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Fulltext Fetal heart sound analysis: a preliminary evaluation

Baskaran A, Sivalingam N

Med J Malaysia, 1996 Mar;51(1):64-7.
PMID: 10967981

The aim of this study, is to determine whether the fine characteristics of the fetal heart sounds could be used to identify intrauterine growth retarded fetuses. A preliminary evaluation, was conducted to compare these characteristics between intrauterine growth retarded fetuses and normal fetuses in the antenatal period after 36 weeks of gestation. Altogether, 7 IUGR fetuses were compared with 12 normal fetuses. An instrument named the Fetal Frequency Phonocardiogram was designed for this purpose. When connected to a personal computer and with a software programme specially written, the fetal heart sound characteristics were analysed. After detailed analysis, there were 3 significant differences between IUGR and normal fetuses, all of which gave a p-value of < 0.01. The frequency of the first heart sound was significantly higher in the IUGR fetuses compared to normal fetuses. The ratio of the amplitude of the first heart sound over the second heart sound was higher in the IUGR group. Finally, the ratio of the time between the first and second heart sound over the cardiac cycle was shorter in the IUGR fetuses. Fetal heart sound analysis, may provide a simple non-invasive method of detecting and monitoring fetuses at risk in the antenatal period.

Matched MeSH terms: Fetal Heart/physiology*
Fulltext Ursodeoxycholic acid prevents ventricular conduction slowing and arrhythmia by restoring T-type calcium current in fetuses during cholestasis

Adeyemi O, Alvarez-Laviada A, Schultz F, Ibrahim E, Trauner M, Williamson C, et al.

PLoS One, 2017;12(9):e0183167.
PMID: 28934223 DOI: 10.1371/journal.pone.0183167

BACKGROUND: Increased maternal serum bile acid concentrations in intrahepatic cholestasis of pregnancy (ICP) are associated with fetal cardiac arrhythmias. Ursodeoxycholic acid (UDCA) has been shown to demonstrate anti-arrhythmic properties via preventing ICP-associated cardiac conduction slowing and development of reentrant arrhythmias, although the cellular mechanism is still being elucidated.
METHODS: High-resolution fluorescent optical mapping of electrical activity and electrocardiogram measurements were used to characterize effects of UDCA on one-day-old neonatal and adult female Langendorff-perfused rat hearts. ICP was modelled by perfusion of taurocholic acid (TC, 400μM). Whole-cell calcium currents were recorded from neonatal rat and human fetal cardiomyocytes.
RESULTS: TC significantly prolonged the PR interval by 11.0±3.5% (P<0.05) and slowed ventricular conduction velocity (CV) by 38.9±5.1% (P<0.05) exclusively in neonatal and not in maternal hearts. A similar CV decline was observed with the selective T-type calcium current (ICa,T) blocker mibefradil 1μM (23.0±6.2%, P<0.05), but not with the L-type calcium current (ICa,L) blocker nifedipine 1μM (6.9±6.6%, NS). The sodium channel blocker lidocaine (30μM) reduced CV by 60.4±4.5% (P<0.05). UDCA co-treatment was protective against CV slowing induced by TC and mibefradil, but not against lidocaine. UDCA prevented the TC-induced reduction in the ICa,T density in both isolated human fetal (-10.2±1.5 versus -5.5±0.9 pA/pF, P<0.05) and neonatal rat ventricular myocytes (-22.3±1.1 versus -9.6±0.8 pA/pF, P<0.0001), whereas UDCA had limited efficacy on the ICa,L.
CONCLUSION: Our findings demonstrate that ICa,T plays a significant role in ICP-associated fetal cardiac conduction slowing and arrhythmogenesis, and is an important component of the fetus-specific anti-arrhythmic activity of UDCA.

Matched MeSH terms: Fetal Heart/drug effects*; Fetal Heart/metabolism; Fetal Heart/physiopathology
Fulltext Successful implantation via in Vitro Fertilization (IVF) in Hospital Wanita Kanak-Kanak Sabah: single centre experience

Dg Marshitah Pg Baharuddin, Hatta Tarmizi, Nathira Abdul Majed, Sardiana Sarmidi, Rahmatia Ibrahim, Sabilah Mohd Tahir, et al.

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):88-88.
MyJurnal

Introduction: Implantation is one of critical step in human reproductive processes. There are many factors that affect successful implantation. Good quality embryo or blastocyst is a prerequisite to successful implantation together with a receptive endometrium. The purpose of this study is to describe the patient clinical profile and to investigate the factors of interest association with implantation status. Methods: This is a cross sectional study involving patients planned for in vitro fertilization (IVF) treatment in the hospital infertility clinic. All demographic data and clinical profile data of the patient in each visit was recorded. Among the data taken were, physical examination data, patient history, causes of infertility, hormonal investigation and outcome at the end of treatment (presence of fetal heart). Successful implantation is indicated by presence of fetal heart. Results: A total of 246 patients record were collected. Mean age of the patient was 34.2 (SD = 4.12) years old. Mean BMI was 24.5 kg/m2 (SD=4.70). Mean of infertility years among the patients was 5.9 years (SD= 3.40). Most cause of infertility was tubal issues 87 cases (35.4%). The prevalence of successful implantation was 12.8% ((95% CI 7.8%, 17.8%). None of the factors of interest (age, BMI, infertility duration, progesterone at baseline, progesterone at trigger day) were found associated with successful implantation. Out of 224 patients, 53 (21.5%) were having elevated progesterone level at trigger day. However, in this study, there is no conclusive evidence that level of progesterone is associated with successful implantation. Conclusion: The successful implantation in our setting is approximately 1/10 of IVF treatment. Implantation involved a complex mechanism, thus there is wide variety of etiologies to predict for successful implantation. Thus, further study on wide comprehensive of risk factors is warranted.

Matched MeSH terms: Fetal Heart
Caudal block analgesia in labouring women

Kuah KB

Med J Malaysia, 1974 Mar;28(3):187-90.
PMID: 4278020
Matched MeSH terms: Fetal Heart/drug effects