[Fetal renal ultrasound investigation in toxaemic pregnancies]. / A magzati vese ultrahangvizsgálata toxaemiás terhességekben.

INTRODUCTION: A relationship was sought between renal hyperechogenicity and the hypoxic state of fetuses. MATERIAL AND METHODS: 120 pathological pregnancies were examined between the 28th and 36th weeks. The echogenicity of the fetal kidneys was examined with Combison 530 3D ultrasound equipment fitted with a 3-5 MHz transabdominal transducer. The serum kidney and liver functions and plasma electrolytes of the mothers were examined and blood was collected from the pulsating umbilical artery for determination of the same serum parameters. After delivery, the physical condition of the neonates was followed and their kidneys were examined with the same ultrasound equipment within the first 5 days. RESULTS: There was a significant difference between the cases with fetal renal hyperechogenicity and without it for the pathological neonatal clinical outcome (chi-square test with Yates correction, p < 0.01). There were significantly more intrauterine retarded fetuses (6 cases, 40%) in cases with fetal renal hyperechogenicity, than in the control group (3 cases, 3%). The mode of delivery was caesarean section in 7 cases (46%) in group with fetal renal hyperechogenicity, while it were 6 cases (6%) in control group. The risk for pathological outcome is 6 times more in cases with fetal renal hyperechogenicity. CONCLUSION: The results demonstrate that fetuses exhibiting renal hyperechogenicity in pathological pregnancies require particularly careful obstetric control and neonatological consultation. It is important that hyperechogenic cases be admitted to a perinatal intensive care unit. Fetal renal hyperechogenicity is considered to be associated with an enhanced risk of adverse perinatal outcome.

Incidence and outcome of congenital cytomegalovirus infection in selected groups of preterm and full-term neonates under intensive care.

Congenital cytomegalovirus (CMV) infection is the leading cause of mental retardation and hearing impairment. Examination for the presence of CMV infection was carried out in a selected population of 70 neonates. Urine samples were tested for CMV by means of a nested polymerase chain reaction. CMV was detected in 6 (16.7%) of the 36 preterm newborns and in 5 (14.7%) of the 34 full-term newborns. One preterm neonate died and the remaining 10 newborns were followed up. Two children born at full-term did not excrete CMV at 2 years of age and were symptom-free. Of 8 CMV-excreting children (5 preterm and 3 full-term), 2 were symptom-free (1 preterm and 1 term). Symptomatic CMV disease developed in 6 children (4 preterm and 2 full-term), with mental retardation (n=4), hearing loss (n=1), strabismus (n=2) or bronchial asthma (n=1). Screening of such neonates is important; those identified as congenitally CMV-infected can be monitored to correct any sequelae immediately.

Antioxidant enzyme activities are decreased in preterm infants and in neonates born via caesarean section.

OBJECTIVES: To investigate the antioxidant defense potential of human neonates according to gestational age and mode of delivery. STUDY DESIGN: Four study groups were established, full-term normal spontaneous vaginal delivery (FT-NSVD, n=24), full-term caesarean section (FT-CS, n=19), preterm normal spontaneous vaginal delivery (PT-NSVD, n=15) preterm caesarean section (PT-CS, n=21). The activity of catalase (CAT), glutathion peroxidase (GPX), Cu/Zn superoxide dismutase (Cu/Zn-SOD) were determined from cord blood. Statistical analysis was made by ANOVA. RESULTS: CAT activity was significantly higher in full-term than in preterm newborns. In both the categories, neonates born via caesarean section had significantly lower CAT activities. GPX activity was significantly higher in the FT-NSVD group than in any other group. Cu/Zn-SOD activity was significantly higher in full-term neonates than in preterms and no difference was found related to the mode of delivery. CONCLUSIONS: Prematurity and caesarean section may cause a deficiency of antioxidant defense in human newborn.