Predicting pH at birth in pregnancies with abnormal pulsatility index and positive end-diastolic velocity in the umbilical artery

Objectives: To identify potential associations between fetal surveillance tests and acidosis at birth in pregnancies with abnormal but positive end-diastolic velocity in the umbilical artery. Methods: A prospective case-control study [group 1: pH < 7.2; group 2: pH >= 7.2] including 46 fetuses with abnormal but positive end-diastolic velocity in the umbilical artery was conducted between February 2007 and March 2009. Outcome variables were evaluated by univariate analysis and compared between the two groups. Clinically relevant and statistically significant variables were analyzed by logistic regression. Results: Abnormal nonstress test, presence of deceleration, and absent fetal breathing movements were statistically significant. Logistic regression analysis revealed that fetal heart rate (FHR) deceleration in the nonstress test is the only predictor of fetal acidosis at birth (p = 0.024; OR = 8.2; 95% CI: 1.2-52). Conclusions: In fetuses with positive end-diastolic flow velocity, acute variables of the antenatal surveillance tests are correlated with acidosis at birth and FHR deceleration in the nonstress test is the only predictor of fetal acidosis.

Feature-oriented regional modeling and simulations (FORMS) for the western South Atlantic: Southeastern Brazil region

The multi-scale synoptic circulation system in the southeastern Brazil (SEBRA) region is presented using a feature-oriented approach. Prevalent synoptic circulation structures, or ""features,"" are identified from previous observational studies. These features include the southward-flowing Brazil Current (BC), the eddies off Cabo Sao Tome (CST - 22 degrees S) and off Cabo Frio (CF - 23 degrees S), and the upwelling region off CF and CST. Their synoptic water-mass (T-S) structures are characterized and parameterized to develop temperature-salinity (T-S) feature models. Following [Gangopadhyay, A., Robinson, A.R., Haley, PJ., Leslie, W.J., Lozano, C.j., Bisagni, J., Yu, Z., 2003. Feature-oriented regional modeling and simulation (forms) in the gulf of maine and georges bank. Cont. Shelf Res. 23 (3-4), 317-353] methodology, a synoptic initialization scheme for feature-oriented regional modeling and simulation (FORMS) of the circulation in this region is then developed. First, the temperature and salinity feature-model profiles are placed on a regional circulation template and objectively analyzed with available background climatology in the deep region. These initialization fields are then used for dynamical simulations via the Princeton Ocean Model (POM). A few first applications of this methodology are presented in this paper. These include the BC meandering, the BC-eddy interaction and the meander-eddy-upwelling system (MEUS) simulations. Preliminary validation results include realistic wave-growth and eddy formation and sustained upwelling. Our future plan includes the application of these feature models with satellite, in-situ data and advanced data-assimilation schemes for nowcasting and forecasting the SEBRA region. (c) 2008 Elsevier Ltd. All rights reserved.