Fetal diagnosis and therapy
-
Fetal. Diagn. Ther. · Jul 1998
Comparative StudyDoes the hemoglobin concentration in fetal blood interfere with the accuracy of fetal reflection pulse oximetry?
Our goal was to investigate the influence of the fetal hemoglobin (Hb) concentration on the accuracy of reflection pulse oximetry. ⋯ Pulse oximetry measurements seem to reflect oxygen saturation in fetal blood, however further improvement is necessary. The Hb concentration in fetal blood does not interfere with the accuracy of fetal pulse oximetry and need not be taken into consideration in calibration curves.
-
Fetal. Diagn. Ther. · Nov 1997
Urine beta-core fragment, a potential screening test for ectopic pregnancy and spontaneous abortion.
The incidence of ectopic pregnancy in the United States has risen 6-fold in the last three decades. It now accounts for about 2% of reported pregnancies. Tests are now needed to identify ectopic pregnancy before it is clinically evident. ⋯ Diagnosis of ectopic pregnancy could be confirmed by transvaginal ultrasound, and ectopic pregnancy terminated early by nonsurgical methods, with minimal mortality or fertility loss. Major fetal defects that cause spontaneous abort pregnancies may also be recognized by transvaginal ultrasound. In such cases, chorionic villous sampling or possibly termination may be considered.
-
This case presents a woman with a fetus having a large hydrocephalus and other lethal malformations. The problem was how to avoid an unnecessary cesarean section at delivery because of the breech position of the baby. The solution was prenatal ultrasonographic-guided cephalocentesis after which a vaginal delivery could take place without any complications for the mother.
-
Fetal. Diagn. Ther. · Sep 1997
Comparative StudyCardiovascular responses of goat fetuses to hypercapnia during extrauterine incubation using extracorporeal membrane oxygenation.
The purpose of this study was to assess the effects of changes in fetal PaCO2 on circulatory functions without maternal influences. In 5 goat fetuses that were incubated using an extrauterine incubation system with arteriovenous extracorporeal membrane oxygenation, fetal carotid arterial blood flow, heart rate, mean blood pressure, and serum catecholamine levels were determined under the conditions of several grades of hypercapnia without hypoxemia. The hypercapnia was induced gradually by decreasing the flow of gas to the membrane oxygenator located on the extracorporeal circulation system. ⋯ Although a slight increase was observed in the heart rate at the mild hypercapnia stage, severe hypercapnia induced bradycardia in all cases. The mean arterial pressure and rate of extracorporeal circulation were unchanged during hypercapnia. We found that cerebral blood flow increased due to hypercapnia's direct effect on the vascular system, but the response of the peripheral chemoreceptor to hypercapnia seemed to be attenuated in chronic stimulation because bradycardia was induced in chronic hypercapnia.
-
Fetal. Diagn. Ther. · Mar 1997
Case ReportsChorioamniotic membrane separation: a potentially lethal finding.
Sonographic detection of chorioamniotic membrane separation (CMS) has been considered a benign incidental finding. We now report 6 cases of CMS identified by prenatal ultrasound; 1 in an otherwise normal pregnancy and 5 following fetal surgery. Following membrane separation, amniotic bands formed and compromised the umbilical cord in 4 cases leading to 2 fetal deaths. ⋯ Following fetal surgery, serial ultrasound evaluation and close fetal monitoring are indicated. In otherwise unremarkable pregnancies, clinician awareness of the possibility of amniotic band formation following CMS should be heightened. In either situation, knowledge of this potential life-threatening complication may identify cases in which cord compromise requires emergent delivery or fetoscopic release of the strangulating amniotic band.