摘要:

Reference ranges for the various components of fetal heart rate (FHR) patterns with gestation were established from the study of 119 fetuses at 20–39 weeks. These fetuses were proved by cordocentesis to be normoxaemic and nonanaemic. The mean baseline FHR decreased, while the baseline variability, both for amplitude and oscillation frequency, increased with gestation. The number and amplitude of accelerations increased, and the frequency and duration of decelerations decreased with gestation. These data indicate that in the interpretation of FHR patterns adjustments according to the gestational age of the fetus should be mad

ISSN:1015-3837    

DOI:10.1159/000263424

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

There is presently no information concerning the ontogeny and control of arginine vasopressin (AVP) in the human fetus. AVP was measured in 22 nonanemic control fetuses and 7 fetuses with hemolytic anemia undergoing 13 intravascular transfusions. Each transfused fetus received pancuronium (0.3 mg/kg) and furosemide (2 mg/kg). Compared to the control group of nonanemic fetuses with hemolytic disease, AVP was significantly lower in the anemic fetus prior to transfusion (2.6 ± 0.4 μU/ml versus 10.4 ± 4.1 μU/ml, p < 0.05). This suggests that hemolytic anemia is associated with a relative increase in fetal intravascular volume. Intravascular transfusion was associated with a significant increase in AVP (p < 0.05). These findings could not be explained by changes in either blood pressure, plasma osmolality, or fetal oxygenat

ISSN:1015-3837    

DOI:10.1159/000263425

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

The pathogenesis of the prune belly syndrome is unclear. The proposed etiologies include a distal obstructive uropathy or a mesodermal defect of the anterior abdominal wall and urinary tract. Detection of increased intravesicular pressure might identify those fetuses with an obstructive etiology who, therefore, would benefit from shunting.

ISSN:1015-3837    

DOI:10.1159/000263426

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

The original description of intraperitoneal transfusion calls for contrast-dye infusion and X-ray confirmation of placement of the needle free in the peritoneal cavity. Ultrasound methods, using air or saline as contrast media, have been described to replace the X-rays. This report illustrates at least one way in which the ultrasound findings at intraperitoneal transfusion may be illusory, allowing misplaced transfusion into the fetal colon. In specific instances, use of radiopaque dye at intraperitoneal transfusion may still be helpful.

ISSN:1015-3837    

DOI:10.1159/000263427

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

We report successful selective feticide of an anomalous, comprising twin by using intracardiac potassium chloride injection at 26 weeks gestation. This was associated with later delivery and survival of a very low birth weight infant with normal neurodevelopmental follow-up at 2 years. We suggest that selective feticide in such cases may have an important role to play in management.

ISSN:1015-3837    

DOI:10.1159/000263428

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Some recent reports have suggested that invasive testing is unnecessary when ultrasound either confirms or refutes a neural tube defect (NTD). However, counseling for recurrence risks and the possibilities for in utero therapy would be significantly altered by an aneuploid karyotype. We report our experience with 53 pregnancies affected by NTD in which we found 13.2% of these fetuses with abnormal chromosomes. In view of the higher than previously published incidence of aneuploidy, we.believe that fetal karyotypes are essential in the evaluation of all fetuses with NTDs.

ISSN:1015-3837    

DOI:10.1159/000263429

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

The analysis of urine obtained from fetuses with hydronephrosis, seen on ultrasound, can give a misleading assessment of residual renal function. Additional parameters for assessment of fetal renal function would be helpful. We have used SDS-polyacrylamide gel electrophoresis to separate urinary proteins from a fetus with obstructive uropathy and severe oligohydramnios, already present at 18 weeks of gestation. The dilated urinary bladder of the fetus was successfully shunted in utero with a double pigtail catheter which worked for 17 weeks, and a boy without renal or pulmonary insufficiency was born at 36 weeks. In this case the prenatal protein analysis by electrophoresis was a better indicator of the ultimate good pregnancy outcome than the evaluation of urinary electrolytes and osmolarity alone. We therefore suggest the addition of this test to the profile of renal function studies performed on fetal urine.

ISSN:1015-3837    

DOI:10.1159/000263430

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Fetal behavior was studied in 17 cases of fetal abnormalities including nonimmune hydrops fetalis and in 11 cases of intrauterine growth retardation (IUGR) in comparison to 30 healthy fetuses. Breathing movements, rapid eye movements and trunk movements were observed ultrasonically and analyzed using a computer-assisted system. The cases with central nervous system anomalies showed a markedly different behavioral pattern. In the fetal abnormalities without chromosomal anomalies, the cases without major behavioral disorders were cured by neonatal treatment. IUGR cases with decreased trunk, breathing and REM period were finally diagnosed as having fetal distress by fetal heart rate monitoring. The findings on fetal behavior hint at the possibility of diagnosing abnormalities in neural development as well as in well-being.

ISSN:1015-3837    

DOI:10.1159/000263431

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Models to predict normal fetal growth have been of limited accuracy. Abnormal growth is even more problematic. We have developed a mathematical modeling system based on observed body and brain weights to study fetal growth patterns in midgestational trisomy 18 fetuses. Third-degree polynomial-based analysis using observed fetal body and brain weights to generate predicted weights for various organ systems allows for the comparative study of growth patterns at various fetal weights and gestational ages. Our data suggest that what has been previously called symmetrical intrauterine growth retardation associated with aneuploid fetuses is really an asymmetrical pattern that is dynamic in nature and may change through the course of pregnancy.

ISSN:1015-3837    

DOI:10.1159/000263432

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

A case of non-immune fetal hydrops, diagnosed as mucopolysaccharidosis VII with hypoalbuminemia, was treated in utero with albumin transfusions via cordocentesis on five occasions. Blood samples were taken for analysis of full blood count and blood gases before and after the transfusions. Pulsed Doppler ultrasound examinations of the arterial waveform were performed in the umbilical arteries and the descending fetal aorta and analyzed for the pulsatility index (PI). The hemoglobin concentration and the hematocrit decreased from Ill ± 5 g/l and 0.335 ± 0.008 to 95 ± 5 g/l and 0.282 ± 0.023 (mean ± SD), respectively, after the transfusions. The calculated blood volume increased more than the given volume, indicating an autotransfusion causing additional plasma volume expansion. The blood gases were not significantly changed by transfusion. The PI decreased both in the umbilical arteries (p < 0.05) and the descending fetal aorta, indicating peripheral vasodilatation. A positive correlation was found between the umbilical artery PI and the hematocrit before and after the albumin transfusion (r = 0.59; p < 0.05). This relation could be due to covariation with other factors, e.g. peripheral vasodilatation secondary to the increased blood volume and the puncture of the umbilical vein itself. No improvement of the hydrops was seen after the albumin transfusions. The fetus died in utero during spontaneous labor after 30 gestational w

ISSN:1015-3837    

DOI:10.1159/000263433

出版商:S. Karger AG    

年代:1989

数据来源: Karger