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Cuello JP, Martínez Ginés ML, García Domínguez JM, Tejeda-Velarde A, Lozano Ros A, Higueras Y, Meldaña Rivera A, Goicochea Briceño H, Garcia-Tizon S, de León-Luis J, Medina Heras S, Fernández Velasco JI, Pérez-Pérez S, García-Martínez MÁ, Pardo-Rodríguez B, Domínguez-Mozo MI, García-Calvo E, Estévez H, Luque-García JL, Villar LM, Alvarez-Lafuente R. Short-chain fatty acids during pregnancy in multiple sclerosis: A prospective cohort study. Eur J Neurol 2021; 29:895-900. [PMID: 34662474 DOI: 10.1111/ene.15150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 08/27/2021] [Accepted: 10/07/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND PURPOSE Short-chain fatty acids (SCFAs) can have pro- or anti-inflammatory properties, but their relationship with multiple sclerosis (MS) relapses during pregnancy remains unknown. This study aimed to explore SCFA profiles in MS patients during pregnancy and to assess their association with the appearance of relapses during pregnancy and postpartum. METHODS We prospectively included 53 pregnant MS patients and 21 healthy control women. Patients were evaluated during pregnancy and puerperium. SCFAs were measured by liquid chromatography-mass spectrometry. RESULTS Sixteen patients (32%) had relapses during pregnancy or puerperium, and 37 (68%) did not. All MS patients showed significant increases in acetate levels during pregnancy and the postpartum period compared to non-MS women. However, propionate and butyrate values were associated with disease activity. Their values were higher in nonrelapsing patients and remained similar to the control group in relapsing patients. The variable that best identified active patients was the propionate/acetate ratio. Ratios of <0.36 during the first trimester were associated with higher inflammatory activity (odds ratio = 165, 95% confidence interval = 10.2-239.4, p < 0.01). Most nonrelapsing patients showed values of >0.36, which were similar to those in healthy pregnant women. CONCLUSIONS Low propionate/acetate ratio values during the first trimester of gestation identified MS patients at risk of relapses during pregnancy and the postpartum period.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Silvia Pérez-Pérez
- Research Group on Environmental Factors in Degenerative Diseases, Health Research Institute of the San Carlos Clinical Hospital/Spanish Multiple Sclerosis Network, Madrid, Spain
| | - María Ángel García-Martínez
- Research Group on Environmental Factors in Degenerative Diseases, Health Research Institute of the San Carlos Clinical Hospital/Spanish Multiple Sclerosis Network, Madrid, Spain
| | - Beatriz Pardo-Rodríguez
- Research Group on Environmental Factors in Degenerative Diseases, Health Research Institute of the San Carlos Clinical Hospital/Spanish Multiple Sclerosis Network, Madrid, Spain
| | - María Inmaculada Domínguez-Mozo
- Research Group on Environmental Factors in Degenerative Diseases, Health Research Institute of the San Carlos Clinical Hospital/Spanish Multiple Sclerosis Network, Madrid, Spain
| | - Estefanía García-Calvo
- Department of Analytical Chemistry, Faculty of Chemical Sciences, Complutense University of Madrid, Madrid, Spain
| | - Héctor Estévez
- Department of Analytical Chemistry, Faculty of Chemical Sciences, Complutense University of Madrid, Madrid, Spain
| | - Jose Luis Luque-García
- Department of Analytical Chemistry, Faculty of Chemical Sciences, Complutense University of Madrid, Madrid, Spain
| | | | - Roberto Alvarez-Lafuente
- Research Group on Environmental Factors in Degenerative Diseases, Health Research Institute of the San Carlos Clinical Hospital/Spanish Multiple Sclerosis Network, Madrid, Spain
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Trobo Marina D, Bravo C, Lancharro Á, Gámez Alderete F, Marín C, de León-Luis J. Neonatal magnetic resonance imaging in double aortic arch diagnosed prenatally by ultrasound. J OBSTET GYNAECOL 2016; 36:526-8. [PMID: 26979672 DOI: 10.3109/01443615.2015.1110125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 11/13/2022]
Abstract
Congenital double aortic arch (DAA) is an uncommon vascular anomaly; however, its prenatal detection is associated with congenital heart defects and chromosomal abnormalities, including 22q11 deletion. We present a case of DAA diagnosed prenatally. DAA can be diagnosed by prenatal ultrasound in the transverse three vessel-trachea view, which shows a trident image formed by a complete vascular ring and the ductus arteriosus. Postnatal magnetic resonance images in this view correlate well with prenatal ultrasound images and help in confirmation of diagnosis, evaluation of the risk of airway or esophageal compression, and planning of surgery.
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Affiliation(s)
- Duna Trobo Marina
- a Department of Obstetrics and Gynecology , Hospital General Gregorio Marañón, Universidad Complutense de Madrid , Madrid , Spain
| | - Coral Bravo
- a Department of Obstetrics and Gynecology , Hospital General Gregorio Marañón, Universidad Complutense de Madrid , Madrid , Spain .,b Department of Obstetrics and Gynecology , Hospital Central de La Defensa Gómez Ulla, Universidad de Alcalá de Henares , Madrid , Spain , and
| | - Ángel Lancharro
- c Department of Radiology , Hospital General Gregorio Marañón, Universidad Complutense de Madrid , Madrid , Spain
| | - Francisco Gámez Alderete
- a Department of Obstetrics and Gynecology , Hospital General Gregorio Marañón, Universidad Complutense de Madrid , Madrid , Spain
| | - Carlos Marín
- c Department of Radiology , Hospital General Gregorio Marañón, Universidad Complutense de Madrid , Madrid , Spain
| | - Juan de León-Luis
- a Department of Obstetrics and Gynecology , Hospital General Gregorio Marañón, Universidad Complutense de Madrid , Madrid , Spain
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Ferreres-García K, de León-Luis J, Seoane E, García-Marqués E, Sanjuan C, Ortiz-Quintana L. [A case study of anaphylaxis in a pregnant woman]. Ginecol Obstet Mex 2014; 82:188-193. [PMID: 24779274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We report a case of anaphylaxis in a 35+5 week of pregnancy patient who came to the Emergency Room with shortness of breath, hypotension and loss on fetal wellbeing. Due to her medical history and given the clinical picture at that time, an anaphylactic shock was suggested as the most probable diagnose. The administration of dexchlorpheniramine and methylprednisolone resulted in an immediate and positive reaction. Simultaneously, an improvement in the fetus cardiotocographic record was objectified. The patient was hospitalized for 48 hours, after which she was discharged. In case of suspicion of anaphylaxis in a pregnant woman, four aspects should be handled: the severity of the anaphylaxis chart, individual complications regarding a pregnant woman, unfavorable effects of the regularly used treatment during that specific gestation, and the need of fetal extraction based of gestational age.
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Ruiz-Labarta FJ, Pérez-Fernández R, Gámez-Alderete F, Pintado-Recarte MDP, Hernández-Martín C, de León-Luis J. [Prenatal ultrasonic diagnosis and follow-up of fetal splenic cysts: report of two cases. Review of the literature]. Ginecol Obstet Mex 2013; 81:602-607. [PMID: 24483043] [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] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Congenital splenic cysts are rare entities wich are not frequently diagnosed in prenatal sonographies and there is only a few literature wich report these medical cases. The aim of this article is to introduce this sonographic discovery and study whether there are impacts for the newborn, association with cormosomopathy or fetal pathology. We describe two medical cases of fetal splenic cysts wich were diagnosed in our service by ultrasonography at 29 and 32 weeks of gestation, their antenatal monitoring and postnatal evolution. Besides theses, it is made a review of this entity in medical literature, examination about the: etiology, prenatal diagnosis, prenatal and postnatal following and complications. In conclusion, the congenital splenic cyst has a good prognosis with an spontaneous postnatal resolution in the majority of the cases. No association was observed between cromosopathy or fetal pathology with the examined cases.
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Affiliation(s)
- Francisco Javier Ruiz-Labarta
- Departamento de Obstetricia y Ginecología, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, España
| | - Ricardo Pérez-Fernández
- Departamento de Obstetricia y Ginecología, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, España
| | - Francisco Gámez-Alderete
- Departamento de Obstetricia y Ginecología, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, España
| | - María del Pilar Pintado-Recarte
- Departamento de Obstetricia y Ginecología, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, España
| | - Concepción Hernández-Martín
- Departamento de Obstetricia y Ginecología, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, España
| | - Juan de León-Luis
- Departamento de Obstetricia y Ginecología, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, España
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Navarro-González T, Bravo-Arribas C, Fernández-Pacheco RP, Gámez-Alderete F, de León-Luis J. [Perinatal outcome after prenatal diagnosis of intra-abdominal umbilical vein varix]. Ginecol Obstet Mex 2013; 81:140-145. [PMID: 23672115] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Progress in echographic techniques, particularly, high-resolution echography and color Doppler, as well the higher deep on knowledge and systematization in fetal anatomy exploration, are the main responsible of the increased number of cardiovascular anomalies diagnosed prenatally. OBJECTIVE To describe the sonographic findings and perinatal outcomes in cases with prenatal ultrasound diagnosis of intra-abdominal umbilical vein varix. MATERIAL AND METHODS A descriptive and retrospective study of cases with prenatal ultrasound diagnosis of umbilical vein varix. The diagnosis is performed at the level of the abdominal circumference when the diameter of the vessel is above the established parameters for a certain gestational age. Variables concerning maternal-fetal features, ultrasound findings and perinatal outcomes of affected cases are described. RESULTS From August 2008 to August 2012 14 cases of intraabdominal umbilical vein varix were diagnosed in our center with a mean gestational age at diagnosis of 29 weeks. Of the 14 cases, 35% had associated anomalies, mostly cardiovascular anomalies. No chromosomal defects were detected. Perinatal outcomes in newborns were favorable, with mean gestational age at delivery of 38 weeks. Only one case of monochorionic-monoamniotic twin pregnancy required preterm elective termination secondary to a twin-to-twin transfusion syndrome. CONCLUSION Prenatal diagnosis of intra-abdominal umbilical vein varix should be followed by further studies given its possible association with other anomalies, chromosomal defects and cases of stillbirth. However, isolated cases of umbilical vein varix, representing a majority, often evolve favorably with few complications.
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Affiliation(s)
- Teresa Navarro-González
- Unidad de Medicina Fetal, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, España
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Bravo Arribas C, Gámez Alderete F, Pérez R, Ortiz-Quintana L, de León-Luis J. [Diagnosis of isolated fetal aberrant right subclavian artery]. Ginecol Obstet Mex 2012; 80:425-429. [PMID: 22826972] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
UNLABELLED A case of a fetal isolated aberrant right subclavian artery (ARSA) diagnosis and discuss its clinical implications and the methodology used to assess the fetal right subclavian artery by transabdominal ultrasound in normal cases and those with ARSA is reported. CLINICAL CASE A 35-year-old pregnant woman in her twentieth week of pregnancy was evaluated at our Fetal Medicine Unit. An isolated ARSA was detected by a transabdominal ultrasound scan of the fetus. The visualization of this anomaly was achieved through an axial view of the fetal thorax, at the level of the three vessels and trachea scanning plane. It was observed that the origin of ARSA from the aortic arch was close to the ductus arteriosus and it followed a retrotracheal course towards the right arm. The described methodology used to assess the right subclavian artery could be useful for prenatal diagnosis in cases of ARSA. Based on this protocol, further studies could be performed to evaluate the utility of ARSA as a sonographic marker for chromosomal abnormality and congenital heart disease. After the diagnosis of an isolated ARSA, the performance of a fetal karyotype test is still debatable.
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Affiliation(s)
- Coral Bravo Arribas
- Departamento de Obstetricia y Ginecología, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, España
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Sánchez P, Gámez F, de León-Luis J, Antonio Carrillo J, Martínez R. [Fetal ovarian cyst: prenatal diagnosis, perinatal outcome and treatment. Case series and literature review]. Ginecol Obstet Mex 2012; 80:84-90. [PMID: 22519216] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Ovarian cysts in fetal abdominal tumors are more frequently diagnosed during pregnancy. Most of the time are usually small, asymptomatic and resolve spontaneously during pregnancy or in early neonatal life. OBJECTIVE To describe the clinical and ultrasound cases with prenatal diagnosis of ovarian cyst treated in our center between 2002 and 2005. MATERIAL AND METHODS Descriptive and observational cases of fetal ovarian cyst diagnosedbefore birth. The variables maternal and perinatal most relevant clinical data obtained at diagnosis and after birth. RESULTS We explored 9.198 fetuses, of which there were 10 cases of ovarian cyst diagnosed between the second and third trimesters of pregnancy. All cases were unilateral andsonographic appearance homogeneous. In four cases there was spontaneous disappearance during the remaining gestational period. In the other six cases, four missing in the first 12 months and only two image persisted more than a year. CONCLUSIONS Based on our results and in accordance with the literature, the prenatal diagnosis of fetal ovarian cyst is usually associated with a conservative approach with serialultrasound monitoring to rule out rare serious complications. During the neonatal period spontaneous disappearance is often the case and the surgical approach is indicated in cases with suspected persistent or torsion or hemorrhage, with cystectomy as first choice.
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Martínez R, Gámez F, de León-Luis J, Suárez G, Sanchez P, Orizales C. [Perinatal outcomes after prenatal ultrasound diagnosis of persistence of right umbilical vein]. Ginecol Obstet Mex 2012; 80:73-78. [PMID: 22519214] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To describe the ultrasound findings, maternal and perinatal variables in cases with a prenatal diagnosis of persistence of right umbilical vein. PATIENTS AND METHODS A descriptive analysis of cases with prenatal diagnosis of persistence of right umbilical vein in the Fetal Medicine Unit, Department of Obstetrics and Gynecology, Hospital Universitario Severo Ochoa. We described ultrasound findings, maternal and perinatal variables. RESULTS We explored 9198 fetuses and 6 cases (0.06%) were diagnosis prenatally of persistent right umbilical vein, between 20 and 29 weeks of gestation. The male/female ratio was 1/1. Ductus venosus was presented in all cases. Two fetuses (33%) were proved to have other structural anomalies and their parents opted for termination of the pregnancy. All cases had no chromosomal anomaly associated and after birth, neonatal developments were favorable. CONCLUSION Based on our results and a literature review, after prenatal diagnosis of persistent right umbilical vein, an exhaustive morphological study, which included a fetal echocardiography, is mandatory in order to rule out other structural malformations. Indication for fetal karyotype study has to be individualized considering persistence right umbilical vein type and other ultrasound findings.
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Affiliation(s)
- Raquel Martínez
- Facultativo Especialista de Area, Sección de Medicina Fetal, Departamento de Obstetricia y Ginecología, Hospital Universitario Severo Ochoa, España
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