By Diana Bianchi, Timothy Crombleholme, Mary D'Alton
State of the art reference deals a cohesive, multidiscilinary approac h to analysis, administration, and sometimes, remedy of the fetal sufferer. This e-book discusses the whole implications of a fetal sonograp hic or chromosomal prognosis - from prenatal administration to long term o utcome for the affected baby. Balanced, scholarly, non-directive guid e illuminates the newest study for sensible use via these clinician s who deal with a fetus or neonat with a sonographically detected anomaly.
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Extra resources for Fetology: Diagnosis and Management of the Fetal Patient
Sample text
Inadvertent entry into the extraembryonic coelom, resulting in amniotic bands, has also been suggested. This seems unlikely because actual bands have not been observed in any cases. The most plausible proposed mechanism is a form of vascular insult leading to under-perfusion of the fetus ( Brent 1990). CVS could cause disruption of the vessels supplying the extracorporeal fetal circulation. This disruption would result in the release of vasoactive peptides, producing fetal vasospasm and hypoperfusion of the fetal peripheral circulation.
1986; Brambati et al. 1986; Shulman et al. 1990). The elevation in MSAFP levels is not related to the technique used to retrieve villi but seems to depend on the quantity of tissue aspirated ( Shulman et al. 1990). Levels will return to normal ranges by 16 to 18 weeks of gestation, thus allowing serum screening to proceed according to usual prenatal protocols. All Rh-negative, nonsensitized women who are undergoing CVS should receive Rho(D) immune globulin after the procedure. Exacerbation of Rh immunization following CVS has been described.
Ultrasound image of the same case shown in Figure 2-8, demonstrating the use of color Doppler to enhance visualization of the umbilical cord. See color plate. Once a sample of blood has been aspirated, it is essential to verify that it is fetal in origin. The most definitive way to do this is to compare the mean corpuscular volume (MCV) of the red cells to that of a sample of maternal blood. This is easily performed on small aliquots of blood by a standard channeling instrument. It is preferable to have this instrument in the procedure room.