Frederick C. Battaglia

A practical classification of newborn infants by weight and gestational age

A classification of newborn infants based upon gestational age and birth weight is proposed. The advantages of establishing such a routine on a nursery service, and the possibility of superimposing neonatal mortality rates upon gestational-age and birth-weight data are presented.

Diagnostic value of blood sampling in fetuses with growth retardation

Background Fetuses with intrauterine growth retardation are delivered if they have evidence of distress, as manifested by abnormalities in the fetal heart rate and umbilical-artery blood flow. We studied whether umbilical-blood sampling might provide further information useful for management. Methods We measured hemoglobin and lactate concentrations, oxygen content, pH, blood gas levels, and base deficit in umbilical-vein blood and correlated these measurements with the heart rate and umbilical-artery wave forms recorded by Doppler velocimetry in 56 fetuses with growth retardation. Twenty-one fetuses had normal heart rates and normal results of velocimetry, 24 had normal heart rates and abnormal results of velocimetry (indicative of decreased diastolic flow), and 11 had abnormal heart rates and abnormal results of velocimetry. Results None of the 21 fetuses with normal heart rates and velocimetry had hypoxia or acidemia. Of the 24 fetuses with normal heart rates and abnormal velocimetry, 4 (17 percent) ha...

Hypernatremia and intracranial hemorrhage in neonates.

Abstract Records of all newborn admissions over a two-year period were reviewed for the occurrence of hypernatremia and intracranial hemorrhage. When restrictive criteria for the use of sodium bica...

Umbilical amino acid concentrations in normal and growth-retarded fetuses sampled in utero by cordocentesis

Fetal plasma amino acid concentrations were obtained by cordocentesis at midgestation in 11 normal (appropriate for gestational age) fetuses and at late gestation in 12 small-for-gestational-age fetuses, and at cesarean section in 14 normal term infants. In normal fetuses total molar amino acid concentrations and fetal/maternal total molar concentration ratios did not change significantly between the second and third trimesters. Fetal and maternal concentrations of most amino acids were significantly correlated at both midgestation and late gestation. Small-for-gestational-age fetuses had significantly lower concentrations of total alpha-aminonitrogen; this was mainly because of a reduction of the branched chain amino acids valine, leucine, and isoleucine, and of lysine and serine. Maternal arterial concentrations of phenylalanine, arginine, histidine, and alanine were elevated in small-for-gestational-age pregnancies. Thus there are only minor changes in amino acid concentrations between midgestation and late gestation in normal fetuses with a constant fetal/maternal ratio. In small-for-gestational-age infants a significant reduction in alpha-aminonitrogen and in most essential amino acids was demonstrable in utero weeks before delivery.

Measurement of Umbilical Arterial Blood Flow to the Sheep Placenta and Fetus in Utero: DISTRIBUTION TO COTYLEDONS AND THE INTERCOTYLEDONARY CHORION

A method of estimating the magnitude and distribution of umbilical blood flow by means of radioactive microspheres in sheep fetuses in utero is described. Simultaneous measurements of total umbilical flow by this method and the steady-state diffusion technique showed agreement within ±11%. In 11 fetuses of 90 to 150 days gestational age, the distribution of umbilical flow to the intercotyledonary chorion was 6.2±0.8% of the total. This information has been used to estimate the effect of venous admixture of cotyledonary and noncotyledonary blood on the umbilical vein-uterine vein concentration difference of inert molecules with flow-limited transplacental clearance.

Human Chorionic Gonadotropin: Its Possible Role in Maternal Lymphocyte Suppression

Human chorionic gonadotropin completely inhibits the response of lymphocytes to phytohemagglutinin. The effect is both reversible and noncytotoxic. These observations support the theory that the fetus is accepted because human chorionic gonadotropin represents trophoblastic surface antigen and blocks the action of maternal lymphocytes.

Imbilical amino acid concentrations in appropriate and small for gestational age infants: a biochemical difference present in utero☆

Plasma amino acid concentrations were determined in 28 pregnant women and their infants at term. Samples were obtained from 17 appropriate for gestational age and eight small for gestational age infants at cesarean section, while three small for gestational age fetuses were studied in utero by transabdominal cord sampling by means of ultrasonic guidance. Small for gestational age fetuses have significantly lower concentrations of alpha-aminonitrogen, compared with those of appropriate for gestational age fetuses, in both the umbilical artery and vein. Most of the difference is accounted for by the branched chain amino acids valine, leucine, and isoleucine. In contrast, hydroxyproline concentration is significantly higher in both the umbilical artery and vein of small for gestational age fetuses. The sum of the branched chain amino acid concentrations in the umbilical vein is directly related to maternal arterial values in both appropriate for gestational age and small for gestational age fetuses. Maternal arterial concentrations were slightly lower in small for gestational age fetuses and the regression analysis of umbilical venous versus maternal arterial branched chain amino acid concentrations was significantly different for small for gestational age and appropriate for gestational age infants. Umbilical venoarterial concentration differences in normal fetuses are significantly positive for most essential amino acids and for total alpha-aminonitrogen. In contrast, these differences were significant only for four essential amino acids in small for gestational age infants, while the total alpha-aminonitrogen venoarterial difference was not significant. The data obtained by transabdominal cord sampling from relatively undisturbed fetuses were in agreement with the data obtained at cesarean section; this information suggests that these differences between small for gestational age and appropriate for gestational age infants reflected steady-state conditions.

Circulatory Changes in the Reproductive Tissues of Ewes during Pregnancy

The blood flows to reproductive organs were measured by means of radionuclide-labeled microspheres in 24 pregnant ewes with gestational ages ranging from 38 to 141 days. The microspheres were injected

Effect of estrogens on the uterine blood flow of oophorectomized ewes

Abstract Quantitative information about dilatation of uterine blood vessels after administration of estrogens is needed, e.g., the dose response of uterine blood flow to estrogens, whether different estrogens are equipotent in inducing vasodilation, the maximum obtainable blood flow to the nonpregnant uterus under maximum estrogen stimulation, and the related chain of biochemical events. The type of biological preparation developed and the results obtained thus far form the substance of this report.

Effect of estradiol-17β on blood flow to reproductive and nonreproductive tissues in pregnant ewes

The effect of estradiol-17beta (1 mug per kilogram) on regional blood flow and cardiac output was studied by means of radionuclide-labeled microspheres in 6 nonpregnant and 13 pregnant ewes five to seven days after operation. Estradiol caused vasodilation in myometrium, endometrium, and placental cotyledons throughout pregnancy, but these responses were significantly less than the fifteenfold increase seen in the nonpregnant uterine tissues. Significant vasodilation also occurred in the ovaries, cervix, vagina, uterine tubes, mammary gland, skin, and adrenal glands of pregnant ewes. Cardiac output increased by 14%. No significant change in uterine oxygen consumption was associated with the increase in blood flow to the pregnant uterus.