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Eric Jauniaux - One of the best experts on this subject based on the ideXlab platform.
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Hepcidin and iron species distribution inside the first-trimester human Gestational Sac
Molecular Human Reproduction, 2010Co-Authors: Patricia Evans, Tereza Cindrova-davies, Graham J. Burton, Shanthi Muttukrishna, John B. Porter, Eric JauniauxAbstract:We have investigated factors affecting iron distribution in the first-trimester Gestational Sac, by the measurement of trans- ferrin, non-transferrin-bound iron (NTBI) and pro-hepcidin (Hep) in maternal serum, coelomic fluid (CF) and amniotic fluid (AF) and by immunostaining for Hep in villous and secondary yolk Sac biopsies. These samples were obtained from 15 first-trimester pregnancies at 8- 11 weeks gestation. Transferrin concentrations were significantly lower in fetal (0.56 mg/ml) than maternal serum (1.71 mg/ml), with very low concentrations in CF and AF (0.09 mg/ml). In contrast, transferrin saturations were significantly higher in fetal (77%) than maternal serum (33%). NTBI was present in fetal serum, CF and AF, presumably as a consequence of low transferrin concentrations in these com- partments. Pro-Hep was present at lower levels in fetal (140.0+ 11.1) than maternal serum (206.2+ 9.2) and at low concentrations in CF (19.4+ 3.1) and AF (21.8+ 5.2). Immunostaining with Hep antibody was found in the syncytiotrophoblast of first-trimester placenta as well as in mesothelial and endodermal layers of the secondary yolk Sac at 10 weeks. The presence of Hep in syncytiotrophoblast cells of first- trimester placenta as well as in mesothelial and endodermal layers of the secondary yolk Sac suggest a key regulatory role for this protein in iron transfer to the first-trimester fetus. The low transferrin concentrations and the presence of NTBI in CF and AF suggest that transferrin- independent iron transfer is important in early gestation.
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Relationships between TGFβ Proteins and Oxygen Concentrations Inside the First Trimester Human Gestational Sac
PLOS ONE, 2008Co-Authors: Shanthi Muttukrishna, S Suri, Nigel P. Groome, Eric JauniauxAbstract:In early pregnancy, the O(2) gradient between the maternal circulation and the Gestational Sac tissues modulates trophoblast biological functions. The aim was to evaluate if placental partial pressure of oxygen (PaO(2)) modulates in vivo synthesis of specific placental proteins inside the first trimester Gestational Sac. Matched samples of peripheral venous blood, blood from the placental bed (PB), coelomic fluid (CF) and placental tissue were obtained in 37 normal pregnancies at 6-12 weeks gestation. PaO(2) was measured in PB and CF using an IRMA blood gas monitor. Inhibin A, activin A, sEng, PlGF, sFlt-1 and free VEGF concentrations were measured in all samples. HSP 70 was measured in placental extracts. ANOVA showed approximately 60% increase in PB PaO(2) (P = 0.02) between after 10 weeks gestation. Unpaired Student's T-test between two groups (6-9 weeks vs 9-12 weeks) shows a significant increase in MS Activin A (P = 0.001), CF activin A (P
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relationships between tgfβ proteins and oxygen concentrations inside the first trimester human Gestational Sac
PLOS ONE, 2008Co-Authors: Shanthi Muttukrishna, S Suri, Nigel P. Groome, Eric JauniauxAbstract:In early pregnancy, the O(2) gradient between the maternal circulation and the Gestational Sac tissues modulates trophoblast biological functions. The aim was to evaluate if placental partial pressure of oxygen (PaO(2)) modulates in vivo synthesis of specific placental proteins inside the first trimester Gestational Sac. Matched samples of peripheral venous blood, blood from the placental bed (PB), coelomic fluid (CF) and placental tissue were obtained in 37 normal pregnancies at 6-12 weeks gestation. PaO(2) was measured in PB and CF using an IRMA blood gas monitor. Inhibin A, activin A, sEng, PlGF, sFlt-1 and free VEGF concentrations were measured in all samples. HSP 70 was measured in placental extracts. ANOVA showed approximately 60% increase in PB PaO(2) (P = 0.02) between after 10 weeks gestation. Unpaired Student's T-test between two groups (6-9 weeks vs 9-12 weeks) shows a significant increase in MS Activin A (P = 0.001), CF activin A (P<0.001), MS P1GF (P = 0.001), CF PlGF (P<0.001), MS sFLT-1 (P = 0.03), CF sFLT-1 (P = 0.01), HSP 70 in placental extracts (P = 0.04) and a significant decrease in PB inhibin A levels (P<0.001) and PB sFLT-1 (P = 0.02) . Multiple correlation analysis showed a significant negative correlation between PB inhibin A levels and gestation (r = -0.45, P<0.05) and PB PaO(2) (r = -0.5, P = 0.008) and also between sFLT-1 and PB PaO(2) (P = 0.03). There was a positive correlation (P<0.01) between PlGF, sEng and VEGF levels in the placental extracts. Our results indicate a direct relationship in the early intrauterine PaO(2) in vivo and inhibin A and sFLT-1 concentrations confirming our hypothesis that specific placental proteins are regulated by intrauterine O(2) tension.
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Transfer of folic acid inside the first-trimester Gestational Sac and the effect of maternal smoking
American Journal of Obstetrics and Gynecology, 2007Co-Authors: Eric Jauniaux, Jemma Johns, B Gulbis, Olivera Spasic-boskovic, Graham J. BurtonAbstract:Objective The objective of the study was to investigate the transfer pathways of folic acid inside the first-trimester Gestational Sac and to evaluate the impact of maternal smoking. Study Design Folate and cotinine levels were evaluated in maternal serum (n = 125) and coelomic fluid (n = 42), and immunostaining was used to identify folate receptors in placental villi, decidual tissue, and secondary yolk Sacs from normal pregnancies at 6-12 weeks' gestation. Results Folate receptors-α were found on the apical surface of syncytiotrophoblast, uterine glandular epithelial cells, and mesothelial layer of the yolk Sac. Significantly higher ( P P P Conclusion Uterine glands and the secondary yolk Sac play key roles in supplying folic acid to the developing fetus before the placental circulations are established, and maternal smoking does not seem to impair directly its transfer mechanism in early pregnancy.
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Distribution and transfer pathways of antioxidant molecules inside the first trimester human Gestational Sac
The Journal of Clinical Endocrinology and Metabolism, 2004Co-Authors: Eric Jauniaux, Tereza Cindrova-davies, Jemma Johns, Christina Dunster, Joanne Hempstock, Frank J. Kelly, Graham J. BurtonAbstract:The first-trimester human placenta has limited antioxidant enzyme capacity. We investigated the distribution and transfer pathways of antioxidant molecules inside the first trimester Gestational Sac. The coelomic fluid of the exocoelomic cavity, which borders the inside of the first-trimester placenta, contained a very low level of reduced glutathione. Glutathione disulfide was undetectable in most coelomic samples, suggesting that the role of glutathione-related detoxification system is limited in fetal fluid compartments. The coelomic fluid contained similar concentrations of ascorbic and uric acid to maternal plasma. The levels of α- and γ-tocopherol were lower in coelomic fluid, compared with maternal plasma. The presence of these molecules inside the early Gestational Sac suggests that they may play an essential role in the fetal tissues’ antioxidant capacity at a time when the fetus is most vulnerable to oxidative stress. We also demonstrated by immunostaining the presence of α-tocopherol transfer p...
Recep Has - One of the best experts on this subject based on the ideXlab platform.
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Management of Cesarean Heterotopic Pregnancy With Transvaginal Ultrasound–Guided Potassium Chloride Injection and Gestational Sac Aspiration, and Review of the Literature
Journal of Minimally Invasive Gynecology, 2012Co-Authors: Funda Gungor Ugurlucan, Ercan Bastu, Murat Dogan, Ibrahim Kalelioglu, Sebnem Alanya, Recep HasAbstract:Abstract Cesarean scar pregnancy is one of the rarest forms of ectopic pregnancy, located in the scar from a previous cesarean section. There are few reports of such pregnancies, and there is no consensus about the best management. Herein is reported a case of cesarean heterotopic pregnancy, diagnosed at 6 weeks' gestation and successfully treated via transvaginal ultrasound–guided potassium chloride injection and Gestational Sac aspiration, with preservation of the intrauterine pregnancy.
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management of cesarean heterotopic pregnancy with transvaginal ultrasound guided potassium chloride injection and Gestational Sac aspiration and review of the literature
Journal of Minimally Invasive Gynecology, 2012Co-Authors: Funda Gungor Ugurlucan, Ercan Bastu, Murat Dogan, Ibrahim Kalelioglu, Sebnem Alanya, Recep HasAbstract:Abstract Cesarean scar pregnancy is one of the rarest forms of ectopic pregnancy, located in the scar from a previous cesarean section. There are few reports of such pregnancies, and there is no consensus about the best management. Herein is reported a case of cesarean heterotopic pregnancy, diagnosed at 6 weeks' gestation and successfully treated via transvaginal ultrasound–guided potassium chloride injection and Gestational Sac aspiration, with preservation of the intrauterine pregnancy.
Graham J. Burton - One of the best experts on this subject based on the ideXlab platform.
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Hepcidin and iron species distribution inside the first-trimester human Gestational Sac
Molecular Human Reproduction, 2010Co-Authors: Patricia Evans, Tereza Cindrova-davies, Graham J. Burton, Shanthi Muttukrishna, John B. Porter, Eric JauniauxAbstract:We have investigated factors affecting iron distribution in the first-trimester Gestational Sac, by the measurement of trans- ferrin, non-transferrin-bound iron (NTBI) and pro-hepcidin (Hep) in maternal serum, coelomic fluid (CF) and amniotic fluid (AF) and by immunostaining for Hep in villous and secondary yolk Sac biopsies. These samples were obtained from 15 first-trimester pregnancies at 8- 11 weeks gestation. Transferrin concentrations were significantly lower in fetal (0.56 mg/ml) than maternal serum (1.71 mg/ml), with very low concentrations in CF and AF (0.09 mg/ml). In contrast, transferrin saturations were significantly higher in fetal (77%) than maternal serum (33%). NTBI was present in fetal serum, CF and AF, presumably as a consequence of low transferrin concentrations in these com- partments. Pro-Hep was present at lower levels in fetal (140.0+ 11.1) than maternal serum (206.2+ 9.2) and at low concentrations in CF (19.4+ 3.1) and AF (21.8+ 5.2). Immunostaining with Hep antibody was found in the syncytiotrophoblast of first-trimester placenta as well as in mesothelial and endodermal layers of the secondary yolk Sac at 10 weeks. The presence of Hep in syncytiotrophoblast cells of first- trimester placenta as well as in mesothelial and endodermal layers of the secondary yolk Sac suggest a key regulatory role for this protein in iron transfer to the first-trimester fetus. The low transferrin concentrations and the presence of NTBI in CF and AF suggest that transferrin- independent iron transfer is important in early gestation.
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Transfer of folic acid inside the first-trimester Gestational Sac and the effect of maternal smoking
American Journal of Obstetrics and Gynecology, 2007Co-Authors: Eric Jauniaux, Jemma Johns, B Gulbis, Olivera Spasic-boskovic, Graham J. BurtonAbstract:Objective The objective of the study was to investigate the transfer pathways of folic acid inside the first-trimester Gestational Sac and to evaluate the impact of maternal smoking. Study Design Folate and cotinine levels were evaluated in maternal serum (n = 125) and coelomic fluid (n = 42), and immunostaining was used to identify folate receptors in placental villi, decidual tissue, and secondary yolk Sacs from normal pregnancies at 6-12 weeks' gestation. Results Folate receptors-α were found on the apical surface of syncytiotrophoblast, uterine glandular epithelial cells, and mesothelial layer of the yolk Sac. Significantly higher ( P P P Conclusion Uterine glands and the secondary yolk Sac play key roles in supplying folic acid to the developing fetus before the placental circulations are established, and maternal smoking does not seem to impair directly its transfer mechanism in early pregnancy.
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Distribution and transfer pathways of antioxidant molecules inside the first trimester human Gestational Sac
The Journal of Clinical Endocrinology and Metabolism, 2004Co-Authors: Eric Jauniaux, Tereza Cindrova-davies, Jemma Johns, Christina Dunster, Joanne Hempstock, Frank J. Kelly, Graham J. BurtonAbstract:The first-trimester human placenta has limited antioxidant enzyme capacity. We investigated the distribution and transfer pathways of antioxidant molecules inside the first trimester Gestational Sac. The coelomic fluid of the exocoelomic cavity, which borders the inside of the first-trimester placenta, contained a very low level of reduced glutathione. Glutathione disulfide was undetectable in most coelomic samples, suggesting that the role of glutathione-related detoxification system is limited in fetal fluid compartments. The coelomic fluid contained similar concentrations of ascorbic and uric acid to maternal plasma. The levels of α- and γ-tocopherol were lower in coelomic fluid, compared with maternal plasma. The presence of these molecules inside the early Gestational Sac suggests that they may play an essential role in the fetal tissues’ antioxidant capacity at a time when the fetus is most vulnerable to oxidative stress. We also demonstrated by immunostaining the presence of α-tocopherol transfer p...
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The Human First Trimester Gestational Sac Limits Rather than Facilitates Oxygen Transfer to the Foetus—A Review
Placenta, 2003Co-Authors: Eric Jauniaux, B Gulbis, Graham J. BurtonAbstract:Abstract Oxygen (O 2 ) free radicals are a potential teratologic threat to the foetal tissues and are known to be involved in the pathophysiology of common human pregnancy disorders such as miscarriage and pre-eclampsia. During the first two months of human gestation, the placenta surrounds the whole Gestational Sac, the villi contain only a few capillaries located mainly within the centre of the mesenchymal core, the trophoblastic layer is twice the thickness it will be in the second trimester, the foetal red cells are nucleated and the exocoelomic cavity (ECC) occupies most of the space inside the Gestational Sac. The ECC contains no oxygen transport system, but anti-oxidant molecules that may provide additional protection to the embryo from oxidative damage are present. Ultrasound and anatomical studies have also demonstrated that the intervillous circulation starts in the periphery of the placenta at around 9 weeks of gestation, and that it becomes continuous and diffuse in the entire placenta only after 12 weeks. Overall, these anatomical features provide indirect evidence that the architecture of the human first trimester Gestational Sac limits foetal exposure to O 2 to what is strictly necessary for its development. These results are in agreement with the concept that the placenta and foetus develop in a physiologically low O 2 environment and that its metabolism must be essentially anaerobic. Because of these anatomical arrangements, different nutritional pathways to those operating during most of pregnancy must serve the first-trimester foetus. Up to 9 weeks of gestation, foetal nutrition appears to depend on uterine glandular secretions that are delivered into the intervillous space, supplemented by maternal plasma proteins and other molecules that may percolate through the trophoblastic shell. These molecules diffuse through, or are transported by, the trophoblast of the villi and the chorionic plate into the ECC. From here they are absorbed by the secondary yolk Sac (SYS), in which the extraembryonic circulation is probably first established. At the end of the first trimester, the SYS and two-thirds of the placental mass degenerate, and the ECC is progressively obliterated by the enlarging amniotic cavity. The trophoblastic plugs occluding the utero-placental arteries are gradually dislocated, allowing maternal blood to flow into the intervillous space, and the uterine glands involute. These major anatomical transformations modify considerably the spatial relationships between the maternal tissues and the developing embryo, and, consequently, the materno-embryonic exchange pathways. Overall the comparison of morphological features with physiological findings reveals that the architecture of the human first trimester Gestational Sac is designed to limit foetal exposure to oxygen to that which is strictly necessary for its development, and that during early pregnancy alternative nutritional pathways are in use.
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The human first trimester Gestational Sac limits rather than facilitates oxygen transfer to the foetus--a review.
Placenta, 2003Co-Authors: Eric Jauniaux, B Gulbis, Graham J. BurtonAbstract:Oxygen (O2) free radicals are a potential teratologic threat to the foetal tissues and are known to be involved in the pathophysiology of common human pregnancy disorders such as miscarriage and pre-eclampsia. During the first two months of human gestation, the placenta surrounds the whole Gestational Sac, the villi contain only a few capillaries located mainly within the centre of the mesenchymal core, the trophoblastic layer is twice the thickness it will be in the second trimester, the foetal red cells are nucleated and the exocoelomic cavity (ECC) occupies most of the space inside the Gestational Sac. The ECC contains no oxygen transport system, but anti-oxidant molecules that may provide additional protection to the embryo from oxidative damage are present. Ultrasound and anatomical studies have also demonstrated that the intervillous circulation starts in the periphery of the placenta at around 9 weeks of gestation, and that it becomes continuous and diffuse in the entire placenta only after 12 weeks. Overall, these anatomical features provide indirect evidence that the architecture of the human first trimester Gestational Sac limits foetal exposure to O2 to what is strictly necessary for its development. These results are in agreement with the concept that the placenta and foetus develop in a physiologically low O2 environment and that its metabolism must be essentially anaerobic. Because of these anatomical arrangements, different nutritional pathways to those operating during most of pregnancy must serve the first-trimester foetus. Up to 9 weeks of gestation, foetal nutrition appears to depend on uterine glandular secretions that are delivered into the intervillous space, supplemented by maternal plasma proteins and other molecules that may percolate through the trophoblastic shell. These molecules diffuse through, or are transported by, the trophoblast of the villi and the chorionic plate into the ECC. From here they are absorbed by the secondary yolk Sac (SYS), in which the extraembryonic circulation is probably first established. At the end of the first trimester, the SYS and two-thirds of the placental mass degenerate, and the ECC is progressively obliterated by the enlarging amniotic cavity. The trophoblastic plugs occluding the utero-placental arteries are gradually dislocated, allowing maternal blood to flow into the intervillous space, and the uterine glands involute. These major anatomical transformations modify considerably the spatial relationships between the maternal tissues and the developing embryo, and, consequently, the materno-embryonic exchange pathways. Overall the comparison of morphological features with physiological findings reveals that the architecture of the human first trimester Gestational Sac is designed to limit foetal exposure to oxygen to that which is strictly necessary for its development, and that during early pregnancy alternative nutritional pathways are in use.
Jacob Bornstein - One of the best experts on this subject based on the ideXlab platform.
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prediction of abortion using three dimensional ultrasound volumetry of the Gestational Sac and the amniotic Sac in threatened abortion
Journal of Clinical Ultrasound, 2012Co-Authors: Ella Ophir, R Tendler, Mohamad Kais, V. Grinin, Marwan Odeh, Jacob BornsteinAbstract:Purpose. To determine whether Gestational Sac volume (GSV) or amniotic Sac volume (ASV) and/or the difference between them can predict abortion in women with first-trimester threatened abortion. Methods. Ninety patients between 6 and 12 weeks of gestation presenting with vaginal bleeding were studied. Seventy-six delivered after 24 weeks of gestation (group A) and 14 aborted before 20 weeks of gestation (group B). All patients had a singleton viable pregnancy demonstrated by transvaginal ultrasound. Gestational Sac and amniotic Sac volumes were measured in all the patients using three-dimensional transvaginal ultrasound with Virtual Organ Computer-aided Analysis software, and the Gestational Sac volume − amniotic Sac volume (GSV − ASV) was calculated. Results. The groups did not differ in terms of age, parity, number of previous abortions, or term deliveries. The GSV (group A: mean 32.0 ± 27.7 cm3; group B: 26.7 ± 29.1 cm3) and the ASV (group A: 21.1 ± 25.5 cm3; group B: 20.6 ± 26.0 cm3) were not statistically different, while the GSV − ASV was significantly smaller in group B (aborting before week 20) (group A: 10.9 ± 10.9 cm3; group B: 6.1 ± 8.6 cm3; p < 0.05). Using receiver operator curves, the area under the curve for predicting normal pregnancy outcome of the GSV − ASV measurement was 0.654. When the GSV − ASV was 1.8 cm3 or less, abortion was predicted with 84% sensitivity and 43% specificity. Conclusions. The measurement of the GSV and the ASV are not good predictors of abortion in patients with first-trimester vaginal bleeding, whereas the use of the GSV − ASV may be helpful in predicting the outcome of pregnancy. © 2012 Wiley Periodicals, Inc. J Clin Ultrasound 40:389–393, 2012
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Gestational Sac volume in missed abortion and anembryonic pregnancy compared to normal pregnancy
Journal of Clinical Ultrasound, 2010Co-Authors: Marwan Odeh, Ella Ophir, R Tendler, Mohamad Kais, V. Grinin, Jacob BornsteinAbstract:Purpose. To compare Gestational Sac (GS) volume (GSV) between normal pregnancies and missed abortions and anembryonic pregnancies and to determine at what Gestational age differences in GS volume become evident. Methods. GSV in missed abortion and anembryonic pregnancy were measured using three-dimensional ultrasound and the results were compared with GSV in normal pregnancies. Pregnancies between 6 and 12+6 Gestational weeks of age according to last menstrual period were included in normal pregnancies, missed abortions, and anembryonic pregnancies. Results. There were 141 normal pregnancies and 82 missed or anembryonic abortions. GSV was significantly larger in normal pregnancies than in missed or anembryonic abortion: 27.51 ± 25.25 cm3 and 8.04 ± 10.54 cm3, respectively (p < 0.001). When stratified by weeks, statistically significant differences were found beginning at 7 weeks, while GSV measurements were not significantly different between the normal and abnormal pregnancies from 6 to 6+6 weeks. Conclusion. GSV in missed abortion and anembryonic pregnancies is significantly smaller than in normal pregnancies, starting at 7 weeks of Gestational age. This finding may be helpful in the diagnosis of missed abortion or anembryonic pregnancies in selected cases. © 2010 Wiley Periodicals, Inc. J Clin Ultrasound 38:367-371, 2010
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three dimensional sonographic volumetry of the Gestational Sac and the amniotic Sac in the first trimester
Journal of Ultrasound in Medicine, 2008Co-Authors: Marwan Odeh, Yael Hirsh, Simon Degani, E Ofir, V. Grinin, Jacob BornsteinAbstract:Objective. The purpose of this study was to measure the volumes of the Gestational Sac and amniotic Sac in normal pregnancies during the first trimester with 3-dimensional sonography to prepare nomograms. Methods. One hundred fifty-one patients between 6 and 12 weeks’ gestation were studied. Nine aborted and were excluded, leaving 142 patients for evaluation. Inclusion criteria were a singleton viable pregnancy shown by transvaginal sonography and continuation of the pregnancy beyond 24 weeks. Women with known thrombophilia or fetal malformations were excluded. In all patients, Gestational Sac and amniotic Sac volumes were measured by 3-dimensional transvaginal sonography with virtual organ computer-aided analysis software. Results. The mean Gestational Sac volume was 20.35 mL (range, 0.7‐113 mL) and correlated closely with the Gestational age (GA) (r 2 = 0.769; P << .001) and crown-rump length (CRL) (r 2 = 0.823; P << .001). The mean amniotic Sac volume was 3.69 mL (range, 0.01‐92.1 mL) and also had a strong correlation with the GA (r 2 = 0.869; P << .001) and CRL (r 2 = 0.919; P << .001). Conclusions. Gestational Sac and amniotic Sac volumes
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Three-Dimensional Sonographic Volumetry of the Gestational Sac and the Amniotic Sac in the First Trimester
Journal of Ultrasound in Medicine, 2008Co-Authors: Marwan Odeh, Yael Hirsh, Simon Degani, E Ofir, V. Grinin, Jacob BornsteinAbstract:Objective. The purpose of this study was to measure the volumes of the Gestational Sac and amniotic Sac in normal pregnancies during the first trimester with 3-dimensional sonography to prepare nomograms. Methods. One hundred fifty-one patients between 6 and 12 weeks’ gestation were studied. Nine aborted and were excluded, leaving 142 patients for evaluation. Inclusion criteria were a singleton viable pregnancy shown by transvaginal sonography and continuation of the pregnancy beyond 24 weeks. Women with known thrombophilia or fetal malformations were excluded. In all patients, Gestational Sac and amniotic Sac volumes were measured by 3-dimensional transvaginal sonography with virtual organ computer-aided analysis software. Results. The mean Gestational Sac volume was 20.35 mL (range, 0.7‐113 mL) and correlated closely with the Gestational age (GA) (r 2 = 0.769; P
Vny Chan - One of the best experts on this subject based on the ideXlab platform.
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op09 27 three dimensional measurement of Gestational Sac and amniotic fluid volume in pregnancies affected by homozygous α thalassemia
Ultrasound in Obstetrics & Gynecology, 2006Co-Authors: M Chen, M Yeung, Mary Hoi Yin Tang, Pak Chung Ho, K Y Leung, Vny ChanAbstract:Objective: To evaluate the use of three-dimensional measurement of Gestational Sac and amniotic fluid volume in predicting homozygous α-thalassemia. We hypothesize that polyhydramnios, a sign of hydrops, is associated with affected pregnancies. Methods: Pregnancies at risk of homozygous α-thalassemia and normal controls were prospectively studied at 9–14 weeks of gestation using three-dimensional ultrasonography. Gestational Sac and amniotic fluid volume were measured by multiplanar technique. Fetuses affected by homozygous α-thalassemia were predicted by two-dimensional ultrasonographic measurement of the fetal cardiothoracic ratio and placental thickness, and confirmed by an invasive test followed by DNA study. Results: From June 2002 to May 2004, 46 pregnancies at risk of homozygous α-thalassemia were prospectively studied. 11 of them were affected. The Gestational Sac volume and amniotic fluid volume increased with gestation and crown rump length. Mean (± SD) Gestational Sac volume /crown rump length quotient and mean (± SD) amniotic fluid volume /crown rump length quotient in affected pregnancies were larger than those in unaffected pregnancies (1.72 ± 0.55 vs 1.65 ± 0.49 and 1.55 ± 0.51 vs 1.40 ± 0.44, respectively). But the difference was not statistically significant (P > 0.05). Conclusions: It seems that three-dimensional Gestational Sac or amniotic fluid volumetry is not predictive of homozygous αthalassemia.
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OP09.27: Three‐dimensional measurement of Gestational Sac, and amniotic fluid volume in pregnancies affected by homozygous α‐thalassemia
Ultrasound in Obstetrics & Gynecology, 2006Co-Authors: M Chen, M Yeung, Mary Hoi Yin Tang, K Y Leung, Chin Peng Lee, Vny ChanAbstract:Objective: To evaluate the use of three-dimensional measurement of Gestational Sac and amniotic fluid volume in predicting homozygous α-thalassemia. We hypothesize that polyhydramnios, a sign of hydrops, is associated with affected pregnancies. Methods: Pregnancies at risk of homozygous α-thalassemia and normal controls were prospectively studied at 9–14 weeks of gestation using three-dimensional ultrasonography. Gestational Sac and amniotic fluid volume were measured by multiplanar technique. Fetuses affected by homozygous α-thalassemia were predicted by two-dimensional ultrasonographic measurement of the fetal cardiothoracic ratio and placental thickness, and confirmed by an invasive test followed by DNA study. Results: From June 2002 to May 2004, 46 pregnancies at risk of homozygous α-thalassemia were prospectively studied. 11 of them were affected. The Gestational Sac volume and amniotic fluid volume increased with gestation and crown rump length. Mean (± SD) Gestational Sac volume /crown rump length quotient and mean (± SD) amniotic fluid volume /crown rump length quotient in affected pregnancies were larger than those in unaffected pregnancies (1.72 ± 0.55 vs 1.65 ± 0.49 and 1.55 ± 0.51 vs 1.40 ± 0.44, respectively). But the difference was not statistically significant (P > 0.05). Conclusions: It seems that three-dimensional Gestational Sac or amniotic fluid volumetry is not predictive of homozygous αthalassemia.