摘要:

Postterm pregnancies of more than 290 completed gestational days (n = 110) were simultaneously supervised after admission by pulsed Doppler ultrasound of the common carotid and the umbilical arteries, nonstress and contraction stress tests (NST/CST) and vibroacoustic stimulation tests (VAST). The results of these tests were blinded for the clinicians. Further decision making was based mainly on fetal heart rate (FHR) monitoring. The prognostic value of tests performed < 3 days before birth predicting fetal distress, low Apgar and pH values in the umbilical artery were compared by receiver operator characteristics. Results of the NSTs and fetal Doppler measurements of the ratio of resistance indices of common carotid/umbilical artery were more predictive of later fetal distress than both, VAST and CST (p 0.05, respectively). There were no significant differences in the prediction of low Apgar values. NST was the only significant test for predicting a low pH in the umbilical artery immediately after birth compared to the other examinations (p < 0.05). The results suggest that even in prolonged pregnancies VAST and CST might be released from routine supervision.

ISSN:1015-3837    

DOI:10.1159/000263899

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

A substantial proportion of perinatal losses in polyhydramnios occur as unexplained normally formed stillbirths. In order to investigate the relationship between fetal condition and raised amniotic pressure (AP), fetal blood gas and acid-base status were determined together with AP in 22 pregnancies with polyhydramnios. At fetal blood sampling, 8 (36%) had a venous pH value and 16 (73%) a pO2 value below the reference range. Both fetal pH and pO2 were significantly negatively correlated with the degree of elevation in AP (y = 7.43 ––0.036x, r = 0.56, p = 0.006, where y = pH and x = AP z score, and y = ––1.6 – 0.48x, r = 0.54, p = 0.01, where y = pO2 z score, respectively). Although some of these fetuses were hydropic, had congenital anomalies, or were from multiple pregnancies, univariate and multiple logistic regression analyses indicated that the above associations could not be accounted for by these potentially confounding variables. This work suggsts that abnormal fetal blood gas status in human pregnancies with polyhydramnios is associated with el

ISSN:1015-3837    

DOI:10.1159/000263900

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

In a cross-sectional study of 75 singleton pregnancies at 16–38 weeks gestation serum cobalamin and ferritin concentrations were measured in fetal and maternal blood samples. Fetal serum cobalamin concentration did not change significantly with gestation but ferritin concentration increased. The median fetal serum concentrations of both ferritin and cobalamin were significantly higher than the respective values in the mother. The median fetal-maternal ratio for ferritin was 3.2 and for cobalamin 1.2. These findings demonstrate that from at least 16 weeks gestation, there is efficient iron storage in the fetus and transfer of cobalamin from the mother to the fetus against a concentration gradien

ISSN:1015-3837    

DOI:10.1159/000263901

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Following the 1990 FDA approval of the Trophocan® catheter for use in transcervical chorionic villus sampling (CVS), an increasing number of US physicians have begun offering the procedure. To obtain privileges to perform CVS, some states such as California have enacted legislation requiring the performance of a certain number of CVS procedures in pregnancies in which the patient has already chosen first-trimester abortion. This practice is not universally feasible for legal, logistic, or financial reasons. We describe our approach to training in a busy reproductive genetics service. The physician initially trains by performing amniocentesis to optimize skills in ultrasound-directed needle guidance and placement. During this initial period, he or she also assists in performing transab-dominal CVS procedures. The initial transcervical CVS cases should be performed in those situations requiring minimal catheter manipulation, or in those individuals undergoing CVS in the setting of spontaneous abortion. Cases of increasing difficulty should only be performed as skill and familiarity increase. For a physician already skilled and experienced in ultrasound-guided invasive procedures, sequential periods of observation at a busy center allows him or her to become familiar with the common pitfalls in performing transcervical CVS, and thus avoid them. Using this approach, we have performed over 5,000 CVS procedures and trained 6 reproductive genetics fellows in transcervical CVS

ISSN:1015-3837    

DOI:10.1159/000263902

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The occurrence and serum concentrations of adenocarcinoma-associated antigen (ACAA) were studied during the fetal period of life, in newborns and in their mothers. The mean concentrations were significantly higher in fetal, newborn and maternal sera when compared with the mean concentration of ACAA in healthy, nonpregnant adults. Thus, ACAA appears to show fetospecific features as is known for other oncofetal proteins. ACAA should be recognized not only as a potential tumor marker, but also as a normal protein constituent of human serum.

ISSN:1015-3837    

DOI:10.1159/000263903

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Microbial invasion and growth in amniotic fluid play an important role in infectious perinatal morbidity and mortality. In order to determine the influence of amniocentesis (ACT) on intra-amniotic infection development, we performed a study of 239 complete microbiological examinations of amniotic fluid specimens obtained by serial interventions. In 1 case (0.42%), during the second procedure, Staphylococcus epidermidis was discovered. Neither spontaneous abortion nor preterm labor were provoked by the procedure. We can conclude that ACT has been confirmed as a safe and successful intrauterine intervention if it is made in a proper manner.

ISSN:1015-3837    

DOI:10.1159/000263904

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Though echogenic fetal bowel has been associated with meconium ileus and/or peritonitis, it may be a normal finding in the second trimester. The purpose of this study is to determine which characteristics might distinguish fetuses ultimately having abnormal outcomes in a population at low risk for cystic fibrosis. Seven fetuses with echogenic bowel were identified: 5 fetuses ≤ 20 weeks gestation (group 1) and 2 fetuses 20–25 weeks gestation (group 2) at diagnosis. Four of 5 group 1 fetuses had resolution of the echogenic bowel during the second trimester. One group 2 fetus had a persistent mass associated with growth deficiency and trisomy 18. The neonatal bowel evaluation was normal in the remaining 2 fetuses although echogenic findings persisted into the third trimester. In a low-risk population, echogenic bowel usually resolves without neonatal sequelae. Even when persistent into the third trimester, echogenic bowel does not uniformly herald an abnormal outcome. Echogenic bowel coexistent with other abnormalities (such as growth deficiency or structural malformations) may be a comarker for aneuplo

ISSN:1015-3837    

DOI:10.1159/000263905

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Interrupted aortic arch type B associated with ventricular septal defect (n = 17) or atrioventricular septal defect (n = 2) was induced in 19 of 300 fetuses by maternal administration of bisdiamine on the 9th and 10th day of pregnancy. After rapid whole-body freezing on the 21st day, the fetuses were studied by means of serial cross-sectional photographs of the frozen thorax. In fetuses with interrupted aortic arch, the ascending aorta was small, and the ratio of its diameter to the diameter of the pulmonary trunk was 0.64 ± 0.03 (mean ± SEM) in contrast to 0.96 ± 0.02 in the control. The aortic arch was interrupted distal to the left common carotid artery (type B of Cerolia and Patton) in all cas

ISSN:1015-3837    

DOI:10.1159/000263906

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

To clarify the effect of experimentally increased blood flow to the aortic isthmus, in situ cross-sectional morphology of the aortic isthmus and the juxtaductal descending aorta was studied in fetal rats. Indomethacin (10 mg/kg) was administered to 10 near-term pregnant rats, and fetuses were studied 4 and 24 h later with cesarean section, rapid whole-body freezing, sectioning on a freezing microtome in a plane perpendicular to the aortic isthmus, and photographing cross-sections. Fetuses without treatment served as controls. The ductus was constricted and its cross-sectional area was 12 ± 3% (mean ± SEM, % of control; p < 0.05 vs. control) at 4 and 24 h. The aortic isthmus was enlarged and the cross-sectional area was 146 ± 5% at 24 h in response to the increased flow. These results support the concept that the size of the fetal aortic isthmus can change rapidly depending on the flow in late gestati

ISSN:1015-3837    

DOI:10.1159/000263907

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Congenital seminal vesicular cysts represent a rare embryological malformation usually associated with ipsilateral renal dysplasia. We report a case which was diagnosed antenatally as a ureterocele and found postnatally to be a seminal vesicular cyst.

ISSN:1015-3837    

DOI:10.1159/000263908

出版商:S. Karger AG    

年代:1994

数据来源: Karger