|
|
Indicators of systemic inflammation in spontaneous and instrumental delivery. Influence on neonatal concentrations of inflammatory markers.
Šibíková, Michaela ; Janota, Jan (advisor) ; Bayer, Milan (referee) ; Straňák, Zbyněk (referee)
8 ABSTRACT The inflammatory process, associated with endothelium activation, is one of the possible mechanisms of the initiation of spontaneous delivery. The mode of delivery may affect the concentrations of inflammatory molecules and microvesicles produced by endothelial cells. These biomarkes might be used to detect neonatal pathologies. The aim of our study was to assess endothelial biomarkers in cord and neonatal blood following different modes of delivery: i.e. spontaneus vaginal delivery and elective cesarean section. The study group consisted of neonates and their mothers after uncomplicated pregnancy and spontaneous vaginal delivery (spontaneous group) and after elective caesarean section (elective group). The patient samples were taken from the cord blood and from the peripheral venous blood of the newborns between 48- 72 hours of life. Soluble biomarkers were measured using a multiplex immunoassay based on the Luminex® xMAP platform. The concentration of microvesicles and surface antigen-specific microvesicles was determined by flow cytometry. We found significantly increased concentrations of cord blood soluble endothelial markers and cell-membrane derived endothelium specific microvesicles after spontaneous vaginal delivery compared to elective cesarean section. Irrespective of the delivery mode...
|
|
|
Doppler parameters of myocardial dysfunction in very low birth weight infants
Širc, Jan ; Straňák, Zbyněk (advisor) ; Plavka, Richard (referee) ; Janota, Jan (referee)
Preterm neonate is exposed to significant hemodynamic changes after delivery. Cardiac and extracardiac shunts, especially ductus arteriosus, play an important role in this process. Failure of postnatal adaptation and persistent patent ductus arteriosus (PDA) may lead to cardiac overload and circulatory failure with hypoperfusion of vital organs and in turn adversely affect the short-term and long-term morbidity and mortality of these patients. Newborns with very low birth weight are at highest risk, however the possibilities for diagnosing circulatory failure in this patient group are limited. Clinical presentation and physical examination are nonspecific and involve subjective measures. Functional echocardiography provides information on systolic and diastolic heart function as well as the possibility to measure cardiac output and superior vena cava flow (SVC flow). Much of what is known about ventricular function pertains to systole rather than diastole. Near infrared spectroscopy provides another noninvasive method, enabling the measurement of tissue oxygenation including that of the brain. Cerebral oxygenation can be measured by placing the probe on the head of the neonate. Further possibility to help diagnose circulatory system failure are biochemical markers, commonly used in diagnosing...
|
|
|
The importance of tissue oxygenation changes in monochorionic twins for predicting severe neonatal morbidity
Korček, Peter ; Straňák, Zbyněk (advisor) ; Bayer, Milan (referee) ; Janota, Jan (referee)
Despite improvements in perinatal outcome in recent decades, multiple pregnancies are associated with increased risk of complications including preterm birth, fetal growth restriction (FGR) and twin-twin transfusion syndrome (TTTS). Fetal circulatory disturbances and immature cerebral vasculature increase the risk for serious perinatal injury and adverse neurodevelopmental outcome in multiple births. Cerebral oxygenation (crSO2) monitoring using near-infrared spectroscopy (NIRS) is increasingly used in high-risk infants. However, limited data are available in twin preterm infants with respect to cerebral tissue perfusion. The aim of this project was to measure crSO2 using NIRS in preterm monochorionic and dichorionic twins during the first 72 hours of life and find out correlation between underlying fetal conditions and crSO2 development. We divided the study population into 4 subgroups based on major fetal pathology: donor (1) and recipient (2) monochorionic twins (with TTTS), selective FGR infants (3) and twins without fetal compromise (4). We observed significant variation in crSO2 among the subgroups using mixed model analysis. The recipient twins exhibited the lowest crSO2 throughout the study period, whereas the FGR and donor twins presented with the highest values. Nevertheless, we found no...
|
|
|
Doppler parameters of myocardial dysfunction in very low birth weight infants
Širc, Jan ; Straňák, Zbyněk (advisor) ; Plavka, Richard (referee) ; Janota, Jan (referee)
Preterm neonate is exposed to significant hemodynamic changes after delivery. Cardiac and extracardiac shunts, especially ductus arteriosus, play an important role in this process. Failure of postnatal adaptation and persistent patent ductus arteriosus (PDA) may lead to cardiac overload and circulatory failure with hypoperfusion of vital organs and in turn adversely affect the short-term and long-term morbidity and mortality of these patients. Newborns with very low birth weight are at highest risk, however the possibilities for diagnosing circulatory failure in this patient group are limited. Clinical presentation and physical examination are nonspecific and involve subjective measures. Functional echocardiography provides information on systolic and diastolic heart function as well as the possibility to measure cardiac output and superior vena cava flow (SVC flow). Much of what is known about ventricular function pertains to systole rather than diastole. Near infrared spectroscopy provides another noninvasive method, enabling the measurement of tissue oxygenation including that of the brain. Cerebral oxygenation can be measured by placing the probe on the head of the neonate. Further possibility to help diagnose circulatory system failure are biochemical markers, commonly used in diagnosing...
|
|
| |
|
| |
guest ::
RSS feed.