Complications of cordocentesis in high-risk pregnancies: Effects on fetal loss or preterm delivery

Between 1990 and 1993, 166 cases underwent cordocentesis and were followed for at least the following 4 weeks in the Prenatal Diagnosis and Therapy Centre of Vienna University. The indications for the procedure were structural malformations in 46·4 per cent of the cases, other high-risk diagnoses in 48·8 per cent, and maternal age over 35 years in only 4·8 per cent. We investigated retrospectively all cases of complications resulting in fetal loss or preterm labour. Abortion, intrauterine fetal death, chorioamnionitis, and preterm delivery occurred in 0·6, 5·4, 0·6 and 9·0 per cent of these cases, respectively, adding up to a total of 26 cases (15·7 per cent). Although this rate looks relatively high, 20 of the 26 cases had already displayed signs implying a complicated prognosis. Neither maternal age, gestational age, number of attempts, nor placental location correlated with fetal loss or preterm delivery. Significantly higher rates of fetal loss or preterm delivery were observed when cordocentesis was performed in cases diagnosed as duodenal/intestinal stenosis or hydrops–ascites–hydrothroax/hygroma colli (P=0·0488 and P=0·0005). The frequency of complications did not decrease as the experience of the operators increased.     

Pure fetal blood samples obtained by cordocentesis: Technical aspects of 322 cases

Three hundred and twenty-two percutaneous umbilical blood samplings were performed over 4 years in our prenatal diagnostic centre. A 3·5 MHz sector ultrasound transducer was used to guide a 22·5-gauge needle under local anaesthesia. Sampling was performed fcir rapid fetal karyotyping (within 72 h) in 120 cases, for diagnosis of fetal toxoplasmosis in 133 cases, for determination of the severity of Rh immunization in 15 cases, and for diagnosis of congenital rubella in 4 cases. Pure fetal blood was obtained in 98·7 per cent of the cases after two attempts. The approach to the cord was either transamniotic or trans-piacental. Puncturing was preferentially done at the placental insertion of the cord (72·2 per cent of the cases) and the mean blood sample volume was 3·5 ml. The rate of fetal death in utero was 1 9 per cent, including two cases of amnionitis, one trisomy 18, and one severe bradycardia. The failures were due to sampling at an early stage of pregnancy (before gestation week 18), to maternal obesity, oligohydramnios, and the inexperience of the operator.     

Prenatal diagnosis of thrombocytopenia absent radius syndrome by ultrasound and cordocentesis

The prenatal diagnosis of thrombocytopenia absent radius (TAR) syndrome, utilizing ultrasound and cordocentesis, is described. To our knowledge, this represents the first prenatal diagnosis of this condition in an index case. The diagnostic evaluation of a fetus with upper extremity limb reduction defects is discussed.     

Prenatal diagnosis of haemoglobin disorders by cordocentesis at 12 weeks' gestation

Prenatal diagnosis of haemoglobin disorders is accepted to be a useful procedure to avoid births of infants with homozygous diseases. Advances in sampling and molecular techniques, such as polymerase chain reaction (PCR) and chorionic villus sampling (CVS), have made earlier and safer first-trimester prenatal diagnosis possible. However, these procedures need previous studies of at-risk couples, which can be very time-consuming when a number of different β-thalassaemia mutations occur in the region. We describe the possibility of making a first-trimester prenatal diagnosis by cordocentesis and fetal blood analysis at the 12th week of gestation. We found no statistically significant difference (p>0.05) between β/γ values in fetuses at the 12th and 18th weeks of gestation. In seven affected fetuses aborted at the 12th week of gestation, the diagnosis was confirmed in all cases by PCR analysis. These findings suggest that early cordocentesis could be an alternative procedure to CVS and PCR analysis.     

颤蚓对活性污泥沉降性能的影响

系统考察了低、中、高3种不同污泥浓度下(TSS≈4 g·L-1、6 g·L-1和8 g·L-1),一定的颤蚓投加比例对活性污泥沉降性能的影响,并同时考察了颤蚓对污泥特性的影响.研究结果表明,投加颤蚓后60min内,活性污泥沉降速率明显加快,60min时的污泥容积相对于未投加颤蚓前可减少8%～42%;而且.这种效应对污泥浓度高的活性污泥更为显著和有效.然而.通过对污泥特性的分析表明,颤蚓在短时间内(1～3h)对污泥平均粒径、Zeta 电位并无多少影响;此时污泥容积指数(SVI)和胞外聚合物含量(EPS)却反而略有增加.     

有机物对ANAMMOX反应器运行性能的影响

研究了有机物对ANAMMOX反应器运行性能的影响.在没有有机物的条件下,进水基质(氨氮和亚硝氮)浓度为70～280 mg·L-1,容积总氮负荷为0.29～0.72 kg·m-3·d-1,氨氮去除率86.0%～99.7%,亚硝氮去除率88.7%～99.3%.添加有机物(酵母膏100 mg·L-1)后,ANAMMOX反应器运行性能与容积总氮负荷有关.容积总氮负荷低于0.43 kg·m-3·d-1时,有机物对ANAMMOX反应器运行性能的影响较小,氨氮和亚硝氮去除率保持在94%以上;但当容积总氮负荷为0.72 kg·m-3·d-1时,有机物对ANAMMOX反应器运行性能产生严重影响,氨氮和亚硝氮去除率降至75%以下.停止添加有机物并降低容积总氮负荷,可在短期内消除有机物对ANAMMOX反应器运行性能的影响.     

盐度对厌氧氨氧化反应器运行性能的影响

考察了厌氧氨氧化反应器处理高盐度、高浓度含氮废水的可行性.结果表明,高盐度显著抑制厌氧氨氧化活性,这种抑制具有可逆性.在30g·L-1(以NaCl计)盐度条件下,未驯化泻泥的厌氧氨氧化活性比对照(无盐水质条件)低67.5%;驯化污泥的厌氧氨氧化活性只比对照低45.1%.由高盐环境转移到低盐环境(无盐水)时,驯化污泥的厌氧氨氧化活性可提高43.1%.通过逐渐提高盐浓度,并调整反应器容积负荷避免基质抑制,可使厌氧氨氧化反应器适应30g·L-1(以NaCl计)盐度,其处理效能与对照期接近.但由于高盐度条件对厌氧氨氧化细菌生长的负面影响,反应器长期运行于高盐度条件下,容易出现功能衰退.     

磷酸盐对CANON工艺的脱氮特性研究

为考察全程自养脱氮(CANON)处理高浓度含氮磷废水的可能性,以人工配制高氨氮废水为进水,研究了磷酸盐对连续流CANON工艺的脱氮性能的影响.结果表明:CANON反应器控制p H在7.60~7.80,HRT为16.5 h和温度(30±1)℃的条件下,当磷酸盐浓度为30 mg·L~(-1)时,反应器的脱氮性能达到最高,NH+4-N平均去除率为98.3%,TN的平均去除率85.3%,NRR为1.1 kg·m~(-3)·d-1.磷酸盐浓度大于30 mg·L~(-1)时,反应器内的微生物浓度逐渐降低,总氮去除效率逐渐降低.在整个磷酸盐试验期间,磷酸盐对短程硝化无明显影响,而对ANAMMOX反应影响较大.