Prenatal diagnosis in advanced maternal age. Amniocentesis or CVS,a patient's choice or lack of information?

Ninety-six women of advanced maternal age were interviewed about the way they obtained information on prenatal diagnosis and about how the decision was made as to what procedure was to be performed (transabdominal chorionic villus sampling (TA-CVS) or amnio-centesis). In the CVS group, women visited their physician or midwife earlier in pregnancy (mean 7.1 weeks) than those in the amniocentesis group (mean 10.7 weeks). The availability of prenatal diagnosis was not mentioned during the first antenatal visit in 55 per cent of women from the amniocentesis group as opposed to 25 per cent from the TA-CVS group. Approximately 40 per cent of women eligible for prenatal diagnosis did not receive any information from the referring body prior to counselling at our centre. Only 29 per cent of women who underwent amniocentesis had actually chosen this procedure; 71 per cent were too late to undergo TA-CVS at 12 weeks. It is concluded that information to the patient must be improved in order to ensure early referral for prenatal diagnosis.     

Reproductive behaviour and prenatal diagnosis following genetic termination of pregnancy in women of advanced maternal age

One hundred and fifty-one women of advanced maternal age who underwent genetic termination of pregnancy (TOP) were studied for their reproductive behaviour and the type of procedure for prenatal diagnosis in a subsequent pregnancy. A total of 59 women (39 per cent) had a further pregnancy. In all continuing pregnancies prenatal diagnosis was performed, of which 75 per cent consisted of chorionic villus sampling (CVS). Reproductive behaviour following a genetic termination was negatively correlated with maternal age and parity. Both reproductive behaviour and the choice to undergo a diagnostic procedure in the next pregnancy were independent of the type of diagnostic procedure in the previous affected pregnancy.     

Ecoprofit-Styria-prepare Thirteen pollution prevention case studies in the Styrian industry

The paper focuses upon the organization of a federal state-funded pollution prevention project in the Styrian industry. The project includes 13 companies from the textile, pulp and paper, machine building, wood working and printed circuit board manufacturing industries, covering most of the sectors and sizes in the Styrian industry. It started in January 1994 and will last for one year. It will demonstrate the possibilities of pollution prevention and the need for further research work. This project will make use of the methods and tools that were refined in the Austrian Prepare project. As a first step, a systematic balance of all the inputs and outputs of a company is made, after which the weak points and inefficiencies of material and energy use are identified and the options for improvements, both economical and ecological, are defined. Consequently, modifications in products and production lead to a situation with less waste and emissions. The preliminary lessons from these projects are presented: as a rule, the utilities (consumption of process materials and water, cleaning, energy, preparatory and finishing steps) are treated as black boxes and usually represent a considerable optimization potential. In these areas especially there is usually a lack of information and coordination as well as a need for a systematic and comprehensive approach. Leadership in the company and creative consultants are needed for starting lasting successful pollution prevention projects.