Amino acids in amniotic fluid in the 15th-16th weeks of gestation and preterm labor.

OBJECTIVE: To investigate amino acids in amniotic fluid collected at the time of genetic amniocentesis. METHODS: We analyzed 128 fluids from the 15(th) week of gestation and 53 from the 16(th) week of gestation from normal pregnancies, and eight in the 15(th) week and seven in the 16(th) week from pregnancies that lead to preterm deliveries. We calculated the mean values for each week and the ratios between each pair of amino acids. The data for both groups (normal and preterm delivery) were compared. RESULTS: The most abundant amino acid in both groups was alanine. The comparisons of the groups showed significant differences for isoleucine in the 15(th) gestational week (p<0.05). Some amino acids had different evolutions between both gestational ages on comparing the normal group and preterm group. Eighteen ratios in the 15(th) week showed significant differences (mainly in the ratios of arginine and taurine), and three in the 16(th) week. CONCLUSIONS: The amino acid profiles in amniotic fluid, particularly in the 15(th) week of gestation, showed differences in the pregnancies that lead to preterm delivery.

The use of activated recombinant coagulation factor VII during haemarthroses and synovectomy in a patient with congenital severe factor V deficiency.

Factor V deficiency is a rare hereditary bleeding disorder. Currently, FV concentrates are not available, and the treatment of spontaneous bleeding or bleeding associated with invasive procedures is transfusion of fresh frozen plasma (FFP). However, FFP transfusion can lead to the development of inhibitor to FV, and is associated with several potential transfusion reactions including allergic reactions. We report a patient with congenital severe FV deficiency with repeated haemarthroses of a shoulder joint, and progressively severe allergic reactions to FFP transfusions. In addition, the patient also developed acute pulmonary oedema. Activated recombinant coagulation factor VII (rFVIIa) was used as an alternative haemostatic agent to FFP. We describe the use of rFVIIa in this patient during haemarthroses, synovectomy, and physiotherapy.

Respuesta de la pupila fetal en las anomalías del sistema nervioso / Pupil response in fetuses with nervous system anomalies

Objetivo: Estudiamos el estado pupilar basal y la respuesta de la pupila fetal al Doppler color (DC) en casos con malformaciones del sistema nervioso antes de las 23 semanas.Material y métodos: Las pupilas de 12 fetos con alguna malformación del sistema nervioso fueron estudiadas mediante ultrasonidos entre las semanas 16 y 23 de gestación. Las áreas de las pupilas e iris en situación basal y posterior al estímulo DC fueron comparadas con los datos de normalidad previamente publicados.Resultados: La gran mayoría de los fetos tenían alguno de los parámetros analizados anormales, sobre todo en el tipo de respuesta al DC y la cuantificación de ésta. Habitualmente las malformaciones del sistema nervioso presentan una respuesta inversa a la esperada y/o responden de forma exagerada.Conclusión: Estos resultados permiten utilizar este tipo de test en el estudio fetal de alta resolución que realizamos antes de las 22 semanas. Este reflejo fetal puede indicarnos el estado sináptico de una de las vías nerviosas fetales y el tono refléxico fetal. (AU)