Fetal gastroschisis: a report of 2 cases.

Background: The risk of stillbirth in fetuses diagnosed with gastroschisis may range from 6% to 12%. Currently there is no agreement on the role of antepartum fetal surveillance, as fetal death within days of reassuring antepartum fetal testing has been reported.

Cases: In 2 cases of fetal gastroschisis, fetal gastric distension was associated with decreased fetal movements and nonreactive nonstress tests.

Atypical variable decelerations and intrauterine growth restriction.

Variable decelerations of the fetal heart rate are the most common changes noted during continuous fetal monitoring. In general, they are presumed to represent a normal response to fetal baroceptor stimulation. When atypical features are present, other considerations are warranted.

The significance of transvaginal ultrasonographic evaluation of the cervix in women treated with emergency cerclage.

Objective: Our purpose was to determine whether perioperative transvaginal ultrasonographic evaluation of the incompetent cervix treated with emergency cerclage is predictive of pregnancy outcome.

Study Design: Twenty-nine women who underwent emergency cerclage at 16 to 26 weeks of gestation had transvaginal ultrasonographic evaluation of the cervix within 48 hours before and after surgery and at least three times thereafter until 28 weeks of gestation. The following measurements were obtained: (1) funnel width, (2) funnel length, (3) endocervical canal length, (4) the distance between the internal and external os, (5) upper cervix (length of closed endocervical canal above the cervical cerclage), (6) lower cervix (endocervical canal length below suture), and (7) cervical index (1+ Funnel length/Endocervical canal length).

Adverse perinatal outcome in patients with an abnormal umbilical coiling index.

Objective: To evaluate perinatal outcome in neonates with hypocoiled and hypercoiled cords.

Methods: From February 18 through June 13, 1994, 635 placentas from deliveries of at least 24 weeks' gestation were examined for umbilical coiling. The umbilical coiling index was calculated by dividing the total number of coils by the length of the cord.

Phenytoin and magnesium sulfate effects on fetal heart rate tracings assessed by computer analysis.

Objective: To compare the effects of maternally administered phenytoin and magnesium sulfate on the fetal heart rate (FHR) using computer analysis.

Methods: Thirty-six nonlaboring preeclamptic women between 27-41 weeks' gestation were treated with either phenytoin or magnesium sulfate in a nonrandomized fashion. All fetuses were deemed to be well by traditional electronic-biophysical criteria.

Premature rupture of the membranes at term. A comparison of induced and spontaneous labors.

Analysis of 150 patients at term (greater than 36 weeks) with premature rupture of the membranes (PROM) was made. In the group followed conservatively, 87.5% (98 of 112) began labor within 48 hours, and only 3.

Prognostic components of the nonreactive nonstress test.

From January 1976 to November 1978, 2592 nonstress tests were performed at the authors' institution on 862 fetuses, of which 2239 (86.3%) had reactive and 353 (13.6%) had nonreactive results.

Betamethasone and hormonal status of the pregnant diabetic woman.

A case is presented illustrating the complicating effects of antepartum steroids on a pregnant diabetic woman. The possible rapid deterioration of the diabetic state and the temporary suppression of estriol production are discussed.

Amniotic fluid optical density and neonatal respiratory outcome.

A simple, rapid, economical, and accurate test to assess fetal pulmonary maturity on a 24-hour basis, 7 days a week, is urgently needed. A 15-minute test has been developed that correlates well with fetal pulmonary maturity. Optical density (OD) readings at 650 nm of greater than or equal to 0.

24-hour urine creatinine excretion in pregnancy.

A total of 489 consecutive 24-hour urine collection from 162 patients were analyzed for creatinine excretion. The 24-hour creatinine excretion increased with the urine volume. Creatinine excretions in 24-hour urine collections were not statistically different between in- and out-patients.

Premature rupture of the membranes: a conservative approach.

A conservative approach was followed in 188 patients with premature rupture of the membranes (PROM) over a 2 year period. There were no neonatal deaths from sepsis, and only one infant showed a positive central bacteriologic culture. Fifty-seven percent of all patients less than 37 weeks' gestation had a latent period of 24 hours and 19% went beyond 7 days before labor began.

Positive correlation of optical density at 650 nm. with lecithin/sphingomyelin ratios in amniotic fluid.

In this study, we have attempted to correlate optical density measurements of amniotic fluids with L/S ratios. We may conclude, with over a 98 per cent accuracy, that fluids having optical density readings of 0.15 and above, at 650 nm.