ABSTRACT
In two cases of erythroblastosis fetalis, combined intravascular and intraperitoneal transfusions were used successfully.
Subject(s)
Blood Transfusion, Intrauterine , Blood Transfusion/methods , Erythroblastosis, Fetal/therapy , Adult , Combined Modality Therapy , Female , Humans , Infant, Newborn , Male , Peritoneum , PregnancyABSTRACT
Benign familial macrocephaly is an autosomal dominant disorder associated with a large absolute circumference of the head. In this disorder serial growth demonstrates a proportional rather than an excessive rate of growth. To date, we are not aware of any published case reports that confirm the diagnosis prenatally. We report a case of benign familial macrocephaly diagnosed in utero by ultrasonographic evaluation. This case report points out the necessity of combining appropriate family history and physical examination in cases of prenatally detected anomalies.
Subject(s)
Brain Diseases/diagnosis , Gigantism/diagnosis , Head/abnormalities , Prenatal Diagnosis , Adult , Brain Diseases/congenital , Brain Diseases/genetics , Female , Gigantism/congenital , Humans , Pregnancy , UltrasonographyABSTRACT
Most maternal serum alpha-fetoprotein (MSAFP) screening programs are set up with the goal of prenatal detection of fetal neural tube defects. It is also commonly accepted that MSAFP testing yields many false-positive results. Screening programs commonly utilize schemata that identify abnormal levels of MSAFP as greater than 2.5 multiples of the median (MOM) and also recommend two abnormal values before initiating ultrasound evaluation. Our pilot program evaluating obstetric outcomes found that 21 of the 29 women with elevated MSAFP values (greater than 2.0 MOM) eventually developed significant pregnancy management changes or complications of pregnancy. Thus, we believe that the use of MSAFP screening solely for the purpose of detecting fetal neural tube defects is inconsequential relative to its usefulness in detecting other pregnancy abnormalities. We also believe that ultrasound evaluation should be accomplished after the first abnormal value and that the cutoff of 2.5 MOM should be lowered to at least 2.0.
Subject(s)
Fetal Monitoring/methods , Neural Tube Defects/diagnosis , alpha-Fetoproteins/analysis , Adult , Evaluation Studies as Topic , Female , Humans , Pregnancy , Pregnancy OutcomeABSTRACT
Magnetic resonance imaging has been of limited value in fetal evaluation due to the prolonged duration of image construction and uncontrolled fetal movement. This limitation can be overcome safely by immobilizing the fetus with an intramuscular injection of pancuronium bromide.
Subject(s)
Fetal Movement/drug effects , Magnetic Resonance Imaging , Pancuronium/therapeutic use , Adult , Congenital Abnormalities/diagnosis , Female , Humans , Injections, Intramuscular , Pancuronium/administration & dosage , PregnancyABSTRACT
Recent court decisions and advances in medical technology have put the doctor in the position of serving many masters at the same time. The conflicts created often do not deal with good or bad medicine, but rather with the concept of alternative choices. It is unfair to ask the medical field to be solely responsible for making decisions involving such widespread social and economic consequences.
Subject(s)
Congenital Abnormalities , Disclosure , Gynecology , Informed Consent/legislation & jurisprudence , Malpractice/legislation & jurisprudence , Obstetrics , Amniocentesis , Confidentiality/legislation & jurisprudence , Female , Humans , Infant, Newborn , Maternal Age , Obstetrics/standards , Pregnancy , Pregnancy, High-Risk , Pregnant Women , Risk , United States , alpha-Fetoproteins/analysisABSTRACT
A total of 1312 nonstress tests were performed in the 14-month period between May 1, 1981, and June 30, 1982. There were 323 tests in 194 patients that were nonreactive and subsequently required a contraction stress test using nipple stimulation. The authors found that the results obtained using nipple stimulation were as predictable as contraction stress tests using oxytocin infusion.
