The theory on establishment of programmed in the fetal period and chronic diseases haven’t still given out anything clearly but in most of studies, they showed that there is a relation between fetal growing with cardiovascular diseases, hypertension and metabolic syndrome. Its establishment of programmed in fetal period doesn’t replace other risk factors but adding more the environmental factor to these diseases. Currently, the important of fetal nutrition and mother nutrition in pregnancy period are paid attention as well as other nutrition issue in the transition period.
Nutrition Therapy ; Cardiovascular Diseases ; Chronic Disease ; Fetal Nutrition Disorders

The “Barker hypothesis” postulates that a number of organ structures and associated functions undergo programming during embryonic and fetal life, which determines the set point of physiological and metabolic responses that carry into adulthood. Hence, any stimulus or insult at a critical period of embryonic and fetal development can result in developmental adaptations that produce permanent structural, physiological and metabolic changes, thereby predisposing an individual to cardiovascular, metabolic and endocrine disease in adult life. This article will provide evidence linking these diseases to fetal undernutrition and an overview of previous studies in this area as well as current advances in understanding the mechanism and the role of the placenta in fetal programming.
Adult ; Chronic Disease ; Critical Period (Psychology) ; Embryonic and Fetal Development ; Endocrine System Diseases ; Fetal Development* ; Fetal Nutrition Disorders ; Humans ; Malnutrition ; Placenta

OBJECTIVE: We aim to analyze each variable of FHR in high risk pregnancies, namely intrauterine growth restriction (IUGR) and pregnancy-induced hypertension (PIH) including chronic hypertensive vascular disease (CHVD), mild and severe preeclampsia to build an objective decision basis using correlation analysis. METHODS: The patients were divided into two groups (500 normal pregnancies and 500 high risk pregnancies related to IUGR, CHVD, mild and severe preeclampsia), and then subdivided into intrauterine pregnancy before 24 weeks, 25-39 weeks, and after 40 weeks. We compared the canonical correlation between each group using variables of FHR after nonstress test (NST). RESULTS: In high risk pregnancies, the linearity was 0.6-0.8 in intrauterine pregnancy before 24 weeks, 0.53-0.68 in 25-29 weeks, 0.50-0.60 in 30-34 weeks, 0.38-0.45 in 35-39 weeks and 0.42-0.55 in after 40 weeks. In normal pregnancies, the linearity was 0.44-0.52 in intrauterine pregnancy before 24 weeks, 0.38-0.45 in 25- 39 weeks which was stable, and there was no specific change in after 40 weeks. Before 32 weeks, canonical variates of FHR_D and FHR_I revealed highest (0.36, 0.47 respectively) in high risk pregnancy and fetal movement and signal loss was the most valuable factors in normal pregnancy. In between 33 to 37 weeks, fetal movement (0.40) and signal loss (0.48) were related most closely in high risk pregnancies and 0.34 and 0.49 respectively in normal pregnancies which show similar pattern. In contrast, FHR_D was most highly related to the duration of pregnancy and FHR_I to fetal movement (0.38) in high risk pregnancy. In normal pregnancies, fetal movement (0.40) and signal loss (0.52) showed the highest linearity. CONCLUSION: The pregnancy with intrauterine growth restriction and pregnancy induced hypertension has more linear relation and less complexity in each variable of FHR than the normal pregnancy group. The formal, functional underdevelopment of fetus may results in the increasement of the linear depedent relation in each variable of FHR in these type of high risk pregnancies.
Female ; Fetal Development* ; Fetal Growth Retardation ; Fetal Heart* ; Fetal Movement ; Fetus ; Heart Rate, Fetal* ; Humans ; Hypertension, Pregnancy-Induced* ; Pre-Eclampsia ; Pregnancy ; Pregnancy* ; Pregnancy, High-Risk ; Vascular Diseases

Fetal pericardial effusion appears as a common type of fetal hydrops, but rarely isolated. The causes are heart failure by cardiac anomaly and arrhythmia (most common), kidney anomaly, erythroblastosis fetalis, non-immune fetal hydrops, intrauterine growth retardation, chromosomal anomaly and transient etc. If chromosomal anomalies such as 21 trisomy, 18 trisomy or 13 trisomy exists, isolated pericardial effusion may exist without cardiac anomaly or arrhythmia. Otherwise, the chromosomal anomaly must be suspected when isolated pericardial effusion is observed on fetal echocardiography. We experienced a case of large amount of isolated pericardial effusion antenatally detected by fetal echocardiography at 32weeks of gestational age in a neonate who needed pericardiocentesis and confirmed trisomy 21. We report a case of isolated pericardial effusion with brief review of related literature.
Arrhythmias, Cardiac ; Down Syndrome* ; Echocardiography ; Erythroblastosis, Fetal ; Fetal Growth Retardation ; Gestational Age ; Heart Failure ; Humans ; Hydrops Fetalis ; Infant, Newborn* ; Kidney ; Pericardial Effusion* ; Pericardiocentesis ; Trisomy*

Fetal pericardial effusion appears as a common type of fetal hydrops, but rarely isolated. The causes are heart failure by cardiac anomaly and arrhythmia (most common), kidney anomaly, erythroblastosis fetalis, non-immune fetal hydrops, intrauterine growth retardation, chromosomal anomaly and transient etc. If chromosomal anomalies such as 21 trisomy, 18 trisomy or 13 trisomy exists, isolated pericardial effusion may exist without cardiac anomaly or arrhythmia. Otherwise, the chromosomal anomaly must be suspected when isolated pericardial effusion is observed on fetal echocardiography. We experienced a case of large amount of isolated pericardial effusion antenatally detected by fetal echocardiography at 32weeks of gestational age in a neonate who needed pericardiocentesis and confirmed trisomy 21. We report a case of isolated pericardial effusion with brief review of related literature.
Arrhythmias, Cardiac ; Down Syndrome* ; Echocardiography ; Erythroblastosis, Fetal ; Fetal Growth Retardation ; Gestational Age ; Heart Failure ; Humans ; Hydrops Fetalis ; Infant, Newborn* ; Kidney ; Pericardial Effusion* ; Pericardiocentesis ; Trisomy*

Nonimmune hydrops fetalis is becoming a predominant form of fetal hydrops due to the declining incidence of immune hydrops fetalis triggered by Rh isoimmunization. Infantile polycystic kidney appeared to be related to hydrops fetalis whether it is causal or merely coincidental and may represent another entry to differential diagnoses. Infantile polycystic kidney was diagnosed by an elevated maternal serum alpha-fetoprotein (AFP) value coupled with an ultrasonographic abnormality scanned as a multicystic mass with ascites in the fetal abdomen antenatally. This study presents a case of infantile polycystic kidney that resulted in a stillborn baby with hydrops fetalis and extensive placental calcification; it was the first case in Korea in which nonimmune hydrops fetalis was associated with infantile polycystic kidney in consecutive siblings by autosomal recessive inheritance in one family. In addition, this paper comprehensively reviews the incidence, etiology, prenatal diagnosis and proper management of nonimmune hydrops fetalis.
Adult ; Female ; Fetal Death/complications ; Fetal Diseases/*complications/pathology ; Human ; Hydrops Fetalis/*complications/pathology ; Pedigree ; Polycystic Kidney Diseases/*complications/pathology ; Pregnancy ; Recurrence

Fetal hydrops is often serious and associated with a high perinatal motality rate. Cardiac causes of fetal hydrops include congenital heart diseases and rhythm disturbances. An irregular fetal heart rate may indicate atrial fibrillation and atrial flutter with variable AV conduction. Fetal atrial flutter is characterized by the pressence of flutter waves which are regular sawtooth undulations in the baseline that are larger than p waves. Authors experienced a case of fetal atrial flutter with hydrops fetalis at 30 week's gestation which was confirmed by fetal M-mode echocardiogram and electrocardiography. A new born infant had shown to have atrial flutter in utero and after delivery was successfully converted to normal sinus rhythm with digoxin and quinidene.
Atrial Fibrillation ; Atrial Flutter* ; Digoxin ; Edema* ; Electrocardiography ; Female ; Heart Diseases ; Heart Rate, Fetal ; Humans ; Hydrops Fetalis* ; Infant ; Pregnancy

OBJECTIVE: The cordocentesis is regarded as an useful procedure for the prenatal evaluation of fetal disease, but it's complications are fetal loss, umbilical cord bleeding, umbilical cord hematoma, fetal bradycardia, fetomaternal hemorrhage, abruptio placentae, and chorioamnionitis due to it's invasiveness. The fetal bradycardia following cordocentesis is transient and self-limited in most cases, and the prevalence rate of fetal bradycardia following cordocentesis was reported to be between 1.5 and 13 per cent. The purpose of this study was to evaluate the association of fetal heart rate pattern following cordocentesis with adverse pregnancy outcome. METHODS: We investigated retrospectively the fetal heart rate following cordocentesis, the Apgar score of neonate, the birth weight of neonate, gestational age at delivery, preterm delivery, intrauterine growth retardation, stillbirth, and chromosome analysis in 64 codocenteses between 1 February 2000 and 28 February 2001. Normal fetal heart rate was defined as 100 up to 170 bpm, fetal bradycardia as less than 100 bpm lasting one more minute, and fetal tachycardia as more than 170 bpm lasting one more minute. RESULTS: 1. Fetal heart rate pattern following the cordocentesis was normal in 53 cases (82.8%), bradycardia in 6 cases (9.4%) and tachycardia in 5 cases (7.8%). 2. The pregnancy outcome was well-being fetus at birth in 51 cases, terminated pregnancy in 5 cases, intrauterine growth restricted fetus in 5 cases, preterm birth in 1 case and intrauterine death in 2 cases. 3. Mean Apgar-1minute/-5minute scores in neonates were 8.4 +/- 0.2/9.3 +/- 0.2 in the normal fetal heart rate group, 6.8 +/- 1.7/7.6 +/- 1.9 in fetal bradycardia group and 8.4 +/- 0.2/9.4 +/- 0.2 in fetal tachycardia group, that showed no statistically significant difference between groups. 4. The gestational weeks at birth/birth weight were 38.9 +/- 0.4 weeks/3193 +/- 90 g in normal fetal heart rate group, 36.8 +/- 3.2 weeks/2733 +/- 340 g in bradycardia group and 40.0 +/- 0.2/3465 +/- 21 g in tachycardia group, that showed no statistically significant difference between groups. 5. The number of puncture at the same time of cordocentesis was one in 45 cases, two in 15 cases and three in 4 cases. 6. There was no difference in fetal heart rate pattern following cordocentesis between 60 cases of normal and 4 cases of abnormal cardiovascular findings sonographycally. 7. The karyotyping was normal in 60 cases and abnormal in 4 cases, each of which was 46,XY,inv(9),46,X,i(Xq)/45,X,47,XY,+mar, and 46,XX,t(7;15)(q10;q10) respectively. CONCLUSION: Fetal bradycardia or tachycardia following cordocentesis was not associated with adverse pregnancy outcomes.
Abruptio Placentae ; Apgar Score ; Birth Weight ; Bradycardia ; Chorioamnionitis ; Cordocentesis* ; Female ; Fetal Diseases ; Fetal Growth Retardation ; Fetal Heart* ; Fetomaternal Transfusion ; Fetus ; Gestational Age ; Heart Rate, Fetal* ; Hematoma ; Hemorrhage ; Humans ; Infant, Newborn ; Karyotyping ; Parturition ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Premature Birth ; Prevalence ; Punctures ; Retrospective Studies ; Stillbirth ; Tachycardia ; Umbilical Cord

Fetal alcohol syndrome can be suspected in infants born to mothers with a prenatal history of alcohol abuse if the child exhibits characteristic facial features, together with intrauterine growth retardation, multiple neurological abnormalities, and multiorgan defects. If only a few of the above criteria are satisfied, the term fetal alcohol effects is used. We experienced a neonate who presented with hydrocephalus, low birth weight, seizure, right renal agenesis, characteristic facial features and a maternal history of alcohol abuse, and diagnosed him as fetal alcohol syndrome(FAS), with accompanying meconium aspiration syndrome, and persistent pulmonary hypertension of the newborn. There is no definite cure for FAS, but it can be prevented by maternal abstinence from drinking; thus maternal education, understanding and early diagnosis of those affected are of importance.
Alcoholism ; Child ; Drinking ; Early Diagnosis ; Education ; Fetal Alcohol Spectrum Disorders* ; Fetal Growth Retardation ; Humans ; Hydrocephalus ; Hypertension, Pulmonary* ; Infant ; Infant, Low Birth Weight ; Infant, Newborn* ; Meconium Aspiration Syndrome ; Mothers ; Seizures

Fetal tachycardia is at risk for developing low cardiac output, non-immune hydrops fetalis and ultimately fetal death. Spontaneous resolution of supraventricular tachycardia (SVT) is common during the first year of age, but some infants need long-term antiarrhythmic therapy. In almost neonatal tachyarrhythmia including SVT, adenosine is the drug of the first choice. Digoxin is used to treat the SVT which is not controlled with adenosine. Class Ic and III antiarrhythmic drugs are additionally recommended for the disease unresponsive to digoxin. Intravenous amiodarone is highly effective and safe in an infant with refractory or life threatening tachycardia. Some cases have been reported that amiodarone combined with digoxin therapy is effective for treating tachycardia. We herein report a case of a preterm infant-born at 32 weeks of gestational age-with hydrops fetalis and life-threatening refractory SVT accompanied by multiple congenital heart diseases. SVT was initially not responsive to adenosine therapy, however, it was then successfully controlled with combination therapies of amiodarone and digoxin.
Adenosine ; Amiodarone* ; Anti-Arrhythmia Agents ; Cardiac Output, Low ; Digoxin* ; Edema* ; Fetal Death ; Heart Diseases* ; Heart* ; Humans ; Hydrops Fetalis* ; Infant ; Infant, Newborn ; Infant, Premature* ; Tachycardia ; Tachycardia, Supraventricular*