ISSN:1015-3837    

DOI:10.1159/000264431

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

We report a case of spontaneous reversal in utero of hydrops fetalis caused by parvovirus B19 maternal-fetal infection. The route leading to fetal hydrops is not fully understood. Severe anemia with hypoxemia and viral fetal myocarditis have been incriminated. Then the main issue is fetal death or spontaneous abortion. Cases of spontaneous reversal of hydrops fetalis are unusual. Fetal regenerative anemia is a good prognostic factor and emphasizes the place of conservative management.

ISSN:1015-3837    

DOI:10.1159/000264432

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Objective: To determine whether transient acute maternal hypoxemia during the end of pregnancy may cause neuronal damage in fetal rat brains. Study Design: Nine pregnant rats (4 study and 5 controls) at 16–17 gestational days were studied. The study rats were placed in a chamber and breathed a gas mixture of 11.8% oxygen, 4.95% CO2, and nitrogen for either 1 or 2 h, while the control animals breathed room air. Tail venous blood was collected and gases were evaluated at the beginning and conclusion of the exposure periods. After 72 h of recovery, at 19–20 days’ gestation, the fetal cardiovascular systems were perfused with saline and formalin. The brains were embedded in paraffin, sectioned in coronal plane, and stained with hematoxylin and eosin. Histologic assessment of sections was performed by a neuropathologist blinded to the protocol. Statistical analysis of the data was performed using analysis of variance and the chi-square test. Results: Exposure to the gas mixture resulted in decreased maternal pO2 from 39.9 ± 7.6 mm Hg in the control group to 28.8 ± 2.0 mm Hg in the 2-hour hypoxia group (p < 0.05). No significant changes in maternal pH or pCO2 status have been noted. A total of 34 fetal rat brains served as controls and 26 brains as the hypoxia study group. There was a significant increase in isolated neuronal damage, including necrosis and shrinkage of cells, with karyorrhexis (fragmentation and breakage of the nucleus) in the hippocampus, basal ganglia, thalamus, and hypothalamus in the hypoxemia rats as compared with controls. Conclusion: Transient maternal hypoxemia may cause neuronal necrosis in vulnerable regions of the fetal rat brain, including the hippocampus, basal ganglia, thalamus, and hypot

ISSN:1015-3837    

DOI:10.1159/000264433

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

We have tested the hypothesis that the limited fetal ventricular distensibility is not only an intrinsic cardiac characteristic but is also contributed to by the pressure exerted by the intrathoracic organs. To this purpose we have studied the diastolic cardiac function by Doppler velocimetry in 11 fetuses during fetal breathing and in 22 fetuses during apnea, controlling for gestational age at examination and heart rate. Inspiration was associated with a significant increase in left ventricular compliance, as measured by deceleration time (inspiration 182.6 ± 15.5 s vs. expiration 137.1 ± 13.1 s vs. apnea 151.7 ± 51.8 s), and in ventricular filling, as measured by velocity time integral (inspiration 0.086 ± 0.020 m vs. expiration 0.064 ± 0.014 m vs. apnea 0.065 ± 0.011m), compared with both the expiration and apnea groups. These increases most likely reflect changes in venous return and ventricular end-diastolic volume secondary to a decrease in intrathoracic pressue during fetal brea

ISSN:1015-3837    

DOI:10.1159/000264434

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Objective: Our goal was to determine the effect of endoscopic white light on the developing mammalian retina by quantitative histological analysis. Study Design: Albino rats at postnatal days 10 (n = 16) and 16 (n = 20) were exposed to endoscopic white light for 1 h, while an equal number of littermate controls were not exposed, but otherwise treated identically. The thickness of the outer nuclear layer (ONL) and the total retinal thickness were measured light microscopically using a computer-assisted morphometry program. Results: We found no statistically significant decrease in the thickness of the ONL or the total retinal thickness, nor were any significant decreases found in the ONL or the total retinal thickness for male or female groups. Conclusion: Endoscopic white light does not cause damage to the developing rodent neural retina detectable at the light microscopic level.

ISSN:1015-3837    

DOI:10.1159/000264435

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Sonographic detection of chorioamniotic membrane separation (CMS) has been considered a benign incidental finding. We now report 6 cases of CMS identified by prenatal ultrasound; 1 in an otherwise normal pregnancy and 5 following fetal surgery. Following membrane separation, amniotic bands formed and compromised the umbilical cord in 4 cases leading to 2 fetal deaths.In the first case, a CMS was detected by ultrasound at 22 weeks’ gestation in an otherwise uncomplicated pregnancy. Because CMS was considered benign and umbilical cord blood flow was ample, the mother was followed by intermittent sonographic examinations. Fetal demise occurred 2 weeks later, clearly due to umbilical cord strangulation by an amniotic band. Surprised by this unexpected outcome, we reviewed our experience with CMS after hysterotomy for fetal surgery. Out of more than 40 fetal surgical cases, we have 5 cases in which CMS was recognized after hysterotomy. Three of these fetuses had umbilical cord compromise by a band of amniotic membrane leading to 1 fetal death.This experience demonstrates that membrane separation may be associated with amniotic band formation which can lead to cord strangulation and fetal compromise. Following fetal surgery, serial ultrasound evaluation and close fetal monitoring are indicated. In otherwise unremarkable pregnancies, clinician awareness of the possibility of amniotic band formation following CMS should be heightened. In either situation, knowledge of this potentially life-threatening complication may identify cases in which cord compromise requires emergent delivery or fetoscopic release of the strangulating amniotic ban

ISSN:1015-3837    

DOI:10.1159/000264436

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Objective: Women with elevated maternal serum alpha-fetoprotein (MSAFP) and normal amniotic fluid alpha-fetoprotein (AFAFP) are at an increased risk of an adverse pregnancy outcome. Such MSAFP elevations are probably the consequence of transplacental leakage caused by placental abnormalities. These may result in disturbed bloodflow through placental vessels. The purpose of this study was to assess whether measurement of such disturbances by Doppler velocimetry of the umbilical artery has a predictive value for pregnancy outcome. Study Design: The study group consisted of 85 patients, in whom the only finding was elevated maternal serum alpha-fetoprotein. Systolic/diastolic (S/D) ratios were calculated using a continuous wave Doppler measurement of the umbilical artery, performed at 6 to 8-week intervals. Serial results for each individual were incorporated into a single ‘Velocimetry Score’. Results: In group B (14 patients) with an abnormally elevated umbilical S/D ratio, a higher incidence of intrauterine growth retardation (42.9%), preterm deliveries (78.6%), and fetal loss (42.9%) was noted, as compared with group A (71 patients) with a normal S/D ratio. Conclusions: Umbilical artery Doppler velocimetry may serve as a predictor of pregnancy outcome in the high-risk group characterized by elevated MS

ISSN:1015-3837    

DOI:10.1159/000264437

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

This study was undertaken to test the effects of erythromycin as an adjunct to tocolysis for preterm labor in women with vaginal cultures positive for Ureaplasma urealyticum. The study group consisted of 18 women in active preterm labor with pregnancies between 26 and 34 weeks of gestation and intact membranes who received 500 mg erythromycin orally every 8 h for 10 days. Seventeen women with similar characteristics served as controls and received no antibiotics. In all women contractions were suppressed with ritodrine. Erythromycin treatment resulted in a statistically significant greater mean delay of delivery (36.4 days) than among the control group (23.2 days). Higher proportion of term pregnancies (7 versus 3 pregnancies), higher mean birth weight (2,745 versus 2,474 g), lower neonatal morbidity (22.2 versus 41.2%) and shorter mean neonatal hospitalization time (9.6 versus 12.1 days) were observed, although these differences were not statistically significant. Adjunctive erythromycin treatment given to women treated for preterm labor with intact membranes and positive vaginal cultures for U. urealyticum appears to prolong gestation and to improve perinatal outcome.

ISSN:1015-3837    

DOI:10.1159/000264438

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

The serum screening test for trisomy 21 was offered to all pregnant women in East Finland during 1993. The results and the women’s views on trisomy screening are reported here. A total of 9,343 (89%) of the pregnant women participated in the screening. A total of 615 women were eligible for amniocentesis or chorionic villus sampling; among them 22 pregnancies were affected by Down syndrome. Fifteen of them were detected by double screening; in 2 missed cases only maternal-serum alpha-fetoprotein had been determined. In all 5 cases missed by double screening the maternal age was less than 30 years. The women’s attitudes were studied by means of a questionnaire, which was mailed to 214 women. The response rate to our questionnaire was 74%. A total of 87% of respondents highly or very highly valued the opportunity to participate in the screening. Despite the existing problems caused by late testing, 87% of respondents want to be tested again in their future pregnanc

ISSN:1015-3837    

DOI:10.1159/000264439

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

The present study provides detailed neonatal and congenital malformation follow-up from 695 women enrolled in a prospective randomized multicenter study comparing the safety and accuracy of early (11–12 weeks of gestation) and midtrimester amniocentesis (15–16 weeks of gestation). No differences were found for total pregnancy loss (difference 0.4%; CI ––3.6 to 4.4%), obstetrical or neonatal outcome. The incidence of congenital anomalies was 2.4 and 2.6% for the early amniocentesis and midtrimester amniocentesis groups, respectively. Respiratory problems were present in 2.1 and 1.6%, respectively. Musculoskeletal problems were present in 0.9 and 2.4%, respectively. It must be emphasized that before early amniocentesis can be considered as an alternative to midtrimester amniocentesis or chorionic villus sampling, careful evaluation of any fetal effects must be considered and further large randomized trials are ne

ISSN:1015-3837    

DOI:10.1159/000264440

出版商:S. Karger AG    

年代:1997

数据来源: Karger