In a group of 19 normal pregnant women, plasma lipids were extracted, phospholipids were isolated, and the fatty acid (FA) compositions were measured by capillary gas chromatography. Blood samples were taken at 36 wk, at labor, and at 6 wk postpartum. The FA profiles showed deficiencies of w6 and t3 FA (w indicating the length of the terminal saturated chain), the latter more severe, at all three times. Mean melting point (MMP) was calculated for each sample as an index of "fluidity" based upon all FA present. MMP varied linearly with total polyunsaturated FA and with double bond index, current measures of "fluidity" and essential FA status. MMP was elevated 9-11TC in plasma phospholipids of women during pregnancy and labor and postpartum. Lactating mothers showed less recovery from the deficiencies than did the nonlactating mothers, but neither approached normal at 6 wk. The changes seen in phospholipid profiles suggest a significant transfer of w3 and w6 polyunsaturated FA from the mother to the fetus. These FA are essential for normal fetal growth and development; their relative deficiency in maternal circulation suggests that dietary supplementation may be indicated.Abnormalities of pattern of fatty acids (FA) within plasma and tissue phospholipids (PL) occur in nutritional deficiency of essential fatty acids (EFA) in animals (1-4) and humans (5-8). In Sjogren-Larsson syndrome (9), Reye syndrome (10), cirrhosis and alcoholism (11), multiple sclerosis (12), and other diseases of humans (13-16), significant disturbances of pattern of polyunsaturated fatty acids (PUFA) also occur. Nutritional deficiencies of both w6 and O3 PUFA § occur in humans (5, 16). Genetic diseases may be associated with deficiencies of PUFA as the result of faulty PUFA metabolism. Growth, stress, or excessive loss and replacement of tissue all increase the requirement for PUFA, and unless intake is equal to increased need, deficiency occurs. In pregnancy, growth of new tissue raises the requirement for EFA. The purpose of this study was to assess the EFA status of women whose pregnancies were normal, at 36 wk of pregnancy, at the time of labor, and at 6 wk postpartum for both lactating and nonlactating women. SUBJECTS AND METHODSNormal Pregnancies. All subjects chosen for study were normotensive Caucasians with normal singleton pregnancies seen at the Mayo Clinic. Written consent was obtained from the subjects before enrollment. Patients were excluded from study if they had any major underlying medical disease, hypertension, or previous history of complicated pregnancy. All were nonsmokers. Prior to having blood samples drawn, patients abstained from aspirin-containing drugs for 7 days and from other nonsteroidal antiinflammatory agents for the previous 48 hr. The mean age (+SD) was 29.2 + 4.3 yr, with a range of 24-36 yr. This study was approved by the Committee on the Use of Human Subjects of the University of Minnesota and by the Institutional Review Board at the Mayo Clinic. At 36 wk, venous blood was drawn from the left arm....

No abstract

No abstract

To test the hypothesis that preterm delivery of fetal gastroschisis prevents serious gastrointestinal compromise, facilitates primary surgical closure, and improves surgical outcome, we enrolled 16 women in a management plan. This included high-resolution ultrasound, weekly re-evaluation of the fetal gut (> or = 26 weeks), corticosteroids, and delivery if evidence of bowel compromise was present > 30 weeks. These fetuses were compared with 16 consecutive patients treated prior to establishment of this plan. Comparison of prospective trial patients with controls revealed significant differences in age at delivery (34.2 versus 37.7 weeks), serious bowel compromise (0 versus 70%), use of a surgically constructed silo (0 versus 77%), wound complications (0 versus 23%), duration of total parenteral nutrition (18.7 versus 34.7 days), time to full enteral feeding (19.1 versus 35.1 days), and hospital discharge (22.7 versus 37.7 days). Elective preterm delivery using specific ultrasound criteria resulted in improved surgical outcome without significant morbidity secondary to prematurity.