Prenatal diagnosis of a rare heteropagus

The prenatal diagnosis by ultrasound of an unusual case of supernumerary head is reported. The problems of differential diagnosis, the pathological findings after voluntary interruption of the pregnancy, and the problems of obstetric management are presented.     

The safety of fetoscopy: (I). Effect of umbilical vessel puncture on the fetal heart rate and cord histology

The fetal heart rate (FHR) was continuously monitored during 42 umbilical vessel punctures performed at the placental insertion of the cord in 24 diagnostic fetoscopies in which pure fetal blood was obtained. In only one patient did a deceleration first appear during puncture and aspiration of fetal blood. In two patients decelerations preceded fetoscopy and in two others they began during the fetoscopy but before puncture of an umbilical vessel. In 19 patients, the FHR did not change at all during the procedure. Fetal haemorrhage after sampling was either absent or minimal. Six pregnancies were terminated because a positive diagnosis had been made and 18 healthy babies were born. Umbilical cords were examined after 7 terminations of pregnancy and after 6 deliveries. In the former group the puncture could just be seen with the naked eye and the needle track was demonstrated histologically in 6. No traces of the puncture or other abnormalities were found in the cords after delivery. Fetal blood sampling from umbilical cord vessels, particularly at the placental insertion of the cord, is the technique of choice since pure fetal blood can be obtained without increasing the risk of fetoscopy.     

Natural background concentrations of nutrients in the German Bight area (North Sea)

Natural background concentrations of nutrients are needed for the assessments of eutrophication processes and their status. Natural background concentrations of total nitrogen (TN) and total phosphorus (TP) were modelled for the rivers discharging into the German Bight and the Rhine considering individual catchment sizes, freshwater flows and soil types. These data were validated by comparison with data from unpolluted rivers. The consistency of modelled and some compiled nutrient concentrations was confirmed by their area-specific load dependency on freshwater discharges. Pristine inorganic nutrient concentrations were deduced from modelled relations to TN and TP in unpolluted rivers. Pristine nutrient gradients between rivers and offshore waters were estimated by linear mixing until a salinity of 32, continued by hyperbolic fits towards recent mean offshore values (salinity 34.5?C35). Based on these gradients and recent mean salinities, maps of pristine surface gradients were plotted for the whole German Bight. Variability was transferred from recent conditions as percentage of standard deviation. Reported historical nutrient data and concentrations from unpolluted rivers, coastal and offshore North Sea waters are discussed concerning their relations to natural background conditions.