Large fetal sacrococcygeal teratomas: could early delivery improve outcome?

Objective: To determine if gestational age (GA) at delivery or tumor size impacts outcome in neonates with very large sacrococcygeal teratomas (SCTs).

Methods: Retrospective chart review from 1990 to 2006 of live-born infants with very large SCTs, defined as diameters exceeding 10 cm. Data analyzed using the independent t test and Fisher's exact test, with p values <0.

Intrahepatic vein for fetal blood sampling: one center's experience.

Objective: The objective of the study was to examine 1 center's experience with fetal blood sampling via the fetal intrahepatic vein (IHV) and cordocentesis.

Study Design: Consecutive IHV and cordocentesis procedures between July 1987 and February 2006 were compared with respect to success rates, streaming at the sampling site, nonreassuring fetal heart rate (NRFHR), or need for urgent delivery post procedure. A subanalysis of cases with fetal thrombocytopenia was performed.

Intrapartum electronic fetal heart rate monitoring and the identification of metabolic acidosis and hypoxic-ischemic encephalopathy.

Objective: The purpose of this study was to determine whether electronic fetal monitoring can identify fetuses with metabolic acidosis and hypoxic-ischemic encephalopathy.

Study Design: The cases were 107 nonanomalous chromosomally normal fetuses with an umbilical arterial pH < 7.0 and base excess < or = 12 mmol/L.

Neonatal nucleated red blood cells and the prediction of cerebral white matter injury in preterm infants.

Objective: To estimate whether neonates with cerebral white matter injury have significant elevations in nucleated red blood cell counts and to estimate their predictive ability in identifying injury.

Methods: This case-control study identified 176 infants born at 23-34 weeks of gestation between November 1994 and October 2004 at a single university hospital and with cerebral white matter injury characterized by periventricular leukomalacia (PVL) or ventriculomegaly due to white matter atrophy. A control was matched to each case using the subsequent delivery within 7 days of that gestational age without brain injury.

Can electronic fetal monitoring identify preterm neonates with cerebral white matter injury?

Objective: Although preterm delivery occurs in only 10% of all births, these infants are at high risk for cerebral white matter injury and constitute a third of all cerebral palsy cases. Our objective was to estimate if electronic monitoring can identify preterm fetuses diagnosed with brain injury during the neonatal period.

Methods: In this case-control study, 150 consecutive neonates with ultrasonography-diagnosed cerebral white matter injury were matched by gestational age within 7 days to 150 controls with normal head ultrasonograms.

Cord gas analysis, decision-to-delivery interval, and the 30-minute rule for emergency cesareans.

Objective: Our primary objective was to examine the relationship between umbilical arterial gas analysis and decision-to-delivery interval for emergency cesareans performed for nonreassuring fetal status to determine if this would validate the 30-minute rule.

Study Design: For this retrospective cohort study, all cesarean deliveries performed for nonreassuring fetal status from September 2001 to January 2003 were reviewed. A synopsis of clinical information that would have been available to the clinician at the time of delivery and the last hour of the electronic fetal heart rate tracing prior to delivery were reviewed by three different maternal-fetal medicine specialists masked to outcome, who classified each delivery as either emergent (delivery as soon as possible) or urgent (willing to wait up to 30 minutes for delivery) since immediacy of the fetal condition is the key factor affecting the type of anesthesia used.

Are histopathologic chorioamnionitis and funisitis associated with metabolic acidosis in the preterm fetus?

Objective: Perinatal infection increases the risk of neonatal neurologic injury. Our objective is to determine whether histologically confirmed chorioamnionitis and funisitis is associated with fetal metabolic acidosis.

Study Design: This is a retrospective cohort study of all infants 34 weeks or less born at a single tertiary hospital admitted to the neonatal intensive care unit (NICU) between April 1999 and September 2002.

Neonatal cerebral white matter injury in preterm infants is associated with culture positive infections and only rarely with metabolic acidosis.

Objective: Neonatal cerebral white matter injury represents a major precursor for neurological impairment and cerebral palsy. Our objective was to identify risk factors associated with its development.

Study Design: This retrospective case-control study of all births between 23 and 34 weeks gestation at a single university hospital between May 1994 and September 2001 identified 150 cases with white matter injury characterized by periventricular leukomalacia or ventricular dilatation from white matter atrophy that were chromosomally normal and did not have other congenital anomalies.

An amniotic fluid index < or =5 cm within 7 days of delivery in the third trimester is not associated with decreasing umbilical arterial pH and base excess.

Objective: To determine if an amniotic fluid index (AFI) < or =5.0 cm within 7 days of delivery in the third trimester is associated with decreasing umbilical arterial pH and base excess.

Study Design: Cases for this retrospective cohort study were all pregnancies > or =26 weeks with intact membranes and an AFI < or =5.

Association of prematurity and neonatal infection with neurologic morbidity in very low birth weight infants.

Objective: To identify risk factors predictive of neurologic morbidity in very low birth weight (VLBW) infants.

Methods: This is a case-control study of all infants weighing 1500 g or less admitted to a single tertiary neonatal intensive care unit between April 1999 and December 2001. The case group were those neonates with neurologic morbidity including intraventricular hemorrhage, seizures, hydrocephalus, and periventricular leukomalacia.

Phimosis as a cause of the prune belly syndrome: comparison to a more common pattern of proximal penile urethra obstruction.

The pathogenesis of the prune belly syndrome (PBS) remains controversial, but two theories predominate. The first theory supports an obstructive phenomenon early in gestation leading to irreversible damage to the genitourinary tract and abdominal wall. The second theory suggests mesodermal injury between the 6th and 10th weeks of gestation as the primary abnormality.