s100b protein concentrations in amniotic fluid are higher in monoamniotic than in diamniotic twins and singleton pregnancies

S100B is an acidic calcium-binding protein of the EF-hand family present in the central nervous system, where it is located mainly in glial cells (1). It has been suggested that the protein is involved in various cellular functions, but precisely which is still a matter of debate. The protein has been found to act at physiologic concentrations as a cytokine with a neurotrophic role in experimental models, in cell cultures, and in biological fluids such as cord blood, peripheral blood, and urine (1)(2)(3)(4). This hypothesis has been corroborated by measurements of S100B protein in amniotic fluid in the second trimester of pregnancy (5). The present work, following from an earlier study, investigates amniotic fluid S100B concentrations in twins. We performed a case-control study (between January 1998 and June 2002) of 49 women with physiologic twin pregnancies (27 monoamniotic and 22 diamniotic) who underwent amniocentesis to exclude chromosomal abnormalities between the 15th and 18th weeks of gestation (mean, 16.5 weeks). The control group consisted of 490 singleton pregnancies matched for gestational age and weight at sampling and normal neonatal outcome (5 control fetuses for each twin fetus). Appropriate fetal growth was defined by the presence of ultrasonographic signs (when biparietal diameter and abdominal circumference were between the 10th and 90th percentiles) according to the normograms of Campbell and Thoms (6) and by postnatal confirmation of a birth weight between the 10th and 90th percentiles according to our population standards after correction for maternal height, weight, and parity and the sex of the newborns. Exclusion criteria included intrauterine growth retardation; gestational hypertension; diabetes and infections; fetal malformations; chromosomal abnormalities; maternal exposure to alcohol, cocaine, or smoke; perinatal asphyxia; and dystocia. The local ethics committee approved the study protocol, and the parents of the fetuses examined gave

ULTRAZVUČNI PREGLED PRIMARNOG I SEKUNDARNOG NEPCA

The new 3-4D technologies offer a particular and precise study of some anatomical parts otherwise difficult or impossible to visualize with the traditional 2-D technique. The study of the secondary palate, hard and soft palate of the uvula, in the last two years gained much attention by the researchers because the 3-D ultrasound allows visualizing the secondary palate. Based on the personal experience, the authors illustrate the scan technique of the secondary palate by 3-D ultrasound in sagittal, coronal and axial plane (multiplanar view) with 3D reconstruction, introducing some new possibilities of 3D scan like Tomographic Ultrasound Imaging (TUI) technique. Comparing different technical methods, authors are convinced that most useful is depiction of the palate in the 3-D axial and sagittal plane beginning from the first trimester of pregnancy, but the best results are achieved between the 18 and 25 weeks of gestation. The time needed to render the 3-D image is usually few minutes. The quality of the scan depends, as for the any other 3-D scan, on the fetal position and maternal weight. The association of the facial and palate clefting with chromosomopathies and genetic syndromes which is difficult to depict by 2-D ultrasound, will prompt the investigators to visualize the secondary palate by 3-D scan from the first trimester of pregnancy.Nove ultrazvučne 3-4/D tehnologije nude posebno i precizno izučavanje nekih anatomskih dijelova, koje je inače teško ili nemoguće vidjeti tradicionalnom 2-D tehnikom. Istraživanje sekundarnog nepca, onoga tvrdoga, te ¬mekoga nepca – uvule u posljednje dvije godine je usmjerilo pozornost istraživača, jer 3-D ultrazvuk omogućuje viđenje sekundarnog nepca. Autori na temelju vlastita iskustva prikazuju način snimanja sekundarnog nepca 3-D ultrazvukom, rekonstrukcijom sagitalne, koronarne i aksijalne ravnine, uvodeći nove mogućnosti ultrazvučne tehnike – tomografsko ultrazvučno snimanje (Tomographic Ultrasound Imaging – TUI). Uspoređujući razne metode tehnike autori vjeruju da je najkorisnije otkrivanje nepca u 3-D aksijalnoj i sagitalnoj ravnini, već u prvom tromjesečju, a najbolji je uspjeh otkrivanja s 18–25 tjedana trudnoće. Vrijeme potrebno da se postigne 3-D slika je obično nekoliko minuta. Kvaliteta slike ovisi, kao za bilo koju drugu 3-D sliku, o položaju fetusa i o pretilosti trudnice. Povezanost rascjepa lica i nepca s kromosomopatijama i nasljednim sindromima, koje je teško otkriti 2-D ultrazvukom, omogućuje pretraživaču da pomoću 3-D tehnike vidi sekundarno nepce od prvog tromjesečja trudnoće

Regression of fetal cerebral abnormalities by primary cytomegalovirus infection following hyperimmunoglobulin therapy

Objective To assess the effects of maternal and intra-amniotic hyperimmunoglobulin (HIG) infusions among cytomegalovirus (CMV) infected fetuses with ultrasound abnormalities following a primary CMV infection. Patients and Methods The subjects were fetuses with CMV-associated cerebral and other ultrasound abnormalities. Three mothers were treated with HIG infusions during pregnancy and two were untreated. Fetal ventricle size, organ echodensity and placental thickness were measured by ultrasound before and after HIG infusions. The children were evaluated between 3 and 7 years of age. Results The ventriculomegaly of all three fetuses of HIG-treated mothers regressed and the ascites, hepatic echodensities, periventricular echodensities, and intestinal echodensities disappeared. Their sensorial, mental and motor development was normal at 4, 4.7, and 7 years of age. In contrast, both infants born of untreated mothers had signs and symptoms of severe CMV cerebropathy. Conclusion The outcomes of the infants born to HIG-treated mothers support the efficacy of HIG as a treatment for CMV-infected fetuses with ultrasound cerebral abnormalities. Copyright (C) 2008 John Wiley & Sons, Ltd

Placental and Umbilical Cord Anomalies Diagnosed by Two- and Three-Dimensional Ultrasound

The aim of this review is to present a wide spectrum of placental and umbilical cord pathologies affecting the pregnancy. Placental and umbilical cord anomalies are highly associated with high-risk pregnancies and may jeopardize fetal well-being in utero as well as causing a predisposition towards poor perinatal outcome with increased fetal and neonatal mortality and morbidity. The permanent, computerized perinatology databases of different international centers have been searched and investigated to fulfil the aim of this manuscript. An extended gallery of prenatal imaging with autopsy correlation in specific cases will help to provide readers with a useful iconographic tool and will assist with the understanding and definition of this critical obstetrical and perinatological issue

Skeletal dysplasia with bowing long bones: Proposed flowchart for prenatal diagnosis with case demonstration

Abstract Objective Skeletal dysplasia with bowing long bones is a rare group of multiple characterized congenital anomalies. Materials and Methods We introduce a simple, practical diagnostic flowchart that may be helpful in identifying the appropriate pathway of obstetrical management. Results Herein, we describe four fetal cases of bent bony dysplasia that focus on ultrasound findings, phenotype, molecular tests, distinctive X-ray features, and chondral growth plate histology. The first case was a typical campomelic dysplasia resulting from a de novo mutation in the SOX9 gene. The second fetus was affected by osteogenesis imperfecta Type II carrying a mutation in the COLA1 gene. The third case was a rare presentation of campomelic dysplasia, Cumming type, in which SOX9 examination was normal. Subsequently, a femoral hypoplasia unusual facies syndrome is also discussed. Conclusion Targeted molecular tests and genetic counseling are required for supplementing ultrasound imaging in order to diagnose the correct skeletal disorders

ULTRAZVUČNI PREGLED PRIMARNOG I SEKUNDARNOG NEPCA

The new 3-4D technologies offer a particular and precise study of some anatomical parts otherwise difficult or impossible to visualize with the traditional 2-D technique. The study of the secondary palate, hard and soft palate of the uvula, in the last two years gained much attention by the researchers because the 3-D ultrasound allows visualizing the secondary palate. Based on the personal experience, the authors illustrate the scan technique of the secondary palate by 3-D ultrasound in sagittal, coronal and axial plane (multiplanar view) with 3D reconstruction, introducing some new possibilities of 3D scan like Tomographic Ultrasound Imaging (TUI) technique. Comparing different technical methods, authors are convinced that most useful is depiction of the palate in the 3-D axial and sagittal plane beginning from the first trimester of pregnancy, but the best results are achieved between the 18 and 25 weeks of gestation. The time needed to render the 3-D image is usually few minutes. The quality of the scan depends, as for the any other 3-D scan, on the fetal position and maternal weight. The association of the facial and palate clefting with chromosomopathies and genetic syndromes which is difficult to depict by 2-D ultrasound, will prompt the investigators to visualize the secondary palate by 3-D scan from the first trimester of pregnancy.Nove ultrazvučne 3-4/D tehnologije nude posebno i precizno izučavanje nekih anatomskih dijelova, koje je inače teško ili nemoguće vidjeti tradicionalnom 2-D tehnikom. Istraživanje sekundarnog nepca, onoga tvrdoga, te ¬mekoga nepca – uvule u posljednje dvije godine je usmjerilo pozornost istraživača, jer 3-D ultrazvuk omogućuje viđenje sekundarnog nepca. Autori na temelju vlastita iskustva prikazuju način snimanja sekundarnog nepca 3-D ultrazvukom, rekonstrukcijom sagitalne, koronarne i aksijalne ravnine, uvodeći nove mogućnosti ultrazvučne tehnike – tomografsko ultrazvučno snimanje (Tomographic Ultrasound Imaging – TUI). Uspoređujući razne metode tehnike autori vjeruju da je najkorisnije otkrivanje nepca u 3-D aksijalnoj i sagitalnoj ravnini, već u prvom tromjesečju, a najbolji je uspjeh otkrivanja s 18–25 tjedana trudnoće. Vrijeme potrebno da se postigne 3-D slika je obično nekoliko minuta. Kvaliteta slike ovisi, kao za bilo koju drugu 3-D sliku, o položaju fetusa i o pretilosti trudnice. Povezanost rascjepa lica i nepca s kromosomopatijama i nasljednim sindromima, koje je teško otkriti 2-D ultrazvukom, omogućuje pretraživaču da pomoću 3-D tehnike vidi sekundarno nepce od prvog tromjesečja trudnoće

Effects of temperature on pre-analytical stability of S100B protein concentrations in urine of healthy full-term infants.

none5GAZZOLO D; FRULIO R; P. BRUSCHETTINI; LITUANIA M; MICHETTI F.Gazzolo, D; Frulio, Rosanna; Bruschettini, PIER LUIGI; Lituania, M; Michetti, F

Adrenomedullin increases in term asphyxiated newborns developing intraventricular hemorrhage

Objectives: Adrenomedullin (AM) is a newly discovered vasodilator peptide that participates in the regulation of cerebral blood flow. The aim of this study was to investigate whether circulating AM was increased in infants with prenatal asphyxia who developed intraventricular hemorrhage (WIT). Design and methods: A case-control study was performed on 40 fall-term asphyxiated newborns: 20 developed IVH (group A) and 20 did not (group 13). Forty term healthy newborns represented the control group. Biochemical laboratory parameters, neurological patterns, cerebral ultrasound scanning, and Doppler velocimetry were assessed at 12 and 72 h from birth. Plasma AM concentration was measured at 12 h from birth by means of a specific RIA. Results: AM levels were significantly higher in group A (20.2 +/- 5.2 fmol/ml) than in group B (8.4 +/- 2.1 fmol/ml) or controls (9.3 +/- 2.6 fmol/ml). In asphyxiated newborns, AM concentration was correlated with middle cerebral artery P1 value only in group B. Conclusions: Increased concentration of AM at 12 h from birth in asphyxiated newborns who later developed IVH suggests that this peptide may participate in the loss of cerebral vascular autoregulation in response to hypoxia and could be useful to discriminate, among newborns at risk, those with an adverse neurological outcome. (C) 2004 The Canadian Society of Clinical Chemists. All rights reserved