402 SPO Abstracts

377 PRENATAL DIAQ'IIa;IS OF NDlNATAL Au.otMMlNE 'I1tROMBOCYI'OPENIA USINGAN AI...U:U'.-SPEaFIC OU<DNUa.E011DE PROBE. Jdaosm JM MlW-hmd J~ Handlette vsr; l1-eedlDll J*. Sq1ILlI-Blrtlett J~ UtiYa'sity ~Tamto, a.u.ta and Hood Outer d !EWiscmsin. Mlw. Wise. OIUirDVE: The predictim d nematal allaillD"llne tbroRJocyt~ia (NAIl) in ..... ected folies is usually based upal infall1ltim IIbwt pe frequeucies dtbe antip systems inmved.pareatal pbealjypingand fetal p1l1dct COInts. A:ceady tbe use d a1lde-speci fie oli pudmide pr* typiogfa- PIA antips bas been described todctermine tbe risk d secood II" su'*q_t fetuses io flmilies Mere <lie iof.lI .... !be di..,asis d anti-PIA I-nnilled NAIT. ThisdJject dtbis repat is to describe tbe lirst case io Micb preaalal dill!lKJ8is d PIA antigen status _ ~isbed usingtbis technolOl!Y. STUDY DESIQ'II:This is a case repat desaibinf)a PIAl DqlIItive \QIBI (3 prmrusly ..... ected pregnancies. paternal pben<type PIA 11 A2) Mounder1la1l cba-imic villus saqlliof)(O'S)aI 10 weeks ptllim to determine tbe PIA stilus tiber fetus . An.,lilicatim. bybridiDlim and illD"llno1OJ![icdctectimtipomicr.NAcmtlliningthealldic polyllQ"pbism lIlsWlled .wth !be PIA allmntipus _ perfa-nn usin!: fetal rNA eJltr8Cled frantbeOTStissue. RfSUL'IS: 11Ie oliplldtaide PIA typinf)coaIirnn an ..... ected fdus (fetal p1l1det pbeo(jype PIA II A2)and!be results e<rrdlled perfectly "'th the fetal serolOJ![ic type. CON<1USlONS: Aa:urlle ideotiliCllim dfetuses II risk (a- NAn' 'IIbose fllbers are beteraE)'ps fa- tbe PIA anti~ is possible usingtbis tecbooOl!Y. Blrly _ rdiallle reoopitioo d a1TectW fetuses allOM preolltal therllpy to be instituted if necessary; 1\bed fetuses arefrund to be un ..... ected. inwsive and expensive prealllal inter_tim alii be mided.

378 FETOPATHIC EFFECTS OF HYDRALAZINE ON PREGNANT RATS (PRI AND THEIR FETUSES. ~ fofsiI.'. Ernest Abel'. John Hannigan'. Mark I Evans. David B Cotton. Dept of ObIGyn Wayne State U. Detroit. MI. OBJECTIVE: Hydralazine is considered safe for use during pregnancy. Although it is considered nonteratogenic based on extensive clinical experience. its safety for use in pregnancy has not been confirmed by rigorous scientnic investigation. STUDY DESIGN:70 PR (10ltreatment group) were treated with hydralazine (ad lib. O. 15. 30 mglkd/d) either by gavage or subcutaneously (SC) from gestational day 8-19. On day 20 maternal physical activity was assessed in an automated activity monitor. PR were then sacrificed and uterine contents examined. Fetuses were fixed in Bouin's solution and evaluated individually by Wilsons method of tera1oiogic exam. Using each Ilt1er as the unit of analysis, data were analyzed by 2-way ANOVA. D~ferences between effects by route of administration were subsequently analyzed by 1-way ANOVA, and differences between doses were examined by Duncan Muttiple Range Test. RESULTS: When given by gavage, hydralazine did not affect maternal weight gain, fetal birthweight, or placental weight. ~owever, by SC route. there was reduced maternal weight gain, Increased maternal mortality. and decreased fetal (but not placental) weights. There was no increased incidence of fetal anomalies in any group, nor was there effect on maternal activity. CONCLUSIONS:1. Hydralazine given by subO injection has a dose related adverse affect on fetal groW1h. 2. The elevated maternal mortality and reduced ma1ernal weight gain also observed in higher dose SC treated animals suggests that the lower birth weights seen in these animals may refl9CI maternal drug toxicity ra1her than true fetopathic effect. However, the absence of drug influence on maternal activity is contradictory and leaves this question unanswered. 3. Hydralazine does not appear to have Significant teratogenic effects in rats as assessed by anatomic exam.

J anua ry 1993 Am J Obstet Gynecol

379 MANAGEMENT OF ISOLATED FETAL CHOROID PLEXUS CYSTS (CIC). ~,s. Hunter, K. WilliatnlOD, C . W.iner. DepI.ofOb/Gyn.,

Univ. of Iowa, Iowa City, IA.

OBJECTIVE: An .uociation betw .. n CPC (eope<:iaUy tho.. > S nun) .D<I

.neuploidy hal b .. n ... ported. In c .... with ilOltted CPC .D<I nonnal AFP or

triple JCfeCDi (AFP, cltriol, HCG), we have not routinely adviled

amniocemeail. The prelent report detail, our experieoce with thil mARl.lcment

scheme.

STUDY DESIGN: In our refenal b.aed populatioo. 6,402 p.lie ... underw ...

I.vel n UItnIOUD<I .xamination betw .. n 7/89 .D<I 8/92. All c .... wid! fetal

CPC we ... includ.d in obi. study . Follow""p OOftOp01l w .... perfonned to

.aae .. the rclOlution of the cyBtl and to examine further for the pretence of

additional ItrUctural malfollnltiona. AFP or triple KreeDi were offered to .U

p.lie"", betw .. n 1S-20 w .. ks ,.ltalion.

RESULTS: A lotal of 29 c."s off.tal CPC w .... id.ntified (0.4%). Av.rag.

OA of preacntation wa. 19.5 ± 0.6 week.. All CPC RlIOlved, on the average

4. t ± 0.4 week. after fint being identified. III 4 calCI, other Itructural

malfonnatioDi were observed. Aneuploidy (T·18) w .. noted in 1 of thclC

(2S"). Ofth. 2S c .... with ilOlated CPC, 20 had AFP or tripl. 1O",.n tellliDB.

15/20 (7S") had nonnal OC .... ninll "'lUlta. The 5 c .... with .bDOnnal IOrull>

wen offered .nd underwem .mnioccoaeaia. No CI. of aneuploidy WI. found

in .ny of the c .... of ioolated CPC. 12 (48%) of the ioolated CPC w .... :.:S

mm. 7 (28%) we ... bilateral . Ov.rall, b.aed on ov.r 13,000 limp'" from •

ltatewid. lO .... niDB propom, w. found only 4 c .... of T-21 (113500) .nd 1

c ... orT-18 (1/13 ,000) with.!l!!!!!l!! triple IO_D.

CONCLUSION: In our limited .. ri •• , w. fouD<l DO .uociation of ioolated f.tal

CPC with aneuploidy. This information lUucltl triple .creen .00 maternal agc

can be uacful for counlCling patienb with ilOl.tcd CPC regarding

anvUoccnteail.

380 Tolerance to Acute Phenobarbital Challenge In Mature Rat Offspring Produced by Prenatal Exposure. G. T. Livezey", ..Q;. §mlJI1 W. Rayburn, S. Smith". Dept of OB/GYN, Unlv of Nebraska, Omaha, NE. OBJECnvE:To assess changes In electroencephalographic responses to phenobarbital In mature rat offspring produced by prenatal exposure. STUDY DESIGN: Twenty-four female Sprague-Dawley rats received 0, 20, 40, or 60 mg/kg phenobarbital for 28 days prior to breeding and throughout their 21 day gestation. The Electroencephalograms (EEG) of 1-year-old offspring 01 both sexes were telemetrically monitored for 24 hrs before and alter a 60 mg/kg challenge. Total spectral power and the percentage 01 the total spectral power In selected frequency bands were calculated. RESULTS: After acute phenobarbital challenge, total EEG spectral power was 1) not changed In control females, control males, and prenatal-6() males, 2) Increased In prenatal-20 and -40 females, and, 3) decreased In prenatal-60 females, prenatal-20 and -40 males. Both SaKes displayed a prenata/­dosfHIependent reversal of acute challenge effects on delta, theta, alpha, and beta 1-5 activities. CONCLUSIONS: Although the total power effects are complaK, the frequency dIstribution effects Indicate a prenatal-dose­dependent tolerance to acute phenobarbital challenge. These results suggest that prenatal exposure to phenobarbital may produce a permanent subsensitlvity to phenobarbital and other related drugs.