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Re: hiccupsFrom: ainsron (ainsron@sbcglobal.net)Tue Apr 27 11:36:52 2004
Patients treat it like it is the Bible. "It is true because I saw it there." Never mind that there is no supporting data, simply author's opinion. There is not a lot of supporting information I could find on fetal hiccups. Fetal hiccups in the baboon. American Journal of Physiology. 267(6 Pt 2):R1479-87, 1994 Dec. Bouts of hiccuping are recognized by pregnant women as distinct episodic movements of their fetuses. Ultrasound imaging of these fetuses has documented the occurrence of hiccups from early gestation through parturition. This study provides a systematic characterization of prenatal hiccuping in the fetal baboon (Papio species). Tracheal fluid pressure was recorded from 11 chronically instrumented fetal baboons for 21.5 +/- 7.3 consecutive days (mean +/- SD) over a range in gestation from 124 to 164 days (term 175 days). In an initial review of pressure recordings by visual inspection, hiccups were recognized as distinctive high-amplitude fluctuations in tracheal pressure that were readily discriminated from fetal breaths. Automated techniques were then developed and validated to detect hiccups and summarize their features. The mean hiccup amplitude was w 23.0 +/- 3.1 mmHg, inspiratory time was 0.26 +/- 0.03 s, and expiratory time was 0.27 +/- 0.02 s. Each of these features discriminated hiccups from breaths (P < 0.001). Hiccuping incidence (1.8 +/- 0.4% of time), rate (26.2 +/- 6.2 min-1), bout duration (4.3 +/- 0.8 min), and the interval between bouts (3.35 +/- 0.60 h) were also different (P < 0.01) from breathing. These features of hiccups remained relatively constant over the latter third of gestation with the exception of an increase in duration of the expiratory time interval (r = 0.54, P < 0.01). Despite their vigorous nature, bouts of hiccuping were not associated with transitions in behavioral state. Moreover, the features of hiccups were not differentiated by state. Bouts of hiccuping recurred in a cyclic fashion, on average every 3-4 h. Journal of Ultrasound in Medicine. 12(11):641-3, 1993 Nov Absent and reversed UA end-diastolic blood flow is usually a poor prognostic sign. However, in 19 fetuses evaluated in the Fetal Diagnosis and Treatment Unit, we observed an unusual pattern of intermittent, significantly decreased, or reversed UA blood flow that coincided with a demonstration of fetal hiccuping. No evidence of cardiac arrhythmia, heart failure, or uteroplacental dysfunction was found in these fetuses. With one exception, all Doppler evaluations were otherwise normal. A potential mechanism of intermittent fetal UA blood flow reversal is discussed. Ronald E. Ainsworth -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Richard Chudacoff, MD Sent: Tuesday, April 27, 2004 8:45 AM To: Multiple recipients of list OB-GYN-L Subject: Re: hiccups I hate that book Richard Chudacoff, MD I will never be an old man. To me, old age is always 15 years older than I am. Francis Bacon Imagination was given to man to compensate him for what he is not; a sense of humor to console him for what he is. Francis Bacon -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Dr. Ainsworth Sent: Tuesday, April 27, 2004 10:35 AM To: Multiple recipients of list OB-GYN-L Subject: hiccups A patient recently asked about fetal hiccups in pregnancy and was concerned because she read (and brought in a copy for me to read) a section in "What to expect when you are expecting," that stated frequent hiccups in late pregnancy, >2-4 times daily, is associated with cord entanglements or knots. I have never seen a reference to that before, has anyone else?
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