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Middle cerebral artery flow velocity waveforms in normal and small-for-gestational-age fetuses
Citations from the Literature labour were excluded, G. vaginalis was also significantly associated with preterm PROM (OR 2.7, CI 1.1-6.5, P < 0.05). The presence of vaginal enteropharyngeal bacteria (E. coli, Klebsiella spp., Haemophilw spp., Staph. aureus) in the midtrimester was not predictive of preterm birth, but when these organisms were found in labour, they appeared to have been acquired later in the pregnancy. Conclusion: Women carrying G. vaginalis or U. urealyticum during the midtrimester had nearly twice the risk of pretenn birth, while women positive for V. urealyticum had more than a threefold risk of preterm PROM.
The effect of cesuean sectioo 011intraventricular hemorrhage in thepretemlinfallt
Anderson G.D.; Bada H.S.; Shaver D.C.; Harvey C.J.; Korones S.B.; Wong S.P.; Arheart K.L.; Magi11 H.L. USA AM J OBSTET GYNECOL 1992 166/4 (1091-1101) Objective: The null hypothesis is that active labor is a more important factor with regard to both timing and progression of periventricular-intraventricular hemorrhage than is route of delivery. Infants delivered by cesarean section after entering the active phase of labor will behave in a manner similar to that of previously studied infants delivered vaginally as to when periventricular-intraventricular hemorrhage occurs and frequency of progression. Study design: The 106 infants of 85 women delivered by cesarean section were the subjects of this study. Forty-six infants were-in the no-labor group, 33 in the latent-phase labor group and 27 in the active-phase labor group. Head ultrasonographic examinations were performed at delivery, at 1,6, 12 and 24 h and then daily for the first 7 days of life. Continuous variables were compared by one-way analysis of variance among those infants with no hemorrhage or with periventricular-intraventdcular hemorrhage. Categoric variables were compared by chi2 analysis and Fisher’s exact test when appropriate. A P value of co.05 was considered significant. Results: There was no difference in the frequency of early hemorrhage (s I h of age), late hemorrhage (> 1 h of age), or overall periventricular-intraventricular hemorrhage in the infants not in labor, in latent-phase labor, or in active-phase labor at the time of cesarean section. However, the frequency of grade 3 or 4 hemorrhage and the progression of hemorrhage were significantly higher in the infants whose mothers had an active phase of labor compared with infants whose mothers had no labor or did not progress beyond the latent phase. Infants who had early periventricular-intraventricular hemorrhage (S 1 h of age) also had a higher frequency of progression of hemorrhage. Conclusions: Cesarean section before the active phase of labor does not change the overall frequency of hemorrhage but results in a lower frequency of progression to grade 3 or 4 hemorrhage. We do not feel that these data support performing more cesarean sections for preterm delivery as a method of preventing progression of periventricular-intraventricular hemorrhage in the preterm infant.
365
artery flow velocity waveforms in normal and small-for-gest8tional-age fetuses
MiddIe eerehi
Mari G.; Deter R.L. USA AM J OBSTET GYNECOL 1992 16614(1262-1270) The middle cerebral artery flow velocity waveforms were obtained in 16 normal fetuses in a longitudinal study and in 128 normal fetuses in a cross-sectional study with pulsed Doppler ultrasonography. The pulsatility index values of the middle cerebral artery were higher at 25 to 30 weeks’ gestation than those observed during the two periods of major cerebral cellular multiplication in the human fetus. In 9 of the 16 fetuses studied longitudinally we compared the pulsatility index values obtained at the end of gestation with those obtained at 1 month after delivery; no significant difference was observed. The pulsatility index of the middle cerebral artery was also determined in 33 small-for-gestational-age fetuses. A middle cerebral artery pulsatility index value below our normal range was recorded in 9 of the 33 small-for-gestational-age fetuses (27.3%). These small-for-gestational-age fetuses with abnormal pulsatility index values had a significantly higher incidence of abnormal fetal heart rate and admission into the neonatal intensive care unit. There were three deaths in the nine small-for-gestationalage fetuses with abnormal pulsatility index values (33.3%) and three deaths in the 24 small-for-gestational-age fetuses with normal pulsatility index values (12.5%). Our data indicate that the pulsatility index of the middle cerebral artery in the normal human fetus has a parabolic pattern during pregnancy and does not change significantly after delivery. The results suggest that the small-for-gestational-age fetus with a normal middle cerebral artery pulsatility index is at lower risk than the fetus with abnormal pulsatility index values; moreover, management of the small-for-gestational-age fetus may be aided by the study of the middle cerebral artery waveforms. Randomised controlled trial of effect of ftiil on pregnmcy duration
supplementrtioo
Olsen SF.; Sorensen J.D.; Secher N.J.; Hedegaard M.; Henriksen T.B.; Hansen H.S.; Grant A. DNK LANCET 1992 339/8800 (1003-1007) The high birthweights and long duration of pregnancy in the Fame Islands led us to suggest that a high intake of marine-fatderived n-3 fatty acids might prolong pregnancy by shifting the balance of production of prostagiandins involved in parturition. We have compared the effects on pregnancy duration, birthweight and birth length of a fish-oil supplement, a control olive-oil supplement and no supplementation. 533 healthy Danish women in week 30 of pregnancy were randomly assigned in a ratio of 2/1/l to fish oil (four 1 g Pikasol capsules [containing 2.7 g n-3 fatty acids] per day), olive oil (four 1 g capsules per day), or no supplement. The three groups differed in mean length of gestation (P = 0.006) which was highest in the fish-oil group and lowest in the olive-oil group; the result was similar when the analysis was restricted to women with an estimate of gestation length based on early ultrasound findings (443 women). Pregnancies in the fish-oil group were on average Int J Gynecol Obstet 39
The effect of cesuean sectioo 011intraventricular hemorrhage in thepretemlinfallt
Anderson G.D.; Bada H.S.; Shaver D.C.; Harvey C.J.; Korones S.B.; Wong S.P.; Arheart K.L.; Magi11 H.L. USA AM J OBSTET GYNECOL 1992 166/4 (1091-1101) Objective: The null hypothesis is that active labor is a more important factor with regard to both timing and progression of periventricular-intraventricular hemorrhage than is route of delivery. Infants delivered by cesarean section after entering the active phase of labor will behave in a manner similar to that of previously studied infants delivered vaginally as to when periventricular-intraventricular hemorrhage occurs and frequency of progression. Study design: The 106 infants of 85 women delivered by cesarean section were the subjects of this study. Forty-six infants were-in the no-labor group, 33 in the latent-phase labor group and 27 in the active-phase labor group. Head ultrasonographic examinations were performed at delivery, at 1,6, 12 and 24 h and then daily for the first 7 days of life. Continuous variables were compared by one-way analysis of variance among those infants with no hemorrhage or with periventricular-intraventdcular hemorrhage. Categoric variables were compared by chi2 analysis and Fisher’s exact test when appropriate. A P value of co.05 was considered significant. Results: There was no difference in the frequency of early hemorrhage (s I h of age), late hemorrhage (> 1 h of age), or overall periventricular-intraventricular hemorrhage in the infants not in labor, in latent-phase labor, or in active-phase labor at the time of cesarean section. However, the frequency of grade 3 or 4 hemorrhage and the progression of hemorrhage were significantly higher in the infants whose mothers had an active phase of labor compared with infants whose mothers had no labor or did not progress beyond the latent phase. Infants who had early periventricular-intraventricular hemorrhage (S 1 h of age) also had a higher frequency of progression of hemorrhage. Conclusions: Cesarean section before the active phase of labor does not change the overall frequency of hemorrhage but results in a lower frequency of progression to grade 3 or 4 hemorrhage. We do not feel that these data support performing more cesarean sections for preterm delivery as a method of preventing progression of periventricular-intraventricular hemorrhage in the preterm infant.
365
artery flow velocity waveforms in normal and small-for-gest8tional-age fetuses
MiddIe eerehi
Mari G.; Deter R.L. USA AM J OBSTET GYNECOL 1992 16614(1262-1270) The middle cerebral artery flow velocity waveforms were obtained in 16 normal fetuses in a longitudinal study and in 128 normal fetuses in a cross-sectional study with pulsed Doppler ultrasonography. The pulsatility index values of the middle cerebral artery were higher at 25 to 30 weeks’ gestation than those observed during the two periods of major cerebral cellular multiplication in the human fetus. In 9 of the 16 fetuses studied longitudinally we compared the pulsatility index values obtained at the end of gestation with those obtained at 1 month after delivery; no significant difference was observed. The pulsatility index of the middle cerebral artery was also determined in 33 small-for-gestational-age fetuses. A middle cerebral artery pulsatility index value below our normal range was recorded in 9 of the 33 small-for-gestational-age fetuses (27.3%). These small-for-gestational-age fetuses with abnormal pulsatility index values had a significantly higher incidence of abnormal fetal heart rate and admission into the neonatal intensive care unit. There were three deaths in the nine small-for-gestationalage fetuses with abnormal pulsatility index values (33.3%) and three deaths in the 24 small-for-gestational-age fetuses with normal pulsatility index values (12.5%). Our data indicate that the pulsatility index of the middle cerebral artery in the normal human fetus has a parabolic pattern during pregnancy and does not change significantly after delivery. The results suggest that the small-for-gestational-age fetus with a normal middle cerebral artery pulsatility index is at lower risk than the fetus with abnormal pulsatility index values; moreover, management of the small-for-gestational-age fetus may be aided by the study of the middle cerebral artery waveforms. Randomised controlled trial of effect of ftiil on pregnmcy duration
supplementrtioo
Olsen SF.; Sorensen J.D.; Secher N.J.; Hedegaard M.; Henriksen T.B.; Hansen H.S.; Grant A. DNK LANCET 1992 339/8800 (1003-1007) The high birthweights and long duration of pregnancy in the Fame Islands led us to suggest that a high intake of marine-fatderived n-3 fatty acids might prolong pregnancy by shifting the balance of production of prostagiandins involved in parturition. We have compared the effects on pregnancy duration, birthweight and birth length of a fish-oil supplement, a control olive-oil supplement and no supplementation. 533 healthy Danish women in week 30 of pregnancy were randomly assigned in a ratio of 2/1/l to fish oil (four 1 g Pikasol capsules [containing 2.7 g n-3 fatty acids] per day), olive oil (four 1 g capsules per day), or no supplement. The three groups differed in mean length of gestation (P = 0.006) which was highest in the fish-oil group and lowest in the olive-oil group; the result was similar when the analysis was restricted to women with an estimate of gestation length based on early ultrasound findings (443 women). Pregnancies in the fish-oil group were on average Int J Gynecol Obstet 39