Obstetric performance in patients with the lupus anticoagulant and/or anticardiolipin antibodies.

Antiphospholipid antibodies, notably the lupus anticoagulant and anticardiolipin antibodies, are associated with recurrent fetal wastage, pregnancy complications, and thromboses. Aggressive medical treatment using aspirin and steroids has been recommended. Fifty-one patients with antiphospholipid antibodies, only four with underlying connective tissue disorders, were followed through 53 pregnancies.

Difficulty of fetal monitoring in a fetus with intracardiac tumors.

Fetal intracardiac tumors are rare but, when present, are a common cause of poor or uninterpretable fetal heart tracings due to fetal arrhythmias. The most frequently encountered tumor, the rhabdomyoma, is associated with tuberous sclerosis. We present a case demonstrating this difficulty of fetal monitoring in a fetus with an arrhythmia later found to be due to multicentric intracardiac rhabdomyomas.

Acardiac fetus in a triplet pregnancy.

The acardiac monster represents one of the most severe but rare congenital anomalies. It occurs only in multiple gestations associated with vascular anastomoses between the affected fetus and its co-twin. The prenatal diagnosis of an acardiac fetus must be suspected in any multiple gestation in which cardiac activity cannot be documented sonographically in a growing fetus.

Successful pregnancy after pharmacologic suppression of a circulating anticoagulant in a woman with previous pregnancy losses and pulmonary emboli. A case report.

A woman had two second-trimester fetal deaths two weeks after genetic amniocenteses, and her puerperal courses were also complicated by pulmonary emboli. During her next pregnancy a circulating anticoagulant was demonstrated that had been absent between her pregnancies. It was suppressed with aspirin and prednisone.

Nonstress testing.

Physiologic considerations on regulation of the fetal heart rate are reviewed. The types of fetal heart rate acceleration are classified and illustrated. Data from 509 patients undergoing 1,281 nonstress tests are presented, with emphasis on indications, technique, and interpretation.

Oxytocin challenge test.

This study reviews the indications, interpretation, and practical application of the oxytocin challenge test (OCT) in 154 patients undergoing 375 tests. It emphasizes aspects of technique which may make the "challenge" nonphysiologic and the stress, therefore, nonquantifiable. Thirty-four positive or suspicious tests were obtained in 22 patients.

Intrauterine growth retardation: obstetrical aspects.

We have just begun our study of fetal growth retardation. Prenatal influences upon fetal growth are poorly understood and little studied. One may list multiple etiologies, catalogue numerous physiologic processes, and still not know in any given child what went wrong.

Obstetric aspects of the Guillan-Barré syndrome.

Two additional cases of Guillain-Barre syndrome complicating pregnancy are reported and the 25 previously published cases reviewed. While fetal prognosis is generally favorable, the occurrence of the disease in late pregnancy is a high-rish maternal condition. Respiratory failure and aspiration pneumonitis may result in premature labor and maternal mortality.