Continuous subcutaneous insulin infusion (CSII) in pregnant diabetic patients

The efficacy of the insulin infusion pump (CSII) in pregnancy was examined in 12 diabetic patients and compared with intermittent insulin therapy (IIT). In patients poorly controlled on IIT constant and rapid equilibrium was achieved with CSII (mean of glucose levels: CSII versus IIT=84 versus 137 mg/dl; S.D. = 36 versus 63 mg/dl; mean amplitude of glycemic excursion (MAGE)=65 versus 112 mg/dl. In patients well controlled on IIT, CSII led to a reduction in the variation of glucose excursions (S.D.= 29 versus 36 mg/dl; MAGE=48 versus 76 mg/dl). CSII generally produced a reduction of 20–37 per cent of daily insulin dose (in three cases there was an increase of dose with the achievement of glycemic control). Furthermore in CSII treated-patients amniotic glucose, insulin and C-peptide concentrations werefound tobeinthenormalrange(22.1±10.1 mg/dl; 5.2±2.7μ/ml; 1.25±0.71 ng/ml, respectively). All infants were horn at or near-term, had no macrosomia or neonatal problems. It is concluded that CSII is a highly efficient way to achieve normal glucose levels in pregnancy, not only in type I, hut also in type II or gestational diabetes.     

Prenatal ultrasound diagnosis of fetal scoliosis with termination of the pregnancy: Case report

Gross scoliosis of the fetal thoracic spine was diagnosed at 18 weeks gestation. The pregnancy was terminated and the fetus found to have webbing of the neck and an imperforate anus in addition to vertebral defects.     

Prenatal diagnosis of endocardial fibroelastosis

In a case of fetal heart failure caused by endocardial fibroelastosis, prenatal echocardiography clearly demonstrated; a thickened endocardium. We therefore suggest that an abnormal endocardium may be detected in utero by ultrasound, thus representing an important clue in the differential diagnosis of fetal nonimmune hydrops and in the evaluation of pregnancies at risk for endocardial fibroelastosis.     

广西夏季异常降雨量的前馈网络预报模型

以1957～2001年广西37个基准站的夏季(6～8月)平均降水量为基础,将夏季降水量距平百分率大于等于20%、小于等于-23%作为异常多雨和少雨年,建立广西夏季降水量"0、1"化的异常序列,利用前馈网络的非线性映射技术,构造广西夏季降水异常预报模型.通过对该模型的预报检验分析发现,该预报模型不仅能准确地报出历史样本的异常多雨和异常少雨年,并且对2002～2004年的独立样本预报也全部正确.这为异常降水的短期气候预测业务工作提供了新的思路和方法.     

Prenatal measurement of the fetal cerebellum and cisterna cerebellomedullaris by ultrasound

The fetal cerebellum can be visualized with ultrasound throughout the second trimester. We describe a technique for measuring the transverse and anteroposterior cerebellar diameters and the measurement of the cisterna magna in the same plane between 14 and 32 weeks gestation. Nomograms for these measurements against gestational age showed good correlation, and narrow confidence limits for the transverse cerebellar diameter. The transverse cerebellar diameter was also measured directly in 79 fetuses after mid-trimester abortion and the measurements obtained were compared with the ultrasound TCD nomogram. Good correlation, was obtained between the post mortem measurements and the ultrasound TCD nomogram. Routine use of these measurements and nomograms should prove valuable in the diagnosis of congenital abnormality of the posterior fossa and may also be of use in assessing the effect of severe intrauterine growth retardation and other insults on cerebellar growth and development. The narrow confidence limits obtained with the TCD nomogram should enable it to be used with confidence in clinical practice.     

Genetic amniocentesis: 505 cases performed before the sixteenth week of gestation

Between May 1987 and November 1988, 505 early amniocentesis within the 15th week of gestation were performed at the First Department of Obstetrics and Gynaecology,‘L. Mangiagalli’ of the University of Milan and at the Department of Obstetrics and Gynaecology of ‘Gaslini’ hospital in Genoa. A total number often abnormal fetal karyotypes were diagnosed. In addition, one case of pseudomosaicism (not confirmed on fetal blood) and one case of osteogenesis imperfecta type II (observed at ultrasound examination) were also detected. Eleven pregnancies were therefore terminated because of an abnormal fetus. Out of 494 pregnancies (excluding terminated pregnancies) there were 16 fetal losses within the 28th week; ten of these occurred in the 2 weeks following the procedure. There were 475 live-births, of which 447 were term deliveries and the other 28 deliveries occurred before the 37th week of gestation.     

The fetal behavioural states: An ultrasonic study

In order to accurately detect the fetal behavioural state, we simultaneously measured fetal heart rate and multiple fetal activities in 27 healthy pregnant women at 38 to 40 weeks of gestation. We ultrasonically identified gross body movements, breathing movements and micturition. Analysis of fetal heart rate allowed us to distinguish two different patterns of fetal behaviour: active and quiet phases. The frequency distribution of the analysed fetal events was significantly different in these two phases. These data suggest that a complete biophysical profile of the fetus is effective in differentiating behavioural states and may improve the predictive accuracy of fetal heart rate analysis alone.