Oszukowski P

Laser acupuncture and low-calorie diet during visceral obesity therapy after menopause

Acta Obstet Gynecol Scand 2003; 82: 69–73.

Selected trace elements concentrations in pregnancy and their possible role — literature review

The aim of this study was to review the role of selected trace elements in pregnancy and fetal development. Citations related to the role of iron (Fe), zinc (Zn), manganese (Mn), copper (Cu) and selenium (Se) during pregnancy were searched in PubMed, Medline, Web of Science, using keywords and MeSH terms. Inadequate supply of trace elements can cause abnormalities of fetal development and predispose a child to disorders later on in life. Trace elements are the key elements of complex enzymes responsible for the modulation of the antioxidant defense system of the organism. It has been suggested that there is a correlation between reduced levels of trace elements essential for antioxidant function in the body of pregnant women, and an increased risk of developing preeclampsia. Trace elements are components of numerous regulatory enzymes and hormones essential to the division and differentiation of fetal cells and their further development. Mineral deficiencies in pregnant women can cause birth defects of the central nervous system, and growth disorders. Future research should be directed to explain the interaction between trace elements, and establish the optimum levels of macro and micronutrients supplementation, as well as determine the reference values for trace elements in the maternal serum, umbilical cord blood and amniotic fluid.

Benign but fatal. A case of a newborn with congenital osteochondroma.

Osteochondroma is one of the most frequent benign bone tumors in children. Its incidence is hard to determine because this tumor usually is asymptomatic. These tumors may present as solitary, nonhereditary lesions or as hereditary multiple osteochondromas that are inherited in an autosomal dominant manner. Although osteochondromas are usually asymptomatic, significant symptoms may occur because of complications such as bone fracture, bone deformation, or joint problems. The tumor may also mechanically compress nerves or vessels. Osteochondromas growing inwardly may cause injury to internal organs. The authors present a preterm (34 weeks of corrected gestational age) neonate in whom osteochondroma, although histologically benign, caused death because of its size and location. Prenatal ultrasound imaging performed during the third trimester of pregnancy showed bilateral hydrothorax and hydroperitoneum as well as heterogeneous parenchymal area on the right side of the thorax. After birth, the neonates condition was extremely severe. Although intensive and multidirectional treatment was applied, the condition of the infant continued to deteriorate and he died 26 h after birth. The autopsy confirmed presence of the tumor - osteochondroma - that caused total mediastinal shift with significant hypoplasia of both lungs and with signs of significant compression of the superior and inferior vena cava.

Cell-free fetal DNA testing in prenatal diagnosis: Recommendations of the Polish Gynecological Society and the Polish Human Genetics Society

This paper contains a joint position of the Polish Gynecological Society and Polish Human Genetics Society on the cell-free fetal DNA testing in prenatal diagnosis. We present situations where the cell-free fetal DNA testing should be applied and cases in which performing of the test is not useful. We indicate what diagnostic steps should be performed before the test and how the test results should be interpreted and followed.

Evaluation of erythromycin concentration in the umbilical artery serum

OBJECTIVES The aim of the study was to investigate the effectiveness of erythromycin in preventing intrauterine infection caused by group B streptococcus (GBS). MATERIAL AND METHODS The study included 20 pregnant women with GBS-positive screening or whose laboratory screening was not available, who delivered between April 17, 2013 and July 22, 2013. The women were given 600 mg of erythromycin intravenously After delivery blood was drawn in parallel from maternal antecubital vein and umbilical cord artery Serum erythromycin concentrations were evaluated using enzyme-linked immunosorbent assay (ELISA) kit. Statistical analysis for measurable and non-measurable characteristics were performed, correlation coefficients for each pair of variables were calculated in order to investigate the sought dependence. RESULTS Mean placental transfer of erythromycin was 2.04%. There was a high correlation between umbilical artery serum and maternal serum erythromycin concentration. Selected variables of mothers in the control group had no effect on serum erythromycin concentration in the umbilical artery CONCLUSIONS Transplacental transfer of erythromycin is limited (2.04%). Intravenous application of erythromycin at a dose of 600 mg does not allow to achieve the value of MIC50 and MIC90 for erythromycin against strains S. agalactiae in umbilical artery serum, what suggests a compromised efficacy in the treatment of intrauterine fetal infections. At the same time, the placenta seems to be an effective barrier reducing fetal exposure when this macrolide is used to treat maternal infections.

OP21.04: Obstetrical outcome in 80 pregnancies with prenatally diagnosed hypoplastic left heart syndrome (HLHS) at a referral center

A. Levey1, L. L. Simpson2,3, C. S. Kleinman1,3, J. Glickstein1,3, S. M. Levasseur1,3, I. Williams1,3 1Pediatrics, Division of Pediatric Cardiology, Columbia University College of Physicians & Surgeons, New York, NY, USA; 2Obstetrics & Gynecology, Division of Maternal Fetal Medicine, Columbia University College of Physicians & Surgeons, New York, NY, USA; 3The Center for Prenatal Pediatrics, Morgan Stanley Children’s Hospital of New York, New York, NY, USA

P26.22: Sonography in fetal ovarian cysts

routine ultrasound. A bilateral renal disease with oligohydramnios was diagnosed in her first pregnancy and the baby was stillborn with Potter sequence. In the actual pregnancy the ultrasound done at 26 + 4 weeks of gestation showed right pyelocalicial and proximal ureteral dilatation with narrowing. In the neonatal period a 3D scan with multiplanar views demonstrated a megaureter associated with ureteral valve and a distal ureteral stenosis. The diagnosis was confirmed via surgical exploration and histology. While rare this might be a cause of ureteral obstruction with progressive upper tract dilatation. We emphasize the value of multiplanar 3D which allowed a diagnosis that only few years ago was privative of excretory urography.

P39.02: Fetal echocardiography in ovarian cysts

ranged from 2 to 36 (mean, 18.87 ± 13.07) months. In most cases the tumor masses decreased after birth (n = 6), but had no change in utero (n = 5). Three of them were diagnosed as tuberous sclerosis after birth, and none of them needed surgical intervention. Conclusion: Fetal cardiac tumors and their effect on the fetal cardiac function could be well evaluated by two-dimensional and Doppler echocardiography. The fetal cardiac tumor may have little effect on the fetal well being, both prenatally and postnatally. We cannot suggest the definite association of fetal rhabdomyomas and tuberous sclerosis.

OP02.08: Non immune hydrops fetalis (270 cases)—optimization of diagnosis and therapy

our series of fetuses with pleural effusion treated with thoracoamniotic shunting. Methods: Between 1992 and 2005, 53 fetuses with pleural effusion were referred to our unit and underwent thoraco-amniotic shunting. In all cases a detailed fetal anatomy scan and karyotyping were performed. A search for maternal infection was done in every case. A double pigtail catheter (Rocket, London, UK) was inserted by one operator under ultrasound guidance using local anesthesia when a complication like hydrops or polyhydramnios was found. Results: There were 35 bilateral and 18 unilateral shunt placements. In all 53 cases the procedure was successful. In two cases there was termination of pregnancy because of abnormal karyotype. There were 12 neonatal deaths. There were 34 survivors, with a follow-up at 1–7 years for 45% of cases. Survival rate was 90% for fetuses without hydrops and 58% for those which were hydropic, compared with an overall survival rate of 59% and 35%, respectively, as reported in untreated cases. Conclusions: Thoraco-amniotic shunt may improve outcome for fetuses with pleural effusion expecially if complicated with hydrops.

P03.29: Fetal Diagnostic Centre for Ultrasound and Echocardiography—ten years' experience

Results: In 40 euploid fetuses and 34 aneuploid fetuses 159 measurements of JLS volume and NT thickness were analyzed. The volume of JLS and gestational age showed a quadratic relation (p < 0.01) with a maximum size at 96 days. The maximum volume of the JLS was larger in fetuses with aneuploidy compared to euploidy (3.54 vs. 0.96 cm3) and the JLS were longer present (range 43 vs. 30 days). Time lag analysis revealed that enlargement of the NT preceded an increase in volume of the JLS (p < 0.001) in all fetuses. Conclusion: Increased NT is associated with a disturbed lymphatic development in which NT enlargement precedes enlargement of JLS. Aneuploid fetuses seem to have a more severe disturbance of lymphatic development.