Gonzalo Moscoso

FETAL BREATHING MOVEMENTS AS PREDICTOR OF FAVOURABLE PREGNANCY OUTCOME AFTER OLIGOHYDRAMNIOS DUE TO MEMBRANE RUPTURE IN SECOND TRIMESTER

In 11 pregnancies complicated by oligohydramnios due to spontaneous rupture of the membranes in the second trimester of pregnancy fetal breathing movements were assessed regularly by ultrasonographic examinations. In the 6 cases in which fetal breathing movements were detected the babies were liveborn and there was no evidence of pulmonary hypoplasia or the other non-renal features of Potters syndrome. In the other 5 cases there were no fetal breathing movements. 1 pregnancy was terminated electively, and 1 ended in an intrauterine death; the remaining 3 infants died in the neonatal period. All 5 cases showed necropsy evidence of pulmonary hypoplasia. These findings indicate that premature and prolonged rupture of membranes in the second trimester of pregnancy does not uniformly result in a poor prognosis. They suggest that fetal breathing movements could be used as a predictor of favourable neonatal outcome.

The developing human biliary system at the porta hepatis level between 11 and 25 weeks of gestation: A way to understanding biliary atresia. Part 2

The developing biliary system in normal human embryos from 29 days to 8 weeks post‐fertilization was studied. The primitive extrahepatic bile duct that originates from the embryonic hepatic foregut diverticulum is in contact with the hepatic anlage from the start of organogenesis and remains so throughout the gestational ages examined. The primitive extrahepatic bile duct maintains continuity with the ductal plate from which intrahepatic bile ducts are eventually formed. Contrary to long‐held concepts of biliary development, no ‘solid stage’ of entodermal occlusion of the common bile duct lumen was found at any stage of gestation in the material investigated. Therefore, biliary atresia is not caused by incomplete vacuolization of the ‘solid stage’.

Development of the early human placenta: a morphometric study.

The placentae of 46 normal pregnancies artificially terminated between 6 and 15 weeks of gestation were investigated morphologically to provide trends in early villous development. Study of the specimens included phase contrast microscopic examination and histomorphometric investigation in all cases, and scanning electron microscopy in ten cases. Histomorphometric measurements included the villous barrier thickness i.e. the distance between the intervillous space and the villous capillary lumen, the trophoblastic layer thickness and the volume fraction of each villous constituents, i.e. trophoblast, stroma and capillaries. Significant negative correlations were observed between gestational age and the villous barrier and trophoblastic thickness. The data obtained were separated into two groups, embryonic (5-10 weeks) and fetal (11-15 weeks) groups, and compared. The mean barrier thickness, the mean trophoblastic thickness, the mean volume fraction for trophoblast and the sprouting-villous index were significantly greater during the embryonic period compared with the fetal period. The mean volume fraction for the stroma and for the fetal capillaries, and the mean number of capillary profiles per villous profile were significantly smaller during the embryonic period than during the fetal period. The comparison of placental histomorphometric data obtained in cases of normal early pregnancies with those observed in cases of abnormal early pregnancies could help us to elucidate the origin of anatomical and biological changes in these cases.

Molecular cloning of human GATA-6 DNA binding protein: high levels of expression in heart and gut

Human GATA-6 has been cloned from foetal heart by a combination of PCR-based methods and cDNA library screening. The 3.8 kbp cDNA has a coding sequence of 1347 bp the 449 aa protein is virtually identical in the two zinc-finger binding domains to other human GATA sequences, but varies considerably in the amino and carboxy terminal regions. The sequence shows greatest similarity to GATA-6-like sequences from rat, mouse, chicken and Xenopus. Northern analysis and in situ hybridisation show that GATA-6 is expressed at high levels in human adult and foetal heart as well as in gut derivatives. It is postulated that GATA-6, in concert with GATA-4, plays a crucial role in the regulation of cardiac differentiation.

Myocarditis and fulminant hepatic failure from coxsackievirus B infection.

A case of fulminant hepatic failure in association with myocarditis is reported. Presentation suggested an acute hepatitis which was complicated by cardiac failure. Evidence of severe myocarditis was found at autopsy.