Placental Chorioangioma with Nonimmune Hydrops Fetalis.

A 38-year-old woman was found to have a large placental chorioangioma. The fetus was studied using ultrasound. The pregnancy became complicated by hydrops fetalis, polyhydramnios, and abruptio placenta.

Graves' Disease Pharmacotherapy in Women of Reproductive Age.

Graves' disease is an autoimmune disorder in which inappropriate stimulation of the thyroid gland results in unregulated secretion of thyroid hormones resulting in hyperthyroidism. Graves' disease is the most common cause of autoimmune hyperthyroidism during pregnancy. Treatment options for Graves' disease include thioamide therapy, partial or total thyroidectomy, and radioactive iodine.

Outcomes of pregnancies at risk for hypertensive complications managed using impedance cardiography.

We assessed the effect of antihypertensive therapy guided by impedance cardiography on maternal and fetal outcomes in pregnancies at risk for hypertensive complications. We performed a retrospective review of the outcomes of 318 singleton pregnancies with chronic hypertension or prior preterm delivery due to preeclampsia whose antihypertensive therapy was guided by impedance cardiography. Hemodynamic subsets were compared using analysis of variance.

Serotyping group B streptococci in a small community hospital: an analysis of distribution and site of isolation.

Objective: To determine the prevalence and site of isolation of different serotypes of group B streptococcus (GBS) colonization or infection at a small community hospital.

Methods: GBS isolates were obtained from a small community hospital and were then serotyped as la, Ib, II, III, IV, V or nontypeable. Hospital records were reviewed for patient sex, age and pregnancy status as well as the site of GBS isolation.

Differences in innate immunologic response to group B streptococcus between colonized and noncolonized women.

Objective: To evaluate the functional capacity of granulocytes and monocytes from pregnant and nonpregnant women in relation to group B streptococcus (GBS) colonization status.

Methods: Engulfment of fluorescent GBS by peripheral blood phagocytes from GBS-colonized and noncolonized women was measured by flow cytometry. Intracellular superoxiode generated in response to GBS challenge to monocytes and granulocytes enriched from peripheral blood of these women was also measured by flow cytometry, and extracellular superoxide was determined by colorimetric assay.

Decreased Approximate Entropy of Heart Rate Variability in the Hypoxic Ovine Fetus.

>Objective: Variability of the fetal heart rate (FHR) is used clinically to assess fetal well being. Approximate entropy (ApEn) is a statistic that quantifies the regularity of a time series. This study was designed to test whether ApEn changed in the FHR of the hypoxic ovine fetus.

Platelet and hemorrhagic disorders associated with pregnancy: a review. Part I.

Disorders of coagulation remain an important potential cause of maternal morbidity and mortality. Bleeding disorders in pregnancy, unlike disorders of hypercoagulability, most often can have little impact on the mother but devastating consequences for the fetus. Further complicating the issue is that not all disorders of coagulation are inherited.

Umbilical venous velocity pulsations are related to atrial contraction pressure waveforms in fetal lambs.

Objective: To identify the source of umbilical venous velocity pulsations, times of transmission from the atrial contraction pressure waveform to velocity waves in the inferior vena cava, ductus venosus, intra-abdominal umbilical vein, and intra-amniotic umbilical vein were examined.

Methods: Five lamb fetuses at 125-135 days' gestation were instrumented with solid state pressure transducers in the inferior vena cava, fluid-filled catheters in the inferior vena cava and descending aorta, and epicardial pacemakers. Three to 5 days postoperatively, inferior vena cava, ductus venosus, and umbilical vein velocities were examined with Doppler ultrasound.

Umbilical venous Doppler velocity pulsations and inferior vena cava pressure elevations in fetal lambs.

Objective: To examine effects of fluid administration on inferior vena cava pressure and umbilical venous Doppler velocities in the term fetal lamb.

Methods: With the ewe given inhalation anesthetics, eight chronically instrumented intrauterine fetal lambs at 125-135 days' gestation were given normal saline fluid boluses. Inferior vena cava peak pressures and umbilical venous Doppler velocities were measured before, during, and after administration of normal saline.

Effect of hypoinsulinemia on growth in the fetal rabbit.

Insulin is an important regulatory hormone in the control of fetal growth. In a fetal rabbit model, a non-ruminant species, the effects of insulin deprivation on glucose, growth and protein metabolism were studied. The fetuses of 10 pregnant New Zealand white rabbits in one uterine horn received a subcutaneous injection on day 25 of gestation (term = 30 days) of 0.

Changes in umbilical arterial and venous blood flow velocity waveforms during late decelerations of the fetal heart rate.

Objective: To compare umbilical arterial and venous Doppler velocity waveforms during labor in fetuses with normal heart rate tracings and fetuses with late decelerations.

Methods: During labor, umbilical arterial and venous Doppler flow velocity waveforms were obtained between and during contractions in 20 fetuses (ten with normal heart rate tracings and ten with late decelerations). The umbilical arterial systolic-diastolic (S/D) velocity ratios were compared, and umbilical venous velocities were examined for the presence or absence of venous pulsations.

A practical approach to umbilical artery pH and blood gas determinations.

The use of the Apgar score as a means of identifying birth asphyxia has been challenged. Routine umbilical cord blood pH has been recommended as a more objective measure of the condition of the newborn. The purposes of this study were to evaluate a simplified and selective method of umbilical artery pH blood sampling and to determine the effect of delay in sampling upon umbilical artery pH, carbon dioxide pressure (PCO2), and oxygen pressure (PO2).

The dimension of chaos in the fetal heart rate.

Variability in the fetal heart rate is known to be a sign of fetal well-being, and yet the origins of the variations remain unclear. This study incorporated the nonlinear analytic techniques of phase-space reconstruction and dimensional analysis to 12 normal heart rate tracings obtained from fetal scalp electrodes of fetuses in labor. Phase-space attractors were constructed with the method of time delays and showed characteristics consistent with those of nonlinear chaotic systems.

Effects of fetal insulin deficiency on growth in fetal lambs.

Insulin may be an important regulator of growth in late fetal life. To assess the importance of endogenous insulin release in regulation of normal fetal growth, eight fetal lamb pairs were given either an intravenous injection of streptozocin (STZ), a nitrosourea that selectively damages pancreatic beta-cells, or buffer infusion (controls). In six preparations, twins were used, and in two cases, triplets, thus allowing for comparison between treated and control fetuses residing in the same intrauterine environment.