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Author

Edgar Hernandez-Andrade

Other affiliations: University of Barcelona, Hebron University, Lund University  ...read more
Bio: Edgar Hernandez-Andrade is an academic researcher from Wayne State University. The author has contributed to research in topics: Umbilical artery & Intrauterine growth restriction. The author has an hindex of 31, co-authored 95 publications receiving 2387 citations. Previous affiliations of Edgar Hernandez-Andrade include University of Barcelona & Hebron University.


Papers
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Journal Article
TL;DR: IUGR fetuses showed signs of cardiac dysfunction from early stages with the progression of fetal compromise, together with the appearance of biochemical signs of cell damage.

240 citations

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TL;DR: The fetal brain demonstrates cerebral-cerebellar and cortical-subcortical connectivity and long-range functional connectivity is more prominent in older fetuses.

124 citations

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TL;DR: Increases in cerebral blood perfusion and middle cerebral artery Doppler discriminates SGA fetuses that are at risk for abnormal neurobehavior.

112 citations

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TL;DR: To assess the feasibility and impact on perinatal outcome of fetoscopic laser coagulation of placental anastomoses in monochorionic twins with selective intrauterine growth restriction and intermittent absent or reversed end‐diastolic flow in the umbilical artery, in comparison with expectant management.
Abstract: Objectives To assess the feasibility and impact on perinatal outcome of fetoscopic laser coagulation of placental anastomoses in monochorionic twins with selective intrauterine growth restriction (sIUGR) and intermittent absent or reversed end-diastolic flow (iAREDF) in the umbilical artery (Type III), in comparison with expectant management. Methods This is a descriptive study of the outcome of 18 cases of monochorionic twins with Type III sIUGR treated with laser, and 31 pregnancies managed expectantly over the same period. All newborns underwent neonatal brain ultrasound scans. Perinatal outcome and the incidence of neurological damage were compared between the two groups. Results Laser coagulation could be performed in only 88.9% (16/18) of cases owing to technical difficulties, and in 12.5% (2/16) a second procedure was required to achieve complete coagulation of the large artery-to-artery anastomosis. Mean gestational age at delivery was 31.0 (range, 26–33) weeks in the expectant management group and 32.6 (range, 23–38) weeks in the laser group (P = 0.32). Overall perinatal survival was 85.5% (53/62) and 63.9% (23/36), respectively (P = 0.02). Intrauterine demise of the smaller twin occurred in 19.4% (6/31) and 66.7% (12/18), respectively (P = 0.001), and was associated with death of the cotwin in 50% (3/6) and 0% (0/12) of these cases, respectively (P = 0.02). The prevalence of periventricular leukomalacia in the larger fetus was 4/28 (14.3%) in the expectant management group and 1/17 (5.9%) in the laser group (P = 0.63). Conclusions Laser coagulation in sIUGR-iAREDF pregnancies is technically difficult and not always feasible. Placental dichorionization significantly increases the proportion of fetuses with intrauterine death of the growth-restricted twin, but it protects the normal twin from its cotwin's death in the event of demise of the growth-restricted twin. Copyright © 2008 ISUOG. Published by John Wiley & Sons, Ltd.

109 citations

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01 Jul 2004-Placenta
TL;DR: In this study, in situ hybridization and real-time PCR was used to study the gene expression of monoamine transporters, such as NET, SERT, VMAT2, EMT and OCT1/2, in normal as well as in pre-eclamptic placentae, and quantitative analysis showed a significant lower expression of NET and EMT mRNAs inPre-e Clampsia as compared to the control group.

104 citations


Cited by
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TL;DR: A protocol is proposed that integrates current evidence to classify stages of fetal deterioration and establishes follow-up intervals and optimal delivery timings, which may facilitate decisions and reduce practice variability in this complex clinical condition.
Abstract: Small fetuses are defined as those with an ultrasound estimated weight below a threshold, most commonly the 10th centile The first clinically relevant step is the distinction of ‘true’ fetal growth restriction (FGR), associated with signs of abnormal fetoplacental function and poorer perinatal outcome, from constitutional small-for-gestational age, with a near-normal perinatal outcome Nowadays such a distinction should not be based solely on umbilical artery Doppler, since this index detects only early-onset severe forms FGR should be diagnosed in the presence of any of the factors associated with a poorer perinatal outcome, including Doppler cerebroplacental ratio, uterine artery Doppler, a growth centile below the 3rd centile, and, possibly in the near future, maternal angiogenic factors Once the diagnosis is established, differentiating into early- and late-onset FGR is useful mainly for research purposes, because it distinguishes two clear phenotypes with differences in severity, association with preeclampsia, and the natural history of fetal deterioration As a second clinically relevant step, man

513 citations

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TL;DR: In this article, the authors found that placenta-related fetal growth restriction arises primarily due to deficient remodeling of the uterine spiral arteries supplying the placentas during early pregnancy, leading to selective suppression of protein synthesis and reduced cell proliferation.

489 citations

Journal Article
TL;DR: In the paper, etiology, diagnostics and monitoring of IUGR and its consequences for the child and for the course of neonatal periode are described.
Abstract: Intrauterine growth restriction (IUGR) is found in 1-10% of all pregnancies, and among women with risk factors even twice often. It is connected to worse obstetric results, and its complications can arise long time after delivery. In the paper we described etiology, diagnostics and monitoring of IUGR and its consequences for the child and for the course of neonatal periode.

478 citations

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TL;DR: The quest to effectively predict PE in the first trimester of pregnancy is fueled by the desire to identify women who are at high risk of developing PE, so that necessary measures can be initiated early enough to improve placentation and thus prevent or at least reduce the frequency of its occurrence.

475 citations

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TL;DR: To construct gestational age (GA)‐based reference ranges for the uterine artery (UtA) mean pulsatility index (PI) at 11–41 weeks of pregnancy, the mean pulsatile index was calculated by subtracting the age of the mother and the child from the patient to construct reference ranges.
Abstract: Objectives To construct gestational age (GA)-based reference ranges for the uterine artery (UtA) mean pulsatility index (PI) at 11-41 weeks of pregnancy. Methods A prospective cross-sectional observational study was carried out of 20 consecutive singleton pregnancies for each completed gestational week at 11-41 weeks. UtAs were examined by color and pulsed Doppler imaging, and the mean PI, as well as the presence or absence of a bilateral protodiastolic notch, were recorded. Polynomials were fitted by means of least-square regression to estimate the relationship between the mean UtA-PI and GA. Results A total of 620 women were included. A second-degree polynomial (Log(e) mean UtA-PI = 1.39 - 0.012 x GA + GA(2) x 0.0000198, with GA measured in days), after a natural logarithmic transformation, was selected to model our data. There was a significant decrease in the mean UtA-PI between 11 weeks (mean PI, 1.79; 95(th) centile, 2.70) and 34 weeks (mean PI, 0.70; 95(th) centile, 0.99). It then became more stable up until 41 weeks (mean PI, 0.65; 95(th) centile, 0.89). Conclusions The mean UtA-PI shows a progressive decrease until the late stages of pregnancy. Reference ranges for mean UtA-PI may have clinical value in screening for placenta-associated diseases in the early stages of pregnancy, and in evaluating patients with pregnancy-induced hypertension and/or small-for-gestational age fetuses during the third trimester.

474 citations