1/15. Prenatal confirmation of periventricular leukomalacia in a surviving monochorionic-diamniotic twin after death of the other fetus: a case report.A 30-year-old woman was found to be carrying monochorionic-diamniotic twins at 7 weeks of gestation. The growth-retarded fetus died at 21 weeks of gestation. At 28 weeks of gestation, periventricular leukomalacia was detected in the brain of the surviving fetus by transvaginal ultrasonography. A female baby presenting with microcephaly was born at 39 weeks of gestation, and CT of the brain showed microcephaly and marked hydrocephalus. At 12 months of age, the surviving infant presented with severe physical growth retardation, and frequent episodes of clonic convulsions.- - - - - - - - - - ranking = 1keywords = gestation (Clic here for more details about this article) |
2/15. Neonatal periventricular leukomalacia preceded by fetal periventricular echodensity.OBJECTIVE: The purpose of this prospective study is to verify whether fetal periventricular echodensity (PVE) precedes neonatal periventricular leukomalacia (PVL). methods: Fetal brains were studied with transvaginal scan in 63 high-risk fetuses from 17 to 32 weeks of pregnancy, PVE echogenicity was quantified with ultrasonic histogram, and neonatal brains and clinical courses were studied after birth. RESULTS: No fetal cystic PVL was found, instead, fetal PVE was detected in 42 fetuses. The quantified echogenicity value was higher in PVE than in normal brain. Four cases developed neonatal PVL among 28 preterm and 1 among 14 term births. Neonatal PVL developed in the 23 cases of persistent fetal PVE, whereas no neonatal PVL was found when fetal PVE was negative or disappeared. Cord compression signs were common in PVL cases. CONCLUSION: Neonatal PVL was preceded by antepartum persistent fetal PVE in the present study.- - - - - - - - - - ranking = 0.10509790100306keywords = pregnancy (Clic here for more details about this article) |
3/15. Intrauterine cerebral infarcts and bilateral frontal cortical leukomalacia following chronic maternal inhalation of carburetor cleaning fluid during pregnancy.Little is known about the effect of inhalation of methanol and other solvents on the pregnancy and the growth of the fetus. We report a preterm male infant who developed cerebral infarcts in utero, leading to large areas of bilateral frontal cortical leukomalacia following chronic maternal inhalation of carburetor-cleaning fluid during pregnancy. The infant presented with acute fetal distress with significant metabolic acidosis at birth. Initial hypotonia was followed by generalized hypertonicity. This infant did not exhibit typical facial features of fetal alcohol syndrome.- - - - - - - - - - ranking = 0.63058740601833keywords = pregnancy (Clic here for more details about this article) |
4/15. Motor outcome differences between two groups of children with spastic diplegia who received different intensities of early onset physiotherapy followed for 5 years.The objective of this study is to determine the clinical effectiveness of early onset long-term intensive physiotherapy on motor development in children with spastic diplegic cerebral palsy (CP). The study was a non-randomized cohort study with 62 months (mean) follow-up. The participants were ten infants who were first examined before 3 months of age corrected for prematurity. All had a gestational age of less than 33 weeks and a birth weight of less than 2000 g. Brain magnetic resonance imaging revealed periventricular white matter injury in nine subjects and moderate grade bilateral porencephaly in one. Five completed a full course of training of 52 months (mean), two did not receive therapy, and three received an insufficient course of therapy. The study was conducted at the Regional Center for Children with Disabilities including outpatient clinics and a school for children with special needs. The Vojta Method was used, which is an extensive family oriented physiotherapy program which uses isometric strengthening of muscles with tactile stimulation. Subjects were evaluated for the highest motor developmental level at the outcome evaluation 59 months (mean) after initiation of therapy. Four of the five who completed training could either stand still for 5 s or walk at the time of the outcome evaluation 52 months after the beginning of the therapy program. None of the five subjects with no training or insufficient training could accomplish this task when evaluated 64 months following therapy initiation. This was a statistically significant difference (P = 0.0278). A consistently applied physiotherapy program resulted in better motor outcomes in this group of children at risk for developing spastic diplegic CP.- - - - - - - - - - ranking = 0.25keywords = gestation (Clic here for more details about this article) |
5/15. Fetal trauma: brain imaging in four neonates.The purpose of this paper is to describe brain pathology in neonates after major traffic trauma in utero during the third trimester. Our patient cohort consisted of four neonates born by emergency cesarean section after car accident in the third trimester of pregnancy. The median gestational age ( n=4) was 36 weeks (range: 30-38). Immediate post-natal and follow-up brain imaging consisted of cranial ultrasound ( n=4), computed tomography (CT) ( n=1) and post-mortem magnetic resonance imaging (MRI) ( n=1). pathology findings were correlated with the imaging findings ( n=3). Cranial ultrasound demonstrated a huge subarachnoidal hemorrhage ( n=1), subdural hematoma ( n=1), brain edema with inversion of the diastolic flow ( n=1) and severe ischemic changes ( n=1). In one case, CT demonstrated the presence and extension of the subarachnoidal hemorrhage, a parietal fracture and a limited intraventricular hemorrhage. Cerebellar hemorrhage and a small cerebral frontal contusion were seen on post-mortem MRI in a child with a major subarachnoidal hemorrhage on ultrasound. None of these four children survived (three children died within 2 days and one child died after 1 month). Blunt abdominal trauma during pregnancy can cause fetal cranial injury. In our cases, skull fracture, intracranial hemorrhage and hypoxic-ischemic encephalopathy were encountered.- - - - - - - - - - ranking = 0.46019580200611keywords = gestation, pregnancy (Clic here for more details about this article) |
6/15. Periventricular leukomalacia and retinopathy in a term infant born to a mother with asthma.A male child, born at 37 5 gestational weeks (GWs) (birthweight 2000g) after intrauterine growth retardation (IUG; -3 SD), to a mother treated during pregnancy for asthma, developed periventricular leukomalacia and retinopathy with total retinal detachment in the left eye and partial detachment in the right eye. Apart from basic asthma treatment with terbutalin, budesonid, and fenoterolhydrobromid throughout the pregnancy, she was treated with intravenous or oral cortisone for 6.5 weeks from 28 5 GWs. In addition she developed deep venous thrombosis at 29 GWs and was treated with heparin until delivery. Psychotic symptoms during the 31st GW were treated with diazepam, haloperidol, and levomepromazin. Functional sequelae for the child were visual impairment (visual acuity 5/60), uneven intellectual profile (Wechsler Pre-school and Primary Scale of intelligence, Verbal IQ 94 and Performance IQ 32 at 8y of age), and autistic-like behaviour. The possibility that pre- and perinatal risk factors (e.g. severe maternal illness, IUGR, and cortisone treatment) in a term infant may create conditions for developing eye and brain pathologies commonly closely related to preterm birth should be considered.- - - - - - - - - - ranking = 0.46019580200611keywords = gestation, pregnancy (Clic here for more details about this article) |
7/15. Visual field defects in prematurely born patients with white matter damage of immaturity: a multiple-case study.PURPOSE: White matter damage of immaturity may affect visual, motor and cognitive functions. This multiple-case study presents standardized perimetry results in six teenagers and young adults born prematurely with visual dysfunction due to white matter damage of immaturity of pre- or perinatal origin. methods: Six subjects, aged 13-25 years, born at a gestational age of 28-34 weeks, with white matter damage of immaturity documented by MRI, and optic disc appearances documented by fundus photography, were examined with manual and computerized quantitative perimetry. RESULTS: All subjects had subnormal visual field (VF) function, although the depth and extension of the VF defects differed between subjects. The inferior VF function was more deviant than the superior in all cases. The concordance between the VF defects detected with the different techniques was good, although the static computerized techniques revealed slightly more abnormality. CONCLUSION: White matter damage of immaturity may affect the VF. The lower VF is often more affected than the upper. The abnormalities can be demonstrated by both manual and computerized perimetry.- - - - - - - - - - ranking = 0.25keywords = gestation (Clic here for more details about this article) |
8/15. Neonatal periventricular leukomalacia due to severe, poorly controlled asthma in the mother.BACKGROUND: We report a neonatal case of cystic periventricular leukomalacia (PVL) in which the hypoxia was considered to have been caused by severe asthma in the mother, who had not taken any medication during pregnancy because she was anxious about its possible effects on her unborn child. methods: After the mother had severe exacerbation of asthma for five days, the baby was born at 36 weeks in gestation, weighing 2100 g, and with moderate asphyxia. Although the baby had been aggressively treated in a neonatal intensive care unit, at birth, an ischemic area had been formed in the periventricular areas in the brain echogram. We suspected that she had severe brain damage due to prenatal hypoxia. RESULTS: The baby was found to have cystic PVL by ultrasonography at age 15 days, and diplegia at age 4 months. CONCLUSIONS: The poorly controlled, persistent and severe asthma of the mother may have caused prenatal hypoxia, resulting in the cystic PVL and lower limb palsy. Pregnant patients with poorly controlled asthma should be advised of the great risk of this condition to the fetus. Also, patients should be assured of the safety of modern asthma treatments.- - - - - - - - - - ranking = 0.35509790100306keywords = gestation, pregnancy (Clic here for more details about this article) |
9/15. Periventricular leukomalacia: ultrasonic and neuropathological correlations.Ultrasound scans of a preterm neonate (27 weeks gestation) at seven weeks of age showed periventricular echo-free cavities, but these were no longer visible at 15 weeks, three weeks before the infant died. At autopsy, a linear glial scar, extending from the periventricular white-matter into the white axis of the parasagittal gyrus, was found in the area occupied by the periventricular cysts. The larger cavity was reduced to a slit-like excavation in the midst of glial tissue. Unsuspected focal infarcts in the cerebral cortex were also found. This observation demonstrates that transient echo-free cavities represent foci of cystic necrosis, which are subject to secondary collapse. In the authors' experience, the linear extension of periventricular leukomalacia (PVL) into the core of parasagittal gyri is a frequent feature of PVL, and one which cannot easily be accounted for by the usual explanations of border-zone ischaemic softening.- - - - - - - - - - ranking = 0.25keywords = gestation (Clic here for more details about this article) |
10/15. pregnancy and functional paraganglioma.The association of pregnancy with a catecholamine-secreting tumor is rare. The high maternal and fetal mortality rate is significantly reduced when the diagnosis is made antepartum and adequate management is started. In 1979 Burgess reviewed 42 cases with antepartum diagnosis, demonstrating the benefits of alpha-blockade (Obstet Gynecol 1979; 53:266-270). When diagnosis was made in the third trimester of pregnancy, a combined procedure of cesarean section and tumor resection was best. The best surgical approach in first- and second-trimester diagnosis, however, remains controversial. A case with second-trimester diagnosis is described. Following a period of alpha- and beta-blockade, a combined surgical procedure in the third trimester resulted in a healthy mother and infant. Follow-up procedures included a meta-iodobenzylguanidine scan of the mother. Postpartum, ultrasonography of the child's brain revealed periventricular leucomalacia. The prognosis associated with this finding is poor. Some more recent information about certain aspects of these tumors is also discussed.- - - - - - - - - - ranking = 0.21019580200611keywords = pregnancy (Clic here for more details about this article) |
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