Prenatal sonographic diagnosis of intracranial haemorrhage: Report of a case with a sinusoidal fetal heart rate tracing,and review of the literature

The sinusoidal fetal heart rate pattern has been described in association with severe fetal anaemia, with fetal hypoxaemia, and with the administration of parenteral narcotics. Here, we report a case of decreased fetal movement in which a sinusoidal tracing was recorded. The sonographic diagnosis of a massive fetal intracranial haemorrhage was made. A non-interventive approach was taken and the fetus died soon after in utero. We review 28 previous cases in which the prenatal sonographic diagnosis of fetal intracranial haemorrhage was made, including the underlying maternal and fetal factors and neonatal outcomes. We propose that the sinusoidal tracing in this case was due to the intracranial bleed and suggest that fetal intracranial haemorrhage be considered in the sonographic evaluation of the fetus with a sinusoidal pattern.     

Prenatal diagnosis in two cases of de novo complex balanced chromosomal rearrangements. Three-year follow-up in one case

We report two cases of apparently balanced complex de novo chromosomal rearrangements (BCCR) detected prenatally at 17 weeks and 10 weeks of gestation, respectively. Chromosomes were studied using GTG-banding and fluorescent in situ hybridization (FISH). In one case four chromosomes and in the other case three chromosomes were involved in the rearrangements. One of the pregnancies was terminated and no external or internal abnormalities were detected at autopsy. The other pregnancy continued to term. Level III ultrasound examination showed no abnormalities. The child is now 3 years old and has neither congenital anomalies nor evidence of delayed psychomotor development.     

First-trimester prenatal diagnosis of aspartylglucosaminuria

Fetal aspartylglucosaminuria (AGU) was studied during the first trimester of pregnancy in six at-risk pregnancies using chorionic villus samples. The activity of aspartylglucosaminidase (AGA) was high in five cases, indicating an unaffected fetus. This was confirmed through delivery of healthy newborns with a normal pattern of urinary oligosaccharides. Low enzyme activity in an uncultured biopsy specimen and in cultured amniotic fluid cells in one case demonstrated that the fetus was affected. The pregnancy was terminated and the prenatal diagnosis was confirmed by showing reduced AGA activity in cultured fibroblasts of the fetus.     

Neural tube defects in trisomy 18

In a retrospective survey, the incidence of neural tube defects in liveborn trimsomy 18 was found to be 6·2 per cent. Based on these data one would expect to find trisomy 18 in 1 of the 117 patients with myeloidysplasia; the incidence of trisomy 18 in dysraphic fetuses would be anticipated to be higher. These observations underscore the need for amniocentesis karyotyping of fetuses with neural tube defects, and the importance of careful examination of infants born with neural tube defects.     

Trace element speciation in selected smelter-contaminated soils in Anaconda and Deer Lodge Valley, Montana, USA

Long-term copper smelting in the Anaconda and Deer Lodge Valley area of Montana has resulted in an extensive area of trace element contamination. Aerial extent of contamination is generally established, but total analysis of soils does not correlate to relative degree of impact on vegetation growth. Three pedons (Beaverell, Cetrack and Judco) were analyzed by routine soil characterization methods, aqua regia microwave digestion, sequential chemical extraction, and X-ray diffraction analysis with the objective of providing a better understanding of chemical forms and potential reactivity of selected trace elements (Cd, Co, Cr, Cu, Hg, Mn, Ni, P, Pb). Surface horizons of soils are more acidic than subsoils, with pH for all horizons ranging from 4.0 to 8.7. Beaverell is the most contaminated in the upper 20 cm with the sum of total extractable (SUM_TE) trace elements by microwave digestion ranging from 1836 to 3605 mg kg⁻¹, largest H₂O-soluble (WS) and exchangeable (EX) fractions (e.g. 1.6 and 9.3%, respectively), and smallest residual (RES) fraction (e.g. 14.3%). Cetrack has greater SUM_TE elements than Judco, though a lower WS+EX fraction due to the effects of alkaline pH, carbonates and high P. Oxide (OX), organic matter/sulfide (OM/S), and RES fractions predominate over WS, EX, and specially-sorbed/carbonate-bound fractions (SS/CAR) for all horizons. Copper, Zn, Pb and Cd are elevated in surface over subsurface horizons in these latter fractions, indicating these elements were anthropogenic additions. X-ray data indicate that Pb, Cu, Cr and Cd partially exists as both OX and sulfide mineral forms.