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1
Content available remote Development of the cardiac venous system in prenatal human life
100%
EN
The human coronary sinus is an evolutionary modification of the terminal part of the left sinus horn. Anatomically, the coronary sinus is a short, broad vessel that runs along the coronary groove situated on the diaphragmatic surface of the heart. This structure, which opens into the right atrium, collects blood from the great cardiac vein and from other veins of the heart as well. In this study, we assessed the growth and dimensions of the coronary sinus at the fourth and eighth months of fetal development from whole material received from the Nicolaus Copernicus University, Collegium Medicum, Department of Histology and Embryology in Bydgoszcz. A group of 219 specimens, 105 male and 114 female fetuses, presented no visible malformations or developmental abnormalities. The results of this study determined that the dimension of the coronary sinus during prenatal development is not sexually dimorphic. Furthermore, following a monthly period of rapid growth in length of this structure, there are no further increases in length after the six months gestation. Finally, we concluded that the dimensions of the coronary sinus obtained during autopsy are similar to those determined through intravital ultrasound examination. The diameter of the coronary sinus is the best parameter to monitoring the fetal age and the growing of the fetus. Accordingly, we suggest that the best way of estimate for proper blood drainage from heart veins is study of coronary sinus volume.
2
Content available remote A fetus with meckel-gruber syndrome associated with isomerism
88%
EN
Abstract. Meckel-Gruber syndrome (MKS) is an autosomal recessive lethal malformation. As far as we know, the rate of incidence for the syndrome is 0.02 per 10,000 births. It is estimated that Meckel-Gruber syndrome accounts for 5% of all neural tube defects in Finland. Objective. The aim of this study is to present a case of a fetus with Meckel-Gruber syndrome associated with complete left isomerism. Method. The fetus was obtained after medical interruption of the pregnancy during the fifteenth gestational week. The mother was 36 years old and in a consanguineous marriage. The antenatal ultrasound examination revealed a polymalformative syndrome, leading to a postmortem examination. The fetopathological study of the fetus was conducted at the Centre for Maternity and Neonatology, Tunis, Tunisia, in 2008. Results. The female fetus had a significantly deformed ballooning abdomen, pes equinovarus, flexion of the wrist and a total posterior cleft palate. The central nervous system abnormalities were occipital encephalocele, cystic dilatation of the fourth ventricle, agenesis of corpus callosum and hydrocephalus. The study of the internal organs found dextrocardia, irregular lobulation of the lungs, left isomerism, and polysplenia. The microscopic examination revealed bilateral cystic dilation of the kidneys, fibrous proliferation of the liver and ectasic dilatation of the billiary ducts, representing a ductal plate malformation of the liver. Conclusion. The case is diagnosed with Meckel-Gruber syndrome associated with complete left isomerism, cleft palate and possibly Dandy-Walker syndrome.
3
Content available Treatment of trauma in pregnancy
63%
EN
Trauma is the most common non-obstetric cause of death among pregnant women, affecting 5–7% of them. In the case of an accident, all first-aid efforts should take into account both the mother and the fetus. In most cases, treating a pregnant woman does not differ from the ITLS (International Trauma Life Support) principles. However, one has to consider the possibility of pregnancy-characteristic injuries as well as the fact that physiological pregnancy can mask some life and health threatening symptoms.
PL
Urazy w ciąży są najczęstszą pozapołożniczą przyczyną zgonów ciężarnych i dotyczą około 5–7% kobiet. Przystępując do udzielania pomocy kobiecie ciężarnej na miejscu wypadku należy pamiętać, że działania ratujące zdrowie i życie muszą obejmować dwie osoby – matkę i jej nienarodzone dziecko. W większości przypadków zaopatrzenie urazów u ciężarnej nie odbiega od schematu ITLS (International Trauma Life Support), należy jednak pamiętać, że może u niej dojść do szczególnych obrażeń typowych tylko dla ciąży. Nie bez znaczenia jest również fakt, że zmiany zachodzące w fizjologicznej ciąży mogą maskować groźne dla zdrowia i życia objawy.
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