There will always be birth defects and pregnancy complications due to factors beyond our control. However, we are rapidly discovering many interventions women can use to optimize their chances of having a healthy pregnancy and baby. Most of these, such as immunization and normalization of a diabetic woman's glycosylated hemoglobin ...

OBJECTIVE: To determine the relation between blood folic acid and serum vitamin B12 in neural tube defect pregnancies using data from the MRC Vitamin Study and a literature review of all studies. DESIGN: Stored blood samples collected as part of a randomised trial of vitamin supplementation in the prevention of ...

OBJECTIVE: The aim of the study was to evaluate the significance of unexplained elevated maternal serum alpha-fetoprotein in singleton pregnancies as a predictor of fetal risk. METHOD: A retrospective study of 1582 consecutive women who attended the antenatal clinic at Oldham and District General Hospital, Oldham, UK, over a 6-month ...

The objective in the Hungarian randomised double-blind controlled trial was to study the preventive effect of periconceptional multivitamin supplementation on neural tube-defects and other congenital abnormalities. There were 2,471 and 2,391 informative offspring (prenatally diagnosed and terminated malformed fetuses, stillborn fetuses, and liveborn infants) in the multivitamin and placebo-like trace ...

Congenital nephrosis of the Finnish type (CNF) is inherited as an autosomal recessive trait which maps to the long arm of chromosome 19. The disease causes massive proteinuria, and renal transplantation in early neonatal life is the only effective treatment. Prenatal diagnosis, usually in high-risk families, depends on the analysis ...

OBJECTIVE: Our purpose was to assess the effect of multifetal pregnancy reduction on maternal serum levels of analytes used for screening low-risk women for fetal chromosome abnormalities and neural tube defects. STUDY DESIGN: Peripheral blood samples were obtained between 15.09 and 20.9 weeks' gestation from 10 consecutive women who had ...

Essential thrombocythemia (ET) in pregnancy is associated with adverse perinatal outcome, which is likely due to thrombosis of the uteroplacental circulation. Obstetrical management is still controversial. Different therapeutic protocols have been adopted, including the use of aspirin, plateletpheresis, and interferon. We herein report a case of ET treated with interferon-2 ...

OBJECTIVE: To determine if unexplained low second-trimester maternal serum unconjugated estriol (MSuE3) is a useful predictor of complications of pregnancy. STUDY DESIGN: Between February 1, 1990, and January 3, 1993, 10,492 patients underwent prenatal screening using second-trimester maternal serum alpha-fetoprotein (MSAFP), maternal serum human chorionic gonadotropin (MShCG) and MSuE3. One ...

The study comprised 2,361 women, each with two consecutive normal uncomplicated pregnancies screened at 15-20 weeks gestation for maternal serum alpha-fetoprotein levels (AFP). In 1,816 of these women, maternal serum human chorionic gonadotropin (hCG) levels were tested as well. The proportion of women who had a second high AFP level ...

A third case of triploid partial molar pregnancy with fetal neural tube and abdominal-wall defect, detected through maternal serum alphafetoprotein and hCG screening for Down's syndrome is reported. A 23-year-old woman had elevated serum alphafetoprotein and hCG levels at routine screening at the 16th week of gestation. Ultrasound examination suggested ...

Thirty years ago, it was suggested that maternal intake of certain vitamins during pregnancy affected the incidence of serious fetal malformations. Subsequent research has revealed that folate (folic acid), a B vitamin, plays a crucial role in the development of the central nervous system during the early weeks of gestation, ...

The objective of the study was to assess whether the association known in singleton pregnancies of high maternal serum alpha-fetoprotein (AFP) or human chorionic gonadotropin (HCG) with adverse outcomes applies also to multifetal gestations. Maternal serum AFP and HCG were evaluated in 207 multifetal pregnancies. High values were defined as ...

The aim of this work was to disclose risk factors associated with birth defects which were heterogeneously distributed in the different geographic regions sampled by the Latin American Collaborative Study of Congenital Malformations (ECLAMC). The material included 2,159,065 hospital births, delivered in the 1967-1989 period in 24 geographic regions of ...

OBJECTIVE: Our purpose was to determine whether third-trimester maternal serum alpha-fetoprotein predicts adverse perinatal outcome and whether use of both second- and third-trimester maternal serum alpha-fetoprotein enhances the positive predictive value for various abnormal outcomes. STUDY DESIGN: A cohort study with obstetric outcome assessed by chart analysis after delivery was ...

OBJECTIVE: Our purpose was to evaluate the origin of alpha-fetoprotein in the maternal circulation and coelomic fluid of pregnancies with an empty gestational sac on first-trimester ultrasonographic examination. STUDY DESIGN: The alpha-fetoprotein level and the affinity of alpha-fetoprotein for concanavalin A Sepharose was measured between 8 and 11 weeks of ...

We investigated the mechanisms of alphafetoprotein (AFP) transfer across the human placenta by correlating measurements of AFP transfer with cytochemical localization of AFP. Placental cotyledons were dually perfused in vitro with either the fetal or maternal perfusate containing umbilical cord plasma as a source of AFP. Steady state AFP clearance, ...

Maternal serum alpha-fetoprotein (MSAFP) concentration values were measured in relation to maternal age and fetal sex in the 16th to 20th gestational weeks in samples taken from 9,556 pregnancies with the outcome of live, mature and healthy infants. Our results show positive significance between MSAFP concentration and maternal age (p ...

OBJECTIVE: To determine the impact of prenatal diagnosis on the birth prevalence of neural tube defects (NTDs) in Atlanta during 1990 through 1991. METHODS: Live-born and stillborn infants with NTDs who were at least 20 weeks' gestation were ascertained by the Metropolitan Atlanta Congenital Defects Program (MACDP), a population-based birth ...

OBJECTIVE: To determine the value of cytogenetic evaluation in fetuses with isolated neural tube defects diagnosed by prenatal ultrasound. METHODS: Fifty-five thousand two hundred sixty obstetric ultrasounds performed for various indications at the Indiana University Prenatal Diagnostic Center from July 1988 to March 1994 were reviewed using a computerized data ...

A group of 13 individuals with neural tube defects (NTD) despite maternal periconceptional folate supplementation was examined to determine precisely which closure sites along the neural tube had failed during embryogenesis. All the common forms of NTD, and thus all the usual closure sites, were represented. This suggests that folate ...

We have evaluated the changes in maternal serum and coelomic fluid biochemical composition following two different methods of cervical ripening, i.e. mechanical and biochemical. Each study group included 20 women between 8 and 12 weeks of gestation who were requesting termination for psychosocial reasons. In the first group, a 3 ...

The reported prevalence of anencephaly and spina bifida in the United States has steadily declined since the late 1960s. During this time, the ability to diagnose these defects prenatally has progressed rapidly. Many U.S. birth defects surveillance systems ascertain defects only among live-born infants or among infants and fetuses beyond ...

OBJECTIVE: Our purpose was to present the findings of a project to determine the efficacy of including routine fetal karyotyping in the investigation of an elevated maternal serum alpha-fetoprotein concentration. STUDY DESIGN: Targeted ultrasonographic examinations were performed in 658 patients with elevated maternal serum alpha-fetoprotein levels. The scans were normal ...

Spina bifida is one of the most common human birth defects. In fetuses with open spina bifida, the spinal cord remains exposed to the amniotic fluid (AF) throughout gestation. Results of prenatal examinations suggest that affected fetuses exhibit leg movement until the third trimester but become paralyzed later in pregnancy, ...

OBJECTIVE: To determine if maternal alpha fetoprotein (AFP) is elevated in lupus pregnancy and, if so, whether it is associated with treatment or outcome. METHODS: Maternal serum AFP values were obtained once during Weeks 16.3 to 31.7 in 54 pregnancies followed prospectively. AFP was measured by the Maryland State Health ...

Normal ranges of amniotic fluid alpha-fetoprotein (AFP) and acetylcholinesterase activity (AChE) are described for gestational weeks 11-14 using rocket gel immunoelectrophoresis for AFP quantitation and a monoclonal antibody (4F19) enzyme antigen immunoassay for AChE activity measurement. The normal ranges were established by the examination of 281 amniotic fluid samples from ...

A unique case of a female born with four major malformations, ectrodactyly, diaphragmatic hernia, ventricular septal defect, and agenesis of the corpus callosum is reported. The patient had a normal birth weight, normal head circumference and a normal karyotype. There was no significant facial dysmorphism. The family history was unremarkable ...

alpha 2A- and alpha 2B-adrenoreceptors (AR), identified by Northern blotting in rat myometrium, showed a differential expression during the course of pregnancy. Indeed, the alpha 2A-AR transcript was present at mid-pregnancy, whereas high levels of alpha 2B-AR mRNA could be detected at term. The role of these subtypes in modulating ...

Since pathologic changes of the placenta have been found in preeclamptic pregnancies, a relationship between fetal-maternal hemorrhage and preeclampsia was investigated. Sixty-two women with singleton pregnancies in the third trimester were studied. Thirty-one of these women with preeclampsia were matched with 31 normotensive healthy pregnant women. Maternal serum levels of ...

OBJECTIVE: To determine the sensitivity of antenatal screening methods for neural tube defects in population-based screening in South Australia in 1986-1991, and whether ultrasound can replace serum alpha-fetoprotein screening in terms of achieving an equivalent level of sensitivity. DESIGN AND SETTING: Ascertainment of all births and terminations of pregnancy with ...

OBJECTIVE: To develop an artificial intelligent diagnostic system with neural networks to determine genetical disorders and fetal health problems by using maternal serum markers ('Triple Test') and maternal age. STUDY DESIGN: A total of 112 pregnant women were referred to Fetal Medicine Unit of Hacettepe University Hospital for fetal ultrasonography ...

We hypothesize that the neurologic deficit associated with open spina bifida is not directly caused by the primary defect but rather is due to chronic mechanical and chemical trauma since the unprotected neural tissue is exposed to the intrauterine environment. We report here that exposure of the normal spinal cord ...

The premammalian forms do not show the metencephalic and myelencephalic divisions of the rhombencephalon. The seven longitudinal grey columns, in relation to the seven nerve components are direct cranial uninterrupted continuations from the spinal cord. The isthmus rhombencephali is a tubular structure. The phylogenetically ancient ependyma rich in tanycytes lines ...

Maternal serum alphafetoprotein (MSAFP) screening has been set up in Asturias, in the north of Spain, in 1987 in order to make possible the prenatal diagnosis of neural tube defects (NTD) to overall pregnancy population. This large study shows the high sensitivity and specificity of MSAFP screening when it is ...

The research represents a trial to demonstrate the changes which probably took place in AFP levels as a tumor marker among pregnant egyptian women suffering from bilharzial and cancerous infestations. It was found that combination of schistosomal infection with pregnancy leads to obvious high significant increase in AFP in late ...

Fetomaternal haemorrhage (FMH) was studied after 46 cordocenteses. alpha-Fetoprotein (AFP) concentration and Kleihauer staining of maternal blood, taken both before and after the procedure, revealed increases in AFP values of more than 40 per cent in 30 per cent of the patients examined; fetal haemorrhage of more than 0.25 ml ...

Neural tube defects (NTDs) are common and serious malformations that originate early in pregnancy. In the United States, approximately 4000 pregnancies each year are affected by the two most common NTDs (spina bifida and anencephaly), and an estimated 2500 infants are born with NTDs. Based on a Public Health Service ...

OBJECTIVE: We hypothesize that loss rates after amniocentesis do not differ in transplacental and nontransplacental taps performed by experienced operators. STUDY DESIGN: Subjects were 1000 women undergoing second-trimester amniocentesis: 745 were referred for maternal age; 132 for positive maternal serum alpha-fetoprotein screens, 41 indicating a risk for fetal neural tube ...

Charles Meryon, an important artist of the 19th century, had a congenital defect in color vision. Meryon recognized this defect during his study of art, and he gradually gave up painting in favor of etching. This biographical article includes reproductions of some of Meryon's etchings and one oil painting. "Ghost ...

We present a catastrophic case of aplasia cutis congenita from a pregnancy complicated by elevated maternal serum and amniotic fluid alpha-fetoprotein levels and a positive acetylcholinesterase. Delivery occurred at 27 weeks 1 day after premature rupture of membranes with chorioamnionitis. The neonate lacked > 90% of its skin and died.

Needle embroyfetoscopy (NEF) permits direct visualization of the embryo/fetus with a specially designed 16-gauge double-barrel instrument sheath which is passed transabdominally into the amniotic cavity. We report the case of a woman with a MSAFP of 2.5 MOM who had declined amniocentesis. A targeted ultrasound examination of the spine revealed ...

We evaluated the pregnancy outcome of all patients with elevations of both maternal serum alpha-fetoprotein and human chorionic gonadotropin since institution of combined serum screening at our program. After analysis of 34,404 samples, 99 patients were found to have significant elevations of both maternal serum alpha-fetoprotein and human chorionic gonadotropin. ...

OBJECTIVE: To audit routine measurement of alpha-fetoprotein (AFP) and acetylcholinesterase in amniotic fluid (AF) samples obtained at second-trimester amniocentesis. METHODS: We reviewed retrospectively 1737 consecutive AF specimens obtained for cytogenetic evaluation over a 4-year period and routinely assayed for AFP and acetylcholinesterase. In all instances, high-resolution ultrasonography was performed before ...

Total alpha-fetoprotein (AFP) concentrations and proportions of AFP non-reactive with the lectin concanavalin A (Con A) were studied in extracellular fluid of 22 first-trimester fetuses. Total AFP concentrations were significantly lower in fetuses with Down's syndrome than in those with Mendelian-inherited diseases and normal karyotypes. The proportion of non-Con-A-reactive AFP ...

The objective of this study was to determine in total prevalence of neural tube defects (NTD) in northeastern France during 1979-1992 inclusive, the impact of prenatal diagnosis on birth prevalence. All births and termination of pregnancy affected by NTD were ascertained from multiple sources thank to our registry of congenital ...

The object of this study was to explore the role of folate in the pathophysiology of neural tube defects (NTD). Maternal and fetal serum and red blood cell folate were assayed in 14 cases of NTDs and compared with 14 controls with other malformations and matched for gestational age (range ...

OBJECTIVE: To assess the impact of prenatal screening on the birth prevalence of three categories of structural congenital anomaly: abdominal wall defects (omphalocele and gastroschisis), renal agenesis/dysgenesis, and limb reduction defects. SETTING: Glasgow, Scotland, United Kingdom. METHODS: Data on the selected defects were obtained retrospectively from the population based Glasgow ...

A 26-year-old pregnant woman was diagnosed as having hepatocellular carcinoma at 16 weeks of gestation when extremely high levels of alpha-fetoprotein were found on a routine screening examination. The pregnancy was terminated, and a right hepatectomy was performed. Although such cases are rare, this one suggests that early measurement of ...

We assayed alpha fetoprotein (AFP) in serum samples from 2,735 women during 14 to 20 weeks of gestation. Serum AFP levels were elevated in the presence of neural tube defect (NTD) and gut atresia in fetus, twin pregnancies, preterm delivery and neonatal complications. In two of the 23 cases of ...

We present data from a case series in France of pregnant women who lost 2 to 14 kg during the first month after conception and whose fetuses developed neural tube defects (NTDs). Preliminary epidemiologic evidence from other data sets suggest that relative lack of weight gain during pregnancy may be ...