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Seol HJ, Kim HY, Cho GJ, Oh MJ. Hourly fetal urine production rate in isolated oligohydramnios at term. PLoS One 2021; 16:e0250659. [PMID: 34019576 PMCID: PMC8139465 DOI: 10.1371/journal.pone.0250659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 04/08/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the hourly fetal urine production rate (HFUPR) via three-dimensional ultrasonography in women with isolated oligohydramnios and compare with normal pregnant women at term. MATERIALS AND METHODS This was a prospective observational cohort study of 112 women from 34 to 40 6/7 weeks' gestation. They were classified into three groups according to the amniotic fluid index (AFI) and ultrasonographic estimated fetal weight (EFW) as isolated oligohydramnios (defined as AFI below 5% and appropriate EFW corresponding to gestational age) (n = 34) and IUGR (defined as EFW below 5% corresponding to gestational age irrespective amniotic fluid) (n = 17), and normal pregnancy (n = 61). HFUPR was measured using three-dimensional virtual organ computer-aided analysis. Adverse perinatal outcomes in all participants were examined. RESULTS There was no significant difference in HFUPR between patients with isolated oligohydramnios and women with normal pregnancies (median, 40.0 mL/h [interquartile range [IQR] 31.0-66.5] vs. 48.6 [31.5-81.2], p = 0.224). HFUPR was significantly decreased in the IUGR group (13.8 mL/h [IQR 10.1-24.8]), compared to the normal pregnancy group (p<0.001) and the isolated oligohydramnios group (p<0.001). HFUPR was significantly decreased in neonates with adverse perinatal outcomes compared to the control (24.7 mL/h [IQR 13.4-47.4] vs. 43.6 [29.8-79.0], p = 0.016). CONCLUSION HFUPR was not decreased in patients with isolated oligohydramnios but was decreased in patients with IUGR when compared to normal controls at term.
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Affiliation(s)
- Hyun-Joo Seol
- Department of Obstetrics & Gynecology, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Ho Yeon Kim
- Department of Obstetrics & Gynecology, College of Medicine, Korea University, Seoul, Korea
| | - Geum-Joon Cho
- Department of Obstetrics & Gynecology, College of Medicine, Korea University, Seoul, Korea
| | - Min-Jeong Oh
- Department of Obstetrics & Gynecology, College of Medicine, Korea University, Seoul, Korea
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Fagerquist MA, Sethi V, Skytteren E, Oden A. Intra-observer repeatability when assessing the foetal urinary bladder volume by the Virtual Organ Computer-aided AnaLysis and SUM-OF-CYLINDERS methods: A pilot study. ULTRASOUND (LEEDS, ENGLAND) 2018; 25:156-165. [PMID: 29410691 DOI: 10.1177/1742271x17709854] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Accepted: 04/19/2017] [Indexed: 11/17/2022]
Abstract
Introduction The aim of this study was to compare the intra-observer repeatability when using two different methods for estimating the volume of foetal urinary bladders. Method The urinary bladders of 20 foetuses were documented by three-dimensional ultrasound. Standard deviation was compared when the volumes of identical bladder images were repeatedly estimated using the Virtual Organ Computer-aided AnaLysis and the experimental SUM-OF-CYLINDERS methods. Results No systematic deviation was found between the estimated volumes when using these two methods. Standard deviation was smaller for the SUM-OF-CYLINDERS compared to the Virtual Organ Computer-aided AnaLysis method (p < 0.0001). In relation to bladder volumes of 5-25 ml, standard deviation was 11-14% for the Virtual Organ Computer-aided AnaLysis and 4-5% for the SUM-OF-CYLINDERS method. Conclusions Using three-dimensional ultrasound images adapted for the Virtual Organ Computer-aided AnaLysis method, foetal urinary bladder volumes can also be estimated using the SUM-OF-CYLINDERS method. The SUM-OF-CYLINDERS method employs technical advances which may result in a lower standard deviation and therefore higher intra-observer repeatability.
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Affiliation(s)
- Mats A Fagerquist
- Department of Obstetrics and Gynecology, Innlandet Hospital Trust, Kongsvinger Hospital, Norway.,Department of Obstetrics and Gynecology, North Elfsborg County Hospital, Trollhattan, Sweden
| | - Vivek Sethi
- Department of Obstetrics and Gynecology, Akershus University Hospital, Lorenskog, Norway
| | - Eli Skytteren
- Department of Obstetrics and Gynecology, Innlandet Hospital Trust, Kongsvinger Hospital, Norway
| | - Anders Oden
- Chalmers University of Technology, Gothenburg, Sweden
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Chang AN, Kamm KE, Stull JT. Role of myosin light chain phosphatase in cardiac physiology and pathophysiology. J Mol Cell Cardiol 2016; 101:35-43. [PMID: 27742556 DOI: 10.1016/j.yjmcc.2016.10.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 10/07/2016] [Accepted: 10/10/2016] [Indexed: 11/18/2022]
Abstract
Maintenance of contractile performance of the heart is achieved in part by the constitutive 40% phosphorylation of myosin regulatory light chain (RLC) in sarcomeres. The importance of this extent of RLC phosphorylation for optimal cardiac performance becomes apparent when various mouse models and resultant phenotypes are compared. The absence or attenuation of RLC phosphorylation results in poor performance leading to heart failure, whereas increased RLC phosphorylation is associated with cardiac protection from stresses. Although information is limited, RLC phosphorylation appears compromised in human heart failure which is consistent with data from mouse studies. The extent of cardiac RLC phosphorylation is determined by the balanced activities of cardiac myosin light chain kinases and phosphatases, the regulatory mechanisms of which are now emerging. This review thusly focuses on kinases that may participate in phosphorylating RLC to make the substrate for cardiac myosin light chain phosphatases, in addition to providing perspectives on the family of myosin light chain phosphatases and involved signaling mechanisms. Because biochemical and physiological information about cardiac myosin light chain phosphatase is sparse, such studies represent an emerging area of investigation in health and disease.
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Affiliation(s)
- Audrey N Chang
- Department of Physiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
| | - Kristine E Kamm
- Department of Physiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - James T Stull
- Department of Physiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
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Lee SM, Jun JK, Kim SA, Lee EJ, Kim BJ, Park CW, Park JS. Usefulness of fetal urine production measurement for prediction of perinatal outcomes in uteroplacental insufficiency. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2014; 33:2165-2171. [PMID: 25425374 DOI: 10.7863/ultra.33.12.2165] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVES To evaluate whether fetal urine production measurement is useful for predicting adverse outcomes in patients with uteroplacental insufficiency. METHODS We enrolled patients with uteroplacental insufficiency at 24 to 40 weeks' gestation and normal pregnancies matched for gestational age and divided them into 3 groups according to perinatal outcomes: group 1 (n = 141), a control group of normal pregnancies; group 2 (n = 29), uteroplacental insufficiency without adverse outcomes; and group 3 (n = 18), uteroplacental insufficiency with adverse outcomes. An adverse outcome was defined as 1 or more of the following: (1) cesarean delivery because of fetal distress; (2) admission to the neonatal intensive care unit; (3) cord arterial pH less than 7.15 at birth; and (4) low 5-minute Apgar score (<7). The fetal urine production rate was obtained by serial bladder volume measurement using virtual organ computer-aided analysis. For bladder volume determination, we scanned the bladder in the 3-dimensional mode and defined the bladder surface contour in the reference plane, repeating the rotation of the reference plane with an angle of 30° and determining the surface contour on each plane. Statistical methods, including the Mann-Whitney U test, Fisher exact test, χ(2) test, and Kruskal-Wallis analysis of variance, were used. RESULTS Group 3 had a lower mean fetal urine production rate than groups 1 and 2, whereas the urine production rate was not different between groups 1 and 2 (group 1, 49.0 mL/h; group 2, 59.4 mL/h; group 3, 20.7 mL/h; P < .001 between groups 1 and 3 and between groups 2 and 3). This difference between groups 2 and 3 remained significant after adjusting for the amniotic fluid index, umbilical artery Doppler pulsatility index, and presence of fetal growth restriction. CONCLUSIONS Uteroplacental insufficiency cases with adverse perinatal outcomes had a lower fetal urine production rate than those without adverse outcomes. This difference might be used to predict adverse perinatal outcomes in uteroplacental insufficiency.
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Affiliation(s)
- Seung Mi Lee
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea (S.M.L., J.K.J., S.A.K., B.J.K., C.-W.P., J.S.P.); Department of Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea (S.M.L., B.J.K.); and Samsung Medison Co, Seoul, Korea (E.J.L.)
| | - Jong Kwan Jun
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea (S.M.L., J.K.J., S.A.K., B.J.K., C.-W.P., J.S.P.); Department of Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea (S.M.L., B.J.K.); and Samsung Medison Co, Seoul, Korea (E.J.L.).
| | - Su Ah Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea (S.M.L., J.K.J., S.A.K., B.J.K., C.-W.P., J.S.P.); Department of Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea (S.M.L., B.J.K.); and Samsung Medison Co, Seoul, Korea (E.J.L.)
| | - Eun Ja Lee
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea (S.M.L., J.K.J., S.A.K., B.J.K., C.-W.P., J.S.P.); Department of Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea (S.M.L., B.J.K.); and Samsung Medison Co, Seoul, Korea (E.J.L.)
| | - Byoung Jae Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea (S.M.L., J.K.J., S.A.K., B.J.K., C.-W.P., J.S.P.); Department of Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea (S.M.L., B.J.K.); and Samsung Medison Co, Seoul, Korea (E.J.L.)
| | - Chan-Wook Park
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea (S.M.L., J.K.J., S.A.K., B.J.K., C.-W.P., J.S.P.); Department of Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea (S.M.L., B.J.K.); and Samsung Medison Co, Seoul, Korea (E.J.L.)
| | - Joong Shin Park
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea (S.M.L., J.K.J., S.A.K., B.J.K., C.-W.P., J.S.P.); Department of Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea (S.M.L., B.J.K.); and Samsung Medison Co, Seoul, Korea (E.J.L.)
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3D Ultrasonography to Evaluate Fetal Urinary Production Rates in Twin Gestation: Construction of a Normal Value Curve. Twin Res Hum Genet 2013; 17:45-50. [DOI: 10.1017/thg.2013.82] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Objective: The aim of this study was to assess fetal urinary production rates (FUPR) in twin gestations using 3D ultrasonography with VOCAL® (virtual organ computer-aided analysis) and to develop a curve of normal values for the target population. Methods: A cross-sectional study was performed in 30 normal twin pregnancies with gestational ages ranging from 20 to 34 weeks. FUPR was measured using a three-dimensional ultrasound (3D US) virtual organ computer-aided analysis (VOCAL) system. FUPR (ml/hour) was calculated during the filling phase using the equation UPR = (VFB2 - VFB1)/time. The values for UPR were plotted as a function of fetal biometry (biparietal diameter) to generate a nomogram. Results: A total of 41 normal twin fetuses with gestational ages between 20 and 34 weeks were investigated. Eleven were excluded because of inadequate bladder contour image quality and/or the observation of micturition in one or both fetuses. Linear regression analysis of FUPR as a function of biparietal diameter (BPD) shows the normal range for UPR by fetal biometry and is expressed by the following equation: Ln(UPR) = -5.0121 + 0.0548 BPD (R2 0.3386, p value <.001). There was no statistically significant difference when the UPR was stratified by chorionicity. Conclusions: The use of biometric parameters to predict fetal FUPR seems to be useful. In twin pregnancies, BPD is the variable that is most closely related to FUPR. For each 1 mm increase in BPD, there is a 5% increase in FUPR. Chorionicity did not affect FUPR.
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Abstract
Introduction: Amniotic fluid, once thought to merely provide protection and room for necessary movement and growth for the fetus, is now understood to be a highly complex and dynamic system that is studied as a data point to interpret fetal wellbeing. Methods: Assessment of amniotic fluid volume is now routine when performing a sonographic evaluation of fetal status and is an important consideration in the assessment and management of perinatal morbidity and mortality.1,2 In this review, we will cover the dynamics that affect amniotic fluid volume, review methods for measurement and quantification of volume, review definitions for normative data as related to neonatal outcomes, and provide evidence based guidance on the workup and management options for oligoydramnios and polyhydramnios in singleton and twin pregnancies. Conclusions: When abnormalities of fluid exist, appropriate workup to uncover the underlying etiology should be initiated as adverse fetal outcomes are sometimes associated with these variations from normalcy.
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Affiliation(s)
| | - Everett F Magann
- University of Arkansas for Medical Sciences Little Rock Arkansas USA
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