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ABSTRACT: There are abundant cases of obstetric emergencies demanding prompt intervention. Emergency cesarean sections are classified into stable, urgent and immediate surgeries, although there is significant overlap between three groups. Stable emergency cesarean sections are performed in patients with stable maternal and fetal physiology, but who need surgery before unstability occurs. Urgent cesarean sections refer to situations in which maternal and/or fetal physiology is unstable, whereas the immediate cesarean section is used for life-threatening condition such as sustained fetal bradycardia, maternal cardiopulmonary arrest. In most cases the key to proper management is the prompt communication between obstetricians and anesthesiologists. Anesthesiologists must have a clear understanding of certain obstetric emergencies. In the event of sustained fetal bradycardia caused by placental abruption, cord prolapse, uterine rupture etc, delivery by immediate cesarean section within 25 minutes improve long-term neonatal neurologic outcome. Although cardiopulmonary arrest in pregnancy is very uncommon, peripartum cesarean section should be considered within 5 minutes not only for maternal resuscitation but for neonatal survival. Only a well-coordinated teamwork of all involved specialities will guarantee optimal prognosis of mother and fetus.
Masui. The Japanese journal of anesthesiology 09/2012; 61(9):917-23; discussion 923-4.
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ABSTRACT: Endometriosis is one of the most common gynecological diseases in women of reproductive age. Although cyclooxygenase (COX)-2 inhibitors are effective in the treatment of endometriosis, the adverse cardiovascular effects associated with these inhibitors have limited their use. Microsomal prostaglandin E synthase-1 (mPGES-1) is an inducible enzyme downstream of COX-2 in prostaglandin E(2) biosynthesis. Previously, we developed mPGES-1 knockout mice (mPGES-1(-/-)) and have identified for the first time the roles of ectopic lesion- and host-associated mPGES-1 in angiogenesis and the growth of endometrial tissues. When mPGES-1(-/-) endometrial fragments were implanted into wild type (WT) mice (mPGES-1(-/-)→WT), or WT fragments implanted into mPGES-1(-/-) mice (WT→mPGES-1(-/-)), the growth of the implants was suppressed at days 14 and 28 after implantation, compared toWT→WT transplantation. An even greater degree of suppression was observed in mPGES-1(-/-) endometrial fragments implanted into mPGES-1(-/-) mice (mPGES-1(-/-)→mPGES-1(-/-)). After WT-WT implantation, mPGES-1 expression was localized at the border of the implanted endometrial tissues. Microvessel density, determined by CD31 immunostaining, was markedly suppressed in the mPGES-1(-/-) endometrial fragments implanted into mPGES-1(-/-) mice, with some suppression also observed in the mPGES-1(-/-)→WT and WT→mPGES-1(-/-) groups. The expression of vascular endothelial growth factor (VEGF-A) was significantly reduced in mPGES-1(-/-) endometrial tissues implanted into mPGES-1(-/-) mice at days 14 and 28, in comparison to the WT→WT group. These results suggested that mPGES-1 enhanced angiogenesis and growth of the endometrial implant, and indicate that mPGES-1 may be a good therapeutic target for endometriosis.
Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie 02/2011; 65(1):77-84. · 2.24 Impact Factor
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Emi Kamoshita,
Kan Amano,
Yuji Kanai,
Junko Mochizuki,
Yasuhiro Ikeda,
Shinzo Kikuchi,
Akihiro Tani,
Takashi Shoda,
Toshiyuki Okutomi,
Masahiko Nowatari, Nobuya Unno
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ABSTRACT: To examine the effect of the interval between onset of sustained fetal bradycardia and cesarean delivery on long-term neonatal neurologic prognosis.
A retrospective observational case-series performed with patients who had sudden-onset and sustained (<100 beats per minute) fetal bradycardia during labor. Fetal heart rate was monitored closely until cesarean delivery. The effect of the interval between the onset of bradycardia and delivery on neonatal neurologic prognosis was examined.
Among 2267 deliveries in 2002-2003 at Kitasato University Hospital, 19 pregnancies met the inclusion criteria. Episodes of fetal bradycardia were due to umbilical cord prolapse (n=5), placental abruption (n=4), uterine rupture (n=3), maternal respiratory failure (n=1), and other causes (n=6). Mean onset of fetal bradycardia to delivery interval (BDI) was 20.5±8.9 minutes. Mean decision-to-cesarean delivery interval was 11.4±3.9 minutes. BDI was negatively correlated with umbilical arterial pH at delivery. There were 3 postnatal deaths. Neurologic assessment at the age of 2 years revealed that 15 of 16 children were neurologically normal. When the BDI was less than 25 minutes, all term pregnancies led to normal neonatal neurologic development.
In the event of sustained intrapartum fetal bradycardia, delivery by emergency cesarean within 25 minutes improved long-term neonatal neurologic outcome.
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 10/2010; 111(1):23-7. · 1.41 Impact Factor
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ABSTRACT: The aim of this study was to clarify the relation of human papillomavirus (HPV) genotypes and physical status in the cervical neoplasm of Japanese patients with the grade of the disease. Human papillomavirus genotype was detected using a linear array genotyping assay. Human papillomavirus status, diffuse or punctate signal pattern, was studied by biotynyl-tyramide-based in situ hybridization for positive cases of HPV-16. Human papillomavirus types 16, 52, 58, and 31, in descending order of frequency, were prevalent. The rates of HPV infection in patients with cervical intraepithelial neoplasia (CIN) or squamous cell carcinoma (SCC) were significantly higher than those in patients without cervical lesions. The frequency of HPV single infection in SCC was higher than that in CIN1 or CIN2. In an unspecified-risk HPV, types 66 and 70 were found in SCC and 62, 71, and 82 were detected in CIN3. The diffuse pattern was more frequent in CIN, and the punctate pattern was more frequent in SCC. Human papillomavirus types 16, 52, 58, and 31 were frequently detected in Japanese women with cervical neoplasias, and several unspecified-risk HPVs might be high-risk types. A single infection of HPV and a punctate signal pattern seemed to be closely correlated with cervical carcinogenesis.
International Journal of Gynecological Cancer 11/2009; 19(8):1396-401. · 1.65 Impact Factor
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ABSTRACT: PROBLEM AND METHOD OF STUDY: We have shown that Tokishakuyaku-san (Toki) and Sairei-to (Sai) enhance T helper-1 (Th1) cytokine release from peripheral blood mononuclear cells (PBMCs); thereby, they could be a therapeutic means in the treatment of autoimmunity related recurrent abortion in which T helper-2 (Th2) polarization is exaggerated, the condition purported to benefit from these herbal medicines. However, an open question is whether these medicines might enhance Th1 cytokine release in decidual tissues and thereby stimulate the killer activity, thus, working counterproductively by accelerating maternal alloimmune reactions toward fetal tissues. To address this, we examined the effects of these medicines on the release of cytokines from decidual mononuclear cells (DMCs) in comparison with PBMCs on the assumption that they might act differently on these cell types. The effects of these medicines were investigated as related to human leukocyte antigen (HLA)-G, a nonclassical HLA class I antigen expressed on trophoblasts and a putative crucial player involved in fetomaternal immune interplay. RESULTS: Regarding Th1 cytokines, Toki marginally increased the release of tumor necrosis factor (TNF)-α, but not interferon (IFN)-γ from DMCs while Sai did not affect the release of both. Both Toki and Sai were without effect in modulating the release of interleukin (IL)-4, a member of Th2 cytokines. Interestingly, the presence of HLA-G reduced the release of Th1 cytokines from DMCs regardless of the addition of Toki, Sai or none. These findings are in sharp contrast with PBMCs on which these medicines seem to act so as to enhance Th1 polarization and attenuate Th2 polarization. CONCLUSION: Differential effects of Toki and Sai on the release of Th1/Th2 cytokines between DMCs and PBMCs may afford the rationale of these medicines in the treatment of autoimmunity-related recurrent abortion.
American Journal Of Reproductive Immunology 07/2008; 46(5):369 - 372. · 2.17 Impact Factor
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ABSTRACT: PROBLEM AND METHOD OF STUDY: To get insight into the basis for the empirical usage of herbal medicines in the treatment of recurrent abortion, we examined whether Tokishakuyaku-san (Toki) and Sairei-to (Sai) modulate T helper-1 (Th1) and T helper-2 (Th2) cytokine release from peripheral blood mononuclear cells (PBMCs). The effects of these medicines were investigated as related to human leukocyte antigen (HLA)-G, a non-classical HLA class I antigen expressed on trophoblasts and a putative crucial player involved in fetomaternal immune interplay. RESULTS: Toki and Sai increased the release of Th1 group cytokines, tumor necrosis factor (TNF)- and interferon (IFN)- while preserving the inhibitory effect of HLA-G on the release of these cytokines. As for Th2 group cytokine release, Toki was without effect in modulating interleukin (IL)-4 release, regardless of the presence of HLA-G, whereas Sai nullified the effect of the presence of HLA-G to stimulate the release of IL-4 without affecting its release in the absence of HLA-G. CONCLUSION: Toki and Sai may have therapeutic potential, particularly in autoimmunity-related recurrent abortion where Th2 response is pathologically enhanced, but not in recurrent abortion involving alloimmune fetomaternal derangement, a condition of, rather, an enhanced Th1 response.
American Journal Of Reproductive Immunology 06/2008; 44(6):342 - 346. · 2.17 Impact Factor
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ABSTRACT: Recently, multifractal analysis based on generalized concepts of fractals has been applied to biological tissues composed of complex structures.
Using digitized images of the maternal surface of 278 placentas, multifractal parameters were measured with a fractal analysis software.
The values of alpha(min), alpha(0), alpha(max) and the degree of multifractality given by the alpha(max) - alpha(min) difference calculated from 278 placentas were 1.840 +/- 0.068, 2.089 +/- 0.034, 2.856 +/- 0.128 and 1.017 +/- 0.136, respectively. A significant decrease of alpha(min) and as a consequence a significant increase in the degree of multifractality were observed according to gestational age. The alpha(0) value of the placenta complicated by pregnancy-induced hypertension (PIH) was significantly higher than that without PIH. The alpha(min) and alpha(0) values of the placenta having intrauterine growth restriction (IUGR) were significantly higher than those without IUGR. On the other hand, the presence of chorioamnionitis did not change multifractal properties of the maternal surface of the placenta.
The multifractal parameters may be objective indices of the heterogeneity or complexity of the macroscopic morphology of the maternal surface of the placenta. Multifractal analysis holds a promise for quantitatively evaluating physiological and pathological development of the placenta.
Gynecologic and Obstetric Investigation 06/2008; 66(2):127-33. · 1.28 Impact Factor
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ABSTRACT: To examine whether the heart rate dynamics of a monochorionic diamniotic (MD) twin fetus is different from a dichorionic diamniotic (DD) twin fetus by nonlinear methods of time series analysis.
32 fetal heart rate (FHR) recordings from healthy MD twin fetuses and 58 recordings from healthy DD twin fetuses were used. Nonlinear analyses included attractor reconstruction, calculation of the largest Lyapunov exponents, and estimation of correlation dimension.
FHR of healthy twin fetuses was shown to have unique nonlinear characteristics. The largest Lyapunov exponent significantly increased during the pregnancy period. In 30-36 weeks, correlation dimension in MD twins was significantly lower than that in DD twins. In DD twins, we observed a significant increase of correlation dimension from 22-29 to 30-36 weeks. In 22-29 weeks, the difference of the values of correlation dimension in each MD twin pair was significantly lower than that in each DD twin pair.
The heart rate dynamics of healthy MD and DD twin fetuses becomes more chaotic according to gestational age. From the viewpoint of the FHR-regulating system, a pair of MD twins seems to have a more strict binding than a pair of DD twins before 30 weeks' gestation.
Gynecologic and Obstetric Investigation 02/2008; 65(2):73-80. · 1.28 Impact Factor
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ABSTRACT: Detrended fluctuation analysis (DFA) has recently been validated as an excellent method by which to analyze heart rate variability and distinguish healthy subjects from patients with various types of the cardiac nervous system dysfunction.
One hundred and nineteen fetal heart rate (FHR) recordings obtained from healthy normal fetuses and 68 recordings obtained from small-for-gestational-age (SGA) fetuses were analyzed by DFA to examine gestational and pathologic changes of the scaling exponent, alpha.
In normal fetuses, a significant increase was observed in both the short-term (<or=30 s) alpha(1) and long-term (>30 s) alpha(2) scaling exponents according to gestational age. The alpha(1) values of SGA fetuses were not significantly different from those of healthy normal fetuses; however, the alpha(2) values of the former group (0.955 +/- 0.152) were significantly higher than those of normal subjects (0.887 +/- 0.128; p = 0.001).
The alpha(2) exponent appears to be a sensitive probe for detecting subtle, and possibly important, changes that occur in fetuses with intrauterine growth restriction, and may be helpful in the early and noninvasive detection of placental insufficiency or incipient intrauterine growth restriction. The use of DFA techniques offers great promise for understanding FHR behavior.
Gynecologic and Obstetric Investigation 01/2008; 65(2):116-22. · 1.28 Impact Factor
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Yuzuru Niibe,
Kazushige Hayakawa,
Shinpei Tsunoda,
Tadayuki Kanai,
Manami Imai,
Masahide Arai,
Tsutomu Arai,
Miwa Kawaguchi,
Toshiko Jobo,
Yukihiro Hamada,
Kazuo Yago, Nobuya Unno
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ABSTRACT: In order to evaluate the safety and efficacy of chemoradiotherapy using nedaplatin for locally advanced uterine cervical carcinoma in Japanese patients, we have started a single-institute phase II trial. Eligibility criteria include: (i) pathologically proven squamous cell carcinoma or adenocarcinoma, (ii) clinical FIGO stage Ib, IIa, or IIb with bulky tumor (> 40 mm) or pelvic lymph node swelling, or (iii) clinical FIGO stage IIIa, IIIb and IVa, (iv) no para-aortic lymph node swelling. A combination of external beam radiation and high dose rate intracavitary irradiation is given. Nedaplatin (30 mg/m2) is intravenously infused on a weekly basis for five times. The primary endpoint is 3-year overall survival, and the secondary endpoints are tumor response, 2-year overall survival, 3-year progression-free survival, acute adverse events, protocol treatment compliance, and late adverse events. We plan to recruit 45 patients within 3 years.
Japanese Journal of Clinical Oncology 02/2007; 37(1):70-2. · 1.78 Impact Factor
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Emi Kamoshita,
Yasuhiro Ikeda,
Mamoru Fujita,
Hideki Amano,
Atsuhiko Oikawa,
Tastunori Suzuki,
Yasuhumi Ogawa,
Shohei Yamashina,
Sadahiro Azuma,
Shuh Narumiya, Nobuya Unno,
Masataka Majima
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ABSTRACT: E-type prostaglandins have been reported to be proangiogenic in vivo. Thus, we examined prostaglandin receptor signaling relevant to wound-induced angiogenesis. Full-thickness skin wounds were created on the backs of mice, and angiogenesis in wound granulation tissues was estimated. Wound closure and re-epithelization in EP3 receptor knockout mice (EP3-/-) were significantly delayed compared with their wild-type (WT) mice, whereas those in EP1-/-, EP2-/-, and EP4-/- were not delayed. Wound-induced angiogenesis estimated with CD31 immunohistochemistry in EP3-/- mice was significantly inhibited compared with that in WT mice. Immunoreactive vascular endothelial growth factor (VEGF) in wound granulation tissues in EP3-/- mice was markedly less than that in WT mice. Wound closure in WT mice was delayed significantly by VEGF neutralizing antibody compared with control IgG. Wound-induced angiogenesis and wound closure were significantly suppressed in EP3-/- bone marrow transplantation mice compared with those in WT bone marrow transplantation mice. These were accompanied with the reductions in accumulation of VEGF-expressing cells in wound granulation tissues and in mobilization of VEGF receptor 1-expressing leukocytes in peripheral circulation. These results indicate that the recruitment of EP3-expressing cells to wound granulation tissues is critical for surgical wound healing and angiogenesis via up-regulation of VEGF.
American Journal Of Pathology 11/2006; 169(4):1458-72. · 4.89 Impact Factor
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ABSTRACT: Many studies on the physiology of the cardiovascular system reported that nonlinear chaotic dynamics may govern the generation of the heart rate signal.
To examine whether the heart rate dynamics of an intrauterine growth restricted (IUGR) fetus is different from a healthy normal fetus by nonlinear methods of time series analysis.
One hundred nineteen fetal heart rate (FHR) recordings from healthy normal fetuses, and 69 recordings from IUGR fetuses were analyzed. Nonlinear analyses included attractor reconstruction, calculation of the largest Lyapunov exponents using the Wolf algorithm, and estimation of correlation dimension. The largest Lyapunov exponents from normal fetuses were checked by means of surrogate-data test.
Abnormal FHR patterns of IUGR fetuses such as decreased variability and repetitive late decelerations presented a remarkably different structure in the reconstructed attractor. Surrogate data suggest that the FHR of healthy normal fetuses has unique nonlinear characteristics. The largest Lyapunov exponents were positive for all of 119 healthy normal fetuses, indicating that the FHR control system is sensitive to initial conditions. The values of IUGR fetuses were significantly lower than those of normal subjects. In normal fetuses, significant changes of correlation dimension according to gestational age were observed. In IUGR fetuses, however, such changes were not found.
The heart rate dynamics of IUGR fetuses is less chaotic than that of normal fetuses. Decreased system complexity suggested by correlation dimension may limit the IUGR fetuses' ability to maintain cardiovascular integrity, and therefore, to adapt to the variety of internal and external cardiovascular stresses.
Early Human Development 05/2006; 82(4):217-26. · 2.05 Impact Factor
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ABSTRACT: Decelerations of fetal heart rate (FHR) are the results of many pathophysiological factors that modulate the intrinsic rate of the heart. FHR change is a complex phenomenon and can be viewed as a type of nonlinear dynamic system. This paper presents a qualitative model of FHR decelerations based on catastrophe theory, especially to account for abrupt heart rate changes seen in variable decelerations.
One of the elementary catastrophes, the cusp catastrophe, was used to model FHR changes seen in variable, late, and early decelerations.
Catastrophe theory describes typical variable decelerations as an abrupt response to a slowly changing force of attack (uterine contraction) and physiological defense. Because of its three-dimensionality and topological features, the cusp catastrophe model provides a qualitatively satisfying description of FHR decelerations.
The organized complexity of living systems offers the best hope for the application of catastrophe theory. The nature of the elementary catastrophes will be essential knowledge in the mathematical analysis of biology.
Gynecologic and Obstetric Investigation 02/2006; 61(2):72-9. · 1.28 Impact Factor
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ABSTRACT: We present a fetus with progressive massive subcutaneous lymphangiomas leading to intrauterine death. A 28-year-old woman was referred to our hospital because of a precordial cystic mass of the fetus. An ultrasound revealed lymphangiomas extending from bilateral axillae to the anterior chest wall. At 18 weeks' gestation, amniocentesis was performed and the karyotype of the fetus was found to be normal 46, XY. Thereafter the lesions increased in size gradually and spread over the body. Amniotic fluid decreased, pericardial, and pleural effusion appeared, and cardiomegaly became evident. The fetus died in utero at 25 weeks' gestation. Postmortem examination revealed a male fetus surrounded with multicystic soft masses spreading over the body, and syndactyly (left third and fourth fingers) was present. Histologically, a number of irregularly dilated lymphatics extended through subcutaneous tissues to the skeletal muscles. No communications between the cysts and the thoracic or abdominal cavity existed, and no lymphatic dilations in the viscera were confirmed. As far as we know, such conditions have rarely been reported. Considering that in previous literature, a favorable prognosis of a fetus with an atypically located (lateral cervical or non-cervical) lymphangioma with a normal karyotype has been reported, our case may be included in a distinct pathological entity. When we find a lymphangioma in a fetus, careful follow-up by ultrasound is mandatory.
Congenital Anomalies 01/2006; 45(4):154-6.
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ABSTRACT: Abstract We report on a fetus with a congenital pulmonary myofibroblastic tumor, the prenatal detection of which with imaging modalities has not been reported up until now. A 32-year-old woman was referred to our hospital at 29 weeks' gestation because of severe fetal hydrops. Sonograms and magnetic resonance imaging showed a large solid tumor in the left thorax. The fetus died in utero the next day. Autopsy confirmed that the tumor was confined to the lower lobe of the left lung, and circulatory insufficiency from compression by the tumor was considered to be the cause of fetal hydrops and demise. Histologic examination revealed that the tumor was composed of uniform short spindle cells with no atypia and a large number of vessels. In addition, with immunohistochemical studies, the tumor cells were stained for calponin but not for cluster differentiation (CD)-31, CD-34, alpha-smooth muscle actin or S-100.
Journal of Obstetrics and Gynaecology Research 01/2006; 31(6):552-5. · 0.94 Impact Factor
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ABSTRACT: We report two cases of fetofetal transfusion in monochorionic triamniotic triplet pregnancies. Case 1: At 23 weeks' gestation an amnioreduction was carried out. Three days later, the donor triplet died in utero. Immediately after that, a cardiotocogram of the triplet who had been thought to be unaffected by the fetofetal transfusion, showed a non-reassuring fetal status. Although cesarean section was carried out, none of the triplets survived. Case 2: At 24 weeks' gestation a woman was transferred to our center because of fetofetal transfusion in monochorionic triplets. Cesarean section was carried out. However, the recipient died on the 75th day after birth, and the others had neurological problems. Previous reports on fetofetal transfusion in triplets are very limited. The prognosis of this condition has been reported to be severe, irrespective of chorionicity, gestational age at delivery, maternal age, and parity. When managing a monochorionic or dichorionic triplet pregnancy, serial and careful ultrasound examination is mandatory to find early symptoms of this serious condition.
Journal of Obstetrics and Gynaecology Research 11/2005; 31(5):414-20. · 0.94 Impact Factor
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ABSTRACT: The present study characterizes the immunological responses induced by superantigen and the underlying pathological mechanism using T-cell receptor-transgenic mice (TCR-Tg) to enable the ligand toxic shock syndrome toxin-1 (TSST-1) to induce a cytokine storm.
Three kinds of pregnant mice which could respond to TSST-1 at various levels were injected with TSST-1 on gestation day 17.5 and then the incidence of fetal/newborn death, production of cytokines including serum interleukin-2 (IL-2) and the histological status of the placenta were examined on day 18.5.
The incidence of fetal/newborn death and the concentrations of cytokines such as IL-2 were higher in TCR-Tg mother than those in other strains of mice. Pathological examinations revealed that the placenta was congestive and apoptotic in TCR-Tg mice.
Superantigen injection into pregnant mice appears to increase the incidence of fetal/newborn death through an IL-2-dependent immunological pathway.
American journal of reproductive immunology (New York, N.Y.: 1989) 11/2005; 54(4):232-9. · 3.05 Impact Factor
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ABSTRACT: We report prenatal diagnosis of an amniotic sheet by magnetic resonance imaging (MRI) at 28 weeks' gestation. The amniotic sheet divided the uterine cavity into 2 compartments, with the fetus and placenta located in the upper portion of the amniotic cavity. Although prenatal diagnosis of amniotic sheets can be performed with ultrasonography, the wider field of view and excellent tissue contrast provided by MRI may allow better spatial visualization of the amniotic sheet and, therefore, improve the diagnostic accuracy.
American Journal of Obstetrics and Gynecology 10/2005; 193(3 Pt 1):881-4. · 3.47 Impact Factor
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ABSTRACT: We report two cases of a fetus with sirenomelia sequence which showed oligohydramnios and a single umbilical artery. The first case was of a single fetus with symelia apus and only one leg. Prenatal diagnosis of this case was possible. The second case was of a dichorionic-diamniotic twin pregnancy in which one fetus had symelia dipus with two fused lower extremities. Prenatal diagnosis of the condition was not made. In both cases, the fetuses died shortly after birth from respiratory distress due to severe pulmonary hypoplasia. Absence of urinary tract, imperforate anus, and spine deformity were confirmed in both cases. Although prenatal diagnosis of symelia dipus seems difficult, this condition must be considered in a fetus with severe oligohydramnios.
Congenital Anomalies 10/2005; 45(3):93-5.
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ABSTRACT: Currently, the standard method of diagnosis of twin reversed arterial perfusion (TRAP) sequence is ultrasound imaging. The use of MRI for flow visualization may be a useful adjunct to US imaging for assessing the presence of retrograde blood flow in the acardiac fetus and/or umbilical artery. The technical challenge in fetal MRI flow imaging, however, is that fetal electrocardiogram (ECG) monitoring required for flow imaging is currently unavailable in the MRI scanner. A non-gated MRI flow imaging technique that requires no ECG monitoring was developed using the t-test to detect blood flow in 20 slices of phase-contrast MRI images randomly scanned at the same location over multiple cardiac cycles. A feasibility study was performed in a 24-week acardiac twin that showed no umbilical flow sonographically. Non-gated MRI flow images clearly indicated the presence of blood flow in the umbilical artery to the acardiac twin; however, there was no blood flow beyond the abdomen. This study leads us to conjecture that non-gated MRI flow imaging is sensitive in detecting low-range blood flow velocity and can be an adjunct to Doppler US imaging.
Pediatric Radiology 09/2005; 35(8):826-9. · 1.67 Impact Factor
