ISSN:1015-3837    

DOI:10.1159/000263921

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

A 4-year retrospective review of cordocentesis at a single center with four operators identified 182 patients undergoing 214 cordocenteses. The major indications were chromosomal, fetal platelet and rhesus evaluation. The procedure was successful in 95%. A positive genetic diagnosis was present in 18% with 64% having trisomy 18, 21 or 13. The procedural pregnancy loss rate was 3.25, 1.25 and 2.75% for chromosomal and nonchromosomal indications and total population, respectively. The overall fetal loss rate (procedural, nonprocedural) in chromosomal risk population was 47%. This overall pregnancy loss risk should be included in patient counselling.

ISSN:1015-3837    

DOI:10.1159/000263922

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Prepregnancy counselling is efficient in cases of chronic maternal disease, selection of medication and avoiding bad life habits. A new policy is the use of folic acid in the periconceptional period for the purpose of reducing the chance of having a baby with neural tube defects (NTD). Research in progress at the Department of Obstetrics and Gynaecology in Nijmegen, the Netherlands, is presented demonstrating that a derangement of methionine-homocysteine metabolism could be the underlying mechanism of pathogenesis and prevention with folic acid. Such derangement was found in ± 20% of cases with NTD, recurrent miscarriage and placental infarcts (abruption) and offers new possibilities for primary prevention in three major areas

ISSN:1015-3837    

DOI:10.1159/000263923

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The authors describe the first case of an isolated bilateral radial ray reduction occurring in a fetus exposed in utero to valproic acid; the diagnosis was made by ultrasound during the second trimester. This case of an isolated radial ray reduction associated with valproic acid use in pregnancy is a reminder for sonographers to carefully examine not only the cardiac and neurologic system, but also the extremities, when a fetus is exposed in utero to valproic acid.

ISSN:1015-3837    

DOI:10.1159/000263924

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Current management strategies to prevent fetal intracranial haemorrhage in perinatal alloimmune thrombocytopenia (PAIT) include serial platelet transfusion and/or maternal high-dose intravenous immunoglobulin (IVIG) administration. The former involves multiple invasive procedures, while the latter is both expensive and of questionable efficacy. We report the use of direct fetal IVIG in 2 fetuses with PAIT, undergoing serial intrauterine platelet transfusions. Fetal IVIG had no effect on fetal platelet count. We conclude that direct fetal IVIG administration does not appear to have a role in the management of PAIT, and that current management strategies remain far from ideal.

ISSN:1015-3837    

DOI:10.1159/000263925

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The objective was to assess the association of fetal liver function tests in various (noninfectious) abnormal fetal conditions. Liver function tests and complete blood counts were evaluated in 72 consecutive fetal blood specimens obtained by cordocentesis. The indications for cordocentesis included: fetal malformation (24), red blood cell alloimmunization (23), possible fetal infection (17), oligohydramnios (5), and immunologic thrombocytopenic purpura (3). Statistical analysis included analysis of variance and linear regression analysis. Liver function tests including total protein, albumin, total bilirubin, alanine and aspartate aminotransferase were all within the range of previously published normal values. However, fetal γ-glutamyltransferase levels (mean ± SEM)were 157.1 ± 15.1 IU/l (norm: 24.4 ± 1.2 IU/l; p < 0.001). There were no statistically significant differences in the γ-glutamyltransferase levels between the various groups of fetal abnormalities. Mean fetal γ-glutamyltransferase levels in 8 normal fetuses were 106.2 ± 17.5 IU/l. In conclusion, fetal γ-glutamyltransferase levels are significantly elevated in several abnormal fetal con

ISSN:1015-3837    

DOI:10.1159/000263926

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

We report the clinical and pathologic findings of 2 siblings affected with congenital nephrotic syndrome (CNS). The parents were a nonconsanguineous Mexican couple. The first sibling was born at term and developed proteinuria, hypoproteinemia, edema and ascites by its second month of life; he died septic at 6 months of age. The second sibling was diagnosed with congenital nephrosis during the second trimester of pregnancy. Prenatal demonstration of reno-placentomegaly can help in making the presumptive diagnosis of CNS in patients with high maternal serum and amniotic fluid AFP, normal acetylcholinesterase and normal karyotype. The pathologic findings of the kidneys of these siblings demonstrate that tubular microcysts are not critical to the disease process and are only the manifestation of a progressive disease in which the primary renal defect probably resides in a lack of integrity of the glomerular epithelial cells serving as filter.

ISSN:1015-3837    

DOI:10.1159/000263927

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Abnormal fetal biometry is considered a marker for fetal trisomy. We prospectively evaluated the biparietal diameter/femur length ratio to identify Down syndrome fetuses. This ratio was calculated when women ( 1.5 SD above the mean is a useful adjunct to identify Down syndrome in pregnancies at risk by an abnormal biochemical screen.

ISSN:1015-3837    

DOI:10.1159/000263928

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

We report what we believe is the first percutaneous transvenous intracardiac cardiac pacing of a fetus. The case is important because it demonstrates that transvenous fetal cardiac pacing is technically possible and provides a basis for development of the technology.

ISSN:1015-3837    

DOI:10.1159/000263929

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Umbilical artery flow curves were obtained by Doppler ultra-sonography before, during, and after episodes of fetal bradycardia in the active stage of labor in 6 women. Between 126 and 1,607 Doppler wave forms were analyzed for each patient. During the periods of bradycardia all the umbilical artery resistance flow parameters increased (p < 0.00001). The increase in resistance did not precede the change in heart rate. This study presents an accurate and reproducible method for continuous evaluation of the changes in the impedance of fetal blood flow during fetal heart rate changes, thereby enabling detailed assessment of circulatory disturbances occurring during labor and delivery.

ISSN:1015-3837    

DOI:10.1159/000263930

出版商:S. Karger AG    

年代:1994

数据来源: Karger