Congenital glioblastoma coexisting with vascular developmental anomaly.

Congenital central nervous tumours form a unique group of neoplasms. They are different from other tumour groups not only due to the onset time but also to their histopathology, anatomic location, and biologic behaviour. Congenital glioblastoma is one of the rarest types of congenital brain tumours and is uncommon in the prenatal period. We report a rare case of congenital glioblastoma detected prenatally by ultrasound examination and magnetic resonance imaging at 26 gestational weeks. Based on MRI findings and consultation of a team of specialists, pregnancy was terminated at 28 weeks. The newborn presented hydrops foetal. The child died shortly after birth due to cardiorespiratory insufficiency. At autopsy a large tumour with a spongy-like appearance was found. The tumour involved nearly the whole right cerebral hemisphere and led to marked hydrocephalus. In the histological and immunohistochemical examination, the tumour presented features of glioblastoma. Neoplastic cells were immunopositive for GFAP, S-100 protein and negative for neuronal markers. Frequent mitoses and high MIB-1 labelling index were seen in the tumour areas. The coexistence of tumour and vascular developmental anomaly was stated. The conglomerates of numerous, distended, thin-walled foetal-like blood vessels were located beside the tumour tissue, which presented disturbance in differentiation and maturation of the vascular net. Such coexistence of malignant glioma with vascular developmental anomaly is unique.

[Prevalence of group B streptococcal colonization in pregnant women and their newborns based on the results of examination of patients in the Obstetric and Gynecology Department of the National Research Institute of Mother and Child--a pilot study]. / Czestosc wystepowania kolonizacji paciorkowcami beta hemolizujacymi grupy B kobiet ciezarnych i noworodkow--okreslona na podstawie badan przeprowadzonych u pacjentek Polikliniki i Kliniki Poloznictwa i Ginekologii Instytutu Matki i Dziecka--badanie pilotazowe.

UNLABELLED: Group B streptococcus is a main cause of perinatal infections and neonatal sepsis. In Poland there is no epidemiological data of the prevalence group B streptococcal colonization in pregnant women and the risk for their newborns. OBJECTIVES: The aim of the study is to define the prevalence of streptococcal B colonization in pregnant women and their newborns. MATERIALS AND METHODS: The pregnant women and their newborns from Obstetric and Gynecology Department of National Research Institute of Mother and Child were included to our study during 2001 and 2002 years. Cervical, vaginal and perianal swab were obtained. Women with positive cultures were treated with antibiotic during labor. The external swabs of their neonate were obtained. RESULTS: 1678 pregnant women took part in our study. The GBS (streptococcus agalactiae) colonization was found in 331 women. The prevalence of pregnant women group B streptococcal colonization in the study is 19.7%. 70 of 203 neonates form mothers with positive results of our screening, had the GBS colonization confirmed. The prevalence of confirmed streptococcal colonization in neonates was 34.5%. One newborn developed early onset neonatal sepsis, during the study period. CONCLUSIONS: The prevalence of pregnant women group B streptococcal colonization about 20%. For the prevention of newborns intrapartum infections a major thing is the prevalence of the transmission risk to newborns from mothers with a GBS colonization and the appropriate intrapartum management.

[Intraamniotic surfactant supply as RDS prevention]. / Doowodniowe podanie surfaktantu jako profilaktyka zespolu zaburzen oddychania--doniesienie wstepne.

The importance of steroids given antenatally to the mothers in prevention of the respiratory distress syndrome (RDS) is unquestionable. Also intra tracheal surfactant application in newborn is proven method of prevention and treatment of RDS. However both options have some limitations and new methods useful in prevention of RDS are still needed. The aim of the study was to evaluate the efficiency and safety of the procedure of the intraamniotic surfactant supply as RDS prevention. Natural surfactant (Alveofact - Boehringer Ingelheim) has been given to 15 women at 24-32 weeks of pregnancy, two hours before expected childbirth (mainly cesarean section). To 8 of these women corticosteroids have been earlier administered. Just before surfactant injection amniotic liquid samples were taken to confirm lung immaturity and the patients were administered Aminophilline intravenously to provoke fetal breathing movements. Surfactant has been administered through the needle under direct ultrasound guidance into the amniotic cavity as close as possible to the fetal mouth and nose. Patients with the evidence of chorionamnionitis and fetal malformations were excluded from the study. No complications were observed during and after the procedure. None of the newborns had symptoms of severe asphyxia, the birth weight comprised between 670-1650 g (mean 1207). There was radiological evidence of RDS in two newborns and in 7 mechanical ventilation was needed. Of 15 newborns 13 survived (86.6%). There was no need for postpartum surfactant therapy in any case. Some authors expressed their view that this method is promising and further studies are desirable. In our study surfactant has been injected into the amniotic cavity shortly before childbirth, and Aminophilline has been administered intravenously in order to provoke fetal breathing movements before surfactant injection. The safety of the procedure was confirmed and the results of intraamniotic surfactant supply seems to be favourable to newborns. Small number of cases does not allow to draw any far-reaching conclusions. Still our preliminary results are encouraging and the study should be continued.