摘要:

Fetal stem cell transplantation may rely on material from therapeutic abortions. It is essential that the stem cell transplant does not transmit any microorganism that may affect the fetus and that genetically abnormal cells are avoided. To evaluate such contamination, human fetal stem cells collected February 1992 – December 1993 were analyzed for bacterial and fungal growth, and the placentas were karyotyped. Four samples of 70 were positive for different pathogens. Serological screening of 43 women during this period resulted in five seroconver-sions and revealed one carrier of anti-HCV. Karyotyping revealed two abnormal findings out of 72 samples. Thus, the concept of using material from therapeutic abortions is saf

ISSN:1015-3837    

DOI:10.1159/000264065

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Objective: To determine if unexplained low second-trimester maternal serum human chorionic gonadotropin (MShCG) is a useful predictor of complications of pregnancy. Study design: Between 2/1/90 and 1/3/91, 3,116 patients underwent prenatal screening using second-trimester maternal serum α-fetoprotein (MSAFP), MShCG and maternal serum unconjugated estriol (MSuE3). Among these, there were 160 patients with complete obstetrical history who had second-trimester MShCG < 0.4 multiples of the median (MoM). These were compared to 261 controls with complete obstetrical history and a normal second-trimester MSAFP, MSuE3 and MShCG. Results: No differences were found in gestational age at delivery, neonatal weight, premature rupture of membranes or pregnancy loss. The relative risk of pregnancy-induced hypertension in the study group was 0.29 (p < 0.01) and that of gestational diabetes was 0.3 (p < 0.05). Only when low MShCG was associated with a high or low MSAFP or low MSuE3 was there a significantly increased loss of pregnancy (relative risk 11.7; p < 0.0001). Conclusion: The data suggest that second-trimester MShCG < 0.4 MoM by itself has no influence on the outcome of pregnancy

ISSN:1015-3837    

DOI:10.1159/000264066

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The critical need for rapid and reliable karyotype analysis can be no greater than in the setting of sonographic fetal anomalies. Fluorescent in situ hybridization (FISH) directly applied to interphase chromosomes can decrease the time required to identify the common aneuploidies. Our retrospective study reviewed 50 consecutive patients with sonographic fetal anomalies who underwent FISH. Within this high risk group, nonmosaic chromosomal aneuploidies were present in 16% of the fetuses (8 of 50), and 2 additional fetuses had cytogenetic abnormalities: 1 case, 46, XY,-12,+der(12)t(12;13)(p13; q14.1), and 1 case a 10% mosaic for trisomy 21. Of the 10 cytogenetically abnormal fetuses, FISH was able to identify correctly all 8 of the nonmosaic aneuploidies within 2 days of receipt of the specimen in the laboratory. Clinical decisions can be made on the basis of concordant FISH and ultrasound abnormalities, shortening the decision-making process for most of the aneuploid cases. However, our experience demonstrates some of the limitations of current FISH protocols and the continued necessity for formal karyotype analysis.

ISSN:1015-3837    

DOI:10.1159/000264067

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Flow cytometry was used to determine lymphocyte subpopulations in maternal blood from 143 pathological pregnancies: 50 with fetal aneuploidy; 32 with missed abortions; 12 with ectopic pregnancies; 20 with multi-fetal pregnancies, and 29 with pregnancies complicated by intrauterine growth retardation (IUGR). The values were compared to those of 240 women with normal singleton pregnancies at 8–40 weeks of gestation and 20 non-pregnant controls. In early pregnancy (8–10 weeks), compared to non-pregnant values, there was a decrease in the percentage of CD4+ cells and CD4+ to CD8+ ratio and an increase in the percentage of CD8+ cells. In later pregnancy, the CD4+ cell percentage and CD4+ to CD8+ ratio increased and the CD8+ cell percentage decreased to reach non-pregnant values at term. The percentage of natural killer (CD3–– and CD 16/56+) cells decreased with gestation, while the percentage of B (CD 19+) cells did not change significantly. In IUGR, the percentage of CD4+ cells and CD4+ to CD8+ ratio were decreased, while the percentage of CD8+ cells was increased. In contrast, in the groups of missed abortions and ectopic pregnancies, the CD4+ to CD8+ ratio was increased. In multifetal pregnancies and those with fetal aneuploidies there were no significant differences in maternal lymphocyte subpopulations from

ISSN:1015-3837    

DOI:10.1159/000264068

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

The efficacy of the polymerase chain reaction (PCR) in the first-trimester prenatal diagnosis of Duchenne muscular dystrophy (DMD) was examined. Twenty-seven fetuses from 26 Japanese pedigrees at risk for DMD were analyzed. PCR-restriction fragment length polymorphism analysis, multiplex PCR, and dinucleotide repeat polymorphism analysis were used. Of 16 males, 11 were determined to be unaffected, 4 were affected, and the remaining 1 was undetermined. Of the 11 female fetuses, 1 was diagnosed as a noncarrier, 4 were carriers, and the carrier status of the remaining 6 was not determined at the option of the patients, although DNA polymorphisms could be detected in those patients. Prenatal diagnosis by PCR analysis was possible in 96% of the fetuses tested (26 of 27).

ISSN:1015-3837    

DOI:10.1159/000264069

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

We performed percutaneous umbilical blood sampling, under ultrasound guidance, in both twins of 11 twin pregnancies in whom twin-to-twin transfusion syndrome was suspected. Chorionicity and the presence of placental vascular anastomoses were assessed postnatally. The hemoglobin concentration, hematocrit and other biochemical variables in fetal blood were evaluated in both twins. The mean hemoglobin difference between the large and small twins was 4.8 g/dl (range 1.8–8.1 g/dl) in 5 monochorionic discordant twin pairs, and 1.2 g/dl in a monochorionic twin pair without discordancy. Hemoglobin values did not differ between dichorionic twins. The mean hematocrit difference between monochorionic discordant twins was 18.3%. In dichorionic discordant twins, the inter-twin hematocrit difference was very small. Total protein and albumin were normal in all twin

ISSN:1015-3837    

DOI:10.1159/000264070

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

A rare case of craniorachischisis associated with trisomy 18 is described. The diagnosis was made by endovaginal sonography during the first trimester of pregnancy. The case is interesting for two reasons. First, it confirms the importance of carrying out an accurate sonographic examination during the first trimester. Second, it shows us that the postmortem examination should be performed by an experienced anatomist: embryos need to be embedded in paraffin wax for microscopic observation and, at present, little is known about the abnormalities of embryo anatomy.

ISSN:1015-3837    

DOI:10.1159/000264071

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Ductus venosus links the umbilical vein and the portal vein to the inferior vena cava. It is of great significance for the developing fetus but of minor importance to the growing infant where it normally obliterates and is transformed to the ligamentum venosum. An absent ductus venosus implies that the oxygenated blood from the umbilical vein has to circulate through the liver. We report 4 cases with this malformation. Prenatally, three fetuses had an extreme hydrops, especially hydrothorax. In two fetuses hydrops was severe already in the second trimester of pregnancy. Termination was performed. In the third case, hydrops was first diagnosed in the 36th week of gestation. The fourth case had an ultrasound examination in the 34th week of gestation. There was no hydrops but a disproportion with a very small head and abdominal diameter compared to femur length. Postpartum both these infants died. At autopsy, the only structural malformation in the three hydrops cases was an absent ductus venosus. In the fourth case there were other anomalies.

ISSN:1015-3837    

DOI:10.1159/000264072

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Despite improvements in surgical techniques, the results of open fetal surgery to correct congenital diaphragmatic hernia have been disappointing. Hysterotomy induces preterm labour and, where there is a large volume of liver in the fetal chest, reduction of the liver into the abdomen induces immediate fetal death. Less invasive techniques, using both open surgery and fetoscopy, are being developed in the hope of reducing fetal demise. These techniques include blocking the trachea, the creation of an artificial gastroschisis and induction of graft tolerance for postnatal lung transplantation.

ISSN:1015-3837    

DOI:10.1159/000264073

出版商:S. Karger AG    

年代:1994

数据来源: Karger

ISSN:1015-3837    

DOI:10.1159/000264074

出版商:S. Karger AG    

年代:1994

数据来源: Karger