The Journal of maternal-fetal medicine最新文献

{"title":"Sonographically estimated fetal weight percentile as a predictor of preterm delivery.","authors":"A. Lysikiewicz, L. Bracero, N. Tejani","doi":"10.1080/714052715","DOIUrl":"https://doi.org/10.1080/714052715","url":null,"abstract":"Objective : To evaluate the association between relative growth restriction and preterm birth. Study methods : Pregnant women referred for sonographic fetal weight assessments between 24 and 34 weeks of gestation were studied for gestational age at delivery. If a patient underwent more than one study, only the last one was considered. Patients with delivery induced iatrogenically or with abnormal growth patterns due to known pathology, such as maternal diabetes or fetal congenital anomaly, were excluded. A gestational age of 37 weeks or less was considered preterm and a gestational age of more than 37 weeks at delivery was considered term. Fetal weight estimation was obtained by Hadlock's formula based on biparietal diameter, femur length, and head and abdominal circumferences. The estimated fetal weight percentile was computed according to William's tables. Mean gestational age and incidence of preterm delivery for each fetal weight percentile between 1 and 100, at increments of 10, were calculated. The ...","PeriodicalId":79464,"journal":{"name":"The Journal of maternal-fetal medicine","volume":"6 1","pages":"44-47"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74046713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perinatal outcome following fetal single umbilical artery diagnosis.","authors":"B. Pierce, V. Dance, R. K. Wagner, C. Apodaca, P. Nielsen, B. Calhoun","doi":"10.1080/714052705","DOIUrl":"https://doi.org/10.1080/714052705","url":null,"abstract":"Objective : We report the frequency of associated congenital abnormalities in fetuses with a single umbilical artery as well as the sensitivity, specificity, positive predictive value and negative predictive value of ultrasound for detecting these abnormalities. We also report the pregnancy outcome of fetuses complicated by single umbilical artery, both isolated and with other congenital anomalies. Methods : All pregnancies complicated by fetal single umbilical artery from 1995 to 1999 were identified. A retrospective chart review was performed on both the prenatal records and the ultrasound records of these pregnancies, determining the nature and incidence of other congenital abnormalities. Delivery data were collected to include gestational age at delivery, Apgar score, birth weight, mode of delivery, fetal gender and any complications. 011 Results : Ninety-two pregnancies were identified with a fetal single umbilical artery, of which outcome data were available for 65. Forty-eight (74%) cases were iden...","PeriodicalId":79464,"journal":{"name":"The Journal of maternal-fetal medicine","volume":"119 1","pages":"59-63"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85177141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal serum levels of type I and type III procollagen peptides in pre-eclamptic pregnancy.","authors":"H. Yamamoto, G. Lambert-Messerlian, H. Silver, R. Kudo, L. Kellner, J. Canick","doi":"10.1080/714904294","DOIUrl":"https://doi.org/10.1080/714904294","url":null,"abstract":"Objective : To compare maternal serum levels of two markers of collagen synthesis, procollagen I carboxy-terminal peptide (PICP) and procollagen III amino-terminal peptide (PIIINP), in patients with pre-eclampsia and in controls. Methods : PICP and PIIINP were measured by radioimmunoassay in maternal serum samples from patients diagnosed with pre-eclampsia at 32 weeks' gestation or later and in controls from the same period of gestation. For PICP, 37 cases and 36 controls were studied; for PIIINP, 12 cases and 19 controls were studied. Results : Both PICP and PIIINP levels were significantly elevated in patients with pre-eclampsia. PICP and PIIINP levels were, on average, 20% and 80% higher than in controls, respectively. Conclusions : These results are in agreement with previous findings that maternal serum levels of PICP and PIIINP are mildly elevated in patients with pre-eclampsia. These markers are unlikely to be useful in the prediction of pre-eclampsia.","PeriodicalId":79464,"journal":{"name":"The Journal of maternal-fetal medicine","volume":"18 1","pages":"40-43"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88308572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of fetal heart monitoring in the first stage of labor.","authors":"T. Stefos, A. Sotiriadis, P. Tsirkas, I. Korkontzelos, D. Papadimitriou, D. Lolis","doi":"10.1080/714052716","DOIUrl":"https://doi.org/10.1080/714052716","url":null,"abstract":"Objective : To evaluate the usefulness of continuous electronic fetal heart rate (FHR) monitoring in the first stage of labor. Methods : A total of 814 pregnant women in labor without identifiable risk factors was divided into two groups. In group A (468 cases), continuous FHR monitoring began in the earliest phase of the first stage of labor (cervical dilatation h 4 cm), while in group B (346 cases) it began when the cervical dilatation was > 4 cm. Initial FHR tracings were normal in all 814 cases. The fetal monitoring findings were analyzed at 10-min intervals, and comparisons were made between the two groups concerning FHR findings and their correlation with the state of the newborns. Results : No significant difference was found between the two groups in the incidence of repetitive variable decelerations (1.9% and 1.7%, respectively); sporadic variable decelerations (9.2% and 8.7%, respectively); persistent repetitive late decelerations that resulted in Cesarean section (1.1% and 1.4%, respectivel...","PeriodicalId":79464,"journal":{"name":"The Journal of maternal-fetal medicine","volume":"14 1","pages":"48-51"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74619331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Levels of interleukin-6 in second-trimester amniotic fluid are not predictive of adverse neonatal outcome.","authors":"D. Hasson, C. Spong, A. Ghidini","doi":"10.1080/714052713","DOIUrl":"https://doi.org/10.1080/714052713","url":null,"abstract":"Objective : Elevation of interleukin (IL)-6 in the amniotic fluid (AF) during the second trimester is associated with increased risk of preterm delivery. AF IL-6 levels of > 2950 pg/ml within 72 h of delivery are predictive of neonatal brain white-matter lesions, such as periventricular leukomalacia (PVL). The objective of this study was to evaluate whether the presence of elevated AF IL-6 during the early second trimester was associated with the occurrence of relevant neonatal morbidity including PVL or perinatal mortality. Methods : We performed a historical cohort study of women who underwent mid-trimester amniocentesis and had known AF IL-6 levels and pregnancy outcome information available. Included were singleton gestations, without fetal structural or chromosomal anomalies. Results : Among the 50 woman-neonate pairs included in the study, six had AF IL-6 levels above 2950 pg/ml. Occurrence of neonatal complications requiring admission to the neonatal intensive care unit (14% vs. 33%, p = 0.1) and p...","PeriodicalId":79464,"journal":{"name":"The Journal of maternal-fetal medicine","volume":"89 1","pages":"35-39"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80228373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute effect of exercise on blood glucose and insulin levels in women with gestational diabetes.","authors":"M. Avery, A. J. Walker","doi":"10.1080/714904296","DOIUrl":"https://doi.org/10.1080/714904296","url":null,"abstract":"Objective : To evaluate the effect of a single session of exercise (cycling), at rest (control condition) and at two intensity levels (low- and moderate-intensity exercise conditions), on blood glucose and insulin in pregnancy complicated by gestational diabetes mellitus (GDM). Methods : A one-group repeated measures design was used. Women aged 18-38 with GDM, no other complications, not on insulin, and not exercising regularly were recruited. The women rested or exercised at the two intensities for 30 min and rested for 2 h after each session. Blood was sampled for blood glucose, insulin and hematocrit at baseline and every 15 min. Results : There was no difference at baseline in blood glucose levels. The blood glucose level was significantly lower for each exercise condition compared to rest, and for moderate compared to low-intensity exercise (5.2 vs. 4.3 vs 3.9 mmol/l) at the end of exercise (30 min), and for the two exercise conditions compared to rest at 15 min after exercise (4.9 vs 4.4 vs. 4.0 mmo...","PeriodicalId":79464,"journal":{"name":"The Journal of maternal-fetal medicine","volume":"68 1","pages":"52-58"},"PeriodicalIF":0.0,"publicationDate":"2001-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86042784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do maternal-fetal medicine practice characteristics influence high-risk referral decisions by general obstetrician-gynecologists?","authors":"A. Vintzileos, C. Ananth, J. Smulian, W. Scorza, R. Knuppel","doi":"10.1080/jmf.10.2.112.115-7","DOIUrl":"https://doi.org/10.1080/jmf.10.2.112.115-7","url":null,"abstract":"Objective : To determine whether the decision of the general obstetrician-gynecologist to refer high-risk obstetric patients depends on the type of practice of the maternal-fetal medicine (MFM) specialist. Methods : A questionnaire was mailed to 935 general obstetrician-gynecologists who were asked whether the MFM specialist's practice characteristics would influence their decision to refer their high-risk obstetric patients. Potential MFM practice components presented in the survey included: MFM, high-risk obstetrics, low-risk obstetrics or general obstetrics and gynecology. Results : A total of 140 (15%) general obstetrician-gynecologists responded, 110 of whom were practicing obstetrics. Of the practicing responders, 77% stated that they were more likely to refer their high-risk obstetric patients if the MFM specialist practiced only MFM and high-risk obstetrics; 69% were less likely to refer their patients when the MFM specialist, in addition to MFM, practiced general obstetrics; and 75% were less likely to refer their patients when the MFM specialist also practiced general obstetrics and gynecology. The MFM practice setting (university vs. community hospital vs. private practice), as well as the geographic location and years of practice of the respondents, did not influence the general obstetrician-gynecologists' decision to refer their high-risk obstetric patients. Conclusion : General obstetrician-gynecologists are more likely to refer high-risk obstetric patients if the MFM specialist practiced only MFM and high-risk obstetrics.","PeriodicalId":79464,"journal":{"name":"The Journal of maternal-fetal medicine","volume":"10 1","pages":"112 - 115"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/jmf.10.2.112.115-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60757164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cigarette smoking and pre-eclampsia: their association and effects on clinical outcomes","authors":"M. Newman, M. Lindsay, W. Graves","doi":"10.1080/jmf.10.3.166.170","DOIUrl":"https://doi.org/10.1080/jmf.10.3.166.170","url":null,"abstract":"Objective : To determine the effects of smoking on pre-eclampsia in an inner-city, predominantly African-American prenatal population. Methods : We performed a retrospective cohort study of all primigravidas who delivered singletons in our institution between 1980 and 1989. The study population consisted of 1862 smokers and 16 508 non-smokers. Univariate analysis and multiple logistic regression were used to identify relationships between smoking and adverse outcomes. Results : The pre-eclampsia rate was significantly lower among smokers (11.3% vs. 13.0%, OR 0.85, 95% CI 0.73-0.99). Smokers with pre-eclampsia had higher rates of infants with low birth weight (OR 1.44, 95% CI 1.26-1.65) and very low birth weight (OR 1.85, 95% CI 1.55-2.20) and higher rates of placental abruption (OR 3.49, 95% CI 1.65-7.28) compared to non-smoking pre-eclamptics. This relationship persisted after correction for age, race, chronic hypertension and pre-eclampsia as confounding variables. Conclusions : Cigarette smoking was associated with a lower rate of pre-eclampsia among primigravidas independently of other maternal factors. Perinatal outcomes were significantly worsened among pre-eclamptics who smoked.","PeriodicalId":79464,"journal":{"name":"The Journal of maternal-fetal medicine","volume":"9 1","pages":"166 - 170"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/jmf.10.3.166.170","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60757595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shortened gestational age following multifetal pregnancy reduction: can chronic placental inflammation be the explanation?","authors":"A. Lembet, B. Selam, S. Gaddipati, R. Berkowitz, C. Salafia","doi":"10.1080/jmf.10.3.149.154","DOIUrl":"https://doi.org/10.1080/jmf.10.3.149.154","url":null,"abstract":"Objective : This study tests the hypothesis that chronic inflammatory foci in the placentas of siblings that undergo multifetal pregnancy reduction are associated with shortened gestational length. Methods : Among 446 patients who underwent multifetal pregnancy reduction (MPR), 56 delivered at Mount Sinai Hospital, 37 (66%) had their placentas referred to surgical pathology and 29 (78%) of the 37 patients had tissue sampled from the placenta of the reduced sibling. Slides were reviewed (by C.M.S.) blinded to clinical data. Lesions were diagnosed using previously published criteria. Specifically, inflammatory lesions were correlated with the various perinatal parameters. Non-parametric testing considered p < 0.05 to be significant. Results : Ten (35%) of 29 patients had chronic inflammation in the reduced placenta. Their gestational age at delivery was 33.1 - 3.2 weeks, compared to 35.8 - 2.3 weeks in those without chronic inflammation ( Z = m 2.53, p = 0.01). There was no difference between the cases with and those without chronic inflammation in the reduced placenta, in regard to past reproductive history or clinical assessment of the MPR procedure (e.g. the number of attempts, duration of the procedure, or post-procedural complications). Conclusion : The majority of patients who underwent MPR did not develop a chronic inflammatory response to the process of 'resorbing' the placental tissues of the reduced sibling. However, a significant number (35%) of women who delivered viable offspring after MPR had chronic inflammation in the placenta, and had a shortened gestational length.","PeriodicalId":79464,"journal":{"name":"The Journal of maternal-fetal medicine","volume":"10 1","pages":"149 - 154"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/jmf.10.3.149.154","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60757643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Etiology and outcome of hydrops fetalis","authors":"K. Ismail, W. Martin, S. Ghosh, M. Whittle, M. Kilby","doi":"10.1080/jmf.10.3.175.181-9","DOIUrl":"https://doi.org/10.1080/jmf.10.3.175.181-9","url":null,"abstract":"Objectives : To identify the etiology and pregnancy outcome of hydrops fetalis in a cohort of pregnancies referred to a tertiary maternal fetal medicine center in the UK. These data allow the review of a large series of pregnancies affected by hydrops fetalis and emphasize the importance of investigation and then treatment of individual cases. This provides parents with improved information and especially specific prognostic information. Methods : A retrospective review of 63 consecutive cases of hydrops fetalis managed between September 1996 and March 1999. Results : Of the pregnancies, 12.7% ( n = 8) were associated with an 'immune' etiology. Of these, 62.5% ( n = 5) had fetal anemia due to anti-D, 25% ( n = 2) anti-Kell and 12.5% ( n = 1) anti-c antibodies. The remaining 55 cases (87.3%) had a non-immune cause. Eight (14.5%) were due to human parvovirus B19 infection. Fourteen cases (25.5%) were associated with aneuploidy and, in four (7.3%), a primary hydrothorax was the cause of the non-immune hydrops fetalis. A cardiac cause was found in five (9.1%) cases. Three of these had supraventricular tachycardia and one had congenital complete heart block. Cystic hygroma was associated with hydrops fetalis in six cases. Twin-twin transfusion syndrome was the cause for hydrops in two cases. Massive transplacental hemorrhage was identified in one case. Fetal akinesia and muscular dystrophy caused hydrops in one case each. In 14.5% (8/55) of cases no obvious cause was identified and these were classified as 'idiopathic'. Three other cases could not be classified because parents declined investigations (unclassified). In the pregnancies with non-immune hydrops fetalis, the outcome was favorable in 27.3% (15/55) of cases. Conclusion : The prognosis of hydrops fetalis differs markedly between different etiological groups. Etiologies range from treatable causes with a good outcome and probably no long-term side-effects (as in case of parvovirus B19), to others which are incompatible with life or are associated with considerable perinatal morbidity and mortality.","PeriodicalId":79464,"journal":{"name":"The Journal of maternal-fetal medicine","volume":"10 1","pages":"175 - 181"},"PeriodicalIF":0.0,"publicationDate":"2001-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/jmf.10.3.175.181-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60757758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}