A5061077814- Pregnancy and preeclampsia studies
- Congenital Heart Disease Studies
- Cardiovascular Issues in Pregnancy
- Birth, Development, and Health
- Gestational Diabetes Research and Management
- Prenatal Screening and Diagnostics
- COVID-19 Impact on Reproduction
- Maternal and fetal healthcare
- Assisted Reproductive Technology and Twin Pregnancy
- Cardiovascular Function and Risk Factors
- COVID-19 and healthcare impacts
- Cardiac Arrhythmias and Treatments
- Cardiac Structural Anomalies and Repair
- Congenital Diaphragmatic Hernia Studies
- Congenital Anomalies and Fetal Surgery
- Preterm Birth and Chorioamnionitis
- Neonatal and fetal brain pathology
- Neonatal Respiratory Health Research
- Fetal and Pediatric Neurological Disorders
- Renal and Vascular Pathologies
- Cleft Lip and Palate Research
- Parvovirus B19 Infection Studies
- Ultrasound in Clinical Applications
- Cardiac Imaging and Diagnostics
- Systemic Sclerosis and Related Diseases
University of Maryland, Baltimore
2014-2024
University of Maryland, College Park
2024
University of Maryland Medical Center
2011-2023
Harris Birthright Research Centre for Fetal Medicine
2007-2011
King's College Hospital
2007-2011
Abstract Objective To identify the sequence of progression arterial and venous Doppler abnormalities from onset placental insufficiency in intrauterine growth restriction (IUGR). Methods Prospective observational study singletons with IUGR (abdominal circumference < 5 th percentile) who underwent serial standardized umbilical artery (UA), middle cerebral (MCA), ductus venosus (DV) vein (UV) surveillance. Time intervals between progressive patterns deterioration were related to UA status...
Abstract Objective To investigate the performance of non‐stress test (NST), computerized fetal heart rate analysis (cCTG), biophysical profile scoring (BPS) and arterial venous Doppler ultrasound investigation in prediction acid–base status growth restriction. Methods Growth‐restricted fetuses, defined by abdominal circumference < 5 th percentile umbilical artery (UA) pulsatility index > 95 percentile, were tested NST, cCTG, BPS, UA, middle cerebral (MCA), ductus venosus (DV) vein (UV)...
To study if the duration of individual Doppler abnormalities is an independent predictor adverse outcome in fetal growth restriction (FGR) caused by placental dysfunction.This was a secondary analysis patients with FGR (abdominal circumference < 5(th) percentile and umbilical artery (UA) pulsatility index (PI) elevation) who had at least three examinations before delivery. Days absent/reversed UA end-diastolic velocity (UA-AREDV), low middle cerebral PI (brain sparing), ductus venosus (DV)...
In-vitro animal studies suggest that high glucose levels impair fetal cardiac function early in gestation. We aimed to study whether evidence of first-trimester myocardial dysfunction can be detected fetuses women with pregestational diabetes mellitus.Women mellitus underwent echocardiography at 11-14 weeks' gestational age. In normal anatomy, the preload, diastolic function, global performance and placental afterload were studied by Doppler ductus venosus (DV), mitral tricuspid early/atrial...
Abstract Objective The challenges of the first‐trimester examination fetal heart may in part be overcome by technical advances three‐dimensional (3D) ultrasound techniques. Our aim was to standardize 3D imaging approach cardiac provide most consistent and accurate display anatomy. Methods Low‐risk women with normal findings on screening at 11 13 + 6 weeks had using following sequence: (1) identification four‐chamber view; (2) four‐dimensional (4D) volume acquisition spatiotemporal image...
A four-dimensional (4D) fetal echocardiographic technique utilizing spatiotemporal image correlation, tomographic ultrasound imaging display (STIC-TUI echo) and color Doppler has previously been shown to be effective in displaying the examination planes constituting extended cardiac examination. The aim of this study was evaluate performance first-trimester STIC-TUI echo identifying complex congenital heart disease (CHD) high-risk pregnancies.This a prospective patients presenting at...
Abstract: Intrauterine hypoxia is a significant clinical challenge in obstetrics that affects both the pregnant mother and fetus. can occur women living at high altitude and/or with cardiovascular disease. In addition, placental be generated by altered development spiral artery remodeling leading to insufficiency dysfunction. Both conditions impact normal maternal homeostasis preeclampsia impair transfer of O 2 /nutrient supply resulting fetal growth restriction. This review discusses...
Background Complete atrioventricular block (CAVB) is a complication of maternal antibody positivity and treatment fetal disease controversial in terms efficacy safety. We hypothesized that dexamethasone for anti-Ro/SSA antibody-mediated cardiac leads to better pregnancy outcomes than expectant management.Methods A retrospective multi-center cohort study positive pregnancies with conduction reported by participating North American Fetal Therapy Network (NAFTNet) centers between January 2010...
Studies indicate a very low rate of SARS-CoV-2 detection in the placenta or occasionally vertical transmission COVID-19 pregnancy. Delta variant has become dominant strain over world and possesses higher infectivity due to mutations its spike receptor-binding motif.To determine whether increased potential for infection transmission, we analyzed placenta, umbilical cord, fetal membrane from case where an unvaccinated mother her neonate were positive. A 35-year-old primigravida with underwent...
To identify the range of waveform abnormalities in ductus venosus (DV) characterized by their timing cardiac cycle and to evaluate if they can be categorized into distinct patterns.DV velocity ratios were calculated from peak velocities during ventricular systole (S), end-systolic relaxation (v), early diastole (D) atrial (a) (S/v, S/D, v/D, S/a, v/a D/a ratios). The converted Z-scores elevation > 2 SD was assigned as abnormal. Combinations ratio grouped define patterns distribution related...
To examine the relationships between ductus venosus (DV) pulsatility index for veins (PIV), individual DV velocity ratios and diastolic global myocardial cardiac function.Doppler measurements of DV, atrioventricular (AV) valves ventricular in- outflow were analyzed. The DV-PIV phases (systole (S), end-systolic relaxation (v), early diastole (D), atrial systole (a), S/v, S/D, S/a, v/D, v/a D/a ratios) calculated. ratio late peak velocities across AV was calculated (E/A ratio). Left modified...
We hypothesized that the physiological adaptations of fetus in response to chronic intrauterine hypoxia depend on its sex and gestational age exposure. Pregnant guinea pigs were exposed room air (normoxia, NMX) or 10.5% O2 (hypoxia, HPX) at either 25 days (early onset) 50 (late gestation until term (~65 days). evaluated effects HPX hemodynamic cardiac function indices using Doppler ultrasound determined sex-related differences near-term fetuses. Indices uterine/umbilical artery pulsatility...
The importance of the 11–14-week ultrasound exam beyond screening for chromosomal abnormalities is becoming more apparent in era non-invasive prenatal testing1, 2. In fact, measurement nuchal translucency and its establishment obstetric practice worldwide can be considered renaissance ultrasound. This has fundamentally changed care by moving detection major abnormalities, including cardiac to early stages gestation. allows earlier enhanced pregnancy delivery planning, as well availability...
To determine which prenatal ultrasound findings indicate the need to also obtain PCR studies for viral genome in women undergoing midtrimester amniocentesis.This was a retrospective observational study on that underwent amniotic fluid karyotyping and testing history or based indication. Amniotic tested adenovirus, cytomegalovirus, respiratory syncytial virus, enterovirus, Epstein-Barr parvovirus B19 using multiplex with multiple appropriate controls. Ultrasound were coded as normal abnormal...
ABSTRACT Objectives During human pregnancy, placental extravillous trophoblasts replace vascular smooth muscle and elastic tissue within the walls of uterine spiral arteries, thereby remodeling them into distensible low‐resistance vessels to promote perfusion. The present study determined whether B‐flow/spatiotemporal image correlation (STIC) M‐mode ultrasonography provides an in‐vivo imaging method able digitally quantify artery luminal distensibility as a physiological index during...
Abstract Facial clefts are among the most common congenital defects. Ultrasound (US) imaging of secondary fetal palate, especially detection isolated defects, remains challenging. Currently described two‐dimensional (2D) and three‐dimensional methods technically demanding impractical for application during routine anatomy evaluation. As an adjunct method, magnetic resonance can provide additional information but has its limitations. We present a novel 2D US approach using axial sagittal...
Abstract Background Respiratory infections have long been associated with higher maternal and perinatal morbidity. Early data did not report an increased risk of SARS-CoV-2 infection or disease severity in pregnancy. However, surveillance from the Center for Disease Control Prevention (CDC) indicates a severe death pregnant women symptomatic infection, although this is subject to ascertainment bias. Objective To explore association between COVID-19 pregnancy our university-based hospital...
To determine if B-flow/spatiotemporal image correlation (STIC) M-mode ultrasonography detects a decrease in spiral artery luminal diameter and volume flow during the first trimester non-human primate model of impaired remodeling (SAR).Pregnant baboons were treated daily with estradiol benzoate on days 25-59 (term, 184 days), or remained untreated. On day 60 gestation, (in seven untreated 12 estradiol-treated baboons) four eight quantified by B-flow/STIC ultrasonography. In addition, 15 18...
Tricuspid valve malformations (TVMs) account for approximately 1% of all congenital heart defects (CHDs)1. leaflets are deformed in TVM, with apical displacement Ebstein's anomaly (EA) and deficient coaptation tricuspid dysplasia (TVD). Intrauterine/neonatal death is a possible consequence the management TVM and, thus, prediction prognosis crucial. Other than echocardiographic criteria2, no individual fetal Doppler parameter has been proposed as predictor neonatal affected fetuses....
Human parturition involve many events among mother, fetus, and placenta, the initiation of these is consequence activation a series endocrine immune responses. Multiple underlying pathways account for cascade that culminate in spontaneous preterm labor. In this study, we aimed to characterize signaling placental origin at molecular levels.
Previous studies performed with earlier generation ultrasound suggest poor correlation between sonographic fetal weight estimates (SEFW) and birth (BW), especially for macrosomic infants. As prediction of excessive growth is important counseling patients about risks macrosomia, it was our aim to study accuracy current equipment. This an IRB approved retrospective that had SEFW measurement within 3 weeks delivery. Biometry head, abdomen (AC) femur done on high-resolution equipment utilizing...