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PubMedDate not supplied

Maternal mortality in the Irish Republic, 1989-1991.

The aim was to study the numbers and causes of Maternal Mortality in the Irish Republic in the years 1989-1991, inclusive and publish sufficient detail to allow for international comparative studies. Maternal Deaths were identified via Death Certificates, Coroners' Reports and Hospital Annual Reports. Details of these deaths were then obtained from relevant clinicians and analysed by the authors with further consultation with involved parties, if necessary. There were nineteen deaths notified in the three year period. According to ICD9 these were classified as five direct, seven indirect, and seven fortuitous deaths. Amongst the five Direct deaths, two were associated with amniotic fluid embolism, and one with each of eclampsia, septicaemia and pulmonary embolism, a direct maternal mortality rate of 3.2 per 100,000 births.

Cause of Death↗

PubMed1977

Disseminated intravascular coagulation in pregnancy.

The DIC syndrome is the most common cause of an abnormal hemorrhage tendency during pregnancy and the puerperium and reflects systemic activation of the coagulation cascade by circulating thromboplastic material, with secondary activation of the fibrinolytic system. Its presence in a pregnant patient almost invariably is evidence of an underlying obstetric disorder such as abruptio placentae, eclampsia, retention of a dead fetus, amniotic fluid embolism, placental retention or bacterial sepsis. Diagnosis of the DIC syndrome rests on the demonstration of reduced levels of fibrinogen and platelets, prolongation of the thrombin, prothrombin and partial thromboplastin times, and the presence of fibrin/fibrinogen degradation products (FDP) in the serum. Therapy consists of prompt removal of the source of procoagulant material, replacement of depleted clotting factors and, in some cases, anti-coagulation with heparin.

Blood Coagulation Tests↗

PubMed1998

How to lower perinatal mortality? Perinatal care in Japan.

OBJECTIVE: To review the 30-year history of perinatal medical care in Japan, and the recently initiated regionalization system of perinatal centers, new technologies and treatments in obstetric and neonatal medicine developed in Japan. STATISTICAL DATA: Maternal and neonatal health statistics of Japan released by the Ministry of Health and Welfare, Japanese Society of Obstetrics and Gynecology, Japanese Pediatric Society, and Tokyo Women's Medical University. LABORATORY DATA: Serological assay and immunohistochemical staining employing TKH-2 antibody for the diagnosis of amniotic fluid embolism, and assaying granulocyte elastase as a specific inflammatory marker in mucous samples from the uterine cervical canal for the prediction of preterm labor or premature rupture of membranes. TREATMENTS: Urinary trypsin inhibitor (Urinastatin) for the prevention of preterm delivery, and a double-blind, placebo-controlled, randomized trial of antithrombin-III therapy in severe preeclampsia. CONCLUSION: Over the last 30 years, the statistical data of perinatal health care, such as maternal and perinatal mortality rates, have markedly improved in Japan. These results are supported by the advanced technologies and newly developed treatments in obstetric and neonatal medicine. The regionalization of perinatal centers, a national project in order to assure a systematic collaboration among primary, secondary, and tertiary centers, has just started in Japan. It also aims at systematization of the function of perinatal centers on the national level through the informative promoting action.

Female↗

PubMed1997

Renal and amniotic fluid responses to umbilicoplacental embolization for 20 days in fetal sheep.

We determined the effects of placental insufficiency induced by umbilicoplacental embolization on fetal renal function and amniotic fluid volume and composition. Pregnant ewes underwent surgery at 115 +/- 2 days after mating (term approximately 147 days) for implantation of fetal vascular, bladder, and amniotic sac catheters. We studied five fetuses from 120 to 140 days during umbilicoplacental embolization and six control fetuses. Umbilicoplacental embolization reduced fetal arterial partial pressure of oxygen from 24.1 +/- 0.5 mmHg (pretreatment) to 14.6 +/- 0.2 mmHg. Fetal body weights were reduced to 80% of control values. Urine production and glomerular filtration rate in treated fetuses were significantly lower than in controls at 135 days of gestation. Amniotic fluid volume was not different between embolized and control animals. Fetal urine production in treated fetuses, when adjusted for body weight, was not different from that in control fetuses. We conclude that, in fetal growth restriction, reduced kidney weight, rather than hypoxemia per se is responsible for reduced urine production, which, if severe and prolonged, may contribute to oligohydramnios.

Amnion↗

PubMedDate not supplied

Rhodamine B fluorescence as a stain for amniotic fluid squames in maternal pulmonary embolism and fetal lungs.

Rhodamine B fluorescence is presented as a simple, rapid, highly sensitive, permanent method for the histologic detection of squames in maternal amniotic fluid emboli and fetal lungs in cases of intrauterine asphyxia. The method may be used on alcohol fixed smears or formalin fixed paraffin sections. The application of this procedure allows for identification of sparsely distributed fetal squames which otherwise may be overlooked by less sensitive tinctorial methods which may also be more tedious in technical preparation and screening.

Amniotic Fluid↗

PubMed1963