1.  Title: Low plasma protein C values predict mortality in low birth weight neonates with septicemia. Author: Venkataseshan S; Dutta S; Ahluwalia J; Narang A Source: Pediatric Infectious Disease Journal. 2007 Aug;26(8):684-688. Abstract: Septicemia activates coagulation and decreases activated protein C (APC). Low APC in adults is associated with multiorgan dysfunction and mortality, but such data in neonates are lacking. Being deficient in APC, neonates may be especially vulnerable to the effects of low APC. This cohort study was conducted on 40 neonates with severe bacterial septicemia to determine the relationship between plasma APC values and mortality, time to mortality, and hazard of dying. Low birth weight neonates with sepsis, organ dysfunction, and systemic inflammatory response syndrome were enrolled after parental consent. Plasma APC was assayed at enrollment and subjects were followed for 14 days from enrollment. Low birth weight neonates, who had major malformations, severe birth asphyxia, or received blood products before APC assay, were excluded. Primary outcome: comparison of APC level between survivors and nonsurvivors. Secondary outcomes: survival with low versus normal APC; and hazard ratio of APC, adjusted for birth weight, Score for Neonatal Acute Physiology and number of affected organs. Forty of 74 eligible neonates were included. Twenty-five of the enrolled neonates died within 14 days. APC levels in nonsurvivors were lower than in survivors [median (interquartile range) %, 15 (4.5-21) versus 33 (18 -55); P < 0.001]. Ten nonsurvivors versus 1 survivor had low APC (P = 0.03). Positive predictive value (PPV) of low APC values for mortality was 90.9%. Survival in the low APC group (n = 11) was shorter than in normal APC group [median (95% confidence interval) days, 3 (2.3-3.7) versus 10, P value < 0.001]. APC value was independently associated with hazard of dying [adjusted risk 0.95 (95% confidence interval 0.92-0.99), P = 0.02]. Each 1% rise in APC decreased the hazard of dying by 5%. Mortality was higher and duration of survival shorter in septic neonates with lower plasma ACP. The latter was an independent predictor of the hazard of dying. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | PROSPECTIVE STUDIES | INFANT | LOW BIRTH WEIGHT | NEONATAL DISEASES AND ABNORMALITIES | INFANT MORTALITY | PNEUMONIA | ALPHA FETOPROTEINS | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Birth Weight | Body Weight | Physiology | Biology | Diseases | Mortality | Population Dynamics | Pulmonary Effects | Blood Proteins | Hemic System Document Number: 319097 |
| 2. Peer Reviewed Title: Elevated maternal midtrimester serum free beta-human chorionic gonadotropin levels in vegetarian pregnancies that cause increased false-positive down syndrome screening results. Author: Cheng PJ; Chu DC; Chueh HY; See LC; Chang HC Source: American Journal of Obstetrics and Gynecology. 2004 Feb;190(2):442-447. Abstract: The aim of this study was to examine whether midtrimester maternal serum free ß-human chorionic gonadotropin and a-fetoprotein levels for Down syndrome screening differed in vegetarian pregnancies and omnivore pregnancies and to evaluate whether maternal serum vitamin B/12 concentration affected these maker levels. Ninety-eight vegetarian and 122 omnivore singleton pregnancies were studied. Reference levels of free ß-human chorionic gonadotropin and a-fetoprotein were based on a population of 6312 singleton euploid pregnancies that had been surveyed previously. Serum free ß-human chorionic gonadotropin and a-fetoprotein levels were measured by enzyme immunoassay or radioimmunoassay. Multiples of the median values were calculated to determine whether different diet habits affected serum biomarker levels. Maternal serum vitamin B/12 levels were determined with radioimmunoassay. The free ß-human chorionic gonadotropin multiples of the median values were elevated significantly in the vegetarian pregnancies group (1.28 multiples of the median) compared with that of the reference population (1.00 multiples of the median) (P<001). A negative association between the serum free b-human chorionic gonadotropin multiples of the median values and the concentration of maternal serum vitamin ß12 was observed in the vegetarian pregnancies. No correlation was found between the a-fetoprotein multiples of the median values and the maternal serum vitamin B/12 concentration. The current data showed that the midtrimester maternal serum free ß-human chorionic gonadotropin levels increased in vegetarian pregnancies and led to an elevated false-positive rate in screening for Down syndrome compared with pregnant women with regular diet and resulted in unnecessary invasive procedures. It is necessary to establish vegetarian pregnancy a-fetoprotein and ß-human chorionic gonadotropin reference levels to correct increased false-positive screening results. (author's) Language: English Keywords: TAIWAN | RESEARCH REPORT | CLINICAL RESEARCH | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | PREGNANCY COMPLICATIONS | PREGNANCY, SECOND TRIMESTER | GONADOTROPINS, CHORIONIC | ALPHA FETOPROTEINS | MENTAL RETARDATION | SCREENING | LABORATORY EXAMINATIONS AND DIAGNOSES | DIET | VITAMIN B COMPLEX | Asia, Eastern | Asia | Developed Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Diseases | Pregnancy | Reproduction | Gonadotropins | Hormones | Endocrine System | Physiology | Biology | Blood Proteins | Hemic System | Intelligence | Personality | Psychological Factors | Behavior | Examinations and Diagnoses | Nutrition | Health | Vitamins and Minerals Document Number: 190830 |
| 3. Title: Second trimester total human chorionic gonadotropin, alpha-fetoprotein and unconjugated estriol in predicting pregnancy complications other than fetal aneuploidy. Author: Duric K; Skrablin S; Lesin J; Kalafatic D; Kuvacic I Source: European Journal of Obstetrics, Gynecology and Reproductive Biology. 2003 Sep 10;110(1):12-15. Abstract: Objective: To assess the value of alpha-fetoprotein (AFP), total human chorionic gonadotropin (ThCG) and unconjugated estriol in predicting certain complications of pregnancy other than fetal aneuploidy. Study design: Among 2384 women that underwent biochemical screening between 15 and 22 weeks of gestation, pregnancy outcome was evaluated in 677 women under 35 years of age according to serum marker levels by using cut-off points discriminative for Down syndrome or neural tube defect (NTD). Results: High alpha-fetoprotein levels (MoM >/= 2.0) were found to be significantly more frequent (P < 0.05) in cases of fetal growth restriction (odds ratio = 2.7), miscarriage (odds ratio = 4.4) and intrauterine fetal death (odds ratio = 5.8). High chorionic gonadotropin levels (MoM >/= 2.02) were associated with intrauterine growth restriction (odds ratio = 2.1; P < 0.05), miscarriage (odds ratio = 4; P < 0.01), preterm birth (odds ratio = 2.5; P < 0.05), and intrauterine fetal death (odds ratio = 4.2; P < 0.01). Among pregnancies with intrauterine growth restriction and threatening preterm delivery, low unconjugated estriol levels (MoM _ Language: English Keywords: CROATIA | RESEARCH REPORT | CLINICAL RESEARCH | PROSPECTIVE STUDIES | PREGNANT WOMEN | PREGNANCY COMPLICATIONS | FETUS | ALPHA FETOPROTEINS | GONADOTROPINS, CHORIONIC | ESTRIOL | MATERNAL AGE | GESTATIONAL AGE | INTRAUTERINE GROWTH RETARDATION | FETAL DEATH | PREMATURE LABOR | SCREENING | PREMATURE BIRTH | Europe, Southeastern | Europe | Developing Countries | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Diseases | Pregnancy | Reproduction | Blood Proteins | Hemic System | Physiology | Biology | Gonadotropins | Hormones | Endocrine System | Estrogens | Parental Age | Age Factors | Congenital Abnormalities | Neonatal Diseases and Abnormalities | Mortality | Population Dynamics | Pregnancy Outcomes | Examinations and Diagnoses Document Number: 187544 |
4.  Peer Reviewed Title: Prenatal exclusion of Beta thalassaemia major by examination of maternal plasma. Author: Chiu RW; Lau TK; Leung TN; Chow KC; Chui DH; Lo YM Source: Lancet. 2002 Sep 28;360(9338):998-1000. Abstract: The discovery of the presence of fetal deoxyribonucleic acid in maternal plasma has provided a new approach for non-invasive prenatal diagnosis. At present, the prenatal diagnosis of beta thalassemia relies on invasive methods. The authors designed allele-specific primers and a fluorescent probe for detection of the codon 41/42 (-CTTT) mutation in the beta globin gene from maternal plasma by real-time polymerase chain reaction. The specificity and sensitivity of the allele-specific assay was confirmed by subjecting plasma, buffy coat, and amniotic fluid samples from 100 pregnancies to screening for the mutation. Subsequently, the assay was applied to the prenatal testing of eight fetuses at risk of beta thalassemia major, the aim being to exclude fetal inheritance of paternally transmitted codon 41/42 mutation. The fetal genotype was completely concordant with conventional analysis and beta thalassemia major was excluded in two of the pregnancies non-invasively. (author's) Language: English Keywords: HONG KONG | RESEARCH REPORT | CLINICAL RESEARCH | PREGNANT WOMEN | FETUS | ALPHA FETOPROTEINS | GENETIC TECHNIQUES | Developed Countries | Asia, Eastern | Asia | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Blood Proteins | Hemic System | Physiology | Biology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses Document Number: 172101 |
| 5. Title: Weight-correction formula for maternal serum screening for Down syndrome in Taiwan. Author: Jou HJ; Wu SC; Lu YM; Liao WC; Hsieh FJ Source: Journal of the Formosan Medical Association. 2000 Dec;99(12):931-5. Abstract: This study examined the relationship between maternal weight and serum marker concentrations (alpha-fetoprotein [AFP] and human chorionic gonadotropin [hCG] to develop a weight-correction formula for second-trimester Down syndrome screening in Taiwan. The authors conducted a prospective observational study based on data from 18,016 pregnant Taiwanese women who participated in a second-trimester Down syndrome screening program at Taiwan Adventist Hospital. The relationship between maternal weight and the multiple of median (MoM) concentrations of serum markers was analyzed using two methods; one involved all the observational data (all point method), while the other involved only the median concentrations at various gestational ages (median regression method). In each method, several statistical approaches were used, including simple-linear, reciprocal, quadratic, and log-transformation linear regression. The correlation between maternal body weight and serum marker concentrations using the all point regression method was very poor, while the median regression method achieved a good fit. The reciprocal regression analysis had the best fit between AFP MoM concentration and maternal weight, while the best fit between hCG MoM concentration and maternal weight was achieved with quadratic regression analysis. The present study has developed a race-specific weight-correction formula for Taiwanese women. This formula is expected to be helpful in second-trimester Down syndrome screening programs in Taiwan. (author's) Language: English Keywords: TAIWAN | RESEARCH REPORT | CLINICAL RESEARCH | PROSPECTIVE STUDIES | BODY WEIGHT | ALPHA FETOPROTEINS | GONADOTROPINS, CHORIONIC | CHROMOSOME ABNORMALITIES | SCREENING | PREGNANCY, SECOND TRIMESTER | Asia, Eastern | Asia | Developed Countries | Research Methodology | Studies | Physiology | Biology | Blood Proteins | Hemic System | Gonadotropins | Hormones | Endocrine System | Neonatal Diseases and Abnormalities | Diseases | Examinations and Diagnoses | Pregnancy | Reproduction Document Number: 156022 |
| 6. Title: Ethnicity, bioethics, and prenatal diagnosis: the amniocentesis decisions of Mexican-origin women and their partners. Author: Browner CH; Preloran HM; Cox SJ Source: American Journal of Public Health. 1999 Nov;89(11):1658-66. Abstract: Because of the acceptance of alpha-fetoprotein (AFP) screening as a noninvasive, inexpensive, but effective diagnostic technique in the 1980s, new constituents were introduced to prenatal diagnosis. These new constituents include women from lower and working class ethnic minority backgrounds, who have higher rates of amniocentesis refusal compared to others. This study investigates the considerations of Mexican-origin women who were screened positive for AFP and deciding whether to undergo amniocentesis or not. 379 patient charts were reviewed to obtain data on sociodemographic characteristics and reproductive history, which is connected to the result of the amniocentesis decision. A total of 147 women and 120 male partners were interviewed to give information on a wide range of variables of their decision making process. Findings showed that the woman's attitudes toward doctors, medicine, prenatal care, and risk-taking are significant factors affecting the decision. The case summaries revealed how varied and indeterminate the decision-making process is. In conclusion, health care providers who offer counseling to these women need to be more sensitive to the way these ethnic minority women make their decision about amniocentesis. Language: English Keywords: CALIFORNIA | UNITED STATES OF AMERICA | RESEARCH REPORT | PREGNANT WOMEN | ETHNIC GROUPS | WOMEN | MINORITY GROUPS | SOCIOECONOMIC STATUS | CULTURAL BACKGROUND | AMNIOCENTESIS | TESTING | ALPHA FETOPROTEINS | Developed Countries | North America | Americas | Population Characteristics | Demographic Factors | Population | Socioeconomic Factors | Economic Factors | Genetic Techniques | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Measurement | Research Methodology | Blood Proteins | Hemic System | Physiology | Biology Document Number: 145661 |
| 7. Peer Reviewed Title: Prevalence of neural tube defects in South Australia, 1966-91: effectiveness and impact of prenatal diagnosis. Author: Chan A; Robertson EF; Haan EA; Keane RJ; Ranieri E; Carney A Source: BMJ. British Medical Journal. 1993 Sep 18;307(6906):703-6. Abstract: The authors sought to determine trends in total prevalence of neural tube defects in South Australia during the period 1966 through 1991, the impact of prenatal diagnosis on birth prevalence, and the effectiveness of prenatal screening for neural tube defects during the period 1986 through 1991. The authors studied 1058 births and terminations of pregnancy affected by neural tube defects during 1966-1991. Data on births and terminations and information on prenatal screening came from the South Australian perinatal and abortion statistics collections, birth defects registers, and the state maternal serum alpha fetoprotein screening program. Main outcome measures of the study were total prevalence and birth prevalence of individual and all neural tube defects and the proportion of screened cases detected prenatally. Total prevalence of neural tube defects during the period 1066-1991 was 2.01/1000 births with no upward or downward trend. However, birth prevalence fell significantly (by 5.1% a year) with an 84% reduction from 2.29/1000 births in 1966 to 0.35/1000 in 1991 (relative risk = 0.16, 95% confidence interval 0.07-0.34). The fall was 96% for anencephaly and 82% for spina bifida. 85% of defects, both open and closed, were detected before 28 weeks gestation in women screened by serum alpha fetoprotein or midtrimester ultrasonography, or both, in 1986-1991 (99.0% for anencephaly and 75.7% for spina bifida). While the total prevalence of neural tube defects in South Australia remained stable, the prenatal diagnosis and termination of pregnancy resulted in an 84% fail in birth prevalence during 1966-1991. Screening detected over four-fifths of the cases during 1986-1991. (author's modified) Language: English Keywords: AUSTRALIA | PREVALENCE | EXAMINATIONS AND DIAGNOSES | CONGENITAL ABNORMALITIES | SCREENING | ALPHA FETOPROTEINS | DATA ANALYSIS | NEUROLOGIC EFFECTS | Developed Countries | Oceania | Measurement | Research Methodology | Neonatal Diseases and Abnormalities | Diseases | Blood Proteins | Hemic System | Physiology | Biology Document Number: 090124 |
| 8. Title: Changes in the concentration of alpha-fetoprotein and placental hormones following two methods of medical abortion in early pregnancy. Author: Thong KJ; Norman JE; Baird DT Source: BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY. 1993 Dec;100(12):1111-4. Abstract: 335 healthy women undergoing termination of 1st trimester pregnancy with amenorrhea of 56 days or less were studied in order to examine the occurrence of feto-maternal hemorrhage in women. The control group comprised 100 women in early pregnancy. Venous blood was taken on day 0 and 48 hours later. The mifepristone group included blood samples from 140 of the 150 women. Each women received a single oral dose of mifepristone of either 200 mg (n = 50), 400 mg (n = 43) or 600 mg (n = 47). Venous blood was taken in similar fashion, but the 2nd sample was taken before insertion of a 1 mg gemeprost pessary. The gemeprost along group included 95 women who had 1 mg gemeprost pessaries inserted to a maximum dose of 3 mg or until abortion occurred. Blood was collected before insertion of the 1st gemeprost pessary (0 hour) and 24 hours later. The rise in alpha-fetoprotein (AFP) concentration was significantly greater in the groups who had a medical abortion (p = 0.01) compared with the control group. In Group 1, there was a moderate rise in the plasma concentration of AFP (P <0.0001), estradiol (P < 0.0002), hCG (P < 0.0001) and progesterone (NS) over 48 hours. Only 5% of women had an AFP rise of 38% or greater within 48 hours. In group 2, 61 to 69% of women bled following administration of mifepristone. Women had a significant rise in AFP concentration (P <0.001) within 48 hours, and 27% had an AFP rise 38% or greater. A rise in plasma hCG was demonstrated, while plasma progesterone remained unchanged over 48 hours. There was a significant reduction in plasma estradiol 48 hours after taking mifepristone (P <0.02). All women in group 3 bled following insertion of gemeprost, and 89% aborted within 24 hours after the 1st gemeprost pessary. An overall increase in AFP concentration was detected (P <0.0001). 33% of women had an increase of 38% or greater in AFP. A significant reduction in plasma hCG (p <0.0001), estradiol (P <0.0001) and progesterone (P <0.0001) occurred within 24 hours after abortion. Language: English Keywords: SCOTLAND | RESEARCH REPORT | COMPARATIVE STUDIES | LABORATORY PROCEDURES | ABORTION | RU-486 | BLEEDING | ALPHA FETOPROTEINS | PROGESTERONE | ESTRADIOL | United Kingdom | Europe, Western | Europe | Developed Countries | Studies | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Fertility Control, Postconception | Family Planning | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Signs and Symptoms | Diseases | Blood Proteins | Hemic System | Progestational Hormones | Estrogens Document Number: 092074 Notification |
| 9. Title: Acute phase proteins in "small for dates" babies. II. Haptoglobin, transferrin, alpha-1-feto protein, alpha-1-acid glycoprotein and caeruloplasmin levels. Author: Salimonu LS Source: AFRICAN JOURNAL OF MEDICINE AND MEDICAL SCIENCES. 1992 Oct;21(1):55-9. Abstract: Haptoglobin, transferrin, alpha-1-fetoprotein (AFP), alpha-1-acid glycoprotein (AAGP), and caeruloplasmin levels were estimated in 14 "small-for-dates" (SFD) and 31 "appropriate-for-dates" (AFD) babies by the single radial immunodiffusion method. The mean caeruloplasmin level was observed to be significantly reduced in the SFD babies when compared with the AFD babies (t = 3.4582, p < 0.02). None of the other 4 acute phase proteins showed any significant differences in mean concentration between the SFD babies and the controls. The diminished caeruloplasmin levels observed in SFD babies agree with the previous reports in postnatal undernutrition. The authors' findings of no significant differences in the other 4 acute phase proteins between SFD and AFD babies are however at variance with previous observations of elevated levels of AFP, haptoglobin, and AAGP and reduced levels of transferrin in malnourished infants. (author's) Language: English Keywords: NIGERIA | BLOOD PROTEINS | ALPHA FETOPROTEINS | MEASUREMENT | MALNUTRITION | DEFICIENCY DISEASES | INFANT NUTRITION | INFANT | LABORATORY PROCEDURES | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Hemic System | Physiology | Biology | Research Methodology | Nutrition Disorders | Diseases | Nutrition | Health | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Laboratory Examinations and Diagnoses | Examinations and Diagnoses Document Number: 083703 |
| 10. Title: The psychosocial sequelae of a second-trimester termination of pregnancy for fetal abnormality. Author: White-Van Mourik MC; Connor JM; Ferguson-Smith MA Source: PRENATAL DIAGNOSIS. 1992 Mar;12(3):189-204. Abstract: 84, or 87% of all women from West Scotland who had second trimester termination of pregnancy for fetal abnormalities in 1986, and 68 spouses, participated in a study of psychosocial sequelae. A structured questionnaire was administered during a home visit 2 years after the termination. Gestations ranged from 12 to 27 weeks (median 19). The women's ages ranged from 17 to 46 years (median 27), that of their partners was 17-48 (median 29). Indications for the abortions were tabulated. Only 5% of the women were without partners. 15% were unemployed. 33% of the pregnancies were the couples' 1st. 76% of the abnormal pregnancies were directed by the West of Scotland Alpha-fetoprotein screening program. 72% of the pregnancies had been planned, 26% had been unplanned but were welcome, and only 2% of women were still ambivalent. 2 couples regretted their decision. At 2 years 20% of women were having crying spells, sadness, and irritability. Husbands reported listlessness, poor concentration, and irritability up to 1 year afterward. 12% of couples marital problems resulting in separation of 2% and 1 divorce. Physical symptoms such as palpitations and panic attacks were only reported by those under 25. 1 woman and 1 man required in-patient treatment; 11 women received counseling; 5 took anti depressants. 3 men had counseling and 3 took antidepressants. A majority of men reported confusing and conflicting reactions to their wives' feelings which may have led to social isolation and lack of communication. 55% of the women and 58% of the men said they had not discussed their feelings with anyone. There were no specific psychological sequelae linked to specific fetal abnormalities or religious beliefs. Immaturity, inability to communicate needs, low self-esteem, lack of social support, and secondary infertility all were associated with dysfunctional grieving. It was concluded that such grief and emotional turmoil could be shortened by skilled preparatory counseling. Language: English Keywords: SCOTLAND | RETROSPECTIVE STUDIES | ABORTION | PREGNANCY, SECOND TRIMESTER | PARTNER COMMUNICATION | EMOTIONS | REGRET | STRESS | ALPHA FETOPROTEINS | SCREENING | MENTAL HEALTH | MENTAL DISORDERS | DEPRESSION | COUNSELING | POSTABORTION | SPOUSE | SEPARATION | United Kingdom | Europe, Western | Europe | Developed Countries | Studies | Research Methodology | Fertility Control, Postconception | Family Planning | Pregnancy | Reproduction | Interpersonal Relations | Behavior | Psychological Factors | Blood Proteins | Hemic System | Physiology | Biology | Examinations and Diagnoses | Health | Diseases | Clinic Activities | Program Activities | Programs | Organization and Administration | Family Relationships | Family Characteristics | Family and Household | Marriage | Nuptiality Document Number: 073696 Notification |
| 11. Peer Reviewed Title: [Significant effects on alpha-fetoprotein (AFP) concentration in maternal serum in pregnancy] Untersuchungen von Einflussgrossen auf die alpha-Fetoprotein (AFP)-Konzentration im mutterlichen Serum wahrend der Schwangerschaft. Author: Greiff R; Schlosser H; Amse T Source: ZENTRALBLATT FUR GYNAKOLOGIE. 1991;113(5):253-7. Abstract: The influence of oral contraceptives, nicotine, analgesics, and thyroid hormones, as well as the age of pregnant women, their parity, and babies birthweights on the concentration of maternal serum alpha fetoprotein (AFP) was examined in 200 patients in order to determine the reliability of AFP determinations in the serum of pregnant women. There were correlations only with nicotine consumption. The results confirmed that there was an insignificant influence of these factors on maternal serum AFP and underlined the reliability and stability of this prenatal screening technique. (author's modified) (summaries in GER, ENG) Language: German Keywords: FEDERAL REPUBLIC OF GERMANY | PREGNANCY | ALPHA FETOPROTEINS | MEASUREMENT | TOBACCO USE | ORAL CONTRACEPTIVES | ANALGESIA | ANTENATAL CARE | SCREENING | HEMATOLOGIC TESTS | Europe, Central | Europe | Developed Countries | Reproduction | Blood Proteins | Hemic System | Physiology | Biology | Research Methodology | Behavior | Contraceptive Methods | Contraception | Family Planning | Treatment | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Examinations and Diagnoses | Laboratory Procedures | Laboratory Examinations and Diagnoses Document Number: 068685 |
| 12. Title: Human chorionic gonadotrophin and alpha-fetoprotein levels in matched samples of amniotic fluid, extraembryonic coelomic fluid, and maternal serum in the first trimester of pregnancy. Author: Wathen NC; Cass PL; Kitau MJ; Chard T Source: PRENATAL DIAGNOSIS. 1991 Mar;11(3):145-51. Abstract: Physicians used transvaginal ultrasound to guide the aspiration needle into the amniotic fluid and extraembryonic celomic fluid from 32 women at 7-12 weeks gestation in St. Bartholomew's Hospital or Homerton Hospital in London, England. They also collected blood. Their intent was to determine the levels of alpha fetoprotein (AFP) [a fetal product] and human chorionic gonadotropin (hCG) [a placental product]. All of the these women had normal pregnancies, but were in the hospital to undergo a therapeutic abortion. Levels of hCG in the amniotic fluid stood significantly lower (median 6.3 U/ml) than those in the extraembryonic celomic fluid (400 U/ml; p<.001). Serum levels of hCG were in between those in the fluids (75 U/ml). AFP levels in the amniotic fluid (26 U/ml) and extraembryonic celomic fluid ((24 U/ml) were not significantly different. No definitive trend in hCG or AFP levels with gestation in the 2 fluids occurred. A possible explanation for the higher levels of hCG levels in the extraembryonic celomic fluid may be that the extraembryonic celom is next to the chorion from where hCG originates. The amnion effectively separates the extraembryonic celom from the amniotic fluid. Perhaps the extraembryonic celomic fluid works as a sump for hCG. These results stress the importance of confirming the exact site of aspiration in the 1st trimester amniocentesis. Moreover, the transvaginal ultrasound is superior to the abdominal ultrasound in distinguishing between the 2 cavities since it has the necessary degree of resolution. It also is an effortless and precise method amniocentesis. These results also suggest that physicians can make and earlier diagnosis of neural tube defects since AFP leaks into its surroundings at a very early gestation. Language: English Keywords: UNITED KINGDOM | METHODOLOGICAL STUDIES | LABORATORY EXAMINATIONS AND DIAGNOSES | AMNIOCENTESIS | HEMATOLOGIC TESTS | ALPHA FETOPROTEINS | GONADOTROPINS, CHORIONIC | PREGNANCY, FIRST TRIMESTER | ABORTION | GESTATIONAL AGE | United Kingdom | Europe, Western | Europe | Developed Countries | Examinations and Diagnoses | Genetic Techniques | Laboratory Procedures | Blood Proteins | Hemic System | Physiology | Biology | Gonadotropins | Hormones | Endocrine System | Pregnancy | Reproduction | Fertility Control, Postconception | Family Planning | Fetus Document Number: 068344 Notification |
| 13. Title: Changes in circulating alphafetoprotein following administration of mifepristone in first trimester pregnancy. Author: Chard T; Olajide F; Kitau M Source: BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY. 1990 Nov;97(11):1030-2. Abstract: Fetomaternal hemorrhage-induced rises in circulating alphafetoprotein (AFP) levels can occur as a result of invasive procedures in the 1st half of pregnancy, including amniocentesis and induced abortion. In this study, 30 women under 9 weeks of gestation were given a single oral dose of 600 mg of RU-486 followed 48 hours later be insertion of a vaginal pessary containing 1 mg of gemeprost. All 30 women aborted within 2-4 hours of gemeprost administration. There was moderate bleeding for 24 hours after the abortion in 2 women. In the 4-hour period following RU-486 administration, subjects did not show any change over baseline values in AFP levels. However, 2 days later, before gemeprost administration, 21 women showed a significant increase (median of 87%, range 6-660%) in AFP. This finding suggests that fetal blood can enter the maternal circulation during pregnancy termination, and the RU-486 is not able to counteract this process. The 70% rate of elevation of AFP with RU-486 is in fact higher than that recorded for surgical termination of 1st-trimester abortion (58%). Surprising was the finding that these changes in circulating AFP occurred before the administration of prostaglandin. Language: English Keywords: CLINICAL RESEARCH | ABORTION | RU-486 | PROSTAGLANDINS | ALPHA FETOPROTEINS | MATERNAL-FETAL EXCHANGE | CHANGES | Research Methodology | Fertility Control, Postconception | Family Planning | Hormone Antagonists | Hormones | Endocrine System | Physiology | Biology | Blood Proteins | Hemic System | Pregnancy | Reproduction | Social Change Document Number: 064360 Notification |
| 14. Title: Forgotten mothers. Author: Faulkner A Source: COMMUNITY OUTLOOK. 1990 Jun;:8, 11-2. Abstract: A woman in England chose to terminate her pregnancy at 18 weeks because ultrasound revealed severe spina bifida and hydrocephalus and the chances for survival were limited, and if the baby did live, the quality of life would also have been limited. The midwives at the West Middlesex Hospital gave her the needed guidance and emotional support during the 24 hour labor. They also encouraged her to see the baby which she did not regret. Upon dismissal, however, emotional support from midwives stopped and feelings of isolation and depression engulfed her. A health visitor stopped by her home 2 weeks after the abortion, but she basically only attended to the woman's physical needs. The visitor did steer her towards a support organization for women who had an abortion because of congenital malformations (SATFA), however. Nevertheless another health visitor called when the woman was around 33 weeks along in her 3rd pregnancy and around the time her miscarried baby (2nd pregnancy) was due to see how she was doing. The health visitor had not heard about the miscarriage. This exhibited a lack of communication between general practitioners, hospitals, antenatal clinics, and community services. In addition, this was the only contact she had had with a midwife or health visitor during her 3rd pregnancy. She had visited her general practitioner, however. In England, each individual health authority determines its policy on midwife visits. Many community midwives are already busy visiting mothers so there is little incentive to also visit women who underwent an abortion. SATFA tries to fill the emotional gap by helping mothers to deal with the profound grief. Further, it has meetings when women who experienced such as abortion tell health visitors of their pain and bewilderment. Language: English Keywords: UNITED KINGDOM | CRITIQUE | CASE STUDIES | ABORTION | ABORTION, SPONTANEOUS | MOTHERS | DEPRESSION | EMOTIONS | AMNIOCENTESIS | ALPHA FETOPROTEINS | ULTRASONICS | CONGENITAL ABNORMALITIES | POSTPARTUM PROGRAMS | MIDWIVES AND MIDWIFERY | United Kingdom | Europe, Western | Europe | Developed Countries | Studies | Research Methodology | Fertility Control, Postconception | Family Planning | Pregnancy Complications | Diseases | Parents | Family Relationships | Family Characteristics | Family and Household | Mental Disorders | Psychological Factors | Behavior | Genetic Techniques | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Blood Proteins | Hemic System | Physiology | Biology | Neonatal Diseases and Abnormalities | Family Planning Programs | Health Personnel | Delivery of Health Care | Health Document Number: 066191 Notification |
| 15. Peer Reviewed Title: Regional prevalence of hepatitis B, delta, and human immunodeficiency virus infection in southern Africa: a large population survey. Author: Dusheiko GM; Brink BA; Conradie JD; Marimuthu T; Sher R Source: AMERICAN JOURNAL OF EPIDEMIOLOGY. 1989 Jan;129(1):138-45. Abstract: Although hepatitis B infection is endemic in southern Africa, a changing epidemiology of the disease has recently been documented in the region. The authors surveyed migrant southern African male mineworkers during 1986 to establish the prevalence of chronic hepatitis B and D (delta) infection in their areas of origin. Hepatitis B surface antigen (HBsAg) was tested in 29,312 adult male mineworkers from 18 geographic regions, encompassing the diverse tribal and linguistic groups in the region, as well as in expatriate mineworkers from neighboring southern African countries. The same cohort was also tested for antibody to human immunodeficiency virus (HIV). Selected hepatitis B carriers were also tested for hepatitis B virus deoxyribonucleic acid (DNA), antibody to hepatitis D (anti-HD), and alpha-fetoprotein. The overall prevalence of HBsAg in this survey was 9.9%. However, the prevalence varied from 5.5%-14% in different ethnic groups. A minority of carriers (4.9%) had replicative hepatitis B infection and were hepatitis B virus DNA- positive. Only 0.6% of tested carriers were anti-HD positive. Alpha- fetoprotein determinations were abnormal in 1.2% of hepatitis B-positive men. These date show that although chronic hepatitis B infection remains widespread in southern Africa,carrier rates vary significantly from region to region. In contrast, hepatitis D coinfection remains extremely uncommon. These baseline seroprevalence data also establish that HIV infection was, in 1986, a rare infection in the indigenous population of South Africa. (author's) Language: English Keywords: SOUTH AFRICA | AFRICA, SOUTHERN | PREVALENCE | HIV INFECTIONS | HEPATIC EFFECTS | MIGRANT WORKERS | GEOGRAPHIC FACTORS | ETHNIC GROUPS | LABORATORY EXAMINATIONS AND DIAGNOSES | ALPHA FETOPROTEINS | RURAL POPULATION | VIRAL DISEASES | SCREENING | ANALYSIS | TRANSMISSION | Africa, Sub Saharan | Africa | Developing Countries | Measurement | Research Methodology | Diseases | Physiology | Biology | Labor Force | Human Resources | Economic Factors | Population | Cultural Background | Population Characteristics | Demographic Factors | Examinations and Diagnoses | Blood Proteins | Hemic System | Infections Document Number: 058206 |
| 16. Title: Second trimester screening for trisomy 21 [letter] Author: Osathanondh R; Canick JA; Abell KB; Stevens LD; Palomaki GE; Knight GJ; Haddow JE Source: Lancet. 1989 Jul 1;2(8653):52. Abstract: Second trimester maternal serum levels of alpha-fetoprotein (AFP), unconjugated estriol (uE3), and human chorionic gonadotropin (hCG), when used in combination with maternal age, define the risk of fetal trisomy 21 better than any previously described method. A screening program based on such a multivariate risk model has been estimated to detect 60% of pregnancies with fetal trisomy 21 while requiring amniocentesis in about 5% of the screened population. We have measured AFP, uE3, and hCG in sera from 26 consecutive patients just before elective termination of a fetus with trisomy 21. These samples were obtained 13 days (9-28 days) after amniocentesis and the average gestational age was 18.4 weeks (16-22 completed weeks). A 2nd set of 23 control samples was collected from patients with pregnancies having no known chromosomal abnormalities undergoing elective 2nd trimester terminations without a preceding amniocentesis. All results are reported as multiples of the unaffected median (MoM), based on reference data from 735 pregnancies. The median MoMs for AFP, uE3, and hCG were 0.84, 0.66, and 2.59, in trisomy 21 and 1.17, 1.07, and 1.12, in the control pregnancies. These levels confirm earlier findings of lowered AFP and uE3, and raised hCG levels in pregnancies with fetal trisomy 21. Regression analysis revealed weak correlations between the markers in both affected and control pregnancies, again similar to earlier findings (all pairwise correlation coefficients had an absolute value of 0.26 or less). The median likelihood ratio for pregnancies with fetal trisomy 21 was 4.5 while for unaffected pregnancies the median was 0.18 (figure). 81% of the fetal trisomy 21 pregnancies had a likelihood ratio above 1.0, while 91% of the control pregnancies had a likelihood ratio below 1.0. These results provide further evidence that the measurement of maternal serum AFP, uE3, and hCG in the 2nd trimester can substantially enhance prenatal screening for trisomy 21. (author's modified) Language: English Keywords: PREGNANCY, SECOND TRIMESTER | ALPHA FETOPROTEINS | ESTRIOL | GONADOTROPINS, CHORIONIC | MATERNAL AGE | RISK FACTORS | GENETIC TECHNIQUES | ANALYSIS | Pregnancy | Reproduction | Blood Proteins | Hemic System | Physiology | Biology | Estrogens | Hormones | Endocrine System | Gonadotropins | Parental Age | Age Factors | Population Characteristics | Demographic Factors | Population | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Research Methodology Document Number: 057331 |
| 17. Title: [Systemic lupus erythematosus during therapy with oral estrogen-progestin. Considerations apropos of a case] Lupus eritematoso sistemico in corso di terapia con estroprogestinici orali. Considerazioni a proposito di un caso. Author: Gueli N; Toto A; Tartaglione E; Lucianetti MC; Screnci M; Sauli V; Carmenini G Source: CLINICA TERAPEUTICA. 1987 May 31;121(4):299-304. Abstract: A 21 year old female was hospitalized for ambulatory difficulties affecting the hands, feet, and cervical vertebrae with increasing frequency since age 14 accompanied by a great deal of pain, tumefaction and reddening as well as temperature of 37.5 degrees Celsius. these symptoms regressed spontaneously in 2-3 days. She also suffered from pyorrhea alveolaris, had hypermenorrhea and irregular cycle, and after taking a triphasic pill (Trigynon), shed gained 15 kg. Examination at admission also showed cutaneous manifestations, tachycardia, modest respiratory insufficiency, traces of protein in the urine, and hypergammaglobulinemia. 20 days of cortisone therapy produced no improvement, the pain continued and her febrile state was 37.2-37.5 degrees Celsius. Suspecting systemic lupus erythematosus, the test for anti-DNA autoantibodies was negative and alpha-fetoproteinemia was demonstrated by high blood levels. After suspension of estrogen- progesterone use, cortisone treatment was started with deflazacort (Flantadin) with a dose of 60 mg/day. The temperature abated on the 2nd day after therapy and the pain also ceased after a few days. Alpha- fetoproteinemia became normal 20 days later, and after 90 days of therapy, G and M immunoglobulin values returned to normal. There was no evidence of hepatic lesions,possibly alpha-fetoproteinemia occurred without hepatic cell dependence on autoantibodies, as under estrogen- progesterone treatment. Language: Italian Keywords: ITALY | CASE STUDIES | SYSTEMIC LUPUS ERYTHEMATOSUS | ORAL CONTRACEPTIVES, PHASIC | ETHINYL ESTRADIOL | NORGESTREL | TREATMENT | ALPHA FETOPROTEINS | SIDE EFFECTS | ORAL CONTRACEPTIVES, SIDE EFFECTS | CONTRACEPTIVE AGENTS, SIDE EFFECTS | WOMEN | Europe, Southern | Europe | Developed Countries | Studies | Research Methodology | Diseases | Oral Contraceptives, Combined | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Progestin | Blood Proteins | Hemic System | Physiology | Biology | Contraceptive Safety | Safety | Public Health | Health | Demographic Factors | Population Document Number: 060393 |
| 18. Title: Prenatal ultrasound diagnosis of fetal scoliosis with termination of the pregnancy: case report. Author: Henry RJ; Norton S Source: PRENATAL DIAGNOSIS. 1987 Nov;7(9):663-6. Abstract: In some medical centers, routine high definition ultrasonic assessment of the fetus has replaced serum alpha fetoprotein (AFP) screening for neural tube defects. This article presents the 1st reported case of prenatal diagnosis of pure structural scoliosis--a condition that, even without other associated structural abnormalities carries a poor prognosis given the lower limb weakness, autonomic nervous system dysfunction, and respiratory problems. In this case, an ultrasound scan was performed at 18 weeks' gestation in a UK clinic in a 27-year-old primigravida. The pregnancy had been uncomplicated, with no history of drug ingestation or viral illness, and the fundal height was consistent with gestational age. The only abnormality revealed was gross fetal spinal scoliosis, almost to an angle of 90 degrees, at the lower thoracic level. The spinal canal and overlying skin appeared intact, with no evidence of a classical neural tube defect in both longitudinal and transverse scanning of the spine. The serum AFP estimation was 51 Ku/L (normal range at 18 weeks, less than 77 Ku/L). This normal serum AFP result was explained by the lack of obvious breach of the meninges. The parents opted for pregnancy termination. The fetus was found to have webbing of the neck and an imperforate anus in addition to vertebral defects. Language: English Keywords: CASE STUDIES | FETUS | ULTRASONICS | SCREENING | CONGENITAL ABNORMALITIES | ALPHA FETOPROTEINS | EXAMINATIONS AND DIAGNOSES | PREVENTION AND CONTROL | Studies | Research Methodology | Pregnancy | Reproduction | Neonatal Diseases and Abnormalities | Diseases | Blood Proteins | Hemic System | Physiology | Biology Document Number: 057530 |
| 19. Title: Alpha-fetoprotein levels in maternal plasma during therapeutic abortion induced by a prostaglandin analogue. Author: Tan KC; Kottegoda SR; Karim SM; Ratnam SS Source: Singapore Journal of Obstetrics and Gynaecology. 1985 Nov;16(3):186-8. Abstract: Plasma alpha-fetoprotein (AFP) levels were measured in 27 women with uncomplicated mid-trimester pregnancy and in 27 patients of comparable gestational age with missed abortion, before and at termination induced by intramuscular administration of 16, 16-dimethyl-PGE2 p-benzaldehyde semicarbazone ester. The mean plasma AFP levels measured before drug administration were significantly higher in cases of missed abortion than those in normal pregnancy. A significant rise of plasma AFP levels occurred in cases of mid-trimester pregnancy after administration of the prostaglandin analog. On the other hand, plasma AFP levels in patients with missed abortion showed no significant changes after the drug. It is suggested that, regardless of whether abortion was spontaneous or induced, plasms AFP levels rise when there is fetal distress or if fetal death occurs in the uterus and that exogenous prostaglandin does not affect the plasma AFP levels once the fetus is dead. (author's) Language: English Keywords: ALPHA FETOPROTEINS | PROSTAGLANDINS, SYNTHETIC | PROSTAGLANDINS | ABORTION | ABORTION, SPONTANEOUS | Blood Proteins | Hemic System | Physiology | Biology | Endocrine System | Fertility Control, Postconception | Family Planning | Pregnancy Complications | Diseases Document Number: 035544 Notification |
| 20. Title: [Nodular regenerative hyperplasia, hepatocellular carcinoma and oral contraceptives (letter)] Hyperplasie nodulaire regenerative, carcinome hepatocellulaire et contraceptifs oraux. Author: Bretagne JF; Deugnier Y; Launois B; Gosselin M; Ferrand B; Gastard J Source: Gastroenterologie Clinique et Biologique. 1984 Oct;8(10):768-9. Abstract: A case of nodular regenerative hyperplasia (NRH) and hepatocellular carcinoma in a 31-year-old user of oral contraceptives (OCs) is described. The patient had taken OCs since the age of 19 and had been treated 3 years previously with Clomid and Humegon for induction of ovulation. Clinical examination revealed only an isolated hepatomegalie and laboratory tests indicated a slight elevation of serum gamma-glutamyl-transpeptidase activity to 73 UI/1. The liver was homogenous on sonography, of micronodular surface at laparoscopy, and a needle biopsy indicated probable "peri-sinusoidal deposits". Clinical examination 9 months later revealed a voluminous hepatomegalie and splenomegalie. Fibroscopy showed grade II varices. Sonogram and scanning showed a tumor in the left lobe of the liver surrounded by a voluminous, homogenous hepatomegalie. The alpha-feto-protein level was above 8000 ng/ml. A left lobectomy was performed after which examination of the specimen showed a quite well differentiated trabecular hepatocellular carcinoma. The condition was diagnosed as a hepatocellular carcinoma enclosed within a nodular regenerative hyperplasia. The postoperative course was marked by progressive deterioration of the general condition, tumor extension to the right lobe, and increase in the alpha-feto-protein level. The patient died 9 months later. Among the 128 cases of NRH published to date, only 2 were associated with hepatocellular carcinoma, 1 in a 73 year old women in whom the 2 conditions were diagnosed simultaneously, and the other in a 35 year old woman on OCs presenting with digestive bleeding caused by rupture of an esophageal varice. NRH was diagnosed during surgery to treat the hemorrhage, and a tumor was suspected due to elevation of the alpha-feto-protein level but was not observed until autopsy a year later. The 3 cases raise the question of whether NRH is a precancerous lesion. The observation in 2 of the cases of elevated alpha-feto-protein levels suggests that this indicator should be monitored in patients with NRH to permit early diagnosis and possible surgical cure in case of metastasis. The 3 cases also raise questions about the pathogenic role of combined OCs in inducing NRH, hepatocellular carcinoma, or malignant transformation of NRH. Language: French Keywords: ORAL CONTRACEPTIVES | CONTRACEPTIVE AGENTS, FEMALE | CONTRACEPTION | FAMILY PLANNING | LIVER NEOPLASMS | NEOPLASMS | HEPATIC EFFECTS | DISEASES | LABORATORY EXAMINATIONS AND DIAGNOSES | EXAMINATIONS AND DIAGNOSES | COMPLICATIONS | ALPHA FETOPROTEINS | PROTEINS | CASE STUDIES | Contraceptive Methods | Contraceptive Agents | Physiology | Biology | Blood Proteins | Hemic System | Studies | Research Methodology Document Number: 029427 |
| 21. Title: Does smoking influence serum alpha-fetoprotein levels in mid-trimester pregnancies? Author: Haddow JE; Palomaki G; Kloza EM; Knight GJ; Wylie P Source: British Journal of Obstetrics and Gynaecology. 1984 Dec;91(12):1188-91. Abstract: The effects of cigarette smoking during pregnancy on serum alpha-fetoprotein (AFP) levels was assessed in 1925 consecutive women at 16-18 weeks, gestation who subsequently delivered a liveborn singleton infant. Cotinine and AFP were measured in sera in all study subjects and answers to a smoking questionnaire were analyzed in 894 subjects. Mean serum AFP levels for the 308 self-reported smokers and the 586 nonsmokers were similar at all 3 gestational weeks. When analyzed by cotinine levels, cigarette smoking again had no measurable effect on serum AFP levels. However, infants born to women who smoked were an average of 198 gm lighter than those born to nonsmokers. The finding that cigarette smoking during pregnancy does not influence serum AFP levels differs from that reported in an earlier study, despite the fact that women in both studies had similar median body weights. It is concluded that, unless data to the contrary appear, meternal smoking habits should not be part of the interpretive process for maternal serum AFP levels. Language: English Keywords: CLINICAL RESEARCH | TOBACCO USE | SOCIAL BEHAVIOR | BEHAVIOR | PREGNANCY | REPRODUCTION | BIOLOGY | ALPHA FETOPROTEINS | BLOOD PROTEINS | PROTEINS | Research Methodology | Hemic System | Physiology Document Number: 028361 |
| 22. Title: Hepatocellular carcinoma in the non-cirrhotic liver: a comparison with that complicating cirrhosis. Author: Melia WM; Wilkinson ML; Portmann BC; Johnson PJ; Williams R Source: Quarterly Journal of Medicine. 1984 Summer;53(211):391-400. Abstract: The clinicopathological features of 50 patients with hepatocellular carcinoma arising in a noncirrhotic liver are described and compared with those of 100 patients in whom tumors arose as a complication of cirrhosis. The noncirrhotic patients were significantly younger, more often female, and had a less strong association with serum markers of hepatitis B virus infection. Liver function tests and serum alpha fetoproteins were less often abnormal and survival was significantly better than in the cirrhotic group. The different etiological factors, clinical features, and prognosis of hepatocellular carcinoma arising in the noncirrhotic liver compared to the more common form of hepatocellular carcinoma which complicates cirrhosis justifies detailed investigation by liver biopsy and other techniques. (author's modified) Language: English Keywords: COMPARATIVE STUDIES | UNITED KINGDOM | EUROPE, NORTHERN | EUROPE | LIVER NEOPLASMS | DISEASES | LIVER CIRRHOSIS | HEPATIC EFFECTS | EXAMINATIONS AND DIAGNOSES | LABORATORY EXAMINATIONS AND DIAGNOSES | SURVIVORSHIP | LENGTH OF LIFE | TREATMENT | EVALUATION | POPULATION CHARACTERISTICS | AGE DISTRIBUTION | SEX DISTRIBUTION | ALPHA FETOPROTEINS | PROTEINS | ORAL CONTRACEPTIVES | CONTRACEPTIVE AGENTS, FEMALE | Studies | Research Methodology | Europe, Western | Developed Countries | Neoplasms | Physiology | Biology | Mortality | Population Dynamics | Demographic Factors | Population | Age Factors | Sex Factors | Blood Proteins | Hemic System | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents Document Number: 029002 |
| 23. Peer Reviewed Title: Effects of smoking on fetoplacental-maternal system during pregnancy. Author: Mochizuki M; Maruo T; Masuko K; Ohtsu T Source: American Journal of Obstetrics and Gynecology. 1984 Jun 15;149(4):413-20. Abstract: Fetoplacental function and maternal nutritional status were assessed in order to clarify the mechanism of retarded fetal growth in pregnant women who smoked. Dehydroepiandrosterone sulfate (DHA-S) loading tests and measurements of cotinine, a major metabolite of niccotine, were also made. In heavy smokers, urinary estriol and serum levels of human placental lactogen (hPL) were lower than those in nonsmokers. There was no difference in maternal nutrition between smokers and nonsmokers. Heavy smokers demonstrated a lower conversion of DHA-S to estradiol than did nonsmokers. Levels of cotinine in maternal blood and umbilical cord blood of heavy smokers were remakably higher than those in nonsmokers. Microscopic examination showed atrophic and hypovascular changes in placental villi from mothers who smoked. These results suggest that retarded fetal growth in heavy smokers is due to impairment of uteroplacental circulation as a ressult of the vasoconstricting effect of nicotine. (author's modified) Language: English Keywords: TOBACCO USE | PREGNANCY | MATERNAL NUTRITION | NUTRITION | REPRODUCTION | SOCIAL BEHAVIOR | BEHAVIOR | LABORATORY PROCEDURES | LABORATORY EXAMINATIONS AND DIAGNOSES | EXAMINATIONS AND DIAGNOSES | ANATOMY | HISTOLOGY | SIDE EFFECTS | ESTRIOL | ALPHA FETOPROTEINS | PROTEINS | REPRODUCTIVE CONTROL AGENTS | COPPER | LIPID METABOLIC EFFECTS | INORGANIC CHEMICALS | METABOLIC EFFECTS | DISEASES | BIRTH WEIGHT | Health | Biology | Treatment | Estrogens | Hormones | Endocrine System | Physiology | Blood Proteins | Hemic System | Family Planning | Metals | Vitamins and Minerals | Lipids | Ingredients and Chemicals | Body Weight Document Number: 024489 |
| 24. Title: [Hepatoblastoma in an infant after a Estroprogestational intake by the mother during pregnancy] Epatoblastoma in lattante dopo assunzione di estroprogestinici da parte della madre in gravidanza. Author: Pilotti G; Bosco M; Leo D; Ricci C; Suria G Source: PEDIATRIA MEDICA E CHIRURGICA. 1984 Mar-Apr;6(2):323-5. Abstract: A 4-month old child was brought into an Italian hospital. At birth, there had been no abnormalities, diseases, radiation exposure, or consumption pharmaceutical products, except that the mother, unaware of the pregnancy, had taken an oral contraceptive (OC) during the 1st month. During the first 3 months the child had been fed mother's milk and had been vaccinated for polio at the 3rd month. The little girl was hospitalized because she appeared to be very pale and was suffering from abdominal pain. X-rays determined that she had hepatoblastoma, which could have been due to the contraceptive ingested by the mother. The following points should be considered: 1) The age of the child. In 75% of cases, hepatoblastoma occurs in the first 2 years after birth. Among the causes of death in North American children who died before the 28th day because of tumors there is a great frequency of teratomas, neuroblastomas, and hepatic tumors. 2) The absence of clinical symptoms before the hepatoblastoma. 3) The rapid terminal progression. 4) The negative alpha fetoproteins research. 5) The use by mothers of an estroprogestinic contraceptive during the 1st month of pregnancy. Cases have been noted of hepatic tumors correlated to the taking of androgens, steroid anabolics, and estrogens and estrogen-based OCs. A case of hepatoblastoma was diagnosed in 1977 after the mother had taken 18-methyl-norethisterone in a dosage of 30 ug/day for the first 3 months of pregnancy. The case described here is similar. Language: Italian Keywords: ITALY | EUROPE, SOUTHERN | EUROPE | CASE STUDIES | ORAL CONTRACEPTIVES, SIDE EFFECTS | CONTRACEPTIVE AGENTS, PROGESTIN | CONTRACEPTIVE AGENTS, FEMALE | CONTRACEPTION | FAMILY PLANNING | CHILD HEALTH | BIOLOGY | ALPHA FETOPROTEINS | BLOOD PROTEINS | PROTEINS | HEPATIC EFFECTS | DISEASES | SIDE EFFECTS | CONTRACEPTIVE METHODS | CONTRACEPTIVE AGENTS, SIDE EFFECTS | Developed Countries | Studies | Research Methodology | Contraceptive Safety | Safety | Public Health | Health | Contraceptive Agents | Hemic System | Physiology | Treatment Document Number: 032452 |
| 25. Title: Maternal plasma estradiol and progesterone levels during therapeutic abortion induced by 16, 16 dimethyl PGE2 p-benzaldehyde semicarbazone ester. Author: Tan KC; Goh VH; Karim SM; Ratnam SS; Kottegoda SR Source: Prostaglandins, Leukotrienes and Medicine. 1984 May;14(2):215-24. Abstract: Estradiol and progesterone levels in maternal plasma after administration of 16, 16-dimethyl-prostaglandin E2 (PGE2) p-benzaldehyde semicarbazone ester (16, 16-PGE2) every 6 hours for abortion were studied in 27 women in the 2nd trimester of pregnancy and in 49 patients with fetal death in utero. Basal maternal plasma levels of estradiol and progesterone measured before PG injection were significantly lower in cases of fetal death in utero than in the other subjects. After, 16, 16-PGE2 injection, plasma levels of estradiol and progesterone fell more rapidly and to a greater extent in cases of fetal death in utero than in those with normal pregnancies at corresponding gestations; the decline of plasma estradiol levels was quicker and more marked than that of progesterone. Thus, 16, 16-PGE2 appears to exert a differential effect on estradiol and progesterone biosynthesis. (author's modified) Language: English Keywords: ESTRADIOL | PROGESTERONE ANALYSIS | ESTROGENS | HORMONES | CORPUS LUTEUM HORMONES | PROSTAGLANDINS, ADMINISTRATION AND DOSAGE | CARBOXYLIC ACIDS | ORGANIC CHEMICALS | ABORTION | FERTILITY CONTROL, POSTCONCEPTION | FAMILY PLANNING | LABORATORY PROCEDURES | LABORATORY EXAMINATIONS AND DIAGNOSES | EXAMINATIONS AND DIAGNOSES | PREGNANCY, SECOND TRIMESTER | PREGNANCY | FETAL DEATH | MORTALITY | DEMOGRAPHIC FACTORS | POPULATION DYNAMICS | ANALYSIS | ALPHA FETOPROTEINS | PROTEINS | Endocrine System | Physiology | Biology | Progesterone | Progestational Hormones | Prostaglandins | Ingredients and Chemicals | Reproduction | Population | Research Methodology | Blood Proteins | Hemic System Document Number: 027109 Notification |
| 26. Title: Hepatomas in young women on oral contraceptives: report of two cases and review of the literature. Author: Gala KV; Griffin TW Source: Journal of Surgical Oncology. 1983 Jan;22(1):11-4. Abstract: Hepatocellular carcinoma (HCC) developed in 2 women who had ingested oral contraceptives (OCs) for a long period of time. 1 of the patients had hepatoma restricted to the liver, and it was successfully resected. The other patient presented with metastatic HCC to the sacrum and lung, and she died after an initial response to chemotherapy over a 12-month period. Review of the literature showed 23 previously reported cases of HCC associated with pill use since 1973. Although the reported instances of HCC in OC users are few in number, the majority of affected females were in their 20s and early 30s, without any preexisting liver disease. Even though the risk of developing HCC on OCs is low, this association adds to the list of complications induced by OCs in premenopausal women. 2 cases are reported and the literature reviewed. (author's) Language: English Keywords: CASE STUDIES | ORAL CONTRACEPTIVES, SIDE EFFECTS | CONTRACEPTIVE AGENTS, FEMALE | REPRODUCTIVE CONTROL AGENTS | CONTRACEPTION | ALPHA FETOPROTEINS | HISTOLOGY | CONTRACEPTIVE METHODS | SIDE EFFECTS | Studies | Research Methodology | Contraceptive Safety | Safety | Public Health | Health | Contraceptive Agents | Family Planning | Blood Proteins | Hemic System | Physiology | Biology | Treatment Document Number: 013560 |
| 27. Title: Maternal serum hormone changes during abortion induced with 9-deoxo-16, 16-dimethyl-9-methylene prostaglandin E2. Author: Bremme K; Eneroth P; Bygdeman M Source: Journal of Endocrinological Investigation. 1982 Nov-Dec;5(6):387-91. Abstract: Serum hormone levels in women undergoing successful 1st and 2nd trimester abortions induced by 9-deoxo-16, 16-dimethyl-9-methylene prostaglandin E2 (PGE2) vagitories have been measured. Significantly decreased levels of prolactin (P<0.01) and TSH (P<0.05) were seen in both groups of women but the drop appeared sooner, within 2 hours, in 1st trimester abortions. Regardless of gestational length, there was a significant decrease in serum human chorionic gonadotropin (hCG) (P<0.01) concentrations in maternal serum 6 hours into treatment. In the 2nd trimester abortions, total estriol, alpha-fetoprotein, and lactoplacental hormone(hPL) were analyzed in maternal serum but the levels did not change over the 8 hour investigation period. It is suggested that the PGE2 derivative most likely affects the maternal pituitary secretion of prolactin and TSH, possibly via direct or indirect interference with TRH mechanism(s). (author's) Language: English Keywords: PROSTAGLANDINS, ADMINISTRATION AND DOSAGE | ABORTION | PREGNANCY, FIRST TRIMESTER | PREGNANCY, SECOND TRIMESTER | PREGNANCY | PROLACTIN ANALYSIS | GONADOTROPINS, PITUITARY | GONADOTROPINS | HORMONES | GONADOTROPINS, CHORIONIC | ALPHA FETOPROTEINS | ESTRIOL | ESTROGENS | ANALYSIS | AGE FACTORS | PARITY | Prostaglandins | Endocrine System | Physiology | Biology | Fertility Control, Postconception | Family Planning | Reproduction | Prolactin | Pituitary Hormones | Blood Proteins | Hemic System | Research Methodology | Population Characteristics | Demographic Factors | Population | Fertility Measurements | Fertility | Population Dynamics Document Number: 014611 Notification |
| 28. Title: Evaluating fetomaternal hemorrhage by alphafetoprotein and Kleihauer following therapeutic abortions. Author: Hay DL; Horacek I; Paull J Source: International Journal of Gynaecology and Obstetrics. 1982 Feb;20(1):1-3. Abstract: In a survey of 75 patients at 6-11 weeks gestation, fetomaternal hemorrhage (FMH) was detected by significant rises (>2S.D.) in maternal alphafetoprotein (AFP) levels in 57% of patients, while increased fetal cells were detected by Kleihauer test in 24% of patients. With increasing gestation, FMH was detected more readily by both tests; however, in evaluating FMH at less than 10 weeks gestation, AFP was found to be a more sensitive and reliable marker than the Kleihauer test. We suggest that there is a gray zone for the Kleihauer test in early gestation, when erythroblasts containing embryonic hemoglobins are gradually replaced in the fetal circulation by erythrocytes containing fetal hemoglobin. (author's) Language: English Keywords: ABORTION | PREGNANCY, FIRST TRIMESTER | ALPHA FETOPROTEINS | BLEEDING | LABORATORY PROCEDURES | HEMOGLOBIN LEVEL | ANALYSIS | AGE FACTORS | Fertility Control, Postconception | Family Planning | Pregnancy | Reproduction | Blood Proteins | Hemic System | Physiology | Biology | Signs and Symptoms | Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Research Methodology | Population Characteristics | Demographic Factors | Population Document Number: 009851 Notification |
| 29. Title: An autopsy case of primary hepatoma associated with an oral contraceptive. Author: Horii K; Yasui M; Adachi Y; Yamamoto T; Ishida O; Itoh H Source: Hepato-Gastroenterology. 1982;29(5):187-90. Abstract: Primary hepatoma was found in a 38-year female who had been using an oral contraceptive for 28 months. Histologically, the hepatoma was a well-differentiated hepatocellular carcinoma. Alpha fetoproteins were not increased and tests for HBs antigen were negative. Carcinoembryonic antigen was elevated remarkably before death. The findings of hepatic arteriography and peritoneoscopy suggested metastic tumors of the liver rather than primary hepatoma. During the course of the disease, phlebothrombosis occurred and spread widely in the lower left limb. The observation of erythrocytosis indicated the presence of a tumor producing erythropoetin or an erythropoetinlike substance. (author's) Language: English Keywords: JAPAN | ORAL CONTRACEPTIVES, SIDE EFFECTS | CONTRACEPTIVE AGENTS, FEMALE | CONTRACEPTION | LYNESTRENOL | MESTRANOL | LABORATORY PROCEDURES | ALPHA FETOPROTEINS | HISTOLOGY | CONTRACEPTIVE METHODS | SIDE EFFECTS | Asia, Eastern | Asia | Developed Countries | Contraceptive Safety | Safety | Public Health | Health | Contraceptive Agents | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Estrogen | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Blood Proteins | Hemic System | Physiology | Biology | Treatment Document Number: 012402 |
| 30. Title: [The liver and the "pill." Pt.2. Liver tumors] Leber und "Pille". Teil 2: Lebertumoren. Author: Eisenburg J Source: Fortschritte der Medizin. 1981 Oct 8;99(38):1527-32. Abstract: Since the introduction of oral contraceptives (OCs), a wide variety of harmless physiological and clinically important side effects have been reported and have received increasing attention, especially as evidence has recently grown that long-term use of OCs may cause a variety of liver tumors and different hepatic vascular lesions. They may cause a reversible reduction in hepatic excreting function, resulting in pruritus and jaundice. They may also multiply the incidence of cholesterol cholelithiasis. The authors present their personal experience with 8 patients presenting with benign hepatic tumors and 4 patients with vascular lesions, involving the hepatic venus outflow-system (Budd-Chiari syndrome), possibly related to long-term ingestion of OCs. 1 case of malignant hepatoma, developing within an area of focal nodular hyperplasia during a 2 year control period suggests that a transformation of steroid associated benign hepatic tumors to malignancies may occur. The 4 patients with Budd-Chiari displayed similar symptoms; the others varied in their mode of presentation. In tumor patients, the clinical spectrum extended from absence of any symptoms (3) to fulminant hemorrhagic shock with rebound tenderness by liver rupture (2). The size of the tumor and whether there is intrahepatic or extrahepatic bleeding are determining symptomatology and clinical course. In 1/3 of the patients, either a family doctor or the patient himself found an upper abdominal mass tumor during routine examination. Pain in the right hypochondrium was a major symptom in 1/2 of the patients and was usually misinterpreted as cholecystolithiasis or irritable colon pain. Laboratory tests were either normal or mildly abnormal, but never diagnostic. In 2 patients, there was a slight elevation of alphal-fetoprotein and in 1 patient who later developed a malignant hepatoma, the levels increased steadily over the 2 year control period. Diagnosis was confirmed by laparoscopy in 4 patients and by laparotomy in the other 4. Computerized axial tomography was performed on all patients, but the ultimate diagnosis requires a tissue specimen. The mean duration of contraception treatment was 8 years and the mean age of patients was 33.63 years. Except for the 1 patient who died as the result of the malignant hepatoma, all other patients were alive 2-3 years after detection. Thus, use of OCs should be short-term; women taking the pill for more than 5 years should have a routine 6-month screening with abdominal examination to detect hepatomegaly. If a tumor is detected, close monitoring of the tumor size by ultrasonography or computerized tomography is necessary. There seems little risk for malignant transformation and there is greater risk for hemorrhage even after many months after OC discontinuation. (author's) Language: German Keywords: ORAL CONTRACEPTIVES, SIDE EFFECTS | HEPATIC EFFECTS | LIVER NEOPLASMS | LAPAROSCOPY | LAPAROTOMY | LABORATORY PROCEDURES | ALPHA FETOPROTEINS | CONTRACEPTIVE METHODS | SIDE EFFECTS | Contraceptive Safety | Safety | Public Health | Health | Physiology | Biology | Neoplasms | Diseases | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Surgery | Treatment | Laboratory Examinations and Diagnoses | Blood Proteins | Hemic System | Contraception | Family Planning Document Number: 007085 |
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