[Fetal heart rate. Attempt at its quantitative evaluation during labor].
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Biomedical subjects
Publications and source records attributed to C Sureau.
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The authors report an interesting case of arterio-venous fistula in the uterine vessels in a young two-para of 23 years of age. A pulsatile and throbbing mass was found in the right parametrium at her post-natal visit after the second delivery, although no abnormal sign had been noted during the pregnancy. The diagnosis was confirmed by arteriography. Two surgical procedures have not been able to cure this patient entirely of these multiple fistulae which were congenital in origin. The production of an arterial embolus finally got over the difficulty of removing the residual troubles at the same time allowing the patient to keep her uterus. Following this case, the authors discuss the aetiology of acquired or congenital fistulae and the means by which this rare vascular pathological condition can be diagnosed and treated in the pelvis.
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The authors present three cases of fetal hypothyroidism following amniofetography, after they have reviewed the technique and complications of this procedure. (For outlining the fetus by injecting radio-opaque iodides into the amniotic sac). These are cases of hypothyroidism in the fetus caused by overdosage with iodides. The fetal thyroid is blocked by the large quantity of iodine which is necessary for amniofetography. The indications then for amniofetography should be reviewed. The only valid indication that remains is for the diagnosis of neurological malformations and especially spina bifida. Whenever amniofetography has been carried out the newborn should be assessed for thyroid function routinely.
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The authors using an electronic calculator have measured 3 parameters, which allowed them to carry out quantitative evaluations of rapid variations in basal fetal cardiac rhythms (fluctuation) of 29 samples of fetal heart rate obtained during labour. The three parameters are: 1. Mean variation by intervals. 2. Values for differences in intervals approaching zero. 3. Zero changes in the derived curve. Each of these parameters was compared with the values of fluctuations which were obtained by visual analysis quantified on the same samples of tracings. The results of these coefficients of correlation show that the chosen parameters enable quantitative values for these fluctuations to be obtained.
We have examined 1,200 placentas in a fresh state and have compared the results of these examinations with maternal pathology on the one hand and the neo-natal pathology on the other hand. It turns out that most abnormalities of pregnancy are associated in a significant way with the pathological findings in the placenta, and that the good or pathological health of the newborn is significantly associated with the normal of pathological character of the placenta. The principal weakness in this method of examination is the absence of information about infection. This is why it seems important to us to carry out smears from the placenta before examining it macroscopically.