摘要:

Purpose: Establish a clinically relevant threshold for urinary β2-microglobulin (β2m) to predict the presence of several renal damage in fetuses with obstructive uropathies. Methods: Retrospective review was conducted of urinary β2m levels, clinical outcomes, and pathological findings in 36 fetuses evaluated for presumed obstructive uropathy. Patients were divided into those free of renal injury (group 1, n = 13) and those with clinical or pathological evidence of severe irreversible renal injury (group 2, n = 23). Results: Including all patients, a threshold β2m 6 was able to predict the presence of severe renal damage with a 83% sensitivity and 71% specificity. β2m levels tended to decrease with increasing gestational age among those patients without renal injury (group 1), while β2m levels increased among those with severe renal damage (group 2). There was no difference in mean β2m levels in those 20 weeks of gestation (p 1O predicted the presence of severe renal damage with 100% sensitivity and specificity. Conclusions: Urinary β2 20 weeks, may be a clinically useful marker to detect the presence of severe renal damage due to obstructive uropathy and thus be an important adjuvant in the proper selection of fetuses for antenatal inter

ISSN:1015-3837    

DOI:10.1159/000264415

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Objective: To evaluate the prognosis of prenatally diagnosed gastroschisis. Study Design: In a retrospective study, we analyzed the clinical and echographic data of gastroschisis. These data were correlated with fetal outcome including delivery, surgical procedure, follow-up in the neonatal intensivecase unit and in the gastropediatric unit. Result: Twenty cases were analyzed. The overall survival rate was 85%. Classical criteria were analyzed (maximal bowel dilatation, thickening of bowel wall). Fetuses with both severe perivisceritis and meconium-stained amniotic fluid were born earlier than fetuses with mild perivisceritis and normal amniotic fluid (p < 0.01). Conclusion: Our data suggest that an inflammatory response could follow bowel exposure to amniotic fluid. This response could lead to perivisceritis and premature birth. This hypothesis is currently under investigation.

ISSN:1015-3837    

DOI:10.1159/000264416

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Objective. Prenatally diagnosed methylmalonic aciduria (MMA) has been treated in only a few fetuses, and has been done empirically with maternally administered cyanocobalamin (B12) in attempts to ameliorate sequelae that include failure to thrive, developmental delay, dehydration, and coma. There has not been a systematic attempt to titrate doses to fetal response. We investigated the alterations in maternal dosage necessary to keep maternal plasma (MP) and urine (MU) levels of MMA in the normal range secondary to the ability of pharmacological doses of B12 to catalyze the reaction of methylmalonylcoenzyme A to succinyl-coenzyme A. Methods. A 28-year-old woman, with a 3-year-old son affected with MMA, underwent amniocentesis at 15 weeks which showed a normal karyotype, elevated amniotic fluid MMA, and decreased amniocyte 5′-deoxyadenosylcobalamin, propionate, and methyltetrahydrofolate. MP and MU MMA levels were measured biweekly. B12 doses were altered periodically according to laboratory-determined levels. Results. MP and MU levels varied with gestational age and in response to increases in maternally administered B12. Conclusions. With increasing ges4tation, fetal, and placental size, increasing doses of B12 are necessary to maintain MP and MU levels of MMA within normal range. The data suggest that close surveillance and frequent measurements of MMA are necessary to properly titrate B12 treatmen

ISSN:1015-3837    

DOI:10.1159/000264418

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Background: The association ofhyperthyroidism and pregnancy is a rare but serious condition which can jeopardize fetal outcome. Classical follow-up relies on: serial clinical and echographic assessment; serial funipuncture to determine fetal thyroid status, and maternal propylthiouracil (PTU) treatment to treat fetal and/or maternal hyperthyroidism. Case: We report the case of a euthyroid patient with Graves’ disease who had already been delivered of two hyperthyroid fetuses; the present pregnancy revealed a hyperthyroid fetus diagnosed by funipuncture. Echography showed a fetal goiter at 28 weeks of gestation (WG) with important signal on colored Doppler echography. We observed an extinction of this signal as maternal PTU treatment was intensified. The patient was delivered of a mildly hyperthyroid newborn at 37 WG. Both newborn and patient are doing well. Conclusion: Fetal thyroid assessment by colored Doppler echography could help in the management of fetal thyroid dysfunctio

ISSN:1015-3837    

DOI:10.1159/000264419

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

There is a huge plastic industry in the Kingdom of Saudi Arabia, where plastic wares are widely used. Locally manufactured jerricans were brought from the market and cut into small chips of 0.5 cm in the larger dimension. Four gram chips were extracted with 20 ml normal saline solution in the autoclave for 1 h at 121°C. The extract was prepared daily and administered at a dose of 20 ml/ kg/day i.p. to MFI mice during gestation. The control group was given normal saline. Both groups included at least 20 pregnant mice each. The prenatal effects of the extract were investigated with respect to the gestational period, neonatal mortality, body weight, body growth rate, body length, eye opening, weight of the internal organs, blood enzymes, and nervous system (neuromuscular junction analgesia and behavior) by using the accelerating Rota-rod treadmill (Ugo Basile, Varese, Italy), a hot plate and an automatic reflex conditioner of the offspring. All the results were subjected to t test. The results indicated that prenatally administered aqueous plastic extract increased the percentage of liver weight (p < 0.05), raised the aspartate aminotransferase activity (p < 0.01) and alanine aminotransferase activity (p < 0.05), reduced the gestational period (p < 0.01), reduced the body weight at birth (p < 0.01), reduced the body growth rate (p < 0.01, p < 0.05), and reduced the endurance time on the Rota-rod treadmill (p < 0.01 p < 0.05)

ISSN:1015-3837    

DOI:10.1159/000264420

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

In order to evaluate the effect of laser coagulation on placental vessels and to define the optimal power density that should be used for this procedure, coagulation of placental vessels and histological examination were performed on freshly delivered placentae. This study suggests that 45- to 55-watt (6,000–7,666 J/cm2) shots can cause adequate placental injury. The extent of vascular lesions depends upon incident beam energy, fiber diameter, distance and angle to the vesse

ISSN:1015-3837    

DOI:10.1159/000264421

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

A case is presented in which X-linked ichthyosis was diagnosed prenatally using fluorescence in situ hybridization. Fetal sex was known by second trimester ultrasound in a woman with very low second trimester MSUE3. All of the 15 maternal peripheral blood metaphase spreads examined displayed two hybridization signals on one X chromosome (one in the steroid sulfatase region (Xp22.3) and one in the centromeric region), but only one hybridization signal (in the X centromeric region) on the other X chromosome. Thus, one of the X chromosome had a deletion in the Xp22.3 region, a result which was consistent with carrier status for steroid sulfatase deficiency and X-linked ichthyosis. In the 15 metaphase spreads that were examined from the amniotic fluid sample, the X chromosome displayed one hybridization signal in the control region, but no hybridization signal in the steroid sulfatase region. Thus, the X chromosome of this male fetus had a deletion in the steroid sulfatase region, a result that was consistent and demonstrated postpartum X-linked ichthyosis.

ISSN:1015-3837    

DOI:10.1159/000264422

出版商:S. Karger AG    

年代:1997

数据来源: Karger

ISSN:1015-3837    

DOI:10.1159/000264423

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

We present a case of intrauterine parvovirus B19 infection, diagnosed by detection of B19 DNA in the amniotic fluid obtained at 15 weeks of gestation for chromosome analysis in an asymptomatic pregnancy, causing hydrops fetalis 7 weeks later. Following intrauterine transfusion, rapid resolution of hydrops could be observed and a healthy boy was born at 38 weeks of gestation. The respective laboratory data obtained from the examination of the amniotic fluid and maternal, fetal, and neonatal blood offer interesting insights into the dynamics of maternal-fetal parvovirus B19 infection.

ISSN:1015-3837    

DOI:10.1159/000264424

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

In this case we report functional pulmonary atresia in a fetus with significant tricuspid valve regurgitation and severe ascites, with spontaneous improvement without prenatal intervention and a subsequent follow-up at 8 weeks after birth.

ISSN:1015-3837    

DOI:10.1159/000264425

出版商:S. Karger AG    

年代:1997

数据来源: Karger