Newborn brachial plexus injuries: The twisting and extension of the fetal head as contributing causes.

The exact mechanism of the causation of brachial plexus injury (BPI) has long been a matter of controversy. It is our opinion that the twisting and the extension of the fetal head, during the labour and delivery process, will increase the stretching of the neck, thus contributing to the labour forces as the cause of BPI. Our opinions are offered to other researchers and readers for their consideration of how the labour forces can cause BPI.

Motherhood, metabolic changes and evolution.

The most important metabolic changes in pregnancy are facilitated anabolism when food is available and accelerated catabolism during fasting. In combination with the acquisition of haemochorial placenta, bipedalism and obligatory prematurity at birth these evolutionary choices have been the prerequisite conditions for the rapid growth of the fetal brain and its further postnatal development.

[Preliminary clinical study of the use of itraconazole in the treatment of vulvovaginal candidiasis]. / Studio clinico preliminare sull'impiego dell'itraconazolo nel trattamento della vulvovaginite da candida.

Thirty women (28 of childbearing age and 2 in the menopause), affected by acute Candida albicans vulvovaginitis were treated orally with a new antimycotic triazole derivative, itraconazole. Twenty patients were administered with 200 mg/die of itraconazole for three days. In tests carried out 7 and 30 days after the end of therapy the following results were observed. Negative cultures in 95% of patients and in 75% of patients; absence of leukorrhea in 60% of patients and in 65% of patients; disappearance of pruritus in 95% of patients and in 80% of patients. Ten patients were administered with an acute dose of itraconazole (400 mg). In the same tests, carried out 7 and 30 days after the end of therapy reported above the results were as follow. Negative culture in 80% and 60% of patients; absence of leukorrhea in 50% and 60% of patients; absence of pruritus in 70% and 50% of patients. In the first group of patients one case of slight nausea was reported whilst in the second group there were two cases of nausea, one of gastralgia and one of urticaria. No systemic side-effect was seen.

Immunohistochemical detection of terminal complement complex and S protein in normal and pre-eclamptic placentae.

Terminal complement complex and S protein were searched for in term placentae obtained from 13 women with normal pregnancy and 15 patients with moderate or severe form of pre-eclampsia. Terminal complement complex was found to localize in the fibrinoid material of the decidua of the basal plate, in the stroma of the chorionic villi and in the vessel walls, as subendothelial deposits. S protein had a quite different distribution, being detected in the syncytiotrophoblast located both in the chorionic villi and in the decidua of the basal plate (DBP) and also on the endothelial cells of fetal stem vessels. Mild deposits of C3 were found in the decidua of the basal plate and also in the stroma and on the basal membranes of the villi. Reactivity for C9 neoantigen was also observed in the cytoplasm of some cells, which were recognized to be macrophages by the presence in their cytoplasm of acid phosphatase and by their reaction with a monoclonal antibody specific for macrophages. Differences in complement deposition in normal and pre-eclamptic placentae were essentially quantitative. Possible mechanisms of complement activation are discussed.

Birth rate and perinatal mortality in Italy during the years 1964 through 1986.

"Between 1964 and 1986 the number of births in Italy declined from over one million per year to little more than half a million per year. The perinatal mortality rate declined from 37.3/1,000 to 12.8/1,000. Using the year 1964 as [the] reference year, the total number of babies who were saved from perinatal death by socio-economic and medical improvements during the 22 years between 1965 and 1986 can be calculated as 435,005."

Score systems in perinatal medicine.

Details of some common scoring systems in use for perinatal medicine are outlined. Their advantages and limitations are briefly discussed.

Practical application of the Bristol Perinatal Growth Chart to Mediterranean populations.

The Bristol Perinatal Growth Chart (gestogram) has been applied to different Mediterranean populations and compared to traditional percentile intrauterine growth charts. The opinion is stressed that the gestogram system can successfully replace traditional intrauterine growth charts and offers the advantage of greater simplicity and adaptability.

Toxoplasmosis and pregnancy: the prevention of congenital toxoplasmosis.

Programs to prevent congenital toxoplasmosis based on the evaluation of serologic tests can be performed at three periods: 1. before pregnancy (serologic, epidemiologic screening of "at risk" women); 2. during pregnancy (detection by seroconversion); 3. at delivery (diagnosis of evident or latent congenital infection). The screening devices, the IHA, IFA, and IgM-IFA tests, should be performed first and after 3 weeks possibly repeated. During pregnancy the observation of seroconversion or, in any case, an increase in serologic titer at the second blood withdrawal and, at delivery, high serologic titers are signs of fetal risk. The significance of the data has furthermore to be evaluated by specific IgM quantification on pure serologic fractions and by in vivo isolation of Toxoplasma gondii from amniotic fluid, placenta, or the newborn CSF, blood, and/or tissue. This data may suggest the necessity of therapeutic termination of pregnancy or application of a specific chemoprophylaxis/chemotherapy.

[Standardization criteria for the study of fetal lung maturity by means of gas-liquid chromatography of the fatty acid content of the amniotic fluid]. / Contributo ai criteri di standardizzazione per lo studio della maturita polmonare fetale mediante GLC degli acidi grassi contenuti nel liquido amniotico.

Gas-chromatographic analysis of the fatty acids (P/S ratio) in 10 samples of amniotic fluid and 10 samples of the pellets obtained after centrifugation of amniotic fluid at 3500 X g for 60 minutes were carried out to evaluate the effects of contaminants that might be present in amniotic fluid. The P/S ratio is used as an index of the degree of maturity of the fetal or neonatal lung. We propose a standard procedure of centrifugation for 60 minutes at 3500 X g followed by extraction and gas-chromatography as a rapid, valid way to measure the P/S ratio.