Transcervical chorionic villus sampling and midtrimester oligohydramnios

Article Abstract:

First-trimester transcervical chorionic villus sampling is a method of prenatal diagnosis in which a tissue sample containing fetal cells is removed from the area of the uterus where the fetus is attached. This procedure is associated with a rate of pregnancy loss of between 2 and 5 percent. It is possible that midtrimester oligohydramnios, insufficient amount of amniotic fluid, is a complication of the procedure that appears later in pregnancy. This complication has a poor prognosis and is often associated with fetal abnormalities. To learn more about the association between chorionic villus sampling and midtrimester oligohydramnios, a prospective study of women referred for genetic counseling at one medical center was undertaken. They chose either chorionic villus sampling (477 women), which was performed between 9 and 12 weeks gestation, or amniocentesis, removal of a sample of amniotic fluid containing fetal cells (395 women), which was performed between 15 and 20 weeks. The outcome of pregnancy in all patients was monitored; only those with normal fetal karyotypes were included in the analysis. The women who chose chorionic villus sampling were more likely than those in the amniocentesis group to have bleeding after the procedure and to have abnormal test results. Those in the former group also had higher rates of miscarriage, midtrimester oligohydramnios, chromosomal anomalies, and metabolic disorders. Severe oligohydramnios developed in 12 (2.7 percent) of the pregnancies of women who underwent chorionic villus sampling and in none of those in the amniocentesis group. Forty-two percent of the women who underwent chorionic villus biopsy, and who developed oligohydramnios, bled immediately after the procedure; the rate of bleeding was 8.8 percent among those with normal volumes of amniotic fluid. Midtrimester oligohydramnios was also associated with elevated levels of maternal serum alpha-fetoprotein. None of the 12 infants affected by oligohydramnios survived. The results indicate that first-trimester transcervical chorionic villus sampling may be associated with an increased risk for midtrimester oligohydramnios. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Complications and side effects, Risk factors, Oligohydramnios, Chorionic villus sampling

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Humerus and femur length shortening in the detection of Down's syndrome

Article Abstract:

The humerus and femur of fetuses with Down's syndrome may be shorter than those of normal fetuses. The humerus is the bone that extends from the shoulder to the elbow, and the femur is the bone that extends from the hip to the knee. Among 45 fetuses with Down's syndrome who underwent ultrasonography, 11 (24%) had a shorter than average humerus and 11 had a shorter than average femur. Of 942 normal fetuses who underwent ultrasonography, 43 (5%) had a shorter than average humerus and 44 had a shorter than average femur. The risk of Down's syndrome was eleven times higher for fetuses with both a short humerus and a short femur than for other fetuses. Fetuses with other chromosomal abnormalities such as trisomy one or Turner syndrome may also have shorter limbs than normal fetuses. Ultrasound measurements of limb length could be incorporated into prenatal screening programs for chromosomal abnormalities.

Abnormalities, Diagnosis, Fetus, Down syndrome, Femur, Humerus

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