Correlation of heart external dimensions with body external dimensions of human foetuses

In an evaluation of foetal hearts in II and III pregnancy semester, correlation with exterior foetal dimensions should be taken into consideration. It is interesting also if all exterior heart dimensions are correlated at the same level with overall body dimensions. The subject of examination was 204 foetuses of both sexes, including 106 males and 98 females, in 5th and 6th month of foetal life. Foetuses were fixed for minimum 3 months in 9% formalin solution. They were taken from natural abortions, without exterior features of developmental malformations. Examined material was evaluated in month groups of morphological age. The number of foetuses in different groups was various. Exterior heart dimensions were considered: height, width, heart depth, and also heart circumference in coronary sulcus (atrial-ventricular). Exterior dimensions of foetuses were: vertex-plantare, vertex-tubulare. All exterior dimensions of heart are closely and strongly correlated with both exterior dimensions of foetuses

External diameters of the pulmonary arteries in human foetuses: an anatomical, digital and statistical study

This study defines the growth patterns for the external diameters of the pulmonary arteries in human foetuses, including relationships with sex, side of body (right-left) and foetal age. Using anatomical dissection, digital-image analysis (system of Leica Q Win Pro 16) and statistical analysis (ANOVA, regression analysis), a range of external diameters for the right and left pulmonary arteries in 128 spontaneously aborted human foetuses aged 15-34 weeks was examined. No significant gender differences were found (p > 0.05). In the examined age range the values of the external diameter of the right pulmonary artery ranged from 0.97 &#177; 0.24 to 2.95 &#177; 0.89 mm, according to the linear function y = -0.7753 + 0.1148 x &#177; 0.4580 (r = 0.83; p < 0.001). The values of the external diameter of the left pulmonary artery ranged from 0.88 &#177; 0.25 to 2.63 &#177; 0.80 mm, in accordance with the linear relationship y = -0.6228 + 0.1007 x &#177; 0.4280 (r = 0.81; p < 0.001). The external diameters of the right pulmonary artery were greater than those of the left pulmonary artery (p < 0.001). Parallel to the increase in the values of the external diameters of both the pulmonary arteries, the pulmonary artery-to-ascending aorta diameter ratio (the relative diameter of the pulmonary artery) decreased with advanced foetal age from 0.46 &#177; 0.10 to 0.43 &#177; 0.13 for the right pulmonary artery, and from 0.43 &#177; 0.10 to 0.39 &#177; 0.12 for the left one. The growth curves generated may be useful as reference data for foetal diagnosis

The normal growth of the thoracic aorta in human foetuses

The present study was performed on 128 spontaneously aborted human foetuses aged 15-34 weeks in order to establish normal values for thoracic aorta dimensions at various gestational ages. Using anatomical dissection, digital-image analysis (the Leica QWin Pro 16 system) and statistical analysis (ANOVA, regression analysis) the growth of the length, the original and terminal external diameters and the volume of the thoracic aorta during gestation was examined. No significant gender differences were found (p > 0.05). The growth curves were generated of the best fit for the plot for each morphometric feature against gestational age. Both the length and external diameters of the thoracic aorta increased in proportion to the advance in foetal age. The length ranged from 12.49 &#177; 1.85 mm to 48.82 &#177; 6.31 mm according to the linear function y = &#8211;19.654 + 2.0512 x &#177; 3.5168. The original external diameter ranged from 1.25 &#177; 0.28 mm to 5.65 &#177; 0.48 mm according to the linear fashion y = -2.3834 + 0.2367 x &#177; 0.3850. The terminal external diameter ranged from 1.15 &#177; 0.26 mm to 5.18 &#177; 0.45 mm, in agreement with the linear model y = -2.1438 + 0.2156 x &#177; 0.3555 (r = 0.96, p < 0.001 for each feature). The volume of the thoracic aorta ranged from 15.75 &#177; 8.06 mm3 to 1158.01 &#177; 301.85 mm3 according to the quadratic function y = 1376.2 - 154.42 x + 4.419 x2 &#177; 125.6 (R2 = 0.90). The growth curves generated from my data may be useful as a reference for foetal echocardiographers, who must distinguish abnormal from normal foetal development

The normal growth of the pulmonary trunk in human foetuses

The rate of growth of the pulmonary trunk during gestation has not been sufficiently determined. The present study was performed on 128 spontaneously aborted human foetuses aged 15-34 weeks in order to compile normative data for pulmonary trunk dimensions at various gestational ages. With the use of anatomical dissection, digital-image analysis (the Leica QWin Pro 16 system) and statistical analysis (ANOVA, regression analysis) a range of measurements (length, diameter and volume) was analysed for the pulmonary trunk during gestation. No significant gender differences were found (p > 0.05). Growth curves were generated of the best fit for the plot for each morphometric feature against gestational age. The results obtained show a statistically significant correlation (p < 0.001) between the parameters examined and gestational age. Both the length and diameter of the pulmonary trunk were found to increase in a linear fashion throughout gestation. The length ranged from 3.17 &#177; 0.36 mm to 13.54 &#177; 1.39 mm, according to the linear function y = -5.6035 + 0.5705 x &#177; 0.9171 (r = 0.96). The diameter ranged from 1.51 &#177; 0.24 mm to 5.30 &#177; 1.53 mm, according to the linear model y = -1.4813 + 0.2154 x &#177; 0.7452 (r = 0.86). The pulmonary trunk volume ranged from 5.94 &#177; 2.21 mm3 to 312.37 &#177; 154.34 mm3, according to the quadratic function y = 143.2 - 20.961 x + 0.791 x2 &#177; 63.306 (R2 = 0.74). The growth curves generated from my data may be useful as a reference for foetal echocardiographers in the detection of congenital cardiovascular abnormalities

Possible usefulness of echocardiographic Z-scores in autopsy routine of the foetal great vessels

Background: Abnormal diameters of foetal vessels are common findings in congenital heart defects. However, it is difficult for pathologist to assess whether the diameters of the vessels are normal or not and to compare with echocardiographic data. The Z-score is a dimensionless quantity representing the distance between the raw score and population mean in standard deviation units. Using Z-score, we can compare single cases to average standards in the population. Aim: To compare diameters of great arteries measured in specimens fixed in 10% formalin solution to normal values obtained on echocardiography using Z-scores. Material and methods: The study was performed on 43 formalin-fixed normal foetal hearts aged from 19 to 40 weeks of gestation. Each specimen was dissected and the following diameters were measured: aortic valve (AoV), ascending aorta (AAo), descending aorta (DAo), aortic isthmus (AoI), ductus arteriosus (DA), pulmonary trunk valve (PV), and pulmonary arteries (RPA and LPA). Z-score parameters were calculated for all structures using the Foetal Echo Z-score Calculator. Results: Z-score values of all measured foetuses were mostly found to fit within the echocardiographic norms, although the most reliable results were obtained for foetuses aged 23 weeks. This group was represented by the highest number of specimens. The minimal and maximal Z-score values were, respectively: AoV &#8211;3.45, 1.4; AAo &#8211;4.24, &#8211;0.11; DAo &#8211;2.12, 1.29; PV &#8211;3.21, 0.69; RPA &#8211;3.4, 0.84; LPA &#8211;2.25, 0.31; AoI &#8211;1.97, 0.96; DA &#8211;3.56, &#8211;1.52. Conclusions: The diameters of great arteries measured on autopsy are comparable to the results obtained from echocardiographic measurement. Z-score values for foetal echocardiography can be applied to post-mortem examination

The morphological investigations on the heart and some vessels of bovine foetus between the 15th and 25th weeks of gestation

Background: The aim of this study was to define the morphological and morphometric development of the foetus heart obtained from the domestic cattle in the gestation period of 15–25 weeks. Materials and methods: For this purpose, a total of 30 hearts belonging to cattle foetuses (15 males, 15 females) were used. The ages of foetuses were calculated according to the forehead-to-tail length and examined in three different groups. After dissection; biometric, macroanatomic, morphometric and histological findings were obtained from the foetal hearts according to the groups. In addition, mean values of the morphometric findings were determined. Results: As a result of the study, it was found that with the advancing age the convexity of margo ventricularis dexter increased and margo ventricularis sinister transformed from a convex-concave shape to a flat shape. The heart-to-body weight ratio was determined as 0.08% for Group II female foetuses and 0.09% for all other groups. The heart heights for Groups I, II, and III females were identified as 26.21, 41.00, and 46.27 mm, respectively, and for the males 26.45, 34.89, and 47.15 mm, respectively. In the statistical analysis, it was determined that all the morphometric values measured from the heart correlated significantly with the forehead-to-tail length. Conclusions: The data obtained as a result of the study is thought to help understand the morphological and morphometrical development of the heart, pioneer the attempts to create a foetal cattle heart model, and thus help in the diagnosis of the foetal heart pathologies.acieleck

Growth and development of the human intervertebral disc

The object of this study is to compare the growth and development of a lumbar intervertebral disc with those in the thoracic and cervical regions from embryonic life to childhood. Particular attention is paid to changes during and following the establishment of the secondary curvatures of the vertebral column. Current knowledge of development of the intervertebral disc is reviewed.Postmortem material from 67 cases and a large series of radiographs are used in histological and mensural studies. The vertical dimensions of the 'total disc' (which includes the cartilage plates), its parts, and the vertebral body above the disc are measured in each region at every age. Notochordal remnants in vertebrae and discs are used as 'natural markers' from which horizontal dimensions are measured in the median plane to give an indication of growth anteriorly and posteriorly from the position of the notochord.Notochordal cells appear to multiply during foetal life and infancy, playing an important role in growth and extension of the notochordal nucleus pulposus up to about three years, but they degenerate and disappear from about three to seven years.As the notochordal nucleus pulposus grows rapidly in V volume, principally by increase in its macoid matrix (notably in lumbar discs), the anulus fibrosus and cartilage plates bounding it become thinner. Associated with thinning of the cartilage plates, vertical growth of the central part of the 'total disc' slows down during the first two postnatal years.As secondary cervical and lumbar curvatures are established, the cervical and lumbar notochordal nuclei pulposi respectively move to more anterior and central positions, but the thoracic notochordal nucleus pulposus remains posteriorly situated. From two years onwards, the central parts of lumbar discs grow rapidly in height though the heights of the central parts of thoracic discs remain almost unchanged. The central situation of the lumbar nucleus pulposus in childhood, and the rapid increase in height of the central part of the lumbar 'total disc' from two to seven years are associated with corresponding changes in the shape of the cephalic and caudal end surfaces of lumbar vertebral bodies from convexity to concavity.During the same period (about two to seven years) there is an increase in the rate of antero- posterior growth of the lumbar vertebral column without any increase in its lateral growth rate.The present investigation throws further light on the work of Houston and Zaleski (1967) who demonstrate a relationship between 'activity' and vertebral body shape, and suggests that the rate of anteroposterior growth of the lumbar vertebral column, the vi the rate of vertical growth of lumbar vertebrae and 'total discs', and their changes in shape during childhood, all depend to some extent on the assumption of the normal erect posture

Referencing echocardiographic measurements for premature and low-birth weight infants

Thesis (M. Tech. (Clinical Technology)) -- Central University of technology, Free State, 2012Introduction: Reference ranges for cardiac measurement are available for adults, children and term infants but the same cannot be said for preterm or small for gestational age (SGA) infants surviving as a result of modern intensive care units. No published data of reference ranges for preterm infants exists for the South African population. Infants with congenital heart disease are twice as likely to be small for their gestational age and these reference ranges may affect clinical management decisions, therapeutic response and prognosis of these neonates. The aim was thus to establish reference ranges for cardiac dimensions and functional values for preterm and low birth weight infants for central South Africa and compare them with international standards. Methods: A total of 290 infants of less than 34 weeks of age and weighing less than 2500g at birth were examined during a twelve month period by echocardiography during the first 0-28 days of life. The study assessed normative cardiac measurements divided in M-Mode, 2-D and functional measurement for these infants in 3 weight groups. Exclusion criteria were applied to any condition affecting the size and functionality of the cardiac system. The following dimensions were measured: Standard M-Mode values for the left ventricle, 2D measurements of valve mitral and tricuspid orifices, as well as functional assessments including Shortening fraction (SF %), Ejection fraction (EF %), and Muscle performance Index (MPI)-index of the Left and Right ventricle. Measurements were done by the leading edge methodology following the ASE recommendations. A longitudinal study was also done to examine changes in these indices over the first month- on day 14 and day 28 of life. Interobserver differences were calculated for the variability between measurements of a single scan- 25 babies were re-measured and produced good repeatability. Results: 290 infants were included to produce Referance ranges of measurements (means and standard deviations) for 3 weight groups namely: <0.999g, 1000-1499g, and 1500g – 2500g. The gestational age’s ranges between 26-38 weeks with a median of 31 weeks, gender distribution was almost equal with a slight female preponderance. Body surface area ranged from a minimum from 0.076 m² and a maximum of 0.184 m², the body weight ranged between a minimum of 690g and a maximum of 2500g with a median of 1360g. Discussion: The left ventricular diastolic and systolic, interventricular septum, posterior wall, aortic and left atrium dimensions showed a proportionate increase in diameter with an increase in body weight There were no differences in cardiac dimensions between Small for Gestational age” (SGA) versus “Average for Gestational age” (AGA). Gender and race played no role in any functional measurements or with the cardiac sizes. Weight correlated well with BSA and the data suggest that weight only can be used to develop tables for clinical use. Cardiac chambers increased with BSA and weight and functional measurements stayed the same throughout the weight groups. Systolic and global functions were remarkably similar and constant throughout weight categories. . The longitudinal study also confirmed that the values are applicable to all low birth weight infants up to 28 days of age. Differences existed between some of the average South African infant’s cardiac chambers and international values. The Inter Ventricular Septum (IVS) and Posterior Wall (PW) measured thicker and the Left Atrium larger. This could be due to numerous factors that should be investigated further. Conclusion: The study emphasized the profound effect of growth and weight gain on the cardiac structure and that population specific reference values should therefore be developed and used

Theoretical and technical aspects of using the Doppler umbilical flow waveform to assess compromised foetal circulation

Includes bibliography.The aim of this thesis was to investigate the feasibility of using the shape of the umbilical flow waveform, obtained clinically with Doppler ultrasound, to monitor the condition growth impaired foetuses. This aim was addressed via the following . 1. Survey the literature to obtain information regarding : a) the foetal blood flow distribution for normal foetuses. b) the effect of placental pathology and maternal hyperoxygenation in compromised foetuses. 2. Model the foetal circulation to investigate the effect, on the umbilical flow waveform, of physiological changes resulting from placental insufficiency. 3. Perform a theoretical and practical assessment of Doppler ultrasound by considering its suitability in monitoring foetal condition, through alterations in the umbilical blood flow waveform shape. 4. Clinically gather and analyse umbilical blood flow waveforms from foetuses currently on a trial to investigate appropriate protocols for the assessment of maternal hyperoxygenation