213 results on '"García-Díaz, Lutgardo"'
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2. Maternal and obstetric outcomes after Ex-Utero Intrapartum Treatment (EXIT): a single center experience
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Domínguez-Moreno, Marta, Chimenea, Ángel, García-Díaz, Lutgardo, and Antiñolo, Guillermo
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- 2023
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3. Assessing the impact of pregnancy planning on obstetric and perinatal outcomes in women with pregestational diabetes mellitus
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Chimenea, Angel, Calderón, Ana María, Antiñolo, Guillermo, Moreno-Reina, Eduardo, and García-Díaz, Lutgardo
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- 2024
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4. Mode of delivery, perinatal outcome and neurodevelopment in uncomplicated monochorionic diamniotic twins: a single-center retrospective cohort study
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Chimenea, Angel, García-Díaz, Lutgardo, and Antiñolo, Guillermo
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- 2022
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5. Maternal and Neonatal Outcomes After Ex-Utero Intrapartum Treatment for Congenital Diaphragmatic Hernia: A Case Series.
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Chimenea, Angel, Domínguez-Moreno, Marta, Barrera-Talavera, María, García-Díaz, Lutgardo, and Antiñolo, Guillermo
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DIAPHRAGMATIC hernia ,SURGICAL site infections ,DELIVERY (Obstetrics) ,PREGNANCY complications ,NEONATAL intensive care ,SURGICAL wound dehiscence ,SURGICAL blood loss - Abstract
Introduction Despite advances in neonatal intensive care, fetuses with congenital diaphragmatic hernia (CDH) remain to have a poor prognosis. Exclusive postnatal treatment is inadequate in patients with moderate CDH (observed than expected lung-to-head ratio [O/E LHR] 26–45%) and can lead to respiratory failure at birth, requiring extracorporeal membrane oxygenation in 75% of cases. An ex-utero intrapartum treatment (EXIT) procedure may be beneficial in these cases, improving the fetal-neonatal transition. Material and Methods We review all pregnancies with fetal isolated left CDH with moderate O/E LHR delivered by EXIT in our center from January 2007 to December 2022. Maternal and neonatal variables were analyzed. As primary outcomes, we included neonatal survival and mortality rates, surgical and infectious complications, uterine scar dehiscence, and blood loss during EXIT. As secondary outcomes, we studied recurrences of the diaphragmatic defect, long-term evolution, subsequent pregnancies, and mode of delivery. Results A total of 14 patients were delivered by the EXIT procedure, with a neonatal survival rate of 85.7%. All these children had optimal physical and neurocognitive development and no pulmonary morbidity. We found no major complications and 7.1% of minor maternal complications. There were no cases of surgical wound infection or endometritis. The median decrease in hemoglobin during the EXIT procedure was 1.9 mg/dL, and only one case required postoperative transfusion. Two out of the 14 women became pregnant again, and both pregnancies were uneventful. Conclusions In our series, the EXIT procedure allows for adequate airway management associated with a high neonatal survival rate in patients with moderate O/E LHR CDH, with a low rate of neonatal and maternal complications. [ABSTRACT FROM AUTHOR]
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- 2024
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6. Long-Term Neurodevelopmental Outcome After Selective Fetoscopic Laser Therapy for Stage I Twin-Twin Transfusion Syndrome.
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Chimenea, Angel, García-Díaz, Lutgardo, and Antiñolo, Guillermo
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CHILD psychopathology , *FETOSCOPY , *TREATMENT effectiveness , *DESCRIPTIVE statistics , *LASER therapy , *ODDS ratio , *FETOFETAL transfusion , *CONFIDENCE intervals , *SURGERY - Abstract
Twin-twin transfusion syndrome (TTTS) is a serious complication in monochorionic (MC) pregnancies. Fetoscopic laser surgery (FLS) is the primary treatment for advanced TTTS, but managing Quintero stage I TTTS is still controversial. We conducted an observational study evaluating the 2-year neurodevelopment of fetuses, which underwent FLS for stage I TTTS, compared with advanced TTTS and uncomplicated monochorionic diamniotic twins (MCDTs). The study included 156 children: 14 in stage I TTTS group, 28 in advanced TTTS group, and 114 in uncomplicated twin group. In stage I TTTS, 92.9% showed normal neurodevelopment, with no severe neurological impairments observed. These results were comparable with uncomplicated twins (92.1% normal neurodevelopment, P =.921, adjusted odds ratio [aOR] = 1.56, 95% confidence interval [CI] = 0.42-5.79; 1.8% severe impairment, P =.617). Advanced TTTS had a non-significant lower rate of normal neurodevelopment (89.3%, P =.710, aOR = 1.31, 95% CI = 0.12-14.87). In conclusion, FLS for stage I TTTS shows favorable long-term neurodevelopmental outcomes, similar to uncomplicated MC pregnancies. [ABSTRACT FROM AUTHOR]
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- 2024
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7. Maternal effects induced by oral digoxin during treatment of fetal tachyarrhythmia: Case series and literature review
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Chimenea, Ángel, García-Díaz, Lutgardo, Méndez, Ana, and Antiñolo, Guillermo
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- 2021
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8. Implementación de la clasificación de Robson: hacia la adecuación de la tasa de cesárea
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García Díaz, Lutgardo, Vilches Arenas, Ángel, Universidad de Sevilla. Departamento de Cirugía, Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública, Castillo Cantero, Isabel Adela, García Díaz, Lutgardo, Vilches Arenas, Ángel, Universidad de Sevilla. Departamento de Cirugía, Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública, and Castillo Cantero, Isabel Adela
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Introducción: La atención al parto es una de las causas de ingreso hospitalario más frecuente, y la cesárea, por lo tanto, una de las intervenciones quirúrgicas más realizadas en nuestro medio. El aumento en la tasa de cesáreas observado en las últimas décadas se ha convertido en una preocupación a nivel mundial. En 2014 la OMS propuso el sistema de clasificación Robson como un estándar global para evaluar, monitorizar y comparar las tasas de cesáreas. Objetivos: El objetivo final de este trabajo es adecuar la tasa de cesáreas en el hospital universitario Virgen del Rocío, mediante el análisis e identificación de factores y grupos de riesgo, implementando la clasificación de Robson; así como la elaboración de un modelo predictivo para el parto por cesárea en nuestro medio. Material y métodos: Se trata de un estudio observacional descriptivo de carácter retrospectivo que incluye los nacimientos acontecidos entre el 1 de enero de 2019 y el 31 de diciembre de 2019 en el Hospital Universitario Virgen del Rocío. Resultados: La tasa de cesáreas en el Hospital Universitario Virgen del Rocío ha aumentado un 3,51% desde el año 2010. La edad media de nuestras pacientes se situó en 31,6 años, siendo la obesidad la comorbilidad más frecuente [15,6% IC 95% (14,7;16,6)]. El 58% [IC 95% (56,7;59,4)] de nuestras pacientes eran nulíparas, y un 11,2% [IC 95% (10,4;12,1)] contaban con el antecedente de una cesárea anterior. El 34,2% [IC 95% (33,0;35,6)] de los partos se iniciaron mediante inducción. Las indicaciones de inducción más frecuentes fueron la RPM 32,8% [IC 95% (30,6;35,0)] y EPRO [IC 95% (22,8;26,9)]. El 74,6% [IC 95% (72,2;76,9)] de las cesáreas que se realizaron fueron urgentes. Las indicaciones más frecuentes fueron el riesgo de pérdida de bienestar fetal 25,6% [IC 95% (23,2;28,0)], seguido de la cicatriz uterina 20,0% [IC 95% (17,9;22,2)] y de la falta de progresión (19,5%) [IC 95% (17,4;21,7)]. Los grupos de Robson más prevalentes fueron el 3 con un 24,2% [IC 95% (23,0
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- 2024
9. Prenatal diagnosis of VACTERL association after early-first trimester SARS-COV-2 infection
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Chimenea, Àngel [0000-0003-4839-2034], García-Díaz, Lutgardo [0000-0001-5040-4896], Calderón, Ana María [0000-0002-6793-0339], Antiñolo, Guillermo [0000-0002-2113-074X], Chimenea, Ángel, García-Díaz, Lutgardo, Calderón, Ana María, Antiñolo, Guillermo, Chimenea, Àngel [0000-0003-4839-2034], García-Díaz, Lutgardo [0000-0001-5040-4896], Calderón, Ana María [0000-0002-6793-0339], Antiñolo, Guillermo [0000-0002-2113-074X], Chimenea, Ángel, García-Díaz, Lutgardo, Calderón, Ana María, and Antiñolo, Guillermo
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Organogenesis is a period of fetal development with a special vulnerability to biological and environmental agents. There are some viral infections whose transmission in the first trimester carries a significant risk for the development of congenital anomalies. Although the possibility of vertical transmission of SARS-CoV-2 during pregnancy has been demonstrated, there are no studies evaluating the impact of SARS-CoV-2 infection in the first trimester and its possible association with congenital anomalies. In this communication, we present the case of a pregnant woman with early SARS-CoV-2 infection, prenatally diagnosed with fetal VACTERL association by mid-trimester ultrasound. Further studies are needed to determine the causal association.
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- 2023
10. A Detailed Exploration of the Ex Utero Intrapartum Treatment Procedure with Center-Specific Advancements.
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Domínguez-Moreno, Marta, Chimenea, Ángel, Viegas-González, María Remedios, Morales-Muñoz, Clara, García-Díaz, Lutgardo, and Antiñolo, Guillermo
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UMBILICAL cord clamping ,EPIDURAL anesthesia ,EPIDURAL catheters ,CATHETERIZATION ,UTERUS ,GENERAL anesthesia - Abstract
The Ex Utero Intrapartum Treatment (EXIT) procedure has long been an invaluable tool in managing complex fetal conditions requiring airway interventions during the transition from intrauterine to extrauterine life. This technical note offers an in-depth examination of the EXIT procedure, emphasizing the refinements and innovations introduced at our center. The technique focuses on meticulous preoperative assessment and uses distinctive techniques and anesthetic methodologies. A multidisciplinary team assembles to plan the EXIT procedure, emphasizing patient communication and risk discussion. Our technique involves atraumatic access to the uterine cavity, achieved through the application of a uterine progressive distractor developed for this purpose. Following the use of this distractor, vascular clamps and a stapling device (Premium Poly Cs-57 Autosuture
® , Medtronic) are employed. Our anesthetic approach employs general anesthesia with epidural catheter placement. Maternal operation involves low transverse laparotomy and intraoperative ultrasonography-guided hysterotomy. Fetal exposure includes gentle extraction or external version, ensuring airway access. After securing fetal airway access, umbilical cord clamping and maternal abdominal closure conclude the procedure. By revisiting the core principles of EXIT and incorporating center-specific advancements, we enhance our understanding and technical expertise. To our knowledge, this is the first time a detailed description of the technique has been published. [ABSTRACT FROM AUTHOR]- Published
- 2024
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11. Exploring the Potential of Artificial Intelligence Language Models in Obstetrics with a Focus on Fetal Medicine: An Evaluation of the Perplexity AI Model.
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Chimenea, Angel, García-Díaz, Lutgardo, and Antiñolo, Guillermo
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LANGUAGE models , *ARTIFICIAL intelligence , *OBSTETRICS , *ARTIFICIAL languages , *HEART block , *MACHINE learning - Abstract
This document explores the potential of AI language models in the field of fetal medicine. It discusses how these models can assist specialists in assessing fetal anomalies, determining imaging protocols, and aiding in research and training. However, it also emphasizes the need for caution and recognition of limitations, as biases and inaccuracies can impact patient care. The document provides a comparison of different AI language models and their features, advantages, and disadvantages. It concludes by emphasizing the importance of a comprehensive evaluation process for AI language models in fetal medicine. [Extracted from the article]
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- 2024
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12. Can We Safely Decrease Early-Term Delivery and Cesarean Section Rate in Pregnancies Complicated by Fetal Transposition of Great Arteries?
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Chimenea, Angel, primary, García-Díaz, Lutgardo, additional, Méndez, Ana, additional, and Antiñolo, Guillermo, additional
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- 2023
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13. Maternal and Neonatal Outcomes After Ex-Utero Intrapartum Treatment for Congenital Diaphragmatic Hernia: A Case Series
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Chimenea Toscano, Ángel, additional, Dominguez-Moreno, Marta, additional, Barrera-Talavera, María, additional, García-Díaz, Lutgardo, additional, and Antiñolo, Guillermo, additional
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- 2023
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14. Two Year Neurodevelopmental Outcome after Fetoscopic Laser Therapy for Twin–Twin Transfusion Syndrome: Comparison with Uncomplicated Monochorionic Diamniotic Twins
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Chimenea, Ángel, primary, García-Díaz, Lutgardo, additional, and Antiñolo, Guillermo, additional
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- 2023
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15. Ex-Utero Intrapartum Treatment (EXIT): indications and outcome in fetal cervical and oropharyngeal masses
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García-Díaz, Lutgardo, Chimenea, Angel, de Agustín, Juan Carlos, Pavón, Antonio, and Antiñolo, Guillermo
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- 2020
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16. Transplacental Treatment of Fetal Tachyarrhythmia: Current Trends and Future Perspectives
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Chimenea, Ángel, primary, Vargas-Rodríguez, Carmen, additional, García-Díaz, Lutgardo, additional, and Antiñolo, Guillermo, additional
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- 2023
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17. Survey about the current use of fetal MRI in Spain
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Caro-Domínguez, Pablo, García-Díaz, Lutgardo, Rebollo Polo, M., Caro-Domínguez, Pablo, García-Díaz, Lutgardo, and Rebollo Polo, M.
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[EN] In June 2019 in Seville, at the first course in fetal MRI, endorsed by the Spanish Society of Medical Radiology (SERAM) and the Spanish Society of Pediatric Radiology (SERPE), the Spanish fetal MRI group was founded. To establish this group, a questionnaire was designed for radiologists dedicated to prenatal imaging in Spain and disseminated to the SERAM's members. The questions were related to the type of hospital, to MRI studies (magnetic field, gestational age, use of sedation, number of studies per year, proportion of fetal neuroimaging studies), and to teaching and research about fetal MRI. A total of 41 responses were received from radiologists in 25 provinces (88% working in public hospitals). Very few radiologists in Spain perform prenatal ultrasonography (7%) or prenatal CT. MRI is done in the second trimester (34%) or in the third trimester (44%). In 95% of centers, fetal brain MRI studies predominate. In 41% of the centers, studies can be done on 3 T MRI scanners. Maternal sedation is used in 17% of centers. The number of fetal MRI studies per year varies widely, being much higher in Barcelona and Madrid than in the rest of Spain., [ES] En junio de 2019 se organizó en Sevilla el primer curso de resonancia magnética (RM) fetal, con el aval de las sociedades españolas de Radiología Médica (SERAM) y Radiología Pediátrica (SERPE), y se fundó el grupo español de RM fetal. Para establecer este grupo, se diseñó un cuestionario para radiólogos que se dediquen a la imagen prenatal en España que anunció la Sociedad Española de Radiología a sus socios. Las preguntas estaban relacionadas con el tipo de hospital, con los estudios de RM (campo magnético, edad gestacional, uso de sedación, número de estudios por año, proporción de estudios de neuroimagen fetal) y con la docencia e investigación de la RM fetal. Recogimos 41 respuestas de 25 provincias (88% hospitales públicos). Muy pocos radiólogos realizan ecografía (7%) o tomografía computarizada prenatal en España. La RM se realiza en el segundo trimestre (34%) o tercer trimestre (44%). En el 95% de los centros predominan los estudios del cerebro fetal. El 41% de los centros tienen la posibilidad de realizar sus estudios en RM 3 Tesla. La sedación materna se usa en el 17% de los centros. El número de estudios de RM fetal por año es muy variable, siendo mucho mayor en Barcelona y Madrid que en el resto de España.
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- 2023
18. Two Year Neurodevelopmental Outcome after Fetoscopic Laser Therapy for Twin–Twin Transfusion Syndrome: Comparison with Uncomplicated Monochorionic Diamniotic Twins
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Chimenea, Ángel, García-Díaz, Lutgardo, Antiñolo, Guillermo, Chimenea, Ángel, García-Díaz, Lutgardo, and Antiñolo, Guillermo
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Background: Twin–twin Transfusion Syndrome (TTTS) represents a significant complication in monochorionic twin pregnancies, caused by an unbalanced shunting of blood through intertwin placental vascular anastomoses. Despite advances in fetoscopic laser surgery, TTTS is still associated with a high rate of cerebral injury. However, there are no studies comparing these pregnancies with uncomplicated monochorionic diamniotic (MCDA) twin pregnancies, establishing the baseline risk of neurodevelopmental impairment. The aim of this study is to evaluate the odds of neurodevelopmental impairment in MCDA twins who undergo fetoscopic laser surgery for twin–twin transfusion syndrome, in comparison to a cohort of uncomplicated MCDA twin pregnancies. Study design: This is a retrospective cohort study of children born from MCDA twin pregnancies at a single center between 2008 and 2019. A routine, standardized follow-up assessment was conducted at a minimum of 2 years after delivery. The primary outcome of this was a 2 year neurodevelopmental impairment. Neurological, motor, and cognitive development was assessed by using the revised Brunet–Lézine scale. Results: 176 children met the enrolment criteria. Of these, 42 (24%; TTTS group) underwent fetoscopic laser surgery for TTTS during pregnancy, and 134 (76%; uncomplicated MCDA group) were uncomplicated MCDA pregnancies. The primary outcome was found in four children (9.52%) in the TTTS group and ten children (7.46%) in the uncomplicated MCDA group (p = 0.67, aOR 2.82, 95% CI 0.49–16.23). Major neurologic impairment was found in 2.38% after fetoscopic laser surgery and 1.49% in uncomplicated MCDA twins (p = 0.70, aOR 0.97, 95% CI 0.22–4.24). The data were adjusted by birth order, birth weight, and gestational age at birth. Conclusions: The outcome in MCDA twins who underwent fetoscopic laser surgery for TTTS is comparable to the outcome in uncomplicated MCDA twins. Our findings emphasize the need for long-term neurodevelopmental fol
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- 2023
19. Prenatal ultrasound, magnetic resonance imaging and therapeutic options for fetal thoracic anomalies: a pictorial essay
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Universidad de Sevilla, Consorcio de Bibliotecas Universitarias de Andalucía, Caro-Domínguez, Pablo, Victoria, Teresa, Ciet, Pierluigi, Torre, Estrella de la, Chimenea, Ángel, García-Díaz, Lutgardo, Sainz-Bueno, José Antonio, Universidad de Sevilla, Consorcio de Bibliotecas Universitarias de Andalucía, Caro-Domínguez, Pablo, Victoria, Teresa, Ciet, Pierluigi, Torre, Estrella de la, Chimenea, Ángel, García-Díaz, Lutgardo, and Sainz-Bueno, José Antonio
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Congenital thoracic anomalies are uncommon malformations that require a precise diagnosis to guide parental counseling and possible prenatal treatment. Prenatal ultrasound (US) is the gold standard imaging modality to first detect and characterize these abnormalities and the best modality for follow-up. Fetal magnetic resonance imaging (MRI) is a complementary tool that provides multiplanar assessment and tissue characterization and can help estimate prognosis. Prenatal treatment is increasingly being used in fetuses with signs of distress and to potentially decrease morbidity and mortality. In this essay, the authors illustrate side-by-side US, MRI and therapeutic options for congenital thoracic anomalies in cases that presented to a tertiary pediatric hospital during the 7-year period 2014–2021. Entities included are congenital diaphragmatic hernia, congenital pulmonary airway malformation, bronchopulmonary sequestration, hybrid lesions, foregut duplications cysts and congenital lobar overinflation. Treatment options include maternal steroids, thoraco-amniotic shunt and fetal endotracheal occlusion. Recognition of typical findings in congenital thoracic anomalies is helpful to establish diagnosis, predict prognosis and plan perinatal treatment.
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- 2023
20. Diagnóstico prenatal de atresia de yeyuno con ecografía 3D con reconstrucción en superficie (HDlive): reporte de caso y revisión de la literatura
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Chimenea-Toscano, Ángel, García-Díaz, Lutgardo, and Antiñolo-Gil, Guillermo
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- 2021
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21. Prenatal diagnosis of VACTERL association after early‐first trimester SARS‐COV‐2 infection
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Chimenea, Angel, primary, García‐Díaz, Lutgardo, additional, Calderón, Ana María, additional, and Antiñolo, Guillermo, additional
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- 2022
- Full Text
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22. Machine Learning to Predict Pre-Eclampsia and Intrauterine Growth Restriction in Pregnant Women
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Gómez-Jemes, Lola, primary, Oprescu, Andreea Madalina, additional, Chimenea-Toscano, Ángel, additional, García-Díaz, Lutgardo, additional, and Romero-Ternero, María del Carmen, additional
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- 2022
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23. Resolution of maternal Mirror syndrome after succesful fetal intrauterine therapy: a case series
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Chimenea, Angel, García-Díaz, Lutgardo, Calderón, Ana María, Heras, María Moreno-De Las, and Antiñolo, Guillermo
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- 2018
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24. Thrombosed ductus arteriosus aneurysm: prenatal diagnosis and perinatal outcome
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Mendez, Ana, primary, Chimenea, Ángel, additional, García-Díaz, Lutgardo, additional, and Antiñolo, Guillermo, additional
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- 2022
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25. Diabetes pregestacional: análisis de la influencia de parámetros analíticos, clínicos y ecográficos en los resultados obstétricos y perinatales
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García Díaz, Lutgardo, Moreno Reina, Eduardo, Universidad de Sevilla. Departamento de Cirugía, Calderón Cabrera, Ana María, García Díaz, Lutgardo, Moreno Reina, Eduardo, Universidad de Sevilla. Departamento de Cirugía, and Calderón Cabrera, Ana María
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La diabetes mellitus es una enfermedad crónica que imprime una importante carga de enfermedad al embarazo, convirtiéndose en un importante problema de salud pública. La heterogeneidad subyacente a este proceso de enfermedad nos invita a desarrollar herramientas que nos ayuden a predecir el riesgo individual para el desarrollo de complicaciones, adaptando la atención a nivel pre y postconcepcional. El presente estudio pretende determinar aquellos parámetros al inicio del embarazo que permiten predecir resultados adversos y la aparición de anomalías congénitas en gestantes con diabetes mellitus pregestacional, así como elaborar una calculadora de riesgo de cesárea a partir de estos parámetros. Para ello, desarrollamos un estudio observacional de cohortes retrospectivo, incluyendo 456 gestantes afectas de diabetes mellitus pregestacional atendidas en el Hospital Universitario Virgen del Rocío de Sevilla en el periodo 2012-2018. Partiendo de este planteamiento inicial, en cada objetivo se realizó un diseño ad hoc para responder específicamente a la hipótesis a contrastar. Los resultados de la investigación han permitido obtener las siguientes conclusiones: (i) la hemoglobina glicada en primera visita del embarazo y la hipertensión arterial pregestacional son los principales factores predictivos en primer trimestre de resultados adversos en gestantes con diabetes mellitus pregestacional; (ii) hemos desarrollado una calculadora de riesgo de cesárea a partir variables identificadas en primer trimestre en gestantes con diabetes mellitus pregestacional, que puede ser empleada para asesorar a las pacientes diabéticas desde el inicio del embarazo a fin de disminuir la tasa de cesárea; (iii) la miocardiopatía hipertrófica supone un importante problema de salud en hijos de madres diabéticas, con una baja tasa de diagnóstico prenatal. Un valor de hemoglobina glicada en primer trimestre superior a 7,15% nos ayuda a determinar qué fetos tendrán mayor probabilidad de desarrollarla, Diabetes mellitus is a chronic disease with a greater impact on pregnancy health, becoming a major public health problem. The heterogeneity underlying this disease invites us to develop tools that help to predict individual risk for the development of pregnancy complications, adapting care at the pre- and postconception level. The present study aims to establish the predictors of adverse obstetric and perinatal outcomes at the beginning of pregnancy, and the occurrence of congenital anomalies in pregnant women with pregestational diabetes mellitus, as well as to develop a predictive risk calculator for cesarean delivery based on these parameters. A retrospective observational cohort study was conducted, including 456 pregnant women with pregestational diabetes mellitus treated at the Virgen del Rocío University Hospital in Seville between 2012 and 2018. Based on this initial approach, an ad hoc design was carried out for each objective to specifically respond to the hypothesis to be tested. The results of the investigation allowed us to obtain the following conclusions: (i) glycated hemoglobin in the first pregnancy visit and chronic hypertension are the main predictors in the first trimester of adverse outcomes in pregnant women with pregestational diabetes mellitus; (ii) we have developed a predictive risk calculator for cesarean delivery based on variables identified in the first trimester in pregnant women with pregestational diabetes mellitus, which can be used to adapt the follow-up of the diabetic patients from the beginning of pregnancy in order to reduce the cesarean section rate; (iii) hypertrophic cardiomyopathy is an important health problem in children of diabetic mothers, with a low rate of prenatal diagnosis. A glycated hemoglobin value in the first trimester greater than 7.15% helps us to determine which fetuses will have a greater probability of developing it, with a potential increase of 73.7% in the rate of prenatal diagnosis; (iv) our study confi
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- 2022
26. Evolución de los neonatos afectos de hernia diafragmática congénita de riesgo intermedio nacidos mediante EXIT (ex-utero intrapartum treatmeant)
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Antiñolo Gil, Guillermo, García Díaz, Lutgardo, Congregado Loscertales, Miguel, Universidad de Sevilla. Departamento de Cirugía, Barrera Talavera, María Dolores, Antiñolo Gil, Guillermo, García Díaz, Lutgardo, Congregado Loscertales, Miguel, Universidad de Sevilla. Departamento de Cirugía, and Barrera Talavera, María Dolores
- Abstract
La hernia diafragmática congénita (HDC) es una patología que afecta a 1 de cada 3000 recién nacidos. El realizar un correcto diagnóstico precoz, permite establecer el pronóstico y optimizar el tratamiento en cada caso. Las opciones de tratamiento en la actualidad abarcan desde la interrupción de la gestación, a la utilización de terapias fetales específicas así como terapias postnatales exclusivas en función del grado de defecto y del deseo de los progenitores. Los fetos con hernias de rango intermedio pueden presentar una insuficiencia respiratoria grave en un alto porcentaje de casos cumpliendo criterios de ECMO hasta en un 78 %. Por ello la terapia postnatal exclusiva puede ser insuficiente. La oclusión traqueal fetoscópica (terapia FETO) utilizada como terapia fetal en los fetos de pronóstico grave, en la actualidad no está recomendada en las de pronóstico intermedio ya que el aumento de la supervivencia es muy relativo y por el contrario sí que presenta una alta tasa de prematuridad asociada. El procedimiento EXIT (Ex utero intrapartum treatment) permite una reexpansión controlada y el inicio de las medidas de protección pulmonar en el mismo momento del nacimiento que pueden favorecer a la terapia postnatal exclusiva, disminuyendo necesidades de ECMO y evitando la prematuridad de la terapia FETO. Objetivos Con el presente trabajo se pretende: - Determinar si estos fetos se pueden beneficiar de un nacimiento mediante EXIT. - Definir los beneficios, la seguridad y riesgos de la técnica EXIT sobre las madres y sobre los fetos afectos de HDC aislada de rango intermedio. - Establecer los factores que influyen en los resultados en términos de supervivencia y complicaciones tras la realización de EXIT. Material y método Se ha desarrollado un estudio observacional retrospectivo y descriptivo de 14 casos de HDC izquierdas aisladas de pronóstico intermedio, los cuales nacieron mediante EXIT entre Enero de 2007 y Diciembre de 2018 realizado en Unidad de Gestión Clínica de
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- 2022
27. Mode of delivery, perinatal outcome and neurodevelopment in uncomplicated monochorionic diamniotic twins: a single-center retrospective cohort study
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Universidad de Sevilla. Departamento de Cirugía, Chimenea Toscano, Ángel, García Díaz, Lutgardo, Antiñolo Gil, Guillermo, Universidad de Sevilla. Departamento de Cirugía, Chimenea Toscano, Ángel, García Díaz, Lutgardo, and Antiñolo Gil, Guillermo
- Abstract
Background There is no agreement on the effect of planned mode of delivery in the perinatal morbidity and neurodevelopment in uncomplicated monochorionic diamniotic as well as regarding the safest mode of delivery. In this paper we have aimed to analyze the impact of the mode of delivery in uncomplicated monochorionic diamniotic twins ≥ 32 weeks of gestation. Material and methods This study included 72 women, followed and attended at our department, with uncomplicated monochorionic diamniotic pregnancies who had a birth between 32.0 and 37.6 weeks of gestation from January 2012 to December 2018. Outcomes were recorded in women who underwent planned vaginal delivery (induced or spontaneous onset of labor), and women who underwent a planned cesarean section for any reason that excluded vaginal delivery. Primary outcomes included: (1) A composite of any of the following: neonatal death, 5-min Apgar score < 4, respiratory distress syndrome, bronchopulmonary dysplasia, sepsis, periventricular leukomalacia, intraventricular hemorrhage, and necrotizing enterocolitis. (2) Neurodevelopmental status at 2 years of corrected age. Results In this period, 42 women (58.3%) had a planned vaginal delivery, and 30 women (41.7%) had a planned cesarean section. In the first group, 64.3% had a vaginal delivery. The rate of successful vaginal delivery was similar regardless the onset of labor. We did not find a higher composite perinatal morbidity in the planned vaginal delivery group (planned vaginal delivery: 3.6% vs. planned cesarean section: 8.3%, aOR 1.36, 95% CI 0.24–7.81). Considering the onset of labor, it was more frequent in the spontaneous subgroup (8.3% vs. 0%). The rate of neurodevelopmental impairment was higher in the planned cesarean section group, without reaching statistical significance [10.2% vs. 4.9%, aOR 1.53 (95% CI 0.37–6.29)]. Conclusions In uncomplicated monochorionic diamniotic twins at ≥ 32 weeks of gestation, when the first twin is in vertex presentation, our
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- 2022
28. Machine Learning to Predict Pre-Eclampsia and Intrauterine Growth Restriction in Pregnant Women
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Universidad de Sevilla. Departamento de Tecnología Electrónica, Universidad de Sevilla. Departamento de Cirugía, Universidad de Sevilla. TIC150: Tecnología Electrónica e Informática Industrial, Gómez-Jemes, Lola, Oprescu, Andreea M., Chimenea-Toscano, Ángel, García-Díaz, Lutgardo, Romero Ternero, María del Carmen, Universidad de Sevilla. Departamento de Tecnología Electrónica, Universidad de Sevilla. Departamento de Cirugía, Universidad de Sevilla. TIC150: Tecnología Electrónica e Informática Industrial, Gómez-Jemes, Lola, Oprescu, Andreea M., Chimenea-Toscano, Ángel, García-Díaz, Lutgardo, and Romero Ternero, María del Carmen
- Abstract
The use of artificial intelligence in healthcare in general and in obstetrics and gynecology in particular has great potential. Specifically, machine learning methods could help improve the health and well-being of pregnant women, closely monitoring their health parameters during pregnancy, or reducing maternal and perinatal morbidity and mortality with early detection of pathologies. In this work, we propose a machine learning model to predict risk events in pregnancy, in particular the prediction of pre-eclampsia and intrauterine growth restriction, using Doppler measures of the uterine artery, sFlt-1, and PlGF values. For this purpose, we used a public dataset from a study carried out by the University Medical Center of Ljubljana, in which data were collected from 95 pregnant women with pre-eclampsia and intrauterine growth restriction. We adopted a multi-label approach to accomplish the prediction task. Different classifiers were evaluated and compared. The performance of each model was tested in terms of accuracy, precision, recall, F1 score, Hamming loss, and AUC-ROC. On the basis of these parameters, a variation of the decision tree classifier was found to be the best performing model. Our model had a robust recall metric (0.89) and an AUC ROC metric (0.87), taking into account the size of the data and the unbalance of the class.
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- 2022
29. Towards a data collection methodology for Responsible Artificial Intelligence in health: A prospective and qualitative study in pregnancy
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Universidad de Sevilla. Departamento de Tecnología Electrónica, Universidad de Sevilla. Departamento de Cirugía, Universidad de Sevilla. TIC150: Tecnología Electrónica e Informática Industrial, Oprescu, Andreea M., Miró Amarante, Gloria, García Díaz, Lutgardo, Rey Caballero, Victoria Eugenia, Chimenea Toscano, Ángel, Martínez-Martínez, Ricard, Romero Ternero, María del Carmen, Universidad de Sevilla. Departamento de Tecnología Electrónica, Universidad de Sevilla. Departamento de Cirugía, Universidad de Sevilla. TIC150: Tecnología Electrónica e Informática Industrial, Oprescu, Andreea M., Miró Amarante, Gloria, García Díaz, Lutgardo, Rey Caballero, Victoria Eugenia, Chimenea Toscano, Ángel, Martínez-Martínez, Ricard, and Romero Ternero, María del Carmen
- Abstract
A medical field that is increasingly benefiting from Artificial Intelligence applications is Gyne- cology and Obstetrics. In previous work, we exposed that Artificial Intelligence (AI) technology and obstetric control by physicians can enhance pregnancy health, leading to better pregnancy outcomes and overall better experience, also reducing any possible long-term effects that can be produced by complications. This work presents a data collection methodology for responsible AI in Health and a case study in the pregnancy domain. It is a qualitative descriptive study on the preferences and expectations expressed by pregnant women regarding responsible AI and affective computing. A 41-items structured interview was distributed among 150 pregnant pa- tients attending prenatal care at Hospital Virgen del Rocío and the Clinic Victoria Rey (Seville, Spain) during the months of October and November 2020. A substantial interest in intelligent pregnancy solutions among pregnant women has been revealed in this study. Participants with a lower level of interest reported privacy concerns and lack of trust towards AI solutions. Re- garding affective computing based intelligent solutions specifically, most participants reported positively and no significant difference was found between women having a healthy or a high risk pregnancy on this matter. Our findings also suggest that a high demand of personalized intelligent solutions exists among participants. On the topic of sharing pregnancy data with the healthcare provider in favor of scientific research, pregnant women assisting public health- care services were found to be more likely to share their data when the provider was a public healthcare system rather than a private entity. Pregnant women who are interested in using an AI pregnancy application share a strong idea that it needs to be responsible, trustworthy, useful, and safe. Likewise, we found that pregnant women would change their mind about their concerns and they wou
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- 2022
30. Perinatal palliative care: from fetal to neonatal life.
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Chimenea, Angel, García-Díaz, Lutgardo, Ferrari, Araceli, and Antiñolo Gil, Guillermo
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- 2024
- Full Text
- View/download PDF
31. Antenatal diagnosis of jejunal atresia by 3D HDlive ultrasound: Case report and literature review
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Chimenea-Toscano, Ángel, García-Díaz, Lutgardo, and Antiñolo-Gil, Guillermo
- Subjects
atresia de yeyuno ,prenatal diagnosis ,diagnóstico prenatal ,ecografía 3D ,ultrasonography ,ecografía ,3-D ultrasound ,Jejunal atresia - Abstract
Resumen Objetivos: Reportar el caso de una paciente con diagnóstico prenatal de atresia de yeyuno y hacer una revisión de la literatura en torno al resultado y al diagnóstico de esta entidad, implementando el uso de métodos no convencionales: ecografía tridimensional (3D) o resonancia magnética fetal (RM). Materiales y métodos: Se reporta el caso de una gestante de 18 años, remitida a la Unidad de Medicina Materno-Fetal, Genética y Reproducción del Hospital Virgen del Rocío de Sevilla (España), por feto con imagen quística abdominal, peristáltica, compatible con atresia de yeyuno, la cual se confirmó con ecografía 3D modo HDlive. Se realizó una búsqueda bibliográfica en Medline/PubMed, LILACS y Google Scholar, restringiendo por tipo de idioma (inglés y español) y fecha de publicación (enero de 1995 a junio de 2020). Se incluyeron estudios primarios de reportes y series de caso, que abordaran el resultado y el diagnóstico prenatal de esta patología. Resultados: La búsqueda identificó 1.033 títulos, de los cuales cuatro estudios cumplieron con los criterios de inclusión, estos fueron reporte o series de casos. En total se reportaron doce fetos con diagnóstico prenatal de atresia de yeyuno detectada con métodos no convencionales. Una gestación finalizó con óbito a la semana 26 de gestación y en todos los demás casos, el diagnóstico se ratificó durante el periodo neonatal, requiriendo la resección del segmento comprometido. Dos neonatos desarrollaron síndrome de intestino corto como consecuencia de una resección intestinal amplia. El resto experimentó una evolución posoperatoria favorable. Conclusión: La literatura disponible en torno al diagnóstico prenatal de atresia de yeyuno utilizando métodos no convencionales es escasa y se limita a reporte o series de casos. La literatura revisada sugiere que, en presencia de dilatación intestinal, la ecografía 3D y la resonancia magnética fetal podrían tener cierta utilidad a la hora de caracterizar la porción atrésica y establecer el diagnóstico diferencial. Se requieren más estudios que evalúen la utilidad diagnóstica de estas dos alternativas. Abstract Objectives: To report the case of a patient with a prenatal diagnosis of jejunal atresia and to review the literature regarding the results and prenatal diagnosis of this entity, implementing the use of non-conventional methods (3D ultrasound or magnetic resonance imaging). Material and methods: Report of a case of an 18-year-old pregnant woman referred to the Maternal-Fetal Medicine, Genetics and Reproduction Unit of the Virgen del Rocío Hospital in Seville due to fetus with abdominal peristaltic cystic image, consistent with jejunal atresia, confirmed with 3D HDLive mode ultrasound. A bibliographic search was carried out in Medline/PubMed, Google Scholar and LILACS, restricting by type of language (English and Spanish) and date of publication (January 1995 to June 2020). Primary studies of reports and case series relating to the outcome and prenatal diagnosis of this pathology were included. Results: The search identified 1,033 titles, of which four studies met the inclusion criteria, these being reports or case series. A total of twelve fetuses with a prenatal diagnosis of jejunal atresia detected with unconventional methods were reported. In all cases, the prenatal diagnosis was confirmed during the neonatal period, which required resection of the compromised segment; one of them died and two neonates developed short bowel syndrome because of a wide bowel resection. The postoperative course in the remaining cases was favorable. Conclusion: The available literature on the prenatal diagnosis of jejunal atresia using non-conventional methods is scarce and is limited to case reports or case series. The literature reviewed suggests that, in the presence of intestinal dilation, 3D ultrasound and magnetic resonance imaging could be of some use in characterizing the atretic portion and establishing the differential diagnosis. More studies are required to evaluate the diagnostic utility of these two alternatives.
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- 2021
32. Interstitial 10p deletion derived from a maternal ins(16;10)(q22;p13p15.2): Report of the first familial case of 10p monosomy affecting to two familial members of different generations
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Fernández, Raquel M., Sánchez, Javier, García-Díaz, Lutgardo, Peláez-Nora, Yolanda, González-Meneses, Antonio, Antiñolo, Guillermo, and Borrego, Salud
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- 2016
- Full Text
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33. Perinatal palliative care: from fetal to neonatal life
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Chimenea, Angel, primary, García-Díaz, Lutgardo, additional, Ferrari, Araceli, additional, and Antiñolo Gil, Guillermo, additional
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- 2021
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34. Gestación gemelar monocorial. Terapia fetal, resultados perinatales y valoración del neurodesarrollo postnatal
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Antiñolo Gil, Guillermo, García Díaz, Lutgardo, Universidad de Sevilla. Departamento de Cirugía, Chimenea Toscano, Ángel, Antiñolo Gil, Guillermo, García Díaz, Lutgardo, Universidad de Sevilla. Departamento de Cirugía, and Chimenea Toscano, Ángel
- Abstract
Además de las complicaciones propias derivadas de la gemelaridad (prematuridad, rotura prematura de membranas), los gemelos monocoriales están expuestos a complicaciones propias de este tipo de gestación que pueden amenazar la vida y la salud de ambos fetos. La presencia de anastomosis vasculares intraplacentarias imprime una mayor carga de enfermedad, elevando la morbilidad y mortalidad perinatal general, con un posible efecto sobre el neurodesarrollo a largo plazo. Además, esta conexión hemodinámica hace que lo sucedido a un feto pueda tener impacto en el co-gemelo. La situación afecta incluso a las gestaciones gemelares no complicadas, lo cual nos obliga a buscar parámetros que permitan predecir la aparición de eventos adversos perinatales y una posible alteración del neurodesarrollo. Por otra parte, la impronta del tipo de parto en estas gestaciones se encuentra en debate, con un amplio abanico de aproximaciones que abarcan desde la cesárea electiva al intento de parto vaginal, incluso con el segundo gemelo en presentación pelviana. La complicación específica más prevalente en la gestación monocorial es el síndrome de transfusión feto-fetal (STFF), que ocurre ante la presencia de un intercambio de volumen asimétrico a través de las anastomosis interfetales. La evolución natural en ausencia de tratamiento del STFF es la pérdida de ambos fetos en torno al 90% de los casos, asociando una morbilidad neurológica > 50% en los fetos supervivientes, siendo especialmente notable en los estadios III y IV. La coagulación láser fetoscópica es actualmente el tratamiento de elección, consiguiendo una supervivencia de al menos un feto en aproximadamente el 80% de los casos. No obstante, su impacto en el desarrollo ha sido estudiado en pocas ocasiones, sobre todo en comparación con la gestación monocorial no complicada. Con el presente trabajo se pretende: • Determinar las características basales, de cribado, complicaciones generales y específicas, y resultados obstétricos y pe
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- 2021
35. Diagnóstico prenatal de atresia de yeyuno con ecografía 3D con reconstrucción en superficie (HDlive): reporte de caso y revisión de la literatura
- Author
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Universidad de Sevilla. Departamento de Cirugía, Chimenea-Toscano, Ángel, García Díaz, Lutgardo, Antiñolo Gil, Guillermo, Universidad de Sevilla. Departamento de Cirugía, Chimenea-Toscano, Ángel, García Díaz, Lutgardo, and Antiñolo Gil, Guillermo
- Abstract
Objetivos: reportar el caso de una paciente con diagnóstico prenatal de atresia de yeyuno y hacer una revisión de la literatura en torno al resultado y al diagnóstico de esta entidad, implementando el uso de métodos no convencionales: ecografía tridimensional (3D) o resonancia magnética fetal (RM). Materiales y métodos: se reporta el caso de una gestante de 18 años, remitida a la Unidad de Medicina Materno-Fetal, Genética y Reproducción del Hospital Virgen del Rocío de Sevilla (España), por feto con imagen quística abdominal, peristáltica, compatible con atresia de yeyuno, la cual se confirmó con ecografía 3D modo HDlive. Se realizó una búsqueda bibliográfica en Medline/PubMed, LILACS y Google Scholar, restringiendo por tipo de idioma (inglés y español) y fecha de publicación (enero de 1995 a junio de 2020). Se incluyeron estudios primarios de reportes y series de caso, que abordaran el resultado y el diagnóstico prenatal de esta patología. Resultados: la búsqueda identificó 1.033 títulos, de los cuales cuatro estudios cumplieron con los criterios de inclusión, estos fueron reporte o series de casos. En total se reportaron doce fetos con diagnóstico prenatal de atresia de yeyuno detectada con métodos no convencionales. Una gestación finalizó con óbito a la semana 26 de gestación y en todos los demás casos, el diagnóstico se ratificó durante el periodo neonatal, requiriendo la resección del segmento comprometido. Dos neonatos desarrollaron síndrome de intestino corto como consecuencia de una resección intestinal amplia. El resto experimentó una evolución posoperatoria favorable. Conclusión: la literatura disponible en torno al diagnóstico prenatal de atresia de yeyuno utilizando métodos no convencionales es escasa y se limita a reporte o series de casos. La literatura revisada sugiere que, en presencia de dilatación intestinal, la ecografía 3D y la resonancia magnética fetal podrían tener cierta utilidad a la hora de caracterizar la porción atrésica y establecer el d, Objectives: To report the case of a patient with a prenatal diagnosis of jejunal atresia and to review the literature regarding the results and prenatal diagnosis of this entity, implementing the use of non-conventional methods (3D ultrasound or magnetic resonance imaging). Material and methods: Report of a case of an 18-year-old pregnant woman referred to the Maternal-Fetal Medicine, Genetics and Reproduction Unit of the Virgen del Rocío Hospital in Seville due to fetus with abdominal peristaltic cystic image, consistent with jejunal atresia, confirmed with 3D HDLive mode ultrasound. A bibliographic search was carried out in Medline/PubMed, Google Scholar and LILACS, restricting by type of language (English and Spanish) and date of publication (January 1995 to June 2020). Primary studies of reports and case series relating to the outcome and prenatal diagnosis of this pathology were included. Results: The search identified 1,033 titles, of which four studies met the inclusion criteria, these being reports or case series. A total of twelve fetuses with a prenatal diagnosis of jejunal atresia detected with unconventional methods were reported. In all cases, the prenatal diagnosis was confirmed during the neonatal period, which required resection of the compromised segment; one of them died and two neonates developed short bowel syndrome because of a wide bowel resection. The postoperative course in the remaining cases was favorable. Conclusion: The available literature on the prenatal diagnosis of jejunal atresia using non-conventional methods is scarce and is limited to case reports or case series. The literature reviewed suggests that, in the presence of intestinal dilation, 3D ultrasound and magnetic resonance imaging could be of some use in characterizing the atretic portion and establishing the differential diagnosis. More studies are required to evaluate the diagnostic utility of these two alternatives.
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- 2021
36. Artificial Intelligence in Pregnancy: A Scoping Review
- Author
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Oprescu, Andreea M., Miró-Amarante, Gloria, García-Díaz, Lutgardo, Beltrán-Romero, Luis Matías, Rey, Victoria E., Romero-Ternero, M. Carmen, [Oprescu, Andreea M.] Univ Seville, Dept Tecnol Elect, Seville 41012, Spain, [Miro-Amarante, Gloria] Univ Seville, Dept Tecnol Elect, Seville 41012, Spain, [Romero-Ternero, Mcarmen] Univ Seville, Dept Tecnol Elect, Seville 41012, Spain, [Garcia-Diaz, Lutgardo] Univ Seville, Dept Cirugia, Seville 41009, Spain, [Garcia-Diaz, Lutgardo] Hosp Univ Virgen del Rocio, Seville 41013, Spain, [Beltran, Luis M.] Univ Seville, Dept Med, Seville 41009, Spain, [Beltran, Luis M.] Hosp Univ Virgen del Rocio, Serv Med Intern, Seville 41013, Spain, [Rey, Victoria E.] CAREMUJER Clin Ginecol, Seville 41018, Spain, and Universidad de Sevilla
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Risk ,Artificial intelligence ,data privacy ,Signal to noise ratio ,algorithm ,Depression ,Affective computing ,methodology ,IT security ,Care ,Classification ,Decision-support-system ,Association ,Fetus ,machine learning ,Pregnancy ,pregnancy well-being ,framework ,Health ,Diagnosis ,Psychology ,pregnancy health ,Machine learning techniques ,Prediction ,Algorithms - Abstract
Artificial Intelligence has been widely applied to a majority of research areas, including health and medicine. Certain complications or disorders that can appear during pregnancy can endanger the life of both mother and fetus. There is enough scientific literature to support the idea that emotional aspects can be a relevant risk factor in pregnancy (such as anxiety, stress or depression, for instance). This paper presents a scoping review of the scientific literature from the past 12 years (2008-2020) to identify which methodologies, techniques, algorithms and frameworks are used in Artificial Intelligence and Affective Computing for pregnancy health and well-being. The methodology proposed by Arksey and O'Malley, in conjunction with PRISMA-ScR framework has been used to create this review. Despite the relevance that emotional status can have as a risk factor during pregnancy, one of the main findings of this study is that there is still not a significant amount of literature on automatic analysis of emotion. Health enhancement and well-being for pregnant women can be achieved with artificial intelligence or affective computing based devices, hence future work on this topic is strongly suggested. The authors would like to thank Sergio Díaz and Pablo Pérez for taking the time to read this article and for proposing some improvements. They would also like to thank University of Seville Library staff for their support during the document search phase.
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- 2020
37. Prenatal diagnosis of VACTERL association after early‐first trimester SARS‐COV‐2 infection.
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Chimenea, Angel, García‐Díaz, Lutgardo, Calderón, Ana María, and Antiñolo, Guillermo
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PRENATAL diagnosis ,SARS-CoV-2 ,VIRUS diseases ,FETAL development ,INFECTION - Abstract
Organogenesis is a period of fetal development with a special vulnerability to biological and environmental agents. There are some viral infections whose transmission in the first trimester carries a significant risk for the development of congenital anomalies. Although the possibility of vertical transmission of SARS‐CoV‐2 during pregnancy has been demonstrated, there are no studies evaluating the impact of SARS‐CoV‐2 infection in the first trimester and its possible association with congenital anomalies. In this communication, we present the case of a pregnant woman with early SARS‐CoV‐2 infection, prenatally diagnosed with fetal VACTERL association by mid‐trimester ultrasound. Further studies are needed to determine the causal association. [ABSTRACT FROM AUTHOR]
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- 2023
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38. Ex-Utero Intrapartum Treatment (EXIT): indications and outcome in fetal cervical and oropharyngeal masses
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Universidad de Sevilla. Departamento de Cirugía, García Díaz, Lutgardo, Agustín, Juan Carlos de, Pavón, Antonio, Antiñolo Gil, Guillermo, Universidad de Sevilla. Departamento de Cirugía, García Díaz, Lutgardo, Agustín, Juan Carlos de, Pavón, Antonio, and Antiñolo Gil, Guillermo
- Abstract
Background: The “Ex-Utero Intrapartum Treatment” (EXIT) procedure allows to ensure fetal airway before completion of delivery and umbilical cord clamping while keeping uteroplacental circulation. Airway obstruction in fetal oropharyngeal and cervical masses can be life-threatening at birth. In those situations, controlled access to fetal airway performed by a trained multidisciplinary team allows safe airway management, while feto-maternal circulation is preserved. We aim to review the indications and outcome of the EXIT procedure in a case series of fetal cervical and oropharyngeal masses. Methods: We have carried out a retrospective review of all patients with fetal cervical and oropharyngeal masses who underwent an EXIT procedure between 2008 and 2019. Variables evaluated included indication for EXIT, ultrasound and MRI findings, the need of amnioreduction, gestational age at EXIT, birth weight, complications, operative time, survival rate, pathological findings, and postnatal evolution. Five patients are included in this series. One additional case has already been published. Results: The diagnosis were cervical teratoma (n = 1), epulis (n = 1) and lymphangioma (n = 3). Polyhydramnios was present in 2 patients, requiring amnioreduction in one of them. Mean gestational age at EXIT was 36–37 weeks (range, 34–38 weeks). Median EXIT time in placental support was 9 min (range, 3–22 min). Access to airway was successfully established in EXIT in all cases. All children born by EXIT are currently healthy and without complications. Conclusion: The localization and characteristics of the mass, its relationship to the airway, and the presence of polyhydramnios seem to be major factors determining indications for EXIT and clinical outcome.
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- 2020
39. Artificial lntelligence in Pregnancy: A Scoping Review
- Author
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Universidad de Sevilla. Departamento de Tecnología Electrónica, Universidad de Sevilla. Departamento de Cirugía, Universidad de Sevilla. TIC150: Tecnología Electrónica e Informática Industrial, Universidad de Sevilla. CTS106: Genética Médica en Ciencias de la Salud (Sistema Sanitario Público de Andalucía. Fundación Pública Andaluza para la Gestión de la Investigación en Salud de Sevilla (FISEVI)), Oprescu, Andreea M., Miró Amarante, Gloria, García Díaz, Lutgardo, Beltrán Romero, Luis Matías, Rey Caballero, Victoria Eugenia, Romero Ternero, María del Carmen, Universidad de Sevilla. Departamento de Tecnología Electrónica, Universidad de Sevilla. Departamento de Cirugía, Universidad de Sevilla. TIC150: Tecnología Electrónica e Informática Industrial, Universidad de Sevilla. CTS106: Genética Médica en Ciencias de la Salud (Sistema Sanitario Público de Andalucía. Fundación Pública Andaluza para la Gestión de la Investigación en Salud de Sevilla (FISEVI)), Oprescu, Andreea M., Miró Amarante, Gloria, García Díaz, Lutgardo, Beltrán Romero, Luis Matías, Rey Caballero, Victoria Eugenia, and Romero Ternero, María del Carmen
- Abstract
Artificial Intelligence has been widely applied to a majority of research areas, including health and medicine. Certain complications or disorders that can appear during pregnancy can endanger the life of both mother and fetus. There is enough scientific literature to support the idea that emotional aspects can be a relevant risk factor in pregnancy (such as anxiety, stress or depression, for instance). This paper presents a scoping review of the scientific literature from the past 12 years (2008-2020) to identify which methodologies, techniques, algorithms and frameworks are used in Artificial Intelligence and Affective Computing for pregnancy health and well-being. The methodology proposed by Arksey and O'Malley, in conjunction with PRISMA-ScR framework has been used to create this review. Despite the relevance that emotional status can have as a risk factor during pregnancy, one of the main findings of this study is that there is still not a significant amount of literature on automatic analysis of emotion. Health enhancement and well-being for pregnant women can be achieved with artificial intelligence or affective computing based devices, hence future work on this topic is strongly suggested.
- Published
- 2020
40. Artificial Intelligence in Pregnancy: A Scoping Review
- Author
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Universidad de Sevilla, Oprescu, Andreea M., Miró-Amarante, Gloria, García-Díaz, Lutgardo, Beltrán-Romero, Luis Matías, Rey, Victoria E., Romero-Ternero, M. Carmen, Universidad de Sevilla, Oprescu, Andreea M., Miró-Amarante, Gloria, García-Díaz, Lutgardo, Beltrán-Romero, Luis Matías, Rey, Victoria E., and Romero-Ternero, M. Carmen
- Abstract
Artificial Intelligence has been widely applied to a majority of research areas, including health and medicine. Certain complications or disorders that can appear during pregnancy can endanger the life of both mother and fetus. There is enough scientific literature to support the idea that emotional aspects can be a relevant risk factor in pregnancy (such as anxiety, stress or depression, for instance). This paper presents a scoping review of the scientific literature from the past 12 years (2008-2020) to identify which methodologies, techniques, algorithms and frameworks are used in Artificial Intelligence and Affective Computing for pregnancy health and well-being. The methodology proposed by Arksey and O'Malley, in conjunction with PRISMA-ScR framework has been used to create this review. Despite the relevance that emotional status can have as a risk factor during pregnancy, one of the main findings of this study is that there is still not a significant amount of literature on automatic analysis of emotion. Health enhancement and well-being for pregnant women can be achieved with artificial intelligence or affective computing based devices, hence future work on this topic is strongly suggested.
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- 2020
41. Giant right atrial aneurysm. Prenatal diagnosis and outcome of a rare congenital abnormality
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Chimenea, Ángel, García-Díaz, Lutgardo, Moreno de las Heras, María, Coserria, Félix, Antiñolo, Guillermo, Chimenea, Ángel, García-Díaz, Lutgardo, Moreno de las Heras, María, Coserria, Félix, and Antiñolo, Guillermo
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- 2020
42. Artificial Intelligence in Pregnancy: A Scoping Review
- Author
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Universidad de Sevilla. Departamento de Tecnología Electrónica, Universidad de Sevilla. Departamento de Cirugía, Universidad de Sevilla. Departamento de Medicina, Oprescu, Andreea M., Miró Amarante, Gloria, García Díaz, Lutgardo, Beltrán Romero, Luis Matías, Rey, Victoria E., Romero Ternero, María del Carmen, Universidad de Sevilla. Departamento de Tecnología Electrónica, Universidad de Sevilla. Departamento de Cirugía, Universidad de Sevilla. Departamento de Medicina, Oprescu, Andreea M., Miró Amarante, Gloria, García Díaz, Lutgardo, Beltrán Romero, Luis Matías, Rey, Victoria E., and Romero Ternero, María del Carmen
- Abstract
Artificial Intelligence has been widely applied to a majority of research areas, including health and medicine. Certain complications or disorders that can appear during pregnancy can endanger the life of both mother and fetus. There is enough scientific literature to support the idea that emotional aspects can be a relevant risk factor in pregnancy (such as anxiety, stress or depression, for instance). This paper presents a scoping review of the scientific literature from the past 12 years (2008-2020) to identify which methodologies, techniques, algorithms and frameworks are used in Artificial Intelligence and Affective Computing for pregnancy health and well-being. The methodology proposed by Arksey and O'Malley, in conjunction with PRISMA-ScR framework has been used to create this review. Despite the relevance that emotional status can have as a risk factor during pregnancy, one of the main findings of this study is that there is still not a significant amount of literature on automatic analysis of emotion. Health enhancement and well-being for pregnant women can be achieved with artificial intelligence or affective computing based devices, hence future work on this topic is strongly suggested.
- Published
- 2020
43. Ex-Utero Intrapartum Treatment (EXIT): indications and outcome in fetal cervical and oropharyngeal masses
- Author
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García-Díaz, Lutgardo, primary, Chimenea, Ángel, additional, de Agustín, Juan Carlos, additional, Pavón, Antonio, additional, and Antiñolo, Guillermo, additional
- Published
- 2020
- Full Text
- View/download PDF
44. Terapia fetal 2: transfusión intrauterina
- Author
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Antiñolo Gil, Guillermo, primary and García Díaz, Lutgardo, additional
- Published
- 2019
- Full Text
- View/download PDF
45. Prenatal management and perinatal outcome in giant placental chorioangioma complicated with hydrops fetalis, fetal anemia and maternal mirror syndrome
- Author
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García-Díaz Lutgardo, Carreto Práxedes, Costa-Pereira Susana, and Antiñolo Guillermo
- Subjects
Fetal chorioangioma ,Hydrops fetalis ,Fetal anemia ,Fetal therapy ,Mirror syndrome ,Gynecology and obstetrics ,RG1-991 - Abstract
Abstract Background Giant placental chorioangiomas have been associated with a number of severe fetal complications and high perinatal mortality. Case presentation We report a case of giant chorioangioma with fetal hydrops, additionally complicated by severe anemia, mild cardiomegaly with hyperdinamic heart circulation and maternal mirror syndrome. Intrauterine blood transfusion and amniodrainage was performed at 29 weeks. Worsening of the fetal and maternal condition prompted us to proceed with delivery at 29 + 5 weeks. The newborn died 3 hours later due to pulmonary hypoplasia and hemodynamic failure. Maternal course was favourable, mirror syndrome resolved in the second day and the patient was discharged four days following delivery. Conclusions In the case described here, fetal condition got worse despite of the anemia correction and amniodrainage. Our outcome raises the issue whether additional intrauterine clinical intervention, as intersticial laser, should have been performed to stop further deterioration of the fetal condition when progressive severe hydrops develops.
- Published
- 2012
- Full Text
- View/download PDF
46. Terapia fetal
- Author
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Antiñolo Gil, Guillermo, primary and García Díaz, Lutgardo, additional
- Published
- 2019
- Full Text
- View/download PDF
47. Giant right atrial aneurysm. Prenatal diagnosis and outcome of a rare congenital abnormality
- Author
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Chimenea, Ángel, primary, García-Díaz, Lutgardo, additional, Moreno-De las Heras, María, additional, Coserria, Félix, additional, and Antiñolo, Guillermo, additional
- Published
- 2019
- Full Text
- View/download PDF
48. Ultrasound, Echocardiography, MRI, and Genetic Analysis of a Fetus with Congenital Diaphragmatic Hernia and Partial 11q Trisomy
- Author
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Fernández-Perea, Yolanda, García-Díaz, Lutgardo, Sánchez, Javier, Antiñolo, Guillermo, and Borrego, Salud
- Subjects
Article Subject - Abstract
Congenital diaphragmatic hernia (CDH) is a serious birth defect with a significant mortality and morbidity. The current and constant progress in ultrasound techniques has led to the improvement of the prenatal diagnosis of this malformation. CDH is a developmental defect whose etiology is heterogeneous and takes place when the pleuroperitoneal folds and septum transversum fail to converge and fuse. Survival depends on the extent of pulmonary hypoplasia and the disease may be potentially worsened by the presence of added congenital defects. 40% of CDH cases are associated with at least one additional anomaly. The ultrasound diagnosis is established with essential signs: loss of uniform echogenicity of lungs and marked mediastinal shift. We report the case of a fetus with isolated CDH diagnosed at 21 weeks of gestation by ultrasound and confirmed by RMI, whose genetic analysis of amniotic fluid cells identified a de novo partial trisomy of the long arm of chromosome 11. Different genetic causes have been associated with CDH. Moreover, it is expectable that the use of new techniques for prenatal diagnosis will reveal novel CNVs associated with CDH and will help us to estimate the recurrence risk for this defect as well as for other associated anomalies.
- Published
- 2017
- Full Text
- View/download PDF
49. TGA+ CIV con cono subpulmonar: del feto al modelo tridimensional
- Author
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Manso, Begoña, primary, García-Díaz, Lutgardo, additional, and Valverde, Israel, additional
- Published
- 2017
- Full Text
- View/download PDF
50. TGA+VSD and Subpulmonary Conus: From Fetus to a 3-dimensional Model
- Author
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Manso, Begoña, primary, García-Díaz, Lutgardo, additional, and Valverde, Israel, additional
- Published
- 2017
- Full Text
- View/download PDF
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