Prenatal diagnosis and outcomes of five cases of mosaicism for an isochromosome of 20q

Five cases of mosaicism for an isochromosome of 20q have been detected from a total of 50 000 cases analysed for prenatal diagnosis by amniocentesis. Karyotypes were designated mos 46,X_/46,X_,i(20q). In all cases, the abnormal cell line was detected in more than one primary culture, thus fulfilling the criterion for true (level III) mosaicism. Indications for prenatal diagnosis were parental anxiety (two cases), low maternal serum alpha-fetoprotein (AFP) (two cases), and high maternal serum AFP (one case). Level II ultrasounds on all five fetuses were normal, and the abnormal cell line was never detected in fetal blood and/or cord blood. All five pregnancies were continued and had normal outcomes, with birth weights ranging from 2.4 to 3.8 kg. The development of all five children has been normal, with the oldest child in the study now 4 years of age. We suggest that the abnormal cell line in each case was of extrafetal origin, and that this may be one of the more common examples of this phenomenon, occurring in approximately 1/10000 prenatal diagnoses. Mosaicism i(20q) may have been missed in the past because of the higher resolution necessary to detect this subtle change.     

Introduction of early amniocentesis to routine prenatal diagnosis

With growing awareness of the problems associated with prenatal cytogenetic diagnoses after CVS, attempts have been made to provide early amniocentesis as an alternative to CVS. Since 1990, at our clinic the gestational age limit for routine diagnostic amniocentesis has been successively lowered, first to 14 and then to 13 weeks of gestation. Thus, 811 prenatal diagnoses were performed after early amniocentesis at 13 weeks (n = 217) and at 14 weeks of gestation (n = 594). No problems were encountered. Culture failure was never observed in the early samples. Using the criteria ‘number of colonies’ and ‘culture duration until harvest’, early samples taken at 14 weeks did not differ significantly from the controls after standard amniocentesis performed at 15 and 16 weeks, respectively, whereas a minority of samples taken at 13 weeks experienced some delay in culturing. However, in each group at least 85 per cent of samples led to a diagnosis fulfilling our standard criteria of a safe diagnosis (at least 20 metaphases of at least five colonies from at least one primary culture after trypsinization) within 15 days. Some differences between the different groups can be recognized: culture duration of less than 11 days tends to be increasing after standard amniocentesis, whereas long culture duration (more than 20 days) is more often associated with early amniocentesis. However, this trend is only minimal and did not result in an increased risk of missing a diagnosis.     

Limb reduction and chorion villus sampling

Upper limb reduction was diagnosed by ultrasound scan at 17 weeks after chorion villus sampling at 9 weeks' gestation. Pregnancy was terminated and necropsy confirmed limb reduction in an otherwise normal fetus. The relationship of limb reduction to amniotic band syndrome is discussed.     

Gold mining in Siberia and the Far East as a source of mercury contamination of the environment

ＩｎｔｒｏｄｕｃｔｉｏｎＳｉｂｅｒｉａａｎｄｔｈｅＦａｒＥａｓｔａｒｅｔｈｅｏｌｄｅｓｔａｎｄｔｈｅｒｉｃｈｅｓｔｇｏｌｄ ｍｉｎｉｎｇａｒｅａｓｏｆＲｕｓｓｉａ .Ｉｎｔｅｎｓｉｖｅｇｏｌｄ ｍｉｎｉｎｇｈｅｒｅｓｔａｒｔｅｄｉｎｔｈｅｂｅｇｉｎｎｉｎｇｏｆｔｈｅ 19ｔｈｃｅｎｔｕｒｙ(Ｖｙａｚｅｌｓｈｃｈｉｋｏｖ ,1963) .Ｆｏｒｔｈｅｍｏｓｔｐａｒｔｇｏｌｄ ｂｅａｒｉｎｇｏｒｅｓａｎｄｓａｎｄｓｗｅｒｅｐｒｏｃｅｓｓｅｄｗｉｔｈｔｈｅｕｓｅｏｆａｍａｌｇａｍａｔｉｏｎｍｅｔｈｏｄｆｏｒｇｏｌｄｅ…