Cytomegalovirus Infection in Pregnancy

Cytomegalovirus (CMV) infection is of great importance to obstetrician-gynecologists because maternal infection is relatively common and can result in severe injury to the fetus. The greatest risk to the fetus occurs when the mother develops a primary CMV infection in the first trimester. Forty to 50% of infants delivered to mothers with primary CMV infections will have congenital infections. Of these neonates, 5–18% will be overtly symptomatic at birth. Approximately 30% of severely infected infants die, and 80% have severe neurologic morbidity. Eighty-five to 90% of infants will be asymptomatic, and 10–15% of these babies subsequently have sequelae such as visual and auditory defects. If the mother develops a recurrent or reactivated CMV infection during pregnancy, the risk of a severe congenital infection is very low. Perinatal infection, as opposed to congenital infection, may result from exposure to the virus during delivery or lactation and rarely leads to serious sequelae. Antimicrobial therapy and immunotherapy for CMV are, at present, unsatisfactory. Therefore, all patients, pregnant women in particular, must be educated about preventive measures

The Evolution of the Southeastern North American Margin From Integrated Analyses of Potential Field Data: Continent-Continent Collision and Rifting

The southeastern North American margin (SENAM) is one of the world’s oldest intact passive margins, containing the ancient southern Appalachian Mountains, the South Georgia Rift (SGR), and the Central Atlantic Magmatic Province (CAMP). Potential field data is used in combination with seismic imaging, borehole data, and surface geology to better constrain the lithospheric configuration created by Appalachian orogenesis and Atlantic rifting. In combination with filtering techniques, maps and 2D potential field forward models, and Euler inverse modeling are used to illuminate the pre-Cretaceous basement including basement faults, shear zones, and granites in the hinterland of the southern Appalachians, and rift basins and mafic intrusions beneath the Atlantic coastal plain and continental shelf. Focusing on the Laurentia – peri-Gondwana suture zone, modeling confirms the importance of low-angle basement thrust faults in producing Alleghanian uplift and exhumation of metamorphic core complexes. The Appalachian paired gravity anomaly is explained by an increase in crustal thickness and a decrease in upper crustal density northwest of the Carolina superterrane, suggesting that Grenville-age basement rocks extend southeastward beneath the coastal plain. The source of the enigmatic and controversial Brunswick Magnetic Anomaly (BMA) is interpreted to be a series of late-stage rift-related mafic intrusions segmented by incipient fracture zones. This interpretation is supported by the observation that the BMA is independent and inboard of the East Coast Magnetic Anomaly, implying a pre-drift source, and that the amplitude and frequency of the anomaly change nearshore across the Blake Spur fracture zone that divides the offshore BMA, where continental breakup occurred, from the onshore BMA. Basin boundaries of the SGR were revised using tilt derivative maps of gravity and filtered magnetic data. These maps delineate the northern boundaries of the SGR in South Carolina, and suggest the existence of a class of lenticular basins peripheral to the SGR developed within the Piedmont (Carolina) magnetic terrane. A major crustal boundary between the Piedmont and Charleston-Brunswick magnetic terranes in eastern Georgia and South Carolina is proposed as the Suwannee (Alleghanian) suture. The Tifton and McClellan magnetic anomalies are interpreted to be mega-scale mafic igneous complexes, which are evidence of focused rift-related magmatism

Sheathing of the Endovaginal Ultrasound Probe: Is It Adequate?

The purpose of this prospective investigation was to compare two methods for sheathing of the endovaginal ultrasound-probe. The study was conducted over a 7-month period in 1991–1992. In the first half of the investigation, latex examination gloves were used to sheath the endovaginal probe; during the second half of the investigation, latex condoms were used. Following the ultrasound examination, the probes were inspected for gross contamination by the ultrasonographer. The sheaths were then tested for perforations by filling them with water to twice their usual volume and observing for leaks. Fifty unused gloves and condoms were similarly tested to determine the prevalence of preexisting defects. One hundred twenty-eight gloves and 102 condoms from patients were tested. Four gloves (3.1%, 95% C.I. 1.6–4.6%) and seven condoms (6.9%, 95% C.I. 4.4–9.4%) had perforations (NS). When the probe was covered by a glove, one instance of visible contamination occurred (0.78%, 95% C.I. 0–1.6%) compared with eight instances when the probe was covered with a condom (7.8%, 95% C.I. 5.2–10.4%, P < .007). The prevalance of preexisting defects in the 50 unused gloves was 2%, which is not significantly different from the prevalence in used gloves. There were no defects in the 50 unused condoms compared with 7 in the used condoms (P = .057). Visible contamination of the endovaginal probe with blood or genital tract secretions is more likely when condoms are used as sheaths. However, even gloves provide imperfect coverage of the probe, illustrating the need for thorough decontamination of the endovaginal instrument after each use

Incidence of Chorioamnionitis in Patients With Meconium-stained Amniotic Fluid

Objective: The goal of this study was to determine if meconium staining of the amniotic fluid (MSAF) is a marker for chorioamnionitis

Market Failure, Human Capital, and Job Search Dynamics in South Africa: The Case of Duncan Village

This paper argues that the economic literature on unemployment and poverty in South Africa has under-explored potentially important feedback mechanisms which, because they serve to change the structure of labour markets and affect human capital trajectories, serve to endogenise labour market exclusion

Assessment of the Value of Routine Blood Cultures in the Evaluation and Treatment of Patients With Chorioamnionitis

Objective: The objective of this investigation was to determine the usefulness of blood cultures in evaluating patients with chorioamnionitis who were treated in accordance with a specific antibiotic protocol

Assessment of the Value of Routine Blood Cultures in the Evaluation and Treatment of Patients With Chorioamnionitis

ABSTRACT Objective: The objective of this investigation was to determine the usefulness of blood cultures in evaluating patients with chorioamnionitis who were treated in accordance with a specific antibiotic protocol. Methods: We reviewed the records of 539 patients with chorioamnionitis who delivered at our facility over a 3 year period (July 1, 1989-June 30, 199