RESUMO
The concentrations of reverse triiodothyronine (3,3',5'-T3 or rT3) in amniotic fluid (AF) were measured by radioimmunoassay in 81 patients with various complications of pregnancy and in 39 normal pregnant patients at equivalent gestational age. In normal pregnancy, AFrT3 concentrations decreased with advancing gestational age. At 21-25, 26-30, 31-35, and 36-40 weeks of normal pregnancy, AFrT3 concentrations (mean +/- SE) were 353 +/- 62 (n = 6), 131 +/- 49 (n = 7), 94 +/- 25 (n = 14), and 93 +/- 5 (n = 20) ng/dl, respectively (ranges: 200-600, 57-350, 66-135, and 50-135). Both normal and supranormal values of AFrT3 were found in patients with complicated pregnancy. In patients with RH isoimmune disease, higher than normal AFrT3 concentrations were associated with seriously affected or gravely ill fetuses wheras normal AFrT3 concentrations predicted a more favorable outcome. There was a good correlation between AFrT3 and AF pigment (deltaOD450) levels (r = 0.70, P less than 0.001). In complicated pregnancy other than erythroblastosis fetalis, AFrT3 concentrations were not of any prognostic significance, and there was no correlation between AFrT3 and lecithin/spingomyelin ratio. The data suggest that AFrT3 determination may help in the assessment of the fetal condition in erythroblastosis fetalis.
Assuntos
Líquido Amniótico/análise , Complicações na Gravidez/metabolismo , Tri-Iodotironina Reversa/análise , Tri-Iodotironina/análise , Feminino , Humanos , Gravidez , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , RadioimunoensaioRESUMO
Continuous ultrasonic observation of needle placement for aspiration, biopsy, or catheter placement is a novel and specific use of phased array imaging. In the case of IUTx, catheter placement into the fetal peritoneal space is accomplished rapidly, with reduced risk of fetal trauma, and without exposure to ionizing radiation. Experience with 27 transfusions in 11 patients is presented.
Assuntos
Transfusão de Sangue Intrauterina/métodos , Ultrassom , Feminino , Humanos , GravidezRESUMO
Ultrasound-facilitated intrauterine transfusion was performed on 35 fetuses. Eleven fetuses were hydropic and less than 26 weeks' gestation at the time of the first intrauterine transfusion (IUT). Only two (18%) neonates survived. Twelve fetuses were not hydropic and less than 26 weeks' gestation at time of IUT. Six (50%) neonates survived. Corrected neonatal survival rates for three hydropic and nine nonhydropic fetuses transfused after 26 weeks were 100% and 78%, respectively. The presence of ascites documented by ultrasound is an adequate indication for an IUT and permitted earlier detection of sicker fetuses; however, as a therapeutic aid, ultrasound neither diminished the fetal morbidity and mortality associated with the procedure nor completely eliminated the need for radiography to confirm proper intra-abdominal localization of the transfusion tubing.