Factors associated with multiple-pass procedures during chorionic villus sampling: A video analysis

Multiple placental passes during chorionic villus sampling (CVS) increase the risk of fetal loss; however, specific factors that predispose to repeat aspiration have not been delineated. To identify anatomic and technical variables associated with multiple-pass procedures, a detailed review of 205 videotaped CVS procedures (single pass = 163; multiple pass = 42) was performed, blinded to pregnancy outcome. The route of sampling did not influence the need for multiple aspiration attempts (transabdominal—30/ 135; transcervical—12/70), nor was placental location alone discriminatory. However, the combination of a posterior placenta and uterine retroversion was observed more frequently in the multiple-pass cohort (8/42 vs. 9/163; p<0.05). In transabdominal cases, suboptimal needle placement (e.g., perpendicular to the placental long axis) was more common in the initial aspiration of a multiple-pass procedure (21/30 vs. 38/105;p<0.01), while limited penetration of the catheter tip (e.g., just inside the placental edge) characterized a majority of multiple-pass cases in the transcervical subset (7/12 vs. 3/58; p<0.0001). A case-control cohort was constructed to evaluate the impact of these technical variables on sampling efficacy, independent of the influence of uterine position and placental site. In that analysis, suboptimal location and/or orientation of the sampling device remained characteristic of multiple-pass cases. We conclude that further reduction in the frequency of multiple-pass procedures might be achieved by consistent placement of the device tip in the central placental mass. Unlike amniocentesis, where any point of amnion entry will suffice, this technical nuance should be emphasized with CVS to maximize the single-pass success rate.     

The significance of prenatal diagnosis of choroid plexus cysts

A case is described of the prenatal diagnosis of choroid plexus cysts at 17 weeks' gestation which persisted beyond 36 weeks but could not be detected after delivery. At birth the child was found to have trisomy 18.     

Serial Elastic Elements in the Damselfly Wing: Mobile Vein Joints Contain Resilin

 Two main types of joints occur in the damselfly wing: mobile and immobile. Some longitudinal veins (RP2^–, RP3&4^–, and MP^–) are elastically joined with cross veins, whereas other longitudinal veins (IR1⁺, IR2⁺, MA⁺, CuA'⁺) are firmly joined with cross veins. In this study we mapped the distribution of serial elastic elements in the wing. The occurrence of resilin, a rubberlike protein, in mobile joints suggests that the automatic twisting mechanism of the leading edge by aerodynamic force works not by flexibility but by the elasticity of these joints. First, it should result in elastic energy storage in the distal areas of the wing. Second, serial elastic elements of wing presumably act as dampers of an aerodynamic force, which are responsible for gradual twisting of the leading edge. Received: 16 March 1999 / Accepted in revised form: 26 August 1999     

Exclusion of citrullinaemia in the first trimester of pregnancy by direct assay of argininosuccinate synthetase in chorionic villi

Citrullinaemia was presumed to be excluded in a fetus at risk by the direct assay of argininosuccinate synthetase in chorionic villi. The diagnosis was confirmed after amniocentesis by normal argininosuccinate synthetase activity in the cultured amniotic fluid cells and by a normal citrulline concentration in the amniotic fluid. The prediction of a normal fetus was confirmed at term by the birth of a non-citrullinaemic boy.     

Forestry Mitigation Options for Mexico: Finding Synergies between National Sustainable Development Priorities and Global Concerns

We examine carbon (C) reference and mitigation scenarios for the Mexicanforest sector between the year 2000 and 2030. Estimates are presentedseparately for the period 2008–2012.Future C emissions and capture are estimated using a simulation modelthat: a) allocates the country land use/land cover classes among differentfuture uses and categories using demand-based scenarios for forestryproducts; b) estimates the total C densities associated to each land usecategory, and c) determines the net carbon implications of the process ofland use/cover change according to the different scenarios.The options analyzed include both afforestation/reforestation, such ascommercial, bionenergy and restoration plantations, and agroforestrysystems, and forest conservation, through the sustainable management ofnative forests and forest protection.The total mitigation potential, estimated as the difference between the totallong-term carbon stock in the reference and the mitigation scenario reaches300 × 10⁶ Mg C in the year 2012 and increases to 1,382 × 10⁶ Mg C in 2030. The average net sequestration in the 30 year period is 46 × 10⁶ Mg C yr^-1, or 12.5 × 10⁶ Mg C yr^-1 within the period 2008 to 2012. The costs of selected mitigation options range from 0.7–3.5 Mg C^-1 to 35 Mg C^-1. Some options are cost effective.