Potter's syndrome in the second trimester—prenatal screening and pathological findings in 60 cases of oligohydramnios sequence

Fifty-two second-trimester and eight third-trimester (>28/40) autopsies with clinical or pathological evidence of oligohydramnios sequence (“Potter's syndrome”) were reviewed. Twenty-eight cases had renal anomalies (71 per cent in terminations following prenatal ultrasound), 27 had no renal malformation (35 per cent with chorioamnionitis), and five had external assessments only. In 15 cases, the renal lesion was part of a multiple malformation syndrome. Seven cases had a lesion which either recurred in a sibling in the same family or was a recognized autosomal recessive syndrome. Three cases had an abnormal karyotype, two of which had renal anomalies. Maternal serum alpha-fetoprotein (AFP) did not discriminate between cases with renal malformations and those without. Pulmonary hypoplasia was commoner in third-trimester than in second-trimester cases. External appearance and absent umbilical artery were not reliable predictors of underlying internal anomalies. These findings reflect the shift from postnatal to prenatal diagnosis in modern practice. In this series, mainly second-trimester cases, 50 per cent of cases had no malformations, in a condition which is traditionally associated with renal disease. The high incidence of chorioamnionitis suggests that the mechanism of oligohydramnios is occult amniotic fluid leakage. Prenatal diagnosis of oligohydramnios in the second trimester is dependent on ultrasound scanning and a full post-mortem examination is necessary to identify any underlying fetal cause.     

Fetal renal artery flow velocity waveforms in the presence of congenital renal tract anomalies

Colour Doppler flow mapping of the renal arteries and subsequent pulsed Doppler measurement of impedance to flow in these vessels were attempted in 33 fetuses with postnatally confirmed renal pathology. The majority presented with unilateral or bilateral hydronephro-sis (n = 21) and bilateral renal agenesis (n = 8). Renal artery blood flow could be visualized in all, except for the eight cases of bilateral renal agenesis. Bilateral flow velocity recordings were collected in six out of 12 cases of bilateral hydronephrosis and in five out of nine cases of unilateral hydronephrosis. The pulsatility index (PI), as a measure of downstream impedance, was in the normal range in 16 out of 18 kidneys (88 per cent) in bilateral hydronephrosis and in 12 out of 14 kidneys (85 per cent) in unilateral hydronephrosis. The PI was significantly higher in severe hydronephrosis compared with mild hydronephrosis. In four cases of unilateral multicystic kidney, the PI was always higher on the affected side. Colour Doppler flow mapping and pulsed Doppler evaluation may be helpful in our understanding of renal vascularization in renal pathology and in confirming the diagnosis of renal agenesis.     

BIOLOGICAL INDICATORS AND BIOLOGICAL EFFECTS OF ESTUARINE/COASTAL POLLUTION1

ABSTRACT: Sustained interest in and concern about the health status of the aquatic environment has resulted in extensive research focused on (1) effects of pollution on survival, growth, and reproduction of resource species at all life stages; (2) diseases of fish and shellfish, as they may be related to pollution and as they may serve as indicators of environmental stress; and (3) contaminant body burdens in fish and shellfish - their effects on the aquatic animals and their potential effects on humans. Effects, lethal and sublethal, of pollutants on life history stages of fish and shellfish have been documented, as have impacts on local stocks in badly degraded habitats, but as yet there has been no adequate quantitative demonstration of effects on entire aquatic species - probably because of the difficulty in sorting out relative effects of the many environmental factors that influence abundance. Sublethal effects, especially those that result in disease, have been examined intensively, and some diseases and disease syndromes have been associated statistically with pollution. Other pollution indicators (biochemical, physiological, genetic, behavioral, and ecological) have also received some attention, as have body burdens of contaminants in aquatic species. Research, especially that conducted during the past decade, has done much to clarify the many pathways and toxic effects of contaminants on aquatic animals, and has also helped to identify mechanisms for survival of fish and shellfish in the presence of environmental changes caused by human activities.     

Design-based estimators and power analyses of trend tests for the proportion of fish that exhibit gross pathological disorders

Methods for estimating the proportion of fish that exhibit gross pathological disorders and for estimating the variance of these estimates are defined. The methods are for the situation in which a probability-based sampling design is used to collect fish for examination, but geographic locations (rather than individual fish) are assigned probabilities of being selected for sampling. To illustrate the use of the methods, they are applied to data collected during the 1992 EMAP- Estuaries sampling program in the Louisianian Province (i.e., the Gulf of Mexico). Separate estimates of the proportion of fish with gross pathological disorders are computed for demersal species, commercial species, pelagic species, and all species as one group. In addition, a test for trend in the proportion of fish that exhibit gross pathological disorders is defined, and analyses of the power of the test are presented. The power analyses are based on a general underlying model of the random distribution patterns of fish and the random process of catching fish. The power analyses also take into account the features of the sampling designs used for collecting fish. Component parameter estimates were computed using data from the 1992 EMAP-Estuaries sampling program in the Louisianian Province. Results from these analyses suggest that the EMAP-Estuaries sampling designs are capable of detecting a 0.15% change per year in the proportion of fish (all species groups combined) with gross pathological disorders in estuaries of the Louisianian Province over a 12-year period with a power of at least 80%. © Rapid Science 1998