Gestational Disorders Research Articles

Sudden infant death syndrome (SIDS) and disordered blood flow

Naeye (1) has long linked SIDS with low utero-placental blood flow and foetal hypoxia. Gestational hypotension, maternal smoking and disorders of the foetal membranes are considered by Naeye to promote brainstem and neurological abnormalities. Naeye also found that SIDS' victims often showed a growth lag after birth and suggested a reduced oxygen environment after birth which pointed to chronic under-ventilation of the lungs. Another abnormality observed by Naeye was that brown fat was retained for an abnormally long time. Now Mitchell (New Zealand Herald, 27.11.90) has concluded a 3-year study of SIDS' victims in New Zealand and found a combination of stomach sleeping position, mothers' smoking and bottle feeding was implicated in 79% of SIDS' victims. (The sleeping position and maternal smoking may be additive in disordered blood flow). The effect of circulatory shock (cardiogenic) on skeletal muscle mitochondrial activity shows there is a large decrease in the activity of the mitochondrial enzyme cytochrome oxidase during circulatory shock. There is also a reduced capacity to oxidase succinate, pyruvate and palmitoyl carnitine (2). These authors discuss cellular oxidative damage due to severe hypoxia during circulatory shock and the effect on the skeletal muscle mitochondrial electron transport chain (ETC). The reasons for carnitine supplement to these patients are explained. It was concluded that during the course of circulatory shock in humans inactivation or damage to the mitochondrial ETC plays a crucial role in cellular oxidative damage. The activation of brown fat mitochondria via the ETC revolves around elevated blood flow, and the high content of cytochromes which give this tissue its characteristic brownish colour (3)). Other forms of interrupted blood flow, similar to cardiogenic shock disorders in skeletal muscle, will be discussed.

Conditions Associated with Nonimmune Hydrops Fetalis

The author examines a number of disorders associated with nonimmune hydrops fetalis; included are hematologic, cardiovascular, pulmonary, renal, gastrointestinal, and hepatic disorders, congenital neoplasms, chromosomal disorders, heritable disorders, congenital infections, disorders of the placenta and cord, and gestational disorders.

Paired measurements of total and unconjugated estriol in maternal plasma during the 2nd and 3rd trimester of pregnancy - their relationship to intrauterine growth retardation.

Growth retarded fetuses and neonates have higher morbidity and mortality rates than normally developed infants of comparable age [4, 5, 16, 19, 20, 24]. During the immediate neonatal period, smallfor-date infants run an increased risk of infection, are particularly prone to hypoglycemia and have difficulties in maintaining normal body temperature. Subsequently some of these infants will not attain normal body size, and a considerable number will suffer from neurologic impairment [8,10, 23]. Early detection of intrauterine growth retardation (IUGR) and careful monitoring of the affected fetuses, both by biophysical and biochemical means, are of substantial interest to the obstetrician. Once fetal growth retardation is recognized, the obstetrician will attempt to normalize fetal growth during the further course of the pregnancy by elimination of maternal causes contributing to the gestational disorder (nicotine, drug abuse, maternal malnutrition, etc.) or by intensive therapy of accompanying maternal complications (toxemia, gestational diabetes, etc?) In some cases, early delivery of a viable fetus will be accomplished before irreversible damage or death has occurred. During the 2nd and 3rd trimester of pregnancy, the major proportion of estriol circulating in maternal blood and being excreted through maternal urine and feces is synthesized in the fetoplacental unit [6, 7]. Normal maternal plasma estriol levels indicate fetal well-being, whereas abnormal estriol profiles are mostly associated with abnormal fetal development or fetal distress [14]. The study was designed to examine the possibilities of predicting fetal growth retardation as early as during the 2nd trimester of pregnancy by means of total and unconjugated estriol assay in maternal plasma and to compare the usefulness of these two feto-placental function tests in the antepartum Identification of growth retardation.

HLA Antigen Studies in Women with Recurrent Gestational Disorders

The frequencies of HLA antigens were determined in an experimental group of women with recurrent gestational disorders mainly expressed as spontaneous abortions of unknown etiology. The estimated antigen frequencies in this group were compared with the antigen frequencies in 158 unrelated persons (79 couples with no record of secondary infertility). A significantly higher frequency of antigen HLA-A9 was found in the experimental group as compared with the controls (corrected P = 0.0015). A greater degree of HLA compatibility was found between each woman from this group and her husband, considering 45 couples, as compared with 79 control couples. These results indicate that gene(s) close to the HLA region may have an influence on the reproductive performance in humans.

Diseases of the retina.

During the past 10 years ophthalmologists have altered the point of view of physicians toward minor disorders of gestation by demonstrating that and Toxoplasma may produce severe structural defects in the fetus. Further studies on who were affected by maternal infections during the first trimester of pregnancy (in the Australian epidemic of 1940 to 1943) have revealed a high percentage of retinal lesions. Hamilton and associates ' studied the in the Tasmanian Institution for the Blind. Deaf and Dumb and found that of the 29 who were deaf from maternal infections, 13 had retinitis. Morlet2 examined 60 rubella children in Western Australia and found that 36 of them had chorioretinal lesions. The fundus changes were divided into three types: (1) gross and general pigmentary changes; (2) fine, pepper-like pigmentary changes mainly in the periphery, and (3) waxy, disklike lesions with no obvious pigmentary changes. None of the in Morlet's study who were so affected showed loss of central visual acuity attributable to the retinal lesions. Franceschetti and Bock 3 reported megalopapilla as a new congenital abnor¬ mality. A man aged 25 with a slightly hypermetropie refractive error had disks

EPIDEMIOLOGY OF ENCEPHALO-OPHTHALMIC DYSPLASIA

During the past decade ophthalmologists have pioneered advances in the knowledge of prenatal disease which have transcended the confines of their specialty and acted as a ferment on investigations by pediatricians, obstetricians, pathologists and students of public health. The first impetus came from the observations of Gregg on the permanent consequences to infants which follow rubella of the mother in early pregnancy. 1 A drastically altered point of view of physicians toward minor disorders of gestation was the result. The implications are that the principle at work is the key to many of the structural defects characteristic of the the developmental period of life. 2 Thus, Terry's demonstration 3 that retrolental fibroplasia is a defect not merely of infants, but for the most part of prematurely born infants, challenged further study and interpretation. Krause 4 established that the condition was generally associated with dysplasia of the brain—hence the name encephalo-ophthalmic