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The prevalence of antibodies for one or more HCV antigens was 2.3% of 1,347 mothers at childbirth. Compared with the principal factors studied, the presence of antibodies was more frequent in women who were carriers of HIV infection (3/3), in those who had suffered liver diseases (5/37) or who had had transfusion (3/25). This was as opposed to women who did not have any risk factor (p < 0.001). The prevalence of HCV-RNA was 1.3%; in relation to the antibody state, such a condition was more frequent in subjects with antibodies for 3 or 4 antigens (about 80%) compared with those who were positive for 1 or 2 antigens. HCV-RNA of the same genotype as the mother (type 1; 1a) was also found in the funicular blood of 2 of the 18 babies born to mothers who were positive for HCV-RNA. In the course of the follow-up (from the 3rd to the 18th month) the viral RNA was not found in any of the babies, nor was it found in the 2 who were positive at birth. Even the antibodies gradually disappeared, although slowly. At the 10th month, 91% of the babies resulted as having no antibodies and at the 18th month none of the babies resulted as having antibodies. Breast-feeding also appeared to have no influence on the transmission of the infection; out of 18 viremic mothers indeed 12 (67%) breast-fed their babies.

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Double umbilical pulsatile venous flow is a rare event generally associated with fetal right heart failure. We observed, at 21 weeks' gestation, this venous flow pattern in a case of twin-twin transfusion syndrome occurring in the recipient twin affected by severe hydrops. In spite of a spontaneous remission of fetal hydrops at 30 weeks, the fetus died suddenly in utero, 2 weeks later. We hypothesized that this unexpected event was related to reversed acute twin-twin transfusion, and concluded that fetal hydrops remission in twin-twin transfusion syndrome must not be considered as a reassuring prognostic index but as an indication of the need for continuing biophysical monitoring.

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In 62 cases of gynecological malignancies, 16 of the ovarian, 31 of the endometrium and 15 of the cervix, the EGF-R status was evaluated in order to establish its prognostic value and its correlation with other classical prognostic factors. We have failed to demonstrate any correlation between EGF-R status and stage, grade and hormonal receptors, ER/PgR, in ovarian and cervical cancer. In contrast, in endometrial cancer, we observed significantly lower levels of EGF-R in poorly differentiated tumors. Moreover, a weak negative relationship between EGF-R and PgR status was found. Regarding survival, we noticed a better prognosis in patients with ovarian cancer EGF-R positive, but without statistical significance.

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Using a 3.5-MHz duplex Doppler system, 45 normal-growth and 45 growth-retarded fetuses were studied between 30-41 weeks' gestation. Velocity recordings were obtained from the middle cerebral artery and umbilical artery to calculate the ratio between the two pulsatility indexes. The cerebral-umbilical Doppler ratio is usually constant during the last 10 weeks of gestation. Therefore, a single cutoff value (1.08) was used, above which velocimetry was considered normal and below which it was considered abnormal. The cerebral-umbilical Doppler ratio provided a better predictor of small for gestational age newborns and adverse perinatal outcome than either the middle cerebral artery or umbilical artery alone. In fact, in predicting those newborns who were small for gestational age, the cerebral-umbilical ratio had a 70% diagnostic accuracy [(true positive + true negative)/total number of cases], compared with 54.4% for the middle cerebral artery and 65.5% for the umbilical artery. The results were more encouraging for prediction of adverse perinatal outcome; diagnostic accuracy for the cerebral-umbilical ratio was 90%, compared with 78.8% for the middle cerebral artery and 83.3% for the umbilical artery.

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We have prospectively studied 117 premature infants < or = 1500 gm (VLBW) to assess the relationship between maternal, obstetric, fetal and newborn complications and the grade of periventricular-intraventricular hemorrhage (PVH-IVH). PVH-IVH was documented by cranial ultrasonography in 41% of surviving neonates. 83% of infants with PVH-IVH grade I-II survived as compared to the 39% of infants with PVH-IVH grade III-IV (p < .001). Maternal and obstetric complications were not associated with PVH-IVH (NS). Newborn respiratory complications (p < .004) and major infections (p < .02) are independent variables associated with PVH-IVH. Immaturity at delivery, metabolic acidosis, respiratory distress syndrome and recurrent apnea are important mechanisms of cerebral injury contributing to severity of PVH-IVH.

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The motor activity of myometrial strips from pregnant human uterus was characterized in vitro by the use of inhibitory compounds acting on the smooth muscle contractility at different levels. Spontaneous contractions were not inhibited by tetrodotoxin or a series of membrane receptor antagonists, like anticholinergics, antihistaminics, alpha-adrenergic blocking agents, antiserotoninergics and opioid receptor antagonists, thus excluding neuronal involvements or a local release of endogenous mediators active on the respective membrane receptors. The ineffectiveness of indomethacin (10(-5) M) minimizes a role for excitatory prostaglandins. Isoprenaline and selective beta 2-adrenergic stimulants, like salbutamol and hexoprenaline (up to 10(-5) M), failed to affect the amplitude of spontaneous contractions. Conversely the adenylate cyclase activator, forskolin, had a concentration-dependent inhibitory effect. Ca2(+)-free medium, trifluoperazine and all the calcium channel blockers examined produced a concentration-dependent inhibition of the spontaneous contractions in the following order of sensitivity: nifedipine much greater than verapamil much greater than diltiazem greater than trifluoperazine. The inhibitory effect of nifedipine was not overcome by excess calcium concentration in the bathing medium, but was completely restored by addition of the calcium agonist Bay K 8644 10(-7) M. From these data it can be concluded that the spontaneous activity of pregnant human myometrium in vitro is independent of neural or humoral mechanisms. The inhibitory effect of Ca(+)-free medium and the efficacy of calcium channel blockers support the view that calcium influx is an important step in initiating the contractile activity of uterine smooth muscle.

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The Authors have executed a retrospective study about the incidence of intrahepatic cholestasis in pregnancy in 85 patients hospitalized in the department of Obstetrics and Gynaecology, University of Parma. Particularly, they have investigated about the incidence of fetal distress, about the intrauterine death, and about poor intrauterine fetal growth.

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