Changes in fetal hemodynamics with ritodrine tocolysis.

OBJECTIVE: To evaluate the effect of ritodrine on the fetal cardiovascular system. METHODS: Cardiac and extracardiac Doppler waveforms were recorded in 12 fetuses prior to and during ritodrine therapy used for preterm labor. Maternal and fetal heart rates, the Doppler pulsatility indices of the umbilical artery, middle cerebral artery, descending thoracic aorta and renal artery, and time velocity integrals of the atrioventricular valves and the ductus arteriosus, were measured. RESULTS: Ritodrine infusion caused an increase in maternal and fetal heart rates, the left cardiac output as measured by the product of time velocity integral and heart rate, and the pulsatility index of the middle cerebral artery, and a decrease in the pulsatility index of the umbilical artery. CONCLUSIONS: Ritodrine infusion may alter placental and cerebral blood flow and may have a selective effect on the left side of the heart.

Effect of hysterectomy on ovarian blood supply and function.

Ovarian blood supply and function were assessed before and after hysterectomy in 43 patients and 30 healthy subjects (control group). Before the hysterectomy, transvaginal colour Doppler resistance index values of ovarian artery and hormonal levels were measured. Five days and 6 months after operation, all these measurements were repeated and compared with those of a control group. The sole hormone whose serum level decreased on the 5th postoperative day was oestradiol. Serum levels of all the other hormones remained unchanged 5 days and 6 months after the surgical operations. We also did not find any statistically significant difference between the preoperative, the postoperative and the control group resistance index of the ovarian arteries. We propose that the decision whether to preserve or remove the ovaries must be based on assessment of their functional status. Advantages and disadvantages of leaving ovaries intact should be carefully evaluated and the most useful approach applied to each patient on an individual basis.

Twin sisters with impetigo herpetiformis.

Impetigo herpetiformis is a rare and serious pustular eruption resembling pustular psoriasis that mostly occurs in pregnant women. The etiology of the disease is unclear and it is not known if genetic factors play a role. We present two sisters (twins) with impetigo herpetiformis supporting an inheritance pattern.