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Normal Fetuses (normal + fetuse)
Kinds of Normal Fetuses Selected AbstractsDevelopment of olfactory epithelium in the human fetus: Scanning electron microscopic observationsCONGENITAL ANOMALIES, Issue 3 2009Mitsuhiro Kimura ABSTRACT Aims:, Human olfactory epithelium becomes functional at birth, but prenatal development remains unclear. In the present study, we aimed to clarify the development of human olfactory epithelium using scanning electron microscopy (SEM). Methods:, The development of human olfactory epithelium was observed in 24 externally normal fetuses, which were formalin-fixed and long-preserved, with a crown-rump length (CRL) of 102,336 mm (gestational week 14,38). The olfactory mucosa in the superior wall of the nasal septum near the choana were dissected and observed under SEM. We examined the number of olfactory vesicles per unit area, diameter of olfactory vesicles, and number and length of cilia on olfactory vesicles. Results:, At circa (ca) CRL 100 mm (ca 14 weeks), olfactory epithelium displayed several olfactory vesicles with 1,2 short cilia per unit area. At ca CRL 150 mm (ca 18 weeks), olfactory vesicles were present in small clusters, and cilia were longer. At CRL lager than 225 mm (ca 26 weeks), olfactory vesicles became located separately from each other, while length and number of cilia per olfactory vesicle were further increased. Conclusion:, The present findings suggest that fetal olfactory epithelium becomes morphologically almost the same as that in adults in late gestation, much later than previously thought. [source] An examination of different fetal specific antibodies and magnetic activated cell sorting for the enrichment of fetal erythroblasts from maternal bloodCONGENITAL ANOMALIES, Issue 3 2002Xiao Xi Zhao ABSTRACT, The aim of the present study was to compare the rates of fetal cells obtained after separation from maternal blood by magnetic activated cell sorting (MACS) using different fetal specific antibodies, and to evaluate the potential role of this method in the prenatal diagnosis of fetal trisomies. Peripheral blood samples were obtained from 42 women carrying chromosomally normal fetuses and from 4 women with aneuploid fetuses (2 cases of 47,XX,+18 and 2 of 47,XY,+21) at 9,20 weeks of gestation. After fetal cells were enriched by MACS with three different monoclonal antibodies (GPA, CD71, CD14), fluorescence in situ hybridization (FISH) with chromosome X, and Y-specific probes was performed to detect the rates of fetal cells in the samples sorted. FISH with chromosome 13-, 18-, and 21-specific probes was carried out to compare proportions of cells with three-signal nuclei in chromosomally normal and abnormal groups. In male infants, X-and Y-positive cells were detected in 80%, 73.3%, and 66.6% of samples after the separation by antibodies CD14, GPA, and CD71, respectively. The percentage of nuclei with three signals was increased in pregnancies with trisomy, ranging between 2% and 5.18%. Pregnancies with normal fetuses showed 0 to 3.7% of nuclei with three signals. The data demonstrate that fetal cell detection varies depending on the antibodies used for cell sorting. This study provides further evidence on the feasibility of screening for fetal chromosomal abnormalities by enriching maternal blood for fetal cells and using FISH. [source] Fetal cyclic motor activity in diabetic pregnancies: Sensitivity to maternal blood glucoseDEVELOPMENTAL PSYCHOBIOLOGY, Issue 1 2003Steven S. Robertson Abstract Spontaneous fetal movement in the last third of human gestation is dominated by irregular oscillations on a scale of minutes (cyclic motility, CM). The core properties of these oscillations are stable during the third trimester of gestation in normal fetuses, but disrupted by poorly controlled maternal diabetes. Here we investigated whether fetal CM is linked to short-term instabilities in maternal glucose metabolism. The fetuses of 40 mothers with type I (n,=,28) or gestational (n,=,12) diabetes were studied one to six times between 27 and 40 postmenstrual weeks of gestation. Fetal movement and maternal blood glucose concentration were measured during two separate periods of fetal activity in each session. Fetal CM was quantified with spectral analysis. Early in the third trimester, changes in the rate of oscillation in fetal CM between the two periods of activity were inversely related to changes in maternal blood glucose levels. Fetal CM was unrelated to concurrent maternal blood glucose levels at any point in the third trimester. The pattern of results suggests that disruption of the temporal organization of spontaneous fetal motor activity in pregnancies complicated by maternal diabetes represents an acute response to fluctuations in the metabolic environment rather than an alteration of CM development. © 2003 Wiley Periodicals, Inc. Dev Psychobiol 42: 9,16, 2003. [source] A biometric study of the fetal orbit and lens in normal pregnanciesJOURNAL OF CLINICAL ULTRASOUND, Issue 2 2009Kanchapan Sukonpan MD Abstract Purpose. To construct nomograms of the size of the fetal orbit and lens and to evaluate the relationships between the gestational age and the biometry of the fetal orbit and lens. Method. Six hundred two normal pregnant women were evaluated from 15 to 40 weeks of gestation. Fetal orbital and lens measurements were added to routine biometric measurements for normal fetuses. Results. A total of 595 measurements were used for analyses. A strong linear correlation was observed between gestational age and orbital diameter, orbital circumference, and orbital surface. A linear correlation was also found between gestational age and lens diameter, lens circumference, and lens surface. A linear growth function was observed between biparietal diameter and both the orbital diameter and the lens diameter. Conclusion. Orbital and lens measurements provide data that correlate with fetal growth and development. These data may also help detect fetal ocular abnormalities. © 2008 Wiley Periodicals, Inc. J Clin Ultrasound, 2009 [source] Four-dimensional sonography with B-flow imaging and spatiotemporal image correlation for visualization of the fetal heartJOURNAL OF CLINICAL ULTRASOUND, Issue 4 2008Toshiyuki Hata MD Abstract Purpose. To use B-flow imaging with 4-dimensional (4D) sonography and spatiotemporal image correlation (STIC) in the evaluation of normal fetal heart and congenital heart disease during pregnancy. Method. Volume data sets of the fetal heart were acquired with automated transverse and longitudinal sweeps of the anterior chest wall. We studied 13 normal fetuses and 2 fetuses with congenital heart disease (1 double-outlet right ventricle and 1 hypoplastic left heart syndrome) at gestation ages ranging from 13 to 39 weeks using transabdominal 4D B-flow sonography with STIC (4D BF-STIC). Results. 4D BF-STIC demonstrated dynamic angiographic features in both normal and abnormal fetal hearts. 4D BF-STIC images could not be obtained in 2 normal fetuses at 18.1 and 33.1 weeks because of the high fetal heart rate and inappropriate fetal position. In normal fetal heart, characteristic hemodynamic changes in both atria and ventricles were clearly demonstrated in systole and diastole. 4D BF-STIC also allowed visualization of the relationship, size, and course of the outflow tracts, thus helping the examiner to better understand the relationships between the vessels. In a case of hypoplastic left heart syndrome, dramatic hemodynamic changes including the right atrium, right ventricle, and pulmonary artery were evident. In a case of double-outlet right ventricle with ventricular septal defect, left-to-right shunt flow through a ventricular septal defect was clearly shown, as were great arteries originating in parallel from the right ventricle. Conclusion. 4D BF-STIC provides a means of real-time 3-dimensional evaluation of fetal intracardiac and extracardiac hemodynamics in the second and third trimesters. This novel technique assists in the evaluation of fetal cardiac hemodynamics and may play an important role in future fetal cardiac research and in the evaluation of congenital heart disease in the fetus. © 2008 Wiley Periodicals, Inc. J Clin Ultrasound, 2008. [source] Sonographic measurement of the fetal cerebellum, cisterna magna, and cavum septum pellucidum in normal fetuses in the second and third trimesters of pregnancyJOURNAL OF CLINICAL ULTRASOUND, Issue 4 2003Selami Serhatlioglu MD Abstract Purpose Absence of the cavum septum pellucidum (CSP), the cisterna magna (CM), or both, and enlargement of either or both structures are associated with various central nervous system malformations. In an effort to determine normal sizes and relationships between these cranial structures, we measured the CSP and CM in normal fetuses in the second and third trimesters of pregnancy using transabdominal sonography. Methods Women with uncomplicated pregnancies and normal singleton fetuses between 16 and 38 weeks' menstrual age were included in this prospective study. The width and anteroposterior (AP) diameters of the CSP were measured on the transverse transventricular plane, and the AP diameter of the CM was measured on the transcerebellar plane from the posterior aspect of the cerebellar vermis to the inner edge of the cranium. The transverse and AP diameters of the cerebellum were also measured. In addition, we measured the biparietal diameters (BPDs). Results In total, 130 women participated; 64 were examined in their second trimester and 66 in their third trimester. The mean age of the women was 27.4 ± 4.8 years (range, 18,38 years), and the mean menstrual age of the fetuses was 26.9 ± 6.7 weeks (range, 16,38 weeks). The mean BPD was 66.8 ± 18.7 mm (range, 30,96 mm). The mean width and AP diameter of the CSP and the mean AP diameter of the CM differed significantly between the second and third trimesters (p < 0.001). All measured parameters correlated significantly with menstrual age and BPD. Conclusions In normal fetuses, the CSP and CM should be visible on transabdominal sonography between 16 and 38 weeks' menstrual age. Because abnormalities in these cranial structures may be indicative of central nervous system malformations, the availability of mean sonographic measurements from normal fetuses should be helpful in determining the need for additional testing in fetuses with abnormal measurements. © 2003 Wiley Periodicals, Inc. J Clin Ultrasound 31:194,200, 2003 [source] Fetal nasal bone length and Down syndrome during the second trimester in a Chinese populationJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 4 2008Jeng-Hsiu Hung Abstract Objective:, The purpose of the present study was to build a database of reference ranges of fetal nasal bone length (NBL) in a Chinese population. The accuracy rate of detecting Down syndrome was also analyzed using fetal NBL as a marker. Methods:, The control group of fetuses included 342 normal singleton pregnancies with no chromosomal or congenital anomalies. The present study was a cross-section study and the control group was used to construct percentile values of NBL from 13 to 29 gestational weeks of age. Two-dimensional ultrasonography was used for the nasal bone studies. Measurements of NBL were collected and each fetus contributed a single value to the reference sample. During the study period, 14 fetuses with Down syndrome were examined. Measurement of fetal NBL was made during amniocentesis, with gestational age ranging from 13 to 19 weeks. Results:, From 342 normal fetuses with gestational age ranging from 13 to 29 weeks, reference ranges of NBL were constructed. The reference ranges were constructed from the 100(1 , p)% reference range: , where , = 25 , exp(3.58 , 0.044 × t + 0.0006 × t2), with , being the fitted mean of regression model and t being gestational age (weeks). Using fetal NBL, the regression model was Pr(Down syndrome) = exp(W)/[1 + exp(W)], where W = 0.62,4.80 × NBL (multiples of the median) in predicting Down syndrome. Fetal NBL was found to have a sensitivity and specificity of 0.78 and 0.78, respectively, in predicting Down syndrome in the second trimester of pregnancy. Conclusions:, Fetal NBL measurement can provide a simple and useful algorithm to predict Down syndrome during the second trimester of pregnancy. [source] The pre-natal development and osseous growth of the human cerebellar fieldORTHODONTICS & CRANIOFACIAL RESEARCH, Issue 3 2003J.F. Lomholt Structured Abstract Authors , Lomholt JF, Nolting D, Hansen BF, Stoltze K, Kjær I Objectives , To describe the pre-natal development of the bones that enclose the cerebellum and part of the brain stem (the neuro-osteological cerebellar field) in the mid-sagittal plane. Design , Radiographic, cephalometric and histologic examination of normal pre-natal human fetuses; 50 normal fetuses, with crown-rump length of 18,227 mm and approximate gestational age from 6 to 26 weeks. Results , The cerebellar field expressed extensive growth during development both sagittally and vertically. Because of changes in shape, the field was displaced in an anterio-caudal direction. Conclusion , In the present study we recorded normal measurements of size, shape and position of the cerebellar field. These standards can be used as references in skeletal analysis of cases with cranial abnormalities and cerebellar malformations. [source] The nuchal translucency and the fetal heart: a literature reviewPRENATAL DIAGNOSIS, Issue 8 2009S. A. Clur Abstract In this overview the current knowledge of the relationship between an increased nuchal translucency (NT) measurement and fetal heart structure and function in chromosomally normal fetuses is reviewed. Relevant pathophysiological theories behind the increased NT are discussed. Fetuses with an increased NT have an increased risk for congenital heart disease (CHD) with no particular bias for one form of CHD over another. This risk increases with increasing NT measurement. Although the NT measurement is only a modestly effective screening tool for all CHD when used alone, it may indeed be effective in identifying specific CHD "likely to benefit" from prenatal diagnosis. The combination of an increased NT, tricuspid regurgitation and an abnormal ductus venosus (DV) Doppler flow profile, is a strong marker for CHD. A fetal echocardiogram should be performed at 20 weeks' gestation in fetuses with an NT , 95th percentile but < 99th percentile. When the NT measurement is , 99th percentile, or when tricuspid regurgitation and/or an abnormal DV flow pattern is found along with the increased NT, an earlier echocardiogram is indicated, followed by a repeat scan at around 20 weeks' gestation. The resultant increased demand for early fetal echocardiography and sonographers with this special expertise needs to be planned and provided for. Copyright © 2009 John Wiley & Sons, Ltd. [source] Clinical implication of isolated right dominant heart in the fetusPRENATAL DIAGNOSIS, Issue 8 2007Eui Jung Abstract Objective To evaluate the clinical implication of isolated right dominant heart (RDH) in fetal echocardiography. Study design We reviewed the medical records of pregnant women diagnosed with fetal RDH at Asan Medical Center from December 1999 to December 2005. The criteria of RDH were the ratio of right-to-left atrial and ventricular width and the ratio of the diameter of pulmonary artery-to-aorta were greater than 1.5. Fetuses with congenital heart disease, including coarctation of the aorta (CoA), noncardiac anomalies or chromosomal abnormalities were excluded. Results RDH was identified in 44 fetuses. Twenty-nine (66%) were confirmed to have normal heart and 15 (34%) had cardiac anomalies by postnatal echocardiogrphy; 11 CoA, 1 interruption of aortic arch, 1 patent ductus arteriosus, and 2 ventricular septal defect. Mean gestational age at presentation with RDH was later in normal fetuses as compared to fetuses with CoA (p < 0.005). Only 26% (4/15) of fetuses presenting with RDH during the second-trimester were found to have normal heart postnatally, compared with 86% (25/29) of those diagnosed in the third-trimester. Conclusion RDH in the fetus is a risk factor for postnatal CoA particularly when diagnosed in the second-trimester, and should be an indication for neonatal echocardiography. Copyright © 2007 John Wiley & Sons, Ltd. [source] CGH analysis in a cohort of 17 chromosomally normal fetuses with an increased nuchal translucencyPRENATAL DIAGNOSIS, Issue 12 2003Sophie Brisset No abstract is available for this article. [source] Some observations of the structure of the choroid plexus and its cystsPRENATAL DIAGNOSIS, Issue 13 2002Ivan Kraus Abstract The structure of the choroid plexus was studied in five normal human embryos, three normal fetuses and three fetuses with choroid plexus cysts. These were detected by ultrasound and the fetuses were karyotypically normal. The choroid plexus appears in the lateral cerebral ventricles at the seventh developmental week. The early structure is lobulated with vessels running in the mesenchymal stroma and forming capillary nets under the single-layered ependymal epithelium. This embryonal structure is converted into the fetal type during the ninth developmental week as the embryonal capillary net is replaced by elongated loops of wavy capillaries that lie under regular longitudinal epithelial folds. The choroid plexus cysts exhibited accumulation of fluid within distended mesenchymal stroma and did not show the wavy folds on this surface, which was smooth. Within this connective tissue of the cyst wall were distended angiomatous interconnecting thin-walled capillaries. Therefore, filled cavities were not lined by any epithelium. We suggest that fetal choroid plexuses cysts (at least in many cases) are in fact pseudocysts exhibiting angiomatous patterns of capillaries in their walls. Copyright © 2002 John Wiley & Sons, Ltd. [source] Transcervical chorionic villus sampling in multiple pregnancies using a biopsy forcepsPRENATAL DIAGNOSIS, Issue 3 2002Gemma Casals Abstract Objective The aim of this study was to assess the effectiveness and safety of chorionic villus sampling (CVS) performed in multiple pregnancies by means of a transcervical biopsy forceps. Methods The study included CVS performed from January 1990 to March 2000 in our Unit. The results were analysed in two consecutive periods, period A (1990,1994) and period B (1995,2000), in an attempt to assess the effect of increasing experience. Results Seventy-five samplings were performed in 39 multiple pregnancies, 38 twin sets and one triplet. A cytogenetic report was obtained in 73% of cases in period A and in 98% in period B. An abnormal karyotype was observed in 11 samples. The need for subsequent amniocentesis decreased from 38% in period A to 10% in period B. The spontaneous fetal loss rate in chromosomally and structurally normal fetuses before the 20th week decreased from 8.7% in period A to 3.3% in period B. The fetal loss rate after the 20th week was 3.3% in period B and none in period A. It must be noted that in three out of the four cases of fetal loss an amniocentesis was needed after CVS. Conclusion Our results suggest that effectiveness and safety improved with increasing experience. Transcervical chorionic villus sampling allows an earlier prenatal genetic diagnosis in multiple pregnancies and this may be particularly relevant for a safer selective termination when chosen by parents if one of the fetuses has an abnormal karyotype. Copyright © 2002 John Wiley & Sons, Ltd. [source] Infection and fetal loss in the mid-second trimester of pregnancyAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 3 2010Ben ALLANSON Introduction:, Chorioamnionitis is a common cause of second trimester pregnancy loss, usually due to ascending infection. This study investigates the prevalence and bacteriology of chorioamnionitis in cases of spontaneous pregnancy loss in previable gestations (16,22 weeks). Methods:, Fetal losses between 16- and 22-week gestation were identified from the institutional database over a three-year period. Cases with an autopsy were identified, pathology reports reviewed, and maternal features noted (clinical symptoms, blood count and vaginal culture results). Second trimester medical termination for fetal abnormality during the same time period served as controls for the confounding influence of labour. Results:, A total of 101 cases of spontaneous non-anomalous non-macerated fetal losses and 103 control cases of induced loss for fetal anomaly were identified. Median gestation of cases was 19 weeks (interquartile range (IQR) 17, 21) and of controls was 20 weeks (IQR 19, 21). Maternal white cell count was higher in cases (median 13.6 IQR 10.8, 16.6) than in controls (9.9 IQR 7.6, 11.5) (P < 0.01). Seventy-eight (77.2%) of 101 cases and no controls had histological chorioamnionitis. A fetal reaction was identified in 48.7% of cases with chorioamnionitis, and the frequency of fetal reaction increased as gestation advanced (5.3% at 16-week gestation vs 33.3% at 22-week gestation). In cases with chorioamnionitis 36/76 (47.4%) were culture positive, whereas 4/25 (16%) without chorioamnionitis were culture positive. Conclusion:, In otherwise normal fetuses, chorioamnionitis is a common finding in mid-trimester pregnancy loss. Routine culture methods have a low sensitivity for isolation of the causative micro-organisms. This inflammatory process seems to predate the onset of labour and appears a primary mechanism in the aetiology of such losses. [source] Defective development of sensory neurons innervating the levator ani muscle in fetal rats with anorectal malformationBIRTH DEFECTS RESEARCH, Issue 7 2009Kaoping Guan Abstract BACKGROUND: Defects of the pelvic nerve innervation of levator ani muscle are associated with poor postoperative anorectal function in patients with anorectal malformation (ARM). We have previously shown deficient development of motoneurons innervating the levator ani muscle in rats with ARM. In this study we investigate whether there is a deficiency in the development of sensory neurons that innervate the levator ani muscle in rats with ARM. METHODS: ARM was induced by ethylenethiourea (ETU) in fetal rats. Retrograde tracer fluorogold (FG) was injected into the levator ani muscle. Serial transverse sections encompassing the entire length of the lumbosacral spinal cord were examined. The number of FG-labeled sensory neurons was scored and compared between fetuses with ARM and normal fetuses. RESULTS: The number of FG-labeled sensory neurons innervating the levator ani muscle in normal control fetuses, ETU-fed fetuses with no malformation, low type of imperforate anus, high type of imperforate anus, and high type of imperforate anus combined with neural tube defects were determined to be (mean ± SEM) 11,804 ± 2362, 10,429 ± 1708, 2886 ± 705, 1026 ± 425, and 964 ± 445, respectively. FG-labeled sensory neurons in fetuses with imperforate anus with or without neural tube defects were significantly fewer than in control and ETU-fed fetuses without malformation (p < 0.05). CONCLUSIONS: Defective sensory neurons innervating the levator ani muscle is a primary anomaly that coexists with the alimentary tract anomaly in ARM during fetal development. Nerve innervation deficiency of the pelvic muscles contributes to the poor postoperative anorectal functions in ARM patients. Birth Defects Research (Part A), 2009. © 2009 Wiley-Liss, Inc. [source] Detection of malformations in chromosomally normal fetuses by routine ultrasound at 12 or 18 weeks of gestation,a randomised controlled trial in 39 572 pregnanciesBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 6 2006S Saltvedt Objective, To compare the antenatal detection rate of malformations in chromosomally normal fetuses between a strategy of offering one routine ultrasound examination at 12 gestational weeks (gws) and a strategy of offering one routine examination at 18 gws. Design, Randomised controlled trial. Setting, Multicentre trial including eight hospitals. Population, A total of 39 572 unselected pregnant women. Methods, Women were randomised either to one routine ultrasound scan at 12 (12,14) gws including nuchal translucency (NT) measurement or to one routine scan at 18 (15,22) gws. Anomaly screening was performed in both groups following a check-list. A repeat scan was offered in the 12-week scan group if the fetal anatomy could not be adequately seen at 12,14 gws or if NT was ,3.5 mm in a fetus with normal or unknown chromosomes. Main outcome measures, Antenatal detection rate of malformed fetuses. Results, The antenatal detection rate of fetuses with a major malformation was 38% (66/176) in the 12-week scan group and 47% (72/152) in the 18-week scan group (P= 0.06). The corresponding figures for detection at <22 gws were 30% (53/176) and 40% (61/152) (P= 0.07). In the 12-week scan group, 69% of fetuses with a lethal anomaly were detected at a scan at 12,14 gws. Conclusions, None of the two strategies for prenatal diagnosis is clearly superior to the other. The 12-week strategy has the advantage that most lethal malformations will be detected at <15 gws, enabling earlier pregnancy termination. The 18-week strategy seems to be associated with a slightly higher detection rate of major malformations, although the difference was not statistically significant. [source] Changes in nuchal translucency thickness in normal and abnormal karyotype fetusesBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 6 2003Maria A. Zoppi Objective To investigate the dynamic trend of the nuchal translucency thickness between fetuses with normal and abnormal karyotype. Design Prospective observational study. Setting Ospedale Microcitemico, Cagliari, Italy. Population A cohort of 305 first trimester fetuses. Methods Fetuses with a nuchal translucency greater than or equal to the 95th centile were invited for a second nuchal translucency measurement. The finding of an ,increased or unchanged' or ,diminished' thickness was compared in fetuses with normal and abnormal karyotype. Main outcome measures Nuchal translucency and karyotype. Results Median maternal age was 35 years (min 17, max 44) and median crown,rump length at first visit was 50 mm (min 38, max 80). A second nuchal translucency measurement was carried out in 292 fetuses, resulting in increased or unchanged values in 95 cases and decreased nuchal translucency in 197 cases. Two hundred and twenty-six (77.4%) fetuses had normal karyotype and 66 (22.6%) had abnormal karyotype (44 trisomies 21, 10 trisomies 18, 5 trisomies 13, 4 cases of 45 X0, 1 case of 47,XXY, 1 case of 47,XXX and 1 translocation). In the 66 chromosomally abnormal fetuses, the second nuchal translucency measurement was enlarged or unchanged in 37 (56%), and diminished in 29 (44%), while in the 226 normal fetuses the second nuchal translucency measurement was enlarged or unchanged in 58 cases (25%) and diminished in 168 (75%) (relative risk 2.6, 95% confidence interval 1.7,4.0). Conclusion In fetuses with abnormal karyotype, the second nuchal translucency measurement tends to be increased or unchanged, while in normal cases the size of nuchal translucency is generally reduced. [source] Is an atherogenic lipoprotein profile in the fetus a prerequisite for placental vascular disease?BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 4 2000Jian Wang Senior Scientific Officer Objective To measure the blood apolipoprotein A-1 and apolipoprotein B in the fetal circulation in normal pregnancy and in pregnancy with evidence of vascular disease in the fetal umbilical placental circulation defined in the antenatal period by Doppler ultrasound study. Design An observational study to compare fetal plasma apolipoprotein levels in normal and complicated pregnancy. Setting A university hospital tertiary referral obstetric unit. Samples Umbilical vein blood was collected at delivery from 22 normal fetuses delivered by elective caesarean section for non fetal reasons and 30 fetuses with evidence of umbilical placental vascular disease identified antenatally by Doppler ultrasound study. Methods Plasma apolipoprotein A-1 and B were determined using an enzyme-linked immunosorbent assay (ELISA) methods. Main outcome measures Fetal plasma levels of apolipoprotein A-1 and B were measured. Results There was a significantly lower level of fetal plasma apolipoprotein A-1 in placental insufficiency [placental insufficiency vs normal pregnancy, median 0.30 g/L (interquartile range 0.24, 0.39 g/L) vs 0.35 g/L (0.31, 0.42 g/L), P= 0.045]. In contrast, the levels of fetal plasma apolipoprotein B in placental insufficiency [0.20 g/L (0.17, 0.26 g/L)] were significantly increased compared with normal pregnancy [0.16 g/L (0.14, 0.20 g/L), P= 0.03]. The ratio of fetal plasma apolipoprotein B to A-1 was also substantially higher in placental insufficiency [0.68 (0.55, 0.83)] than in normal pregnancy [0.45 (0.36, 0.60), P= 0.0003]. Conclusions Our study has demonstrated that levels of fetal plasma apolipoprotein A-1, apolipoprotein B and the ratio of apolipoprotein B to A-1 were altered in the fetuses who are victims of umbilical placental insufficiency in the same direction as in adults associated with a high risk of atherogenesis. [source] | |||||||||||||