A case of amniotic band syndrome diagnosed at 16 weeks gestation is presented. The pregnancy was complicated by cervical incompetence. Restriction of fetal head movement was important in sonographic diagnosis.

The concentrations of cefotiam dihydrochloride (CTM) in maternal and fetal blood and in amniotic fluid were determined by bioassay in 38 women at parturition. With an intravenous infusion of 1 g of CTM, the decline in concentration of CTM in maternal blood was biphasic; CTM was not detectable at 6 h after administration. Peak levels of CTM in umbilical cord blood (13.0 to 23.9 pug/ml) were attained between 15 and 28 min after intravenous infusion; those in amniotic fluid (19.6 to 23.5 ,ug/ml) were attained at ca. 2.5 h.When one considers using antibiotics for pregnant women, placental drug transfer must be taken into account. Substantial transfer to the fetus and amniotic fluid is not necessarily a disadvantage if the drug exerts minimal side effects. In fact, this may make the drug a reasonable choice for treatment of amnionitis and fetal infection. Accordingly, we studied the placental transfer of cefotiam dihydrochloride (CTM) (Pansporin; Takeda Chemical Industries, Ltd., Osaka, Japan), a cefem with a broad spectrum (6, 9), to the fetus and amniotic fluid.Seven normal pregnant women (four primiparas and three multiparas, aged 24 to 37 years) who agreed to participate in this study were each given 1 g of CTM dissolved in 10 ml of distilled water by intravenous infusion during weeks 37 to 41 of pregnancy. Blood samples were collected at 5, 15, 30, 60, 120, 180, and 300 min after infusion.Also, 38 normal pregnant women in labor (17 primiparas and 21 multiparas, aged 21 to 37 years) who agreed to participate in this study were each given 1 g of CTM by intravenous infusion. Maternal and fetal (umbilical cord) blood were collected at parturition. Amniotic fluid was obtained by induced rupture of membranes immediately before parturition to minimize contamination of the fluid by maternal blood. Each of the mothers delivered a normal term baby via easy labor.The concentrations of CTM in serum and in amniotic fluid were determined by bioassay, using the cylinder-plate diffusion method (5, 9) and Proteus mirabilis ATCC 21100 as the assay organism. Sensitivity of the procedure applied to blood and amniotic fluid was 0.2 p.g/ml.