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The purpose of this integrative literature review was to provide a compilation and review of literature related to perinatal outcomes of clients with antepartum or intrapartum oligohydramnios and management decisions applied to these clients. This paper is intended to synthesize and summarize the most current knowledge retrieved in these topics between the years of 1990- 2000. A general search using key terms was conducted, and yielded 63 prospective articles comprised of full articles, abstracts, and literature reviews. Seventeen articles on oligohydramnios, amniotic fluid volume measurements, and perinatal outcomes were retained out of the 35 that were found. The search for the literature discussing management of oligohydramnios produced 9 articles, of which 3 were found to be pertinent to this project. Twelve of the total 39 articles retained were literature reviews and were used for citation and identification of additional information material to this topic. Seven of the 39 articles were retained for the sole purpose of enabling the author to provide a descriptive, thorough review on the relevant concepts of this review. Studies reviewing amniotic fluid volume/oligohydramnios and perinatal outcomes suggest great variance among likelihood of adverse perinatal outcomes. Studies reviewing management of oligohydramnios suggest amnioinfusion may have obstetrical and perinatal benefits for the client with oligohydramnios. Aggressive management including indication for cesarean section related to fetal distress and labor induction were implied with minimal discussion on conservative management for these clients.

Abstract not available

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.

Tez (Tıpta Uzmanlık) - Süleyman Demirel Üniversitesi, Tıp Fakültesi, Nöroşirürji Anabilim Dalı, 2007. / Bibliyografya var.

Made available in DSpace on 2014-08-13T14:50:40Z (GMT). No. of bitstreams: 0 Previous issue date: 2013Bitstream added on 2014-08-13T18:01:28Z : No. of bitstreams: 1 000747189.pdf: 1571276 bytes, checksum: cb0e6f84e4a758217e41fa9ef75dba98 (MD5) / Changes in the Pentraxin 3 (PTX3) expression throughout pregnancy are not well established but in pregnancy complications higher expression have been described. To evaluate expression of PTX3 in amniotic fluid (AF) throughout the last weeks of normal pregnancies and in pregnancies complicated by preterm delivery (PTD). A crosssectional study was conducted with 120 pregnant women in term and PTD. Samples of AF from all patients were obtained during cesarean section. Amniochorion membranes were collected to localization of PTX3 using immunohistochemistry. Regarding term pregnancies, PTX3 expression increased slightly throughout weeks, but these expressions are not statistically different. Among preterm pregnancies, those with preterm labor (PL) had a higher PTX3 levels than those not in labor and there was a risk increased of 1% in the occurrence of PL when there was a rise of 1 pg/mL of PTX3. Amniotic epithelial, chorionic and decidual cells presented immunoexpression of PTX3. PTX3 is a physiologic constituent of the AF, and its expression is elevated in the presence of spontaneous PL suggesting that PTX3 play a role in the innate immune response during the gestational complications that are related with an infectious/inflammatory conditions. The amniochorion membranes are sources of PTX3

Orientador: Márcia Guimarães da Silva / Coorientador: Rodrigo Paupério Soares de Camargo / Banca: Gisele Alborghetti Nai / Banca: Denise Fecchio / Resumo: Não disponível / Abstract: Changes in the Pentraxin 3 (PTX3) expression throughout pregnancy are not well established but in pregnancy complications higher expression have been described. To evaluate expression of PTX3 in amniotic fluid (AF) throughout the last weeks of normal pregnancies and in pregnancies complicated by preterm delivery (PTD). A crosssectional study was conducted with 120 pregnant women in term and PTD. Samples of AF from all patients were obtained during cesarean section. Amniochorion membranes were collected to localization of PTX3 using immunohistochemistry. Regarding term pregnancies, PTX3 expression increased slightly throughout weeks, but these expressions are not statistically different. Among preterm pregnancies, those with preterm labor (PL) had a higher PTX3 levels than those not in labor and there was a risk increased of 1% in the occurrence of PL when there was a rise of 1 pg/mL of PTX3. Amniotic epithelial, chorionic and decidual cells presented immunoexpression of PTX3. PTX3 is a physiologic constituent of the AF, and its expression is elevated in the presence of spontaneous PL suggesting that PTX3 play a role in the innate immune response during the gestational complications that are related with an infectious/inflammatory conditions. The amniochorion membranes are sources of PTX3 / Mestre

Orientador: Jose Guilherme Cecatti / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-04T02:22:31Z (GMT). No. of bitstreams: 1 Dertkigil_MarciaSanJuan_M.pdf: 457919 bytes, checksum: d1358d139b645249677efe81ba78ad49 (MD5) Previous issue date: 2005 / Resumo: Objetivo - Avaliar as possíveis mudanças no volume de líquido amniótico em gestantes submetidas à imersão em água durante atividade física moderada. Método: Foi realizado um estudo prospectivo comparando o ILA (índice de líquido amniótico) antes e depois da imersão em água e atividade física. Foram selecionadas gestantes do Ambulatório de Pré Natal Normal do Hospital das Clínicas da Universidade Estadual de Campinas, que aceitaram participar do estudo sobre atividade física na gestação. As gestantes foram alocadas aleatoriamente em dois grupos (com ou sem hidroginástica, respectivamente grupo A ou B). As gestantes do grupo A praticaram atividade física moderada na água, em imersão subtotal, três vezes por semana, com cinqüenta minutos cada sessão, em piscina aquecida a 30º C, desde o segundo trimestre da gestação até o parto. Foram excluídas mulheres com antecedentes de duas ou mais cesáreas, gravidez de risco ou condições que contra-indicassem a prática de atividade física (hipertensão arterial, placenta prévia e história de abortos de repetição, etc.). As gestantes foram avaliadas semanalmente, a partir de 20 semanas, para estimativa do ILA e edema pré-imersão (antes da sessão de hidroginástica) e pós-imersão (após a hidroginástica). Um segundo avaliador também obtinha dados do ILA das gestantes para avaliação da variabilidade inter-observador. Para os procedimentos de análise, foram utilizados os programas Epi.Info 2000 e SAS. Na análise estatística, as variáveis quantitativas foram comparadas através do teste t de Student ou do teste não paramétrico de Wilcoxon. Para a comparação da variabilidade das medidas inter-observador, foi utilizado o coeficiente de correlação linear. Foi estabelecido um nível de significância de 5%. Resultados: No total, 25 gestantes participaram do estudo, entre 19 e 36 anos, entre maio de 2003 e dezembro de 2004, tendo sido realizadas 232 avaliações do ILA pré e pós-imersão nestas gestantes, com uma média de 9,28 avaliações por mulher. Verificou-se aumento do ILA pós-imersão em relação ao ILA pré-imersão em todas as idades gestacionais estudadas, variando entre 8,8 e 21,5 % de aumento. Essa variação foi significativa para a grande maioria das idades gestacionais e não houve uma tendência significativa de aumento ou diminuição desta diferença com a idade gestacional. Houve uma boa correlação das medidas do ILA pré e pós-imersão entre os dois examinadores, com coeficiente de correlação entre os examinadores respectivamente de 0,78 e de 0,70. O edema de membros inferiores esteve presente em cerca de 23% das observações após a 29º semana, e regrediu após a imersão. Conclusões: houve um aumento significativo do ILA em quase todas as idades gestacionais, podendo ser efetivo o tratamento de imersão em água para aumentar o ILA / Abstract: Objective - To evaluate possible changes in the amniotic fluid index (AFI) among pregnant women practicing moderate physical activity in water immersion. Method: a prospective study was performed, comparing the AFI pre and post immersion in water for physical activity. Pregnant women from the Pre Natal Outpatient Clinic in the hospital of the University of Campinas who accepted to participate in the study on physical activity during pregnancy were selected. They were randomly allocated in two groups (with and without water aerobic, respectively group A and B). The women in group A practiced moderate physical activity in water under subtotal immersion, three times a week, in sessions of 50 minutes each, in swimming pool heated at 30º C, from the second trimester of pregnancy until delivery. Women with history of two or more cesarean sections, high risk pregnancy or conditions contra-indicating physical activity practice (hypertension, placenta previa, history of recurrent abortions, etc.) were excluded. The women were evaluated weekly with an ultrasound exam in order to estimate the pre and post immersion AFI and also a clinical screening for edema. A second examiner also obtained the AFI values in order to evaluate the inter observer variability. For statistical analysis the programs Epi.Info 2000 and SAS were used. The quantitative variables were compared with Student t or non parametric Wilcoxon test. For evaluation of inter observer variability of the measures, the linear correlation coefficient was used. A 5% significance level was previously determined. Results: a total of 25 pregnant women participated in the study between May 2003 and December 2004, with age ranging from 19 to 36 years and 232 ultrasound evaluations of pre and post immersion AFI, with a mean of 9.28 exams per woman. An increase in the post immersion AFI compared to pre immersion was observed in all gestational ages studied, ranging from 8.8 and 21.5%. These changes were significant for the vast majority of gestational ages and there was not a significant trend of increase or decrease of this difference with gestational age. There was a good agreement on pre and post immersion AFI values between both examiners, with a correlation coefficient of respectively 0.78 and 0.70. The edema of legs was detected in around 23% of weekly observations after 29 weeks and decreased after immersion. Conclusions: there was a significant increase of AFI in almost all gestational ages, then the treatment of immersion in water for increasing the AFI could be effective / Mestrado / Tocoginecologia / Mestre em Tocoginecologia