Assessment of fetal autonomic nervous system activity by fetal magnetocardiography: comparison of normal pregnancy and intrauterine growth restriction.

OBJECTIVE: To clarify the developmental activity of the autonomic nervous system (ANS) of the normal fetus and intrauterine growth restriction (IUGR) cases using fetal magnetocardiography (FMCG). SUBJECTS AND METHODS: Normal pregnancy (n = 35) and IUGR (n = 12) cases at 28-39 and 32-37 weeks of gestation, respectively, were included in this study. The R-R interval variability was used to calculate the coefficient of variance (CV(RR)) and low frequency/high frequency (LF/HF) ratio. RESULTS: The value of CV(RR) in the normal pregnancy group displayed a slight increasing trend with gestational age. However, no such trend was observed in the IUGR group. In contrast, the LF/HF ratio in both the normal pregnancy group and the IUGR group clearly increased over the gestational period; the normal group showing statistical significance. CONCLUSION: The development of fetal ANS activity in IUGR cases might differ from that observed in the normal pregnancy group, and this may facilitate early detection of IUGR.

Clinical assessment of neoadjuvant chemotherapy and interval cytoreductive surgery for unresectable advanced ovarian cancer.

Sixty-five patients with unresectable advanced epithelial ovarian cancer who underwent exploratory laparotomy or unilateral oophorectomy were reviewed. Forty-five of 65 patients received 3.8 cycles of neoadjuvant chemotherapy (NAC) and were successfully debulked at interval cytoreductive surgery (IRS); 31 of 45 showed no evidence of disease. Patients with residuals <1 cm at IRS had a high possibility of achieving clinical remission. Patients who failed to receive IRS showed poor prognosis. Also, 63 patients who underwent conventional primary debulking surgery with residuals >1 cm were investigated as a contrast. No significant difference was observed in patient survival between the NAC group and the conventional treatment group. NAC and IRS offered patients with unresectable tumors survival similar to that of those with suboptimally resectable tumors at primary debulking. We conclude that this strategy has potential benefits for the patients with clinically aggressive ovarian cancer who are unable to receive standard treatment.