Postmortem chorionic villus sampling is a better method for cytogenetic evaluation of early fetal loss than culture of abortus material

Article Abstract:

While it is known that a large proportion of fertilized ova - more than 50 percent - are lost before pregnancy has progressed past the second trimester, and that chromosomal abnormalities contribute significantly to that rate, successful karyotyping (determining the fetal chromosomal profile) of miscarried tissue is hampered by the difficulty of obtaining living fetal cells for testing. It is possible that chorionic villus sampling, a method of prenatal diagnosis that takes cells from the part of the placenta in closest proximity to the mother, could provide important information in this regard. Karyotyping results from 102 cases of fetal death were analyzed. Fetal loss was diagnosed with ultrasound examination in 76 cases; karyotyping was performed on 33 skin biopsy specimens (19 from spontaneously miscarried tissue and 14 from tissue obtained from uterine evacuation); biopsy of the products of conception (36, placenta and fetal membranes); amniocentesis (7, sampling of the fluid in which the fetus is suspended); and chorionic villus sampling (26, a prenatal diagnostic method that obtains fetal tissue from the part of the placenta most closely attached to the uterus). Results showed that slightly more than 63 percent of the skin biopsy specimens failed to grow, with somewhat better results from cultures of the products of conception (36 percent failure). Four of the amniocentesis attempts did not grow, representing a 57 percent failure. However, successful karyotyping was performed for all chorionic villus samples. The rates of chromosomal abnormalities for each kind of tissue are presented, as are relevant fetal diagnostic factors; it seems likely that chromosomal abnormalities occur more frequently than is currently suspected. The results indicate that chorionic villus sampling after fetal loss can provide important information concerning the reasons the loss occurred. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Diagnosis, Causes of, Chromosome abnormalities, Miscarriage, Karyotypes, Fetal death, Chorionic villus sampling

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The clinical utility of maternal body mass index in pregnancy

Article Abstract:

The effect of maternal size on the outcome of pregnancy has been studied in the maternal weight range of 100 to 200 pounds. The results provide information for assessing the risk of health problems at the initial prenatal visit. The maternal body mass index is calculated as body weight in kilograms divided by height in meters. This measurement has been shown to be more appropriate than weight alone in predicting disease and death rates in nonpregnant women. The validity of using the body mass index to assess the risk of developing adverse weight-related problems in pregnancy was determined in 6,270 pregnant women. The body mass index increased with age, number of births, and increased gestational age (length of pregnancy). It was greater in black women, compared with nonblack women. Extremely large values for maternal weight and body mass index were effective in assessing the risk of adverse obesity-related outcomes, including pregnancy-related diabetes and hypertensive disorders, abnormally large fetal body, and difficult labor. Body mass index was more effective than maternal weight in predicting the risk of pregnancy-related diabetes. Extremely low values for maternal weight and body mass index were predictive of infants who were small for their gestational ages, born prematurely, had low birth weights, and died at childbirth. These findings suggest that calculating body mass index is not more advantageous than simply weighing women when trying to predict the risk of adverse maternal weight-related pregnancy outcomes. Theses results are not consistent with those obtained in the nonpregnant female population. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Physiological aspects, Pregnant women, Weight gain, Pregnancy, Complications of, Pregnancy complications

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