Intrauterine E.coli inoculation alters PURKINJE cell morphology, tumor necrosis factor- and calbindin expression in the developing brain

Abstract

tion about pregnancy and delivery in dwarf women would be useful to LPs and their healthcare providers. STUDY DESIGN: A retrospective cohort study of LPs with R one prior conception (regardless of outcome), pertaining to her pregnancy and delivery experience, maternal physical status preand post-delivery, and general opinions about pregnancy in LPs. LP women were recruited via a genderand age-specific mailing to members of the Little People of America, Inc. following Medical Advisory Board and IRB approval. RESULTS: To date, 45 women representing 94 total pregnancies with 12 different skeletal dysplasia diagnoses are enrolled, including achondroplasia (26), pseudoachondroplasia (4), hypochondroplasia (3), diastrophic dysplasia (2), other dysplasias (10). 72 liveborn infants were delivered via cesarean section (39 general anesthesia-GA, 33 spinal and/or epidural), 16 miscarriages, and 1 termination. 4 liveborn infants were delivered vaginally; 2 without anesthesia to a mother with hypochondroplasia, 2 with epidural to a mother with femoral focal hypoplasia. One pregnancy is ongoing. CONCLUSION: Thus far, there is no apparent increased rate of pregnancy loss or fetal complications related to maternal dwarf condition. Most LP women require cesarean section due to cephaloplevic disproportion, yet vaginal delivery is noted in skeletal dysplasias with minimal truncal or pelvic disproportion. Many LPs have carried successful pregnancies and delivered with adequate pain control, under both regional and GA. We neither promote nor discourage childbearing in LP women, yet there is little medical literature regarding pregnancy and delivery in dwarfs. We present practical experiences with obstetrics and obstetrical anesthesia from the dwarf and healthcare provider perspective for others who choose to have children and those who provide their medical care.