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Fetal Therapies (2):
Recent article
Fetal Therapies
Prenatal Diagnosis (31)3 2011
Abstract
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Abstract
We performed a literature search without language restriction in Cochrane library and PubMed (1970-2009). Case series and cohort screening studies, pathogenesis and management of complications of MC pregnancy were included.
Elevated risk for intrauterine fetal death (IUFD) and twin-to-twin transfusi...
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PMID: 20629496
PDF is available here.
PDF is available here.
Prenatal Diagnosis (30)7 2010
Abstract
Abstract
We present a case of a CPMT resected by antenatal fetal surgery at 23 weeks in gestation, with additional tumor resected following birth when the infant was 6 weeks of age. The pathology of this lesion showed a marked increase in the cartilaginous component after birth as well as a decrease in cellu...
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PMID: 20367454
PDF is available here.
PDF is available here.
Abstract
Congenital adrenal hyperplasia (CAH) is caused by a defect in any of the 5 enzymes necessary for the synthesis of cortisol. However, in more than 90% of cases, CAH results from a defect in the enzyme 21-hydroxylase. Antenatal dexamethasone for the treatment of fetuses with CAH was introduced in 1978...
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PMID: 20214835
PDF is available here.
PDF is available here.
Abstract
In August 2004, the National Institutes of Health organized a 'Workshop on Fetal Therapy' to develop a plan for the maternal-fetal, surgical, and neonatal evaluation and treatment of pregnancies that might benefit from in-utero therapy. At the completion of the workshop several recommendations were...
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PMID: 19556173
PDF is available here.
PDF is available here.
Abstract
Among 113 fetuses that underwent FCI, 24 of which were older than 28 0/7 weeks gestation, 2 were found to have DA constriction due to indomethacin therapy within 24 hours of intervention. Both of these were 30-week fetuses with hypoplastic left heart syndrome and restrictive or intact atrial septum....
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PMID: 20016136
PDF is available here.
PDF is available here.
Zentralblatt für Chirurgie (134)6 2009
Abstract
Congenital diaphragmatic hernia (CDH) occurs sporadically with an incidence of 1:2,500 live births. Despite the progress in neonatal intensive care, CDH remains associated with a mortality of at least 30 % in isolated cases. The in essence surgically correctable defect of the diaphragm enables the p...
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PMID: 20020380
PDF is available here.
PDF is available here.
Abstract
Gestational age of the cases at diagnosis and at delivery was 15-32 and 17-38 weeks, respectively. Two cases without intervention were lost at 17 and 32 weeks. The mean time of procedure for bipolar coagulation and alcohol ablation were 30 and 10 min, respectively. One of the four cases of alcohol a...
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PMID: 18726110
PDF is available here.
PDF is available here.
Abstract
Treatment of congenital diaphragmatic hernia (CDH) challenges obstetricians, pediatric surgeons, and neonatologists. Persistent pulmonary hypertension (PPHT) associated with lung hypoplasia in CDH leads to a high mortality rate at birth. PPHT is principally due to an increased muscularization of the...
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PMID: 19104834
PDF is available here.
PDF is available here.
Abstract
We investigated IUHCT in the canine leukocyte adhesion deficiency (CLAD) model. Haploidentical IUHCT resulted in stable low-level donor cell chimerism in all dogs that could be analyzed by sensitive detection methodology (4 of 10) through 18 months of follow-up. In the 2 CLAD recipients, low-level c...
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PMID: 19203720
PDF is available here.
PDF is available here.
Abstract
Meconium passage in MMCs can occur early in fetal life. Fetal MMC repair may reduce the duration of meconium exposure, thereby potentially limiting the toxic injury to the vulnerable neural elements....
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PMID: 19278315
PDF is available here.
PDF is available here.
Abstract
We evaluated the effect of IM fetal single-dose dexamethasone (4 mg/kg) on fetoplacental and fetal circulation two hours before and 0-4 hours after CST in 38 fetuses after the 32nd week of gestation. RESULT: Changes in the umbilical artery (UA) resistance index (RI) after fetal CST (AU RI1) were sig...
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PMID: 20101859
PDF is available here.
PDF is available here.
Abstract
Hemophagocytic lymphohistiocytosis (HLH) is a rare autosomal recessive disorder of infancy and childhood that is invariably fatal if not treated. We report on the first patient to receive post-natal HSCT for HLH after receiving in utero chemotherapy for disease stabilization.
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PMID: 18819128
PDF is available here.
PDF is available here.
Prenatal Diagnosis (29)1 2009
Abstract
Abstract
Multidirectional diagnostic approach is essential for the implementation of causal treatment of NHF. In case of idiopathic NHF the only management is symptomatic therapy, fetal monitoring and preterm delivery....
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PMID: 20010490
PDF is available here.
PDF is available here.
Journal of Pediatric Surgery (43)12 2008
Abstract
We have previously shown that a vesico-amniotic shunt (V-A shunt) produces fibrotic bladders with poor compliance in normal fetal lambs. We hypothesized that using a ventriculo-peritoneal shunt (V-P shunt) as a V-A shunt in normal bladders may preserve the filling/emptying cycle and normal bladder d...
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PMID: 19040946
PDF is available here.
PDF is available here.
Abstract
Progress in prenatal diagnosis has led to more frequent detection of fetal abnormalities which, if left untreated, would be fatal or cause severe disabilities despite optimal postnatal care. Intrauterine surgery is possible in selected cases. Most procedures involve microendoscopy with local or regi...
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PMID: 19445376
PDF is available here.
PDF is available here.
Prenatal Diagnosis (28)11 2008
Abstract
To the best of our knowledge, this is the first insight into the possible link between ITGA9 and CC in human fetuses. The identification of pathogenetic mutations and their possible link to the clinical responses of particular treatments may contribute to better pregnancy counseling and management....
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PMID: 18973153
PDF is available here.
PDF is available here.
Abstract
We describe our recent experience and some of the more common abnormalities with their management considerations that may be encountered by the oral and maxillofacial surgeon on the fetal diagnosis and treatment team....
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PMID: 18848093
PDF is available here.
PDF is available here.
Abstract
Neural stem cells retain an undifferentiated state and produce neurotrophic factors in the short term after delivery to the fetal spinal cord, in the setting of experimental MMC. Further scrutiny of NSC delivery to the spinal cord as a therapeutic strategy against spina bifida is warranted....
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PMID: 18707035
PDF is available here.
PDF is available here.
Abstract
In utero hematopoietic stem cell transplantation (IUHCT) is a potential therapeutic alternative to postnatal hematopoietic stem cell transplantation (HSCT) for congenital hematologic disorders that can be diagnosed early in gestation and can be cured by HSCT. The rationale is to take advantage of no...
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PMID: 18541191
PDF is available here.
PDF is available here.
Sao Paulo Medical Journal (126)4 2008
Abstract
We present a case in which a cyst-amniotic shunt was placed instead of performing this procedure. CASE REPORT: A cyst-amniotic shunt was placed at 33 weeks of gestation because of a large macrocystic adenomatoid malformation of the lung associated with severe mediastinal shift and polyhydramnios. Al...
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PMID: 18853037
PDF is available here.
PDF is available here.
Abstract
BACKGROUND: Neonatal survival and prognosis are closely linked with development of hydrops in cases of sustained fetal tachycardia. Several antiarrhythmic medications are available for conversion to sinus rhythm. CASE: An 18-year-old woman had an audible fetal arrhythmia at 25 weeks' gestation. Feta...
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PMID: 18567282
PDF is available here.
PDF is available here.
Pediatrics (121)5 2008
Abstract
Infants who were < or = 32 weeks' gestation and remotely treated with antenatal steroids (average 21 days) had a significantly lower respiratory compliance compared with matched infants who were ideally treated with antenatal steroids. We speculate that the lower respiratory system compliance may re...
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PMID: 18450845
PDF is available here.
PDF is available here.
Prenatal Diagnosis (28 Suppl 1) 2008
Abstract
Abstract
Gene Therapy (15)7 2008
Abstract
We examined dystrophin expression, spread of vector, morphology and specific force production of the tibialis anterior muscle 9 weeks after intramuscular in utero injection. Recombinant dystrophin was expressed in the hindlimb muscles, with the majority of animals having expression in two muscles of...
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PMID: 18273052
PDF is available here.
PDF is available here.
Journal of Pathology (214)5 2008
Abstract
We first confirmed that col1 alpha 2-deficient homozygous mice show abnormal collagen deposition in the glomeruli, which increases in frequency and severity with postnatal age. Intrauterine transplantation of human MSCs from first trimester fetal blood led postnatally to a reduction of abnormal homo...
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PMID: 18266309
PDF is available here.
PDF is available here.
Abstract
Open spina bifida remains a major source of disability despite an overall decrease in incidence. It is frequently diagnosed prenatally and can thus - potentially - be treated by fetal surgery. Animal studies and preliminary human studies strongly suggest that at least a portion of the neurological a...
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PMID: 17714997
PDF is available here.
PDF is available here.
Abstract
Fetal growth restriction remains a major cause of perinatal morbidity and mortality in modern obstetric practice. Placental insufficiency is the most common association, but is often a diagnosis of exclusion. Currently, no treatment can ameliorate or reverse established growth restriction: maximisin...
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PMID: 17698415
PDF is available here.
PDF is available here.
Abstract
Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is one of the major causes of both severe thrombocytopenia and intracranial haemorrhage in fetuses and term neonates. The incidence of FNAIT is estimated to be one in 1000-2000 births. FNAIT is caused by maternal immunoglobulin G alloantibodies,...
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PMID: 17936686
PDF is available here.
PDF is available here.
Abstract
Fetal and perinatal loss rates are much higher in monochorionic than in dichorionic pregnancies. This is likely to be at least in part a consequence of chorio-angiopagus and severe early onset of twin-to-twin transfusion syndrome (TTTS). TTTS occurs in approximately 15% of all monochorionic pregnanc...
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PMID: 18262471
PDF is available here.
PDF is available here.
Abstract
Fetal cardiac dysrhythmias are potentially life-threatening conditions. However, intermittent extrasystoles, which are frequently encountered in clinical practice, do not require treatment. Sustained forms of brady- and tachyarrhythmias might require fetal intervention. Fetal echocardiography is ess...
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PMID: 18243806
PDF is available here.
PDF is available here.
Abstract
Gene therapy uses the intracellular delivery of genetic material for the treatment of disease. A wide range of diseases - including cancer, vascular and neurodegenerative disorders and inherited genetic diseases - are being considered as targets for this therapy in adults. There are particular reaso...
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PMID: 17900991
PDF is available here.
PDF is available here.
Abstract
The concept of fetal therapy is well established for many disorders diagnosed before birth but practical issues regarding its introduction into clinical practice are more difficult. Cardiac malformations are common, with major lesions affecting about 3.5 per thousand pregnancies; however, only a sma...
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PMID: 17697798
PDF is available here.
PDF is available here.
Abstract
The clinical course of primary fetal hydrothorax is unpredictable. Whereas smaller unilateral effusions might remain stable or even regress, this is rarely the case with larger collections. Bilateral effusions, hydrops, preterm delivery and the lack of antenatal therapy are all associated with poor...
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PMID: 18280793
PDF is available here.
PDF is available here.
Abstract
Congenital diaphragmatic hernia (CDH) can be diagnosed in the prenatal period either as part of other anomalies or as an isolated birth defect. The clinical impact of this surgically correctable anatomical defect lies in its impairment of lung development. Currently, up to 30% of babies with isolate...
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PMID: 18082455
PDF is available here.
PDF is available here.
Abstract
Abstract
Congenital urinary tract obstruction is a heterogenous condition with a varying natural history. Accurate diagnosis within the late-first and second trimesters allows for counselling of the parents and planning of multi-disciplinary care for the pregnancy and newborn. Antenatal investigations to pre...
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PMID: 17904905
PDF is available here.
PDF is available here.
Abstract
Fetal therapy raises ethical concerns in relation to the balance of potential benefit and harm, autonomy and informed consent, and the duties of the clinician to the pregnant women and fetus. Invasive therapy should be recommended only when it has a realistic chance of saving the life of the fetus a...
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PMID: 17892972
PDF is available here.
PDF is available here.
Abstract
Prenatal diagnosis, surveillance, and treatment of fetal tumors is limited to case reports, small series, and single-institution experience....
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PMID: 17766186
PDF is available here.
PDF is available here.
Abstract
Fetal therapy is a new branch of medicine, developing quickly now, that deals with diseases and congenital anomalies diagnosing and therapy in an unborn child--in utero. Nowadays, fetus has become a fully-privileged patient for medical and surgical therapies. The aim of the review is to present the...
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PMID: 18634271
PDF is available here.
PDF is available here.
Abstract
Sacrococcygeal teratomas (SCTs) are the most common germinal cell neoplasms of the fetus and neonate. They originate during embryonic development when the primitive streak fails to differentiate among mesodermal, ectodermal, and endodermal tissues in the embryonic disc. This article discusses the fe...
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PMID: 18557266
PDF is available here.
PDF is available here.
Abstract
INTRODUCTION: Fetal thyrotoxicosis, often caused by maternal Grave's disease, can have adverse effects on fetal outcomes, such as growth impairment or fetal hydrops. Therefore, intrauterine treatment is recommended. Objective: To describe the experience of intrauterine medical treatment of fetal thy...
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PMID: 18033967
PDF is available here.
PDF is available here.
Abstract
The normal fetal cardiac rhythm is characterized by a regular heart rate ranging between 100 and 160 -180 beats/min with a normal 1: 1 atrioventricular electromechanical relationship during each cardiac cycle. Fetal tachycardia occurring in approximately 0.5% of all pregnancies and it is an importan...
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PMID: 18393872
PDF is available here.
PDF is available here.
Abstract
Tachyarrhythmias can occur at any age from the developing fetus through adulthood. However, in deference to adult-onset ischemic cardiac issues, abnormal heart rhythms occurring in the young are often due to developmental alterations of the cardiac conduction tissue, genetically-inherited changes of...
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PMID: 18393873
PDF is available here.
PDF is available here.
Endocrine Journal (54)5 2007
Abstract
We experienced a case of fetal goitrous hypothyroidism in an infant delivered by a 33-year-old woman receiving 300 mg/day of propylthiouracil (PTU) for hyperthyroidism due to Graves' disease. A large fetal goiter (maximum diameter, 60 mm) was detected by magnetic resonance imaging (MRI) at 36 weeks...
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PMID: 17917306
PDF is available here.
PDF is available here.
Abstract
Posterior urethral valves are the main cause of fetal lower urinary tract obstruction (LUTO) with typical sonographic signs like urinary tract dilatation and reduction of amniotic fluid. LUTO is associated with a high rate of perinatal mortality and is the main cause of kidney failure in early child...
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PMID: 18176906
PDF is available here.
PDF is available here.
Abstract
In this study, the results of the closure of a standardized lip and maxillary alveolar defect in several stages of gestation were documented. Early intervention led to better esthetic results, but increased the risk of abortion by 25%. There was no prevention of scarring in subcutaneous and muscle t...
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PMID: 18022473
PDF is available here.
PDF is available here.
Abstract
The ePR model gave 66.7% sensitivity (6 of 8 final abnormal fetal rhythm cases were predicted correctly in fetuses >20 weeks) and 96.2% specificity. mPR gave 44.4% sensitivity (4 of 9 cases) and 88.5% specificity. Z scores for ePR (zPR) were calculated from 199 normal fetuses. The area under the rec...
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PMID: 17085531
PDF is available here.
PDF is available here.
Abstract
Reported herein is a case of hydrops fetalis in which the cord blood expressed cytomegalovirus (CMV) antigen. Fetal ascites was removed from an infected fetus with hydrops in utero and 2.5 g CMV hyperimmunoglobulin was administered into the fetal abdominal cavity at 28 weeks gestation. After immunog...
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PMID: 17845336
PDF is available here.
PDF is available here.
Ginekologia polska (78)8 2007
Abstract
We also tried to determinate the outcome of fetal surgical treatment. OFS was performed in 10 out of 15 cases with prenataly diagnosed myelomeningocele. Patients were qualified for the surgery on the basis of precisely determined inclusion criteria and after assessment by multidisciplinary team of s...
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PMID: 18050616
PDF is available here.
PDF is available here.
Prenatal Diagnosis (27)7 2007
Abstract
Abstract
Abstract
We have previously established a mouse model of alpha-thalassemia. These mice mimic the human alpha-thalassemic conditions and can be used as preclinical models for fetal gene therapy. We tested a lentiviral vector containing the HS 2, 3, and 4 of the beta-LCR, a central polypurine tract element, an...
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PMID: 17496141
PDF is available here.
PDF is available here.
Pediatric Research (61)3 2007
Abstract
Fetuses with transposition and abnormalities of the foramen ovale and/or ductus arteriosus detected by ultrasound may develop severe hypoxemia postnatally. Higher than normal oxygen content in the pulmonary artery has been considered to be responsible. Patterns of blood flow in the normal fetus and...
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PMID: 17314701
PDF is available here.
PDF is available here.
Abstract
Our results demonstrate that 100% of surviving recipients demonstrate engraftment at 1 week of age, but that 70% of allogeneic recipients lose engraftment by 1 month of age, and 80% ultimately fail to sustain long-term chimerism. In contrast, all congenic recipients maintain stable, long-term, multi...
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PMID: 17023584
PDF is available here.
PDF is available here.
Abstract
It is important to recognize that it is only during our lifetime, the last decades of the 20th century, that the fetus has become a patient, with much of the credit due to the powerful imaging and sampling techniques now available. The secret life of the fetus has been revealed and with it the detai...
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PMID: 17301662
PDF is available here.
PDF is available here.