Early amniocentesis: alphafetoprotein levels in amniotic fluid, extraembryonic coelomic fluid and maternal serum between 8 and 13 weeks

Article Abstract:

The levels of two proteins, alphafetoprotein (AFP) and acetylcholinesterase (AChE), in the amniotic fluid surrounding the fetus are measured during the second trimester, or second three months of pregnancy. These measurements help in the detection of defects of the neural tube, the embryonic tissue that gives rise to the brain and spinal cord. Amniotic fluid is obtained by amniocentesis, in which a needle is inserted through the abdominal wall into the amniotic sac to withdraw amniotic fluid. Current efforts have focused on the feasibility of performing amniocentesis in the first trimester. However, the measurement of AChE before 11 weeks of pregnancy is unreliable for detecting neural tube defects, and the normal AFP levels before 11 weeks of pregnancy are not known. Ultrasonography, the use of sound waves to visualize the fetus, has shown that in the first trimester, there are two cavities within the uterus, the amniotic cavity and extraembryonic coelom, which have different amounts of biochemical factors. Hence, the site from which the amniotic fluid is sampled during amniocentesis must be identified. The normal values for AFP levels in the amniotic fluid between 8 and 12 weeks of pregnancy were determined. The differences in AFP levels between the amniotic cavity and extraembryonic coelom were also measured. The study involved 150 women with normal pregnancies who underwent ultrasonography before first trimester termination of pregnancy. The amniotic fluid levels of AFP were very high at 8 weeks, fell rapidly until 10 weeks, and increased slightly thereafter. Thus, between 8 and 10 weeks of pregnancy, the amniotic fluid AFP levels declined with increasing gestational age, or weeks of pregnancy. In contrast, the AFP levels in the extraembryonic coelomic fluid were not related to gestational age. Because of the rapid decrease in amniotic AFP levels between 8 and 10 weeks of pregnancy and the small amount of amniotic fluid at this time, amniocentesis before 11 weeks of pregnancy is not practical. Furthermore, the findings underline the importance of determining the site of sampling during first trimester amniocentesis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Pregnancy proteins, Amniocentesis, Acetylcholinesterase, Alpha fetoproteins

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The effects of pregnancy on previous incontinence surgery. Case report

Article Abstract:

This case report illustrates the effects of pregnancy on a woman who had previously undergone surgery for urinary incontinence. The patient was 37 years old in 1990 when she became pregnant for the third time. She had two children at that time who were both delivered vaginally. After the second delivery in 1983, the patient complained of urgency and urge incontinence (inability to retain urine because of a strong urge to urinate). Surgery (colposuspension) was carried out after exercises failed to control the problem. The third delivery was accomplished by cesarean section because of the patient's surgical history. Before the delivery, the patient had abnormalities on several measures of urethral function. These values returned to normal after delivery. She also had more frequent urination during the day and night. For women who have undergone surgery for genuine stress incontinence (inability to retain urine during coughing, sneezing, or similar stress), pregnancy is not advised. If possible, women should complete all desired pregnancies before undergoing this surgical procedure. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Urinary incontinence

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The coelomic cavity - a reservoir for metals

Article Abstract:

The extraembryonic coelom may provide the developing human embryo with a storehouse of metals necessary for proper development and protect the embryo from excessive metal concentrations. The extraembryonic coelom is a cavity in the membranes outside the body of the embyro. Researchers took samples of extraembryonic coelom fluid and amniotic fluid from 17 women at 9 to 12 weeks gestation who were terminating their pregnancy. The samples were analyzed for calcium, magnesium, iron, copper, zinc, manganese, lead and cadmium. The concentrations of most of the metals were much higher in extraembryonic coelom fluid than in amniotic fluid. The extraembryonic coelom is believed to provide nutrition to the developing fetus before the placenta is completely formed. It could also protect the fetus from potentially harmful metals such as lead and cadmium.

Metals (Materials), Fetal tissues, Metals in the body

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