phenylephrine-hydrochloride and Fetal-Death

Review of published cases of pregnancies in which coumarin derivatives or heparin were administered demonstrates that use of either class of anticoagulant carries substantial risks. Of 418 reported pregnancies in which coumarin derivatives were used, one-sixth resulted in abnormal liveborn infants, one-sixth in abortion or stillbirth and, at most, two-thirds in apparently normal infants. In addition to the expected hemorrhagic complications, fetal effects of coumarin derivative administration include a specific embryopathy and central nervous system abnormalities. All available cases (including unpublished ones) of warfarin embryopathy and central nervous system abnormalities following gestational exposure to coumarin derivatives are reviewed, various complications are tabulated, critical periods of teratogenesis are discussed and possible mechanisms proposed. The use of heparin during gestation does not result in a significantly better outcome of pregnancy. In 135 published cases, the infants in one-eighth were stillborn, in one-fifth premature (a third of whom died) and, again at most, in two-thirds apparently normal. Because of the substantial risks of both clases of anticoagulants, and the inherent risks of pregnancy complicated by the indications for anticoagulation, prevention of pregnancy is usually indicated. If pregnancy occurs, a relatively normal outcome can be anticipated in about two-thirds of the pregnancies regardless of the anticoagulant used. Heparin does not appear to be a clearly superior alternative to coumarin derivatives.

Topics: Abnormalities, Drug-Induced; Adult; Central Nervous System; Chondrodysplasia Punctata; Coumarins; Female; Fetal Death; Fetal Diseases; Gestational Age; Hemorrhage; Heparin; Humans; Infant, Newborn; Male; Nose; Pregnancy; Pregnancy Complications, Cardiovascular; Risk; Syndrome

Topics: Adult; Eye Abnormalities; Female; Fetal Death; Fetal Diseases; Humans; Infant, Newborn; Nose; Pregnancy; Pregnancy in Diabetics

Multiple pterygium syndromes include at least 15 different entities characterized by multiple pterygia or webs of the skin and multiple congenital anomalies. We describe a female infant who presented with a distinct constellation of multiple anomalies consisting of pterygia of the inguinal, intercrural and popliteal areas, flexion contractures and arthrogryposis of some joints, craniofacial anomalies including ectropion, medial canthal web, blepharophimosis, hypoplasia of nose, oral and nasopharyngeal cavities, vocal cords and tongue, micrognathia, orolabial synechiae secondary to pterygia, low set ears, alopecia, sad and expressionless face, short neck, asymmetric nipples, anal stenosis, rectal polyp, hypoplastic labia majora, complete syndactyly of all fingers and toes, pes equinovarus, bandlike web between feet, and absence of the nails and phalangeal-palmar creases. Radiological examination showed synostosis, absence or hypoplasia of metacarpal, metatarsal and phalangeal bones on feet and hands, and hypoplasia of pelvic bones and scapulae. This pattern of anomalies does not fit entirely any of the known multiple pterygium syndromes. Autosomal recessive inheritance is most likely due to the presence of three similarly affected siblings and normal parents.

Topics: Abnormalities, Multiple; Alopecia; Bone and Bones; Facies; Family Health; Female; Fetal Death; Foot Deformities, Congenital; Genes, Recessive; Hand Deformities, Congenital; Humans; Infant; Infant, Newborn; Male; Mouth; Nose; Pharynx; Syndactyly; Syndrome; Tongue; Vocal Cords

Topics: Abnormalities, Drug-Induced; Adult; Anticoagulants; Chondrodysplasia Punctata; Female; Femur; Fetal Death; Fetal Growth Retardation; Gestational Age; Humans; Male; Nose; Pregnancy; Syndrome; Ultrasonography, Prenatal; Warfarin

Noses of 6 stillborn infants with unilateral lip and complete palate cleft were dissected and analysed. The surgical dissection revealed that the lower lateral cartilages are asymmetrical on both sides, indicating displacement of the lower lateral cartilages and the cartilageous septum which deviates to the normal side. Paired T Test shown that there is no significant difference between two sides in length and width. The conclusion is that the nasal deformities of the lip and palate cleft are congenital and one of the major causal factors is the displacement of lower lateral cartilages and cartilageous septum in the cleft side.

Topics: Abnormalities, Multiple; Anthropometry; Cartilage; Cleft Lip; Cleft Palate; Female; Fetal Death; Humans; Male; Nose; Pregnancy

Topics: Abortion, Spontaneous; Cesarean Section; Female; Fetal Death; Genitalia, Female; Humans; Infant, Newborn; Infant, Premature; Mycoplasma; Mycoplasma Infections; Nose; Pharynx; Pregnancy

Nine patients with aberrations in development and placement of the eyes and periocular structures who also had serious defects in central nervous system development were evaluated in order to better understand normal ocular development. Included were an incompletely developed twin stillborn infant who lacked both eyes and the nose, a stillborn infant with cyclopia hypognathia, 6 spontaneous abortuses with varying degrees of holoprosencephaly, and a 17-year-old male with a serious defect in central nervous system development whose right eye was positioned laterally above the right ear. In all cases, evidence indicates that orbital and periocular structures are determined by the underlying optic vesicle rather than independently derived as has been suggested by previous studies.

Topics: Abnormalities, Severe Teratoid; Adolescent; Anophthalmos; Central Nervous System; Diseases in Twins; Eye; Eye Abnormalities; Female; Fetal Death; Head; Humans; Infant, Newborn; Male; Nose; Orbit; Pregnancy

Sixteen pregnant cows were challenged with infectious bovine rhinotracheitis virus intranasally. One had a mummified fetus, four aborted, one calf was stillborn, two live fetuses were taken at the abattoir and eight calves were born alive. Of the eight born alive, five were dead by 12 days of age. Four of these had the usual lesions of infectious bovine rhinotracheitis as well as lesions in the intestine and peritoneum and two of the four had a fibrinous pneumonia thought to be caused by aspiration of milk. The lesions, results of virus isolation and fluorescent antibody testing are recorded in these four calves. Attention is drawn to the intestinal lesions, the peritonitis and fibrinous pneumonia and the ease with which the underlying infectious bovine rhinotracheitis infection may be overlooked.

Topics: Abortion, Veterinary; Adrenal Glands; Animals; Animals, Newborn; Cattle; Eye; Female; Fetal Death; Infectious Bovine Rhinotracheitis; Intestines; Kidney; Larynx; Liver; Lung; Mouth; Muscles; Nose; Pregnancy; Spleen

Topics: Abnormalities, Multiple; Ankylosis; Cesarean Section; Clubfoot; Ear, External; Face; Female; Fetal Death; Fingers; Hip; Humans; Infant, Newborn; Knee; Lung; Nose; Pregnancy; Syndrome; Ulna

Topics: Abortion, Spontaneous; Bacteriuria; Birth Weight; Boston; Cervix Uteri; Ethnicity; Female; Fetal Death; Genitalia, Female; Gestational Age; Hemorrhage; Humans; Infant, Newborn; Mycoplasma; Mycoplasma Infections; Nose; Obstetric Labor, Premature; Pharynx; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Infectious; Prospective Studies; Socioeconomic Factors

Topics: Abortion, Veterinary; Animals; Bacteriological Techniques; Cattle; Cattle Diseases; Culture Media; Endometrium; Female; Fetal Death; Lung; Male; Methods; Milk; Mycoplasma; Mycoplasma Infections; Nose; Penis; Pregnancy; Semen; Synovial Fluid; Vagina

Topics: Adaptation, Biological; Birth Injuries; Brain Injuries; Extraembryonic Membranes; Female; Fetal Death; Fetus; Hearing Disorders; Humans; Infant, Newborn; Infant, Premature, Diseases; Labor, Obstetric; Nose; Otitis Media; Pregnancy; Respiration; Respiratory Distress Syndrome, Newborn; Respiratory Tract Infections

Topics: Anophthalmos; Extremities; Face; Female; Fetal Death; Humans; Limbic System; Nose; Pregnancy