1/20. Fetal brain infection with human parvovirus B19.Intrauterine parvovirus B19 infection is known to be one of the causes of hydrops fetalis. However, there are few reports of the pathologic changes in the central nervous system. Postmortem examination of a fetus revealed multinucleated giant cells of macrophage/microglia lineage and many small calcifications around the vessels, predominantly in the cerebral white matter. parvovirus B19 genome dna was detected in the nucleus of the multinucleated giant cells and solitary endothelial cells by polymerase chain reaction amplification and in situ polymerase chain reaction methods. capsid antigen was also demonstrated in the cytoplasm of the endothelial cells by immunofluorescent assay. Thus, intrauterine B19 parvovirus infection could be associated with marked neuropathologic changes in the fetal brain at the midembryonal period. Neurologic follow-up of complications may be necessary for children who survive the intrauterine infection.- - - - - - - - - - ranking = 1keywords = embryo (Clic here for more details about this article) |
2/20. Congenital varicella syndrome: a rare case of central nervous system involvement without dermatological features.An unusual case of congenital varicella syndrome with significant central nervous system involvement, but without dermatological features at birth is described. The mother contracted chicken pox at 15 weeks' gestation. Congenital varicella syndrome involves multiple systems, but rarely without skin lesions identifiable at birth. Although varicella infection in pregnant women is an uncommon complication, the fetal embryopathy that may result can be devastating. Antenatal diagnosis of fetal embryopathy during the first 20 weeks of pregnancy should be established by amniocentesis or cordocentesis when a mother presents in the first trimester with chicken pox, and appropriate risk counselling provided.- - - - - - - - - - ranking = 2keywords = embryo (Clic here for more details about this article) |
3/20. The natural history of varicella embryopathy: a 25-year follow-up.A patient with clinically and immunologically proven varicella embryopathy achieved substantial recovery after initial severe developmental delay and manages well with her residual physical disabilities in adulthood.- - - - - - - - - - ranking = 5keywords = embryo (Clic here for more details about this article) |
4/20. A case of pregnancy complicated by the development of a tubo-ovarian abscess following in vitro fertilization and embryo transfer.Tubo-ovarian abscess is an uncommon complication in pregnant women. In this report, we present a patient who developed a tubo-ovarian abscess during pregnancy following in vitro fertilization and embryo transfer (IVF-ET). Despite treatment with intravenous antibiotics she delivered at 22 weeks of gestation. After delivery, she underwent a left salpingo-oophorectomy. review of the literature revealed only 26 reported cases of tubo-ovarian or pelvic abscess during pregnancy. pelvic inflammatory disease, previous laparotomy, and structural genital anomalies are known risk factors for pelvic abscess during pregnancy. Pelvic abscess resulting as a complication of vaginal oocyte retrieval has been reported. Therefore, although enabling women with organic pelvic disease such as endometriosis and hydrosalpinx to achieve pregnancy, assisted reproductive techniques may potentially result in pelvic infection during pregnancy. This case suggests that a preconception evaluation and treatment for such conditions should be considered for women undergoing treatment for infertility.- - - - - - - - - - ranking = 5keywords = embryo (Clic here for more details about this article) |
5/20. Two cases of systemic candida glabrata infection following in vitro fertilization and embryo transfer.Presented here are two cases of systemic candida glabrata infection diagnosed in two expectant mothers and their fetuses at 34 and 22 weeks' gestation. The underlying risk factors in case 1 were in vitro fertilization and embryo transfer, recurrent yeast vaginitis and two intravenous injections of betamethasone. The risk factors in case 2 were in vitro fertilization and embryo transfer, recurrent yeast vaginitis, antibiotics for treatment of a urinary tract infection due to morganella morganii and amniocentesis. In both cases, vaginal fluid yielded growth of a yeast that was not identified. candida glabrata was isolated from samples obtained from the mothers and their babies. Since candida glabrata lacks hyphae, membranitis and infection of the fetuses were demonstrated only on slides stained with Gomori Grocott and periodic acid-Schiff. Both cases suggest that for such pregnancies the follow-up of vaginal fluid should include the identification of any yeasts grown on selective Candida medium. In case of premature rupture of membranes, systematic sampling of mothers and their infants or fetuses should be associated with microscopic study of placentas, membranes and stillborn fetuses with Gomori Grocott and periodic acid-Schiff staining techniques.- - - - - - - - - - ranking = 6keywords = embryo (Clic here for more details about this article) |
6/20. Use of recombinant human activated protein c in treatment of severe sepsis in a pregnant patient with fully symptomatic ovarian hyperstimulation syndrome.BACKGROUND: Severe sepsis during pregnancy is a life-threatening condition for the mother, due to multiorgan failure and uncontrolled inflammatory response. It is associated with high risk of death for the fetus. CASE REPORT: The paper presents the course and treatment of severe iatrogenic sepsis in a patient in very early pregnancy. The sepsis was a result of complications after overstimulation of the ovaries in the course of treatment of infertility. The risk of the patient's death, assessed in the intensive care Unit according to apache II and SAPS II scores was 73%, whereas indirect assessment of the embryo in the 3(rd) week of pregnancy, based on determination of serum gestational hormone levels was ambiguous, but rather unfavorable. The patient's condition improved considerably after intensive treatment, including, among others, the use of activated protein c (APC). After the completion of treatment, in the 5(th) week of pregnancy, the gestational hormone levels increased to the values appropriate for such fetal age. The development of pregnancy was also confirmed by ultrasonography. CONCLUSIONS: The paper presents a case of severe sepsis in the course of ovarian hyperstimulation syndrome, not described in the literature so far, as well as the first successful administration of activated protein c in 21-day pregnancy.- - - - - - - - - - ranking = 1keywords = embryo (Clic here for more details about this article) |
7/20. Prenatal exposure to fluconazole: an identifiable dysmorphic phenotype.BACKGROUND: fluconazole is a triazole antifungal used to treat mycotic infections. fluconazole is reported to act as a teratogen when used continuously at a dosage of 400-800 mg daily. fluconazole embryopathy was previously reported in 4 cases. The common features that were also seen in the current case include multiple synostosis (including craniosynostosis and digital synostosis), congenital heart defects, skeletal anomalies, and recognizable dysmorphic facial features. CASE: We report the case of a 9-month-old male born to a 30-year-old woman following a 37-week pregnancy. The pregnancy was complicated by maternal human immunodeficiency virus (hiv) infection and multiple drug exposures, including fluconazole (400 mg/day) until the fifth month and then from 6 months to term, efavirenz, nevirapine, methadone, dapsone, pentamidine, and trimethoprim-sulfamethoxazole. At birth the infant had seizures related to neonatal abstinence syndrome and was noted to have multiple congenital anomalies. On examination at age 9 months, he had craniosynostosis secondary to coronal and lambdoidal suture closures, shallow orbital region, hypoplastic supraorbital ridges, hypertelorism, and mild ptosis. He had radioulnar synostosis and metacarpophalangeal-proximal interphalangeal symphalangism of D2-D5 bilaterally. CONCLUSIONS: The findings of cranial synostosis, multiple symphalangism, and long-bone abnormalities in our case are typical of other reported cases of fluconazole embryopathy. Our patient showed no evidence of embryopathy due to efavirenz, and he did not have the features of Antley-Bixler or other craniosynostosis syndromes. We review the literature regarding the teratogenic effects of prenatal exposure to fluconazole and provide additional evidence that prenatal fluconazole exposure has a clearly identifiable phenotype.- - - - - - - - - - ranking = 3keywords = embryo (Clic here for more details about this article) |
8/20. Congenital rubella cataract: a timely reminder in the new millennium?Maternal infection with rubella in the first trimester is an important cause of congenital cataract. Any injury affecting the foetus following maternal rubella infection in the phase of organogenesis results in congenital defects collectively termed as congenital rubella syndrome (CRS). Although rubella embryopathy is a less common cause for congenital cataract than in the past, it is still seen. The number of cases reduced to one in 1997 after which there were no new cases till 2002. However, there have been two new cases of CRS in 2003. Herein another one in early 2004 is reported. Outbreaks of CRS will continue until the percentage of susceptible individuals is reduced to a minimum through immunization. The majority of rubella cases in australia are confined to young female immigrants, many coming for marriage. We must continue to immunize children, identify and immunize vaccine failures and susceptible women before they become pregnant, and to screen pregnant women so they can be vaccinated after delivery.- - - - - - - - - - ranking = 1keywords = embryo (Clic here for more details about this article) |
9/20. Varicella embryopathy.Varicella embryopathy is a rare entity afflicting infants born to mothers who have contracted varicella during the first 20 weeks of pregnancy. The teratogenicity of varicella has not been established from epidemiologic studies, but isolated case reports describe characteristic malformations following early maternal infection. We describe a male neonate delivered at 40 weeks' gestation to a 26-year-old grava 2, para 2 mother who developed varicella during the first trimester. The infant lived 7 days and died of bronchopneumonia. At postmortem examination there was growth retardation, multiple cicatricial skin lesions, flexion contractures of all major joints, hypoplastic right diaphragm, bilateral hydroureters and mucosal fibrosis of the trachea, as well as intestinal fibrosis and colonic stricture. The brain contained areas of cystic necrosis involving the frontal, parietal, temporal, and occipital lobes, with generalized ventriculomegaly. The midbrain, pons, and medulla were hypoplastic. There was denervation atrophy of muscles of the lower limbs and loss of dorsal root ganglia as well as of neurons of the anterior horn of the spinal cord. The cerebral white matter was degenerated, with proliferation of reactive astrocytes. chorioretinitis was not observed. Immunocytochemical stains using two commercially available antivaricella antibodies were negative in all tissues examined. The sporadic nature and pathogenesis of the varicella embryopathy, which may have been caused by focal defects in the fetal T-cell immune response, are discussed.- - - - - - - - - - ranking = 6keywords = embryo (Clic here for more details about this article) |
10/20. Confirmed rabies exposure during pregnancy: treatment with human rabies immune globulin and human diploid cell vaccine.A review of the literature shows 24 cases of pregnant human exposure to rabies virus through confirmed rabid animal bites. Historically, these patients received passive immunization with equine rabies immunoglobulin and/or purified vero cell vaccine or duck embryo vaccine. With the recent development of human-derived rabies vaccines, we report an additional case of human gestational rabies exposure, which was treated with human rabies immune globulin and human diploid cell vaccine.- - - - - - - - - - ranking = 1keywords = embryo (Clic here for more details about this article) |
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