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Luo S, Chen Y, Zhou W, Canavese F, Li L. Pioneering a chick embryo model to explore the intrauterine etiology of developmental dysplasia of the hip in oligohydramnios conditions. Osteoarthritis Cartilage 2024; 32:869-880. [PMID: 38588889 DOI: 10.1016/j.joca.2024.03.118] [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: 09/26/2023] [Revised: 03/12/2024] [Accepted: 03/14/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVE To explore the impact of oligohydramnios on fetal movement and hip development, given its association with developmental dysplasia of the hip (DDH) but unclear mechanisms. METHODS Chick embryos were divided into four groups based on the severity of oligohydramnios induced by amniotic fluid aspiration (control, 0.2 mL, 0.4 mL, 0.6 mL). Fetal movement was assessed by detection of movement and quantification of residual amniotic fluid volume. Hip joint development was assessed by gross anatomic analysis, micro-computed tomography (micro-CT) for cartilage assessment, and histologic observation at multiple time points. In addition, a subset of embryos from the 0.4 mL aspirated group underwent saline reinfusion and subsequent evaluation. RESULTS Increasing volumes of aspirated amniotic fluid resulted in worsening of fetal movement restrictions (e.g., 0.4 mL aspirated and control group at E10: frequency difference -7.765 [95% CI: -9.125, -6.404]; amplitude difference -0.343 [95% CI: -0.588, -0.097]). The 0.4 mL aspirated group had significantly smaller hip measurements compared to controls, with reduced acetabular length (-0.418 [95% CI: -0.575, -0.261]) and width (-0.304 [95% CI: -0.491, -0.117]) at day E14.5. Histological analysis revealed a smaller femoral head (1.084 ± 0.264 cm) and shallower acetabulum (0.380 ± 0.106 cm) in the 0.4 mL group. Micro-CT showed cartilage matrix degeneration (13.6% [95% CI: 0.6%, 26.7%], P = 0.043 on E14.5). Saline reinfusion resulted in significant improvements in the femoral head to greater trochanter (0.578 [95% CI: 0.323, 0.833], P = 0.001). CONCLUSIONS Oligohydramnios can cause DDH by restricting fetal movement and disrupting hip morphogenesis in a time-dependent manner. Timely reversal of oligohydramnios during the fetal period may prevent DDH.
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Affiliation(s)
- Shaoting Luo
- Department of Pediatric Orthopedics, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110000, PR China
| | - Yufan Chen
- Department of Pediatric Orthopedics, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110000, PR China
| | - Weizheng Zhou
- Department of Pediatric Orthopedics, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110000, PR China
| | - Federico Canavese
- Department of Pediatric Orthopedic Surgery, Lille University Centre, Jeanne de Flandre Hospital, 59000 Lille, France
| | - Lianyong Li
- Department of Pediatric Orthopedics, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110000, PR China.
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Płomiński J, Olesińska J, Kamelska-Sadowska AM, Nowakowski JJ, Zaborowska-Sapeta K. Congenital Muscular Torticollis-Current Understanding and Perinatal Risk Factors: A Retrospective Analysis. Healthcare (Basel) 2023; 12:13. [PMID: 38200919 PMCID: PMC10778664 DOI: 10.3390/healthcare12010013] [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: 10/08/2023] [Revised: 12/09/2023] [Accepted: 12/12/2023] [Indexed: 01/12/2024] Open
Abstract
INTRODUCTION Congenital muscular torticollis (CMT) is an asymmetrical head position resulting from structural changes in the sternocleidomastoid (SCM) muscle that occurs early during a child's development or due to perinatal trauma. Children with CMT exhibit a marked imbalance in tension between the SCMs. In a typical clinical picture, an ultrasound scan is performed to reveal characteristic lesions, such as tissue fibrosis or post-traumatic changes. An early diagnosis of CMT in newborns and the implementation of treatment offer the chance of a complete resolution. Torticollis treatment aims to restore the SCM's normal function. Surgical treatment is performed when conservative methods fail to improve the patient's condition. The indications that surgery is needed include a marked shortening of the SCM, persistent fibrosis in the muscle, constant head and facial asymmetry, and rotation or lateral flexion in the cervical spine restricted by >15°. Of all the newborn and infant anomalies, congenital torticollis is the third most common after hip dysplasia and equinovarus deformities. Some authors demonstrate that torticollis coexists with hip dysplasia. AIM The aim of this study was to collect data on infants referred to paediatric rehabilitation and to identify the risk factors associated with CMT in this group of patients, as well as to assess demographic and clinical characteristics concerning risk factors. MATERIALS AND METHODS The target population for this retrospective study consisted of 111 infants aged 0 to 5 months born in Poland and diagnosed with and undergoing treatment due to CMT. The following were determined: the relationship between the side of the CMT location and the type of delivery (caesarean section vs. vaginal), the relationship between the body weight at birth and the side of the CMT location, the relationship between the extent of SCM thickening and the type of delivery, and the incidence of CMT depending on the order of delivery. RESULTS AND CONCLUSIONS The data revealed that CMT is less common in female infants (n = 51, 46%) compared to male (n = 61, 54%) infants, in whom a greater birth weight was reported (p < 005). Seventy-six percent (76%) of the paediatric patients with CMT were the offspring of primipara mothers. More often, children born via vaginal delivery had left-sided torticollis with a more significant broadening of the SCM, as shown on ultrasound scans, than right-sided torticollis. Theories of torticollis development pathophysiology should be deepened and systematised, and further research is needed.
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Affiliation(s)
- Janusz Płomiński
- Prof. Adam Gruca Independent Public Clinical Hospital CMKP, 05-400 Otwock, Poland;
- Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland
| | - Jolanta Olesińska
- Department of Physiotherapy, College of Rehabilitation, 01-234 Warsaw, Poland;
- Department of Physiotherapy, Prof. Jan Bogdanowicz Children’s Hospital, 03-924 Warsaw, Poland
| | - Anna Malwina Kamelska-Sadowska
- Department of Rehabilitation and Orthopedics, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland;
- Regional Specialised Children’s Hospital, 10-561 Olsztyn, Poland
| | - Jacek Józef Nowakowski
- Department of Ecology and Environmental Protection, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland;
| | - Katarzyna Zaborowska-Sapeta
- Department of Rehabilitation and Orthopedics, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland;
- Regional Specialised Children’s Hospital, 10-561 Olsztyn, Poland
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Poacher AT, Hathaway I, Crook DL, Froud JLJ, Scourfield L, James C, Horner M, Carpenter EC. The impact of the introduction of selective screening in the UK on the epidemiology, presentation, and treatment outcomes of developmental dysplasia of the hip. Bone Jt Open 2023; 4:635-642. [PMID: 37607720 PMCID: PMC10444535 DOI: 10.1302/2633-1462.48.bjo-2022-0158.r1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/24/2023] Open
Abstract
Aims Developmental dysplasia of the hip (DDH) can be managed effectively with non-surgical interventions when diagnosed early. However, the likelihood of surgical intervention increases with a late presentation. Therefore, an effective screening programme is essential to prevent late diagnosis and reduce surgical morbidity in the population. Methods We conducted a systematic review and meta-analysis of the epidemiological literature from the last 25 years in the UK. Articles were selected from databases searches using MEDLINE, EMBASE, OVID, and Cochrane; 13 papers met the inclusion criteria. Results The incidence of DDH within the UK over the last 25 years is 7.3/1,000 live births with females making up 86% of the DDH population (odds ratio 6.14 (95% confidence interval 3.3 to 11.5); p < 0.001). The incidence of DDH significantly increased following the change in the Newborn and Infant Physical Examination (NIPE) guidance from 6.5/1,000 to 9.4/1,000 live births (p < 0.001). The rate of late presentation also increased following the changes to the NIPE guidance, rising from 0.7/1,000 to 1.2/1,000 live births (p < 0.001). However, despite this increase in late-presenting cases, there was no change in the rates of surgical intervention (0.8/1,000 live births; p = 0.940). Conclusion The literature demonstrates that the implementation of a selective screening programme increased the incidence of DDH diagnosis in the UK while subsequently increasing the rates of late presentation and failing in its goal of reducing the rates of surgical intervention for DDH.
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Affiliation(s)
| | | | | | | | | | - Catherine James
- Trauma Department, University Hospital of Wales, Cardiff, UK
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Anant M, Murmu S, Priya S. A Randomized Trial of Inpatient and Home-Based Maternal Oral Hydration Therapy in Isolated Oligohydramnios and Its Effect on Amniotic Fluid Index and Perinatal Outcome. Cureus 2023; 15:e41326. [PMID: 37539407 PMCID: PMC10396315 DOI: 10.7759/cureus.41326] [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] [Accepted: 07/03/2023] [Indexed: 08/05/2023] Open
Abstract
Background Isolated oligohydramnios, without any known fetal/maternal abnormality, may be associated with insufficient oral intake (such as water, glucose, and rehydration therapy). Therefore, the present study was conducted to assess the improvement following maternal hydration. Method A total of 50 cases of isolated oligohydramnios (other high-risk pregnancy conditions not present) were included in the study (25 in each group). Patients were encouraged for an additional 2 liters of oral rehydration solution intake daily along with regular diet. The fluid intake was unsupervised in the home group and supervised in the hospital group. Serial amniotic fluid index (AFI) measurements and fetal monitoring were performed. Birth weight and APGAR scores were recorded, and data were analyzed. Results The two groups were comparable in terms of demographics and baseline laboratory findings. AFI significantly improved in the hospital group compared to the home group (p-value: <0.001). Birth weight, placental weight, and APGAR scores were also significantly better in the hospital group than in the home group. Conclusion Maternal oral hydration therapy improves the amniotic fluid volume and subsequently improves the perinatal outcome. Due to poor compliance with home-based treatment, institution of supervised hydration therapy is recommended.
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Affiliation(s)
- Monika Anant
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Patna, Patna, IND
| | - Suhagini Murmu
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Patna, Patna, IND
| | - Swati Priya
- Obstetrics and Gynecology, All India Institute of Medical Sciences, Deoghar, Deoghar, IND
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Poacher AT, Froud JLJ, Caterson J, Crook DL, Ramage G, Marsh L, Poacher G, Carpenter EC. The cost effectiveness of potential risk factors for developmental dysplasia of the hip within a national screening programme. Bone Jt Open 2023; 4:234-240. [PMID: 37051819 PMCID: PMC10067325 DOI: 10.1302/2633-1462.44.bjo-2022-0135.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
Aims Early detection of developmental dysplasia of the hip (DDH) is associated with improved outcomes of conservative treatment. Therefore, we aimed to evaluate a novel screening programme that included both the primary risk factors of breech presentation and family history, and the secondary risk factors of oligohydramnios and foot deformities. Methods A five-year prospective registry study investigating every live birth in the study’s catchment area (n = 27,731), all of whom underwent screening for risk factors and examination at the newborn and six- to eight-week neonatal examination and review. DDH was diagnosed using ultrasonography and the Graf classification system, defined as grade IIb or above or rapidly regressing IIa disease (≥4o at four weeks follow-up). Multivariate odds ratios were calculated to establish significant association, and risk differences were calculated to provide quantifiable risk increase with DDH, positive predictive value was used as a measure of predictive efficacy. The cost-effectiveness of using these risk factors to predict DDH was evaluated using NHS tariffs (January 2021). Results The prevalence of DDH that required treatment within our population was 5/1,000 live births. The rate of missed presentation of DDH was 0.43/1000 live births. Breech position, family history, oligohydramnios, and foot deformities demonstrated significant association with DDH (p < 0.0001). The presence of breech presentation increased the risk of DDH by 1.69% (95% confidence interval (CI) 0.93% to 2.45%), family history by 3.57% (95% CI 2.06% to 5.09%), foot deformities by 8.95% (95% CI 4.81% to 13.1%), and oligohydramnios nby 11.6% (95 % CI 3.0% to 19.0%). Primary risk factors family history and breech presentation demonstrated an estimated cost-per-case detection of £6,276 and £11,409, respectively. Oligohydramnios and foot deformities demonstrated a cost-per-case detected less than the cost of primary risk factors of £2,260 and £2,670, respectively. Conclusion The inclusion of secondary risk factors within a national screening programme was clinically successful as they were more cost and resource-efficient predictors of DDH than primary risk factors, suggesting they should be considered in the national guidance. Cite this article: Bone Jt Open 2023;4(4):234–240.
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Affiliation(s)
- Arwel T. Poacher
- Trauma Department, University Hospital of Wales, Cardiff, UK
- Correspondence should be sent to Arwel T. Poacher. E-mail:
| | | | | | | | | | - Luke Marsh
- Cardiff University School of Medicine, Cardiff, UK
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Ahmed B. Amnioinfusion in severe oligohydramnios with intact membrane: an observational study. J Matern Fetal Neonatal Med 2021; 35:6518-6521. [PMID: 34024224 DOI: 10.1080/14767058.2021.1918081] [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: 10/21/2022]
Abstract
OBJECTIVE The objective of this article was to evaluate the outcome of transabdominal amnioinfusion in pregnant patients with oligohydramnios. METHOD This is a prospective observational study involving 80 cases of oligohydramnios treated with transabdominal amnioinfusion guided by ultrasound, in the period between 2011 and 2016. The patients were treated in two centers; however, all the procedures were performed by the same operator. RESULTS The mean gestational age at the first treatment was 24 weeks. Some patients received more than one amnioinfusion. The mean interval between the first infusion and delivery was 31 d. Perinatal and neonatal mortalities were 45% and 35%, respectively. There were five cases of chorioamnioitis and in majority of the cases; the final diagnosis was made after amnioinfusion. CONCLUSION The procedure has been proven to be very safe. The result showed a high perinatal mortality which was not surprising, as these pregnancies were complicated by a major fetal malformation. Significantly, this study showed that the diagnosis accuracy of the concomitant congenital fetal malformation was significantly improved. The diagnosis accuracy had a major impact on the management of patients, especially the mode of delivery.
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Affiliation(s)
- Badreldeen Ahmed
- Weill Cornell Medicine-Qatar, Doha, Qatar.,Feto Maternal Center, Doha, Qatar.,Medical School, Qatar University, Doha, Qatar
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Abstract
This study aimed to assess the association between maternal-isolated oligohydramnios (IO) and offspring long-term neurological complications. A population-based retrospective cohort study was conducted, including all births at a single tertiary medical center in Israel between the years 1991 and 2014. Multiple pregnancies and potential pregnancy complications associated with oligohydramnios were excluded. The computerized obstetrical database was linked with the computerized dataset of all pediatric hospitalizations of the same medical center. Evaluation of cumulative neurological-associated hospitalizations rate over time was compared using a Kaplan-Meier survival curve. The Weibull survival parametric model was conducted to assess the neurological-associated hospitalization risk in the presence of IO, while accounting for potential confounders. A total of 190,259 pregnancies were included in the study, of which 4063 (2.13%) pregnancies were complicated with IO. Total neurological-related hospitalizations were significantly more common in the IO group (3.7% in the IO group and 3.0% in the comparison group, p = 0.005). Pervasive developmental disorder, movement disorders, developmental disorders, and degenerative and demyelization disorders were all specific neurological diagnoses significantly more common in the exposed group. The survival curve demonstrated a significantly higher cumulative hospitalization rate in the exposed group (log-rank p = 0.001). Using a multivariate model adjusting for gestational age, maternal age, and labor induction, an independent association between IO and long-term neurological morbidity of the offspring was observed (adjusted hazard ratio 1.203; 95% CI 1.02-1.42). In summary, a significant association was found between pregnancies complicated by IO and long-term neurological morbidity of the offspring.
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Abstract
Breech, family history, first born and female sex are the main risk factors described for developmental dysplasia of the hip (DDH). Foot abnormalities and oligohydramnios have also been listed. Recent studies have discredited torticollis, multiple gestation pregnancy, mode of delivery and prematurity as risk factors. Definition of oligohydramnios in the literature is inconsistent. Our aim was to investigate the term oligohydramnios and evaluate whether it should be considered a risk factor for DDH. All live births in our institution between 2001 and 2014 were included. We identified all pregnancies classed as reduced amniotic fluid (AF) or oligohydramnios over that period. Data on DDH, breech presentation, female sex and positive family history were collected. The significance level was set to 5%. We identified 73 990 live births, 3408 pregnancies were classed as reduced AF or oligohydramnios. The incidence of DDH (Graf type IIb and higher) was 1: 1000 (75 babies, 18 bilateral). Oligohydramnios/reduced AF was found in 12 (16%) DDH babies. Breech presentation was found in 24 (32%), positive family history in 19 (25%) and female sex in 71 (94.7%). Oligohydramnios was found to be associated with a higher odds ratio (OR) for DDH [OR = 3.9, 95% confidence interval (CI): 2.1-7.3] as were breech presentation (OR = 10.6, 95% CI: 6.5-17.1) and female sex (OR = 19.1, 95% CI: 7-52.4). All examined risk factors showed statistical significance (P < 0.05). A regression analysis was performed to control for interactions and confounding factors and confirmed the findings. On the basis of our findings the diagnosis of reduced AF/oligohydramnios in consecutive antenatal sonographic scans should be regarded as an independent risk factor for DDH and be considered in any future studies regarding DDH. Level of evidence: Level IV: Case series.
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Is higher mean platelet volume an additional predictive marker of oligohydramnios and polyhydramnios? JOURNAL OF CONTEMPORARY MEDICINE 2019. [DOI: 10.16899/jcm.605491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Taneja A, Arora K, Chopra I, Naik SS. Pregnancy Outcomes in Isolated Oligohydramnios during Second Trimester: A Case Series. J Clin Diagn Res 2017; 11:QR01-QR02. [PMID: 28969220 DOI: 10.7860/jcdr/2017/27722.10502] [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: 02/19/2017] [Accepted: 07/15/2017] [Indexed: 11/24/2022]
Abstract
Oligohydramnios is associated with increased maternal and foetal morbidities. However, some of the recent studies have shown no adverse effect of isolated oligohydramnios on perinatal outcome and recommends continuation of pregnancy. Pregnancies between 18-28 weeks with isolated Oligohydramnios were included. History and physical examination was recorded in a pre-designed proforma. All the cases received care as per the protocol. A total of seven patients were recruited of which one was a twin pregnancy with Oligohydramnios in both sacs. The mean age at presentation was 30 years. Three patients went into spontaneous explusion at an average gestational age of 22-24 weeks. One patient with twins delivered vaginally at 32 weeks. Rest were delivered by caesarean section between 34-35 weeks (indication in majority of the cases was foetal distress and cord compression). None of the babies suffered any complication and were discharged in good condition. Isolated oligohydramnios during second trimester does not increase adverse perinatal outcome significantly (but increases the caesarean section rate) and therefore, should not be an indication for termination of pregnancy.
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Affiliation(s)
- Ashima Taneja
- Professor, Department of Obstetrics and Gynaecology, Dayanand Medical College, Ludhiana, Punjab, India
| | - Kamaldeep Arora
- Assistant Professor, Department of Paediatrics, Dayanand Medical College, Ludhiana, Punjab, India
| | - Isha Chopra
- Senior Resident, Department of Obstetrics and Gynaecology, Dayanand Medical College, Ludhiana, Punjab, India
| | - Sushree Samiksha Naik
- Senior Resident, Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Abstract
The aim of the study was to investigate the etiology and pregnancy outcomes in mothers with polyhydramnios through prenatal diagnosis and pregnancy outcome analysis of pregnant women with polyhydramnios. One hundred and thirty women were enrolled. Fifty pregnant women with polyhydramnios were categorized as the case group, and 80 pregnant women with normal amniotic fluid were categorized as the control group. The causes of polyhydramnios and the pregnancy outcomes were analyzed. Two cases had chromosomal abnormalities, seven had severe α-thalassemia, 15 had fetal anomalies, four had maternal-fetal diseases and 22 had unexplained idiopathic polyhydramnios. Significantly, higher occurrences of cesarean section, preterm birth, fetal anomaly, fetal distress, fetal macrosomia and female fetuses occurred in patients with polyhydramnios than in patients without polyhydramnios. Polyhydramnios is associated with a higher occurrence of adverse perinatal outcomes. Intensive monitoring of the maternal-fetal condition and prenatal diagnosis is important in patients with polyhydramnios.
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Affiliation(s)
- Li-Ling Liu
- a Department of Obstetrics and Gynecology , The First Affiliated Hospital of Guangxi Medical University , Nanning , China
| | - Li-Hong Pang
- a Department of Obstetrics and Gynecology , The First Affiliated Hospital of Guangxi Medical University , Nanning , China
| | - Bi-Ye Deng
- a Department of Obstetrics and Gynecology , The First Affiliated Hospital of Guangxi Medical University , Nanning , China
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Anomalías nefrourológicas congénitas. Una visión para el pediatra. An Pediatr (Barc) 2015; 83:442.e1-5. [DOI: 10.1016/j.anpedi.2015.07.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 07/30/2015] [Indexed: 10/22/2022] Open
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Palacios Loro M, Segura Ramírez D, Ordoñez Álvarez F, Santos Rodríguez F. Congenital anomalies of the kidney and urinary tract. A vision for the paediatrician. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2015. [DOI: 10.1016/j.anpede.2015.07.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
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Benzer N, Tazegül Pekin A, Yılmaz SA, Seçilmiş Kerimoğlu Ö, Doğan NU, Çelik Ç. Predictive value of second and third trimester fetal renal artery Doppler indices in idiopathic oligohydramnios and polyhydramnios in low-risk pregnancies: A longitudinal study. J Obstet Gynaecol Res 2014; 41:523-8. [DOI: 10.1111/jog.12601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 08/16/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Nilgün Benzer
- Department of Obstetrics and Gynecology; Faculty of Medicine; Selçuk University; Konya Turkey
| | - Aybike Tazegül Pekin
- Department of Obstetrics and Gynecology; Faculty of Medicine; Selçuk University; Konya Turkey
| | - Setenay Arzu Yılmaz
- Department of Obstetrics and Gynecology; Faculty of Medicine; Selçuk University; Konya Turkey
| | | | - Nasuh Utku Doğan
- Department of Obstetrics and Gynecology; Faculty of Medicine; Akdeniz University; Antalya Turkey
| | - Çetin Çelik
- Department of Obstetrics and Gynecology; Faculty of Medicine; Selçuk University; Konya Turkey
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Özkan MB, Özkan E, Emiroglu B, Özkaya E. Doppler Study of the Fetal Renal Artery in Oligohydramnios with Post-term Pregnancy. J Med Ultrasound 2014. [DOI: 10.1016/j.jmu.2013.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Abstract
Introduction: Amniotic fluid, once thought to merely provide protection and room for necessary movement and growth for the fetus, is now understood to be a highly complex and dynamic system that is studied as a data point to interpret fetal wellbeing. Methods: Assessment of amniotic fluid volume is now routine when performing a sonographic evaluation of fetal status and is an important consideration in the assessment and management of perinatal morbidity and mortality.1,2 In this review, we will cover the dynamics that affect amniotic fluid volume, review methods for measurement and quantification of volume, review definitions for normative data as related to neonatal outcomes, and provide evidence based guidance on the workup and management options for oligoydramnios and polyhydramnios in singleton and twin pregnancies. Conclusions: When abnormalities of fluid exist, appropriate workup to uncover the underlying etiology should be initiated as adverse fetal outcomes are sometimes associated with these variations from normalcy.
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Affiliation(s)
| | - Everett F Magann
- University of Arkansas for Medical Sciences Little Rock Arkansas USA
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