Cardiodynamic studies in the newborn. 3. Heart rate patterns in infants with idiopathic respiratory distress syndrome.
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Biomedical subjects
Publications and source records attributed to A J Rudolph.
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A syndrome consisting of colobomatous microphthalmia, heart disease, abnormalities of the external ear with associated hearing loss, and mental retardation is described. Nine children and one adult were evaluated. There is not race or sex predilection. The syndrome can be heritable, as shown by a mother and daughter who were among the patients. In addition to the four major components enumerated, multiple other anomalies may be associated. In some cases, the syndrome may occur incompletely. Whenever two or more of the four components are recognized, the other systems usually affected should be investigated.
Between the twenty-seventh and thirty-fourth weeks of gestation, the appearance of the anterior vascular capsule of the lens (tunica vasculosa lentis) has been established to be useful in accurately estimating gestational age. Thirty-three infants assessed by maternal dates and Dubowitz scoring were studied with the direct ophthalmoscope following dilatation of the pupil in the first 24 hours of life. Five discordant twins, eight concordant twins, and twenty singletons were determined to be markedly small for gestational age on the basis of birth weight (less than tenth percentile). As in infants who are appropriately sized for dates, the disappearance of the anterior vascular capsule of the lens in infants who are small for dates correlates well with their gestational age and is reliable for gestational age assessment (p less than 0.0005).
The disappearance of the anterior vascular capsule of the lens (tunica vasculosa lentis) in the preterm infant has been established to be useful in accurately estimating gestational age between the twenty-seventh and thirty-fourth weeks in infants appropriate or small for gestational age. Six infants have been studied with abnormalities of the anterior vascular capsule of the lens in which congenital TORCH infection has been documented (1 toxoplasmosis, 2 rubella, 2 cytomegalovirus, and 1 herpes simplex virus). Since the anterior vascular capsule generally atrophies symmetrically and completely after the thirty-fourth week of gestation, the findings of marked asymmetry and/or persistence and hypertrophy of the anterior vascular capsule of the lens warrants initiation of TORCH studies in the newborn infant.
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