Maternal alcohol abuse is associated with elevated fetal erythropoietin levels

Article Abstract:

Erythropoietin is a hormone in the kidney that is responsible for stimulating red blood cell production; however, in the fetus, production of erythropoietin occurs in the liver as well as the kidneys. Oxygen in the arterial blood determines whether more erythropoietin needs to be synthesized, to produce more red blood cells and thus increase oxygen levels. In the presence of reduced oxygen (hypoxemia) in the fetus, elevated levels of erythropoietin can be in found in umbilical cord blood. The most common cause of fetal damage is maternal alcohol use. In order to study the possible effects of maternal alcohol abuse on the fetus, concentrations of erythropoietin concentrations in the umbilical blood of infants was studied. Forty pregnant women with a history of alcohol abuse were studied; 28 were heavy drinkers and 12 were classified as moderate drinkers. Fetal alcohol effects were seen in 20 infants born to the women who drank alcohol during pregnancy. Erythropoietin levels were above the normal range in 35 percent of infants. The elevation of erythropoietin correlated with the amount of alcohol consumed. Erythropoietin in fetal blood is entirely of fetal origin and elevations are regarded as signs of fetal hypoxemia. Since alcohol readily crosses the placenta, the elevation in erythropoietin levels may be due to a direct alcohol-induced effect. Maternal alcohol abuse was considered the main cause for elevated erythropoietin levels; however, it is still uncertain whether this is a direct effect or is mediated by fetal hypoxemia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Fetus, Physiological aspects, Alcoholism, Erythropoietin, Fetal alcohol syndrome, Prenatal influences, Blood chemical analysis, blood, Alcoholism in pregnancy

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Outpatient therapeutic abortion with mifepristone

Article Abstract:

Mifepristone (RU 486) is a drug that blocks the action of progesterone, a hormone essential to maintaining pregnancy. The antiprogesterone effect of mifepristone makes it an attractive nonsurgical agent to induce abortion. Pregnancy is successfully terminated in 60-80 percent of the women who take 400-800 milligrams (mg) of mifepristone in two to four doses. The effectiveness of a lower dose of mifepristone was studied in 50 women attending an outpatient abortion clinic in Finland. The pregnant women were given one 600 mg dose of mifepristone. Vaginal bleeding began in 48 patients one to three days later and two patients had no bleeding. Complete abortion was successful in 36 women. Although pregnancy was terminated in another eight patients, some fragments of the placenta were detected by ultrasonographic imaging. Mifepristone failed to induce abortion in a total of five patients, who later required surgical evacuation of the products of conception. The effect of mifepristone did not depend on the level of chorionic gonadotropin hormone (hCG, which is secreted by the placenta and reflects the stage of pregnancy) or the time since the last menstrual period. No unusual side effects were reported. Although 600 mg of mifepristone caused abortion in 72 percent of the women, it produced incomplete abortion in 18 percent, and was ineffectual in 10 percent. These findings indicate that the lower dose of mifepristone may not be adequate. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Evaluation, Dosage and administration, Abortion, Abortifacients, Mifepristone

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Acquired immunodeficiency syndrome and Pneumocystis carinii infection in a pregnant woman

Article Abstract:

The case report of a pregnant woman with AIDS and Pneumocystis carinii pneumonia (a type of pneumonia that often develops in AIDS patients) is presented. Unlike the other four cases reported in the medical literature in which pregnant women had AIDS and P. carinii pneumonia, this patient survived. At her initial prenatal admission, the patient was 31 weeks pregnant and was acutely ill with a pulmonary infection. Blood tests revealed the presence of HIV (human immunodeficiency virus) infection, although the patient denied drug abuse or other exposure to the virus. Closer scrutiny of her medical records revealed a diagnosis of HIV infection three years previously. She underwent treatment with antibiotics, ventilatory (breathing) support, and steroid drugs. Uterine contractions began on the fourth day of hospitalization but stopped after steroid therapy began. After 35 days in the hospital, she gave birth to an apparently healthy boy, who later tested positive for HIV infection. The mother was alive at the time of the report, after two subsequent hospitalizations. The fact that this pregnant patient, who received steroid drugs, survived, while others who received only antibiotic treatment did not suggests that this approach may be useful. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, HIV infection, HIV infections, Pneumocystis carinii pneumonia, AIDS (Disease), AIDS (Disease) in pregnancy

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