Association between the Concentrations of Essential and Toxic Elements in Mid-Trimester Amniotic Fluid and Fetal Chromosomal Abnormalities in Pregnant Polish Women
Joanna SuliburskaJakub PankiewiczAdam SajnógMagdalena PaczkowskaBeata NowakowskaEwa BakinowskaDanuta BarałkiewiczRafał Kocyłowski
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Abstract:
The present study aimed to investigate the relationship between the concentrations of essential and toxic elements present in the amniotic fluid (AF) and fetal chromosomal abnormalities in pregnant women. A total of 156 pregnant white Polish women aged between 20 and 43 years and screened to detect high risk for chromosomal defects in the first trimester were included in the study. AF samples were collected from these women during routine diagnostic and treatment procedures at mid-gestation (15-22 weeks of their pregnancies). The concentrations of various minerals in the AF were determined by inductively coupled plasma mass spectrometry. Genomic hybridization and cytogenetic karyotyping were performed to detect chromosomal aberrations in the fetuses. The genetic analysis revealed chromosomal aberrations in 19 fetuses (over 12% of all the evaluated women). The major abnormalities identified were trisomy 21 (N = 11), trisomy 18 (N = 2), and triploidy (N = 2). Fetuses with chromosomal abnormalities more frequently showed lower manganese concentration in the AF in the second trimester as compared to those with normal karyotype. A coincidence was observed between high iron levels in the AF and a higher risk of chromosomal abnormalities in the fetuses.Keywords:
Trisomy
Amniocentesis
42 pregnancies were monitored by transabdominal amniocentesis followed by karyotyping. Biochemical assays of cultured amniotic fluid cells, 50 analysis of alpha1-fetoprotein and estimations of the number of y-bodies in the amniotic fluid cells was also made. One chromosomal aberration (47, XY, + 18) was found in 13 pregnancies tested because of advanced maternal age. In 6 pregnancies with a recurrence risk of Down's Syndrom, one fetus with abnormal karyotype (46, XY, 5p-) was detected.
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The effect of amniocentesis and drainage of amniotic fluid on lung development in Macacafascicularis
Summary. Amniocentesis and withdrawal of amniotic fluid was performed on pregnant monkeys ( Macaco fascicularis ) at two stages in development, either between 47 and 64, or between 85 and 95 days gestation. After birth the lungs of each infant monkey were studied using precise morphometric techniques, and compared with those in a control group of animals. The lungs after amniocentesis had alveoli of normal maturity but reduced in number and increased in size, features which both reduce the relative area for gas exchange. There was also a reduction in the number of respiratory airways. These changes occurred regardless of the time of amniocentesis, the amount of fluid removed and even if the membranes were simply punctured with no fluid removal. There is some evidence to suggest that similar sublethal effects may be present in human infants after maternal amniocentesis.
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The amniocentesis to gain increasing importance ought to be examined whether an alteration of the bacterial flora of the amniotic fluid was caused by repeated amniocentesis. 128 samples of amniotic fluid selected by abdominal amniocentesis were placed in microbiological cultures. Bacteria was isolated in 30 cases, originated predominantly by pollution. Under the circumstance of strong sterile conditions the amniocentesis proven even when repeated a diagnostical way of procedure which does not represent any danger to mother nor child.
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In mid-trimester amniocentesis (MTA), 12–15 ml of amniotic fluid is aspirated for cytogenetic analysis. When a similar volume of amniotic fluid is removed by early amniocentesis (EA), it represents a significant proportion of the total amniotic fluid volume in the first trimester. The fluid depletion, which may persist for 7 to 10 days, is considered to impair development of fetal lungs and extremities and, possibly, contribute towards procedure-related congenital abnormalities and miscarriages. By only removing 7 ml of amniotic fluid, we have demonstrated a total miscarriage rate (3·8 per cent) comparable with previous large studies (Table V), a low incidence of respiratory difficulties at birth (2·7 per cent) and a low incidence of fixed flexion deformities (1·6 per cent), at the expense of a small increase in the incidence of culture failure (2·2 per cent). © 1998 John Wiley & Sons, Ltd.
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A dose of 3 g of carnitine was orally administered through 48 hours to six patients, between the 31st and 35th weeks of pregnancy, in a bid to induce foetal lung maturation. The process of foetal lung maturation proper was monitored by transabdominal amniocentesis, prior to and following medication. No increase in surfactants in the amniotic fluid was recordable by means of this method.
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Simultaneous sampling of amniotic fluid from two sites within the amniotic cavity proximal and distal to the fetal mouth was performed. The lecithin-sphingomyelin (L/S) ratio of amniotic fluid obtained close to the fetal mouth was usually higher than that of amniotic fluid obtained from a site distal to the fetal mouth (20 of 26 cases). Differences of up to 0.7 in the two L/S ratios were measured. This suggested that pooling of amniotic fluid phospholipids occurred and in cases of borderline pulmonary maturity the site of amniocentesis may have influenced the predictive value of the L/S ratio.
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