Use of the Foley cordostat grasping device for selective ligation of the umbilical cord of an acardiac twin: a case report

Article Abstract:

A new fetal surgical procedure to salvage the viable twin in cases of acardius syndrome is described. In acardius syndrome, one of identical twins has no heart. The other twin's heart supports both circulations. The acardiac twin always dies and the risk of death for the other twin from heart failure is 50% to 75%. A women asked for surgery to save one twin in such a pregnancy. The uterus was lifted out under regional anesthesia. The umbilical cord of the acardiac twin was located on ultrasound. A small incision was made in the uterus, that twin's umbilical cord was grasped and lifted out with a Foley Cordostat, and the umbilical cord was tied off. The uterus was replaced, and the incisions repaired. Although there were complications with the pregnancy and the surviving twin was delivered by emergency cesarean at 35 weeks gestation, she survived and is healthy. This procedure is less likely to cause complications than removing the nonviable twin or inserting a coil in the umbilical cord to induce formation of a clot.

Usage, Abnormalities, Fetus, Surgery, Fetal surgery, Twins, Surgical equipment and supplies, Surgical instruments

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Chorioamnionitis caused by Capnocytophaga: case report

Article Abstract:

Chorioamnionitis can be caused by Capnocytophaga, a bacterium that is mostly found in the human oral cavity. Chorioamnionitis is inflammation of the fetal membranes. A 27-year-old pregnant woman with contractions at 25 weeks was admitted to a hospital. She mentioned a pink discharge the week before and a previous episode of oral-genital sex. The antibiotic ampicillin was given. After a Gram stain of the amniotic fluid showed gram-negative rods and many white blood cells, the diagnosis of chorioamnionitis was made. A cesarean section was performed. The child was diagnosed with chronic lung disease, but remained fairly healthy at 1.5 years of age. The mother and baby did well with ampicillin treatment postpartum. The infection appears to respond well to antibiotics.

Health aspects, Causes of, Complications and side effects, Bacterial infections, Chorioamnionitis, Ampicillin

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Cardiovascular effects of a mu-selective opioid agonist (tyrosine-D-arginine-phenylalanine-lysine-NH2) in fetal sheep: sites and mechanisms of action

Article Abstract:

A form of opiate called DALDA appears to have fewer adverse effects on the fetus. Opiates are often used as painkillers during during delivery but they can cross the placenta and adversely affect the fetus. Researchers tested DALDA by giving pregnant sheep an intravenous dose of the chemical. It caused an increase in the heart rate of the fetal lamb, but did not affect blood pressure. DALDA binds to the mu opioid receptor, which is one of three different opioid receptors. Opiates that bind to this receptor have fewer side effects.

Physiological aspects, Opioids, Cardiovascular system, Circulatory system

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