1/8. Neonatal periventricular leukomalacia preceded by fetal periventricular echodensity.OBJECTIVE: The purpose of this prospective study is to verify whether fetal periventricular echodensity (PVE) precedes neonatal periventricular leukomalacia (PVL). methods: Fetal brains were studied with transvaginal scan in 63 high-risk fetuses from 17 to 32 weeks of pregnancy, PVE echogenicity was quantified with ultrasonic histogram, and neonatal brains and clinical courses were studied after birth. RESULTS: No fetal cystic PVL was found, instead, fetal PVE was detected in 42 fetuses. The quantified echogenicity value was higher in PVE than in normal brain. Four cases developed neonatal PVL among 28 preterm and 1 among 14 term births. Neonatal PVL developed in the 23 cases of persistent fetal PVE, whereas no neonatal PVL was found when fetal PVE was negative or disappeared. Cord compression signs were common in PVL cases. CONCLUSION: Neonatal PVL was preceded by antepartum persistent fetal PVE in the present study.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/8. Intrauterine cerebral infarcts and bilateral frontal cortical leukomalacia following chronic maternal inhalation of carburetor cleaning fluid during pregnancy.Little is known about the effect of inhalation of methanol and other solvents on the pregnancy and the growth of the fetus. We report a preterm male infant who developed cerebral infarcts in utero, leading to large areas of bilateral frontal cortical leukomalacia following chronic maternal inhalation of carburetor-cleaning fluid during pregnancy. The infant presented with acute fetal distress with significant metabolic acidosis at birth. Initial hypotonia was followed by generalized hypertonicity. This infant did not exhibit typical facial features of fetal alcohol syndrome.- - - - - - - - - - ranking = 6keywords = pregnancy (Clic here for more details about this article) |
3/8. Fetal trauma: brain imaging in four neonates.The purpose of this paper is to describe brain pathology in neonates after major traffic trauma in utero during the third trimester. Our patient cohort consisted of four neonates born by emergency cesarean section after car accident in the third trimester of pregnancy. The median gestational age ( n=4) was 36 weeks (range: 30-38). Immediate post-natal and follow-up brain imaging consisted of cranial ultrasound ( n=4), computed tomography (CT) ( n=1) and post-mortem magnetic resonance imaging (MRI) ( n=1). pathology findings were correlated with the imaging findings ( n=3). Cranial ultrasound demonstrated a huge subarachnoidal hemorrhage ( n=1), subdural hematoma ( n=1), brain edema with inversion of the diastolic flow ( n=1) and severe ischemic changes ( n=1). In one case, CT demonstrated the presence and extension of the subarachnoidal hemorrhage, a parietal fracture and a limited intraventricular hemorrhage. Cerebellar hemorrhage and a small cerebral frontal contusion were seen on post-mortem MRI in a child with a major subarachnoidal hemorrhage on ultrasound. None of these four children survived (three children died within 2 days and one child died after 1 month). Blunt abdominal trauma during pregnancy can cause fetal cranial injury. In our cases, skull fracture, intracranial hemorrhage and hypoxic-ischemic encephalopathy were encountered.- - - - - - - - - - ranking = 2keywords = pregnancy (Clic here for more details about this article) |
4/8. Periventricular leukomalacia and retinopathy in a term infant born to a mother with asthma.A male child, born at 37 5 gestational weeks (GWs) (birthweight 2000g) after intrauterine growth retardation (IUG; -3 SD), to a mother treated during pregnancy for asthma, developed periventricular leukomalacia and retinopathy with total retinal detachment in the left eye and partial detachment in the right eye. Apart from basic asthma treatment with terbutalin, budesonid, and fenoterolhydrobromid throughout the pregnancy, she was treated with intravenous or oral cortisone for 6.5 weeks from 28 5 GWs. In addition she developed deep venous thrombosis at 29 GWs and was treated with heparin until delivery. Psychotic symptoms during the 31st GW were treated with diazepam, haloperidol, and levomepromazin. Functional sequelae for the child were visual impairment (visual acuity 5/60), uneven intellectual profile (Wechsler Pre-school and Primary Scale of intelligence, Verbal IQ 94 and Performance IQ 32 at 8y of age), and autistic-like behaviour. The possibility that pre- and perinatal risk factors (e.g. severe maternal illness, IUGR, and cortisone treatment) in a term infant may create conditions for developing eye and brain pathologies commonly closely related to preterm birth should be considered.- - - - - - - - - - ranking = 2keywords = pregnancy (Clic here for more details about this article) |
5/8. Neonatal periventricular leukomalacia due to severe, poorly controlled asthma in the mother.BACKGROUND: We report a neonatal case of cystic periventricular leukomalacia (PVL) in which the hypoxia was considered to have been caused by severe asthma in the mother, who had not taken any medication during pregnancy because she was anxious about its possible effects on her unborn child. methods: After the mother had severe exacerbation of asthma for five days, the baby was born at 36 weeks in gestation, weighing 2100 g, and with moderate asphyxia. Although the baby had been aggressively treated in a neonatal intensive care unit, at birth, an ischemic area had been formed in the periventricular areas in the brain echogram. We suspected that she had severe brain damage due to prenatal hypoxia. RESULTS: The baby was found to have cystic PVL by ultrasonography at age 15 days, and diplegia at age 4 months. CONCLUSIONS: The poorly controlled, persistent and severe asthma of the mother may have caused prenatal hypoxia, resulting in the cystic PVL and lower limb palsy. Pregnant patients with poorly controlled asthma should be advised of the great risk of this condition to the fetus. Also, patients should be assured of the safety of modern asthma treatments.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
6/8. pregnancy and functional paraganglioma.The association of pregnancy with a catecholamine-secreting tumor is rare. The high maternal and fetal mortality rate is significantly reduced when the diagnosis is made antepartum and adequate management is started. In 1979 Burgess reviewed 42 cases with antepartum diagnosis, demonstrating the benefits of alpha-blockade (Obstet Gynecol 1979; 53:266-270). When diagnosis was made in the third trimester of pregnancy, a combined procedure of cesarean section and tumor resection was best. The best surgical approach in first- and second-trimester diagnosis, however, remains controversial. A case with second-trimester diagnosis is described. Following a period of alpha- and beta-blockade, a combined surgical procedure in the third trimester resulted in a healthy mother and infant. Follow-up procedures included a meta-iodobenzylguanidine scan of the mother. Postpartum, ultrasonography of the child's brain revealed periventricular leucomalacia. The prognosis associated with this finding is poor. Some more recent information about certain aspects of these tumors is also discussed.- - - - - - - - - - ranking = 2keywords = pregnancy (Clic here for more details about this article) |
7/8. Acute appendicitis in pregnancy and the occurrence of major intraventricular hemorrhage and periventricular leukomalacia.BACKGROUND: infection and endotoxemia have been associated with neurologic injury in the newborn. In addition, recent reports have noted an increased incidence of fetal neurologic injury in the presence of intrauterine infection. CASES: Three pregnancies complicated by acute appendicitis and refractory preterm labor resulting in the delivery of neonates who developed early major intraventricular hemorrhage and/or periventricular leukomalacia are described. CONCLUSION: We hypothesize that extrauterine infections like acute appendicitis may play a role in the occurrence of neonatal neurologic injury.- - - - - - - - - - ranking = 4keywords = pregnancy (Clic here for more details about this article) |
8/8. death of one twin followed by extremely variable flow velocity waveforms in the surviving fetus.Intrauterine death of one fetus after the second trimester in a twin pregnancy, with continuation of the pregnancy is a rare complication. The risks of morbidity and mortality for the surviving fetus are high. A 32-year-old woman was admitted to the antenatal ward at 27 weeks gestation because of intrauterine death of one twin. During the first 24 h after the death of one twin, Doppler ultrasound assessment showed a remarkable variability in flow velocity waveforms in the umbilical artery of the surviving fetus. Changes from reversed to normal end-diastolic flow velocities were recorded within 6 min. These findings are explained by twin-to-twin transfusion due to intravascular blood pressure changes, or by release of vasoactive substances by the dead fetus.- - - - - - - - - - ranking = 2keywords = pregnancy (Clic here for more details about this article) |