Prophylactic amnioinfusion in pregnancies complicated by oligohydramnios: a prospective study

Article Abstract:

Amnioinfusion is the injection of fluids into the amniotic membranes, which surrounds the fetus, and is usually performed to induce abortion. This procedure has also been shown to help in decreasing the number of variable decelerations, or episodes of slowed fetal heart rate, during active labor. In addition, amnioinfusion can reduce the incidence of newborn complications due to fetal defecation during childbirth. Premature rupture of the membranes (PROM) results in oligohydramnios, or decreased amniotic fluid volume, and increased acidity of umbilical blood. Amnioinfusion with warm salt solution has been shown to reduce the acidity of umbilical blood in patients with PROM. The benefits of amnioinfusion were assessed in pregnancies complicated by oligohydramnios, which were at or beyond full term. Patients received amnioinfusion with either warmed saline or saline at room temperature, or else they received no treatment. The frequency and severity of variable decelerations were reduced in patients treated with amnioinfusion as compared with untreated patients. Amnioinfusion did not affect the electrolyte levels of the newborns, and warming the amnioinfusion solution had no additional benefit. Amnioinfusion did not improve hydrogen levels in umbilical blood or rates of cesarean sections for fetal distress in full-term pregnancies as compared with its reported beneficial effects in premature deliveries. This discrepancy may be related to the ability of the full-term fetus to tolerate variable slowing of the heart rate without undergoing the rapid changes in metabolism observed in the premature fetus. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Physiological aspects, Fetal heart rate, Oligohydramnios, Amnion

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Multiple gestation complicated by the death of one fetus

Article Abstract:

In a multiple pregnancy, the death of a fetus before the onset of labor may cause the death or illness of the surviving fetus. Seventeen multiple pregnancies were studied to evaluate the risk after death of one fetus. The incidence of the death of a fetus in multiple pregnancy was 2.6 percent. Severe illness arose in only one case, a case of monochorionic gestation, where the two fetuses shared the same chorionic sac, the outermost membrane of an embryo. The death of one fetus should not be the determining factor in deciding on the mode of delivery. Renal function studies and neurological assessment should be part of the doctor's neonatal examination.

Case studies, Risk factors, Pregnancy, Complications of, Pregnancy complications, Multiple birth, Fetal death

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Atriopeptin in the twin transfusion syndrome

Article Abstract:

Atriopeptin, a peptide hormone secreted by cells in the atrium of the heart, causes the kidney to increase the excretion of urine (diuresis) as well as excretion of abnormally high amounts of sodium in the urine (natriuresis) and changes to the vascular system. In twin transfusion syndrome, one fetus transfuses blood to its twin. In two severe cases, the concentration of atriopeptin was much higher in the recipient twin than in the fetus giving blood, which may indicate possible causes of changes seen in this disease of twins.

Research, Measurement, Diseases, Blood transfusion, Twins, Natriuretic peptides, Diseases in twins

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