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Frans J Hoek - One of the best experts on this subject based on the ideXlab platform.
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umbilical vein administration of oxytocin for the management of retained placenta is it effective
American Journal of Obstetrics and Gynecology, 1991Co-Authors: Maarten G P Huber, Hajo I J Wildschut, Kees Boer, Gunilla Kleiverda, Frans J HoekAbstract:In a multicenter randomized controlled trial involving 220 women with retained placenta no beneficial effects could be established of intraumbilical vein administration of 10 IU of oxytocin in 20 ml of saline solution. A reduction was not gained in the rate of manual removal of the placenta and there was no decrease in the amount of blood loss. Oxytocin only induced a minor shortening of the median time interval from administration to the spontaneous expulsion of the placenta as compared with a placebo injection. Maternal serum a-fetoprotein levels before and after intraumbilical vein injection did not show evidence of Fetomaternal Transfusion.
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Umbilical vein administration of oxytocin for the management of retained placenta : is it effective ?
American Journal of Obstetrics and Gynecology, 1991Co-Authors: Maarten G P Huber, Hajo I J Wildschut, Kees Boer, Gunilla Kleiverda, Frans J HoekAbstract:In a multicenter randomized controlled trial involving 220 women with retained placenta no beneficial effects could be established of intraumbilical vein administration of 10 IU of oxytocin in 20 ml of saline solution. A reduction was not gained in the rate of manual removal of the placenta and there was no decrease in the amount of blood loss. Oxytocin only induced a minor shortening of the median time interval from administration to the spontaneous expulsion of the placenta as compared with a placebo injection. Maternal serum a-fetoprotein levels before and after intraumbilical vein injection did not show evidence of Fetomaternal Transfusion.
Diana W Bianchi - One of the best experts on this subject based on the ideXlab platform.
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the influence of fetal loss on the presence of fetal cell microchimerism a systematic review
Arthritis & Rheumatism, 2003Co-Authors: Kiarash Khosrotehrani, Kirby L Johnson, Alain Dupuy, Diana W BianchiAbstract:Objective Fetal cells enter the maternal circulation during most pregnancies. Their persistence for years occurs in only some women and has been associated with several autoimmune diseases such as systemic sclerosis. The objective of this study was to determine whether pregnancy history influences the persistence of fetal microchimeric cells. Methods We reviewed all reports of studies on fetal cell microchimerism, defined as male DNA in maternal tissue, that describe individual pregnancy histories, disease diagnoses, and microchimerism status. The total numbers of pregnancies, births, and sons, the history of fetal loss (spontaneous abortion and elective termination), and the presence of a maternal autoimmune disease were tested as factors potentially associated with persistent microchimerism. Results One hundred twenty-four subjects from 11 studies met the inclusion criteria. Only fetal loss was significantly associated with the presence of microchimerism (odds ratio 2.4, 95% confidence interval 1.2–6.0). Conclusion These results suggest that Fetomaternal cell trafficking following fetal loss may be important for the engraftment of microchimeric cells in maternal tissue. This may be due to an increased amount of Fetomaternal Transfusion or to transfer of a cell type that is more likely to engraft. We recommend that investigators in future studies on microchimerism report detailed pregnancy information, since these data are critical for the understanding of factors that influence the development of fetal cell microchimerism.
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Fetal Cell-free Plasma DNA Concentrations in Maternal Blood Are Stable 24 Hours after Collection: Analysis of First- and Third-Trimester Samples
Clinical Chemistry, 2003Co-Authors: Robert M. Angert, Erik S. Leshane, Lisa Y.s. Chan, Laurent C. Delli-bovi, Diana W BianchiAbstract:The discovery of intact fetal cells in maternal blood has led to the possibility of noninvasive prenatal genetic testing. Although extensive work has been performed on maternal blood in the hope of developing a reliable method for the recovery of intact fetal cells, the total number of recoverable cells is quite small, averaging 19 nucleated fetal cells in 16 mL of blood (1)(2). This is contrasted by a relatively large amount of cell-free fetal DNA detectable in maternal plasma (3). Recent studies suggest that cell-free fetal DNA in maternal plasma can be used as a diagnostic tool for diseases of pregnancy, such as preeclampsia or preterm labor, or for fetal anomalies, such as Down syndrome (4)(5)(6)(7). Because of these potential applications, it is of great importance to determine whether cell-free fetal DNA concentrations remain stable in a test tube after phlebotomy. In this report we evaluate the effects of time after phlebotomy on the quantity of cell-free fetal DNA in blood samples from a pregnant woman and a woman who has just undergone termination of pregnancy. The post-termination samples were used because in the first trimester, there are relatively few fetal cells present in maternal blood. The termination procedure increases Fetomaternal Transfusion (8). We hypothesized that after phlebotomy, apoptotic fetal cells that die in the venipuncture tube would release their DNA. We also asked whether more fetal cells undergo apoptosis as a result of exposure to the maternal bloodstream and cytokines. In both cases, we hypothesized that cell-free fetal DNA concentrations would increase in the blood samples over time. This study was performed with Institutional Review Board approval and with informed consent from participants at Tufts-New England Medical Center. For early-gestation samples, 29 women who were 6–17 weeks pregnant were recruited from …
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fetal cells in the mother from genetic diagnosis to diseases associated with fetal cell microchimerism
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2000Co-Authors: Diana W BianchiAbstract:Abstract Fetal cells circulate in the blood of pregnant women. When the gestation is normal, fetal cells are low in number. Complications of pregnancy, such as pre-eclampsia, or fetal cytogenetic abnormalities, such as Down’s syndrome, increase Fetomaternal Transfusion. The isolation of fetal cells from maternal blood is currently under active investigation as a non-invasive method for prenatal diagnosis. The fetal cells that are most commonly used for non-invasive genetic diagnosis, the nucleated erythrocyte and the trophoblast, are highly differentiated and do not persist post-partum. In the context of studying fetal cells in maternal blood it was discovered that fetal progenitor cells originating from a prior pregnancy could also be detected. This led to the appreciation that unlike fetal DNA in plasma, which is cleared almost immediately following delivery, fetal cells persist for decades post-partum. Following pregnancy, labor, and delivery, a woman becomes a chimera. Transfused fetal stem and progenitor cells appear to be capable of further differentiation and migration to maternal organs. A further research agenda is needed to explore the newly appreciated phenomenon of bi-directional Fetomaternal cell trafficking. Any consideration of the fetus as a patient must also consider the fetus as a potential source of therapeutic stem cells for the mother.
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First trimester prenatal diagnosis: fetal cells in the maternal circulation.
Seminars in Perinatology, 1999Co-Authors: Barbara Pertl, Diana W BianchiAbstract:The recovery of fetal cells from the maternal circulation represents a promising approach to noninvasive prenatal diagnosis. Advances in techniques of sensitive molecular genetic analysis have enabled the conclusive demonstration of the presence of fetal cells in maternal blood. In most pregnancies, there are few fetal cells detectable. In some abnormal pregnancies, there appears to be increased Fetomaternal Transfusion, which facilitates recognition of aneuploid fetal cells. This review article describes general strategies of fetal cell isolation, current technical challenges, and clinical applications that are envisioned for the future. The increased appreciation of fetal cell microchimerism, and its association with complications of pregnancy and the postpartum development of autoimmune disease, is also discussed.
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Current knowledge about fetal blood cells in the maternal circulation.
Journal of perinatal medicine, 1998Co-Authors: Diana W BianchiAbstract:The aim of this review is to summarize the current status and future prospects of noninvasive prenatal genetic analysis by the isolation of fetal cells from the maternal circulation. The presence of fetal cells in maternal blood is no longer considered controversial. A variety of cell separation methods recover fetal cells from maternal blood; these differ in cost-effectiveness and required expertise. Fetal cell types that are useful for prenatal diagnosis are terminally differentiated and are unlikely to persist post-partum. Most investigators are isolating trophoblast sprouts, nucleated erythrocytes, or both from maternal blood. Advances in the understanding of cell surface and cytoplasmic protein expression have translated into better and more specific fetal cell identification. Fetal cells, once identified, are being screened for the presence of aneuploidy using chromosome-specific probes on interphase nuclei. Significant progress in single gene and single cell analysis has expanded the diagnostic possibilities for noninvasive fetal testing. Although fetal cells are generally rare in maternal blood samples, they appear to be more common when the fetus has trisomy 21. This is beneficial for clinical diagnosis. Furthermore, a large Fetomaternal Transfusion occurs at the time of labor and delivery in all pregnant women. This may establish fetal cell microchimerism in the mother, which may be implicated in the subsequent development of diseases such as scleroderma that are more common in women. The study of fetal cells in maternal blood, while technically challenging, provides a unique opportunity to explore the immunobiology of pregnancy.
A. Pál - One of the best experts on this subject based on the ideXlab platform.
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Fetomaternal Transfusion after amniocentesis and cordocentesis
Irish Journal of Medical Science, 2011Co-Authors: J. Sikovanyecz, E. Horváth, N. Pásztor, A. Keresztúri, J. Szabó, A. PálAbstract:Objective To compare the extent of Fetomaternal Transfusion after amniocentesis and cordocentesis. Setting Three-hundred and forty-five amniocentesis and 268 cordocentesis were performed for genetic indications. The extent of Fetomaternal Transfusion was calculated on the basis of the maternal serum alpha-fetoprotein level changes. Results The mean Fetomaternal Transfusion was 6.3 and 62 μL in the amniocentesis and cordocentesis groups, respectively. Transplacental needle passage and longer procedural time were risk factors for Fetomaternal Transfusion. The frequency of transplacental passage was higher and the procedural time was longer in the cordocentesis group. The fetal loss rate was 1.17% after amniocentesis and 1.2% after cordocentesis, respectively. Conclusions Cordocentesis causes more injury to the extrafetal compartment, which results in a higher level of Fetomaternal Transfusion. However, though a nearly ten times higher Fetomaternal Transfusion was observed after cordocentesis, there was no essential difference in pregnancy outcome between the two groups.
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role of the vascular endothelial growth factor in the inverse relationship between increased nuchal translucency thickness and Fetomaternal Transfusion
Journal of Perinatal Medicine, 2011Co-Authors: J. Sikovanyecz, E. Horváth, J. Szabó, Imre Földesi, Zoltan Kozinszky, A. PálAbstract:Objective: To elucidate the possible etiological role of the vascular endothelial growth factor (VEGF) in the inverse correlation between nuchal translucency (NT) thickness and Fetomaternal Transfusion (FMT). Methods: The level of FMT was determined prospectively in 80 viable, singleton pregnancies in which 10―14-week ultrasonographic scanning, NT thickness measurement; chorionic villus sampling (CVS) for fetal karyotyping and VEGF concentration determination were performed. The grouping procedures were based either on NT thickness ( < 2 MoM in Group I, and ≥2 MoM in Group II), or on karyotype (euploid in Group A, and aneuploid in Group B). The level of FMT was determined via maternal serum α-fetoprotein levels before and after CVS. The FMT and the VEGF concentration of the chorionic tissue were analysed in comparisons between Groups I and II, and between Groups "A" and "B". Results: The mean level of FMT after CVS was 72.5± 21.3 μL and 19.28±5.4 μL in Groups I (n=44) and II (n = 36), respectively (P<0.02). The VEGF concentration of the chorionic tissue in Groups I and II was 40.6± 16.7 pg/mg protein and 21.1 +6.3 pg/mg protein, respectively (P=0.28). The mean level of FMT was 57.9 ± 15.0 μL and 8.1 ± 3.9 μL in Groups A and B, respectively (P<0.003). The VEGF concentration of the chorionic tissue in Groups A and B was 25.9±10.7 pg/mg protein and 21.3±11.3 pg/mg protein, respectively (P=0.77). Conclusion: No difference exists in the VEGF concentration in the aspirated chorionic tissue between Groups I and II and between Groups A and B. A higher level of FMT was observed among the aneuploid pregnancies after CVS than among the euploid cases. Chorionic VEGF does not influence the inverse relationship between the pre-CVS NT thickness and FMT.
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Role of the vascular endothelial growth factor in the inverse relationship between increased nuchal translucency thickness and Fetomaternal Transfusion.
Journal of Perinatal Medicine, 2011Co-Authors: J. Sikovanyecz, E. Horváth, J. Szabó, Imre Földesi, Zoltan Kozinszky, A. PálAbstract:Objective: To elucidate the possible etiological role of the vascular endothelial growth factor (VEGF) in the inverse correlation between nuchal translucency (NT) thickness and Fetomaternal Transfusion (FMT). Methods: The level of FMT was determined prospectively in 80 viable, singleton pregnancies in which 10―14-week ultrasonographic scanning, NT thickness measurement; chorionic villus sampling (CVS) for fetal karyotyping and VEGF concentration determination were performed. The grouping procedures were based either on NT thickness ( < 2 MoM in Group I, and ≥2 MoM in Group II), or on karyotype (euploid in Group A, and aneuploid in Group B). The level of FMT was determined via maternal serum α-fetoprotein levels before and after CVS. The FMT and the VEGF concentration of the chorionic tissue were analysed in comparisons between Groups I and II, and between Groups "A" and "B". Results: The mean level of FMT after CVS was 72.5± 21.3 μL and 19.28±5.4 μL in Groups I (n=44) and II (n = 36), respectively (P
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Fetomaternal Transfusion after amniocentesis and cordocentesis
Irish Journal of Medical Science, 2010Co-Authors: J. Sikovanyecz, E. Horváth, N. Pásztor, A. Keresztúri, J. Szabó, A. PálAbstract:Objective To compare the extent of Fetomaternal Transfusion after amniocentesis and cordocentesis.
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Increased nuchal translucency and decreased Fetomaternal Transfusion after chorionic villus sampling.
Ultrasound in Obstetrics and Gynecology, 2003Co-Authors: J. Sikovanyecz, E. Horváth, A. Pál, János Gellén, Kornélia Wayda, J. SzabóAbstract:Objective To investigate the relationship between nuchal translucency (NT) and Fetomaternal Transfusion (FMT) after chorionic villus sampling (CVS). Methods The level of FMT was determined in 272 viable, singleton pregnancies in which 10–14-week ultrasound scanning, NT measurement and CVS for fetal karyotyping had been performed. The pre-CVS NT was measured transvaginally, and the women were divided into two groups, i.e. those with NT < 2.5 mm (Group 1) or ≥ 2.5 mm (Group 2). The level of FMT was determined via the maternal serum alpha-fetoprotein levels before and after CVS. FMT was analyzed in relation to the pre-CVS NT. Results Of the 272 pregnancies, 213 were in Group 1 and 59 in Group 2. The mean levels of FMT after CVS were 23.3 ± 12.2 and 5.4 ± 2.9 µL in Groups 1 and 2, respectively (P 100 µL was found in 19 cases in Group 1, whereas the maximum in Group 2 was 67.2 µL. Aneuploidies were diagnosed in 17 cases, 15 (88.2%) of them in Group 2. When the pregnancies with adverse outcome were excluded from the two groups, a higher level of FMT was observed in Subgroup 1 than in Subgroup 2 (P < 0.01). Conclusions The mean level of FMT after CVS was significantly lower in pregnancies with an increased pre-CVS NT, a relationship observed in euploid pregnancies also. An increased pre-CVS NT seems to be inversely correlated with the FMT increase after CVS. Further studies are planned to investigate the background to this phenomenon. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.
Maarten G P Huber - One of the best experts on this subject based on the ideXlab platform.
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umbilical vein administration of oxytocin for the management of retained placenta is it effective
American Journal of Obstetrics and Gynecology, 1991Co-Authors: Maarten G P Huber, Hajo I J Wildschut, Kees Boer, Gunilla Kleiverda, Frans J HoekAbstract:In a multicenter randomized controlled trial involving 220 women with retained placenta no beneficial effects could be established of intraumbilical vein administration of 10 IU of oxytocin in 20 ml of saline solution. A reduction was not gained in the rate of manual removal of the placenta and there was no decrease in the amount of blood loss. Oxytocin only induced a minor shortening of the median time interval from administration to the spontaneous expulsion of the placenta as compared with a placebo injection. Maternal serum a-fetoprotein levels before and after intraumbilical vein injection did not show evidence of Fetomaternal Transfusion.
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Umbilical vein administration of oxytocin for the management of retained placenta : is it effective ?
American Journal of Obstetrics and Gynecology, 1991Co-Authors: Maarten G P Huber, Hajo I J Wildschut, Kees Boer, Gunilla Kleiverda, Frans J HoekAbstract:In a multicenter randomized controlled trial involving 220 women with retained placenta no beneficial effects could be established of intraumbilical vein administration of 10 IU of oxytocin in 20 ml of saline solution. A reduction was not gained in the rate of manual removal of the placenta and there was no decrease in the amount of blood loss. Oxytocin only induced a minor shortening of the median time interval from administration to the spontaneous expulsion of the placenta as compared with a placebo injection. Maternal serum a-fetoprotein levels before and after intraumbilical vein injection did not show evidence of Fetomaternal Transfusion.
J. Sikovanyecz - One of the best experts on this subject based on the ideXlab platform.
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Fetomaternal Transfusion after amniocentesis and cordocentesis
Irish Journal of Medical Science, 2011Co-Authors: J. Sikovanyecz, E. Horváth, N. Pásztor, A. Keresztúri, J. Szabó, A. PálAbstract:Objective To compare the extent of Fetomaternal Transfusion after amniocentesis and cordocentesis. Setting Three-hundred and forty-five amniocentesis and 268 cordocentesis were performed for genetic indications. The extent of Fetomaternal Transfusion was calculated on the basis of the maternal serum alpha-fetoprotein level changes. Results The mean Fetomaternal Transfusion was 6.3 and 62 μL in the amniocentesis and cordocentesis groups, respectively. Transplacental needle passage and longer procedural time were risk factors for Fetomaternal Transfusion. The frequency of transplacental passage was higher and the procedural time was longer in the cordocentesis group. The fetal loss rate was 1.17% after amniocentesis and 1.2% after cordocentesis, respectively. Conclusions Cordocentesis causes more injury to the extrafetal compartment, which results in a higher level of Fetomaternal Transfusion. However, though a nearly ten times higher Fetomaternal Transfusion was observed after cordocentesis, there was no essential difference in pregnancy outcome between the two groups.
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role of the vascular endothelial growth factor in the inverse relationship between increased nuchal translucency thickness and Fetomaternal Transfusion
Journal of Perinatal Medicine, 2011Co-Authors: J. Sikovanyecz, E. Horváth, J. Szabó, Imre Földesi, Zoltan Kozinszky, A. PálAbstract:Objective: To elucidate the possible etiological role of the vascular endothelial growth factor (VEGF) in the inverse correlation between nuchal translucency (NT) thickness and Fetomaternal Transfusion (FMT). Methods: The level of FMT was determined prospectively in 80 viable, singleton pregnancies in which 10―14-week ultrasonographic scanning, NT thickness measurement; chorionic villus sampling (CVS) for fetal karyotyping and VEGF concentration determination were performed. The grouping procedures were based either on NT thickness ( < 2 MoM in Group I, and ≥2 MoM in Group II), or on karyotype (euploid in Group A, and aneuploid in Group B). The level of FMT was determined via maternal serum α-fetoprotein levels before and after CVS. The FMT and the VEGF concentration of the chorionic tissue were analysed in comparisons between Groups I and II, and between Groups "A" and "B". Results: The mean level of FMT after CVS was 72.5± 21.3 μL and 19.28±5.4 μL in Groups I (n=44) and II (n = 36), respectively (P<0.02). The VEGF concentration of the chorionic tissue in Groups I and II was 40.6± 16.7 pg/mg protein and 21.1 +6.3 pg/mg protein, respectively (P=0.28). The mean level of FMT was 57.9 ± 15.0 μL and 8.1 ± 3.9 μL in Groups A and B, respectively (P<0.003). The VEGF concentration of the chorionic tissue in Groups A and B was 25.9±10.7 pg/mg protein and 21.3±11.3 pg/mg protein, respectively (P=0.77). Conclusion: No difference exists in the VEGF concentration in the aspirated chorionic tissue between Groups I and II and between Groups A and B. A higher level of FMT was observed among the aneuploid pregnancies after CVS than among the euploid cases. Chorionic VEGF does not influence the inverse relationship between the pre-CVS NT thickness and FMT.
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Role of the vascular endothelial growth factor in the inverse relationship between increased nuchal translucency thickness and Fetomaternal Transfusion.
Journal of Perinatal Medicine, 2011Co-Authors: J. Sikovanyecz, E. Horváth, J. Szabó, Imre Földesi, Zoltan Kozinszky, A. PálAbstract:Objective: To elucidate the possible etiological role of the vascular endothelial growth factor (VEGF) in the inverse correlation between nuchal translucency (NT) thickness and Fetomaternal Transfusion (FMT). Methods: The level of FMT was determined prospectively in 80 viable, singleton pregnancies in which 10―14-week ultrasonographic scanning, NT thickness measurement; chorionic villus sampling (CVS) for fetal karyotyping and VEGF concentration determination were performed. The grouping procedures were based either on NT thickness ( < 2 MoM in Group I, and ≥2 MoM in Group II), or on karyotype (euploid in Group A, and aneuploid in Group B). The level of FMT was determined via maternal serum α-fetoprotein levels before and after CVS. The FMT and the VEGF concentration of the chorionic tissue were analysed in comparisons between Groups I and II, and between Groups "A" and "B". Results: The mean level of FMT after CVS was 72.5± 21.3 μL and 19.28±5.4 μL in Groups I (n=44) and II (n = 36), respectively (P
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Fetomaternal Transfusion after amniocentesis and cordocentesis
Irish Journal of Medical Science, 2010Co-Authors: J. Sikovanyecz, E. Horváth, N. Pásztor, A. Keresztúri, J. Szabó, A. PálAbstract:Objective To compare the extent of Fetomaternal Transfusion after amniocentesis and cordocentesis.
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Increased nuchal translucency and decreased Fetomaternal Transfusion after chorionic villus sampling.
Ultrasound in Obstetrics and Gynecology, 2003Co-Authors: J. Sikovanyecz, E. Horváth, A. Pál, János Gellén, Kornélia Wayda, J. SzabóAbstract:Objective To investigate the relationship between nuchal translucency (NT) and Fetomaternal Transfusion (FMT) after chorionic villus sampling (CVS). Methods The level of FMT was determined in 272 viable, singleton pregnancies in which 10–14-week ultrasound scanning, NT measurement and CVS for fetal karyotyping had been performed. The pre-CVS NT was measured transvaginally, and the women were divided into two groups, i.e. those with NT < 2.5 mm (Group 1) or ≥ 2.5 mm (Group 2). The level of FMT was determined via the maternal serum alpha-fetoprotein levels before and after CVS. FMT was analyzed in relation to the pre-CVS NT. Results Of the 272 pregnancies, 213 were in Group 1 and 59 in Group 2. The mean levels of FMT after CVS were 23.3 ± 12.2 and 5.4 ± 2.9 µL in Groups 1 and 2, respectively (P 100 µL was found in 19 cases in Group 1, whereas the maximum in Group 2 was 67.2 µL. Aneuploidies were diagnosed in 17 cases, 15 (88.2%) of them in Group 2. When the pregnancies with adverse outcome were excluded from the two groups, a higher level of FMT was observed in Subgroup 1 than in Subgroup 2 (P < 0.01). Conclusions The mean level of FMT after CVS was significantly lower in pregnancies with an increased pre-CVS NT, a relationship observed in euploid pregnancies also. An increased pre-CVS NT seems to be inversely correlated with the FMT increase after CVS. Further studies are planned to investigate the background to this phenomenon. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.