Postmaturity: how far is it a clinical entity in its own right?

In 1990 we adopted a protocol of antepartum testing for all booked pregnant patients, permitting healthy pregnancies to go beyond 42 completed weeks of gestation. This retrospective study regards 84 patients delivering after 42 completed weeks of pregnancy and a control group of 1351 patients delivering after 37 completed and before 41 completed weeks of pregnancy. Records were revised for maternal age and parity, previous obstetric history, managing and complications of the actual pregnancy, labour and mode of delivery, neonatal biometric data and outcome. Only 4 patients delivered after 43 completed weeks of gestation, while none in the series delivered later than 44 completed weeks after the beginning of the last menstrual period. The overall frequency of caesarean birth was higher, but not significantly, in study group. Average neonatal birthweight and length were significantly greater in the study group. No significant difference in neonatal outcome was observed between study and control groups in terms of perinatal mortality. Low 1' Apgar score was significantly more frequent in the study group, but a similar frequency of 5' Apgar score and need for intensive care was observed in the two groups.

[Persistent atrial paralysis. Observation of a clinical case and review of the literature]. / Paralisi atriale persistente. Osservazione di un caso clinico e revisione della letteratura.

A total, primitive, persistent, non-familial auricular standstill was observed in a twenty-two year old female with right hemiplegia and aphasia. The diagnosis was confirmed by electrocardiogram, fluoroscopy, echocardiography and intra-atrial recording and pacing. The patient was treated with permanent pacemaker and anticoagulant drugs. The various clinical presentations, diagnostic criteria, and therapeutic choices are reviewed.

[Atrial fibrillation and flutter in children]. / Fibrillazione e flutter atriale nell'infanzia.

Flutter and atrial fibrillation are extremely rare in children. Their aetiology and pathogenesis vary from one case to another. The clinical picture may be influenced by a number of factors (age, duration of the arrhythmia, ventricular frequency), while the natural history is often related to the presence or otherwise of associated cardiopathies. There is no standard treatment. Digitalis with or without other antiarrhythmic drugs is often employed as the drug of choice, though its place may be taken by ayodarone or verapamil.