[Intracellular potassium in normal and pathological pregnancy. II. Experimental results].

Intraerythrocyte potassium was determined on samples from 198 physiologic, 88 hypertensive and 92 diabetic pregnant women. An increasing trend was observed during puerperium after the day 3, but a significant difference among the groups was not detected. These results may be due to a wider involvement of other cations (sodium, calcium) in the pathophysiology of pregnancy.

[Hypertension and syncytiotrophoblast: morpho-structural aspects].

Hypertension is a pathological condition that involves maternal fetal relationship. In hypertension placenta displays a syncytiotrophoblast plasmalemma with aspects of anomalous behaviour concerning Intramembranous Particles (IMP) and actin content of microvilli cytoskeleton. Decrease of syncytiotrophoblast microvilli IMP and microvilli actin further sustain the tendency of hypertensive placenta to show some features of immaturity that might deeply influence fetal-maternal exchanges during pregnancy associated with pathological status.

Behavioural state transitions in healthy and growth retarded fetuses.

The transitions, i.e. time intervals between two different behavioural states, were studied in 10 healthy and 10 growth retarded fetuses (IUGR) in near term pregnancies.

Prenatal cerebral Doppler ultrasonography and neonatal neurologic outcome.

The significance of fetal cerebral blood flow analysis in the prediction of neonatal neurologic outcome was investigated on 87 fetuses at risk for chronic hypoxia. Blood flow velocity waveforms were recorded from the fetal internal carotid artery immediately before cesarean section; newborns underwent neurologic follow-up until discharged from the neonatal division. Neonatal outcome was considered abnormal in presence of a postasphyxial encephalopathy.

Hemodynamic changes in growth retarded fetuses during maternal oxygen administration as predictors of fetal outcome.

The changes in fetal hemodynamics during maternal administration of 60% humidified oxygen were assessed by Doppler ultrasonography in 15 growth retarded fetuses characterized by abnormal blood flow velocity waveforms. During oxygen treatment, nine fetuses exhibited temporary hemodynamic modifications as expressed by a recovery toward the normal range of vascular impedance in the descending aorta and internal carotid artery, whereas no changes were found in the remaining six fetuses. In this latter group, a rapid deterioration of fetal condition occurred and all the fetuses were delivered by emergency cesarean section within 9 days from the Doppler examination.

Integrated neuropsychopathological approach in patients affected by amenorrhea.

A compared study of neurovegetative modifications (following stress stimula) and of psychopathological aspects in patients affected by amenorrhea was carried out. Such an integrated approach is useful for a better definition of clinical characteristic and for a selection of a suitable therapeutic approach.

Morphological development of the human placenta in normal and complicated gestation: a quantitative and ultrastructural study.

In order to evaluate the structural potentialities of the placenta, we analyzed placentas in the following conditions: normal full term gestation, hypertensive status, twin pregnancy and abortion at 8-12 weeks of gestation, comparing cell structures, surface organization and tissue reaction. We quantitatively evaluated (1) the arborization of the placental villous tree, and (2) the microvillous density per unit of surface area, paralleling these data with ultrastructural and immunohistochemical features. In early gestation (8-12 weeks of pregnancy) the limited degree of branching of placental villi parallels a reduced number of clefts per unit of surface area (0.

Are blood flow velocity waveforms related to umbilical cord acid-base status in the human fetus?

Doppler blood flow velocity waveforms from fetal umbilical artery, descending aorta, internal carotid artery and maternal uterine arteries were recorded in 50 fetuses near term undergoing cesarean section before the onset of labor in order to evidence eventual relationships with the fetal acid-base status. The primary indications for cesarean section were in 16 cases an elective repeated cesarean section and in the remaining cases maternal hypertension often associated with fetal growth retardation and/or fetal distress. The technique of anesthesia was strictly standardized and fetal blood gas levels and acid-base status were analyzed in umbilical artery and vein immediately after birth.

Calcium and sodium transport in gestational hypertension.

The enzymatic activities of Na+/K+ ATPase and Ca2+ ATPase were determined on erythrocyte membranes from 9 normotensive and 9 gestational hypertensive pregnant women near term. A reduction in the activity of the Na+/K+ ATPase and a relative increase in the activity of the Ca2+ ATPase were found in the hypertensive patients, possibly due to a conformational alteration of erythrocyte membranes. This observation supports the possible role of the transmembrane cation transport in the pathogenesis of gestational hypertension.

Umbilical cord blood rheology in relation to maternal disease and fetal hypoxia.

Erythrocyte aggregation was studied in 60 samples of cord blood taken at delivery from neonates whose mothers suffered from hypertension or diabetes in pregnancy or from neonates who showed hypoxia during labor. Erythrocyte aggregation significantly increased in the cord blood of neonates who suffered from hypoxia during labor, and in neonates from hypertensive and diabetic mothers. The effects of maternal disease or intrapartum hypoxia may therefore stimulate fetal erythropoiesis and cause major changes in cord blood rheology.

Tryptophan availability and fetal behavioral states.

Behavioral state instability in growth-retarded fetuses might be related to a decrease in serotonine production. Tryptophan maternal and cord blood values after elective cesarean section have been investigated by means of high performance liquid chromatography in 20 growth-retarded fetuses due to pregnancy-induced hypertension (PIH) and 20 normal pregnancies as control group. The feto-maternal ratio of tryptophan is significantly higher in normal fetuses than in PIH growth-retarded fetuses (p less than 0.

Short-term effects of maternal oxygen administration on blood flow velocity waveforms in healthy and growth-retarded fetuses.

To determine whether maternal oxygen administration affects fetal hemodynamics, we investigated 10 healthy fetuses and 10 growth-retarded fetuses near term by means of Doppler ultrasonography. The growth-retarded fetuses were characterized by abnormal blood flow velocity waveforms. Velocity waveforms were simultaneously recorded at 5-minute intervals from the fetal descending aorta and internal carotid artery before, during, and after maternal oxygen administered through a face mask that delivered 60% oxygen.

Computer-assisted analysis of fetal behavioural states.

A computerized system which simultaneously acquires and quantifies several ultrasonically detected fetal activities, including gross body movements, breathing movements, and eye movements, was developed in order to obtain additional quantitative data on fetal behaviour. Movements were automatically related to fetal heart rate allowing computation of their mean incidence, duration, lag time and percentage time spent moving during different heart rate patterns. The incidence of various behavioural states was also calculated.

Effect of general anesthesia on syncytiotrophoblast plasma membranes from human placenta.

This investigation shows that a general anesthetic produces similar effects in vivo and in vitro. Anesthesia with a barbituric drug, Thiopental, induces an increase in membrane fluidity and a decrease in the activity of acetylcholinesterase in syncytiotrophoblast plasma membranes (SPM) obtained from placentas after caesarean section. The same effects can be reproduced in vitro after anesthetic addition to the isolated plasma membranes.

Lymphocytes subset in hyperandrogenic women with polycystic ovarian disease.

The correlation between the sex steroids and the immune system is already known but the relationships between testosterone, progesterone, estradiol, cortisol and the immune system are still controversial. The Authors have studied lymphocytes subset in ten women with polycystic ovarian disease (PCOD); it was observed: 1) a decrease of T8 in 64% and of natural killer activity (NK) in 60% of patients, and an increase of T4/T8 ratio in 55%; 2) a significant negative correlation between androstenedione and testosterone (P less than 0.05); 3) a significant positive correlation between the decreased T8 lymphocytes and NK cells and the increase of testosterone and androstenedione serum values.

Sodium/potassium-adenosine triphosphatase on erythrocyte ghosts from pregnant women and its relationship to pregnancy-induced hypertension.

The regulation of electrolytes has been proposed as a possible determinant in hypertensive conditions, including pregnancy-induced hypertension. We report a study of sodium/potassium-adenosine triphosphatase in erythrocyte membranes of 59 patients with pregnancy-induced hypertension and 48 normotensive pregnant controls. The kinetics of the enzyme were also investigated, and the enzyme activity related to different degrees of pathology.

Abnormal membrane cation transport in pregnancy-induced hypertension.

An abnormality of sodium handling has been suggested as one of the mechanisms responsible for the development of pregnancy-induced hypertension. We analysed the plasma and urinary concentrations, and the intraerythrocyte activities of Na and K, and the RBC membrane Na+/K+-ATPase activity of 77 hypertensive and 133 normal pregnant women. Umbilical cord blood of infants from 21 hypertensive and 28 control women was studied.

Doppler echocardiographic assessment of atrioventricular velocity waveforms in normal and small-for-gestational-age fetuses.

A prospective longitudinal study determined the physiological patterns of blood flow velocity waveforms in normal and in small-for-gestational-age (SGA) fetuses. Using a Pulsed Doppler Duplex system, 125 normally grown fetuses and 35 SGA fetuses were studied longitudinally at between 27 and 42 weeks gestation. In normal fetuses the ratio between the E velocity (early passive ventricular filling) and the A velocity (active ventricular filling during atrial contraction) increased progressively during pregnancy in both transmitral and transtricuspid waveforms, approaching 1 at term.