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Patino M, Jaimes C, Robson CD. Fetal Head and Neck Imaging. Magn Reson Imaging Clin N Am 2024; 32:413-430. [PMID: 38944431 DOI: 10.1016/j.mric.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2024]
Abstract
Prenatal MRI plays an essential role in the evaluation of the head and neck. This article overviews technical considerations and both isolated and syndromic anomalies of the fetal calvarium, globes and orbits, ears, maxilla, mandible, and neck.
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Affiliation(s)
- Manuel Patino
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA; Pediatric Imaging Research Center, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Camilo Jaimes
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA; Pediatric Imaging Research Center, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Caroline D Robson
- Neuroradiology Division, Department of Radiology, Boston Children's Hospital, Harvard Medical School, Main Building 2nd Floor, 300 Longwood Avenue, Boston, MA 02115, USA.
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Combs CA, Rosario AD, Balogun OA, Bowman ZS, Amara S. Selection of Standards for Sonographic Fetal Head Circumference by Use of z-Scores. Am J Perinatol 2024; 41:e2625-e2635. [PMID: 37487545 DOI: 10.1055/a-2135-6838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
OBJECTIVE This study aimed to evaluate which of five established norms should be used for sonographic assessment of fetal head circumference (HC). STUDY DESIGN Cross-sectional study using pooled data from four maternal-fetal medicine practices. Inclusion criteria were singleton fetus, gestational age 220/7 to 396/7 weeks, biometry measured, and fetal cardiac activity present. Five norms of HC were studied: Jeanty et al, Hadlock et al, the INTERGROWTH-21st Project (IG-21st), the World Health Organization Fetal Growth Curves (WHO), and the National Institutes of Child Health and Human Development Fetal Growth Studies unified standard (NICHD-U). The fit of our HC measurements to each norm was assessed by these criteria: mean z-score close to 0, standard deviation (SD) of z close to 1, low Kolmogorov-Smirnov D-statistic, high Youden J-statistic, close to 10% of exams >90th percentile, close to 10% of exams <10th percentile, and close to 2.28% of exams >2 SD below the mean. RESULTS In 23,565 ultrasound exams, our HC measurements had the best fit to the WHO standard (mean z-score 0.10, SD of z = 1.01, D-statistic <0.01, J-statistic 0.83-0.94). The SD of the Jeanty reference was much larger than all the other norms and our measurements, resulting in underdiagnosis of abnormal HC. The means of the IG-21st and NICHD-U standards were smaller than the other norms and our measurements, resulting in underdiagnosis of small HC. The means of the Hadlock reference were larger than all the other norms and our measurements, resulting in overdiagnosis of small HC. Restricting the analysis to a low-risk subgroup of 4,423 exams without risk factors for large- or small-for-gestational age produced similar results. CONCLUSION The WHO standard is likely best for diagnosis of abnormal HC. The Jeanty (Chervenak) reference suggested by the Society for Maternal-Fetal Medicine had poor sensitivity for microcephaly screening. KEY POINTS · There are >30 norms for fetal HC.. · It is unknown which norm should be used.. · The WHO standard fits our data best.. · The Chervenak reference is not sensitive for microcephaly..
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Affiliation(s)
- C Andrew Combs
- Pediatrix Center for Research, Education, Quality and Safety, Pediatrix Medical Group, Sunrise, Florida
- Obstetrix of San Jose, Campbell, California
| | | | | | | | - Sushma Amara
- Eastside Maternal-Fetal Medicine Specialists, Bellevue, Washington
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Sukenik-Halevy R, Mevorach N, Basel-Salmon L, Matar RT, Kahana S, Klein K, Agmon-Fishman I, Levy M, Maya I. Chromosomal microarray testing yield in 829 cases of microcephaly: a clinical characteristics-based analysis for prenatal and postnatal cases. Arch Gynecol Obstet 2024:10.1007/s00404-024-07388-3. [PMID: 38494511 DOI: 10.1007/s00404-024-07388-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 01/14/2024] [Indexed: 03/19/2024]
Abstract
INTRODUCTION Microcephaly, characterized by abnormal head growth, can often serve as an initial indicator of congenital, genetic, or acquired disorders. In this study, we sought to evaluate the effectiveness of chromosomal microarray (CMA) testing in detecting abnormalities in both prenatal and postnatal cases of microcephaly. MATERIALS AND METHODS CMA Testing: We conducted CMA testing on 87 prenatally-detected microcephaly cases and 742 postnatal cases at a single laboratory. We evaluated the CMA yield in relation to specific clinical characteristics. RESULTS In prenatal cases, pathogenic and likely pathogenic (LP) results were identified in 4.6% of cases, a significantly higher rate compared to low-risk pregnancies. The male-to-female ratio in this cohort was 3, and the CMA yield was not influenced by gender or other clinical parameters. For postnatal cases, the CMA yield was 15.0%, with a significantly higher detection rate associated with dysmorphism, hypotonia, epilepsy, congenital heart malformations (CHM), learning disabilities (LD), and a history of Fetal growth restriction (FGR). No specific recurrent copy number variations (CNVs) were observed, and the rate of variants of unknown significance was 3.9%. CONCLUSIONS The yield of CMA testing in prenatal microcephaly is lower than in postnatal cases (4.6% vs. 15%). The presence of microcephaly, combined with dysmorphism, hypotonia, epilepsy, CHD, LD, and FGR, significantly increases the likelihood of an abnormal CMA result.
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Affiliation(s)
- Rivka Sukenik-Halevy
- Genetic Institute, Meir Medical Center, Kfar Saba, Israel.
- School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
| | - Nir Mevorach
- Genetic Institute, Meir Medical Center, Kfar Saba, Israel
| | - Lina Basel-Salmon
- School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
- Recanati Genetic Institute, Rabin Medical Center, Petah Tikva, Israel
- Felsenstein Medical Research Center, Rabin Medical Center, Petah Tikva, Israel
- Pediatric Genetics Unit, Schneider Children's Medical Center, Petah Tikva, Israel
| | | | - Sarit Kahana
- Recanati Genetic Institute, Rabin Medical Center, Petah Tikva, Israel
| | - Kochav Klein
- Recanati Genetic Institute, Rabin Medical Center, Petah Tikva, Israel
| | | | - Michal Levy
- School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
- Recanati Genetic Institute, Rabin Medical Center, Petah Tikva, Israel
| | - Idit Maya
- School of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
- Recanati Genetic Institute, Rabin Medical Center, Petah Tikva, Israel
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Haddad L, Hadi E, Leibovitz Z, Lev D, Shalev Y, Gindes L, Lerman-Sagie T. Small size, big problems: insights and difficulties in prenatal diagnosis of fetal microcephaly. Front Neurosci 2024; 18:1347506. [PMID: 38533444 PMCID: PMC10964924 DOI: 10.3389/fnins.2024.1347506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/27/2024] [Indexed: 03/28/2024] Open
Abstract
Microcephaly is a sign, not a diagnosis. Its incidence varies widely due to the differences in the definition and the population being studied. It is strongly related to neurodevelopmental disorders. Differences in definitions and measurement techniques between fetuses and newborns pose a great challenge for the diagnosis and prognostication of fetal microcephaly. A false positive diagnosis can result (in countries where it is legal) in erroneous termination of pregnancy, where a false negative diagnosis might lead to the birth of a microcephalic newborn. Microcephaly in growth restricted fetuses deserves special attention and separate evaluation as it is an important prognostic factor, and not necessarily part of the general growth retardation. Several genetic syndromes incorporating microcephaly and intrauterine growth retardation (IUGR) are discussed. Deceleration of the head circumference (HC) growth rate even when the HC is still within normal limits might be the only clue for developing microcephaly and should be considered during fetal head growth follow up. Combining additional parameters such as a positive family history, associated anomalies, and new measurement parameters can improve prediction in about 50% of cases, and thus should be part of the prenatal workup. Advances in imaging modalities and in prenatal genetic investigation along with the emergence of new growth charts can also improve diagnostic accuracy. In this article, we review the different definitions and etiologies of fetal microcephaly, discuss difficulties in diagnosis, investigate the reasons for the low yield of prenatal diagnosis, and provide improvement suggestions. Finally, we suggest an updated algorithm that will aid in the diagnosis and management of fetal microcephaly.
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Affiliation(s)
- Leila Haddad
- Fetal Neurology Clinic, Wolfson Medical Center, Holon, Israel
- Obstetrics & Gynecology Ultrasound Unit, Wolfson Medical Center, Holon, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Efrat Hadi
- Fetal Neurology Clinic, Wolfson Medical Center, Holon, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Diagnostic Ultrasound Unit, The Institute of Obstetrical and Gynecological Imaging, Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel
| | - Zvi Leibovitz
- Obstetrics & Gynecology Ultrasound Unit, Bnai Zion Medical Center, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute, Haifa, Israel
| | - Dorit Lev
- Fetal Neurology Clinic, Wolfson Medical Center, Holon, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Medical Genetics Unit, Wolfson Medical Center, Holon, Israel
| | - Yoseph Shalev
- Obstetrics & Gynecology Ultrasound Unit, Wolfson Medical Center, Holon, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Liat Gindes
- Fetal Neurology Clinic, Wolfson Medical Center, Holon, Israel
- Obstetrics & Gynecology Ultrasound Unit, Wolfson Medical Center, Holon, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tally Lerman-Sagie
- Fetal Neurology Clinic, Wolfson Medical Center, Holon, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Neurology Unit, Wolfson Medical Center, Holon, Israel
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Chien SC, Chen CP. Genetic Counseling of Fetal Microcephaly. J Med Ultrasound 2024; 32:1-7. [PMID: 38665355 PMCID: PMC11040482 DOI: 10.4103/jmu.jmu_18_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 03/10/2023] [Indexed: 04/28/2024] Open
Abstract
Fetal microcephaly is a small head with various losses of cerebral cortical volume. The affected cases may suffer from a wide range in severity of impaired cerebral development from slight to severe mental retardation. It can be an isolated finding or with other anomalies depending on the heterogeneous causes including genetic mutations, chromosomal abnormalities, congenital infectious diseases, maternal alcohol consumption, and metabolic disorders during pregnancy. It is often a lifelong and incurable condition. Thus, early detection of fetal microcephaly and identification of the underlying causes are important for clinical staff to provide appropriate genetic counseling to the parents and accurate management.
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Affiliation(s)
| | - Chih-Ping Chen
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Biotechnology, Asia University, Taichung, Taiwan
- Institute of Clinical and Community Health Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Obstetrics and Gynecology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Medical Laboratory Science and Biotechnology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Pei SP, Guan HL, Jin F. Prenatal diagnosis of microcephaly through combined MRI and ultrasonography: Analysis of a case series. Medicine (Baltimore) 2023; 102:e36623. [PMID: 38115306 PMCID: PMC10727632 DOI: 10.1097/md.0000000000036623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/22/2023] [Indexed: 12/21/2023] Open
Abstract
INTRODUCTION Intrauterine microcephaly is a complex and lifelong condition that poses significant ethical challenges for clinicians and parents. The prognosis of microcephaly is highly variable and depends on the underlying cause and severity. In addition, microcephaly is often associated with various comorbidities, including intellectual disability, developmental delay, and epilepsy. Ultrasonography (US) is currently the most commonly used imaging modality for detecting microcephaly in the second trimester of pregnancy. However, antenatal brain magnetic resonance imaging (MRI) is increasingly being used as a more sensitive tool to identify structural abnormalities that may suggest a specific diagnosis. In this study, we report a case series of microcephaly diagnosed through the combination of MRI and US. PATIENT CONCERNS How to utilize a combination of MRI and US to screen for fetal microcephaly. DIAGNOSIS Based on the results of US and MRI examinations, patient 1 was found to have other craniocerebral malformations, patient 2 demonstrated macrogyria, and patient 3 exhibited skull irregularities. INTERVENTIONS The pregnancies of all 3 patients were terminated through the induction of labor by injecting Rivanol into the amniotic cavity. OUTCOMES The 3 patients were discharged after a period of observation. CONCLUSION US is an important tool for diagnosing fetal microcephaly. However, MRI can overcome the limitations of US and detect additional brain structural abnormalities, thereby providing more specific and valuable prenatal diagnostic information. Therefore, combining MRI and US has significant diagnostic value for fetal microcephaly.
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Affiliation(s)
- Shu-ping Pei
- Department of Obstetrics, Tongde hospital of Zhejiang province, Hangzhou, China
| | - Hai-lian Guan
- Department of Obstetrics, Tongde hospital of Zhejiang province, Hangzhou, China
| | - Feng Jin
- Department of Obstetrics, Tongde hospital of Zhejiang province, Hangzhou, China
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Dhombres F, Massoud M. [A pragmatic comparison of fetal biometry curves]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2023; 51:524-530. [PMID: 37739067 DOI: 10.1016/j.gofs.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
INTRODUCTION The fetal biometrics charts recommended in France for ultrasound screening include measurements of head circumference (HC), biparietal diameter (BIP), abdominal circumference (AC) and femur length (FL). New international growth standards have been recommended since 2022. The aim of this work is to quantitatively describe the differences between these biometric curves. METHODS The biometry curves from the French College for Fetal Ultrasound, OMS and INTERGROWTH-21 are pragmatically compared based on their original quantile regression equations (superposition and quantification of differences in millimeters and in proportion) for different percentiles of clinical interest. RESULTS Compared with the new charts, CFEF underestimates HC<-3DS and AC<10eP. The proportions of differences between the CFEF and INTERGROWTH-21 or WHO curves always remained <5%. The proportions of difference of the 3rd percentile of HC and FL, 10th and 90th percentile of AC were always lower than 2%, 2%, 5% and 4% respectively, between OMS and INTERGROWTH-21. CONCLUSION The switch to prescriptive standards suggests an improvement in the detection of fetuses with AC<10th percentile, an improvement in the detection of prenatal onset microcephaly, with no argument for a decrease in the detection rate of severe constitutional bone disease or modification of obstetrical guidelines.
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Affiliation(s)
- Ferdinand Dhombres
- Sorbonne université, AP-HP, hôpital Trousseau, service de médecine fœtale, GRC26 et inserm LIMICS, Paris, France.
| | - Mona Massoud
- Université Claude-Bernard Lyon I, hospices civils de Lyon, service obstétrique et médecine fœtale, centre hospitalier Lyon Sud, Lyon, France
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Moadab G, Pittet F, Bennett JL, Taylor CL, Fiske O, Singapuri A, Coffey LL, Van Rompay KKA, Bliss-Moreau E. Prenatal Zika virus infection has sex-specific effects on infant physical development and mother-infant social interactions. Sci Transl Med 2023; 15:eadh0043. [PMID: 37878673 DOI: 10.1126/scitranslmed.adh0043] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 10/02/2023] [Indexed: 10/27/2023]
Abstract
There is enormous variation in the extent to which fetal Zika virus (fZIKV) infection affects the developing brain. Despite the neural consequences of fZIKV infection observed in people and animal models, many open questions about the relationship between infection dynamics and fetal and infant development remain. To further understand how ZIKV affects the developing nervous system and the behavioral consequences of prenatal infection, we adopted a nonhuman primate model of fZIKV infection in which we inoculated pregnant rhesus macaques and their fetuses with ZIKV in the early second trimester of fetal development. We then tracked their health across gestation and characterized infant development across the first month of life. ZIKV-infected pregnant mothers had long periods of viremia and mild changes to their hematological profiles. ZIKV RNA concentrations, an indicator of infection magnitude, were higher in mothers whose fetuses were male, and the magnitude of ZIKV RNA in the mothers' plasma or amniotic fluid predicted infant outcomes. The magnitude of ZIKV RNA was negatively associated with infant growth across the first month of life, affecting males' growth more than females' growth, although for most metrics, both males and females evidenced slower growth rates as compared with control animals whose mothers were not ZIKV inoculated. Compared with control infants, fZIKV infants also spent more time with their mothers during the first month of life, a social behavior difference that may have long-lasting consequences on psychosocial development during childhood.
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Affiliation(s)
- Gilda Moadab
- Department of Psychology, University of California, Davis, Davis, CA 95616, USA
- California National Primate Research Center, University of California, Davis, Davis, CA 95616, USA
| | - Florent Pittet
- California National Primate Research Center, University of California, Davis, Davis, CA 95616, USA
| | - Jeffrey L Bennett
- Department of Psychology, University of California, Davis, Davis, CA 95616, USA
- California National Primate Research Center, University of California, Davis, Davis, CA 95616, USA
| | - Christopher L Taylor
- California National Primate Research Center, University of California, Davis, Davis, CA 95616, USA
| | - Olivia Fiske
- California National Primate Research Center, University of California, Davis, Davis, CA 95616, USA
| | - Anil Singapuri
- Department of Pathology, Microbiology and Immunology, University of California, Davis, Davis, CA 95616, USA
| | - Lark L Coffey
- Department of Pathology, Microbiology and Immunology, University of California, Davis, Davis, CA 95616, USA
| | - Koen K A Van Rompay
- California National Primate Research Center, University of California, Davis, Davis, CA 95616, USA
- Department of Pathology, Microbiology and Immunology, University of California, Davis, Davis, CA 95616, USA
| | - Eliza Bliss-Moreau
- Department of Psychology, University of California, Davis, Davis, CA 95616, USA
- California National Primate Research Center, University of California, Davis, Davis, CA 95616, USA
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Gafner M, Boltshauser E, D'Abrusco F, Battini R, Romaniello R, D'Arrigo S, Zanni G, Leibovitz Z, Yosovich K, Lerman-Sagie T. Expanding the natural history of CASK-related disorders to the prenatal period. Dev Med Child Neurol 2023; 65:544-550. [PMID: 36175354 DOI: 10.1111/dmcn.15419] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 08/24/2022] [Accepted: 08/24/2022] [Indexed: 11/30/2022]
Abstract
AIM To assess whether microcephaly with pontine and cerebellar hypoplasia (MICPCH) could manifest in the prenatal period in patients with calcium/calmodulin-dependent serine protein kinase (CASK) gene disorders. METHOD In this international multicentre retrospective study, we contacted a CASK parents' social media group and colleagues with expertise in cerebellar malformations and asked them to supply clinical and imaging information. Centiles and standard deviations (SD) were calculated according to age by nomograms. RESULTS The study consisted of 49 patients (44 females and 5 males). Information regarding prenatal head circumference was available in 19 patients; 11 out of 19 had a fetal head circumference below -2SD (range -4.1SD to -2.02SD, mean gestational age at diagnosis 20 weeks). Progressive prenatal deceleration of head circumference growth rate was observed in 15 out of 19. At birth, 20 out of 42 had a head circumference below -2SD. A total of 6 out of 15 fetuses had a TCD z-score below -2 (range -5.88 to -2.02). INTERPRETATION This study expands the natural history of CASK-related disorders to the prenatal period, showing evidence of progressive deceleration of head circumference growth rate, head circumference below -2SD, or small TCD. Most cases will not be diagnosed according to current recommendations for fetal central nervous system routine assessment. Consecutive measurements and genetic studies are advised in the presence of progressive deceleration of head circumference growth rates or small TCD. WHAT THIS PAPER ADDS Progressive deceleration of fetal head circumference growth rate can be observed. A small transcerebellar diameter is an additional important manifestation. Most cases will not be diagnosed according to current recommendations for fetal central nervous system routine assessment. Consecutive measurements are advised when measurements are within the low range of norm.
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Affiliation(s)
- Michal Gafner
- Department of Pediatrics B, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eugen Boltshauser
- Pediatric Neurology (Emeritus), Children's University Hospital, Zürich, Switzerland
| | - Fulvio D'Abrusco
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Roberta Battini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Department of Developmental Neuroscience, Istituto di Ricovero e Cura a Carattere Scientifico Fondazione Stella Maris, Pisa, Italy
| | - Romina Romaniello
- Neuropsychiatry and Neurorehabilitation Unit, Scientific Institute IRCCS, Italy
| | - Stefano D'Arrigo
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico 'Carlo Besta', Milan, Italy
| | - Ginevra Zanni
- Unit of Muscular and Neurodegenerative Disorders Laboratory of Molecular Medicine, Department of Neurosciences, Bambino Gesù Children's Hospital, Rome, Italy
| | - Zvi Leibovitz
- Obstetrics and Gynaecology Ultrasound Unit, Bnai-Zion Medical Center, Haifa, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Fetal Neurology Clinic, Wolfson Medical Center, Holon, Israel
| | - Keren Yosovich
- Magen Center for Rare Diseases, Wolfson Medical Center, Holon, Israel
- Molecular Genetics Laboratory, Wolfson Medical Center, Holon, Israel
| | - Tally Lerman-Sagie
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Fetal Neurology Clinic, Wolfson Medical Center, Holon, Israel
- Magen Center for Rare Diseases, Wolfson Medical Center, Holon, Israel
- Pediatric Neurology Unit, Wolfson Medical Center, Holon, Israel
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Gouveia I, Geraldo AF, Godinho C, Castedo S. Feingold syndrome type 1: a rare cause of fetal microcephaly (prenatal diagnosis). BMJ Case Rep 2023; 16:e254366. [PMID: 36889805 PMCID: PMC10008251 DOI: 10.1136/bcr-2022-254366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023] Open
Abstract
We report a case of fetal microcephaly found during the second trimester ultrasound and confirmed by further ultrasound scans and fetal MRI. The array comparative genomic hybridisation analysis of the fetus and the male parent showed a 1.5 Mb deletion overlapping the Feingold syndrome region, an autosomal dominant syndrome that can cause microcephaly, facial/hand abnormalities, mild neurodevelopmental delay and others. This case illustrates the need for a detailed investigation by a multidisciplinary team to provide prenatal counselling regarding a postnatal outcome to the parents and orient their decision towards the continuation or termination of pregnancy.
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Affiliation(s)
- Inês Gouveia
- Obstetrics and Gynecology, Centro Hospitalar de Vila Nova de Gaia Espinho EPE, Vila Nova de Gaia, Portugal
| | - Ana Filipa Geraldo
- Diagnostic Neuroradiology Unit, Radiology Department, Centro Hospitalar de Vila Nova de Gaia Espinho EPE, Vila Nova de Gaia, Portugal
| | - Cristina Godinho
- Obstetrics and Gynecology, Centro Hospitalar de Vila Nova de Gaia Espinho EPE, Vila Nova de Gaia, Portugal
| | - Sérgio Castedo
- Genetics Department of Faculty of Medicine, Universidade do Porto, Porto, Portugal
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
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Sukenik-Halevy R, Golbary Kinory E, Laron Kenet T, Brabbing-Goldstein D, Gilboa Y, Basel-Salmon L, Perlman S. Prenatal gender-customized head circumference nomograms result in reclassification of microcephaly and macrocephaly. AJOG GLOBAL REPORTS 2023; 3:100171. [PMID: 36864987 PMCID: PMC9972400 DOI: 10.1016/j.xagr.2023.100171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Local and worldwide prenatal charts for estimated fetal weight and postnatal charts for head circumference are gender specific. However, prenatal head circumference nomograms are not gender customized. OBJECTIVE This study aimed to create gender-customized curves to assess between-gender head circumference differences and to study the clinical significance of using such gender-customized curves. STUDY DESIGN A single-center retrospective study was conducted between June 2012 and December 2020. Prenatal head circumference measurements were obtained from routine estimated fetal weight ultrasound scans. Postnatal head circumference measurement at birth and gender were retrieved from computerized neonatal files. Head circumference curves were created, and the normal range was defined for the male and female subpopulations. After applying gender-specific curves, we analyzed the outcome of cases classified as microcephaly and macrocephaly according to non-gender-customized curves, which were reclassified as normal according to gender-specific curves. For these cases, clinical information and postnatal long-term outcomes were retrieved from patients' medical records. RESULTS The cohort included 11,404 participants (6000 males and 5404 females). The curve for male head circumference was significantly higher than the female curve for all gestational weeks (P<.0001). Applying gender customized curves resulted in fewer cases of male fetuses defined as 2 standard deviations above the normal range and female fetuses defined as 2 standard deviations below of the normal range. Cases reclassified as normal head circumference after the application of gender-customized curves were not related to increased adverse postnatal outcomes. The rate of neurocognitive phenotypes was not higher than the expected rate in both male and female cohorts. Polyhydramnios and gestational diabetes mellitus were more common in the normalized male cohort, whereas oligohydramnios, fetal growth restriction, and cesarean delivery were more common in the normalized female cohort. CONCLUSION Prenatal gender-customized curves for head circumference can reduce the overdiagnosis of microcephaly in females and macrocephaly in males. According to our results, gender-customized curves did not affect the clinical yield of prenatal measurements. Therefore, we suggest that gender-specific curves be used to avoid unnecessary workup and parental anxiety.
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Affiliation(s)
- Rivka Sukenik-Halevy
- Raphael Recanati Genetic Institute, Rabin Medical Center - Beilinson Hospital, Petah Tikva, Israel (Prof. Sukenik-Halevy, Dr Brabbing-Goldstein, and Prof. Basel-Salmon)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (Prof. Sukenik-Halevy, Dr. Ms Gollbary Kinory, Prof. Gilboa, Basel-Salmon, and Perlman)
- Genetic Institute, Meir Medical Center, Kfar Saba, Israel (Prof. Sukenik-Halevy)
- Corresponding author: Rivka Sukenik-Halevy, MD
| | - Ella Golbary Kinory
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (Prof. Sukenik-Halevy, Dr. Ms Gollbary Kinory, Prof. Gilboa, Basel-Salmon, and Perlman)
| | - Tamar Laron Kenet
- Neonatal Department, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel (Dr Laron Kenet)
| | - Dana Brabbing-Goldstein
- Raphael Recanati Genetic Institute, Rabin Medical Center - Beilinson Hospital, Petah Tikva, Israel (Prof. Sukenik-Halevy, Dr Brabbing-Goldstein, and Prof. Basel-Salmon)
- Ultrasound Unit, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel (Dr Brabbing-Goldstein, Prof. Gilboa, and Perlman)
| | - Yinon Gilboa
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (Prof. Sukenik-Halevy, Dr. Ms Gollbary Kinory, Prof. Gilboa, Basel-Salmon, and Perlman)
- Ultrasound Unit, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel (Dr Brabbing-Goldstein, Prof. Gilboa, and Perlman)
| | - Lina Basel-Salmon
- Raphael Recanati Genetic Institute, Rabin Medical Center - Beilinson Hospital, Petah Tikva, Israel (Prof. Sukenik-Halevy, Dr Brabbing-Goldstein, and Prof. Basel-Salmon)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (Prof. Sukenik-Halevy, Dr. Ms Gollbary Kinory, Prof. Gilboa, Basel-Salmon, and Perlman)
- Pediatric Genetics Clinic, Schneider Children's Medical Center of Israel, Petah Tikva, Israel (Prof. Basel-Salmon)
- Felsenstein Medical Research Center, Petah Tikva, Israel (Prof. Basel-Salmon)
| | - Sharon Perlman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (Prof. Sukenik-Halevy, Dr. Ms Gollbary Kinory, Prof. Gilboa, Basel-Salmon, and Perlman)
- Ultrasound Unit, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel (Dr Brabbing-Goldstein, Prof. Gilboa, and Perlman)
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12
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Fetal Ultrasound and Magnetic Resonance Imaging Abnormalities in Congenital Cytomegalovirus Infection Associated with and without Fetal Growth Restriction. Diagnostics (Basel) 2023; 13:diagnostics13020306. [PMID: 36673117 PMCID: PMC9857471 DOI: 10.3390/diagnostics13020306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/18/2023] Open
Abstract
Congenital cytomegalovirus infection (cCMV) can cause fetal growth restriction (FGR) and severe sequelae in affected infants. Clinicians generally suspect cCMV based on multiple ultrasound (US) findings associated with cCMV. However, no studies have assessed the diagnostic accuracy of fetal US for cCMV-associated abnormalities in FGR. Eight FGR and 10 non-FGR fetuses prenatally diagnosed with cCMV were examined by undergoing periodic detailed US examinations, as well as postnatal physical and imaging examinations. The diagnostic accuracy of prenatal US for cCMV-associated abnormalities was compared between FGR and non-FGR fetuses with cCMV. The diagnostic sensitivity rates of fetal US for cCMV-related abnormalities in FGR vs. non-FGR fetuses were as follows: ventriculomegaly, 66.7% vs. 88.9%; intracranial calcification, 20.0% vs. 20.0%; cysts and pseudocysts in the brain, 0% vs. 0%; ascites, 100.0% vs. 100.0%; hepatomegaly, 40.0% vs. 100.0%; splenomegaly, 0% vs. 0%. The diagnostic sensitivity of fetal US for hepatomegaly and ventriculomegaly in FGR fetuses with cCMV was lower than that in non-FGR fetuses with cCMV. The prevalence of severe long-term sequelae (e.g., bilateral hearing impairment, epilepsy, cerebral palsy, and severe developmental delay) in the CMV-infected fetuses with FGR was higher, albeit non-significantly. Clinicians should keep in mind the possibility of overlooking the symptoms of cCMV in assessing fetuses with FGR.
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Leibovitz Z, Lerman-Sagie T, Haddad L. Fetal Brain Development: Regulating Processes and Related Malformations. Life (Basel) 2022; 12:life12060809. [PMID: 35743840 PMCID: PMC9224903 DOI: 10.3390/life12060809] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 11/16/2022] Open
Abstract
This paper describes the contemporary state of knowledge regarding processes that regulate normal development of the embryonic–fetal central nervous system (CNS). The processes are described according to the developmental timetable: dorsal induction, ventral induction, neurogenesis, neuronal migration, post-migration neuronal development, and cortical organization. We review the current literature on CNS malformations associated with these regulating processes. We specifically address neural tube defects, holoprosencephaly, malformations of cortical development (including microcephaly, megalencephaly, lissencephaly, cobblestone malformations, gray matter heterotopia, and polymicrogyria), disorders of the corpus callosum, and posterior fossa malformations. Fetal ventriculomegaly, which frequently accompanies these disorders, is also reviewed. Each malformation is described with reference to the etiology, genetic causes, prenatal sonographic imaging, associated anomalies, differential diagnosis, complimentary diagnostic studies, clinical interventions, neurodevelopmental outcome, and life quality.
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Affiliation(s)
- Zvi Leibovitz
- Obstetrics-Gynecology Ultrasound Unit, Department of Obstetrics and Gynecology, Fetal Neurology Clinic, Wolfson Medical Center, Holon and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 5822012, Israel;
- Obstetrics-Gynecology Ultrasound Unit, Bnai-Zion Medical Center, Rappaport Faculty of Medicine, The Technion, Haifa 31048, Israel;
- Correspondence:
| | - Tally Lerman-Sagie
- Obstetrics-Gynecology Ultrasound Unit, Department of Obstetrics and Gynecology, Fetal Neurology Clinic, Wolfson Medical Center, Holon and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 5822012, Israel;
- Pediatric Neurology Unit, Wolfson Medical Center, Holon and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 5822012, Israel
| | - Leila Haddad
- Obstetrics-Gynecology Ultrasound Unit, Bnai-Zion Medical Center, Rappaport Faculty of Medicine, The Technion, Haifa 31048, Israel;
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Fried S, Gafner M, Jeddah D, Gosher N, Hoffman D, Ber R, Mayer A, Katorza E. Correlation between 2D and 3D Fetal Brain MRI Biometry and Neurodevelopmental Outcomes in Fetuses with Suspected Microcephaly and Macrocephaly. AJNR Am J Neuroradiol 2021; 42:1878-1883. [PMID: 34385141 DOI: 10.3174/ajnr.a7225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 05/03/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Definitions of fetal microcephaly and macrocephaly are debatable. A better understanding of their long-term prognoses would help guide parental education and counseling. This study aimed to explore the correlation between 2D and 3D fetal brain MR imaging biometry results and the long-term neurodevelopmental outcomes. MATERIALS AND METHODS This analysis is a historical cohort study. Fetal brain biometry was measured on 2D and 3D MR imaging using a volumetric MR imaging semiautomated algorithm. We measured and assessed the following brain structures: the supratentorial brain volume and cerebellar volume and cerebellar volume/supratentorial brain volume ratio, in addition to commonly used 2D brain MR imaging biometric variables, including occipitofrontal diameter, biparietal diameter, and transcerebellar diameter. Microcephaly was defined as ≤ 3rd percentile; and macrocephaly, as ≥ 97th percentile, corresponding to -2 SDs and +2 SDs. The neurodevelopmental outcome of this study cohort was evaluated using the Vineland-II Adaptive Behavior Scales, and the measurements were correlated to the Vineland standard scores. RESULTS A total of 70 fetuses were included. No significant correlation was observed between the Vineland scores and either the supratentorial brain volume, cerebellar volume, or supratentorial brain volume/cerebellar volume ratio in 3D or 2D MR imaging measurements, after correction for multiple comparisons. No differences were found among fetuses with macrocephaly, normocephaly, or microcephaly regarding the median Vineland standard scores. CONCLUSIONS Provided there is normal brain structure on MR imaging, the developmental milestone achievements in early years are unrelated to 2D and 3D fetal brain MR imaging biometry, in the range of measurements depicted in this study.
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Affiliation(s)
- S Fried
- From the Sackler School of Medicine (S.F., M.G., D.J., D.H., R.B., A.M., E.K.), Tel-Aviv University, Tel-Aviv, Israel
- Department of Obstetrics and Gynecology (S.F., E.K.), Sheba Medical Center, Tel-Hashomer, Israel
| | - M Gafner
- From the Sackler School of Medicine (S.F., M.G., D.J., D.H., R.B., A.M., E.K.), Tel-Aviv University, Tel-Aviv, Israel
- Department of Pediatrics B (M.G.), Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - D Jeddah
- From the Sackler School of Medicine (S.F., M.G., D.J., D.H., R.B., A.M., E.K.), Tel-Aviv University, Tel-Aviv, Israel
| | - N Gosher
- Hadassah Medical School (N.G.), The Hebrew University of Jerusalem, Jerusalem, Israel
| | - D Hoffman
- From the Sackler School of Medicine (S.F., M.G., D.J., D.H., R.B., A.M., E.K.), Tel-Aviv University, Tel-Aviv, Israel
| | - R Ber
- From the Sackler School of Medicine (S.F., M.G., D.J., D.H., R.B., A.M., E.K.), Tel-Aviv University, Tel-Aviv, Israel
| | - A Mayer
- From the Sackler School of Medicine (S.F., M.G., D.J., D.H., R.B., A.M., E.K.), Tel-Aviv University, Tel-Aviv, Israel
- Department of Diagnostic Radiology (A.M.), Sheba Medical Center, Tel-Hashomer, Israel
| | - E Katorza
- From the Sackler School of Medicine (S.F., M.G., D.J., D.H., R.B., A.M., E.K.), Tel-Aviv University, Tel-Aviv, Israel
- Department of Obstetrics and Gynecology (S.F., E.K.), Sheba Medical Center, Tel-Hashomer, Israel
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The Accuracy of Sonographic Fetal Head Circumference in Twin Pregnancies. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2021; 43:1159-1163. [PMID: 33621678 DOI: 10.1016/j.jogc.2021.02.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess the accuracy of sonographic estimation of fetal head circumference in twin gestations. METHODS A retrospective analysis of sonographic evaluations of twin gestations >34 weeks, performed within 7 days of delivery, in a single university-affiliated medical centre. Sonographic head circumference was compared with neonatal head circumference. Measures of accuracy included systematic error, random error, proportion of estimates within 5% of neonatal head circumference, and reliability analysis. Accuracy of sonographic head circumference was compared between the first and second twin. RESULTS Overall, 103 twin gestations were evaluated at a median of 4 days before delivery. The majority of twins were dichorionic-diamniotic (83%). Median gestational age at delivery was 37 weeks, with a median birthweight of 2645 grams for the first twin and 2625 grams for the second twin. For all fetuses, median sonographic head circumference was lower than the neonatal head circumference (first twin: 317.5 vs. 330 mm; second twin: 318.4 vs. 330 mm, P > 0.05 for both). Measures of accuracy showed no significant difference between first and second twin. There was no difference in the number of sonographic head circumference evaluations that were within 5% of the neonatal head circumference between fetuses (64% for both twins). Cronbach α value was higher for the second twin (0.746 vs. 0.613), suggesting higher accuracy for head circumference measurement for the second twin. CONCLUSION In our cohort, sonographic head circumference underestimated postnatal head circumference. Accuracy measurements were not significantly different between the first and second twin.
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Bardin R, Krispin E, Salman L, Navon I, Shmueli A, Perlman S, Gilboa Y, Hadar E. Association of term isolated microcephaly with mode of delivery and perinatal outcome - a retrospective case-control analysis. BMC Pregnancy Childbirth 2021; 21:115. [PMID: 33563226 PMCID: PMC7871588 DOI: 10.1186/s12884-021-03613-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 02/02/2021] [Indexed: 11/10/2022] Open
Abstract
Background We aimed to evaluate the association of isolated fetal microcephaly measured by ultrasound prior to delivery at term with mode of delivery and perinatal outcome. Methods A single-center retrospective study was conducted in 2012–2016. Fetal microcephaly was defined as head circumference > 2 standard deviations of the mean for gestational age and sex. We compared the obstetric, delivery, and outcome parameters of women in whom ultrasound performed up to 10 days prior to term delivery showed isolated fetal microcephaly (study group) or normal head circumference (reference group). Exclusion criteria were intrauterine fetal death, birthweight below the 10th percentile, and antepartum cesarean delivery for any indication. Results Of 3677 women included in the study, 26 (0.7%) had a late ultrasound finding of isolated fetal microcephaly. Baseline characteristics were similar in the two groups except for estimated fetal weight based on abdominal circumference and biparietal diameter, which was lower in the microcephaly group (3209.8 ± 557.6 vs. 2685.8 ± 420.8 g, p < .001). There was no significant between-group difference in rate of vaginal operative deliveries (11.7% vs 14.8%, respectively, p = 0.372). The study group had no intrapartum cesarean deliveries compared to 6.3% of the reference group (NS). Compared to controls, neonates in the study group were smaller (3323.2 ± 432.2 vs. 2957.0 ± 330.4 g, p < .001), with lower birthweight percentile (60.5 ± 26.5 vs. 33.6 ± 21.5%, p < .001) and were more often males (48.2 vs. 90.0%, p < .001). No significant differences were noted in perinatal outcomes between the groups, including admission to neonatal intensive care unit, intraventricular hemorrhage, 5-min Apgar score < 7, asphyxia, seizures, and sepsis. Conclusions Isolated microcephaly in term fetuses is not advantageous for a vaginal delivery, nor does it does not pose a greater than normal risk of adverse perinatal outcome.
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Affiliation(s)
- Ron Bardin
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Eyal Krispin
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lina Salman
- Hillel Yaffe Medical Center, Hadera; affiliated to Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | - Inbal Navon
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anat Shmueli
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sharon Perlman
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yinon Gilboa
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eran Hadar
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva; affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Immunoglobulin fetal therapy and neonatal therapy with antiviral drugs improve neurological outcome of infants with symptomatic congenital cytomegalovirus infection. J Reprod Immunol 2020; 143:103263. [PMID: 33422744 DOI: 10.1016/j.jri.2020.103263] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/09/2020] [Accepted: 11/25/2020] [Indexed: 11/20/2022]
Abstract
Infants with symptomatic congenital cytomegalovirus infection (cCMV) suffer from long-term sequelae. This study aimed at evaluating the efficacy of combining immunoglobulin (Ig) fetal therapy (FT) and neonatal therapy (NT) with antiviral drugs to improve neurological outcomes of affected infants. Women whose fetuses had symptomatic cCMV received Ig injection into the fetal peritoneal cavity and/or maternal blood as FT, while affected newborns received oral valganciclovir or intravenous ganciclovir as NT. We compared the neurological outcomes at ≥18 months old between infants receiving FT with or without NT (FT group) and those receiving NT only (NT group). From 2009-2019, 15 women whose fetuses had symptomatic cCMV received FT, while 19 newborns received NT only. In FT group, two newborns died, and two were <18 months old. Neurological outcomes of the remaining 11 infants in FT group were as follows: normal 45.5 %, mild impairments 36.4 %, and severe impairments 18.2 %. In NT group, one newborn died, one's parents refused the follow-up, one was <18 months old, and two had only chorioretinitis as symptoms. Neurological outcomes of the remaining 14 infants in NT group were as follows: normal 21.4 %, mild impairments 14.3 %, and severe impairments 64.3 %. The proportion of infants with severe impairments in FT group was significantly lower than that in NT group (18.2 % vs 64.3 %, p < 0.05). This is the first trial demonstrating that the combination of Ig FT and NT with antiviral drugs may be more effective in improving neurological outcomes of newborns with symptomatic cCMV as compared to NT only.
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Gafner M, Fried S, Gosher N, Jeddah D, Sade EK, Barzilay E, Mayer A, Katorza E. Fetal Brain Biometry: Is there an Agreement among Ultrasound, MRI and the Measurements at Birth? Eur J Radiol 2020; 133:109369. [PMID: 33126174 DOI: 10.1016/j.ejrad.2020.109369] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/18/2020] [Accepted: 10/20/2020] [Indexed: 01/02/2023]
Abstract
PURPOSE Measurement of the fetal brain can be achieved by different modalities, we aimed to assess the agreement between these methods and the head circumference at birth. METHODS A retrospective study conducted between 2011-2018 at a tertiary referral medical center. Sonographic head circumference (HC), 2D MRI bi-parietal diameter (BPD) and occipito-frontal diameter (OFD), 3D MRI supra-tentorial volume (STV), and head circumference (HC) at birth were measured and converted into centiles according to gestational age. Spearman's rank correlation coefficient was used to assess the correlation between the modalities. RESULTS A total of 88 fetuses were included. Mean gestational age at the time of fetal US and brain MRI acquisition were 34.4 ± 2.8 and 34.6 ± 2.6 weeks, respectively. A correlation was found between prenatal sonographic HC and the 3D MRI STV centiles (Rs = 0.859, p < 0.001), the BPD in 2D MRI (Rs = 0.813, p < 0.001), and the OFD in 2D MRI (Rs = 0.840, p < 0.001). Sonographic HC, OFD on 2D MRI, and STV on 3D MRI were all found to be correlated with the HC at birth (Rs = 0.865, p < 0.001; Rs 0.816, p < 0.001; Rs = 0.825, p < 0.001, respectively). CONCLUSIONS There is a statistically significant agreement among the different prenatal clinically used modalities for measuring fetal brain and the head circumference at birth, however, this correlation is not perfect. Further study is needed to investigate the long-term prognosis of these fetuses.
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Affiliation(s)
- Michal Gafner
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | - Shalev Fried
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Noa Gosher
- Hadassah Medical School, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Danielle Jeddah
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Eliel Kedar Sade
- Department of Obstetrics and Gynecology, Samson Assuta Ashdod Hospital, Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel
| | - Eran Barzilay
- Department of Obstetrics and Gynecology, Samson Assuta Ashdod Hospital, Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel
| | - Arnaldo Mayer
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Department of Diagnostic Radiology, Sheba Medical Center, Ramat-Gan, Israel
| | - Eldad Katorza
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Department of Diagnostic Radiology, Sheba Medical Center, Ramat-Gan, Israel; Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat-Gan, Israel
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De Bie I, Boucoiran I. N o 380 - Évaluation et prise en charge de la microcéphalie détectée avant la naissance. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2020; 41:862-869. [PMID: 31126435 DOI: 10.1016/j.jogc.2019.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIF Informer les fournisseurs canadiens de soins de santé périnatale des critères diagnostiques de la microcéphalie fœtale et fournir l'information sur les analyses pertinentes, le pronostic, et la prise en charge prénatale et périnatale en lien avec a cette observation prénatale. DESTINATAIRES Tous les fournisseurs de soins de maternité (fournisseurs principaux de soins de santé) et de soins de pédiatrie; les conseiller(e)s en génétique; les infirmièr(e)s en soins de maternité; les infirmièr(e)s practicien(ne)s, les administrateur(trice)s provinciaux de soins de maternité; les étudiant(e)s, en médecine; les résident(e)s postdoctoraux et les stagiaires (fellows). RéSULTATS: Fournir de meilleurs conseils et une prise en charge clinique adéquate aux femmes et aux familles qui ont reçu un diagnostic prénatal de microcéphalie fœtale. DONNéES PROBANTES: La documentation publiée est tirée de recherches effectuées en 2018 dans le moteur PubMed et les bases de données Medline, CINAHL et Cochrane Library au moyen de mots-clés anglais pertinents (prenatal ultrasound, prenatal imaging, fetal, antenatal ou prenatal microcephaly). Des publications supplémentaires ont été sélectionnées à partir des notices bibliographiques de ces articles. PéRIODE DE RECHERCHE: Sept ans (2010-2018); la dernière recherche a été effectuée le 19 avril 2018. L'auteur principal a terminé la validation des articles. AVANTAGES, PRéJUDICES ET COûTS: Le présent document renseigne les lecteurs au sujet (1) des critères diagnostiques de la microcéphalie fœtale, (2) de ses étiologies potentielles et (3) des analyses et options de prise en charge avant et après la naissance. Il propose une méthode fondée sur des données probantes pour établir le diagnostic et déterminer la prise en charge de la microcéphalie détectée avant la naissance. Ces recommandations sont fondées sur l'opinion d'experts, mais n'ont pas fait l'objet d'une évaluation économique de la santé. Une mise en œuvre aux échelles locale ou provinciale sera requise. Les auteurs reconnaissent que l'accès aux services et ressources mentionnés varie au Canada. Par conséquent, ces recommandations ont été formulées dans la perspective de promouvoir l'accès et de fournir une orientation pour toutes les provinces et tous les territoires du pays. CRITèRES: La solidité des données probantes indiquées s'appuie sur les critères décrits dans le rapport du Groupe d'étude canadien sur les soins de santé préventifs. RECOMMANDATIONS.
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De Bie I, Boucoiran I. No. 380-Investigation and Management of Prenatally Identified Microcephaly. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2020; 41:855-861. [PMID: 31126434 DOI: 10.1016/j.jogc.2018.10.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To update Canadian maternity care and reproductive health care providers on the diagnostic criteria of fetal microcephaly and provide information on the relevant investigations, prognosis, and pre- and perinatal management of this prenatal finding. INTENDED USERS All maternity care (most responsible health provider [MRHP]) and pediatric providers; genetic counsellors; maternity nurses; nurse practitioners; provincial maternity care administrators; medical students; postgraduate residents, and fellows. OUTCOMES To provide better counselling and appropriate clinical management to women and families who have received a prenatal diagnosis of fetal microcephaly. EVIDENCE Published literature was retrieved through searches of PubMed or Medline, CINAHL, and The Cochrane Library in 2018, using appropriate key words (prenatal ultrasound, prenatal imaging, fetal, antenatal, or prenatal microcephaly). Additional publications were identified from the bibliographies of these articles. SEARCH PERIOD Seven years (2010-2018); completed final search April 19, 2018. The primary author completed validation of the articles. BENEFITS, HARMS, AND COSTS This document educates readers about (1) the diagnostic criteria for fetal microcephaly, (2) its potential etiologies, (3) investigation and management options both pre- and postnatally. It proposes an evidence-based approach to the diagnosis and management of prenatally detected microcephaly. These recommendations are based on expert opinion and have not been subjected to a health economics assessment. Local or provincial implementation will be required. The authors recognize that there is variability across Canada in access to the cited services and resources. As such, these recommendations were developed in an attempt to promote access and to provide guidance for all provinces and territories across the country. VALUES The quality of evidence was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care. RECOMMENDATIONS
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Pasternak Y, Singer A, Maya I, Sagi-Dain L, Ben-Shachar S, Khayat M, Greenbaum L, Feingold-Zadok M, Zeligson S, Sukenik Halevy R. The yield of chromosomal microarray testing for cases of abnormal fetal head circumference. J Perinat Med 2020; 48:553-558. [PMID: 32721143 DOI: 10.1515/jpm-2020-0048] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Chromosomal microarray analysis (CMA) is the method of choice for genetic work-up in cases of fetal malformations. We assessed the detection rate of CMA in cases of abnormal fetal head circumference (HC). METHODS The study cohort was based on 81 cases of amniocenteses performed throughout Israel for the indication of microcephaly (53) or macrocephaly (28), from January 2015 through December 2018. We retrieved data regarding the clinical background, parental HCs and work-up during the pregnancy from genetic counseling summaries and from patients' medical records. RESULTS There was only one likely pathogenic CMA result (1.89%): a 400-kb microdeletion at 16p13.3 detected in a case of isolated microcephaly. No pathogenic results were found in the macrocephaly group. Most fetuses with microcephaly were female (87.8%), while the majority with macrocephaly were males (86.4%). CONCLUSIONS The results imply that CMA analysis in pregnancies with microcephaly may carry a small yield compared to other indications. Regarding macrocephaly, our cohort was too small to draw conclusions. In light of the significant gender effect on the diagnosis of abnormal HC, standardization of fetal HC charts according to fetal gender may normalize cases that were categorized outside the normal range and may increase the yield of CMA for cases of abnormal HC.
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Affiliation(s)
- Yael Pasternak
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amihood Singer
- Community Genetics, Public Health Services, Ministry of Health, Jerusalem, Israel
| | - Idit Maya
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Recanati Genetic Institute, Rabin Medical Center, Petah Tikva, Israel
| | - Lena Sagi-Dain
- Genetics Institute, Carmel Medical Center, affiliated to the Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Shay Ben-Shachar
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Genetics Institute, Sorasky Medical Center, Tel Aviv, Israel
| | - Morad Khayat
- Institute of Human Genetics, Haemek Medical Center, Afula, Israel
| | - Lior Greenbaum
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; The Danek Gertner Institute of Human Genetics, Sheba Medical Center, Tel Hashomer, Israel; and The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Israel
| | | | - Sharon Zeligson
- Medical Genetics Institute, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Rivka Sukenik Halevy
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Recanati Genetic Institute, Rabin Medical Center, Petah Tikva, Israel
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22
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Sanapo L, Herrera N, Cristante C, Bulas DI, Russo S, Schlatterer SD, du Plessis AJ, Mulkey SB. How prenatal head ultrasound reference ranges affect evaluation of possible fetal microcephaly. J Matern Fetal Neonatal Med 2019; 34:2529-2534. [PMID: 31533505 DOI: 10.1080/14767058.2019.1670163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Different fetal ultrasound (US) nomograms of the head circumference (HC) have been established; however, comparisons between the detection rates of microcephaly among US nomograms are few and inconsistent. We aimed to compare the prenatal diagnostic rate of fetal microcephaly (FM) among four widely used US nomograms of the fetal HC, when applied to the same group of fetuses. METHODS We retrospectively identified singleton pregnancies complicated by fetal HC < 5th percentile for gestational age (GA) by US, without other risk factors for FM and with normal fetal brain MRI. Raw values of HC by US were converted to z-scores using four nomograms (Chervenak = A, Hadlock = B, Gelber = C, Papageorghiou = D). Z-scores value of the HC were classified as normal, possible normal, or microcephaly if values were >-2, ≤ -2 and >-3, or ≤ -3, respectively and compared among the four nomograms. RESULTS Fifty one fetuses at a mean (±SD) GA of 28 (±4) weeks were included. The four nomograms resulted in different z-score values of the fetal HC for the same subject (p < .001) and none of them showed 100% agreement. Reference C and D showed the highest agreement in classifying subjects as normal, possible normal, or with microcephaly (simple Kappa = 0.8915, % agreement = 94.1%), while A and B had the lowest agreement (simple Kappa = 0.0977, % agreement = 51.0%). CONCLUSIONS Despite the use of similar prenatal cutoff z-score values of the fetal HC, the four nomograms led to different diagnostic rates of FM. More consistent diagnostic criteria are therefore needed to define FM, especially in the absence of other risk factors for FM and normal fetal brain MRI, since the prenatal diagnosis can affect pregnancy management.
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Affiliation(s)
- Laura Sanapo
- Division of Fetal and Transitional Medicine, Children's National Health System, Washington, DC, USA.,Department of Clinical Research & Leadership School of Medicine and Health Sciences, George Washington University, Washington, DC, USA
| | - Nicole Herrera
- Division of Biostatistics and Study Methodology, Children's National Health System, Washington, DC, USA
| | - Caitlin Cristante
- Division of Fetal and Transitional Medicine, Children's National Health System, Washington, DC, USA
| | - Dorothy I Bulas
- Division of Diagnostic Imaging and Radiology, Children's National Health System, Washington, DC, USA
| | - Stephanie Russo
- Division of Fetal and Transitional Medicine, Children's National Health System, Washington, DC, USA
| | - Sarah D Schlatterer
- Division of Fetal and Transitional Medicine, Children's National Health System, Washington, DC, USA
| | - Adre J du Plessis
- Division of Fetal and Transitional Medicine, Children's National Health System, Washington, DC, USA.,Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.,Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Sarah B Mulkey
- Division of Fetal and Transitional Medicine, Children's National Health System, Washington, DC, USA.,Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.,Department of Neurology, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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23
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Wilkof Segev R, Gelman M, Maor-Sagie E, Shrim A, Hallak M, Gabbay-Benziv R. New reference values for biometrical measurements and sonographic estimated fetal weight in twin gestations and comparison to previous normograms. J Perinat Med 2019; 47:757-764. [PMID: 31373899 DOI: 10.1515/jpm-2019-0207] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 07/15/2019] [Indexed: 11/15/2022]
Abstract
Objective To construct new reference values for biometrical measurements and sonographic estimated fetal weight (sEFW) in twin gestations and compare them to previously published normograms. Methods A retrospective analysis of sEFW evaluations of twin gestations was performed between 2011 and 2016 in a single university-affiliated medical center. sEFW was calculated using the Hadlock 1985 formula. To avoid selection bias, one evaluation per pregnancy was randomly selected. Following mathematical transformation to obtain normality of values, normograms were constructed using a best-fit regression model for estimation of mean and standard deviation at each gestational age (GA). Normograms were validated by applying all observations to ensure equal distribution at parallel percentiles. Our normograms were then compared to previously published sEFW normograms for twin gestations. Results A total of 864 sEFW evaluations were performed on 195 twin pregnancies at 22-39 gestational weeks. Of them, 390 entered the primary analysis. The rest were left for validation. Seventy percent of the cohort were dichorionic-diamniotic twins (136/195), 16% (32/195) were monochorionic-diamniotic twins and three (1.5%) were monochorionic-monoamniotic twins. Twenty-four fetuses lacked data on chorionicity. The rest were monochorionic twins or were of unknown chorionicity. Values corresponding to the 2.5th, 10th, 50th, 90th and 97.5th percentiles for sEFW are presented for every GA. Validation by applying all 864 evaluations on constructed normograms was achieved. Comparison to previously published twins' sEFW normograms demonstrated wide variation between curves. Conclusion New reference values for biometrical measurements and sEFW in twin gestations are presented for clinical and research use. Comparison to other curves demonstrates the wide variability and need for further investigation on twin's normal growth.
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Affiliation(s)
- Renana Wilkof Segev
- Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera 38100, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
| | - Milana Gelman
- Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera 38100, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
| | - Esther Maor-Sagie
- Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera 38100, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
| | - Alon Shrim
- Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera 38100, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
| | - Mordechai Hallak
- Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera 38100, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
| | - Rinat Gabbay-Benziv
- Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera 38100, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
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24
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Ultrasound diagnosis of microcephaly: a comparison of three reference curves and postnatal diagnosis. Arch Gynecol Obstet 2019; 300:1211-1219. [PMID: 31493089 DOI: 10.1007/s00404-019-05234-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 06/27/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE To evaluate which reference curve (RC)-Snijders, Intergrowth 21st (IG21) and World Health Organization (WHO)-is more accurate for microcephaly diagnosis. METHODS Retrospective cohort study with more than 30,000 exams in more than 11,000 women. Microcephaly was confirmed by a neonatologist at birth and positive predictive values (PPVs) and misdiagnosis were assessed. RESULTS A total of 71 cases were confirmed as microcephaly at birth. IG21 and Snijders PPVs showed to be more significant over WHO's (p < 0.001), without difference between them (p = 0.39). All RC were superimposed and did not show significant difference. When evaluated in different fragments, three trends were observed (until 30 weeks, between 30 and 36 and after 36 weeks of gestational age), with the latter interval showing a significant difference between IG21 and WHO (p = 0.0079). Conversely, WHO exhibited only one misdiagnosis, a much lower rate than Snijders, who missed eight cases and IG21, nine. CONCLUSION WHO's RC appears to misdiagnose fewer cases, which could be useful for a population screening, while IG21's RC presented a more significant PPV, being more useful for a more precise final diagnosis in reference centers.
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25
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Leibovitz Z, Lerman-Sagie T. Diagnostic approach to fetal microcephaly. Eur J Paediatr Neurol 2018; 22:935-943. [PMID: 29970280 DOI: 10.1016/j.ejpn.2018.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 05/05/2018] [Accepted: 06/08/2018] [Indexed: 12/01/2022]
Abstract
Microcephaly in utero is conventionally defined as a fetal head circumference (HC) 3SD below the mean for gestational age according to Jeanty et al.'s reference range. Prediction of microcephaly at birth (micB) based on conventional prenatal biometry is associated with a high percentage of false positive diagnoses and as a result, in countries in which it is an option, termination of pregnancy may be offered in cases that would have culminated in birth of a normocephalic child. A false negative diagnosis is rarer, but may lead to the birth of a symptomatic microcephalic child. In this review we present the results of our recent studies aimed at improvement of accurate prenatal detection of microcephaly including: (1), application of two new reference ranges for fetal HC in cases with a prenatal diagnosis of microcephaly based on the conventional reference; (2) assessment whether integration of additional parameters (stricter fetal HC cut-offs, small-for-gestational age (SGA), decreased HC/abdominal circumference and HC/femur length ratios, presence of associated malformations and family history) can improve prediction; (3), estimation of the difference between Z-scores of prenatal HC and the corresponding occipitofrontal circumference (OFC) at birth in order to propose an adjustment for better prediction of the actual OFC deviation at birth; (4), assessment whether micB diagnosis can be improved by accurate detection of false positive Fmic cases whose small HC is due to an acrocephalic-like head deformation by applying a new reference range of a vertical measurement of the fetal head: foramen magnum-to-cranium distance (FCD). The conventional and new reference ranges for fetal HC, all result in considerable over-diagnosis of fetal microcephaly (ranging from 43% to 33%). The use of the new references does not significantly improve micB prediction compared with the conventional one, whilst integrating additional parameters results in a better positive predictive value (PPV), but an increase in false negatives. The degree of Fmic severity is significantly over-estimated compared to the corresponding micB. The difference between the postnatal OFC deviation from the mean and the prenatal HC ranges from -0.74 SD to -1.95 SD for various fetal HC references. Application of the reference range for vertical cranial dimensions enables exclusion of fetuses with a small HC associated with a vertical cranial deformity without missing those with actual micB. Combining the fetal HC with the developed FCD criteria raised the PPV of micB to 78%. CONCLUSIONS: Prediction of micB can be improved by integrating additional parameters and by application of the FCD criteria, however the correct diagnosis of Fmic remains challenging. An algorithm for evaluation of fetal microcephaly is provided.
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Affiliation(s)
- Zvi Leibovitz
- Obstetrics-Gynecology Ultrasound Unit, Bnai-Zion Medical Center and Rappaport Faculty of Medicine, The Technion, Haifa, Israel; Fetal Neurology Clinic, Obstetrics-Gynecology Ultrasound Unit, Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | - Tally Lerman-Sagie
- Fetal Neurology Clinic, Obstetrics-Gynecology Ultrasound Unit, Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Pediatric Neurology Unit, Wolfson Medical Center, Holon and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv-Aviv, Israel
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26
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Chon AH, Mamey MR, Schrager SM, Vanderbilt DL, Chmait RH. The relationship between preoperative fetal head circumference and 2-year cognitive performance after laser surgery for twin-twin transfusion syndrome. Prenat Diagn 2018; 38:173-178. [PMID: 29314091 DOI: 10.1002/pd.5204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 12/18/2017] [Accepted: 12/25/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To determine the relationship between preoperative fetal head circumference (HC) and cognitive performance among children treated with laser surgery for twin-twin transfusion syndrome (TTTS). METHODS Donor and recipient twin HCs were measured preoperatively (16-26 weeks' gestation) and at 2 years corrected age. Multilevel multivariate regression models were used to test pregnancy and child-level risk factors for lower Battelle Developmental Inventory Second Edition (BDI-2) scores. A repeated-measures ANOVA was used to examine HC growth among recipients and donors between preoperative and 2 years. RESULTS Ninety-nine children were evaluated. The average BDI-2 score for the cohort was 101.4 (SD = 12.2). After controlling for covariates, larger preoperative HC percentiles were significantly associated with an increase in total BDI-2 scores (β = 0.29; P < 0.001), where a 12.5% increase in preoperative HC percentile was associated with 1-point increase in total BDI-2 score. The mean recipient and donor twin HC percentiles preoperatively and at age 2 years were 51st percentile vs 20th percentile (P = .050) and 60th percentile vs 49th percentile (P = .676), respectively. CONCLUSION Smaller preoperative HC percentiles identified children at risk of lower, but still within normal range, total BDI-2 scores. The discordance in HC percentiles between the donor and recipient twin decreased after laser surgery.
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Affiliation(s)
- Andrew H Chon
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Mary Rose Mamey
- Department of Pediatrics, Division of Hospital Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Sheree M Schrager
- Department of Pediatrics, Division of Hospital Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Douglas L Vanderbilt
- Department of Pediatrics, Division of General Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Ramen H Chmait
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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27
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Yaniv G, Katorza E, Tsehmaister Abitbol V, Eisenkraft A, Bercovitz R, Bader S, Hoffmann C. Discrepancy in fetal head biometry between ultrasound and MRI in suspected microcephalic fetuses. Acta Radiol 2017; 58:1519-1527. [PMID: 28304179 DOI: 10.1177/0284185117698865] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Microcephaly is one of the most common fetal structural abnormalities, and prenatal microcephaly is considered a group I malformation of cortical development diagnosed according to ultrasound (US) skull measurements. Purpose To evaluate the agreement between fetal head US and magnetic resonance imaging (MRI) biometric measurements of suspected microcephalic fetuses. Material and Methods This institutional review board-approved retrospective study with waived informed consent included 180 pregnant women and was conducted at our medical center from March 2011 to April 2013. Biparietal diameter (BPD) and occipitofrontal diameter (OFD) results of fetal head US normograms were compared to normograms for MRI. We used Pearson and Spearman rho non-parametric correlation coefficients to assess the association between two quantitative variables, paired t-test for paired quantitative variables, and McNemar test for paired qualitative variables. Results The average BPD but not the average OFD percentiles in fetal head US differed significantly from the MRI results ( P < 0.0001). When looking at the accepted microcephaly threshold, both BPD and OFD percentiles differed significantly from MRI ( P < 0.0001 and P < 0.004, respectively). There was no correlation between US-measured skull biometry and MRI-measured brain biometry. Estimated cerebrospinal fluid volumes were significantly lower in the study group compared to 120 fetuses with normal findings in prenatal head US and MRI. Also, we have created a MRI-based normogram of fetal head circumference and gestational age. Conclusion The diagnosis of microcephaly by US alone may be insufficient and ideally should be validated by MRI before a final diagnosis is established.
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Affiliation(s)
- Gal Yaniv
- Department of Diagnostic Imaging, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eldad Katorza
- Department of Obstetrics and Gynecology, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Vered Tsehmaister Abitbol
- Department of Diagnostic Imaging, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Arik Eisenkraft
- The Institute for Research in Military Medicine, The Faculty of Medicine, The Hebrew University of Jerusalem, Israel
- The IDF Medical Corps
- Department of Pediatrics, Safra Children’s Hospital, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronen Bercovitz
- Department of Diagnostic Imaging, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Salim Bader
- Department of Diagnostic Imaging, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Chen Hoffmann
- Department of Diagnostic Imaging, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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28
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Abstract
Craniosynostosis is the premature fusion of the calvarial sutures that is associated with a number of physical and intellectual disabilities spanning from pediatric to adult years. Over the past two decades, techniques in molecular genetics and more recently, advances in high-throughput DNA sequencing have been used to examine the underlying pathogenesis of this disease. To date, mutations in 57 genes have been identified as causing craniosynostosis and the number of newly discovered genes is growing rapidly as a result of the advances in genomic technologies. While contributions from both genetic and environmental factors in this disease are increasingly apparent, there remains a gap in knowledge that bridges the clinical characteristics and genetic markers of craniosynostosis with their signaling pathways and mechanotransduction processes. By linking genotype to phenotype, outlining the role of cell mechanics may further uncover the specific mechanotransduction pathways underlying craniosynostosis. Here, we present a brief overview of the recent findings in craniofacial genetics and cell mechanics, discussing how this information together with animal models is advancing our understanding of craniofacial development.
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Affiliation(s)
- Zeinab Al-Rekabi
- Department of Mechanical Engineering, University of Washington, 3900 E Stevens Way NE, Seattle, WA, 98195, USA
- Seattle Children’s Research Institute, Center for Developmental Biology and Regenerative Medicine, 1900 9 Ave, Seattle, WA, 98101, USA
| | - Michael L. Cunningham
- Seattle Children’s Research Institute, Center for Developmental Biology and Regenerative Medicine, 1900 9 Ave, Seattle, WA, 98101, USA
- Department of Pediatrics, Division of Craniofacial Medicine and the, University of Washington, 1959 NE Pacific St., Seattle, WA, 98195, USA
| | - Nathan J. Sniadecki
- Department of Mechanical Engineering, University of Washington, 3900 E Stevens Way NE, Seattle, WA, 98195, USA
- Department of Bioengineering, University of Washington, 3720 15 Ave NE, Seattle WA, 98105, USA
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29
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Chaudhary I, M Tripathi A, Yadav G, Saha S. Effect of Casein Phosphopeptide-amorphous Calcium Phosphate and Calcium Sodium Phosphosilicate on Artificial Carious Lesions: An in vitro Study. Int J Clin Pediatr Dent 2017; 10:261-266. [PMID: 29104386 PMCID: PMC5661040 DOI: 10.5005/jp-journals-10005-1447] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 02/08/2017] [Indexed: 11/23/2022] Open
Abstract
Aim To compare new remineralizing agents calcium sodium phosphosilicate paste and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste with that of fluoridated toothpaste in remineralization of early carious lesions using scanning electron microscopy and energy-dispersive X-ray (SEM-EDX) analysis. Materials and methods Sixty sound extracted premolars were collected and placed in demineralizing solution for 4 days to produce artificial carious lesions. All specimens were evaluated for any loss of mineral content using SEM-EDX analysis. Samples were randomly assigned to three groups: Group I: Fluoridated toothpaste (control), group II: CPP-ACP paste, and group III: Calcium sodium phosphosilicate paste. Specimens were then treated with above-mentioned remineralizing agents and again measured for mineral content using SEM-EDX analysis. Results Group III (calcium sodium phosphosilicate paste) showed highest significant difference followed in descending order by group II (CPP-ACP paste) and group I (fluoridated toothpaste). Conclusion Calcium sodium phosphosilicate paste showed maximum remineralizing potential compared with CPP-ACP and fluoridated toothpastes. How to cite this article Chaudhary I, Tripathi AM, Yadav G, Saha S. Effect of Casein Phosphopeptide-amorphous Calcium Phosphate and Calcium Sodium Phosphosilicate on Artificial Carious Lesions: An in vitro Study. Int J Clin Pediatr Dent 2017;10(3):261-266.
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Affiliation(s)
- Iqra Chaudhary
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry, Sardar Patel Post Graduate Institute of Dental & Medical Sciences Lucknow, Uttar Pradesh, India
| | - Abhay M Tripathi
- Professor and Head, Department of Pedodontics and Preventive Dentistry, Sardar Patel Post Graduate Institute of Dental & Medical Sciences Lucknow, Uttar Pradesh, India
| | - Gunjan Yadav
- Reader, Department of Pedodontics and Preventive Dentistry, Sardar Patel Post Graduate Institute of Dental & Medical Sciences Lucknow, Uttar Pradesh, India
| | - Sonali Saha
- Reader, Department of Pedodontics and Preventive Dentistry, Sardar Patel Post Graduate Institute of Dental & Medical Sciences Lucknow, Uttar Pradesh, India
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30
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Prajapati D, Nayak R, Pai D, Upadhya N, K Bhaskar V, Kamath P. Effect of Resin Infiltration on Artificial Caries: An in vitro Evaluation of Resin Penetration and Microhardness. Int J Clin Pediatr Dent 2017; 10:250-256. [PMID: 29104384 PMCID: PMC5661038 DOI: 10.5005/jp-journals-10005-1445] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Accepted: 02/02/2017] [Indexed: 11/23/2022] Open
Abstract
Aim To evaluate the effectiveness of resin infiltration on artificial caries lesion by assessing the depth of resin penetration and the change in microhardness of lesion postinfiltration. Materials and methods Totally 45 human extracted premolars were used to create an artificial demineralized lesion in enamel using demineralizing solution. A total of 15 samples (group I) were infiltrated with resin. The depth of resin penetration was studied using scanning electron microscope (SEM). Other half (n = 30) of samples was equally divided into three subgroups and Vickers hardness number (VHN) values were obtained to measure the surface microhardness as group 11 a—before demineralization, 11 b—after demineralization, IIc—postresin infiltration. Results Mean depth of penetration in group I was 516.8 urn. There was statistically significant increase in VHN values of demineralized lesion postresin infiltration (independent Student’s t-test, p < 0.001). Conclusion Penetration depth of the resin infiltrant was deep enough to render beneficial effects, while significant increase in microhardness was observed postresin infiltration. Clinical significance Infiltrant used can be considered as a valid treatment option for noncavitated lesions. How to cite this article Prajapati D, Nayak R, Pai D, Upadhya N, Bhaskar VK, Kamath P. Effect of Resin Infiltration on Artificial Caries: An in vitro Evaluation of Resin Penetration and Microhardness. Int J Clin Pediatr Dent 2017;10(3):250-256.
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Affiliation(s)
- Deepesh Prajapati
- Senior Lecturer, Department of Pedodontics, NIMS Dental College and Hospital Jaipur, Rajasthan, India
| | - Rashmi Nayak
- Professor and Head, Department of Pedodontics and Preventive Dentistry, Manipal College of Dental Sciences, Manipal, Karnataka, India
| | - Deepika Pai
- Reader, Department of Pedodontics and Preventive Dentistry, Manipal College of Dental Sciences, Manipal, Karnataka, India
| | - Nagraj Upadhya
- Associate Professor, Department of Dental Materials, Manipal College of Dental Sciences, Manipal, Karnataka, India
| | - Vipin K Bhaskar
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry, Mahe Institute of Dental Sciences & Hospital, Marie, Puducherry, India
| | - Pujan Kamath
- Private Practitioner, Department of Pedodontics and Preventive Dentistry, Manipal College of Dental Sciences, Manipal, Karnataka, India
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Sekhri P, Sandhu M, Sachdev V. Emerging Understanding of Emotional Intelligence of Teenagers. Int J Clin Pediatr Dent 2017; 10:289-292. [PMID: 29104391 PMCID: PMC5661045 DOI: 10.5005/jp-journals-10005-1452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 01/26/2017] [Indexed: 11/29/2022] Open
Abstract
Aim Emotional intelligence (EI) is the ability to use emotions effectively and productively. It is becoming increasingly clear that these skills are one of the primary foundations for better performance of students in classrooms and in the society as well and EI provides the basis for competencies important "in almost every job." So we accessed the EI of teenagers as a guide of their academic score. Study design We analyzed the correlation of academic score to the EI of teenagers in regular schools and part-time unconventional coaching institute using the Bar-On Emotional Quotient questionnaire. Results and conclusion The results of our study showed that empathy and self-actualization were highly developed in students of regular conventional school than those attending part-time unconventional coaching institute. The academic score had a significantly positive correlation with empathy, whereas a significantly negative correlation with interpersonal relations. Empathy, interpersonal relation, and impulsive control were significantly higher in females than males. Therefore by inculcating and working toward development of EI in the young generation, we can hope to achieve a more positive environment. How to cite this article Sekhri P, Sandhu M, Sachdev V. Emerging Understanding of Emotional Intelligence of Teenagers. Int J Clin Pediatr Dent 2017;10(3):289-292.
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Affiliation(s)
- Punya Sekhri
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry, I.T.S Centre for Dental Studies and Research, Muradnagar, Uttar Pradesh, India
| | - Meera Sandhu
- Professor, Department of Pedodontics and Preventive Dentistry, I.T.S Centre for Dental Studies and Research, Muradnagar, Uttar Pradesh, India
| | - Vinod Sachdev
- Professor and Head, Department of Pedodontics and Preventive Dentistry, I.T.S Centre for Dental Studies and Research, Muradnagar, Uttar Pradesh, India
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32
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S Mayall S, Chaudhary S, Kaur H, Manuja N, Ravishankar T, A Sinha A. Comparison of Dermatoglyphic Pattern among Cleft and Noncleft Children: A Cross-sectional Study. Int J Clin Pediatr Dent 2017; 10:245-249. [PMID: 29104383 PMCID: PMC5661037 DOI: 10.5005/jp-journals-10005-1444] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 01/16/2017] [Indexed: 11/24/2022] Open
Abstract
Background Oral clefts are among the common congenital birth defects with a broad phenotypic gamut. Since the epidermal ridges of the fingers and palms as well as the facial structures like lip, alveolus, and palate are formed from the same embryonic tissues during the same embryonic period, the genetic and environmental factors responsible for causing cleft lip and palate might also affect dermatoglyphic patterns. Aim Thus, study was undertaken to compare the dermato-glyphic pattern of children with orofacial clefts and normal children and to determine the correlation of dermatoglyphics with orofacial clefts. Materials and methods Total study sample consisted of 120 children in the age group of 3 to 16 years being divided into study and control groups. Dermatoglyphic data obtained from both control and study groups were then subjected to statistical analysis. Results Statistically no significant difference was found in the dermatoglyphic pattern and atd angle for both the groups. Conclusion It was observed that dermatoglyphics in orofacial clefts may not be distinctive. Further, large-scale studies are recommended to confirm the same. How to cite this article Mayall SS, Chaudhary S, Kaur H, Manuja N, Ravishankar T, Sinha AA. Comparison of Derma-toglyphic Pattern among Cleft and Noncleft Children: A Cross-sectional Study. Int J Clin Pediatr Dent 2017;10(3):245-249.
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Affiliation(s)
- Sandeep S Mayall
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry, Teerthanker Mahaveer Dental College and Research Centre, Moradabad Uttar Pradesh, India
| | - Seema Chaudhary
- Professor and Head, Department of Pedodontics and Preventive Dentistry, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Harsimran Kaur
- Reader, Department of Pedodontics and Preventive Dentistry, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Naveen Manuja
- Professor, Department of Pedodontics and Preventive Dentistry, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Telegi Ravishankar
- Reader, Department of Pedodontics and Preventive Dentistry, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Ashish A Sinha
- Reader, Department of Pedodontics and Preventive Dentistry, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India
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Mace P, Milh M, Girard N, Sigaudy S, Quarello E. [How to deal with a fetal head circumference lower than the third percentile?]. ACTA ACUST UNITED AC 2017; 45:491-511. [PMID: 28870427 DOI: 10.1016/j.gofs.2017.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 07/17/2017] [Indexed: 11/29/2022]
Abstract
The prenatal finding of a head circumference (HC) below the 3rd percentile (p) remains, in the same way as short femur or increased nuchal translucency with normal karyotype, one the most difficult situations for the praticionner in the setting of prenatal diagnosis. Microcephaly is a gateway to possible cerebral pathologies, but the main objective is to identify serious prenatal situations. A standardized HC measurement, the use of adapted reference tools and charts, longitudinal following of cephalic biometrics in high-risk situations, and systematic central nervous system analysis can increase the diagnostic performance of ultrasound which is often disappointing for microcephaly. The early distinction between associated or isolated microcephaly makes it possible to quickly orient the prenatal management and counseling. Fetal MRI and genetic counseling are fundamental in this context, making it possible to specify at best the etiological diagnosis and to provide assistance to the neuropediatrician in the establishment of an often uncertain prognosis. The recent increase in cases of microcephaly concomitant with the epidemic of the ZIKA virus is an additional argument to improve our practices and the daily apprehension of HC<3rd p.
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Affiliation(s)
- P Mace
- Centre de diagnostic prénatal, hôpital La Timone enfant, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - M Milh
- Centre de diagnostic prénatal, hôpital La Timone enfant, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France; Service de neurologie pédiatrique, hôpital La Timone enfants, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France; Inserm, GMGF UMR_S 910, Aix Marseille université, 13385 Marseille, France
| | - N Girard
- CRMBM UMR CNRS 7339, faculté de médecine, Aix Marseille université (AMU), 13385 Marseille, France; Service de neuroradiologie diagnostique et interventionnelle, hôpital La Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - S Sigaudy
- Centre de diagnostic prénatal, hôpital La Timone enfant, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France; Département de génétique médicale, hôpital La Timone enfant, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
| | - E Quarello
- Unité d'échographie et de diagnostic prénatal, hôpital Saint-Joseph, 26, boulevard de Louvain, 13285 Marseille cedex 08, France; Institut de médecine de la reproduction, 6, rue Rocca, 13008 Marseille, France.
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Nakhjavani YB, Nakhjavani FB, Jafari A. Mesial Stripping of Mandibular Deciduous Canines for Correction of Permanent Lateral Incisors. Int J Clin Pediatr Dent 2017. [DOI: 10.5005/jp-journals-10005-1441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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Chibueze EC, Parsons AJQ, Lopes KDS, Yo T, Swa T, Nagata C, Horita N, Morisaki N, Balogun OO, Dagvadorj A, Ota E, Mori R, Oladapo OT. Diagnostic Accuracy of Ultrasound Scanning for Prenatal Microcephaly in the context of Zika Virus Infection: A Systematic Review and Meta-analysis. Sci Rep 2017; 7:2310. [PMID: 28536443 PMCID: PMC5442132 DOI: 10.1038/s41598-017-01991-y] [Citation(s) in RCA: 282] [Impact Index Per Article: 40.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 04/05/2017] [Indexed: 12/17/2022] Open
Abstract
To assess the accuracy of ultrasound measurements of fetal biometric parameters for prenatal diagnosis of microcephaly in the context of Zika virus (ZIKV) infection, we searched bibliographic databases for studies published until March 3rd, 2016. We extracted the numbers of true positives, false positives, true negatives, and false negatives and performed a meta-analysis to estimate group sensitivity and specificity. Predictive values for ZIKV-infected pregnancies were extrapolated from those obtained for pregnancies unrelated to ZIKV. Of 111 eligible full texts, nine studies met our inclusion criteria. Pooled estimates from two studies showed that at 3, 4 and 5 standard deviations (SDs)
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Affiliation(s)
- Ezinne C Chibueze
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan.
| | - Alex J Q Parsons
- Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | | | - Takemoto Yo
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
| | - Toshiyuki Swa
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
- Graduate School of Human Sciences, Osaka University, Osaka, Japan
| | - Chie Nagata
- Department of Education for Clinical Research, National Center for Child Health and Development, Tokyo, Japan
| | - Nobuyuki Horita
- Pulmonology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Naho Morisaki
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Olukunmi O Balogun
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
| | - Amarjargal Dagvadorj
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
- Department of Health Informatics, Kyoto University, Yoshida Konoe-cho, Syako-ku, Kyoto, Japan
| | - Erika Ota
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
- St. Luke's International University, Graduate school of Nursing, Global Health Nursing, Tokyo, Japan
| | - Rintaro Mori
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
| | - Olufemi T Oladapo
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research World Health Organization, Geneva, Switzerland
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Faschingbauer F, Heimrich J, Raabe E, Kehl S, Schneider M, Schmid M, Beckmann MW, Schild RL, Mayr A. Longitudinal z Score Distribution in Sonographic Fetal Biometry: Influence of Examiner and Experience. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:1021-1028. [PMID: 28258637 DOI: 10.7863/ultra.16.06031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 08/08/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To analyze the influence of examiners and their experience on the quality of biometric measurements via the evolution of z scores in a longitudinal multicenter study. METHODS This retrospective study included 4607 sonographic fetal biometric examinations performed by 18 examiners at the beginning of their sonography training. To analyze the quality of biometric measurements, z scores comparing the individual measurements with the expected values from a standard population were computed. To investigate the effect of examiners and their experience, we applied a multivariable regression analysis via generalized additive mixed models. RESULTS Mean z scores for biparietal diameter, abdominal circumference, and femur length were statistically different from the expected value of 0 (P < .001); no significant differences were found for head circumference measurements. Regression analyses showed a significant effect of the number of examinations on the distribution of z scores for each type of measurement. This effect yielded z score values close to the expected value of 0 at 100 to 200 examinations for all biometric measurements, indicating good consistency with the distribution of values in the reference population. Near the end of the study period, an increasing tendency toward either overestimation (head circumference) or underestimation (biparietal diameter, abdominal circumference, and femur length) was observed. CONCLUSIONS A longitudinal analysis of the z score distribution for quality control of biometry is feasible. A prospective and automatized use of this technique could help identify potential systematic errors and therefore improve the detection rate for high-risk pregnancies.
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Affiliation(s)
- Florian Faschingbauer
- Department of Obstetrics and Gynecology, University Hospital of Erlangen, Erlangen, Germany
| | - Jutta Heimrich
- Department of Obstetrics and Gynecology, University Hospital of Erlangen, Erlangen, Germany
| | - Eva Raabe
- Department of Obstetrics and Gynecology, University Hospital of Erlangen, Erlangen, Germany
| | - Sven Kehl
- Department of Obstetrics and Gynecology, University Hospital of Erlangen, Erlangen, Germany
| | - Michael Schneider
- Department of Obstetrics and Gynecology, University Hospital of Erlangen, Erlangen, Germany
| | - Matthias Schmid
- Department of Medical Informatics, Biometry, and Epidemiology, Rheinische Friedrich-Wilhelms-University of Bonn, Bonn, Germany
| | - Matthias W Beckmann
- Department of Obstetrics and Gynecology, University Hospital of Erlangen, Erlangen, Germany
| | - Ralf L Schild
- Department of Obstetrics and Perinatal Medicine, Perinatalzentrum Hannover, Diakonischen Dienste Hannover Frauenkliniken, Hannover, Germany
| | - Andreas Mayr
- Department of Medical Informatics, Biometry, and Epidemiology, Rheinische Friedrich-Wilhelms-University of Bonn, Bonn, Germany
- Department of Medical Informatics, Biometry, and Epidemiology, University of Erlangen-Nuremberg, Erlangen, Germany
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Abstract
An estimated 276,000 babies die within 4 weeks of birth every year, worldwide, from congenital anomalies. Better quality ultrasound screening can increase the detection of these fetal malformations in the prenatal period. Prenatal counseling for the pregnant woman and her family, regarding the nature of the disease and prognosis is necessary. Options for management in prenatal, perinatal, intrapartum, neonatal, and childhood periods need to be thoroughly discussed, so that the family can make an informed decision. A multidisciplinary approach is usually needed once a decision has been made to optimize fetal outcome, to plan for the timing and location as well as the mode of delivery. In most of the cases, vaginal delivery can be attempted. An elective cesarean delivery should be reserved for maternal concern of dystocia, certain fetal conditions that cesarean delivery will optimize perinatal outcome, or if the parents have a psychosocial determination to have a live-born infant.
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Affiliation(s)
- Tuangsit Wataganara
- Division of Maternal-Fetal Medicine, Faculty of Medicine Siriraj Hospital, Department of Obstetrics and Gynecology, 2 Prannok Road, Bangkoknoi, Bangkok
| | - Amos Grunebaum
- Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, NY
| | - Frank Chervenak
- Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, NY
| | - Miroslaw Wielgos
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw
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K Suma N, K Shashibhushan K, Subba Reddy VV. Effect of Dentin Disinfection with 2% Chlorhexidine Gluconate and 0.3% Iodine on Dentin Bond Strength: An in vitro Study. Int J Clin Pediatr Dent 2017; 10:223-228. [PMID: 29104379 PMCID: PMC5661033 DOI: 10.5005/jp-journals-10005-1440] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 01/25/2017] [Indexed: 11/23/2022] Open
Abstract
Objective Cavity preparation is a surgical procedure that attempts to remove all infected dentin.1 Bacteria left beneath the filling material is greatest threat to the pulp. To reduce the potential for residual caries development and sensitivity, an antibacterial solution with the ability to disinfect the prepared tooth surface would be of help.2 So this study was conducted to evaluate and compare the effect of dentin disinfection with 2% chlorhexidine gluconate (Consepsis) and 0.3% iodine (Ora5) on shear bond strength (SBS) of self-etch adhesives to dentin. Materials and methods Buccal surfaces of 36 caries-free permanent third molars were ground to expose dentin. All specimens were mounted on acrylic block, divided randomly into three groups, namely group I (control), group II (Con-sepsis), and group III (Ora5). After the application of cavity disinfectant and bonding procedures as per manufacturer’s instructions, composite cylinders were built. Then SBS was measured using universal testing machine. Results Statistical analysis of the measurements were made using one-way analysis of variance (ANOVA), which showed that when cavity disinfectants (Consepsis and Ora5) were used there was significant reduction in SBS of composite to dentin when compared with that of control group. Interpretation and conclusion The results indicate that the use of commercially available cavity disinfectants, Consepsis containing 2% chlorhexidine gluconate and Ora5 containing 0.3% iodine and 0.15% potassium iodide with self-etch adhesive (Adper Prompt), would significantly lower SBS of composite to dentin. How to cite this article Suma NK, Shashibhushan KK, Reddy VVS. Effect of Dentin Disinfection with 2% Chlorhexidine Gluconate and 0.3% Iodine on Dentin Bond Strength: An in vitro Study. Int J Clin Pediatr Dent 2017;10(3):223-228.
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Affiliation(s)
- Nelamakanahalli K Suma
- Reader, Department of Pediatrics and Preventive Dentistry, V S Dental College & Hospital, Bengaluru, Karnataka, India
| | - Kukkalli K Shashibhushan
- Professor, Department of Pediatrics and Preventive Dentistry, College of Dental Sciences, Davangere, Karnataka, India
| | - V V Subba Reddy
- Director, Department of Pediatrics and Preventive Dentistry, College of Dental Sciences, Davangere, Karnataka, India
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Verma N, Bansal A, Tyagi P, Jain A, Tiwari U, Gupta R. Eruption Chronology in Children: A Cross-sectional Study. Int J Clin Pediatr Dent 2017; 10:278-282. [PMID: 29104389 PMCID: PMC5661043 DOI: 10.5005/jp-journals-10005-1450] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 02/26/2017] [Indexed: 11/23/2022] Open
Abstract
Aims and objectives The purpose of this study is to determine the appropriate reference standard for eruption timing of primary teeth in infants and preschool children of Bhopal city and to determine the role of various factors affecting the eruption of primary dentition. Materials and methods A cross-sectional study was conducted among the infants and preschool children (4-36 months) attending the local government or private hospitals, and vaccination centers. Prior to the study, Institutional Ethical Committee clearance and informed written consent from the parents were obtained. The data were collected from full-term infants and preschool children of 4 to 36 months from Bhopal city. Oral examination was done under adequate natural light by a single examiner using mouth mirror and probe. Teeth present in the oral cavity were noted by using Federation Dentaire Internationale system of nomenclature in the preformed pro-forma. The teeth were considered as erupted, when any part of its crown had penetrated the gingiva and was visible in the oral cavity. Height, weight, birth weight, and other close-ended questions in questionnaire were asked from parents. Results and conclusion The data collected were statistically analyzed and it was observed that significant relation exists between tooth eruption and birth weight, feeding habits, socioeconomic status, and body mass index (BMI). Based on the findings, it may be concluded that Indian children experienced delayed eruption of primary teeth when compared with children of different countries and standard norms. How to cite this article Verma N, Bansal A, Tyagi P, Jain A, Tiwari U, Gupta R. Eruption Chronology in Children: A Cross-sectional Study. Int J Clin Pediatr Dent 2017;10(3):278-282.
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Affiliation(s)
- Neha Verma
- Postgraduate Student, Department of Pediatric and Preventive Dentistry, People's Dental Academy, Bhopal, Madhya Pradesh, India
| | - Arpana Bansal
- Reader, Department of Pedodontics and Preventive Dentistry, People's Dental Academy, Bhopal, Madhya Pradesh, India
| | - Parimala Tyagi
- Professor, Department of Pedodontics and Preventive Dentistry, People's Dental Academy, Bhopal, Madhya Pradesh, India
| | - Ankur Jain
- Reader, Department of Pedodontics and Preventive Dentistry, People's Dental Academy, Bhopal, Madhya Pradesh, India
| | - Utkarsh Tiwari
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry, People's Dental Academy, Bhopal, Madhya Pradesh, India
| | - Ruchika Gupta
- Postgraduate Student, Department of Community and Preventive Dentistry, People's Dental Academy, Bhopal, Madhya Pradesh, India
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Dutta B, S Dhull K, Das D, Samir PV, K Verma R, Singh N. Evaluation of Antimicrobial Efficacy of various Intracanal Medicaments in Primary Teeth: An in vivo Study. Int J Clin Pediatr Dent 2017; 10:267-271. [PMID: 29104387 PMCID: PMC5661041 DOI: 10.5005/jp-journals-10005-1448] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 02/28/2017] [Indexed: 11/23/2022] Open
Abstract
Introduction Bacteria and their products play a primary etiological role in the initiation and perpetuation of pulpoperiapical pathosis. Intracanal medication is important for endodontic success as it eliminates microorganisms that persist after chemomechanical preparation. Aim To compare antimicrobial efficacy of calcium hydroxide powder, triple antibiotic paste, calcium hydroxide with 2% chlorhexidine solution, and triple antibiotic paste with 2% chlorhexidine solution. Materials and methods A total of 48 nonvital primary teeth were included in this study. After access opening first microbiological sample (s1) was collected by using absorbent paper point introducing into canal. Second microbilogical sample (s2) was taken following chemomechanical preparation and the teeth were divided into four groups: Group I: calcium hydroxide (CH) powder with distilled water; group II: CH with 2% chlorhexidine solution; group III: triple antibiotic powder with distilled water; group IV: triple antibiotic paste with 2% chlorhexidine solution. Then the canals were filled with any one group of the medicament and cavity was temporarily sealed with zinc oxide eugenol. After 1 week, a postmedication sample (s3) was collected. Then the canal was filled with Metapex, restored with glass ionomer cement. Conclusion From the experiments carried out in this study, with the limitations, an inference can be drawn that a combination of antimicrobial agent used as intracanal medicament is definitely better than single agent like Ca(OH)2. How to cite this article Dutta B, Dhull KS, Das D, Samir PV, Verma RK, Singh N. Evaluation of Antimicrobial Efficacy of various Intracanal Medicaments in Primary Teeth: An in vivo Study. Int J Clin Pediatr Dent 2017;10(3):267-271.
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Affiliation(s)
- Brahmananda Dutta
- Professor and Head, Department of Pedodontiocs and Preventive Dentistry, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar Odisha, India
| | - Kanika S Dhull
- Reader, Department of Pedodontiocs and Preventive Dentistry, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar Odisha, India
| | - Debasmita Das
- Postgraduate Student, Department of Pedodontiocs and Preventive Dentistry, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar Odisha, India
| | - P V Samir
- Senior Lecturer, Department of Pedodontiocs and Preventive Dentistry, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar Odisha, India
| | - Rajnish K Verma
- Senior Lecturer, Department of Pedodontiocs and Preventive Dentistry, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar Odisha, India
| | - Nipa Singh
- Senior Resident, Department of Microbiology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar Odisha, India
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Thomas A, Thakur S, Habib R. Comparison of Antimicrobial Efficacy of Green Tea, Garlic with Lime, and Sodium Fluoride Mouth Rinses against Streptococcus mutans, Lactobacilli species, and Candida albicans in Children: A Randomized Double-blind Controlled Clinical Trial. Int J Clin Pediatr Dent 2017; 10:234-239. [PMID: 29104381 PMCID: PMC5661035 DOI: 10.5005/jp-journals-10005-1442] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 02/28/2017] [Indexed: 11/23/2022] Open
Abstract
Introduction With greater awareness worldwide, the use of herbs and herbal products has increased to a large extent. Objective To evaluate and compare the antimicrobial efficacy of green tea, garlic with lime, and 0.05% sodium fluoride (NaF) mouth rinses against Streptococcus mutans, Lactobacilli species, and Candida albicans. Materials and methods A total of 45 children aged 4 to 6 years with severe early childhood caries (S-ECC; based on decayed extracted filled [defs] score) were selected. Children were divided randomly into three equal groups and were asked to rinse with the prescribed mouth rinse once daily for 2 weeks after breakfast under supervision. A base-line and postrinsing nonstimulated whole salivary sample (2 mL) was collected and tested for the number of colony-forming units (CFUs). The data were statistically analyzed using Statistical Package for the Social Sciences (SPSS) version 16.0 software with one-way analysis of variance (ANOVA) and Tukey’s post hoc test. Results A statistically significant fall in colony count was found with the three mouth rinses in S. mutans (p < 0.001, p < 0.001) and Lactobacilli spp. (p < 0.001, p < 0.001), but not against C. albicans (p = 0.264, p = 0.264). On comparison, no statistically significant difference was found against S. mutans (p = 1, p = 0.554, p = 0.572), lactobacilli spp. (p = 0.884, p = 0.999, p = 0.819), and C. albicans (p = 0.999, p = 0.958, p = 0.983). Conclusion The findings of this study indicate that green tea and garlic with lime mouth rinse can be an economical alternative to NaF mouth rinse both for prevention and therapeutics. How to cite this article Thomas A, Thakur S, Habib R. Comparison of Antimicrobial Efficacy of Green Tea, Garlic with Lime, and Sodium Fluoride Mouth Rinses against Streptococcus mutans, Lactobacilli species, and Candida albicans in Children: A Randomized Double-blind Controlled Clinical Trial. Int J Clin Pediatr Dent 2017;10(3):234-239.
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Affiliation(s)
- Ann Thomas
- Professor, Department of Pedodontics, A.J. Institute of Dental Sciences Mangaluru, Karnataka, India
| | - Sneha Thakur
- Postgraduate Student, Department of Pediatric and Preventive Dentistry, A.J. Institute of Dental Sciences, Mangaluru, Karnataka, India
| | - Rishika Habib
- Postgraduate Student, Department of Pedodontics, A.J. Institute of Dental Sciences Mangaluru, Karnataka, India
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Sunitha B, Puppala R, Kethineni B, K Mallela M, Peddi R, Tarasingh P. Clinical and Radiographic Evaluation of Four Different Pulpotomy Agents in Primary Molars: A Longitudinal Study. Int J Clin Pediatr Dent 2017; 10:240-244. [PMID: 29104382 PMCID: PMC5661036 DOI: 10.5005/jp-journals-10005-1443] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 02/16/2017] [Indexed: 11/23/2022] Open
Abstract
Background The medicament formocresol (FC) used for pulpotomy in primary teeth has great concerns regarding its toxicity due to one of its constituent formaldehyde which acts by tissue fixation. Therefore, new medicaments were introduced which claimed preservation and regeneration of pulp. Aim The present study is aimed to compare and evaluate the clinical and radiographic success of FC, pulpotec, mineral trioxide aggregate (MTA), and emdogain (EMD) as pulpotomy medicaments in human primary molars. Design A sample of 21 patients with 84 teeth were selected. All the patients have at least four teeth eligible for pulpotomy according to selection criteria. In each mouth, the teeth selected were randomly allocated into four groups with 21 each. Results After 24 months of follow-up, the clinical success rates were FC (94%), pulpotec (94%), MTA (100%), and EMD (83%) and radiographically FC (88%), pulpotec (83%), MTA (94%), and EMD (72%), which were statistically not significant (p > 0.05). Conclusion The outcome of this study demonstrates MTA has a high success rate compared with FC, pulpotec, and EMD as pulpotomy agent. In addition, MTA, pulpotec, and EMD can be considered as alternatives to FC as pulpotomy agent. How to cite this article Sunitha B, Puppala R, Kethineni B, Mallela MK, Peddi R, Tarasingh P. Clinical and Radiographic Evaluation of Four Different Pulpotomy Agents in Primary Molars: A Longitudinal Study. Int J Clin Pediatr Dent 2017;10(3):240-244.
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Affiliation(s)
- B Sunitha
- Assistant Professor, Department of Pedodontics and Preventive Dentistry, Sri Venkata Sai Institute of Dental Sciences, Mahbubnagar Telangana, India
| | - Ravindar Puppala
- Professor and Head, Department of Pedodontics and Preventive Dentistry, Sri Venkata Sai Institute of Dental Sciences, Mahbubnagar Telangana, India
| | - Balaji Kethineni
- Professor, Department of Pedodontics and Preventive Dentistry, Sri Venkata Sai Institute of Dental Sciences, Mahbubnagar Telangana, India
| | - Manoj K Mallela
- Professor, Department of Pedodontics and Preventive Dentistry, Sri Venkata Sai Institute of Dental Sciences, Mahbubnagar Telangana, India
| | - Ravigna Peddi
- Associate Professor, Department of Pedodontics and Preventive Dentistry, Sri Venkata Sai Institute of Dental Sciences, Mahbubnagar Telangana, India
| | - P Tarasingh
- Assistant Professor, Department of Pedodontics and Preventive Dentistry Government Dental College, Hyderabad, Telangana, India
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Gelber SE, Grünebaum A, Chervenak FA. Prenatal screening for microcephaly: an update after three decades. J Perinat Med 2017; 45:167-170. [PMID: 27662643 DOI: 10.1515/jpm-2016-0220] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 08/17/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Due to the recent outbreak of Zika virus, there has been a newfound interest in fetal and neonatal microcephaly. In 1984, Chervenak et al. proposed criteria for the prenatal ultrasound diagnosis of microcephaly as ≤3 standard deviations (SD) from the mean. Despite improvements in medicine these criteria have not been reevaluated in 30 years. OBJECTIVE To examine how the original 1984 Chervenak et al. criteria for the diagnosis of fetal microcephaly apply to a current population utilizing modern ultrasound equipment and techniques. STUDY DESIGN Retrospective database review of 27,697 ultrasound exams between 18 and 40 weeks' gestation. Mean and SDs were calculated for each week of gestation from 18 to 40 completed weeks and these were compared to the 1984 data. RESULTS There is no statistically significant difference in gestational age-specific mean head circumference (HC) between the two studied populations. Because the current dataset is larger the SD differ. CONCLUSIONS The 1984 ultrasound criteria for microcephaly remain valid. Physicians today have two alternatives: either use the 3SD cutoff as recommended by Chervenak et al. and endorsed by the Society for Maternal-Fetal Medicine (SMFM) or develop a new dataset for one's population with statistical validation.
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Pathak S, Shashibhushan KK, Poornima P, Reddy VS. In vitro Evaluation of Stainless Steel Crowns cemented with Resin-modified Glass Ionomer and Two New Self-adhesive Resin Cements. Int J Clin Pediatr Dent 2016; 9:197-200. [PMID: 27843249 PMCID: PMC5086005 DOI: 10.5005/jp-journals-10005-1363] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 03/18/2016] [Indexed: 11/23/2022] Open
Abstract
AIMS To assess and compare the retentive strength of two dual-polymerized self-adhesive resin cements (RelyX U200, 3M ESPE & SmartCem2, Dentsply Caulk) and a resin-modified glass ionomer cement (RMGIC; RelyX Luting 2, 3M ESPE) on stainless steel crown (SSC). MATERIALS AND METHODS Thirty extracted teeth were mounted on cold cured acrylic resin blocks exposing the crown till the cemento-enamel junction. Pretrimmed, precontoured SSC was selected for a particular tooth. Standardized tooth preparation for SSC was performed by single operator. The crowns were then luted with either RelyX U200 or SmartCem2 or RelyX Luting 2 cement. Retentive strength was tested using Instron universal testing machine. The retentive strength values were recorded and calculated by the formula: Load/Area. STATISTICAL ANALYSIS One-way analysis of variance was used for multiple comparisons followed by post hoc Tukey's test for groupwise comparisons. Unpaired t-test was used for intergroup comparisons. RESULTS RelyX U200 showed significantly higher retentive strength than rest of the two cements (p < 0.001). No significant difference was found between the retentive strength of SmartCem2 and RelyX Luting 2 (p > 0.05). CONCLUSION The retentive strength of dual-polymerized self-adhesive resin cements was better than RMGIC, and RelyX U200 significantly improved crown retention when compared with SmartCem2 and RelyX Luting 2. HOW TO CITE THIS ARTICLE Pathak S, Shashibhushan KK, Poornima P, Reddy VVS. In vitro Evaluation of Stainless Steel Crowns cemented with Resin-modified Glass Ionomer and Two New Self-adhesive Resin Cements. Int J Clin Pediatr Dent 2016;9(3):197-200.
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Affiliation(s)
- Sidhant Pathak
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry, College of Dental Sciences, Davangere, Karnataka, India
| | - K K Shashibhushan
- Professor, Department of Pedodontics and Preventive Dentistry, College of Dental Sciences, Davangere, Karnataka, India
| | - P Poornima
- Professor and Head, Department of Pedodontics and Preventive Dentistry, College of Dental Sciences, Davangere, Karnataka, India
| | - Vv Subba Reddy
- Professor, Department of Pedodontics and Preventive Dentistry, College of Dental Sciences, Davangere, Karnataka, India
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Jaiswara C, Srivastava VK, Dhiman N. Autotransplantation of a Strange Positioned Impacted Central Incisor in a surgically Prepared Socket: A Miracle Esthetic Concept. Int J Clin Pediatr Dent 2016; 9:269-272. [PMID: 27843261 PMCID: PMC5086017 DOI: 10.5005/jp-journals-10005-1375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 03/28/2016] [Indexed: 11/23/2022] Open
Abstract
Esthetics is a prime concern for a young lady. Any anomaly in the anterior tooth may create anxiety and depression. This anxiety and depression may hamper her married life and overall personality. This case report reveals an unerupted right central incisor situated in a strange position, creating space in the maxillary anterior region and giving an unesthetic appearance. Autotransplantation is a method of choice for a strangely positioned impacted central incisor in a new appropriate site. This method offers a new treatment option for some clinical situations if orthodontic approach is not possible. It permits tooth movement to a distant or the opposite side of the same dental arch as well as to the opposite jaw. This procedure also offers potential benefits of reestablishment of normal alveolar process development, esthetics, functions, and arch integrity. This procedure has the potential to become a viable alternative treatment plan for young patients of low socioeconomic status, allowing the reestablish-ment and restoration of a missing tooth and their functions. This article discusses methods of auto-reimplantation of a tooth in a fresh surgically prepared socket, its biological principle, and establishment of functions, esthetics, and phonetics.
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Affiliation(s)
- Chandresh Jaiswara
- Assistant Professor, Department of Oral Surgery, Faculty of Dental Sciences Institute of Medical Sciences, Banaras Hindu University Varanasi, Uttar Pradesh, India
| | - Vinay K Srivastava
- Associate Professor, Department of Dentistry, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi Uttar Pradesh, India
| | - Neeraj Dhiman
- Assistant Professor, Department of Oral Surgery, Faculty of Dental Sciences Institute of Medical Sciences, Banaras Hindu University Varanasi, Uttar Pradesh, India
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Yadav RD, Raisingani D, Jindal D, Mathur R. A Comparative Analysis of Different Finishing and Polishing Devices on Nanofilled, Microfilled, and Hybrid Composite: A Scanning Electron Microscopy and Profilometric Study. Int J Clin Pediatr Dent 2016; 9:201-208. [PMID: 27843250 PMCID: PMC5086006 DOI: 10.5005/jp-journals-10005-1364] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 03/20/2016] [Indexed: 11/23/2022] Open
Abstract
The continuous development of esthetically acceptable adhesive restorative material has made a variety of tooth-colored materials available for clinical use. The advent of visible light polymerizing resin and the use of finer filler particles permit resin composites to be polished to higher degree. The effect of polishing systems on surface finish has been reported to be material-dependent, and the effectiveness of these systems was mostly product-dependent. Hence, the purpose of this study was to evaluate the efficiency of finishing and polishing systems on the surface roughness of nanofilled, microfilled, and hybrid composite restorative materials available in the market. HOW TO CITE THIS ARTICLE Yadav RD, Raisingani D, Jindal D, Mathur R. A Comparative Analysis of Different Finishing and Polishing Devices on Nanofilled, Microfilled, and Hybrid Composite: A Scanning Electron Microscopy and Profilometric Study. Int J Clin Pediatr Dent 2016;9(3):201-208.
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Affiliation(s)
- Rishi D Yadav
- Reader, Department of Conservative Dentistry and Endodontics, New Horizon Dental College and Research Institute, Bilaspur Chhattisgarh, India
| | - Deepak Raisingani
- Professor and Head, Department of Conservative Dentistry and Endodontics Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan India
| | - Divya Jindal
- Postgraduate Student, Department of Conservative Dentistry and Endodontics Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan India
| | - Rachit Mathur
- Senior Lecturer, Department of Conservative Dentistry and Endodontics Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan India
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Somani R, Jaidka S, Singh DJ, Sibal GK. Comparative Evaluation of Shear Bond Strength of Various Glass Ionomer Cements to Dentin of Primary Teeth: An in vitro Study. Int J Clin Pediatr Dent 2016; 9:192-196. [PMID: 27843248 PMCID: PMC5086004 DOI: 10.5005/jp-journals-10005-1362] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 02/28/2016] [Indexed: 11/24/2022] Open
Abstract
Aim To evaluate and compare shear bond strength of various glass ionomer cements (GICs) to dentin of primary teeth. Materials and methods Sample size taken for the study was 72 deciduous molars with intact buccal or lingual surfaces. Samples were randomly divided into three groups, i.e., groups A, B, and C and were restored with conventional type II GIC, type II light cure (LC) GIC, and type IX GIC respectively. Thermocycling was done to simulate oral conditions. After 24 hours, shear bond strength was determined using Instron Universal testing Machine at crosshead speed of 0.5 mm/ minute until fracture. Results were tabulated and statistically analyzed. Results It was found that the shear bond strength was highest in group B (LC GIC) 9.851 ± 1.620 MPa, followed by group C (type IX GIC) 7.226 ± 0.877 MPa, and was lowest in group A (conventional GIC) 4.931 ± 0.9735 MPa. Conclusion Light cure GIC was significantly better than type IX GIC and conventional GIC in terms of shear bond strength. How to cite this article Somani R, Jaidka S, Singh DJ, Sibal GK. Comparative Evaluation of Shear Bond Strength of Various Glass Ionomer Cements to Dentin of Primary Teeth: An in vitro Study. Int J Clin Pediatr Dent 2016;9(3):192-196.
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Affiliation(s)
- Rani Somani
- Head, Department of Pedodontics and Preventive Dentistry, DJ College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India
| | - Shipra Jaidka
- Professor, Department of Pedodontics and Preventive Dentistry, DJ College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India
| | - Deepti J Singh
- Reader, Department of Pedodontics and Preventive Dentistry, DJ College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India
| | - Gurleen K Sibal
- Student, Department of Pedodontics and Preventive Dentistry, DJ College of Dental Sciences and Research, Modinagar, Uttar Pradesh, India
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Sekhon HK, Sircar K, Kaur G, Marwah M. Evaluation of Role of Myofibroblasts in Oral Cancer: A Systematic Review. Int J Clin Pediatr Dent 2016; 9:233-239. [PMID: 27843256 PMCID: PMC5086012 DOI: 10.5005/jp-journals-10005-1370] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 03/02/2016] [Indexed: 12/23/2022] Open
Abstract
Aim To conduct a systematic review on the role of myofibroblasts in progression of oral cancer. The myofibroblast is essential for the integrity of the mammalian body by virtue of its role in wound healing, but it also plays a negative role due to their role in promoting tumor development. Settings and design Systematic review. Materials and methods Bibliographic searches were conducted in several electronic databases using all publications in PubMed, PubMed central, EMBASE, CancerLit, Google scholar, and Cochrane CCTR between 1990 and June 2015. Results The search of all publications from various electronic databases revealed 1,371 citations. The total number of studies considered for systematic review was 43. The total number of patients included in the studies was 990. Conclusion Myofibroblasts are a significant component in stroma of oral cancer cases, though not identified in all cases. This systematic review shows that clinical, pathological, and immunohistochemistry tests have correlated the presence of high myofibroblast count in oral cancer cell stroma. Key Messages Myofibroblasts play a significant role in oral cancer invasion and progression. Various studies have demonstrated their association with oral cancer. This review tends to highlight their role in the pathogenesis of oral cancer over the decade. How to cite this article Sekhon HK, Sircar K, Kaur G, Marwah M. Evaluation of Role of Myofibroblasts in Oral Cancer: A Systematic Review. Int J Clin Pediatr Dent 2016;9(3):233-239.
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Affiliation(s)
- Harjeet K Sekhon
- Senior Lecturer, Department of Oral Pathology and Microbiology, D.J. College of Dental Sciences & Research, Modinagar, Uttar Pradesh, India
| | - Keya Sircar
- Head, Department of Oral Pathology and Microbiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Gurbani Kaur
- Ex-post Graduate Student, Department of Periodontology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Muneet Marwah
- Postgraduate, Department of Prosthodontics, Government Dental College Thiruvananthapuram, Kerala, India
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Hassan AF, Yadav G, Tripathi AM, Mehrotra M, Saha S, Garg N. A Comparative Evaluation of the Efficacy of Different Caries Excavation Techniques in reducing the Cariogenic Flora: An in vivo Study. Int J Clin Pediatr Dent 2016; 9:214-217. [PMID: 27843252 PMCID: PMC5086008 DOI: 10.5005/jp-journals-10005-1366] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 03/02/2016] [Indexed: 11/23/2022] Open
Abstract
Background Caries excavation is a noninvasive technique of caries removal with maximum preservation of healthy tooth structure. Aim To compare the efficacy of three different caries excavation techniques in reducing the count of cariogenic flora. Materials and methods Sixty healthy primary molars were selected from 26 healthy children with occlusal carious lesions without pulpal involvement and divided into three groups in which caries excavation was done with the help of (1) carbide bur; (2) polymer bur using slow-speed handpiece; and (3) ultrasonic tip with ultrasonic machine. Samples were collected before and after caries excavation for microbiological analysis with the help of sterile sharp spoon excavator. Samples were inoculated on blood agar plate and incubated at 37°C for 48 hours. After bacterial cultivation, the bacterial count of Streptococcus mutans was obtained. Statistical analysis All statistical analysis was performed using SPSS 13 statistical software version. Kruskal-Wallis analysis of variance, Wilcoxon matched pairs test, and Z test were performed to reveal the statistical significance. Results The decrease in bacterial count of S. mutans before and after caries excavation was significant (p < 0.001) in all the three groups. Conclusion Carbide bur showed most efficient reduction in cariogenic flora, while ultrasonic tip showed almost comparable results, while polymer bur showed least reduction in cariogenic flora after caries excavation. How to cite this article Hassan AF, Yadav G, Tripathi AM, Mehrotra M, Saha S, Garg N. A Comparative Evaluation of the Efficacy of Different Caries Excavation Techniques in reducing the Cariogenic Flora: An in vivo Study. Int J Clin Pediatr Dent 2016;9(3):214-217.
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Affiliation(s)
- Afrah Fatima Hassan
- Student, Department of Pedodontics and Preventive Dentistry Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Gunjan Yadav
- Reader, Department of Pedodontics and Preventive Dentistry Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Abhay Mani Tripathi
- Professor, Department of Pedodontics and Preventive Dentistry Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Mridul Mehrotra
- Professor, Department of Microbiology, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Sonali Saha
- Reader, Department of Pedodontics and Preventive Dentistry Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Nishita Garg
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
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