Ovarian torsion related to sudden infant death.
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Female↗
Biomedical subjects
R G Sugarman
Publications and source records attributed to R G Sugarman.
Intrauterine hydrocephalus and ventriculomegaly: associated anomalies and fetal outcome.
Advances in fetal diagnostic techniques have opened many areas to prenatal anatomical scrutiny. Intrauterine hydrocephalus and ventriculomegaly are conditions which are readily diagnosed. Fetal intervention has been undertaken in humans in order to minimize the craniofacial disfigurement and to maximize the growth potential of the brain. To justify such an approach, the significance of all anomalies should be recognized prior to treatment. The authors have reviewed 41 cases of hydrocephalus diagnosed in utero in order to define associated anomalies and patient outcome. 75% of our personal series and 72% of the reviewed literature cases had other anomalies of the central nervous system. Other system malformations, some of which proved fatal, were seen commonly. Prenatal diagnostic techniques did not always reveal these additional problems. The outcome of these pregnancies is not good. Approximately one third of these fetuses have survived to be treated postnatally and to be followed up clinically. Only 7.5% of this series were felt to have attained normal developmental milestones. The remainder of the survivors have various focal and/or global cerebral deficits.
Abnormalities, Multiple↗
Successful pregnancy after high dose chemotherapy and marrow transplantation for treatment of aplastic anemia.
A 29-year-old woman with severe idiopathic aplastic anemia was given immunosuppressive therapy with procarbazine, 37.5 mg/kg, antithymocyte globulin, 36 mg IgG/kg, and cyclophosphamide, 200 mg/kg. This was followed by a marrow transplant from her HLA identical sister, immunosuppressive therapy with intermittent methotrexate for 3 months postgrafting and ultimate restoration of hematopoiesis. Two years after transplantation the patient delivered a healthy male infant. This is the first successful pregnancy after a high dose chemotherapy and marrow transplantation for treatment of aplastic anemia.
Adult↗
Fetal arrhythmia.
Seven human fetuses with intermittently recurring cardiac arrhythmias of ectopic origin were studied intensively during labor and the early neonatal period. Neonatal outcome, judged by Apgar scores and neonatal acid-base parameters, was favorable in all 7 patients. Three of the seven arrhythmias reverted spontaneously to sinus rhythm within 72 hours, and six of the seven resolved by 5 days of age. One neonate, with supraventricular tachycardia, developed congestive heart failure, necessitating digitalization, but was free of symptoms at 6 weeks and showed no evidence of congenital heart disease. The literature on fetal cardiac arrhythmias is reviewed. A number of etiologic mechanisms and several methods of pharmacologic therapy of these irregularities have been proposed. These cases suggest, however, that fetal arrhythmias of ectopic origin need not represent signs of fetal distress or cardiac anomaly and may be inocuous. Evidence to date indicates that in utero pharmacologic treatment of fetal arrhythmias is not indicated.
Adolescent↗
Phosphatidylinositol and phosphatidylglycerol in amniotic fluid: indices of lung maturity.
The minor phospholipids in amniotic fluid from normal pregnancies were correlated with the well-established index of lung maturity, the lecithin/sphingomyelin (L/S) ratio. When the L/S ratio was less than 1.0, the acidic phospholippids phosphatidylglycerol (PG) and phosphatidylinositol (PI) were absent or low in concentration (0.0 to 2.5 per cent of lipid phosphorus). Parallel to the increase in the L/S ratio to 2.0, the content of PI increased 6.0 to 8.5 per cent of lipid phosphorus. PG, the unique phospholipid of lung surfactant, first appeared and PI concomitantly decreased when the L/S ratio exceeded 2.0, indicating the secretion of mature lung surfactant. Analysis of PI and PG in amniotic fluid as markers of surfactant seems to be of value as an additional index of prenatal evaluation of lung maturity and may be particularly useful when the specimen is contaminated with blood.
Amniotic Fluid↗