Breccias of the Adnet Formation: indicators of a Mid-Liassic tectonic event in the Northern Calcareous Alps (Salzburg/Austria)

Stratigraphy, lithology and depositional structures of Liassic red limestone-breccias of the Adnet Formation, including the 'Adnet Scheck', were studied at several outcrops of the Northern Calcareous Alps (NCA) south-east of Salzburg. A four-fold lithostratigraphic division is proposed for the Adnet Formation of the Osterhorn Mountains: the hemipelagic Schmiedwirt (Sinemurian) and Kehlbach (Carixian) members are separated from the pelagic Saubach Member (Toarcian) by a layer of amalgamated breccias (Scheck Member, probably Domerian to early Toarcian). Several other breccia beds occur locally from the base of the Kehlbach Member up to the lower Saubach Member. Although the sediments overlying the Scheck Member breccias are of coeval age, the ages of the underlying strata are very different. This can be explained by submarine Liassic erosion during a period of resedimentation from the middle Carixian until the early Toarcian. At least 10–15?m of partly lithified sediments were eroded by gravity flows. The entire Kehlbach Member and up to two-thirds of the Schmiedwirt Member were removed at Adnet. The breccias originated from submarine debris flows. Repeated flows over a long period and the depositional setting exclude a triggering by sea-level fluctuations. Most probably they arose from tectonically triggered slumps and slides of superficial sediments. The 'Scheck' was initiated on the steep upper slope of the drowned Triassic Adnet reef and flowed to the north-east.The Pliensbachian to early Toarcian period of tectonic activity indicated by the breccias was the most important during the Liassic in the Osterhorn Mountains and other parts of the NCA. From the large-scale regional distribution of the breccias and in accord with published data, a roughly north-east trending strike-slip fault zone is proposed, crossing the NCA south of the Osterhorn block, with a peaking activity during the Pliensbachian to early Toarcian as the cause of the tectonic movements.     

The association between alpha-fetoprotein and βhcg levels prior to and following chorionic villus sampling in cases that spontaneously miscarried

Maternal serum alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (βhCG) measurements taken prior to chorionic villus sampling (CVS) in 21 patients who subsequently miscarried were compared with measurements in a control group of 113 patients with uneventful pregnancies. Patients with AFP levels of 10 iu/ml or more prior to the CVS had a 4·3 times greater risk of miscarriage (95 per cent confidence interval 1·3–13·6). AFP levels obtained 1 week after the CVS in the 13 patients with late miscarriages were higher than in the control group (P = 0·06). Patients miscarrying had a greater rise in AFP (P = 0·06) and a greater fall in βhCG levels (P = 0·04) following the CVS procedure, compared with the control subjects. Each 10-unit change in the difference between AFP or βhCG levels prior to and 1 week following the CVS was associated with a significantly increased risk for late miscarriage. Elevated maternal serum AFP levels early in pregnancy and changes in AFP and βhCG levels following CVS may predict an increased risk for subsequent miscarriage.     

Adverse outcome in pregnancy following amniotic fluid isolation of Ureaplasma urealyticum

Infections in pregnancy with Ureaplasma urealyticum have been associated with a wide range of adverse outcomes, such as early abortion, stillbirth, prematurity, and neonatal morbidity and mortality. Causality has been difficult to demonstrate secondary to the high prevalence of asymptomatic lower genital tract (LGT) colonization and culture data from inaccessible or potentially contaminated sites. Between 1985 and 1989, 2461 second-trimester genetic amniocenteses were evaluated at the cytogenetics section of the Children's Hospital Medical Center of Akron. All were cultured for the genital mycoplasmas: Mycoplasma hominis and Ureaplasma urealyticum. A total of nine patients were positive, all for Ureaplasma urealyticum, with one patient excluded because of subsequent therapeutic abortion. In addition, complete follow-up data, such as indication for amniocentesis, serum alpha-fetoprotein levels, gestational age at parturition, and out- come of pregnancy, were available on 86 Ureaplasma-negative (U –) patients during an approximate 2-year span within the time-frame of the study. This was in part due to physician response to a questionnaire sent after amniocentesis. Of the eight positive cultures, 100 per cent were associated with an adverse outcome, defined as fetal loss or premature delivery. This was significant compared with the U–group (p<0.001) with a more than eight times greater risk of adverse outcome. Six (75 per cent) resulted in spontaneous miscarriage within 4 weeks of amniocentesis and at less than 21 weeks' gestation. Two (25 per cent) delivered prematurely, with one (12.5 per cent) neonatal death at 24+ weeks. Histological examination of all eight placentae and the seven fetuses revealed a 100 per cent incidence of chorioamnionitis and pneumonia, respectively. In addition, in four of the five cases (80 per cent), cultures were positive for Ureaplasma urealyticum in pure culture from either placenta, fetal lung, or both tissues. The remaining case (20 per cent) was negative for aerobes, anaerobes, and mycoplasmas. The study demonstrates a significant association and supports a causal relationship between isolation of Ureaplasma from mid-trimester amniotic fluid with fetal wastage and premature birth.     

Chorionic villus sampling: Analysis of fetal losses to delivery,placental pathology,and cervical microbiology

A population of 1639 patients were seen for chorionic villus sampling (CVS). Embryonic death was identified at ultrasound in 5.3 per cent of patients. The number of patients undergoing CVS was 1551, with 1416 transcervical procedures and 135 transabdominal procedures. The most common indication for CVS was advanced maternal age. Spontaneous pregnancy losses identified by increased risk of pregnancy loss with increasing aspiration attempts. The total fetal loss for this population was 5.4 per cent with the pregnancy loss estimated due to procedure being 1.2 per cent. Analysis of placentae from patients having CVS and amniocen-tesis showed no differences. Microbiological assessment prior to CVS was similar to previous publications.