Methods for prenatal assessment of fetal cardiac function

Fetal cardiac function is increasingly recognized as a marker of disease severity and prognosis in selected fetal conditions. Magnetic resonance imaging (MRI) has been used in experimental (animal) fetal cardiology but the lack of a noninvasive fetal electrocardiogram (ECG) to trigger image acquisition remains a major limiting factor precluding its application in humans. Fetal medicine specialists are therefore limited to ultrasound to evaluate human fetal cardiac function. In this review, we aim to provide a complete overview of the different ultrasound techniques that can be used for fetal cardiac function assessment and we discuss their (theoretical) strengths and shortcomings. Conventional methods include M-mode assessment of ventricular contractility and Doppler assessment of the precordial veins and cardiac output (CO). More recent techniques such as the measurement of the myocardial performance index (MPI), myocardial motion analysis with tissue Doppler, speckle tracking and three-dimensional (3D) ultrasound techniques are also discussed. Copyright © 2009 John Wiley & Sons, Ltd.     

Association of serum levels of perfluoroalkyl substances with gestational diabetes mellitus and postpartum blood glucose

This study was conducted to examine the association of perfluoroalkyl substance(PFAS)exposure with gestational diabetes mellitus(GDM) risk and postpartum fasting blood glucose.We used a 1:2 matched case–control study with 84 GDM subjects and 168 healthy pregnant women from Beijing, China. The maternal blood was collected at 1–2 days before delivery, and eight linear isomers and fourteen branched isomers were determined in maternal serum.Logistic regression analyses were performed to evaluate the associations after adjusting for potential confounders. The median of the sum of levels of total PFASs was 4.24 ng/m L with a interquartile range(IQR) of 2.82–6.54 ng/m L. Although maternal PFAS exposure was not associated with risk of GDM, significant positive associations were observed between evaluated exposure to specific PFAS congeners and increasing blood glucose. The odds ratio(ORs) of the highest category of postpartum fasting blood glucose for perfluoro-1-metylheptylsulfonat(1 m-PFOS), perfluoro-3/4-metylheptylsulfonat(3 m+4 m-PFOS), perfluoro-5-metylheptylsulfonat(5 m-PFOS), and perfluorohexane sulfonate(PFHx S) were 2.03(95% CI: 1.09–3.77), 1.93(95% CI:1.04–3.58), 2.48(95% CI: 1.33–4.65), and 2.26(95% CI: 1.21–4.21), respectively, suggesting negative effects of maternal exposure to specific PFAS compounds on glucose metabolism.     

True trisomy 15 mosaicism,detected by amniocentesis at 12 weeks of gestation and fetal echocardiography

A case of mosaicism of trisomy 15, with two-thirds of the cells trisomic, was detected at 12 weeks of gestation in amniotic fluid cell cultures obtained with the filtration technique. Ultrasound examination at 13 weeks showed a nodule protruding into the amniotic cavity which was speculated to be remnants of a co-twin, causing the trisomic cell line. At 20 weeks of gestation, a malformation scan (level III) was normal, but supplementary fetal echocardiography revealed a severe cardiac defect (mitral atresia and a ventricular septal defect). Fetal lymphocytes obtained by cordocentesis showed trisomy 15 mosaicism, but only in 5 per cent of the mitoses. After termination, the same percentage of trisomy 15 mosaicism was found in cells from skin and tendon as in the original early amniocentesis. No sign of earlier twinning was found in the placenta or membranes. We conclude that mosaicism in early amniotic fluid obtained by the filter technique in this case reflected the true karyotype accurately and that supplementary echocardiography added significantly to the interpretation of the clinical implications.     

Maternal serum free α- and free β-human chorionic gonadotrophin in pregnancies with insulin-dependent diabetes mellitus: Implications for screening for Down's syndrome

A study was performed to investigate the concentrations of the α and β free sub-units of human chorionic gonadotrophin (free α-hCG and free β-hCG) in maternal serum between 15 and 22 weeks of pregnancy in 126 pregnancies among 92 women with insulin-dependent diabetes mellitus (IDDM). Each IDDM pregnancy was matched with two control singleton pregnancies for gestational age (same completed week) and duration of sample storage (same calendar quarter). The median free α-hCG level in the IDDM pregnancies was 0·86 multiples of the median (MOM) for pregnancies without IDDM at the same gestational age (P<0·002) (95 per cent confidence interval 0·80–0·94). The corresponding free β-hCG level was 0·96 MOM (95 per cent confidence interval 0·85–1·09). These results enable free α-hCG values to be adjusted so that antenatal screening for Down's syndrome can be performed using this marker in IDDM pregnancies as well as in non-diabetic pregnancies.     

不同填料甲苯生物滤塔中微生物群落结构与代谢功能解析

对填料为珍珠岩、玻璃珠和聚苯乙烯泡沫(EPS)的甲苯生物滤塔中微生物群落的结构和代谢功能进行了分析.结果表明,在稳定运行阶段,生物滤塔的微生物群落结构相似且与接种物存在较大差异.3种填料的生物滤塔中在门水平上的优势菌均为变形菌门Proteobacteria(36.1%~67.5%)、放线菌门Actinobacteria(4.3%~43.4%)、厚壁菌门Firmicutes(3.0%~16.4%)和拟杆菌门Bacteroidetes(1.9%~10.2%);属水平上,相同的优势属为红球菌属Rhodococcus(2.4%~38.5%)和假单胞菌属Pseudomonas(5.9%~25.3%),在珍珠岩生物滤塔中相对丰度更高的属为戴沃斯氏菌属Devosia、戈登氏菌属Gordonia和根瘤菌科某属Rhizobiales_E,在玻璃珠和EPS生物滤塔中相对丰度更高的属为着色菌科某属Chromatiaceae_A和Fluviicola.不同填料的生物滤塔中微生物群落整体碳源代谢能力相似且相比接种物均显著下降,微生物群落结构与代谢呈现一致性,多样性水平均为珍珠岩EPS玻璃珠.与接种物相比,不同填料的生物滤塔中微生物结构物种多样性都降低,代谢多样性都升高.