Fetal Retention Research Articles

Umbilical cord 'pseudo-vasculitis' following second trimester fetal death: a clinicopathological and immunohistochemical study of 13 cases.

Amniotic fluid bacterial infection is an occasional cause of second trimester septic abortion. We describe an autolysis-related histological artifact, umbilical cord 'pseudo-vasculitis', which can erroneously implicate amniotic bacterial infection in fetal death. Clinicopathological features of 13 second trimester fetal deaths with umbilical cord pseudo-vasculitis are reported. In four cases (31%), an incorrect pathological diagnosis of umbilical vasculitis had initially been rendered. Umbilical cords from five cases of pseudo-vasculitis and one comparison fetus (18-week septic abortion with true umbilical vasculitis), were studied with chloroacetate esterase and with immunohistochemical staining for myeloperoxidase, muscle-specific actin (HHF35) and smooth muscle actin. Histologically, umbilical pseudo-vasculitis exhibited numerous small, rounded, degenerating cells with irregular, multilobed nuclei (closely resembling neutrophils) located within the umbilical vessel wall. Immunohistochemical studies demonstrated that all cells resembling neutrophils were of smooth muscle origin. Moderate to severe fetal autolysis was present in all cases of umbilical pseudo-vasculitis, suggesting that this finding represents autolysis of umbilical vascular smooth muscle secondary to post moderate fetal retention. Vascular smooth muscle in other fetal and placental locations did not demonstrate the finding, suggesting that this striking degenerative artifact of smooth muscle is restricted to the umbilical cord.

Reducing fetal contamination of radiostrontium by water soluble chitosan

The purpose of this study is to evaluate whether water soluble chitosan, a natural nontoxic chelator, can reduce fetal contamination of radiostrontium in pregnant mice. Various forms of water soluble chitosans (10% or 1% powder, or 1% solution) were given to pregnant mice before or after contamination of 0.005 μCi/B.W(g) Sr‐85. Transplacental transfer of Sr‐85 to fetus was 6.8±2.7% of injected dose, when Sr‐85 was administered at the 20th day of pregnancy. Fetal radioactivity was significantly reduced when mother mice were treated with water soluble chitosan before contamination of Sr‐85. Water soluble chitosans of 10% or 1% powder, or 1% solution significantly reduced fetal retention of Sr‐85 to 2.3±0.7%, 2.7±0.8%, and 2.0±0.9%, respectively. However, fetal contamination was not reduced, when water soluble chitosans of 10% or 1% powder, or 1% solution were administered after maternal contamination of Sr‐85. From these data we can conclude that water soluble chitosan could reduce fetal contamination of ra...

Influence of maternal dietary Zn intake on expression of diabetes-induced teratogenicity in rats.

Diabetic rat pregnancies are characterized by altered maternal and fetal Zn metabolism and a higher frequency of fetal malformations. In this study, the effect of varying maternal dietary Zn on pregnancy and fetal outcome and on maternal and fetal trace element status were investigated. Starting on day 0 of gestation, streptozocin-induced diabetic and nondiabetic control rats were fed a low-Zn diet (4.5 micrograms/g diet), an adequate-Zn diet (24.5 micrograms/g diet), or a high-Zn diet (500 micrograms/g diet) throughout gestation. Fetuses were taken by cesarean section on gestation day 20. Fetuses from diabetic dams were smaller, weighed less, and had less calcified skeletons and more malformations than fetuses from control dams. In the controls, maternal dietary Zn had a minor effect on fetal malformation frequency. In contrast, in the diabetic animals, the low-Zn diet had a strong teratogenic effect. In diabetic dams, the adequate- and high-Zn diets improved fetal length and weight more than it did in fetuses from nondiabetic dams. However, supplemental dietary Zn during diabetic pregnancy did not further improve malformation frequencies. Liver and kidney Zn, Cu, and metallothionein concentrations were higher in diabetic dams than in control dams. In contrast, liver Zn, Cu, and metallothionein concentrations in fetuses of diabetic dams were lower than in fetuses from control dams, regardless of maternal dietary Zn intake. These results show that diabetes during pregnancy can amplify the teratogenic effects of a mild maternal Zn deficiency.(ABSTRACT TRUNCATED AT 250 WORDS)

Influence of Ethanol Consumption on Maternal-Fetal Transfer of Zinc in Pregnant Rats on Day 14 of Pregnancy

The hypothesis that a biochemical lesion underlying the development of fetal alcohol syndrome is an ethanol-induced reduction in placental zinc transfer was tested. Placental zinc transfer was assessed in control and ethanol-fed dams on d 14-15 of pregnancy. Litters from ethanol-fed dams were characterized by a high resorption frequency and fewer live fetuses per litter than litters from control dams. In addition, fetuses from the ethanol-fed dams weighed less than control fetuses. However, despite the negative effects of ethanol intake on litter outcome, placental and fetal retention of 65Zn was similar in the two groups. Therefore, an ethanol-induced fetal zinc deficiency does not seem to have a role in the production of the gross structural malformations associated with fetal alcohol syndrome when adequate zinc is provided in the diet.

Iron and Zinc Concentrations and 59Fe Retention in Developing Fetuses of Zinc-Deficient Rats

Because disturbances in iron metabolism might contribute to the teratogenicity of zinc deficiency, we examined the effect of zinc deficiency on fetal iron accumulation and maternal and fetal retention of 59Fe. Pregnant rats were fed from mating a purified diet containing 0.5, 4.5 or 100 µg Zn/g. Laparotomies were performed on d 12, 16, 19 and 21 of gestation. Maternal blood and concepti were analyzed for zinc and iron. Additional groups of dams fed 0.5 or 100 µg Zn/g diet were gavaged on d 19 with a diet containing 59Fe. Six hours later maternal blood and tissues, fetuses and placentas were counted for 59Fe. Maternal plasma zinc, but not iron, concentration was affected by zinc deficiency on d 12. Embryo zinc concentration on d 12 increased with increasing maternal dietary zinc, whereas iron concentration was not different among groups. On d 16–21 plasma iron was higher in dams fed 0.5 µg Zn/g diet than in those fed 4.5 or 100 µg/g, whereas plasma zinc was lower in dams fed 0.5 or 4.5 µg Zn/g than in those fed 100 µg Zn/g diet. On d 19 zinc concentration in fetuses from dams fed 0.5 µg/g zinc was not different from that of those fed 4.5 µg/g zinc, and iron concentration was higher in the 0.5 µg Zn/g diet group. The increase in iron concentration in zinc-deficient fetuses thus occurs too late to be involved in major structural teratogenesis. Although whole blood concentration of 59Fe was not different in zinc-deficient and control dams, zinc-deficient dams had more 59Fe in the plasma fraction. Retention of 59Fe in maternal tissues and litters was not different in zinc-deficient and control groups, but 59Fe/g body weight in zinc-deficient fetuses was 170% of that in control rats. Analysis of zinc, iron and copper distribution by gel filtration chromatography showed that the increase in tissue iron was in the ferritin-hemosiderin peak in maternal and fetal liver and placenta.

726 BIOAVAILABILITIES OF CALCIUM (CA) AND PHOSPHORUS (P) ARE HIGHER IN FORTIFIED MOTHER'S MILK COMPARED TO COMMERCIAL FORMULA

Bioavailabilities of Ca and P in human milk and commercial formula preparations have not been assessed at similar levels of nutrient intakes. In this study, the utilization of Ca and P was compared during the first two postnatal mo in 2 groups of preterm infants fed either fresh mother's milk fortified with lyophiiized human milk skim fractions and added Ca lactate and P salts (Group FM, birthweight, 1088 ± 53 g; gestation 28 ± 0.3 wk, Mean ± SEM) or a commercial formula designed for preterm infants (Group CM, 1057 ± 49 g; 29 ± 0.2 wk). Two 96-h balance studies were conducted at wk 3 and 7. Similar daily intakes were maintained in both groups: Ca 112 ± 2, P 68 ± 3, and nitrogen 486 ± 6 mg/kg and energy 129 ± 1 kcal/kg. Net Ca retention and absorptions of Ca and P were higher for group FM. The ratio and absolute values of Ca/P retention observed in Group FM approximated estimates of fetal retention more closely than those in Group CM. These results indicate that despite similar levels of intake for both groups, the bioavailability of Ca and P in FM was higher than in CM and that Ca and P adequacy can be maintained in preterm infants for two months when they are fed FM.

Soluble fibrin monomer complexes and other hemostatic parameters in patients with intrauterine fetal death.

Hemostatic parameters, especially soluble fibrin monomer complexes, have been studied in 114 patients with intrauterine fetal death. The patients were classified into three groups according to the duration of fetal retention. A correlation was observed between a longer duration of fetal retention and the hemostatic alteration. Moreover, in the groups of patients in which this hemostatic disorder was more evident, an improvement in these alterations was detected after fetal evacuation. A hemorrhagic picture with consumption of coagulation factors and cross-linked fibrin oligomers was detected after uterine evacuation in only 1 case and required an emergency hysterectomy and the administration of blood and plasma. In the rest of the patients, fetal evacuation was sufficient to normalize the parameters and no hemorrhagic complications were observed. The favorable evolution and minimal hemostatic alterations in the majority of the patients with intrauterine fetal death, when early obstetric management was established, are discussed.

Pregnancy-associated depression of cell-mediated immunity.

Pregnancy has been known for some time to be associated with depressed aspects of cell-mediated immunity (CMI) that permit fetal retention but that also may interfere with resistance to specific infectious and neoplastic agents. Clinical and laboratory findings of loss of resistance have been extensively documented. Gestation appears to be associated with depression of selective aspects of CMI. Levels of hormones and other serum factors that may modulate lymphocyte or macrophage synthesis, activation, and/or function shift considerably during pregnancy. The induction and maintenance of pregnancy-associated immune deficiency probably rely on a multifactorial mechanism. Further research is needed to identify agents that would prevent fetal rejection while permitting adequate defense against infection and malignancy; to identify strains particularly dangerous during gestation; and to develop vaccines against the nonshared antigens of such strains.

Transplacental passage and embryonic-fetal accumulation of hexachlorophene in mice

Whole-body autoradiography and liquid scintillation counting were used to study the transplacental passage and embryonic-fetal localization of hexachlorophene (HCP) in the mouse. In early gestation (Days 8–9) there was a selective accumulation of HCP in the fetal neural epithelium, e.g., in the brain and optic vesicles and in the neural tube. Although weaker, a certain uptake was observed also in the endoderm, ectoderm, and somites. In late gestation, the fetal retention of HCP was pronounced, giving considerably higher concentrations in the fetal tissues than in the maternal blood. The fetal retention of HCP increased as the pregnancy progressed. In the late gestational fetuses the distribution pattern was even, compared to that of the early embryos, the strongest labeling being observed in the blood. The uptake in the fetal liver was low when compared to the maternal, but in the fetal intestine the concentration was fairly high. As was the case in the adult animal, a blood-brain barrier was observed also in the full term fetuses.

MANAGEMENT OF MISSED ABORTION AND FETAL DEATH IN UTERO

Termination of pregnancy in missed abortion and intra-uterine fetal death was accomplished using vaginal suppositories of 20 mg PGE2 in 31 cases and the results were compared with oxytocin induction (with or without estrogen pre-treatment) in 17 cases at the doses routinely used in our hospital. The PG suppositories proved much more superior (96.7%) than oxytocin (47.7%), but induced a higher rate of side effects. The latter were not serious and were generally tolerated by the patients. There was a positive correlation between duration of fetal retention in utero and the induction expulsion time. The over all patient acceptance of the method was quite favourable and the approach appears to be a definite advance towards management of these cases.

Plasma amino acid concentrations in umbilical cord vein and artery of newborn infants after elective cesarean section or spontaneous delivery

Twenty-four infants delivered by elective cesarean section and 23 spontaneously born infants were studied for plasma amino acid concentrations of the umbilical cord vein and artery. Normal labor was not found to influence plasma amino acid concentrations. In both spontaneously and operatively born infants, similar venous-arterial gradients were found for all essential and five nonessential amino acids. Based on the differences of venous and arterial concentrations and the umbilical cord blood flow, the daily fetal retention of single amino acids was calculated.

Management of missed abortion and fetal death in utero

Termination of pregnancy in missed abortion and intra-uterine fetal death was accomplished using vaginal suppositories of 20 mg PGE 2 in 31 cases and the results were compared with oxytocin induction (with or without estrogen pre-treatment) in 17 cases at the doses routinely used in our hospital. The PG suppositories proved much more superior (96.7%) than oxytocin (47.7%), but induced a higher rate of side effects. The latter were not serious and were generally tolerated by the patients. There was a positive correlation between duration of fetal retention in utero and the induction expulsion time. The over all patient acceptance of the method was quite favourable and the approach appears to be a definite advance towards management of these cases.

Parturition and Lactogenesis in rabbits with high spinal cord transection.

The effect of high spinal cord transection (T2–T3) performed on days 25–27 of pregnancy on subsequent parturition and lactation was studied in New Zealand white rabbits. Parturition was initiated in all spinal rabbits within the normal time (30–32 days), but severe dystocias were found in nearly all cases. Thus, only 10 of 66 fetuses were born alive and 9 of 13 rabbits delivered exclusively dead fetuses. Retention of dead fetuses or placentae in the uteri and parturition with long intervals between individual deliveries were commonly observed. Milk secretion was noted in all spinal rabbits post partum. In 5 rabbits in which daily milk yields were determined, milk secretion was initiated and maintained during the first week of lactation. Yet the milk yields were significantly smaller than those obtained in 3 intact control rabbits.

MATERNAL-FETAL MORTALITY IN MICE WITH ISOANTIBODIES TO PATERNAL GAMMA-GLOBULIN ALLOTYPES.

A high incidence of maternal and fetal deaths has been observed in pregnant mice with isoantibodies to paternal y-globulin allotypes. BALB/c females were immunized to produce isoantibodies to C57BL/6 y-globulin and mated to C57BL/6 males; similarly, C57BL/6 females were immunized to produce isoantibodies to BALB/c y-globulin and mated to BALB/c males. Fifty per cent of the BALB/c pregnant mice succumbed at term; the number of progeny surviving per pregnant mouse was 30% of the control groups. No maternal deaths occurred in the C57BL/6 pregnant mice; no live progeny were delivered. Retention of fetuses in utero as well as grossly misshapen and severely bruised fetuses were observed in both strains.

Placental Transfer of Strontium in Rats

Various subcutaneous doses of Sr/sup 85/ and Sr/sup 90/ were given to adult female rats, some of which were pregnant. Analysps of fetuses from the pregnant rats revealed that gestational injection day was the most important factor governing fetal retention of Sr received through the placenta. Litters from dams injected on the nineteenth gestational day contained an average of three times the fractional dose of those injected on day 17, and 16 times that of those injected on day 15. Young rats showed a continued increase in Sr burden from birth until weaning. There was a marked disparity in Sr metabolism between pregnant and nonpregnant rats. The dams retained less Sr and excreted larger quantities through the kidneys than did their nonpregnant counterparts. (

Studies on the transfer of phosphate from mother to foetus in the rabbit.

AbstractThe transfer of phosphate from mother to foetus was studied in rabbits with radioactive P. As in guinea pigs the inorganic phosphate concentration is higher in the foetal than in the maternal plasma, and the transfer takes place against the gradient. The transfer rates calculated from experiments of 30 min duration did only exceed or approach the rate of foetal P retention when the foetal and placental uptake rates were combined. In an experiment of 120 min duration the foetal uptake alone equalled the foetal retention. The combined foetal and placental uptake rates in experiments of varying duration were relatively constant.In some of the rabbits gestation was artificially prolonged by daily injections of progesterone. The foetal P concentration increases up to but not beyond term. The placental concentration is fairly constant in the second half of gestation and after term, but goes up when intrauterine foetal death occurs, indicating that the placenta stays alive for some time and continues to take up phosphate. The active transport mechanism in the placenta must be localized to the chorionic cells, probably at their boundary toward the intervillous space, building up in the placenta a phosphate pool, from which the foetus is supplied.

Effect of potassium thiocyanate on fetal retention of radioiodine.

IN A recent study by Rugh and Booth (1954) of the effect of treatment of the pregnant mouse with thiouracil, methimazole, and thyrotrophic hormone prior to the injection of radioiodine, it was demonstrated that the expected radioiodine damage to both the mother and the fetus (Rugh 1951) was modified. Thiouracil particularly was found to protect both the maternal and fetal thyroids against radiation-induced necrosis. Potassium thiocyanate (KSCN) has been used clinically to alter radioiodine absorption and retention by the thyroid gland (Stanley and Astwood 1949; Beierwaltes 1950; Reveno and Rosenbaum 1950; Bartels and Sjogren 1951; Stone et al., 1952). It markedly inhibited I131 uptake by rat thyroids (Williams et al., 1950). The present study was directed toward the fetus. The thiocyanate was injected into the pregnant mouse before, simultaneously with, or after the injection of radioiodine (NaI131) and the effect on radioiodine retention by the mother and the fetus was determined.

Death and retention of fetus in the uterine cavity during pregnancy: Rodringuez, Lopez B.: Rev. port. obst. ginec. e cir. 5: 40, 1952

Death and retention of fetus in the uterine cavity during pregnancy: Rodringuez, Lopez B.: Rev. port. obst. ginec. e cir. 5: 40, 1952

Ovarian pregnancy

An unusual case of ectopic pregnancy, without history or symptoms indicative of pregnancy.Arrest of development and retention of fetus in sac.Specimen conforms to requirements of Speigelberg, plus recovery of fetus in situ.

Prolonged retention of fetus from an extrauterine pregnancy

Prolonged retention of fetus from an extrauterine pregnancy