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Intrapartum Fetal Heart Monitoring
Young, Bruce K
ORIGINAL:0009578
ISSN: n/a
CID: 1498092
The role of cord blood banks
Young, Bruce K
ORIGINAL:0009543
ISSN: 1044-307x
CID: 1478982
Fetal Therapy Update : Where Are We Today?
Young, Bruce K
ORIGINAL:0009577
ISSN: n/a
CID: 1498082
Screening For Fetal Disease
Young, Bruce K
ORIGINAL:0009576
ISSN: n/a
CID: 1498072
Intrapartum fetal monitoring today
Schwartz, Nadav; Young, Bruce K
The literature on intrapartum fetal monitoring is reviewed emphasizing the pathophysiology, and current practice guidelines are discussed. FHR monitoring, ancillary tests, and investigational modalities are considered
PMID: 16519612
ISSN: 0300-5577
CID: 66854
Vaginal birth after cesarean section: X-ray pelvimetry at term is informative [Editorial]
Young, Bruce K
PMID: 16764061
ISSN: 0300-5577
CID: 66853
Heterogeneity in fetal immunocompetence during the second trimester of gestation. Implications for treatment of nonimmune genetic disorders by in utero transplantation
Tse, Doris B; Ching, Elbert; Yousefzadeh, Nora; Roque, Hank; Young, Bruce K
OBJECTIVE: To address the role that alloreactivity may play and better define the window for histoincompatible stem cell transplantation in utero. SUBJECTS, MATERIAL AND METHODS: We studied 9 fetal blood specimens obtained by cardiocentesis during elective abortions in the second trimester by multicolor flow cytometry and in vitro stimulation. RESULTS: Lymphocytes ranged from adult levels (3/9) to >90% leukocytes. Six specimens had T cells within adult range. T cells in the other specimens were reduced, while B cells were conversely elevated. This variability did not correlate with gestational age, or leukocyte composition. Following 4 h of mitogenesis, fetal CD4+ and CD8+ T cells from 1 of 5 specimens showed a response similar to that of maternal T cells, while the other 4 specimens showed a diminished response (0.3 +/- 0.2-fold). This heterogeneity did not correlate with gestational age, or lymphocyte subset distribution. Following 18 h of in vitro mitogenesis, fetal T cells from 2 specimens showed a response similar to that of maternal T cells (0.8 +/- 0.2-fold). Despite that, one specimen gave a 3-fold greater response in a one-way mixed lymphocyte reaction vs. maternal cells compared to the other specimen. CONCLUSION: We determine that fetal immunocompetence differs greatly during the second trimester and assessment of host vs. donor reactivity prior to in utero transplantation is likely to potentiate more favorable outcomes
PMID: 15824493
ISSN: 1015-3837
CID: 56179
Combined sonographic and endoscopic umbilical cord occlusion in twin and triplet gestations
Young, Bruce K; Stephenson, Courtney D; Mackenzie, Andrew P; Roman, Ashley S; Rebarber, Andrei; Minior, Victoria K; Mayberry, Patricia; Timor-Tritsch, Ilan E
OBJECTIVE: To review our experience with a minimally invasive technique for umbilical cord occlusion as a method of selective feticide in monochorionic sets. STUDY DESIGN: Umbilical cord occlusion was completed using 3 mm bipolar cautery under ultrasound guidance (3D/4D, n = 6; 2D, n = 6) with pre and post ligation endoscopic evaluation. RESULTS: 12 cases of monochorionic sets where selective feticide was performed were identified during the period 2000 to present. There were four triplet and eight twin gestations in the study cohort. Median interval from intervention to delivery was 16 weeks (range, 5-19). All co-twins survived the procedure and 15 of 16 were delivered after 33 weeks. CONCLUSIONS: Umbilical cord occlusion in monochorionic sets can be accomplished in a minimally invasive manner with combined endoscopic and ultrasound guidance in both twin and triplet pregnancies
PMID: 16318617
ISSN: 0300-5577
CID: 62605
Endoscopic closure of fetal membrane defects: comparing iatrogenic versus spontaneous rupture cases
Young, B K; Mackenzie, A P; Roman, A S; Stephenson, C D; Minior, V; Rebarber, A; Timor-Tritsch, I
OBJECTIVE: Currently, physicians manage preterm premature rupture of membranes (PPROM) by expectant management or termination of the gestation. A therapy aimed at sealing membranes would be optimal to maintain the pregnancy and achieve a normal neonate. Our objective was to compare an endoscopic technique for intrauterine closure of fetal membrane defects after both iatrogenic and spontaneous rupture of membranes. METHODS: Our technique was performed on four patients experiencing PPROM spontaneously and four patients after genetic amniocentesis. Intrauterine endoscopy allowed direct visualization of membrane defects. Rapid sequential injections of platelets, fibrin glue and powdered collagen slurry were administered at the site of the defect and of trocar placement. Sonography for amniotic fluid index, nitrazine and fern testing and pad count were performed after each procedure at three intervals: immediately post-procedure, and after 24 and 48 h. RESULTS: Eight patients underwent endoscopic intrauterine sealing of ruptured membranes between 16 and 24 weeks of gestation: four were spontaneous ruptures and four were ruptures post-amniocentesis. In the post-amniocentesis group, three patients delivered viable infants at 26, 32 and 34 weeks. In one patient, the membranes ruptured again 12 h after the sealing procedure and she decided to undergo termination of pregnancy. Of the four spontaneous rupture patients, two experienced preterm labor and delivery within 2 days of the procedure. One patient was diagnosed with fetal demise 12 h post-procedure, and one patient delivered a neonate at 31 weeks of gestation with severe respiratory distress syndrome. CONCLUSIONS: This technique for sealing ruptured membranes is effective after amniocentesis, but may not be of benefit with spontaneous rupture
PMID: 15590453
ISSN: 1476-7058
CID: 55599
Umbilical cord blood banking
Young, Bruce K
ORIGINAL:0009541
ISSN: 8750-0507
CID: 1478962