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Fetal environment.

Kinare A - Indian J Radiol Imaging (2008)

Bottom Line: These three main components decide whether there will be an uneventful pregnancy and the successful birth of a healthy baby.Population and race also influence pregnancy outcomes to some extent in certain situations.USG is the most sensitive imaging tool currently available for evaluation of these factors and can offer considerable information in this area.

View Article: PubMed Central - PubMed

Affiliation: Department of Ultrasound, K.E.M. Hospital, Jehangir Hospital, Pune, India.

ABSTRACT
The intrauterine environment has a strong influence on pregnancy outcome. The placenta and the umbilical cord together form the main supply line of the fetus. Amniotic fluid also serves important functions. These three main components decide whether there will be an uneventful pregnancy and the successful birth of a healthy baby. An insult to the intrauterine environment has an impact on the programming of the fetus, which can become evident in later life, mainly in the form of cardiovascular diseases, diabetes, and certain learning disabilities. The past two decades have witnessed major contributions from researchers in this field, who have included ultrasonologists, epidemiologists, neonatologists, and pediatricians. Besides being responsible for these delayed postnatal effects, abnormalities of the placenta, umbilical cord, and amniotic fluid also have associations with structural and chromosomal disorders. Population and race also influence pregnancy outcomes to some extent in certain situations. USG is the most sensitive imaging tool currently available for evaluation of these factors and can offer considerable information in this area. This article aims at reviewing the USG-related developments in this area and the anatomy, physiology, and various pathologies of the placenta, umbilical cord, and the amniotic fluid.

No MeSH data available.


Related in: MedlinePlus

Twin gestation. Molar changes are seen in the first placenta. Sagittal image shows both placentae to be anterior. A typical bunch-ofgrapes appearance (arrow) is present in the first placenta. The second placenta (arrowhead) is normal
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Figure 0012: Twin gestation. Molar changes are seen in the first placenta. Sagittal image shows both placentae to be anterior. A typical bunch-ofgrapes appearance (arrow) is present in the first placenta. The second placenta (arrowhead) is normal

Mentions: Hydatidiform mole falls in the general category of gestational trophoblastic disease. The group includes molar pregnancy, invasive mole, and choriocarcinoma. Complete and partial moles are the two types of molar pregnancies. The two conditions are differentiated histopathologically. USG appearances of a mole are quite typical, though the classical bunch-of-grapes or snowstorm appearance may not be seen always [Figure 12]. On USG, it is seen as a complex and echogenic intrauterine mass, containing small cystic spaces, which correspond to the hydropic villi. In case the villi are too small, an echogenic mass may be the only feature seen [Figure 13]. It can also be seen as a large fluid collection in a cavity, in which case it may simulate the appearance of retained products of an abortion. A partial mole has a triploid or a tetraploid karyotype and a hydropic placenta is always evident.[29] Color and power mode are usually confirmatory and the classical ‘ball of vascularity’ is encountered in the majority of cases. USG also plays a key role in monitoring the response to therapy in treated cases and, along with β-human chorionic gonadotropin (HCG) estimation, forms the backbone of the approach to treatment. Carter et al. found the uterine artery pulsatility index a strong prognostic parameter; it also correlated well with the β-HCG titers. In the first and early second trimester, the flow is typically high velocity and low impedance, which is contrary to what is seen in normal gestation. Color Doppler is also extremely useful in the assessment of invasive disease [Figure 14]. Vascular cystic foci can be reliably identified in the myometrium in these cases.[30]


Fetal environment.

Kinare A - Indian J Radiol Imaging (2008)

Twin gestation. Molar changes are seen in the first placenta. Sagittal image shows both placentae to be anterior. A typical bunch-ofgrapes appearance (arrow) is present in the first placenta. The second placenta (arrowhead) is normal
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2747450&req=5

Figure 0012: Twin gestation. Molar changes are seen in the first placenta. Sagittal image shows both placentae to be anterior. A typical bunch-ofgrapes appearance (arrow) is present in the first placenta. The second placenta (arrowhead) is normal
Mentions: Hydatidiform mole falls in the general category of gestational trophoblastic disease. The group includes molar pregnancy, invasive mole, and choriocarcinoma. Complete and partial moles are the two types of molar pregnancies. The two conditions are differentiated histopathologically. USG appearances of a mole are quite typical, though the classical bunch-of-grapes or snowstorm appearance may not be seen always [Figure 12]. On USG, it is seen as a complex and echogenic intrauterine mass, containing small cystic spaces, which correspond to the hydropic villi. In case the villi are too small, an echogenic mass may be the only feature seen [Figure 13]. It can also be seen as a large fluid collection in a cavity, in which case it may simulate the appearance of retained products of an abortion. A partial mole has a triploid or a tetraploid karyotype and a hydropic placenta is always evident.[29] Color and power mode are usually confirmatory and the classical ‘ball of vascularity’ is encountered in the majority of cases. USG also plays a key role in monitoring the response to therapy in treated cases and, along with β-human chorionic gonadotropin (HCG) estimation, forms the backbone of the approach to treatment. Carter et al. found the uterine artery pulsatility index a strong prognostic parameter; it also correlated well with the β-HCG titers. In the first and early second trimester, the flow is typically high velocity and low impedance, which is contrary to what is seen in normal gestation. Color Doppler is also extremely useful in the assessment of invasive disease [Figure 14]. Vascular cystic foci can be reliably identified in the myometrium in these cases.[30]

Bottom Line: These three main components decide whether there will be an uneventful pregnancy and the successful birth of a healthy baby.Population and race also influence pregnancy outcomes to some extent in certain situations.USG is the most sensitive imaging tool currently available for evaluation of these factors and can offer considerable information in this area.

View Article: PubMed Central - PubMed

Affiliation: Department of Ultrasound, K.E.M. Hospital, Jehangir Hospital, Pune, India.

ABSTRACT
The intrauterine environment has a strong influence on pregnancy outcome. The placenta and the umbilical cord together form the main supply line of the fetus. Amniotic fluid also serves important functions. These three main components decide whether there will be an uneventful pregnancy and the successful birth of a healthy baby. An insult to the intrauterine environment has an impact on the programming of the fetus, which can become evident in later life, mainly in the form of cardiovascular diseases, diabetes, and certain learning disabilities. The past two decades have witnessed major contributions from researchers in this field, who have included ultrasonologists, epidemiologists, neonatologists, and pediatricians. Besides being responsible for these delayed postnatal effects, abnormalities of the placenta, umbilical cord, and amniotic fluid also have associations with structural and chromosomal disorders. Population and race also influence pregnancy outcomes to some extent in certain situations. USG is the most sensitive imaging tool currently available for evaluation of these factors and can offer considerable information in this area. This article aims at reviewing the USG-related developments in this area and the anatomy, physiology, and various pathologies of the placenta, umbilical cord, and the amniotic fluid.

No MeSH data available.


Related in: MedlinePlus