RESUMEN
INTRODUCTION: Placental morphology findings in SARS-CoV-2 infection are considered nonspecific, although the role of trimester and severity of infection are underreported. Therefore, we aimed to investigate abnormal placental morphology, according to these two criteria. METHODS: This is an ancillary analysis of a prospective cohort study of pregnant women with suspected SARS-CoV-2 infection, managed in one maternity, from March 2020 to October 2021. Charting of clinical/obstetric history, trimester and severity of COVID-19 infection, and maternal/perinatal outcomes were done. Placental morphological findings were classified into maternal and fetal circulatory injury and acute/chronic inflammation. We further compared findings with women with suspected disease which tested negative for COVID-19. Diseases' trimester of infection and clinical severity guided the analysis of confirmed COVID-19 cases. RESULTS: Ninety-one placental discs from 85 women were eligible as a COVID-19 group, and 42 discs from 41 women in negative COVID-19 group. SARS-CoV-2 infection occurred in 68.2% during third trimester, and 6.6% during first; 16.5% were asymptomatic, 61.5% non-severe and 22.0% severe symptomatic (two maternal deaths). Preterm birth occurred in 33.0% (one fetal death). Global maternal vascular malperfusion (MVM) were significant in COVID-19 group whether compared with negative COVID-19 tests group; however, fetal vascular malperfusion lesions and low-grade chronic villitis were not. Three placentas had COVID-19 placentitis. Decidual arteriopathy was associated with infection in first/mid trimester, and chorangiosis in asymptomatic infections. DISCUSSION: Placental abnormalities after an infection by COVID-19 were more frequent after first/mid-trimester infections. Extensive placental lesions are rare, although they may be more common upon underlying medical conditions.
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COVID-19 , Enfermedades Fetales , Complicaciones Infecciosas del Embarazo , Nacimiento Prematuro , Femenino , Embarazo , Humanos , Recién Nacido , SARS-CoV-2 , COVID-19/patología , Placenta/patología , Estudios Prospectivos , Complicaciones Infecciosas del Embarazo/patología , Nacimiento Prematuro/patología , Inflamación/patología , Enfermedades Fetales/patología , Índice de Severidad de la EnfermedadRESUMEN
Maternal consumption of polyphenol-rich foods has been associated with fetal ductus arteriosus constriction (DAC), but safety of chocolate exposure in fetal life has not been studied. This experimental study tested the hypothesis that maternal cocoa consumption in late pregnancy causes fetal DAC, with possible associated antioxidant effects. Pregnant Wistar rats, at the 21st gestational day, received by orogastric tube cocoa (720 mg/Kg) for 12 h, indomethacin (10 mg/Kg), for 8 h, or only water, before cesaren section. Immediately after withdrawal, every thorax was obtained and tissues were fixed and stained for histological analysis. The ratio of the narrowest part of the pulmonary artery to the fetal ductus inner diameter and increased ductal inner wall thickness characterized ductal constriction. Substances reactive to thiobarbituric acid were quantified. Statistical analysis used ANOVA and Tukey test. Cocoa (n = 33) and indomethacin (n = 7) reduced fetal internal ductus diameter when compared to control (water, n = 25) (p < 0.001) and cocoa alone increased ductus wall thickness (p < 0.001), but no change was noted in enzymes activity. This pharmacological study shows supporting evidences that there is a cause and effect relationship between maternal consumption of cocoa and fetal ductus arteriosus constriction. Habitual widespread use of chocolate during gestation could account for undetected ductus constriction and its potentially severe consequences, such as perinatal pulmonary hypertension, cardiac failure and even death. For this reason, dietary guidance in late pregnancy to avoid high chocolate intake, to prevent fetal ductal constriction, may represent the main translational aspect of this study.
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Chocolate/efectos adversos , Conducto Arterioso Permeable/etiología , Conducto Arterial/anomalías , Efectos Tardíos de la Exposición Prenatal/etiología , Animales , Constricción Patológica/etiología , Constricción Patológica/patología , Conducto Arterial/patología , Conducto Arterioso Permeable/patología , Femenino , Enfermedades Fetales/etiología , Enfermedades Fetales/patología , Feto/anomalías , Feto/patología , Masculino , Exposición Materna/efectos adversos , Embarazo , Efectos Tardíos de la Exposición Prenatal/patología , Ratas , Ratas WistarRESUMEN
OBJECTIVE: To analyze adverse fetal and neonatal outcomes of Zika virus infection by the timing of infection during pregnancy. Method: Cohort study of 190 pregnancies with 193 offspring with a positive RT-PCR test for Zika virus (March/2016 to April/2017). RESULTS: Death or defects related to congenital Zika virus infection were identified in 37.3% of fetuses and newborns, and microcephaly in 21.4% of the newborns. The proportion of small for gestational age newborns was 21.9%. Maternal symptoms in the first trimester were significantly associated with the birth of newborns with microcephaly/cerebral atrophy, small for gestational age and with the deaths (one abortion, one stillbirth and the two neonatal deaths). Maternal infection during the second trimester was further associated with asymptomatic newborns at birth. The study showed that 58.5% of the offspring with microcephaly and / or cortical atrophy were small for gestational age, with an evident decrease in symptomatic offspring without microcephaly, 24.1%, and with only 9.1% in the asymptomatic group. CONCLUSION: This study showed that the earlier the symptoms appear during gestation, the more severe the endpoints. We found a higher percentage of small for gestational age newborns exposed to Zika virus early in gestation. We also found a group of apparently asymptomatic newborns with proven Zika infection, which highlights the importance of follow up studies in this population.
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Enfermedades Fetales/patología , Enfermedades del Recién Nacido/patología , Complicaciones Infecciosas del Embarazo/patología , Infección por el Virus Zika/patología , Adulto , Brasil/epidemiología , Estudios de Cohortes , Estudios Transversales , Femenino , Enfermedades Fetales/diagnóstico , Enfermedades Fetales/virología , Feto , Estudios de Seguimiento , Humanos , Recién Nacido , Enfermedades del Recién Nacido/diagnóstico , Enfermedades del Recién Nacido/virología , Microcefalia/virología , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Virus Zika , Infección por el Virus Zika/diagnóstico , Infección por el Virus Zika/virologíaRESUMEN
OBJECTIVES: To describe placental findings on prenatal ultrasound and anatomopathological examination in women with Zika virus (ZIKV) infection, and to assess their association with congenital ZIKV infection and severe adverse outcome, defined as fetal loss or congenital Zika syndrome (CZS). METHODS: This was a prospective study of pregnancies undergoing testing for maternal ZIKV infection at a center in French Guiana during the ZIKV epidemic. In ZIKV-positive women, congenital infection was defined as either a positive reverse transcription polymerase chain reaction result or identification of ZIKV-specific immunoglobulin-M in at least one placental, fetal or neonatal sample. Placental ZIKV-infection status was classified as non-exposed (placentae from non-infected women), exposed (placentae from ZIKV-infected women without congenital infection) or infected (placentae from ZIKV-infected women with proven congenital infection). Placentae were assessed by monthly prenatal ultrasound examinations, measuring placental thickness and umbilical artery Doppler parameters, and by anatomopathological examination after live birth or intrauterine death in women with ZIKV infection. The association of placental thickness during pregnancy and anatomopathological findings with the ZIKV status of the placenta was assessed. The association between placental findings and severe adverse outcome (CZS or fetal loss) in the infected group was also assessed. RESULTS: Among 291 fetuses/neonates/placentae from women with proven ZIKV infection, congenital infection was confirmed in 76 cases, of which 16 resulted in CZS and 11 resulted in fetal loss. The 215 remaining placentae from ZIKV-positive women without evidence of congenital ZIKV infection represented the exposed group. A total of 334 placentae from ZIKV-negative pregnant women represented the non-exposed control group. Placentomegaly (placental thickness > 40 mm) was observed more frequently in infected placentae (39.5%) than in exposed placentae (17.2%) or controls (7.2%), even when adjusting for gestational age at diagnosis and comorbidities (adjusted hazard ratio (aHR), 2.02 (95% CI, 1.22-3.36) and aHR, 3.23 (95% CI, 1.86-5.61), respectively), and appeared earlier in infected placentae. In the infected group, placentomegaly was observed more frequently in cases of CZS (62.5%) or fetal loss (45.5%) than in those with asymptomatic congenital infection (30.6%) (aHR, 5.43 (95% CI, 2.17-13.56) and aHR, 4.95 (95% CI, 1.65-14.83), respectively). Abnormal umbilical artery Doppler was observed more frequently in cases of congenital infection resulting in fetal loss than in those with asymptomatic congenital infection (30.0% vs 6.1%; adjusted relative risk (aRR), 4.83 (95% CI, 1.09-20.64)). Infected placentae also exhibited a higher risk for any pathological anomaly than did exposed placentae (62.8% vs 21.6%; aRR, 2.60 (95% CI, 1.40-4.83)). CONCLUSIONS: Early placentomegaly may represent the first sign of congenital infection in ZIKV-infected women, and should prompt enhanced follow-up of these pregnancies. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Enfermedades Fetales/patología , Enfermedades Placentarias/patología , Complicaciones Infecciosas del Embarazo/patología , Infección por el Virus Zika/patología , Virus Zika , Adulto , Epidemias , Femenino , Muerte Fetal/etiología , Enfermedades Fetales/epidemiología , Enfermedades Fetales/virología , Guyana Francesa/epidemiología , Humanos , Placenta/patología , Placenta/virología , Enfermedades Placentarias/epidemiología , Enfermedades Placentarias/virología , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/virología , Estudios Prospectivos , Ultrasonografía Doppler , Ultrasonografía Prenatal , Arteria Uterina/diagnóstico por imagen , Infección por el Virus Zika/epidemiología , Infección por el Virus Zika/virologíaRESUMEN
Bovine parainfluenza virus-3 (BPIV-3) is a recognized respiratory pathogen of cattle, and it has also been identified in aborted fetuses. However, little is known of this agent as a reproductive pathogen and detailed descriptions of fetal pathology on natural cases are lacking in the scientific literature. This article describes and illustrates lesions in a fetus spontaneously aborted by a first-calving Holstein heifer, naturally infected with BPIV-3 genotype A, broadening the current knowledge on fetal pathology by this virus. Fetal autopsy revealed diffusely reddened, rubbery and unexpanded lungs. Histologically, there was necrotizing bronchiolitis/alveolitis with intraluminal fibrin exudate and syncytial cells in the bronchiolar/alveolar spaces, and non-suppurative peribronchiolitis and perivascular interstitial pneumonia. In the small intestine there was multifocal necrotizing cryptitis and occasional necrotic syncytial enterocytes. Intralesional and extralesional BPIV-3 antigen was detected by immunohistochemistry in the lung and small intestine, and BPIV-3a was identified in fetal tissues by RT-PCR and sequencing.
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Aborto Veterinario/patología , Enfermedades de los Bovinos/patología , Enfermedades Fetales/veterinaria , Virus de la Parainfluenza 3 Bovina , Infecciones por Respirovirus/veterinaria , Aborto Veterinario/etiología , Aborto Veterinario/virología , Animales , Bovinos , Enfermedades de los Bovinos/virología , Femenino , Enfermedades Fetales/patología , Enfermedades Fetales/virología , Feto/patología , Feto/virología , Virus de la Parainfluenza 3 Bovina/genética , Filogenia , Embarazo , Infecciones por Respirovirus/complicaciones , Infecciones por Respirovirus/patología , Infecciones por Respirovirus/virologíaRESUMEN
ABSTRACT Purpose: To assess the need for postnatal evaluation and the medium term outcome in patients with isolated unilateral low grade prenatally detected hydronephrosis. Materials and Methods: We prospectively selected 424 patients (690 kidney units) with a prenatal diagnosis of urinary tract dilatation between 2010 and 2013. We included only those patients with isolated unilateral low-grade hydronephrosis who underwent at least 2 postnatal ultrasound examinations. The Society for Fetal Urology (SFU) grading system was utilized for assessment of the hydronephrosis. We excluded patients with bilateral dilation or other urological abnormalities. The fate of hydronephrosis including resolution, stability or worsening was documented. Results: A total of 66 infants (44 boys and 22 girls) with antenatally diagnosed unilateral urinary tract dilation (23 right and 43 left) were identified. Ultrasounds showed SFU grade 1 hydronephrosis in 32 patients (48%) and SFU grade 2 hydronephrosis in 34 (52%). After a mean follow-up period of 32 months (range 12 to 60), 37 patients (56%) had complete resolution of hydronephrosis while the remaining 29 were stable (44%). None of our patients developed UTIs during follow-up and none required surgical intervention. Conclusions: Prenatally detected, isolated unilateral low-grade hydronephrosis usually have a favorable prognosis. All cases in our cohort showed either stability or resolution of hydronephrosis without any harmful consequences. Based on our findings on medium-term in this category of patients, long-term follow-up is not warranted.
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Humanos , Masculino , Femenino , Ultrasonografía Prenatal/normas , Cuidados Posteriores/normas , Enfermedades Fetales/diagnóstico por imagen , Hidronefrosis/embriología , Hidronefrosis/diagnóstico por imagen , Factores de Tiempo , Índice de Severidad de la Enfermedad , Factores Sexuales , Estudios Prospectivos , Edad Gestacional , Medición de Riesgo , Estimación de Kaplan-Meier , Enfermedades Fetales/patología , Hidronefrosis/patologíaRESUMEN
PURPOSE: To assess the need for postnatal evaluation and the medium term outcome in patients with isolated unilateral low grade prenatally detected hydronephrosis. MATERIALS AND METHODS: We prospectively selected 424 patients (690 kidney units) with a prenatal diagnosis of urinary tract dilatation between 2010 and 2013. We included only those patients with isolated unilateral low-grade hydronephrosis who underwent at least 2 postnatal ultrasound examinations. The Society for Fetal Urology (SFU) grading system was utilized for assessment of the hydronephrosis. We excluded patients with bilateral dilation or other urological abnormalities. The fate of hydronephrosis including resolution, stability or worsening was documented. RESULTS: A total of 66 infants (44 boys and 22 girls) with antenatally diagnosed unilateral urinary tract dilation (23 right and 43 left) were identified. Ultrasounds showed SFU grade 1 hydronephrosis in 32 patients (48%) and SFU grade 2 hydronephrosis in 34 (52%). After a mean follow-up period of 32 months (range 12 to 60), 37 patients (56%) had complete resolution of hydronephrosis while the remaining 29 were stable (44%). None of our patients developed UTIs during follow-up and none required surgical intervention. CONCLUSIONS: Prenatally detected, isolated unilateral low-grade hydronephrosis usually have a favorable prognosis. All cases in our cohort showed either stability or resolution of hydronephrosis without any harmful consequences. Based on our findings on medium-term in this category of patients, long-term follow-up is not warranted.
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Cuidados Posteriores/normas , Enfermedades Fetales/diagnóstico por imagen , Hidronefrosis/diagnóstico por imagen , Hidronefrosis/embriología , Ultrasonografía Prenatal/normas , Femenino , Enfermedades Fetales/patología , Edad Gestacional , Humanos , Hidronefrosis/patología , Estimación de Kaplan-Meier , Masculino , Estudios Prospectivos , Medición de Riesgo , Índice de Severidad de la Enfermedad , Factores Sexuales , Factores de TiempoRESUMEN
Well-controlled intrauterine development is an essential condition for many aspects of normal adult physiology and health. This process is disrupted by poor maternal nutrition status during pregnancy. Indeed, physiological adaptations occur in the fetus to ensure nutrient supply to the most vital organs at the expense of the others, leading to irreversible consequences in tissue formation and differentiation. Evidence indicates that maternal undernutrition in early life promotes changes in key hormones, such as glucocorticoids, growth hormones, insulin-like growth factors, estrogens and androgens, during fetal development. These alterations can directly or indirectly affect hormone release, hormone receptor expression/distribution, cellular function or tissue organization, and impair tissue growth, differentiation and maturation to exert profound long-term effects on the offspring. Within the male reproductive system, maternal protein malnutrition alters development, structure, and function of the gonads, testes and prostate gland. Consequently, these changes impair the reproductive capacity of the male offspring. Further, permanent alterations in the prostate gland occur at the molecular and cellular level and thereby affect the onset of late life diseases such as prostatitis, hyperplasia and even prostate cancer. This review assembles current thoughts on the concepts and mechanisms behind the developmental origins of health and disease as they relate to protein malnutrition, and highlights the effects of maternal protein malnutrition on rat prostate development and homeostasis. Such insights on developmental trajectories of adult-onset prostate disease may help provide a foundation for future studies in this field.
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Enfermedades Fetales/etiología , Enfermedades Fetales/patología , Desnutrición/complicaciones , Próstata/crecimiento & desarrollo , Enfermedades de la Próstata/etiología , Enfermedades de la Próstata/patología , Adulto , Animales , Femenino , Humanos , Masculino , Fenómenos Fisiologicos Nutricionales Maternos , EmbarazoRESUMEN
Gastroschisis (GS) is an abdominal wall defect that results in histological and morphological changes leading to intestinal motility perturbation and impaired absorption of nutrients. Due to its anti-inflammatory, antioxidant, and neuroprotective effects, cannabidiol (CBD) has been used as a therapeutic agent in many diseases. Our aim was to test the effect of maternal CBD in the intestine of an experimental model of GS. Pregnant rats were treated over 3 days with CBD (30 mg/kg) after the surgical induction of GS (day 18.5 of gestation) and compared to controls. Fetuses were divided into 4 groups: 1) control (C); 2) C+CBD (CCBD); 3) gastroschisis (G), and 4) G+CBD (GCBD). On day 21.5 of gestation, the fetuses were harvested and evaluated for: a) body weight (BW), intestinal weight (IW), and IW/BW ratio; b) histometric analysis of the intestinal wall; c) immunohistochemically analysis of inflammation (iNOS) and nitrite/nitrate level. BW: GCBD was lower than CCBD (P<0.005), IW and IW/BW ratio: GCBD was smaller than G (P<0.005), GCBD presented lower thickness in all parameters compared to G (P<0.005), iNOS and nitrite/nitrate were lower concentration in GCBD than to G (P<0.005). Maternal use of CBD had a beneficial effect on the intestinal loops of GS with decreased nitrite/nitrate and iNOS expression.
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Antiinflamatorios/uso terapéutico , Cannabidiol/uso terapéutico , Enteritis/prevención & control , Enfermedades Fetales/metabolismo , Gastrosquisis/metabolismo , Intestinos/efectos de los fármacos , Animales , Modelos Animales de Enfermedad , Femenino , Enfermedades Fetales/patología , Gastrosquisis/patología , Inmunohistoquímica , Nitratos/metabolismo , Óxido Nítrico Sintasa de Tipo II/análisis , Nitritos/metabolismo , Embarazo , Ratas , Ratas Sprague-DawleyRESUMEN
Gastroschisis (GS) is an abdominal wall defect that results in histological and morphological changes leading to intestinal motility perturbation and impaired absorption of nutrients. Due to its anti-inflammatory, antioxidant, and neuroprotective effects, cannabidiol (CBD) has been used as a therapeutic agent in many diseases. Our aim was to test the effect of maternal CBD in the intestine of an experimental model of GS. Pregnant rats were treated over 3 days with CBD (30 mg/kg) after the surgical induction of GS (day 18.5 of gestation) and compared to controls. Fetuses were divided into 4 groups: 1) control (C); 2) C+CBD (CCBD); 3) gastroschisis (G), and 4) G+CBD (GCBD). On day 21.5 of gestation, the fetuses were harvested and evaluated for: a) body weight (BW), intestinal weight (IW), and IW/BW ratio; b) histometric analysis of the intestinal wall; c) immunohistochemically analysis of inflammation (iNOS) and nitrite/nitrate level. BW: GCBD was lower than CCBD (P<0.005), IW and IW/BW ratio: GCBD was smaller than G (P<0.005), GCBD presented lower thickness in all parameters compared to G (P<0.005), iNOS and nitrite/nitrate were lower concentration in GCBD than to G (P<0.005). Maternal use of CBD had a beneficial effect on the intestinal loops of GS with decreased nitrite/nitrate and iNOS expression.
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Animales , Femenino , Embarazo , Ratas , Cannabidiol/uso terapéutico , Gastrosquisis/metabolismo , Enteritis/prevención & control , Enfermedades Fetales/metabolismo , Intestinos/efectos de los fármacos , Antiinflamatorios/uso terapéutico , Inmunohistoquímica , Ratas Sprague-Dawley , Gastrosquisis/patología , Modelos Animales de Enfermedad , Óxido Nítrico Sintasa de Tipo II/análisis , Enfermedades Fetales/patología , Nitratos/metabolismo , Nitritos/metabolismoRESUMEN
Fetal hepatic calcifications can be caused by infections, chromosomal disorders, thrombotic events, ischemic hepatic necrosis and subcapsular hematomas among others events. Its features and clinical significance are still not well known. We performed an observational study to describe fetal hepatic calcifications and its association with main clinical and histopathological findings from the fetal autopsy database, between 2007 and 2014. Raw odds ratio analysis was performed. We reviewed 591 fetal autopsies: 14 cases with hepatic calcifications, 102 fetuses with chromosomal disorders; 13 with diagnosis of TORSCH (toxoplasma, rubella, syphilis, cytomegalovirus, herpes virus 1 and 2, and others) and 207 with any abnormality in the umbilical cord (UC). The relation between hepatic calcifications and chromosomal disorders in our series had significance. It is known that hepatic calcifications are common in chromosomal disorders, transplacental infections and UC abnormalities, those conditions are risk factor for hepatic calcifications formation; we suggest hepatic calcifications should alert the pathologists in order to consider these etiologies in first instance.
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Calcinosis/patología , Enfermedades Fetales/patología , Hepatopatías/patología , Adolescente , Adulto , Autopsia , Calcinosis/epidemiología , Colombia/epidemiología , Bases de Datos Factuales , Femenino , Enfermedades Fetales/epidemiología , Humanos , Hepatopatías/epidemiología , Adulto JovenRESUMEN
In October 2015, Zika virus (ZIKV) outbreak the Brazilian Ministry of Health (MoH). In response, the Brazilian Society of Medical Genetics established a task force (SBGM-ZETF) to study the phenotype of infants born with microcephaly due to ZIKV congenital infection and delineate the phenotypic spectrum of this newly recognized teratogen. This study was based on the clinical evaluation and neuroimaging of 83 infants born during the period from July, 2015 to March, 2016 and registered by the SBGM-ZETF. All 83 infants had significant findings on neuroimaging consistent with ZIKV congenital infection and 12 had confirmed ZIKV IgM in CSF. A recognizable phenotype of microcephaly, anomalies of the shape of skull and redundancy of the scalp consistent with the Fetal Brain Disruption Sequence (FBDS) was present in 70% of infants, but was most often subtle. In addition, features consistent with fetal immobility, ranging from dimples (30.1%), distal hand/finger contractures (20.5%), and feet malpositions (15.7%), to generalized arthrogryposis (9.6%), were present in these infants. Some cases had milder microcephaly or even a normal head circumference (HC), and other less distinctive findings. The detailed observation of the dysmorphic and neurologic features in these infants provides insight into the mechanisms and timings of the brain disruption and the sequence of developmental anomalies that may occur after prenatal infection by the ZIKV.
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Brotes de Enfermedades , Enfermedades Fetales/epidemiología , Microcefalia/epidemiología , Complicaciones Infecciosas del Embarazo/epidemiología , Infección por el Virus Zika/epidemiología , Anticuerpos Antivirales/líquido cefalorraquídeo , Encéfalo/anomalías , Encéfalo/virología , Brasil/epidemiología , Femenino , Enfermedades Fetales/diagnóstico por imagen , Enfermedades Fetales/patología , Feto , Humanos , Inmunoglobulina G/líquido cefalorraquídeo , Lactante , Microcefalia/complicaciones , Microcefalia/diagnóstico por imagen , Microcefalia/patología , Neuroimagen , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/patología , Síndrome , Virus Zika/crecimiento & desarrollo , Virus Zika/inmunología , Virus Zika/patogenicidad , Infección por el Virus Zika/complicaciones , Infección por el Virus Zika/diagnóstico por imagen , Infección por el Virus Zika/patologíaRESUMEN
INTRODUCTION: Several epidemiologic studies in humans have shown a relationship between pregestational obesity and congenital malformations in offsprings. However, there are no experimental evidence in animal models of obesity and pregnancy that reproduce the teratogenesis induced by this pathological condition. OBJECTIVE: To evaluate the effect of monosodium glutamate-induced obesity on embryonic development. METHODS: Female rats received subcutaneously (4 mg/g body weight) monosodium glutamate (MSG) solution or saline solution 0.9% (vehicle control) at days 2, 4, 6, 8, and 10 of life. At 90 days of age, all animals were mated, and on day 11 of pregnancy, the animals were killed. Biochemical variables (glucose, triglycerides, total cholesterol, and insulin) were determined in plasma of dams and embryo homogenates (DNA and protein content, advanced oxidation protein products). Embryos were evaluated for malformations, crown-rump length, and somite number. RESULTS: Obese rats presented higher triglyceride levels as compared to nonobese rats. Increased proportion of malformed embryos, decreased crown-rump length, somite number, DNA, and protein content were observed in offspring of obese rats. CONCLUSION: The model of obesity induced with MSG reproduces the maternal obesity-induced teratogenesis. The hypertriglyceridemia observed in MSG obese pregnant rats could be related to increased birth defect.
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Enfermedades Fetales/metabolismo , Obesidad/embriología , Obesidad/metabolismo , Complicaciones del Embarazo , Animales , Glucemia/metabolismo , Colesterol/sangre , Largo Cráneo-Cadera , Modelos Animales de Enfermedad , Femenino , Enfermedades Fetales/etiología , Enfermedades Fetales/patología , Insulina/sangre , Masculino , Obesidad/inducido químicamente , Obesidad/complicaciones , Embarazo , Ratas , Ratas Wistar , Glutamato de Sodio/toxicidad , Somitos/patología , Triglicéridos/sangreRESUMEN
We present a male newborn child with a sacrococcygeal mass who was sent to clinic 46 of the Mexican Social Security Institute located in Gomez Palacio, Durango, Mexico for pediatric/neonatal surgical resolution. The mass was detected on gestation week 24 in the sacrococcygeal area and was initially interpreted as a myelomeningocele. On gestation week 32, the mass had grown, so the diagnosis of cystic hygroma was posed. The child was born at 38 weeks of gestational age with a large tumor in the sacrococcygeal area. Images were obtained, and tumor resection was performed without complications. Pathologic examination confirmed the diagnosis of sacrococcygeal teratoma. The postoperative course was uneventful and there were no further complications.
Se presenta el caso de un recién nacido del género masculino que es enviado a la clínica 46 del Instituto Mexicano del Seguro Social de Gómez Palacio, Durango, México para manejo por cirugía pediátrica y neonatología, por la presencia de una masa en región sacrococígea que fue detectada en la semana 24 de gestación como probable mielomeningocele. A las 32 semanas de gestación se observó un mayor crecimiento y se sospechó de un higroma quístico. Se programa cesárea a las 38 semanas de gestación y, después de exámenes imagenológicos, se realiza resección del tumor sin complicaciones. El estudio anatomopatológico confirmó el diagnóstico de teratoma sacrococcígeo. La evolución posoperatoria inmediata y su condición en la actualidad, son satisfactorias.
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Enfermedades Fetales/diagnóstico , Diagnóstico Prenatal , Teratoma/diagnóstico , Femenino , Enfermedades Fetales/patología , Enfermedades Fetales/cirugía , Humanos , Recién Nacido , Masculino , México , Embarazo , Región Sacrococcígea , Teratoma/congénito , Teratoma/cirugíaRESUMEN
OBJECTIVE: To describe the anatomical structures that form the anterior (AC) and posterior (PC) complexes of the fetal brain and to categorize their anomalies in fetuses with cerebral abnormalities. METHODS: We analyzed retrospectively volume datasets from 100 normal fetuses between 20 and 30 weeks' gestation. On the axial transventricular plane, our analysis of the AC included the interhemispheric fissure (IHF), the callosal sulcus (CS), the genu of the corpus callosum (CC), the cavum septi pellucidi (CSP) and the anterior horns (AH) of the lateral ventricles. The PC included the splenium of the CC, the medial wall of the lateral ventricles, the CS and the parieto-occipital fissure (POF). We then categorized AC/PC findings in 32 fetuses with agenesis of the septi pellucidi, schizencephaly, callosal dysgenesis, cortical malformation and hypoxic-ischemic brain injury. RESULTS: The structures forming the AC and PC were visible in 100% and 92%, respectively, of normal cases. In the AC, the CSP was square-shaped in 73% of cases and it was triangular in 27%; the AH was comma-shaped in 92% of cases and triangular in the remainder. In the PC, the splenium of the CC interrupted and bridged the midline and was delimited posteriorly by the CS and the IHF. The POF was visible posteriorly. We categorized AC and PC abnormalities according to the main deviation from normality in their anatomical structures. The AC was abnormal in 30/32 cases and the PC was abnormal in 16/32 cases. In the two cases with normal AC, the PC was abnormal. CONCLUSION: Normal appearance of AC and PC seems to be a strong indicator of fetal central nervous system normality. Morphological abnormalities in both complexes are robust markers of midline defects, but not exclusively so. The majority of fetuses with cortical malformations showed a defect in the AC.
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Agenesia del Cuerpo Calloso/diagnóstico por imagen , Ecoencefalografía , Enfermedades Fetales/diagnóstico por imagen , Malformaciones del Sistema Nervioso/diagnóstico por imagen , Tabique Pelúcido/patología , Ultrasonografía Prenatal , Agenesia del Cuerpo Calloso/embriología , Agenesia del Cuerpo Calloso/patología , Ecoencefalografía/métodos , Femenino , Enfermedades Fetales/patología , Edad Gestacional , Humanos , Malformaciones del Sistema Nervioso/embriología , Malformaciones del Sistema Nervioso/patología , Embarazo , Estudios Retrospectivos , Tabique Pelúcido/anomalías , Tabique Pelúcido/embriologíaRESUMEN
PURPOSE: We compared and contrasted the structure of the gubernaculum testis in fetuses with prune belly syndrome and normal controls. MATERIALS AND METHODS: We studied a total of 6 gubernacula from 3 male fetuses with prune belly syndrome and a total of 14 from 7 male fetuses without an anomaly. Gubernacular specimens were cut into 5 µm sections and stained with Masson trichrome to quantify connective tissue and smooth muscle cells, with Weigert stain to observe elastic fibers and with picrosirius red with polarization to observe collagen. Immunohistochemical analysis was done with tubulin to observe the nerves. Images were captured with a BX51 microscope and DP70 camera (Olympus®). Stereological analysis was done with Image-Pro and ImageJ (MediaCybernetics®) using a grid to determine volumetric density. Means were statistically compared with the Mann-Whitney test. All tests were 2-sided with p <0.05 considered statistically significant. RESULTS: Prune belly syndrome fetuses were at 17 to 31 weeks of gestation and control fetuses were at 12 to 35 weeks of gestation. Quantitative analysis showed no difference in the volumetric density of smooth muscle cells in prune belly syndrome vs control gubernacula (mean 15.70% vs 19%, p = 0.2321). Collagen fiber analysis revealed a predominance of green areas in prune belly syndrome gubernacula, suggesting collagen type III, and a predominance of red areas in control gubernacula, suggesting collagen type I. Elastic fibers were significantly smaller in prune belly syndrome gubernacula than in control gubernacula (mean 14.06% vs 24.6%, p = 0.0190). Quantitative analysis demonstrated no difference in the volumetric density of nerves in prune belly syndrome or control gubernacula (mean 5.200% vs 3.158%, p = 0.2302). CONCLUSIONS: The gubernaculum in fetuses with prune belly syndrome had altered concentrations of collagen and elastic fibers. These structural alterations could be one of the factors involved in cryptorchidism in prune belly syndrome.
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Criptorquidismo/embriología , Enfermedades Fetales/patología , Feto/embriología , Síndrome del Abdomen en Ciruela Pasa/embriología , Testículo/embriología , Colágeno/metabolismo , Tejido Conectivo/embriología , Largo Cráneo-Cadera , Criptorquidismo/metabolismo , Tejido Elástico/embriología , Tejido Elástico/metabolismo , Enfermedades Fetales/metabolismo , Humanos , Inmunohistoquímica , Masculino , Miocitos del Músculo Liso/metabolismo , Síndrome del Abdomen en Ciruela Pasa/metabolismo , Escroto/embriología , Testículo/metabolismoRESUMEN
OBJECTIVES: To describe placental pathological findings in late-onset small-for-gestational age (SGA) births for which Doppler signs of placental insufficiency are lacking. METHODS: A series of placentas were evaluated from singleton pregnancies of SGA births (birth weight below the 10th percentile) delivered after 34 weeks with normal umbilical artery Doppler (pulsatility index below the 95th percentile), that were matched by gestational age with adequate-for-gestational age (AGA) controls. Using a hierarchical and standardized system, placental lesions were classified histologically as consequence of maternal underperfusion, fetal underperfusion or inflammation. RESULTS: A total of 284 placentas were evaluated (142 SGA and 142 AGA). In the SGA group, 54.2% (77/142) of the placentas had weights below the 3rd percentile for GA while it was a 9.9% (14/142) in the AGA group (p < 0.001). Only 21.8% (31/142) of SGA placentas were free of histological abnormalities, while it was 74.6% (106/142) in the AGA group (p < 0.001). In the abnormal SGA placentas (111/142) there were a total of 161 lesions, attributable to MUP in 64% (103/161), FUP in 15.5% (25/161), and inflammation in 20.5% (33/161). DISCUSSION: In most placentas of term SGA neonates with normal UA Doppler histological abnormalities secondary to maternal underperfusion prevail, reflecting latent insufficiency in uteroplacental blood supply. This is consistent with the higher risk of adverse perinatal outcome reported in this population and underscores a need for new markers of placental disease. CONCLUSIONS: A significant proportion of late-onset SGA births with normal umbilical artery Doppler may still be explained by placental insufficiency.
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Diagnóstico Tardío , Enfermedades Fetales/patología , Retardo del Crecimiento Fetal/patología , Placenta/patología , Circulación Placentaria , Insuficiencia Placentaria/patología , Adulto , Femenino , Enfermedades Fetales/diagnóstico por imagen , Enfermedades Fetales/inmunología , Enfermedades Fetales/fisiopatología , Retardo del Crecimiento Fetal/etiología , Retardo del Crecimiento Fetal/inmunología , Humanos , Recién Nacido , Recién Nacido Pequeño para la Edad Gestacional , Masculino , Análisis por Apareamiento , Placenta/inmunología , Enfermedades Placentarias/diagnóstico por imagen , Enfermedades Placentarias/inmunología , Enfermedades Placentarias/patología , Enfermedades Placentarias/fisiopatología , Insuficiencia Placentaria/diagnóstico por imagen , Insuficiencia Placentaria/inmunología , Insuficiencia Placentaria/fisiopatología , Embarazo , Tercer Trimestre del Embarazo , Nacimiento Prematuro , Estudios Prospectivos , Nacimiento a Término , Ultrasonografía Prenatal , Arterias Umbilicales/diagnóstico por imagenRESUMEN
Congenital splenic cysts are rare entities wich are not frequently diagnosed in prenatal sonographies and there is only a few literature wich report these medical cases. The aim of this article is to introduce this sonographic discovery and study whether there are impacts for the newborn, association with cormosomopathy or fetal pathology. We describe two medical cases of fetal splenic cysts wich were diagnosed in our service by ultrasonography at 29 and 32 weeks of gestation, their antenatal monitoring and postnatal evolution. Besides theses, it is made a review of this entity in medical literature, examination about the: etiology, prenatal diagnosis, prenatal and postnatal following and complications. In conclusion, the congenital splenic cyst has a good prognosis with an spontaneous postnatal resolution in the majority of the cases. No association was observed between cromosopathy or fetal pathology with the examined cases.