Mid-trimester hyperechogenic bowel in a fetus of Japanese origin: caution in interpreting reported CFTR mutation (L548Q).
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Cystic Fibrosis↗
Biomedical subjects
B M Castle
Publications and source records attributed to B M Castle.
Health reforms.
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Health Services Administration↗
Serial fetal blood sampling for the management of pregnancies complicated by severe rhesus (D) isoimmunization.
Fifty-one pregnancies complicated by rhesus (D) isoimmunization have been managed by serial fetal blood sampling between 17 and 36 weeks gestation as an alternative to amniocentesis for delta OD453 measurements. In 36 pregnancies where the fetus was shown to be rhesus (D) positive and both measurements were made before any intrauterine fetal transfusions, the delta OD453 value gave misleading predictions on 13 of 63 occasions (21%). Fetal haematocrit estimations provided a direct assessment of the haemopoietic compensation occurring, but fetal bilirubin and albumin concentrations did not correlate directly with disease severity. It is proposed that pregnancies complicated by severe isoimmunization can be more precisely managed by serial fetal blood sampling for haematocrit estimation than amniocentesis for delta OD453 measurement thus avoiding unnecessary intervention or delayed treatment.
Female↗
Prostaglandin release from preparations used vaginally for the induction of labour.
The release and absorption profiles from the vagina of PGE2 in different vehicles used for cervical ripening and labour induction have been studied observing changes in concentrations of PGE metabolite (PGEM) and PGF metabolite (PGFM). In all groups a rise in PGEM concentration occurred over the 6 hour observation time but with wide variation. The profiles obtained differed markedly between the preparations under investigation correlating with the uterine contractions generated. PGFM generally showed little change. The model used could be explored further to enable modification of the vehicles used for PGE2 incorporation to achieve improved clinical results.
Abortion, Therapeutic↗
In-utero intravascular transfusion of the fetus for the management of severe Rhesus isoimmunization--a reappraisal.
Ten fetuses, severely affected by Rhesus (D) haemolytic disease, received one to three intravascular blood transfusions at between 18 and 30 weeks gestation, with the use of fetoscopically guided needles into one of the umbilical cord vessels. Although the technique was successfully accomplished in all cases, the fetal response to the procedure was varied. Only two fetuses survived beyond the neonatal period, and one child subsequently died principally because of the problems resulting from premature delivery. The reason for the low rate of survival has been explored and the continued use of the method described is now questioned.
Blood Transfusion, Intrauterine↗
Maternal plasma prostaglandin E2 metabolite levels during human pregnancy and parturition.
Because of methodological problems associated with the measurement in biological fluids of both prostaglandin E2 (PGE2) and its unstable principal circulating metabolite 13,14-dihydro-15-keto-PGE2 (PGEM), there is little reliable information on these prostaglandins in human pregnancy and parturition. The recent discovery of a stable PGEM degradation product 11-deoxy-13,14-dihydro-15-keto-11 beta, 16 epsilon-cyclo-PGE2 (bicyclo-PGEM) has provided a means of studying endogenous plasma levels of PGEM which circumvents the problems encountered with direct measurements of PGE2 and PGEM. Using a radioimmunoassay for bicyclo-PGEM we have therefore determined maternal peripheral plasma PGE2 metabolite levels during human gestation. PGE2 metabolite levels did not alter significantly during the second or third trimesters nor during labour. This contrasts with maternal peripheral plasma levels of the principal circulating metabolite of PGF2 alpha 13,14-dihydro-15-keto-PGF2 alpha (PGFM) which increases several fold during labour. Compared to PGE2 therefore, PGF2 alpha may be quantitatively the more significant prostaglandin associated with human parturition.
Dinoprostone↗
The presence or absence of fetal breathing movements predicts the outcome of preterm labour.
54 patients admitted to hospital in labour before the 34th week of pregnancy had real-time ultrasonography to establish the presence or absence of fetal breathing movements. In 19 of 20 pregnancies with no detectable fetal breathing, delivery occurred within 48 h whereas in 25 of 34 with fetal breathing on admission, pregnancy continued for a week or more; of the remaining 9, 7 had had spontaneous rupture of the membranes (with amnionitis in 4). If the presence of fetal breathing identifies cases in which preterm labour will subside spontaneously, this sign should be of value both in trials of treatment and in clinical management.
Dinoprostone↗