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 PDFInfo
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- 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
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- fetus
- risk
- hypoxic
- ischemic encephalopathy
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- 210000003754 fetus Anatomy 0.000 title claims abstract description 17
- 206010070511 Hypoxic-ischaemic encephalopathy Diseases 0.000 title claims abstract description 14
- 208000037212 Neonatal hypoxic and ischemic brain injury Diseases 0.000 title claims abstract description 14
- 208000009973 brain hypoxia - ischemia Diseases 0.000 title claims abstract description 14
- 208000033300 perinatal asphyxia Diseases 0.000 title claims abstract description 14
- 238000000034 method Methods 0.000 title claims abstract description 13
- JVTAAEKCZFNVCJ-UHFFFAOYSA-N lactic acid Chemical compound CC(O)C(O)=O JVTAAEKCZFNVCJ-UHFFFAOYSA-N 0.000 claims abstract description 20
- 235000014655 lactic acid Nutrition 0.000 claims abstract description 10
- 239000004310 lactic acid Substances 0.000 claims abstract description 10
- 102000004169 proteins and genes Human genes 0.000 claims abstract description 9
- 108090000623 proteins and genes Proteins 0.000 claims abstract description 9
- 210000004381 amniotic fluid Anatomy 0.000 claims abstract description 8
- 238000002669 amniocentesis Methods 0.000 claims abstract description 4
- 238000002604 ultrasonography Methods 0.000 claims description 3
- 230000036266 weeks of gestation Effects 0.000 claims description 2
- 230000035935 pregnancy Effects 0.000 abstract description 4
- 239000003814 drug Substances 0.000 abstract description 2
- 230000001605 fetal effect Effects 0.000 description 5
- 210000003169 central nervous system Anatomy 0.000 description 3
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 3
- 208000035475 disorder Diseases 0.000 description 3
- 206010021143 Hypoxia Diseases 0.000 description 2
- 210000003815 abdominal wall Anatomy 0.000 description 2
- 210000004556 brain Anatomy 0.000 description 2
- 230000002490 cerebral effect Effects 0.000 description 2
- 238000003745 diagnosis Methods 0.000 description 2
- 230000007774 longterm Effects 0.000 description 2
- 230000003287 optical effect Effects 0.000 description 2
- 230000010355 oscillation Effects 0.000 description 2
- 206010003840 Autonomic nervous system imbalance Diseases 0.000 description 1
- 230000002159 abnormal effect Effects 0.000 description 1
- 230000015572 biosynthetic process Effects 0.000 description 1
- 208000015114 central nervous system disease Diseases 0.000 description 1
- 210000001638 cerebellum Anatomy 0.000 description 1
- 230000001684 chronic effect Effects 0.000 description 1
- 230000001143 conditioned effect Effects 0.000 description 1
- 238000000537 electroencephalography Methods 0.000 description 1
- 230000001146 hypoxic effect Effects 0.000 description 1
- 238000002690 local anesthesia Methods 0.000 description 1
- 238000005259 measurement Methods 0.000 description 1
- 210000000653 nervous system Anatomy 0.000 description 1
- 201000007532 polyhydramnios Diseases 0.000 description 1
- 210000003625 skull Anatomy 0.000 description 1
- 238000002798 spectrophotometry method Methods 0.000 description 1
- 238000005303 weighing Methods 0.000 description 1
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- Investigating Or Analysing Biological Materials (AREA)
Abstract
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
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| Application Number | Priority Date | Filing Date | Title |
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| MDS20140095A MD897Z (en) | 2014-06-24 | 2014-06-24 | Method for predicting the risk of development of hypoxic-ischemic encephalopathy in the fetus |
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| MDS20140095A MD897Z (en) | 2014-06-24 | 2014-06-24 | Method for predicting the risk of development of hypoxic-ischemic encephalopathy in the fetus |
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| MD897Z true MD897Z (en) | 2015-11-30 |
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Citations (3)
| 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 |
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2014
- 2014-06-24 MD MDS20140095A patent/MD897Z/en not_active IP Right Cessation
Patent Citations (3)
| 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 |
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| Publication number | Publication date |
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| MD897Y (en) | 2015-04-30 |
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