Multiple cardiac rhabdomyomas detected in utero.

Prenatal fetal echocardiography studies detected large multiple cardiac rhabdomyomas and led to the diagnosis of tuberous sclerosis. Despite episodes of bradyarrhythmias and severe lung compression in utero, the neonate did well and was discharged home on day 20 of life. On day 30 of life, the infant expired at home from cardiac arrest secondary to arrhythmia.

Transverse vaginal septum: case report and review of the literature.

A case of perforated complete transverse vaginal septum in the upper third of the vagina in a patient presenting at 19 years of age for evaluation of primary infertility. Diagnosis was made by hysterosalpingography. The patient was treated surgically and conceived 2 months after the procedure.

Fetal cardiac hypertrophy and cardiac function in diabetic pregnancies.

Objective: Our purpose was to evaluate the relationship between fetal cardiac wall hypertrophy and ventricular function in fetuses of metabolically controlled, insulin-requiring diabetics.

Study Design: M-mode directed fetal echocardiography included measurements of left and right ventricular free wall and interventricular septal thickness and ventricular diastolic and systolic dimensions. Fetal measurements included biparietal diameter, estimation of fetal weight, and cardiac area/thoracic area.

Mood disorders, psychiatric symptoms, and distress in women presenting for infertility evaluation.

Women who undergo treatment for infertility frequently report depression, but it is crucial to distinguish between subjective distress, symptoms, and clinical depressive disorders. In the initial assessment of a prospective, longitudinal study, 59 women presenting for infertility treatment were compared with 35 women presenting for routine gynecological care. Infertility patients and controls were not significantly different on self-report measures of partner satisfaction, sexual functioning, or self-esteem.

Elevated alpha-fetoprotein in pregnancy complicated by aplasia cutis after exposure to methimazole.

A case of aplasia cutis after exposure to methimazole (Tapazole) in early pregnancy is described. Elevated maternal serum alpha-fetoprotein (MSAFP) and amniotic fluid alpha-fetoprotein (AFP) were found. Elevated MSAFP and amniotic fluid AFP in women exposed to methimazole may suggest this rare fetal condition.

Herrmann-Opitz syndrome: report of an affected fetus.

In 1969, Herrmann and Opitz described a syndrome of acrocephaly, oligosyndactyly, hypertelorism, and mental retardation. We report on a second case, a fetus with cleft palate, urethral astresia, oligohydramnios, and intrauterine death.

Prenatal diagnosis of sickle hemoglobinopathies: the experience of the Columbia University Comprehensive Center for Sickle Cell Disease.

We report here an evaluation of 55 pregnancies at risk for a sickle hemoglobinopathy prenatally diagnosed by restriction-endonuclease analysis, with the endonucleases MstII and HpaI, of amniocyte DNA. The diagnosis was completed in all cases. Eleven fetuses were predicted to be affected, of which six were terminated.

Hydrolethalus (Salonen-Herva-Norio) syndrome: further clinicopathological delineation.

Two brothers with severe CNS abnormalities, cleft lip/palate, polydactyly, and lung hypoplasia are reported as examples of the hydrolethalus syndrome, an autosomal recessive disorder. Death from cardiopulmonary arrest occurred in patient 1 at age 4 months and in patient 2 at age 17 days. Detailed radiological and neuropathological description is provided on patient 2.

Improved methods of direct and cultured chromosome preparations from chorionic villous samples.

A new method is described for preparing direct mitotic chromosome spreads from chorionic villous samples, which has resulted in sufficiently high yields of well-banded metaphases to permit a complete standard chromosomal diagnosis in 20 of 20 cases. A method of establishing monolayer cultures from this material that can be harvested from 3 to 7 days after initiation is also presented.

Genetic counseling before prenatal diagnosis for advanced maternal age: an important medical safeguard.

Genetic counseling before amniocentesis has been advocated by many geneticists with little evidence to support their contention. Records of patients referred exclusively for advanced maternal age were evaluated for additional diagnostic information obtained from the genetic counseling process that could place these patients at additional risks for previously unsuspected fetal abnormalities. A significant number of patients (43.

Amniotic fluid analysis for antimicrobial factors.

The antimicrobial factors in amniotic fluid (AF) were analyzed in 81 women during various periods of gestation. The AF inhibited the growth of E. coli 026 when the phosphate/zinc ratio was less than 200 or iron less than or equal to 1.

Prenatal diagnosis and management of nonimmunologic hydrops fetalis.

As problem pregnancies are increasingly subjected to ultrasound evaluation, the prenatal diagnosis of hydrops fetalis is being made more and more frequently. The authors encountered 5 cases of this disorder in 12,830 deliveries (1:2566) and made the diagnosis prior to delivery in 4 of the 5 cases. Amniocentesis and amniotic fluid bilirubin determination have been performed in association with ultrasound scan and a battery of other diagnostic tests, and the results have been correlated with fetal outcome.

Control of perinatal infection by traditional preventive measures.

A 9-year review of nosocomial infections occurring in the department of obstetrics and gynecology of a major teaching hospital demonstrated the dramatic effect of strict asepsis and isolation on postoperative infection rates. With rigidly enforced preventive measures and without the use of prophylactic antibiotics, the rates of wound infection and endometritis and the relative prevalence of gram-negative aerobic organisms cultured from these infections could be reduced substantially. The role of anerobes in these infections was not established, since adequate techniques for the accurate diagnosis of anaerobic infection were not available at the time of this study.

Reduced hepatic bilirubin uridine diphosphate glucuronyl transferase and uridine diphosphate glucose dehydrogenase activity in the human fetus.

Hepatic bilirubin uridine diphosphate glucuronyl transferase (UDPG-T) activity was 0.14 and 0.22 units in two fetuses aged 17 and 22 weeks, respectively, and less than 0.

Microflora of the cervix during normal labor and the puerperium.

The normal flora of the cervix was studied in 50 healthy women in labor and on the third day postpartum. Aerobic bacteria were the exclusvie isolates in 25% of these women, and 75% had anaerobic bacteria in addition to aerobes. Anaerobes were always found in association with aerobes.

Amniotic fluid contamination during internal fetal monitoring.

The risk of infections associated with intrauterine fetal monitoring was evaluated in 30 consecutive labors. Amniotic fluid samples collected through the intrauterine catheter were found to be contaminated with bacteria in 15 of 30 consecutively monitored patients during labor. Aerobes were the exclusive isolates in eight, anaerobes in five and both in two patients.

The management of severe preeclampsia and eclampsia with intravenous diazoxide.

Twelve patients with either severe preeclampsia (9) or eclampsia (3) were treated with intravenous diazoxide, 300-mg bolus, for the reduction of diastolic blood pressure (less than or equal 110 torr) after the usual and customary measures had been initiated to include parenteral MgSO4 and diazepam. Diazoxide precipitously decreased both systolic and diastolic blood pressure proportionately (35-50%); the nadir was invariably reached in 5-15 minutes. Diastolic pressure never fell below 50 torr, and mean arterial pressure always exceeded 70 torr.

Sampling the fetoplacental circulation. II. Combined laparoscopy-fetoscopy in the pregnant ovine.

Induction of pneumoperitoneum, laparoscopy, and intrauterine endoscopy (fetoscopy) were successfully accompished in 23 pregnant sheep at 45 to 60 days' gestational age. The fetoscope, a conventional 2.7 mm.

Antimicrobial effect of amniotic fluid against anaerobic bacteria.

Amniotic fluid samples were obtained at term and tested for their antimicrobial effect on anaerobes, Peptostreptococcus (Ps.) anaerobius, Peptococcus (Pc.) prevotii, Bacteroides (B.

Sampling the fetoplacental circulation. I. The pregnant ovine.

Intrauterine endoscopy (fetoscopy) was successfully accomplished in 26 specially prepared pregnant sheep at 85 to 110 days' gestational age, with the use of a conventional 2.7 mm. Hopkins straightforward wide-angle telescope (Stortz 27018A) encased in a prototype 3.