Möbius syndrome in infant exposed to cocaine in utero (original) (raw)
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Intracranial hemorrhage in a neonate following prenatal cocaine exposure
Pediatric Neurology, 1989
A term infant who had a positive urine drug screen for cocaine is reported. There was ultrasonographic evidence of an intracranial hemorrhage. A small area of low echogenicity in the left caudothalamic groove documented at 96 hours of age was resolved on repeat ultrasonography at 16 days of age. This neonate was born by repeat cesarean section and growth was appropriate for gestational age. The findings indicate the importance of considering cerebrovascular events in neonates exposed to cocaine in utero.
Maternal cocaine abuse and fetal renal arteries: a morphometric study
Pediatric Nephrology, 2000
The purpose of the present study was to evaluate the pathological findings and perform morphometric analysis of the renal arteries of fetuses exposed to cocaine in utero. The control group consisted of 22 stillborn fetuses of unknown etiology whose mothers' urine was negative for cocaine or any other vasoactive substances. The study group comprised 29 stillborn fetuses whose mothers' urine was positive only for cocaine on the day of admission. Sections of fetal kidneys (4 µm), stained with hematoxylin and eosin and periodic acid-Schiff reagent, were examined under light microscopy (×40) to identify interlobular arteries. Morphometric analysis of these arteries was performed using a selfassembled system with a touch-sensitive screen as an interactive peripheral. Their inner and outer circumferences were measured by outlining them on the screen with a stylus. The radius (r) was calculated from the measurement of the circumference (2.π.r). The difference of the radii of the outer and inner circumferences was the thickness of the arterial wall. The interlobular arterial thickness was significantly greater (P<0.001) in the cocaineexposed group (mean 15.46±5.8 µm, 2SD) compared with the normal (mean 9.03±3.96 µm, 2SD). There was a significantly (P<0.001) positive relation with advancing gestational ages in both groups. The circumferences of the lumen of the arteries showed a significant (P<0.05) relation with advancing gestational ages in the normal group only. In the cocaine-exposed group, the arterial lu-men circumference (mean 167.88±17.58 µm, 2SD) was significantly (P<0.001) smaller than in the normal group (mean 227.73±6.82 µm, 2SD). Thus, maternal cocaine abuse is associated with thickening of the interlobular arterial wall of the fetal kidney and narrowing of the lumen.
Pathologic and laboratory correlation in microcephaly associated with prenatal cocaine exposure
Early Human Development, 2001
The Authors report a case where cocaine abuse during pregnancy assessed by drug analysis at various site was associated with fútal microcephaly. Fútal pathologic findings revealed anomalies in neuronal migration and in the vascular architecture in the brain. Such anomalies might be the result of prolonged exposure to cocaine in utero, aggravated by the high concentration of cocaine metabolites in the amniotic fluid over a prolonged period. D
Journal of Pediatrics, 1993
We conducted a prospective cohort study of 323 consecutively born very low birth weight infants (_<1499 gm) to determine any association between prenatal cocaine exposure and (I) intracranial ultrasonographic abnormalities and (2) other adverse perinatal outcomes. The infants were assigned to either a cocaine-exposed group (n = 86) or a cocaine-nonexposed group (n = 446) on the basis of combined detection methods for prenatal maternal cocaine abuse including maternal history, maternal and infant urine immunoassay (Emit)i and meconium analysis (high-performance liquid chromatography and gas chromatography-mass spectrometry). Ninety-one infants were not assigned because of early death before complete testing (n = 80) or missed tests (n = 11). The detected incidence of cocaine exposure in the assigned population was 37% (86/232). Meconium testing with high-performance liquid chromatography and gas chromatography-mass spectrometry was the sole means of detection in 30% (26/86) of cases. The cocaine-nonexposed infants did not differ from the cocalne-exposed infants in the incidence of intraventricular hemorrhage (36% vs 35%), grades III and IV intraventricular hemorrhage (44% vs 14%), or periventricular leukomalacia (4% vs 2%). Adverse outcomes increased by cocaine exposure were abruptio placentae (8% vs 18%; p = 0.046), surgical ligation of a patent ductus arteriosus (4% vs 7%; p = 0.02), and seizures (5% vs 17%; p = 0.004). We Conclude that prenatal cocaine expoSure does not increase the Incidence or severity of intracranial hemorrhage or periventricular leukomalacia but does increase the risk of abruptio placentae, surgical llgatlon of a patent ductus arteriosus and seizures in very low birth weight infants. (J PEDIAI'R 1993;122:438-45)
Maternal cocaine abuse: the spectrum of radiologic abnormalities in the neonatal CNS
AJNR. American journal of neuroradiology
The purpose of this study was to determine the pattern and frequency of CNS abnormalities in the offspring of cocaine-abusing mothers. The study group consisted of a retrospective review of all neonates born or admitted to our neonatal intensive care unit over a 1-year period who met criteria for maternal cocaine abuse (43 patients). A control group (62 patients) was obtained from patients seen during the same interval and the cases were matched for gestational age and race. The radiologic studies were analyzed by two independent reviewers, and CNS abnormalities were assessed by means of sonography, CT, or MR. By matching the study and control groups for gestational age, we eliminated the higher frequency of prematurity. This allowed us to determine if maternal cocaine use was associated with any intracranial abnormalities other than those seen with prematurity. The frequency of intracranial hemorrhage, ventricular enlargement, and periventricular leukomalacia was not significantly ...
Cerebral blood flow regulation in neonatal rabbits is altered by chronic cocaine administration
Brain Research, 1997
Maternal cocaine abuse has several deleterious effects in the newborn, including perinatal asphyxia, hypoxia, and hypercapnia. We Ž . hypothesized that chronic cocaine exposure during development may alter cerebral blood flow CBF regulation. We studied 16 neonatal Ž . rabbits that had received cocaine 20 mgrkg, i.p. b.i.d. or saline since birth. Changes in CBF were measured by laser doppler flowmetry Ž . Ž . Ž . Ž . before baseline , and during hypercapnia FiCO s 7.5% , hypoxia FiO s 12% , and asphyxia apnea for 1 min . During hypercapnia, 2 2 Ž . CBF increased less in cocaine than in control animals 28 " 3% vs. 69 " 10%, P -0.05 . During hypoxia, CBF increased similarly in Ž both groups. During reventilation after asphyxia, CBF increased more in cocaine than in control animals 391 " 52% vs. 225 " 43%, . P -0.05 . Chronic cocaine exposure during brain development appears to alter CBF regulation to hypercapnia and asphyxia, which may put the drug exposed newborn at risk for neurologic injury around birth.
Effect of maternal cocaine abuse on renal arterial flow and urine output of the fetus
American Journal of Obstetrics and Gynecology, 1994
OBJECTIVE: Our purpose was to study the short-term effect of maternal cocaine abuse on blood flow of the fetal kidney and the fetal hourly urine output. STUDY DESIGN: Thirty-three pregnant patients of various gestational ages with a history of cocaine abuse were studied. Patients were included if the urine specimen was positive for cocaine on the day of study. Patients were excluded if the urine specimen was positive for any other vasoactive substances or medications. Color and pulsed wave Doppler studies were used to obtain the flow velocity waveform of the fetal renal artery. The resistance index was calculated from systolic and diastolic values of flow velocity waveforms, Longitudinal, transverse, and anteroposterior diameters of the fetal urinary bladder were measured from transverse and coronal images at their maximum diameters, and the bladder volume was calculated. The hourly urine output of the fetus was measured from the difference in the bladder volume at half-hour intervals. As controls, 110 normal pregnancies between 19 and 40 weeks were similarly studied for normal values. The resistance index of the fetal renal artery and the hourly fetal urine output of the two groups were compared. RESULTS: The resistance index of the fetal renal artery of normal pregnancies had a negative association with gestational age (p < 0.05). Cocaine-exposed fetuses had a significantly higher resistance index of the renal artery (p < 0.01) than did normal fetuses of corresponding gestational ages. A decrease in the hourly urine output of cocaine-exposed fetuses was observed, compared with normal controls of corresponding gestational ages (p < 0.001).