Thesis (doctoral)--Airlangga University, 1985. / Errata slip inserted. Thesis statement inserted. Vita. Includes bibliographical references.

Thesis (M.Phil) - University of Queensland, 2004. / Includes bibliography.

Thesis (M.S.)--University of Wisconsin--Madison, 1949. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves i-iii).

Zugl.: Berlin, Humboldt-Universiẗat, Diss., 2003.

Zugl.: Wien, Univ., Diss., 2010

München, Techn. Univ., Diss., 2004.

Orientador: Wilter Ricardo Russiano Vicente / Coorientador: Maria Emilia Franco Oliveira / Coorientador: Marcus Antônio Rossi Feliciano / Banca: Luciana Cristina Padilha Nakaghi / Banca: Felipe Farias Pereira da Câmara Barros / Banca: Erika da Silva Carvalho Morani / Banca: Eliandra Antonia Pires Buttler / Resumo: O entendimento acerca da fisiologia do processo gestacional e desenvolvimento embrionário/fetal oferece conhecimento para que se tome decisões acertadas em relação ao manejo da fêmea gestante, além destes animais serem utilizados como modelo experimental para a medicina humana, o que reforça a importância do estudo da gestação em ovinos. Nesse contexto, a ultrassonografia se apresenta como melhor opção para avaliar o desenvolvimento da gestação. É uma tecnologia segura que permite que se façam avaliações repetidas durante todo o processo gestacional. Objetivou-se estudar o desenvolvimento fisiológico embrionário/fetal durante a gestação de ovelhas por meio da ultrassonografia a fim de se obter parâmetros de normalidade que possam ser utilizados como referência para o diagnóstico de possíveis alterações do desenvolvimento embrionário/fetal e desenvolver fórmulas para predição de idade gestacional. Foram utilizadas 30 ovelhas Santa Inês pesando 45,4±4,3 kg, entre 2 e 5 anos e realizados exames ultrassonográficos semanais desde a 3ª, até a 21ª semana gestacional. Para a análise estatística, realizou-se teste de "Shapiro" para normalidade, com medidas reais ou transformadas correlacionadas com as semanas gestacionais pelo teste de "Spearman". Quando significativo, foram testados os ajustes dos parâmetros e semanas gestacionais à modelos de regressão. Foi utilizado nível de significância de 5% e os resultados apresentados como média±DP (desvio padrão). Foram avaliados os diâmetros... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The understanding about the physiology of the gestational process and embryonic/fetal development offers tools to make wise decisions regarding the management of the pregnant female, besides, these animals are used as experimental models, which reinforces the importance of the study of gestation in sheep. In this context, ultrasonography is the best option for the evaluation of gestation. It is safe and allows repeated evaluations to be made throughout the gestational process. The objective of this study was to assess the embryonic/fetal physiological development during pregnancy of sheep by means of ultrasonography in order to obtain normality parameters that can be used as a reference for the diagnosis of embryonic/fetal development alterations and to develop formulas for estimate gestational age. Thirty Santa Ines sheep weighing 45.4±4.3kg, between 2 and 5 years old were used. Ultrasound examinations were performed weekly from the 3rd to the 21st gestational week. For the statistical analysis Shapiro test was performed for normality with real or transformed measurements correlated with the gestational weeks by the Spearman test. When significant, parameter adjustments and gestational weeks were tested for regression models. A significance level of 5% was used and the results presented as mean ± SD (standard deviation). The gestational vesicle (GV), abdominal (AD), thoracic (TD), biparietal (BPD), ocular orbit (OO) and placentonium (PL) diameters were evaluated, as well as ... (Complete abstract click electronic access below) / Doutor

Orientadores: Edmur Franco Carelli, Donizeti Cesar Honorato / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-07T00:02:05Z (GMT). No. of bitstreams: 1 Zambelli_HelderJoseLessa_D.pdf: 2096605 bytes, checksum: 4301e19acb61840bd8e5b92ebacf6cef (MD5) Previous issue date: 2006 / Resumo: O diagnóstico pré-natal da mielomeningocele permite melhor planejamento de sua abordagem e, mais recentemente, um possível reparo intra-útero. Este estudo analisa a evolução neurocirúrgica de 98 crianças com mielomeningocele, tratadas no período pós-natal através de cirurgia tradicional, de janeiro de 1994 a dezembro de 2002, no centro de referência em medicina fetal da Universidade Estadual de Campinas (UNICAMP). Desta avaliação retrospectiva, foi elaborado um protocolo próprio para cirurgia fetal para prevenção de hidrocefalia, identificando-se os fetos que se beneficiariam com a correção intra-útero da mielomeningocele. O estudo revelou uma realidade caracterizada pelo prognóstico ruim e pelo alto índice de complicações decorrentes da mielomeningocele, principalmente no que se diz respeito à hidrocefalia. Com isso, no protocolo foram incluídos somente fetos com um tamanho ventricular menor que 14 mm no momento da cirurgia, fetos entre 20 e 25 semanas de gestação, fetos com defeitos situados abaixo de L3-L4, fetos com mielomeningocele como malformação isolada e ausência de anomalias cromossômicas, tendo como critérios de exclusão: a primiparidade, fetos com lesão abaixo de S1 e a incapacidade de entendimento das gestantes dos riscos materno-fetais. Apesar da correção intra-útero para prevenção de hidrocefalia ter uma aplicação bastante restrita em nosso meio, é uma nova opção de tratamento para as mães brasileiras, já que a legislação do país não prevê a interrupção médica da gravidez, quando complicada por fetos com mielomeningocele / Abstract: Prenatal diagnosis of myelomeningocele has permitted a better planning for optimum management of the disease. More recently, it has allowed for a possible intrauterine repair of the spinal defect. This study analyzed neurosurgical outcome of 98 children with myelomeningocele, postnatally treated with traditional surgery, from January 1994 to December 2002, in the Fetal Medicine referral center at the Universidade Estadual de Campinas (UNICAMP). From this retrospective evaluation, a suitable protocol for fetal surgery was developed for the prevention of hydrocephalus, identifying fetuses that would benefit from intrauterine repair of myelomeningocele. The study revealed a reality characterized by a poor prognosis and a high rate of complications due to myelomeningocele, particularly hydrocephalus. Thus, included in the protocol were only fetuses with ventricular size measuring less than 14 mm at the time of surgery; fetuses between 20 and 25 weeks of gestation; fetuses with defects located below L3-L4; fetuses with myelomeningocele as isolated malformation and absence of chromosomal abnormalities. Criteria of exclusion were: primiparity, fetuses with lesions below S1 and pregnant women¿s lack of understanding of the maternal-fetal risks. Intrauterine repair for the prevention of hydrocephalus has a very limited application in our setting. However, it is a new therapeutic option for Brazilian mothers, since in this country legislation is against medical termination of pregnancies affected with fetal myelomeningocele / Doutorado / Neurologia / Doutor em Ciências Médicas

Barker's "fetal origin hypothesis" advocates that the diseases in later life originate through adaptations that fetus makes when it is undernourished. These adaptations, whether cardiovascular, metabolic, or endocrine, permanently change the structure, and functions of the body, and pave the road to chronic killer diseases in later life, such as; coronary heart diseases, related disorders, stroke, diabetes, and hypertension. The main objective of the study, both prospective, and retrospective, covering the subjects from 0 to 1 year, and 3 to 15 years, respectively, is to test the Barker "fetal origin hypothesis" that nutrition in early life does influence the disease pattern in later life. The research is specifically designed to study the relationship between infant body size, placental weight, blood pressure, and lipid profile in late infancy; and whether or not the relationship between high blood pressure, and low birthweight is initiated in uterus, or during the infancy. The prospective studies were carried out in Prince Salman Bin Abdulaziz Hospital in Riyadh, KSA. The sampling was performed systematically. Every fifth child born in the delivery room was selected in the obstetric ward. A total of 1026 neonates were included in the prospective studies. The retrospective studies were conducted in Deraya Primary Health Care Centre, and data were collected from the medical record department, which included 1505 subjects, aged 3 to 15 years. The babies with major congenital malformations were excluded both studies included questionnaires, anthropometric measurements, and critical evaluation of haematological and biochemical parameters. The data collected, both prospective and retrospective and retrospective studies, were categorised, analysed, and statistically interpreted by using the Statistical Package for Social Science SPSS/PC+V9.0. Normal distributions of data were confirmed by using the Kolmogorow-Smirnow Test. In all cases, significance was assumed at P < 0.05. The major findings do support Barker's epidemiological data, and evidences. Although, it is still somewhat too early, and premature to confirm these findings, due to the length of period covered, the data presented, both prospective and retrospective, do point out, and lead to the following major conclusions: Chronic diseases are being imprinted "Programmed" in feto-placental unit during pregnancy, and infancy, there is indeed a strong association between birthweight, especially, low birthweight, and placental weight, blood pressure, lipid metabolism in early infancy, and in childhood. Low birthweight, <2500gms is strongly associated with elevated systolic blood pressure, and low birthweight infants, if survived, are predisposed to inevitable disabilities of all kinds, and chronic diseases in later life.

M.Tech. / It is difficult to manage a pregnancy when fetal age, health status or potential pregnancy risks are not known. The aim of this study was to assess the impact of routine ultrasound screening as compared to selective use of ultrasound in the mid-trimester of pregnancy, on women using South African government health services. The three objectives investigated included assessment of the availability of reliable menstrual histories in the study population, the influence of ultrasound dating on obstetric management and the effect of ultrasound on pregnancy outcome due to the early detection of high risk pregnancies. A cluster randomised trial of 962 women was performed to test the hypothesis that midtrimester routine ultrasound screening in low risk pregnancies would result in improved antenatal care and perinatal outcome. Groups of eligible pregnant women were randomly selected to have either a routine scan followed by normal antenatal care or routine antenatal care which only allows for the selective use of ultrasound, in line with South African Antenatal Care Policy. Statistical analysis of the results confirmed that ultrasound dating is a more accurate predictor of the expected date of delivery when compared to other dating methods. Improved pregnancy dating resulted in a significant reduction in induction of labour for post-term pregnancy in the ultrasound screening group, suggesting a positive effect of ultrasound screening on obstetric management. No improvement was demonstrated in perinatal morbidity or mortality. The early detection of anomalous fetuses only led to one therapeutic abortion. The study did not possess the statistical power to demonstrate improved outcomes when multiple pregnancies were detected early in pregnancy. Currently there appears to be no urgent need to implement a routine antenatal screening programme in the Gauteng public health sector. In view of the fact that a third of the participants indicated that they were unsure of menstrual dates, and one third of the participants in the ultrasound screening group presented with an unreliable menstrual history, it is proposed that unsure dates be considered as a valid indication for the selective use of ultrasound in mid-trimester pregnancy.