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Biomedical subjects

D Bogdan

Publications and source records attributed to D Bogdan.

7 recordsLinked to original sources

Color Doppler of the splenic artery in the prenatal diagnosis of heterotaxic syndromes.

The objective of this paper is to determine whether color and pulsed Doppler of the splenic artery is helpful in the prenatal diagnosis of polysplenia or asplenia in heterotaxic syndromes. Over a 3-year period, localization of the splenic artery by color and pulsed Doppler was attempted on all fetuses with the diagnosis of heterotaxic syndromes. Postnatal follow-up was obtained on all neonates. The diagnosis of heterotaxic syndromes was performed on eight fetuses during the study period. Mean gestational age at diagnosis was 20.1 weeks. All fetuses had situs ambiguous and complex cardiac abnormalities. All pregnancies were managed expectantly and none were terminated. The splenic artery was imaged by color and pulsed Doppler in 6 of 8 fetuses, all with one or multiple spleens confirmed postnatally. The splenic artery could not be imaged in two fetuses, both with asplenia confirmed postnatally. The perinatal mortality rate was 88% (7 of 8) and the one surviving infant is currently alive and well at 3 years of age. Color and pulsed Doppler of the splenic artery can aid in the prenatal diagnosis of heterotaxic syndromes. This information is of value and should result in improved prenatal counseling and management of affected pregnancies.

Abnormalities, Multiple↗

Doppler flow velocimetry of the splenic artery in the human fetus: is it a marker of chronic hypoxia?

OBJECTIVE: The aim of this investigation was to describe splenic artery flow velocity waveforms in the appropriate- and small-for-gestational-age human fetus. STUDY DESIGN: Splenic artery flow velocity waveforms were prospectively obtained from 95 appropriate- and 15 small-for-gestational-age fetuses with pulsed Doppler ultrasonography. The resistance index was used to quantify the Doppler waveform. RESULTS: A second-degree polynomial model expressed the changes of the resistance index in appropriate-for-gestational-age fetuses with advancing gestation (y = 0.057x [Weeks] - 0.001x2, r = 0.53, p < 0.001). In 14 of 15 (93%) small-for-gestational-age fetuses the splenic artery resistance index was below the mean for gestational age. In five of 15 (33%) small-for-gestational-age fetuses the resistance index of the splenic artery was < 2 SEMs. A trend toward a higher hematocrit was noted in the five fetuses with splenic artery resistance index values < 2 SEMs (50.2%) compared with other small-for-gestational-age fetuses (43.0%). CONCLUSION: Our results suggest that some small-for-gestational-age fetuses have decreased resistance at the level of the splenic artery. We postulate that the increased erythropoietin level, stimulated by hypoxia, results in decreased resistance at the level of the splenic artery in small-for-gestational-age fetuses. Finally, management of the small-for-gestational-age fetus may be aided by the study of the splenic artery waveforms.

Blood Flow Velocity↗