[Preterm delivery: detection of risks and preventive treatment].

Every year around the world some 13 million premature children are born. Most of these children are born in developing countries, and they account for the largest share of perinatal morbidity and mortality. This review study analyzed scientifically validated data on interventions to prevent at least some portion of these preterm deliveries and to lessen their impact on neonatal health.

A new tool for measuring the suckling stimulus during breastfeeding in humans: the orokinetogram and the Fourier series.

The Fourier series was used to analyse the oral movements recorded by the orokinetogram during breastfeeding in human babies. This is a new method that allows recording of oral movements without introducing any extrinsic element between the nipple and the mouth of the baby. The advantage of displaying suckling activity after fast Fourier transform (FFT) is that this algorithm allows storage, quantification and frequency analysis of the oral movements throughout a suckling bout, which enables the total oral activity to be measured.

[Intensified insulin therapy in the management of gestational diabetes].

A total of 35 pregnancies in 28 Pregestational Diabetic Patients (PDP) were followed with the goal of achieving and maintaining near normoglycemia (as many pre-postprandial glycemias as possible between 60-140 mg/dl); 13 patients (16 pregnancies) were assigned to Subcutaneous Continuous Preprogrammed Insulin Infusion (SCII) because of high risk pregnancies (HRP) (at least one of the following: former history of spontaneous abortions, stillbirths, premature deliveries and/or sterility). The remaining 12 PDP's (15 pregnancies with no past history of the above nature) were treated with Multiple Conventional Insulin Injections (MCII). Both groups were comparable regarding the following clinical parameters: age, time of onset and class of diabetes.

Chronic villitis of unknown aetiology in recurrent intrauterine fetal growth retardation.

Although recurrent chronic villitis of unknown aetiology (CVUA) has been documented in a few instances, placental lesions in recurrent intrauterine growth retardation have not, to the best of our knowledge, been reported. In the present study ten cases of recurrent intrauterine growth retardation have been described; a high incidence of severe CVUA was found in both first and successive pregnancies. If, as has been proposed, CVUA is due to a maternal immune response to placental antigens, subsequent pregnancies with the same father might be similarly affected.

Placental lesions in maternal autoimmune diseases.

We have investigated the presence and clinical implications of maternal vascular lesions and chronic villitis of unknown etiology (CVUE) in 18 placentas of 15 mothers with several autoimmune diseases (AD), including, for the first time, idiopathic thrombocytopenic purpura, autoimmune thyroid diseases, and multiple sclerosis. The group with AD had significantly more maternal vascular lesions and CVUE than the control group. We did not find lesions that could be attributed to any of the diseases in particular.

Intrauterine growth retardation of unknown etiology: II. Serum complement and circulating immune complexes in maternal sera and their relationship with parity and chronic villitis.

Significantly lower CH50 levels were found in women with small for gestational age (SGA) infants. The lowest values corresponded to nulliparous with placental chronic villitis (124.0 +/- 10.

Primary chronic abortion, preeclampsia, idiopathic intrauterine growth retardation, hydatidiform mole, and choriocarcinoma: a unifying concept.

Different degrees of maternal hyporesponse, as far as blocking activity is concerned, are proposed for primary chronic abortion, preeclampsia, and idiopathic intrauterine growth retardation. On the other hand, a maternal hyperresponse to fetal antigens with a higher production of blocking antibodies may be related to an unusual proliferation of the trophoblast in cases of hydatidiform mole and choriocarcinoma.

Chronic villitis of unknown aetiology and decidual maternal vasculopathies in sustained chronic hypertension.

Ninety-six full-term placentae were examined in the study. Of the 96 pregnancies, 72 were normotensive and 24 were complicated by hypertension. Of the 24 hypertensive pregnancies, 19 patients had chronic hypertension only, and 5 had chronic hypertension with superimposed preeclampsia.

Deficiency of blocking factors in intrauterine growth retardation and its relationship with chronic villitis.

We tested sera from 22 women and their singleton full-term infants for inhibition in one-way mother/father mixed lymphocyte culture (MLC). Ten of these infants were small for gestational age (SGA) and 12 of them adequate for gestational age (AGA). Twenty placentas from these cases (ten from SGA infants and ten from AGA infants) were histologically studied.

Absence of Wharton's jelly around the umbilical arteries: an unusual cause of perinatal mortality.

Three cases are described in which Wharton's jelly was completely absent around the umbilical cord arteries but was present around the umbilical vein. All three instances of this anomaly were associated with perinatal death.

Chronic villitis of unknown aetiology and intrauterine growth-retarded infants of normal and low ponderal index.

Placentae from 211 term pregnancies were studied. The placentae were divided into three groups: group I, 57 placentae from neonates with birthweight over the 25th centile of the normal birthweight curve; group II, 49 placentae from neonates whose birthweight fell between the 10th and 25th centiles of this curve, and group III, 105 placentae from neonates whose birthweights were below the 10th centile of the curve. Each of the studied groups were divided into two subgroups, one comprising those infants with a normal Ponderal Index (PI) and the other comprising those with a low PI.

Chronic villitis of unknown etiology and maternal arterial lesions in preeclamptic pregnancies.

Placental lesions from 361 singleton full-term pregnancies were studied. These placentas were divided into two major groups: the study group consisting of 146 placentas from mothers with pregnancy-induced hypertension and a normotensive control group, which included 215 placentas from mothers with normal pregnancies. Each group was divided into three subgroups according to the allocation of infant's birthweight in the normal ponderal curve.

Intrauterine growth retardation of unknown etiology. I. Serum complement and circulating immune complexes in mothers and infants.

Complement (C) and circulating immune complexes (CIC) levels were measured in 22 full-term pregnant women and 15 of their small-for-gestational-age (SGA) offspring in order to seek evidence supporting an immunological etiology for placental lesions related to idiopathic intrauterine growth retardation. We used 19 normal full-term pregnant women and 18 of their infants with birthweight above the 25th centile of the ponderal curve as a control population for this study. C levels were significantly lower in mothers of SGA infants than in controls (146.

Maternal vascular lesions in placentae of small-for-gestational-age infants.

Placentae from 140 term pregnancies were studied. Seventy-four were from uncomplicated pregnancies in which the neonates were within the normal weight range for their gestational age. The remaining 66 placentae were from pregnancies whose infants were small for gestational age (SGA).

Immunohistochemical findings in acute atherosis associated with intrauterine growth retardation.

Lesions of acute atherosis in 23 placentas from pregnancies complicated by fetal growth retardation (less than tenth percentile) were studied by an immunoperoxidase staining. Twelve of them were from normotensive pregnancies, ten complicated by pregnancy induced hypertension, and the remaining associated with systemic lupus erythematosus. Twenty-three placentas with physiological changes of the spiral arteries corresponding to normal pregnancies served as controls.

A nodule of adrenocortical tissue within a human placenta: light microscopic and immunocytochemical findings.

A case of adrenocortical tissue within a human placenta is described, this being the second example of such a phenomenon. Immunocytochemistry showed that the adrenal tissue reacted positively for DHEA-S but negatively for 17-OH progesterone and cortisol. This suggests that the heterotopic adrenal tissue resembled metabolically the fetal zone of the adrenal cortex.

Chronic villitis of unknown aetiology in placentae of idiopathic small for gestational age infants.

Placentae from 63 term pregnancies were studied. Of these, 19 were from normal pregnancies in which the neonates were within the normal weight range for their gestational age. The remaining 44 placentae were from pregnancies in which the infants were small for their gestational age (SGA).

Passage of mannitol from mother to amniotic fluid and fetus.

Ten pregnant women and three pregnant sheep received mannitol intravenously. The results show that during late pregnancy this substance appears in amniotic fluid, and when the fetus is alive, its concentration increases with time, reaching values which are higher than those simultaneously obtained in maternal plasma. The experiments performed in sheep show that in fetal urine the concentration of mannitol reached values 10 to 20 times higher than those found in fetal plasma.

Transference of para-amino-hippurate from the mother to the amniotic fluid.

There are few studies in which substances mainly cleared by the kidney are injected to the mother and the time course of their concentrations in amniotic fluid is analyzed. This type of studies may contribute to the knowledge of the transference of substances through the mother-fetus-amniotic fluid complex. Thirteen pregnant women were studied.

Disappearance of para-amino-hippurate from amniotic fluid.

Eight pregnant women and three pregnant sheep received 400 mg of para-amino-hippurate (PAH) intraaminotically. Serial samples of amniotic fluid and maternal blood were obtained. In sheep samples of fetal blood were also withdrawn.