OBJECTIVE: Recombinant human erythropoietin (rhEPO) increases fetal hemoglobin synthesis in nonpregnant thalassaemic patients. We used rhEPO in 4 pregnant patients with heterozygous beta-thalassemia and anemia to study its effect on erythropoiesis, F cell production, and HbF synthesis. METHODS: Patients were treated with a combination therapy of rhEPO and iron. The effect on HbF synthesis was assessed by the percentage of F reticulocytes, F cells, and total HbF, erythropietis by reticulocyte count, and hemoglobin measurements and iron status by ferritin levels, transferrin saturation, and percentage of hypochromic red cells. RESULTS: RhEPO caused an increase of F reticulocytes (1.5 to 10.5 fold), F cells (5.0 to 7.7 fold), and HbF (1.4 to 2.2 fold). All patients showed an increase of young, immature reticulocytes and had elevated reticulocytes at the end of therapy. Hemoglobin increased with a range from 0.3 to 1.5 g/dL. Transferrin saturation and ferritin levels were normal at the end of the study. There was an increase of the percentage of hypochromic red cells, indicating functional iron deficiency after rhEPO administration despite supplemental iron. CONCLUSIONS: RhEPO stimulates both HbF synthesis and erythropoiesis in pregnant patients with heterozygous beta-thalassemia and anemia. Since it is known that high HbF levels ameliorate thalassemia symptoms in nonpregnant patients, use of rhEPO for the treatment of severe anemia in thalassaemic patients during pregnancy might be further evaluated.

Adult↗

PubMedDate not supplied

Role of duplex color Doppler ultrasound, computed tomography, and MR angiography in the diagnosis of septic puerperal ovarian vein thrombosis.

BACKGROUND: Septic puerperal ovarian vein thrombosis (SPOVT) is one of the underlying etiologies of puerperal fever. A correct diagnosis of this condition is important because adequate treatment requires additional administration of anticoagulants. The purpose of this study was to evaluate the role of duplex color Doppler ultrasound (CDUS), computed tomography (CT), and magnetic resonance angiography (MRA) in the detection of SPOVT. METHODS: Twenty-six patients with puerperal fever suspected to be due to SPOVT and unresponsive to broad antibiotic treatment for at least 48 h were included in a prospective study using CDUS, CT, and MR imaging including MRA. Examinations were analyzed and then correlated to a standard of reference gathered from surgical and clinical follow-up data and from results of imaging. RESULTS: SPOVT was present in nine patients (right side n = 8, bilateral n = 1). CDUS was inconclusive due to gaseous distention of the bowel or obesity in 13 of 26 cases. After counting inconclusive findings as wrong results for statistical purposes, sensitivity, specificity, and accuracy for CDUS were 55.6%, 41.2%, and 46.2%, respectively. CT had a sensitivity of 77.8% with a specificity of 62.5%; accuracy was 68.0%. MRA rendered conclusive results in all evaluated patients, resulting in a sensitivity and specificity of 100%. CONCLUSION: MRA is recommended in all patients with inconclusive CDUS findings and persistent suspicion for SPOVT. CT has the advantage of more rapid access and lower cost and thus will probably remain a sufficiently accurate alternative. Septic puerperal ovarian vein thrombosis (SPOVT)-Computed tomography-Magnetic resonance angiography-Ultrasound.

Adult↗

PubMedDate not supplied

Uteroplacental blood flow velocity waveforms in the second and third trimesters of normal pregnancy as related to the placenta location.

The systolic/diastolic ratios (A/B) of uteroplacental blood flow velocity waveforms as related to the placenta location were investigated by continuous-wave Doppler ultrasound in 67 normal pregnancies at 18-21 weeks, in 111 at 31-33 weeks, and in 34 at 40-41 weeks of gestation. Using real-time ultrasound, the placenta was located laterally in 48%, posteriorly in 30% and anteriorly in 22% of the pregnancies. A/B values decreased slightly with advancing gestational age. With lateral placenta location, statistically significant higher A/B values were found in vessels on the nonplacental side at 31-33 weeks of gestation (2.07 +/- 0.43 versus 1.74 +/- 0.27; p less than 0.05). In the other gestational age groups there were no statistically significant differences between A/B values in the vessels on the placental and nonplacental sides. There were also no differences in A/B values between left and right uteroplacental vessels with anterior or posterior placenta locations in any of the gestational age groups.

Blood Flow Velocity↗

PubMedDate not supplied

Fetal and preterm newborn cerebral blood flow velocity.

Using Doppler ultrasound, cerebral blood flow velocities (CBFV) in the first month of life of normoxemic preterm infants born in the 28th gestational week with stable circulatory conditions were examined. The results were compared with fetal CBFV in the 28th to 32nd weeks of pregnancy. Peak systolic (PSV), end-diastolic (EDV) and time averaged maximum velocities (TAMV) were evaluated from the Doppler shifts recorded from the middle cerebral artery (MCA). Cerebral circulatory changes in neonates in the first 4 weeks of life were much more pronounced than in fetuses at the corresponding gestational age (28-32 weeks). After the rapid increase in neonatal CBFV in the first 3 weeks of life, our results appear to indicate a stabilisation between the 3rd and 4th week (corresponding to the 32 gestational weeks). The significance of, and possible mechanisms for, these changes are discussed.

Blood Flow Velocity↗

PubMedDate not supplied

Risks the passive smoker runs.

Explore the source record for details and available documents.

Air Pollution↗

PubMedDate not supplied

Calibration of a reflectance pulse oximeter in fetal lambs for arterial oxygen saturations below 70%.

OBJECTIVE: To calibrate a reflectance pulse oximeter developed at the Division of Perinatal Physiology, University Hospital of Zurich, for monitoring of oxygen saturations below 70%. METHODS: Oxygen saturation measured noninvasively with the reflectance pulse oximeter in fetal sheep was compared with oxygen saturation of arterial blood samples measured by a conventional two-wavelength oximeter. Oxygen saturation was varied by stepwise reduction of the inspired oxygen concentration of the ewe. RESULTS: A total of 58 data pairs was obtained from five fetuses, with a range of 10.9-73.5% for the reference method and 6.8-69.2% for the pulse oximetry oxygen saturation values. There was good correlation between the results obtained by the two methods (r2 = .89, P < .0001), with a 95% confidence interval of +/- 12.5%. The pulse oximeter showed a precision of 6.2% oxygen saturation. CONCLUSION: The Zurich reflectance pulse oximeter offers valid measurements of oxygen saturation levels down to 10% oxygen saturation, and is therefore suitable for monitoring the fetus during delivery.

Animals↗

PubMedDate not supplied

Unexplained elevated serum hCG is associated with raised amniotic fluid erythropoietin levels in second-trimester pregnancies.

OBJECTIVE: This study was designed to investigate the association between the concentrations of maternal serum hCG and amniotic fluid erythropoietin during the second trimester of pregnancy. METHODS: In a prospective case-control study, 42 consecutive singleton pregnancies showing unexplained elevated serum hCG concentrations (>2.0 multiples of the median, MoM) in Down's syndrome screening and 27 control pregnant women undergoing midtrimester amniocentesis because of a previous cytogenetic abnormality were studied. RESULTS: The mean amniotic fluid erythropoietin concentration in the study group was 1.8 (range 0.61-8.7) MoM, whereas it was 1.1 (range 0.71-3. 96) MoM in the controls (p = 0.035). A significantly increasing relationship (p < 0.05) was found between the concentrations of maternal serum hCG and amniotic fluid erythropoietin. CONCLUSIONS: The results of the current study revealed in vivo the association between elevated hCG and amniotic fluid erythropoietin levels which, in turn, supports the concept of early placental damage. The underlying pathology seems to be sufficient to cause an erythroblastic response.

Adult↗

PubMedDate not supplied

Prenatal ultrasound diagnosis of a femur-fibula-ulna complex during the first half of pregnancy.

A case of fetal femur-fibula-ulna (FFU) complex diagnosed by ultrasound is presented. Ultrasonographic features of a fetus displaying bilateral femoral hypoplasia, aplasia of the right forearm and the right hand, ray defects of the left hand are described. The importance of an early diagnosis of this malformation is emphasized with respect to parental counselling concerning prognosis and further prenatal management.

Adult↗