Mark I Evans

Coercion for Fetal Therapy

The “fetus as a patient” has over the past two decades become an accepted concept in obstetrics.1 A specific field of fetal medicine has developed as a recognized subspecialty.2 There are, however, complex interactions that emerge from the alteration of roles and responsibilities that have evolved over the past decade. Maternal-fetal conflicts for standard and experimental indications are likely to abound in the coming decade.3

Amniotic Fluid Platelet Factor 4 and Beta- Thromboglobulin

Platelet activating factor (PAF), a powerful platelet activator, has been identified in human embryos and fetuses, and may induce fetal lung maturation. The potential effect of PAF on fetal platelets as indicated by release of beta-thromboglobulin (BTG) and platelet factor 4 (PF4) has not been investigated. We measured BTG and PF4 in amniotic fluid from 78 genetic and 35 pulmonary maturity amniocenteses. BTG and PF4 were higher in the genetic amniocentesis samples (p < 0.001 in each case) than in the lung maturity samples. BTG and PF4 did not correlate with the pulmonary maturity parameters as measured by the lecithin to sphingomyelin ratio and phosphatidylglycerol concentration. Our findings suggest a fetal origin of BTG and PF4 in amniotic fluid.