Severe symmetric intrauterine growth retardation associated with topical use of triamcinolone

Article Abstract:

Triamcinolone is a topical agent, a fluorinated steroid, used to treat a variety of skin conditions. A 28-year-old pregnant woman had atopic dermatitis, a skin allergy causing severe itching. The pregnancy appeared normal until the 29th week of pregnancy, when it was observed that the fetus was the size of a 24th week fetus. The amount of fluid surrounding the fetus was abnormally small. When it was ascertained that the patient was taking 40 mg of triamcinolone per day for a skin allergy, the medication was stopped. Hospitalized bed rest was initiated and all other medical tests were unrevealing. At week 31 the fetus was delivered by cesarean section. Although the fetus was growth retarded (1.5 pounds), no other physical abnormalities or rashes were found. The infant remained in the hospital and developed necrotizing enterocolitis, a condition in the intestines which required multiple operations. The infant remained alive but was fed intravenously. Studies on animals have found that triamcinolone can cause defects in primates. In the absence of other causative factors triamcinolone is suspected of causing growth retardation in this fetus. Topical fluorinated steroids in large doses over an extended period of time should not be used during pregnancy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Fetus, Development and progression, Drug therapy, Birth weight, Low, Low birth weight, Fetal growth retardation, Atopic dermatitis, Triamcinolone

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The natural history of thrombocytopenia associated with preeclampsia

Article Abstract:

Preeclampsia is a serious condition in pregnancy which features hypertension, headaches, edema (fluid retention) in the legs, and excretion of a blood protein, usually a symptom indicative of kidney dysfunction. Frequently, thrombocytopenia, or low levels of platelets, which are blood cells important for clotting, is also present in this disorder. Preeclampsia resolves following delivery. which should lead to loss of substances that are associated with platelet depletion. To determine if thrombocytopenia resolves after obstetrical delivery, the occurrence of thrombocytopenia, which occurred in 61 of 237 patients with preeclampsia, was assessed. Levels of platelets rose in half of the women by the second day following delivery, in 90 percent of women by the third day, and in 97 percent of women by day four. Platelet levels were diminished for a longer time in two women, both of whom had other systemic diseases. The results indicate that postpartum patients who had preeclampsia should have rising platelet levels by the third day postpartum. Platelet levels should be close to normal by the fourth day following delivery unless other serious disease is present. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Preeclampsia, Thrombocytopenia

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The clinical implications of subchorionic placental lucencies

Article Abstract:

The detection of subchorionic placental lucencies (''clear'' places within the ultrasound image of the placenta) often leads to patients being referred for more detailed studies. To evaluate whether these lucencies are associated with a poor pregnancy outcome, 56 patients were studied in detail, 18 of whom had subchorionic placental lucencies. In two of the 40 pregnancies for which follow-up was possible, perinatal death occurred (shortly after delivery in one case and in premature delivery in the other). These two infant deaths were unrelated to placental abnormality. Such abnormalities do not seem to be related to a poor outcome of pregnancy, and need not lead to more detailed studies unless certain criteria are met. These criteria include the absence of blood flow within the lucencies and the presence of other fetal abnormalities as seen on ultrasound. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Usage, Diagnosis, Physiological aspects, Prognosis, Placenta, Prenatal diagnosis, Placental diseases, Placenta diseases, Prenatal ultrasonography, Ultrasonics in obstetrics

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