Selective feticide of the affected twin by fetoscopic air embolism

Three twin pregnancies, each with one affected fetus (by microcephaly, haemophilia A and spina bifida respectively) were encountered. Selective feticide was performed at the patient's request by injection of filtered air into an umbilical vessel by fetoscopy. The method was successful in all three pregnancies two of which resulted in a live, healthy baby.     

2,3,7,8,-四氯苯噁英对NIH小鼠早期妊娠和生殖激素的影响

用不同剂量的2,3,7,8 四氯苯二英(2,3,7,8 tetrachlorodibenzopdioxin,TCDD)对小鼠胚胎附植数量和生长发育情况进行剂量反应评估,分析TCDD对假孕小鼠子宫蜕膜生长状况的影响以及比较胚胎种植前后染毒效果.所有样本采集血液,测定母体血清雌二醇和孕酮的浓度变化.结果表明,50和100ng·(kg·d)-1TCDD处理的孕鼠,胚胎附植数量明显减少(P<0 05),着床后胚胎出现发育迟缓,质量减轻(P<0 05);同等剂量TCDD处理的假孕小鼠,子宫蜕膜生长受到了极显著的抑制(P<0 01);种植前后染毒效果比较发现种植前期染毒的小鼠胚胎对TCDD更为敏感.母体血清雌二醇浓度随剂量和染毒时段有不同程度的升高,而孕酮浓度则极显著下降(P<0 01).由此表明低剂量TCDD可能通过对生殖激素的干扰,强烈影响NIH小鼠妊娠早期生殖生理状态和着床后胚胎的发育.实验同时证明小鼠也可作为早期妊娠毒物研究的供试动物,用以筛选动物和人类早期妊娠的有害化合物.     

Prenatal diagnosis of sex chromosome aneuploidy: possible reasons for high rates of pregnancy termination

Sex chromosome aneuploidy (SCA), when detected in amniocentesis, is usually an unexpected result of a test carried out for another purpose. For most SCAs, the prognosis is milder and less predictable than trisomy 21, and therefore parents are faced with a difficult decision regarding the option of pregnancy termination. While studies from Europe and the USA report a declining trend in termination rates for SCA, our local experience is different. During the period 1989–1998, we diagnosed 60 SCA (including mosaics) in 20 106 amniocenteses (0.29%) and 48 (80%) of these pregnancies were terminated, a significantly higher proportion than has been reported in Europe and the USA. The present study shows that the difference between our experience and others' may be related to differences in cultural norms and values. Thirty women were interviewed, of whom 23 terminated and seven continued the pregnancy. Interview analyses showed that the main reason behind the decision to terminate the pregnancy was associated with the parents' fear of non-specific abnormality of the child, and concerns about abnormal sexual development. Although genetic counseling practised in our center aims to be non-directive, 56% of the women reported that the counseling was either directive towards termination, or that they at least felt that the counselor's attitude was pro-termination. Most women (93%) reported themselves as having come to terms with their decision. Copyright © 2001 John Wiley & Sons, Ltd.