I'll keep my eyes open. Good luck on your quest.
---
> -----Original Message-----
> From: James S Smeltzer MD [SMTP:gaperina@mindspring.com]
> Sent: Wednesday, January 27, 1999 6:24 AM
> To: Multiple recipients of list
> Subject: Re: Ultrasound markers of fetal anemia
>
> Addendum:
>
> I was told by reliable sources (Josh?) at the SMFM (SPO) that VMax of the
> MCA is a reliable indicator for need for invasive testing (amnio,
> cordocentesis), which makes sense to me teleologically, as my subspecialty
> thesis was on how great the MCA is for determining fetal reserve, but
> darned if I can find the reference to prove this in medline!?? Help me
> out
> here! - Jim S
>
> At 09:54 PM 1/19/1999 -0600, you wrote:
[DuBose, Terry] <snip >
[DuBose, Terry]
Ovid Technologies, Inc. Email Service
------------------------------
Search for: from 13 keep 1-2
------------------------------
Citations: 1-2
------------------------------
***************************
Database: Medline <1995 to January 1999 Week 4>
--
Search Strategy (Your Citations from Set 14):
----------------------------------------------------------------------------
-
----------------------------------------------------------------------------
1 "FETAL".mp.
----------------------------------------------------------------------------
19013
2 Ultrasonography, doppler/ or Ultrasonography, doppler,
4534
color/ or Ultrasonography, doppler, duplex/ or
Ultrasonography, doppler, pulsed/
3 Blood flow velocity/ or Brain/ or Cerebral arteries/ or
38585
Cerebrovascular circulation/
4 1 and 2 and 3
189
5 limit 4 to human
178
6 "TESTING".mp.
25093
7 5 and 6
1
8 from 7 keep 1
1
9 4 and 6
1
10 "DOPPLER".mp.
9550
11 1 and 3
1180
12 10 and 11
262
13 6 and 12
2
14 from 13 keep 1-2
2
***************************
<1>
[Use Link to view the full text]
Unique Identifier
98059030
Authors
Bernstein PS. Minior VK. Divon MY.
Institution
Department of Obstetrics and Gynecology, Albert Einstein College of
Medicine,
Bronx, NY 10461-2373, USA.
Title
Neonatal nucleated red blood cell counts in
small-for-gestational age fetuses with abnormal umbilical artery
Doppler studies.
Source
American Journal of Obstetrics & Gynecology. 177(5):1079-84, 1997 Nov.
Local Messages
*ALL AT: UAMS*
Abstract
OBJECTIVE: The presence of elevated nucleated red blood cell
counts in neonatal blood has been associated with
fetal hypoxia. We sought to determine whether
small-for-gestational-age fetuses with abnormal umbilical artery
Doppler velocity waveforms have elevated
nucleated red blood cell counts. STUDY DESIGN: Hospital
charts of neonates with the discharge diagnosis of small for gestational
age
(birth weight < 10th percentile) who were delivered between October 1988
and
June 1995 were reviewed for antepartum testing, delivery
conditions, and neonatal outcome. We studied fetuses who had an umbilical
artery systolic/diastolic ratio within 3 days of delivery and a complete
blood cell count on the first day of life. Multiple
gestations, anomalous fetuses, and infants of diabetic mothers were
excluded.
Statistical analysis included the Student t test, chi 2 analysis, analysis
of
variance, and simple and stepwise regression. RESULTS: Fifty-two infants
met
the inclusion criteria. Those with absent or reversed end-diastolic
velocity (n = 19) had significantly greater nucleated red
blood cell counts than did those with end-diastolic
velocity present (n = 33) (nucleated red
blood cells/100 nucleated cells +/- SD: 135.5 +/- 138 vs
17.4 +/- 23.7, p < 0.0001). These infants exhibited significantly longer
time
intervals for clearance of nucleated red blood cells from
their circulation (p < 0.0001). They also had lower birth
weights (p < 0.05), lower initial platelet count (p = 0.0006), lower
arterial
cord blood pH (p < 0.05), higher cord blood
base deficit (p < 0.05), and an increased likelihood of cesarean section
for
"fetal distress" (p < 0.05). Multivariate analysis
demonstrated that absent or reversed end-diastolic velocity
(p < 0.0001) and low birth weight (p < 0.0001) contributed to the
elevation
of the nucleated red blood cell count, whereas gestational
age at delivery was not a significant contributor. CONCLUSION: We observed
significantly greater nucleated red blood cell counts and
lower platelet counts in small-for-gestational-age fetuses with abnormal
umbilical artery Doppler studies. This may suggest that
antenatal thrombotic events lead to an increased placental impedance.
Fetal response to this chronic condition may result in an
increased nucleated red blood cell count.
<2>
Unique Identifier
97132555
Authors
Mari G. Abuhamad AZ. Keller M. Verpairojkit B. Ment L. Copel JA.
Institution
Department of Obstetrics and Gynecology, Yale University, New Haven, CT,
USA.
Title
Is the fetal brain-sparing effect a risk
factor for the development of intraventricular hemorrhage in the preterm
infant? [see comments].
Comments
Comment in: Ultrasound Obstet Gynecol 1997 Jun;9(6):429
Source
Ultrasound in Obstetrics & Gynecology. 8(5):329-32, 1996 Nov.
Local Messages
*PART AT: UAMS (CHECK ONLINE CATALOG)*
Abstract
The intrauterine identification of fetuses at risk of developing
intraventricular hemorrhage would be helpful to the perinatologist, in
light
of the recent results which suggest that indomethacin given to the infant
reduces the risk of developing intraventricular hemorrhage. We
hypothesized
that fetuses undergoing brain sparing, as identified by a
lowered pulsatility index (PI) in the middle cerebral
artery, and delivered prior to 34 weeks may differ in terms of being at
risk
for intraventricular hemorrhage from those fetuses without the
brain-sparing effect. The middle cerebral
artery PI was studied in 43 fetuses between 25 and 33.6 weeks' gestation.
The
pregnancies were complicated by pre-eclampsia, intrauterine growth
restriction (IUGR) and preterm labor. A cranial sonogram was performed
during
the first postnatal week in all the neonates. Intraventricular hemorrhage
was
present in 6/22 infants with a normal middle cerebral artery
PI (group A) and 0/21 with an abnormal middle cerebral
artery PI (group B) (p < 0.05). The mothers of the six fetuses who
developed
intraventricular hemorrhage underwent preterm labor. IUGR fetuses and
pre-eclampsia were more common in group B. No difference was found between
the two groups when the following variables were compared: (1) gestational
age at the time of the Doppler study; (2) gestational age at
delivery; (3) antenatal exposure to steroids; (4) antenatal exposure to
magnesium; (5) Apgar score greater than 6 at 5 min; (6) respiratory
distress
syndrome in the newborn; (7) necrotizing enterocolitis; (8) Cesarean
section;
and (9) sepsis in the infant. Although the mean birth weight was
significantly lower in group B than group A, no fetus in this group
developed
intraventricular hemorrhage. The fetal
brain-sparing effect, pre-eclampsia and IUGR were associated
with a lower risk of neonatal intraventricular hemorrhage than was preterm
labor. Preterm labor appears to be a key factor in the development of
intraventricular hemorrhage and must be included when
testing associations with intraventricular hemorrhage.
