Faculty Bibliography

Women with the rare blood group p are known to have an increased rate of abortions. The case of a 36-year-old woman is presented who had had 7 spontaneous abortions in the first trimester and no live child. When treated by plasma exchange begun early in pregnancy and continued until the 29th week, she delivered a normal child. Time to begin, amount and length of time necessary to continue plasma exchange in these patients are considered. In addition, the question of which fraction of the anti-PP1Pk could be responsible for abortion is discussed. To our knowledge, this is the first case of a woman of p phenotype with no live children but with multiple abortions treated by this method, which should be seriously considered in similar cases

The sensory receptors of the human fetus and their adequate stimulation are reviewed. Emphasis is put on the two main sensory routes through which the fetus may be stimulated: the hearing and the cutaneous senses. Most experimental and descriptive studies were done in these two well-defined areas. The core of the review deals with the description of sensory stimulation of the fetus as a function of the known behavioral states. It is postulated, and a series of experimental works cited in support, that reactions of the fetus to external stimuli, irrespective of the route through which they are presented, are subject to modulation by these states. It is proposed that an adequate stimulus in the normal, physiological range produces little or almost no effect in deep sleep (state 1 fetal) and does not change this state, whereas an inadequate stimulus which is strong ('painful') produces a definite change in state 1 fetal and is capable of triggering a change from state 1F to 2F (active sleep or rapid-eye-movement sleep)

Tubo-ovarian abscess in postmenopausal women is a distinct and rare entity. The disease is usually diagnosed on the operating table and its high rate of postoperative complications and mortality commands special attention. By presenting our experience with four cases of tubo-ovarian abscess in postmenopausal women, we would like to re-emphasize the importance of including this disease in the differential diagnosis of the surgeon and the gynecologist. Early laparotomy is essential to reduce morbidity and mortality

The fetal heart rate response to acute hypoxemia was observed during an accidental drop in oxygen concentration inspired by the mother in labor. There was a marked increase in FHR variability in the early stage of hypoxia and also during the recovery phase. While an increase in fetal heart variability is generally considered to be a normal physiological event, it may also indicate a state of fetal hypoxemia associated with an intact fetal circulation, and should be treated with caution during labor

Five fetuses with cystic hyroma were diagnosed in our department during a period of 5 months. Four of them were identified by an ultrasonic examination. No common causative factor was found to explain the appearance of such a rare anomaly in 5 cases over a very short period of time

The accuracy of estimating fetal weight with real-time ultrasonography was studied in 81 fetuses. The technique is described and results are compared with those obtained by the B-scan technique. The absolute mean error was 228 g or 8.3% of the mean weight. Sixty percent of the measurements fell within 10% of the actual birth weight. The estimates were more accurate in the low (less than 1500 g) and in the high (more than 4000 g) weight groups. The easy access, simple technique, and reasonable accuracy of realtime scanners, as well as the development in progress for more reliable instruments, enable us to advocate its value for estimation of fetal weight in the delivery suite

The fetal heart rate pattern of a dying fetus due to tightening of a true knot of cord is presented. Sinusoidal pattern was electronically recorded along wih bradycardia--tachycardia. The importance of the sinusoidal pattern is discussed. It seems to imply fetal compromise if observed together with other signs of moderate fetal distress

Fetal respiratory movements (FRM) were studied using abdominal strain gauges (tocodynamometers). The patterns of the FRM were evaluated during both active and quiet fetal time periods, which were determined by the fetal heart rate (FHR) and fetal body movement (FM). The FRM were classified into Regular and Irregular patterns based on neonatal respiratory criteria for sleep-state studies in the term infant. Evaluation of the breath-to-breath intervals (BBI) showed statistically significant respiratory differences during active and quiet fetal time periods. Irregular fetal respiratory movement patterns were noted during fetal active periods. It would appear that the correlation of regular fetal respiratory movement with fetal quiet periods in the term fetus adds additional evidence that a quiet sleep state may exist in the term fetus