Alain Patrick Vokaer

A single cervical fetal fibronectin screening test in; population at low risk for preterm delivery: an improvement on clinical indicators?

Objective To assess the accuracy of a single cervical fetal fibronectin test to predict spontaneous preterm delivery in an unselected antenatal population.

Fetal hypopituitarism: perinatal endocrine and morphological studies in two cases.

We report two infants with congenital absence of the anterior pituitary gland, documented by magnetic resonance imaging (MRI) or autopsy. In cord plasma obtained at birth from both infants, prolactin (PRL), pituitary growth hormone (hGH), placental growth hormone (hPGH) and thyrotropin (TSH) were undetectable; cortisol was low; thyroxine (T4) was 31 nmol/l in one infant and 85 nmol/l in the other infant who had been treated prenatally with intra‐amniotic L‐T4 administration. In maternal plasma at birth, PRL, hPGH and T4 were normal and hGH was undetectable. These observations suggest that plasma hGH and PRL in the fetus are exclusively of fetal pituitary origin, hPGH is secreted into the maternal circulation and is not transferred to the fetus and fetal growth can be normal in the absence of hGH, hPGH and PRL in fetal plasma.

Use of chlorhexidine during labor: How effective against neonatal group B streptococci colonization?

Dear Editor, Neonatal septicemia with group B streptococci (GBS) is associated with high morbidity and mortality rates. Intrapartum antibiotic administration to selected at-risk mothers is actually held as the sole treatment with proven efficacy in reducing transmission of GBS from mother to infant (1). Burman and the Swedish Chlorhexidine Study Group (2) reported that vaginal disinfection with chlorhexidine may provide an efficient prevention of neonatal infection with GBS without any significant adverse effects. Their regimen consisted in vaginal flushings with 60 ml chlorhexidine diacetate 0.2% repeated every 6 hours during labor. Since this procedure might be felt rather more constraining for mothers than common nursing care, we looked at the possible efficacy of chlorhexidine lubrified surgical gloves for routine vaginal examinations performed from admission in the labor ward to delivery. Consecutively, fifty-nine pregnant women antenatally screened as GBS carriers were prospectively and randomly allocated in two groups at the onset of labor: vaginal examinstions of the treated group were systematically performed with gloves lubrified with 5 ml chlorhexidine digluconate 1% cream; the control group was examined with uncoated gloves. Swabs for microbiological examination were sampled on different cutaneous areas of the newborn at delivery. We were unable to demonstrate any significant effect of this disinfection procedure on mother-infant GBS vertical transmission: 11 newborns out of 28 (390/,> were colonized in the treated groups versus 13 out of 31 (42%) in the control group (x2 = 0.003). From these results, we suggest that chlorhexidine lubrication of gloves used for vaginal examinations is ineffective in preventing GBS colonization of the newborn. One might consequently speculate about the real efficacy of chlorhexidine in preventing neonatal GBS transmission.

Antibody to estrogen-induced protein (IP) and quantification of the protein in rat uterus by a radioimmunoassay.

Abstract Antibodies to a rat uterine estrogen-induced protein (IP) have been prepared in rabbit and characterized by gel diffusion and immunoelectrophoresis. A radioimmunoassay for IP has been developed using this antibody and (125I)-labelled IP. Using this assay, significant levels of IP were detected in uteri of both immature and unstimulated castrated adult rats. Within 12 hours after injection of estradiol, the content of IP increased by almost 100 per cent. The amounts of the protein in mature rats varied according to the stage of estrous cycle.

First sickle cell crisis triggered by induction of labor in a primigravida

Sickle cell anemia is a severe disorder that rarely spares affected adults. We describe here a 32-year-old pregnant woman who presented her first lifetime symptoms of her disease during induction of labor at term. We therefore discuss the possible causes that may have triggered this inaugural crisis.

Benzodiazepine use during pregnancy: a prospective study

Recently, clinical and epidemiological human studies suggested that benzodiazepines (BZD) may act as human teratogens [l-7]. Data on BZD use during pregnancy are scarce. The only (retrospective) study of BZD use during pregnancy was in Gothenburg, Sweden, where maternal (12th week of pregnancy) serum samples were analyzed; positive results were found in 7% of the pregnant women (2160). These rates are much higher than the estimated incidence (from interviews and outpatient prescriptions) of l-3% [4]. Other studies about the incidence of BZD use during pregnancy are only based on the frequency of BZD prescriptions (81. We performed a prospective study on the incidence of BZD use in unselected pregnant women, attending the prenatal consultation in a Brussels public hospital (low to middle social class). Serum samples of 307 pregnant women (mean age 27.5 years, range 15.2-44.6 years) were screened for the presence of BZD. The samples were taken at an average of 17 weeks 6 days gestation, according to ultrasounds (range 15-25 weeks). A complete history (including intake of BZD and other medications) was systematically performed. Drug addicted women (hard and soft drugs, multiple medications) were not included in the study. The screening method for BZD was performed using a fluorescence polarization immunoassay technology (Abbott Laboratories, NC, USA). The sensitivity, detined as the lowest measurable concentration which can be distinguished from zero, was determinated to be 12 rig/ml. None of these 307 pregnant women had a history of

Cyclic Nucleotides and Cell Growth

Recent speculation concerning the role of cyclic nucleotides in the control of cell proliferation centres on mechanism in which cyclic AMP and cyclic GMP have opposing regulatory actions. (Hadden et al. 3 (1); Kram and Tomkins, (2); Goldberg et al., (3)). According to this model, cyclic AMP and cyclic GMP act as intracellular signals, respectively negative and positive, for cell growth in response to changes occurring in the environment. This hypothesis was developed independently as the result of personal investigations on the role of cyclic AMP and cyclic GMP as mediators of the “pleiotypic control” of cell growth proposed by Tomkins and co-workers, and of the work in Goldberg’s laboratory on the “Yin Yang or dualism hypothesis” of biological control through opposing actions of cyclic AMP and cyclic GMP.