Objetivos: avaliar a contribuição do fluxo anormal no ducto venoso de 11 a 13 6/7 semanas no rastreamento de anomalias cromossômicas, defeitos estruturais e prognóstico gestacional. Método: 1221 gestações únicas foram submetidas a Dopplervelocimetria do ducto venoso após o rastreamento pela translucência nucal (TN). Resultados: os defeitos cromossômicos foram diagnosticados em 22 fetos. O fluxo no ducto venoso estava anormal em 84 fetos, a TN estava acima do 95o percentil em 160 casos e ambos marcadores estiveram anormais em 41 fetos. A sensibilidade, especificidade, valores preditivos positivo e negativo para defeitos cariotípicos corresponderam respectivamente a 86,4%, 86,9%, 11,9% e 99,7% considerando a TN aumentada, 68,2%, 96,9%, 31,3%, 99,3% para anomalias do fluxo do ducto venoso e 68,2%, 97,6%, 36,6%, 99,3% analisando ambos os marcadores. Investigando malformações estruturais, esses valores foram de 43,8%, 92,9%, 8,3%, 99,1% para uma TN aumentada, 25%, 92,6%, 4,8%, 98,8% para anomalias do fluxo do ducto venoso e 25%, 97,9%, 15,4%, 98,9% para ambos os marcadores. Nos casos com TN aumentada, a proporção de nascidos vivos morfológica e cariotipicamente normais diminui de 93,8% nos fetos com fluxo no ducto venoso normal para 77,3%, quando anormal. Conclusão: a avaliação do ducto venoso de 11 a 13 6/7 semanas de gestação pode ser utilizada no rastreamento de anomalias cromossômicas fetais e pode ajudar a reduzir a taxa de falso-positivo quando combinado com a medida da TN. Em fetos com TN aumentada o fluxo anormal no ducto venoso aumenta a probabilidade de resultados gestacionais adversos / Objective: To evaluate the association between abnormal ductus venosus at 11 - 13 6/7 weeks\' gestation and chromosomal abnormalities, structural defects and fetal outcome. Methods: Ductus venosus waveform (DVFVW) and nuchal translucency (NT) thickness were prospectively evaluated in 1221 singleton pregnancies. Results: The DVFVW was abnormal in 84 cases, NT was above the 95th centile in 160 cases and both markers were observed in 41 fetuses. Chromosomal defects were diagnosed in 22 fetuses. The sensitivity, specificity and positive predictive values for an abnormal karyotype were respectively 86.4%, 86.9%, 11.9% for an increased NT; 68.2%, 96.9%, 31.3% for DVFVW abnormalities and 68.2%, 97.6%, 36.6% for both markers. Regarding structural defects, this values were 43.8%, 92.9%, 8.3% for an abnormal NT, 25%, 92.6%, 4.8% for DVFVW abnormalities and 25%, 97.9%, 15.4% for both. Considering those cases of unexplained fetal demise, the percentages were 44.4%, 85.9%, 5% for NT abnormalities, 22.2%, 92.6%, 4.8% for an abnormal DVFVW and 22.2%, 98%, 15.4% for both. In cases with increased NT measurement, the percentage of livebirths with normal karyotype and no major fetal structural defects decreased from 93.8% in normal DVFVW fetuses to 77.3%, when abnormal. Conclusion: Ductus venosus assessment at 11 - 13 6/7 weeks\' gestation is useful in screening for fetal chromosomal abnormalities and may help to reduce the false-positive rate when combining with NT thickness measurement. Abnormal DVFVW is also associated with an increase of adverse perinatal outcome in fetuses with enlarged NT. However, the value of DVFVW assessment in cases with normal NT measurement is unclear

Pang, Weng I. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 116-148). / Abstracts in English and Chinese. / ABSTRACT --- p.i / 摘要 --- p.iv / ACKNOWLEDGEMENTS --- p.vi / PUBLICATIONS --- p.vii / TABLE OF CONTENTS --- p.viii / LIST OF TABLES --- p.xiii / LIST OF FIGURES --- p.xv / LIST OF ABBREVIATIONS --- p.xvi / Chapter SECTION I: --- BACKGROUND --- p.1 / Chapter CHAPTER 1: --- CIRCULATING NUCLEIC ACIDS IN PRENATAL DIAGNOSIS --- p.2 / Chapter 1.1 --- Prenatal diagnosis --- p.2 / Chapter 1.2 --- Circulating fetal DNA in maternal plasma --- p.2 / Chapter 1.2.1 --- Biology of circulating fetal DNA --- p.2 / Chapter 1.2.2 --- Clinical applications of circulating fetal DNA --- p.3 / Chapter 1.2.2.1 --- Qualitative fetal-specific sequence detection --- p.4 / Chapter 1.2.2.2 --- Quantitative aberration detection --- p.4 / Chapter 1.2.3 --- Circulating fetal epigenetic markers --- p.5 / Chapter 1.3 --- Circulating fetal RNA in maternal plasma --- p.6 / Chapter 1.3.1 --- Biology of circulating fetal RNA --- p.6 / Chapter 1.3.2 --- Clinical applications of circulating fetal RNA --- p.8 / Chapter 1.3.2.1 --- Quantitative aberration detection --- p.8 / Chapter 1.3.2.2 --- Chromosomal aneuploidy detection --- p.9 / Chapter 1.3.3 --- Enrichment of fetal RNA --- p.10 / Chapter 1.4 --- Circulating microRNA in maternal plasma --- p.10 / Chapter CHAPTER 2: --- FETAL GROWTH AND WELL-BEING --- p.12 / Chapter 2.1 --- Normal fetal growth --- p.12 / Chapter 2.1.1 --- Role of the mother --- p.12 / Chapter 2.1.2 --- Role of the placenta --- p.12 / Chapter 2.1.3 --- Role of the fetus --- p.13 / Chapter 2.1.4 --- Role of the somatotrophic axis --- p.15 / Chapter 2.2 --- Abnormal fetal growth --- p.15 / Chapter 2.2.1 --- Intrauterine growth restriction --- p.16 / Chapter 2.1.2 --- Definition of IUGR --- p.16 / Chapter 2.2.3 --- Risk factors of IUGR --- p.17 / Chapter 2.2.4 --- Diagnosis of IUGR --- p.20 / Chapter 2.2.4.1 --- Biometric tests --- p.20 / Chapter 2.2.4.2 --- Biophysical tests --- p.21 / Chapter 2.2.4.3 --- Biochemical tests --- p.22 / Chapter 2.2.4.4 --- Others --- p.22 / Chapter 2.3 --- Limitations of current modalities in fetal growth assessment --- p.23 / Chapter 2.4 --- Aims of this thesis --- p.24 / Chapter SECTION II: --- MATERIALS AND METHODS --- p.26 / Chapter CHAPTER 3: --- QUANTITATIVE ANALYSIS OF CIRCULATING RNA --- p.27 / Chapter 3.1 --- Sample collection and processing --- p.27 / Chapter 3.1.1 --- Preparation of plasm a --- p.27 / Chapter 3.1.2 --- Preparation of blood cells --- p.27 / Chapter 3.1.3 --- Preparation of placental tissues --- p.27 / Chapter 3.2 --- Total RNA extraction --- p.28 / Chapter 3.2.1 --- Plasma and blood cells --- p.28 / Chapter 3.2.2 --- Placental tissues --- p.32 / Chapter 3.3 --- Quantitative measurements of nucleic acids --- p.32 / Chapter 3.3.1 --- Principles of real-time quantitative PCR --- p.33 / Chapter 3.3.2 --- One-step QR T-PCR assays for placental mRNA quantification --- p.3 7 / Chapter 3.3.3 --- QPCR assays for checking genomic DNA contamination --- p.43 / Chapter 3.4 --- Statistical analysis --- p.45 / Chapter SECTION III: --- EVALUATION OF PLACENTA-DERIVED MRNA AS POSSIBLE MARKERS FOR FETAL GROWTH ASSESSMENT --- p.46 / Chapter CHAPTER 4: --- SELECTION OF POTENTIAL FETAL GROWTH MRNA MARKERS FOR MATERNAL PLASMA DETECTION --- p.47 / Chapter 4.1 --- Introduction --- p.47 / Chapter 4.2 --- Materials and methods --- p.49 / Chapter 4.2.1 --- Sample collection and processing --- p.49 / Chapter 4.2.2 --- Experimental design --- p.49 / Chapter 4.2.3 --- RNA extraction and quantification --- p.51 / Chapter 4.2.4 --- Statistical analysis --- p.51 / Chapter 4.3 --- Results --- p.52 / Chapter 4.3.1 --- Identification of potential fetal growth mRNA markers in maternal plasma --- p.52 / Chapter 4.3.2 --- Development of real-time QR T-PCR assays --- p.56 / Chapter 4.3.3 --- Validation of maternal plasma detectability and pregnancy-specificity --- p.58 / Chapter 4.3.4 --- Assessment of the gestational trend in maternal plasma --- p.64 / Chapter 4.4 --- Discussion --- p.68 / Chapter CHAPTER 5: --- RELATIONSHIP BETWEEN CIRCULATING PLACENTAL MRNA AND FETAL GROWTH --- p.72 / Chapter 5.1 --- Introduction --- p.72 / Chapter 5.2 --- Materials and methods --- p.73 / Chapter 5.2.1 --- Sample collection and processing --- p.73 / Chapter 5.2.2 --- "Ultrasound measurement, placental weight and birth weight.…" --- p.74 / Chapter 5.2.3 --- Experimental design --- p.74 / Chapter 5.2.4 --- RNA extraction and quantification --- p.75 / Chapter 5.2.5 --- Statistical analysis --- p.75 / Chapter 5.3 --- Results --- p.75 / Chapter 5.3.1 --- Expression of potential growth markers in placental tissues --- p.76 / Chapter 5.3.2 --- Relationship between circulating placental mRNA and birth measurements --- p.76 / Chapter 5.3.3 --- Relationship between circulating placental mRNA and fetal biometric measurements --- p.77 / Chapter 5.4 --- Discussion --- p.85 / Chapter SECTION IV: --- CLINICAL APPLICATION OF POTENTIAL FETAL GROWTH MARKERS IN THE ASSESSMENT OF IUGR --- p.93 / Chapter CHAPTER 6: --- QUANTITATIVE ANALYSIS OF PLACENTAL MRNA IN IUGR WITH OR WITHOUT PET --- p.94 / Chapter 6.1 --- Introduction --- p.94 / Chapter 6.2 --- Materials and methods --- p.95 / Chapter 6.2.1 --- Sample collection and processing --- p.95 / Chapter 6.2.2 --- Experimental design --- p.96 / Chapter 6.2.3 --- RNA extraction and quantification --- p.96 / Chapter 6.2.4 --- Statistical analysis --- p.97 / Chapter 6.3 --- Results --- p.97 / Chapter 6.3.1 --- Cross-sectional comparison of placental mRNA concentrations --- p.97 / Chapter 6.3.2 --- Longitudinal comparison of placental mRNA concentrations --- p.102 / Chapter 6.4 --- Discussion --- p.103 / Chapter SECTION V: --- CONCLUDING REMARKS --- p.107 / Chapter CHAPTER 7: --- CONCLUSION AND FUTURE PERSPECTIVES --- p.108 / Chapter 7.1 --- A strategy for identifying circulating placental MRNA markers for fetal growth assessment --- p.108 / Chapter 7.2 --- Implications of mRNA marker development strategy --- p.111 / Chapter 7.3 --- Prospects for future work --- p.112 / REFERENCES --- p.116

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Abstract not available

Bibliography: leaves [11-1]-11-19 / 1 v. (various pagings) : ill ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, 1987

"March 2003" / Includes bibliographical references (leaves 237-297) / ix, 297 leaves : ill. (some col.), plates (col.) ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, School of Agriculture and Wine, Discipline of Animal Science, 2005

This study examined the effects of maintaining exercise training throughout pregnancy upon metabolic and physical properties of parametrial fat cells and fetal growth in Wistar rats. Eight weeks prior to mating the animals (n=10) were trained to run for 2 hrs/day, 5 days/wk at 31 m/min up an 8 0 incline. Control animals (n=6) remained sedentary. All animals were mated and trained animals resumed running on the second day of gestation. There was no variation in body weight (p > 0.05) between the trained (T) and sedentary control (S) rats at mating but S weight was significantly greater (p < 0.05) at Day 19. The T mothers had significantly smaller fat cells (p < 0.05) than S but cell number did not differ (p > 0.05). The rate of glucose oxidation (1C-1) by cells from T animals was significantly higher (p < 0.05) than the S in the presence of insulin, but much lower than oxidation rates of non-pregnant trained animals. In terms of the fetus, training reduced litter size (p < 0.05) and increased the incidence of fetal resorption. The results of this study indicate that the training adaptation of the adipocytes is largely lost during pregnancy but insulin responsiveness is maintained at a higher level than sedentary controls. This coupled with the apparent adverse effects of the training on the fetus suggests that exercise during pregnancy should be more closely investigated.Ball State UniversityMuncie, IN 47306

The interrelation among maternal dietary intake, pregravid weight, amount and pattern of gestational weight gain and cigarette smoking in influencing the balance between fetal growth and maternal postpartum weight retention was in investigated in 1,330 healthy participants in the PEI Nutritional Counselling Program. Among nonsmokers, gestational weight gain was the main predictor of postpartum weight retention and explained 65.3% of its variability, while explaining only 4.7% of infant birth weight variability. Women with higher postpartum weight retention gained more weight during pregnancy and most of the difference between higher and lower weight retention groups occurred in the first 20 weeks. When comparing infant size between smoking and nonsmoking mothers, birth weight increased linearly with maternal weight gain in all weight status groups except in overweight nonsmokers where birth weight reached a plateau at weight gains $>$17 kg. Among smokers, infant length increased at a higher rate with weight gain than nonsmokers. Although higher weight gains seemed to partially mitigate the effect of smoking on the risk of small-for-gestational-age (SGA) infants, such risk remained $>$10% at elevated weight gains among underweight smokers. The effects of smoking in reducing maternal and infant weights were not mediated by lower energy intake, as smokers consumed more energy than nonsmokers after controlling for physical activity and pregravid weight. The independent relative risks of SGA infants due to maternal smoking, pregravid underweight and low weight gain, were 3.23, 1.80 and 1.72 respectively, implying that smoking has the greatest effect on SGA. Based on current smoking prevalence in Canada, the population etiologic fraction of SGA due to the direct effect of smoking is 30.8%; approximately twice that for maternal underweight or low weight gain. Efforts to increase infant birth weight through higher maternal weight gain would require impractically high ene

This thesis presents quantitative tools for the metabolomic analysis of amniotic fluid (AF) using vibrational spectroscopy. A total of 300 AF samples were collected for this retrospective cohort study and both Raman and near infrared (NIR) spectra were measured. Spectral data was compressed using a Haar wavelet transform and stage-wise multilinear regression (MLR). Calibration models were calculated for glucose, lactate and uric acid concentrations in AF. Birth weight, gestational diabetes mellitus (GDM) and gestational age were classified with the resulting compressed Raman and NIR spectra, using a genetic algorithm (GA) and a cross-validation approach. Results show that both Raman and NIR spectra of AF were not able to estimate the concentrations of glucose, lactate or uric acid with high precision. However, metabolomic analysis of AF Raman and NIR spectra was capable of estimating the development of GDM, abnormal birth weights as well as gestational ages with sensitivities >75% and specificities >77%. In addition, Raman and NIR metabolomic profiles showed a statistical difference in patients delivering preterm. Of the two spectroscopic analyses studied, NIR spectroscopy of AF has the potential to become a robust and non-invasive diagnostic tool for maternal and fetal health.

Bibliography: leaves 192-212. / xv, 212 leaves ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / The present study investigates the relationships between fetal growth, as manifest in size and shape at birth, and later blood pressure and blood lipids, in an Australian cohort. Data on these outcomes for cohort members at age 8 years are available from a previous study. Birth details (body weight, placental weight, head circumference, chest circumference and length) are abstracted from hospital records. In addition, a follow up of cohort members is undertaken to collect new data pertaining to the two cardiovascular risk factors at 20 years of age. Socio-economic circumstances are characterised at birth, age 8 and age 20. / Thesis (Ph.D.)--University of Adelaide, Dept. of Public Health, 1997?