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1
Content available remote Preterm Delivery of Twins
100%
EN
The incidence of twin gestation has increased over the past decades and contributes to an increased rate of spontaneous preterm birth and increased mortality and morbidity up to adult age. Prevention of spontaneous preterm birth in twin pregnancies differs from interventions in singleton pregnancies. Up to now, many treatment modalities have been investigated such as bed rest, tocolytics, antibiotics, cerclage or progestagens, but have failed to prevent prematurity rates in twin gestations or were even combined with harmful effects. Cervical pessaries might be a non-invasive cost-effective option, but it is mandatory to evaluate vaginal progesterone and cervical pessaries in twin gestations with a short cervix in further randomized trials.
EN
Twin molar pregnancy with a hydatidiform mole and a coexisting live fetus is a rare form of gestational trophoblastic disease associated with an increased risk of obstetric complications and poor perinatal outcome. Prenatal diagnosis is essential for couple counseling and follow-up in Tertiary Reference Centers. Magnetic resonance imaging is important for the diagnostic differentiation of placental mesenchymal dysplasia and exclusion of myometrial invasion. Here we present a case of twin molar pregnancy with a hydatidiform mole and a coexisting live fetus diagnosed at gestational week 14 using two-dimensional (2D) and three-dimensional (3D) ultrasound and magnetic resonance imaging. We also describe the obstetric management and postmolar follow-up.
PL
Zaśniad groniasty stanowi łagodną postać ciążowej choroby trofoblastycznej (gestational trophoblastic disease, GTD)(1). W Brazylii ciążowa choroba trofoblastyczna stwierdzana jest 5–10 razy częściej(2) niż w Stanach Zjednoczonych i Europie(3,4). Zaśniad groniasty powstaje w wyniku nieprawidłowego zapłodnienia komórki jajowej i może przybierać dwie formy: zaśniadu groniastego całkowitego lub zaśniadu groniastego częściowego(1). Z klinicznego punktu widzenia taka reprodukcja materiału genetycznego może prowadzić do rozwinięcia się ciążowej neoplazji trofoblastu, która bez wdrożenia właściwego leczenia może skutkować śmiercią kobiety(1–4). Artykuł w wersji polskojęzycznej jest dostępny na stronie http://jultrason.pl/index.php/wydawnictwa/volume-17-no-71
EN
The relationship between the type and size of placenta and the development of twin fetuses is still discussed in perinatology. The objective of this paper is to answer the question whether the final weight and size of placenta is a limiting factor for fetal growth in twin pregnancy. The study material consisted of 1,261 pairs of fetuses from monochorionic (MC) and dichorionic (DC) twin pregnancies, born by cesarean section between pregnancy weeks 22 and 41 at the Perinatology and Gynecology Department of the Poznan University of Medical Sciences between 2003 and 2009. Histological examination of secundines, placental weights, and birth weight of twins were evaluated, and the newborn condition was assessed by the Apgar score. Statistical evaluation by analysis of variance assessed placental growth related to gestational age and also the effect of placental-fetal weight ratio on neonate clinical condition. We observed an increase in placenta growth until 38 weeks of pregnancy in twins sharing one placenta and until 36 weeks of pregnancy in twins with separate placentas. Between 22 and 35 weeks of pregnancy, the placental-fetal weight ratio in twins sharing one placenta was higher and they were also smaller than twins with separate placentas The placental-fetal weight ratio was comparable in all twins at delivery and was associated with the clinical condition of newborns. Newborns who received an Apgar score of 8 or more 10 minutes post delivery had a lower ratio than neonates with Apgar score equal to or lower than 7 (p≤0.01). Although these latter twins had both smaller placentas and smaller birth weights, their placental-fetal weight ratios were significantly higher than those of twins born in good condition. Placental growth decreases before pregnancy term but does not limit fetal birth weight in twin pregnancy.
EN
A combined application of independent component analysis and projective filtering of the time-aligned ECG beats is proposed to solve the problem of fetal ECG extraction from multi-channel maternal abdominal electric signals. The developed method is employed to process the four-channel abdominal signals recorded during twin pregnancy. The signals are complicated mixtures of the maternal ECG, the ECGs of the fetal twins and noise of other origin. The independent component analysis cannot separate the respective signals, but the proposed combination of the methods allows to suppress the maternal ECG and when the level of noise is low it leads to an effective separation of the twins' signals.
Logopedia
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2020
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tom 49
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nr 2
177-196
PL
W niniejszym artykule podjęto temat rozwoju mowy dzieci urodzonych z ciąży mnogiej. Z uwagi na specyficzne uwarunkowania społeczne, a także szczególne obciążenia neotologiczne bliźniąt, należą one do grupy dzieci z ryzykiem zaburzeń rozwojowych. Przejawem zaburzeń rozwoju dzieci z ciąż mnogich mogą być zaburzenia dynamiki w nabywaniu systemu językowego. Na potrzeby niniejszego opracowania badań dokonano analizy porównawczej stanu kompetencji i sprawności językowych w zakresie poszczególnych podsystemów języka grupy dzieci z ciąży pojedynczej oraz grupy bliźniąt. Za problemem badawczy przyjęto pytanie: czy szczególne uwarunkowania biologiczne i środowiskowe bliźniąt determinują dynamikę nabywania przez nie systemu językowego? Badaniem objęto dziewięcioro dzieci 3-letnich, w tym trzy pary rodzeństwa bliźniaczego stanowiących grupę badaną oraz troje dzieci urodzonych z ciąży pojedynczej, stanowiących grupę kontrolną.
EN
This article presents the subject of speech development of twin-born children. Due to the significant importance of environmental and neotological factors, twins are considered to be at risk of developmental disorders. This is manifested by language delay and quantitative and qualitative differences in all aspects of the language, compared to children born from single pregnancies. In this study it was made a comparative analysis of the state of linguistic competences of all language subsystems in the group of single- and twin-born children. The research problem has become the question: do the specific biological and environmental conditions of twin pregnancy determine the dynamics of acquiring the language system by them? The study concerned nine 3-year-old children, including three pairs of twins constituting the research group and three children born from a single pregnancy constituting the control group.
11
51%
EN
We propose to tackle the problem of maternal abdominal electric signals decomposition with a combined application of independent component analysis and projective or adaptive filtering. The developed method is employed to process the four-channel abdominal signals recorded during twin pregnancy. These signals are complicated mixtures of the maternal ECG, the ECGs of the fetal twins and noise of various origin. Although the independent component analysis cannot separate the respective signals, the proposed combination of the methods deals with this task successfully. A simulation experiment confirms high efficiency of this approach.
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