Triploidy syndrome with theca lutein cysts and severe pre-eclampsia.
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Biomedical subjects
Publications and source records attributed to R C Cefalo.
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Familial respiratory distress syndrome in full-term newborn infants is a rare occurrence. Our patient delivered three consecutive full-term infants who developed findings consistent with respiratory distress syndrome. All three died from autopsy-proven hyaline membrane disease. Analysis of the activities of four enzymes that play an important role in the biosynthesis of lecithin (choline kinase, choline phosphotransferase, phospholipase A and lysolecithin acyltransferase) failed to disclose an abnormality in lung samples in our patient with familial respiratory distress syndrome.
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This investigation was undertaken to study the effect of reduction of placental surface area on fetal growth. The right horn of the bicornuate uterus was removed in nonpregnant ewes, the ewes were bred and 11 out of 15 became pregnant. Near term, under experimental conditions, maternal and fetal blood gases, pH, uterine and umbilical blood flows were measured or calculated. Fetal, placental membrane, uterine, and cotyledonary weights and number of cotyledons were recorded. The experimental hemi-hysterectomized group was compared to a control group of 14. Results show that: (1) weight per cotyledon was significantly greater (p less than 0.01) in the hemi-hysterectomized series than in the controls, (2) loss of a significant number of placentation sites was compatible with the production of term-sized fetuses, (3) since the difference between the number of cotyledons in the hemihysterectomized and control groups is significantly less than the number of implantation sites removed, the efficiency of implantation is improved, and (4) there were no changes in blood flows, PO2, PCO2, and fetal oxygen consumption.
Four patients with preterm rupture of the membranes were treated conservatively. During the period of observation (five to nine weeks), each fetus displayed a normal rate of growth as measured by serial biperietal diameter determinations.
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The effect of induced maternal hyperthermia (1.5 degrees C rise over 60 min) on the uterine and umbilical circulations was examined in two groups of chronically instrumented pregnant sheep. Hyperventilation occurred in both groups. In the group in which the resultant respiratory alkalosis was untreated (N = 5), uterine blood flow decreased to 53 +/- 3% (mean +/- SE; P less than 0.01) of control at maximal maternal temperature. Umbilical blood flow also decreased 30 +/- 6% (P less than 0.01) below control levels. In the other group, normocapnia was maintained (N = 4). Uterine blood flow decreased in this group to 75% +/- 2% (P less than 0.01) of control levels, but umbilical blood flow did not significantly change. There was no significant change in maternal or fetal mean arterial pressure during hyperthermia in either group. Thus, maternal hyperthermia per se results in a significant decrease in uterine blood flow primarily through an effect on uterine vascular resistance, but without a concomitant change in umbilical blood flow.
A system that produces hyperthermia in pregnant sheep in a consistent and reproducible manner was designed. The experimental approach was through control of ambient temperature and relative humidity in a closed chamber; the sheep was unable to lose its metabolic heat in an environment of 42 degrees C and 75% relative humidity. This system resulted in a steady and progressive temperature rise of 2.5 degrees C in the maternal abdominal aorta in 120 +/- 17 min.
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Fetal ventral wall malformations may be diagnosed prenatally with ultrasound. These include omphalocele, gastroschisis, or even thoracic defects with or without ectopia cordis. It is important whenever such a defect is found to carefully define the full extent of the lesion prior to parental counselling. Described and illustrated here is the prenatal diagnosis with real-time ultrasound at 17 weeks gestation of a rare thoraco-abdominal ventral wall defect including omphalocele, bifid sternum, diaphragmatic aplasia, and pericardial aplasia with incomplete ectopia cordis. The technique is described and the importance of the complete, accurate delineation of anatomic malformations is emphasized.