin cells from the fetus are found in the amniotic fluid. These cells contain DNA, which can be tested to see if the fetus carries the same alterations in the genes (called mutations) that cause a genetic condition in an affected family member. If the specific mutation in the affected individual is unknown, it is possible to test the enzyme activity in the cells of the fetus. Although these methods are effective at determining whether a pregnancy is affected or not, they do not generally give information regarding the severity or the course of the condition.
    [Show full text]
  • ENT of UATION MEMOR the HUMAN FETUS Cothelijne Van Heter
    PDF hosted at the Radboud Repository of the Radboud University Nijmegen The following full text is a publisher's version. For additional information about this publication click this link. http://hdl.handle.net/2066/146798 Please be advised that this information was generated on 2021-09-24 and may be subject to change. ENT OF UATION MEMOR THE HUMAN FETUS Cothelijne van Heter • DEVELOPMENT OF HABITUATION AND MEMORY IN THE HUMAN FETUS Van Heteren, Cathelijne Francisca - Development of habituation and memory in the human fetus - 2001 Thesis University Nijmegen - with réf.- with summary m Dutch -136 p. ISBN: 90-9015000-5 Print: Grafisch Bedrijf Ponsen &i Looijen BV Wageningen Graphic Design Marie-Louise Dusée No part of this book may be reproduced in any form without permission of the author. This research project was financially supported by ZorgOnderzoek Nederland and the Hersenstichting Nederland. Publication of this thesis was financially supported by ATL Nederland BV, Ferring BV, GlaxoSmithKline, Hitachi Ultrasound BV, Medical Dynamics, Novo Nordisk Farma BV, Organon Nederland BV, Pie Medical Benelux BV, Sanofi-Synthélabo, Schering Nederland BV. DEVELOPMENT OF HABITUATION AND MEMORY IN THE HUMAN ?-f τ'••<, Een wetenschappelijke proeve op het gebied van de Medische Wetenschappen Proefschrift ter verkrijging van de graad van doctor aan de Katholieke Universiteit Nijmegen, volgens besluit van het College van Decanen in het openbaar te verdedigen op vrijdag 5 oktober 2001 des namiddags om 1.30 uur precies door Cathelijne Francisca van Heteren
    [Show full text]
  • The Empire Plan SEPTEMBER 2018 REPORTING ON
    The Empire Plan SEPTEMBER 2018 REPORTING ON PRENATAL CARE Every baby deserves a healthy beginning and you can take steps before your baby is even born to help ensure a great start for your infant. That’s why The Empire Plan offers mother and baby the coverage you need. When your primary coverage is The Empire Plan, the Empire Plan Future Moms Program provides you with special services. For Empire Plan enrollees and for their enrolled dependents, COBRA enrollees with their Empire Plan benefits and Young Adult Option enrollees TABLE OF CONTENTS Five Important Steps ........................................ 2 Feeding Your Baby ...........................................11 Take Action to Be Healthy; Breastfeeding and Your Early Pregnancy ................................................. 4 Empire Plan Benefits .......................................12 Prenatal Testing ................................................. 5 Choosing Your Baby’s Doctor; New Parents ......................................................13 Future Moms Program ......................................7 Extended Care: Medical Case High Risk Pregnancy Program; Management; Questions & Answers ...........14 Exercise During Pregnancy ............................ 8 Postpartum Depression .................................. 17 Your Healthy Diet During Pregnancy; Medications and Pregnancy ........................... 9 Health Care Spending Account ....................19 Skincare Products to Avoid; Resources ..........................................................20 Childbirth Education
    [Show full text]
  • Amniocentesis
    Amniocentesis Family history of an open neural tube defect Infection About Integrated Genetics If a close relative has been born with an open neural Great care is taken to prevent infection. Therefore, tube defect, such as spina bifida or anencephaly, infection following amniocentesis is very rare. there may be an increased risk to other pregnancies However, a woman with fever or any flu-like symptoms Integrated Genetics has been in the family. after amniocentesis should call her doctor for advice. a leader in genetic testing Abnormal maternal serum screening test Harm to the fetus and counseling services for over 25 years. Screening tests performed on a sample of blood Since the ultrasound image gives the doctor exact from a pregnant woman can identify pregnancies information about the location of the fetus inside the This brochure is provided at risk for the common chromosome abnormalities, uterus, the risk that the needle will harm the fetus is by Integrated Genetics as including Down syndrome and open neural extremely low. an educational service for tube defects. When the screening results show physicians and their patients. Rh problems that a pregnancy has a high risk for one of these For more information on problems, amniocentesis for diagnostic testing is If a woman having an amniocentesis has Rh our genetic testing and recommended. negative blood type, and the baby’s father has Rh positive blood type, the woman should have counseling services, Abnormal ultrasound an injection of Rh immune globulin following the please visit our web sites: If an ultrasound shows an abnormality, procedure. This helps prevent Rh disease in the baby.
    [Show full text]
  • Cardiotocography and Ultrasound in Obstetrical Practice Ariana Rabac 1,2,*
    Student Scientific Conference RiSTEM 2021, Rijeka, 10. 06. 2021 ISBN: 978-953-8246-22-7 Cardiotocography and ultrasound in obstetrical practice Ariana Rabac 1,2,* 1 Clinical Hospital Centre Rijeka, [email protected] 2 University of Rijeka, Faculty of Healthcare Abstract: Monitoring the fetus during pregnancy and childbirth is a great challenge for the obstetric team. Proper monitoring of the fetus during pregnancy and childbirth is very important in order to detect deviations and complications in a timely manner and thus for a better perinatal outcome for the newborn and the mother. In this paper, a brief description of cardiotocography and ultrasound, as two main methods for fetus monitoring is provided. Keywords: Cardiotocography, Delivery, Fetus, Pregnancy, Ultrasound 1. Introduction Monitoring the fetus during pregnancy and childbirth is a great challenge for the obstetric team. Proper monitoring of the fetus during pregnancy and childbirth is very important in order to detect deviations and complications in a timely manner and thus for a better perinatal outcome for the newborn and the mother. Monitoring the fetus in pregnancy and childbirth is still a very current topic today. Modern perinatology aims to enable the birth of a healthy newborn. Today, obstetrics uses modern and sophisticated devices that monitor the fetus during pregnancy and childbirth. We use cardiotocography and ultrasound to monitor the fetus during pregnancy and childbirth. In this article, a brief description of both procedures will be provided. 2. Cardiotocography Cardiotocography is a method of monitoring the fetus during pregnancy and childbirth. Cardiotocography is most commonly used around the 30th week of pregnancy and is used until the end of labor.
    [Show full text]
  • Increased Incidence of Cytogenetic Abnormalities in Chorionic Villus Samples from Pregnancies Established by in Vitro Fertilization and Embryo Transfer (Ivf-Et)
    PRENATAL DIAGNOSIS, VOL. 15: 975-980 (1995) INCREASED INCIDENCE OF CYTOGENETIC ABNORMALITIES IN CHORIONIC VILLUS SAMPLES FROM PREGNANCIES ESTABLISHED BY IN VITRO FERTILIZATION AND EMBRYO TRANSFER (IVF-ET) P. A. I”TVELD, D. VAN OPSTAL, c. VAN DEN BERG, M. VAN OOIJEN, H. BRANDENBURG*, L. PIJPERS*$, M. G. J. JAHODA*, TH. STUNEN? AND F. J. LOS Departments of Clinical Genetics, *Obstetrics and Gynaecology and ?Epidemiology and Biostatistics, University Hospital Dijkzigt and Erasmus University, Rotterdam; SMerwede Hospital, Dordrecht, The Netherlands Received 9 January I995 Revised 23 May 1995 Accepted 18 June 1995 SUMMARY We studied 201 pregnancies that were established by in vitro fertilization and embryo transfer (IVF-ET) and compared the frequency of cytogenetic abnormalities with that found in a large control population matched for indication group (advanced maternal age) and time of sampling. A total of 252 IVF-ET fetuses were cytogenetically analysed by either chorionic villus sampling (CVS; n=80) or amniocentesis (n= 172). Eleven chromosome abnormalities were found in the CVS group (13.8 per cent); among them, a 45,X/46,X,dic(Y)(ql1)/46,X,delCY)(qll) mosaic that was found in an IVF pregnancy established by intracytoplasmic sperm injection (ICSI), four cases of trisomy 21, and three cases of trisomy 7 confined to the placenta. The results indicate a statistically significant three- to five-fold increase in both confined placental abnormalities (P<0.008) and true fetal chromosome anomalies (W0.04).In the amniocentesis group, identical rates (1.7 per cent) of chromosome abnormalities were found in the IVF-ET and control groups.
    [Show full text]
  • Role of Vibroacoustic Stimulation Test in Prediction of Fetal Outcome in Terms of Apgar Score
    International Journal of Reproduction, Contraception, Obstetrics and Gynecology Singh K et al. Int J Reprod Contracept Obstet Gynecol. 2015 Oct;4(5):1427-1430 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20150724 Research Article Role of vibroacoustic stimulation test in prediction of fetal outcome in terms of Apgar score Kalpana Singh*, Chankya Das Department of Obstetrics & Gynaecology, Guwahati Medical College & Hospital, Guwahati, Varanasi, Uttar Pradesh, India Received: 05 August 2015 Accepted: 19 August 2015 *Correspondence: Dr. Kalpana Singh, E-mail: [email protected] Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: Role of vibroacoustic stimulation test in prediction of fetal outcome in terms of Apgar score. Aim: To know the efficacy of vibroacoustic stimulation test in prediction of fetal outcome. Methods: The study was conducted in department of obstetrics and gynecology at Guwahati Medical College, in duration of 2007-2009. Total 200 high risk patients underwent VAST. Results: VAST done among all these patients and according to fetal response divided into VAST reactive and non- reactive. In 162 (81%) patients VAST was reactive and 38 (19%) non-reactive. Among VAST (162) reactive patients, 126 (77.77%) went for spontaneous vaginal delivery and for 36 (22.22%) induction planned. Induction failed in 9 patients and cesarean section done. Total babies shifted to NICU 13 (6.5%), 4 babies expired (2%) and 9 (4.5%) improved.
    [Show full text]
  • Prenatal Care Book – 30 Days of Your Baby’S Birth
    August 2014 Prenatal NEW YORK STATE HEALTH INSURANCE PROGRAM Care (NYSHIP) for Empire Plan enrollees and for their enrolled dependents, COBRA enrollees with their Empire Plan Congratulations on your benefits and Young Adult Option enrollees pregnancy! Every baby deserves a healthy beginning. You can take steps before your baby is even born to help Five Important Steps to Having a Healthy Baby ensure a great start for your 1. Call your doctor infant. That’s why The Empire As soon as you think you are pregnant, call your doctor. Plan offers mother and baby You can do the most for your baby during the first three the coverage you need. months of pregnancy, so try to start your doctor visits as When your primary coverage soon as possible. is The Empire Plan, The The Empire Plan covers your maternity care under the Empire Plan Future Moms Medical/Surgical Program. You may choose a participating Program provides you with or non-participating provider for your maternity care. special services. Participating Provider If you choose a participating provider (obstetrician, family practice physician or certified nurse-midwife), there are no copayments for prenatal visits, delivery or your six-week checkup 3 Early Symptoms of Pregnancy after delivery. You pay only your copayment for covered services 4 Take Action to Be Healthy at participating laboratories. Exercise During Pregnancy To locate an Empire Plan participating provider or laboratory, call 5 Prenatal Testing The Empire Plan toll free at 1-877-7-NYSHIP (1-877-769-7447) 6 The Future Moms Program and select the Medical Program.
    [Show full text]
  • Cardiotocography and Beyond: a Review of One
    Cardiotocography and beyond: a review of one-dimensional Doppler ultrasound application in fetal monitoring Faezeh Marzbanrad, Monash University Lisa Stroux, University of Oxford Gari D. Clifford, Emory University Journal Title: Physiological Measurement Volume: Volume 39, Number 8 Publisher: IOP Publishing: Hybrid Open Access | 2018-08-01, Pages 08TR01-08TR01 Type of Work: Article | Post-print: After Peer Review Publisher DOI: 10.1088/1361-6579/aad4d1 Permanent URL: https://pid.emory.edu/ark:/25593/v0g2k Final published version: http://dx.doi.org/10.1088/1361-6579/aad4d1 Copyright information: © 2018 Institute of Physics and Engineering in Medicine. Accessed September 26, 2021 7:07 AM EDT HHS Public Access Author manuscript Author ManuscriptAuthor Manuscript Author Physiol Manuscript Author Meas. Author manuscript; Manuscript Author available in PMC 2019 August 14. Published in final edited form as: Physiol Meas. ; 39(8): 08TR01. doi:10.1088/1361-6579/aad4d1. Cardiotocography and Beyond: A Review of One-Dimensional Doppler Ultrasound Application in Fetal Monitoring Faezeh Marzbanrad1, Lisa Stroux2, and Gari D. Clifford3,4 1Department of Electrical and Computer Systems Engineering, Monash University, Clayton, VIC, Australia 2Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK 3Department of Biomedical Informatics, Emory University, Atlanta, GA, USA 4Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA Abstract One-dimensional Doppler ultrasound (1D-DUS) provides a low-cost and simple method for acquiring a rich signal for use in cardiovascular screening. However, despite the use of 1D-DUS in cardiotocography (CTG) for decades, there are still challenges that limit the effectiveness of its users in reducing fetal and neonatal morbidities and mortalities.
    [Show full text]