1/28. Fetal seizures causing increased heart rate variability during terminal fetal hypoxia.Fetal seizures together with both abnormal breathing movements and fluctuations in fetal blood pressure and heart rate resulting in increased fetal heart rate variability have been observed in brain-damaged fetal sheep shortly after an asphyxial insult. We report a clinical example of convulsions and increased heart rate variability during terminal fetal hypoxia.- - - - - - - - - - ranking = 1keywords = mal, seizure (Clic here for more details about this article) |
2/28. fetal heart rate during a maternal grand mal epileptic seizure.Although maternal ingestion of antiepileptic drugs is strongly suspected of causing congenital defects, particularly oral clefts, the effect of epilepsy itself or a combined effect of drug intake and epilepsy have not been excluded as etiological factors. Very little is known about fetal oxygenation during a maternal grand mal epileptic seizure. We describe two cases in which fetal heart rate was recorded during a maternal epileptic seizure during labor. The first fetus became clearly asphyctic as judged from the fetal heart rate recording: immediately after the epileptic seizure there was a 13-minute continuous bradycardia wave with decreased short-term variability. After the bradycardia a phase of tachycardia with decreased short-term and long-term variability occurred. In the other fetus there was only a short period of bradycardia, which was followed by a phase of tachycardia and decreased short-term and long-term variability. Both fetuses were vigorous at birth 43 and 87 minutes, respectively, after the epileptic seizures of their mothers. We conclude that a maternal grand mal epileptic seizure can be ominous to the fetus. It is therefore important that epileptic seizures are controlled by optimal medication throughout pregnancy.- - - - - - - - - - ranking = 183.24618108315keywords = grand mal, mal, seizure (Clic here for more details about this article) |
3/28. Four cases of the ex utero intrapartum treatment (EXIT) procedure: anesthetic implications.The ex utero intrapartum treatment (EXIT) procedure is a method of maintaining utero-placental circulation during cesarean section to gain time to secure a potentially obstructed fetal airway. Four cases of the EXIT procedure are described with special reference to the maternal anesthetic technique. Deep volatile anesthesia (approximately 2 MAC) with isoflurane or sevoflurane for a prolonged period of time, in three cases in combination with an intravenous nitroglycerin infusion, was used to ensure a fully relaxed uterus during the procedure. All mothers were maintained hemodynamically stable with preserved utero-placentary perfusion. It was possible to intubate the tracheas of two fetuses, whereas in the other two tracheostomies had to be performed. Fetal gas exchange was not negatively affected during the EXIT procedure as evidenced by normal blood gas values in the umbilical artery at the time of delivery. After reducing the concentration of volatile anesthetic, delivery of the neonate and administration of oxytocin, uterine contractility was promptly re-established and there were no signs of uterine atony in the postoperative period. All four neonates survived the procedure without complications.- - - - - - - - - - ranking = 0.88173589027208keywords = mal (Clic here for more details about this article) |
4/28. Endothelial, inducible and neuronal nitric oxide synthase in congenital pulmonary lymphangiectasis.Abnormal growth and development of lymphatic pulmonary structures leads to severe hypoxia in congenital pulmonary lymphangiectasis (CPL). This case study aims to determine the cellular source and topographical distribution of the nitric oxide synthases in CPL. It studies the post mortem tissue of a term newborn with the clinical course and histological findings of CPL and three controls without pulmonary pathology. It was found that endothelial cells of pulmonary arteries and lymphatic structures stained significantly more for endothelial nitric oxide synthase protein in the CPL patient compared to the controls. The authors conclude that synthesis of endothelial nitric oxide synthase is upregulated in vascular and lymphatic endothelial cells in congenital pulmonary lymphangiectasis.- - - - - - - - - - ranking = 0.88173589027208keywords = mal (Clic here for more details about this article) |
5/28. Dental abnormalities associated with a chromosome 2 deletion.This case report describes the dental and physical anomalies observed in a young female patient who had a chromosome abnormality involving deletion of the q 33-q 35 region of chromosome 2. The dental dysplasia observed in this patient is proposed to be of genetic origin but the complication of anoxia at birth makes it difficult to assign the intellectual and physical impairments solely to the genetic deletion.- - - - - - - - - - ranking = 6.1721512319046keywords = mal (Clic here for more details about this article) |
6/28. perinatal mortality in the infants of diabetic women.The causes of 50 perinatal deaths which occurred over an 18-year period in the infants of women with either established (n = 205) or gestational (n = 2,442) diabetes were studied. The perinatal mortality rate in these groups was 5.4% and 1.6% respectively and the causes of deaths were similar in both groups. Intrauterine hypoxia was found to be the commonest cause of death, followed by congenital malformations and respiratory distress syndrome. The implications of these findings for measures to reduce such deaths are discussed.- - - - - - - - - - ranking = 0.88173589027208keywords = mal (Clic here for more details about this article) |
7/28. Occult fetomaternal haemorrhage as a cause of fetal mortality and morbidity.Spontaneous fetomaternal haemorrhage is an important, but usually overlooked, cause of perinatal mortality and morbidity. Although fetomaternal bleeding in the third trimester of pregnancy is common it is normally less than 0.1 ml. A fetal macrotransfusion (greater than 5 ml) is uncommon, but is important because it is insidious, unexpected and usually occurs in completely normal pregnancies. This paper analyses the perinatal mortality and morbidity associated with occult fetomaternal haemorrhage at the Royal women's Hospital, Melbourne. It may lead to fetal distress before and during labour, unexplained stillbirth, or nonhaemolytic neonatal anaemia. A Kleihauer test on maternal blood will readily detect fetomaternal bleeding, and we describe a simple way of calculating the absolute volume of fetal red cells present. Greater awareness of the problem may eventually lead to diagnosis sufficiently early to permit effective treatment.- - - - - - - - - - ranking = 1.7634717805442keywords = mal (Clic here for more details about this article) |
8/28. Use of 31P magnetic resonance spectroscopy to characterize evolving brain damage after perinatal asphyxia.We investigated postasphyxial brain damage with 31P magnetic resonance spectroscopy (MRS) and correlated it with neurologic assessment and standard laboratory evaluation during the first 10 months of life in 1 infant, baby G. We compared these observations to 31P MRS data from 7 healthy term newborns, 1 normal infant examined serially over the first 8.5 months of life, and 5 other term infants following perinatal asphyxia. MRS noninvasively provides biochemical correlates of the evolution of brain damage following perinatal asphyxia and suggests that pH derived from the inorganic phosphate peak may serve as a marker for brain injury.- - - - - - - - - - ranking = 0.88173589027208keywords = mal (Clic here for more details about this article) |
9/28. Severe fetal brain injury without evident intrapartum asphyxia or trauma.Two appropriate-for-dates term infants were born after uncomplicated labors and atraumatic deliveries. They were depressed at birth, developed seizures on the first day of life, and followed clinical courses compatible with hypoxic-ischemic encephalopathy. However, the umbilical cord vessel pH and blood gases were normal. The children are now severely retarded and have cerebral palsy. These cases prove that the events of labor and delivery may not be responsible for all cases of brain damage in surviving children.- - - - - - - - - - ranking = 0.90538871221766keywords = mal, seizure (Clic here for more details about this article) |
10/28. Radiological colpocephaly: a congenital malformation or the result of intrauterine and perinatal brain damage.The term colpocephaly, meaning disproportional enlargement of the occipital horns of the lateral ventricles, was considered in the past to be a distinct congenital malformation acquired in early intrauterine life. During the last few years several cases were reported in whom a variety of intrauterine and perinatal causes could be associated with this radiological picture. We report on 9 children with radiological colpocephaly in whom intrauterine and/or perinatal injury to the developing brain seemed to be the cause of colpocephaly. It is evident from our observations that "radiological colpocephaly" is a non-specific finding caused frequently by CNS damage acquired during intrauterine and perinatal life.- - - - - - - - - - ranking = 4.4086794513604keywords = mal (Clic here for more details about this article) |
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