ISSN:0029-7844    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0029-7844    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0029-7844    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0029-7844    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0029-7844    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveTo determine whether neonatal lymphocyte or nucleated red blood cell (RBC) counts can be used to date fetal neurologic injury.MethodsSingleton, term infants with hypoxic-ischemic encephalopathy, permanent neurologic impairment, and sufficient laboratory data were divided into two groups: infants with preadmission injury, manifested by a nonreactive fetal heart rate (FHR) pattern from admission until delivery; and infants with acute injury, manifested by a normal FHR pattern followed by a sudden prolonged FHR deceleration. Lymphocyte and nucleated RBC values were compared with published high normal counts for normal neonates: 8000 lymphocytes/mm3and 2000 nucleated RBCs/mm3.ResultsThe study population consisted of 101 neonates. In the first hours of life, lymphocyte counts were elevated among injured newborns, and then the counts rapidly normalized. Brain-injured neonates were 25 times more likely to have a lymphocyte count greater than 8000 than were normal neonates (54 [62%] of 87 versus 6 [7%] of 84; odds ratio 25.5; 95% confidence interval 8.8, 80.1;P< .001). The mean lymphocyte count tended to be higher in the pread-mission-injury group than in the acute-injury group. In comparison, nucleated RBC values were not correlated as strongly with neonatal hours of life; nucleated RBC counts tended to be higher and persist longer among neonates with preadmission injury than among those with acute injury.ConclusionCompared with normal levels, both lymphocyte and nucleated RBC counts were elevated among neonates with fetal asphyxial injury. Both counts appear to be more elevated and to remain elevated longer in newborns with preadmission injury than in infants with acute injury. However, the rapid normalization of lymphocyte counts in these injured neonates limits the clinical usefulness of these counts after the first several hours of life.

ISSN:0029-7844    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveTo investigate possible delivery-related impaired neonatal hepatocellular integrity by assessment of arterial and venous umbilical cord plasma levels of glutathione S-transferase Alpha 1-1.MethodsGlutathione S-transferase Alpha 1-1 levels were assessed in arterial and venous umbilical cord, and maternal venous plasma samples. The influence of maternal, delivery, and neonatal characteristics on arterial umbilical cord glutathione S-transferase Alpha 1-1 levels was studied, using linear regression analysis after log-transformation.ResultsMedian (range) arterial umbilical cord glutathione S-transferase Alpha 1-1 plasma levels were higher than venous umbilical cord levels (9.68 [0.64–1125] μg/L and 7.66 [0.78–987.5] μg/L, respectively,P< .005). Median (range) arterial and venous umbilical cord glutathione S-transferase Alpha 1-1 levels were higher than, and did not correlate with, maternal venous plasma levels (8.79 [1.79–183] μg/L and 6.47 [1.58–164.5] μg/L versus 1.47 [0.46–10.4] μg/L,P< .001). Neonates born vaginally demonstrated higher median (range) levels than those delivered by cesarean (13.41 [1.02–1125] μg/L and 5.73 [0.64–172.90] μg/L, respectively,P< .001). Neonates with unfavorable pH (arterial pH under 7.20) demonstrated higher median (range) levels than those with normal pH (arterial pH at least 7.20) (15.15 [0.77–1125] μg/L and 8.82 [0.64–120.90] μg/L, respectively,P< .001). Stepwise multiple linear regression analysis showed that birth weight had the largest influence on arterial umbilical cord glutathione S-transferase Alpha 1-1 levels, followed by arterial base deficit, and route of delivery.ConclusionArterial umbilical cord glutathione S-transferase Alpha 1-1 plasma levels, being unrelated to maternal venous levels, might give a reliable impression of early neonatal hepatocellular integrity and may become an additional indicator of neonatal condition immediately after birth.

ISSN:0029-7844    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveTo ascertain the clinical significance of right fetal cardiac axis.MethodsFetal cardiac axis was assessed prospectively in ultrasound examinations of 16,562 fetuses over a 6-year period.ResultsTwenty-two fetuses had a right cardiac axis. When classified by ventricular and atrial configuration, six fetuses had mirror-image hearts with situs inversus, 12 had rotation of the heart axis alone, and four had inversion of the ventricles. Fourteen of the 22 had underlying structural cardiac defects, most of which were atrioventricular septal defects, double outlet right ventricles, or common atria. The chromosomes and/or phenotypes of all 22 were normal. All four fetuses with polysplenia and asplenia died. Major extracardiac defects were few (two) but lethal.ConclusionRight cardiac axis in the fetus is associated with a high incidence of structural cardiac defects. In the absence of severe extracardiac defects, polysplenia, or asplenia, neonatal outcome was good.

ISSN:0029-7844    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveTo evaluate the feasibility of examining the fetal ear with three-dimensional ultrasound.MethodsIn 125 pregnancies between 19 and 38 weeks of gestation, fetal ears were evaluated by three-dimensional ultrasound. The volume images with surface rendering were analyzed to depict the morphology, lying axis, orientation, and cranial location of the fetal ears.ResultsThree-dimensional images of one or both ears were successfully reconstructed in 105 fetuses. Among them, 18 fetuses had anomalous ears. The anomalous ears, including microtia, low-set ear with slope axis, abnormal ear orientation, and edematous ear, were confirmed after delivery. Three-dimensional ultrasound consistently displayed fetal ear abnormalities with greater accuracy and clarity.ConclusionBecause anomalous ears may be a part of complex fetal malformations, it is important to recognize ear abnormalities. Due to the complexity of the fetal ear, three-dimensional ultrasound offers more important information than two-dimensional ultrasound, which simply gives auricular geometry. We suggest that three-dimensional ultrasound can be used better to examine the fetal ear and may prove to be useful for prenatal diagnosis and genetic counseling.

ISSN:0029-7844    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveTo determine the fetal Rhcgenotype by using the polymerase chain reaction (PCR) amplification procedure and maternal blood at the different steps of the fetal cell enrichment process.MethodsMaternal peripheral venous blood samples were obtained from 11 pregnant women homozygous for the C antigen before amniocentesis. Three were not alloimmunized and eight were alloimmunized. The fathers were known to be heterozygous or homozygous for the c antigen by serologic testing. The mononuclear cell layer was isolated from maternal blood and flow sorted using monoclonal antibodies to CD36 or CD71 and glycophorin A. This was followed by PCR of the blood, mononuclear cells, and the sorted cells with allele-specific primers to RhCcgenes. Gel electrophoresis was performed to predict fetal Rhcgenotype. The fetal RhCcgenotype was confirmed by serologic and DNA testing.ResultsAll infants were positive for the Rhcgene. The positive fetal Rhcgenotype was determined correctly in three of the 11 maternal blood samples without enrichment, in six of the nine mononuclear cell samples, and in seven of the eight sorted cell samples. The fetal genotype from one sorted sample was predicted to be homozygousC. One infant was determined by serology on cord blood to be negative for the c antigen, but repeated infant DNA amplification was consistent with thecgenotype.ConclusionNoninvasive fetal Rhcgenotyping can be determined by PCR amplification of the rare fetal cells in maternal blood. These data reaffirm that enrichment of maternal blood for fetal cells is necessary to improve the sensitivity of the test.

ISSN:0029-7844    

出版商:OVID    

年代:1998

数据来源: OVID