摘要:

We performed a retrospective study of 26 pregnancies with chronic immune thrombocytopenic purpura (ITP) or incidental ITP. Thirteen pregnancies were followed without the use of percutaneous umbilical blood sampling (PUBS) and 13 were followed sampling PUBS at 36–40 weeks of gestation. The overall prevalence of neonatal thrombocytopenia was 27%: 50% in chronic ITP, 12.5% in incidental ITP. Symptomatic thrombocytopenia occurred only in infants born to mothers with chronic ITP. Without the use of PUBS, 2 symptomatic thrombocytopenic fetuses were vaginally delivered and there was a high rate of cesarean sections in normal fetuses. Owing to PUBS, a decrease of the cesarean section rate in normal fetuses was observed, but one fetal bradycardia (due to the technique) was encountered. PUBS resulted helpful to indicate the best route of delivery and reducing unnecessary cesarean sections in women with chronic ITP, but in presence of incidental ITP the use of PUBS remains an open questio

ISSN:1015-3837    

DOI:10.1159/000263815

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The purpose of this study was to determine whether the need for late neonatal transfusion can be predicted in fetuses who received intrauterine transfusions. The records of 36 patients who underwent intrauterine transfusion were reviewed. New-borns who required late transfusions had a lower reticulocyte count at their last intrauterine transfusion, a longer duration between their lowest fetal reticulocyte count and delivery, and a higher umbilical cord blood hemoglobin and percent adult red cells on Kleihauer-Betke stain at delivery. The need for late transfusions appears to be related to the extent and duration of fetal bone marrow suppression.

ISSN:1015-3837    

DOI:10.1159/000263816

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Platelet activating factor (PAF), a powerful platelet activator, has been identified in huma embryos and fetuses, and may induce fetal lung maturation. The potential effect of PAF on fetal platelets as indicated by release of β-thromboglobulin (BTG) and platelet factor 4 (PF4) has not been investigated. We measured BTG and PF4 in amniotic fluid from 78 genetic and 35 pulmonary maturity amniocenteses. BTG and PF4 were higher in the genetic amniocentesis samples (p < 0.001 in each case) than in the lung maturity samples. BTG and PF4 did not correlate with the pulmonary maturity parameters as measured by the lecithin to sphingomyelin ratio and phosphatidylglycerol concentration. Our findings suggest a fetal origin of BTG and PF4 in amniotic fluid

ISSN:1015-3837    

DOI:10.1159/000263817

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Amniotic fluid acetylcholinesterase (ACHE) has been used to evaluate neural tube defects. It has also been detected in ventral wall defects. However, the role of ACHE to differentiate between omphalocele and gastroschisis has not been established. We examined amniotic fluid ACHE in 16 pregnancies complicated by gastroschisis and 8 by omphalocele. One ruptured omphalocele was excluded. ACHE was negative in all 7 omphaloceles and either positive or suspicious in all gastroschises (χ2 = 17.3, p < 0.0001). Amniotic fluid ACHE may be useful to differentiate between omphalocele and gastroschisis

ISSN:1015-3837    

DOI:10.1159/000263818

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

A fetus affected by trisomy 18 was observed serially on ultrasound from 14 to 21 weeks of gestation. The earliest and sole dysmorphic feature noted at 14 weeks of gestation were non-septated nuchal cysts. At 17 weeks the ultrasound examination was considered normal. However, at 21 weeks gestation, bilateral choroid plexus cysts, clubfoot, growth retardation and overlapping fingers were observed. These findings suggest that the dysmorphology associated with trisomy 18 is dynamic in nature and may change along the course of pregnancy.

ISSN:1015-3837    

DOI:10.1159/000263819

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Platelet factor 4 (PF4) and β-thromboglobulin (BTG) are unique markers of irreversible platelet activation. We measured PF4 and BTG in amniotic fluid from 102 genetic amniocenteses, in which 78 had normal amniotic fluid α-feto-protein (AFP) levels with normal pregnancies, and 24 had high amniotic fluid AFP levels with abnormal pregnancies. PF4 and BTG were significantly higher in the abnormal pregnancy/elevated amniotic fluid AFP group (p < 0.002 in each case) and correlated with AFP expressed as multiples of the median (p < 0.05 and p < 0.0001, respectively). Our results are compatible with passage of PF4 and BTG across fetal membranes and/or enhanced fetal platelet activation in fetuses with structural anomalies and elevated AF

ISSN:1015-3837    

DOI:10.1159/000263820

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The incidence of chromosomal abnormalities in spontaneous abortions is much higher than commonly appreciated. Using postmortem chorionic villus sampling (as we have previously described), our much increased yield of results allows us to divide embryos into two groups based upon potential viability. Embryonic size at the time of demise correlated with viability, i.e., the more ‘viable’ the embryo for term survival. Even in the absence of chromosomal results, the size of the embryonic pole can be used to infer, to a degree, the type of abnormal

ISSN:1015-3837    

DOI:10.1159/000263821

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

A pregnancy was terminated at 24 weeks of amenorrhea when tetraploidy (92 XXXX) was diagnosed in fetal blood subsequent to ultrasonographic detection of a polymalformation syndrome. The severity of the neurological deficit in tetra-ploid infants and their death befor 2 years of age require that prenatal diagnosis by cordocentesis be performed for analysis of fetal blood in cases of equivocal and nonspecific polymalformation syndrome and justify that medically-induced termination of pregnancy is suggested in the event of intrauterine tetraploidy diagnosis.

ISSN:1015-3837    

DOI:10.1159/000263822

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The short- and long-term effects of simultaneous administration of terbutaline and betamethasone were investigated in 8 gravidas treated for preterm labor. Their plasma concentrations of glucose, insulin, glucagon, C-peptide, lactate and potassium were compared to a control group receiving intravenous magnesium sulfate and betamethasone. The patients on terbutaline therapy had a marked hyperglycemia at 11 h which remained elevated for 48 h. There was a simultaneous rise in plasma insulin and C-peptide, and a fall in plasma glucagon. Lactate levels were markedly elevated. Only 1 of the 8 patients had an abnormal glucose tolerance test at 1 week of therapy. The metabolic changes of control patients were minimal in comparison and there was no lacticacidemia. This suggests that glucocorticoids potentiate the hyperglycemic response of terbutaline.

ISSN:1015-3837    

DOI:10.1159/000263823

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Antenatal diagnoses of fetal ovarian cysts have not usually been confirmed until postnatal surgery. We describe 2 cases of hemorrhage into fetal ovarian cysts in which cyst aspiration in utero allowed both confirmation of the diagnosis prenatally and obviated the need for neonatal surgery. In both cases, cytology of the cyst aspirate demonstrated luteinized granulosa cells and biochemistry showed estradiol levels of > 10,000 pmol/l, indicating ovarian etiology. Hemorrhage, which had been suspected on ultrasound, was confirmed by cytology, showing hemosiderin-laden macrophages. There was no evidence of recurrence in either case following aspiration. The described association of fetal hypothyroidism was excluded by testing thyroid function in cord blood and/or cyst aspirate. We suggest that intrauterine aspiration contributes to the management of fetal ovarian cysts by confirming their ovarian origin, demonstrating the presence or absence of hemorrhage and facilitating preservation of ovarian function both by reducing the risk of torsion and the need for neonatal surgery.

ISSN:1015-3837    

DOI:10.1159/000263824

出版商:S. Karger AG    

年代:1993

数据来源: Karger