By Dev Maulik, James P. Youngblood, Prasad Yarlagadda (auth.), Manohar Rathi M.D. (eds.)
Current Perinatology, II, explores the latest significant study ideas used in the review, analysis, and administration of the high-risk mom and her infant. the amount might be an important reference for pediatricians, perinatologists, and neonatologists, in addition to for nurses and allied future health group of workers heavily concerned with the care of the high-risk mom, fetus, and baby. themes awarded contain perinatal Doppler; Doppler echocardiography of the human fetus; invasive fetal overview through fetal blood sampling; prediction, prevention, and remedy of preterm exertions; percutaneous umbilical blood sampling and intravascular fetal treatment; present and destiny views for fetal genetic analysis; present ideas of substance abuse while pregnant; more moderen equipment of analysis and remedy of neonatal sepsis; scientific functions of neonatal pulmonary functionality trying out; and present administration of hypoplastic left center syndrome. Discussions of stabilization and transportation of the severely ailing obstetric sufferer and of ache administration within the neonatal extensive care unit might be of curiosity to either physicians and nurses.
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2 6 . 27 The frequency of actual low fetal platelet counts has been surprisingly low. Although Moise2 6 found counts below normal (150,000) in 23%, clinically important thrombocytopenia (below 50,000) was only seen in 1 of 23 sampled fetuses. 2 6 also found a difference between two twins (151,000 and 104,000), suggesting that sampling only one fetus in such a setting is insufficient. Scioscia27 similarly reported clinically important thrombocytopenia in only one of 20 fetuses studies. Since the appearance of that report, we have studied an additional 20 mothers with no further significant fetal thrombocytopenia (Grannum, unpublished observations).
In the Wiscott-Aldrich syndrome, an X-linked disorder, fetal platelets are diminished in number and smaller than normal. 21 Fortunately, the other disorders have not been associated with excessive bleeding from the cord after puncture. Maternal isoirnmune thrombocytopenic purpura (ITP) is a more common disorder. While maternal production of IgG antibodies to her own platelets is generally held to be the cause of the disorder, clinical detection of the antibodies is relatively insensitive. The presentation is that of maternal thrombocytopenia, with no defects in the red or white cell lines.
Have Liley charts outlived their usefulness? Am J Obstet Gynecol. 1986;155:90-94. 46. Reece EA, Copel JA, Scioscia AL, et al. Diagnostic fetal umbilical blood sampling in the management of isoimmunization. Am J Obstet Gynecol. 1988; 159: 1057 -1062. 47. Frigoletto FD, Umansky I, Birnholz J, et al. Intrauterine transfusion in 365 fetuses during fifteen years. Am J Obstet Gynecol. 1981;139:781-790. 48. Watts DH, Luthy DA, Benedetti TJ, et aI. Intraperitoneal fetal transfusion under direct ultrasound guidance.