Pons Anteroposterior and Cerebellar Vermis Craniocaudal Diameters in Fetuses With Down Syndrome

Objectives To investigate the pons anteroposterior diameter (APD) and cerebellar vermis craniocaudal diameter (CCD) of fetuses with Down syndrome (DS). Methods This was a prospective observational study including 200 low-risk pregnancies and 18 pregnancies with fetuses who had DS. A midsagittal view was obtained to measure the pons APD and cerebellar vermis CCD. Gestational age-related 5th, mean, and 95th percentiles for the pons APD and cerebellar vermis CCD between 18 and 32 weeks' gestation were created from the low-risk population. Each measurement of a fetus with DS was plotted on growth charts, and those below the 5th percentile for gestational age were considered small. Results The pons APD and cerebellar vermis CCD measurements were below the 5th percentile for gestational age in 7 of the 18 (38.8%) fetuses with DS. Fetuses who had pons APDs below the 5th percentile for gestational age also had cerebellar vermis CCDs below the 5th percentile. Fetuses who had pons and cerebellar vermis measurements below the 5th percentile for gestational age on the initial examination continued to have small measurements during follow-up. Conclusions Fetal pons and cerebellar vermis abnormalities could be observed prenatally in fetuses with DS, which could help in the antenatal counseling and postnatal follow-up of such pregnancies

Mid-trimester amniotic fluid angiogenin, lactate dehydrogenase and fibronectin in the prediction of preterm delivery

Objective: Our purpose was to compare angiogenin, lactate dehydrogenase (LDH) and fibronectin levels in mid-trimester amniotic fluid of patients with preterm and term deliveries and to find out their predictive values for preterm birth. Study Design: A prospective cohort study was conducted in 55 pregnancies with singleton gestations that underwent amniocentesis at 15-20 weeks for standard genetic indications. Amniotic fluid angiogenin, lactate dehydrogenase and fibronectin levels were measured by enzyme-linked immunosorbent assay (ELISA), radial immundiffusion technic and automated analyzer, respectively. Results: Five patients delivered preterm, five developed signs or symptoms of threatened preterm, labor and 45 had term delivery after an uneventful pregnancy. Demographic data were not significantly different. Amniotic fluid angiogenin and lactate dehydrogenase levels were significantly higher in patients with preterm than term deliveries (P < 0.001 and 0.02, respectively). Receiver-operator characteristic curve analysis showed that the amniotic fluid angiogenin had the best screening efficiency in predicting preterm delivery. An angiogenin level of 35 ng/ml was the optimal cut-off value for the prediction of preterm delivery, with a sensitivity of 100% and specificity of 91%. Conclusion: Second-trimester angiogenin is found to be quite effective in the prediction of preterm delivery. Preexisting intrauterine ischemia may be an important risk factor for preterm delivery and already be present in the early mid-trimester. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved

PREGNANCY OUTCOMES OF 115 CASES WITH MATERNAL HEART DISEASE

Objective: To evaluate the outcomes of pregnancies with maternal heart disease

Fetal left ventricular modified myocardial performance index and renal artery pulsatility index in pregnancies with isolated oligohydramnios before 37 weeks of gestation

Objective: The aim was to evaluate fetal left modified myocardial performance index (Mod-MPI) and renal artery Doppler parameters in fetuses with isolated oligohydramnios and a normal amount of amniotic fluid

Plasma and placental levels of interleukin-10, transforming growth factor-beta(1), and epithelial-cadherin in preeclampsia

OBJECTIVE: To investigate the plasma and placental levels of interleukin-10 (IL-10), transforming growth factor-beta(1) (TGF-beta(1)), and epithelial-cadherin (E-cadherin) in normotensive and preeclamptic pregnancies

Prediction of preeclampsia with maternal mid-trimester placental growth factor, activin A, fibronectin and uterine artery Doppler velocimetry

Objective: To assess whether alterations in the serum levels of placental growth factor, activin A and fibronectin could be detected in patients before they become preeclamptic. And to evaluate and compare the clinical utility of these markers and uterine artery Doppler velocimetry in predicting preeclampsia. Methods: One hundred and twenty-two normotensive women were prospectively included in the study. Peripheral venous blood samples were obtained and Doppler examination of the uterine arteries was performed between 21 and 26 weeks' gestation. Serum levels of placental growth factor, activin A and fibronectin were measured by enzyme-linked immunoassay and radial immundiffusion technic. Results: Mid-trimester maternal serum activin A and fibronectin levels and average S/D ratios were significantly higher whereas placental growth factor levels were significantly Lower in women who subsequently developed preeclampsia than remained normotensive (p < 0.001). The best cut-off values for predicting preeclampsia of placental. growth factor, activin A and fibronectin based on. ROC curve analysis were 90 pg/ml, 14 ng/ml and 370 mg/l respectively. The areas under the curve equal to 0.993, 0.972, 0.872 and 0.813 for placental growth factor, activin A, fibronectin and uterine artery Doppler respectively were determined for the prediction of preeclampsia. Conclusion: Placental growth factor, activin A, fibronectin and uterine artery Doppler are all potentially useful as predictors of preeclampsia. Maternal serum midtrimester PGF has the highest predictive value and activin A with a compatible accuracy for early identification of preeclampsia. (c) 2005 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved

Complete Hydatidiform Mole and Co-Existing Live Fetus after Intracytoplasmic Sperm Injection: A Case Report and Literature Review

Introduction: Twin pregnancy with complete hydatidiform mole and co-existing fetus (CHMCF) is an uncommon obstetric entity and may occur after assisted reproductive technologies. These pregnancies are associated with severe complications for both mother and fetus and the management is challenging. Case Report: We report a twin pregnancy after intracytoplasmic sperm injection (ICSI) treatment with CHMCF which delivered at 26 gestation weeks due to severe preeclampsia. The 625g neonate survived without any complication. The woman had persistent trophoblastic disease with lung metastasis and was treated with single agent methotrexate. We also present a brief review of the literature about the outcomes of CHMCF after ICSI. Conclusion: CHMCF may occur after ICSI treatment. Pregnancies with CHMCF are associated with severe complications however under close follow-up successful outcomes could be achieved in such pregnancies

Evaluation of obstetric outcomes and prognostic factors in pregnancies with chronic kidney disease

Objective: To evaluate the obstetric outcomes of pregnancies with chronic kidney disease (CKD) and to assess the prognostic factors on adverse obstetric outcomes