Changes in vitelline and utero-placental hemodynamics: implications for cardiovascular development

Linask, Kérsti K.; Han, Mingda; Bravo-Valenzuela, Nathalie Jeanne

doi:10.3389/fphys.2014.00390

Cited by 33 publications

(36 citation statements)

References 88 publications

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“…This same conclusion was reached in the United States, in Ohio, where the rates of cardiac anomalies detection were < 50% with obstetric echography. 21 Previous studies emphasize the importance of routine fetal tracking for cardiopathy through fetal echocardiography due to the fact that this exam is more sensitive and specific, [1][2][3][4][5][6][7][8][11][12][13][14][22][23][24][25][26] which is in line with what has been found in our study, in which the sensitivity of fetal echocardiography was superior to other ultrasounds.…”

Section: Discussionsupporting

confidence: 90%

“…2 In addition, the effects of environmental exposures to elements such as lithium, alcohol and cigarette smoke may compromise the development of the vascular system that, according to animal-based hemodynamic studies performed on vitelline and placental circulations, had demonstrated a relationship with changes in normal heart and vascular development. 5 In the course of the last decade, there was an increase in the prevalence of congenital cardiopathy diagnosed during prenatal period, especially due to the improvement of obstetric screening. 6 The diagnosis of congenital cardiopathy during prenatal is considered beneficial for the neonate, allowing the preparation of the team and the immediate delivery of the newborn to specialized pediatric medical assistance, therefore decreasing the morbidity that occurs because of metabolic alterations, acidosis, hypoxemia, and target organ damage, besides preventing major emotional trauma in the parents, providing them with enough time to understand the disease and with a clear and real idea of the prognosis of the fetus.…”

Section: Introductionmentioning

confidence: 99%

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Accuracy of Prenatal Diagnosis of Congenital Cardiac Malformations

Pinheiro

Varisco

Silva³

et al. 2018

Rev Bras Ginecol Obstet

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Objective To evaluate the accuracy of the diagnosis of fetal heart diseases obtained through ultrasound examinations performed during the prenatal period compared with the postnatal evaluation. Methods A retrospective cohort study with 96 pregnant women who were attended at the Echocardiography Service and whose deliveries occurred at the Complexo Hospitalar Santa Casa de Porto Alegre, in the state of Rio Grande do Sul, Brazil. Risk factor assessment plus sensitivity and specificity analysis were used, comparing the accuracy of the screening for congenital heart disease by means of obstetrical ultrasound and morphological evaluation and fetal echocardiography, considering p < 0.05 as significant. The present study was approved by the Research Ethics Committee of the Institution. Results The analysis of risk factors shows that 31.3% of the fetuses with congenital heart disease could be identified by anamnesis. The antepartum echocardiography demonstrated a sensitivity of 97.7%, a specificity of 88.9%, and accuracy of 93% in the diagnosis of congenital heart disease. A sensitivity of 29.3% was found for the obstetric ultrasound, of 54.3% for the morphological ultrasound, and of 97.7% for the fetal echocardiography. The fetal echocardiography detected fetal heart disease in 67.7% of the cases, the morphological ultrasound in 16.7%, and the obstetric ultrasound in 11.5% of the cases. Conclusion There is a high proportion of congenital heart disease in pregnancies with no risk factors for this outcome. Faced with the disappointing results of obstetric ultrasound for the detection of congenital heart diseases and the current unfeasibility of universal screening of congenital heart diseases through fetal echocardiography, the importance of the fetal morphological ultrasound and its performance by qualified professionals is reinforced for a more appropriate management of these pregnancies.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Accuracy of Prenatal Diagnosis of Congenital Cardiac Malformations

Pinheiro

Varisco

Silva³

et al. 2018

Rev Bras Ginecol Obstet

View full text Add to dashboard Cite

show abstract

“…The early implanted embryo relies on diffusion of nutrients and wastes from the maternal tissues but its survival requires intact placental and embryonic circulation after about E10 17 . During the development of normal circulation, myocardial development and cardiac morphogenesis depend on the patterns of blood flow streams returning from the extraembryonic tissues 18 . Therefore, placental abnormalities in the SENP2 mutants likely disrupt cardiac development by altering hemodynamic forces of blood returning to the heart, perhaps through modulation of pathways responsive to shear stress 18 .…”

Section: Discussionmentioning

confidence: 99%

Extraembryonic but not embryonic SUMO-specific protease 2 is required for heart development

Maruyama

Lin

Chiu

et al. 2016

Sci Rep

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SUMO-specific protease 2 (SENP2) activities to remove SUMO from its substrates is essential for development of trophoblast stem cells, niches and lineages. Global deletion of SENP2 leads to midgestation lethality, and causes severe defects in the placenta which is accompanied by embryonic brain and heart abnormalities. Because of the placental deficiencies, the role of SENP2 in development of the embryonic tissues has not been properly determined. The brain and heart abnormalities may be secondary to placental insufficiency. Here we have created a new mouse strain permitting conditional inactivation of SENP2. Mice homozygous for germline deletion of the conditional allele exhibit trophoblast defects and embryonic abnormalities resembling the global SENP2 knockout. However, tissue-specific disruptions of SENP2 demonstrate its dispensable role in embryogenesis. Placental expression of SENP2 is necessary and sufficient for embryonic heart and brain development. Using a protease deficient model, we further demonstrate the requirement of SENP2-dependent SUMO modification in development of all major trophoblast lineages. SENP2 regulates sumoylation of Mdm2 which controls p53 activities critical for G-S transition of mitotic division and endoreduplication in trophoblast proliferation and differentiation, respectively. The differentiation of trophoblasts is also dependent on SENP2-mediated activation of p57Kip2, a CDK-specific inhibitor required for endoreduplication.

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“…In uterus, hemodynamics between placenta and fetal heart can vary with gestational age [64,65], and reference intervals for cardiac biomarkers in neonates could be diferent from those in adults. Therefore, establishment of reference intervals is necessary to use cardiac biomarkers in neonates.…”

Section: Cardiac Biomarkersmentioning

confidence: 99%

Reference Intervals of Platelets, Lymphocytes and Cardiac Biomarkers in Umbilical Cord Blood

Kim¹,

Hur²,

Moon³

et al. 2017

Umbilical Cord Blood Banking for Clinical Application and Regenerative Medicine

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The umbilical cord blood (UCB) can be used for early detection of neonatal diseases. The UCB can be used for early detection of neonatal diseases. Establishing reference intervals is essential for appropriate interpretation of results of laboratory tests using UCB and for correct medical decisions of pediatricians and neonatologists. The use of proper reference intervals provides reliable information to pediatricians and neonatologists; thus, they could make correct medical decisions for neonates. This chapter discussed reference intervals of platelets, lymphocytes, and cardiac biomarkers in UCB according to the Clinical Laboratory Standards Institute guidelines. Except iatrogenic anemia, thrombocytopenia is the most common hematologic abnormality in neonates. Immature platelet fraction is a novel parameter to estimate megakaryopoiesis and can be useful to understand the mechanism of thrombocytopenia, platelet destruction or bone marrow failure, in neonates. Lymphocyte counts, T cell and B cell, can relect status of immune system in fetus and neonates. Especially Tregs in UCB may contribute to maintain the immune homeostasis in the feto-maternal relationship, and the presence of Tregs would be essential to prevent immune dysregulation in fetus and neonates. Congenital heart disease or defect is the most common birth defect in newborns. Cardiac biomarkers are essential to evaluate heart function and to give information of myocardial injury, necrosis, or myocardial stretch. There are no current guidelines for their routine use in children.

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Changes in vitelline and utero-placental hemodynamics: implications for cardiovascular development

Cited by 33 publications

References 88 publications

Accuracy of Prenatal Diagnosis of Congenital Cardiac Malformations

Accuracy of Prenatal Diagnosis of Congenital Cardiac Malformations

Extraembryonic but not embryonic SUMO-specific protease 2 is required for heart development

Reference Intervals of Platelets, Lymphocytes and Cardiac Biomarkers in Umbilical Cord Blood

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