Biomedical subjects

Eduard Gratacos

Publications and source records attributed to Eduard Gratacos.

3 recordsLinked to original sources

PubMed2006

Umbilical artery pulsatility index: reliability at different sampling sites.

OBJECTIVES: To analyse the inter-observer and inter-artery reliability of the umbilical artery (UA) pulsatility index (PI) at different sampling sites. METHODS: One hundred consecutive singleton pregnancies between 24 and 40 weeks were included. The PI was calculated by two independent operators from both umbilical arteries at the placental end, at a free-floating loop and at the perivesical segment. Reliability analyses were performed between observers and between arteries at each sampling site. RESULTS: The mean percentage of PI difference between arteries was 15.2, 14.5 and 22% at the placental end, free-loop and perivesical site, respectively. The Intraclass correlation coefficients at each site were 0.51, 0.59 and 0.67, respectively. Whereas about 20% of cases showed a percentage of PI difference between arteries greater than 20% at free-loop and placental end sites, and at the perivesical site this figure was 45%. CONCLUSIONS: The perivesical sampling site for UA PI calculation is more reliable than at a free-floating loop, albeit without significance, and is significantly more reliable than at the placental end of the umbilical cord. Since discordances in PI between both arteries are more pronounced at the perivesical site, it seems mandatory to evaluate both arteries in this segment.

Adult↗

PubMed2005

Persistent elevation of cell-free fetal DNA levels in maternal plasma after selective laser coagulation of chorionic plate anastomoses in severe midgestational twin-twin transfusion syndrome.

OBJECTIVE: This study was undertaken to determine whether laser thermocoagulation for twin-twin transfusion syndrome (TTTS) causes increased cell-free fetal DNA levels in maternal plasma, potentially as a result of placental injury. STUDY DESIGN: We enrolled 34 patients with twin pregnancies complicated by severe TTTS who underwent fetoscopic selective laser ablation of placental vascular anastomoses. Blood samples were drawn before and sequentially after the procedure. Fetal DNA in maternal plasma was quantified by polymerase chain reaction amplification of a Y-chromosome sequence. RESULTS: Compared with baseline, median elevations of fetal DNA levels were 0.8% at 30 minutes ( P = .32), 15.8% at 60 minutes ( P = .1), 179.5% at 24 hours ( P = .003), and 172.9% at 48 hours ( P = .003). Factors associated with increased fetal DNA levels at 24 hours after procedure included longer operation time, higher number of vessels ablated, and subsequent in utero fetal death ( P = .01, .04, and .04, respectively). CONCLUSIONS: Persistent elevation of fetal DNA levels in maternal plasma after laser ablation suggests that circulating fetal DNA could derive from placental injury. Plasma fetal DNA analysis may be an additional prognostic marker for fetal outcome after laser therapy.

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PubMed2004

Fetoscopic surgery in triplet pregnancies: a multicenter case series.

OBJECTIVE: The purpose of this study was to evaluate the feasibility of fetoscopic surgery in complicated monochorionic and dichorionic triplet pregnancies. STUDY DESIGN: This was a case series of fetoscopic surgery in 12 cases of monochorionic (n = 5) or dichorionic (n = 7) triamniotic triplets complicated by severe feto-fetal transfusion (n = 8), twin reversed arterial perfusion sequence (n = 3), or discordant for an anomaly (n = 1). Six underwent cord occlusion, and 6 had laser coagulation of the vascular anastomoses. RESULTS: All procedures were successfully completed, and the outcome was comparable to that reported for similar procedures in twins. Eighty-three percent of fetuses survived, and 13% had long-term problems. CONCLUSION: Fetoscopic surgery may be considered as a therapeutic option in complicated triplet pregnancies, with results similar to those found in twins.

Adult↗