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Is Fetal Echo Usefull in an Inavsive Therapy in Chest Anomalies?

Abstract

The aim of this study was to check whether echocardiography is useful in patients with thoracic anomalies undergoing an invasive therapy in utero.

Material and Methods: Retrospective analysis of 42 pregnant women and their fetuses (2003 - 2012), which, due to the chest anomalies had genetic ultrasound and ECHO and then were subjected to an invasive intrauterine therapy.

Results: The mean maternal age was 30.2 years, there were 18 high risk pregnancies and 24 low-risk pregnancies, the average gestational age at diagnosis was 28.2 wks (17 - 38), the average week of delivery was 35 wks (24 - 41), the average birth weight was 2700g (700 - 4050g). The average number of fetuses with chest anomalies undergoing therapy in utero in our center was 4.2 per year. The most common anomaly was hydrothorax, then CALM and DH and one case of AS. Anomalies coexisted with generalized edema, ascites and/or polyhydramnios. Most often shunts and/or decompression of pleural fluid and / or abdominal cavity were performed. Structural heart defects occurred in 6 fetuses and functional anomalies in echocardiography were recorded in 29 fetuses (73%).

Selected group of 19 fetuses had echocardiography before and after surgery. In 14 fetuses hemodynamic improvement was observed and in 5 patients fetal functional changes have persisted. The time from the last treatment to the delivery averaged was 40,2 days (2 to 140).

The follow-up was analyzed in a group of 37 fetuses: there were 2 intrauterine deaths, 11 deaths after delivery and 24 infants were discharged home. Mean hospitalization duration of the live-born infants was 23.7 days (1 - 70). Hospitalization of 14 neonates with hemodynamic improvement after surgery was 25.5 days and in a group of five fetuses with no improvement after surgery, was mean 45.6 days.

Conclusions: The number of fetuses undergoing an invasive therapy due to anomalies of the chest during 2003 - 2012 remained at a similar level (an average of approximately 4 patients per year). Thoracic defects were often accompanied by functional anomalies in the circulatory system. Majority (73%) of fetuses had shown a significant improvement in cardiac efficiency after an invasive treatment. In the group of fetuses in which the interventional procedure has improved cardiovascular hemodynamics, average duration of hospitalization was shorter as compared to the group without haemodynamic improvement (25,5 days versus 45,6), however there was no statistically significant difference.

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Evaluation of the prognostic and predictive value of free light chains in patients with chronic lymphocytic leukemia – preliminary results

Biochem 2014 51 528 – 42 [11] Morabito F, de Filippi R, Laurenti L, et al. The cumulative amount of serum-free light chain is a strong prognosticator in chronic lymphocytic leukemia. Blood 2011;118:6353–61. 10.1182/blood-2011-04-345587 Morabito F de Filippi R Laurenti L et al The cumulative amount of serum-free light chain is a strong prognosticator in chronic lymphocytic leukemia Blood 2011 118 6353 – 61 [12] Dogaru M, Lazăr V, Coriu D. Assessing the efficiency of free light chain assay in monitoring patients with multiple myeloma before and after

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Plerixafor for patients who fail cytokine-or chemotherapy-based stem cell mobilization: Results of a prospective study by the Polish Lymphoma Research Group (PLRG)

Transplant 2017;52:1212–4. 10.1038/bmt.2017.103 Chabannon C Bijou F Grouin JM Drillat P Milpied N Mohty M The choice of in-hospital or home administration for plerixafor injection to poor mobilizers has no adverse consequence on subsequent hematopoietic stem cell harvest Bone Marrow Transplant 2017 52 1212 – 4 [34] Azar N, Ouzegdouh M, Choquet S, Leblond V. Impact of plerixafor (Mozobil) on hospital efficiency: a single center experience. J Clin Apher 2018;33:5–13. 10.1002/jca.21551 Azar N Ouzegdouh M Choquet S Leblond V

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Selected factors influencing angiogenesis and hematopoietic niche

: association with mobilization efficiency and potential predictive significance. Transfusion 2011;51(2):319–27. doi: 10.1111/j.1537-2995.2010.02863.x 10.1111/j.1537-2995.2010.02863.x Lysák D Hrabětová M Vrzalová J Changes of cytokine levels during granulocyte-colony-stimulating factor stem cell mobilization in healthy donors: association with mobilization efficiency and potential predictive significance Transfusion 2011 51 2 319 27 10.1111/j.1537-2995.2010.02863.x [42] Szmigielska-Kapłon A, Krawczyńska A, Czemerska M, et al. Angiopoietins in

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