American journal of perinatology
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The case of an 18-year-old pregnant woman with cryptococcal meningitis treated with amphotericin B and flucytosine since the third trimester of pregnancy is reported. She delivered a normal baby. The maternal outcome was favorable. There is no evidence of congenital infection in the newborn.
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Molecular amplification of parvovirus B19 DNA in an amniotic fluid sample was used to confirm the etiologic agent of a case with fetal hydrops. The polymerase chain reaction (PCR) method used is easy and fast to perform. We have a 2-year experience on its use in clinical parvovirus B19 diagnosis. ⋯ In addition to strict laboratory standards, the use of two different sets of PCR primers and probes confirms positive findings. Positive parvovirus PCR on amniotic fluid confirms fetal parvovirus infection in cases of fetal nonimmune hydrops. Intrauterine transfusions may be necessary in cases with severe fetal anemia.
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A term, 2500 g infant was circumcised at 2 days of age. The circumcision was uneventful, with no excessive bleeding. Analgesia was provided by prilocaine, 0.5 cc, and subsequently, the neonate developed methemoglobinemia. Alternatives to analgesia with prilocaine are discussed.
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Clinical Trial
Pressor response to cycle ergometry in the midtrimester of pregnancy: can it predict preeclampsia?
Ninety-seven primigravid patients were prospectively studied to assess the predictive value of the pressor response to aerobic exercise as a screening test for preeclampsia. The blood pressure response to cycle ergometry exercise to a maternal pulse of 140 beats/min was recorded on each subject. Each subject was studied in the second trimester of pregnancy at a mean gestational age of 23 weeks (range, 18 to 27). ⋯ An increase of diastolic pressure of 20 mm Hg with moderate cycle ergometry exercise in the second trimester may predict a subset of patients at elevated risk of preeclampsia in the third trimester. However, the positive predictive value of this 20 mm Hg pressor increase (11%) limits its applicability as a screening test. Thus, we cannot recommend the use of an exercise screening test at this time.
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Comparative Study
Effect of body position on the blood gases and ventilation volume of infants with chronic lung disease before and after feeding.
The effect of body position before and after tube feeding was evaluated in six extremely immature infants who were being mechanically ventilated because of chronic lung disease. Their mean birthweight and gestational age were 722.7 g (range, 540 to 994) and 24.9 weeks (range, 23.9 to 26.0), respectively. This study was performed at a mean postnatal age of 47.5 days (range, 21 to 85 days). ⋯ Also the prone position showed a significant decrease in heart rate before and after feeding and a tendency to decrease transcutaneous carbon dioxide tension values before feeding. There were no significant differences in minute ventilation despite increased tidal volume in the prone position, most likely due to a decrement of the spontaneous respiratory rate in the prone positioning. We conclude that the prone position may offer an advantage over the supine position in the management of extremely immature infants with chronic lung disease before and after feeding.