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Navon I, Romano A, Pardo A, Matot R, Toledano Y, Barbash Hazan S, Hadar E. Flat maternal glucose response curve and adverse pregnancy outcome. J Perinatol 2023; 43:1101-1104. [PMID: 37173359 DOI: 10.1038/s41372-023-01691-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 04/21/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVE The significance of a flat oral glucose tolerance test (OGTT) response curve in pregnancy remains unclear. We investigated the association of a flat curve with pregnancy outcomes. STUDY DESIGN Retrospective cohort study. Flat OGTT curve was defined by an area under the curve below the 10th percentile. Pregnancy outcomes were compared between flat and normal curve. RESULTS Of the 2673 eligible women, 269 had a flat response curve. Compared with the normal-response group, the flat-curve group had a lower mean birthweight (3363 ± 547 g vs. 3459 ± 519 g, p < 0.005), higher probability of small for gestational age (SGA) (19% vs. 12%, p < 0.005, aOR = 1.75, 95% CI 1.24-2.47), and 5-min Apgar score < 7 (1.12% vs. 0.29%, p < 0.05, aOR = 3.95, 95% CI 1.01-15.5). There were no differences in obstetric or maternal outcomes. CONCLUSIONS Flat OGTT is associated with lower birthweight, higher rates of SGA, and low Apgar scores. Detecting this previously unrecognized risk group, could potentially reduce these complications.
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Affiliation(s)
- Inbal Navon
- Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, 4941492, Israel.
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel.
| | - Asaf Romano
- Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, 4941492, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel
| | - Anat Pardo
- Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, 4941492, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel
| | - Ran Matot
- Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, 4941492, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel
| | - Yoel Toledano
- Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, 4941492, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel
| | - Shiri Barbash Hazan
- Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, 4941492, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel
| | - Eran Hadar
- Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, 4941492, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel
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Houri O, Walfisch A, Shilony A, Zafrir-Danieli H, Hendin N, Matot R, Navon I, Hadar E. Decision-to-delivery interval and neonatal outcomes in intrapartum umbilical cord prolapse. BMC Pregnancy Childbirth 2023; 23:463. [PMID: 37349738 DOI: 10.1186/s12884-023-05788-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 06/15/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND Rapid delivery is important in cases of umbilical cord prolapse to prevent hypoxic injury to the fetus/neonate. However, the optimal decision-to-delivery interval remains controversial. OBJECTIVE The aim of the study was to investigate the association between the decision-to-delivery interval in women with umbilical cord prolapse, stratified by fetal heart rate pattern at diagnosis, and neonatal outcome. STUDY DESIGN The database of a tertiary medical center was retrospectively searched for all cases of intrapartum cord prolapse between 2008 and 2021. The cohort was divided into three groups according to findings on the fetal heart tracing at diagnosis: 1) bradycardia; 2) decelerations without bradycardia; and 3) reassuring heart rate. The primary outcome measure was fetal acidosis. The correlation between cord blood indices and decision-to-delivery interval was analyzed using Spearman's rank correlation coefficient. RESULTS Of the total 103,917 deliveries performed during the study period, 130 (0.13%) were complicated by intrapartum umbilical cord prolapse. Division by fetal heart tracing yielded 22 women (16.92%) in group 1, 41 (31.53%) in group 2, and 67 (51.53%) in group 3. The median decision-to-delivery interval was 11.0 min (IQR 9.0-15.0); the interval was more than 20 min in 4 cases. The median cord arterial blood pH was 7.28 (IQR 7.24-7.32); pH was less than 7.2 in 4 neonates. There was no correlation of cord arterial pH with decision-to-delivery interval (Spearman's Ρ = - 0.113; Ρ = 0.368) or with fetal heart rate pattern (Spearman's Ρ = .425; Ρ = .079, Ρ = - .205; Ρ = .336, Ρ = - .324; Ρ = .122 for groups 1-3, respectively). CONCLUSION Intrapartum umbilical cord prolapse is a relatively rare obstetric emergency with an overall favorable neonatal outcome if managed in a timely manner, regardless of the immediately preceding fetal heart rate. In a clinical setting which includes a high obstetric volume and a rapid, protocol-based, response, there is apparently no significant correlation between decision-to-delivery interval and cord arterial cord pH.
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Affiliation(s)
- Ohad Houri
- Helen Schneider Hospital for Women, Rabin Medical Center - Beilinson Hospital, 39 Jabotinsky St., 4941492, Petach Tikva, Israel.
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Asnat Walfisch
- Helen Schneider Hospital for Women, Rabin Medical Center - Beilinson Hospital, 39 Jabotinsky St., 4941492, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Adi Shilony
- Helen Schneider Hospital for Women, Rabin Medical Center - Beilinson Hospital, 39 Jabotinsky St., 4941492, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hadas Zafrir-Danieli
- Helen Schneider Hospital for Women, Rabin Medical Center - Beilinson Hospital, 39 Jabotinsky St., 4941492, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Natav Hendin
- Helen Schneider Hospital for Women, Rabin Medical Center - Beilinson Hospital, 39 Jabotinsky St., 4941492, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ran Matot
- Helen Schneider Hospital for Women, Rabin Medical Center - Beilinson Hospital, 39 Jabotinsky St., 4941492, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Inbal Navon
- Helen Schneider Hospital for Women, Rabin Medical Center - Beilinson Hospital, 39 Jabotinsky St., 4941492, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eran Hadar
- Helen Schneider Hospital for Women, Rabin Medical Center - Beilinson Hospital, 39 Jabotinsky St., 4941492, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Doctory N, Romano A, Navon I, Barbash-Hazan S, Bardin R, Hadar E. Placental location and obstetrical-neonatal outcomes: A retrospective study. Int J Gynaecol Obstet 2023; 160:641-645. [PMID: 35749141 DOI: 10.1002/ijgo.14316] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 06/11/2022] [Accepted: 06/20/2022] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To explore the potential association of lateral placentation with pregnancy outcome. METHODS The database of a tertiary medical center was searched for women who gave birth to a singleton neonate from 2012 to 2020 for whom placental location was documented during antepartum sonographic examination. Clinical data were compared between patients with a central (anterior/posterior/fundal) or lateral placenta using standard statistics. The primary outcome measure was neonatal birthweight, and secondary outcome measures were pregnancy complications and mode of delivery. RESULTS The cohort included 12 306 women: 11 608 (94%) with a central placenta and 698 (5.6%) with a lateral placenta. The lateral placenta group had higher rates (P < 0.05) of prior and current cesarean delivery, assisted delivery, and preterm birth. On multivariate regression analyses, placental location (adjusted odds ratio [aOR], 1.36; 95% confidence interval [CI], 1.11-1.66) and maternal age (aOR, 1.02; 95% CI, 1.01-1.03) were associated with risk of preterm birth. Lateral placenta (aOR, 1.22; 95% CI, 1.02-1.47), maternal age (aOR, 1.07; 95% CI, 1.06-1.08), parity (aOR, 0.32; 95% CI, 0.28-0.35), and prior cesarean delivery (aOR, 12.00; 95% CI, 10.60-13.60) were associated with risk of current cesarean delivery. CONCLUSION The findings suggest that lateral placentation may pose a risk of preterm birth and cesarean delivery compared with central placentation.
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Affiliation(s)
- Neta Doctory
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Asaf Romano
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Inbal Navon
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shiri Barbash-Hazan
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ron Bardin
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eran Hadar
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Navon I, Wertheimer A, Hochberg A, Sapir O, Ben-Haroush A, Altman E, Domniz N, Shochat T, Shufaro Y. P-770 Is there an association between blood hCG elevation rate in very early IVF pregnancy and adverse pregnancy outcomes? Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Is a slow elevation rate between the first and second hCG values following a successful fresh IVF cycle associated with long-term pregnancy outcomes?
Summary answer
A slow rate of hCG elevation in early IVF pregnancies is associated with an increased risk for low birth weight neonates.
What is known already
IVF pregnancies are associated with higher prevalence of late obstetrical complications such as preterm birth, preeclampsia and small for gestational age. Different baseline characteristics and treatment parameters are associated with obstetrical complications. Abnormal, mostly slow, hCG elevation patterns have been strongly associated with short-term adverse pregnancy outcomes such as non-viability, miscarriage, early fetal demise and ectopic pregnancies. However, the long-term impact of slow hCG elevation rate on pregnancies that do continue to term is unknown.
Study design, size, duration
Single center cohort study between 2008-2019 including 703 fresh cycles resulting in live singleton birth. Full obstetrical data for these pregnancies was available.
Participants/materials, setting, methods
The first blood hCG measurement was performed 14±1.4 days after ovum pick-up (OPU), and the second one 48-72h later. The slope between the two measurements was calculated and adjusted per day. Slow hCG elevation was defined as a slope value below the 10th percentile. Maternal and short-term neonatal outcomes were compared between cycles with a slow elevation (n = 71) and a “normal” elevation (n = 632) in hCG values. Multivariate analysis was used to control for potential confounders.
Main results and the role of chance
There were no differences between the slow and normal hCG elevation groups in maternal age, numbers of retrieved oocytes, ICSI rates, number of transferred and usable embryos, and gestational age at delivery. Neonates from cycles with a slow hCG elevation weighed significantly less (2876±619 gr vs. 3083±553 gr, p < 0.005) and were at a higher risk (21% vs. 12%, OR = 1.96, 95% CI 1.06-3.64) of having low birth weight (LBW) (below 2500 grams). Women with slow hCG elevation rate had more hypertension-preeclampsia related complications (11% vs. 6%, p < 0.05), although barely reaching statistical significance in the multivariate analysis (OR = 1.76, 95% CI 1.0-3.6).
Limitations, reasons for caution
Retrospective design, single center, applicability to fresh cycles only.
Wider implications of the findings
Very early (5th week) initial blood hCG elevation slope, measured only in IVF gestations, might be a novel marker for identifying patients at risk for hypertensive complications during pregnancy and low birth-weight neonates. Tighter prenatal care for these patients could potentially reduce pregnancy complications and improve long-term outcome.
Trial registration number
not applicable
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Affiliation(s)
- I Navon
- Rabin Medical Center, Infertility and IVF Unit- Helen Schneider Hospital for Women , Petah Tikva, Israel
| | - A Wertheimer
- Rabin Medical Center, Infertility and IVF Unit- Helen Schneider Hospital for Women , Petah Tikva, Israel
| | - A Hochberg
- Rabin Medical Center, Infertility and IVF Unit- Helen Schneider Hospital for Women , Petah Tikva, Israel
| | - O Sapir
- Rabin Medical Center, Infertility and IVF Unit- Helen Schneider Hospital for Women , Petah Tikva, Israel
| | - A Ben-Haroush
- Rabin Medical Center, Infertility and IVF Unit- Helen Schneider Hospital for Women , Petah Tikva, Israel
| | - E Altman
- Rabin Medical Center, Infertility and IVF Unit- Helen Schneider Hospital for Women , Petah Tikva, Israel
| | - N Domniz
- Rabin Medical Center, Infertility and IVF Unit- Helen Schneider Hospital for Women , Petah Tikva, Israel
| | - T Shochat
- Rabin Medical Center, Infertility and IVF Unit- Helen Schneider Hospital for Women , Petah Tikva, Israel
| | - Y Shufaro
- Rabin Medical Center, Infertility and IVF Unit- Helen Schneider Hospital for Women , Petah Tikva, Israel
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Hadar E, Wolff L, Tenenbaum-Gavish K, Eisner M, Shmueli A, Barbash-Hazan S, Bergel R, Shmuel E, Houri O, Dollinger S, Brzezinski-Sinai NA, Sukenik S, Pardo A, Navon I, Wilk Y, Zafrir-Danieli H, Wiznitzer A. Mobile Self-Operated Home Ultrasound System for Remote Fetal Assessment During Pregnancy. Telemed J E Health 2021; 28:93-101. [PMID: 33729014 DOI: 10.1089/tmj.2020.0541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background: Mobile medical devices for self-patient use are a rapidly evolving section of telehealth. We examined the INSTINCT® ultrasound system, a portable, self-operated ultrasound device attached to a commercial smartphone for remote fetal assessment. We aimed to evaluate whether it is feasible to use remote fetal assessment during pregnancy. Materials and Methods: This is an observational noninterventional trial. We included women with a singleton fetus at 14 + 0 to 39 + 6 gestational weeks. Each participant received the device for a self-use period of 7-14 days and was instructed to perform one to three scans a day. Participants completed a self-assessment questionnaire to evaluate safety and usability (i.e., user experience and satisfaction). Each scan was evaluated for fetal heart activity, amniotic fluid volume, fetal tone, fetal body, and breathing movements. Results: One hundred women, completing 1,360 self scans, used the device for 8.1 ± 1.5 days, performing an average of 13.6 ± 6.2 scans each. There were no device-related serious adverse events. Success in detection was 95.3% for fetal heart activity, 88.3% for body movements, 69.4% for tone, 92.2% for normal amniotic fluid volume, and 23.8% for breathing movements. Interobserver agreement was 94.4% for fetal heart rate activity, 85.9% for body movements, 69.5% for fetal tone, 86.9% for amniotic fluid volume, and 94.0% for breathing movements. Self-assessed user experience was rated at 4.4/5, whereas device satisfaction was rated at 3.9/5. Conclusion: The INSTINCT ultrasound system is a feasible solution for remote sonographic fetal assessment. Further studies are needed to assess its role and impact in telehealth antenatal care and fetal surveillance.
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Affiliation(s)
- Eran Hadar
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Leor Wolff
- Translational Innovation and eHealth Wing, Clalit Health Services, Tel-Aviv, Israel
| | - Kinneret Tenenbaum-Gavish
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Michal Eisner
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Anat Shmueli
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Shiri Barbash-Hazan
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Riki Bergel
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Elyasaf Shmuel
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Ohad Houri
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Sarah Dollinger
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Noa A Brzezinski-Sinai
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Shay Sukenik
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Anat Pardo
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Inbal Navon
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Yulia Wilk
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Hadas Zafrir-Danieli
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Arnon Wiznitzer
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Greenman Y, Kuperman Y, Drori Y, Asa SL, Navon I, Forkosh O, Gil S, Stern N, Chen A. Postnatal ablation of POMC neurons induces an obese phenotype characterized by decreased food intake and enhanced anxiety-like behavior. Mol Endocrinol 2013; 27:1091-102. [PMID: 23676213 DOI: 10.1210/me.2012-1344] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Proopiomelanocortin (POMC) neurons in the arcuate nucleus of the hypothalamus are central components of systems regulating appetite and energy homeostasis. Here we report on the establishment of a mouse model in which the ribonuclease III ribonuclease Dicer-1 has been specifically deleted from POMC-expressing neurons (POMC(ΔDCR)), leading to postnatal cell death. Mice are born phenotypically normal, at the expected genetic ratio and with normal hypothalamic POMC-mRNA levels. At 6 weeks of age, no POMC neurons/cells could be detected either in the arcuate nucleus or in the pituitary of POMC(ΔDCR) mice. POMC(ΔDCR) develop progressive obesity secondary to decreased energy expenditure but unrelated to food intake, which was surprisingly lower than in control mice. Reduced expression of AgRP and ghrelin receptor in the hypothalamus and reduced uncoupling protein 1 expression in brown adipose tissue can potentially explain the decreased food intake and decreased heat production, respectively, in these mice. Fasting glucose levels were dramatically elevated in POMC(ΔDCR) mice and the glucose tolerance test revealed marked glucose intolerance in these mice. Secondary to corticotrope ablation, basal and stress-induced corticosterone levels were undetectable in POMC(ΔDCR) mice. Despite this lack of activation of the neuroendocrine stress response, POMC(ΔDCR) mice exhibited an anxiogenic phenotype, which was accompanied with elevated levels of hypothalamic corticotropin-releasing factor and arginine-vasopressin transcripts. In conclusion, postnatal ablation of POMC neurons leads to enhanced anxiety and the development of obesity despite decreased food intake and glucocorticoid deficiency.
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Affiliation(s)
- Yona Greenman
- Institute of Endocrinology, Metabolism, and Hypertension, Tel Aviv-Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
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Tang A, Watson JW, Aclander J, Alster J, Asryan G, Averichev Y, Barton D, Baturin V, Bukhtoyarova N, Carroll A, Gushue S, Heppelmann S, Leksanov A, Makdisi Y, Malki A, Minina E, Navon I, Nicholson H, Ogawa A, Panebratsev Y, Piasetzky E, Schetkovsky A, Shimanskiy S, Zhalov D. n-p short-range correlations from (p,2p+n) measurements. Phys Rev Lett 2003; 90:042301. [PMID: 12570411 DOI: 10.1103/physrevlett.90.042301] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2002] [Indexed: 05/24/2023]
Abstract
We studied the 12C(p,2p+n) reaction at beam momenta of 5.9, 8.0, and 9.0 GeV/c. For quasielastic (p,2p) events p(f), the momentum of the knocked-out proton before the reaction, was compared (event by event) with p(n), the coincident neutron momentum. For |p(n)|>k(F)=0.220 GeV/c (the Fermi momentum) a strong back-to-back directional correlation between p(f) and p(n) was observed, indicative of short-range n-p correlations. From p(n) and p(f) we constructed the distributions of c.m. and relative motion in the longitudinal direction for correlated pairs. We also determined that 49+/-13% of events with |p(f)|>k(F) had directionally correlated neutrons with |p(n)|>k(F).
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Affiliation(s)
- A Tang
- Department of Physics, Kent State University, Kent, Ohio 44242, USA
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Leksanov A, Alster J, Asryan G, Averichev Y, Barton D, Baturin V, Bukhtoyarova N, Carroll A, Heppelmann S, Kawabata T, Makdisi Y, Malki A, Minina E, Navon I, Nicholson H, Ogawa A, Panebratsev Y, Piasetzky E, Schetkovsky A, Shimanskiy S, Tang A, Watson JW, Yoshida H, Zhalov D. Energy dependence of nuclear transparency in C (p,2p) scattering. Phys Rev Lett 2001; 87:212301. [PMID: 11736334 DOI: 10.1103/physrevlett.87.212301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2001] [Indexed: 05/23/2023]
Abstract
The transparency of carbon for (p,2p) quasielastic events was measured at beam momenta ranging from 5.9 to 14.5 GeV/c at 90 degrees c.m. The four-momentum transfer squared (Q2) ranged from 4.7 to 12.7 (GeV/c)(2). We present the observed beam momentum dependence of the ratio of the carbon to hydrogen cross sections. We also apply a model for the nuclear momentum distribution of carbon to obtain the nuclear transparency. We find a sharp rise in transparency as the beam momentum is increased to 9 GeV/c and a reduction to approximately the Glauber level at higher energies.
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Affiliation(s)
- A Leksanov
- Physics Department, Pennsylvania State University, University Park, Pennsylvania 16801, USA
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Rahav A, Alster J, Ashery D, Lichtenstadt J, Navon I, Piasetzky E, Amaudruz P, Botje M, Burger W, Ingram CH, Schumacher RA, Sennhauser U, Wood SA. Measurement of the 12C( pi,2 pi ) reactions and possible evidence of a double- Delta excitation. Phys Rev Lett 1991; 66:1279-1282. [PMID: 10043165 DOI: 10.1103/physrevlett.66.1279] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Mukhopadhyay S, Levenson S, Segel RE, Garino G, Geesaman D, Schiffer JP, Stephans G, Zeidman B, Ungricht E, Jackson H, Kowalczyk R, Ashery D, Piasetsky E, Moinester M, Navon I, Smith LC, Minehart RC, Das GS, Whitney RR, Mckeown R, Anderson B, Madey R, Watson J. Pion absorption by 3He at the Delta -resonance energy. Phys Rev C Nucl Phys 1991; 43:957-972. [PMID: 9967139 DOI: 10.1103/physrevc.43.957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Smith LC, Minehart RC, Ashery D, Piasetsky E, Moinester M, Navon I, Geesaman DF, Schiffer JP, Stephens G, Zeidman B, Levinson S, Mukhopadhyay S, Segel RE, Anderson B, Madey R, Watson J, Whitney RR. Reaction 3He( pi +,pp)p at T pi =350 and 500 MeV. Phys Rev C Nucl Phys 1989; 40:1347-1362. [PMID: 9966109 DOI: 10.1103/physrevc.40.1347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Ahmad S, Azuelos G, Blecher M, Bryman DA, Burnham RA, Clifford ET, Depommier P, Dixit MS, Gotow K, Hargrove CK, Hasinoff M, Leitch M, Macdonald JA, Mes H, Navon I, Numao T, Poutissou JM, Poutissou R, Schlatter P, Spuller J, Summhammer J. Search for muon-electron and muon-positron conversion. Phys Rev D Part Fields 1988; 38:2102-2120. [PMID: 9959362 DOI: 10.1103/physrevd.38.2102] [Citation(s) in RCA: 53] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Bryman DA, Clifford ET, Leitch MJ, Navon I, Numao T, Schlatter P, Dixit MS, Hargrove CK, Mes H, Burnham RA, Hasinoff M, Poutissou J, Macdonald JA, Spuller J, Azuelos G, Depommier P, Martin J, Poutissou R, Blecher M, Gotow K, Carter AL, Anderson HL, Wright SC. Search for micro-e conversion in Ti. Phys Rev Lett 1985; 55:465-468. [PMID: 10032360 DOI: 10.1103/physrevlett.55.465] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Navon I, Fuchs Z, Modan M. [Hazards of accidents in hospitalized patients at Sheba Medical Center: a survey]. Ahot Beyisrael 1983; 34:3-9, 39. [PMID: 6560515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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