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ABSTRACT: In the presence of severe hyperbilirubinemia in Crigler-Najjar syndrome Type II, a fetus is at risk for kernicterus. A 34-year-old woman, gravida 4, para 1, with Crigler-Najjar syndrome Type II was treated with phenobarbital administration following phototherapy during each of 2 pregnancies. Both infants were healthy and developed normally.
Journal of Obstetrics and Gynaecology Research 03/2001; 27(1):33-5. · 0.94 Impact Factor
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ABSTRACT: To know the effect of brief-repetitive intermittent hypoxia-ischemia on the development of perinatal brain damage.
Seven-day-old Wistar rats underwent ligation of the unilateral common carotid artery. The animals were allocated to three groups (n=12 in each group) and exposed to 8% oxygen as follows: group A: continuous exposure for 180 min; group B: continuous exposure for 90 min; and group C: 10 min of exposure repeated at 10-min intervals over a period of 180 min (total exposure time, 90 min). Seventy-two hours after exposure to hypoxia, the cerebral cortex was examined to assess the degree of neuronal necrosis and brain damage was classified into four grades of severity, 0-3. To evaluate the extent of brain damage, we used immunohistochemical staining with TIB-128 antibody, which reacts to MAC-1 antigen specific to microglia, and observed the glial reaction in the cerebral cortex, hippocampus, thalamus, and striatum.
All the brain damage observed in groups A-C occurred on the side where the ligation was performed. The most severe damage was found in group A animals, of which seven showed significant neuronal necrosis, having a grade 2 or more advanced lesion. In group B, neuronal necrosis was modest, with only one animal having a grade 2 lesion. In group C, a significant neuronal necrosis was found in six animals despite having the same period of hypoxic exposure as those in group B. MAC-1 positive cells appeared in the cerebral cortex of histologically damaged animals and extended to the hippocampus, thalamus, and striatum in severely damaged animals from groups A, B, and C.
Examination of the neonatal rat model suggested that repetitive and intermittent, rather than continuous hypoxia-ischemia, causes pronounced damage in the immature brain.
Brain and Development 09/2000; 22(5):315-20. · 2.12 Impact Factor
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ABSTRACT: To determine whether, and if so how, iNOS expresses and affects brain injury induced by hypoxia-ischemia in an immature brain.
Seven-day-old Wistar rat pups were exposed to right common carotid artery ligation followed by 1.5 hours of hypoxia. The time course of iNOS mRNA expression, enzymatic activity, and protein production in the cerebral cortex were determined. The extent of the infarct area in the cerebral cortex and the production of 3-nitrotyrosine (a biomarker of peroxynitrite) were compared between the control pups and pups treated with S-methyl-isothiourea (a selective iNOS inhibitor).
In the cortex ipsilateral to carotid ligation, iNOS mRNA appeared from 6 hours to 24 hours after hypoxia-ischemia and disappeared at 48 hours. The iNOS protein and its activity also increased at 12 hours and reached a maximum level at 48 hours after the insult. The percentage of damage in the cerebral cortex was significantly higher in the control pups than in treated pups (31.9 vs 10.6%). Tri-nitrotyrosine following iNOS expression-positive cells were located predominantly at the infarct and peri-infarct regions.
iNOS expression might be an important determinant of ischemic immature brain injury.
Journal of Obstetrics and Gynaecology Research 07/2000; 26(3):227-34. · 0.94 Impact Factor
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ABSTRACT: To determine the effects of external light stimulation on fetal behavioral states and know the difference from those of vibroacoustic stimulation.
A flashlight and a vibroacoustic stimulator was applied directly on the maternal abdomen to determine the response of 56 normal fetuses at 36-40 weeks gestation. Fetal heart rate (FHR) and body movements were recorded using an actocardiograph, and fetal eye movements were observed using real-time ultrasonography. Using Nijhuis's criteria, the fetal behavioral states (1F-4F) were determined. FHR acceleration was considered a fetal response to the stimulations.
The lag time between stimulation and fetal response was within 4 s. A positive response rate to the light stimulation was higher at behavioral states 2F (82%) and 3F (83%) than at state 1F (4%). Light stimulation changed the behavioral state of two of the six 3F fetuses (33%) from 3F to 4F. No change of state was observed in fetuses that were in states 1F and 2F. For vibroacoustic stimulation, fetal response was 100% positive and changes of states were observed frequently irrespective of the behavioral state before the stimulation.
Fetal response to light stimulation is closely connected to fetal behavioral states and may reflect some distinct stages of the sleep-wakefulness cycle.
Early Human Development 06/2000; 58(2):153-65. · 2.05 Impact Factor
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ABSTRACT: This is the first report of placenta previa increta in which the placenta villi penetrated the entire thickness of the uterine myometrium, but did not invade the pubocervical fascia. Ultrasonographic and magnetic resonance imaging findings are described.
Journal of Obstetrics and Gynaecology Research 11/1999; 25(5):303-7. · 0.94 Impact Factor
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ABSTRACT: When pregnancy is continued after death of one fetus in monochorionic twin pregnancy, the surviving fetus sometimes exhibits intrauterine death or brain damage. Hysterotomy and selective delivery of an intrauterine dead fetus was performed in order to prevent intrauterine death or brain damage of the surviving fetus at 24 weeks' gestation in a monochorionic twin pregnancy. The healthy baby except for immaturity was born at 30 weeks' gestation, and exhibited no brain damage postnatally. When one fetus has died in utero before maturity of surviving fetus, hurried selective delivery of dead fetus should be one of the useful treatments to prevent intrauterine death or brain damage of the surviving fetus in monochorionic twin pregnancy.
Journal of Perinatal Medicine 02/1997; 25(1):115-7. · 1.70 Impact Factor
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ABSTRACT: Cranial ultrasonography was carried out at least three times a week during the first 16 days of life in all 53 premature newborns born within study period. If a cyst of more than three mm was detected in the periventricular region by fourteenth day of life, it was judged to be antenatal PVL. Periventricular echodensity was classified into mild, moderate or severe periventricular echodensity (PVE). Among 53 newborns, 11 babies (20.8%) were diagnosed as having antenatal PVL. Cysts were observed in the first two days in 9 cases (81.8%) out of 11 babies, and in bilateral periventricular regions in 8 cases (72.7%) out of 11 babies. All 3 babies with severe PVE in the periventricular region had PVL at the time of diagnosis or developed PVL shortely after severe PVE was detected.
Journal of Perinatal Medicine 02/1997; 25(2):180-3. · 1.70 Impact Factor
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ABSTRACT: To clarify the clinical features of and cardiotocographic findings for premature infants with antenatal periventricular leukomalacia (PVL).
Antenatal PVL was judged to be present if a cyst greater than 3 mm in largest diameter was detected in the periventricular region by the 14th day of life on cranial ultrasonography. The clinical features of and cardiotocographic findings for 12 premature infants with antenatal PVL born within 1 year were compared with those of 12 infants chosen as control group matched in gestational age at birth from the premature infants without antenatal PVL born within the study period.
Abnormalities of the umbilical cord such as coiling, excessive torsion and membrane insertion were observed more frequently for infants with antenatal PVL (58.3%) than for control infants (16.7%) (P<0.05). Frequent moderate variable deceleration on the fetal cardiogram was also observed more frequently for infants with antenatal PVL (80.0%) than for control infants (27.3%) (P<0.05).
Abnormalities of the umbilical cord and frequent moderate variable deceleration on fetal cardiotocogram appear to be causes of antenatal PVL in premature infants.
Early Human Development 01/1997; 47(2):195-201. · 2.05 Impact Factor
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Nippon Sanka Fujinka Gakkai zasshi 05/1996; 48(4):289-92.
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ABSTRACT: The movements in two fetuses with congenital myotonic dystrophy were recorded on fetal actocardiograms. The two fetuses showed gross movements associated with FHR accelerations as normal fetus. One of them showed swallowing on amniofetogram, and hiccuping on fetal actocardiogram. Both, however, were extremely hypotonic and neither displayed any gross movement, respiratory movement or swallowing postnatally. Intubation and nasal feeding were required for a long period of time after birth in both cases. The buoyancy of amniotic fluid may help the affected fetus to make gross movement in utero.
Journal of Perinatal Medicine 02/1996; 24(3):277-82. · 1.70 Impact Factor
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ABSTRACT: Two cases of physiologic sinusoidal FHR pattern and one case of pathologic sinusoidal FHR pattern recorded on fetal actocardiograms are reported. The physiologic sinusoidal FHR patterns were recorded during periodic fetal respiratory movements and sucking movements. The physiologic sinusoidal FHR patterns were accompanied and synchronized with periodic fetal movement bursts. The pathologic sinusoidal FHR pattern observed in a case of severe fetal anemia due to massive fetal-to-maternal hemorrhage was not accompanied by any fetal movement bursts. It is suggested that with the use of fetal actocardiogram physiologic sinusoidal FHR pattern can be distinguished from pathologic sinusoidal FHR pattern.
Journal of Perinatal Medicine 02/1994; 22(1):39-43. · 1.70 Impact Factor
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N Nagata
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ABSTRACT: Computer analysis of ultrasonic Doppler actographic signals was done in the fetal active state, resting state and during fetal breathing movement (FBM) in order to more objectively study fetal movements. 1) The amplitude and interval of movement signal spikes were analyzed in 11 voltage steps between 0.05 and 0.55V. The interval distribution showed a uniform pattern in all states when the signals were analyzed at levels below 0.10V. 2) In the fetal resting state, almost all spikes were distributed in the lowest level of amplitude. 3) In the fetal active state, the mean values for spike amplitude were high and the coefficients of variation (CV) were large. The 3-dimensional interval number histograms showed wide distribution until high amplitude and long interval steps. 4) In FBM, the mean values for spike amplitude and CV were smaller, respectively, than those in the active state and the spikes distributed in the short interval steps of 0.5-2.0 seconds. 5) The envelope processing was useful for easier recognition of fetal movement burst in the fetal active state. A very low envelope was formed in the resting state. Analyses during FBM revealed a flat but elevated envelope. The results show the possibility of automatic and objective recognition of fetal behavioral states.
Nippon Sanka Fujinka Gakkai zasshi 03/1989; 41(2):203-9.
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Nippon Sanka Fujinka Gakkai zasshi 02/1989; 41(1):91-2.
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ABSTRACT: Improved FHR records were obtained by the use of a new 1 MHz ultrasound transducer and autocorrelation heart rate meter. The results were compared with conventional 2.5 MHz continuous wave ultrasound device. The rate of the loss of FHR recording was 0 to 6.6% (2.8 +/- 2.1%) in the new device, and it was 2.1 to 23.5% (8.7 +/- 6.2%) in the old one. The loss of FHR record in the 2nd stage of labor was 3.2% when 1 MHz ultrasound and new device were used, and it was 2.0% with direct fetal ECG signal using scalp electrode and the same device. More clear record was obtained with use of ultrasound at a crowning of fetal head than that of direct fetal ECG. In the use of 1 MHz ultrasound, 51% cases in 55 patients showed undisturbed FHR record 1 minute before delivery of the fetus. Slightly noisy but analysable FHR record was obtained in 36%. Hence, the FHR records were clearly evaluated until 1 minute before delivery of the infant in 87% of the cases. Maternal heart rate signal was mixed with FHR in 2 cases in routine intrapartum ultrasonic FHR monitoring. However, the maternal signal disappeared after moving the transducer to other position where fatal heart beat was more clearly detected.
Nippon Sanka Fujinka Gakkai zasshi 06/1988; 40(5):555-60.
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ABSTRACT: Gross fetal movement was detected using a lower frequency ultrasonic Doppler shift than that used in the study of fetal heart action. The movement signal was changed into deflection which was recorded on CTG chart simultaneously with the fetal heart rate (FHR), and was called the fetal actocardiogram. Visual analysis of the actocardiogram showed bursts of active fetal movements in the active fetal state which were concordant with acceleration of FHR. The analysis was useful in the study of fetal behavioural states. Imminent fetal distress produced a loss of FHR acceleration which was accompanied by a burst of fetal movement, i.e. a true non-reactive state of the FHR. The output of the actocardiograph was analysed using a PC98XA computer with a simple statistics of deflection amplitude and interval, displayed as 3-dimensional histograms of the number and frequency, and the formation of the envelope curve of the deflections. The study demonstrated that it is possible to recognize fetal behavioural states automatically. This includes active and resting fetal states as well as fetal breathing movements.
Journal of Perinatal Medicine 02/1988; 16(4):327-31. · 1.70 Impact Factor
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ABSTRACT: A new ultrasonic technique for objective, continuous and simple recordings method of fetal movements on CTG chart has been introduced. Fetal activity and heart-rate will be correlated. This allows a differentiation of fetal active and resting states. The duration of the first one was 24 to 150 minutes, that of the last one 10 to 36 minutes. Fetal actogram is useful in the prediction of imminent fetal distress.
Zentralblatt für Gynäkologie 02/1987; 109(14):873-9.
