Thalamostriate vasculopathy in neonates in the magnet trial: association with placental funisitis and intraventricular hemmorrhage
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ABSTRACT 1122 _Poster Session II, Sunday, 5/2 (poster 75)_ Thalamostriate vessels of increased echo-density are occasionally observed during screening cranial sonography in neonates. This
'thalamostriate vasculopathy' (TSV) has been observed in case studies in neonates with perinatal infection or with chromosomal disorders; however, the clinical relevance, causes,
and outcomes remain unclear. As a short-term neurologic endpoint, serial cranial sonography of neonates was performed in a prospective, randomized trial of intrapartum magnesium sulfate
(MgSO4) in which the long-term objective was to reduce cerebral palsy (Magnesium and Neurologic Endpoint Trial, MAGnet). Entry criteria: <34 wks gestation and preterm labor; exclusions:
pre-eclampsia. In the MAGnet trial, mothers were randomized in two arms to receive either IV MgSO4 (4gm bolus, 2 gm/hr) vs another tocolytic (tocolytic arm, <4cm cervical dilatation) or
MgSO4 (4gm bolus) vs NS (preventive arm, >4 cm dilatation). Placentas were examined by a blinded investigator and prospectively cultured (aerobic, anaerobic, mycoplasmas, and chlamydia)
after the amnion was split from the chorion. In the period 10/95-1/97, 159 neonates remained in the trial and 148 had cranial sonography; of these, 15 (10%) revealed TSV. Epidemiologic,
intrapartum, and neonatal variables were compared: (Table) The groups did not differ in: GA, gender, race, route of delivery, survival, or incidence of RDS; in cord blood pH, total or
ionized [Mg++] or [Ca++]; or in neonatal [Mg++] or [Ca++] over the first 3 days. TSV is associated with both the risk factor of placental funisitis and the adverse outcome of
intraventricular hemorrhage (IVH). Funisitis has been shown by us and others to be associated with neonatal brain injury. Based on these relationships, we conclude that TSV (1) is likely a
pathological finding with clinical relevance, and not just incidental, (2) may be another form of brain injury related to perinatal infection, and (3) may share common pathogenesis with IVH.
AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Neonatology, Radiology, Ob/Gyn, Univ of Chicago, Chicago, IL Robert Covert, Jocelyn Kohn, David Yousefzadeh, Tamar Ben-Ami & Robert
Mittendorf Authors * Robert Covert View author publications You can also search for this author inPubMed Google Scholar * Jocelyn Kohn View author publications You can also search for this
author inPubMed Google Scholar * David Yousefzadeh View author publications You can also search for this author inPubMed Google Scholar * Tamar Ben-Ami View author publications You can also
search for this author inPubMed Google Scholar * Robert Mittendorf View author publications You can also search for this author inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and
permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Covert, R., Kohn, J., Yousefzadeh, D. _et al._ Thalamostriate Vasculopathy in Neonates in the MAGnet Trial: Association with Placental
Funisitis and Intraventricular Hemmorrhage. _Pediatr Res_ 45, 192 (1999). https://doi.org/10.1203/00006450-199904020-01139 Download citation * Issue Date: 01 April 1999 * DOI:
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