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PubMed1992

Cerebral and adrenal monoamine metabolism in the growth-retarded rat fetus under normoxia and hypoxia.

The effect of intrauterine growth retardation (IUGR) on cerebral and adrenal monoamine metabolism was studied in the fetuses of eight nulliparous rat dams after unilateral uterine artery ligation on d 18 of gestation. On d 22 (term = 23 d), four dams were subjected to normoxia and four to hypoxia (10% O2) for 58 min while their hemodynamics and blood gases were monitored. An inhibitor of L-aromatic-decarboxylase (3-hydroxybensylhydrazine) was infused to measure monoamine synthesis rate. After decapitation of the dam, fetuses were delivered by sectio, decapitated, and dissected at -5 degrees C. The body, liver, forebrain, brainstem, and adrenal glands were weighed, and concentrations of monoamine precursors, transmitters, and metabolites were assessed in the three latter organs. The weights of liver and forebrain were reduced in fetuses with IUGR, whereas brainstem and adrenal weights were unaltered. Epinephrine content in adrenals was reduced in proportion to body weight under normoxia but failed to increase under hypoxia as it did in appropriately grown fetuses. There were only minor changes in monoamine metabolism in the brainstem. In the forebrain, however, marked changes were seen, mainly in serotonin metabolism: under normoxia, fetuses with IUGR had decreased levels of serotonin and its metabolite 5-hydroxyindole acetic acid. Under hypoxia, appropriately grown fetuses reduced their concentrations of these substances, whereas fetuses with IUGR paradoxically increased their synthetic activity. It is concluded that a disturbance of central nervous serotonin metabolism prevails in growth-retarded rat fetuses in late gestation and that this disturbance depends on the degree of growth retardation and the degree of perinatal stress.

Adrenal Glands↗
PubMed1997

Maternal adrenalectomy eliminates a surge of plasma dehydroepiandrosterone in the mother and attenuates the prenatal testosterone surge in the male fetus.

Previous work has established a number of sex-related deficits in immune function, behavior, and endocrine responses to stress in the offspring of dams exposed to ethanol. To examine the potential role of maternal glucocorticoids as a mediator of these sexually dimorphic effects in the fetus, we examined the influence of prenatal alcohol exposure in the presence or absence of maternal glucocorticoids on fetal plasma corticosterone (CORT) production. An additional question to be addressed by these studies was whether maternal adrenalectomy could eliminate the known inhibition by ethanol of the prenatal surge of plasma testosterone in male fetuses. Pregnant dams were adrenalectomized (ADX) or sham-adrenalectomized on gestational day (G) 7 and placed on a liquid diet containing 35% ethanol-derived calories or pair-fed an isocaloric control diet throughout the experiment. On G18, G19, and G21, plasma levels of CORT, testosterone, and dehydroepiandrosterone (DHEA) were measured in male and female fetuses and their mothers. Ethanol administration consistently increased maternal plasma CORT levels but did not significantly alter CORT levels in the fetus. Maternal ADX resulted in compensatory increases in fetal CORT levels that were lower in fetuses of ADX dams on alcohol, suggesting a direct effect of ethanol on fetal pituitary-adrenal activity. There were no significant sex differences in fetal plasma CORT levels in response to any of these manipulations. A novel surge of maternal plasma DHEA was found on G19 that was absent in plasma from ADX dams. In spite of the absence of a surge on G19, plasma DHEA levels of ADX dams rose from very low levels at G18 to levels on G21 that were significantly higher than in Sham dams. A normal testosterone surge was observed in male fetuses on G18 and G19 from sham-adrenalectomized dams administered the pair-fed diet. However, this surge was greatly attenuated in males administered ethanol and also in male fetuses from ADX dams. These results reveal a direct inhibitory influence of ethanol on fetal CORT secretion as well as on the prenatal testosterone surge in males. Furthermore, these studies demonstrate the presence of a surge of DHEA in the pregnant rat. Overall, these data suggest that there is a critical adrenal factor in the rat that regulates the maternal surge of DHEA on G19 and the prenatal testosterone surge of male fetuses on G18-19.

Adrenalectomy↗
PubMed2005

The case of monochorionic twin gestation complicated by intrauterine demise of one fetus in the first trimester.

The study investigated the clinical and pathomorphological characteristics of monochorionic diamniotic twin gestations complicated by the spontaneous loss of one fetus during the first trimester. Nine monochorionic diamniotic twin gestations were analyzed in which the demise of one fetus occurred during the first trimester. During the course of the study, 178 twin gestations were sonographically identified during the first trimester. Forty-three (24.2%) were complicated by the intrauterine demise of one fetus before the end of the 12th week of pregnancy. Nine cases were monochorionic diamniotic. The gestational age of the demised fetuses ranged between 5 and 11 weeks (mean 7.4 weeks). The prognoses for the surviving fetuses were rather poor with the surviving co-twin dying 1 to 3 weeks after the first twin, with abortion of both fetuses. In only one case was gestation concluded on the 40th week with delivery of a live neonate. No blood coagulation changes were observed in the affected pregnant women, and the one live newborn did not reveal any haematological or neurological abnormalities. A postnatal study provided evidence for the history of monochorionic diamniotic placentation in all of the cases. In two cases, probable causes of fetal death were established (congenital malformation, the presence of anastomoses between blood vessels). The obtained results suggest an extremely high risk of mortality for the surviving twin fetus following the co-twin's death in cases of monochorial placentation. The morphological evaluation of placentas and fetal membranes enables the establishment of the type of placenta and, in certain cases, the probable cause of the intrauterine demise of one twin fetus during the first trimester of monochorionic diamniotic twin gestation.

Amnion↗
PubMed1996

Comments on past and present situation of intensive monitoring of the fetus during labor.

Modern intensive monitoring of the fetus during labor affords the opportunity for the greatest possible safety to the infant, whilst at the same time dispensing with unnecessary operations to terminate labor which can be dangerous for the mother and her child. Developments over the past 28 years, since cardiotocography has been in clinical use, have unfortunately also been accompanied by confusion and mistakes. We think that there are two main reasons for this: I. Many who use cardiotocography have not assessed its efficiency correctly. Heart rate pattern with all their variations have too often been regarded as the only diagnostic criteria for the determination of fetal hypoxia. However this procedure only allows a rough selection of actually endangered fetuses. In more than 50% of the cases with a suspicious or pathologic cardiotocogram there is no concrete clinical evidence of manifest danger of hypoxia. II. Investigations concerning the practical importance of monitoring the fetus during labor were often not based on actual clinical indications. Attempts were made to prove that continuous electronic monitoring of the fetal heart rate could be replaced by simple traditional auscultation. Furthermore due to failure to appreciate the real efficiency of cardiotocography, this truly excellent method was in fact blamed for the faults arising from wrong interpretation, instead of underlining the lack of logic of the investigators concerned. After all, several prospective studies, that have examined the efficiency of various monitoring strategies, demonstrate the shortcomings of these techniques in the clinical setting and have shown them to have no relevance in every practice. Presently the most suitable way to monitor the fetus during labor is to combine cardiotocography with a biochemical method. At the moment fetal blood analysis is the most suitable test to be performed in cases where the cardiotocogram is not normal. Then the role of fetal blood analysis is to find out whether in fact a danger of hypoxia is threatened or not. Today the most urgent task when monitoring the fetus during labor is not so much to reduce the number of cases of cerebral palsy since these are seldom caused by intrapartum asphyxia. The major objective is now recognised to be to prevent early morbidity of the fetus, newborn, and the consequences that flow from this. The excellent results of combined intensive monitoring of the fetus during labor are particularly well illustrated by the intrapartum mortality in our hospital during different periods when monitoring practice has been progressively and methodically improved by stages. During the period when monitoring consisted of simple auscultation used on its own, the intrapartum mortality was 0.56%. After the introduction of fetal blood analysis--at that time cardiotocography did not yet exist--the mortality sank to 0.32%. During the first ten years of cardiotocography combined with fetal blood analysis the mortality reduced further to 0.17%, and during the following 13 years it reached to a minimal level of 0.4%. Finally, in this review, other aspects are commented on such as oximetry. Oximetry, presently used as pulse oximetry, as an additional biochemical method will possibly be incorporated as the third method of monitoring the fetus during labor. Oximetry could also be used as an automatic alarm system in the labor ward when fetal O2 levels drop below a particular limit to draw the attention of the staff to the case concerned. Up to now this has not been convincingly achieved with the use of cardiotocography.

Cardiotocography↗
PubMed1993

Sex differences in plasma corticosterone in mouse fetuses are mediated by differential placental transport from the mother and eliminated by maternal adrenalectomy or stress.

The effect of changes in maternal corticosterone concentrations, induced by maternal stress, maternal adrenalectomy or both, on concentration of corticosterone in serum and in adrenals of mouse (Mus domesticus) fetuses was examined. Higher baseline serum corticosterone concentrations were found in female fetuses than in male fetuses; however, there was no sex difference in the content of corticosterone in adrenals collected from these fetuses. Sex differences were observed in the fetal response to changes in maternal concentrations of serum corticosterone resulting from stress (bright light and heat) or adrenalectomy, and both factors eliminated the sex difference in corticosterone in fetal serum. When females were injected i.v. with [3H]corticosterone on day 17 of pregnancy, significantly more 3H was recovered from the serum of female than of male fetuses 15 min after the injection, while more 3H was recovered from placentae of male fetuses. This finding suggests that the difference in serum corticosterone in male and female mouse fetuses is due to greater transport of corticosterone from maternal blood across the placenta of female than of male fetuses.

Adrenal Glands↗
PubMed1988

Fetal aortic and pulmonary artery diameters: sonographic measurements in growth-retarded fetuses.

The small size of the head and abdomen in a growth-retarded fetus may lead to inaccurate estimates of gestational age. Therefore, we conducted a study to assess the diameters of the aortic root and pulmonary artery in such fetuses. During the study period, we measured these great vessel diameters at the level of the semilunar valves on all third-trimester obstetric sonograms in which intrauterine growth retardation was suspected. Cases were included in the study if delivery occurred within 1 week of the scan and if growth retardation was confirmed after birth. The study population consisted of 75 growth-retarded fetuses. We compared the relationships between great vessel diameters and gestational age in this study population with norms previously established in our laboratory in 403 normal fetuses. In a similar fashion, we compared the relationships between great vessel diameters and biparietal diameter in our study population with previously established norms. We found no significant difference between great vessel diameters in growth-retarded fetuses and those in normal fetuses of the same gestational age (p greater than .45 for aorta; p greater than .40 for pulmonary artery). In contrast, aortic root diameter was larger in relation to biparietal diameter in growth-retarded fetuses than it was in normal fetuses (p less than .05), and there was a tendency toward the same result for the pulmonary artery. We conclude that the diameters of the aorta and pulmonary artery remain normal in most cases of intrauterine growth retardation. The aorta and pulmonary artery may be useful predictors of gestational age when growth retardation is suspected.

Aorta↗
PubMedDate not supplied

[Longitudinal analysis of arterial Doppler parameters in growth retarded fetuses].

Doppler parameters enable noninvasive and direct detection of placental insufficiency and brain sparing effect, which occurs as an adaptive mechanism to chronic hypoxemia. It is of great interest if further changes of Doppler parameters, which occur after the detection of the first pathologic value, can anticipate a moment of fetal distress. We investigated growth-restricted fetuses with the brain sparing effect in the time interval between the detection of blood flow redistribution until the distress. The aim of our study was to evaluate longitudinally Doppler parameters in umbilical (Aum), medial cerebral (MCA), renal (AR) and femoral (AF) artery, and find: 1) if there are significant changes in their value; 2) the character and time interval of these changes; and 3) if they differ from changes in biophysical profile (BFP). Prospective clinical study evaluated 35 pregnancies with fetal growth restriction. Fetuses were selected for the study if: 1) there were pathologic cerebral/umbilical (C/U) ratio, 2) at least four Doppler examinations in 3-4 days interval were performed and 3) prepartal fetal distress, defined as silent fetal heart rate pattern with spontaneous and late decelerations, was present. In 28 neonates after delivery umbilical artery gas and acid-base status was determined. Blood flow velocity waveforms were evaluated in Aum, MCA, AR, and AF. Arterial blood flow was estimated by pulsatility index (Pi), while in Aum we also used: present end-diastolic velocity (PEDV), absent end-diastolic velocity (AEDV) and reverse end-diastolic velocity (REDV). All of the fetuses were monitored by cardiotocogram (CTG) once to twice a day and by BFP twice a week. Elective Cesarean section was done in the presence of distress, except if severe immaturity or extreme malnutrition occurred. Etiological factors of placental insufficiency were: 1) hypertensive syndrome (n = 26), 2) chronic renal disease (n = 3), 3) primary antiphospholipid syndrome (n = 2), 4) diabetes mellitus (n = 1), 5) cardiac disease (n = 1) and 6) unknown (n = 2). Initial Doppler examination, with the detection of pathological C/U, was done in time interval between 26. to 32. weeks of gestation (wg) (29.4 +/- 2.5); delivery was between 29. to 34. wg (32.2 +/- 1.9); and average body weight was 1327 +/- 245 g. Pathological BFP was registered in 91.4% of fetuses. Cesarian section has not been done, in spite of distress, in two fetuses (5.7%) due to their extreme immaturity and/or malnutrition, so they died "in utero". Hypoxemia was registered in 96.4% (27/28) neonates, while acidosis in 71.4% (20/28). Neonatal morbidity was 93.9% (31/33), neonatal mortality 8.6%, while perinatal mortality was 14.3%. We found high significant difference (P < 0.001) in Pi Aum, Pi ACM and Pi AR in the time interval between the detection of pathological C/U ratio and fetal distress, while the difference was insignificant for the values of Pi AF (table). The value changes are characterized by: continuing increase of Pi Aum, with a maximum in the last week before the distress; biphasic character of PI MCA--tendency to decrease in the first two and significant increase in the last week; and significant increase of Pi AR one and a half week before the distress (table, graphic). Three weeks before the distress in 7 (53.8%) cases we registered PEDV, in 6 (46.2%) AEDV, while we didn't register REDV in any case. In the last week there were 3 (8.6%) PEDV, 23 (65.7%) AEDV and 9 (25.7%) REDV. Significant changes in Doppler parameters suggest that even after the blood redistribution in growth restricted hypoxemic fetuses further haemodynamic changes occur. Preterminal increase in Pi Aum can be due to: 1) release of leucotrien, tromboxan and free oxygen radicals and consecutive vasoconstriction in villous arteries; 2) increase of diastolic arterial pressure as a result of hypoxic-ischemic central nervous system (CNS) insult; 3) decreased combined heart minute volume in preterminal phase of hypoxemia. The increase of Pi MCA values is a result of hypoxic-ischemic CNS insult. As a consequence of hypoxia ischemia occurs by two mechanisms: local vasodilatatory agents production decrease, or due to the brain edema. The increase of Pi AR values can be explained by severe hypoxemia with the failure of local autoregulation of renal blood flow. The greatest changes in BFP values were registered in the first half, while in Doppler parameters in the second half of the studied interval suggesting that Doppler parameters more accurately announce fetal distress. We can conclude the following: 1) fetal distress appears after the presence hypoxic-ischemic CNS insult, and therefore late when sequels are concerned; 2) if the fetus is mature, elective delivery should be planed after the appearance of pathological C/U ratio, or with the pathological BFP at the latest, in order to avoid post-hypoxic sequels; 3) if the fetus is immature, pregnancy can be prolonged safely, in spite of pathological C/U ratio and BFP, with intensive monitoring of Doppler parameters until the detection of their increased values.

Blood Flow Velocity↗
PubMed1992

Responsiveness to adipogenic agents in stromal-vascular cultures derived from lean and preobese pig fetuses: an ontogeny study.

Primary cultures of stromal-vascular (S-V) cells from adipose tissue were used to evaluate characteristics of preadipocytes from lean and preobese fetuses at several ages (50, 75, and 110 d). In insulin-supplemented (1 microM) cultures (serum free) there was a significant age x fetal genotype interaction (P less than .01) for glycerol-phosphate dehydrogenase specific activity (GPDH); GPDH activity was genotype-dependent at 110 d (preobese greater than lean). The responses of S-V cultures (preadipocyte development) to 2% pig serum and to insulin (serum free) were similar. Main effects of genotype and age were significant (P less than .05) for protein levels in pig serum and insulin-treated cultures. There was a significant genotype x age (P less than .05) interaction for GPDH activity and protein levels in cultures treated with dexamethasone + 3-isobutyl-1-methylxanthine (DEX-IBMX). Treatment with DEX-IBMX induced more preadipocyte development in cultures from preobese fetuses than in cultures from lean fetuses at 110 d (P less than .05). The responsiveness of S-V cultures to DEX-IBMX (enhanced development) increased considerably between 50 and 75 d regardless of fetal genotype, but there was little response in cultures form 50-d fetuses. Preadipocyte development in lean and preobese fetuses diverged between 75 and 110 d, resulting in many more preadipocytes in preobese fetuses at 110 d. Therefore, S-V cells from preobese fetuses (late term) may be inherently more sensitive to adipogenic agents than S-V cells from lean fetuses.

1-Methyl-3-isobutylxanthine↗
PubMed1989

Sexual differentiation in litter-bearing mammals: influence of sex of adjacent fetuses in utero.

In rodents and swine, individual differences in a broad range of characteristics correlate with intrauterine position during fetal life. By identifying the intrauterine position of mice at cesarean delivery, we can predict reliably postnatal reproductive traits such as genital morphology, timing of puberty, length of estrous cycles, timing of reproductive senescence, sexual attractiveness, sexual behavior, aggressiveness, daily activity level, body weight and tissue enzyme activity in females; in males we can predict genital and brain morphology, sexual behavior, aggressiveness, daily activity level, body weight, and tissue enzyme activity. In mice, as in all mammals, male fetuses have greater concentrations of testosterone than do females. In addition, female mouse fetuses have greater circulating concentrations of estradiol than do male fetuses, a condition not found in all mammals. A mouse fetus positioned between males has greater concentrations of testosterone than does a fetus of the same sex positioned between females, and a fetus positioned between females has greater concentrations of estradiol than does a fetus of the same sex positioned between males. Gonadal steroids regulate differentiation of secondary sexual characteristics. Studies in which the effects of intrauterine position have been eliminated by exposing fetuses to steroid receptor blockers reveal the critical role of steroids in mediating this phenomenon. The intrauterine position phenomenon provides the only mammalian model for relating postnatal traits to concentrations of endogenous hormones to which individuals are exposed during fetal life. Results from studies using this naturally occurring experimental system in litter-bearing species have given insights concerning the consequences of individual differences in steroid concentrations during sexual differentiation that likely apply to all mammals. One specific hypothesis is that circulating estradiol may interact with testosterone in mediating some aspects of sexual differentiation in rodents and, thus, possibly in other mammals.

Animals↗
PubMed2006

Dynamic motion analysis of fetuses with central nervous system disorders by cine magnetic resonance imaging using fast imaging employing steady-state acquisition and parallel imaging: a preliminary result.

OBJECT: The authors present a novel cine magnetic resonance (MR) imaging, two-dimensional (2D) fast imaging employing steady-state acquisition (FIESTA) technique with parallel imaging. It achieves temporal resolution at less than half a second as well as high spatial resolution cine imaging free of motion artifacts for evaluating the dynamic motion of fetuses in utero. The information obtained is used to predict postnatal outcome. METHODS: Twenty-five fetuses with anomalies were studied. Ultrasonography demonstrated severe abnormalities in five of the fetuses; the other 20 fetuses constituted a control group. The cine fetal MR imaging demonstrated fetal head, neck, trunk, extremity, and finger as well as swallowing motions. Imaging findings were evaluated and compared in fetuses with major central nervous system (CNS) anomalies in five cases and minor CNS, non-CNS, or no anomalies in 20 cases. Normal motility was observed in the latter group. For fetuses in the former group, those with abnormal motility failed to survive after delivery, whereas those with normal motility survived with functioning preserved. The power deposition of radiofrequency, presented as specific absorption rate (SAR), was calculated. The SAR of FIESTA was approximately 13 times lower than that of conventional MR imaging of fetuses obtained using single-shot fast spin echo sequences. CONCLUSIONS: The following conclusions are drawn: 1) Fetal motion is no longer a limitation for prenatal imaging after the implementation of parallel imaging with 2D FIESTA, 2) Cine MR imaging illustrates fetal motion in utero with high clinical reliability, 3) For cases involving major CNS anomalies, cine MR imaging provides information on extremity motility in fetuses and serves as a prognostic indicator of postnatal outcome, and 4) The cine MR used to observe fetal activity is technically 2D and conceptually three-dimensional. It provides four-dimensional information for making proper and timely obstetrical and/or postnatal management decisions.

Encephalocele↗
PubMed1997

Abdominal circumference in fetuses with congenital diaphragmatic hernia: correlation with hernia content and pregnancy outcome.

To assess the value of abdominal circumference measurements in the second trimester as a predictor of mortality in fetuses with congenital diaphragmatic hernia, 34 fetuses with this condition who had had second trimester ultrasonographic evaluation were analyzed retrospectively for abdominal circumference measurements, content of the hernia, and pregnancy outcome. The abdominal circumference was below the fifth percentile in nine of the 27 fetuses (33%) with an isolated defect and in five of the seven fetuses (71%) with additional anomalies. In fetuses with isolated congenital diaphragmatic hernia, an abdominal circumference measurement below the fifth percentile was associated with the presence of the liver (P < 0.05) but not of the stomach in the chest. In 19 continuing pregnancies with an isolated defect, all five fetuses with an abdominal circumference below the fifth percentile either died prenatally (n = 1), soon after birth (n = 1), or after surgery (n = 3). In contrast, only six of the 14 fetuses (43%) with an abdominal circumference measurement within the normal range died, either soon after birth (n = 2) or after surgery (n = 4) (P < 0.05). We conclude that an abdominal circumference measurement below the fifth percentile in the second trimester appears to be a good predictor of a poor prognosis in fetuses with congenital diaphragmatic hernia.

Abdomen↗
PubMed1992

[Effect of thyroxine on lung maturation in rabbit fetuses].

The material comprised 11 pregnant rabbits and 95 fetuses stemming from these rabbits. On the 27-th day of pregnancy laparotomy was performed and 1 microgram of thyroxin was administered to the amniotic sac of each fetus in one uterine horn. The fetuses in the second uterine horn, considered as control group, received 0.9% NaCl into their amniotic sac. On the 28-th day cesarean section was carried out, the fluid was collected, the fetuses were taken out, they were weighed and after the lapse of 45 minutes sacrificed by decapitation. The isolated lungs of the fetuses and the amniotic fluid provided the material for further studies. In the amniotic fluid, the content of lecithin and sphingomyelin was determined by thin-layer chromatography. The lungs of fetuses furnished material being used for accomplishing the following types of investigations: determination of mass weight of the wet lungs, and lungs mass after drying, biochemical examination--lecithin and sphingomyelin content in lung homogenates by thin-layer chromatography; histological examination: hematoxylin and eosin stainings by PAS method, argentation by Perdrau method, oil red, toluidine blue stainings as well as electron microscope examination. It has been disclosed that thyroxin administered into the amniotic sac accelerates the fetal lung maturation in rabbits, expressed by higher content of lecithin and by higher ratio of lecithin to sphyngomyelin in fetal lung homogenates at biochemical examinations; it exerts positive effect on the body mass of fetuses and the fetal lung mass, but it fails to influence the lung hydration degree, the sphyngomyelin content in lung homogenates as well as the content of lecithin in the amniotic fluid. The results of histological examination under light microscope have revealed that the lungs of rabbit fetuses in thyroxin group displayed in 70% morphological maturation. The fetal lungs from the control group hardly in 21.1% showed complete maturation. In electron microscopy the fetal lungs in thyroxin group demonstrated more advanced maturation than in the control group, the interalveolar septa were constructed of smaller number of cells, there was a larger number of mature pneumocytes of II type with more abundant lamellar structures, in the alveolar lumen the surfactant appeared markedly more profusely.

Amnion↗
PubMed2002

[Metabolism of amino acids in fetuses with cytomegalovirus infection and growth retardation].

Aim of the study was to evaluate correlation between valine and glycine, representatives of essential and nonessential amino acids, in fetuses appropriate and small for gestational age with congenital cytomegalovirus infection. Umbilical venous cord blood was obtained by cordocentesis at 22 to 29 weeks' gestation from 18 women (11 in appropriate for gestational age--A, and seven in small for gestational age--B) fetuses with CMV infection. Plasma amino acids were measured with an Beckman M 121 amino acid analyzer. Maternal valine level was 136.0 mmol/l; fetal valine in AGA and SGA fetuses: 219 and 189 mmol/l respectively. Fetomaternal valine ratio was significantly lower in SGA group (1.39 mmol/l-SGA, 1.61 mmol/l AGA, t = -6.9, p < 0.001). Glycine level in maternal blood was 139.0 mmol/l; fetal in SGA and AGA fetuses 137 mmol/l and 176 mmol/l, respectively. Fetomaternal glycine ratio was also significantly lower in SGA group than in AGA, 1.01 and 1.27 respectively (t = -2.96, p < 0.001). Valine/Glycine maternal and fetal ratio did not show any difference between groups. In congenitally CMV infected fetuses with intrauterine growth retardation there is a decreased valine and glycine level, compared to the congenitally CMV infected fetuses with normal intrauterine growth. There is a lower fetal concentration of these amino acids compared to the maternal level in SGA fetuses. A decreased glycine level compared to the valine level has also been found in congenitally CMV infected fetuses with intrauterine growth retardation.

Amino Acids↗
PubMed1991

[The risks for fetus and mother depending on the type of cesarean section].

The author points out the tendency to the increasing frequency of cesarean section (mainly) in the interest of the fetus and mother and emphasizes that in some cases the cesarean section itself represents a risk factor. This factor evolves from the direction and place of the uterine incision--transverse and longitudinal. The isthmic transverse incision of the uterine wall, proposed by Kehrer in 1981, is not always the most suitable, since in could not always assure sufficient space for elegant extraction of the fetus. This remark is referred especially to cases, when cesarean section is performed for a fetus under 32 weeks' gestation and then the lower uterine segment is not dilated enough and the transverse isthmic orifice is small for atraumatic extraction of the fetus. For these and some other states--twin pregnancy, transverse oblique presentation of the fetus, placenta previa varicose vessels of both sides of the uterus and very large fetus, the author proposes low isthmic longitudinal hysterectomy and emphasizes the motives for decision making. Except for advantages for the fetus and mother he points out more perfect adaptation of the edges--a guarantee for healthy and elastic edge, in which dehiscences are observed more rarely during the following deliveries according to foreign authors). The experience of the author in low isthmic longitudinal incision of the uterus is made on 62 cesarean sections, performed by 13 obstetricians, all convinced that this incision creates greater space possibilities--conditions for atraumatic extraction of the fetus.

Adult↗
PubMed1991

[Studies on features of fetal movement and development of human fetus with use of fetal actogram].

In 167 normal fetuses at 26 to 41 weeks of gestation, features of fetal movement and fetal development were investigated with use of actocardiograph in connection with a microcomputer system. The signals of fetal movement obtained by actocardiograph were stored in a floppy disc every 250 ms for 5 minutes through an AD-converter, and were analyzed every 5 minutes with the computer to reveal 3-dimensional (3-D) histograms. The 3-D histogram of fetal movement was composed of number, amplitude and interval of the signals in 11 voltage steps between 0.05 and 0.55V. The histogram clearly indicated state of fetal behavior, being either resting or active state. Fetal movement such as rolling movement, breathing movement and hiccup could be also identified with the computer analysis. In 68 normal fetuses at 14 to 41 weeks of gestation, the cross-correlation between fetal movement and fetal heart rate (FHR) were examined with the computer analysis. Finally fetal responses to acoustic and light stimulation were evaluated with use of pure-tone generator and flashlight. Acoustic stimulation was carried out in 53 normal fetuses at 28 to 41 weeks and light stimulation was performed in 116 normal fetuses at 18 to 41 weeks of gestation. The fetal responses were evaluated with actocardiogram. As a result, 1) Frequency in active state decreased and resting state increased as gestational weeks advanced, and then the frequencies of both state remained constant after 37 weeks of gestation. Duration of resting state also increased from 26 weeks to 37 weeks. These observations may suggest that fetal behavior can be established by 37 weeks of gestation. 2) Frequency in rolling movement decreased until 37 weeks of gestation, and then the movement increased during 38-41 weeks. Frequency in breathing movement increased to 33 weeks of gestation, then it remained constant. Hiccup occurred most frequently at 30-33 weeks, and it decreased thereafter. The function in fetal respiratory movement may be accomplished by 33 weeks of gestation. 3) Positive cross-correlation between fetal movement and FHR was observed as gestational weeks advanced. The correlation coefficient increased from 14 weeks up to 41 weeks. Acceleration of FHR following fetal movement eventually occurred in fetuses at 16 weeks, but the onset of acceleration delayed than normally occurred in developed fetuses. The delay was shortened in fetuses at 24 weeks and this was comparable to the delay in developed fetuses. These results suggest that the linkage of the acceleration of FHR with fetal movement is established at 24 weeks of gestation.(ABSTRACT TRUNCATED AT 400 WORDS)

Acoustic Stimulation↗
PubMed1989

Fetal Doppler echocardiographic assessment of cardiac blood flow velocity in normal fetuses and in those with congenital heart disease.

Ninety fetal Doppler echocardiographic examinations were performed on 72 normal fetuses and 5 with congenital heart disease [2 pulmonary stenosis (PS), 1 pulmonary atresia (PA), 1 tetralogy of Fallot (TOF) and 1 endocardial cushion defect (ECD)] at 16 to 40 weeks of gestational age. The maximum transmitral (MVMax), transtricuspid (TVMax), transaortic (AVMax) and transpulmonary blood flow velocity waveforms (PVMax) were assessed. The detection rates for MVMax, TVMax, AVMax and PVMax in normal fetuses were 69.4%, 68.2%, 77.6% and 43.5%, respectively. MVMax, TVMax, AVMax and PVMax correlated well with gestational age, in the normal fetuses. However, there was no correlation between MVMax, TVMax, AVMax, PVMax and heart rate, in the normal fetuses, respectively. The TVMax/MVMax ratio was one and over in 53 of 55 normal fetuses (96.4%), and the PVMax/AVMax ratio was one and over in 11 of 25 normal fetuses (44%). In cases of PS, the TVMax was relatively low, but the PVMax was definitely high. The TVMax/MVMax ratios in cases of PS were 0.8 and 1.0, respectively. AVMax in a fetus with TOF was definitely low and markedly decreased in the case of ECD. Therefore, fetal Doppler echocardiography is a pertinent diagnostic tool which can be used to analyze cardiac hemodynamics in all fetuses, in utero.

Blood Flow Velocity↗
PubMed1987

[Management of the goat fetus in water using membrane oxygenator by V-A bypass through the cervical vessels--comparison with the A-V bypass method through umbilical vessels].

Fourteen goat fetuses were totally sustained in water by extracorporeal perfusion using a membrane oxygenator. The two groups which underwent perfusion methods may be described as follows: One was an A-V bypass through umbilical vessels which has been reported previously, and the other was a new method, a V-A bypass through cervical vessels. Ten fetuses were perfused by an A-V bypass and the longest survival time was 9 hours. Three fetuses suddenly died shortly after perfusion was started. Four fetuses were perfused by a V-A bypass and the longest survival time was 27 hours. Cardiovascular dynamics were stable from the beginning of perfusion. Autopsy revealed hepatomegaly and bloody ascites in A-V bypassed fetuses but not in the fetuses perfused by a V-A bypass. The A-V bypass through umbilical vessels resembles physiological fetal circulation, and the cannulation technique is not difficult but it needs strict control, especially in the early stages of perfusion. A V-A bypass through cervical vessels doesn't seem to be close to a physiological perfusion for fetuses and the cannulation technique is difficult. But the cardiovascular dynamics are stable, so they are employed for clinical uses in neonatal ECMO. The V-A bypass method seems to be an adequate technique for managing extremely premature fetuses in water.

Animals↗
PubMed1984

Cellular and humoral responses of Brucella abortus-infected bovine fetuses.

Fifty-nine bovine fetuses naturally and experimentally infected with Brucella abortus were studied. Lymphoid hyperplasia in multiple lymph nodes, lymphoid depletion in the thymic cortex, adrenal cortical hyperplasia, and disseminated inflammatory foci composed mainly of large mononuclear leukocytes were present in infected fetuses. Histopathologic changes in naturally infected fetuses were indistinguishable from those infected fetuses inoculated in utero. Fetuses inoculated with 1.0 X 10(3) to 1.0 X 10(5) colony-forming units of strain 2308 B abortus were aborted on postinoculation day (PID) 7 to 19. Fetuses obtained by PID 9 and 10 had increased immunoglobulin concentrations and antibody. Increased cortisol values were present in fetuses obtained as early as PID 6. The initial fetal inflammatory response was composed of large mononuclear leukocytes. In fetuses obtained by PID 9 to 10, moderate numbers of neutrophils mixed with mononuclear leukocytes were present in the inflammatory foci. This shift in the initial inflammatory reaction coincided with the appearance of agglutinating antibody.

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