MD897Z - Method for predicting the risk of development of hypoxic-ischemic encephalopathy in the fetus - Google Patents

Method for predicting the risk of development of hypoxic-ischemic encephalopathy in the fetus Download PDF

Info

Publication number
MD897Z
MD897Z MDS20140095A MDS20140095A MD897Z MD 897 Z MD897 Z MD 897Z MD S20140095 A MDS20140095 A MD S20140095A MD S20140095 A MDS20140095 A MD S20140095A MD 897 Z MD897 Z MD 897Z
Authority
MD
Moldova
Prior art keywords
fetus
risk
hypoxic
ischemic encephalopathy
development
Prior art date
Application number
MDS20140095A
Other languages
Romanian (ro)
Russian (ru)
Inventor
Штефан ГАЦКАН
Ион МЕРЕУЦА
Станислав ГОДОВАНЧУК
Original Assignee
Штефан ГАЦКАН
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Штефан ГАЦКАН filed Critical Штефан ГАЦКАН
Priority to MDS20140095A priority Critical patent/MD897Z/en
Publication of MD897Y publication Critical patent/MD897Y/en
Publication of MD897Z publication Critical patent/MD897Z/en

Links

Landscapes

  • Investigating Or Analysing Biological Materials (AREA)

Abstract

The invention relates to medicine, in particular to obstetrics and gynecology, and can be used to predict the risk of development of hypoxic-ischemic encephalopathy in the fetus.According to the invention, the claimed method consists in that on the 20th…21st week of pregnancy is performed the amniocentesis under echographic control, is determined the concentration of lactic acid and proteins in the amniotic fluid, where the quantitative ratio of lactic acid to proteins is above 12 it is predicted the risk of development of hypoxic-ischemic encephalopathy in the fetus.

Description

Invenţia se referă la medicină, în special la obstetrică şi ginecologie, şi poate fi utilizată pentru pronosticarea riscului de dezvoltare a encefalopatiei hipoxico-ischemice la făt. The invention relates to medicine, in particular to obstetrics and gynecology, and can be used to predict the risk of developing hypoxic-ischemic encephalopathy in the fetus.

Se cunoaşte metoda de diagnostic al dezvoltării sistemului nervos central la făt, care constă în aceea că se efectuează măsurarea diametrului bipariental (DBP) al craniului fătului şi diametrul transversal al cerebelului (DTC) la termenul de la 12 pană la 35 de săptămani de graviditate, se calculează coeficientul de pronostic, acesta fiind raportul dintre DBP/DTC. Pentru valoarea coeficientului la 12...35 de săptămani egal cu 2(±0,1), se estimează o formare normală a creierului fătului. O majorare sau o micşorare a coeficientului vorbeşte despre o evoluţie anormală a creierului fătului cu dezvoltarea ulterioară a afecţiunulor sistemului nervos central [1]. There is a known method of diagnosing the development of the central nervous system in the fetus, which consists in measuring the biparietal diameter (BPD) of the fetal skull and the transverse diameter of the cerebellum (TDC) at the term from 12 to 35 weeks of pregnancy, calculating the prognostic coefficient, which is the ratio of BPD/TDC. For the value of the coefficient at 12...35 weeks equal to 2(±0.1), a normal formation of the fetal brain is estimated. An increase or decrease in the coefficient speaks of an abnormal evolution of the fetal brain with the subsequent development of central nervous system disorders [1].

Dezavantajele metodei cunoscute sunt condiţionate de riscul comiterii unor erori pe parcursul măsurării mărimilor indicate mai sus. The disadvantages of the known method are conditioned by the risk of committing errors during the measurement of the quantities indicated above.

De asemenea, se cunoaşte metoda de pronosticare a riscului apariţiei encefalopatiei hipoxico-ischemice la făt, care constă în aceea că, începând cu a 20-a săptămână de graviditate, se efectuează electroencefalografia fătului, se analizează electroencefalograma şi în cazul în care se determină undele delta de 0,5...3 oscilaţii/s şi undele teta de 4...5 oscilaţii/s cu amplitudinea de 10...20 µW, se pronostichează o dezvoltare normală a sistemului nervos central, dacă undele sunt polimorfe lente cu amplitudinea pană la 10 µW, se pronostichează riscul apariţiei encefalopatiei hipoxico-ischemice [2]. Also, there is a known method for predicting the risk of hypoxic-ischemic encephalopathy in the fetus, which consists in performing fetal electroencephalography starting from the 20th week of pregnancy, analyzing the electroencephalogram, and if delta waves of 0.5...3 oscillations/s and theta waves of 4...5 oscillations/s with an amplitude of 10...20 µW are determined, a normal development of the central nervous system is predicted, if the waves are slow polymorphic with an amplitude of up to 10 µW, the risk of hypoxic-ischemic encephalopathy is predicted [2].

În calitate de cea mai apropiată soluţie serveşte metoda de pronostic al dereglării circulaţiei cerebrale la făt, care constă în aceea că la termenul de graviditate de 30...40 de săptămâni se înregistrează densitatea optică a lichidului amniotic şi în cazul în care densitatea lui este mai mare de 0,04 un. optice se diagnostichează dereglarea circulaţiei cerebrale [3]. The closest solution is the method of predicting cerebral circulation disorders in the fetus, which consists in recording the optical density of the amniotic fluid at 30...40 weeks of gestation, and if its density is higher than 0.04 optical units, cerebral circulation disorders are diagnosed [3].

Dezavantajul acestei metode este estimarea cu un prag scăzut de probabilitate a dereglărilor posthipotoxice ale sistemului nervos central la făt, deoarece asupra stării lichidului amniotic influenţează diferiţi factori, atât de scurtă durată, cat şi de durată indelungată. De aceea, să ne pronunţăm după densitatea lichidului amniotic despre starea sisremului nervos la făt este destul de greu. The disadvantage of this method is the low probability estimate of posthypotoxic disorders of the central nervous system in the fetus, because the state of the amniotic fluid is influenced by various factors, both short-term and long-term. Therefore, it is quite difficult to make a decision about the state of the fetal nervous system based on the density of the amniotic fluid.

Problema pe care o rezolvă invenţia propusă este crearea unei metode simple şi veridice de pronosticare a riscului apariţiei encefalopatiei hipoxico-ischemice la făt. The problem solved by the proposed invention is the creation of a simple and reliable method for predicting the risk of hypoxic-ischemic encephalopathy in the fetus.

Conform invenţiei, metoda revendicată constă în aceea că la termenul de graviditate de 20…21 de săptămâni se efectuează amniocenteza sub control ecografic, se determină cantitatea acidului lactic şi a proteinelor în lichidul amniotic, în cazul în care raportul cantitativ al acidului lactic către proteine este mai mare de 12 se pronostichează riscul apariţiei encefalopatiei hipoxico-ischemice la făt. According to the invention, the claimed method consists in that at the gestational age of 20…21 weeks, amniocentesis is performed under ultrasound control, the amount of lactic acid and proteins in the amniotic fluid is determined, if the quantitative ratio of lactic acid to proteins is greater than 12, the risk of hypoxic-ischemic encephalopathy in the fetus is predicted.

Rezultatul invenţiei constă în determinarea rapidă şi veridică a riscului apariţiei encefalopatiei hipoxico-ischemice la făt. The result of the invention consists in the rapid and accurate determination of the risk of hypoxic-ischemic encephalopathy in the fetus.

Avantajul invenţiei revendicate, faţă de cea mai apropiată soluţie, constă în aceea că se determină concret cantitatea acidului lactic, la stabilirea concentraţiei acidului lactic nu influienţează alţi factori de scurtă durată sau de durată indelungată, totodată este un mod sigur şi simplu de diagnostic. Determinarea timpurie la 20…21 de săptămâni a riscului de dezvoltare a stării hipoxico-ischemice la făt face posibilă o tactică timpurie şi adecvată de tratament. The advantage of the claimed invention, compared to the closest solution, is that the amount of lactic acid is specifically determined, when establishing the concentration of lactic acid other short-term or long-term factors do not influence, at the same time it is a safe and simple way of diagnosis. Early determination at 20…21 weeks of the risk of developing hypoxic-ischemic state in the fetus makes possible an early and adequate treatment tactic.

Metoda se efectuează în felul următor. The method is performed as follows.

La termenul de graviditate de 20…21 de săptămâni se efectuează puncţia sacului amniotic (amniocenteza) sub control ecografic, după prelucrarea locului puncţiei pe peretele abdominal se efectuează anestezia locală, apoi cu un ac lung se trece prin peretele abdominal şi peretele uterin şi îndată ce acul străpunge sacul amniotic, acesta se conectează la seringă şi se colectează 20 ml, pentru examinare se utilizează 0,5 ml de lichid amniotic, cu ajutorul analizatorului biochimic АБхФк-02 (НПП-ТМ, Rusia) prin metoda spectrofotometrică se determină concentraţia acidului lactic şi a proteinelor şi în cazul în care raportul cantitativ al acidului lactic către proteine este mai mare de 12 se pronostichează riscul apariţiei encefalopatiei hipoxico-ischemice la făt. At the gestational age of 20…21 weeks, the amniotic sac is punctured (amniocentesis) under ultrasound control. After processing the puncture site on the abdominal wall, local anesthesia is performed. Then, a long needle is passed through the abdominal wall and uterine wall. As soon as the needle pierces the amniotic sac, it is connected to the syringe and 20 ml is collected. 0.5 ml of amniotic fluid is used for examination. Using the biochemical analyzer АБхФк-02 (НПП-ТМ, Russia), the concentration of lactic acid and proteins is determined by the spectrophotometric method. If the quantitative ratio of lactic acid to proteins is greater than 12, the risk of hypoxic-ischemic encephalopathy in the fetus is predicted.

Exemplu concret de realizare Concrete example of achievement

Pacienta A., 21 ani, a fost internată în centrul mamei şi copilului pentru supraveghere, cu diagnosticul de graviditate de 20 săptămâni, prezentare cefalică. Insuficienţă fetoplacentară cronică compensată. Polihidroamion. Distonie neurocirculatorie de tip mixt. A fost examinat lichidul amniotic conform metodei revendicate, unde s-a stabilit o valoare de 12,8 mmoli/L şi a cantităţii de proteine de 1,06 g/L, obţinându-se un raport de 12,8/1,06 = 12,0, ceea ce ne indică despre dezvoltarea riscului encefalopatiei hipoxico-ischemice la făt. A fost prescris un tratament adecvat, iar la 40 de săptămâni pacienta a născut o fetiţă de 51 cm, cu greutatea de 3400 g, starea copilului după 1 minut de la naştere este de 7 puncte după Apgar, la 5 minute la fel este de 7 puncte. Patient A., 21 years old, was admitted to the mother and child center for observation, with the diagnosis of 20 weeks of pregnancy, cephalic presentation. Compensated chronic fetoplacental insufficiency. Polyhydramnios. Mixed neurocirculatory dystonia. Amniotic fluid was examined according to the claimed method, where a value of 12.8 mmol/L and a protein amount of 1.06 g/L were established, obtaining a ratio of 12.8/1.06 = 12.0, which indicates the risk of developing hypoxic-ischemic encephalopathy in the fetus. Appropriate treatment was prescribed, and at 40 weeks the patient gave birth to a girl measuring 51 cm, weighing 3400 g, the child's condition after 1 minute after birth is 7 points according to Apgar, at 5 minutes it is also 7 points.

Metoda dată a fost efectuată pe un lot de 19 paciente cu vârsta cuprinsă între 20…35 ani, la 17 paciente s-a depistat riscul apariţiei dezvoltării encefalopatiei hipoxico-ischemice la făt. Toate au urmat un tratament adecvat la etape timpurii de dezvoltare a afecţiunilor hipoxice şi toate au născut copii bine dezvoltaţi şi la termen, fără complicaţii. This method was performed on a group of 19 patients aged 20…35 years, 17 patients were found to be at risk of developing hypoxic-ischemic encephalopathy in the fetus. All of them underwent adequate treatment at the early stages of development of hypoxic conditions and all of them gave birth to well-developed and full-term children, without complications.

1. RU 2164082 C1 2001.03.20 1. RU 2164082 C1 2001.03.20

2. MD 3883 G2 2009.12.31 2. MD 3883 G2 2009.12.31

3. SU 1483373 A1 1989.05.30 3. SU 1483373 A1 1989.05.30

Claims (1)

Metodă de pronosticare a riscului de dezvoltare a encefalopatiei hipoxico-ischemice la făt, care constă în aceea că la termenul de graviditate de 20…21 de săptămâni se efectuează amniocenteza sub control ecografic, se determină cantitatea acidului lactic şi a proteinelor în lichidul amniotic, în cazul în care raportul cantitativ al acidului lactic către proteine este mai mare de 12 se pronostichează riscul apariţiei encefalopatiei hipoxico-ischemice la făt.Method for predicting the risk of developing hypoxic-ischemic encephalopathy in the fetus, which consists in performing amniocentesis under ultrasound control at 20-21 weeks of gestation, determining the amount of lactic acid and proteins in the amniotic fluid, if the quantitative ratio of lactic acid to proteins is greater than 12, the risk of developing hypoxic-ischemic encephalopathy in the fetus is predicted.
MDS20140095A 2014-06-24 2014-06-24 Method for predicting the risk of development of hypoxic-ischemic encephalopathy in the fetus MD897Z (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
MDS20140095A MD897Z (en) 2014-06-24 2014-06-24 Method for predicting the risk of development of hypoxic-ischemic encephalopathy in the fetus

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
MDS20140095A MD897Z (en) 2014-06-24 2014-06-24 Method for predicting the risk of development of hypoxic-ischemic encephalopathy in the fetus

Publications (2)

Publication Number Publication Date
MD897Y MD897Y (en) 2015-04-30
MD897Z true MD897Z (en) 2015-11-30

Family

ID=53002931

Family Applications (1)

Application Number Title Priority Date Filing Date
MDS20140095A MD897Z (en) 2014-06-24 2014-06-24 Method for predicting the risk of development of hypoxic-ischemic encephalopathy in the fetus

Country Status (1)

Country Link
MD (1) MD897Z (en)

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
SU1483373A1 (en) * 1986-10-17 1989-05-30 Всесоюзный научно-исследовательский центр по охране здоровь матери и ребенка Method for forecasting disorders of cerebral blood circulation of newborn infants
RU2164082C1 (en) * 2000-03-07 2001-03-20 Новокузнецкий государственный институт усовершенствования врачей Method for diagnosing the central nervous system stage of a fetus
MD3883G2 (en) * 2008-03-31 2009-11-30 Светлана ХАДЖИУ Method for predicting the evolution of development of the central nervous system of fetus
  • 2014

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
SU1483373A1 (en) * 1986-10-17 1989-05-30 Всесоюзный научно-исследовательский центр по охране здоровь матери и ребенка Method for forecasting disorders of cerebral blood circulation of newborn infants
RU2164082C1 (en) * 2000-03-07 2001-03-20 Новокузнецкий государственный институт усовершенствования врачей Method for diagnosing the central nervous system stage of a fetus
MD3883G2 (en) * 2008-03-31 2009-11-30 Светлана ХАДЖИУ Method for predicting the evolution of development of the central nervous system of fetus

Also Published As

Publication number Publication date
MD897Y (en) 2015-04-30

Similar Documents

Publication Publication Date Title
Sandman et al. Prenatal programming of human neurological function
Maršál Intrauterine growth restriction
Sanz‐Cortés et al. Abnormal brain microstructure and metabolism in small‐for‐gestational‐age term fetuses with normal umbilical artery Doppler
Hebbar et al. Reference ranges of amniotic fluid index in late third trimester of pregnancy: what should the optimal interval between two ultrasound examinations be?
Ramin et al. Umbilical artery acid-base status in the preterm infant
Prior et al. Expert review–identification of intra-partum fetal compromise
MD897Z (en) Method for predicting the risk of development of hypoxic-ischemic encephalopathy in the fetus
Özdemir et al. The effects of a history of seizures during pregnancy on umbilical arterial blood gas values in pregnant women with epilepsy
RU2501012C1 (en) Diagnostic technique for neonatal foetal hypoxia
Bonney et al. Twin pregnancy
RU2422094C1 (en) Method of early diagnostics of hypoxic-ischemic injuries of cns in newborn children from mothers with gestosis
RU2639134C2 (en) Method for predicting development of intraventricular hemorrhage in newborns, born after extracorporal fertilization
Smirnova et al. Features of the course of pregnancy and childbirth in women with syndrome of undifferentiated connective tissue dysplasia (literature review
SU1246443A1 (en) Method of diagnostics of postnatal aggravations of mother or newborn
Dai et al. Ultrasonic characteristics and clinical significance of umbilical cord blood flow in acute fetal distress
RU2741699C1 (en) Diagnostic technique for connective tissue dysplasia in newborns
RU2274867C2 (en) Method for carrying out biochemical cardiac activity estimation in newborn babies
Pattamathamakul et al. The impact of fetal growth restriction on prenatal 2D ultrasound and doppler study of the fetal adrenal gland
RU2630461C2 (en) Method for threatening premature birth diagnostics
RU2414715C1 (en) Method for prediction of cerebral affections in newborns
RU2446401C1 (en) Method for prediction of dysthyroidism
Nori et al. Predicting late-term pregnancy: the role of corrected fetal adrenal gland volume in low-risk pregnants
RU2266704C2 (en) Method for diagnosing the cases of chronic fetal hypoxia
Suman Correlation of urinary uric acid, creatinine ratio with the severity of hypoxic ischemic encephalopathy
RU2707095C1 (en) Method for diagnosing the severity of chronic placental insufficiency in women seropositive for cytomegalovirus

Legal Events

Date Code Title Description
FG9Y Short term patent issued
KA4Y Short-term patent lapsed due to non-payment of fees (with right of restoration)
MM4Y Short-term patent definitely lapsed due to non-payment of fees