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.     

姜黄素对宫颈癌淋巴转移动物模型干预效应研究

目的 研究姜黄素对IGF-1调控的宫颈癌淋巴转移动物模型的研究.方法 建立宫颈癌淋巴转移鸡胚尿囊膜（CAM）模型,并观察姜黄素对IGF-1调控的淋巴管生成的作用.结果 ①在健康受精的SPF鸡胚的CAM上接种不同浓度的Hela细胞悬液1×103/L～1×108/L存活率差异没有统计学意义.1×107/L为最适接种浓度.②移植瘤组织切片HE染色课件癌细胞聚集成癌巢,与人宫颈癌形态相似.免疫组化染色,可见移植瘤内有微淋巴管形成③对照组、IGF-1组、Cur组和IGF-1＋ Cur组的LMVD依次为21.28±10.13、28.58±12.26、16.23±8.76和18.23±9.36条/4HP,LVA依次为2.91±1.16、3.42±1.25、2.00±1.51和2.72±1.21％,差异具有统计学意义（P＜0.05）.结论 在鸡胚人宫颈癌移植瘤模型中可观察到姜黄素对IGF-1调控的宫颈癌淋巴管生成的抑制作用.图3,表3,参9.