On the basis of the nucleotide sequence of the urease genes of Ureaplasma urealyticum serotype 8, polymerase chain reaction (PCR) primers were selected, evaluated for specificity and sensitivity, and tested for their ability to detect U. urealyticum in the adult urogenital tract, amniotic fluid, and endotracheal aspirates of newborns. All 14 reference serotypes of U. urealyticum were detected with equal sensitivity (1-10 cfu), whereas multiple strains of 12 other mycoplasma species found in humans as well as eukaryotic DNA were not detected. A total of 638 clinical specimens was evaluated. Results indicate that PCR is equal to if not more sensitive than culture for detection of U. urealyticum. Faster detection of U. urealyticum by PCR (< 24 h) compared to culture (2-5 days) will be particularly important in management of very low birth-weight infants in whom this organism has been shown to be a significant cause of meningitis, respiratory disease, and death. This method of detection will also be helpful in further determining the role of this organism in intraamniotic infection and premature birth.

The factors listed above have apparently become less important in the context of bronchopulmonary dysplasia and other influences, including prenatal conditions, will need to be investigated.

No abstract

Caudal regression sequence (CRS) is a rare congenital defect of the lower spinal segments and the neural tube. Motor symptoms as well as neurological deficits and loss of bladder and bowel function are usually present. CRS is also associated with anomalies in other systems such as the gastrointestinal and genitourinary tract. Etiology and pathogenesis are poorly understood.A newborn presented with anomalies of the spinal column (lumbosacral) with absence/hypoplasia of the 12th thoracic and first lumbar vertebral anomaly body. Bladder and bowel initially were functional. MRangiography exhibited an anomaly of the unpaired vessels originating from the aorta, a likely relict of a persisting vitelline artery.These findings indicate a potential vascular genesis of CRS, much as in sirenomelia.

Infants born by caesarean section (CS) near or at term were observed to display spontaneous facial movements in their first minutes. We hypothesized that those are reproducible. Up to now, nothing was known about the significance, frequency, and determinants of such facial activity. Repetitive eye opening (EO) and tongue thrust (TT) actions were documented during 1 to 5 minutes, 5 to 10 minutes, and 1 to 15 minutes in 102 infants. In addition, 32 infants were recorded on video from minute 2 to minute 10. Infant- and maternal- influencing factors were noted and videos analyzed using Interact (Version 7.1, Mangold International, Arnstorf, Germany). According to our results, 99 of 102 newborns (gestational age, 33 to 42 weeks) performed EO or TT during the first 15 minutes. Preterm and infants with lower Apgar scores and infants born under general anesthesia showed less EO. Infants of smoking mothers, newborns admitted to special care, and infants with lower umbilical artery pH had significantly fewer TT episodes. Within a "normal" population of newborns of > 37 weeks at delivery (n = 57), 97% showed EO and 95% showed TT. In the filmed 32 newborns, infants began EO at 2:40 and TT at 2:34 minutes of life on average. Crying had no influence, but suctioning/intervention reduced EO frequency. In conclusion, EO and TT are occurring regularly during neonatal adaptation. TT seems to be an inborn automatic behavior; numerous occurrences of EO argue for neurological well-being. Both facial actions may initiate maternal-infant attachment.