[USE OF GLUCOSE WITH INSULIN IN THE PREVENTION AND THERAPY OF FETAL ANOXIA].
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Asphyxia Neonatorum↗
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Results for “FETAL DISEASES”
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Fetal cells in the mother: from genetic diagnosis to diseases associated with fetal cell microchimerism.
Fetal cells circulate in the blood of pregnant women. When the gestation is normal, fetal cells are low in number. Complications of pregnancy, such as pre-eclampsia, or fetal cytogenetic abnormalities, such as Down's syndrome, increase fetomaternal transfusion. The isolation of fetal cells from maternal blood is currently under active investigation as a non-invasive method for prenatal diagnosis. The fetal cells that are most commonly used for non-invasive genetic diagnosis, the nucleated erythrocyte and the trophoblast, are highly differentiated and do not persist post-partum. In the context of studying fetal cells in maternal blood it was discovered that fetal progenitor cells originating from a prior pregnancy could also be detected. This led to the appreciation that unlike fetal DNA in plasma, which is cleared almost immediately following delivery, fetal cells persist for decades post-partum. Following pregnancy, labor, and delivery, a woman becomes a chimera. Transfused fetal stem and progenitor cells appear to be capable of further differentiation and migration to maternal organs. A further research agenda is needed to explore the newly appreciated phenomenon of bi-directional fetomaternal cell trafficking. Any consideration of the fetus as a patient must also consider the fetus as a potential source of therapeutic stem cells for the mother.
Animals↗
Isolation of viruses from cultures of bovine endometrial cells.
Endometrial cells from the uteri of pregnant and nonpregnant cattle were cultured. The presence of one or both of two viruses, noncytopathic mucosal disease virus and bovine syncytial virus, was demonstrated in seven of 19 endometria investigated. It was necessary to subculture the cells an average of four times to detect the viral infections. Difficulties were encountered in producing endometrial cell cultures from cows at term or near the end of term and also from older animals. The infections detected may be significant because both of the viruses isolated are capable of infecting the bovine fetus in utero and mucosal disease virus has been associated with bovine fetal diseases.
Animals↗
MALNUTRITION: PROBABLE CAUSE OF FETAL GROWTH RETARDATION.
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Body Weight↗
3rd International Symposium on Circulating Nucleic Acids in Plasma and Serum (CNAPS III). Santa Monica, California, November 9-12, 2003.
There has been a large increase in the number of publications dealing with the detection and characterization of free nucleic acids, reflecting the interest in this field. The third international congress devoted to circulating nucleic acids in serum and plasma (CNAPS III) covered the following areas: DNA in cancer, fetal DNA, RNA in cancer and benign diseases, fetal RNA, and serum proteomic approaches. This meeting report summarizes the state of the art in the field.
Blood Proteins↗
Ultrasound-guided fetal intravascular transfusion in a case of severe rhesus isoimmunization.
Intrauterine intravascular transfusion is the most effective way of correcting the fetal haemoglobin level in severe rhesus haemolytic disease. Fetal anaemia should be corrected as early as possible before the development of hydrops and ascites. When required, the transfusion can be repeated several times. We present in this publication our own experience in a severe rhesus isoimmunization case, where the fetal haemoglobin level was corrected by a successful transfusion in the intra-abdominal part of the fetal umbilical vein in the 31st week of pregnancy and the child was delivered a week later by cesarean section.
Adult↗
Intrauterine diagnosis and management of congenital goitrous hypothyroidism.
The intrauterine recognition and treatment of congenital goitrous hypothyroidism may not only reduce the obstetric complications associated with large goiters, but possibly improve the prognosis for normal growth and mental development of affected fetuses. We present a case of fetal goiter diagnosed at 29 weeks of gestation following routine ultrasound examination. Fetal blood sampling performed at this time confirmed the presence of fetal hypothyroidism. Treatment was performed using a series of intra-amniotic injections between 31 and 36 weeks, initially with tri-iodothyronine (T3) and subsequently with thyroxine. During this period, shrinkage of the fetal goiter, increasing neck flexion and resolution of the polyhydramnios was observed. Following birth, neonatal serum thyroid-stimulating hormone levels were within the normal range but thyroxine was reduced. The baby was started on daily oral thyroxine and, on examination 7 weeks following birth, he appeared clinically and chemically euthyroid. In the absence of maternal thyroid disease, fetal goiter is extremely rare, with only seven cases previously reported in the English literature to have used intra-amniotic thyroxine injections as a form of treatment. This report reviews the current literature regarding the diagnosis and intrauterine management of fetal goiter and considers the possibility of T3 therapy in future cases of congenital hypothyroidism.
Adult↗
Maternal varicella during pregnancy: correlation of maternal history and fetal outcome with placental histopathology.
The authors examined the records from 73 women diagnosed with varicella during pregnancy to correlate placental findings with maternal history and fetal outcome. Fifty-eight of the mothers delivered at the authors' institution, and 19 placentas were available for review. The onset of symptoms of varicella occurred from 27 weeks before delivery to 1 day postpartum. Only on e of the newborns delivered at the authors' institution was diagnosed with probable varicella at birth; the remainder had no unequivocal evidence of infection; however, serological studies were not performed on most of the newborns. The placenta from the newborn with probable varicella showed extensive basal chronic villitis with a lymphohistiocytic infiltrate and occasional multinucleated giant cells. Two other placentas showed rare foci of chronic villitis, and the remainder showed no villitis or other viral-associated changes. Twenty-four (33%) of the 73 women developed varicella pneumonia, and one woman died. Although varicella during pregnancy is associated with high maternal morbidity, fetal disease is uncommon. Most placentas show no virus-associated lesions; however, chronic villitis with multinucleated giant cells in association with a recent history of maternal varicella may be predictive of neonatal infection.
Chickenpox↗
THE OCCURRENCE OF FOETAL ERYTHROPOIESIS AFTER INFANCY.
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Anemia↗
Bluetongue and equine viral arteritis viruses as models of virus-induced fetal injury and abortion.
A number of viruses have the capacity to cross the placenta and infect the fetus to cause, among other potential outcomes, developmental defects (teratogenesis), fetal death and abortion. Bluetongue virus (BTV) infection of fetal ruminants provides an excellent model for the study of virus-induced teratogenesis. This model has shown that only viruses modified by passage in cell culture, such as modified live virus vaccine strains, readily cross the ruminant placenta, and that the timing of fetal infection determines the outcome. Thus, cerebral malformations only occur after fetal infection at critical stages during development and the precise timing of fetal BTV infection determines the severity of the malformation present at birth. Fetal BTV infection also can result in fetal death, followed by abortion or resorption, growth retardation, or no obvious abnormalities, depending on age of the conceptus at infection. Equine arteritis virus (EAV) infection of the equine fetus causes fetal death and abortion but not teratogenesis. These two fetal viral infections are useful not only for the study of teratogenesis and fetal disease, but also to further characterize and compare the complex process that is responsible for normal induction of parturition in ruminants and horses.
Abortion, Veterinary↗
Prenatal diagnosis by amniocentesis.
One of the major applications of somatic cell genetics to clinical medicine is in the area of prenatal diagnosis by genetic amniocentesis, which permits the accurate prediction of fetal disease and allows pregnant women to selectively maintain unaffected fetuses. The more recent developments in recombinant DNA research promise to expand tremendously the potential of this technique.
Amniocentesis↗
[Intrauterine growth curves for German-speaking countries (author's transl)].
The classication of a newborn baby according to gestational and intrauterine growth is important for correct diagnosis of fetal disease or impending dangerous situations. Besides the known gestational age the valid intrauterine growth curve is a prerequisite for this classification. New intrauterine growth curves derived from newborns in the four German speaking countries are presented and their general use is encouraged.
Austria↗
EPIPHYSEAL DEVELOPMENT IN FETAL MALNUTRITION SYNDROME.
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Birth Weight↗
[Characteristics of hemodynamics in cardiomyopathies of newborn infants of diabetic mothers].
The hemodynamics was studied in 42 newborns with diabetic fetal diseases. Clinical and instrumental examinations revealed cardiomyopathy in 28 of these. Hemodynamic disorders were characterized by a low stroke volume resultant from reduced diastolic volume of the left ventricle. The most grave hemodynamic disorders! were detected in patients with the obstructive cardiomyopathy when both diastolic and systolic volumes of the left ventricle were changed, myocardia contractility reduced, and diastolic function suppressed.
Cardiomyopathies↗
Relationship between placental histologic features and umbilical cord blood gases in preterm gestations.
OBJECTIVE: Our purpose was to test the hypothesis that placental histologic lesions reflect abnormal placental respiratory function in preterm gestations. STUDY DESIGN: A retrospective study of preterm deliveries from 22 to 32 weeks revealed 431 patients with umbilical venous or arterial blood gas values. Excluded were stillbirth, multiple gestations, placenta previa, maternal medical diseases, and fetal anomalies. Charts were reviewed for principal indication of delivery, diagnosis of labor, and mode of delivery. Blood gases were studied within 10 minutes of delivery on a model 178 automatic pH analyzer (Corning Med, Boston). Placental data included uteroplacental vascular lesions and related villous lesions, lesions of acute inflammation, chronic inflammation, and coagulation. Contingency tables and analysis of variance considered p < 0.05 as significant. RESULTS: Mean +/- SD umbilical vein pH was 7.36 +/- 0.07 (range 6.94 to 7.56) and umbilical artery pH was 7.30 +/- 0.08 (range 6.83 to 7.55). Increasing severity of uteroplacental thrombosis, villous lesions reflective of uteroplacental vascular pathologic mechanisms, avascular villi, histologic evidence of abruptio placentae, chronic villitis, and increased circulating erythrocytes were associated with decrease in umbilical vein and artery pH, increase in umbilical vein and artery PCO2, and decrease in umbilical vein and artery PO2. Histologic evidence of acute infection and villous edema were associated with a higher pH and PO2 and a lower PCO2 in both umbilical vein and artery. Umbilical vein or artery base excess was not related to placental lesions. Labor was not related to blood gas values in this data set, although a subset of cases of extremely preterm premature rupture of membranes and preterm labor who labored and were delivered by cesarean section had significantly poorer umbilical venous and fetal arterial blood gas values (all p < 0.005). Lesions related to poorer blood gas values were significantly more frequent in preterm preeclampsia and nonhypertensive abruptio placentae than in premature rupture of membranes or preterm labor. CONCLUSIONS: Changes in umbilical vein and artery pH, PO2, and PCO2 are significantly related to lesions of uteroplacental vascular pathologic mechanisms and intraplacental thrombosis. Placental lesions may be associated with chronic fetal distress by altering fetal oxygen availability and acid-base status. Placental immaturity resulting from prematurity may be associated with inefficient placental respiratory function and an increased likelihood of cesarean delivery in cases of premature rupture of membranes or preterm labor. Altered fetal acid-base balance plus excess numbers of circulating nucleated erythrocytes suggests that placental respiratory function is functionally abnormal when these lesions are present and leads to fetal tissue hypoxia.
Acidosis↗
[Results of invasive and pharmacosonographic studies in pregnancy (II: Amniofetography)].
Prenatal diagnosis of fetal diseases and malformations, using invasive techniques is outlined in this paper. The value of amniofetography under present conditions is discussed together with the use of drugs both isolated and in conjunction with fill-up of the amniotic cavity. Indications for puncture of fluid-filled body cavities, with reference being made to patients looked after at the Humboldt-University Berlin, School of Medicine (Charité), Department of Gynaecology and Obstetrics, from 1985 up to 1987, are reported, too.
Congenital Abnormalities↗
A prospective self-controlled study of fertility after second-trimester prostaglandin-induced abortion.
One hundred forty women whose pregnancies were terminated in the second trimester with prostaglandins because of suspected fetal disease have been prospectively followed to assess their subsequent fertility. In six instances difficulties had been experienced in conceiving the pregnancy that was terminated. Since abortion 104 women have conceived, 97% within 24 months of abortion but in five instances after some delay. Only one woman had not succeeded in conceiving a wished-for pregnancy. There were no apparent differences in abortion management between those women readily conceiving and those in whom there was some delay, although termination because of chromosomal reasons or anatomic abnormalities was less commonly followed by another pregnancy as compared with those terminated for rubella or other viral infections. Reduced fertility after a late prostaglandin-induced abortion thus appears to be very infrequent.
Abortion, Induced↗
Fetal and neonatal neurologic case histories: assessment of brain disorders in the context of fetal-maternal-placental disease. Part 2: Neonatal neurologic consultations in the context of adverse antepartum and intrapartum events.
The more conventional role of the pediatric neurologist involves the evaluation of the child after birth. Although the pediatric neurologist rarely attends the delivery of the neonate, consultation by the neurologist should begin immediately following stabilization by the neonatal resuscitation team. Four interrelated aspects of the neurologist's clinical assessment will be discussed in the context of reaching a consultative opinion, which must incorporate knowledge of chronologic events before as well as during labor and delivery. This evaluation encompasses an assessment of levels of arousal, increased or decreased muscle tone, presence of seizures, and effects of systemic diseases on the central nervous system, which are the essential elements of a complete neurologic examination. Documentation of the neonate's neurologic condition, together with knowledge of maternal, fetal, and placental diseases, will help anticipate neuroresuscitative decisions, as well as subsequent neurologic deficits.
Arousal↗