Ultrasonographic scanning of placental thickness and the prenatal diagnosis of homozygous alpha-thalassaemia 1 in the second trimester

In order to evaluate the association between placental thickness (PT) and fetal homozygous alpha-thalassaemia 1 before the appearance of classic ultrasound findings of haemoglobin (Hb) Bart's hydrops fetalis, a total of 473 pregnancies were collected. The control group included 422 normal pregnancies with a gestational age from 14 to 23 weeks and the study group included 51 affected fetuses in the same gestational period. Fetal biparietal diameter (BPD) and PT were measured by high-resolution ultrasound. PT was evaluated against BPD. In the control group, the PT generally increased in parallel with the advancement of gestational age. All PT measurements in the study group were above the mean PT of their respective gestational week in the control group. Forty-six (90 per cent) of the pregnancies in the study group had PT larger than the mean plus two standard deviations of the control group. This study suggests that ultrasound measurement of PT may be a useful aid in the prenatal diagnosis of Hb Bart's hydrops fetalis before its classic findings become apparent in the late second trimester or third trimester.     

The normal fetus of an acardiac twin pregnancy: Perinatal management based on echocardiographic and sonographic evaluation

Experience with three prenatally diagnosed pregnancies complicated by an acardiac twin reveals that ultrasonography and echocardiography are helpful in detecting early signs of in-utero congestive heart failure in the normal twin. The use of Doppler blood flow analysis to determine direction of blood flow, post-mortem placental and fetal angiography, and umbilical cord blood gas determination provided proof that retrograde arterial perfusion occurs in the acardiac fetus. In a fourth pregnancy, an experimental approach to occlude the acardiac twin's umbilical cord was attempted, but was unsuccessful.     

Congenital malformations subsequent to chorionic villus sampling: Outcome analysis of 1048 consecutive procedures

We wished to identify the types and frequencies of malformations among continuing pregnancies exposed to chorionic villus sampling (CVS) and to determine whether selected procedure-related variables differ between the normal and anomalous cohorts. CVS was performed in 1048 patients between May 1988 and January 1992. Prospective assessment of perinatal outcome was ascertained by (1) physician—patient phone contact within 1 week of sampling, (2) ultrasound evaluation of the fetal anatomy at mid-gestation, (3) a detailed post-partum questionnaire completed by the referring obstetrician, and (4) a telephone interview with each patient after the expected date of confinement. Twenty-seven major malformations were documented among 938 pregnancies (live born, n=934; electively terminated, n=4), and included cardiac malformations (5), hypospadias (5), craniosynostosis (2), pyloric stenosis (2), inguinal hernia (2), polydactyly (2), syndactyly, distal extremely hemimelia, anencephaly, hydrocephalus, cleft lip and palate, omphalocele, diaphragmatic hernia, thanatophoric dysplasia, and unilateral cataract. Normal and anomalous cohorts were similar with respect to sampling method (transabdominal/transcervical ratio), mean gestational age at CVS, single-pass success rate, and mean total sample weight. No relationship between any procedure-related variable and the risk of malformation was observed.     

First-trimester ultrasonic diagnosis of twin reversed arterial perfusion sequence

Twin reversed arterial perfusion (TRAP) syndrome sequence is a rare specific anomaly of twin gestation with fused placentae and umbilical anastomosis. This syndrome occurs once in very 35 000–48 000 births and has been described in the second trimester (23-29 weeks of gestation). We report on early sonographic diagnosis (10 and 12 weeks' gestation) of two cases of TRAP sequence, together with their umbilical cord Doppler studies.     

Prenatal diagnosis of acute bladder distension associated with fetal sacrococcygeal teratoma—a case report

A case report of sacrococcygeal teratoma prenatally diagnosed at 23 weeks of amenorrhea, subsequently causing dilatation of both lower and upper urinary tracts is presented. The importance of repeated ultrasonographic evaluation of fetuses with sacrococcygeal teratoma is discussed.     

On Sustainable Development of Social Forestry in Bangladesh: Experiences from Sal (<Emphasis Type="Italic">Shorea Robusta</Emphasis>) Forests

Sustainability in forestry is a complex amalgam of trade-offs among its various dimensions and there is no easy route to achieve sustainable development. It is important that policy process and implementation strategy of these policies should be based on sound information about these trade-offs. There is a growing consensus amongst key forest decision-makers in Bangladesh that traditional forestry is needed to make the transition to more sustainable forestry, which is likely to involve local people in forest management. As a result, the government has initiated a social forestry program from 1981 with the assistance of the Asian Development Bank (ADB) loan and the United Nations Development Program (UNDP) grant and operated mainly in Sal forest areas. The most important objective of this program is to protect, manage, and develop forests in a sustainable way by involving local communities. Although several studies have focused on the management issues of social forestry, none of these studies has evaluated the indicators of sustainable social forestry. The purpose of this study is to evaluate the criteria of sustainable development of social forestry in Bangladesh. The study is based on primary cross-sectional data collected using the multistage stratified sampling technique. In total, 581 social forestry farmers were selected randomly and interviewed using a pre-tested questionnaire. The study evaluated some important components of sustainable development and identified the following conditions of social forestry in Bangladesh:(i) almost all the components of sustainable development of social forestry, although not at the aspiration level, were at good condition;(ii) participants were interested and committed to work with Forest Department in developing social forestry;(iii) they had been utilizing both hard and soft technology in practicing social forestry, although there exists ample scope of development;(iv) income of participants after involving in social forestry had increased, although not at satisfactory level; and(v) process of producing social and material goods had been under progress.However, there exist plenty of scopes for sustainable social forestry development through improving the sustainable development components more carefully.Readers should send their comments on this paper to: BhaskarNath@aol.com within 3 months of publication of this issue.     

Accelerating progress on salt iodisation in Sudan: time for action

This paper uses a public health approach to examine briefly: (a) the progress of universal salt iodisation (USI) in Sudan; (b) the roles of the main actors involved; and (c) the main issues around accelerating USI. The literature, especially that coming from the UN agencies, is analysed and experiences from the recently revitalised USI programme, and related relevant meetings, are distilled. In Sudan the prevalence of goitre is 22 per cent. It is assumed that productivity among the people affected is reduced by 5–25 per cent. Little apparent progress has been made with USI. The Government of Sudan, UN multilateral agencies, international consultative groups, bilateral agencies, global and national non-governmental organisations and, increasingly, the private sector must work together to find innovative approaches to increase awareness of the broader social, public health and nutritional contexts, and to advocate for increased national nd international funding.     

Invasion dynamics of the European shore crab,<Emphasis Type="Italic"> Carcinus maenas</Emphasis>, in Australia

In Australia and most other invaded locations, rates of range expansion by the European shore crab, Carcinus maenas, are typically only a few kilometres per year, despite a planktonic duration upwards of 50 days and off-shore larval development. This relatively static distribution is punctuated by rare episodes of long-distance and large-scale spread, some of which appear to be related to unusual oceanographic conditions and some of which are likely to be human assisted. These observations suggest, first, that long planktonic duration and off-shore development in a marine invertebrate does not preclude very localised recruitment, and, second, that this recruitment norm may be punctuated by brief episodes of wide scale mixing of propagules. Punctuated dispersal has previously been suggested to account for large-scale biogeographic patterns of distribution and speciation, but may also have implications for the processes that stabilise structured spatial metapopulations.     

Transvaginal chorionic villus sampling using transabdominal ultrasound guidance

Transvaginal chorionic villus sampling (CVS) using concurrent transabdominal ultrasound guidance was performed in six women who desired CVS but could not be offered transcervical or transabdominal approaches because of uterine position and placental location. Satisfactory amounts of chorionic villi were obtained in all six cases with no maternal discomfort, an occurrence that contrasts with our experience in transvaginal CVS using endovaginal ultrasound guidance. We believe that transvaginal CVS using concurrent transabdominal ultrasound guidance warrants consideration as an alternative technique for first-trimester CVS in selected patients.     

Prenatal diagnosis of autosomal dominant polycystic kidney disease using flanking DNA markers and the polymerase chain reaction

A prenatal diagnosis was carried out on a 9-week-old fetus at risk for autosomal dominant polycystic kidney disease (ADPKD). Ten members of the family were previously typed using five DNA markers linked to the PKD1 locus on chromosome 16, and one marker linked to the putative PKD2 locus on chromosome 2. The polymerase chain reaction (PCR) was used to amplify the D16S125 locus. Pairwise and multipoint lod scores indicated that the family was most likely segregating a PKD1 mutation. The fetus inherited the disease haplotype from the affected parent. Diagnostic accuracy was greater than 99 per cent, taking into account the possibility of genetic heterogeneity.