Response of neonatal platelets to nitric oxide in vitro.

Objectives: Several studies have demonstrated altered platelet function during nitric oxide inhalation (iNO) in adults and neonates. In vitro NO inhibits activation of fibrinogen receptor glycoprotein (GP) IIb/IIIa in a dose-dependent manner. In neonates GPIIb/IIIa response to stimulation is physiologically attenuated during the first days after birth in comparison to adults; the effects of NO on GPIIb/IIIa in neonates, however, are less established.

Rescue by birth: defective placental maturation and late fetal mortality.

Objective: To estimate the incidence and lethality of placental maturation defect, and to determine the impact of the pattern of placental dysfunction on the risk of recurrent stillbirth or maternal disease in later life.

Methods: Questionnaire and archival analysis of fetal deaths from placental dysfunction at 32-42 weeks (1975-1995 in Zurich), classified as chronic (parenchyma loss) or acute (maturation defect of the terminal chorionic villi). Population survey of 17,415 consecutive unselected singleton placentas (1994-1998 in Berlin).

Isolated fetal ascites caused by primary lymphangiectasia: a case report.

We present a case of isolated fetal ascites diagnosed by ultrasonography at 29 weeks' gestation. Cordocentesis revealed a normal karyotype and negative viral titers. Postnatally, the diagnosis of primary lymphangiectasia was made by intestinal biopsy.

Prenatal therapy of non-immunologic hydrops fetalis caused by severe aortic stenosis.

Congenital aortic stenosis is a rare cause of congestive heart failure and hydrops fetalis. This report describes a case of prenatally diagnosed critical aortic stenosis and endocardial fibroelastosis leading to a severe hydrops fetalis at 27 weeks of gestation. Successful transplacental digitalization was performed and all signs of hydrops resolved within 2 weeks.

Early cessation of breast milk feeding in very low birthweight infants.

This investigation was carried out to comparatively assess the duration of breast milk feeding and to analyze risk factors for early cessation of breast milk feeding in term and very preterm infants. A cohort study was performed in 89 consecutive very low birthweight (VLBW) infants (<1500 g) who survived for at least for one week, and 177 term infants with birthweights >2500 g born in the same hospital matched for gender and multiplicity. Median duration of breast milk feeding, as determined from charts and questionnaires mailed to the mothers at 6 and 12 months corrected age, was 36 days in VLBW infants, compared to 112 days in control infants (P<0.

Il-1 beta, Il-6, Il-8 and G-CSF in the diagnosis of early-onset neonatal infections.

Objective: To determine whether inflammatory cytokine concentrations (Il-1 beta, Il-6, Il-8 and G-CSF) in umbilical cord blood are useful predictors of an early-onset neonatal infection.

Material And Methods: 240 women and their newborns were enrolled in our study and umbilical cord blood samples collected from neonates (n = 240) were subjected to ELISA for Il-1 beta, Il-6, Il-8 and G-CSF. Clinical outcome of the neonates was followed and documented.

HELLP syndrome.

HELLP syndrome is a serious, life-threatening form of pre-eclampsia with a typical laboratory triad. The incidence of the disease is reported as being 0.17-0.

Assessing lymphocyte functions in neonates for revealing abnormal prenatal development of the immune system.

Because it is difficult to assess prenatally induced functional deficits of the human immune system, we developed an ex vivo method for differentiation and maturation of peripheral lymphocytes of newborn, preferentially using umbilical cord blood. Many lymphocyte subsets of newborn infants are "immature" with respect to defined surface receptors. An example of such an immaturity is the almost complete lack of "memory"-type helper T cells (also designated as helper-inducer cells), characterized by expressing the surface receptors: CD4(+)CD45R0(+)CD45RA(-)CD29(high).

[Prevalence and risk factors of iron deficiency in young mothers].

Quality of life and achievements are impaired by unrecognised iron deficiency. The iron requirement of women during their child-bearing age is high and increases in pregnancy. The aim of this study was to determine the prevalence and risk factors for iron deficiency in young mothers under contemporary German life conditions.

[Competent parenting: expectations of young parents of counseling on pregnancy and labor].

Background: Are expecting parents prepared to change their lifestyle to benefit their unborn child? Do they see a need for more knowledge and competence to be good parents? What are the key expectations with respect to pregnancy, delivery conditions, and infant health care? To answer these questions, a study presented them to expecting and young parents in Germany.

Methods: 123 delivery units were selected to represent the 1120 delivery facilities of Germany identified in 1997 from all accessible sources. 109 participated, and of 7862 distributed questionnaires 5900 (75%) were filled-in completely by parents.

Frequency and significance of preterm delivery in twin pregnancies.

Objective: We investigated the frequency of preterm delivery and its influence on the neonatal outcome in twin pregnancies at a perinatal center. Are there differences in the course of twin pregnancies with preterm or term delivery?

Method: A retrospective investigation was carried out at the Department of Obstetrics on 502 twin pregnancies and deliveries between 1978 and 1993. Pregnancy history and clinical parameters were compared among preterm (<37+0 weeks) and term deliveries.

Intravenous drug abuse is an indication for antepartum screening for RH alloimmunization. A case report and review of literature.

Intravenous drug abuse is a risk for alloimmunization in pregnancy. One case is presented of a nulliparous Rhesus-negative parturient who shared her Rhesus-positive partner's needles for the injection of heroin; she subsequently developed elevated antepartum anti-D titers despite routine anti-D prophylaxis.

Perinatal differential diagnosis of cystic kidney disease and urinary tract obstruction: anatomic pathologic, ultrasonographic and genetic findings.

According to the classification of Osathanondh and Potter of cystic kidney diseases an antenatal differential diagnosis is presented, which is based on the anatomic pathologic, ultrasonographic and genetic findings. Since the ultrasound evaluation influences the obstetric and neonatal management, each second and third trimester sonography should consider the most common malformations in pediatric autopsies. The autosomal recessive polycystic kidney disease (ARPK), autosomal dominant polycystic kidney disease (ADPK), multicystic renal dysplasia, obstructive multicystic kidneys and cystic renal malformations found in other syndromes with genetic linkage are discussed in this review.

[Gel agglutination test--a new test system for semiquantitative detection of feto-maternal transfusion in Rhesus incompatibility].

Background: The postpartum administration of an adequate amount of anti-D immunoglobulin to the mother in cases of Rhesus incompatibility requires the exact quantification of the amount of Rh-positive fetal cells that may be present in the Rh-negative maternal circulation. The classical methods to detect an intrapartum fetomaternal hemorrhage are either time-intensive (such as the Kleihauer-Betke test), of low specificity (such as the indirect Coombs test), or technically cumbersome (such as flow cytometry). The goals of our study were to develop a simple screening test that may be used routinely to quantify fetomaternal hemorrhage in cases of Rhesus incompatability and to evaluate this test in clinical practice.

Atopy, the use of condoms, and a history of cesarean delivery: potential predisposing factors for latex sensitization in pregnant women.

Objective: Our purpose was to assess the prevalence of latex sensitization among women admitted for delivery and the relevant risk factors.

Study Design: In a prospective study 333 consecutive patients admitted for delivery were screened for specific immunoglobulin E antibodies to latex and for atopic status. A questionnaire was filled in and included questions about the obstetric and surgical history, known contact with latex, and previous use of condoms.

Activated protein C resistance shows an association with pregnancy-induced hypertension.

A common mutation in the factor V gene, the Leiden mutation, is the most frequent genetic cause of resistance to activated protein C (APC). Recent studies have shown that the prevalence of APC resistance is associated with severe pregnancy-induced hypertension (PIH). Our objective was to determine whether the factor V Leiden mutation is more prevalent in patients who developed severe PIH than in normotensive pregnant women.

Fetal fibronectin as a marker for an imminent (preterm) delivery. A new technique using the glycoprotein lectin immunosorbent assay.

We have developed a new 'glycoprotein lectin immunosorbent assay' (GLIA) which permits the obstetrician to identify accurately pregnant women at risk for preterm delivery. This GLIA uses two lectins for the quantitative detection of glycosylation variants of fibronectins, namely, Maackia amurensis lectin (MAA) for the detection of fetal fibronectin (fFN), and Sambucus nigra lectin (Elderberry bark lectin; SNA). Fibronectin was quantitated in cervicovaginal secretions, amniotic fluid, and plasma of pregnant women.