Download Aspects of Praematurity and Dysmaturity: Groningen 10–12 May by John W. Reynolds (auth.), J. H. P. Jonxis M.D., H. K. A. PDF

By John W. Reynolds (auth.), J. H. P. Jonxis M.D., H. K. A. Visser M.D., J. A. Troelstra M.D. (eds.)

The thought of the foeto-placental unit as an built-in endocrine organ has been outlined lately via many in vivo reviews on the seventeenth- twentieth week of gestation. A functioning foeto-placental unit is important for many of the elevated oestrogen construction of being pregnant and for the supply of glucocorticoids and aldosterone to the foetus. Neither the foetus nor the placenta on my own have the mandatory enzyme platforms for the synthesis of those teams of steroids. even though, whilst the foetus and placenta functionality as a unit, all the enzyme structures are current for the synthesis of those steroids from circulating ldl cholesterol. The placenta, yet now not the mid-gestation foetal adrenal, can synthesize physiologically a great deal of pregnenolone from circulating ldl cholesterol. a part of the pregnenolone is switched over to progesterone within the placenta by means of the 3~-HSD approach (absent within the foetus). The progesterone is transferred to the foetus the place it truly is remodeled by means of C-II, C-17, C-18 and C-21 hydroxylases (all absent within the placenta) to cortisol, corticosterone and aldosterone. Pregnenolone transferred from the placenta to the foetus undergoes 171X-hydroxylation, facet­ chain splitting and sulfurylation (absent within the placenta) and is switched over to DHAS. The DHAS may possibly suffer 161X-hydroxylation (absent within the placenta) within the foetal liver and be transported to the placenta as 161X-OH-DHAS. There it really is subjected to a impartial steroid sulfatase (absent within the foetus) and is switched over to oestriol through motion of the 3~-HSD method and the aromatizing enzyme system.

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Sample text

It was reading this description that prompted me to go and verify the finding and then to try to inject the vessels so displayed. A nylon intravenous cannula is inserted into a spiral artery and injected with a barium gelatine solution. Figure I shows part of a placenta with an injected spinal artery. Slices through the entry of this and similar arteries shows that injection medium passes into the centers of the foetal lobules and may often be seen filling the intralobulair space. Figure 2 demonstrates an X-ray of one of a series of dissections from a single placenta.

Transplacental passage of androgens from the mother is one of the dangers for the foetus. Would you like to comment on this? The third question is, is there another steroid which provides a better indication of foetal distress than oestriol. For instance this 15-hydroxylated compound, it might give a much more accurate indication than oestriol for the obstetrician. Dr. Reynolds: I cannot give you any experimental evidence that cortisol and aldosterone are essential for the functioning of the midterm foetus.

In all cases there were harmonious correlations between weight, height and head circumference; the infants were normal (not twins) at the time of examination; their neurological age was always corresponding to the foetal age calculated from the first day of the last * Centre de Recherches Biologiques Neonatales, Hopital Port-Royal, Paris. 47 NEUROLOGICAL ASSESSMENT Table 1. Neurological assessment of foetal age * I. PASSIVE TONE Week 28 30 34 32 Complete Flexion hypotonia of the thigh Poplital angle Heel to ear Return to flexion of forearm Flexion of the lower limb llO° 150° 100° 36 38 41 Flexion Hypertonic of the four limbs 90° 80° In contact Weak No Strong II.

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