Adjusting the risk for trisomy 21 on the basis of second-trimester ultrasonography

Article Abstract:

A second trimester ultrasound scan may help determine whether a pregnant woman is at high or low risk for a fetus with Down syndrome. The medical literature was searched for second trimester ultrasound studies of physical markers of Down syndrome. A table was generated of the association of the presence or absence of these factors with Down syndrome. The results showed an average detection rate for physicial abnormalities in the fetus of 28%. Scan results can be combined with maternal age and a maternal blood test to help women determine whether to have an amniocentesis. Women of any age may wish to consider amniocentesis if an ultrasound scan is positive for one or more these factors. Reducing the number of amniocenteses would reduce the number of normal fetuses exposed to its risks, which include a pregnancy loss rate of about one per 270 scans. Some preliminary data suggest that the number of women age 35 or more having an amniocentesis can be reduced to 20% of this group without missing any cases of Down syndrome, although this cannot be guaranteed.

Risk factors, Down syndrome

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Gap junction formation in human myometrium: a key to preterm labor?

Article Abstract:

The formation of gap junctions in the smooth muscle of the uterus (myometrium) may play an important role in the onset of both preterm labor and labor at term. Gap junctions are pathways for intercellular communication that are formed between muscle cells. Among 27 samples of myometrium, six were from patients who delivered preterm with no labor, six were from patients with preterm labor, six were from patients who delivered at term with no labor, six were from patients who delivered at term with labor and three were from patients who had a hysterectomy. Gap junction formation occurred in myometrium samples from patients who had term or preterm labor, but not in samples from patients who had not had labor. Interference with gap junction activity may be a potential treatment for preterm labor.

Physiological aspects, Premature labor, Myometrium

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A new method for on-screen ultrasonographic determination of fetal cardiac axis

Article Abstract:

The use of several electronic calipers for on-screen ultrasonic measurement of the axis of the fetal heart may enable doctors to detect fetal heart defects. Abnormal heart axis has been associated with congenital heart defects. Researchers performed ultrasound examinations of two hundred low-risk fetuses using several electronic calipers to measure the placement of the heart axis. This measurement was compared to that obtained by a manual method using a protractor. Both methods yielded similar results. All 200 infants were found to have heart axes in a normal position of 43 degrees, which was confirmed by examining infants after birth. The use of electronic calipers may be more convenient for ultrasonic measurement of fetal heart axis. Three to five sets of calipers should be used.

Fetal heart

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