摘要:

The advent of cordocentesis has made it possible to treat fetuses affected by severe red cell alloimmunization by infusing red cells into umbilical vessels. In addition, serial hematocrits can be followed between transfusions. Twenty fetuses underwent a total of 118 intrauterine procedures. Four transfusion techniques were compared to assess the effect of each method on the stability of the fetal hematocrit between procedures. The change in hematocrit per day for direct intravascular transfusion was -1.06 ± 0.68%, for intraperitoneal transfusion: +0.03 ± 0.6%, for combined exchange intravascular and intraperitoneal transfusion: +0.02 ± 0.3% and for combined direct intravascular and intraperitoneal technique: -0.01 ± 0.4%. The greatest fall in hematocrit was noted with the use of the direct intravascular technique alone (p < 0.001). The combined direct intravascular/intraperitoneal approach produces a stable hematocrit between procedures and offers the possibility of performing intrauterine transfusions at less frequent interv

ISSN:1015-3837    

DOI:10.1159/000263434

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

This study was designed to evaluate the association of placenta previa (PP) with cardiac anomalies in the fetus/neonate. The study group (n = 82 babies) was compared to a control group (n = 82) matched for maternal and gestational age. Five babies of the study group expired within 24 h of delivery, and postmortem examination was carried out in 4 of them. The living children of the control and study group (51 of the 77 babies) underwent complete cardiac workup including physical examination, ECG, chest X-ray and echocardiography. The incidence of congenital cardiac anomalies in the study group was significantly higher (Fisher exact test, p = 0.025). The obstetrician should refer the pregnant woman with PP for echocardiographic studies.

ISSN:1015-3837    

DOI:10.1159/000263435

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

We present a first case in whom fetal hypothyroidism with goiter was both successfully diagnosed and treated in utero. An obstetrical sonogram at 33 weeks revealed a bilobed fetal neck mass, compatible with enlarged thyroid gland, associated with neck hyperextension, reduced gastric fluid, and polyhydramnios. Umbilical blood sampling after volume reduction amniocentesis confirmed fetal hypothyroidism with a euthyroid mother. Fetal T4 measured 1.3 μg/dl, free T4 0.3 ng/dl, and thyroidstimulating hormone 186 μU. Intra-amniotic levothyroxine, 500 μg, was given twice with a 14-day interval. The head flexed, gastric fluid increased, and amniotic fluid levels returned to normal. Prenatal (36 weeks) and neonatal blood sampling demonstrated return to euthyroid indices. Ultrasonic estimates of thyroid volume decreased by over 50%. Vaginal delivery at 39 weeks was incomplicated. The newborn appeared normal and is being maintained on thyroid replacement thera

ISSN:1015-3837    

DOI:10.1159/000263436

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Fetal blood sampling by cordocentesis was performed in 85 cases of fetuses with either nonimmune hydrops fetalis, anomalies, intrauterine growth retardation, maternal immunological disorders, Rh incompatibility, hydronephrosis, polyhydramnios, maternal preeclampsia or fetal tumor. Fetal heart rate monitoring was also recorded before cordocentesis. We evaluated the usefulness of the nonstress test (NST) with regard to fetal hematologic gas profiles including pH, pO2 and pCO2. When the acceleration was classified into reactive and nonreactive group, pH and pO2 were significantly higher in the reactive group than in the nonreactive group. pCO2 was significantly lower in the former than the latter. However, the sensitivity and specificity of the reactive NST predicting fetal umbilical venous pO2 over 20 mm Hg was 79.7 and 68.7%, respectively. The false-positive rate of nonreactive NST predicting hypoxemia below 20 mm Hg pO2 was 44%. As a consequence, we cannot always rely on the NST, and should perform fetal blood sampling to assess fetal condition for further management.

ISSN:1015-3837    

DOI:10.1159/000263437

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Cordocentesis was performed, and fetal blood was sampled in 81 of 93 attempted procedures. In 45 fetuses, who proved to be normal later by normal pregnancy outcome, hematological analyses and blood chemistries were performed. The results showed an increase in total white blood cell count, red blood cell, hemoglobin, hematocrit and platelet count, while the mean corpuscular volume and mean corpuscular hemoglobin decreased during gestation. Total protein and albumin concentrations increased during pregnancy. These results provide information for the diagnosis of fetal hemotological disorders, and assist in making decisions for possible fetal therapy in utero.

ISSN:1015-3837    

DOI:10.1159/000263438

出版商:S. Karger AG    

年代:1989

数据来源: Karger