摘要:

Creatine kinasebrain isoenzyme activity (CK-BB) was measured longitudinally in the serum of 31 pregnant women in the first stage of labor (early and advanced), at delivery, and 1, 6 and 24 h after delivery, in the umbilical cord and in the serum of their neonates on the first day of life. There was no increase in serum CK-BB values of mothers that delivered normally (n = 15) or had an elective cesarean section (n = 5). Pregnant women with signs of fetal distress had an increase in CK-BB levels in the first stage of labor (mean ± SD 4.5 ± 4.9 U/l, p < 0.03) and 6 h after delivery (12 ± 4 U/l, p < 0.0001). Neonates with intrauterine stress also had an increase in their CK-BB to 144 ± 116 U/l at 6 h of life, in comparison with babies born without signs of stress. It appears that CK-BB during labor and in the first hours of life may be indicative of intrauterine str

ISSN:1015-3837    

DOI:10.1159/000264182

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Interferon (IFN) therapy is currently not approved for use during pregnancy. Two HIV-seropositive pregnant women, who were due to undergo abortion in the second trimester of pregnancy, were given a single intramuscular dose of IFN-α, with their informed consent. Blood samples were taken simultaneously from the mothers and fetuses, together with amniotic fluid. IFN was undetectable in the fetal blood and amniotic fluid in both cases. Pharmacokinetic parameters were similar to those in nonpregnant women. We conclude that maternal IFN-α during pregnancy should be safe for the fetus. The indications for IFN therapy in pregnancy could therefore be the same as those in the non-pregnant stat

ISSN:1015-3837    

DOI:10.1159/000264183

出版商:S. Karger AG    

年代:1995

数据来源: Karger

ISSN:1015-3837    

DOI:10.1159/000264184

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Glutathione S-transferase B1 (GST B1) concentration in blood and amniotic fluid from fetuses investigated for a variety of conditions including rhesus (Rh) allo-immunisation was assessed for its usefulness as a measure of liver damage caused by hypoxia in utero. The concentration in blood from the intrahepatic vein (IHV) was 10-fold higher than that from the placental cord insertion suggesting that parenchymal liver cells are damaged during blood sampling from the IHV. As a measure of hepatocellular impairment caused by intra-uterine hypoxia, levels were higher in frankly acidotic fetuses than in normally managed Rh fetuses. The degree of hypoxia required to trigger the release of GST B1 into the plasma remains unclear.

ISSN:1015-3837    

DOI:10.1159/000264185

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Ultrasound examination at 9 weeks of gestation in a 34-year-old primigravida showed a twin pregnancy, with discrepancy in the sizes of the two gestational sacs, whereas the crownrump lengths and fetal heart rates were virtually identical – the result being an abnormal sac size/crownrump length ratio (early oligohydramnios). By 14 weeks discordant heart rates and umbilical artery flow velocities were detected, the discordance between the twins increasing as pregnancy progressed. Biparietal diameters, femoral lengths, and abdominal circumferences were also progressively discordant, and at 28 weeks the smaller twin had no heart beat. At 30 weeks the patient was delivered of a live 1,350-gram infant and a 400-gram dead fetus. This case suggests, in contradistinction to several previous reports, that fetal discordance in twin pregnancies (and perhaps intrauterine growth retardation in general) may be present as early as the first trimeste

ISSN:1015-3837    

DOI:10.1159/000264186

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

For chronic fetal hypoxia due to maternal Ebstein’s anomaly, oxygen was administered daily to the mother by mask for 105 days. At 20 weeks of gestation, umbilical venous blood gases in room air showed pH 7.42, PO2 25.7 mm Hg, PCO2 33.7 mm Hg and O2 saturation 48.7%, and changed to 7.45, 39.1 mm Hg, 25.9 mm Hg and 77.4% on 3 liters/min of oxygen inhalation by mask, respectively. The PO2 of the maternal arterial blood gases increased to 30 mm Hg on oxygen administration at 15 weeks of gestation, but at 25 weeks of gestation the PO2 increased by only about 10 mm Hg. At 30 weeks, intrauterine growth retardation was suspected. Just after the second puncture of the umbilical cord at 31 weeks and 3 days of gestation, 80 bpm fetal bradycardia occurred for several minutes without recovery and emergency cesarean section was done under the general anesthesi

ISSN:1015-3837    

DOI:10.1159/000264187

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

To improve the outcome of severe twin-to-twin transfusion syndrome with 1 hydropic fetus and to prevent ischemic sequelae in the survivor, we developed a technique of selective feticide by vascular embolization of the most severely damaged twin. Acute second trimester polyhydramnios occurred in 4 biamniotic monochorial twin pregnancies, with 1 fetus normal on ultrasound but the other severely damaged by hydrops and hypertrophic hypokinetic cardiomyopathy. The hydropic fetus underwent embolization using a bolus of histoacryl injected into the umbilical vein and fetal heart under ultrasound guidance. In 1 triplet pregnancy with a set of monochorial fetuses, premature labor occurred at 26 weeks, 2 weeks after embolization, and there were 2 neonatal deaths. The 3 other cases resulted in the birth of a normal infant at 31–37 weeks of gestation. This suggests that in twin-to-twin transfusion syndrome with severe polyhydramnios and hydrops of 1 fetus, embolization may salvage the other twi

ISSN:1015-3837    

DOI:10.1159/000264188

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Twin transfusion syndrome is a common complication of monozygotic twin pregnancies. Selective feticide is one of the many different aggressive and invasive therapies that has been suggested to improve an otherwise dismal perinatal outcome. The ideal method of selective feticide remains to be delineated for cases of twin transfusion syndrome that occur remote from term. We describe a case involving the use of intracardiac placement of thrombogenic coils to attempt selective termination.

ISSN:1015-3837    

DOI:10.1159/000264189

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Prenatal diagnosis of dystrophic epidermolysis bullosa (DEB) has been achieved in the past by fetal skin sampling. However, this invasive procedure is associated with a relatively high rate of pregnancy loss. We present a consanguineous Arab family ascertained by 2 affected offspring to be at risk for DEB. In a previous gestation, fetoscopic skin sampling for prenatal diagnosis yielded a false-positive result. In the index pregnancy, abnormally elevated amniotic fluid alpha fetoprotein (13.7 MOM) and positive acetylcholinesterase were highly suggestive of an affected fetus. Fetal skin biopsy was declined. At term, the patient delivered a male infant with DEB that expired on the 3rd day of life. It is apparent from our experience and from review of the literature that in some genodermatoses, markedly elevated alpha-fetoprotein and positive acetylcholinesterase in amniotic fluid are highly suggestive of an affected fetus and may obviate the need for fetal skin sampling in the prenatal diagnosis of these disorders.

ISSN:1015-3837    

DOI:10.1159/000264190

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

We studied 17 fetal rats with vascular ring composed of the left aortic arch and right ductus arteriosus and 7 fetal rats with the mirror-image arrangement. The vascular ring of this type was induced by administration of bis-diamine (200 mg) on the 9th and 10th day of pregnancy in rats. In the most severe case, the esophagus and trachea were compressed completely and no inner space was left, and localized and diffuse tracheal stenosis was prominent. The fetal lung mass was increased as the stenosis of the ring was severe. The thoracic descending aorta was positioned in the left side, and was contrasted with the clinically observed right descending aorta in this postnatal anomaly. Thus we are reporting two new findings in the fetal vascular ring with the left aortic arch and the right ductus arteriosus: increased lung mass and left descending aorta in a fetal animal model.

ISSN:1015-3837    

DOI:10.1159/000264191

出版商:S. Karger AG    

年代:1995

数据来源: Karger