In order to evaluate the development of fetal behavioural states a longitudinal study was performed on 35 healthy fetuses during the last trimester of pregnancy. Fetal heart rate (FHR), gross fetal body movements (FM), fetal eye movements (FEM), fetal breathing movements (FBM) and micturition were simultaneously studied at two-week intervals from 28 weeks gestation onwards. Well-defined fetal behavioural states were observed only after 36 weeks gestation. Between 28 and 36 weeks the quiet-activity cycle of FHR was always detected and some fetal biophysical activities seemed to become related around this cycle.
In order to accurately detect the fetal behavioural state, we simultaneously measured fetal heart rate and multiple fetal activities in 27 healthy pregnant women at 38 to 40 weeks of gestation. We ultrasonically identified gross body movements, breathing movements and micturition. Analysis of fetal heart rate allowed us to distinguish two different patterns of fetal behaviour: active and quiet phases. The frequency distribution of the analysed fetal events was significantly different in these two phases. These data suggest that a complete biophysical profile of the fetus is effective in differentiating behavioural states and may improve the predictive accuracy of fetal heart rate analysis alone.
To assess the role of local immune response against bacterial invasion of the urinary tract we studied 168 patients with bacteriuria. Urinary secretory immunoglobulins A (sIgA) were measured using radial immunodiffusion or enzyme-linked immunosorbent assay (ELISA). In particular, ELISA is a very suitable assay for measuring the low levels of sIgA in urine. Furthermore, we used a quantitative in vitro adherence assay to investigate the attachment of Escherichia coli to human uroepithelial cells after incubation in urine from patients with urinary tract infection. Urine from patients with ileocystoplasty was significantly more potent in inhibiting bacterial adherence than was urine from other groups of patients with urinary tract infection. The presence of high urinary sIgA may help explain the increased antiadherence activity of urine in patients with ileocystoplasty. Mean urinary sIgA in patients with upper urinary tract infection was higher than in patients with uncomplicated infection in the lower urinary tract. Alterations in mucosal immune functions may account for the propensity toward bacterial colonization in women prone to uncomplicated urinary tract infection.
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