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VOLUME 2 , ISSUE 1 ( January-March, 2018 ) > List of Articles

REVIEW ARTICLE

Garbha Samskar: Ayurveda Way of Epigenetic Programming

Shital Chinchalkar, Raman Kaushik

Keywords : Antenatal care, Epigenetics, Garbhadan samskar, Garbhini Paricharya.

Citation Information : Chinchalkar S, Kaushik R. Garbha Samskar: Ayurveda Way of Epigenetic Programming. J Res Ayurvedic Sci 2018; 2 (1):42-49.

DOI: 10.5005/jp-journals-10064-0038

License: CC BY-NC 3.0

Published Online: 00-03-2018

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background: It is the need of the hour to establish the role of Ayurveda in antenatal care, which is under national rural health programs. Human evolvement throughout the conception to adulthood is conjoined association, shaped within cells, of nature [the deoxyribonucleic acid (DNA) we inherit] and nurture (the comprehensive nutritional, social, and physical environment). The augmenting field of epigenetic has perception that environment and individual lifestyle can directly interact with genome to influence epigenetic transformation. Ayurveda sighted the urge for the physical, mental, and spiritual anticipation of the mother to be for the momentous event of childbirth and emphasis has been given on care of mother during antenatal period. Aim: To ascertain the importance of Garbha Samskar with special reference to epigenetic programming and antenatal care. Results: Developing living being seems to have a wide range of perceptivity to epigenetic modulation. Befitting drift in epigenetic modifications is essential for embryogenesis, early fetal development, and early postnatal growth. Thereupon, the inappropriate endowment of epigenetic changes during critical developmental periods as a result of changes in maternal diet and other environmental components may induce pediatric developmental diseases and even influence health in adulthood. Garbha Samskar as explained in classical texts of Ayurveda involves the combination of Garbhadan samskar (preparation of to be mother and father prior 3 months of conception) and Garbhini Paricharya (planned program of observation, education, lifestyle modification, nutritional and medical management of pregnant lady). Conclusion: By adopting the custom of Garbha Samskar, antenatal care along with epigenetic programming can be done in order to have a healthy progeny. Clinical significance: Garbha Samskar may be considered as Ayurveda antenatal care and a novel preventive measure in the context of adverse epigenetic changes.


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  1. Kane PV. Samskar, chapter VI, history of Dharmashastras Vol II, Part I Bhandarkar Oriental Research Institute, 1941. pp. 190-191.
  2. Dr. Ghanekar Bhaskar Govind, “Ayurveda Rahasyadeepika” commentary on Sushruta Samhita, Sharira Sthana chapter 2, verse no. 34. New Delhi; Meherchand Lachamandas Publications, reprint edition; 2008. p. 38.
  3. Shastri Kasinath, Chaturvedi Gorakhnath. Vidyotini Hindi Commentary on Charaka Samhita of Charaka, Sharira Sthana, chapter 8, verse no. 4,7 22th edition, Varanasi: Chaukhambha Bharati Academy; 1996. p. 918.
  4. Dr. Ghanekar Bhaskar Govind, “Ayurveda Rahasyadeepika” commentary on Sushruta Samhita, Sharirsthana chapter 2, verse no. 29, New Delhi: Meherchand Lachamandas Publications, reprint edition; 2008. p. 34.
  5. Shastri Kasinath, Chaturvedi Gorakhnath. Vidyotini Hindi Commentary on Charaka Samhita of Charaka, Sharira Sthana, chapter 8, verse no. 10-11, 22th edition, Varanasi: Chaukhambha Bharati Academy; 1996. pp. 922-923.
  6. Shastri Kasinath, Chaturvedi Gorakhnath. Vidyotini Hindi Commentary on Charaka Samhita of Charaka, Sutra Sthana, chapter 25, verse no. 40, 22th edition. Varanasi: Chaukhambha Bharati Academy; 1996.
  7. Tripathi Brahmanand, Vidyotini Hindi Commentary on Ashtanga Hridaya, Sharirsthana, chapter 1, verse no. 20-21, 1st edition, Varanasi: Chaukhambha Sanskrit Prakashan; 1999. p. 173.
  8. Dr. Ghanekar Bhaskar Govind, “Ayurveda Rahasyadeepika” commentary on Sushruta Samhita, Sharirsthana chapter 2, verse no. 48, New Delhi: Meherchand Lachamandas Publications, reprint edition; 2008. p. 53.
  9. Dr. Ghanekar Bhaskar Govind, “Ayurveda Rahasyadeepika” commentary on Sushruta Samhita, Sharirsthana, chapter 2, verse no. 35. New Delhi: Meherchand Lachamandas Publications, reprint edition; 2008. p. 41.
  10. Shastri Hargovinda Amarakosha—edited with “Sarala- Maniprabja” Hindi commentary, Varanasi: Chaukhamba Sanskrit Sansthana; 2001.
  11. Shastri Ambikadutta, “Ayurveda-Tatva-Sandipika” Hindi Commentary (editor), Varanasi: Chaukhamba Sanskrit Sansthana, Sharira Sthana chapter 10 verse no. 3, edition reprint; 2017. p. 98.
  12. Shastri Kasinath and Chaturvedi Gorakhnath, Vidyotini Hindi Commentary on Charaka Samhita of Charaka, Sharira Sthana, chapter 8, verse no. 32, 22th edition, Varanasi: Chaukhambha Bharati Acadamy; 1996. p. 937.
  13. Yadavji Trikamji, editor, Commentary: Ayurveda Tatva Sandipika Hindi Commentary of Acharya Ambika Datta Shastri on Sushruta Samhita of Sushruta, Sharira Sthana, chapter 10, verse no. 3, 13th edition, Varanasi: Chowkhambha Sanskrit Sansthan; 2002. p. 73.
  14. Shastri Ramavalamba Nirmala, Hindi Commentary on Harit Samhita Tritiya Sthana chapter 49, verse no. 2, 1st edition, Varanasi: Prachya Prakashana; 1985. p. 86.
  15. Shastri Kasinath and Chaturvedi Gorakhnath, Vidyotini Hindi Commentary of Acharya on Charaka Samhita of Charaka, Sharira Sthana, chapter 4, verse no. 18, 22th edition, Varanasi: Chaukhambha Bharati Acadamy; 1996. p. 87.
  16. Yadavji Trikamji, editor, Commentary: Ayurveda Tatva Sandipika Hindi Commentary of Acharya Ambika Datta Shastri on Sushruta Samhita of Sushruta, Sharira Sthana, chapter 3, verse no. 19-26, 13th edition, Varanasi: Chowkhambha Sanskrit Sansthan; 2002. p. 24.
  17. Tripathi Brahmanand, Vidyotini Hindi Commentary on Ashtanga Hridaya, Sharira Sthana, chapter 1, verse no. 44-47, 1st edition, Varanasi: Chaukhambha Sanskrit Prakashan; 1999. p. 174.
  18. Athavale Anant Damodar Indu Commentary on Astanga Sangraha, Sharira sthana, chapter 2, verse no. 36, 1st edition, Pune: Shree Mada Atreya Prakashana; 1980. p. 278.
  19. Shri Satyapal Bhishagacharya, Hindi Commentary on Kashypa Samhita, Sharira Sthana chapter 5, verse no. 16-20, 4th edition, Varanasi: Chaukhambha Sanskrit Sansthan; 1988. p. 84.
  20. Dr. Ghanekar Bhaskar Govind, “Ayurveda Rahasyadeepika” Commentary on Sushruta Samhita, Sharirsthana, chapter 3, verse no. 17, New Delhi: Meherchand Lachamandas Publications, reprint edition; 2008. p. 88.
  21. Shastri Kasinath and Chaturvedi Gorakhnath, Vidyotini Hindi Commentary of Acharya on Charaka Samhita of Charaka, Sharira Sthana, chapter 8, verse no. 21, 22th edition, Varanasi: Chaukhambha Bharati Academy; 1996. p. 928.
  22. Waddington CH. The epigenotype. Endeavour 1942;1:18-20.
  23. Byrne CD, Phillips DI. Fetal origins of adult disease: epidemiology and mechanisms. J Clin Pathol 2000 Nov;53(11):822-828.
  24. Bird A. DNA methylation patterns and epigenetic memory. Genes Dev 2002 Jan;16(1):6-21.
  25. Li E. Chromatin modification and epigenetic reprogramming in mammalian development. Nat Rev Genet 2002;3:662-673.
  26. Gabory A, Attig A, Junien C. Developmental programming and epigenetics. Am J Clin Nutr 2011 Dec;94(6 Suppl): 1943S-1952S.
  27. Katari S, Turan N, Bibikova M, Erinle O, Chalian R, Foster M, Gaughan JP, Coutifaris C, Sapienza C. DNA methylation and gene expression differences in children conceived in vitro or in vivo. Hum Mol Genet 2009 Oct;18(20):3769-3778.
  28. Agrawal AA. Phenotypic plasticity in the interactions and evolution of species. Science 2001 Oct;294(5541):321-326.
  29. Rossiter MC. Maternal effects as adaptations. Edited by Fox TA. and Mousseau CW. London: Oxford University Press, 1999.
  30. Painter RC, Roseboom TJ, Bleker OP. Prenatal exposure to the Dutch famine and disease in later life: an overview. Reprod Toxicol 2005 Sep-Oct;20(3):345-352.
  31. Heijmans BT, Tobi EL, Stein AD, Putter H, Blauw GJ, Susser ES, Slagboom PE, Lumeye LH. Persistent epigenetic differences associated with prenatal exposure to famine in humans. Proc Natl Acad Sci USA 2008;105(44):17046-17049.
  32. Watkins AJ, Wilkins A, Cunningham C, Perry VH, Seet MJ, Osmond C, Eckert JJ, Torrens C, Cagampang FR, Cleal J, et al. Low protein diet fed exclusively during mouse oocyte maturation leads to behavioural and cardiovascular abnormalities in offspring. J Physiol 2008 Apr;586(8):2231-2244.
  33. Steegers-Theunissen RP, Obermann-Borst SA, Kremer D, Lindemans J, Siebel C, Steegers EA, Slagboom PE, Heijmans BT. Periconceptional maternal folic acid use of 400 microg per day is related to increased methylation of the IGF2 gene in the very young child. PLoS One 2009 Nov;4(11):e7845.
  34. Jang H, Serra C. Nutrition, epigenetics, and diseases. Clin Nutr Res 2014 Jan;3(1):1-8.
  35. Ghanekar Bhaskar Govind, “Ayurveda Rahasyadeepika” commentary on Sushruta Samhita, Sharirsthana chapter 2, verse no. 48, New Delhi: Meherchand Lachamandas Publications, reprint edition; 2008. p. 53.
  36. Ghanekar Bhaskar Govind, “Ayurveda Rahasyadeepika” commentary on Sushruta Samhita, Sharirsthana chapter 2, verse no. 54, New Delhi: Meherchand Lachamandas Publications, reprint edition; 2008. p. 55.
  37. Goel A, Nadkarni T, Muzumdar D, Desai K, Phalke U, Sharma P: Giant pituitary tumors: a study based on surgical treatment of 118 cases. Surg Neurol. 2004 May;61(5):436-445.
  38. Goel A: Treatment of basilar invagination by atlantoaxial joint distraction and direct lateral mass fixation. J Neurosurg Spine. 2004 Oct;1(3):281-6.
  39. Goel A, Muzumdar, Desai K Anterior tentorium-based epidermoid tumours: Results of radical surgical treatment in 96 cases. “Br J Neurosurg. 2006 Jun;20(3):139-45.
  40. Malvankar-Mehta MS, Chen YN, Iordanous Y, Wang WW, Costella J, Hutnik CML. iStent as a solo procedure for glaucoma patients: a systematic review and meta-analysis. PLoS One2015;10(5):e0128146.
  41. Malvankar-Mehta MS, Iordanous Y, Chen YN. iStent with phacoemulsification versus phacoemulsification alone for patients with glaucoma and cataract: a meta-analysis. PLoS One2015;10(7):e0131770.
  42. Bahler CK, Smedley GT, Zhou J, Johnson DH. Trabecular bypass stents decrease intraocular pressure in cultured human anterior segments. Am J Ophthalmol2004;138(6):988-994.
  43. Gedde SJ, Herndon LW, Brandt JD, Budenz DL, Feuer WJ, Schiffman JC. Postoperative complications in the tube versus trabeculectomy (TVT) study during five years of follow-up. Am J Ophthalmol2012;153(5):804-814.
  44. Iordanous Y, Kent JS, Hutnik CML, Malvankar-Mehta MS. Projected cost comparison of Trabectome, iStent, and endoscopic cyclophotocoagulation versus glaucoma medication in the Ontario Health Insurance Plan. J Glaucoma2014;23:e112-118.
  45. Kaplowitz K, Bussel II, Honkanen R, Schuman JS, Loewen NA. Review and meta-analysis of ab-interno trabeculectomy outcomes. Br J Ophthalmol 2016;100(5):594-600.
  46. Almeida Junior GC, Arakawa L, Santi Neto DD, Cury PM, Lima Filho AA, Sousa SJ, Alves MR, Azoubel R. Preoperative tranilast as adjunctive therapy to primary pterygium surgery with a 1-year follow-up. Arq Bras Oftalmol 2015 Jan-Feb; 78(1):1-5.
  47. Bahar I, Lusky M, Gaton D, Robinson A, Avisar R, Weinberger D. The use of fibrin adhesive in trabeculectomy: a pilot study. Br J Ophthalmol 2006 Nov;90(11):1430.
  48. Bahar I, Weinberger D, Lusky M, Avisar R, Robinson A, Gaton D. Fibrin glue as a suture substitute: histological evaluation of trabeculectomy in rabbit eyes. Curr Eye Res 2006 Jan;31(1):31-36.
  49. Buschmann W, Stemberger A, Blumel G, Leydhecker W. Fibrin adhesion and postoperative anti-fibrinolytic care of conjunctival wounds. Klin Monatsbl Augenheilkd 1984 Mar;184(3):185-188.
  50. Choudhari NS, Neog A, Latka S, Srinivasan B. Fibrin sealantassisted revision of the exposed Ahmed tube. Middle East Afr J Ophthalmol 2015 Jan-Mar;22(1):115-116.
  51. Choudhari NS, Neog A, Sharma A, Iyer GK, Srinivasan B. Authors' reply. Indian J Ophthalmol 2013 Jun;61(6):312-313.
  52. Choudhari NS, Neog A, Sharma A, Iyer GK, Srinivasan B. Our experience of fibrin sealant-assisted implantation of Ahmed glaucoma valve. Indian J Ophthalmol 2013 Jan-Feb;61(1): 23-27.
  53. Dal Pizzol MM, Roggia MF, Kwitko S, Marinho DR, Rymer S. Use of fibrin glue in ocular surgery. Arq Bras Oftalmol 2009 May-Jun;72(3):308-312.
  54. Dintelmann T, Lieb WE, Grehn F. Filtering bleb revision. Techniques and outcome. Ophthalmologe 2002 Dec;99(12): 917-921.
  55. Du TT, Saffra N. Acellular dermal graft as a treatment of recurrent conjunctival wound dehiscence. Arch Ophthalmol 2009 Nov;127(11):1520-1521.
  56. Elmalem VI, Harris GJ. Occurrence and surgical management of a cerebrospinal fluid-filled cystoid space following routine enucleation. Ophthal Plast Reconstr Surg 2012 Sep-Oct;28(5):e117-e118.
  57. Esquenazi S, Rand W, Velazquez G, Grunstein L. Novel therapeutic approach in the management of band keratopathy using amniotic membrane transplantation with fibrin glue. Ophthalmic Surg Lasers Imaging 2008 Sep-Oct;39(5): 418-421.
  58. Freeman PD, Kahook MY, Curtis TH. Glaucoma drainage device implantation in children using fibrin glue. J AAPOS 2010 Apr;14(2):169-171.
  59. Piltz JR, Starita RJ. The use of subconjunctivally administered tissue plasminogen activator after trabeculectomy. Ophthalmic Surg 1994 Jan;25(1):51-53.
  60. Por YM, Tan YL, Mehta JS, Tan DT. Intracameral fibrin tissue sealant as an adjunct in tectonic lamellar keratoplasty for large corneal perforations. Cornea 2009 May;28(4):451-455.
  61. Sakarya Y, Sakarya R, Yildirim A. Sutureless amniotic membrane fixation with fibrin glue in symptomatic bullous keratopathy with poor visual potential. Eur J Ophthalmol 2010 Jan-Feb;20(1):249; author reply 249-250.
  62. Lee GA, Holcombe DJ. Surgical revision of dysfunctional filtration blebs with bleb preservation sliding conjunctival flap and fibrin glue. Eye (Lond) 2010 Jun;24(6):947-953.
  63. Kahook MY, Noecker RJ. Fibrin glue-assisted glaucoma drainage device surgery. Br J Ophthalmol 2006 Dec;90(12):1486-1489.
  64. Valimaki J. Fibrin glue for preventing immediate postoperative hypotony following glaucoma drainage implant surgery. Acta Ophthalmol Scand 2006 Jun;84(3):372-374.
  65. Malhotra C, Jain AK. Human amniotic membrane transplantation: different modalities of its use in ophthalmology. World J Transplant 2014 Jun;4(2):111-121.
  66. Dua HS, Gomes JA, King AJ, Maharajan VS. The amniotic membrane in ophthalmology. Surv Ophthalmol 2004 Jan-Feb;49(1):51-77.
  67. Shimmura S, Shimazaki J, Ohashi Y, Tsubota K. Antiinflammatory effects of amniotic membrane transplantation in ocular surface disorders. Cornea 2001 May;20(4):408-413.
  68. Yazdani S, Mahboobipour H, Pakravan M, Doozandeh A, Ghahari E. Adjunctive mitomycin c or amniotic membrane transplantation for Ahmed glaucoma valve implantation: a randomized clinical trial. J Glaucoma 2016 May;25(5):415-421.
  69. Sheha H, Kheirkhah A, Taha H. Amniotic membrane transplantation in trabeculectomy with mitomycin C for refractory glaucoma. J Glaucoma 2008 Jun-Jul;17(4):303-307.
  70. Khairy HA, Elsawy MF. Trabeculectomy with mitomycin-C versus trabeculectomy with amniotic membrane transplant: a medium-term randomized controlled trial. J Glaucoma 2015 Sep;24(7):556-559.
  71. Rauscher FM, Barton K, Budenz DL, Feuer WJ, Tseng SC. Long-term outcomes of amniotic membrane transplantation for repair of leaking glaucoma filtering blebs. Am J Ophthalmol 2007 Jun;143(6):1052-1054.
  72. Sethi P, Patel RN, Goldhardt R, Ayyala RS. Conjunctival advancement with subconjunctival amniotic membrane draping technique for leaking cystic blebs. J Glaucoma 2016 Feb;25(2):188-192.
  73. Kitagawa K, Yanagisawa S, Watanabe K, Yunoki T, Hayashi A, Okabe M, Nikaido T. A hyperdry amniotic membrane patch using a tissue adhesive for corneal perforations and bleb leaks. Am J Ophthalmol 2009 Sep;148(3):383-389.
  74. Nagai-Kusuhara A, Nakamura M, Fujioka M, Negi A. Longterm results of amniotic membrane transplantation-assisted bleb revision for leaking blebs. Graefes Arch Clin Exp Ophthalmol 2008 Apr;246(4):567-571.
  75. Rai P, Lauande-Pimentel R, Barton K. Amniotic membrane as an adjunct to donor sclera in the repair of exposed glaucoma drainage devices. Am J Ophthalmol 2005 Dec;140(6): 1148-1152.
  76. Ainsworth G, Rotchford A, Dua HS, King AJ. A novel use of amniotic membrane in the management of tube exposure following glaucoma tube shunt surgery. Br J Ophthalmol 2006 Apr;90(4):417-419.
  77. Papadaki TG, Siganos CS, Zacharopoulos IP, Panteleontidis V, Charissis SK. Human amniotic membrane transplantation for tube exposure after glaucoma drainage device implantation. J Glaucoma 2007 Jan;16(1):171-172.
  78. Mulder EJ, Leiblum DM, Visser GH. Fetal breathing movements in late diabetic pregnancy: relationship to fetal heart rate patterns and Braxton Hicks’ contractions. Early Hum Dev 1995 Nov;43(3):225-232.
  79. Schulte FJ, Michaelis R, Nolte R, Albert G, Parl U, Lasson U. Brain and behavioral maturation in newborn infants of diabetic mothers. I. Nerve conduction and EEG patterns. Neuropadiatrie 1969 Jan-Jul;1(1):24-35.
  80. Devoe LD, Youssef AA, Castillo RA, Croom CS. Fetal biophysical activities in third-trimester pregnancies complicated by diabetes mellitus. Am J Obstet Gynecol 1994 Aug;171(2):298-303.
  81. Dierker LJ Jr, Pillay S, Sorokin Y, Rosen MG. The change in fetal activity periods in diabetic and nondiabetic pregnancies. Am J Obstet Gynecol 1982 May;143(2):181-185.
  82. Doherty NN, Hepper PG. Habituation in fetuses of diabetic mothers. Early Hum Dev 2000 Aug;59(2):85-93.
  83. Kainer F, Prechtl HF, Engele H, Einspieler C. Assessment of the quality of general movements in fetuses and infants of women with type-1 diabetes mellitus. Early Hum Dev 1997 Nov;50(1):13-25.
  84. Mulder EJ, O'Brien MJ, Lems YL, Visser GH, Prechtl HF. Body and breathing movements in near-term fetuses and newborn infants of type-1 diabetic women. Early Hum Dev 1990 Nov;24(2):131-152.
  85. Mulder EJ, Visser GH. Growth and motor development in fetuses of women with type-1 diabetes. I. Early growth patterns. Early Hum Dev 1991 May;25(2):91-106.
  86. Mulder EJ, Visser GH. Growth and motor development in fetuses of women with type-1 diabetes. II. Emergence of specific movement patterns. Early Hum Dev 1991 May;25(2):107-115.
  87. Mulder EJ, Visser GH. Impact of early growth delay on subsequent fetal growth and functional development: a study on diabetic pregnancy. Early Hum Dev 1992 Dec;31(2):91-95.
  88. Mulder EJ, Visser GH, Bekedam DJ, Prechtl HF. Emergence of behavioral states in fetuses of type-1 diabetic women. Early Hum Dev 1987 Jul;15(4):231-251.
  89. Mulder EJ, Visser GH, Morssink LP, de Vries JI. Growth and motor development in fetuses of women with type-1 diabetes. III. First trimester quantity of fetal movement patterns. Early Hum Dev 1991 May;25(2):117-133.
  90. Aberg A, Westbom L, Kallen B. Congenital malformations among infants whose mothers had gestational diabetes or preexisting diabetes. Early Hum Dev 2001 Mar;61(2):85-95.
  91. Deregnier RA, Nelson CA, Thomas KM, Wewerka S, Georgieff MK. Neurophysiologic evaluation of auditory recognition memory in healthy newborn infants and infants of diabetic mothers. J Pediatr 2000 Dec;137(6):777-784.
  92. Nelson CA, Wewerka S, Thomas KM, Tribby-Walbridge S, deRegnier R, Georgieff M. Neurocognitive sequelae of infants of diabetic mothers. Behav Neurosci 2000 Oct;114(5):950-956.
  93. Reece EA, Homko CJ. Infant of the diabetic mother. Semin Perinatol 1994 Oct;18(5):459-469.
  94. Reece EA, Homko CJ. Why do diabetic women deliver malformed infants? Clin Obstet Gynecol 2000 Mar;43(1):32-45.
  95. Rizzo T, Metzger BE, Burns WJ, Burns K. Correlations between antepartum maternal metabolism and intelligence of offspring. N Engl J Med 1991 Sep;325(13):911-916.
  96. Rizzo TA, Metzger BE, Dooley SL, Cho NH. Early malnutrition and child neurobehavioral development: insights from the study of children of diabetic mothers. Child Dev 1997 Feb;68(1):26-38.
  97. Schwartz R, Teramo KA. Effects of diabetic pregnancy on the fetus and newborn. Semin Perinatol 2000 Apr;24(2):120-135.
  98. Vaarasmaki MS, Hartikainen A, Anttila M, Pramila S, Koivisto M. Factors predicting peri- and neonatal outcome in diabetic pregnancy. Early Hum Dev 2000 Jul;59(1):61-70.
  99. Robertson SS, Dierker LJ. Fetal cyclic motor activity in diabetic pregnancies: sensitivity to maternal blood glucose. Dev Psychobiol 2003 Jan;42(1):9-16.
  100. Accardo PJ, Blondis TA, Whitman BY. Disorders of attention and activity level in a referral population. Pediatrics 1990 Mar;85(3 Pt 2):426-431.
  101. Ornoy A, Uriel L, Tennenbaum A. Inattention, hyperactivity and speech delay at 2-4 years of age as a predictor for ADDADHD syndrome. Isr J Psychiatry Relat Sci 1993;30(3):155-163.
  102. Smyth TR. Impaired motor skill (clumsiness) in otherwise normal children: a review. Child Care Health Dev 1992 Sep-Oct;18(5):283-300.
  103. Petersen MB, Pedersen SA, Greisen G, Pedersen JF, Mølsted- Pedersen L. Early growth delay in diabetic pregnancy: relation to psychomotor development at age 4. Br Med J (Clin Res Ed) 1988 Feb;296(6622):598-600.
  104. Sells CJ, Robinson NM, Brown Z, Knopp RH. Long-term developmental follow-up of infants of diabetic mothers. J Pediatr 1994 Jul;125(1):S9-S17.
  105. Vladareanu R, Lebit D, Constantinescu S. Ultrasound assessment of fetal neurobehaviour in high risk pregnancies. DSJUOG 2012 Apr-Jun;6(2):132-147.
  106. Talic A, Kurjak A, Ahmed B, Stanojevic M, Predojevic M, Kadic AS, Di Renzo GC. The potential of 4D sonography in the assessment of fetal behavior in high-risk pregnancies. J Matern Fetal Neonatal Med 2011 Jul;24(7):948-954.
  107. Bekedam DJ, Visser GH, de Vries JJ, Prechtl HF. Motor behaviour in the growth retarded fetus. Early Hum Dev 1985 Nov;12(2):155-165.
  108. Cioni G, Prechtl HF. Preterm and early postterm motor behaviour in low-risk premature infants. Early Hum Dev 1990 Sep;23(3):159-191.
  109. Seme-Ciglenecki P. Predictive value of assessment of general movements for neurological development of highrisk preterm infants: comparative study. Croat Med J 2003 Dec;44(6):721-727.
  110. Abo-Yaqoub S, Kurjak A, Mohammed AB, Shadad A, Abdel-Maaboud M. The role of 4-D ultrasonography in prenatal assessment of fetal neurobehaviour and prediction of neurological outcome. J Matern Fetal Neonatal Med 2012 Mar;25(3):231-236.
  111. Athanasiadis AP, Mikos T, Tambakoudis GP, Theodoridis TD, Papastergiou M, Assimakopoulos E, Tarlatzis BC. Neurodevelopmental fetal assessment using KANET scoring system in low and high-risk pregnancies. J Matern Fetal Neonatal Med 2013 Mar;26(4):363-368.
  112. Fauser BC, Tarlatzis BC, Rebar RW, Legro RS, Balen AH, Lobo R, Carmina E, Chang J, Yildiz BO, Laven JS, et al. Consensus on women's health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril 2012 Jan;97(1):28-38.e25
  113. Sirmans SM, Pate KA. Epidemiology, diagnosis and management of polycystic ovary syndrome. Clin Epidemiol 2014; 6:1-13.
  114. Fauser BC, Diedrich K, Bouchard P, Domínguez F, Matzuk M, Franks S, Hamamah S, Simón C, Devroey P, Ezcurra D, et al. Contemporary genetic technologies and female reproduction. Human Reproduction Update 2011 Nov;17(6):829-847.
  115. Balen A, Conway G, Kaltsas G. Polycystic ovary syndrome: the spectrum of the disorder in 1741 patients. Hum Reprod 1995 Aug;10(8):2107-2111.
  116. Azziz R, Sanchez L, Knochenhauer ES, Moran C, Lazenby J, Stephens KC, Taylor K, Boots LR. Androgen excess in women: experience with over 1000 consecutive patients. J Clin Endocrinol Metab 2004 Feb;89(2):453-462.
  117. Wild S, Pierpoint T, McKeigue P, Jacobs H. Cardiovascular disease in women with polycystic ovary syndrome at longterm follow-up: a retrospective cohort study. Clin Endocrinol (Oxf) 2000 May;52(5):595-600.
  118. Hollinrake E, Abreu A, Maifeld M, Van Voorhis BJ, Dokras A. Increased risk of depressive disorders in women with polycystic ovary syndrome. Fertil Steril 2007 Jun;87(6): 1369-1376.
  119. Zawadski JK, Dunaif A. Diagnostic criteria for polycystic ovary syndrome. In: Givens JHF, Merriman G, editors. The polycystic ovary syndrome. Cambridge, MA: Blackwell Scientific; 1992. p. 377-384.
  120. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004 Jan;81(1):19-25.
  121. Azziz R, Carmina E, DeWailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, Janssen OE, Legro RS, Norman RJ, Taylor AE, et al. Position statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J Clin Endocrinol Metab 2006 Nov;91(11):4237-4245.
  122. Lujan ME, Jarrett BY, Brooks ED, Reines JK, Peppin AK, Muhn N, Haider E, Pierson RA, Chizen DR. Updated ultrasound criteria for polycystic ovary syndrome: reliable thresholds for elevated follicle population and ovarian volume. Hum Reprod 2013 May;28(5):1361-1368.
  123. Badawy A, Elnashar A. Treatment options for polycystic ovary syndrome. Int J Womens Health 2011 Feb;3:25-35.
  124. ACOG Committee on Practice Bulletins—Gynecology. ACOG Practice Bulletin No 108: Polycystic ovary syndrome. Obstet Gynecol 2009 Oct;114(4):936-949.
  125. Thessaloniki ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group Consensus on infertility treatment related to polycystic ovary syndrome. Fertil Steril 2008 Mar;89(3): 505-522.
  126. Balen AH. Ovulation induction in the management of anovulatory polycystic ovary syndrome. Mol Cell Endocrinol 2013 Jul;373(1-2):77-82.
  127. Berridge DL, Winter TC. Saline infusion sonohysterography: technique, indications, and imaging findings. J Ultrasound Med 2004 Jan;23(1):97-112.
  128. Allison SJ, Horrow MM, Kim HY, Lev-Toaff AS. Salineinfused sonohysterography: tips for achieving greater success. Radiographics 2011 Nov-Dec;31(7):1991-2004.
  129. O'Neill MJ. Sonohysterography. Radiol Clin North Am 2003 Jul;41(4):781-797.
  130. Bonnamy L, Marret H, Perrotin F, Body G, Berger C, Lansac J. Sonohysterography: a prospective survey of results and complications in 81 patients. Eur J Obstet Gynecol Reprod Biol 2002 Apr;102(1):42-47.
  131. Lindheim SR, Adsuar N, Kushner DM, Pritts EA, Olive DL. Sonohysterography: a valuable tool in evaluating the female pelvis. Obstet Gynecol Surv 2003 Nov;58(11):770-784.
  132. Lindheim SR, Sprague C, Winter TC. Hysterosalpingography and sonohysterography: lessons in technique. AJR Am J Roentgenol 2006 Jan;186(1):24-29.
  133. Jeanty P, Besnard S, Arnold A, Turner C, Crum P. Air-contrast sonohysterography as a first step assessment of tubal patency. J Ultrasound Med 2000 Aug;19(8):519-527.
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