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Last Trimester (last + trimester)
Selected AbstractsStroke in the developing brain and intractable epilepsy: effect of timing on hippocampal sclerosisDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 9 2003Waney Squier FRCP FRC Path A detailed study was made of the pathology of specimens removed by hemispherectomy for the treatment of intractable epilepsy in children with unilateral middle cerebral artery stroke. Neuropathological criteria were used to differentiate strokes that occurred in early intrauterine development (before 28 weeks gestational age) from those occurring in the last trimester, at birth, or after birth: 19 children had early strokes and 21 late. There was no difference in seizure history or occurrence of febrile convulsions in these two groups. Hippocampal tissue was available in 20 patients; pathology in the hippocampus, remote from the infarcted area, showed a marked difference between early-onset and late-onset groups. Hippocampal sclerosis was uncommon in children with early-onset strokes but developed in most of the children whose strokes were of later origin. However, hippocampal sclerosis was more closely related to a clinical history of a late initial precipitating insult irrespective of infarct timing. These findings demonstrate the changing vulnerability of the developing brain and show that hippocampal pathology is more closely related to the timing of an insult than seizure history or the occurrence of febrile convulsions. [source] Maturation of fetal responses to musicDEVELOPMENTAL SCIENCE, Issue 5 2004B.S. Kisilevsky Maturation of fetal response to music was characterized over the last trimester of pregnancy using a 5-minute piano recording of Brahms' Lullaby, played at an average of 95, 100, 105 or 110 dB (A). Within 30 seconds of the onset of the music, the youngest fetuses (28,32 weeks GA) showed a heart rate increase limited to the two highest dB levels; over gestation, the threshold level decreased and a response shift from acceleration to deceleration was observed for the lower dB levels, indicating attention to the stimulus. Over 5 minutes of music, fetuses older than 33 weeks GA showed a sustained increase in heart rate; body movement changes occurred at 35 weeks GA. These findings suggest a change in processing of complex sounds at around 33 weeks GA, with responding limited to the acoustic properties of the signal in younger fetuses but attention playing a role in older fetuses. [source] Social support and postpartum depressive symptomatology: The mediating role of maternal self-efficacyINFANT MENTAL HEALTH JOURNAL, Issue 3 2006Divna M. Haslam Research shows that social support and maternal self-efficacy are inversely related to postpartum depression; however, little is known about the mechanisms by which these variables impact on depressive symptomatology. This study uses path analysis to examine the proposal that maternal self-efficacy mediates the effects of social support on postpartum depressive symptomatology. Primiparous women (n=247) completed questionnaires during their last trimester and then again at 4 weeks' postpartum (n=192). It was hypothesized that higher levels of parental support, partner support, and maternal self-efficacy would be associated with lower levels of depressive symptomatology postpartum and that the relationship between social support and depressive symptomatology would be mediated by maternal self-efficacy. Results indicated that as expected, higher parental support and maternal self-efficacy were associated with lower levels of depressive symptomatology postpartum. Partner support was found to be unrelated to both depressive symptomatology and maternal self-efficacy. Results from the path analysis supported the mediation model. Findings suggest that parental support lowers depressive symptomatology by the enhancement of maternal self-efficacy. [source] The biology of vernix caseosaINTERNATIONAL JOURNAL OF COSMETIC SCIENCE, Issue 5 2006S. B. Hoath Synopsis The biology and physical properties of the uniquely human skin cream ,vernix caseosa' are discussed. This material coats the foetal skin surface during the last trimester of gestation and provides multiple beneficial functions for the foetus and newborn infant. Vernix has a complex structure similar to stratum corneum but lacks lipid lamellae and is more plastic due to the absence of desmosomal constraints. In utero, vernix is made in part by foetal sebaceous glands, interacts with pulmonary surfactant, detaches into the amniotic fluid, and is swallowed by the foetus. At the time of birth, vernix has a remarkably constant water content approximating 80%. Postnatally, vernix is simultaneously a cleanser, a moisturizer, an anti-infective, and an anti-oxidant. Vernix facilitates acid mantle development and supports normal bacterial colonization. Its hydrated cellular structure and unusual lipid composition provide a ,best' solution for the needs of the foetus and newborn, not least of which is the attraction of caregivers. Vernix is an important natural biomaterial of potential interest to cosmetic scientists, and other disciplines involved in product development and therapies targeting the complex interface between the stratum corneum and a changing terrestrial environment. Résumé La biologie et les propriétés physiques de la crème de peau exclusivement humaine ,Vernix caseosa « sont discutées. Ce matériau couvre la surface de la peau foetale pendant le dernier trimestre de gestation et remplit des fonctions avantageuses multiples pour le foetus et le nouveau-né. Le Vernix a une structure complexe semblable au stratum corneum, mais manque de lamelles lipidiques et est plus plastique en raison de l'absence de contraintes desmosomales. In utero, le Vernix est constitué en partie par des glandes sébacées foetales, il interagit avec le surfactant pulmonaire, il se détache dans le liquide amniotique et est avalé par le foetus. Au moment de la naissance, le Vernix a une teneur remarquablement constante en eau de l'ordre de 80%. Après la naissance, le Vernix devient simultanément un produit de lavage, un produit hydratant, un anti-infectieux et un anti-oxydant. Le Vernix facilite le développement du manteau acide et soutient la colonisation bactérienne normale. Sa structure cellulaire hydratée et sa composition en lipide inhabituelle en font ,une des meilleures » solutions pour les besoins du foetus et du nouveau-né, à laquelle le personnel soignant n'attache pas la moindre importance. Le Vernix est un biomatériau naturel important potentiellement intéressant pour les scientifiques cosméticiens et pour les autres disciplines impliquées dans le développement de produits et de thérapies visant l'interface complexe entre le stratum corneum et un environnement terrestre changeant. [source] Dermoscopy is a suitable method for the observation of the pregnancy-related changes in melanocytic neviJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 8 2007AS Aktürk Summary Background, It is a common opinion that expansion and darkening in melanocytic nevi may occur during pregnancy. The main problem is that whether it is a usual finding, or it is a condition that requires suspicion about melanoma. Objectives, It was aimed to find the changes that might occur in the sizes and structures of melanocytic nevi during pregnancy. Methods, Ninety-seven nevi of the 56 pregnant women in the first trimester were evaluated in the study. The localization and size of the nevi were recorded on a standard body diagram. After clinical examination, dermoscopic analyses were applied. Pattern analyses were done, and total dermoscopy scores (TDS) were calculated by applying ABCD scoring system. All subjects were seen again during the third trimester. Results, There was a statistically significant difference between the mean diameters of nevi in the first and third trimester (P = 0.001). Of nevi whose diameters increased, 10 (50.00%) were localized on the front of body, 6 (30.00%) on the face and neck, 3 (15.00%) on the legs, and 1 (5.00%) on the back. The enlargement in diameters was more significant on the front of the body, but there was no statistically significant difference. Compared according to the pattern analysis, new dot formation was observed only on the structure of six nevi during the last trimester. Four of them were localized on the front of the body. There was statistically significant increase in mean TDS in comparison between the first and third trimesters (P = 0008). Conclusions, During the pregnancy, widening in diameters and structure changes of nevi may be seen especially on the front of the body. We also think that these findings might be connected with expansion of the skin during pregnancy. Dermoscopic controls are the first choice of method to analyse the nevi since the patient may not recognize these changes. [source] Impact of delivery mode on electromyographic activity of pelvic floor: Comparative prospective study,NEUROUROLOGY AND URODYNAMICS, Issue 7 2010Simone Botelho Abstract Aims Several studies evidenced the association between pregnancy, mode of delivery and genitourinary symptoms. However, there are still controversies about the role of mode of delivery in the prevention or aggravation of these symptoms. This study aimed to compare the impact of three distinct modes of delivery on pelvic floor muscle contractility. Methods Seventy-five primiparous women were divided into three groups: (1) vaginal delivery with mediolateral episiotomy (n,=,28); (2) elective cesarean section (n,=,26); (3) emergency cesarean section (n,=,21). All patients underwent vaginal digital examination, grading the muscle contractility from 0 to 5 and surface electromyography (EMG) of the pelvic floor during the last trimester of pregnancy and 45 days after delivery. Results There was a significant increase in pelvic floor contractility in the elective cesarean section group, from 2.35 to 2.92 (P,=,0.03), when compared to the vaginal delivery and emergency cesarean section groups. Analysis of electromyography data showed a significant reduction in maximum contraction of the pelvic floor after vaginal delivery, from 39.17 to 31.14,µV (P,=,0.001), which was not observed in both cesarean section groups. Conclusion Vaginal delivery was associated with a decrease in pelvic floor muscle strength and endurance 45 days after delivery when compared to elective cesarean section as well as emergency cesarean section. Neurourol. Urodynam. 29:1258,1261, 2010. © 2010 Wiley-Liss, Inc. [source] Brief communication: The London atlas of human tooth development and eruptionAMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 3 2010S.J. AlQahtani Abstract The aim of this study was to develop a comprehensive evidence-based atlas to estimate age using both tooth development and alveolar eruption for human individuals between 28 weeks in utero and 23 years. This was a cross-sectional, retrospective study of archived material with the sample aged 2 years and older having a uniform age and sex distribution. Developing teeth from 72 prenatal and 104 postnatal skeletal remains of known age-at-death were examined from collections held at the Royal College of Surgeons of England and the Natural History Museum, London, UK (M 91, F 72, unknown sex 13). Data were also collected from dental radiographs of living individuals (M 264, F 264). Median stage for tooth development and eruption for all age categories was used to construct the atlas. Tooth development was determined according to Moorrees et al. (J Dent Res 42 (1963a) 490,502; Am J Phys Anthropol 21 (1963b) 205,213) and eruption was assessed relative to the alveolar bone level. Intraexaminer reproducibility calculated using Kappa on 150 teeth was 0.90 for 15 skeletal remains of age <2 years, and 0.81 from 605 teeth (50 radiographs). Age categories were monthly in the last trimester, 2 weeks perinatally, 3-month intervals during the first year, and at every year thereafter. Results show that tooth formation is least variable in infancy and most variable after the age of 16 years for the development of the third molar. Am J Phys Anthropol, 2010. © 2010 Wiley-Liss, Inc. [source] Blood Lymphocyte Subpopulations, Neutrophil Phagocytosis and Proteinogram During Late Pregnancy and Postpartum in MaresREPRODUCTION IN DOMESTIC ANIMALS, Issue 2 2008R Agrícola Contents The aim of this study was to evaluate peripheral blood lymphocyte subpopulations, neutrophil phagocytic capacity and proteinogram characteristics in mares, during the last trimester of pregnancy and in postpartum. Measurement of phagocytosis and quantification of T-lymphocyte subsets were done by flow cytometry. Quantification of T-lymphocyte subsets was performed with monoclonal antibodies specific for CD2, CD3, CD4 and CD8 cell markers. Natural killer and B-cell counts were estimated mathematically. Serum proteinogram was obtained by electrophoresis. No significant differences were observed between gestation and postpartum on CD4+, CD8+ and NK+ lymphocyte subsets, CD4 : CD8 ratio and phagocytosis. The percentage of cells expressing CD3 (64.2 ± 1.8) and CD2 (68.4 ± 1.7) (Mean ± SEM) was reduced during gestation vs postpartum (69.7 ± 1.5 and 73.8 ± 1.4 respectively) (p < 0.05). During pregnancy, CD19+ (31.6 ± 1.7) was higher than in postpartum (26.2 ± 1.4) (p < 0.05). Total T cells (2911 ± 227 cells/,l), T helper cells (2144 ± 169 cells/,l) and T-cytotoxic cells (767 ± 68 cells/,l) were depressed in pregnancy, when compared with postpartum (4093 ± 337 cells/,l; 3004 ± 276 cells/,l; 1089 ± 94 cells/,l respectively) (p < 0.01). Total white blood cell count was reduced during pregnancy (8815 ± 427 cells/,l) with respect to postpartum (10742 ± 446 cells/,l) (p < 0.01), while neutrophil count did not change. Total proteins, albumin, ,1,,2,,1, ,2, , globulins and albumin : globulin did not differ. Our results suggest that the physiological immune depression occurring in mares, during gestation might be due to T-helper and T-cytotoxic lymphocytes reduction. [source] IPD meta-analysis shows no effect of LC-PUFA supplementation on infant growth at 18 monthsACTA PAEDIATRICA, Issue 1 2009Eva Rosenfeld Abstract Aim: Clinical trials on the effects of long-chain polyunsaturated fatty acids (LC-PUFA) supplementation of formula milk on growth of term and preterm children have shown conflicting results. We examined the effects of LC-PUFAs , especially docosahexaenoic acid (DHA) and arachidonic acid (AA) , on growth at 18 months. Methods: We performed a meta-analysis based on individual patient data (IPD) of 901 children from four large, randomised clinical trials of formula milk with and without LC-PUFAs. Anthropometrics were assessed by z-scores based on weight for age, length for age, head circumference for age and body mass index (BMI) for age at 18 months. The studies differed in LC-PUFA composition and infant characteristics (two studies on preterm children, two on term children). Results: Multivariate regression analyses including the possible confounders, sex, gestational age, birth weight, smoking in the last trimester and maternal age, as well as interaction terms showed no significant effects of LC-PUFA supplementation on any z-score. Subgroup analyses on trials with high amounts of DHA and on studies with duration of supplementation of at least 6 months yielded the same result. These findings cannot be explained by the lack of power. Conclusion: Our IPD meta-analysis shows no evidence that LC-PUFA supplementation affects children's growth at 18 months of age. [source] | ||||||||||