In the last two to three decades, increasing rates of gastroschisis but not of omphalocele have been reported from different parts of the world. The present study represents a register containing 469 children born with abdominal wall defects based on data retrieved from 20 birth cohorts (1970-89) in three nationwide registries. A tentative estimate of the completeness as regards identification of liveborn and stillborn infants is a minimum of 95% and 90% respectively. All cases were reclassified to 166 cases of gastroschisis, 258 of omphalocele and 16 of gross abdominal wall defect. The average point prevalence at birth of gastroschisis was 1.33 per 10 000 live and stillbirths. During the first decade, an increase in prevalence occurred culminating in 1976, followed by a decrease reaching its initial value in 1983 and then a new increase. Overall, no significant linear trend could be demonstrated for the entire period. The average point prevalence at birth for omphalocele was 2.07 and for gross abdominal wall defect 0.12 per 10 000 live and stillbirths with no significant change in the period. The geographical distribution of gastroschisis and omphalocele showed no difference per county.
A birth with fatal outcome for both the mother and the foetus was reported in the Danish medical journal, Bibliothek for Læger in 1868. Here, the article with its two illustrations is summarised because of the vivid description of the course together with the therapeutic considerations expressed by the obstetrician. Due to an earlier osteomyelitis the pregnant woman's spine was deformed and her pelvis was narrowed. The birth came to a standstill, and it became necessary to reduce the circumference of the foetus' cranium by perforation, after which the dead foetus could be delivered. The woman died of infection some days later. Afterwards her deformed lumbar spine and pelvis was removed, preserved and depicted in two lithographs. The preserved pelvis is still extant in the Saxtorphian obstetric collection in Medical Museion, Copenhagen.
The aetiology of abortions and calf mortality in 65 Danish cattle herds consisting of both dairy and beef breeds during a 1-year period is described. All observed aborted foetuses, still-born calves, and calves dying before 6 months of age were necropsied, and relevant microbiological examinations were performed. A total of 240 calves and 66 abortions were submitted corresponding to a calf mortality rate of 7%. The abortion frequency could not be calculated. 43% of the calves died at day 0, while 22% were aborted, 15% died during the first week of life, 9% died from 1 to 4 weeks of age, and 11% died at the age of 1 to 6 months. The most common cause was neonatal pulmonic atelectasis (stillbirth) followed by foetal infections, pneumonia, and septicaemia.
The human bocavirus (HBoV), a newly discovered parvovirus, is closely related to the bovine parvovirus and the canine minute virus, which are known to cause adverse pregnancy outcomes. Another human parvovirus, B19, can lead to fetal hydrops, miscarriage and intrauterine fetal death (IUFD).
To determine the prevalence of HBoV DNA in aborted fetuses and IUFDs. The HBoV serology of the mothers was also studied.
We retrospectively studied all available fetuses (N=535) autopsied during 7/1992-12/1995, and 1/2003-12/2005 in Helsinki, Finland. All available formalin-fixed paraffin-embedded fetal tissues - placenta, heart and liver - of 120 miscarriages, 169 IUFDs, and 246 induced abortions were studied by quantitative PCR. We also measured the HBoV IgM and IgG antibodies in the corresponding maternal sera (N=462) mostly of the first trimester. The IgM-positive sera underwent HBoV PCR.
None of the fetal tissues harbored HBoV DNA. A total of 97% (448/462) of the mothers were positive for IgG antibodies to HBoV, while only 0.9% (4/462) exhibited HBoV-specific IgM antibodies without viremia or respiratory symptoms. One IgM-positive mother had an unexplained fetal loss.
We did not find HBoV DNA in any of the deceased fetuses. Almost all pregnant women were HBoV-IgG positive.
The aim of this study is to determine if there has been a true, absolute, or apparent relative increase in congenital diaphragmatic hernia (CDH) survival for the last 2 decades.
All neonatal Bochdalek CDH patients admitted to an Ontario pediatric surgical hospital during the period when significant improvements in CDH survival was reported (from January 1, 1992, to December 31, 1999) were analyzed. Patient characteristics were assessed for CDH population homogeneity and differences between institutional and vital statistics-based population survival outcomes. SAS 9.1 (SAS Institute, Cary, NC) was used for analysis.
Of 198 cohorts, demographic parameters including birth weight, gestational age, Apgar scores, sex, and associated congenital anomalies did not change significantly. Preoperative survival was 149 (75.2%) of 198, whereas postoperative survival was 133 (89.3%) of 149, and overall institutional survival was 133 (67.2%) of 198. Comparison of institution and population-based mortality (n = 65 vs 96) during the period yielded 32% of CDH deaths unaccounted for by institutions. Yearly analysis of hidden mortality consistently showed a significantly lower mortality in institution-based reporting than population.
A hidden mortality exists for institutionally reported CDH survival rates. Careful interpretation of research findings and more comprehensive population-based tools are needed for reliable counseling and evaluation of current and future treatments.
The adrenals of 194 human fetuses of 17-40 weeks and newborn infants were studied by histological and morphometrical methods. The abortive material was taken at hospitals in the city of Arkhangelsk and regions beyond the Polar circle. The mass of adrenals was found to be reliably less as compared with the norms in middle latitudes, and the rate of increase of this index decreased in the dynamics of pregnancy. The microscopic and stereometric investigations have revealed decreased thickness of the cortex, adaptational and pathological changes of adrenocorticocytes. Little mass of the adrenals was associated in some cases with a premature formation of the cortex zones.
A possible detrimental paternal age effect on offspring health due to mutations of paternal origin should be reflected in an association between paternal age and fetal loss. The authors used data from a prospective study of 23,821 pregnant women recruited consecutively to the Danish National Birth Cohort from 1997 to 1999 to assess the association between paternal age and fetal death. Fathers of the pregnancies were identified by record linkage to population registers. The paternal age-related risks of fetal death and its components, early and late fetal loss, were estimated using survival analysis. Pregnancies fathered by a man aged 50 or more years (n = 124) had almost twice the risk of ending in a fetal loss compared with pregnancies with younger fathers (hazard ratio = 1.88, 95% confidence interval: 0.93, 3.82), after adjustment for maternal age, reproductive history, and maternal lifestyle during pregnancy. Various approaches to adjustment for potential residual confounding of the relation by maternal age did not affect the relative risk estimates. The paternal age-related risk of late fetal death was higher than the risk of early fetal death and started to increase from the age of 45 years. It should, however, be interpreted cautiously because of the restricted number of fetal deaths.
Neonatal mortality (NNM) was investigated in the region of the University Central Hospital of Turku (UCHT), Finland, during a 15-year period from 1968 till 1982. During the study period 81 620 liveborn infants were born. The NNM rate declined from 13.5 in 1968 to 3.0 in 1982 during the study period. Significant declines occurred in NNM due to respiratory distress syndrome (RDS) and asphyxia. The decline in NNM was more obvious during the early neonatal period (0-6 days after birth) and in the low birth weight (LBW) group (BW less than 2500 g). We believe that centralization of obstetric and neonatal services in risk cases and the new neonatal intensive care accounted for the decline in NNM.