Hemorrhage, fetal-maternal

The second aspect of clinical practice that has led to a reassessment of the nature of flow cytometry is the occasional clinical requirement for rare-event analysis. Methods have been developed, particularly with the use of multiparameter gating, to lower background noise in order to provide increased sensitivity for detection of rare cells. In the clinic, this increased sensitivity translates, for example, into earlier diagnosis of relapse in leukemia, more sensitive detection of fetal-maternal hemorrhage, and better ability to screen leukocyte-reduced blood transfusion products for residual white blood cells. Outside the clinic, these methods for rare-event detection have begun to stretch the limits of research applications as well. 

Oxytocin is a hypothalamic nonapeptide that selectively stimulates the smooth muscle of the uterus and mammary glands. It is used in the induction or augmentation of labor and to prevent postpartum hemorrhage, and is well tolerated and effective in a wide range of infusion rates and concentrations. Contraindications to its use include placenta previa or vasa previa, a previous classical uterine incision, pelvic structural deformities, and an abnormal fetal presentation. Large fetal size and high maternal parity are relative contraindications. Prior non-classical cesarean delivery should not preclude oxytocin therapy. 

The answer is c. (Murray, pp 627-661. Scriver, pp 3897—3964. Sack, pp 121-138. Wilson, pp 287-320.) Hemorrhagic disease of the newborn is caused by poor transfer of maternal vitamin K through the placenta and by lack of intestinal bacteria in the infant for synthesis of vitamin K. The intestine is sterile at birth and becomes colonized over the first few weeks. Because of these factors, vitamin K is routinely administered to newborns. Deficiencies of the fat-soluble vitamins A, E, D, and K can occur with intestinal malabsorption, but avid fetal uptake during pregnancy usually prevents infantile symptoms. Hypervltaminosis A can cause liver toxicity but not bleeding, and deficiencies of E (neonatal anemia) or C (extremely rare in neonates) have other symptoms besides bleeding. 

Ritodrine is contraindicated in antepartnm hemorrhage, which demands immediate delivery eclampsia and severe preeclampsia intrauterine fetal death chorioamnionitis maternal cardiac disease pulmonary hypertension maternal hyperthyroidism and uncontrolled maternal diabetes mellitus. Overdosage with ritodrine may canse tachycardia (maternal and fetal), palpitations, cardiac arrhythmia, hypotension, dyspnea, nervousness, tremor, nansea, and vomiting. 

A reduction in postpartum hemorrhaging and no adverse effects on maternal or fetal health were reported in pregnant women that took a schisandra extract during pregnancy (Gaistruk and Taranovskij 1968). In one study, schisandra... 

---