Abstract

The focus of this project is to improve the diagnosis and treatment of fetal disease. Focus is placed on the prenatal diagnosis of congenital anomalies with non-invasive methods (e.g. high resolution ultrasound and color Doppler flow mapping). The most significant contribution of the Branch was the performance of the first successful endoscopic surgical procedure in the human fetus. Transabdominal thin-gauge fetoscopy was used to cystoscopically fulgurate posterior urethral valves in a case of urethral obstruction. This procedure represents a new approach to the treatment of selected fetal congenital anomalies, as well as placental conditions amenable to surgical treatment. The Branch used high resolution ultrasound to establish prenatal diagnosis of conditions heretofore undiagnosed sonographically (e.g. nonrhizomelic chondrodysplasia punctata). Color Doppler flow mapping improved the accuracy of prenatal diagnosis of several other conditions suspected by sonography. The goal of the Branch is to expand the diagnostic and therapeutic indications of embryofetoscopy, as well as the diagnostic capability of high resolution ultrasound and color Doppler flow mapping.

  Funding Agency

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Intramural Research (Z01)
Project #
1Z01HD002401-02
Application #
3756773
Study Section
Project Start
Project End
Budget Start
Budget End
Support Year
2
Fiscal Year
1994
Total Cost
Indirect Cost

  Institution

Name
Eunice Kennedy Shriver National Institute of Child Health & Human Development
Department
Type
DUNS #
City
State
Country
United States
Zip Code

  Publications

Korzeniewski, Steven J; Grigorescu, Violanda; Kleyn, Mary et al. (2013) Transient hypothyroidism at 3-year follow-up among cases of congenital hypothyroidism detected by newborn screening. J Pediatr 162:177-82
Gotsch, Francesca; Romero, Roberto; Espinoza, Jimmy et al. (2010) Prenatal diagnosis of truncus arteriosus using multiplanar display in 4D ultrasonography. J Matern Fetal Neonatal Med 23:297-307
Kusanovic, Juan Pedro; Romero, Roberto; Gotsch, Francesca et al. (2009) Discordant placental echogenicity: a novel sign of impaired placental perfusion in twin-twin transfusion syndrome? J Matern Fetal Neonatal Med :1-4
Lampl, Michelle; Kusanovic, Juan Pedro; Erez, Offer et al. (2009) Growth perturbations in a phenotype with rapid fetal growth preceding preterm labor and term birth. Am J Hum Biol 21:782-92
Mittal, P; Hassan, S S; Espinoza, J et al. (2008) The effect of gestational age and labor on placental growth hormone in amniotic fluid. Growth Horm IGF Res 18:174-9
Than, Nandor Gabor; Abdul Rahman, Omar; Magenheim, Rita et al. (2008) Placental protein 13 (galectin-13) has decreased placental expression but increased shedding and maternal serum concentrations in patients presenting with preterm pre-eclampsia and HELLP syndrome. Virchows Arch 453:387-400
Lee, W; Deter, R L; Sameera, S et al. (2008) Individualized growth assessment of fetal thigh circumference using three-dimensional ultrasonography. Ultrasound Obstet Gynecol 31:520-8
Kusanovic, Juan Pedro; Romero, Roberto; Espinoza, Jimmy et al. (2008) Twin-to-twin transfusion syndrome: an antiangiogenic state? Am J Obstet Gynecol 198:382.e1-8
Chaiworapongsa, Tinnakorn; Espinoza, Jimmy; Gotsch, Francesca et al. (2008) The maternal plasma soluble vascular endothelial growth factor receptor-1 concentration is elevated in SGA and the magnitude of the increase relates to Doppler abnormalities in the maternal and fetal circulation. J Matern Fetal Neonatal Med 21:25-40
Espinoza, J; Romero, R; Kusanovic, J P et al. (2008) Standardized views of the fetal heart using four-dimensional sonographic and tomographic imaging. Ultrasound Obstet Gynecol 31:233-42

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