1/7. Prenatal evaluation of a de novo X;9 translocation.A case of X-autosome translocation was diagnosed prenatally [46,X, t(X;9)(p21.3 approximately 22.1;q22]. We describe the use of fluorescence in situ hybridization (FISH) to estimate the integrity of the Duchenne muscular dystrophy (DMD) gene. X-inactivation studies were used as well to assess the probability of phenotypic abnormalities associated with functional partial disomy X and monosomy 9.- - - - - - - - - - ranking = 1keywords = probability (Clic here for more details about this article) |
2/7. Placental pathology casebook. Chorangiosis of the placenta increases the probability of perinatal mortality.Two apparent acute problems that may occur in labor, nuchal cord and placental abruption, were associated with chorangiosis of the placenta. The importance of complete placental examination in perinatal mortality is re-emphasized. The association of apparent acute obstetrical conditions, e.g., nuchal cord and placental abruption with chorangiosis of the placenta, may be the cause of fetal-newborn deaths that were previously assumed to be issues of labor management.- - - - - - - - - - ranking = 4keywords = probability (Clic here for more details about this article) |
3/7. Maternal blood coagulation factor XIII is associated with the development of cytotrophoblastic shell.We analysed the early implantation tissues of normal women and of a patient with congenital factor xiii deficiency in order to study the role of maternal subunit A of factor XIII (XIIIA) in the development of extravillous cytotrophoblast. The patient had received adequate administration of factor xiiia concentrate only up to 7 weeks of gestation (wG). Her pregnancy was maintained until the latter half of 8 wG, but was terminated by intrauterine fetal death at 9 wG. Immunohistochemical staining of cytokeratin, XIIIA and subunit S of factor XIII was performed in the early implantation tissues of normal women and of this patient. Numerous well-formed cytotrophoblastic shells and Nitabuch's layers were detected in implantation tissues at 7-8 wG in normal women, and XIIIA was present in the intercellular space in well-formed cytotrophoblastic shells, while the cytotrophoblastic shells and Nitabuch's layers in this patient's implantation tissue were poorly-formed. Furthermore, XIIIA was not detected around them. It is suggested that when the maternal plasma activity of factor XIII is low, the concentration of XIIIA at the placental bed is also low, leading to the insufficient formation of cytotrophoblastic shell and therefore an increased probability of miscarriage in patients with congenital factor xiii deficiency.- - - - - - - - - - ranking = 1keywords = probability (Clic here for more details about this article) |
4/7. Triply discordant triplets: probability, management options, and risks.The spontaneous occurrence of triplets is rare. With increased utilization of "assisted reproductive technologies," multifetal gestations have become more common. The empiric fetal risk for major malformation is approximately 3%. In a triplet pregnancy each fetus independently carries this risk so that the probability of having at least one malformed fetus is approximately 9%. It is much less likely to have 2 or 3 simultaneously but discordantly malformed fetuses in a multizygotic triplet gestation (.09% and .0027% risk, respectively). We report on the first case, to our knowledge, of an ovulation-stimulated triplet pregnancy complicated by 3-way discordance for major malformations diagnosed in the late second trimester by ultrasound. fetus A was affected by congenital diaphragmatic hernia and trisomy 21; fetus B had encephalocele, a midline facial defect, and a cleft palate; and fetus C had evidence of unilateral claw hand but an otherwise normal fetal survey. At 19 weeks of gestation, fetus A was found to have spontaneously died, and a selective termination of triplet B was performed. We conclude: (1) the finding of a single major malformation in one fetus should lead to extensive search for malformations in all members of the pregnancy, and (2) the simultaneous occurrence of major malformations in more than one member of a multifetal gestation is a circumstance under which multiple selective termination deserves consideration. In this article we discuss important issues and caveats in the performance of selective termination for abnormal members of multifetal gestations.- - - - - - - - - - ranking = 5keywords = probability (Clic here for more details about this article) |
5/7. Acute fatty liver of pregnancy--survival despite associated severe preeclampsia, coma and coagulopathy.Acute fatty liver of pregnancy is the least common and most serious cause of jaundice of pregnancy. It is rare, fewer than 100 cases having been reported (Koff, 1981). There is a high probability that it is frequently misdiagnosed and categorized vaguely as some form of variant of 'toxaemia of pregnancy' which is not surprising because of its late-pregnancy onset and the production of multi-system manifestations (Holzback, 1976). In the case reported here, there was associated severe preeclampsia with fetal intrauterine death but maternal survival.- - - - - - - - - - ranking = 1keywords = probability (Clic here for more details about this article) |
6/7. Twin pregnancy involving complete hydatidiform mole and partial mole after five years of amenorrhoea.A case of twin pregnancy involving a single fetus and complete hydatidiform mole in a 56-year-old woman after 5 years of amenorrhoea is reported. The patient presented with threatened abortion and was managed with bed rest and blood transfusion. Six weeks after admission and at 20 weeks gestation, she had a spontaneous vaginal delivery of a molar pregnancy and a fresh stillbirth with molar degeneration of the placenta. The uterine cavity was evacuated by suction curettage after delivery and plasma, BHCG was negative 4 weeks subsequently. In a case of pregnancy after a long period of amenorrhoea in the older woman, molar degeneration is a strong probability.- - - - - - - - - - ranking = 1keywords = probability (Clic here for more details about this article) |
7/7. Acute promyelocytic leukemia and pregnancy. A case report.BACKGROUND. Acute promyelocytic leukemia (APL) is an uncommon form of acute myeloid leukemia usually associated with disseminated intravascular coagulation (DIC). pregnancy in patients with APL requires special consideration to maximize the probability of survival of both mother and fetus. methods. A patient with APL diagnosed during pregnancy who developed DIC is described. Obstetric and oncologic management of this difficult patient is discussed, and a pertinent literature review of pregnancy in APL is presented. RESULTS. Of 23 pregnancies in patients with APL reported in the literature (including the present patient), 19 yielded live births, including 8 of 12 who received chemotherapy during late pregnancy and all 3 patients who received all-trans-retinoic acid (ATRA) during late pregnancy. Chemotherapy or ATRA induced complete remission in 72% of treated patients. CONCLUSIONS. Proper management of pregnant patients with APL usually results in a live birth and complete remission of the mother's leukemia, despite the potentially devastating consequences of DIC, which is present at diagnosis in most patients.- - - - - - - - - - ranking = 1keywords = probability (Clic here for more details about this article) |