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Se analizó el plasma residual obtenido del cordón umbilical de 481 recién nacidos a término, sanos, de la provincia de Sancti Spiritus, para determinar a través de métodos enzimáticos y colorimétricos el colesteroltotal y triglicéridos. Se halló la concentración máxima normal del colesterol mediante el cálculo del límite de tolerancia superior (3,15 mmol/L). Diez recién nacidos (2,07 por ciento ) tienen un alto riesgo de padecer de una hipercolesterolemia familiar

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in order to determine the effect of maternal exercise on maternal nutritional status and fetal growth, young (Y=45-50 days old) Wistar rats were divided into 4 groups of 5 to 8 animals: control pregnant (CP), control non-pregnant (CNP), exercise-trained (swimming 1 j/day, 5 days/week, for 19 days) pregnant (TP) and exercise trained non-pregnant (TNP). Four equivalent groups of adult rats (A=90-100 days old) were also formed. Serum glucose, total protein, albumin, hematocrit and liver glycogen were determined in female rats and pups. There were no statistical differences in serum glucose, total protein and albumin levels, litter size or birth weight among exercise-trained animals, controls and their respective pups. Hematocrit was significantly lower in pups of exercise-trained young and control rats of the same age and physiological status (YCNP+4.1 ñ 0.2; YCP = 2.7 ñ 0.9; YTNP + 4.9 ñ 0.8; YTP = 2.7 ñ 0.4; ACNP = 6.1 ñ 0.6; ACP = 3.1 ñ 0.8; ATNP = 6.6 ñ 0.8; ATP = 2.2 ñ 0.9 mg/100 mg). We conclude that pups of adult female rats are spared from the effects of this kind of exercise training during pregnancy. On the other hand, it appears that maternal adaptations to exercise training in young rats are able to preserve only some aspects of pup metabolism

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Foram estudadas 599 amostras de sangue do cordäo umbilical de recém-nascido de Porto Alegre, através de métodos eletroforéticos. A prevalência de Hb Bart's foi de 3,7%, com uma freqüência maior em bebês negros (5,4%) do que em brancos (2,5%). Vinte e um recém-nascidos apresentaram níveis de Hb Bart's entre 1 e 4%, e um 5,1% desta hemoglobina. Esta criança apresentou uma reduçäo no VCM e HCM compatíveis com o traço talassêmico, sendo, portanto, classificada como homozigota para talassemia alfa+, enquanto os recém-nascidos com níveis mais baixos de Hb Bart's foram considerados heterozigotos para esta condiçäo. Cálculos de máxima verossimilhança indicaram que este método detecta somente a metade dos indivíduos-alfa/alfa alfa. Sendo assim, a prevalência do haplótipo-alfa foi estimada em 6% e 2,5% entre negroides e caucasóides, respectivamente. O número de eritrócitos e outros parâmetros hematológicos, a idade gestacional, o peso e os índices de Apgar näo diferiram significativamente entre os bebês e os portadores da Hb Bart's

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To assess the immediate postnatal changes of serum immunoreactive erythropoietin (EP) in infants born after acute or chronic fetal hypoxia, and to estimate the rate of EP disappearance, we studied EP concentration, measured by double-antibody radioimmunoassay, in cord venous plasma and in serum at a mean age of 8 hours in a control group (n = 9) and in three patient groups: (1) infants with polycythemia (n = 10), (2) infants born to mothers with preeclampsia of pregnancy, without (n = 22) or with (n = 11) acidosis at birth, and (3) infants with acute birth asphyxia (n = 19), seven of whom had postnatal hypoxia. In all patient groups, cord venous EP was elevated in comparison with values in control infants. No change was found in EP level between birth and 8 hours in control infants (geometric mean in cord and 8-hour sample: 20 and 16 mU/ml, not significant) or in acutely asphyxiated infants with postnatal hypoxia (122 and 72 mU/ml, not significant), whereas the EP level decreased in all other groups: infants with polycythemia (123 to 24 mU/ml, p less than 0.001), nonacidotic infants (78 to 26 mU/ml, p less than 0.001) and acidotic infants (176 to 38 mU/ml, p less than 0.001) of the preeclampsia group, and acutely asphyxiated infants without postnatal hypoxia (58 to 30 mU/ml, p less than 0.001). The mean (+/- SD) half-time of EP disappearance was 2.6 +/- 0.5 hours in infants with polycythemia and 3.7 +/- 0.9 hours in infants of the preeclampsia group.

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After ultrasonographic diagnosis of oligohydramnios and megabladder presumably caused by urethral obstruction in a 23 weeks gestation fetus, the authors decided for the placemtne of a catheter connecting the fetal bladder cavity to the amniotic chamber. Afterwards, taking into consideration the known association between urinary tract malformations and chromossomic abnormalities, a cordocentesis was performed despite difficulties imposed bu oligohydramnios and postfundal positioning of the placenta. Tests results were avaiable in three days, revealing trisomy 21. The authors conclude that whenever fetal malformation presents itself, chromossomic studies are mandatory before any type of intrauterine therapeutic measure is tried. After the 20th week of gestation cordocentesis is preferable to amniocentesis because it provides quicker results

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Because several human hematopoietic growth factors have been identified and shown to be effective for treatment of congenital or iatrogenic neutropenias, and cord blood contains stimulatory activities for blood-forming cells, we postulated that identification of these factors and analysis of their regulatory role in normal neonates would provide a rationale for their use in treating neonatal infections associated with neutropenia. We studied the plasma levels of granulocyte and granulocyte-macrophage colony-stimulating factors (G-CSF and GM-CSF, respectively) and the frequency of granulomonopoietic colony-forming cells (CFU-GM) in the umbilical cord blood of normal term neonates. Plasma growth factor levels were measured by a biologic assay. Circulating hematopoietic progenitors were assayed for colony formation with different recombinant growth factors used as exogenous growth stimulators. The cell cycle status of these progenitors was analyzed by the thymidine suicide technique. At birth the leukocyte count (mean +/- SD) was 11.0 +/- 3.9 x 10(9)L and the neutrophil count was 5.6 +/- 2.6 x 10(9)/L. The incidence of CFU-GM was significantly higher in umbilical cord blood than in normal adult peripheral blood (p less than 0.005) with up to 40% of the cells in S phase (less than 10% in normal adults). Plasma levels of G-CSF and GM-CSF at birth were 40.8 +/- 2.8 U/ml and 19.9 +/- 5.2 U/ml, respectively (normal adult plasma levels 2.5 +/- 1.5 U/ml for G-CSF and undetectable for GM-CSF). These high levels of G-CSF and GM-CSF in umbilical cord blood of normal neonates might play a role in maintaining adequate neutrophil production.

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Because prenatal exposure to polychlorinated biphenyls (PCBs) and related contaminants has been associated with reduced birth weight, neonatal behavioral anomalies, and poorer recognition memory in infants born to women who have consumed Lake Michigan sports fish, 236 children, previously evaluated for PCB-related deficits in infancy, were assessed at 4 years of age. Prenatal exposure (indicated by umbilical cord serum PCB level) predicted poorer short-term memory function on both verbal and quantitative tests in a dose-dependent fashion. These effects cannot be attributed to a broad range of potential confounding variables, the impact of which was evaluated statistically. Although much larger quantities of PCBs are transferred postnatally via lactation than prenatally across the placenta, exposure from nursing was unrelated to cognitive performance. The data demonstrate the continuation of a toxic impact received in utero and observed initially during infancy on a dimension of cognitive functioning fundamental to learning.

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We conducted a prospective study to determine (1) the maternal-fetal vitamin K1 transport in premature infants after vitamin K1 was given to the mothers antenatally and (2) the vitamin K1 effects on blood coagulation in the babies. Women in labor at less than or equal to 34 weeks of gestation were randomly selected to receive antenatal vitamin K1, 5 mg given intramuscularly (vitamin K1 group), or no vitamin K1 (control group). Eight infants, including one set of twins, were in the vitamin K1 group and six in the control group. Vitamin K1 concentrations were higher in the vitamin K1 group than in the control group (p = 0.06). Activated partial thromboplastin time was prolonged, and factor II coagulation activity and factor II antigen were proportionately decreased in cord plasma in both groups. The average ratio of factor II coagulation activity to antigen was not decreased in either group. Protein induced by vitamin K absence-II (PIVKA-II) was not detectable in any cord plasma sample in either group. These findings support previous reports that the decreased vitamin K-dependent coagulation activity in premature infants is the result of reduced synthesis of precursor proteins, rather than the result of vitamin K deficiency, and suggest that additional vitamin K1 is not likely to improve coagulation activity. Among those infants who underwent cranial ultrasonography, all four in the vitamin K1 group and one of five in the control group had mild intraventricular hemorrhage. Studies of a larger number of patients are necessary before it can be established that maternal antenatal administration of vitamin K1 results in improvement of coagulation and the prevention of intraventricular hemorrhage in premature infants.

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Os autores apresentam uma proposta de técnica de corocentese para obtençäo de amostra sangüínea fetal pura, baseada na experiência do Centro de Medicina Fetal de Goiânia. Descrevem materiais utilizados, táticas para a escolha do local de punçäo cutânea, assepsia e anti-sepsia, introduçäo da cordoagulha, dados de inserçäo do cordäo, confirmaçäo quanto a localizaçäo do vaso puncionado, coleta e acondicionamamento do sangue fetal, com ou sem administraçäo de medicamntos, sangue e/ou seus derivados. Os autores com isto acreditam estar contribuindo com uma etapa importante para o desenvolvimento da propedêutica diagnóstica e terapêutica em Medicina Fetal

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Os autores analisam um total de 29 cordocenteses realizadas em 22 pacientes no Centro de Medicina Fetal de Goiânia (Fêmina Diagnóstico), no período de novembro de 88 a junho de 1989. Relacionam a aceitaçäo do método pelas pacientes, sendo as indicaçöes principais isoimunizaçäo pelo fator Rh e síndrome infecciosa. da Gestaçäo (toxoplasmose). Correlacionam a localizaçäo placentária e a dificuldade técnica do método, assim como a presença de intercorrências, e concluem ser o metodo atual de escolha para obtençäo de amostra sangüínea fetal pura, associado a um baixo risco para o feto

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Thirty newborn babies delivered by elective caesarean section were studied. They were randomly placed in two groups. The first group consisted of newborns who scored 3 or less on the Apgar scale at one minute and 8 or more after five minutes. The other group included newborns which scored 8 or higher at one minute and 9 at five minutes. Blood samples were obtained from the umbilical cord which allowed for the measuring of the infants' pH, serum gases and pyruvic lactic acid levels. An increased level lactate was found in asphyctic infants. Five cases presented lactic acidosis which continued to be persistent in four of them an hour after they were born. Although increased levels of lactate were found also in the control group, they never presented lactic acidosis. No correlation was found between the pH and lactate levels nor between lactate and bicarbonate. A clear correlation between lactic acidosis and fetal distress was documented. It was concluded that lactate quantification is a useful indicator of neonatal asphyxia. Lactic acidosis; Apgar scores; asphyxia.

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Thirty cesarean section-delivered newborn were studied. Fifteen of them scored from 0 to 3 and, 8 and greater on the Apgar scale when measured at one and five minutes, respectively. The other 15 scored 8 or more at one minute and 9 at five minutes. Arterial electrolyte and blood gases were measured in samples obtained from the umbilical cord. The anion gap formula was then applied. The average weight of the depressed newborns was found to be less than for those of the control group. The mean gestational age for both groups was 39 weeks. The average values for electrolyte, bicarbonate and the anion gap were found to be practically the same in both groups. No correlation was found between the pH and the gap nor for the gap and the hydrogen ion concentration [H+]. The correlation between the gap and the bicarbonate was 0.78. No differences were seen between anion gap values for the newborn with lactic acidosis or hyperlactemia when compared to those of the control group. It is therefore concluded that the anion gap is not useful for the detection of newborns suffering from metabolic acidosis. Anion gap; bicarbonate; Apgar score; depressed neonates; metabolic acidosis.

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Con el objetivo de conocer la actividad de las células beta fetales, se determinaron las concentraciones de glucosa, insulina libre y total, y anticuerpos antiinsulínico en el líquido amniótico y la sangre del cordón umbilical de 11 gestantes diabéticas insulinodependientes y sus hijos, y se compararon con las mismas valoraciones en 5 gestantes no diabéticas. Se encontraron diferencias significativas en todos los casos. Se reafirma que la hiperglicemia materna provoca hiperinsulinismo fetal y por ende es causa de la alta morbilidad neonatal en el hijo de madre diabética

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