1.  Title: Early diagnosis, follow-up, and prenatal treatment of a case of TRAP sequence occurring in a dichorionic triamniotic triplet pregnancy. Author: Cavoretto P; Serafini A; Valsecchi L; Lanna M; Rustico MA Source: Journal of Clinical Ultrasound. 2009 Jul-Aug;37(6):350-3. Abstract: We are reporting a case of twin reversed arterial perfusion (TRAP) sequence occurring in a dichorionic triamniotic triplet pregnancy with successful percutaneous prenatal treatment and excellent neonatal outcome. TRAP sequence was diagnosed at 11 weeks in a spontaneous dichorionic-triamniotic triplet. Sonographic assessment showed persistent arterial flow and development of hydrops in the acardiac twin. Percutaneous cord interstitial laser coagulation was performed, and the co-twin subsequently developed growth restriction. The 9-month-old twins have a normal developmental course. This report confirms that fetal intervention is indicated in cases of TRAP sequence in which the acardiac twin presents a significant enlargement on follow-up sonographic examinations. Language: English Keywords: ITALY | SUMMARY REPORT | CASE HISTORIES | PREGNANT WOMEN | FETUS | MULTIPLE BIRTH | FETAL MEMBRANES | VASCULAR DISEASES | GROWTH | EXAMINATIONS AND DIAGNOSES | ULTRASONICS | AMNIOCENTESIS | PREGNANCY OUTCOMES | Developed Countries | Europe, Southern | Europe | Data Collection | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Diseases | Child Development | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Genetic Techniques | Laboratory Examinations and Diagnoses Document Number: 342793 |
| 2. Peer Reviewed Title: Anticipated and perceived pain from midtrimester amniocentesis. Author: Karasahin E; Gungor S; Goktolga; Keskin U; Gezginc K Source: International Journal of Gynecology and Obstetrics. 2008 Jun;101(3):290-294. Abstract: The objective was to evaluate the anticipated and perceived pain and determine the factors contributing to pain perception in women undergoing midtrimester amniocentesis. A visual analog scale was used to quantify pain in this prospective study of 64 women undergoing amniocentesis in the same clinical setting. The analysis was done using the paired-samples t test, analysis of variance, the Kruskal-Wallis test, the Mann-Whitney U test, and Pearson correlation analysis. The postprocedural pain scores were significantly less than the preprocedural pain scores (P less than 0.01). Parity, a previous amniocentesis, the indication for amniocentesis, and the previous loss of a child were factors contributing to pain scores. No correlations were found between pain score and maternal age, week of pregnancy at the time of the procedure, parity, or having lost a child. The perceived pain was less than the anticipated pain, and the factors contributing to pain should be kept in mind when counseling patients undergoing midtrimester amniocentesis. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | CLINICAL RESEARCH | PREGNANT WOMEN | AMNIOCENTESIS | PAIN | PERCEPTION | RISK FACTORS | Europe, Southeastern | Europe | Developing Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Genetic Techniques | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Signs and Symptoms | Diseases | Psychological Factors | Behavior | Biology Document Number: 326724 |
| 3. Peer Reviewed Title: The frequency and significance of intraamniotic inflammation in patients with cervical insufficiency. Author: Lee SE; Romero R; Park CW; Jun JK; Yoon BH Source: American Journal of Obstetrics and Gynecology. 2008 Jun;198(6):633.e1-633.e8. Abstract: The purpose of this study was to determine the frequency and clinical significance of intraamniotic inflammation in patients with acute cervical insufficiency. Amniocentesis was performed in 52 patients with acute cervical insufficiency (cervical dilation, greater than or equal to 1.5 cm) and intact membranes and without regular uterine contractions (gestational age, 17-29 weeks). Amniotic fluid (AF) was cultured for aerobic and anaerobic bacteria and genital mycoplasmas and assayed for matrix metalloproteinase- 8. Intraamniotic inflammation was defined as an elevated AF matrix metalloproteinase-8 concentration (greater than 23 ng/mL). Nonparametric statistics and survival techniques were used for analysis. The prevalence of intraamniotic inflammation was 81% (42/ 52); the prevalence of a positive AF culture was 8% (4/52). Intraamniotic inflammation was present in all cases with a positive AF culture. Preterm delivery within 7 days occurred in 50% of cases (19/38), and delivery before 34 weeks of gestation occurred in 84% of cases (32/ 38) with intraamniotic inflammation but without AF infection. Fifty-five percent of newborn infants (21/38) who were born to mothers with intraamniotic inflammation but without AF infection died immediately after birth (less than 1 day). The amniocentesis-to-delivery interval was shorter in patients with intraamniotic inflammation than in those without inflammation (P less than .05). There were no differences in the interval-to-delivery or the rate of adverse outcome between patients with intraamniotic inflammation and a negative culture and patients with proven AF infection. Intraamniotic inflammation, regardless of AF culture result, is present in approximately 80% of patients with acute cervical insufficiency and is a risk factor for impending preterm delivery and adverse outcomes. (author's) Language: English Keywords: REPUBLIC OF KOREA | RESEARCH REPORT | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | PREGNANCY COMPLICATIONS | AMNIOCENTESIS | CERVICAL DILATATION | BACTERIAL AND FUNGAL DISEASES | PREVALENCE | IMMUNOLOGICAL EFFECTS | NEONATAL MORTALITY | PREGNANCY OUTCOMES | PREMATURE BIRTH | Asia, Eastern | Asia | Developed Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Diseases | Genetic Techniques | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Treatment | Infections | Measurement | Immunity | Immune System | Physiology | Biology | Infant Mortality | Mortality | Population Dynamics | Pregnancy | Reproduction Document Number: 308641 |
4.  Peer Reviewed Title: Effective prediction of preeclampsia by a combined ratio of angiogenesis-related factors. Author: Lim JH; Kim SY; Park SY; Yang JH; Kim My Source: Obstetrics and Gynecology. 2008 Jun;111(6):1403-1409. Abstract: Imbalance between angiogenesis-related factors is closely related to the development of preeclampsia. The objective was to estimate the most effective and accurate predictive biomarker among levels and ratios of angiogenesis-related factors, including soluble fms-like tyrosine kinase 1 (sFlt-1), soluble endoglin, placental growth factor (PlGF), and transforming growth factor-beta1 (TGF-beta1), in women who subsequently developed preeclampsia. A nested cohort study was conducted to estimate the levels of sFlt-1, soluble endoglin, PlGF, and TGF-beta1 in plasma collected in the second trimester from 40 women who subsequently developed preeclampsia and 100 contemporaneous normotensive women. Levels of sFlt-1 and soluble endoglin were significantly higher in women with preeclampsia than in normotensive women, whereas levels of PlGF and TGF-beta1 were lower (P less than .001). In women with preeclampsia, sFlt-1/PlGF, soluble endoglin/TGF-beta1, and the combined ratio of (sFlt-1 + soluble endoglin)/(PlGF+ TGF-beta1) were significantly higher than in normotensive women (P less than .001) and even greater in severe preeclampsia with preterm delivery compared with mild preeclampsia with term delivery (P less than .05). At equivalent sensitivity (85%), the false-positive rate was 45% for sFlt-1, 41% for soluble endoglin, 33% for sFlt-1/PlGF, 21% for soluble endoglin/ TGF-beta1, and 10% for the combined ratio. After adjusting for potential confounding factors, the risks for developing preeclampsia were as follows: odds ratio (OR) 6.9 [95% confidence interval 2.3-20.7] for sFlt-1 level, 7.1 [2.3-21.7] for soluble endoglin level, 6.8 [2.4-19.4] for sFlt-1/PlGF, 38.8 [9.8-154.3] for soluble endoglin/TGF-beta1, and 74.8 [17.6-316.7] for the combined ratio. The combined ratio of angiogenesis-related factors showed the lowest false-positive rate and the highest OR for prediction of preeclampsia, indicating that it may provide more effective prediction of development of preeclampsia. (author's) Language: English Keywords: DEMOCRATIC PEOPLE'S REPUBLIC OF KOREA | RESEARCH REPORT | COHORT ANALYSIS | PREGNANT WOMEN | PREGNANCY, SECOND TRIMESTER | PREECLAMPSIA | HOMEOSTASIS | AMNIOCENTESIS | TESTING | LABORATORY PROCEDURES | RISK FACTORS | Asia, Eastern | Asia | Developing Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Pregnancy Complications | Diseases | Physiology | Biology | Genetic Techniques | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement Document Number: 327247 |
| 5. Title: Sex ratio at birth and excess female child mortality in India: trends, differentials and regional patterns. Author: Arokiasamy P Source: In: Watering the neighbour's garden: The growing demographic female deficit in Asia, edited by Isabelle Attane and Christophe Z. Guilmoto. Paris, France, Committee for International Cooperation in National Research in Demography [CICRED], 2007. :49-72. "Chapters in this volume originate from papers presented at an international seminar organized by the authors in Singapore on 5-7 December 2005". Abstract: The region comprising the northern and western states of India, where evidence of stronger son preference is well documented, has the history of most imbalanced sex ratio. The corresponding link between adverse female/male child mortality differentials and the recent sharp rise in child sex ratios, related to foetal mortality, constitutes the main focus of this analysis. Set in this context, this chapter assesses the evidence of trends and regional patterns in sex bias against female children. It explores the dynamics of gender bias in terms of two proximate determinants of sex ratio, namely, sex ratio at birth and excess female child mortality. (excerpt) Language: English Keywords: INDIA | RESEARCH REPORT | HEALTH SURVEYS | DEMOGRAPHIC ANALYSIS | CHILD, FEMALE | SEX RATIO | CHILD MORTALITY | SEX DISTRIBUTION | HUMAN GEOGRAPHY | EXCESS MORTALITY | DIFFERENTIAL MORTALITY | SEX DISCRIMINATION | AMNIOCENTESIS | ULTRASONICS | ABORTION | Developing Countries | Asia, Southern | Asia | Health | Research Methodology | Child | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Sex Factors | Mortality | Population Dynamics | Geography | Social Sciences | Science | Sociocultural Factors | Social Discrimination | Social Problems | Genetic Techniques | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Fertility Control, Postconception | Family Planning Document Number: 308894 Notification |
| 6. Title: Analysis of amniotic fluid specimens for common chromosome disorders using interphase fluorescence in situ hybridization. Author: Moatter T; Khilji Z; Murad F; Munim S Source: Journal of Pakistan Medical Association. 2007 Apr;57(4):189-192. Abstract: The aim of the study was to examine the usage of multi colour FISH technology as an adjunct to conventional cytogenetics for the prenatal diagnosis of aneuploidy in interphase nuclei from high risk pregnancies. Amniotic fluid samples were collected for interphase FISH analysis using DNA probes for chromosomes 13, 18, 21, X and Y. All the probes were directly labeled with fluorescent molecules. Fluorescent signals were observed under a microscope. A minimum of 100 nuclei with defined hybridization signals were counted for each probe. Seventy-eight amniotic fluid samples were received for FISH analysis. The average age of mothers and their gestational ages were 33 years and 17.5 weeks respectively. Triple test screening was positive in 39.5% of the women followed by advanced maternal age and ultrasonographic abnormalities. Interphase FISH was performed on 76 specimens whereas 2 samples were rejected because of blood contamination. Aneuploidy was identified in 6 out of 76 specimens. Two cases of trisomy 21, two cases of trisomy 18 and one case of monosomy X were detected. In addition, one case showed 10% mosaicism for trisomy 21. Initially 4 (5.3%) samples were uninformative due to technical reasons but gave acceptable scoring signals when reanalyzed. This study has demonstrated that interphase FISH is a rapid and a reliable technique for the enumeration of chromosome number in uncultured amniocytes. Clinicians can use it for making early decisions necessary for the management of high risk pregnancies ultimately saving patients from anxiety and psychological stress. (author's) Language: English Keywords: PAKISTAN | RESEARCH REPORT | CLINICAL RESEARCH | GENETIC TECHNIQUES | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | HIGH RISK WOMEN | ANTENATAL CARE | PREGNANCY, HIGH RISK | AMNIOCENTESIS | ULTRASONICS | MATERNAL AGE, 35 AND OVER | CHROMOSOME ABNORMALITIES | LABORATORY EXAMINATIONS AND DIAGNOSES | Asia, Southern | Asia | Developing Countries | Research Methodology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Reproduction | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Pregnancy | Maternal Age | Parental Age | Age Factors | Neonatal Diseases and Abnormalities | Diseases Document Number: 317911 |
| 7. Title: Perinatal mortality in Rh alloimmunized patients. Author: Nardozza LM; Camano L; Moron AF; Chinen PA; Torloni MR Source: European Journal of Obstetrics, Gynecology and Reproductive Biology. 2007 Jun;132(2):159-162. Abstract: Evaluate and compare the perinatal mortality of Rh-negative pregnancies managed at Sao Paulo Federal University during a 9-year period, using either amniocentesis or middle cerebral artery peak systolic velocity. Descriptive observational study involving 291 consecutive Rh-negative pregnancies managed between January 1995 and January 2004. The perinatal mortality of 99 alloimmunized patients was compared with 192 Rh-negative unimmunized patients (control group). The perinatal mortality of patients managed with amniocenteses was compared to those managed with Doppler studies. There were 74 patients managed with amniocenteses and 25 managed with Doppler studies. Perinatal mortality was significantly higher in the 99 Rh-negative isoimmunized patients than in the 192 unimmunized patients (12.1% versus 1%, p = 0.0001) and did not differ according to the management protocol used (amniocentesis 13.5% versus cerebral Doppler 8.0%, p = 0.725). Mean gestational age and mean weight at birth in pregnancies managed with amniocenteses (35.7 weeks and 2586 g) did not differ significantly from those managed with Doppler (36.3 weeks and 2647 g). Perinatal mortality in Rh-negative alloimmunized patients remains high and does not differ whether pregnancies are managed through amniocentesis or cerebral Doppler evaluation. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | CONTROL GROUPS | CLIENTS | PERINATAL MORTALITY | RH SENSITIZATION | ANEMIA | AMNIOCENTESIS | ULTRASONICS | IMMUNOLOGIC FACTORS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Program Activities | Programs | Organization and Administration | Mortality | Population Dynamics | Demographic Factors | Population | Pregnancy Complications | Diseases | Genetic Techniques | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Immunity | Immune System | Physiology | Biology Document Number: 317141 |
| 8. Peer Reviewed Title: Septostomy with amniodrainage in the treatment of twin-to-twin transfusion syndrome: a 16-case report. Author: Saito M; Pontes AL; Filho FA; Sousa FL; Saito M Source: Archives of Gynecology and Obstetrics. 2007 May;275(5):341-345. Abstract: The objective was to report the treatment results of 16 monochorionic and diamniotic gestations cases, which had complications due to the twin-to-twin transfusion syndrome (TTTS), the neonatal and other possible complications of the septostomy associated to the amniodrainage. Based on ultrasonographic findings, 16 pregnant women were diagnosed with the twin-to-twin transfusion syndrome (TTTS). These cases were divided in two groups: one of them included the fetuses without hydrops and the second included the "recipient" fetuses with hydrops. The therapy measures included septostomy with or without amniodrainage. The following parameters were evaluated: gestational age at the time the septostomy was performed, volume of drained amniotic fluid, gestational age at delivery, birth weight, postnatal evolution, and procedure complications. The average gestational age for this procedure was of 23.6 weeks (from 14 weeks and 1 day to 33 weeks). The gestational age for the septostomy until the delivery was of 8.18 weeks (from 1.0 to 21.3 weeks). The survival rate in the group without hydrops was of 68.7%, while in the second group it was of 25%. Some of the complications were as follows: two cases of premature membrane rupture and one case of preterm labor. Septostomy with amniodrainage, when performed on the initial stages and on earlier gestational ages has good perinatal results. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | CASE STUDIES | PREGNANT WOMEN | PREGNANCY OUTCOMES | MULTIPLE BIRTH | AMNIOCENTESIS | SURGERY | Developing Countries | South America, Eastern | South America | Latin America | Americas | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Genetic Techniques | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Treatment Document Number: 315236 |
| 9. Title: Neglect in the care of pregnant South African women of advanced maternal age [letter] Author: Watcham SJ; Schon S; Christianson AL Source: South African Medical Journal. 2007 Nov;97(11):1064-1071. Abstract: Pregnant women of advanced maternal age (AMA), i.e. over 35 years old, are at increased risk of giving birth to an infant with a chromosomal abnormality. Of South Africa's pregnant population 17.2% falls into the AMA category, which accounts for the high prevalence of Down syndrome, documented to be 1.8 and 2.09 per 1 000 live births in urban and rural populations, respectively. Antenatal care aims to provide a normal pregnancy and delivery of a healthy infant by combating avoidable causes of antenatal and perinatal mortality and morbidity. Health professionals must therefore recognise mothers at high risk, with regard to their own and their unborn baby's wellbeing, and manage these cases appropriately. Genetic counselling and prenatal diagnosis (by amniocentesis and cytogenetic analysis) for women of AMA has been available in academic hospitals in Johannesburg since 1980. In 1990 only 5% of amniocenteses in Johannesburg were performed for black women, who comprise 90% of the pregnant population. This was considered to be due to lack of community awareness of the service and failure by the medical personnel to inform these women of the service at their first antenatal visit to confirm the pregnancy. Since 1994 this service has been free, and it has always been open to referral from the health services outside of the academic hospitals. In 2003 and 2004 there were about 2.1 million births in South Africa, 17.2% (360 000) of which were potentially to women of AMA. The National Health Laboratory Service and KwaZulu-Natal Blood Bank cytogenetic laboratories performed only 1 226 amniocenteses for AMA in this period. Utilisation of public health AMA prenatal diagnosis services is therefore still poor in Johannesburg and nationwide. We investigated why AMA women attending antenatal clinics at the academic Johannesburg and Coronation hospitals were not identified in time to receive AMA counselling and the offer of prenatal diagnosis. (excerpt) Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | KAP SURVEYS | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | MATERNAL AGE, 35 AND OVER | ANTENATAL CARE | GENETIC COUNSELING | AMNIOCENTESIS | LABORATORY EXAMINATIONS AND DIAGNOSES | GESTATIONAL AGE | QUALITY OF HEALTH CARE | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Maternal Age | Parental Age | Age Factors | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Counseling | Clinic Activities | Program Activities | Programs | Organization and Administration | Genetic Techniques | Examinations and Diagnoses | Medical Procedures | Medicine | Fetus | Pregnancy | Reproduction | Health Services Evaluation | Program Evaluation Document Number: 330631 |
| 10. Peer Reviewed Title: Delivering babies in a time of transition in Tula, Russia. Author: Danishevski K; Balabanova D; McKee M; Parkhurst J Source: Health Policy and Planning. 2006 May;21(3):195-205. Abstract: The objective was to investigate the provision of maternal services in the Tula region of Russia, with an emphasis on variations in practice. The study was set in Tula Oblast. Data sources included an obstetric information database detailing all Tula deliveries in 2000 (n = 11 123) and structured interviews with the heads of maternity facilities and hospital maternity departments. Caesarean-section rates varied from 3.3-37%; episiotomy from 9-80%; and amniocentesis from 0-51%. As fertility rates fell since the 1980s, increasing numbers of women were hospitalized for 'pathological pregnancy' in an attempt to preserve infrastructure. Over-medicalization arises in a system typified by excess capacity and large numbers of specialists. Some practice variations were correlated with characteristics of mothers, but others derive from systems structures such as equipment availability. Improvements in practice will require addressing these structural elements and steering the clinical culture towards evidence-based medicine, rather than simply writing new decrees. (author's) Language: English Keywords: RUSSIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | CHILDBIRTH | CESAREAN SECTION | AMNIOCENTESIS | FERTILITY RATE | PREGNANCY COMPLICATIONS | HEALTH FACILITIES | CULTURE | HEALTH POLICY | Developing Countries | Asia, Northern | Asia | Research Methodology | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Pregnancy Outcomes | Pregnancy | Reproduction | Obstetrical Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Genetic Techniques | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Birth Rate | Fertility Measurements | Fertility | Population Dynamics | Diseases | Sociocultural Factors | Policy | Political Factors Document Number: 299915 |
| 11. Title: Prenatal diagnosis of beta-thalassemia in Southern China. Author: Li D; Liao C; Li J; Xie X; Huang Y Source: European Journal of Obstetrics, Gynecology and Reproductive Biology. 2006 Sep-Oct;128(1-2):81-85. Abstract: The objective was to control the birth of thalassemic children in Southern China. DNA-based diagnosis was offered on fetal tissues in pregnancies when ß-globin gene mutations were identifiable in both parents using polymerase chain reaction (PCR)-reverse dot blot (RDB) assay. An automated high-performance liquid chromatography (HPLC) system was used to analyze fetal hemoglobin in pregnancies when mutation was unidentified in at least one parent. Fetal samplings were collected by chorionic villi sampling (CVS) in the first trimester, and by amniocentesis or cordocentesis in the second trimester. Maternal contamination of fetal DNA was ruled out by short tandem repeats (STR) analysis. Five-hundred and forty-five fetuses of 540 at-risk pregnancies were performed prenatal diagnosis. Out of 540 fetuses tested by DNA analysis, 150 were found to be normal, 257 were carriers, whereas 133 were affected. Out of five fetuses diagnosed by HPLC, one fetus was affected and four were unaffected. Totally, 133 pregnancies with affected fetuses, except for one twin pregnancy, were voluntarily terminated, leading to a marked reduction of severe ß-thalassemia in this region. Our prenatal diagnosis strategy proved to be highly effective. DNA- and HPLC-based testing could enable prenatal diagnosis of ß-thalassemia in all at-risk pregnancies. (author's) Language: English Keywords: CHINA | RESEARCH REPORT | CLINICAL RESEARCH | GENETIC TECHNIQUES | CHILDREN | FETUS | CHROMOSOME ABNORMALITIES | CONGENITAL ABNORMALITIES | HEMOGLOBIN LEVEL | GESTATIONAL AGE | MOTHER-TO-CHILD TRANSMISSION | AMNIOCENTESIS | GENETICS | HEREDITARY DISEASES | LABORATORY EXAMINATIONS AND DIAGNOSES | Asia, Eastern | Asia | Developing Countries | Research Methodology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Neonatal Diseases and Abnormalities | Diseases | Hemic System | Physiology | Biology | Transmission | Infections Document Number: 307176 |
| 12. Peer Reviewed Title: Proteomic technology and delayed interval delivery in multiple pregnancies. Author: Buhimschi CS; Pettker CM; Magloire LK; Martin R; Norwitz E Source: International Journal of Gynecology and Obstetrics. 2005 Jul;90(1):48-50. Abstract: Although delayed interval delivery is associated with improved survival after birth for the fetus(es) allowed to remain in the uterus, published case reports on this approach are often criticized for their selection bias. Successful outcomes are rare, perhaps because of underlying intra-amniotic fluid inflammation (IAI). Proteomic technology—surface-enhanced laser desorbtion-ionization (SELDI) and mass-restricted (MR) score—may allow to rapidly and accurately identify inflammation in the absence of clinical or laboratory signs of chorioamnionitis. (excerpt) Language: English Keywords: CONNECTICUT | RESEARCH REPORT | CASE STUDIES | CLINICAL RESEARCH | PREGNANT WOMEN | HISPANICS | CHILDBIRTH | PREGNANCY COMPLICATIONS | ULTRASONICS | MULTIPLE BIRTH | PREGNANCY OUTCOMES | AMNIOCENTESIS | LABORATORY EXAMINATIONS AND DIAGNOSES | Developed Countries | United States of America | North America | Americas | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Ethnic Groups | Cultural Background | Pregnancy | Reproduction | Diseases | Genetic Techniques | Examinations and Diagnoses Document Number: 288801 |
| 13. Peer Reviewed Title: Therapeutic amniocentesis for treatment of twin-twin transfusion syndrome. Author: Has R; Akhan S; Topuz S; Ermis H; Íyibozkurt C Source: Archives of Gynecology and Obstetrics. 2005 Jan;271(1):22-25. Abstract: The objective was to determine whether therapeutic amniocentesis may improve outcomes in patients with twin-twin transfusion syndrome. Eleven patients were managed aggressively with repetitive serial amniocenteses, and six patients were managed conservatively. The time interval between diagnosis and delivery was 17.4 days more in the amniodrainage group, but the difference between the groups was not significant (68.3 ± 41.9 days in the therapeutic amniocentesis group and 50.83 ± 29.7 days in the expectant management group [p = 0.384]). The overall survival rate of the two groups was 38.2%, and was not significantly different between groups (40.9% in the amniocentesis group and 33.3% in the expectant management group; p = 1.00). Two of nine (22.2%) infants in the amnioreduction group, and one of four (25.0%) infants in the expectantly managed group had neurological symptoms. Our results did not show a significant benefit of aggressive therapeutic amniocentesis. A slight improvement in perinatal outcome was observed. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | PROSPECTIVE STUDIES | PREGNANT WOMEN | FETUS | MULTIPLE BIRTH | PREGNANCY COMPLICATIONS | AMNIOCENTESIS | PREGNANCY OUTCOMES | Europe, Southeastern | Europe | Developing Countries | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Diseases | Genetic Techniques | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 298194 |
| 14. Peer Reviewed Title: Amniotic fluid index measurements in normal pregnancy after 28 gestational weeks. Author: Hinh ND; Ladinsky JL Source: International Journal of Gynecology and Obstetrics. 2005;91:132-136. Abstract: The purpose of this study is to establish a normative scale of amniotic fluid index (AFI) or four-quadrant amniotic fluid index throughout gestation in uncomplicated singleton pregnancies, and to identify the lower and upper limits for each gestational week. A prospective longitudinal study was used. One hundred seventeen uncomplicated singleton pregnancies were examined every 4 weeks between 28 and 42 week’s gestation. The uterine cavity was divided into four quadrants. With the use of linear-array, real-time B-scanning, the vertical diameter of the largest pocket in each quadrant was measured. The amniotic fluid index is the sum of these four quadrants. The amniotic fluid index observations from regression equation curve were stratified in week-specific normative curves. The variation between mean AFI of the total population and the means of the preterm was significantly greater than term pregnancies (P < .05). The AFI 2.5%, 5%, 10%, 90% 95% and 97.5% limits about the 50th (124 mm) were 68, 81, 90, 135, 144 and 145 mm, respectively, in term gestation. The 5th and 95th percentile serves as lower and upper limits of normal, respectively for 28—42 weeks gestation. Gestational age-specific values of AFI were established, determining the significant trends of changes in the amniotic fluid volume with gestation. The normogram may have a clinical benefit to accurate, reliable and semiquantitative diagnosis of oligohydramnios and polyhydramnios. (author's) Language: English Keywords: VIETNAM | RESEARCH REPORT | LONGITUDINAL STUDIES | PREGNANT WOMEN | MEASUREMENT | AMNIOCENTESIS | Developing Countries | Asia, Southeastern | Asia | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Genetic Techniques | Laboratory Examinations and Diagnoses | Examinations and Diagnoses Document Number: 292103 |
| 15. Title: Amniotic fluid lamellar body count and its sensitivity and specificity in evaluating of fetal lung maturity. Author: Khazardoost S; Yahyazadeh H; Borna S; Sohrabvand F; Yahyazadeh N Source: Journal of Obstetrics and Gynaecology. 2005 Apr;25(3):257-259. Abstract: This prospective study was designed to perform lamellar body count of amniotic fluid to evaluate fetal lung maturity. Lamellar body counts of 80 amniotic fluid samples from 80 pregnant women (28 -- 40 weeks of gestation) were evaluated. After delivery, each infant was evaluated for any evidence of respiratory distress syndrome. Standard clinical and radiographic criteria were used to diagnose respiratory distress syndrome, and the diagnosis was confirmed by reviewing newborn records. Twenty (25%) infants delivered within 24 hours of sample collection developed RDS. Lamellar body count more than 50000/µl predicted pulmonary maturity. Seventeen out of 20 respiratory distress syndrome cases had been predicted correctly. The negative predictive value of lamellar body count > 50000/µl was 93% and positive predictive value was 48% and the sensitivity for prediction of RDS was 85% and specificity was 70%. Lamellar body count can be used as a favourable predictor of fetal lung maturity because it is quick, simple and universally available. Also it can be used as an extremely inexpensive, reliable screening test for evaluating fetal lung maturity. (author's) Language: English Keywords: IRAN | RESEARCH REPORT | CLINICAL RESEARCH | PROSPECTIVE STUDIES | ESTIMATION TECHNIQUES | FETUS | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | PULMONARY EFFECTS | LABORATORY EXAMINATIONS AND DIAGNOSES | AMNIOCENTESIS | Developing Countries | Middle East | Research Methodology | Studies | Pregnancy | Reproduction | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Physiology | Biology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Genetic Techniques Document Number: 302156 |
| 16. Title: Prenatal diagnostic decision-making in adolescents. Author: Plaga SL; Demarco K; Shulman LP Source: Journal of Pediatric and Adolescent Gynecology. 2005;18:97-100. Abstract: We sought to evaluate the prenatal decision-making of pregnant adolescents identified at increased risk for identifiable fetal genetic abnormalities. Design: A retrospective review of records of gravid women 19 years old or younger undergoing genetic counseling from 2001–2003 (inclusive) was undertaken. Setting: Hospital-based academic center. Participants: Thirty-seven women were identified; four cases did not meet inclusion criteria. Interventions: None. Main Outcome Measure: Decision to undergo or forgo invasive prenatal testing. Of the 33 women included in this study, the average age was 17.6 years (range: 15–19). Eighteen were Latinas, eight were African-Americans, and seven were Caucasians. Sixteen women had positive maternal serum screening outcomes; nine women sought counseling because of personal/family histories of genetic abnormalities, seven sought counseling after fetal structural anomalies were detected by ultrasound, and one woman sought counseling because she and her partner were positive for Mendelian disorder screening (sickle cell disease). Sixteen of the women (48.5%) chose to undergo invasive testing (15 amniocenteses, one chorionic villus sampling) whereas 17 (51.5%) chose to forgo invasive testing. Adolescents offered invasive prenatal diagnosis will chose to undergo or forgo such testing based on diagnostic and personal criteria as do adult women. Nonetheless, unique adolescent issues may make the process by which information is obtained and communicated during counseling to be different from counseling provided to adults. The development of new genetic screening and diagnostic protocols has and will increase the number of pregnant adolescent women who will be offered genetic counseling during their pregnancies. Such an increase in numbers will place considerably more pressure on an already taxed genetic counseling system; accordingly, new counseling paradigms will need to be developed to provide service to an expanded patient population seeking information for an increasing number of genetic issues. (author's) Language: English Keywords: ILLINOIS | RESEARCH REPORT | RETROSPECTIVE STUDIES | GENETIC TECHNIQUES | PREGNANT WOMEN | DECISION MAKING | CHROMOSOME ABNORMALITIES | RECORDS | ANTENATAL CARE | SCREENING | LABORATORY EXAMINATIONS AND DIAGNOSES | AMNIOCENTESIS | GENETIC COUNSELING | UTILIZATION OF HEALTH CARE | United States of America | North America | Americas | Developed Countries | Studies | Research Methodology | Examinations and Diagnoses | Population Characteristics | Demographic Factors | Population | Behavior | Neonatal Diseases and Abnormalities | Diseases | Information Processing | Information | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Counseling | Clinic Activities | Program Activities | Programs | Organization and Administration Document Number: 286986 |
| 17. Peer Reviewed Title: Second-trimester genetic amniocentesis: 5-year experience. Author: Turhan NÖ; Eren Ü; Seçkin NC Source: Archives of Gynecology and Obstetrics. 2005 Jan;271(1):19-21. Abstract: The purpose of this study is to evaluate the data related to the genetic amniocentesis performed in a single university hospital. Medical records were used to analyze indications of amniocentesis, the results of chromosome analysis, complications and pregnancy outcomes from January 1998 through January 2002. Anomaly screening was performed to all patients attending to our Obstetrics and Gynecology Department between 16 and 20 weeks of pregnancy. The staff obstetricians- gynecologists performed all of the second-trimester genetic amniocentesis. Totally 2,686 patients attended to our department between 16 and 20 weeks of pregnancy during the index period. A total of 131 genetic amniocentesis were performed. The indications were advanced maternal age (cut off age 35) in 24, suspicion of genetic abnormality on ultrasound in 15, history of siblings with Down syndrome in 2 and abnormal triple screen in 90 patients, respectively. There were two pregnancy losses due to the procedure; thus the overall complication rate of second-trimester genetic amniocentesis was 1.5%. Being one of the most performed invasive techniques for prenatal diagnose, second-trimester genetic amniocentesis is a reliable and safe method. Although the size of this study is limited, our complication rates are similar to the related literature. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | RETROSPECTIVE STUDIES | GENETIC TECHNIQUES | PREGNANT WOMEN | FETUS | AMNIOCENTESIS | PREGNANCY OUTCOMES | PREGNANCY COMPLICATIONS | SCREENING | LABORATORY EXAMINATIONS AND DIAGNOSES | ULTRASONICS | Europe, Southeastern | Europe | Developing Countries | Studies | Research Methodology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Population Characteristics | Demographic Factors | Population | Pregnancy | Reproduction | Diseases Document Number: 298193 |
| 18. Title: Feminist discourse on sex screening and selective abortion of female foetuses. Author: Moazam F Source: Bioethics. 2004 Jun;18(3):205-220. Abstract: Although a preference for sons is reportedly a universal phenomenon, in some Asian societies daughters are considered financial and cultural liabilities. Increasing availability of ultrasonography and amniocentesis has led to widespread gender screening and selective abortion of normal female foetuses in many countries, including India. Feminists have taken widely divergent positions on the morality of this practice. Feminists from India have strongly opposed it, considering it as a further disenfranchisement of females in their patriarchal society, and have agitated successfully for legislative prohibitions. Libertarian feminists on the other hand, primarily from the United States, have argued that any prohibition of the use of this technology is a curtailment of a woman's reproductive choices and a violation of her right to make autonomous decisions regarding procreation. Using India as an illustrative case, this paper argues that in the context of what prevails in some societies, an ethical argument that hinges on the principle of autonomy as understood in the West can be problematic. Furthermore, a liberal theoretical assumption that it is always better to have more rather than fewer choices may not hold up well against the realities of life for such women. Although feminists have little disagreement concerning substantive matters, it is in the area of strategy that differences of opinion have arisen, their moral reasoning and responses shaped by the culture, ethnicity, class and race to which they belong. A view that a single 'orthodox' feminism of any variety can embody the aspiration of all women reverts to the problematic issues in the evolution of the rationalistic, individualistic, 'male' ethics against which women have consistently raised objections. (author's) Language: English Keywords: INDIA | LITERATURE REVIEW | SONS | SEX DETERMINATION | AMNIOCENTESIS | ETHICS | FEMINISM | CULTURE | SCREENING | Developing Countries | Asia, Southern | Asia | Family Relationships | Family Characteristics | Family and Household | Genetic Techniques | Laboratory Examinations and Diagnoses | Examinations and Diagnoses Document Number: 283906 Notification |
| 19. Title: Sex selective abortions-pre-birth elimination of girls. Author: Patel V Source: Health for the Millions. 2004 Aug-Nov;:61-63. Abstract: As unborn children, the Indian women face covert violence in terms of sex-selection and overt violence in terms of female foeticide after the use of aminocentesis, chorion villai biopsy, sonography, ultrasound and imaging techniques. IVF (In Vitro Fertilization) clinics, for assisted reproduction are approached by infertile couples to produce sons. The result is obvious-Decline in juvenile sex ratio and 60 lakh missing girls in Oto 6 years of age group as per Census of India, 2001. (excerpt) Language: English Keywords: INDIA | PHILOSOPHICAL OVERVIEW | WOMEN | FETUS | ABORTION | AMNIOCENTESIS | REPRODUCTIVE TECHNOLOGIES | ULTRASONICS | SEX RATIO | SEX PRESELECTION | WOMEN'S EMPOWERMENT | INEQUALITIES | Asia, Southern | Asia | Developing Countries | Demographic Factors | Population | Pregnancy | Reproduction | Fertility Control, Postconception | Family Planning | Genetic Techniques | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Sex Distribution | Sex Factors | Population Characteristics | Women's Status | Socioeconomic Factors | Economic Factors Document Number: 280716 Notification |
| 20. Peer Reviewed Title: Prolactin and calcitropic hormones in preterm premature rupture of membranes. Author: Shaarawy M; El-Minawi AM Source: International Journal of Gynecology and Obstetrics. 2004 Mar;84(3):200-207. Abstract: To investigate the role of prolactin and calcitropic hormones in preterm premature rupture of membranes (PPROM) with intrauterine infection. Methods: Amniotic fluid was retrieved by transabdominal amniocentesis from 40 patients with PPROM and 36 normal pregnant women of matched gestational age. Microbial state of amniotic cavity included culture for aerobic and anaerobic bacteria, mycoplasmas and ureaplasma. Maternal serum and fetal serum prolactin, parathyroid hormone mid-molecule PTH-M, 1,25-dihydroxyvitamin D3 and calcitonin were determined by the corresponding radioimmunoassay. Maternal serum and fetal serum electrolytes were determined by ion-selective electrodes. Chlorides were assayed colorimetrically and osmolality was determined by osmometry. Results: Microbiological evaluation of amniotic fluid PPROM revealed aerobic, anaerobic or mixed aerobic anaerobic infections PPROM was associated with significant elevation of both fetal serum and amniotic fluid prolactin concentrations, increased amniotic fluid osmolality, sodium, chlorides and calcium. Amniotic fluid potassium level was significantly decreased, compared with controls. Maternal serum and fetal serum PTH-M, 1,25-dehydroxyvitamin D3 were significantly higher in patients with PPROM than in controls. Conclusions: Increased amniotic fluid prolactin leads to impairment of structural integrity of fetal membranes through electrolytes disturbances. Moreover, increased amniotic fluid calcium induced by increased fetal calcitropic hormones evokes myometrial contraction through prostaglandin E2 release. Both mechanisms may combine to trigger the onset of PPROM associated with intrauterine infection. (author's) Language: English Keywords: EGYPT | RESEARCH REPORT | PREGNANT WOMEN | PROLACTIN | HORMONES | PREGNANCY, THIRD TRIMESTER | FETAL MEMBRANES | AMNIOCENTESIS | INFECTIONS | SERUM CALCIUM LEVEL | LABORATORY EXAMINATIONS AND DIAGNOSES | Africa, North | Africa | Developing Countries | Population Characteristics | Demographic Factors | Population | Pituitary Hormones | Endocrine System | Physiology | Biology | Pregnancy | Reproduction | Fetus | Genetic Techniques | Examinations and Diagnoses | Diseases | Hemic System Document Number: 191018 |
| 21. Title: Amniotic fluid and maternal serum leptin levels in pregnant women who subsequently develop preeclampsia. Author: Chan TF; Su JH; Chung YF; Hsu YH; Yeh YT Source: European Journal of Obstetrics, Gynecology and Reproductive Biology. 2003 May 1;108(1):50-53. Abstract: Objectives: To study the correlation between amniotic fluid leptin levels and maternal serum leptin levels during the early second trimester, and to determine whether the ratios of amniotic fluid leptin levels to maternal serum leptin levels are elevated in pregnant women who subsequently develop preeclampsia. Study design: Samples from 120 pregnant women were included in this prospective study, of which 20 were from pregnant women who subsequently developed preeclampsia and 100 were from normal pregnant women. Both the amniotic fluid and the maternal serum leptin levels were ascertained by radioimmunoassay (RIA). Results: A strong correlation between amniotic fluid leptin levels and maternal serum leptin levels was observed in both preeclamptic and normal pregnant women. In addition, the ratios of amniotic fluid leptin levels to maternal serum leptin levels were positively correlated to amniotic fluid leptin levels, but negatively correlated to maternal serum leptin levels. Furthermore, the ratios of amniotic fluid leptin levels to maternal serum leptin levels in preeclamptic women were significantly higher than those in normal pregnant women. Conclusions: Amniotic fluid leptin levels correlated with maternal serum leptin levels during the early second trimester. The ratios of amniotic fluid leptin levels to maternal serum leptin levels were elevated in preeclamptic women. However, the maternal serum leptin levels themselves showed no such elevation. Therefore, this elevated ratio may be a marker at the early stage of pregnancy in preeclamptic women. (author's) Language: English Keywords: TAIWAN | RESEARCH REPORT | PROSPECTIVE STUDIES | CASE CONTROL STUDIES | STATISTICAL STUDIES | PREGNANT WOMEN | PREECLAMPSIA | AMNIOCENTESIS | LABORATORY EXAMINATIONS AND DIAGNOSES | PREGNANCY, SECOND TRIMESTER | Asia, Eastern | Asia | Developed Countries | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Pregnancy Complications | Diseases | Genetic Techniques | Examinations and Diagnoses | Pregnancy | Reproduction Document Number: 177586 |
| 22. Title: "Partial birth," partial truths. Author: Marcus R Source: Washington Post. 2003 Jun 4;:A27. Abstract: Indeed, even as they dwell on the gory details of the partial-birth procedure, the groups pushing for a ban on it don't seem to be doing anything to make it easier for women to obtain abortions earlier. Rather, the rest of their antiabortion agenda has been devoted to putting practical and legal roadblocks in the way of women seeking abortions at any stage of pregnancy. Thus, a pregnant teenager faced with multiple hurdles -- no abortion provider nearby, no money, a parental consent law -- may end up letting her pregnancy progress to the point where she is seeking a second-trimester abortion. (excerpt) Language: English Keywords: UNITED STATES OF AMERICA | GOVERNMENT OFFICIALS | ABORTION | REPRODUCTIVE RIGHTS | ABORTION LAW | AMNIOCENTESIS | LEGISLATION | POLITICAL FACTORS | North America | Americas | Developed Countries | Administrative Personnel | Organization and Administration | Fertility Control, Postconception | Family Planning | Human Rights | Genetic Techniques | Laboratory Examinations and Diagnoses | Examinations and Diagnoses Document Number: 180193 Notification |
| 23. Peer Reviewed Title: Prenatal sex determination female fooeticide and infanticide. Author: Parvez T Source: JK-Practitioner. 2003 Jul-Sep;10(3):229-230. Abstract: Prenatal sex determination can be done earliest by 10-l1 weeks of Gestational age Here placental tissue sample is taken ultrasound guided known as chrionic villus sampling and sent for chromosomal analysis to genetic laboratories. It carries 0.8% risk of miscarriage. It costs between Rs. 1000-1500 with 95-100% accuracy. Amniocentesis started in 1974 for foetal birth defects, sex linked, genetic and chromosomal disorders. It was used widely for chromosomal analysis and sex determination at 15-16 weeks of Gestational age in genetic laboratories. Risk of miscarriage 0.5%. Ultrasound gives sex details at 16-18 weeks by experts, Most specific at 18-20 weeks of gestational age. Besides this, foetal anomallies and diseases are ruled out at this stage. (excerpt) Language: English Keywords: INDIA | CHINA | PAKISTAN | BANGLADESH | CRITIQUE | SEX DETERMINATION | ULTRASONICS | AMNIOCENTESIS | INFANTICIDE | FETAL DEATH | SEX PRESELECTION | STATISTICS | PREVENTION AND CONTROL | Asia, Southern | Asia | Developing Countries | Asia, Eastern | Genetic Techniques | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Crime | Social Problems | Mortality | Population Dynamics | Demographic Factors | Population | Reproductive Technologies | Reproduction | Research Methodology | Diseases Document Number: 183507 |
| 24. Peer Reviewed Title: Estimation of the amniotic fluid volume using the Cavalieri method on ultrasound images. Author: Sahin B; Alper T; Kokcu A; Malatyalioglu E; Kosif R Source: International Journal of Gynecology and Obstetrics. 2003 Jul;82(1):25-30. Abstract: Objectives: Presently, a design-based and practical method for measuring amniotic fluid volume (AFV) for routine clinical examinations has not been proposed. In this study we describe a new method, which combines the Cavalieri method with ultrasound imaging to estimate AFV. Methods: We measured the AFVs of 14 women in the third trimester of pregnancy, and repeated our measurements three times for each woman. Parallel planimetric ultrasonographic images were obtained at every 2 cm along the longitudinal uterine axis. AFVs were calculated as the total of the multiples of the estimated cut surface areas by the section thickness. Results: The mean estimated AFV was 380.5 cm. The coefficient of error of each measurement was calculated and the mean was 0.108. The coefficient of 3 correlation between the amniotic fluid index and our AFV estimations was 0.87. Conclusions: Design-based and efficient estimation of AFV is possible with the combination of consecutive ultrasound images and the Cavalieri method. (author's) Language: English Keywords: TURKEY | RESEARCH REPORT | CLINICAL RESEARCH | PREGNANT WOMEN | ULTRASONICS | AMNIOCENTESIS | MEASUREMENT | Developing Countries | Europe, Southeastern | Europe | Research Methodology | Population Characteristics | Demographic Factors | Population | Genetic Techniques | Laboratory Examinations and Diagnoses | Examinations and Diagnoses Document Number: 181706 |
| 25. Peer Reviewed Title: Cervical Lactobacillus and leukocyte infiltration in preterm premature rupture of membranes. [Lactobacillus cervical e infiltración de leucocitos en rotura prematura de membranas pretérmino] Author: Silva MG; Peracoli JC; Sadatsune T; Abreu ES; Peracoli MT Source: International Journal of Gynecology and Obstetrics. 2003 May;81(2):175-182. Abstract: Objectives: To evaluate the possible association between microorganisms present in the cervical secretions and amniotic fluid of pregnant women with preterm premature rupture of membranes (PPROM), and histologic chorioamnionitis. Methods: Thirty-seven pregnant women with PPROM and 21 healthy pregnant women were studied. Secretions from the cervical canal and amniotic fluid were collected to isolate microorganisms present in the genital tract. Cervical smears were Gram stained and evaluated microscopically. At delivery, chorioamniotic membranes were collected for histopathologic analysis. Results: Microscopic examination of the cervical secretion smears obtained from the PPROM group showed a low rate of Lactobacillus species, large numbers of leukocytes, and a wide diversity of microorganisms compared with the control group. The PPROM group presented an 80% rate of chorioamnionitis. Staphylococcus aureus isolation in cervical secretion was associated with intense inflammatory infiltrate in the membranes and might play a role in the pathogenesis of PPROM. Conclusions: The low colonization of cervical flora by Lactobacillus species associated with an intense leukocyte infiltrate detected in Gram-stained cervical smears can be considered a rapid method of detecting chorioamnionitis in pregnant women with PPROM. (author's) Spanish Abstract: Objetivos: Evaluar la posible asociación entre los microorganismos presentes en las secreciones cervicales y el líquido amniótico de embarazadas con rotura prematura de membranas pretérmino, y corioamnionitis histológica. Métodos: Se estudiaron treinta y siete embarazadas con rotura prematura de membranas pretérmino y 21 embarazadas saludables. Se obtuvieron las secreciones del canal cervical y del líquido amniótico para aislar los microorganismos presentes en el tracto genital. Los frotis cervicales se tiñeron con tinción de Gram y se evaluaron microscópicamente. Al parto se recogieron las membranas ovulares para su análisis histopatológico. Resultados: El examen microscópico de los frotis de las secreciones cervicales obtenidas del grupo con rotura prematura de membranas pretérmino mostró una baja proporción de especies de Lactobacillus, grandes cantidades de leucocitos, y una amplia diversidad de microorganismos comparados con el grupo control. El grupo con rotura prematura de membranas pretérmino presentó una tasa de corioamnionitis de 80%. El aislamiento de Staphylococcus aureus en la secreción cervical se asoció con infiltrado inflamatorio intenso en las membranas y podría jugar un papel en la patogénesis de la rotura prematura de membranas pretérmino. Conclusiones: La baja colonización de la flora cervical por especies de Lactobacillus, asociada con un infiltrado leucocitario detectado en el frotis cervical teñido con la tinción de Gram, puede considerarse un método rápido de detección de corioamnionitis en embarazadas con rotura prematura de membranas pretérmino. (del autor) Language: English Keywords: BRAZIL | EVALUATION REPORT | CLINICAL RESEARCH | PREMATURE BIRTH | BACTERIAL AND FUNGAL DISEASES | AMNIOCENTESIS | Developing Countries | South America, Eastern | South America | Latin America | Americas | Evaluation | Research Methodology | Pregnancy Outcomes | Pregnancy | Reproduction | Infections | Diseases | Genetic Techniques | Laboratory Examinations and Diagnoses | Examinations and Diagnoses Document Number: 178256 |
| 26. Title: Genetic counseling and prenatal diagnosis in India -- experience at Sir Ganga Ram Hospital. Author: Verma IC; Saxena R; Lall M; Bijarnia S; Sharma R Source: Indian Journal of Pediatrics. 2003 Apr;70(4):293-297. Abstract: The experiences in genetic counseling and prenatal diagnosis at a tertiary genetic center in India are described. Of 3500 subjects provided genetic counseling 28.7% were for prenatal diagnosis, 13.7% for mental retardation +/- malformations, 11.5% for thalassemia, hemophilia and leukemia, 8.5% for neural tube defects and other malformations, and 8% for muscle dystrophy and spinal muscle atrophy. Chromosomal studies in blood (n = 5459) were for recurrent abortions (57.8%), delayed milestones (14.7%), malformations (11%), and infertility and amenorrhea (10.2%). Indications for amniotic fluid studies (n = 835) were advanced maternal age (35.7%), high risk result on triple test (21.3%), previous child with trisomy 21 (21.3%) and abnormalities seen on ultrasound (11.1%). Molecular studies were mostly for thalassemia (843, 24.3%), Duchenne muscular dystrophy (443, 12.5%), fragile X syndrome (367, 10.3%), spinal muscular atrophy (315, 8.9%), thrombophilia profile (233, 6.6%), triplet repeat disorders-spinocerebellar ataxias, Huntington disease and Friedreich ataxia-162 (4.6%), cystic fibrosis 140 (3.9%) and mitochondrial disorders 101 (2.9%). Other disorders for which molecular diagnosis was done were intrauterine infections by PCR on the amniotic fluid, Prader Willi/Angelman syndromes, hemophilia, achondroplasia, congenital adrenal hyperplasia, and Apert syndrome etc. In biochemical studies triple marker tests were the most common (3239), followed by aminoacid chromatography (774). Among neurolipidosis metachromatic leukodystrophy was the commonest, followed by Krabbe's disease, Tay Sach disease and Gaucher disease. Of the mucopolysacharidoses Hurler syndrome was the commonest, followed by Hunter syndrome. These data are compared with previous studies and a change towards increased prenatal diagnostic tests is observed. The commonest indication for amniocentesis has changed to advanced maternal age. CONCLUSION: Advanced molecular, cytogenetic and biochemical techniques have been a useful addition for genetic counseling and prenatal diagnosis in India. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | CLINICAL RESEARCH | ANTENATAL CARE | GENETICS | COUNSELING | AMNIOCENTESIS | EXAMINATIONS AND DIAGNOSES | CONGENITAL ABNORMALITIES | CHROMOSOME ABNORMALITIES | RISK FACTORS | TESTING | Asia, Southern | Asia | Developing Countries | Research Methodology | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Biology | Clinic Activities | Program Activities | Programs | Organization and Administration | Genetic Techniques | Laboratory Examinations and Diagnoses | Neonatal Diseases and Abnormalities | Diseases | Measurement Document Number: 278082 |
| 27. Title: Sex ratios and sex-selective abortions in India: findings from the 1998-99 National Family Health Survey. Author: Arnold F; Roy TK Source: [Unpublished] 2002. Presented at the Symposium on Sex Ratio in India, January 10-11, 2002. Organized by International Institute for Population Sciences, Deonar, Mumbai and Ford Foundation, New Delhi. 18, [9] p. Abstract: This paper presents findings of the 1998-99 National Family Health Survey on sex ratios, use of ultrasound and amniocentesis, and abortions that can help to guide the design policies and programs to alleviate problems related to sex determination of fetuses and sex-selective abortions. Language: English Keywords: INDIA | SUMMARY REPORT | SURVEYS | DATA ANALYSIS | SEX RATIO | CHILD MORTALITY | ABORTION | ULTRASONICS | AMNIOCENTESIS | PROGRAM DESIGN | Asia, Southern | Asia | Developing Countries | Sampling Studies | Studies | Research Methodology | Sex Distribution | Sex Factors | Population Characteristics | Demographic Factors | Population | Mortality | Population Dynamics | Fertility Control, Postconception | Family Planning | Genetic Techniques | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Programs | Organization and Administration Document Number: 163813 Notification |
| 28. Peer Reviewed Title: Sex-selective abortions in India. Author: Arnold F; Kishor S; Roy TK Source: Population and Development Review. 2002 Dec;28(4):759-785. Abstract: Using NFHS-2 data, we examine the evidence for the widespread use in India and in particular states of sex-selective abortions. We proceed by discussing the legal and social setting for abortion in India, examining the extent to which sex ratios at birth reveal the use of modern technologies to avert the birth of daughters, and assessing the level of abortions and links to son preference. Having an abortion, however, does not in itself imply the use of technologies for sex selection. Thus, we present evidence on the use of ultrasound and amniocentesis for sex selection of children. We provide evidence on rules for "stopping behavior" (the intentional cessation of childbearing related to the sex of previous children) being followed by couples that complement the use of sex-selective abortions in India. (excerpt) Language: English Keywords: INDIA | RESEARCH REPORT | POPULATION STATISTICS | DATA ANALYSIS | PREGNANT WOMEN | PARENTS | SONS | ABORTION | SEX PREFERENCE | CHILD WORTH | SEX RATIO | LAWS AND STATUTES | ABORTION LAW | FAMILY SIZE, DESIRED | ULTRASONICS | AMNIOCENTESIS | SEX DETERMINATION | STATISTICS | Asia, Southern | Asia | Developing Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Family Relationships | Family Characteristics | Family and Household | Fertility Control, Postconception | Family Planning | Value Orientation | Psychological Factors | Behavior | Microeconomic Factors | Economic Factors | Sex Distribution | Sex Factors | Family Size | Genetic Techniques | Laboratory Examinations and Diagnoses | Examinations and Diagnoses Document Number: 183396 Notification |
| 29. Peer Reviewed Title: Mother-to-fetus HIV transmission during amniocentesis -- ethical concerns. Author: de Decker HP Source: South African Medical Journal. 2002 Feb;92(2):124-125. Abstract: Before performing an amniocentesis on a pregnant woman, her HIV status must be known to the practitioner. This is to minimise the risk of transmission of HIV to the fetus ('first do no harm'). This principle, however, raises several issues which are at once common to all HIV testing and unique to the setting of antenatal counseling and amniocentesis. In addition to the usual concerns of surrounding the presence or risk of fetal abnormalities and the usual risks of Amniocentesis, an HIV-positive woman attending a pregnancy counseling clinic would have to struggle with the following issues: Her positive HIV status. Her partner's HIV status. The risk of transmission to her fetus. The availability (or not) of antiretroviral treatment, its side-effects and unknown efficacy. Her willingness to continue with the pregnancy in the light of her positive HIV status. She has to consider maternal, paternal and infant AIDS and the possibility that the child will be orphaned, in addition to the morbidity of any fetal abnormalities. The increased risk of transmission due to the amniocentesis. (excerpt) Language: English Keywords: CRITIQUE | PREGNANT WOMEN | MOTHERS | INFANT | HIV INFECTIONS | MOTHER-TO-CHILD TRANSMISSION | EXAMINATIONS AND DIAGNOSES | AMNIOCENTESIS | ETHICS | Population Characteristics | Demographic Factors | Population | Parents | Family Relationships | Family Characteristics | Family and Household | Youth | Age Factors | Viral Diseases | Diseases | Genetic Techniques | Laboratory Examinations and Diagnoses Document Number: 175328 |
| 30. Title: [Amniocentesis] L'amniocentèse. Author: Maanani M; Zraidi M; Chekeiri N; Yousfi M; Ouazzani MC Source: Revue Sages Femmes. 2002 May-Jun;(25):16-18. Abstract: Amniocentesis is the transabdominal needle aspiration of amniotic fluid in the objective of diagnosing congenital malformations at an early stage. In this article, the authors present the indications for amniocentesis, the incidents and accidents connected to it. In fact, amniocentesis is indicated in the presence of chromosomal abnormality in one of the parents, advanced maternal age, when the fetus presents abnormalities or malformations in ultrasound, for assay of alpha-fetoprotein, as a small quantity should lead to suspicion of malformation of the nervous system or the abdominal wall of the baby, and finally, in the presence of Rhesus isoimmunization, as it permits assessing the degree of fetal anemia and pulmonary maturity. Incidents connected to amniocentesis have been described, such as pain at the point of puncture or uterine contractions, which may be treated with antispasmodics and rest, wounds of the hypogastric artery, puncture of the bladder or digestive wounds, loss of amniotic fluid, which may lead to its complete loss, hence the need for antibiotic treatment combined with rest. But in the event that this loss occurs 10 days after the puncture accompanied by uterine contractions, fever, or loss of blood, it may increase the risk of false labor. Other incidents are cited, such as fetal mortality, Rhesus isoimmunization, and puncture failures which depend on the experience of the operator and also connected to the patient's corpulence, the anterior and thick placenta and a fibromyomatous hypertrophy of the uterus. The indication of amniocentesis should be made only by fear of discovery of an abnormality or a clinical situation in specific circumstances, namely, HIV seropositivity, twin pregnancy, hepatitis B, C or any other virus which may severely infect the fetus. French Abstract: L'amniocentèse est la ponction du liquide amniotique par voie trans-abdominale dans le but de diagnostiquer les malformations congénitales à un stade précoce. Dans cet article, les auteurs exposent les indications de l'amniocentèse, les incidents et les accidents qu'ils lui sont liés. En effet, l'amniocentèse est indiquée en présence d'une anomalie chromosomique chez l'un des parents, devant l'âge maternel avancé, lorsque le fœtus présente des anomalies ou des malformations à l'échographie, pour le dosage de l'alfa-feotoprotéine car une faible quantité doit suspecter une malformation du système nerveux ou la paroi abdominal du bébé, et enfin devant l'allo-immunisation Rhésus car elle permet d'apprécier le degré d'anémie et la maturité pulmonaire fœtales. Les incidents liés à l'amniocentèse ont été décrits tels que la douleur au point de ponction ou de contractions utérines, et qui peut être traitée par des antispasmodiques et du repos, les blessures de l'artère hypogastriques, la ponction de la vessie ou des plaies digestives, la perte du liquide amniotique et qui peut amener à sa perte totale d'où la nécessité d'un traitement antibiotique associé au repos. Mais au cas où cette perte survient 10 jours après la ponction accompagnée de contractions utérines, de fièvre ou de perte de sang, elle peut augmenter le risque de fausse couche. Autres incidents sont cités à savoir la mortalité fœtale, l'alloimmunisation Rhésus et les échecs de ponction qui dépendent de l'expérience de l'opérateur et également liés à la corpulence de la patiente, au placenta antérieur et épais ou à une hypertrophie fibromyomateuse de l'utérus. L'indication de l'amniocentèse doit être réalisée seulement par peur de découverte d'une anomalie ou d'une situation clinique dans des circonstances particulières à savoir, la séropositivité HIV, une grossesse sur des jumeaux, l'hépatite B, C ou de tout autre virus susceptible de contaminer gravement le fœtus. Language: French Keywords: MOROCCO | PREGNANT WOMEN | PERSONS LIVING WITH HIV/AIDS | AMNIOCENTESIS | LABORATORY EXAMINATIONS AND DIAGNOSES | CONGENITAL ABNORMALITIES | PAIN | PREMATURE LABOR | FETAL DEATH | RH SENSITIZATION | HEPATITIS | PREGNANCY, MULTIPLE | CONTRAINDICATIONS | COMPLICATIONS | PREVENTION AND CONTROL | TRANSMISSION | Developing Countries | Africa, North | Africa | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Genetic Techniques | Examinations and Diagnoses | Neonatal Diseases and Abnormalities | Signs and Symptoms | Pregnancy Outcomes | Pregnancy | Reproduction | Mortality | Population Dynamics | Pregnancy Complications | Treatment | Infections Document Number: 182882 |
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