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Biomedical subjects

H Nasrat

Publications and source records attributed to H Nasrat.

5 recordsLinked to original sources
PubMed1992

Midpregnancy plasma zinc in normal and growth retarded fetuses--a preliminary study.

OBJECTIVE: To determine plasma zinc concentrations in normally and abnormally growing fetuses. DESIGN: Prospective observational study. SETTING: Fetal Medicine Unit, Queen Charlotte's Maternity Hospital. SUBJECTS: 53 pregnant women attending for fetal blood sampling at between 18 and 40 weeks gestation. 27 fetuses were normal (central group), 11 fetuses were growth retarded and 15 were malformed. MAIN OUTCOME MEASURES: Plasma zinc concentrations in maternal and fetal blood at time of fetal blood sampling. RESULTS: In normally growing fetuses, between 18 and 40 weeks gestation, there was no fall in maternal plasma zinc concentration; the fetal level fell by 36%. In 10 fetuses with symmetrical growth retardation, plasma zinc concentration tended to be low, but was not significantly different from that in the normal control fetuses. CONCLUSION: The results suggest that (i) placental transfer of zinc is an uphill secretory process and that it is a rate-limiting step in the accumulation of zinc by the fetus and (ii) in fetuses with symmetrical intrauterine growth retardation, a low plasma zinc is probably a parallel phenomenon and not necessarily an aetiological factor.

Female↗
PubMed1991

Fetal liver dysfunction in Rh alloimmunization.

The liver enzymes, aspartate transaminase (AST), alanine transaminase (ALT), gamma glutamyl transpeptidase (GGT) and alkaline phosphatase (ALP), were measured in the blood of 25 fetuses with severe Rh alloimmunization at the time of their first, second and third intravascular transfusions and in 17 comparison fetuses. In the comparison group, GGT increased with advancing gestation (r = 0.7; P = 0.002), whereas ALP, AST and ALT did not correlate with gestational age. Rh hydropic fetuses (n = 8) had higher blood ALT levels than the comparison fetuses (P = 0.008) had significantly increased transaminases when compared with non hydropic fetuses (n = 17). In hydropic fetuses, AST correlated with the nucleated red cell count before transfusion (r = 0.94; P = less than 0.0001). Fetal transaminases were no longer increased in hydropic fetuses by the second (AST) or third (ALT) transfusion. In both hydropic and non hydropic fetuses, GGT increased by the second transfusion (median percentage change +85%, range -83% to +596%; P = 0.003). The rise in fetal GGT was transitory and correlated with the increase in fetal haematocrit at the first transfusion (r = 0.58; P = 0.006). This study reports liver dysfunction secondary to extramedullary erythropoiesis in Rh alloimmunization and implicates portal hypertension for the rise in fetal GGT with transfusion.

Alanine Transaminase↗
PubMed1991

Fetal blood sampling from the intrahepatic vein for rapid karyotyping in the second and third trimesters.

One hundred and twelve fetuses with structural anomalies (n = 84), intrauterine growth retardation (n = 21) or amniotic fluid volume disorders (n = 7) detected by ultrasound underwent blood sampling from the intrahepatic vein for rapid karyotyping. The procedure was successful in 95.5%. 12.5% of the fetuses had an abnormal karyotype. Fetal bradycardia was observed in two fetuses (1.8%) and intraperitoneal bleeding in three (2.7%). There were three procedure-related losses but these were not due to the intrahepatic vein sampling itself. Fetal blood sampling is the method of choice for rapid karyotyping in the second and third trimesters, and the intrahepatic vein is an alternate site when access is difficult or failure to sample occurs at the placental cord insertion. Additional advantages of fetal blood sampling at the intrahepatic vein include absence of cord complications, reduced risk of fetal blood loss and fetomaternal haemorrhage, and the lack of need to confirm the fetal origin of the sample.

Blood Specimen Collection↗
PubMed1991

X-ray pelvimetry-reappraisal.

Antenatal erect lateral X-ray pelvimetry was performed for 116 primigravidas and 53 multigravidas because of suspected cephalopelvic disproportion (CPD). Multigravidas were further subgrouped into 4 gravidas and greater than 4 gravidas. In the primigravidas, there was no statistical difference in the mean value of the anteroposterior diameter of the pelvic inlet (APD) of the elective (10.4 cm, +/- 0.6 SD) and the emergency (10.5 cm, +/- 0.9 SD) caesarean section group. In the multigravidas, the mean value of the APD showed a statistically significant decrease with increased parity. In this group, the chances of delivery by caesarean section were 74%, when the APD was less than 10.5 cm, and 12% if the APD was greater than 11.5 cm. It is concluded that cephalopelvic disproportion in primigravidas should only be diagnosed after adequate trial of labour with adequate uterine contractions. In multiparous patients, especially grand multiparas, X-ray pelvimetry is recommended in cases of suspected CPD before a trial of vaginal delivery is conducted, since the mode of delivery seems to depend primarily on the pelvic capacity.

Birth Weight↗