摘要:

The purpose of the study was to examine the sensitivity and specificity of the amniotic fluid Gram stain and leukocyte count in the prediction of positive fetal blood and amniotic fluid cultures in 80 patients with preterm prelabour amniorrhexis. Amniocentesis and cordocentesis were performed and amniotic fluid and fetal blood were cultured for aerobic and anaerobic bacteria. Amniotic fluid was also cultured for Ureaplasma urealyticum and Mycoplasma hominis 30/mm3. Positive amniotic fluid Gram stain provides useful prediction of intrauterine infection with aerobic or anaerobic organisms.

ISSN:1015-3837    

DOI:10.1159/000264270

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The α-fetoprotein concentration in the amniotic fluid of 51 fetuses with isolated nuchal edema and normal karyotypes was compared to that of the next 51 patients of comparable gestational age with normal ultrasounds and karyotypes. The mean α-fetoprotein in amniotic fluid was 1.26 ± 0.45 in the nuchal edema group and 1.01 ± 0.3 in controls (t = 3.287, p = 0.002). Acetylcholinesterase evaluation was indicated by abnormally elevated α-fetoprotein in 4% of amniotic fluid samples from the study group and none of the controls. We concluded that α-fetoprotein is higher in amniotic fluid from pregnancies with isolated fetal nuchal edema and normal karyotype. Possible leakage of protein from enlarged cervical lymphatics associated with fetal nuchal edema may explain these fin

ISSN:1015-3837    

DOI:10.1159/000264271

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

This was a prospective study in 1,492 women with singleton viable pregnancies undergoing chorion villus sampling (CVS) or early amniocentesis (EA) at 10–13 weeks of gestation because of advanced maternal age, parental anxiety or family history of chromosomal abnormality in the absence of parental chromosomal rearrangement. They were offered the option of having CVS or EA, or to be randomised into one of the two tests. CVS was performed in 652 cases (375 by choice and 277 by randomisation) and EA was performed in 840 cases (562 by choice and 278 by randomisation). Both procedures were carried out by transabdominal ultrasound-guided insertion of a needle (20 gauge) using a free-hand technique. The two techniques were similar in providing a sample (CVS 99.3%, EA 100%) and in giving a non-mosaic cytogenetic result (CVS 97.5%, EA 97.9%). Spontaneous loss (intrauterine or neonatal death) after EA (total group 4.9%, randomised subgroup 5.8%) was significantly higher than after CVS (total group 2.1%, randomised subgroup 1.8%; difference 2.8%, 95% CI 1.3–4.3%, and difference 4%, 95% CI 1.3–6.7%). The gestation at delivery and birth weight of the infants after EA and CVS were similar. In the EA group the incidence of talipes equinovarus (1.66%) was higher than in the CVS group (0.48%), but this difference was not signif

ISSN:1015-3837    

DOI:10.1159/000264272

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The objective of the study was to assess whether the association known in singleton pregnancies of high maternal serum α-fetoprotein (AFP) or human chorionic gonadotropin (HCG) with adverse outcomes applies also to multifetal gestations. Maternal serum AFP and HCG were evaluated in 207 multifetal pregnancies. High values were defined as a maternal serum AFP of > 4.5 and a HCG of > 4.0 multiples of the median (MoM), with appropriate adjustments. Results were correlated with premature delivery, stillbirths, or pregnancy termination for fetal anomalies. There were 10 stillbirths, 7 terminations of pregnancy for fetal anomalies, and 66 premature deliveries in the study group. Maternal serum AFP was somewhat higher in abnormal pregnancies than in those with normal outcome (3.4 vs. 2.5 MoM, respectively, NS). A high AFP level was found in 6% of pregnancies with adverse outcomes and in 4% of uncomplicated gestations (NS). High HCG values, also observed in 5% of cases, were all associated with normal outcome. Multiple marker screening suggested an increased risk for aneuploidy in 9% of patients, all of whom were euploid on amniocentesis karyotypes. Maternal serum screening in multiple gestations is confounded by the differing contributions of fetuses, and abnormal results cannot reliably predict adverse pregnancy outcomes

ISSN:1015-3837    

DOI:10.1159/000264273

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The antenatal clinics in the catchment area of the Department of Obstetrics and Gynecology, University Hospital, Lund, were divided into a study group and a control group. At the study antenatal clinics during a 15-month period 1,004 pregnant women received a written and verbal information that a routine ultrasound examination during gestational week 18 should be considered as a prenatal diagnostic method. They even got information on alternatives: to decline all, to have an early abdominal ultrasound examination, or to have both a routine ultrasound examination and an amniocentesis performed. At the control antenatal clinics, 1,408 pregnant women received standard information. No women in either group chose not to have an ultrasound examination performed, but 1% chose an early abdominal examination in the study group. The percentage of women older than 35 years who asked for an amniocentesis was equal in the two groups. However, women younger than 35 years in the study group requested amniocentesis significantly more frequently than the women in the control group.

ISSN:1015-3837    

DOI:10.1159/000264274

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

A 28-week fetus with hydrops and bilateral pleural effusions underwent drainage of both pleural spaces via a single-needle supradiaphragmatic insertion technique. The traditional approach was not feasible due to a persistently unfavorable fetal position. The dependent pleural effusion was drained by a needle which coursed through the nondependent pleural effusion. The needle traversed the midline pleura through an avascular plane. Thereafter the needle was withdrawn into nondependent pleural effusion which was drained. Both lungs expanded with favorable neonatal outcome.

ISSN:1015-3837    

DOI:10.1159/000264275

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Internalization of a pleuroamniotic shunt previously has not been associated with significant fetal or neonatal problems. We report a case in whom the shunt internalized and compressed the lung hilum. A review of the complications of antenatal pleuroamniotic shunting is also presented.

ISSN:1015-3837    

DOI:10.1159/000264276

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The objectives of the study were to assess the ability of a fetal pulse oximeter to measure the fetal oxygen saturation (SPO2) continuously during labor and to assess the correlation between readings of fetal pulse oximetry and cord blood gases at birth. The Nellcor N-400 Fetal Oximeter was used in 62 women prospectively. The mean SPO2 was unchanged at the different stages of normal labor: 53.3 ± 9.1 to 50.1 ± 11.8% (n = 50). The SPO2 recorded during the pushing phase of stage II (n = 40) was correlated significantly with umbilical cord arterial pH (r = 0.55; p = 0.0002), venous pH (r = 0.63; p = 0.0001), venous PCO2 (r = 0.47; p = 0.002) and venous PO2 (r = 0.39; p = 0.01). SPO2 was also correlated with scalp pH (r = 0.52; p < 0.05; n = 21). No side effects were noted. Fetal pulse oximetry could be useful to assess fetal oxygenation during labor and at birt

ISSN:1015-3837    

DOI:10.1159/000264277

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Vesicoamniotic shunting is typically reserved for treatment of fetal obstructive uropathy. We report a case of congenital megacystis without anatomic urinary obstruction in whom a vesicoamniotic shunt was used to improve fetal hemodynamics as measured by Doppler velocimetry.

ISSN:1015-3837    

DOI:10.1159/000264278

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

In a prospective study of 330 pregnant women, measurements of the transverse cerebellar diameter (TCD), abdominal circumference (AC), biparietal diameter (BPD), head circumference (HC) and TCD/AC ratio and HC/AC ratio were obtained using conventional ultrasonography between 16th and 41st weeks of gestation. Measurement of BPD yielded a strong correlation with gestational age (r = 0.9880 and R2 = 0.9761) by cubic regression analysis. The measurement of TCD also had a very close relation with gestational age (r = 0.9767 and R2 = 0.9539). The ratio between TCD and AC was calculated and found to be 0.1436 ± 0.0106 (SD) which remained fairly constant throughout pregnancy, while the BPD/AC ratio declined. The 5th and 95th percentiles for this ratio were 0.1279 and 0.1603. Ten of eleven fetuses with TCD/AC ratios exceeding 2 SD (0.1648) were found to have asymmetrical intrauterine growth retardation upon neonatal examination. It is demonstrated that both BPD and TCD measurements are reliable techniques that correlate well with gestational age, and the TCD/AC ratio is valuable in identifying babies with asymmetrical intrauterine growth retardation

ISSN:1015-3837    

DOI:10.1159/000264279

出版商:S. Karger AG    

年代:1996

数据来源: Karger