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PubMed1970

Pregnancies after chemotherapy of trophoblastic neoplasms.

We have analyzed 88 pregnancies in 50 women who had previously been treated for gestational trophoblastic neoplasms with chemotherapeutic agents. No increase in fetal wastage, congenital abnormalities or complicated pregnancies was noted, suggesting that these drugs do not damage human oocytes in the doses and time periods used. The possibility that recessive mutations have been induced but were undetected cannot be evaluated definitively at present.

Abortion, Spontaneous↗
PubMed2001

Social deprivation and the causes of stillbirth and infant mortality.

AIMS: To investigate the relation between social deprivation and causes of stillbirth and infant mortality. METHODS: Stillbirths and infant deaths in 6347 enumeration districts in Wales were linked with the Townsend score of social deprivation. In 1993-98 there were 211 072 live births, 1147 stillbirths, and 1223 infant deaths. Poisson regression analysis was used to estimate the magnitude of effect for associations between the Townsend score and categories of death by age and the causes of death. The relative risk of death between most and least deprived enumeration districts was derived. RESULTS: Relative risk of combined stillbirth and infant death was 1.53 (95% CI 1.35 to 1.74) in the most deprived compared with the least deprived enumeration districts. The early neonatal mortality rate was not significantly associated with deprivation. Sudden infant death syndrome showed a 307% (95% CI 197% to 456%) increase in mortality across the range of deprivation. Deaths caused by specific conditions and infection were also associated with deprivation, but there was no evidence of a significant association with deaths caused by placental abruption, intrapartum asphyxia, and prematurity. CONCLUSIONS: Collaborative public health action at national and local level to target resources in deprived communities and reduce these inequalities in child health is required. Early neonatal mortality rates and deaths from intrapartum asphyxia and prematurity are not significantly associated with deprivation and may be more appropriate quality of clinical care indicators than stillbirth, perinatal, and neonatal mortality rates.

Abruptio Placentae↗
PubMed1996

Retinopathy of prematurity in infants of birth weight > 2000 g after haemorrhagic shock at birth.

BACKGROUND: The risk of retinopathy of prematurity (ROP) is associated with low birth weight and low gestational age. For ROP screening examination is recommended in infants weighing < or = 1500 g or of less than 32 weeks' gestational age. METHODS: From 1991 ROP screening was performed in 452 premature infants with either a birth weight < or = 1500 g (n = 303) or a birth weight > 1500 g (n = 149) and who required additional oxygen supplementation or underwent surgery with general anaesthesia before estimated term. RESULTS: Unexpectedly, three infants with birth weights between 2080 and 2325 g and a gestational age of 32 or 33 weeks developed stage 2 or 3 ROP. One of these underwent cryocoagulation. In three infants, preterm birth was induced by sudden placental abruption with severe prenatal blood loss followed by haemorrhagic shock. The umbilical cord packed cell volume was reduced to 0.14-0.19 (normal 0.43-0.63). All three infants underwent surgery with general anaesthesia within the first weeks of life. Of the remaining 449 infants none with a birth weight > 1650 g developed any stage of ROP. CONCLUSION: Severe prenatal blood loss requiring blood transfusions and surgery with general anaesthesia may induce higher stages of ROP even in infants with birth weights exceeding the usual screening criteria.

Abruptio Placentae↗