RESUMO
Introducción: La flujometría doppler constituye un método de control y evaluación para determinar la culminación de la gestación, permite entender de una mejor manera la dinámica fetoplacetaria lo que posibilita evitar todo riesgo que pueda dañar la maduración fetal, y a su vez la prematuridad, bajo peso al nacer y patologías de la preeclampsia. Objetivo: Determinar la utilidad de la flujometría doppler color, en el diagnóstico y manejo de la restricción de crecimiento intrauterino en embarazadas preeclámpticas. Métodos: Se realizó un estudio no experimental, transversal, de tipo descriptivo comparativo en el departamento de ecografía de la clínica Bolívar, Babahoyo - Ecuador durante el año 2013. Participaron 96 mujeres gestantes en edades entre 15 a 40 años, a las que se le realizó las intervenciones: Flujometría doppler, prueba de índice cerebro placentario, arteria cerebral media/arteria umbilical; para el análisis se emplearon los indicadores descriptivos entre las variables. Resultados: La prueba de índice cerebro placentario fue descompensada en el 53,1 por ciento de las mujeres, el volumen de líquido amniótico estuvo disminuido en el 46,9 por ciento, y la edad gestacional más vulnerable fue de las 32 a las 37 semanas de gestación. Conclusiones: La flujometría doppler con la prueba índice cerebro placentario es un indicador efectivo y seguro de bienestar fetal cuando esta prueba es normal, y un predictor de resultado adverso, así como un marcador de hipoxia fetal cuando está alterado, convirtiéndose en una herramienta útil para la decisión de interrumpir la gestación cuando la salud del feto está en peligro, o de mantener el embarazo cuando su comportamiento es normal(AU)
Assuntos
Humanos , Feminino , Gravidez , Fluxometria por Laser-Doppler/instrumentação , Pré-Eclâmpsia/diagnóstico , Epidemiologia Descritiva , Estudos TransversaisRESUMO
OBJECTIVE: To assess correlations between maternal serum levels of pro- and anti-angiogenic factors with uterine perfusion in women with early- compared with late-onset preeclampsia, and in healthy pregnant women. DESIGN: Case-control study. SETTING: Antenatal care clinic located within a hospital (São Bernardo do Campo, Brazil). POPULATION: We enrolled 54 preeclamptic and 54 healthy control women who were coming for routine ultrasound at 28-36 weeks' gestation. METHODS: All participants had uterine artery and umbilical Doppler studies and a blood sample to assess maternal serum levels of soluble fms-like tyrosine kinase-1, soluble endoglin, adiponectin and plasminogen activator inhibitor-1. All angiogenic factors were measured using enzyme-linked immunosorbent assay. MAIN OUTCOME MEASURES: Levels of pro- and anti-angiogenic factors in maternal serum, and uterine artery Doppler findings. RESULTS: Concentrations of soluble fms-like tyrosine kinase-1 and soluble endoglin were significantly higher in preeclamptic than control women (p < 0.0001 and p < 0.0001, respectively), especially in those with early-onset (<34 weeks) preeclampsia. These two anti-angiogenic mediators were significantly correlated with increased uterine artery Doppler in the preeclamptic women. Plasminogen activator inhibitor-1 levels were significantly higher in preeclampsia (p = 0.03) but unrelated to uterine artery resistance. Adiponectin levels were similar in cases and controls, independent of body mass index and unrelated to uterine artery resistance. CONCLUSION: Preeclamptic patients have increased soluble fms-like tyrosine kinase-1 and soluble endoglin serum levels and this increase is directly correlated with uterine artery resistance, especially in those with early-onset preeclampsia.
Assuntos
Fluxometria por Laser-Doppler , Pré-Eclâmpsia/sangue , Pré-Eclâmpsia/diagnóstico por imagem , Artéria Uterina/fisiopatologia , Útero/irrigação sanguínea , Resistência Vascular , Adiponectina/sangue , Adolescente , Adulto , Antígenos CD/sangue , Biomarcadores/sangue , Estudos de Casos e Controles , Endoglina , Feminino , Idade Gestacional , Humanos , Fluxometria por Laser-Doppler/instrumentação , Inibidor 1 de Ativador de Plasminogênio/sangue , Pré-Eclâmpsia/fisiopatologia , Gravidez , Receptores de Superfície Celular/sangue , Ultrassonografia , Artérias Umbilicais/diagnóstico por imagem , Artéria Uterina/diagnóstico por imagem , Receptor 1 de Fatores de Crescimento do Endotélio Vascular/sangue , Adulto JovemRESUMO
This study aimed to evaluate the cerebral blood flow of full term small-for-gestational age newborns, using cranial ultrasound Doppler at birth. This study was performed at CAISM/UNICAMP (Tertiary Health Center for Women). Sixty term newborns were selected and divided in two groups: appropriate-for-gestational age (AGA) (36 neonates) and small-for-gestational age (SGA) (24 neonates). Cranial ultrasound Doppler evaluation was performed on both groups, between 24 and 48 hours after birth. Cerebral blood flow velocity (CBFV) was lower in the small-for-gestational age group, in the anterior cerebral artery (ACA). Doppler measurements were different statistically between the groups only for values related to peak systolic flow velocity (PSFV) and mean flow velocity (MFV) in the ACA. There was no significant difference for any evaluated parameters of flow velocity in the middle cerebral artery (MCA). It was concluded that SGA newborns showed PSFV and MFV significantly reduced only in the ACA. Weight/gestational age, neonatal polycythemia and mean arterial blood pressure values were statistically related to MFV in the ACA. In presence of fetal suffering, mean arterial blood pressure values and smoking in the pregnancy were statistically related to MFV in the MCA.
Assuntos
Artérias Cerebrais/fisiologia , Circulação Cerebrovascular/fisiologia , Recém-Nascido Pequeno para a Idade Gestacional/fisiologia , Artéria Cerebral Anterior/diagnóstico por imagem , Velocidade do Fluxo Sanguíneo , Pressão Sanguínea , Artérias Cerebrais/diagnóstico por imagem , Transtornos Cerebrovasculares/etiologia , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Fluxometria por Laser-Doppler/instrumentação , Masculino , Artéria Cerebral Média/diagnóstico por imagem , Artéria Cerebral Média/fisiologia , Estado Nutricional , Insuficiência Placentária/complicações , Gravidez , Estudos Prospectivos , Fatores de Risco , Ultrassonografia Doppler TranscranianaRESUMO
During ablation of tissue with laser pulses rapid sublimation of matter occurs and high pressures are exerted within the tissue, resulting in steam. smoke and particles being expelled. In this paper we report the speed of particles ejected from animal tissue exposed to CO2 laser pulses measured directly by laser Doppler velocimetry (LDV). Speeds recorded just above animal skin were in the range of 9 to 18 m s(-1) for laser pulses of 128 to 384 J cm(-2) respectively. Aerodynamic turbulence slowed the particles down to a critical speed Vc of 4 m s(-1) within a few millimetres above the laser ablation site. Once the particles reach this minimum speed, if no collisions occur, they will only decelerate by gravitational action and the residual kinetic energy will send the particles up to about 0.87 m from the skin surface. Since ejected particles may carry viable cells, acting as disease vectors during laser surgery, our results suggest that the LDV technique should be used to measure the speed of particles ejected from healthy or pathological human tissues, helping to establish safe conditions during laser surgery.
Assuntos
Dióxido de Carbono/metabolismo , Fluxometria por Laser-Doppler/métodos , Animais , Fenômenos Biofísicos , Biofísica , Feminino , Humanos , Cinética , Fluxometria por Laser-Doppler/instrumentação , Lasers , Masculino , Ratos , Ratos Wistar , Pele/patologia , Fatores de TempoRESUMO
Os autores estudam 118 gestacoes com oligoidramnio, utilizando a dopplerfluxometria para diagnostico de centralizacao da circulacao fetal. Verificaram incidencia maior de alteracoes nos exames de carditocografia e perfil biofisico fetal nos casos centralizados. Os resultados neonatais foram semelhantes em ambos os grupos (centralizados e nao centralizados) exceto quando a cardiotocografia e ou perfil biofisico estivessem alterados, quando pode-se constatar maior morbidade neonatal
Assuntos
Humanos , Feminino , Gravidez , Adulto , Artérias Cerebrais , Fluxometria por Laser-Doppler/instrumentação , Oligo-Hidrâmnio/diagnóstico , Cardiotocografia , Viabilidade Fetal , Insuficiência Placentária , Gravidez de Alto Risco , Ultrassom , Ultrassonografia DopplerRESUMO
É realizada uma revisäo dos trabalhos da literatura do uso da dopplerfuxometria na prediçäo da pré-eclampsia. Após um preambulo histórico e colocaçäo dos aspectos básicos do método, säo listados os principais trabalhos da literatura, comparando-as crítica e evolutivamente entre si. Acreditam os autores que há realmente uma associaçäo entre as alteraçöes percebidas pelo metodo e a ocorrência de pré-eclampsia, as custas de detecçäo precoce, através do Doppler, das alteraçäes utero-placentárias classicamente descritas na doença...
Assuntos
Humanos , Feminino , Fluxometria por Laser-Doppler/instrumentação , Pré-Eclâmpsia , Pré-Eclâmpsia/diagnóstico , UltrassomRESUMO
Chronic leg ulceration is a considerable cause of morbidity in homozygous sickle-cell disease. The role of cutaneous blood flow in the pathogenesis of the ulcers is unknown. Compromised perfusion is assumed but there is no direct evidence to support this. We evaluated the response of cutaneous red cell flux (RCF), an index of cutaneous blood flow, to postural change in patients with SS disease, with and without a history of ulcers and in AA controls. Using laser Doppler flowmetry, measurements were made at two sites in the leg in the following groups:-SS patients with a history of ulceration (Group A = ulcers, Group B = scars); without a history of ulceration (Group C) and AA controls (Group D). In Groups A & B, the sites were the ulcer/scar site and a normal site; in Group C & D, medial and lateral sites above the malleoli. A triad of measurements was performed: - the leg horizontal, lowered, then returned to the horizontal. Regardless of history of ulceration, SS patients showed a smaller fall in flow on dependency (p < 0.001), indicating failure of normal postural vasoconstriction. In Groups A & B, the greater fall in flow observed at the ulcer/scar site compared with the normal site may be significant in the development/recurrence of ulcers at these sites. Clarification of the underlying mechanisms of these observations through further study may be important for improving skin nutritive perfusion (AU)