Diagnosis,surveillance, and treatment of the anemic fetus using middle cerebral artery peak systolic velocity measurement

The in utero course of the anemic fetus has improved dramatically, owing to early diagnosis and cordocentesis transfusion. In utero invasive procedures such as amnio- and cordocentesis have become important modalities in the evaluation and treatment of anemic fetuses. However, they carry risks for both the mother and fetus. A valid and sensitive noninvasive means of following the anemic fetus is the evaluation of changes in the middle cerebral artery peak systolic flow velocity (MCA-PSV). This is a sensitive tool for both the evaluation of fetal anemia and response to treatment. Intracerebral vessels respond earliest to the fetal anemic state, and are readily accessible for ultrasound examination. We describe the methodology and evolving clinical applications of MCA-PSV measurement in the fetus, through an overview of the literature describing the development and application of MCA-PSV measurement in fetuses at risk of fetal anemia of various immune and nonimmune etiologies, illustrated by index cases from our center. MCA-PSV measurement is essential in the diagnosis, evaluation, and management of cases of fetal anemia. The use of this modality lessens the need for invasive procedures. The method is readily accessible and should be integrated into the repertoire of all obstetric ultrasound centers. Copyright © 2006 John Wiley & Sons, Ltd.     

The importance of chorionic villus sampling after first trimester diagnosis of cystic hygroma

The prenatal diagnosis of The Turner Syndrome is described at a menstrual age of 12 weeks. Detection of cystic hygroma was followed by vaginal chorionic villous sampling (CVS) which revealed a 45,X karyotype. Early documentation of fetal karyotype in the presence of a cystic hygroma is essential for accurate diagnosis and genetic counselling.     

Studies on the use of power ultrasound in solid–liquid myrobalan extraction process

Focus on eco-friendly processing techniques makes vegetable tanning a viable option in leather processing and establishes the subsequent need for the more efficient methods of extraction in tannin manufacture. Application of ultrasound has been tried in the extraction of tannins from myrobalan nuts in order to improve the extraction efficiency, to perform the extraction under milder process conditions and to reduce the process time. The influence of process parameters such as ultrasonic output power, time and temperature has been studied. Scale-up trials and the use of ultrasound in pulse mode have also been attempted. The results show that a three- to fivefold improvement is possible with ultrasonic output from 20 to 100 W. Extraction efficiency has been calculated from the maximum extractable materials from myrobalan nuts. Extraction efficiency is found to be 90% for ultrasound, 100 W without external heating as compared to 77% for control process at 70 °C for 4 h. Therefore, ultrasound could be employed even dispensing with provision for temperature controls. The use of ultrasound in pulse mode offered 70% extraction efficiency of continuous mode. Scale-up trials indicate that there exists an optimum ultrasonic output power depending on the amount of nuts used, to achieve better extraction efficiency. The effectiveness of ultrasonically extracted tannin solution has also been tested in the tanning process for its applicability. The degree of tanning efficacy has been assessed by shrinkage temperature measurement. The results indicate that ultrasonically extracted tannin solution is suitable for tanning process. Therefore, application of ultrasound in tannin extract manufacture is a viable option with added advantages.     

Membrane fouling control by ultrasound in an anaerobic membrane bioreactor

In this study, ultrasound was used to control the membrane fouling online in an anaerobic membrane bioreactor (AMBR). Short-term running experiments were carried out under different operating conditions to explore feasible ultrasonic parameters. The experimental results indicated that when the crossflow velocity was more than 1.0 m/s, membrane fouling could be controlled effectively only by hydrodynamic methods without ultrasound. When ultrasound was applied, an ultrasonic power range of 60–150 W was suitable for the membrane fouling control in the experimental system. The experimental results showed that the membrane fouling was controlled so well that membrane filtration resistance (ΣR) could stay at 5 × 10¹¹ m⁻¹ for more than a week with the crossflow velocity of 0.75 m/s, which equaled the effect of crossflow velocity of more than 1.0 m/s without ultrasound. Translated from Techniques and Equipment for Environmental Pollution Control, 2006, 7(4): 25–29 [译自: 环境污染治理技术与设备]     

Prenatal diagnosis of a fetus with terminal deletion of chromosome 1 (q41)

Many authors have suggested that individuals affected by a terminal 1q deletion display a phenotypically definable and recognizable syndrome. In all of the 27 cases reported to date, the breakpoints were at band q42 or distally to it. To our knowledge, we report the first case of a terminal 1q41 deletion. Diagnosis was made prenatally by amniocentesis, following ultrasonographic diagnosis of omphalocele, cerebral ventriculomegaly, and increased nuchal fold thickness in a 19-week female fetus. Multiple facial and extremity features were consistent with the proposed distal 1q deletion syndrome; omphalocele, however, has not been reported previously. The absence of liver herniation into the omphalocele sac in this case supports the previously reported association of this finding with chromosomal anomalies.     

A fetus with a parvovirus B19 infection and congenital anomalies

A fetus with multiple structural defects was seen at prenatal ultrasound examination. After termination of the pregnancy a bilateral cleft lip, alveolus, and palate; micrognathia; and webbed joints were seen. Fetal tissues showed indications of infection, intranuclear inclusion bodies, chronic stress, haemolysis, arterial wall damage, and profuse haemorrhage. Parvovirus B19 DNA was detected in fetal tissues by dot hybridization after polymerase chain reaction. The possibility of parvovirus B19 infection leading to congenital malformations is discussed.     

Attitudes to prenatal screening,diagnosis and research among pregnant women who accept or decline an alpha-fetoprotein test

The aim of the study was to describe the opinion of pregnant women who had accepted or declined an alpha-fetoprotein (AFP) test, not only on AFP screening in general, but also on whether every pregnant woman should be offered amniocentesis (AC)/chorionic villus sampling (CVS) and an ultrasound scan for fetal malformations. An additional aim was to describe pregnant women's attitudes concerning continued research in the prenatal field. The study was performed as a questionnaire study in two regions over a 1-year period from 1 October 1988 to 30 September 1989. Results are based on answers from 3331 women who had taken an AFP test and 336 women who had declined the offer of a test. A total of 79 per cent of the women thought that an AFP test, 70 per cent that an ultrasound scan for fetal malformations, and 26 per cent that AC or CVS should be offered to all pregnant women. Fifty-nine per cent of the women were positive towards continued research in the prenatal field. Women who had had an AFP test were generally much more positive towards screening and research than women who had declined, who were generally against. Women who had left school without a high school degree were on average more positive towards the screening issues than women who had this degree. In conclusion, the results obtained in this study strongly suggest that women's attitudes are very dependent on how the prenatal screening programme is already organized in their local area.