Fetal Count Research Articles

Nucleated red blood cells in human fetal scalp capillary blood samples: a feasibility study

Objective: Elevated umbilical cord nucleated red blood cell (NRBC) counts have been suggested as a predictor of adverse perinatal outcome. We sought to evaluate the feasibility of obtaining fetalscalp capillary blood NRBC counts during labor and to assess their correlation with umbilical cord NRBC counts.Methods: Fetal scalp capillary blood specimens were prospectively collected inlaboring patients who underwent scalp sampling because of the presence of an abnormal fetal heart rate pattern. Matched umbilical cord blood samples were collected immediately after birth. Outcome measureswere the feasibility of obtaining fetal scalp NRBC counts and their correlation with umbilical cord NRBC counts.Results: Thirteen term singleton pregnancies formed the study population. In fourpatients, fetal scalp capillary blood sampling was performed twice. Of the attempts to evaluate fetal scalp capillary samples for NRBC counts, 16 out of 17 (94.1%) were successful. The mean fetal scalpcapillary blood NRBC count per 100 white blood cells was 12.6 ± 7.6 (± SD). Umbilical cord mixed, venous and arterial NRBC counts were 15.5 ± 8.8, 13.4 ± 10.7 and 12.6 ±10.7, with p = 0.09, p = 0.59 and p = 0.68, respectively, when compared to the corresponding scalp sample. The Spearman rank correlation between fetal scalp capillary samples and umbilicalcord mixed, venous and arterial NRBC counts were r = 0.86, r = 0.92 and r = 0.95, respectively, with all p values < 0.001.Conclusion: Previous studies have establishedthe clinical utility of umbilical cord NRBC counts. Our study demonstrated that it was possible to obtain NRBC counts from a fetal scalp capillary sample and that these counts correlated highly with umbilicalcord NRBC counts. Future studies are needed to evaluate fetal scalp NRBC counts as a predictor of perinatal outcome.

568 The association of oligohydramnios with fetal nucleated red blood cell count

568 The association of oligohydramnios with fetal nucleated red blood cell count

Fetal nucleated red blood cell counts in peripheral blood of mothers bearing Down syndrome fetus.

Currently, prenatal detection of Down syndrome and other most common aneuploidies relies on invasive procedures such as amniocentesis and villocentesis, and on non-invasive screening tests such as second trimester maternal serum screening (Triple test), and first trimester screening (ULTRA-screen). However, it well known that invasive techniques carry a small risk of fetal loss, while both Triple test and ULTRA-screen are not diagnostic, may miss from 15 - 40 % of cases of Down syndrome, in addition to having a 5 - 8 % rate of false-positives. We now report clear evidence that the number of fetal nucleated red blood cells (FNRBCs) in the maternal circulation is remarkably higher in pregnant women carrying aneuploid fetuses, especially in cases of Down syndrome. These results are in agreement with the findings of other investigators using different methods, and suggest that the number of FNRBCs present in the maternal blood sample could be used as additional marker, in concert with existing screening tests, to improve non-invasive detection of Down syndrome, and other most common aneuploidies.

Transfusions plaquettaires en néonatalogie

Thrombocytopenia occurs in 20% to 40% of infants admitted to a neonatal intensive care unit. Approximately 30% of the newborns with severe thrombocytopenia below 50.10(9)/l platelets receive platelet transfusions. The etiology may be: bacterial infection, DIC and immune mediated thrombocytopenia. The consequences of thrombocytopenia are significant risks of severe intracranial hemorrhage and neurologic morbidity. Therapeutic platelet transfusions are given to actively bleeding neonates with less than 50.10(9)/l platelets. Prophylactic platelet concentrates are usually given to infants with platelets counts below 20.10(9)/l. The standard platelet concentrate (CMV-negative donor) is the product of choice for newborns. Fetal intracranial hemorrhage is possible as soon as 20 weeks of gestation in allo-immune thrombocytopenia. Actually percutaneous umbilical blood sampling is very useful to measure fetal platelets count in order to decide in utero maternal platelet transfusion. Maternal irradiated plateletpheresis concentrates are preferentially infused in this indication. At the end of pregnancy, cesarean section is preferred to normal vaginal delivery if fetal thrombocytopenia below 100.10(9)/l is observed. In pregnant women with auto-immune thrombocytopenia, the decision to carry out percutaneous umbilical blood samples should be weigh relatively to the 3-5% estimated risk of serious consequences. Platelets transfusions are particularly successful in immune thrombocytopenia but less effective in other clinical circumstances.

Fetal haematological response to intra-uterine infection in preterm prelabour amniorrhexis.

The value of fetal haematological indices in the prediction of intra-uterine infection in 91 cases of preterm prelabour amniorrhexis was examined. Cordocentesis and amniocentesis were performed for the diagnosis of intra-uterine infection. The patients were subsequently divided into three groups, depending on the results of fetal blood and amniotic fluid cultures. In group 1 there were 53 patients with negative fetal blood and amniotic fluid cultures, group 2 consisted of 22 patients with negative fetal blood, but positive amniotic fluid cultures, and in group 3 there were 16 patients with positive fetal blood cultures. The mean leucocyte and neutrophil counts in all three groups were significantly higher than normal, and in group 3 the values were significantly higher than in group 1. The leucocyte and neutrophil counts were above the 95th centile of the normal range in 58% (22 cases) and 66% (25 cases), respectively, of the 38 cases with positive fetal blood and/or amniotic fluid cultures and in only 15% (8 cases) and 13% (7 cases), respectively, of the 53 patients with no infection. There were no significant differences between the groups, between the patients with amniorrhexis or for normal haemoglobin concentration, platelet count, or lymphocyte count. In the majority of the cases with positive fetal blood and/or amniotic fluid cultures, there is fetal leucocytosis. Since the results of the fetal leucocyte and neutrophil counts are available within a few minutes after cordocentesis, it would be reasonable to give antibiotics to all patients with a fetal leucocyte count above the 95th centile.

Fetal and neonatal hematologic parameters in red cell alloimmunization: predicting the need for late neonatal transfusions.

The purpose of this study was to determine whether the need for late neonatal transfusion can be predicted in fetuses who received intrauterine transfusions. The records of 36 patients who underwent intrauterine transfusion were reviewed. Newborns who required late transfusions had a lower reticulocyte count at their last intrauterine transfusion, a longer duration between their lowest fetal reticulocyte count and delivery, and a higher umbilical cord blood hemoglobin and percent adult red cells on Kleihauer-Betke stain at delivery. The need for late transfusions appears to be related to the extent and duration of fetal bone marrow suppression.

Intra-Uterine Starvation and Fetal Leucocyte Count

In 104 severely growth-retarded fetuses, the mean white blood cell count (WBC), as well as neutrophil, lymphocyte and monocyte counts were reduced. Furthermore, the severity of the leucopenia was significantly related to the degree of fetal 'smallness' and anaemia. These findings suggest that leucopenia observed in growth-retarded neonates may be a consequence of intra-uterine starvation due to deficiency of haematinics.

Schwangerschaft und Geburt bei idiopathischer thrombozytopenischer Purpura (M. Werlhof)

The managing of the pregnant patient with immune thrombocytopenic purpura (ITP) is complicated by the unavailability of the foetal platelet count and the risk of bleeding. We report on our experiences of 17 pregnancies in 15 patients, who delivered in the Department of Gynaecology of Freiburg University from 1969 to 1989 (frequency: 0.5 per 1,000). ITP was established prior to pregnancy in 9 of 15 patients, and developed in 6 cases during pregnancy. The a patients received steroid therapy ante partum. However, maternal platelet count did not relate to infant platelet count. Eleven infants were born vaginally, six by caesarean section. One of the 17 live births died immediately post partum at the 28th week of gestation. Six infants were temporarily thrombocytopenic at delivery without further morbidity. Based on our experience and the literature, an individual management of delivery for parturient patients with ITP is recommended.

Applications of ultrasonography in reproduction in sheep and goats

Systems using ultrasonography have been used to diagnosis pregnancy and, in some cases, fetal numbers in small ruminants for 2 decades. Now, real-time B mode ultrasound systems are available that, if used correctly, can improve the accuracy of pregnancy diagnosis, fetal counts and fetal viability over previous ultrasound systems (A-mode). Using real-time, the diagnosis of pregnancy can be made as early as 25 days post breeding or near term. Real-time systems can help diagnose reproductive tract disease in both the female and male.

Fate of labeled albumin and erythrocytes following injection into amniotic cavity of sheep.

We have previously described a method to measure the amniotic fluid (AF) volume and fetal swallowing rate in near-term sheep by use of 125I-labeled albumin (RISA) and 51Cr-labeled red blood cells (51Cr-RBC). However, when we measured these volumes on consecutive days, reentry of the radionuclides into the amniotic cavity from fetal urine affected the calculated values of AF volume and swallowing rates. In an attempt to clarify the recirculation problem, we injected RISA and Cr-RBC daily for 9 days into the AF of five chronically catheterized pregnant sheep (124 days gestation on the 1st experimental day). We calculated AF volume and fetal swallowing rate, comparing those values to the values corrected for fetal urine isotopic counts. The mean AF volume and fetal swallowing rate measured by RISA were 808 +/- 48 ml (mean +/- SE) and 559 +/- 29 ml/day, respectively. These values were only slightly different from the corrected volumes, 808 +/- 48 ml and 561 +/- 29 ml/day, respectively, because fetal urine 125I activity reached only 4.8% of AF activity even on the 9th day. In contrast, 51Cr-activity in fetal urine on the 9th day showed 47% of the activity of AF. The mean uncorrected AF volume (785 +/- 44 ml) and swallowing rate (561 +/- 31 ml/day) measured by Cr-RBC were different from the corrected values (790 ml and 570 ml/day, respectively). After the 4th day these differences were particularly conspicuous.(ABSTRACT TRUNCATED AT 250 WORDS)

Density, Home Range, Habitat Use, and Reproduction in Feral Pigs on Santa Catalina Island

A feral pig population on Santa Catalina Island, California, was studied for 17 months beginning in July 1980. A total of 136 pigs was marked and 188 recaptured during capture-recapture studies at two sites. Density was estimated to be 21 to 34 pigs/km2 (95% confidence interval). Dry season home ranges determined from radio-telemetry data were small and differed significantly between boars (2.04 ± 0.20 km2—95% ellipse; 2.44 ± 0.30 km2— harmonic mean method) and sows (0.90 ± 0.23 km2—95% ellipse; 1.46 ± 0.14 km2—harmonic mean method). During the dry season, pigs preferred cool moist canyon bottoms, the result of both a physiological need for free water and behavioral responses to high environmental temperatures. Patterns of utilization during the wet season appeared to be primarily a function of food availability. Seasonality in time of birth was evident, with piglets born in winter and spring (1980) or spring and summer (1981). Litter size as measured by fetal counts was 5.00 ± 0.36 and sows averaged 0.86 ± 0.17 litters over a 12-month period. Most sows were older than 1 year when they first conceived, and litter size increased from puberty and peaked at 2–3 years of age. Intrauterine mortality of fetuses averaged 25% and piglet mortality was estimated to be 58% prior to weaning. Mortality rates appeared to be higher for piglets born in summer than in winter or spring.

Real‐time ultrasound pregnancy diagnosis in the bitch

ABSTRACTA portable real‐time ultrasound scanner was used for pregnancy diagnosis in eight bitches. Pregnancy was detected in seven; one bitch was not pregnant. The period between the 28th and 35th days of gestation seemed to be the most suitable time for counting the foetuses. Details of the foetal bodies were clearly visible after the 40th day of pregnancy. Most of the foetuses were detected. Real‐time ultrasound can be used for the diagnosis of canine pregnancy as a safe, rapid and easy method, although some inaccuracy in foetal count exists.

Fetal and adult hemoglobin in the chronically catheterized sheep fetus.

The switch from fetal to adult hemoglobin (Hb) has been investigated in fetal and newborn lambs. In the period between 125 and 145 days gestation, the proportion of fetal cells containing adult Hb increased significantly in catheterized fetuses. This increase paralleled the rise in fetal plasma cortisol under several different experimental conditions. However, infusion of synthetic adrenocorticotropin (ACTH1-24) into the fetus, which increased fetal plasma cortisol concentrations to levels slightly higher than observed at term, did not bring about any increase in the proportion of cells containing adult Hb. Increasing fetal plasma prolactin (PRL) concentration either by infusion of PRL or by stimulating endogenous PRL release with thyrotropin-releasing hormone (TRH) did not influence the time or rate of the switch. The fetal reticulocyte count was significantly higher in blood samples taken at the time of catheterization in fetuses of 103-115 days gestation than at 116-128 days gestation. In one repeatedly sampled fetus of adult type Hb AB, Hb C was observed at the time when the fetus was anemic. At birth the number of cells containing adult Hb was significantly higher in catheterized lambs than in nonoperated controls.

Pine Vole Reproduction in Relation to Food Habits and Body Fat

Pine Vole Reproduction in Relation to Food Habits and Body Fat

Observations on the development of the febrile response to pyrogens in sheep.

1. An initial injection of intravenous bacterial pyrogen in newborn lambs failed to produce fever, but did cause a fall in the number of circulating blood leucocytes. 2. A second challenge of bacterial pyrogen in 60-h-old lambs caused fever, whereas other 60-h-old lambs, not previously injected with pyrogen, were unresponsive. 3. Thus the newborn lamb requires sensitization, by exposure to endotoxin, before pyrogen-induced fever can occur. 4. When bacterial pyrogen was injected intravenously into the unanaesthetized foetus in utero, foetal and maternal body temperatures remained unchanged in response to the initial challenge and to one or two subsequent injections of bacterial pyrogen in utero, or in the lamb immediately after birth. In all instances the foetal white cell count fell in the 90 min after the injection. 5. The response to both bacterial pyrogen and leucocyte pyrogen appears to depend upon the maturity of the physiological mechanisms involved in pyrogen fever.

RADIOIODINE CONCENTRATION IN FETAL HUMAN THYROID FROM FALLOUT.

Abstract—From July, 1959 to January, 1963, 139 human fetal, 87 adult, 12 child and 154 hog thyroid glands were counted in a spectrometer well-counter system capable of detecting 1.5 pc I131/g of tissue. Neck muscle counts served as background. Using published MPD values of 0.5 rems (population) and 1.5 rems (individual), hog thyroid radioactivity exceeded individual MPD once in September, 1959, and once in September, 1962; exceeded population MPD three times in November, 1961, and three times in August–September, 1962. Human fetal counts never reached the MPD and only once rose to more than half adult thyroid radioactivity. Fetal: maternal thyroid radioactivity in a pregnant woman dying suddenly was 1.08 pc/g: 0.82 pc/g. High radioactivity concentration in hog thyroid always preceded high radioactivity in human adult and fetal thyroids. It is concluded that hog thyroid gland monitoring can be used in lieu of human adult and fetal thyroid gland monitoring until very high concentrations of I131 are found in hog thyroid.